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Arterberry BJ, Peterson SJ, Patrick ME. First semester college experiences: Associations with substance use and mental health. Addict Behav Rep 2024; 19:100552. [PMID: 38817339 PMCID: PMC11137386 DOI: 10.1016/j.abrep.2024.100552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 05/02/2024] [Accepted: 05/13/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction Substance use (SU) and mental health (MH) concerns often occur as students transition from high school to college and may be associated with first semester experiences. Methods Incoming first-year college students at a U.S., predominantly white, midwestern university were recruited for an intervention study. Participants reported on substance use, mental health, and college experiences at the end of their first semester of college (n = 781; 62.9 % female, mean age = 18.06 [SD = 0.24]; 77.2 % non-Hispanic white; 84.6 % heterosexual). Data for these current analyses were cross-sectional. Results Identifying as Black, Indigenous, or another Person of Color, as a sexual minority, or as female was associated with more challenging first semester experiences. Social experiences that represent more social engagement were associated with greater substance use. College experiences reflecting an easier transition were associated with fewer mental health concerns. Alcohol use moderated the relation between academic challenges and mental health with stronger associations found at greater levels of alcohol use. Conclusions First semester experiences were related to student mental health and substance use, suggesting the importance of early, targeted support for students to adjust to campus life.
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Affiliation(s)
- Brooke J. Arterberry
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Sarah J. Peterson
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Megan E. Patrick
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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2
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Gusman MS, Safa MD, Grimm KJ, Doane LD. Contextualizing Bicultural Competence Across Youths' Adaptation From High School to College: Prospective Associations With Mental Health and Substance Use. Clin Psychol Sci 2024; 12:320-343. [PMID: 38571551 PMCID: PMC10989737 DOI: 10.1177/21677026231159667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Bicultural competence, the ability to navigate bicultural demands, is a salient developmental competency for youth of color linked with positive adjustment. This study investigated how discrimination experiences informed developmental trajectories of behavioral and affective bicultural competence across youth's adaptation from high school to college, and how these biculturalism trajectories predicted later adjustment (i.e., internalizing symptoms and binge drinking). Data were collected between 2016 through 2020 and included 206 U.S. Latino youth (Mage=17.59, 64% female, 85% Mexican origin, 11% first and 62% second generation immigrants). Linear latent growth analyses revealed that youth who experienced greater time-varying discrimination demonstrated lower concurrent behavioral and affective bicultural competence. Higher behavioral bicultural competence intercepts were associated with fewer internalizing symptoms in the third college year. No other significant associations emerged for internalizing symptoms or binge drinking. These findings have implications for mental health equity among Latino youth during a critical period of psychopathology onset.
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Affiliation(s)
| | - M. Dalal Safa
- Harvard Graduate School of Education, Harvard University
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3
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Siconolfi D, Tucker JS, Pedersen ER, Perez LG, Dunbar MS, Davis JP, Rodriguez A, Seelam R, D'Amico EJ. Sober Curiosity and Participation in Temporary Alcohol Abstinence Challenges in a Cohort of U.S. Emerging Adults. J Stud Alcohol Drugs 2024; 85:201-209. [PMID: 37917023 PMCID: PMC10941816 DOI: 10.15288/jsad.23-00137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 10/12/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVE Thus far, behavioral health research in the United States has not explored the prevalence or correlates of sober curiosity (SC; exploratory or experimental abstinence or moderation) or temporary alcohol abstinence challenges (TAACs; e.g., "Dry January"), despite significant attention in media and popular discourse. We explored these activities in a sample of U.S. emerging adults (e.g., ages 18-29), a population with higher-risk drinking behavior yet some of the lowest rates of treatment engagement for alcohol use problems. METHOD Survey data were collected in 2021-2022 among participants (n = 1,659; M age = 24.7 years). We assessed SC awareness/engagement and past-year TAAC participation, and differences across demographics and behavioral characteristics. RESULTS Overall, 9% of emerging adults were familiar with SC and 7% had participated in a TAAC in the past year. Half of TAAC participants reported drinking less after the TAAC, and 15% remained abstinent after the TAAC ended. SC familiarity and TAAC were both associated with past-month heavy drinking, cannabis use, higher Alcohol Use Disorders Identification Test (AUDIT) scores, more past-year alcohol and cannabis consequences, past-year substance use treatment, and greater readiness to quit alcohol. CONCLUSIONS Both SC and TAACs may have potential to engage young people with a desire to moderate or eliminate their alcohol consumption. This may occur directly through use of these strategies or by helping them connect to additional services. Future research can help the field understand the uptake of SC and TAACs, gauge efficacy, and identify avenues to link young people to resources and interventions.
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Affiliation(s)
| | | | - Eric R. Pedersen
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
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Vieira JL, Snaychuk LA, Milicevic J, Hodgins DC, Shead NW, Keough MT, Kim HS. Adverse Childhood Experiences and Problematic Cannabis Use: The Role of Emotion Dysregulation and Affective Impulsivity. CANNABIS (ALBUQUERQUE, N.M.) 2024; 6:111-126. [PMID: 38883277 PMCID: PMC11178067 DOI: 10.26828/cannabis/2023/000190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Problematic cannabis use is highly prevalent among postsecondary students. Consequently, there is a need to examine risk factors associated with problematic cannabis use in this population. The present study investigated whether emotion dysregulation mediates the relationship between adverse childhood experiences (ACEs) and problematic cannabis use, and whether affective impulsivity (negative and positive urgency) uniquely moderates this relationship. Participants consisted of current cannabis users (N = 586) recruited from five universities across Canada. Participants completed an online survey containing self-report measures of ACEs, emotion dysregulation, negative and positive urgency, and problematic cannabis use. Among the sample of postsecondary students, 36% (n = 213) met the threshold for problematic cannabis use. Moderated-mediation analyses revealed that ACEs were positively associated with emotion dysregulation and problematic cannabis use. There was also a significant indirect effect of emotion dysregulation on the association between ACEs and problematic cannabis use at moderate and high (but not low) levels of negative urgency, and at moderate and high (but not low) levels of positive urgency. The moderated-mediation models remained significant when controlling for other facets of impulsivity. Results suggest that elevated levels of emotion dysregulation and urgency are important proximal risk factors for problematic cannabis use among postsecondary students with a history of ACEs. While ACEs cannot be modified given their occurrence in the past, interventions that aim to build mindfulness and adaptive emotion regulation skills may be beneficial for reducing the likelihood that these students will engage in impulsive behaviors, such as cannabis use, when experiencing emotional distress.
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Affiliation(s)
- Jenna L Vieira
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Lindsey A Snaychuk
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Jana Milicevic
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - David C Hodgins
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - N Will Shead
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
| | | | - Hyoun S Kim
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
- University of Ottawa Institute of Mental Health Research at the Royal, Ottawa, Ontario, Canada
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Sheerin CM, O’Hara-Payne RK, Lancaster EE, Suarez-Rivas H, Chatzinakos C, Prom-Wormley EC, Peterson RE. Examining interactions between polygenic scores and interpersonal trauma exposure on alcohol consumption and use disorder in an ancestrally diverse college cohort. Front Genet 2024; 14:1274381. [PMID: 38361984 PMCID: PMC10868390 DOI: 10.3389/fgene.2023.1274381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/22/2023] [Indexed: 02/17/2024] Open
Abstract
Introduction: Genetic factors impact alcohol consumption and use disorder (AUD), with large-scale genome-wide association studies (GWAS) identifying numerous associated variants. Aggregate genetic methods in combination with important environmental factors (e.g., interpersonal trauma [IPT]) can be applied to expand our understanding of the ways by which genetic and environmental variables work together to influence alcohol consumption and disordered use. The present study aimed to detail the relationships between genome-wide polygenic scores (PGS) for alcohol phenotypes (i.e., alcohol consumption and AUD status) and IPT exposure as well as the interaction between them across ancestry. Methods: Data were drawn from the Spit for Science (S4S) study, a US college student population, where participants reported on IPT exposure prior to college and alcohol consumption and problems during college (N = 9,006; ancestry: 21.3% African [AFR], 12.5% Admixed Americas [AMR], 9.6% East Asian [EAS], 48.1% European [EUR], 8.6% South Asian [SAS]). Two trans-ancestry PGS were constructed, one for alcohol consumption and another for AUD, using large-scale GWAS summary statistics from multiple ancestries weighted using PRS-CSx. Regression models were applied to test for the presence of associations between alcohol-PGS and IPT main and interaction effects. Results: In the meta-analysis across ancestry groups, IPT exposure and PGS were significantly associated with alcohol consumption (βIPT = 0.31, P IPT = 0.0002; βPGS = 0.09, P PGS = 0.004) and AUD (ORIPT = 1.12, P IPT = 3.5 × 10-8; ORPGS = 1.02, P PGS = 0.002). No statistically significant interactions were detected between IPT and sex nor between IPT and PGS. When inspecting ancestry specific results, the alcohol consumption-PGS and AUD-PGS were only statistically significant in the EUR ancestry group (βPGS = 0.09, P PGS = 0.04; ORPGS = 1.02, P PGS = 0.022, respectively). Discussion: IPT exposure prior to college was strongly associated with alcohol outcomes in this college-age sample, which could be used as a preventative measure to identify students at high risk for problematic alcohol use. Additionally, results add to developing evidence of polygenic score association in meta-analyzed samples, highlighting the importance of continued efforts to increase ancestral representation in genetic studies and inclusive analytic approaches to increase the generalizability of results from genetic association studies.
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Affiliation(s)
- Christina M. Sheerin
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, United States
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States
| | - Rowan K. O’Hara-Payne
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, United States
- Center for Biological Data Science, Virginia Commonwealth University, Richmond, VA, United States
| | - Eva E. Lancaster
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, United States
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States
| | - Hailie Suarez-Rivas
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Chris Chatzinakos
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
- Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
| | - Elizabeth C. Prom-Wormley
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, United States
- Department of Epidemiology, Virginia Commonwealth University, Richmond, VA, United States
| | - Roseann E. Peterson
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, United States
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
- Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
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6
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Davis AK, Arterberry BJ, Xin Y, Hubbard SM, Schwarting CM, Bonar EE. Incremental Predictive Validity of the Dualistic Model of Passion for Cannabis Use Among College Undergraduate Students With and Without a Cannabis Use Disorder. CANNABIS (ALBUQUERQUE, N.M.) 2023; 6:105-126. [PMID: 38035170 PMCID: PMC10683744 DOI: 10.26828/cannabis/2023/000180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Introduction We examined whether the Dualistic Model of Passion (DMP; i.e., obsessive passion [OP] and harmonious passion [HP]) for cannabis use was prospectively associated with cannabis use and use-related outcomes, and with academic performance, relationship attachment style, and social connectedness among college students. We also explored whether the DMP was associated with outcomes when included in a model using established constructs (e.g., coping motives, refusal self-efficacy, cannabis use disorder [CUD] symptoms) as predictors of cannabis use and outcomes. Methods Using a longitudinal cohort design (baseline, 5-month, 10-month [timepoints chosen to better correspond to 9-month academic year]), 513 undergraduate students from two universities who reported using cannabis at least four times in the past month completed a baseline survey (308 meeting criteria for CUD). We used Generalized Estimating Equations to assess longitudinal associations between OP/HP and cannabis use and academic/social outcomes at 5-month and 10-month. Results At baseline, participants were young adults (Mean age = 20.57, SD = 2.51), 78.8% non-Hispanic, 83.8% White, 55.0% female, and 72.3% heterosexual. Greater HP was not associated with greater past month cannabis use or cannabis-related problems. Greater OP was associated with greater past month cannabis use and more cannabis-related problems. There were no significant passion by time interactions. Greater HP was associated with more anxious attachment. OP was associated with less social connection. Conclusion This research suggests that the DMP provides novel information about factors associated with cannabis use and use-related consequences, which can aid in our understanding of cannabis use, misuse, and CUD among college students.
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Affiliation(s)
- Alan K Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University. Columbus, OH USA
- Institute for Population Research, University of Michigan, Ann Arbor, MI USA
| | - Brooke J Arterberry
- Institute for Population Research, University of Michigan, Ann Arbor, MI USA
- Department of Psychology, Iowa State University, Ames, IA USA
| | - Yitong Xin
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University. Columbus, OH USA
| | | | | | - Erin E Bonar
- University of Michigan - Department of Psychiatry; Ann Arbor, MI, USA
- University of Michigan - Addiction Center; Ann Arbor, MI, USA
- University of Michigan - Injury Prevention Center; Ann Arbor, MI, USA
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Montes KS, Dela Cruz M, Vink LH, Jaime SV, Almeida BJ, Aguiluz DY, Arca D, Smith AM, Kapila-Ramirez A, Figueroa-Sierra NC, Infante G. A Mixed-Methods Examination of Language Used by College Students to Describe Alcohol Recovery. HEALTH EDUCATION & BEHAVIOR 2023; 50:629-636. [PMID: 37165982 DOI: 10.1177/10901981231167903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Given that approximately 5% of the U.S. population is currently attending college, research is needed to better understand the language that college students use to describe alcohol recovery regardless of their current drinking behavior. College student perceptions of alcohol recovery are important, given that students may experience an alcohol use disorder themselves or may encounter others with an alcohol use disorder. Research on college student perceptions of alcohol recovery in the literature is scarce but is needed to better understand the alcohol recovery process. The current mixed-methods study examines language that college students use to describe alcohol recovery based on findings from two focus group interviews. The focus groups were conducted with college students who reported using alcohol at least once in their lifetime. All participants (N = 18) were asked questions regarding language perceived to be associated with alcohol recovery. Data were examined within a thematic analysis framework. The three central themes related to alcohol recovery that emerged in the study were harm reduction-based recovery, abstinence-based recovery, and social correlates of recovery. College students rated the terms "recovered," "drinking reduction," and "sobriety" as being highly representative of being in recovery, whereas the terms "bars" and "light drinker" were identified as not being representative of recovery. A better understanding of these themes will help the field understand the language that college students use to describe alcohol recovery.
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Affiliation(s)
- Kevin S Montes
- California State University, Dominguez Hills, Carson, CA, USA
| | | | - Limor H Vink
- California State University, Dominguez Hills, Carson, CA, USA
| | - Saray V Jaime
- California State University, Dominguez Hills, Carson, CA, USA
| | - Bryan J Almeida
- California State University, Dominguez Hills, Carson, CA, USA
| | | | - Diorlene Arca
- California State University, Dominguez Hills, Carson, CA, USA
| | - Alicia M Smith
- California State University, Dominguez Hills, Carson, CA, USA
| | | | | | - Gabriel Infante
- California State University, Dominguez Hills, Carson, CA, USA
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Tucker JA, Cheong J, Stinson LA, Chandler SD. Relationship between drinking risk and preferences for helping resources among emerging adults living in disadvantaged communities in the Southeastern United States. Alcohol Alcohol 2023; 58:539-546. [PMID: 37565459 DOI: 10.1093/alcalc/agad054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/23/2023] [Accepted: 07/21/2023] [Indexed: 08/12/2023] Open
Abstract
Compared to campus-based alcohol interventions for college students, services for emerging adult (EA) risky drinkers who reside off-campus in disadvantaged communities are not well established. This web survey assessed drinking practices, problems, and preferences for professional and lay helping resources spanning digital and in-person formats among community-dwelling EAs to guide services for them and determine whether drinking risk levels varied by preferences for help. Digital respondent-driven sampling recruited EA risky drinkers from disadvantaged communities (N = 356; M age = 23.6 years, 64.0% women, 77.4% employed, 64.9% residing in impoverished areas above the US average, 53.5% income < $20k/year). A web survey assessed participants' drinking practices and problems, including alcohol use disorder symptoms, and help-seeking preferences for smartphone apps; online help; in-person help from doctors, clinics, teachers, and school programs; mutual help groups; and help from friends and family. Preferences were related to participant drinking risks using generalized linear modeling. Modeling results showed that risk levels were related to help-seeking preferences. EAs reporting more negative consequences preferred smartphone apps and help from friends, whereas EAs reporting fewer negative consequences and drinking days preferred professional in-person help (Ps < 0.05). Although >90% fulfilled alcohol use disorder diagnostic criteria, <4% had received an alcohol-related intervention. EAs who are riskier drinkers appear less likely to use professional resources in favor of informal and online resources that allow greater anonymity. Findings can guide services for this underserved population that are responsive to drinker risk levels.
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Affiliation(s)
- Jalie A Tucker
- Center for Behavioral Economic Health Research, University of Florida, Gainesville, FL, United States
| | - JeeWon Cheong
- Center for Behavioral Economic Health Research, University of Florida, Gainesville, FL, United States
| | - Lesleigh A Stinson
- Center for Behavioral Economic Health Research, University of Florida, Gainesville, FL, United States
| | - Susan D Chandler
- Center for Behavioral Economic Health Research, University of Florida, Gainesville, FL, United States
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Helle AC, Boness CL, Masters J, Sher KJ. Alcohol and cannabis co-use: Receptiveness to treatments and application to intervention planning. JOURNAL OF STUDENT AFFAIRS RESEARCH AND PRACTICE 2023; 61:86-102. [PMID: 38504868 PMCID: PMC10947103 DOI: 10.1080/19496591.2023.2177104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Given the prevalence of alcohol and cannabis co-use among college students, prevention for co-use is crucial. We examined hypothetical receptiveness to substance-specific interventions among students who reported co-use. Students who use alcohol and cannabis were more receptive to alcohol interventions than cannabis interventions. Campus prevention experts should consider offering evidence-based alcohol-focused interventions as a potential pathway for decreasing substance use among college students who engage in co-use.
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Affiliation(s)
| | - Cassandra L Boness
- Center on Alcohol, Substance use, And Addictions at the University of New Mexico
| | - Joan Masters
- Partners in Prevention in the Division of Student Affairs at the University of Missouri
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10
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Kerr DCR, Bae H. Comparing National College Health Assessment with other surveys of cannabis use and binge drinking among young adult college students 2008-2018. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-8. [PMID: 37167585 DOI: 10.1080/07448481.2023.2201859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Objective: We considered the utility of National College Health Assessment (NCHA) data relative to other national data for studying college students' cannabis use and binge drinking, and drug policy effects. Participants: Survey data on 18-22-year old college students were drawn from the 2008-2018 NCHA, National Survey on Drug Use and Health (NSDUH), Monitoring the Future (MTF), and Healthy Minds Study (HMS). Methods: Prevalence estimates were compared across data sources in terms of level and change from 2008-2018 using linear regressions, separately for men and women. Results: Mean prevalence estimates for 30-day cannabis use and 2-week binge drinking, and linear time trends did not differ significantly among NCHA, NSDUH, and MTF. Conclusions: NCHA prevalence estimates are similar to those from NSDUH and MTF, NCHA has unique strengths, and some weaknesses can be offset. Findings support the value of NCHA for studying college students' substance use and effects of drug policy.
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Affiliation(s)
- David C R Kerr
- School of Psychological Science, Oregon State University, Corvallis, Oregon, USA
| | - Harold Bae
- Biostatistics Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
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11
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Hatch MR, Bravo AJ, Looby A, Hurlocker MC. Who's at greatest risk? Latent profiles of alcohol and cannabis use and related consequences among college students. Addict Behav 2023; 137:107536. [PMID: 36334313 PMCID: PMC10259160 DOI: 10.1016/j.addbeh.2022.107536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/29/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is significant heterogeneity in alcohol and cannabis use patterns among college students, with some engaging in use patterns that heighten their risk for adverse consequences. Person-centered approaches can help identify those subgroups of students with riskier use patterns. Latent Profile Analyses (LPA) were conducted to identify subgroups based on alcohol and cannabis use frequency and quantity, to explore demographic covariates and to examine mean differences across subgroups on alcohol- and cannabis-related consequences, simultaneous use, and other substance use. METHODS Participants were 2,423 college students (Mage = 20.1; 72 % female) recruited from seven US universities who endorsed past-month alcohol and cannabis use and completed an online survey of substance use behaviors. RESULTS A four-profile solution was the best fitting model. Profile 1 represented "light, infrequent alcohol and cannabis use" (73.8 %), Profile 2 represented "heavy, infrequent alcohol and moderate, frequent cannabis use" (15.9 %), Profile 3 represented "moderate, frequent alcohol and cannabis use" (5.6 %) and Profile 4 represented "very heavy, frequent alcohol and heavy, frequent cannabis use" (4.7 %). Students who identify as male, White non-Hispanic, and/or Greek-affiliated were more likely to be in the heavy alcohol use profiles. Profiles 3 and 4 represent high-risk profiles, with both having a higher likelihood of simultaneous use, Profile 3 endorsing more cannabis consequences, and Profile 4 endorsing more alcohol consequences. CONCLUSION Results suggest that heavy alcohol or heavy co-use heightens risk for serious adverse consequences.
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Affiliation(s)
- Melissa R Hatch
- Department of Psychology, University of New Mexico, 1 University of New Mexico, Albuquerque, NM 87131, USA.
| | - Adrian J Bravo
- Department of Psychological Sciences, William & Mary, P.O. Box 8795, Williamsburg, VA 23187-8795, USA.
| | - Alison Looby
- Department of Psychology, University of Wyoming, 1000 E. University Ave. Laramie, WY 82071, USA.
| | - Margo C Hurlocker
- Department of Psychology, University of New Mexico, 1 University of New Mexico, Albuquerque, NM 87131, USA.
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Ostrowski JL, Durics B, Vallorosi J, Gray AM, Payne E. Frequency of, Confidence in, and Educational Satisfaction With Mental Illness Recognition and Referral Among Certified Athletic Trainers. J Athl Train 2023; 58:71-78. [PMID: 35728262 PMCID: PMC9913050 DOI: 10.4085/1062-6050-0606.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Mental illness recognition and referral are required components of professional athletic training education. However, athletic trainers (ATs) often report feeling underprepared to assist patients with mental health emergencies. OBJECTIVE To determine ATs' frequency of and confidence in psychosocial skill use and their satisfaction with education related to mental illness recognition and referral. DESIGN Cross-sectional study. SETTING Online survey. PATIENTS OR OTHER PARTICIPANTS A total of 226 ATs (86 men, 140 women; age = 35.5 ± 9.9 years, years of practice = 11.9 ± 9.0). MAIN OUTCOME MEASURE(S) The independent variables were professional athletic training program, professional psychosocial courses, highest education level, psychosocial continuing education units, clinical practice setting, and years of experience. For each skill, individuals identified the average frequency with which the skill was performed each year, rated their confidence in performing the skill, and rated their satisfaction with professional education related to the skill. RESULTS Anxiety was reported as the symptom most frequently recognized and referred. Most respondents felt moderately or extremely confident in managing patients with anxiety, panic attacks, depression, suicidal ideation, or eating disorders but less confident or unconfident in managing those with psychosis or substance use disorder. The majority of respondents felt dissatisfied or only slightly satisfied with their education related to mental health recognition and referral. Years of clinical practice and self-reported frequency of referral were significantly associated for managing patients with anxiety disorder (\(\def\upalpha{\unicode[Times]{x3B1}}\)\(\def\upbeta{\unicode[Times]{x3B2}}\)\(\def\upgamma{\unicode[Times]{x3B3}}\)\(\def\updelta{\unicode[Times]{x3B4}}\)\(\def\upvarepsilon{\unicode[Times]{x3B5}}\)\(\def\upzeta{\unicode[Times]{x3B6}}\)\(\def\upeta{\unicode[Times]{x3B7}}\)\(\def\uptheta{\unicode[Times]{x3B8}}\)\(\def\upiota{\unicode[Times]{x3B9}}\)\(\def\upkappa{\unicode[Times]{x3BA}}\)\(\def\uplambda{\unicode[Times]{x3BB}}\)\(\def\upmu{\unicode[Times]{x3BC}}\)\(\def\upnu{\unicode[Times]{x3BD}}\)\(\def\upxi{\unicode[Times]{x3BE}}\)\(\def\upomicron{\unicode[Times]{x3BF}}\)\(\def\uppi{\unicode[Times]{x3C0}}\)\(\def\uprho{\unicode[Times]{x3C1}}\)\(\def\upsigma{\unicode[Times]{x3C3}}\)\(\def\uptau{\unicode[Times]{x3C4}}\)\(\def\upupsilon{\unicode[Times]{x3C5}}\)\(\def\upphi{\unicode[Times]{x3C6}}\)\(\def\upchi{\unicode[Times]{x3C7}}\)\(\def\uppsy{\unicode[Times]{x3C8}}\)\(\def\upomega{\unicode[Times]{x3C9}}\)\(\def\bialpha{\boldsymbol{\alpha}}\)\(\def\bibeta{\boldsymbol{\beta}}\)\(\def\bigamma{\boldsymbol{\gamma}}\)\(\def\bidelta{\boldsymbol{\delta}}\)\(\def\bivarepsilon{\boldsymbol{\varepsilon}}\)\(\def\bizeta{\boldsymbol{\zeta}}\)\(\def\bieta{\boldsymbol{\eta}}\)\(\def\bitheta{\boldsymbol{\theta}}\)\(\def\biiota{\boldsymbol{\iota}}\)\(\def\bikappa{\boldsymbol{\kappa}}\)\(\def\bilambda{\boldsymbol{\lambda}}\)\(\def\bimu{\boldsymbol{\mu}}\)\(\def\binu{\boldsymbol{\nu}}\)\(\def\bixi{\boldsymbol{\xi}}\)\(\def\biomicron{\boldsymbol{\micron}}\)\(\def\bipi{\boldsymbol{\pi}}\)\(\def\birho{\boldsymbol{\rho}}\)\(\def\bisigma{\boldsymbol{\sigma}}\)\(\def\bitau{\boldsymbol{\tau}}\)\(\def\biupsilon{\boldsymbol{\upsilon}}\)\(\def\biphi{\boldsymbol{\phi}}\)\(\def\bichi{\boldsymbol{\chi}}\)\(\def\bipsy{\boldsymbol{\psy}}\)\(\def\biomega{\boldsymbol{\omega}}\)\(\def\bupalpha{\bf{\alpha}}\)\(\def\bupbeta{\bf{\beta}}\)\(\def\bupgamma{\bf{\gamma}}\)\(\def\bupdelta{\bf{\delta}}\)\(\def\bupvarepsilon{\bf{\varepsilon}}\)\(\def\bupzeta{\bf{\zeta}}\)\(\def\bupeta{\bf{\eta}}\)\(\def\buptheta{\bf{\theta}}\)\(\def\bupiota{\bf{\iota}}\)\(\def\bupkappa{\bf{\kappa}}\)\(\def\buplambda{\bf{\lambda}}\)\(\def\bupmu{\bf{\mu}}\)\(\def\bupnu{\bf{\nu}}\)\(\def\bupxi{\bf{\xi}}\)\(\def\bupomicron{\bf{\micron}}\)\(\def\buppi{\bf{\pi}}\)\(\def\buprho{\bf{\rho}}\)\(\def\bupsigma{\bf{\sigma}}\)\(\def\buptau{\bf{\tau}}\)\(\def\bupupsilon{\bf{\upsilon}}\)\(\def\bupphi{\bf{\phi}}\)\(\def\bupchi{\bf{\chi}}\)\(\def\buppsy{\bf{\psy}}\)\(\def\bupomega{\bf{\omega}}\)\(\def\bGamma{\bf{\Gamma}}\)\(\def\bDelta{\bf{\Delta}}\)\(\def\bTheta{\bf{\Theta}}\)\(\def\bLambda{\bf{\Lambda}}\)\(\def\bXi{\bf{\Xi}}\)\(\def\bPi{\bf{\Pi}}\)\(\def\bSigma{\bf{\Sigma}}\)\(\def\bPhi{\bf{\Phi}}\)\(\def\bPsi{\bf{\Psi}}\)\(\def\bOmega{\bf{\Omega}}\)\({\rm{\chi }}_{87}^2\) = 117.774, P = .016) and suicidal thoughts or actions (\({\rm{\chi }}_{87}^2\) = 179.436, P < .001). For confidence, significant positive associations were present between years of practice and self-reported recognition of patients with anxiety disorders (\({\rm{\chi }}_{145}^2\) = 195.201, P = .003) and referral for those with anxiety disorders (\({\rm{\chi }}_{145}^2\) = 15.655, P = .048) or panic attacks (\({\rm{\chi }}_{145}^2\) = 19.790, P = .011). Significant associations were also noted between the number of continuing education units and self-reported confidence in recognizing suicide (\({\rm{\chi }}_{15}^2\) = 26.650, P = .032), referring for suicidal concerns (\({\rm{\chi }}_{18}^2\) = 40.456, P = .002), recognizing substance use (\({\rm{\chi }}_{18}^2\) = 33.649, P = .014), and referring for substance use (\({\rm{\chi }}_{18}^2\) = 30.918, P = .029). No significant associations were related to satisfaction. CONCLUSIONS The ATs with fewer years of clinical practice (ie, who had completed professional programs more recently) expressed higher confidence in mental health recognition and referral than those who had completed professional programs longer ago. We recommend that real-time interactions with individuals who have mental health concerns or emergencies be incorporated into professional education programs and that increased emphasis be placed on continuing education related to these topics.
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Affiliation(s)
| | - Brianna Durics
- Sports Medicine and Rehabilitation Center, Moravian University, Bethlehem, PA
| | - Jessica Vallorosi
- Sports Medicine and Rehabilitation Center, Moravian University, Bethlehem, PA
| | - Ashley Marie Gray
- Sports Medicine and Rehabilitation Center, Moravian University, Bethlehem, PA
| | - Ellen Payne
- Sports Medicine and Rehabilitation Center, Moravian University, Bethlehem, PA
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13
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Schwebel FJ, Richards DK, Pfund RA, Joseph VW, Pearson MR. Using Decision Trees to Identify Salient Predictors of Cannabis-Related Outcomes. J Psychoactive Drugs 2022; 54:419-428. [PMID: 35067209 PMCID: PMC9308832 DOI: 10.1080/02791072.2021.2014081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 09/11/2021] [Accepted: 11/15/2021] [Indexed: 12/31/2022]
Abstract
Cannabis use continues to escalate among emerging adults and college attendance may be a risk factor for use. Severe cases of cannabis use can escalate to a cannabis use disorder, which is associated with worse psychosocial functioning. Predictors of cannabis use consequences and cannabis use disorder symptom severity have been identified; however, they typically employ a narrow set of predictors and rely on linear models. Machine learning is well suited for exploratory data analyses of high-dimensional data. This study applied decision tree learning to identify predictors of cannabis user status, negative cannabis-related consequences, and cannabis use disorder symptoms. Undergraduate college students (N = 7000) were recruited from nine universities in nine states across the U.S. Among the 7 trees, 24 splits created by 15 distinct predictors were identified. Consistent with prior research, one's beliefs about cannabis were strong predictors of user status. Negative reinforcement cannabis use motives were the most consistent predictors of cannabis use disorder symptoms, and past month cannabis use was the most consistent predictor of probable cannabis use disorder. Typical frequency of cannabis use was the only predictor of negative cannabis-related consequences. Our results demonstrate that decision trees are a useful methodological tool for identifying targets for future clinical research.
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Affiliation(s)
- Frank J Schwebel
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM, USA
| | - Dylan K Richards
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM, USA
| | - Rory A Pfund
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM, USA
| | - Verlin W Joseph
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM, USA
| | - Matthew R Pearson
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM, USA
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14
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Si Y, West BT, Veliz P, Patrick ME, Schulenberg JE, Kloska DD, Terry-McElrath YM, McCabe SE. An empirical evaluation of alternative approaches to adjusting for attrition when analyzing longitudinal survey data on young adults' substance use trajectories. Int J Methods Psychiatr Res 2022; 31:e1916. [PMID: 35582963 PMCID: PMC9464329 DOI: 10.1002/mpr.1916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/21/2022] [Accepted: 04/29/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Longitudinal survey data allow for the estimation of developmental trajectories of substance use from adolescence to young adulthood, but these estimates may be subject to attrition bias. Moreover, there is a lack of consensus regarding the most effective statistical methodology to adjust for sample selection and attrition bias when estimating these trajectories. Our objective is to develop specific recommendations regarding adjustment approaches for attrition in longitudinal surveys in practice. METHODS Analyzing data from the national U.S. Monitoring the Future panel study following four cohorts of individuals from modal ages 18 to 29/30, we systematically compare alternative approaches to analyzing longitudinal data with a wide range of substance use outcomes, and examine the sensitivity of inferences regarding substance use prevalence and trajectories as a function of college attendance to the approach used. RESULTS Our results show that analyzing all available observations in each wave, while simultaneously accounting for the correlations among repeated observations, sample selection, and attrition, is the most effective approach. The adjustment effects are pronounced in wave-specific descriptive estimates but generally modest in covariate-adjusted trajectory modeling. CONCLUSIONS The adjustments can refine the precision, and, to some extent, the implications of our findings regarding young adult substance use trajectories.
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Affiliation(s)
- Yajuan Si
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Brady T West
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Philip Veliz
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Megan E Patrick
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - John E Schulenberg
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Deborah D Kloska
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Yvonne M Terry-McElrath
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Sean E McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
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15
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Wojciechowski T. Deviant Peer Association as a Predictor of Development of Risk for Selling Illicit Drugs: Are Effects Age-Graded? JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426221076862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Illicit drug sales present a public health issue that results in proliferation of drug use–related problems, like overdose deaths, stemming from use of illicit drugs. However, there remain gaps in understanding of psychosocial and developmental processes involved with predicting drug sales. Deviant peer association presents one potential risk factor for selling drugs and this relationship may be age-graded. This study examined deviant peer association as a predictor of risk for selling drugs and investigated whether salience of this relationship depended on when exposure to deviant peers occurred. The Pathways to Desistance data were analyzed. Mixed effects logistic regression models were utilized to examine the effects of deviant peer association on odds of selling illicit drugs and cross-level interactions with age variables. Findings indicated that association with deviant peers increased odds of selling illicit drugs. This relationship diminished as participants aged through adolescence, but later increased in magnitude as participants aged.
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16
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Helle AC, Boness CL, Sher KJ. College students' receptiveness to intervention approaches for alcohol and cannabis use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2022; 36:157-176. [PMID: 33749290 PMCID: PMC8455707 DOI: 10.1037/adb0000699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Addressing high-risk alcohol and cannabis use represent major challenges to institutions of higher education. A range of evidence-based treatment approaches are available, but little is known concerning students' receptiveness to such approaches. Prior work identified that students were most open to individual therapy and self-help options for reducing alcohol use, but less open to medication. The current study examines student receptiveness to intervention approaches across a wider range of intervention approaches (e.g., remote/telehealth), and extends to evaluate cannabis intervention receptiveness. METHOD Undergraduate students reported on alcohol and cannabis use, motives for and reasons against use, and openness to an array of interventions for reducing alcohol and cannabis use. RESULTS Informal options (self-help, talking with family/friends), individual therapy, and appointments with a primary care provider (PCP) were endorsed most frequently. Group therapy and medication were less commonly endorsed, though medication was endorsed at a higher prevalence than in prior studies. Women generally expressed higher receptiveness than men. Lower alcohol consumption was associated with increased receptiveness to some approaches. Students at high risk for alcohol and/or cannabis dependence were less receptive to many treatment options. CONCLUSIONS College students were open to a wide variety of approaches for reducing their alcohol and cannabis use. These results can inform selection, implementation, and availability of campus-wide services, especially as low-cost technological-based approaches are expanding. Further attention to existing services (e.g., PCP) for addressing alcohol and cannabis use may be considered, given students' receptiveness to such approaches. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Ashley C. Helle
- University of Missouri, Department of Psychological
Sciences, 200 South 7 Street, Columbia, MO 65211, United State
- Corresponding author:
| | - Cassandra L. Boness
- University of Missouri, Department of Psychological
Sciences, 200 South 7 Street, Columbia, MO 65211, United State
| | - Kenneth J. Sher
- University of Missouri, Department of Psychological
Sciences, 200 South 7 Street, Columbia, MO 65211, United State
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17
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Bonar EE, Goldstick JE, Chapman L, Bauermeister JA, Young SD, McAfee J, Walton MA. A social media intervention for cannabis use among emerging adults: Randomized controlled trial. Drug Alcohol Depend 2022; 232:109345. [PMID: 35144238 PMCID: PMC9549699 DOI: 10.1016/j.drugalcdep.2022.109345] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Cannabis use is increasing among emerging adults (ages 18-25), necessitating the need for prevention interventions. Using a novel platform - social media - we developed an 8-week motivational interviewing and cognitive-behavioral intervention targeting cannabis use among emerging adults. Herein, we report on the feasibility and acceptability of the intervention in a pilot trial. PROCEDURES For NCT04187989 we recruited N = 149 emerging adults who used cannabis (at least 3 times/week for the past month) using social media advertising. Their mean age was 21.0 years (SD = 2.2); 55.7% were female. Most were White (70.5%; 20.1% Black/African American, 9.4% Other races), with 20.1% identifying as Hispanic/Latinx. Participants were randomized to the 8-week intervention or an 8-week attention-placebo control condition, both delivered in secret Facebook groups by electronic health coaches (e-coaches). Follow-up assessments occurred at 3- and 6-months. RESULTS The intervention was well-received and follow-up rates were high; fidelity was good. Intervention participants rated e-coaches significantly higher in terms of helpfulness, warmth, etc., compared to control participants. Intervention participants were more likely to engage with and recommend the group. In terms of percentage reductions in cannabis outcomes, the intervention group evidenced absolute reductions over time in several measures of cannabis consumption across modalities. In an adjusted model, reductions in vaping days in the intervention group, relative to attention-control, reached statistical significance (p = .020, D =.40). CONCLUSIONS This social media intervention for emerging adults' cannabis use was feasible and acceptable in the target population warranting future testing in a fully powered trial.
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Affiliation(s)
- Erin E. Bonar
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA,Center for Sexuality and Health Disparities, University of Michigan, 400 North Ingalls Street, Ann Arbor, MI 48109, USA
| | - Jason E. Goldstick
- Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA,Department of Emergency Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Lyndsay Chapman
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - José A. Bauermeister
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104
| | - Sean D. Young
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California Irvine, Irvine, CA 92697,Department of Emergency Medicine, School of Medicine, University of California Irvine, Irvine, CA 92697
| | - Jenna McAfee
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI 48109
| | - Maureen A. Walton
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA
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18
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Barry DT, Oberleitner DE, Beitel M, Oberleitner LMS, Gazzola MG, Eller A, Madden LM, Zheng X, Bergman E, Tamberelli JF. A Student Walks into Class … Vignettes to Identify Substance Use Disorder Models of Illness among College Students. Subst Use Misuse 2022; 57:1523-1533. [PMID: 35787230 DOI: 10.1080/10826084.2022.2091787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Illness models, including illness recognition, perceived severity, and perceived nature can affect treatment-seeking behaviors. Vignettes are a leading approach to examine models of illness but are understudied for substance use disorders (SUDs). We created vignettes for multiple common DSM-5 SUDs and assessed SUD illness models among college students. METHODS Seven vignettes in which the protagonist meets DSM-5 diagnostic criteria for SUDs involving tobacco, alcohol, cannabis, Adderall, cocaine, Vicodin, and heroin were pilot tested and randomly assigned to 216 college students who completed measures related to illness recognition, perceived severity, and perceived nature. MANOVAs with Scheffe post-hoc tests were conducted to examine vignette group differences on models of illness. RESULTS Vignettes met acceptable levels of clarity and plausibility. Participants characterized the protagonist's substance use as a problem, a SUD, or an addiction most frequently with Vicodin, heroin, and cocaine and least frequently with tobacco and cannabis. Participants assigned to the Vicodin, heroin, and cocaine vignettes were the most likely to view the protagonist's situation as serious and life-threatening, whereas those assigned to the cannabis vignette were the least likely. Numerically more participants characterized the pattern of substance use as a problem (91%) or an addiction (90%) than a SUD (76%), while only 15% characterized it as a chronic medical condition. CONCLUSIONS Illness recognition and perceived severity varied across substances and were lowest for cannabis. Few participants conceptualized SUDs as chronic medical conditions. College students may benefit from psychoeducation regarding cannabis use disorder and the chronic medical condition model of SUDs.
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Affiliation(s)
- Declan T Barry
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,APT Foundation, Inc, New Haven, Connecticut, USA
| | - David E Oberleitner
- APT Foundation, Inc, New Haven, Connecticut, USA.,Department of Psychology, University of Bridgeport, Bridgeport, Connecticut, USA
| | - Mark Beitel
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,APT Foundation, Inc, New Haven, Connecticut, USA
| | - Lindsay M S Oberleitner
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,APT Foundation, Inc, New Haven, Connecticut, USA.,Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Marina Gaeta Gazzola
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,APT Foundation, Inc, New Haven, Connecticut, USA
| | - Anthony Eller
- APT Foundation, Inc, New Haven, Connecticut, USA.,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Lynn M Madden
- APT Foundation, Inc, New Haven, Connecticut, USA.,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Xiaoying Zheng
- APT Foundation, Inc, New Haven, Connecticut, USA.,Yale University, New Haven, Connecticut, USA
| | - Emma Bergman
- APT Foundation, Inc, New Haven, Connecticut, USA.,Quinnipiac School of Medicine, Hamden, Connecticut, USA
| | - Joseph F Tamberelli
- APT Foundation, Inc, New Haven, Connecticut, USA.,Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
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19
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Richards DK, Schwebel FJ, Pearson MR, Study Team PS. A Test of Interaction Effects Between Cannabis Protective Behavioral Strategies and Antecedents of Cannabis-Related Consequences. J Psychoactive Drugs 2022; 54:61-69. [PMID: 33870870 PMCID: PMC8522187 DOI: 10.1080/02791072.2021.1909188] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The purpose of the present study was to examine tests of interaction effects between cannabis protective behavioral strategies use and a range of risk/protective factors for negative cannabis-related consequences. We recruited 2,226 college students (Mage = 20.28, SD = 3.37; 68.8% female; 75.4% White) from 10 universities throughout the U.S. who reported using cannabis in the past month to complete an online survey. Measures assessed cannabis use, negative cannabis-related consequences, cannabis protective behavioral strategies use, and 35 risk/protective factors (including socio-demographic characteristics). Cannabis protective behavioral strategies use was negatively correlated with negative cannabis-related consequences while including the risk/protective factors as covariates. Most importantly, 33% and 54% of the interaction effects tested were statistically significant, depending on the covariates entered into the model. The interaction effects had a consistent pattern such that the positive association between greater risk and negative cannabis-related consequences was weaker as cannabis protective behavioral strategies use increased. Findings suggest that the nature of these interaction effects is not specific for any given risk/protective factor. We draw parallels to research on alcohol protective behavioral strategies and offer suggestions for moving the cannabis protective behavioral strategies field forward.
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20
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Targeting maladaptive reactivity to negative affect in emerging adults with cannabis use disorder: A preliminary test and proof of concept. Behav Res Ther 2022; 150:104032. [DOI: 10.1016/j.brat.2022.104032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 12/27/2021] [Accepted: 01/05/2022] [Indexed: 11/22/2022]
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21
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Sznitman SR, Shochat T, van Rijswijk L, Greene T, Cousijn J. Cannabis and Alcohol Use and Their Associations with Sleep: A Daily Diary Investigation of Single-Use and Co-Use in College Students. Cannabis Cannabinoid Res 2021. [PMID: 34935467 DOI: 10.1089/can.2021.0106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Sleep continuity problems are widespread among college students and may be influenced by single-use and co-use of alcohol and cannabis. We examined the within-person associations of alcohol and cannabis use with subsequent sleep experiences in the everyday life of college students. Materials and Methods: A sample of 80 college students reported prior-night alcohol and cannabis use and sleep experiences for 14 consecutive days. Mixed-effects models examined the within-person relationships between alcohol and cannabis use (single- and co-use) and subsequent (1) sleep-onset latency, (2) total sleep time, (3) number of awakenings, and (4) early awakenings that night. Results: Compared to no-use evenings, alcohol and cannabis, used separately or together (co-use), were associated with shorter sleep-onset latency and longer total sleep time. Students reported more nightly awakenings after alcohol-only use compared to no-use and after co-use, and they reported fewer early awakenings after no-use and co-use. Conclusions: In line with previous experimental findings, we found that alcohol and cannabis use in the everyday life of college students were associated with sleep-inducing effects, and that alcohol use was associated with disturbed sleep continuity. The results suggest that cannabis may curb alcohol's detrimental effect on the number of awakenings and may reduce the incidence of early awakenings. Yet, due to lack of control for potentially important confounders (e.g., quantity of cannabis/alcohol consumed, withdrawal) the current results may be best seen as preliminary and further research is needed before causal inferences can be reached.
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Affiliation(s)
| | - Tamar Shochat
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel
| | - Lukas van Rijswijk
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Talya Greene
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Janna Cousijn
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
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22
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Felton JW, Havewala M, Myerberg L, Lee J, Collado A. Rumination and Co-Rumination and their Associations with Alcohol-Related Problems and Depressive Symptoms among College Students. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2021. [DOI: 10.1007/s10942-021-00418-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Bentley KH, Sakurai H, Lowman KL, Rines-Toth L, McKowen J, Pedrelli P, Evins AE, Yule AM. Validation of brief screening measures for depression and anxiety in young people with substance use disorders. J Affect Disord 2021; 282:1021-1029. [PMID: 33601674 PMCID: PMC7896042 DOI: 10.1016/j.jad.2021.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/03/2020] [Accepted: 01/02/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND It is critical to promptly identify and monitor mood and anxiety symptoms in young people with SUD. The primary aim of this study was to conduct a psychometric validation of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) for depression and anxiety screening in young people seeking outpatient treatment for SUD. Our secondary aim was to compare the performance of the PHQ-9 and GAD-7 to their briefer two-item versions (PHQ-2 and GAD-2) in terms of detecting probable mood and anxiety disorders. METHOD Data were extracted from the electronic health records of patients (ages 14 to 26) who received a diagnostic evaluation following clinical implementation of the PHQ-9 and GAD-7 at a hospital-based outpatient SUD treatment program (N=121, average age 19.1 ± 3.1 years). RESULTS The PHQ-9 and GAD-7 showed excellent internal consistency. A PHQ-9 cut score of 7 or 8 (PHQ-2 cut score: 2) and GAD-7 cut score of 6 (GAD-2 cut score: 2) had the best balance of sensitivity, specificity, and positive and negative predictive power in these data. These measures also showed good convergent and acceptable discriminant validity. LIMITATIONS The sample was predominantly White and non-Hispanic, and a validated (semi-)structured diagnostic interview was not used to establish mood and anxiety disorder diagnoses. CONCLUSIONS Results suggest the PHQ-9 and GAD-7 are reliable and potentially clinically useful screening tools for depression and anxiety in young people with SUD, and that the two-item versions may have similar clinical utility as the full measures.
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Affiliation(s)
- Kate H. Bentley
- Department of Psychiatry, Massachusetts General Hospital,Harvard Medical School
| | - Hitoshi Sakurai
- Department of Psychiatry, Massachusetts General Hospital,Harvard Medical School,Department of Neuropsychiatry, Keio University School of Medicine
| | | | | | - James McKowen
- Department of Psychiatry, Massachusetts General Hospital,Harvard Medical School
| | - Paola Pedrelli
- Department of Psychiatry, Massachusetts General Hospital,Harvard Medical School
| | - A. Eden Evins
- Department of Psychiatry, Massachusetts General Hospital,Harvard Medical School
| | - Amy M. Yule
- Department of Psychiatry, Massachusetts General Hospital,Harvard Medical School,Department of Psychiatry, Boston Medical Center,Boston University School of Medicine
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24
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Stutts LA, Blomquist KK. A longitudinal study of weight and shape concerns and disordered eating groups by gender and their relationship to self-control. Eat Weight Disord 2021; 26:227-237. [PMID: 31960347 DOI: 10.1007/s40519-020-00844-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/02/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Weight/shape concerns and disordered eating are common among young adults. Minimal research has examined these variables longitudinally by gender and in connection to self-control. The present study examined the level of weight/shape concerns and disordered eating at the end of the first and fourth year of college separately by gender and explored differences in self-control. METHODS Participants included 394 female and 157 male undergraduates (N = 551; 40% non-white) who were categorized into three groups using a cluster analysis by gender: low weight/shape concerns and low disordered eating (LowWS-LowDE group), high weight/shape concerns and low disordered eating (HighWS-LowDE group), and high weight/shape concerns and high disordered eating (HighWS-HighDE group). RESULTS Approximately, 62% of women and 54% of men reported having weight/shape concerns and/or disordered eating at the end of the first year of college, and around 51% of women and 44% of men reported having weight/shape concerns and/or disordered eating at the end of the fourth year. Results indicated that those in the HighWS-HighDE group had lower self-control compared to those in the LowWS-LowDE group at the end of the first and fourth year in both women and men. Women, but not men, who worsened in weight/shape concerns and/or disordered eating over time also reported significantly decreased self-control from their first to their fourth year. CONCLUSION Findings support the role of self-control in the maintenance of weight/shape concerns and disordered eating for both women and men. LEVEL III Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Lauren A Stutts
- Department of Health and Human Values, Davidson College, Davidson, NC, 28035, USA.
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25
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McCabe SE, Arterberry BJ, Dickinson K, Evans-Polce RJ, Ford JA, Ryan JE, Schepis TS. Assessment of Changes in Alcohol and Marijuana Abstinence, Co-Use, and Use Disorders Among US Young Adults From 2002 to 2018. JAMA Pediatr 2021; 175:64-72. [PMID: 33044552 PMCID: PMC7551219 DOI: 10.1001/jamapediatrics.2020.3352] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Recent information on the trends in past-year alcohol abstinence and marijuana abstinence, co-use of alcohol and marijuana, alcohol use disorder, and marijuana use disorder among US young adults is limited. OBJECTIVES To assess national changes over time in past-year alcohol and marijuana abstinence, co-use, alcohol use disorder, and marijuana use disorder among US young adults as a function of college status (2002-2018) and identify the covariates associated with abstinence, co-use, and marijuana use disorder in more recent cohorts (2015-2018). DESIGN, SETTING, AND PARTICIPANTS This study examined cross-sectional survey data collected in US households annually between 2002 and 2018 as part of the National Survey on Drug Use and Health. The survey used an independent, multistage area probability sample for all states to produce nationally representative estimates. The sample included 182 722 US young adults aged 18 to 22 years. The weighted screening and weighted full interview response rates were consistently above 80% and 70%, respectively. MAIN OUTCOMES AND MEASURES Measures included past-year abstinence, alcohol use, marijuana use, co-use, alcohol use disorder, marijuana use disorder, prescription drug use, prescription drug misuse, prescription drug use disorder, and other drug use disorders based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. RESULTS The weighted sample comprised 51.1% males. Between 2002 and 2018, there was an annual increase in past-year alcohol abstinence among young adults (college students: 0.54%; 95% CI, 0.44%-0.64%; non-college students: 0.33%; 95% CI, 0.24%-0.43%). There was an annual increase in marijuana use from 2002 to 2018 (college: 0.46%; 95% CI, 0.37%-0.55%; non-college: 0.49%; 95% CI, 0.40%-0.59%) without an increase in marijuana use disorder for all young adults. Past-year alcohol use disorder decreased annually (college: 0.66%; 95% CI, 0.60%-0.74%; non-college: 0.61%; 95% CI, 0.55%-0.69%), while co-use of alcohol and marijuana increased annually between 2002 and 2018 among all young adults (college: 0.60%; 95% CI, 0.51%-0.68%; non-college: 0.56%; 95% CI, 0.48%-0.63%). Young adults who reported co-use of alcohol and marijuana or met criteria for alcohol use disorder and/or marijuana use disorder accounted for 82.9% of young adults with prescription drug use disorder and 85.1% of those with illicit drug use disorder. More than three-fourths of those with both alcohol use disorder and marijuana use disorder reported past-year prescription drug use (78.2%) and illicit drug use (77.7%); 62.2% reported prescription drug misuse. CONCLUSIONS AND RELEVANCE The findings of this study suggest that US colleges and communities should create and maintain supportive resources for young adults as the substance use landscape changes, specifically as alcohol abstinence, marijuana use, and co-use increase. Interventions for polysubstance use, alcohol use disorder, and marijuana use disorder may provide valuable opportunities for clinicians to screen for prescription drug misuse.
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Affiliation(s)
- Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor,Institute for Research on Women and Gender, University of Michigan, Ann Arbor,Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor,Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Brooke J. Arterberry
- Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor,Department of Psychology, Iowa State University, Ames
| | - Kara Dickinson
- Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor
| | - Rebecca J. Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor
| | - Jason A. Ford
- Department of Sociology, University of Central Florida, Orlando
| | - Jennie E. Ryan
- Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor
| | - Ty S. Schepis
- Department of Psychology, Texas State University, San Marcos
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26
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Villarosa-Hurlocker MC, Schutts JW, Madson MB, Jordan HR, Whitley RB, Mohn RC. Screening for alcohol use disorders in college student drinkers with the AUDIT and the USAUDIT: a receiver operating characteristic curve analysis. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 46:531-545. [PMID: 32175778 PMCID: PMC7492430 DOI: 10.1080/00952990.2020.1712410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 12/18/2019] [Accepted: 12/24/2019] [Indexed: 01/02/2023]
Abstract
Background: The Alcohol Use Disorders Identification Test (AUDIT) and its consumption subscale (AUDIT-C) are international gold standard screeners for identifying at-risk drinkers. Items have been modified to reflect United States low-risk drinking guidelines in the USAUDIT and USAUDIT-C, which also perform well in identifying at-risk drinkers. The USAUDIT may also be used to screen for potential AUD, an important first step to identify individuals needing diagnostic testing and treatment referrals. Objectives: The present study sought to evaluate the sensitivity and specificity of each measure in predicting potential AUDs via diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition in a college sample. Methods: Participants were 382 college student drinkers (Mage = 20.2, SD = 1.5; 68.7% female) who completed online surveys assessing alcohol use, at-risk drinking, and AUD symptom endorsement. Receiver operating curves provide optimal cutoff scores for each measure in overall, male, and female samples. Results: Results indicated the AUDIT and USAUDIT are equally superior in detecting potential AUD in the current sample. Recommended cutoff scores for detecting likely AUD with the USAUDIT are 12 for males (sensitivity = 62.0%, specificity = 86.6%) and 8 for females (sensitivity = 65.3%, specificity = 87.7%). Conclusions: Whereas prior work supports the USAUDIT-C in detecting at-risk drinking, the current study supports the AUDIT and USAUDIT in detecting potential AUD. Based on prior work, and in an effort to be consistent with standard US drinking guidelines, we recommend using the USAUDIT in screening and brief interventions across college campuses.
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Affiliation(s)
| | - Joshua W. Schutts
- College of Education and Professional Studies, University of West Florida, Pensacola, FL, USA
| | - Michael B. Madson
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Hallie R. Jordan
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Robert B. Whitley
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Richard C. Mohn
- School of Education, University of Southern Mississippi, Hattiesburg, MS, USA
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27
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Pellegrino AJ, Duck KD, Kriescher DPJ, Shrake ME, Phillips MM, Lalonde TL, Phillips KT. Characterizing symptoms of cannabis use disorder in a sample of college students. JOURNAL OF DRUG ISSUES 2020; 50:524-537. [PMID: 34305171 DOI: 10.1177/0022042620936655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Since legalization of marijuana in several U.S. states in 2012, there has been concern about increases in the development of cannabis use disorder (CUD). The current study examined rates of CUD in Colorado college students who reported regular marijuana use and assessed a range of factors associated with CUD symptoms, including coping motives, concentrate/dab use, mental health concerns (depression, anxiety), age of regular marijuana use, and alcohol use. College students were recruited from a mid-sized university and completed a baseline assessment that included a marijuana urine screen. Participants reported a median of five CUD symptoms and 90% met criteria for CUD. After adjusting for covariates, age of regular marijuana use was negatively associated with number of CUD symptoms, while average daily alcohol drinks was positively associated with number of symptoms. Prevention and intervention efforts at the university level should be increased to reduce negative outcomes associated with problem marijuana use.
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Affiliation(s)
- Alexa J Pellegrino
- School of Psychological Sciences, Campus Box 94, University of Northern Colorado, Greeley, CO 80639
| | - Kerry D Duck
- School of Education, University of Delaware, 113 Willard Hall Education Building, Newark, DE 19716
| | - Dylan P J Kriescher
- School of Psychological Sciences, Campus Box 94, University of Northern Colorado, Greeley, CO 80639
| | - Mackenzie E Shrake
- School of Psychological Sciences, Campus Box 94, University of Northern Colorado, Greeley, CO 80639
| | - Michael M Phillips
- School of Psychological Sciences, Campus Box 94, University of Northern Colorado, Greeley, CO 80639
| | - Trent L Lalonde
- Department of Applied Statistics and Research Methods, Campus Box 124, University of Northern Colorado, Greeley, CO 80639
| | - Kristina T Phillips
- Center for Integrated Health Care Research (CIHR), Kaiser Permanente, 501 Alakawa St., Suite 201, Honolulu, HI 96817
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