Recent alcohol-induced blackouts among heavy drinking college students: A qualitative examination of intentions, willingness, and social context

A daily-level examination of willingness to pregame, blackout, and hook up across drinking days: Associations with respective behavioral outcomes among adolescents and young adults

Research indicates general willingness to drink (i.e., "How willing are you to drink tonight?") fluctuates day-to-day and is associated with daily-level drinking. However, it is unknown whether willingness to engage in specific alcohol-related behaviors is associated with actual engagement in those behaviors above and beyond general willingness to drink at the daily level. The present study examined whether daily-level willingness to engage in specific behaviors (i.e., pre-gaming, blacking out, hooking up) predicted engaging in those respective behaviors on drinking days above and beyond one's general willingness to drink. Participants included adolescents and young adults who were part of a longitudinal ecological momentary assessment (EMA) study on cognitions and alcohol use. Participants (N = 675; 43 % male) who reported drinking on weekend days (i.e., Friday and Saturday [N = 3,727 days]), were included. The study involved a 3-week EMA burst design with bursts occurring quarterly over 12 months. Multilevel logistic regressions indicated on drinking days when participants reported being more willing than their own average to pre-game (OR = 1.77, p <.001), black out (OR = 1.46, p <.05), or drink before hooking up (OR = 1.68, p <.001), they were more likely to pregame, black out, and hook up, respectively, whereas general willingness to drink was not associated with any outcomes at the daily level.Results suggest willingness to engage in specific behaviors may be essential to target in prevention programming in comparison to general willingness to drink when aiming to reduce specific risk behaviors.

Associations among sexual assault history, alcohol use, blackouts, and blackout intentions among college women

Background: Links between alcohol-induced blackouts and sexual assault (SA) are understudied. We tested whether: (1) history of blackouts, past 30-day blackouts, and past 30-day blackout intentions would be higher among women with histories of SA relative to women without; (2) baseline history of blackouts, past 30-day blackouts, and blackout intentions would predict an increase in SA severity (i.e., a continuous variable that considers SA tactic type and assault frequency) at a one-year follow-up. Methods: 1721 undergraduate women completed a baseline survey and 313 completed the follow-up. Results: Women with SA history had 2.10 higher odds of history of blackouts, 1.47 higher odds of past 30-day blackout during "one" drinking episode, 1.78 higher odds of blackout during a "few" drinking episodes, 3.21 higher odds of blackout during "most/all" drinking episodes, and 1.54 higher odds of blackout intentions in the last 30-days. Longitudinally, history of blackouts and past 30-day blackouts at baseline were associated with an increase in SA severity at follow-up, when peak drinks were not controlled. Conclusion: Longitudinal findings provide some evidence that lifetime history of blackouts and past 30-day blackouts are significant predictors of an increase in SA severity at follow-up and therefore an essential target for interventions.

A Dual-Process Decision-Making Model Examining the Longitudinal Associations Between Alcohol-Induced Blackouts and Alcohol Use Disorder Risk Among College Student Drinkers

OBJECTIVE

The purpose of this study was to use a dual-process decision-making model to examine the longitudinal associations between alcohol-induced blackouts (blackouts) and alcohol use disorder (AUD) risk symptoms among college student drinkers.

METHOD

Undergraduate drinkers (N = 2,024; 56% female; 87% White; 5% Hispanic) at a large northeastern university completed online surveys each semester during their first (Time [T] 1, T2), second (T3, T4), third (T5, T6), and fourth (T7, T8) years of college (87% retention across the study). Path analyses were examined testing the longitudinal associations between T1 willingness to experience a blackout, T1 intentions to avoid a blackout, T2-T8 drinking, T2-T8 blackouts, and T8 AUD risk symptoms. Hypotheses 1 and 2 tested the associations between T1 willingness, T1 intentions, T2-T8 drinking, and T2-T8 blackouts. Hypothesis 3 tested the associations between T2-T8 drinking, T2-T8 blackouts, and T8 AUD risk symptoms.

RESULTS

Students experienced an average of 8 (SD = 8) blackouts during college. Approximately 1,514 (88.8%) participants reported experiencing 1 of 8 AUD risk symptoms. T1 willingness was positively associated with T2-T8 blackouts. T2-T8 drinking and T2-T8 blackouts were positively associated with T8 AUD risk symptoms. T1 willingness significantly indirectly affected T8 AUD risk symptoms through its association with T2-T8 blackouts.

CONCLUSIONS

Results estimated that, on average, college student drinkers experienced eight blackouts across 4 years of college, and 88% of participants reported experiencing at least one symptom of AUD in the last semester of college. Willingness to experience a blackout influenced students' AUD risk symptoms through the number of blackouts they experienced throughout college.