Correcting exaggerated drinking norms with a mobile message delivery system: Selective prevention with heavy-drinking first-year college students

Neural responses to reward, threat, and emotion regulation and transition to hazardous alcohol use

AIMS

Reward processing and regulation of emotions are thought to impact the development of addictive behaviors. In this study, we aimed to determine whether neural responses during reward anticipation, threat appraisal, emotion reactivity, and cognitive reappraisal predicted the transition from low-level to hazardous alcohol use over a 12-month period.

METHODS

Seventy-eight individuals aged 18-22 with low-level alcohol use [i.e. Alcohol Use Disorder Identification Test (AUDIT) score <7] at baseline were enrolled. They completed reward-based and emotion regulation tasks during magnetic resonance imaging to examine reward anticipation, emotional reactivity, cognitive reappraisal, and threat anticipation (in the nucleus accumbens, amygdala, superior frontal gyrus, and insula, respectively). Participants completed self-report measures at 3-, 6-, 9-, and 12-month follow-up time points to determine if they transitioned to hazardous use (as defined by AUDIT scores ≥8).

RESULTS

Of the 57 participants who completed follow-up, 14 (24.6%) transitioned to hazardous alcohol use. Higher baseline AUDIT scores were associated with greater odds of transitioning to hazardous use (odds ratio = 1.73, 95% confidence interval 1.13-2.66, P = .005). Brain activation to reward, threat, and emotion regulation was not associated with alcohol use. Of the neural variables, the amygdala response to negative imagery was numerically larger in young adults who transitioned to hazardous use (g = 0.31), but this effect was not significant.

CONCLUSIONS

Baseline drinking levels were significantly associated with the transition to hazardous alcohol use. Studies with larger samples and longer follow-up should test whether the amygdala response to negative emotional imagery can be used to indicate a future transition to hazardous alcohol use.

To move or not to move while on campus: Examining the influence of others

OBJECTIVE

To examine the influence of dynamic and trending descriptive norms on increasing physical activity and decreasing the sedentary behaviors of university students while on campus.

PARTICIPANTS

One-hundred fifty-six university students from a Canadian university completed this study.

METHODS

Participants were randomly assigned to receive one of four online messages containing normative information about the on-campus behavior of university students. On-campus physical activity and sedentary behavior were measured pre- and post-message.

RESULTS

The results revealed that students exposed to the trending norm reported a greater decrease in sedentary behavior than students in the control condition, p = .007.

CONCLUSION

Results provide preliminary experimental evidence that trending norm messages may serve to decrease the sedentary behavior of students while on campus.

Low levels of fitting in on campus moderates the relationship between enhancement drinking motives and drinks per week among college students

The first year of college is often marked by increased levels of alcohol consumption; first-year students also vary in their sense of fitting in on campus. Research has amply documented the links between social and enhancement drinking motives with various alcohol outcomes among college students. However, it is unclear how perceived levels of fitting in on campus potentially buffers or amplifies the relationship between drinking motives and drinking behavior. We explored whether perceptions of fitting in on campus moderated effects of social and/or enhancement drinking motives on drinks per week. A sample of 121 heavy drinking first year college students (50 % female, 58 % non-Latinx White, M = 18 years of age) were assessed twice in their first semester (baseline, 3 months) in the context of an alcohol-specific intervention. Hierarchical linear regressions were conducted to test whether drinking motives (social and enhancement) at baseline prospectively predicted drinks per week at 3 months. We hypothesized a positive association between both drinking motives and drinks per week; whether fitting in moderates these relationships was exploratory. Regression analyses yielded non-significant main effects of social motives, enhancement motives, and feelings of fitting in on drinks per week. There was no significant interaction for social motives, but the interaction between enhancement motives and fitting in was significant. Participants with a low sense of fitting in had a strong positive relationship between enhancement motives and drinks per week. Improving perceptions of fitting in for first-year college students may potentially reduce the association between enhancement drinking motives and drinks per week.

Injunctive Norms and Driving Under the Influence and Riding With an Impaired Driver Among Young Adults in Washington State

PURPOSE

Alcohol- and cannabis-impaired driving behaviors remain a public health concern especially among young adults (i.e., ages 18-25). Limited updates to prevention efforts for these behaviors may be due, in part, to limited understanding of malleable psychosocial predictors. The current study assessed associations between perceived injunctive norms (i.e., acceptability) of driving under the influence of alcohol (DUI-A) and cannabis (DUI-C), and riding with a driver under the influence of alcohol (RWI-A) and cannabis (RWI-C) in Washington State young adults.

METHODS

Participants included 1,941 young adults from the 2019 cohort of the Washington Young Adult Health Survey. Weighted logistic regressions assessed the associations between peer injunctive norms and impaired driving-related behaviors.

RESULTS

A weighted total of 11.5% reported DUI-A, 12.4% DUI-C, 10.9% RWI-A, and 20.9% RWI-C at least once in the past 30 days. Overlap between the outcomes was observed, indicating some young adults had engaged in multiple impaired driving-related behaviors. After controlling for substance use frequency, weighted logistic regressions indicated more positive perceived injunctive norms were associated with nearly 2 ½ times higher odds of DUI-A, 8 times higher odds of DUI-C, 4 times higher odds of RWI-A and six and a half times higher odds of RWI-C.

DISCUSSION

Results increase the understanding of how injunctive norms-a potentially malleable psychosocial factor-are associated with four impaired driving-related outcomes. Prevention programs that focus on assessing and addressing the norms of these outcomes individually and collectively, such as normative feedback interventions and media campaigns, may be helpful in reducing these behaviors.

Using Alcohol and Cannabis as Sleep Aids: Associations with Descriptive Norms Among College Students

PURPOSE

Young adults may use alcohol and cannabis as sleep aids, a risky behavior that can worsen sleep health over time and lead to substance dependence. Perceived norms for such risky behaviors are often overestimated and related to one's own use. This cross-sectional study examined: (a) the extent to which college students overestimated the prevalence of alcohol and cannabis use as sleep aids (i.e., perceived descriptive norms), and (b) the extent to which perceived descriptive norms were associated with students' own use of alcohol and cannabis as sleep aids.

METHODS

2,642 undergraduate college students (Mage = 18.84 years) reported past 30-day use of alcohol and cannabis as sleep aids. Participants also estimated the percent of college students who use alcohol and cannabis as sleep aids (i.e., perceived descriptive norms).

RESULTS

One-sample t-tests revealed participants, on average, overestimated the norms for using alcohol and cannabis as sleep aids. Participants who endorsed past 30-day use of these substances as sleep aids overestimated these norms to an even greater extent. Count regression models showed perceived descriptive norms were associated with students' use of alcohol and of cannabis as sleeps aids, in respective models, even when controlling for sleep difficulties.

CONCLUSIONS

College students may overestimate the prevalence of using alcohol and cannabis as sleep aids, and students who believe these behaviors are more normative report more frequent use of these substances as sleep aids. Taken together, findings may highlight the potential for norm-correcting strategies as a prudent approach to reducing/preventing the use of alcohol and cannabis as sleep aids.

A combined web based intervention and ecological momentary intervention for reducing alcohol use among incoming first-year university students: Results from a three-arm randomised controlled trial

BACKGROUND

The transition from high school to university is associated with increased alcohol use and harm. Web-based interventions (WBIs) and ecological momentary interventions (EMIs) are two methods that have had some success in reducing alcohol use among university students and may be particularly effective if implemented during the transition to university. The aim of the current study was to investigate the effectiveness of a combined WBI and EMI to reduce alcohol use among incoming university students.

METHODS

Incoming first-year students (n = 783, in 2018 and 2019) were randomized into either a WBI + EMI, WBI-only, or an assessment-only condition. All participants completed online questionnaires before university, after their first and second semester, and reported their alcohol use fortnightly throughout their first year. Those in the WBI + EMI and WBI conditions received online feedback about their drinking (i.e., the WBI) immediately following the pre-university survey. Those in the WBI + EMI were also sent eight EMI messages to their mobile phones during Orientation Week and six EMI messages across the academic year aimed at reducing alcohol harm.

RESULTS

There were no significant differences between the conditions in Orientation Week drinking, academic year drinking (both "typical" semester or fortnightly drinking), or alcohol-related harms.

CONCLUSION

A WBI + EMI intervention aimed at the transition to university did not reduce university students' alcohol use. The transition, however, continues to be a period of serious harm where students drink more than any other period.

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.

Examining changes in drinking motives and their influence on drinking behaviors among heavy drinkers during their first year of college

Drinking motives are robustly related to alcohol use behavior from adolescence through young adulthood. Yet, examination of changes in motives during the first year of college, a transitional time associated with both onset of and increases in heavy drinking has been understudied. We examined (a) whether drinking motives change, (b) time-varying effects of motives on alcohol use and consequences, and (c) change in the strength of the association between motives and use and motives and consequences over the first year of college. A sample of 121 heavy drinking first-year students (50% female, 58% Caucasian) completed three assessments (baseline, 3 months, 6 months). Endorsement of social motives declined from 0 to 3 months, while endorsement of coping, enhancement, and conformity motives declined from 3 to 6 months. Social motives were positively associated with alcohol use and consequences across assessments. When motive × time interactions were tested in separate models, the strength of effects of coping motives on drinks per week increased from 0 to 3 months. The strength of the effect of coping and conformity motives on consequences increased from 0 to 3 months and then decreased from 3 to 6 months. Identifying how drinking motives evolve and relate to trajectories of alcohol use may help to understand the development of risky drinking behavior and inform intervention efforts.

Effectiveness of eHealth Technology-Based Interventions in Reducing Substance Misuse Among Older Adults: A Systematic Review

Generally considered an epidemic among young people, substance misuse has been a growing issue among older Americans for the past 40 years. Legal substances, such as alcohol, tobacco, and prescription drugs, including opioids and marijuana, are of primary concern when it comes to aging Baby Boomers. By 2050, 22% of Americans will be aged ≥65 years. Currently, eHealth interventions are receiving attention in treating substance misuse among younger Americans. The current study has two aims: to evaluate the effectiveness of eHealth interventions for older adults treated for substance misuse problems, as well as to investigate behavioral outcomes in reducing substance misuse. A comprehensive search of databases yielded 35,041 articles that examined reductions in substance misuse and problem behaviors as a primary outcome with eHealth interventions delivered to older adults. Once duplicate and irrelevant articles were removed, seven were left to be analyzed. Findings suggest use of technology to assess and intervene with older adults using various substances shows promise and, as a whole, older adults are receptive to online learning, screening and assessment, and interventions. [Journal of Gerontological Nursing, 47(10), 23-29.].