Changes in binge drinking and related problems among American college students between 1993 and 1997. Results of the Harvard School of Public Health College Alcohol Study

Development and implementation of a website assessment tool to evaluate policies and resources for sexual assault and alcohol use on US college campuses

BACKGROUND

Sexual assault on college campuses is a major public health concern. Over half of incidents of sexual violence on college campuses occur in the context of victim or perpetrator alcohol use. Students who have experienced sexual violence, including in the context of alcohol use, are likely to seek information about sexual violence resources and services online.

METHODS

We developed a Website Assessment Tool to capture a student's perspective when navigating campus sexual violence and alcohol websites to find resources and services. The tool evaluates (1) accessibility, (2) comprehensibility, and (3) inclusivity of sexual violence and alcohol prevention information and resources. Alcohol policies and alcohol-related campus resources are also evaluated for linkage to sexual violence information. We assessed websites from 36 college campuses across the USA participating in a sexual violence prevention study.

RESULTS

The accessibility, comprehensibility, and inclusivity of educational content, services, and supports related to sexual violence and alcohol use varied widely. Websites with Title IX regulations, outlining protections against sex-based discrimination, were easily accessible for each school. Identifying whether services were confidential was inconsistent. Sexual violence resources were difficult to locate or embedded in lengthy text and difficult to comprehend, terms were not always defined, and descriptions of services were not explicitly inclusive of diverse populations. The alcohol policies for each school were accessible. Most campuses' (97%) alcohol policies and resources did not include sexual violence-related information or link alcohol-related information to their student counseling or health center website.

CONCLUSIONS

This Website Assessment Tool may be useful for college campuses seeking to optimize their students' receipt of information related to sexual violence and alcohol to increase awareness of sexual violence support services and to connect survivors with resources. Both sexual violence and alcohol use prevention and intervention strategies should include the prevalence and increased risk of alcohol-involved sexual violence on college campuses to help reduce alcohol-involved sexual violence and ensure survivors are connected to supports and services with few to no barriers.

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.

Religiosity in adolescence and body satisfaction and disordered eating in adolescence and young adulthood: cross-sectional and longitudinal findings from project EAT

PURPOSE

This research identified whether adolescent religiosity was associated with body satisfaction and disordered eating in adolescence and early adulthood and explored gender/sex differences in these associations.

METHODS

Project EAT (Eating and Activity in Teens and Young Adults) is a longitudinal cohort study following participants from adolescence into young adulthood. For this analysis (N = 1620), religiosity (importance of religion and frequency of religious service participation) during adolescence was examined as a correlate of body satisfaction and disordered eating (binge eating, maladaptive behaviors intended to lose or maintain weight, eating to cope, and dieting) at the same life stage (EAT-II, 2003-2004, Mage = 19.4 years) and during young adulthood (EAT-IV, 2015-2016, Mage = 31.5 years). Analyses used linear and logistic regression models adjusted for demographics and adolescent body mass index.

RESULTS

During adolescence, females who placed greater importance on religion had higher body satisfaction, 22% higher odds of binge eating, and 19% greater odds of dieting in the past year, while more frequent attendance of religious services was associated with higher body satisfaction and 37% greater odds of dieting past year. Among males, only frequent attendance of religious services was associated with higher adolescent body satisfaction. Longitudinally, among females, only frequent attendance of religious services in adolescence predicted higher levels of body satisfaction in young adulthood. No significant longitudinal associations were observed among males.

CONCLUSIONS

Our findings contribute to understanding the complex interplay between religiosity, gender, and body satisfaction. Further research should explore cultural factors influencing these associations and qualitative aspects of religious experiences to inform nuanced interventions.

LEVEL OF EVIDENCE

Level III, cohort study.

College students' perceptions of positive and negative drinking-related sexual experiences

Objective: During young adulthood, drinking and sexual behaviors are both normative and inextricably linked. While this association is well documented, little is known about how students define positive and negative drinking-related sexual experiences. Methods: Thirty-five undergraduates participated in a focus group about sexual experiences in the context of drinking. Thematic analysis was utilized to identify themes in the data. Results: Students' descriptions of positive drinking-related sexual encounters included having a good time, feeling safe, maintaining control over alcohol, as well as feeling safe in drinking contexts where sexual partners are located. Students' perceptions of negative experiences included specific consequences such as a damaged reputation, loss of control due to alcohol, and concern of engagement in sex when they or a partner was too intoxicated to consent. Conclusion: Gaining a better understanding of how college students view positive and negative drinking-related sexual experiences could inform interventions aimed at promoting student well-being.

A smartphone application to reduce problematic drinking: a feasibility trial

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

TRIAL REGISTRATION

DRKS00014675 (retrospectively registered).

The influence of excessive stress on medical students in the Czech Republic - national sample

PURPOSE

The Czech Republic has been dealing with a long-term shortage of doctors, which, according to demographic forecasts, will continue to worsen due to the retirement of stronger generations of doctors in contrast to the gradual aging of the population, which will require more health care over time. The country´s political set is trying to respond to this shortage and demographic forecasts by gradually increasing financial funding of medical faculties with the aim of increasing the number of graduates of the program in the field of general medicine.

METHODS

Anonymous questionnaire survey was conducted among students and graduates of general medicine at all eight Czech medical faculties. A total of 3183 respondents participated in the survey. There were 2843 medical students, which represents approximately 28% of all medical students in the Czech Republic. The distribution of respondents within the study years was approximately even and approximately corresponded to the real distribution of students between individual faculties in country, which makes survey a national sample. The statistical processing was performed in the statistical software R. Apart from the basic comparison using percentage relative frequencies and Pearson´s chi-squared test, in this study we used Odds ratios (OR) with CI 0,95 from logistic regression model for a better interpretation of some outputs.

RESULTS

The results show that the vast majority of Czech medical students experience excessive stress during their studies, which increases the risk of students´ somatic problems (OR = 4.89, CI 0.95 = (4.11;5.83), p < 0.001)., targeted alcohol use (OR = 2.29, CI 0.95 = (1.73;3.04), p < 0,001) and the use of anxiolytic or antidepressant medication to reduce it (OR = 2.99, CI 0.95 = (2.24;4.01), p < 0.001). Students experiencing higher levels of excessive stress are more likely to leave their studies based on their own decision (4.20 (CI 0.95 (3.39;5.19), p < 0.001) and not to enter clinical practice after graduation (OR = 2.62, CI 0.95 = (2.06;3.33), p < 0.001).

CONCLUSIONS

The survey shows the need for an open discussion at the highest level about the possibilities of reasonable reduction of unnecessary stress during medical studies. Medical students in the Czech Republic are exposed to excessive stress with all the consequences described above. All that remains is to state the existence of unnecessary components of stress, which represent an opportunity to reduce it, thereby achieving better conditions for studying, improvement in the staff situation in the Czech healthcare system and a reduction in inefficiently spent financial resources for the education of young doctors.

TRIAL REGISTRATION

No registration.

A mixed-methods approach to improve the measurement of alcohol-induced blackouts: ABOM-2

BACKGROUND

Alcohol-induced blackouts describe memory loss resulting from alcohol consumption. Approximately half of college students report experiencing a blackout in their lifetime. Blackouts are associated with an increased risk for negative consequences, including serious injury. Research has documented two types of blackouts, en bloc (EB) and fragmentary (FB). However, research is limited by the lack of a validated measure that differentiates between these two forms of blackout. This study used a mixed-methods approach to improve the assessment of FB and EB among young adults. Specifically, we sought to improve the existing Alcohol-Induced Blackout Measure (ABOM), which was derived from a relatively small pool of items that did not distinguish FB from EB.

METHODS

Study 1 used three rounds of cognitive interviewing with U.S. college students (N = 31) to refine existing assessment items. Nineteen refined blackout items were retained for Study 2. Study 2 used face validity, factor analysis, item response theory, and external validation analyses to test the two-factor blackout model among U.S. heavy-drinking college students (N = 474) and to develop and validate a new blackout measure (ABOM-2).

RESULTS

Iterative factor analyses demonstrated that the items were well represented by correlated EB and FB factors, consistent with our hypothesis. External validation analyses demonstrated convergent and discriminant validity. These analyses also provided preliminary evidence for the two factors having differential predictive validity (e.g., FB correlated with enhancement drinking motives, while EB correlated with coping and conformity motives).

CONCLUSIONS

The Alcohol-Induced Blackout Measure-2 (ABOM-2) improves the measurement of blackout experiences among college students. Its use could facilitate the examination of EB and FB as differential predictors of alcohol-related outcomes in future studies.

“#BingeDrinking: Using Social Media to Understand College Binge Drinking (Preprint)

Background

Objective

Methods

Results

Conclusions

A comparison of food and alcohol disturbance (FAD) in sorority and non-sorority women

Objective: College students who are members of groups in which appearance and alcohol norms are highly salient may be at particular risk for engaging in food and alcohol disturbance (FAD) behaviors. This study compared demographically-matched sorority- and non-sorority members on FAD and associated behaviors. Participants: College women who self-identified as being in a sorority (n = 95) were matched with non-sorority peers (n = 95) on age, body mass index (BMI), ethnicity, and race. Methods: Participants completed an online survey assessing alcohol use, eating disorder symptoms, appearance-related peer pressure, FAD behaviors, and demographic information. Mann-Whitney U tests and generalized linear models tested hypotheses. Results: Sorority members reported more alcohol use and FAD behaviors; however, after controlling for year in school, alcohol use, and eating disorder symptoms, Greek status no longer predicted FAD behaviors. Conclusions: Differences in FAD behaviors across sorority- and non-sorority women were due to differences in alcohol consumption.

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.

Protective behavioral strategies underutilization mediates effect of a brief motivational intervention among socially anxious undergraduate drinkers

Social anxiety (SA) is implicated in problematic undergraduate drinking. Brief motivational interventions (BMIs) reduce problematic undergraduate drinking. However, not all students benefit. Identification of vulnerable subgroups is an important next step. The current study examined the role of SA and protective behavioral strategies (PBS) on BMI outcomes. We reanalyzed a subset of data (53.3%; N = 120; 62.5% male) from a randomized trial in which heavy drinking undergraduates were randomized to a BMI or control. SA, past-month typical drinks, peak drinks, weekly quantity, alcohol problems, and PBS were assessed at baseline and 6 weeks. Main effects and interaction among the intervention condition (BMI vs. control) and SA group (low vs. high) were tested on alcohol outcomes and PBS. High SA undergraduates reported greater baseline drinking, more alcohol problems, and lower PBS. Post-BMI, high SA drinkers continued to report greater peak drinks, typical drinks, alcohol problems, and lower PBS use, controlling for baseline use. Among the BMI condition, parallel multiple mediation analyses revealed the PBS subscale Manner of Drinking uniquely mediated the relationship between SA and heavier post-BMI drinking. The PBS Manner of Drinking and Serious Harm Reduction subscales jointly mediated the relationship between SA and greater post-BMI alcohol problems. BMIs may need to be refined to improve outcomes for socially anxious drinkers. Increasing PBS utilization post-BMI may help improve BMI efficacy in this vulnerable group. Clinical implications are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Emotion dysregulation moderates the relationship between alcohol use and eating pathology among heavy-drinking college men

OBJECTIVES

There is limited research examining the relationship between alcohol use and eating pathology in men or factors that may moderate this association. The current study investigated the relationship between alcohol use and eating pathology, and examined emotion dysregulation as a moderator of this association, among heavy-drinking college men.

METHOD

Men mandated to receive an alcohol intervention (N = 88; average age = 19 years) completed questionnaires related to alcohol use, emotion dysregulation, and eating pathology.

RESULTS

Results demonstrated positive relationships between alcohol use and some eating pathology, and a significant interaction between alcohol use and emotion dysregulation. However, results were contrary to hypotheses, such that there was a positive relationship between alcohol use and eating pathology at low levels of emotion dysregulation.

CONCLUSION

Future studies should continue to examine the overall presentation of eating pathology in men and investigate factors that may impact the relationship between alcohol use and eating pathology.

A Group Randomized Trial of the Stop Service to Obviously-Impaired Patrons (S-STOP) Program to Prevent Overservice in Bars and Restaurants in College Communities

BACKGROUND

College student drinking in on-premises establishments has been associated with heavy alcohol consumption and a range of problems including assault, fighting, risky sex, and drinking and driving. Although more strictly enforcing overservice laws might reduce heavy drinking in on-premises establishments, law enforcement agencies have few resource-efficient tools for doing so, resulting in these laws seldom being enforced.

OBJECTIVES

In this paper, we report the results of an evaluation of the Stop Service to Obviously-impaired Patrons (S-STOP) program that was implemented in 303 bars and restaurants in 18 university communities in California using a randomized cross-over design (early vs. delayed implementation). The S-STOP program: (a) deployed pseudo-intoxicated patrons who attempted to purchase a drink when showing obvious signs of intoxication; (b) provided feedback to owners and managers on staff performance; and (c) offered free online refresher training for staff.

RESULTS

Overall, alcohol servers in bars and restaurants in these college communities were willing to serve a pseudo-intoxicated mystery shopper 90% of the time. The study found no evidence that S-STOP reduced the prevalence of alcohol sales to apparently impaired patrons during the two intervention stages of the study.

CONCLUSIONS

The findings highlight the need for developing effective interventions to prevent overservice and should prompt college and university leaders to take the lead in addressing the problem of alcohol overservice at on-premises establishments by working with community leaders, law enforcement, and retailers.

Interplay between personality and antisocial peer affiliation as prospective predictors of marijuana use and academic achievement in the transition into and out of college

Marijuana use has increased in recent cohorts and is associated with several negative outcomes, including poorer academic achievement. Less is known about how personality and peer factors in the first two years of college work together to predict problematic marijuana use and potentially co-occurring academic problems three years later. The longitudinal College Experiences Study (N = 209) was used to address this (N = 209, ~90% white, ~40% male); this study collected data from students in their first year of college, as well as ~1 year later (retention = 85%), and again ~4 years after the initial data collection (retention = 80%). Longitudinal data were analyzed via the traditional cross-lagged panel (CLPM) and the random-intercept CLPM approach. Results were consistent in that there was strong stability in problematic marijuana use, constraint, and antisocial peer affiliation across time, which were predominately influenced by stable, trait-like influences. These factors were also highly correlated but there was less evidence that one predicted the other over time. Nonetheless, greater constraint at Wave 1 was associated with significantly greater cumulative GPA in the transition out of college (βs = 0.43-0.44). Results support the importance of early prevention and intervention of problematic marijuana use, as well as the possibility of using personality-targeted approaches in the first year of college to promote growth in behaviors related to constraint (e.g., staying organized, risk avoidant) in an effort to improve academic success and correlated substance use outcomes by the transition out of college.

A qualitative examination of drinking patterns among community college students

Objective: The purpose of this study was to gain insight about patterns of alcohol use and related consequences among heavy drinking community college students. Participants: About 26 community college students (Mean age 22.3 years, 46% men, 69% White) participated in this study between January and April 2013. Methods: Five qualitative focus group discussions were conducted during formative research preceding a text message intervention; participants were asked about common drinking behavior patterns among community college students, as well as how age and gender affect drinking. Sessions were audio-recorded and transcribed verbatim. Participants also completed a brief quantitative survey about their drinking behavior and its consequences. Results: Qualitative data identified several themes: (1) reasons for drinking, (2) drinking occasions, (3) age- and experience-related differences in drinking, including patterns specific to community college students and women. Conclusion: Research is needed to develop innovative strategies to reduce alcohol harm in this understudied population.

Trait Impulsivity Impedes Maturing Out of Problem Drinking Among Socially Anxious Undergraduates

AIMS

Alcohol use follows a developmental trajectory-steadily increasing and peaking in the early stages of emerging adulthood (e.g. first year of university) and declining thereafter. While most individuals 'mature out' of problem drinking as they move through emerging adulthood, some continue to drink heavily and experience serious problems. Tension reduction theory identifies social anxiety (SA) as a potential risk factor for problem drinking during emerging adulthood. However, mixed data suggest that the associations between SA and drinking behaviours are not straightforward. Cross-sectional studies demonstrate that socially anxious emerging adults are at risk for problem drinking, but only if they are also high in trait impulsivity. This study aimed to expand on previous work by examining trait impulsivity as moderator of the prospective associations between SA and maturing out of problem drinking in emerging adulthood.

METHODS

Undergraduates (N = 302) completed online self-reports at regular intervals (6-months) over an 18-month period, resulting in four waves of data.

RESULTS

Unconditional latent growth curve models indicated that alcohol problems (but not use) declined linearly over time. Next, conditional growth curve models revealed that SA was associated with impeded maturing out of alcohol problems, but this effect was only present in socially anxious participants with high levels of trait impulsivity.

CONCLUSION

Our study advances growing literature on the crucial moderating role that impulsivity plays in the SA pathway to problem drinking. Clinical interventions for problem drinking among socially anxious students should both assess for and target concurrent impulsivity.

Depression, Environmental Reward, Coping Motives and Alcohol Consumption During the COVID-19 Pandemic

Background: Increases in the incidence of psychological distress and alcohol use during the COVID-19 pandemic have been predicted. Behavioral theories of depression and alcohol self-medication theories suggest that greater social/environmental constraints and increased psychological distress during COVID-19 could result in increases in depression and drinking to cope with negative affect. The current study had two goals: (1) to examine self-reported changes in alcohol use and related outcomes after the introduction of COVID-19 social distancing requirements, and; (2) to test hypothesized mediation models to explain individual differences in self-reported changes in depression and alcohol use during the early weeks of the COVID-19 pandemic. Methods: Participants (n = 833) were U.S. residents recruited for participation in a single online survey. The cross-sectional survey included questions assessing environmental reward, depression, COVID-19-related distress, drinking motives, and alcohol use outcomes. Outcomes were assessed via retrospective self-report for two timeframes in the single survey: the 30 days prior to state-mandated social distancing ("pre-social-distancing"), and the 30 days after the start of state-mandated social distancing ("post-social-distancing"). Results: Depression severity, coping motives, and some indices of alcohol consumption (e.g., frequency of binge drinking, and frequency of solitary drinking) were significantly greater post-social-distancing relative to pre-social-distancing. Conversely, environmental reward and other drinking motives (social, enhancement, and conformity) were significantly lower post-social distancing compared to pre-social-distancing. Behavioral economic indices (alcohol demand) were variable with regard to change. Mediation analyses suggested a significant indirect effect of reduced environmental reward with drinking quantity/frequency via increased depressive symptoms and coping motives, and a significant indirect effect of COVID-related distress with alcohol quantity/frequency via coping motives for drinking. Discussion: Results provide early cross-sectional evidence regarding the relation of environmental reward, depression, and COVID-19-related psychological distress with alcohol consumption and coping motives during the early weeks of the COVID-19 pandemic. Results are largely consistent with predictions from behavioral theories of depression and alcohol self-medication frameworks. Future research is needed to study prospective associations among these outcomes.

Negative alcohol-related consequences experienced by young adults in the past 12 months: Differences by college attendance, living situation, binge drinking, and sex

PURPOSE

This study estimated the prevalence of negative consequences associated with alcohol use in a national sample of young adults one or two years after graduating from high school, focusing on differences by college attendance, living situation, binge drinking, and sex.

METHODS

A subsample (N = 1068) of U.S. nationally representative Monitoring the Future study 12th grade students from 2006 to 2016 cohorts was followed-up at modal age 19 or 20 (in 2008-2017) and asked about negative consequences related to their own alcohol use during the past 12 months. Differences in prevalence were estimated and multivariable models examined associations with college attendance, living situation, binge drinking, and sex.

RESULTS

Half of surveyed U.S. 19/20 year-old alcohol users (a third of non-binge drinkers and almost three-quarters of binge drinkers) experienced negative consequences in the past year. The likelihood of experiencing several consequence types was significantly associated with college attendance prior to controlling for living situation. In multivariable models controlling for living situation, unsafe driving due to drinking remained more likely for students attending 2-year colleges or vocational/technical schools than for 4-year college students or non-attenders. In general, negative consequence risk was elevated among young adults not living with parents (vs. those living with parents) and women (vs. men).

CONCLUSION

Negative consequences from alcohol use are prevalent among young adults and differ by college attendance, living situation, binge drinking, and sex. Students at 2-year/vocational/technical schools are at particular risk for unsafe driving, warranting specific research attention and targeted intervention.

Religiosity as a mediating factor in alcohol use and alcohol related problems among students attending a historically black college (HBCU)

Previous research suggests that students at Historically Black Colleges and Universities (HBCUs) frequently have lower rates of drinking and alcohol-related problems. The etiology of such findings is still under debate although some research has suggested the African-American religious experience might account for the differences. The present study aims to provide a comprehensive picture of alcohol consumption, alcohol-related problems, and religiosity among HBCU students and to test the hypothesis that religiosity moderates problematic drinking behavior. The Alcohol Use Disorders Identification Test (AUDIT), the College Alcohol Problems Scale Revised (CAPS-R), the Religious Maturity Scale, and the Salience in Religious Commitment Scale was administered to 144 students at a small southern HBCU. We found that, overall, the subjects were moderate drinkers and experienced few alcohol-related problems. The relationship between religiosity and alcohol-related problems was complex and gender mediated that relationship. The results suggest that although religiosity may act as a buffer to alcohol abuse in some HBCU students, it cannot fully account for the differences in alcohol use between students at HBCUs and other institutions.

A Web-Based, Computer-Tailored Intervention to Reduce Alcohol Consumption and Binge Drinking Among Spanish Adolescents: Cluster Randomized Controlled Trial

Background

Alcohol consumption, including binge drinking (BD) and heavy episodic drinking (HED), is one of the leading risk factors among Spanish adolescents leading to significant social, health, and economic consequences. Reduction of BD and HED in adolescents can be achieved using Web-based, computer-tailored (CT) interventions, providing highly personalized feedback that is adapted to a person’s individual characteristics and needs. Randomized controlled trials assessing the effects of tailored BD reduction programs among Spanish adolescents are scarce.

Objective

The aim of this study was to test the effectiveness of the Web-based, CT intervention Alerta Alcohol, aimed at the prevention of BD in Spanish adolescents. As a secondary outcome, effects on HED, weekly consumption, and any consumption were also assessed. The adherence and process evaluation were assessed.

Methods

A cluster randomized controlled trial conducted among 15 Spanish schools was developed. Each school was randomized into either an experimental condition (EC) (N=742) or a control condition (CC) (N=505). Finally, 351 participants for the EC and 261 for the CC were included in the analysis (N=612). Baseline assessment took place in January and February 2017. Demographic variables and alcohol use were assessed at baseline. Follow-up assessment of alcohol use took place 4 months later in May and June 2017. Participants were compared according to their randomization group (EC versus CC). After the baseline assessment, participants in the EC started the intervention, which consisted of short stories about BD, in which CT feedback was based on the I-Change Model for behavior change. Participants in the CC group only received the baseline questionnaire. Effects of the intervention were assessed using a three-level mixed logistic regression analysis for BD, HED, and any consumption, and a three-level mixed linear regression analysis for weekly consumption.

Results

In total, 1247 adolescents participated in the baseline assessment and 612 participated in the follow-up assessment; the attrition rate was 50.92%. The intervention was effective in reducing HED among adolescents; the odds of HED in the CC was nine times that in the experimental condition (P=.04). No effects were found for BD, weekly consumption, and any consumption. Process evaluations revealed that the adolescents were satisfied with the program (68.8%), would use the program again (52.9%), and would recommend it to someone else (62.8%). Females and non-binge drinkers showed better responses in the process evaluation.

Conclusions

Our intervention was effective regarding HED but not regarding BD, weekly consumption, and any consumption. It may be that limiting alcohol consumption to prevent HED was easier in the Spanish context than it was to carry out further steps, such as reducing other patterns of alcohol consumption. Hence, additional actions are needed to accomplish these latter goals, including community approaches and policy actions aimed at denormalizing alcohol consumption among Spanish adolescents.

Trial Registration

ClinicalTrials.gov NCT03288896; https://clinicaltrials.gov/ct2/show/NCT03288896

International Registered Report Identifier (IRRID)

RR2-10.1186/s12889-018-5346-4

Impulsivity moderates the effect of social anxiety on in-lab alcohol craving

Social anxiety (SA) is thought to relate to alcohol misuse. However, current evidence is inconsistent - especially in young adulthood. Recent non-experimental data show that trait impulsivity moderates the effect of SA on alcohol misuse. Specifically, this work suggests that concurrently elevated impulsivity may draw attention to the immediate, anxiolytic effects of drinking - thus promoting alcohol misuse among those high in SA. Otherwise, without elevated impulsivity, a socially anxious person may not drink due to focusing on alcohol's possible negative outcomes (e.g., embarrassing behaviours). The next step in this research is to examine if impulsivity impacts in-the-moment subjective craving among socially anxious individuals. This was the goal of the present experiment. After baseline measures, undergraduate participants (N = 110) completed the Trier Social Stress Test followed by an alcohol (versus neutral) cue exposure. Subjective craving ratings were collected at both baseline and post-cue exposure. Moderation analyses revealed that socially anxious individuals endorsed strong cravings following an alcohol (but not a neutral) cue exposure, but only if they also had elevated impulsivity. In-lab craving was positively correlated with retrospective reports of alcohol misuse. Our findings demonstrate that impulsivity contributes to SA-related risk for alcohol misuse.

The cost of minority stress: Risky alcohol use and coping-motivated drinking behavior in African American college students

A motivational drinking framework is utilized to understand the relationship between minority stressors (e.g., race-related stress and acculturative stress) and alcohol use behaviors (risky alcohol use and coping-motivated drinking) among a large sample of Black American college students. Six hundred forty-nine Black college students from 8 colleges and universities in the United States were recruited as part of a large, multiwave, cross-sectional study investigating the stress and coping experiences of Black emerging adults. Results from the current investigation provide support for the independent contributions of acculturative stress and race-related stress to the risky alcohol use behavior of Black college students, while acculturative stress significantly predicted coping-motivated drinking behaviors in the sample. Findings underscore the need to better understand the unique relationships between minority stress and risky alcohol use behaviors of Black college students, namely, relationships not shared by their nonminority peers that increase their risk of problem drinking.

Incorporating Writing into a Personalized Normative Feedback Intervention to Reduce Problem Drinking Among College Students

BACKGROUND

Personalized normative feedback (PNF) interventions have repeatedly been found to reduce drinking among undergraduates. However, effects tend to be small, potentially due to inattention to and inadequate processing of the information. Adding a writing component to PNF interventions may allow for greater cognitive processing of the feedback, thereby boosting intervention efficacy. Additionally, expressive writing (EW) has been shown to reduce drinking intentions; however, studies have not examined whether it can reduce drinking behavior. The present experiment evaluated whether including a writing task would improve the efficacy of PNF and whether EW alone can be used to reduce drinking and alcohol-related problems.

METHODS

Heavy drinking undergraduates (N = 250) were randomized to receive either: (i) PNF about their alcohol use; (ii) EW about a negative, heavy drinking occasion; (iii) PNFplus writing about the norms feedback; or (iv) attention control feedback about their technology use in an online brief intervention. Participants (N = 169) then completed a 1-month follow-up survey about their past month alcohol use and alcohol-related problems online.

RESULTS

PNFplus writing reduced alcohol-related problems compared to all other conditions. No significant reductions were found for EW. Both PNF and PNFplus writing reduced perceived norms and perceived norms mediated intervention effects for both feedback conditions.

CONCLUSIONS

The current findings suggest that adding a writing component to traditional norms-based feedback approaches might be an efficacious strategy, particularly for reducing alcohol-related consequences.

Risky Alcohol Consumption and Online Activity Levels

University students engage in risky patterns of alcohol consumption, which may affect their health and performance at university. This study provides a novel analysis which tracked students' interaction with online course materials over time, and examined associations between online activity and alcohol related harm (as indicated by the Alcohol Use Disorders Identification Test). Study 1 tracked 63 undergraduate psychology students in the second half of a semester and found risky drinking behaviors were marginally related to reductions in online study activity. Study 2 tracked 88 undergraduate psychology students in the first half of a semester. Risky drinking behaviors were associated with less online activity after midday. Students reporting more alcohol related harm were less likely to login between 7 pm and midnight, and between 1 am and 6 am. This study demonstrates a potential sensitivity of online activity levels to alcohol use.

Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults: US Preventive Services Task Force Recommendation Statement

IMPORTANCE

Excessive alcohol use is one of the most common causes of premature mortality in the United States. From 2006 to 2010, an estimated 88 000 alcohol-attributable deaths occurred annually in the United States, caused by both acute conditions (eg, injuries from motor vehicle collisions) and chronic conditions (eg, alcoholic liver disease). Alcohol use during pregnancy is also one of the major preventable causes of birth defects and developmental disabilities.

OBJECTIVE

To update the US Preventive Services Task Force (USPSTF) 2013 recommendation on screening for unhealthy alcohol use in primary care settings.

EVIDENCE REVIEW

The USPSTF commissioned a review of the evidence on the effectiveness of screening to reduce unhealthy alcohol use (defined as a spectrum of behaviors, from risky drinking to alcohol use disorder, that result in increased risk for health consequences) morbidity, mortality, or risky behaviors and to improve health, social, or legal outcomes; the accuracy of various screening approaches; the effectiveness of counseling interventions to reduce unhealthy alcohol use, morbidity, mortality, or risky behaviors and to improve health, social, or legal outcomes; and the harms of screening and behavioral counseling interventions.

FINDINGS

The net benefit of screening and brief behavioral counseling interventions for unhealthy alcohol use in adults, including pregnant women, is moderate. The evidence is insufficient to assess the balance of benefits and harms of screening and brief behavioral counseling interventions for unhealthy alcohol use in adolescents.

CONCLUSIONS AND RECOMMENDATION

The USPSTF recommends screening for unhealthy alcohol use in primary care settings in adults 18 years or older, including pregnant women, and providing persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce unhealthy alcohol use. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening and brief behavioral counseling interventions for alcohol use in primary care settings in adolescents aged 12 to 17 years. (I statement).

Personalized Boosters After a Computerized Intervention Targeting College Drinking: A Randomized Controlled Trial

BACKGROUND

Problematic drinking among emerging adult college students is extensive. Computer-delivered interventions (CDIs) have strong appeal because they can be quickly delivered to large numbers of students. Although they are efficacious in the short term, CDIs are not as efficacious as in-person interventions longer term. This study examined the utility of emailed boosters containing personalized feedback after a CDI to enhance and extend reductions among emerging adult college drinkers. Sex and age were explored as potential moderators.

METHODS

Participants were 537 college students (67.4% female) aged 18 to 24 years (M age = 19.65, SD = 1.67) who consumed at least 1 alcoholic drink in the past 2 weeks. They were randomly assigned to CDI-only, CDI + booster email, or an assessment-only control condition, and were assessed up to 9 months postintervention. A booster email with personalized feedback was sent to the CDI + booster email group 2 weeks after completion of the CDI.

RESULTS

Moderation findings for age revealed that the booster may be an effective means to strengthen and extend intervention effects for emerging adults who are of legal drinking age. However, effects were negligible for underage drinkers. Although the booster effect for the overall sample demonstrated a trend in the expected direction, it failed to reach significance. Booster effects were not significantly moderated by sex. Intervention effects were not moderated by either age or sex.

CONCLUSIONS

The present investigation contributes to a limited body of research on boosters to augment main intervention effects in college drinkers. Our study demonstrated that a brief CDI plus a simple email booster with personalized feedback resulted in significant reductions in drinking outcomes for emerging adults of legal drinking age. Efforts to further develop and refine intervention booster strategies represent a promising future direction to minimize harmful drinking among college students.

Resistance to peer influence moderates the relationship between perceived (but not actual) peer norms and binge drinking in a college student social network

INTRODUCTION

Adolescent and young adult binge drinking is strongly associated with perceived social norms and the drinking behavior that occurs within peer networks. The extent to which an individual is influenced by the behavior of others may depend upon that individual's resistance to peer influence (RPI).

METHODS

Students in their first semester of college (N=1323; 54.7% female, 57% White, 15.1% Hispanic) reported on their own binge drinking, and the perceived binge drinking of up to 10 important peers in the first-year class. Using network autocorrelation models, we investigated cross-sectional relationships between participant's binge drinking frequency and the perceived and actual binge drinking frequency of important peers. We then tested the moderating role of RPI, expecting that greater RPI would weaken the relationship between perceived and actual peer binge drinking on participant binge drinking.

RESULTS

Perceived and actual peer binge drinking were statistically significant predictors of participant binge drinking frequency in the past month, after controlling for covariates. RPI significantly moderated the association between perceptions of peer binge drinking and participant's own binge drinking; this association was weaker among participants with higher RPI compared to those with lower RPI. RPI did not interact with the actual binge drinking behavior of network peers.

CONCLUSIONS

RPI may function to protect individuals from the effect of their perceptions about the binge drinking of peers, but not from the effect of the actual binge drinking of peers.

Alcohol use among Norwegian students: Demographics, personality and psychological health correlates of drinking patterns

AIMS

This study investigates demographic, personality, and psychological health correlates of different drinking patterns.

DESIGN

Students at the four largest institutions of higher education in Bergen municipality were invited via email to complete an internet-based questionnaire. The final sample size was 11,236 (39.4%), mean age 24.9 years (SD = 6.5), and 63.3% were women. The survey included the Alcohol Use Disorder Identification Test (AUDIT) and questions about demographics, personality traits, and symptoms of depression and anxiety. Binary logistic regressions were used to identify correlates of different drinking patterns.

RESULTS

A total of 53.0% of the students had an AUDIT score of or above 8 (i.e., hazardous drinking). Being native Norwegian, male, single, without children, non-religious, extroverted, unconscientious, and less open to experience were associated with higher AUDIT scores, drinking frequently, and binge drinking. Having parents with high alcohol or drug use increased the odds of engaging in binge drinking, but this factor was not associated with frequent drinking. Students scoring higher on neuroticism and openness were less likely to report problematic alcohol usage.

CONCLUSIONS

A majority of the students reported alcohol habits that are associated with harm if they persist. This emphasises the need to examine the long-term consequences of students' alcohol use.

The Role of Social, Familial, and Individual-Level Factors on Multiple Alcohol Use Outcomes During the First Year of University

BACKGROUND

The first year of university attendance represents a critical time frame for the development of alcohol use and misuse given changes in autonomy and increased access to alcohol. Prior studies have demonstrated that the establishment of drinking patterns during this period is impacted by an array of demographic, environmental, and familial factors. It is critical to consider such factors jointly, and to understand potentially differential effects on stages of alcohol use/misuse, in order to identify robust predictors that may be targeted in prevention and intervention programming.

METHODS

As part of a longitudinal study, students at a large, public U.S. university were invited to complete online surveys that included questions related to alcohol use, emotional and behavioral health, environmental factors, sociodemographic factors, and familial environment. This study uses data from surveys administered in the fall and spring of the first year of university. We used univariate (maximum N = 7,291) and multivariate (maximum N = 4,788) logistic and linear regressions to evaluate the associations between potential risk and protective factors with 4 alcohol use outcomes: initiation, consumption, problems, and addiction resistance.

RESULTS

In multivariate models, we observed associations between demographic, social/environmental, and personal-level predictors with all 4 alcohol outcomes, several of which were consistent across each stage of alcohol use. A deviant high school peer group was one of the strongest predictors of risk across outcomes. The influence of drinking motives and alcohol expectancies varied by alcohol use outcome. Externalizing characteristics were associated with increased risk across outcomes, while internalizing symptoms were associated with more problems and lower addiction resistance.

CONCLUSIONS

These findings underscore the complex network of factors influencing stages of alcohol use during the first year of university. Importantly, these findings demonstrate that the impact of predictors changes across stages of alcohol use/misuse, which presents opportunities for targeted prevention efforts.

Victimization as a mediator of alcohol use disparities between sexual minority subgroups and sexual majority youth using the 2015 National Youth Risk Behavior Survey

BACKGROUND

Alcohol use among underage youth is a significant public health concern. According to the National Institute on Alcohol Abuse and Alcoholism, alcohol is the "drug of choice" among adolescents, meaning more youth use and abuse alcohol than any other substance. Prevalence of alcohol use is disproportionately higher among sexual minority youth (SMY) than among their heterosexual peers. We examined sexual identity and sexual behavior disparities in alcohol use, and the mediational role of bullying in a sample of high school students.

METHODS

Data from the 2015 National Youth Risk Behavior Survey were used to assess the association between sexual minority status (identity and behavior) and alcohol use with weighted logistic regression. Due to well-documented differences between males and females, we stratified models by gender. Physical and cyberbullying were examined as mediators of the relationship between sexual minority status and alcohol use.

RESULTS

We detected associations between certain subgroups of sexual minority youth and alcohol use across all four drinking variables (ever drank alcohol, age at first drink, current alcohol use, and binge drinking). Most of these associations were found among bisexual-identified youth and students with both male and female sexual partners; these individuals had up to twice the odds of engaging in alcohol use behaviors when compared with sexual majority students. Associations were strongest among females. Bullying mediated sexual minority status and alcohol use only among bisexual females.

CONCLUSIONS

As disparities in alcohol use differ by gender, sexual identity, and sexual behavior, interventions should be targeted accordingly.

Nonmedical Prescription Drug Use by College Students for Recreational and Instrumental Purposes: Assessing the Differences

Nonmedical prescription drug use (NMPDU) is a serious issue on college campuses. We examine the factors affecting instrumental and recreational NMPDU within the same sample, and test the efficacy of learning and strain theories in predicting NMPDU for both instrumental and recreational use. This cross-sectional study utilizes survey data gathered from a convenient but representative sample ( n = 2,466) of students attending a large public university in the Southwestern United States. There is support for learning theory, but not for strain theory, in predicting both recreational and instrumental use. Logistic regression analyses also show that while marijuana smokers, illicit street drug users, and those possessing less of an academic ethic are more likely to partake in NMPDU for both recreational and instrumental purposes, the predictors for recreational and instrumental NMPDU differ in interesting ways with regard to race, gender, binge drinking, living arrangement, and Greek organization membership.

Rates and Correlates of Binge Drinking Among College Students With Disabilities, United States, 2013

OBJECTIVE

Our objective was to provide the first comprehensive picture of alcohol use and binge drinking by US college students with disabilities (SWDs), who represent at least 11% (1.6 million) of the US college student population.

METHODS

In fall 2013, we used a stratified random sampling technique to identify and recruit 2440 SWDs from 122 US colleges and universities. A total of 1285 (53%) SWDs from 61 (50%) colleges and universities completed a survey of alcohol and other drug use and the use of substances by student peers. We conducted 4 multiple logistic regression analyses to compare binge-drinking and non-binge-drinking SWDs by potential correlates of such use and a final model that included only significant variables.

RESULTS

SWDs aged <21 vs ≥21 (odds ratio [OR] = 0.90; 95% confidence interval [CI], 0.82-0.99) who spent more time vs less time socializing (OR = 1.24; 95% CI, 1.11-1.38), who spent less time vs more time studying (OR = -0.89; 95% CI, -0.80 to -0.99), and who used vs did not use marijuana (OR = 1.44; 95% CI, 1.18-1.75) or amphetamines (OR = 1.82; 95% CI, 1.15-2.89) were significantly more likely to binge drink. SWDs who reported using barbiturates were less likely to binge drink than were those who did not use barbiturates (OR = -0.36; 95% CI, -0.21 to -0.61). In the final model, use of amphetamines (OR = 1.74; 95% CI, 1.15-2.65) or marijuana (OR = 1.60; 95% CI, 1.32-1.94) was the highest predictor of binge drinking.

CONCLUSION

SWDs' reported rates of binge drinking, although high, were not as high as those of nondisabled college students. Nevertheless, prevention efforts should be targeted toward college SWDs.

Cognitive control in young heavy drinkers: An ERP study

Substance use disorders have been frequently linked to an impaired cognitive control system. Whether this impaired control is also present in young adults who heavily drink alcohol is still subject to debate. The present study investigated possible impairments in cognitive control in heavy drinkers using behavioral and electrophysiological (EEG) measures. We studied behavioral performance on an inhibitory control and an error-processing task, using a GoNogo task and an Eriksen Flanker task respectively, while ERPs (Nogo-N2/P3 and ERN/Pe) were measured in a group of heavy alcohol drinkers (n=48) and a healthy control group of light drinkers (n=49). Results showed very few impairments in the heavy drinking group either at the behavioral or physiological level. One exception was the error-related Pe amplitude. This ERP component was reduced in heavy drinkers as compared to controls. Given that the Pe reflects a motivational component (i.e., the salience attributed to the making of errors) rather than a basic cognitive deficit, it can be concluded that heavy drinking in this population is not associated with major impaired cognitive control, but rather with impairments that are associated with aberrant attribution of salience to the making of errors. The present EEG findings are consistent with recent reviews and large scale epidemiological studies showing that heavy drinking, in contrast to substance use disorders, in young persons is not necessarily associated with major behavioral impairments in cognitive control.

Student Perceptions of a New Campus Alcohol Policy: Linking Deterrence and Blame Attribution

How do students make judgments about their future behaviors involving the use of alcohol? The present study advances deterrence theory by introducing elements of attribution theory while examining the perceived deterrent effects of a newly instituted dry policy on a college campus. A phone survey of 508 full-time undergraduate students between the ages of 18 and 26 was conducted 1 year following the ban on alcohol. Hypotheses are presented in two models and predict that deterrence (surveillance and enforcement) and blame explain intentions to violate the alcohol policy. These relationships are expected to be mediated by problem attribution and shame and are moderated by gender. Results show that perceived peer surveillance does reduce intentions to violate the policy in the future but formal enforcement does not. Findings further indicate that attributing blame acts to increase the likelihood of experiencing shame, therefore, reducing intentions to violate the alcohol policy. Gender conditioned the effects of surveillance and shame (stronger for females) on future policy violations. Problems that arise from drinking can be understood as another form of attribution that acts to mediate surveillance. Surveillance and blame contribute to the judgment process as students think about violating the alcohol policy, and shame emerges as the key link between deterrence and attribution.

Longitudinal influence of alcohol and marijuana use on academic performance in college students

BACKGROUND

Alcohol and marijuana are the two most abused substances in US colleges. However, research on the combined influence (cross sectional or longitudinal) of these substances on academic performance is currently scant.

METHODS

Data were derived from the longitudinal 2-year Brain and Alcohol Research in College Students (BARCS) study including 1142 freshman students who completed monthly marijuana use and alcohol consumption surveys. Subjects were classified into data-driven groups based on their alcohol and marijuana consumption. A linear mixed-model (LMM) was employed using this grouping factor to predict grade point average (GPA), adjusted for a variety of socio-demographic and clinical factors.

RESULTS

Three data-driven clusters emerged: 1) No/low users of both, 2) medium-high alcohol/no-low marijuana, and 3) medium-high users of both substances. Individual cluster derivations between consecutive semesters remained stable. No significant interaction between clusters and semester (time) was noted. Post-hoc analysis suggest that at the outset, compared to sober peers, students using moderate to high levels of alcohol and low marijuana demonstrate lower GPAs, but this difference becomes non-significant over time. In contrast, students consuming both substances at moderate-to-high levels score significantly lower at both the outset and across the 2-year investigation period. Our follow-up analysis also indicate that when students curtailed their substance use over time they had significantly higher academic GPA compared to those who remained stable in their substance use patterns over the two year period.

CONCLUSIONS

Overall, our study validates and extends the current literature by providing important implications of concurrent alcohol and marijuana use on academic achievement in college.

Sexual temptation: substance abuse, no sex, safe sex, risky sex, and STDs

Background University students' substance abuse and risky sex contribute to sexually transmitted diseases (STDs). Purpose We develop and empirically test a formative theoretical model of sexual temptation involving substance abuse (cigarettes, alcohol, and marijuana), safe sexual behavior (use of condom/barrier for oral and vaginal intercourse), risky sexual behavior (unprotected sex and multiple sexual partners), and STDs: gonorrhea, HIV, and genital herpes. We simultaneously explore these constructs, controlling membership in social groups (fraternity/sorority, varsity athlete, and club sports) and perceived norm of substance abuse. Methods A total of 687 American university students completed the National College Health Assessment (NCHA). We use structural equation modeling (SEM) to test the goodness of fit between our formative theoretical model and actual data. Results Results reveal the following discoveries: membership in campus social groups is positively associated with STDs, whereas perceived norm of peer substance abuse is negatively related to STDs. Under the influence of substance abuse, we test three outcomes of sexual temptation as related to STDs. Those who have no sex do not contract STDs. For those who fall into temptation and have sex, substance abuse is more strongly related to risky sex which leads to STDs than safe sex which does not. Those engaging in risky sex have significantly higher cognitive impairment than those practicing safe sex. Conclusions Substance abuse contributes to STDs through risky sex only. Those having risky sex suffer higher cognitive impairment than those practicing safe sex. We provide novel implications to policy makers, practitioners, and researchers.

Sexual Assault of College Women: A Feminist Interpretation of a Routine Activities Analysis

Sexual assault has been a frequent topic of research for several decades, especially for feminist researchers. Generally, feminist research suggest that there are high levels of sexual assault against women because of a patriarchal, rape-supportive culture. However, not all women have the same heightened risk for sexual assault victimization. Wh the feminist perspective does not adequately account for are the variations in rape victimization rates across the female population. This is where the importance of theory that focuses on individual statuses and lifestyles becomes important. By combining the two perspectives, explanations of sexual assault victimization can be made more vigorous and instructive. The data in this article come from 674 college and university women in 12 southern postsecondary institutions in eight states who completed an in-depth survey. Analyses focused on sexual assault in general and an more serious forms of sexual assault. Findings suggest tat the combination of feminism and routine activity theory enhances explanation of sexual assault victimization risks. Sexual assault victimization risks were influenced primarily by the amount of exposure that respondents had to potential offenders, especially to rape-supportive male per groups. Additionally, the finding between the models of differing degrees of sexual assault victimization are not particularly different.

Conditional Covariation of Binge Drinking with Predictors of College Students' Cheating

Recent research has identified a variety of significant predictors of academic dishonesty, but virtually no studies have examined the conditional relation of binge drinking and students' cheating. Using a survey sample of 289 college students, this study tested the mediating relations of binge drinking with the correlation of independent variables—including opportunity, strain, and self-control—on self-reported academic dishonesty. Low self-control had a stronger correlation with students' cheating behaviors for those who were heavy binge drinkers (β ! –.52) than for students who were nonbingers (β = –.38). Differential relations were found for other key variables, namely, opportunity and strain, at varying severities of binge drinking.

Asian American and White College Students' Heavy Episodic Drinking Behaviors and Alcohol-Related Problems

BACKGROUND

Heavy episodic drinking (HED) and alcohol-related problems appears to be a growing problem among young adult Asian Americans. One promising factor that helps explain within-group differences among Asian American includes nativity. Nativity refers to whether an individual was born in (i.e., second generation or higher) or outside (i.e., first generation) of the United States. Despite this theoretically promising variable, there has been a paucity of literature examining comparing drinking patterns between first and second generation Asians Americans and White college men.

OBJECTIVES

The current study examined the relationship between HED and alcohol-related problems among first- and second-generation Asian American, and White college male students. Interaction between race and the variables in HED and alcohol-related problems models were also investigated.

METHOD

A total of 630 men were recruited of which 489 were Asian American men (407 second generation and 82 first generation) and 148 White students attending a public university in southern California (USA) were recruited.

RESULTS

Results revealed no differences in HED rates between second-generation Asian American and White male college students; however, White students reported higher rates of HED compared to first-generation Asian Americans. No differences in alcohol-related problems were found between all three groups. There were no significant interactions between racial groups, drinking to cope, Greek/fraternity status, and descriptive norms on the alcohol outcomes. Conclusion/importance: Second-generation Asian American young adult men reported similar HED and rates of alcohol-related problems as White men. The present findings suggest that alcohol-related problems among Asian American men are a larger public health concern than previously believed.

Problem signs in law school: Fostering attorney well-being early in professional training

Attorneys suffer from high rates of stress, alcoholism, and mental health problems that are costly for the legal system and impair their abilities to serve their clients. There is some indication that these problems begin in law school. The present study assessed a cohort of law students at an American law school for their reported levels of stress, depression, anxiety, substance use, and overall adjustment/coping. Findings indicate that law students suffer from high levels of stress, anxiety, depression, and alcohol use, and that these problem behaviors fluctuate throughout the course of law school. We discuss the implications for law student/lawyer well-being and legal education.

Day-to-day variations in high-intensity drinking, expectancies, and positive and negative alcohol-related consequences

High-intensity drinking (i.e., women/men consuming 8+/10+ drinks in a day) is prevalent and associated with negative consequences. Occasions of high-intensity drinking have markedly high risk; however, previous research has not examined the predictors of these high-risk drinking days. The current study was designed to examine to what extent positive and negative alcohol expectancies predict high-intensity drinking and whether high-intensity drinking on a given day was associated with drinking consequences and their evaluations that day. Frequently drinking college students (N=342) participated in an intensive longitudinal study of drinking behaviors (N=4645 drinking days). Days with greater positive and negative expectancies were associated with high-intensity drinking. Days with high-intensity drinking were associated with reporting more positive and negative consequences and with evaluating positive consequences more favorably and evaluating negative consequences less favorably, compared to drinking days without high-intensity drinking. Given this, prevention and intervention efforts may consider specifically targeting high-intensity drinking events as a unique phenomenon.