Drinking consequences and subsequent drinking in college students over 4 years

Do hypothetical evaluations of alcohol related consequences change over time? Examining the influence of past and ongoing consequences

OBJECTIVE

Despite experiencing alcohol-related consequences, college students continue to drink at high rates. Hypothetical evaluations of alcohol-related consequences (i.e., evaluations of where potential/hypothetical consequences lie on a spectrum from extremely positive to extremely negative) may contribute to the maintenance of drinking patterns among students. The purpose of the present study was to describe hypothetical evaluations in a sample of students mandated to an alcohol intervention, examine changes over time, and investigate the influence of both baseline and time-varying experienced consequences.

METHOD

This study was a secondary data analysis from a longitudinal randomized controlled trial. Participants were 474 mandated students (Mage = 18.65; 55.5 % male, 77.6 % White). Students completed an initial baseline assessment of demographics, alcohol use, consequences, and hypothetical evaluations, and 3-month and 9-month follow-up assessments that included hypothetical evaluations and experienced consequences.

RESULTS

Hierarchical linear modeling (HLM) analyses revealed significant change in hypothetical evaluations over time such that they became less negative. A piecewise model demonstrated that this change happened between baseline and 3-month, with no additional change between 3-month and 9-month. The experience of consequences at baseline did not significantly moderate changes in either time interval. Time-varying consequences also had no significant effect on same-timepoint hypothetical evaluations.

CONCLUSIONS

This study is the first to examine changes in hypothetical evaluations over time among mandated college students. Counter to expectations, hypothetical evaluations became less negative at 3-month follow-up. Though preliminary, findings add to the understanding of hypothetical evaluations of alcohol-related consequences.

Negative Affect, Harassment and Problematic Alcohol Use in Young Adults

Background: While research suggests that both negative affect and alcohol use are impacted by exposure to harassment (i.e., sexual harassment, generalized harassment or bullying), less is known about the effect of harassment on negative affect subsequently leading to alcohol consumption, particularly in young adults. We examined the mediating role of negative affect on the relationships between sexual and generalized harassment at school and alcohol misuse. Methods: Participants were 2899 incoming freshmen in fall of 2011 who completed a Web-based survey assessing demographics (T0), sexual and generalized harassment at school (T0-T2), negative affect (T3), and problems associated with drinking, binge drinking, and drinking to intoxication (T0, T4, T5). Separate hybrid path models were fitted in Mplus v.8.8 for generalized harassment and sexual harassment and each outcome. Results: Mediation analyses showed a small but significant indirect effect for the sexual harassment model (beta = 0.05, S.E. = 0.01, p < 0.001) and generalized harassment (beta = 0.03, S.E. = 0.01, p < 0.01), indicating that negative affect partially mediated the associations between harassment early in students' college experience and later problems associated with drinking. No significant indirect effects were found for the binge drinking or intoxication models. Conclusions: High levels of negative affect associated with harassment may contribute to longer term impact on problematic use of alcohol in young adults, providing evidence that the effects of harassment on drinking may partly stem from harassment's lingering effects on negative affective pathways.

A daily diary exploration of contexts and experiences associated with planned drinking decisions in young adults

OBJECTIVE

Despite the potential for negative consequences, young adults continually engage in heavy alcohol use. Unplanned (vs. planned) drinking has been of particular interest in several studies, as it is theoretically suggested to be related to poor behavioral regulation and negative consequences. Ecological momentary assessment and daily diary (DD) studies have been used to examine the contexts and consequences of planned and unplanned drinking specifically, resulting in somewhat mixed findings surrounding the factors contributing to and consequences of planned drinking. The present DD study adds to this literature by studying rewarding incentives and physical contexts of planned versus unplanned alcohol use, as well as the experiences, or consequences, of planned drinking events.

METHOD

Ninety-nine young adults took part in a mobile study investigating drinking decisions for the current day and day prior, reporting the rewarding incentives contributing to their decision, the context of drinking events, and the experience of each event.

RESULTS

Planned drinking was associated with being influenced by social/party and alcohol incentives, as well as being at a bar and pregaming. There was a positive relationship between planned drinking and subjective level of intoxication, but not negative or positive experience.

CONCLUSIONS

Planned drinking is likely associated with rewarding incentives and social contexts and may contribute to higher levels of subjective intoxication. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Negative consequences associated with daily alcohol use as a nonlinear function of number of drinks in a daily diary study

INTRODUCTION

Drinking intensity among young adults is associated with greater negative alcohol-related consequences, but often studied using categorical drinking thresholds. This study examined how alcohol-related consequences varied as a continuous function of number of drinks consumed, without imposing thresholds, to identify drink ranges for which risk is greatest.

METHODS

Analyses included daily surveys from the Young Adult Daily Life study (2019-22) in which individuals reported drinking 1 or more alcoholic drinks (n=5219 days; 832 individuals). Time-varying effect models estimated total number of negative alcohol-related consequences and five individual consequences (hangover, drank more than planned, nausea/vomiting, did something embarrassing, blacked out) as a function of the number of drinks consumed among young adult males and females.

RESULTS

Often, increases in the number and prevalence of negative consequences were a nonlinear function of the number of drinks consumed. Females reported few negative consequences on 1-to-3-drink occasions but steep increases in consequences on 4-to-9-drink occasions. Among females, the prevalence of blacking out increased six-fold from 4-drink (3.4%; 95% CI=2.6,4.7) to 9-drink occasions (20.6%; 95% CI=16.1,26.1). Among males, the prevalence of some consequences, while not linear, increased across the full drink range. Blacking out among males increased from 9.6% (95% CI=6.2,14.7) on 10-drink occasions to 23.9% (95% CI=15.0,35.8) on 15-drink occasions.

CONCLUSIONS

Substantial heterogeneity is missed when typical drinking categories are used. In particular, variability in consequences across levels of the traditional binge drinking category suggests that important differences in risk may be missed when assessed as a uniform category.

A smartphone application to reduce problematic drinking: a feasibility trial

BACKGROUND

Problematic drinking is common among college students and associated with various somatic and mental health problems. Given significant evidence for the efficacy of smartphone-based interventions and the frequent use of smartphones among college students, it can be assumed that such interventions have great potential to facilitate access to evidence-based interventions for students suffering from problematic drinking. Thus, we developed a brief intervention that combined a counseling session with an app that utilizes approach-avoidance modification training to reduce alcohol consumption.

METHODS

To test the feasibility and explore the potential efficacy of the intervention, we conducted a before-after single-arm study with N = 11 participants reportedly engaging in problematic drinking, who were instructed to practice with the app for 14 days. Feasibility was assessed with the System Usability Scale (SUS). Outcomes included the reduction of self-reported problematic drinking behavior, dysfunctional attitudes about alcohol, and craving, as well as implicit associations between alcohol and self during the training period. Additionally, self-reported problematic drinking behavior was assessed at a 4-week follow-up.

RESULTS

On average, participants rated app usability on the SUS (possible range: 0 to 100) with M = 84.32 (SD = 6.53). With regard to efficacy, participants reported a significant reduction of problematic drinking behavior (dpre vs. post = 0.91) which was sustained at follow-up (dfollow-up vs. baseline = 1.07). Additionally, participants reported a significant reduction of dysfunctional attitudes about alcohol (dpre vs. post = 1.48). Results revealed no significant changes in craving nor in implicit associations regarding alcohol.

CONCLUSIONS

Findings from this feasibility study provide preliminary evidence that smartphone-based interventions might help reduce problematic drinking in college students. Further research needs to replicate these findings with larger samples in randomized controlled trials.

TRIAL REGISTRATION

DRKS00014675 (retrospectively registered).

Associations of childhood poly-adversity with alcohol problems among undergraduates: adolescent alcohol use trajectories and drinker self-schema

OBJECTIVE

Undergraduate drinking is associated with childhood adversity, early alcohol experience, and drinker self-schema. However, the pathway linking childhood adversity to undergraduate drinking problems remains undefined. This study aimed to identify the effects of childhood poly-adversity on the sequelae of adolescent alcohol-use trajectory, drinker self-schema, and alcohol problems among undergraduates. We also examined whether adolescent alcohol-use trajectory and drinker self-schema mediated the effects of childhood poly-adversity on undergraduate alcohol problems.

METHODS

Baseline data from an ongoing prospective study, which included 851 first- and second-year full-time college students in Taiwan, were used. An anonymous online questionnaire was administered.

RESULTS

The results showed that low poly-adversity and high poly-adversity were associated with the mean of initial alcohol use frequency during adolescence and further alcohol problems at college than those with no adversity. High poly-adversity was also associated with the increase in alcohol use frequency during adolescence. Both initial and increase in alcohol use frequency were associated with higher drinker self-schema scores and further alcohol problems. The indirect effects of high poly-adversity on undergraduate alcohol problems were mediated through adolescent alcohol-use trajectories and drinker self-schema.

CONCLUSION

Findings suggest that early identification of childhood poly-adversity and interventions to decrease adolescent drinking may prevent the formation of drinker self-schema and reduce undergraduate drinking problems.

Peer-led interventions to reduce alcohol consumption in college students: A scoping review

Risky alcohol consumption among college students is a significant public health issue. In the college setting, students can collaborate in the implementation of peer-led interventions. To date, evidence of peer-led programmes in reducing harmful alcohol consumption in this population is inconclusive. The aim of the current scoping review is to provide a broad overview by systematically examining and mapping the literature on peer-led interventions for preventing risky alcohol consumption by college students. The specific aims were to (1) identify the underlying focus of the interventions and assess their (2) effectiveness and (3) feasibility. A comprehensive search was conducted in PubMed, PsycINFO, CINAHL, Cochrane Library, Web of Science, DART-Europe, RCAAP, Trove and ProQuest. The inclusion criteria were peer-led interventions that exclusively addressed alcohol consumption, college students as the target population and interventional studies (randomised controlled trials, quasi-experimental studies, systematic reviews and meta-analyses of interventions). The methodological quality of the articles was evaluated. From 6654 potential studies, 13 were included. Nine interventions were described within these studies: Voice of Reason programme, Brief Advice sessions, Peer Theatre, Alcohol Education programme, Perceptions of Alcohol Norms intervention, Motivational Intervention, Alcohol Skills Training programme, Lifestyle Management Class and the Brief Alcohol Screening and Intervention for College Students. Only the last showed significant reductions in three of the four outcome measures: quantity and frequency of drinking, estimated peak blood alcohol concentration and alcohol-related consequences. It did not significantly decrease the number of heavy-drinking episodes. Peer interventions may be effective in preventing alcohol use among college students, although the evidence is weak and scarce. Further research is needed to strengthen the findings about peer-led interventions.

Examining the impact of early college experiences on the cumulative number of alcohol-related consequences

OBJECTIVE

To estimate the total number of alcohol-related consequences students experience during 4 years of college and examine early college indicators that result in higher rates of consequences.

METHOD

Undergraduate drinkers (N = 1,744; 58% female; 87% White; 5% Hispanic) at a large northeastern university completed an online survey at the end of the fall and spring semesters during their first (T1, T2), second (T3, T4), third (T5, T6), and fourth (T7, T8) years of college (87% retention across the study). First, descriptive statistics were calculated to estimate the total number of alcohol-related consequences students experienced across all 4 years of college. Second, a structural equation model was examined to identify early college indicators that influence individuals experiencing more cumulative consequences.

RESULTS

Students experienced an average of 102 (SD = 89.91) alcohol-related consequences during 4 years of college. Next, early parental approval of consequences, but not peer drinking norms, were positively associated with students' willingness to experience consequences, which in turn, were positively associated with higher alcohol consumption and greater total consequences.

CONCLUSIONS

Results estimated that, on average, students experienced 102 alcohol-related consequences across all 4 years of college. Parental approval of consequences influenced students' total consequences through their willingness to experience consequences and drinking behaviors. Findings from the current study have several important implications for interventions.

Social Threat Reduces Alcohol Consumption among College Students

Aims

Past research suggests that people report a greater desire to consume alcohol when they experience social threat—or threats to their social selves, such as social exclusion. Nevertheless, experimental research on the role of social threat in alcohol consumption is limited. The present study examined the causal relationship between social threat and wine consumption.

Methods

Undergraduate students (N = 83; Mage = 21.8 years old, SDage = 1.62 years old; 72.3% women; 61.4% Latinx/Hispanic) participated in a study under the pretense that they were in a focus group gauging students’ opinions of a bar being constructed at their university. During the study, participants and two confederate researchers completed a group activity in which they selected design elements for the bar. Participants were randomly assigned to one of two conditions. In the social threat condition, confederates rejected participants’ design choices and socially excluded them during a follow-up task. In the social acceptance condition, confederates supported participants’ choices and did not socially exclude them. All participants then completed a wine taste test.

Results

Contrary to predictions, an independent-samples t-test revealed that participants who experienced social threat consumed significantly less wine than those who were socially accepted, t(81) = −2.22, P = 0.03, d = −0.49. Furthermore, a linear regression test revealed that this effect persisted even when controlling for typical alcohol-consumption behavior, b = 56.09, t = −2.50, P = 0.02, d = −0.61.

Conclusion

The relationship between social threat and alcohol consumption may be more nuanced than anticipated. Discussion centers around two potential moderators including positive affect and identity.

Dietary self-monitoring is associated with increased likelihood of problematic alcohol use among college students

Objective: To assess the relationship between dietary self-monitoring and problematic alcohol use including binge drinking, increased body confidence while drinking, and restricting food intake to compensate for alcohol consumption, among college students. Participants: Undergraduate and graduate students from 12 US colleges participating in the Healthy Bodies Study in 2013-2014 and 2014-2015 school years (n = 10,133). Methods: Weighted prevalence was calculated for dietary self-monitoring and problematic alcohol use. Gender-stratified logistic regressions were used to assess relationships. Results: Knowing nutrition facts was associated with restricting to compensate for alcohol consumption among women (OR = 2.42, p < .0001) and men (OR = 1.64, p = .002). Among women, knowing and counting calories predicted all problematic alcohol use behaviors. Among men, knowing calories was associated with restricting to compensate (OR = 2.69, p < .0001) and counting calories was associated with restricting to compensate (OR = 5.10, p < .0001) and increased body confidence while drinking (OR = 2.25, p < .0001). Conclusions: Dietary self-monitoring predicts problematic alcohol use among college students, particularly women.

The dynamic nature of injunctive drinking norms and within-person associations with college student alcohol use

Objective: Perceptions of friends' approval of drinking behaviors (i.e., injunctive drinking norms) play a central role in shaping college students' alcohol use behaviors. However, we know little about the extent that students' perceptions of friends' approval fluctuate over time and whether there are within-person associations between these injunctive norms and alcohol use. To fill this knowledge gap, we estimated within-person variability in perceptions of friends' approval of alcohol use across a 12-month period and examined within-person associations between perceptions of friends' approval and 3 discrete drinking behaviors: number of weekly drinks, hazardous drinking behaviors, and peak estimated blood-alcohol content (peak-eBAC). Method: A sample of college students (N = 433, 54.82% female, Mage = 20.06) reported perceptions of friends' approval of alcohol use and indices of alcohol use behavior at 4 timepoints across a single year. Results: Descriptive estimates of within-person variability of perceived friends' approval revealed that these perceptions fluctuated considerably across the 4 timepoints. After accounting for between-person effects, longitudinal multilevel modeling revealed significant within-person associations between perceptions of friends' approval and (a) number of weekly drinks, (b) hazardous drinking behaviors, and (c) peak-eBAC levels. Students reported heavier alcohol use at timepoints when they perceived their friends as being more approving than usual. Conclusions: Alongside advancing theoretical understanding of social influences on students' alcohol use, the current findings hold important clinical implications for norms-based harm-reduction strategies. To optimize interventions, norms-based approaches may need to be adaptive over time (e.g., boosters) to map onto within-person fluctuations in perceived injunctive norms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Brief Negative Affect Focused Functional Imagery Training Abolishes Stress-Induced Alcohol Choice in Hazardous Student Drinkers

Introduction

Imagery-based stress management therapies are effective at reducing alcohol use. To explore the therapeutic mechanism, the current study tested whether brief functional imagery training linked to personal negative affect drinking triggers would attenuate sensitivity to noise stress-induced alcohol seeking behaviour in a laboratory model.

Methods

Participants were UK-based hazardous student drinkers (N = 61, 80.3% women, aged 18–25) who reported drinking to cope with negative affect. Participants in the active intervention group (n = 31) were briefly trained to respond to personal negative drinking triggers by retrieving an adaptive strategy to mitigate negative affect, whereas participants in the control group (n = 30) received risk information about binge drinking at university. The relative value of alcohol was then measured by preference to view alcohol versus food pictures in two-alternative choice trials, before (baseline) and during noise stress induction.

Results

There was a significant two-way interaction (p < .04) where the control group increased their alcohol picture choice from baseline to the noise stress test (p < .001), whereas the active intervention group did not (p=.33), and the control group chose alcohol more frequently than the active group in the stress test (p=.03), but not at baseline (p=.16).

Conclusions

These findings indicate that imagery-based mood management can protect against the increase in the relative value of alcohol motivated by acute stress in hazardous negative affect drinkers, suggesting this mechanism could underpin the therapeutic effect of mood management on drinking outcomes.

Do alcohol-related consequences and how they are evaluated predict consumption during and days until the next drinking event?

Objective: Alcohol-related consequences are most often examined as outcomes of alcohol use. However, it is also possible that experiencing consequences may predict future drinking behavior. The predictive power of consequences on future drinking behavior may involve both objective experiences of consequences and subjective evaluations of those consequences (i.e., how positive, how negative). The purpose of the present study was to understand how positive and negative alcohol-related consequences-and evaluations of those consequences-predict elements of the next drinking event among college students. Method: 96 participants reported alcohol use and related consequences over a 28-day daily assessment period. Results: Survival analysis and multilevel modeling were used to examine the influence of positive and negative consequences from a given drinking event on latency to and number of drinks consumed at the next drinking event. Contrary to hypotheses, subsequent drinking was not impacted by recent consequences nor how they were perceived. Conclusions: Though theoretically, experiencing alcohol consequences may impact proximal drinking behavior, findings suggest that, in the current sample, other factors have greater importance in the latency between drinking events and amount of alcohol consumed. Future work should continue to identify event-level predictors that impact behavior at the next drinking event, and ways drinkers attempt to avoid repetition of drinking consequences other than simply drinking less (e.g., protective behavioral strategies), as such factors would be valuable targets for intervention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Frequency of Binge Drinking and Perception of Peer Alcohol Use: A Survey of University Students in a Western Canadian Province

OBJECTIVES

College and university student binge drinking is a critical health issue, and studies demonstrate students perceive high rates of drinking among their peers. High alcohol consumption and binge drinking are normalized throughout college and university, and there are gross misperceptions of perceived alcohol use among peers. The purpose of our study was to examine differences in perceptions of peer alcohol use after grouping students based on their frequency of binge drinking over a 2-week period.

METHODS

A one-way analysis of variance test was used to compare the differences in the perception of peer alcohol use after grouping students by their frequency of binge drinking.

RESULTS

Students who binge drink have significantly higher perceptions of peer alcohol use than their non-binge-drinking and abstaining peers.

CONCLUSIONS

These findings provide direction toward the feasibility of using perceptions of peer alcohol use to identify at-risk students to curtail dangerous drinking behavior.

Learning from drinking experiences in college: A test of reciprocal determinism with drinking refusal self-efficacy

Problematic drinking is common in college, with many students experiencing a range of detrimental alcohol-related consequences. An understanding of the etiological factors involved in the development and maintenance of this behavior is important, as it would inform intervention efforts. Drinking refusal self-efficacy (DRSE) plays a central role in drinking behavior. Social learning theory's principle of reciprocal determinism suggests that cognitions such as DRSE are not only learned over time from drinking experiences but also impact an individual's subsequent drinking behavior. To date, no study has tested reciprocal determinism in relation to DRSE. Accordingly, in the current study, we examined within-person reciprocal associations between DRSE and drinking experiences (alcohol use and related consequences) in college drinkers during the first year of college (n = 728). Data were drawn from a larger study of trauma, posttraumatic stress, and substance use in young adulthood. Data were analyzed using a random intercept cross-lagged panel model to disaggregate between-person and within-person effects. At the between-person level, DRSE was negatively associated with both alcohol use and alcohol-related consequences. Furthermore, DRSE exhibited significant negative prospective within-person associations with alcohol-related consequences but not with alcohol consumption. Both alcohol consumption and alcohol-related consequences exhibited significant negative prospective within-person associations with DRSE. As such, findings support reciprocal determinism between alcohol-related consequences and DRSE. These findings have several clinical implications, as they point to a risky learning process that could be targeted in treatment or in prevention programs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Deter the emotions: Alexithymia, impulsivity and their relationship to binge drinking

Introduction

The relevance of both emotion processing and impulsivity to alcohol use and misuse is increasingly recognised, yet there is a scarcity of studies addressing their reciprocal interaction. The present study aimed to examine the role that difficulties in emotion processing and trait impulsivity play in explaining binge drinking pattern of alcohol use in student population. We looked at binge drinking, as it is a risk factor to later alcohol abuse and is a common alcohol drinking habit among students. Alexithymia (from Greek as "deter/repel emotions"), a difficulty in identifying and describing feelings in self and others is increasingly recognised as a feature of alcohol misuse.

Methods

One-hundred and seventy-four student alcohol drinkers were assessed for their drinking habits (Alcohol Use Questionnaire), as well as for alexithymia (Toronto Alexithymia Scale) and impulsivity trait (Barratt Impulsiveness Scale); facial emotional expression judgements were also tested.

Results

A direct relationships between, both, alexithymia and impulsivity, and binge drinking was found. When combined, trait impulsivity partially mediated the relationship between alexithymia and binge drinking. Facial emotional expression judgements also showed a relationship with binge drinking.

Conclusions

These findings highlight the importance of both emotion processing and impulsivity in understanding binge drinking and indicate potential routes for prevention and intervention techniques, especially towards those who may be at risk of later alcohol abuse.

Psychometric Properties of the "Alcohol Consumption Consequences Evaluation" (ACCE) Scale for Young Spanish University Students

Instruments that evaluate alcohol use consequences among young people do not consider the intensive alcohol consumption pattern that is so characteristic during these ages. Some of these instruments are even ineffective in the Spanish population. Hence the interest in developing an instrument more adapted to the reality of our young people. A total of 601 university students (35.9% male and 64.1% female) from 18 to 20 years old were recruited. All of them answered a total of 77 items obtained from the review of both the scientific literature and the different scales used to measure consequences derived from alcohol consumption. In addition, they completed the AUDIT and the Timeline Followback for self-reported consumption. The data were analyzed using factor analysis and a two-parameter logistic model. ROC curve analysis was used to establish cut-off points for different risk levels of alcohol consumption distinguishing between genders. The final 43-item scale Alcohol Consumption Consequences Evaluation (ACCE) (Evaluación de Consecuencias derivadas del Consumo de Alcohol [ECCA]) shows adequate psychometric properties: α = 0.94; unidimensionality through exploratory factor analysis (EFA) (26.25% of explained variance) and confirmatory factor analysis (CFA) (RMSEA = 0.39; TLI and CFI > 0.90). In addition, ROC analyses, both at a global scale and distinguishing between genders, were able to characterize consumers with different levels of risk, obtaining areas under the curve between 0.82 and 0.88. A scale has been obtained that enables the establishment of cut-off points to distinguish between the consequences of low, moderate and high risk alcohol consumption. The clinical utility of the ACCE is highlighted by using one single instrument to perform the screening of a possible alcohol risk consumption as well as identifying the consequences that need to be worked on in the evaluated person’s or group’s intervention.

Learning From Experience? The Influence of Positive and Negative Alcohol-Related Consequences on Next-Day Alcohol Expectancies and Use Among College Drinkers

OBJECTIVE

The purpose of the present study was to examine daily-level associations between alcohol-related consequences and next-day expectancies and alcohol use among frequently drinking college students using a measurement-burst daily diary study.

METHOD

College students (N = 327; mean age = 19.7 years, SD = 1.26; 53.4% female) participated in a yearlong study in which they completed computerized interviews daily via mobile phones for 2 weeks in each academic quarter. Multilevel modeling was used to examine whether positive and negative consequences were associated with next-day alcohol expectancies and alcohol consumption.

RESULTS

Experiencing positive consequences from drinking was significantly associated with higher positive expectancies and a greater number of drinks consumed on the following day. The within-person association between daily consequences and next-day positive expectancies was stronger for those who were in fraternities/sororities compared with those who were not. Negative consequences were significantly associated with higher negative expectancies the next day but were not associated with number of drinks consumed the next day.

CONCLUSIONS

Results of this study highlight the role of direct drinking experiences in influencing future expectations and drinking behavior using a method that enables analysis of both between- and within-person associations.

Behavioral and Cerebral Impairments Associated with Binge Drinking in Youth: A Critical Review

Binge drinking is a widespread alcohol consumption pattern in youth that is linked to important behavioral and cerebral impairments, in both the short and the long term. From a critical review of the current literature on this topic, we conclude that binge drinkers display executive impairments, cerebral modifications, and problems with emotion-related processes. Five key empirical and theoretical topics are discussed to pave the way for future research in the field: (1) the specificity of the brain modifications observed in binge drinkers that may index a compensatory mechanism or result from multiple withdrawals; (2) the nature of the relationship between binge drinking and impairments, suggesting reciprocal influences between excessive alcohol consumption and executive deficits; (3) the possible recovery of brain and cognitive functioning after the cessation of binge drinking; (4) the validity of the continuum hypothesis, suggesting links between binge drinking and severe alcohol use disorders; and (5) the existing strategies to reduce binge drinking habits or rehabilitate the associated cognitive deficits. Future perspectives are described in relation to the questions raised to identify the crucial variables to be addressed in research and clinical practice.

Using latent transition analysis to compare effects of residency status on alcohol-related consequences during the first two years of college

The current study examined two research aims: (1) Identify latent statuses of college students who share common patterns of single or repeated experiences with distinct types of negative alcohol-related consequences during the first two years of college; and (2) Examine how changes in students' living arrangements were associated with transitions in the consequence statuses. Using a sample of college student drinkers (N = 1706), four latent statuses were identified that distinguished among distinct combinations of single and repeated experiences across the multiple consequence subtypes: No Consequences, Physical Non-Repeaters, Multiple Consequences, and Multiple Consequences Repeaters. Students who remained in on-campus living spaces were most likely to belong to lower-risk statuses at T1, and remain in those statuses at T2. We found that moving into Greek housing had strongest effects among students who started in the No Consequences status, while students who moved to off-campus housing were most likely to remain in the Multiple Consequences status. Given that students who moved out of on-campus residences were more likely to transition into high-risk statuses, interventions that target students who intend to move to off-campus or fraternity housing should be implemented during the first year of college.

Prospective Associations of Actual and Perceived Descriptive Norms with Drinking Among Emerging Adults

BACKGROUND

Descriptive norms are commonly associated with participant drinking. However, study participants may incorrectly perceive that their peers drink about the same amount as they do, which would bias estimates of drinking homogeneity.

OBJECTIVES

This research examined the magnitude of associations between emerging adults' reports of their own drinking and peer drinking measured the previous year by measures of (1) participants' perceptions of friends' drinking; and (2) actual drinking reported by nominated peers.

METHODS

The data are from annual surveys conducted in 2014 and 2015, Waves 4 and 5 (the first 2 years after high school) of 7 annual assessments as part of the NEXT Generation Health Study (n = 323). Associations of participant alcohol use with perceived friend use (five closest, closest male, and closest female friends), and with actual peer use. Logistic regression analyses estimated the magnitudes of prospective associations between each measure of peer drinking at W4 and participant drinking at W5.

College alcohol beliefs and drinking consequences: A multiple mediation analysis of norms, expectancies, and willingness to experience drinking consequences

OBJECTIVE

We explored the potential mediating role of willingness to experience drinking consequences and other traditional alcohol outcome predictors (descriptive norms, injunctive norms, positive alcohol expectancies) in explaining the association between college alcohol beliefs ¹ (CABs) and the actual experience of drinking consequences among college students.

PARTICIPANTS

The sample consisted of 415 college students tested in October 2014.

METHODS

Participants responded to an online survey.

RESULTS

When compared to both types of norms and positive alcohol expectancies, CABs demonstrated the strongest associations to both willingness to experience drinking consequences and actual drinking consequences among college students. A multiple mediation analysis revealed that the impact of CABs on students' actual drinking consequences was mediated only through their willingness to experience drinking consequences.

CONCLUSIONS

Students' college alcohol beliefs and their corresponding willingness to experience drinking consequences should be targeted in prevention and intervention programs designed to address the problem of college student drinking.

Emotion dysregulation and peer drinking norms uniquely predict alcohol-related problems via motives

This study examined the relationships between emotion dysregulation, peer drinking norms, drinking motives, and alcohol-related outcomes among 435 college students. We examined the mediating roles of drinking motives when predicting alcohol consumption and related problems from the subscales of the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, 2004) via negative and positive reinforcement models. First, we hypothesized that individuals who lack in emotion regulation strategies or have difficulties in accepting negative emotions are more likely to drink to cope. Additionally, we hypothesized that individuals who act impulsively or become distracted when upset as well as those with higher peer drinking norms are more likely to drink for social and enhancement motives. The results of the path model indicated that limited access to emotion regulation strategies significantly predicted alcohol-related problems via both depression and anxiety coping motives, but did not predict alcohol consumption. Nonacceptance of emotional responses was not significantly associated with coping motives. Impulsivity had a significant direct relationship with alcohol problems. Difficulty in engaging in goal-directed behaviors predicted both enhancement and social motives, but only enhancement motives in turn predicted consumption. Norms indirectly predicted problems via enhancement motives and consumption. The results indicated that using alcohol to reduce negative or to increase positive emotions increases alcohol consumption and alcohol-related problems. Overall, results advance our understanding of the mechanisms of increased alcohol use and problems among college students.

Sex and Drugs and Starting School: Differences in Precollege Alcohol-Related Sexual Risk Taking by Gender and Recent Blackout Activity

Research has demonstrated a link between alcohol use and multiple forms of risky sexual behavior, particularly among college-age individuals. Studies have also linked heavy alcohol use to other problems, such as impaired consciousness resulting from an alcohol-induced blackout, which may impact sexual decision making. However, research has rarely examined sexual risk taking (SRT) in relation to blackouts, nor has it examined this construct during the precollege transition (i.e., the interval of time between high school graduation and college matriculation). This study examined the intersection between alcohol-involved SRT, blackouts, and gender in a sample of precollege individuals with prior alcohol use (N = 229; 54% male, 63% White). Results indicated that, despite drinking less per occasion, women reporting recent blackouts were at increased risk for experiencing unwanted, unsafe, and regretted sexual behaviors compared to men with recent blackouts and their peers with no recent blackouts. Women with recent blackouts also reported differences in alcohol expectancies that may increase their risk for experiencing negative consequences while drinking, including higher social expectancies and lower negative expectancies of danger. Future directions for research and implications for precollege interventions are discussed.

The impact of sleep and psychiatric symptoms on alcohol consequences among young adults

OBJECTIVE

Independent lines of research have documented links between psychiatric symptoms and poor sleep quality, psychiatric symptoms and alcohol use, and alcohol use and poor sleep quality. The current study examined the synergistic effect of poor sleep quality and psychiatric symptoms on alcohol-related consequences in heavy-drinking young adults.

METHOD

Matriculating college students reporting at least one heavy drinking episode over the first nine weeks of the semester (N=385, 52% female) were categorized as experiencing 'good' (n=280) versus 'poor' sleep quality (n=105) and screening 'positive' (n=203) or 'negative' (n=182) for a psychiatric disorder. Sleep quality was assessed using the Pittsburgh Sleep Quality Index; psychiatric diagnosis was assessed using the Psychiatric Diagnostic Screening Questionnaire; and alcohol-related consequences were assessed using the Brief Young Adult Alcohol Consequences Questionnaire. General linear models were used to examine the main effects and interaction between sleep quality and psychiatric symptoms on alcohol-related consequences.

RESULTS

Sleep quality moderated the association between psychiatric screen and alcohol-related consequences among heavy-drinking college students, such that psychiatric symptoms were associated with more alcohol-related consequences in the context of poor sleep quality.

CONCLUSIONS

The combination of poor sleep quality and psychiatric symptoms is associated with increased alcohol-related consequences among heavy-drinking college students. Given the significant interaction between these symptoms, healthcare providers are encouraged to screen for the presence of sleep and psychiatric disorders among heavy-drinking young adults and to provide empirically-supported treatments as appropriate.

The Effect of Residence, School Status, Work Status, and Social Influence on the Prevalence of Alcohol Use Among Emerging Adults

OBJECTIVE

The first year after high school is a transitional year, with increased independence from parental supervision, contact with other independent youth, and exposure to new environments, all of which may influence substance use. This article reports longitudinal predictors of change in the prevalence of alcohol use and heavy episodic drinking among adolescents and environmental correlates (i.e., residence, college attendance, and work status) with drinking the year after high school.

METHOD

A national sample of study participants (N = 2,659; 55% female) in the NEXT Generation Health Study were followed annually from 10th grade (Wave 1) to the year after high school (Wave 4). Longitudinal binary outcomes, including recent (30-day) drinking and two measures of heavy episodic drinking, were examined. Transition models with generalized estimating equations estimated the effect of previous drinking behaviors, social influences, and current residential status and activity (school and/or work) on drinking prevalence.

RESULTS

Drinking increased from 40.5% among high school seniors (Wave 3) to 53.5% in Wave 4 for 30-day use, and from 29.0% to 41.2% for heavy episodic drinking. Significant predictors of 30-day drinking included previous drinking status (odds ratio [OR] = 5.48), peer drinking often (OR = 3.25), parental expectations (OR = 0.91), and current year living on campus (OR = 2.10). The same significant predictors with similar magnitudes were found for both measures of heavy episodic drinking. Peer use did not interact with college attendance or residence.

CONCLUSIONS

Predictors of drinking and heavy episodic drinking during the first year after high school included being White, living on campus, previous drinking, lower parental expectations, and having peers who drink.

Do my peers approve? Interest in injunctive norms feedback delivered online to college student drinkers

Injunctive norms feedback is promising but understudied as a component of college drinking interventions. The aim of the present study was to demonstrate acceptability of injunctive norms feedback delivered to college drinkers via the web. We examined subjective interest in information reflecting peer approval of four sets of drinking behaviors and outcomes, and correlates of interest in the normative feedback. A sample of 221 young adults enrolled in a 2- or 4-year college or university (ages 18-25 years; 52% female) completed online surveys in which they were asked to rate their interest in each of 11 injunctive norms statements. Participants were randomly assigned to one of four sets of statements regarding peer approval of (a) intoxicated behaviors, (b) safe drinking strategies, (c) drinking-related consequences, and (d) drinking behaviors of potential partners. All items were framed to reflect disapproval of risky behaviors and approval of protective behaviors. Across norm sets, participants found the items to be moderately interesting and interest ratings did not differ across sets. Higher scores on the Alcohol Use Disorders Identification Test (AUDIT), stronger perceived approval of drinking in general (injunctive norms), stronger perceptions of drinking among peers (descriptive norms), and female gender were bivariately correlated with more interest. In a multiple regression, female gender, higher AUDIT (consequence subscale), and stronger general drinking injunctive norms remained significantly associated with interest in the pro-moderation statements. An important future direction is to determine whether the presentation of specific types of injunctive norms feedback can result in downward changes in drinking behavior.

Association between protective behavioral strategies and problem drinking among college students in the Republic of Korea

OBJECTIVE

The literature indicates that protective behavioral strategies (PBS) have been effective in addressing problem drinking among college students. However, the effects of PBS on problem drinking have not been thoroughly investigated among Korean college students. Thus, the two study aims were to (a) examine drinking behavior among Korean college students and (b) investigate the effects of PBS on problem drinking.

METHODS

A pilot study was first conducted to obtain information needed to determine a sample size and to examine the understandability and reliability of seven instruments. The instruments were then used to collect data from full-time college students (N=479). The data were analyzed using (a) descriptive statistics such as frequencies and means for the first aim and (b) multivariate logistic regression for the second aim.

RESULTS

Approximately 93% of the respondents had drunk alcohol during the month before the survey, and 72.7% were problem drinkers. The use of PBS significantly decreased the odds of problem drinking (odds ratio [OR]=0.90 [95% CI, 0.87-0.93]). In addition, male gender and positive alcohol expectancy were associated with increased odds of problem drinking (ORs=3.32 [95% CI, 1.59-6.94] and 1.04 [95% CI, 1.01-1.08]), whereas greater age of drinking onset was associated with decreased odds of problem drinking (OR=0.81 [95% CI, 0.70-0.94]).

CONCLUSIONS

Given the prevalence of the drinking problem among Korean college students, it is important to develop and implement interventions that will encourage students to use PBS in order to avoid problem drinking and its negative consequences.

Development of a face-to-face injunctive norms brief motivational intervention for college drinkers and preliminary outcomes

Findings are presented from the first randomized clinical trial that compared changes in alcohol consumption and alcohol-related consequences among college student drinkers from baseline to follow-up across 4 conditions: (a) a new single component injunctive norms brief motivational intervention (IN-BMI) condition; (b) a single component descriptive norms brief motivational intervention (DN-BMI); (c) a combined IN and DN brief motivational intervention (Combined-BMI); and (d) assessment-only control. DN-BMI focused on the juxtaposition of personal, perceived, and actual alcohol use by typical same-sex students at your university. IN-BMI focused on the juxtaposition of personal, perceived, and actual attitudes about alcohol-related consequences by the typical same-sex student at your university. Exploratory analyses assessed the effect of IN-BMI and DN-BMI on matched (e.g., the effect of DN-BMI on perceived DN) and mismatched norms (e.g., the effect of DN-BMI on perceived IN). IN-BMI resulted in greater decreases in alcohol use and consequences when delivered alone and in conjunction with DN-BMI compared with the control condition. Further, the Combined-BMI condition reported greater reductions in alcohol use but not consequences compared to the DN condition. Receiving IN-BMI either alone or in combination with DN-BMI produced greater changes in IN perceptions than were produced in the control group. Grounded in norms theory, this study examined how college student problem drinking is affected by both IN-BMI and DN-BMI alone and in combination. We conclude that IN-BMI alone or in combination with DN-BMI is able to modify alcohol use and reduce alcohol-related consequences. (PsycINFO Database Record