College binge drinking in the 1990s: a continuing problem. Results of the Harvard School of Public Health 1999 College Alcohol Study

Panel Data Analysis of Socioeconomic Factors and COVID-19's Impact on Drinking Habits: Evidence from a Japanese Survey

Alcohol use is closely related to health, emotional state, and social behavior. However, no clear consensus exists on how socioeconomic factors influence drinking habits or how the COVID-19 pandemic affected alcohol use. This study examines these relationships in Japan using panel data from a questionnaire survey (2014-2022), consisting of 10,836 responses provided by 1289 respondents, and logistic regression analysis. The results revealed that males, individuals aged 40-69, cigarette smokers, and those who exercise regularly are more likely to drink alcohol, whereas those working at least 2 days per week, earning higher incomes, and in good health are less likely to drink alcohol. The impact of COVID-19 on drinking behavior varied by region, with significant effects observed in specific regions. Additionally, an identified decline in alcohol use since 2016 highlights rising health awareness and shifting values, particularly among younger generations. These findings underscore the strong association between drinking behavior and socioeconomic attributes and emphasize the need to consider regional differences in policy and cultural influences. Overall, this study provides key insights for future research and public health policies on alcohol use in Japan.

Global scientific research landscape on binge drinking: a comprehensive bibliometric and visualization analysis of trends, collaborations, and future directions

BACKGROUND

Binge drinking constitutes a significant public health concern. Defined as the consumption of five or more alcoholic beverages on a single occasion, binge drinking leads to acute cognitive and motor impairments and is associated with a multitude of detrimental health consequences. Therefore, the aim of this study was to analyse globally published peer-reviewed literature on binge drinking.

METHODS

A thorough search of the Scopus database was conducted to gather all the relevant research. Keywords related to binge drinking were used to locate a wide range of studies. Specific criteria were subsequently applied to narrow the results, ensuring the inclusion of only the most relevant articles. This process yielded a collection of 2,763 research papers. Finally, a software program called VOSviewer was utilized to analyse and visualize the connections between these studies.

RESULTS

A bibliometric analysis was performed to investigate trends in binge drinking research literature published between 1980 and 2024. The findings revealed a significant increase in publications (R²=0.916; p < 0.001), with a peak in 2018 (191 articles). The majority (89.65%, n = 2,477) were research articles, followed by review articles (4.74%, n = 131). Authors from 139 countries contributed to binge-drinking research, with the USA (n = 1,550; 56.1%) and the UK (n = 216; 7.82%) leading in the volume of publications. The National Institute on Alcohol Abuse and Alcoholism (n = 65; 2.35%) and the University of North Carolina at Chapel Hill (n = 63; 2.28%) emerged as the main institutional contributors. The National Institute on Alcohol Abuse and Alcoholism in the United States was the main funding source, supporting 599 articles (21.68%), followed by the National Institutes of Health in the United States, with 544 articles (19.69%). In particular, the post-2016 period witnessed a shift in research themes toward mechanistic investigations alongside studies on societal interventions, reflecting a growing focus on mitigating the broader social impact of binge drinking.

CONCLUSIONS

This study is the first comprehensive analysis of trends in binge drinking research. Over the past decade, binge drinking has increased dramatically, led by the United States, the UK, and Spain. Initially, focused on social and cultural factors, research shifted after 2016 to mechanistic and animal models, shaping future research directions and strategies.

Campus climate impacts on sexual violence: a Bayesian comparison of undergraduate and community colleges

OBJECTIVE

Sexual violence is endemic on college campuses. Four-year campuses present high-risk environments for sexual violence and heavy episodic drinking is a robust risk factor for victimization. However, limited literature exists on sexual violence at two-year institutions, with most research focused on four-year campuses. We examined whether campus climates affect sexual violence prevalence rates.

PARTICIPANTS

Sexual misconduct campus climate data from two-year and four-year campus students.

METHODS

We used Bayesian logistic regressions to compare sexual victimization odds between two- and four-year campuses.

RESULTS

Four-year students were twice as likely to have experienced sexual victimization and 2.5 times more likely to engage in heavy episodic drinking compared to two-year students. The risk of sexual victimization associated with heavy episodic drinking was reliably similar across campus types.

CONCLUSIONS

Campus climates reliably impact student's risk of sexual victimization. Based on these findings, two- and four-year campuses may need to implement distinct prevention services.

An evaluation of the impact of a national Minimum Unit Price on alcohol policy on alcohol behaviours

BACKGROUND

In 2018, Scotland pioneered national legislation which set a Minimum Unit Price (MUP) of 50 pence (∼US$0.64, €0.59) per unit of UK alcohol sold (8 g/10 ml). To inform policy development, we examine the policy effect using the Alcohol Use Disorders Identification Test (AUDIT-C), employing longitudinal data for over 17 200 individuals.

METHODS

The effect of MUP on AUDIT-C scores is inferred by employing difference-in-difference regression. Pre- and post-intervention alcohol behaviours of individuals from Scotland are compared to a matched 'control' from England. Drinking at hazardous and harmful levels could be identified, as well as the frequency of alcohol consumption, number of drinks and heavy episodic drinking. Estimates adjust for demographic, socioeconomic and health characteristics. Potential inequalities by gender, age and household income are examined.

RESULTS

MUP led to an estimated 5.3% reduction in the number of drinks consumed on drinking occasions, though a statistically significant effect on overall reported AUDIT-C scores or drinking at hazardous levels was not detected, with few differential effects for subgroups.

CONCLUSIONS

Differences in the findings of this research compared to other studies may be explained by differences in population coverage collected in the survey data, compared to more comprehensive, population-wide administrative data, as well as sample attrition.

The bystander intervention for problematic alcohol use model (BIPAUM)

Objective: The study aimed to identify phases of bystander intervention (BI) for problematic alcohol use (PAU) among college students. Participants: Twenty focus groups and nine interviews were conducted. Methods: Transcripts were thematically analyzed. Results: The phases of the Bystander Intervention for Problematic Alcohol Use Model (BIPAUM) include: (1) plan in advance, (2) notice and interpret a sign, (3) decide (i.e., assume responsibility, assess support/feasibility to intervene, and identify intervention strategy), (4) intervene, and (5) assess outcomes. Assessing outcomes loops to influence future behavior and each phase is influenced by barriers and facilitators. Conclusions: These unique phases should be considered when designing and evaluating intervention programs for PAU to meet students' needs and better reduce PAU. Future research should empirically test the BIPAUM. The results of the current study demonstrate a promising opportunity for applying BI to PAU, with the goal of reducing risky drinking among college students.

Trauma and alcohol characteristics related to high intensity binge drinking during college

High intensity (HI) binge drinking has emerged as a high-risk drinking phenotype in young adult drinkers, yet few studies have evaluated clinically meaningful correlates of HI binge drinking among young adults at risk for co-occurring psychopathologies, such as interpersonal trauma-exposed drinkers. The present study compared three groups (i.e., HI binge, standard binge, non-binge drinkers) of interpersonal trauma-exposed college student drinkers (N = 221) on alcohol and interpersonal trauma characteristics. Results of one-way ANOVAs indicated that the HI binge group endorsed significantly greater negative alcohol-related consequences relative to the other two groups. The HI binge group endorsed significantly greater enhancement motives compared to the non-binge group, and no group differences were detected for PTSD and interpersonal trauma characteristics. Individuals who engage in HI binge drinking may experience greater alcohol problems due to their use of alcohol to enhance positive mood. HI binge drinking does not differentiate individuals on the basis of interpersonal trauma experiences or related psychopathology.

Intermittent-access operant alcohol self-administration promotes binge-like drinking and drinking despite negative consequences in male and female heterogeneous stock rats

The study of Alcohol Use Disorders (AUD) in preclinical models is hampered by difficulty in training rodents to voluntarily consume high levels of alcohol. The intermittency of alcohol access/exposure is well known to modulate alcohol consumption (e.g., alcohol deprivation effect, intermittent-access two-bottle-choice) and recently, intermittent access operant self-administration procedures have been used to produce more intense and binge-like self-administration of intravenous psychostimulant and opioid drugs. In the present study, we sought to systematically manipulate the intermittency of operant self-administered alcohol access to determine the feasibility of promoting more intensified, binge-like alcohol consumption. To this end, 24 male and 23 female NIH Heterogeneous Stock rats were trained to self-administer 10% w/v ethanol, before being split into three different-access groups. Short Access (ShA) rats continued receiving 30-min training sessions, Long Access (LgA) rats received 16-h sessions, and Intermittent Access (IntA) rats received 16-h sessions, wherein the hourly alcohol-access periods were shortened over sessions, down to 2 min. IntA rats demonstrated an increasingly binge-like pattern of alcohol drinking in response to restriction of alcohol access, while ShA and LgA rats maintained stable intake. All groups were tested on orthogonal measures of alcohol-seeking and quinine-punished alcohol drinking. The IntA rats displayed the most punishment-resistant drinking. In a separate experiment, we replicated our main finding, that intermittent access promotes a more binge-like pattern of alcohol self-administration using 8 male and 8 female Wistar rats. In conclusion, intermittent access to self-administered alcohol promotes more intensified self-administration. This approach may be useful in developing preclinical models of binge-like alcohol consumption in AUD.

Religion and drinking: Differences between two campuses

Levels of religiousness vary by geographic location, but studies of the relationship between religiousness and alcohol are often limited to one region. For our participants (N = 1124; 57.5% female), location was significantly associated with both religiousness and alcohol use. Active religiousness was associated with drinking outcomes. The indirect effects of location on drinks per week through active religiousness were significant. At Campus S, subjective religiousness was associated with more drinks per week, whereas active religiousness was associated with fewer drinks per week. Findings indicate active religiousness is especially relevant when exploring drinking, and location is important when exploring religiousness and alcohol use.

"I'm an adult now": Health risk behaviors and identifying as an adult

Is identifying as an adult associated with lower rates of participation in risky behaviors? This study focuses on how identity affects health behaviors for young adults. We use an original sample of over 500 18- to 29-year-olds in the United States to explore how self-identification as an adult is associated with three clusters of health risk behaviors: substance use, risky sexual behavior, and risky driving behavior. Consistent with our predictions, we find that viewing oneself as an adult is associated with lower levels of participation in each of the health risk behavior outcomes.

Risk Factors for Substance Use across the Lifespan

Substance use is a perennial public health concern with associated health risks and economic impacts on society. In this article, we present a selective review of the epidemiological and clinical literatures on alcohol and substance use from a lifespan developmental perspective. We compare and contrast risk factors for the initiation of use and the development of a substance use disorder in adolescence, young adulthood, middle-age and later life. During adolescence, alcohol use experimentation is at its peak. Specific risk factors have been identified including trauma and parenting style that can increase the risk of substance use for teenagers. Emerging adults and college students are likely to experiment with other substances in addition to alcohol such as nicotine, marijuana, cocaine, and prescription medication such as Adderall. Middle-age and older adults with alcohol and substance use in their developmental histories may have an undiagnosed alcohol use disorder. Others will develop a late-onset substance use disorder in older age, possibly due to a dearth of social support, coping with bereavement, and medical complication. Based on Social Cognitive Theory, the roles of expectancies and self-efficacy are hypothesized to impact substance use and the risk of substance use disorder across the lifespan. Implications of the present review for future research on age-specific risk factors in alcohol use in relation to underlying developmental processes are considered.

A two-stage social network intervention for reducing alcohol and other drug use in residential colleges: Protocol for a feasibility trial

BACKGROUND

In many countries, the rate of binge drinking and alcohol-related harms among students living in residential colleges exceeds that observed among young people in the general population. Peer influence plays a key role in driving alcohol and other drug (AOD) use in colleges. This highlights the potential role of peer influence AOD-interventions in college student-networks. This protocol paper outlines the design of a two-stage social network intervention (SNI) for reducing AOD-use in four Australian first-year residential college networks.

METHODS

In Stage 1, a peer-led workshop will provide education about AOD-use and harm-minimisation strategies to four first-year cohorts in the first week of semester one (N ~ 500). In Stage 2, a targeted SNI will be delivered to the largest co-educational, first-year cohort (N ~ 160), wherein heavy drinking 'Strategic Players' (influential students) will be identified and offered a brief, telephone-delivered motivational interviewing intervention for AOD-use (QuikFix). Participants will complete online surveys at baseline and 12-, 26-, and 52-weeks follow-up.

RESULTS

Recruitment occurred in February 2021 and is now closed. Results are expected to be submitted for publication in late 2022.

CONCLUSIONS

This protocol paper outlines the design of a feasibility trial exploring the impact of applied SNIs for reducing AOD-use and related consequences in residential college student networks. If effective, the two-stage SNI proposed could (i) reduce AOD-use and risk of harm across first-year student networks and (ii) provide an effective brief intervention (QuikFix) to high-risk drinkers who have greatest potential to spread the intervention effects to other risky drinkers in their network.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry (ACTRN12621000494831).

High-risk alcohol use behavior and daily academic effort among college students

Objective It is not well understood whether heavy drinking interferes with academics on specific days or if this relationship simply reflects between-student differences. Participants:N = 736 college students completed 14 consecutive daily assessments during 7 semesters. Methods: Days were classified as non-drinking, moderate drinking, heavy episodic drinking only (HED-only), or high-intensity drinking (HID) days. Multilevel models tested associations between drinking level and academic behaviors. Results: Students were more likely to skip class after engaging in HED-only or HID the previous day. On weekdays, students spent more time on schoolwork when they did not drink the previous day and spent less time on schoolwork when they engaged in HED-only and HID the previous day. On weekends, students spent less time on schoolwork after HED-only days. Conclusions: Heavy drinking is associated with lower academic effort the next day, highlighting the need for college programs targeting heavy alcohol use prevention and daily decision making.

Know Your Safe Drinking Skills: Adaptation Strategies for the College Effect

Objective: The current study investigates the effects of an alcohol-prevention program delivered to college students in a formal classroom setting. Participants: The sample comprised 231 first-year college students who enrolled in a multisection “First Year Experience” course at a large northeastern university in the United States. Method: A naturalistic experiment was conducted, with a baseline evaluation at the beginning of the semester and a post-experiment evaluation near the end of the semester. Results: Social drinking attitudes, proximal drinking norm and the college effect are significant predictors of pre- and post-intervention episodic drinking frequency. The intervention reduced episodic drinking frequency as well as perceived distal and proximal drinking norms. It also increased drinking attitudes and did not change perceived efficacy or drinking-outcome expectancies. Conclusions: Practitioners could consider implementing a similar intervention to allow students to learn and practice safe drinking skills in the first year of their college life.

The influence of multidimensional deprivation on problem drinking developmental trajectory among young adults: a longitudinal study using latent class growth analysis

BACKGROUND

Many young people in Korea today experience deprivation in various areas of life. The social determinants of health approach maintains that social factors play an important role in an individual's physical and mental health. This study aimed to investigate the problem drinking trajectory of young Korean people and identify the effects of multidimensional deprivation on problem drinking.

METHODS

The study used data from 2012 to 2018 found in the Korea Welfare Panel Study. Latent class growth analysis was performed to determine the number of trajectories of problem drinking. After identifying latent classes, a multinomial logistic regression analysis was utilized to examine multidimensional deprivation as a predictor of class membership.

RESULTS

Latent class analysis yielded three groups: (1) a low-level maintenance group (low level of alcohol use maintained at the low level), (2) a moderate-level increasing group (moderate level of problem drinking with a moderate increase in problem drinking), and (3) a risky drinking increasing group (high level of problem drinking with a rapid increase in problem drinking). Results from multinomial logistic regression showed that deprivation in housing and social deprivation increased the probability of belonging to the risky drinking increasing group compared to other reference groups.

CONCLUSION

The study speaks to the need to establish appropriate intervention strategies according to the level and changes in the pattern of alcohol use. The implications of housing and social deprivation concerning problem drinking among young Korean people are also discussed.

A longitudinal study of the moderating effects of romantic relationships on the associations between alcohol use and trauma in college students

BACKGROUND AND AIMS

College students report high levels of alcohol use, which can be exacerbated by interpersonal trauma exposure (IPT). Romantic relationships may represent salient contexts for moderating associations between IPT and alcohol use. We examined whether relationship status, partner alcohol use and relationship satisfaction moderated associations between IPT and alcohol use, and whether these associations varied in a sex-specific manner.

DESIGN

University-wide longitudinal survey of college students.

SETTING

Large, urban public university in mid-Atlantic United States.

PARTICIPANTS

We used two subsets of participants (n = 5673 and 3195) from the Spit for Science project, a longitudinal study of college students. Participants completed baseline assessments during the autumn of their freshman year and were invited to complete follow-up assessments every spring thereafter. Participants were included in the present study if they completed surveys at baseline and at least one follow-up assessment (meanfollow-ups  = 1.70, range = 1-4).

MEASUREMENTS

Predictors included precollege and college-onset IPT, relationship status, partner alcohol use, relationship satisfaction and sex. Alcohol consumption was the primary outcome of interest. Pre-college IPT was measured at baseline and all other measures were assessed at each follow-up.

FINDINGS

Individuals with pre-college IPT consumed more alcohol than those without IPT, but this was mitigated for those in relationships (β = -0.15, P = 0.046, 95% confidence interval (CI) = -0.29, 0.00). Individuals with college-onset IPT consumed more alcohol than those without IPT, and this was more pronounced for those with higher partner alcohol use (β = -0.18, P = 0.001, 95% CI = -0.29, -0.07). Relationship satisfaction was not a significant moderator of the associations between IPT and alcohol use (Ps > 0.05 and 95% CIs include 0).

CONCLUSIONS

Involvement in relationships, but not relationship satisfaction, appears to reduce the effects of interpersonal trauma exposure (IPT) on alcohol use among US college students, while high partner alcohol use appears to exacerbate it. The moderating effects of relationship characteristics depend on the developmental timing of IPT.

Adolescent Intermittent Ethanol (AIE) Enhances the Dopaminergic Response to Ethanol within the Mesolimbic Pathway during Adulthood: Alterations in Cholinergic/Dopaminergic Genes Expression in the Nucleus Accumbens Shell

A consistent preclinical finding is that exposure to alcohol during adolescence produces a persistent hyperdopaminergic state during adulthood. The current experiments determine that effects of Adolescent Intermittent Ethanol (AIE) on the adult neurochemical response to EtOH administered directly into the mesolimbic dopamine system, alterations in dendritic spine and gene expression within the nucleus accumbens shell (AcbSh), and if treatment with the HDACII inhibitor TSA could normalize the consequences of AIE. Rats were exposed to the AIE (4 g/kg ig; 3 days a week) or water (CON) during adolescence, and all testing occurred during adulthood. CON and AIE rats were microinjected with EtOH directly into the posterior VTA and dopamine and glutamate levels were recorded in the AcbSh. Separate groups of AIE and CON rats were sacrificed during adulthood and Taqman arrays and dendritic spine morphology assessments were performed. The data indicated that exposure to AIE resulted in a significant leftward and upward shift in the dose-response curve for an increase in dopamine in the AcbSh following EtOH microinjection into the posterior VTA. Taqman array indicated that AIE exposure affected the expression of target genes (Chrna7, Impact, Chrna5). The data indicated no alterations in dendritic spine morphology in the AcbSh or any alteration in AIE effects by TSA administration. Binge-like EtOH exposure during adolescence enhances the response to acute ethanol challenge in adulthood, demonstrating that AIE produces a hyperdopaminergic mesolimbic system in both male and female Wistar rats. The neuroadaptations induced by AIE in the AcbSh could be part of the biological basis of the observed negative consequences of adolescent binge-like alcohol exposure on adult drug self-administration behaviors.

Binge Drinking: The Top 100 Cited Papers

We conducted a review to analyze the 100 most-cited studies on binge drinking (BD) in the Web of Science (WoS) database to determine their current status and the aspects that require further attention. We carried out a retrospective bibliometric analysis in January 2021. The year of publication, authors, design, subject, journal, institution and lead author’s country, as well as the definition of BD, were extracted from the articles. The data on the country, year, thematic category of the journals and their rank were obtained from the Institute for Scientific Information (ISI) Journal Citation Reports 2020. The number of citations was collected from the WoS, and the h index was collected from the Scopus database. The citation density and Bradford’s law were calculated. The majority of the articles were empirical quantitative studies with a cross-sectional design published between 1992 and 2013 in 49 journals. There were 306 authors, mostly English-speaking and from the USA. The definitions used to describe BD are not homogeneous. The most-cited topics were the analysis of consequences, determinants and epidemiology. There is a need to unify the definitions of BD and base them on scientific evidence. The multidisciplinary nature of BD is not well reflected in each of the thematic areas discussed in this work.

Affective factors explaining the association between depressive functioning and alcohol outcomes among college students

Rates of co-occurring depression and alcohol use are higher among college students than in the general population. Further research is needed to illuminate how the mechanisms with which individuals process negative emotions may clarify the link between depressive symptoms and drinking. Objective: To assess how three potential mediators representing affective functioning (ie, need for affect, distress tolerance, emotion regulation) explain the relationship between depressive symptoms and alcohol use (ie, quantity and problems). Participants: The sample consisted of 227 college student heavy drinkers. Methods: Participants completed computerized self-report surveys in Fall 2016. Results: Path analyses revealed need for affect mediated the association between depressive symptoms and alcohol quantity, while emotion regulation mediated the relationship between depressive symptoms and alcohol-related problems. Conclusions: Findings highlight the importance of various affective functioning mechanisms to the depressive symptom-drinking link. Future research could target these mechanisms in college interventions for co-occurring mood symptoms and alcohol use.

Perceptions of College Campus Alcohol and Sexual Violence Prevention Among Students with Disabilities: "It Was A Joke"

PURPOSE

The purpose of this study was to understand perceptions of campus-based alcohol and sexual violence (SV) prevention programming among college students with disabilities to inform future development of prevention programs appropriate for the needs of these students.

METHOD

The study included semi-structured, qualitative interviews with 51 college students with disabilities who reported histories of SV recruited from a larger parent study investigating a brief universal intervention to reduce alcohol related SV involving 28 campuses across Western Pennsylvania and West Virginia. Interviews focused on college-related experiences of prevention programming, and experiences of health, disability, alcohol use and violence victimization. Data were analyzed using thematic analysis.

RESULTS

Three themes emerged: (1) Students with disabilities described campus prevention programming as ineffective and irrelevant to their experiences, including referring to programs as "a joke," (2) Students wanted multi-dose, developmentally relevant content that directly addresses the complexities of their experiences with disability, alcohol, and violence, and (3) Students called for programing focused on engaging their interests.

CONCLUSIONS

Our results point to the need to augment campus-based programming, with attention to the unique needs and relevant concerns of students with disabilities, within the broader context of campus prevention programming.

Optimal control of alcoholism spreading through awareness over multiplex network

This paper proposes the SISRS epidemic model to represent alcohol addiction among people. The spreading of alcohol addiction is controlled by creating awareness among the people and also by treating them to overcome it. Multiplex network is used to study the dynamics of addiction. Alcoholism spreads over the physical contact layer and follows the SISRS process whereas human awareness spreads over the virtual contact layer and follows the UAU process. Based on the Microscopic Markov Chain Approach competing dynamics of spreading of alcohol addiction and human awareness diffusion are studied. Necessary conditions for the existence of an alcohol-free population are found. An optimal control problem using a suitable cost index is formulated to reduce the alcohol addicts and the optimal control strategy using Pontryagin’s Minimum Principle is determined. Numerical results are developed to find the effect of various parameters and to analyze the effects of different control strategies. The results obtained from this model are closer to the data collected in the National Survey of Drug Use and Health (NSDUH) from 2002 to 2018.

Patterns, Consequences, and Motives in Simultaneous Use of Prescription Stimulant Medication with Alcohol and Marijuana

Nonmedical use of prescription stimulants (NPS) continues to be a concern on college campuses. Previous research demonstrates a strong link between NPS and use of other substances, particularly alcohol and marijuana among college students. Simultaneous use of NPS with other substances has become an increasing concern. Given the high rates of NPS and simultaneous NPS with other substances, research examining substance use patterns and motives among students is warranted. Method: This study evaluated group differences in alcohol and marijuana use patterns, consequences, and motives among college students: a) with no NPS history (No NPS); b) engaged in NPS with no simultaneous use (Non-Sim NPS); and c) engaged in simultaneous NPS with alcohol and/or marijuana (Sim NPS). Participants included 1,108 students from three universities who reported past-year marijuana and alcohol use. Results: Overall, 32.8% reported lifetime NPS with 12.5% indicating NPS in the previous 3 months, of which 51.1% reported simultaneous NPS with alcohol and 40.2% with marijuana. Significant group differences for all drinking and marijuana outcomes were found, with heaviest rates among the Sim NPS group, followed by the Non-Sim NPS group, and the No NPS group. The Sim NPS group reported greater motives for using marijuana to alter the effects of other substances. Conclusions: College students engaged in simultaneous NPS with alcohol and marijuana are a high-risk group that should be the focus of prevention and intervention programs in the campus setting.

Coping Styles Among High School Graduates Aiming to Study Medicine in Dealing With Depressive and Anxious Symptoms

Background: Psychological distress, its associated stressors and resilience factors, and the implications derived for the education and training of medical students and physicians have long been the subject of international studies. The study presented here investigated affective symptoms in association with coping styles in the earliest phase of University medical education: high school graduates aiming to study medicine. Materials and Methods: We conducted a self-report survey at a medical school in Germany among high school graduates who indicated being interested in studying medicine at the university's on-campus recruitment day. The questionnaire included validated instruments for the self-assessment of symptoms of depression (i.e., Patient Health Questionnaire; PHQ-9) and anxiety (i.e., Generalized Anxiety Disorder 7 (GAD-7), and participants were also asked to rate functional and dysfunctional behavior-based coping styles for symptoms of depression and anxiety. Additional variables addressed were gender, motivation, interest in studying medicine, and parental employment in medicine. Results: Of 400 high school graduates, 346 (87%) completed the survey. More than 40 (12.5%) and nearly 30 (8.4%) reported relevant symptoms of depression (PHQ-9 sum score ≥10) and anxiety (GAD-7 sum score ≥10), respectively. Among the graduates, young women had higher values for symptoms of depression than young men, and one's interested exclusively in studying human medicine tended to have marginally higher levels of symptoms of depression than ones who were also interested in other subjects. Relevant functional coping styles included seeking social support, relaxing, engaging in sports, listening to or making music, and reading books, whereas relevant dysfunctional coping styles included consuming alcohol, abusing drugs, restrictive eating, watching TV, surfing the Internet, and withdrawing and ruminating. Conclusion: The results clarify the burden and associated resilience factors of premedical high school graduates at the earliest phase of their University education. As such, they reveal ways to address educational and supportive services and support the need for further investigation into factors of success in studying human medicine.

Does academic streams influence alcohol use in colleges?

BACKGROUND

Alcohol use among college students is a major public health priority owing to its high prevalence and numerous negative outcomes. Most interventions targeting alcohol use among college students consider them as a homogenous entity. There is preliminary evidence from high-income countries that patterns of alcohol use differ across academic streams. This remains unstudied in India.

AIMS

To compare the prevalence and correlates of alcohol use among students enrolled in various collegiate educational streams (medical, nursing, engineering, arts and science, and others [law/fisheries]) in the state of Kerala, India.

SETTINGS AND DESIGN

This is a cross-sectional survey conducted among college students.

MATERIALS AND METHODS

5784 students completed a self-administered questionnaire assessing alcohol use and its correlates in the psycho-social domains.

STATISCAL ANALYSIS

Lifetime prevalence and severity of alcohol use was determined across examined academic streams. A multivariable logistic regression analysis was done separately for each course, to identify factors influencing alcohol use.

RESULTS

The lifetime prevalence of alcohol use varied between 10.6% among nursing students to 41.7% among students pursuing "other" stream (law/fisheries). Students pursuing medicine and nursing had a relatively lower proportion of hazardous users. Consistently across all academic streams, being male and using tobacco increased the risk, while those from the Muslim community had a lower risk of alcohol use. Other examined psychosocial correlates showed varying relationship across courses.

CONCLUSION

The prevalence and psychosocial correlates of alcohol use vary among students pursuing various academic streams. This finding has public health importance as the incorporation of course level characteristics in intervention programs will improve effectiveness.

Dimensions of childhood trauma and their direct and indirect links to PTSD, impaired control over drinking, and alcohol-related-problems

INTRODUCTION

Post-Traumatic Stress Disorder (PTSD) develops after experiencing events that evoke fear, helplessness, or horror. The Hyperarousablity Hypothesis suggests that those with PTSD may drink more to dampen physiological reactivity. We examined the direct and indirect relationships between childhood trauma (e.g., physical-neglect, emotional-abuse, physical-abuse, sexual-abuse) versus an emotionally-supportive-family on PTSD, impaired control over drinking (IC), alcohol-use, and alcohol-related-problems. IC reflects consuming more alcohol than one originally intended.

METHODS

We fit a multiple-group SEM to data on 835 participants. Mediational analyses were conducted by using the (K = 20,000) bootstrap technique with confidence intervals.

RESULTS

Physical-neglect was directly linked to more IC among both genders. Emotional abuse was also found to be directly linked to more PTSD among both genders. Furthermore, PTSD was directly linked to more impaired control over alcohol use (IC) among both genders. Mediational analyses showed that physical-neglect was indirectly linked to more alcohol-related-problems through increased IC. Having an emotionally supportive family was directly linked to fewer PTSD symptoms among women. For both genders, emotional abuse was indirectly linked to more alcohol-related-problems through more PTSD symptoms, impaired control over alcohol use difficulties, and in turn, more alcohol-use. Sexual abuse was indirectly linked to increased alcohol-related- problems through increased PTSD symptoms and more IC, and in turn, more alcohol-use among men.

CONCLUSIONS

Recalled childhood trauma (sexual and emotional abuse) may contribute to PTSD symptoms and dysregulated drinking. In conclusion, our data suggest that reducing PTSD symptoms may assist individuals in regaining control over their drinking.

Is Alcohol Consumption Associated with Poor Perceived Academic Performance? Survey of Undergraduates in Finland

The relationship between academic performance and alcohol consumption among students remains inconsistent. We assessed this relationship, controlling for sociodemographic characteristics across seven faculties at the University of Turku (1177 undergraduates). An online questionnaire assessed: seven sociodemographic characteristics (age, gender, year/discipline of study, accommodation type, being in intimate relationship, parental education, and income sufficiency); two perceived academic performance (students’ subjective importance of achieving good grades and students’ appraisal of their academic performance compared to peers); and six alcohol consumption behaviors (length of time, amount consumed, frequency, heavy episodic drinking, problem drinking, and possible alcohol dependence). Simple logistic regression assessed relationships between sociodemographic and academic variables with alcohol consumption behaviors; multiple logistic regression assessed the same relationships after controlling for all other variables. Students reported long duration and large amount of drinking (46% and 50%), high frequency of drinking (41%), heavy episodic drinking (66%), problem drinking (29%), and possible alcohol dependence (9%). After controlling, gender was associated with all alcohol consumption behaviors, followed by religiosity (associated with four alcohol behaviors), living situation, marital status, age (each associated with two alcohol behaviors), and parental education and year of study (each associated with one alcohol behavior). Study discipline, income sufficiency, importance of achieving good grades, and academic performance compared to peers were not associated with any alcohol behaviors. Universities need to assess problem drinking and alcohol use disorders among students. Prevention strategies are required to reduce risk. Health promotion efforts could focus on beliefs and expectations about alcohol and target student groups at risk for more efficient and successful efforts.

Peer Pressure and Substance Use in Emerging Adulthood: A Latent Profile Analysis

Introduction: Peers play an important role in influencing emerging adults' substance use behaviors, however, research on peer pressure has typically not been extended beyond adolescence to include emerging adulthood. Little research has examined the relationships between various peer pressure domains and emerging adult substance use. Methods: This study used quantitative data from 359 emerging adults (aged 18-29 years, M = 25.46 years; 60.8% female; 74.2% White) to explore the associations between different types of peer pressure (e.g. peer pressure to socialize and peer pressure to use substances) and substance use among a diverse sample of emerging adults. Latent profile analysis and path analysis were used for analysis. Results: Three unique profiles of perceived peer pressure emerged (negative peer pressure, positive peer pressure, and no perceived peer pressure). The negative peer pressure group was more likely to engage in binge drinking, lifetime alcohol use and lifetime marijuana use than the no peer pressure group. The positive peer pressure group was less likely to engage in lifetime alcohol or marijuana use compared to the no peer pressure group. Discussion: Findings suggest that peer pressure is associated with emerging adult substance use, in both negative and positive ways. Results of the current study provide the critical groundwork for more sophisticated studies seeking to understand the pathways by which positive and negative peer pressure impact emerging adult behavior.

Revisiting resilience: Examining the relationships between stress, social support, and drinking behavior among black college students with parental substance use disorder histories

The study examined the role social support plays in the relationship between life stress and problem alcohol use behavior in a sample of Black emerging adults in college with histories of parental substance use disorders (SUD). Participants were 1,007 Black emerging adult college students, recruited as part of a larger multi-wave, multisite, study investigating coping behavior among emerging adults in college. Findings suggest that Black college students with parental SUDs engage in riskier and coping motivated drinking behaviors more than those without such histories, and their alcohol use behaviors are more strongly linked to experiencing life stress, despite similar levels of perceived social support. Social support from friends and sufficient global social support help to mediate this adverse relationship. Parental SUD may serve as a readily identifiable risk factor for risky drinking behavior among Black college students. Implications for future research and clinical practice are presented.

Alcohol consumption, life satisfaction and mental health among Norwegian college and university students

OBJECTIVE

High-level alcohol consumption is common in, and central to, the student community. Among adults, high-level alcohol consumption, and sometimes also low, has been associated with poorer social integration and mental health. We aimed to investigate how alcohol consumption relates to life satisfaction and mental health among students in higher education.

METHODS

Data from the Norwegian study of students' health and well-being (SHoT, 2014, n = 9632) were used. Associations between alcohol consumption (AUDIT; abstainers, low risk, risky and hazardous consumption) and life satisfaction and mental health complaints, as well as number of close friends, and social and emotional loneliness were investigated using linear regression models. Crude models and models adjusted for age, gender and relationship status were conducted.

RESULTS

Students reporting hazardous consumption reported lower life satisfaction, more mental health complaints, and more emotional and social loneliness than students with low risk consumption. Students reporting risky consumption reported slightly reduced life satisfaction and more mental health complaints, but more close friends and less social loneliness. Abstainers did not report reduced life satisfaction or more mental health complaints, despite reporting fewer close friends and more social loneliness.

CONCLUSION

High-level alcohol consumption among students might indicate increased risk of several problems in the future - but also currently. Our findings further imply that the quality of friendships might be more important for life satisfaction and mental health than the number of friends, but also that social integration in student communities might be more difficult for students who do not drink.

Alcohol use and consequences in matriculating US college students by prescription stimulant/opioid nonmedical misuse status

BACKGROUND

US college students have elevated prescription opioid and stimulant misuse rates, with frequent alcohol use and alcohol-related consequences (ARCs). To date, though, no research has examined relationships between opioid and/or stimulant misuse and alcohol quantity/frequency or ARC variables in college students.

METHODS

The 2016-17 AlcoholEDU for College™, a web-based alcohol prevention program, provided data (n = 491,849). Participants were grouped into past 14-day: (1) no misuse; (2) opioid misuse only; (3) stimulant misuse only; and (4) combined misuse. Using multilevel logistic regressions, groups were compared on 14-day alcohol use odds, and among those with use, odds of any ARCs and specific ARCs (e.g., hangover). Multilevel negative binomial regressions compared group members with alcohol use on 14-day total drinks, maximum 24-h drinks and drinking days.

RESULTS

Alcohol use and any ARCs odds were highest in the stimulant (odds ratios [OR] = 3.47 and 2.97, respectively) or opioid misuse only groups (ORs = 3.31 and 2.43, respectively), with the combined misuse group intermediate (ORs = 1.63 and 1.29; reference: no misuse). Mean 14-day drinks decreased from those with combined misuse, to those with stimulant misuse only, opioid misuse only and no misuse (8.22, 7.1, 6.67, and 4.71, respectively).

CONCLUSIONS

College students engaged in 14-day stimulant and/or opioid misuse had higher odds of 14-day alcohol use, higher levels of alcohol use, and a greater likelihood of ARCs, versus students without misuse. These findings suggest that college students with any prescription misuse need alcohol screening, although those with poly-prescription misuse may not need more intensive alcohol interventions.

Alcohol and illicit drug consumption and the association with risky sexual behaviour among Swedish youths visiting youth health clinics

AIMS

High alcohol consumption and use of illicit drugs among young people is of great concern and there is a need to identify arenas where this group can be reached by preventive measures. The aim of the present study was to study prevalence of risky alcohol consumption, illicit drug use, and risky sexual behaviour (RSB) among young people visiting youth health clinics in Stockholm county. Another aim was to explore the association between risky alcohol consumption, illicit drug use and RSB.

METHODS

During autumn 2016, an anonymous questionnaire comprising questions about alcohol, illicit drugs and risky sexual behaviour was given to visitors at 11 youth health clinics in Stockholm county.

RESULTS

A total of 328 youths (M = 18.8 years, 89% girls) answered the questionnaire. Results show that 61.7% had risky alcohol consumption and 41.8% had tried illicit drugs. Risky sexual behaviour was more prevalent among respondents with risky alcohol consumption, and it was more common among non-students than students.

CONCLUSIONS

Findings indicate that a large proportion of visitors at youth health clinics in Stockholm county has a risky alcohol consumption and experiences of other drugs, and also that risky alcohol consumption is associated with three of five RSB outcomes. Non-students seemed to be a particularly exposed risk group with regard to both risky alcohol consumption and RSB. Overall, the results indicate that youth health clinics are an important arena for alcohol prevention.

The contexts of heavy drinking: A systematic review of the combinations of context-related factors associated with heavy drinking occasions

Background

The amount of alcohol consumed during an occasion can be influenced by physical and social attributes of the setting, characteristics and state of individuals, and the interactions of these components. This systematic review identifies and describes the specific combinations and sequences of context-related factors that are associated with heavy drinking occasions.

Materials and methods

We conducted a systematic literature search of MEDLINE, Embase and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Eligible articles were event-level and event-based studies that quantitatively analysed associations of sequences or combinations of context-related factors with event-level alcohol consumption. We extracted information on study design, sample, variables, effect estimates and analytical methods. We compiled a list of combinations and sequences associated with heavier drinking (i.e., ‘risky contexts’) and with lighter drinking (‘protective contexts’). The review protocol was registered with PROSPERO (registration number: CRD42018089500).

Results

We screened 1902 retrieved records and identified a final sample of 65 eligible studies. Daily mood, day of week, location and drinking group characteristics are important drivers of whether an individual engages in a heavy drinking occasion. The direction and magnitude of some associations differed by gender, age, personality and motives, such that in particular social or physical contexts, some people may feel compelled to drink more while others are compelled to drink less. Very few sequences of factors were reported as being associated with event-level alcohol consumption.

Conclusions

Contexts or factors are experienced in specific sequences that shape the broader drinking context and influence drinking behaviours and consequences but are under-studied. Event-level studies such as those using ecological momentary assessment can harness new technologies for data collection and analysis to improve understandings of why people engage in heavy drinking. Continued event-level research will facilitate public health interventions and policies that reduce heavy drinking and alcohol-related harms.

Improvement in therapist skills over sessions in brief motivational interventions predicts client language and alcohol use outcomes

Brief motivational interventions (BMIs) are widely used and efficacious interventions that address alcohol misuse in mandated college students. Consistent with motivational interviewing (MI; Miller & Rollnick, 2013) theory, within-therapist improvements in MI-consistent (MICO) skills over time-that is, as a therapist gains skill through repeated practice-may be associated with concurrent increases in client change language and subsequent changes in behavior. This study examined how therapist skill changed over time and whether within-therapist improvement in MICO skills impacted in-session client change language and subsequent alcohol-related outcomes. BMI sessions (N = 228) from 2 randomized clinical trials that had led to significant reductions in alcohol use and alcohol-related problems in mandated student drinkers were coded using the Motivational Interviewing Skills Code 2.0 (Miller, Moyers, Ernst, & Amrhein, 2003). In both studies, the BMI consisted of a single 45- to 60-min session. Analyses examined session-by-session changes in therapist MICO skills, client change language, and alcohol use outcomes. Therapist MICO skills improved over time, and there were significant increases in client change language and decreases in client discussion of topics other than personal alcohol use. Among relatively heavy-drinking clients, those treated by a more experienced therapist demonstrated greater reductions in alcohol use; however, this association was not mediated by client change language. Increased experience conducting BMIs improved therapist MICO skills over time, which in turn increased the focus on personal alcohol use during the session. However, it remains unclear how client language predicts behavior change following a BMI. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Psychosocial Motivators for Moderate Drinking among Young Asian Flushers in Singapore

Asians are more susceptible to alcohol flush syndrome and its associated health risks because they are genetically predisposed towards it. Guided by the theory of planned behaviour, this research examined the psychosocial factors associated with moderate alcohol consumption, in order to inform the development of a health campaign targeting young Asian "flushers" in Singapore. We employed a mixed-method design comprising an online survey and focus group discussions. The survey results identified perceived behavioural control as the most salient belief associated with moderate drinking intentions, particularly for Asian flushers. Although Asian flushers had more positive attitudes towards, and perceived behavioural control about drinking in moderation, they were more likely to consider that their peers disapprove of such a practice, compared to non-flushers. Additionally, Asian flushers did not consider themselves as having a higher risk of long-term health effects from alcohol consumption than non-Flushers despite their actual high-risk status. Focus group findings suggest that young Asian flushers have poor knowledge of, and skills associated with moderate drinking, in addition to feeling self-imposed social pressure. The study findings provide practical insights into bridging the information gap on Asian flush and promoting Asian flushers' drinking in moderation.

Does binge drinking between the age of 18 and 25 years predict alcohol dependence in adulthood? A retrospective case-control study in France

OBJECTIVE

A retrospective case-control study was conducted to evaluate whether frequent binge drinking between the age of 18 and 25 years was a risk factor for alcohol dependence in adulthood.

SETTING

The Department of Addictive Medicine and the Clinical Investigation Center of a university hospital in France.

PARTICIPANTS

Cases were alcohol-dependent patients between 25 and 45 years and diagnosed by a psychiatrist. Consecutive patients referred to the Department of Addictive Medicine of a university hospital between 1 January 2017 and 31 December 2017 for alcohol dependence were included in the study. Controls were non-alcohol-dependent adults, defined according to an Alcohol Use Disorders Identification Test score of less than 8, and were matched on age and sex with cases. Data on sociodemographics, behaviour and alcohol consumption were retrospectively collected for three life periods: before the age of 18 years; between the age of 18 and 25 years; and between the age of 25 and 45 years. Frequency of binge drinking between 18 and 25 years was categorised as frequent if more than twice a month, occasional if once a month and never if no binge drinking.

RESULTS

166 adults between 25 and 45 years were included: 83 were alcohol-dependent and 83 were non-alcohol-dependent. The mean age was 34.6 years (SD: 5.1). Frequent binge drinking between 18 and 25 years occurred in 75.9% of cases and 41.0% of controls (p<0.0001). After multivariate analysis, frequent binge drinking between 18 and 25 years was a risk factor for alcohol dependence between 25 and 45 years: adjusted OR=2.83, 95% CI 1.10 to 7.25.

CONCLUSIONS

Frequent binge drinking between 18 and 25 years appears to be a risk factor for alcohol dependence in adulthood. Prevention measures for binge drinking during preadulthood, especially frequent binge drinking, should be implemented to prevent acute consequences as injury and death and long-term consequences as alcohol dependence.

TRIAL REGISTRATION NUMBER

NCT03204214; Results.

Genes, Roommates, and Residence Halls: A Multidimensional Study of the Role of Peer Drinking on College Students' Alcohol Use

BACKGROUND

Peer drinking is one of the most robust predictors of college students' alcohol use and can moderate students' genetic risk for alcohol use. Peer effect research generally suffers from 2 problems: selection into peer groups and relying more on perceptions of peer alcohol use than peers' self-report. The goal of the present study was to overcome those limitations by capitalizing on a genetically informed sample of randomly assigned college roommates to examine multiple dimensions of peer influence and the interplay between peer effects and genetic predisposition on alcohol use, in the form of polygenic scores.

METHODS

We used a subsample (n = 755) of participants from a university-wide, longitudinal study at a large, diverse, urban university. Participants reported their own alcohol use during fall and spring and their perceptions of college peers' alcohol use in spring. We matched individuals into their rooms and residence halls to create a composite score of peer-reported alcohol use for each of those levels. We examined multiple dimensions of peer influence and whether peer influence moderated genetic predisposition to predict college students' alcohol use using multilevel models to account for clustering at the room and residence hall level.

RESULTS

We found that polygenic scores (β = 0.12), perceptions of peer drinking (β = 0.37), and roommates' self-reported drinking (β = 0.10) predicted alcohol use (all ps < 0.001), while average alcohol use across residence hall did not (β = -0.01, p = 0.86). We found no evidence for interactions between peer influence and genome-wide polygenic scores for alcohol use.

CONCLUSIONS

Our findings underscore the importance of genetic predisposition on individual alcohol use and support the potentially causal nature of the association between peer influence and alcohol use.

Personalized normative feedback for heavy drinking: An application of deviance regulation theory

Deviance Regulation Theory (DRT) proposes that individuals regulate their behavior to be in line with the behaviors of others. Specifically, individuals desire to stand out in positive way and not stand out in a negative way. DRT has been successfully applied to encourage other health behaviors and offers a unique method to utilize both injunctive norms in combination with descriptive norms in brief alcohol interventions. This randomized controlled trial evaluated a computer-delivered, norms-based personalized feedback intervention which systematically varied the focus on whether specific drinking behaviors were described as common or uncommon (a descriptive norm), whether the drinking behaviors were healthy versus unhealthy, and whether the drinking behaviors were positively or negatively framed (an injunctive norm). Nine-hundred and fifty-nine college drinkers completed baseline, three-month, and six-month follow-up assessments. Results indicated messages focusing on unhealthy drinking behaviors, particularly when described as uncommon, were most effective in reducing drinking and alcohol-related problems over time. This research utilizes deviance regulation theory as a way of improving personalized normative feedback by elucidating how to construct messages for brief interventions based on descriptive characteristics associated with specific target drinking behaviors in combination with perceptions of prevalence and acceptability of such drinking behaviors (an injunctive norm).

Alcohol consumption, interpersonal trauma, and drinking to cope with trauma-related distress: An auto-regressive, cross-lagged model

Alcohol consumption and interpersonal trauma (IPT) co-occur at high rates, particularly in college populations. Two non-mutually-exclusive theories of this comorbidity are the risky behavior model, suggesting that substance use increases likelihood of IPT, and the self-medication model, suggesting that individuals use substances to cope with trauma-related symptoms. Few have simultaneously tested these theories in a sample of college students. Thus, the overarching aim of this longitudinal study (n = 1320) was to identify whether alcohol consumption and IPT are associated with one another, and if IPT and/or posttraumatic stress disorder (PTSD) impacts use of alcohol to cope with trauma-related distress. Data were collected from a longitudinal study of college students attending a large public university. Participants in the current study were on average 18.46 years old at study entry, primarily female (70%), and of diverse racial/ethnic backgrounds (e.g., 49.4% White, 19.7% Black, 17.2% Asian). Results from auto-regressive, cross-lagged models indicated that alcohol consumption preceded IPT exposure. In contrast, IPT was not prospectively associated with alcohol consumption. Those reporting probable PTSD, but not IPT, reported more use of alcohol to cope with trauma-related distress. These findings provide support for the risky behavior model, indicating that those with higher levels of alcohol consumption may be a vulnerable group in terms of likelihood of IPT. Findings also suggest that those reporting probable PTSD may be at risk for use of alcohol to cope with trauma-related distress. Implications of these findings, in light of study limitations, are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Prevalence of binge drinking and relationships between masculine role discrepancy and binge drinking via discrepancy stress among Chinese men

BACKGROUND

Binge drinking is prevalent among male populations. Few studies have investigated masculine role discrepancy (i.e., the perception of being less masculine than the typical 'man')/discrepancy stress (i.e., the strain caused by perceived masculine role discrepancy) and binge drinking among men. This study aims to investigate the prevalence of binge drinking among Chinese men and the associations between masculine role discrepancy and binge drinking via discrepancy stress.

METHODS

A random and population-based telephone survey was conducted among Chinese male adults (n = 2000) in Hong Kong. Their levels of masculine role discrepancy and discrepancy stress and presence of binge drinking were tested.

RESULTS

We found that 12.3% of the participants had binge drinking behaviors during the last three months prior to the survey. Age and marital status were significantly associated with binge drinking behaviors. Discrepancy stress was positively associated with binge drinking, and it positively mediated the relationship between masculine role discrepancy and binge drinking. However, we found a negative direct association between masculine role discrepancy and binge drinking in the mediation model.

CONCLUSION

The study may shed light on a relatively new and important research direction that links up gender roles and substance use problems. It contributes to an understanding of the potential health impact of gender-role related issues as well as determinants of drinking problems.

Transgender college students: Academic resilience and striving to cope in the face of marginalized health

OBJECTIVE

To examine health behavior and outcome disparities between transgender, female, and male participants in a national sample of US college students. Participants and Method Summary: Analyses utilized secondary data from 32,964 undergraduate and graduate students responding to the Fall 2013 American College Health Association-National College Health Assessment; 65.8% were female, 0.4% were transgender, 67.9% were white, and 90.4% were heterosexual.

RESULTS

Transgender students reported more mental health diagnoses, trauma, and suicidality; experienced more violence and less safety, reported more sex partners and sexually transmitted infections (STIs); higher rates of illicit and nonprescription substance use and binge drinking use while engaging in less harm reduction behavior; and reported more barriers to academic success.

CONCLUSIONS

There is an established need for college clinicians and health educators to reduce these disparate outcomes once students arrive on campus through professional training and culturally competent campus prevention and intervention efforts to promote health equity.

A multimodal investigation of contextual effects on alcohol's emotional rewards

Regular alcohol consumption in unfamiliar social settings has been linked to problematic drinking. A large body of indirect evidence has accumulated to suggest that alcohol's rewarding emotional effects-both negative-mood relieving and positive-mood enhancing-will be magnified when alcohol is consumed within unfamiliar versus familiar social contexts. But empirical research has never directly examined links between contextual familiarity and alcohol reward. In the current study, we mobilized novel ambulatory technology to examine the effect of social familiarity on alcohol reward in everyday drinking contexts while also examining how alcohol reward observed in these field contexts corresponds to reward observed in the laboratory. Heavy social drinking participants (N = 48, 50% male) engaged in an intensive week of ambulatory assessment. Participants wore transdermal alcohol sensors while they reported on their mood and took photographs of their social contexts in response to random prompts. Participants also attended 2 laboratory beverage-administration sessions, during which their emotional responses were assessed and transdermal sensors were calibrated to estimate breathalyzer readings (eBrACs). Results indicated a significant interaction between social familiarity and alcohol episode in everyday drinking settings, with alcohol enhancing mood to a greater extent in relatively unfamiliar versus familiar social contexts. Findings also indicated that drinking in relatively unfamiliar social settings was associated with higher eBrACs. Finally, results indicated a correspondence between some mood effects of alcohol experienced inside and outside the laboratory. This study presents a novel methodology for examining alcohol reward and indicates social familiarity as a promising direction for research seeking to explain problematic drinking. (PsycINFO Database Record

If Everyone Is Doing It, It Must Be Safe: College Students' Development of Attitudes toward Poly-Substance Use

Background: While binge drinking on college campuses has been a topic of concern for decades, especially among fraternity and sorority members, recreational drug use is on the rise and mixing alcohol and drugs is now more of a concern than ever. Objective: Social learning theory was used as a framework for understanding how students develop attitudes regarding the possible risks and rewards of various behaviors such as binge drinking and drug use. Method: This research reports the results of 13 focus group discussions with 63 college students. A thematic approach was used and revealed several themes: participating in college culture, experimenting is expected, ignoring risk-taking, and resisting peer pressure. Findings: Participants felt as if it was expected that college students would experiment with alcohol and drugs, and that it was just "part of going away to college." Students reported ignoring the known risks of mixing alcohol and drugs use despite prior education efforts. Conclusions: The findings of this study suggest that alcohol and drug use on college campuses is, at least in part, driven by a perception of college culture and a poor balancing of the risks and rewards associated with these behaviors.

Alcohol policies and attitudes toward alcohol prevention at Swedish student unions

Aims:

High alcohol consumption among young adults is of great concern. About half of all young adults in Sweden are university students, and high alcohol consumption is common in this group. This makes student unions a potential arena for alcohol prevention. Little is known about attitudes toward alcohol prevention and to what extent Swedish student unions have written alcohol policies. The aim of the present study was to investigate whether student union representatives consider alcohol to be a problem, their attitudes toward alcohol prevention, the presence of written alcohol policies at student unions, and factors possibly associated with the existence of such policies.

Methods:

During November 2014, student union representatives (n = 95) were invited to participate in a web-based questionnaire; data were obtained from 78 unions.

Results:

The majority (93%) reported positive attitudes toward alcohol prevention, and many also recognised that alcohol consumption could be a problem (47%). Furthermore, 81% reported having an alcohol policy at their student union. Unions that frequently arranged pubs were more likely to have a policy (OR = 1.9).

Conclusions:

Many participants recognised that alcohol consumption could be a problem and reported positive attitudes toward alcohol prevention in the student union setting. This, together with the fact that the majority of student unions had written alcohol policies, suggests that the student union setting is a promising arena for alcohol prevention.

Examination of associations between risky driving behaviors and hazardous drinking among a sample of college students

OBJECTIVE

Hazardous drinking is associated with other risky behaviors and negative health-related outcomes. This study examined covariation between hazardous drinking scores and the following risky driving behaviors: Falling asleep while driving, texting (receiving and sending) while driving, and driving after consuming alcohol.

METHODS

The participants in this study were a sample of undergraduate students (N = 1,298) who were enrolled in an introductory health course at a large Southeastern university in spring 2016 and completed an online health survey that assessed hazardous drinking, falling asleep while driving, texting while driving, and driving after consuming alcohol. We conducted a series of 2-step regression analyses to examine covariation between hazardous drinking scores (using the Alcohol Use Disorders Identification Test-Consumption [AUDIT-C]) and the risky driving behaviors of interest.

RESULTS

We found that the majority of participants did not drink and drive (91.8%), nor did they fall asleep while driving (80.4%); however, the majority did read a text while driving (81.7%) and sent a text while driving (75.3%). In the full multivariable model, hazardous drinking score was positively associated with drinking and driving (step 2 odds ratio [OR] = 1.28, 95% confidence interval [CI], 1.18, 1.38) and sending a text message while driving (step 2 b = 0.19, P = .01). Hazardous drinking score was also positively associated with reading a text while driving (step 1 b = 0.14, P < .001) and falling asleep while driving (step 1 b = 0.02, P = .02) in the model only controlling for demographic characteristics. The analyses also indicated covariability between the following risky driving behaviors: (1) drinking and driving/reading a text message while driving, (2) drinking and driving/falling asleep and driving, (3) reading a text while driving/sending a text while driving, and (4) sending a text while driving/sleeping and driving.

CONCLUSION

The findings of this study indicate a need for interventions discouraging both hazardous drinking and risky driving behaviors in college student populations; recommendations to reduce risky driving and hazardous drinking are discussed.

Trends in colorectal cancer incidence among younger adults-Disparities by age, sex, race, ethnicity, and subsite

Millennials (ages 18-35) are now the largest living generation in the US, making it important to understand and characterize the rising trend of colorectal cancer incidence in this population, as well as other younger generations of Americans. Data from the New Jersey State Cancer Registry (n = 181 909) and Surveillance, Epidemiology, and End Results program (n = 448 714) were used to analyze invasive CRC incidence trends from 1979 to 2014. Age, sex, race, ethnicity, subsite, and stage differences between younger adults (20-49) and screening age adults (≥50) in New Jersey (NJ) were examined using chi-square; and, we compared secular trends in NJ to the United States (US). Whites, men, and the youngest adults (ages 20-39) are experiencing greater APCs in rectal cancer incidence. Rates among younger black adults, overall, were consistently higher in both NJ and the US over time. When compared to older adults, younger adults with CRC in NJ were more likely to be: diagnosed at the late stage, diagnosed with rectal cancer, male, non-white, and Hispanic. Invasive CRC incidence trends among younger adults were found to vary by age, sex, race, ethnicity, and subsite. Large, case-level, studies are needed to understand the role of genetics, human papillomavirus (HPV), and cultural and behavioral factors in the rise of CRC among younger adults. Provider and public education about CRC risk factors will also be important for preventing and reversing the increasing CRC trend in younger adults.

STI-protective self-efficacy and binge drinking in a sample of university students in the United Kingdom

OBJECTIVE

Alcohol use has consistently been shown to be related to sexual risk-taking behaviours. To assess what factors may contribute to the sexual risk decision-making process, this study examined the relationships among alcohol use (frequency, quantity, and binge drinking), cognitive appraisals of sexual risk taking, sex-related alcohol expectancies, and STI-protective self-efficacy.

METHOD

138 sexually-active university students who drink alcohol completed scales measuring alcohol consumption, appraisals of consequences, sex-related alcohol expectancies, and items regarding STI-protective self-efficacy.

RESULTS

Increasing levels of binge drinking were negatively associated with STI-protective self-efficacy. A moderated mediation analysis revealed that for binge drinkers, stronger appraisals of the positive consequences for having sexual intercourse while intoxicated predicted lower STI-protective self-efficacy indirectly through increasing rates of sex-related alcohol risk expectancies.

CONCLUSION

Findings provide evidence of a need to target binge drinkers and increase their STI-protective self-efficacy by shifting their focus from positive consequences to negative risk consequences of engaging in sexual intercourse while intoxicated.