A quantification of the alcohol use-consequences association in college student and clinical populations: A large, multi-sample study

Pregaming potentiates risk between UPPS-P impulsivity and day-level drinking behavior: A test of person-environment transactions theory

Pregaming represents a uniquely high-risk drinking event for young adults, and subfacets of impulsivity are robust predictors of alcohol use and related negative outcomes. Further, it is likely that pregame events contain social and physical stimuli that are particularly appealing for impulsive individuals, thus exacerbating risk for negative outcomes. However, no prior studies have investigated the extent to which impulsive personality traits interact with pregame events to confer alcohol-related risk. Thus, the present study examined the extent to which UPPS-P (urgency-perseverance-premeditation-sensation seeking-positive urgency) subfacets of impulsivity interact with the occurrence of pregaming to predict relations between pregaming, drinking quantity, and negative alcohol-related outcomes. College students (N = 737) completed a modified, online version of the 30-day Timeline Followback in which they reported drinking quantity, negative consequences, and whether they engaged in pregaming on a given day. Results indicated that sensation seeking and a lack of premeditation moderated relations between pregaming and drinking quantity such that those who are higher in sensation seeking and lower in their ability to plan ahead drank more on pregaming days. Sensation seeking and positive urgency moderated relations between pregaming and negative consequences such that those who are higher in positive urgency experience more consequences on pregaming days whereas those who are higher in sensation seeking experience less consequences. Future studies may benefit from more granular assessments of pregame-related risk as subfacets of impulsivity may confer momentary risk. Prevention efforts targeting the reduction of pregaming frequency, particularly among impulsive individuals, may lower overall risk for heavy drinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Cross-Cultural Comparison of Negative Alcohol-Related Consequences in the United States and Sweden: Measurement Invariance of the Rutgers Alcohol Problem Index

Commensurate measures of alcohol-related consequences across countries and cultures are critical for addressing the global burden of hazardous alcohol use. The Rutgers Alcohol Problem Index (RAPI), developed and validated in the United States, is a popular measure of alcohol problems. This study examined measurement invariance of the RAPI across samples of U.S. and Swedish high school seniors. Latent mean differences in alcohol problems across countries and differences in associations between alcohol problems with alcohol use and protective behavioral strategies (PBS) were also examined. The RAPI was scalar invariant. Swedish students reported fewer problems than U.S. students (latent mean difference = -0.19, p = .047). In both samples, the RAPI was positively correlated with alcohol use frequency and quantity (ps < .001), and negatively correlated with PBS use (ps < .05). Overall, the RAPI demonstrated measurement invariance, and we found evidence for its validity across samples of U.S. and Swedish high school seniors.

Associations between day-level affect profiles and same-day substance use among young adults

OBJECTIVE

Emotions play a critical role in health risk behaviors, including substance use. However, current research often focuses exclusively on average levels of positive and negative affect, neglecting the complexity of daily emotional patterns. By capturing multiple dimensions of affect, including arousal and discrete states, we can improve our understanding of proximal predictors of substance use. The present study demonstrates the utility of a novel methodological approach for assessing affect patterns in daily life in relation to alcohol and cannabis use.

METHOD

Daily diary data from N = 154 young adults who reported recent heavy episodic drinking and simultaneous use of alcohol and cannabis were analyzed using a mixed-indicator latent profile analysis to identify and describe day-level affective patterns and outcomes.

RESULTS

Results revealed five distinct day-level profiles of affect: undifferentiated negative affect days, undifferentiated positive affect days, high-arousal positive affect days, mixed affect days, and low reactivity days. Undifferentiated positive affect days, high-arousal positive affect days, and low reactivity days were associated with significantly greater odds of same-day alcohol use compared to days characterized by undifferentiated negative affect (χ² = 10.55, p = .032).

CONCLUSIONS

Findings suggest that daily affect patterns differentially impact alcohol use and can inform the development of interventions for problematic substance use. Additionally, the innovative methodological approach employed herein could be applicable for investigating the role of emotion in other health behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Longitudinal examination of alcohol use motives, item-level protective behavioral strategies, and alcohol-related consequences

BACKGROUND

Alcohol misuse among college students is a public health concern. Protective behavioral strategies (PBS) can be used before, during, after, or instead of drinking to reduce alcohol use and negative consequences, but findings on their utility at the aggregate level are mixed. Although recent work has provided important information on the performance of individual PBS items, it is limited by research designs that are cross-sectional, do not examine consequences, or do not examine other important correlates, such as drinking motives. This study examines both the association between item-level PBS and alcohol-related negative consequences and the moderating effect of drinking motives longitudinally.

METHODS

College students from two universities (n = 200, 62.5% female, Mage = 20.16) completed the Drinking Motives Questionnaire-Revised, Protective Behavioral Strategies Survey, the Rutgers Alcohol Problem Index, and a measure of the quantity of alcohol use at baseline and 3-month follow-up. Generalized linear models were conducted to assess direct effects of item-level PBS on alcohol-related consequences and the moderating effects of drinking motives.

RESULTS

Two PBS items were associated with fewer alcohol-related consequences at follow-up, and two items were associated with greater alcohol-related consequences at follow-up. Drinking motives differentially moderated associations between item-level PBS and alcohol-related consequences for a proportion in the sample. Enhancement motives moderated the greatest number of associations, followed by coping, conformity, and social motives. Certain PBS (e.g., drink slowly, rather than gulp or chug) were moderated by several drinking motives, whereas other PBS items were not moderated by any motives.

CONCLUSION

Consistent with previous research, some item-level PBS were associated longitudinally with increased negative consequences, and some were associated with decreased negative consequences. Drinking motives, particularly enhancement, moderated several item-level PBS and consequence associations, suggesting that reasons for drinking may be important for understanding the associations between PBS strategies and alcohol-related consequences.

Using Latent Profile Analysis to Examine Cannabis Use Contexts: Associations with Use, Consequences, and Protective Behaviors

OBJECTIVE

College students represent a large portion of the population, and report high rates of cannabis use and related negative outcomes, including interpersonal problems, risky behaviors, or physical dependency. The contexts in which students use cannabis (e.g., at a party, when feeling down or depressed, after a fight with a loved one) likely affect their risk of experiencing consequences. We aimed to discern profiles of cannabis use contexts and compare profiles on use frequency, consequences, and the use of cannabis protective behavioral strategies (PBS).

METHOD

College students were surveyed regarding their cannabis use contexts, frequency, consequences, and PBS use (n = 265; female = 72.8%). We used Latent Profile Analysis to identify patterns of cannabis use contexts and auxiliary testing to compare profiles on use frequency, consequences, and PBS use.

RESULTS

Our examination revealed three latent profiles of cannabis use. The Social Use Profile was associated with use in predominantly social/uplifting contexts. The Physical & Emotional Pain Profile was also associated with use in these contexts but was defined by additional use in response to pain. The All Contexts Profile was associated with frequent use in all contexts, including those that were least endorsed by the other profiles. Profiles differed in cannabis use frequency, PBS use, and the number of consequences experienced, such that profiles were more likely to be associated with more frequent cannabis use, higher risk of experiencing use-consequences, and using fewer PBS as the number of use contexts increased across the profiles.

CONCLUSIONS

The contexts in which people use cannabis are associated with cannabis risk and protection. Prevention and intervention efforts may benefit from considering contexts of cannabis use.

Exploration of dietary beliefs and social cognitive factors that influence eating habits among college students attending a rural Midwestern university

Objective: College students are in a critical period of life where many lifestyle changes occur that influence health. The dietary changes that occur in college can persist throughout life and influence health and weight status. Several factors influence eating behaviors and dietary habits during college, and this study explores the dietary beliefs of college students and the factors that influence students' diets. Participants: Students (n = 49; 20% male; 76% female; 4% other) attending a rural Midwestern university. Methods: Focus groups (n = 7) were used for exploratory research. Demographic and food security data were also collected. Focus group data were analyzed using open coding methods. Themes and subthemes emerged from analysis. Results: Four major themes emerged across focus groups: 1) food and health beliefs; 2) social influence; 3) university influence; and 4) body image beliefs. Conclusions: Findings support offering nutrition education that incorporates foundational nutrition knowledge and cooking skills to all college students.

Associations Between Trait Boredom and Frequency of Cannabis, Alcohol, and Tobacco Use in College Students

Objective

Boredom is a common emotion associated with substance use in college students - a group already at risk for substance misuse. The purpose of this study is to understand how two types of trait boredom (susceptibility and proneness) in college students are associated with frequency of cannabis, alcohol, and tobacco use.

Method

Data were collected from an online survey completed by a sample of undergraduate students (N = 414, Mage = 19.55, 84.5% female; 64.3% White) enrolled at a large public university in the northwest. Multivariate logistic regression was used to evaluate the association between trait boredom and frequency of cannabis, alcohol, and tobacco use after controlling for age, sex, and race.

Results

Boredom susceptibility was a significant predictor of annual, monthly, and weekly cannabis and alcohol use, but only annual and monthly tobacco use. Boredom proneness was only a significant predictor for monthly alcohol use.

Conclusions

Findings were generally consistent across types of substances and frequency of use for boredom susceptibility, indicating students higher in susceptibility, rather than proneness, are a subgroup to target prevention interventions to alleviate boredom and subsequent maladaptive coping mechanisms.

Genetic associations between alcohol phenotypes and life satisfaction: a genomic structural equation modelling approach

Alcohol use (i.e., quantity, frequency) and alcohol use disorder (AUD) are common, associated with adverse outcomes, and genetically-influenced. Genome-wide association studies (GWAS) identified genetic loci associated with both. AUD is positively genetically associated with psychopathology, while alcohol use (e.g., drinks per week) is negatively associated or NS related to psychopathology. We wanted to test if these genetic associations extended to life satisfaction, as there is an interest in understanding the associations between psychopathology-related traits and constructs that are not just the absence of psychopathology, but positive outcomes (e.g., well-being variables). Thus, we used Genomic Structural Equation Modeling (gSEM) to analyze summary-level genomic data (i.e., effects of genetic variants on constructs of interest) from large-scale GWAS of European ancestry individuals. Results suggest that the best-fitting model is a Bifactor Model, in which unique alcohol use, unique AUD, and common alcohol factors are extracted. The genetic correlation (rg) between life satisfaction-AUD specific factor was near zero, the rg with the alcohol use specific factor was positive and significant, and the rg with the common alcohol factor was negative and significant. Findings indicate that life satisfaction shares genetic etiology with typical alcohol use and life dissatisfaction shares genetic etiology with heavy alcohol use.

A comprehensive examination of motivational profiles for alcohol-related behaviors among college students

Recent research demonstrates unique relations of types of motivation for drinking responsibly based on self-determination theory and drinking motives with alcohol-related outcomes among college students. In the present study, we sought to extend prior research by using a person-centered approach to simultaneously consider types of motivation within and across these motivational constructs as well as their synergistic relations with alcohol-related outcomes. We used cross-sectional survey data from 2,808 college students at 10 universities in eight states across the United States who reported past-month alcohol use (Mage = 20.59, SD = 4.18; 72.9% female; 58.2% non-Hispanic White). A series of latent profile analyses were conducted using types of motivation for drinking responsibly and drinking motives as indicators. A five-profile solution was selected as optimal. Mean comparisons indicated that profiles defined by high endorsement of higher quality motivations for drinking responsibly (i.e., more self-determined) and low endorsement of drinking motives in combination were related to the most frequent protective behavioral strategies use, least alcohol use, and fewest negative alcohol-related consequences. Additionally, these profiles were higher on dispositional autonomy and psychological need satisfaction and lower on psychological need frustration. These findings provide initial insight into simultaneously considering motivational profiles for the interrelated behaviors of drinking responsibly and drinking that can be leveraged in college drinking interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Associations between alcohol and cannabis use order, frequency, quantity, and consequences in a college sample of individuals who co-use alcohol and cannabis

BACKGROUND AND OBJECTIVES

Using both alcohol and cannabis (either at the same time or at different times) is common among college students, and is called "co-use." Using these substances simultaneously, such that their effects overlap, is thought to be an especially risky co-use pattern. Gaining a better understanding of how co-use patterns relate to substance use and consequences could aid prevention and intervention efforts.

METHODS

We examined college students (N = 401) who reported using both alcohol and cannabis at least once in the past 30 days. Path analysis was used to explore relations among co-use patterns (number of days in a typical week that participants used both alcohol and cannabis; the number of days using alcohol first, cannabis first, alcohol last, and cannabis last; the number of days of simultaneous use), past-30-day alcohol and cannabis consequences, use frequency, and typical quantities used.

RESULTS

Each additional day of using alcohol first was associated with fewer past-30-day cannabis consequences. Each additional day of using cannabis first was associated with fewer alcohol-related consequences. Each additional day of using alcohol and cannabis on the same day and each additional day of simultaneous use were both associated with less cannabis used and alcohol consumed in a typical week.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

This study is among the first to identify associations between alcohol and cannabis order and outcomes (i.e., consequences and consumption). Results suggest that modifying which substance is used first on a given day could be a practical intervention strategy for individuals who co-use alcohol and cannabis.

Examining Attitude, Norms, and Intentions as Predictors of Prospective Change in Alcohol-Induced Blackouts

OBJECTIVE

Alcohol-induced blackouts are a marker of risk such that they are strong independent predictors of experiencing other adverse alcohol-related social and health effects. Existing work informed by the Theory of Planned Behavior suggests that several of the constructs contained within it, such as perceived norms, personal attitudes toward consumption, and drinking intentions, are reliable predictors of alcohol use, related problems, and blackout experiences. However, research to date has not examined these theoretical antecedents as predictors of change in the occurrence of alcohol-induced blackout. The current work aimed to evaluate descriptive (the rate a behavior occurs) and injunctive (the approval of a behavior) norms, attitudes toward heavy drinking, and drinking intentions as predictors of the prospective change in experiencing a blackout.

METHOD

Using existing data from two samples (Sample 1: N = 431, 68% male; Sample 2: N = 479, 52% male), students mandated to complete an alcohol intervention completed surveys at baseline and 1- and 3-month follow-ups. Latent growth curve models evaluated perceived norms, positive attitude toward heavy drinking, and drinking intention as prospective predictors of the change in blackout over 3 months.

RESULTS

Across both samples, descriptive and injunctive norms and drinking intentions were not significantly predictive of the change in blackout. Only attitude toward heavy drinking significantly predicted prospective change (the slope factor) in blackout in both samples.

CONCLUSIONS

Given the strong association between heavy drinking attitudes and change in blackout, attitudes may represent an important and novel target for prevention and intervention efforts.

Where do heavy drinking college students experience alcohol consequences and where are they perceived to be normative?

High levels of alcohol consumption are common among college students and associated with endorsing negative alcohol-related consequences. Research suggests both drinking norms and location are strong predictors of drinking behavior in college students. Yet, normative perceptions of consequences, and whether they are location-specific, are less well-studied. We tested the hypotheses that college students who drink would have the highest levels of descriptive and injunctive norms for negative consequences, and would self-report the greatest number of negative consequences, at large gatherings/parties relative to someone's home/dorm and/or bars/clubs. Additionally, we explored whether specific acute consequences were more likely in some drinking locations versus others. Participants were 96 full-time undergraduate students who engaged in high-risk drinking. At baseline, participants reported descriptive and injunctive norms for negative consequences in three locations (home/dorm, large gathering/party, bar/club). Over a 28-day period, participants self-reported daily experiences of five alcohol-related consequences in these same locations. With repeated measures analyses of variance, we found that participants perceived their peers experienced more negative consequences and were more approving of negative consequences at large gatherings/parties and small gatherings at someone's home/dorm relative to bars/clubs. Likewise, nonparametric analyses demonstrated that the total number of consequences over the 28-day assessment period also differed by location, with participants reporting more consequences at home/dorm and large gathering/party locations than at bars/clubs. Future research is needed to better understand how the impact of norms on behavior differs across drinking location, and whether location-specific intervention content (e.g., normative correction) would be useful.

A Scoping Review of Risk and Protective Factors for Negative Cannabis Use Consequences

Objective

Numerous reviews have examined risk and protective factors for alcohol-related negative consequences, but no equivalent review of risk and protective factors exists for cannabis-related negative consequences (CRNCs)-a gap filled by the present study. This scoping review examined survey-based research of risk and protective factors for CRNCs such as neglecting responsibilities, blacking out, or needing more cannabis.

Methods

Three databases (PubMed, PsycINFO, and Google Scholar) were searched for peer-reviewed manuscripts published between January 1, 1990, and December 31, 2021. A qualitative synthesis was performed using the matrix method and the results were organized using the socioecological model as a framework.

Results

Eighty-three studies were included in the review. There was considerable variation in measures and operationalizations of CRNCs across studies. Risk factors were identified in the intrapersonal (depression, social anxiety, PTSD, impulsivity, sensation seeking, motives, expectancies), interpersonal/community (trauma, victimization, family and peer substance use, social norms), and social/policy (education, employment, community attachment, legalization, availability of substances) domains of influence. Protective behavioral strategies were a robust protective factor for CRNCs. Males consistently reported more CRNCs than females, but there were no differences observed across race.

Conclusions

Future research should identify person- and product-specific patterns of CRNCs to refine theoretical models of cannabis misuse and addiction. Public health interventions to reduce the risk of negative consequences from cannabis should consider utilizing multilevel interventions to attenuate the cumulative risk from a combination of psychological, contextual, and social influences.

A comprehensive examination of alcohol-related motivations among college students: Unique relations of drinking motives and motivations for drinking responsibly

Drinking motives, or reasons people choose to drink, are well-established risk factors for alcohol use and related negative consequences. Recent research has shown utility in a self-determination theory (SDT) approach for describing motivation for engaging in behaviors that reduce the harms associated with alcohol use (i.e., drinking responsibly). In the present study, we examined the relationship between drinking motives and motivations for drinking responsibly as well as their unique and incremental associations with alcohol-related outcomes (protective behavioral strategies [PBS], consumption, and negative consequences) in two samples of college student drinkers: (a) a random sample (n = 507) recruited from a Hispanic-Serving Institution on the U.S. border with Mexico (Mage = 22.84, SD = 5.84; 67.3% female; 90.9% Hispanic) and (b) a convenience sample (n = 2,808) from Psychology Department research participation pools at 10 universities in 8 U.S. states (Mage = 20.59, SD = 4.18; 72.9% female; 58.2% non-Hispanic White). Autonomous motivations (experience of volition and choice) for drinking responsibly were negatively correlated with drinking motives, but these correlations were small-to-medium in magnitude suggesting nonredundancy between the constructs. Drinking motives were risk factors for alcohol-related outcomes, especially alcohol-related problems, and autonomous motivations for drinking responsibly were protective factors for alcohol-related outcomes, especially PBS. Both motivational constructs predicted alcohol-related outcomes beyond the other, but drinking motives generally accounted for more variance. These findings suggest that integrating motivation in relation to both drinking and drinking responsibly may lead to a better understanding of alcohol-related behaviors and the associated negative consequences among college students. Implications for college drinking interventions are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

What Predicts Willingness to Experience Negative Consequences in College Student Drinkers?

OBJECTIVE

Research has shown that students who were more willing to experience consequences reported higher rates of alcohol consumption and negative consequences. The present study used a longitudinal design to examine intra- and interpersonal consequence-specific predictors of willingness to experience negative consequences.

METHOD

Students (N = 2,024) were assessed in the fall (Time [T] 1) and spring (T2) semesters of their first year in college. Intrapersonal constructs (i.e., expectancies, subjective evaluations, self-efficacy), interpersonal constructs (i.e., peer descriptive, injunctive norms), and personality constructs (i.e., self-regulation, impulsivity, sensation seeking) were assessed at T1 and willingness to experience negative alcohol-related consequences was assessed 6 months later. A structural path model examined the relationship between T1 predictors and T2 willingness. T1 drinking and sex were included as covariates.

RESULTS

These results demonstrated significant positive relationships between T1 participants' subjective evaluations of consequences, expectancies of experiencing consequences, and T2 willingness to experience negative consequences. Further, impulsivity, sensation seeking, and T1 drinking showed significant, positive associations with willingness, whereas higher self-regulation was significantly associated with lower willingness. Men were significantly more willing to experience negative consequences than women. No significant associations were observed between normative perceptions and willingness.

CONCLUSIONS

Intrapersonal and personality constructs, as well as previous drinking, were significantly associated with willingness to experience consequences whereas interpersonal constructs were not. Men were significantly more willing to experience negative consequences. College student interventions may benefit from focusing on significant constructs identified in the current study (e.g., enhancing self-regulation) and focusing on students with higher willingness to experience negative consequences.

Examining the impact of early college experiences on the cumulative number of alcohol-related consequences

OBJECTIVE

To estimate the total number of alcohol-related consequences students experience during 4 years of college and examine early college indicators that result in higher rates of consequences.

METHOD

Undergraduate drinkers (N = 1,744; 58% female; 87% White; 5% Hispanic) at a large northeastern university completed an online survey at the end of the fall and spring semesters during their first (T1, T2), second (T3, T4), third (T5, T6), and fourth (T7, T8) years of college (87% retention across the study). First, descriptive statistics were calculated to estimate the total number of alcohol-related consequences students experienced across all 4 years of college. Second, a structural equation model was examined to identify early college indicators that influence individuals experiencing more cumulative consequences.

RESULTS

Students experienced an average of 102 (SD = 89.91) alcohol-related consequences during 4 years of college. Next, early parental approval of consequences, but not peer drinking norms, were positively associated with students' willingness to experience consequences, which in turn, were positively associated with higher alcohol consumption and greater total consequences.

CONCLUSIONS

Results estimated that, on average, students experienced 102 alcohol-related consequences across all 4 years of college. Parental approval of consequences influenced students' total consequences through their willingness to experience consequences and drinking behaviors. Findings from the current study have several important implications for interventions.

Negative Consequences Related to Nonmedical Prescription Stimulant Use: Development and Psychometric Validation of the Prescription Stimulant Consequences Questionnaire

Nonmedical prescription stimulant use (NPS) is prevalent among undergraduates and associated with several negative consequences. However, no validated measures exist assessing NPS-related consequences. The present study aimed to develop and psychometrically validate a Prescription Stimulant Consequences Questionnaire (PSCQ) for use among college students. A multisite sample of college students endorsing NPS ( N = 715, 68.4% female) completed the PSCQ and measures of NPS frequency and correlates of NPS via an online survey. Exploratory factor analysis supported a 27-item measure, with three factors (i.e., Compulsive Behavior, Risky Behaviors, and Physical and Mental Health) and a total score. Each PSCQ factor and total score demonstrated good internal consistency, and were significantly positively associated with all NPS frequency indicators, route of administration, alcohol-related problems, sleep problems, and depressive/anxiety symptoms. Findings demonstrate support for the psychometric validity and reliability of the newly developed PSCQ, which may demonstrate potential as a screening and outcome measure for intervention.

When are alcohol-related blackout Tweets written in the United States?

BACKGROUND

Alcohol use varies throughout the year and often peaks on weekends or during celebrations (e.g., New Year's). There is not a perfect correlation between alcohol use and negative consequences, and the extent to which one particularly risky consequence-an alcohol-related blackout-is more common during certain times of the year is unknown. Identifying when blackouts occur may help identify which periods are associated with more risk and be critical in designing public health campaigns. Thus, we examined Twitter data to ascertain whether alcohol-related blackouts occur more during certain holidays/celebrations than typical weekends and whether they differed in timing from general alcohol-related Tweets.

METHODS

We used a Twitter-sponsored platform to access unique Tweets written in the United States referencing blackouts (e.g., "blackout") and alcohol generally (e.g., "drunk").

RESULTS

The final dataset included 3.5 million blackout Tweets and 591 million alcohol Tweets (written between 2009 and 2020). Both blackout and alcohol Tweets were written in the late evening, on weekends, and during certain holidays (New Years, St. Patrick's). However, relative to typical weekends, only blackout Tweets were more common during Thanksgiving and only general alcohol-related Tweets were more common during Cinco de Mayo.

CONCLUSION

While blackout and alcohol-related Tweets were similar in time of day (peaking in the evening) and day of week (peaking on weekends), they differed during certain celebrations/holidays, suggesting that while alcohol use may be more common during some celebrations, others are more associated with serious harms.

Emotion-based decision-making as a predictor of alcohol-related consequences in college students

Student drinking during the college years can result in many adverse outcomes. Emotion-based decision-making (EBDM), or the use of emotional information to influence future plans and behavior, may lead to increased harmful consequences of alcohol. The current study examined both the number of types and total frequency of alcohol consequences as a function of EBDM. Undergraduate students from three large universities (n = 814) were assessed on EBDM and typical weekly drinking during their 2nd year of college, and alcohol-related consequences during their 2nd, 3rd, and 4th years. Alcohol-related consequences were operationalized both as unique types of consequences and total consequences experienced in the previous year. Latent growth modeling used EBDM in year 2 to predict unique and total alcohol consequences in years 2, 3, and 4. Students who endorsed higher levels of EBDM experienced a significantly increased total frequency of consequences over the three years, without differences in trajectory between students high and low on this construct. Participants with higher levels of EBDM experienced a significantly greater number of unique consequences at all time points, but these consequences increased at a significantly lower rate than individuals lower on this construct. Findings of this study indicate Emotion-Based Decision-Making may be a useful predictor of harmful consequences of student drinking over time.

The Association between Distress Tolerance and Alcohol Outcomes via Internal Drinking Motives

Previous work suggests that college students who perceive themselves as less able to tolerate negative affect are more motivated to use alcohol to alleviate psychological distress. Recent findings also indicate that distress tolerance influences alcohol outcomes via a positive reinforcement pathway. However, results concerning the association between distress tolerance and alcohol outcomes remain inconsistent. Aim: The present study examined the association between distinctive features of distress tolerance and alcohol outcomes via internal drinking motives (i.e., coping and enhancement) in Argentinean college students. Method: From April to November 2019, a sample of 387 college students with last-month alcohol use (Mean age = 21.09 ± 4.98) completed an online survey assessing alcohol outcomes (past-month frequency of binge drinking and negative alcohol-related consequences), internal drinking motives, and four components of distress tolerance (i.e., tolerance, appraisal, absorption, and regulation). Results: The associations between specific facets of distress tolerance and drinking outcomes were atemporally mediated by coping and enhancement motives. Coping motives significantly mediated the effect of absorption and appraisal on alcohol-related problems (i.e., lower absorption and lower appraisal were associated with more problems via higher coping motives). Enhancement motives significantly mediated the effect of absorption (lower absorption was associated with greater enhancement motives) on binge drinking frequency and alcohol-related problems. Conclusions: Distress tolerance was associated with alcohol outcomes via coping and enhancement motives in this sample of Argentinean undergraduates. The ability to withstand negative affect could be a focal point of interventions to prevent the development of maladaptive patterns of drinking.

An application of moderated nonlinear factor analysis to develop a commensurate measure of alcohol problems across four alcohol treatment studies

BACKGROUND

Self-report measures of alcohol problems are commonly included in studies evaluating treatment and recovery from alcohol use disorder (AUD), but no prior study has examined the replicability of the measurement of alcohol problems across studies with various measures and diverse samples. Further, it is unclear which items may be better indicators of alcohol problems for patient subgroups. In the present study, we integrated data from four large alcohol treatment studies to develop a commensurate measure of alcohol problems using moderated nonlinear factor analysis (MNLFA).

METHODS

Data were from the COMBINE study, Project MATCH, the Relapse Replication and Extension Project (RREP), and the United Kingdom Alcohol Treatment Trial (UKATT), yielding a total sample size of 4414. MNLFA was carried out on the Drinker Inventory of Consequences (COMBINE, MATCH, RREP) and Alcohol Problems Questionnaire (UKATT).

RESULTS

We successfully created a 78-item commensurate measure of alcohol problems and examined differential item functioning (DIF) by study membership, time, and socio-demographic characteristics. Sixty-two items demonstrated intercept DIF, suggesting differences in rates of item endorsement for clients with the same underlying levels of alcohol problems across patient subgroups. Six items demonstrated loading DIF, suggesting differences in the extent to which the items were indicative of alcohol problems across patient subgroups.

CONCLUSIONS

The self-reported measurement of alcohol problems replicates across measures and diverse samples. Items with DIF have clinical implications for the treatment of AUD. Finally, MNLFA scores can be used to test substantive research questions across these studies.

Reconsidering alcohol treatment non-responders: psychosocial functioning among heavy drinkers 3 years following treatment

BACKGROUND AND AIMS

Psychosocial functioning among individuals who exceed low-risk drinking limits (exceed three to four standard drinks for women/men) is heterogeneous. Among those who receive treatment for alcohol use disorder (AUD), recent research found that more than one-half of those who exceeded low-risk limits (i.e. treatment non-responders) reported good psychosocial functioning, commensurate with those who were abstinent or low-risk drinkers (i.e. treatment responders) up to 1 year following treatment. This study aimed to determine if good levels of psychosocial functioning are maintained beyond 1 year.

DESIGN

Secondary analysis of 3-year follow-up data from Project MATCH (Matching Alcoholism Treatment to Client Heterogeneity) and the Combined Pharmacotherapies and Behavioral Interventions study (COMBINE), multi-site alcohol clinical trials conducted in the United States.

SETTING

Eleven sites in COMBINE and nine sites in Project MATCH.

PARTICIPANTS

Individuals with AUD from COMBINE and Project MATCH (n = 1383 and n = 1726) characterized in terms of drinking/functioning at 1-year follow-up and retained at 3-year (n = 641 and n = 790) post-treatment follow-ups.

MEASUREMENTS

Alcohol consumption measured by Form-90 and psychosocial functioning assessed by various instruments at 3 years post-treatment FINDINGS: High-functioning non-responders at 1 year post-treatment maintained a high level of functioning 2 years later and were not significantly different from the abstainers/low-risk drinkers on any functional outcomes (e.g. SF12 Mental Health Mean difference: -1.38 [95% confidence interval (CI) = -4.34, 1.57), SF12 Physical Health Mean difference: -0.43 (95% CI = -2.28, 3.13)].

CONCLUSIONS

Approximately one-half of those who engage in some heavy drinking in the year following treatment for alcohol use disorder appear to maintain high levels of psychosocial functioning up to 3 years following treatment.

I am what I am: A meta-analysis of the association between substance user identities and substance use-related outcomes

OBJECTIVE

Research indicates that a substance user identity (i.e., drinking, smoking, and marijuana identity) is positively correlated with substance use-related outcomes (e.g., frequency, quantity, consequences, and disorder symptoms). The current study aimed to meta-analytically derive single, weighted effect size estimates of the identity-outcome association as well as to examine moderators (e.g., substance use type, explicit/implicit assessment, demographic characteristics, and research design) of this association.

METHOD

Random effects meta-analysis was conducted on 70 unique samples that assessed substance user identity and at least one substance use-related outcome (frequency, quantity, consequences, and/or disorder symptoms), and provided the necessary information for effect size calculations.

RESULTS

Substance user identity was found to be a statistically significant moderate-to-large correlate of all substance use-related outcomes examined in the current study (r _w = .365, p < .001, r_w² = .133). The strongest associations were observed between identity and disorder symptoms (alcohol) and frequency of substance use (tobacco or marijuana). In terms of moderators of the identity-outcome association, the link between explicit drinking identity and alcohol use-related outcomes appeared to be stronger in magnitude than the relationship between implicit drinking identity and alcohol use-related outcomes; however, this difference appears to be largely due to the finding that implicit measures have lower reliability. The strongest identity-outcome association was observed among younger individuals.

CONCLUSIONS

Substance user identity is clearly an important correlate of substance use-related outcomes and this association is stronger among younger individuals. Additional theoretical, empirical, and intervention research is needed to utilize knowledge gleaned from the current study on the identity-outcome association. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Insomnia treatment effects among young adult drinkers: Secondary outcomes of a randomized pilot trial

BACKGROUND

Cognitive behavioral therapy for insomnia (CBT-I) has moderate-to-large effects on insomnia among young adult drinkers, with preliminary data indicating that improvements in insomnia may have downstream effects on alcohol-related consequences. However, the mechanism(s) by which insomnia treatment may facilitate reductions in alcohol-related problems is unclear. Secondary outcome data from a randomized pilot trial were used to examine CBT-I effects on four proposed mediators of the insomnia/alcohol link: alcohol craving, delay discounting, negative affect, and difficulties with emotion regulation.

METHODS

Young adults (ages 18 to 30 years) with insomnia who reported 1+ binge drinking episode (4/5+ drinks for women/men) in the past month were randomized to receive CBT-I (n = 28) or to a sleep hygiene control (n = 28). Outcomes were assessed at baseline, after 5 weeks of treatment, and at 1-month posttreatment.

RESULTS

Relative to those in sleep hygiene, CBT-I participants reported greater decreases in alcohol craving (d = 0.33) at the end of treatment and greater 1-month posttreatment decreases in delay discounting of large rewards (d = 0.42). CBT-I did not have a significant effect on delay discounting of smaller rewards or momentary negative affect. There was also no significant treatment effect on difficulties with emotion regulation, although findings were confounded by a significant group difference at baseline in difficulties with emotion regulation.

CONCLUSIONS

Treatment of insomnia may lead to improvements in alcohol craving and delay discounting of large rewards among young adult drinkers with insomnia. Additional research examining whether improvement in insomnia is a mechanism for improvement in addiction domains is warranted.

Anxiety Symptoms and Alcohol-Related Problems among College Students: A Moderated-Mediation Model of Rumination and Emotion Dysregulation

Prior research has individually linked rumination, anxiety, and emotion dysregulation to alcohol misuse, but limited research has examined a comprehensive model linking these variables together. The present study tested a moderated-mediation model to examine whether emotion dysregulation moderated the indirect association of anxiety symptoms on alcohol-related problems via ruminative thinking styles. Method: Participants were 448 college students who consumed alcohol in the previous month. A plurality of participants identified as being White, non-Hispanic (40.6%), female (68.6%), and reported a mean age of 22.75 (Median = 20.00; SD = 6.84) years. Results: Brooding and reflection subtypes of ruminative thinking mediated the association between anxiety symptoms and alcohol-related problems with higher rates of anxiety symptoms associated with higher ruminative thinking, which in turn was associated with more alcohol-related problems. Further, the indirect effect of anxiety symptoms on alcohol-related problems through ruminative thinking was stronger for individuals who reported high levels of emotion dysregulation compared to those with average and low levels of emotion dysregulation. Conclusions: In support of prior work, our results suggest that ruminative thinking, particularly brooding and reflection, are key mechanisms through which anxiety symptoms relate to problematic alcohol use, especially among individuals with high emotion dysregulation. Additional work is needed to test whether decoupling the associations between negative emotional states and ruminative thinking among college students with high emotion dysregulation is a viable intervention target to reduce problematic alcohol use.

Trajectories of College Alcohol Involvement and Their Associations with Later Alcohol Use Disorder Symptoms

Little is known about what differentiates individuals whose drinking patterns escalate into problematic use following the transition out of college compared to those who learn to drink in a way that is consistent with independent adult roles. Patterns of alcohol use and problems during college may pre-sage progression toward problem drinking in adulthood. The present study sought to examine such patterns in an effort to delineate those at greatest risk. Research has not yet elucidated whether, when, and how these groups diverge. Our results indicate that students who report AUD symptoms one year following graduation reported greater alcohol involvement from the first semester and escalated their involvement with alcohol at a more rapid pace. We observed marked and measurable differences in drinking patterns between those who go on to exhibit AUD symptoms following college and those who do not. A close inspection of these differences reveals that relatively small absolute differences in alcohol consumption add up to large differences in alcohol-related consequences. Thus, markers of longer-term risk are present early in college, and greater escalation of drinking across college is an indicator that intervention is needed. Brief Motivational Interventions could help students to anticipate some of the challenges ahead as they transition from the college environment, as well as the potential deleterious effects of immoderate alcohol use on making a successful transition into adult roles. In addition to the beginning of college, our findings also point to critical periods during which screening and brief intervention may be optimally timed.

Drinking contexts and their association with acute alcohol-related harm: A systematic review of event-level studies on adults' drinking occasions

ISSUES

Event-level alcohol research can inform prevention efforts by determining whether drinking contexts-such as people or places-are associated with harmful outcomes. This review synthesises evidence on associations between characteristics of adults' drinking occasions and acute alcohol-related harm.

APPROACH

We systematically searched Ovid MEDLINE, Ovid PsycInfo and the Web of Science Social Sciences Citation Index. Eligible papers used quantitative designs and event-level data collection methods. They linked one or more drinking contexts to acute alcohol-related harm. Following extraction of study characteristics, methods and findings, we assessed study quality and narratively synthesised the findings.

PROSPERO ID

CRD42018119701.

KEY FINDINGS

Searches identified 95 eligible papers, 65 (68%) of which study young adults and 62 (65%) of which are set in the United States, which limits generalisability to other populations. These papers studied a range of harms from assault to drink driving. Study quality is good overall although measures often lack validation. We found substantial evidence for direct effects of drinking context on harms. All of the contextual characteristics types studied (e.g. people, place, timing, psychological states, drink type) were consistently associated with harms. Certain contexts were frequently studied and associated with harms, in particular, weekend drinking, drinking in licensed premises and concurrent illicit drug use.

IMPLICATIONS

The findings of our review indicate target drinking contexts for prevention efforts that are consistently associated with increased acute alcohol-related harm.

CONCLUSION

A large range of contextual characteristics of drinking occasions are directly associated with acute alcohol-related harm, over and above levels of consumption.

Contextual characteristics of adults' drinking occasions and their association with levels of alcohol consumption and acute alcohol-related harm: a mapping review

BACKGROUND AND AIMS

There is a growing literature using event-level methods to estimate associations between contextual characteristics of drinking occasions, consumption levels and acute harms. This literature spans many research traditions and has not been brought together as a whole. This mapping review aimed to identify and describe the theoretical approaches to conceptualizing drinking occasions, study designs, predictors and outcome measures used in existing research with a view to identifying dominant approaches, research gaps and areas for further synthesis.

METHODS

Eligible papers studied adults' drinking occasions using quantitative event-level methods and considered one or more contextual characteristics (e.g. venue, timing or company) and at least one event-level consumption or acute alcohol-related harm outcome. We systematically searched Ovid MEDLINE, PsycInfo and the Web of Science Social Sciences Citation Index, extracting data on studies' theoretical approach, data collection methods, settings, populations, drinking occasion characteristics and outcome measures.

RESULTS

Searches identified 278 eligible papers (from 1975 to 2019), predominantly published after 2010 (n = 181; 65.1%). Most papers reported research conducted in the United States (n = 170; 61.2%) and half used student participants (n = 133; 47.8%). Papers typically lacked a stated theoretical approach (n = 203; 73.0%). Consistent with this, only 53 (19.1%) papers studied three or more occasion characteristics and most used methods that assume occasion characteristics do not change during an occasion (n = 189; 68.0%). The most common outcome type considered was consumption (n = 224; 80.6%) and only a few papers studied specific acute harm outcomes such as unprotected sex (n = 24; 8.6%), drink driving (n = 14; 5.0%) or sexual violence (n = 9; 3.2%).

CONCLUSIONS

Studies from 1975 to 2019 using event-level methods to estimate associations between contextual characteristics of drinking occasions, consumption levels and acute harms were largely focused on students and consumption outcomes, and most have considered a limited range of contextual characteristics.

Dysregulation as a correlate of cannabis use and problem use

OBJECTIVE

Cannabis users with a dysregulatory risk factor may be particularly vulnerable to engaging in more frequent and problematic cannabis use. Contemporary models of dysregulated behavior suggest that dysregulation emerges due to distinct mechanisms. The current study seeks to examine the dysregulatory correlates of cannabis involvement, including working memory capacity, delay discounting, impulsivity, and reward sensitivity.

METHOD

Participants were 104 non-treatment seeking frequent cannabis users (the average participant used cannabis 71% of the days/past 60 days [SD = 22%], with an average of two uses per day [SD = 1.2]). Mean age was 21.3 (SD = 4.3); 36.5% were female. Working memory was assessed via the Trail-Making Test-B and the Digit Span subtests of the WAIS-III, delay discounting was assessed via a computer-based task, trait impulsivity was self-reported via the Barratt Impulsiveness Scale, and reward sensitivity was self-reported via the Reward Dependence Scale and the Snaith-Hamilton Pleasure Scale.

RESULTS

Structural equation modeling estimated the associations between different facets of dysregulation and cannabis involvement. Results suggest that poor working memory capacity and high trait impulsivity were associated with both use and problem use. Greater delay discounting was associated with problem use, but not with frequency of use. Low reward sensitivity was associated with more frequent cannabis use, but not with problem use.

CONCLUSIONS

Results confirm that the dysregulatory correlates of cannabis involvement consist of multiple dimensions of functioning. Prospective studies that assess the multidimensional structure of dysregulation and cannabis involvement are needed in order to disaggregate the dysregulatory antecedents and consequences of cannabis involvement.

Grandiose and vulnerable narcissism: Associations with alcohol use, alcohol problems and problem recognition

OBJECTIVE

This study fills a gap in the literature by examining the relationship between two types of narcissism, vulnerable and grandiose, and five alcohol-related outcomes (ie, alcohol use, alcohol problems, evaluation and expectancies of problems, and readiness to change).

PARTICIPANTS

345 college students (28% men, 72% women) from a Midwestern university were recruited from undergraduate psychology courses from April 2015 to October 2016.

METHODS

Participants completed an online survey with questionnaires measuring the variables of interest. Multiple regression analyses were used to test the hypotheses.

RESULTS

Grandiose narcissism was a positive predictor of alcohol consumption and a positive (ie, good) evaluation of alcohol-related problems. Vulnerable narcissism was a positive predictor of alcohol-related problems, problem recognition (ie, readiness to change), and problem expectancies.

CONCLUSIONS

The results speak to the effects that different types of narcissism have on alcohol use, alcohol problems and attitudes towards alcohol problems among young adults.

A meta-analytic investigation of the associations between cannabis use and cannabis-related negative consequences

In the current climate of policy change regarding cannabis (i.e., decriminalization, medicalization, and legalization), various stakeholders have a strong interest in determining the associations between cannabis use and important outcomes. The present study sought to quantify the association between indicators of cannabis use and the experience of cannabis-related negative consequences. We found 19 unique studies that examined the associations between cannabis use and negative consequences as measured by 1 of 4 measures: the Marijuana Problems Scale, the Rutgers Marijuana Problem Index, the Cannabis Problems Questionnaire, or the Marijuana Consequences Questionnaire. We used random effects meta-analytic techniques to estimate the average strength of association between cannabis use and negative consequences, determine the level of heterogeneity in effect sizes, and examine possible moderators of these associations (measure of consequences, gender/sex distribution). We found that cannabis use had a medium-sized association with consequences, rw = .367, with high levels of heterogeneity that depended to some extent on the specific consequence measure used. Similar to a meta-analytic integration of the alcohol use-consequences association, we found that most of the variance in cannabis-related negative consequences was not explained by any single indicator of cannabis use, pointing to the fact that additional factors need to be examined to explain the experience of negative consequences from cannabis use and that additional indicators of cannabis use may be needed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Relationship Between Social Anxiety and Alcohol and Marijuana Use Outcomes Among Concurrent Users: A Motivational Model of Substance Use

BACKGROUND

College students with more social anxiety symptoms are particularly vulnerable to problematic alcohol and marijuana use given their susceptibility for elevated anxiety symptoms in social settings combined with the normative nature of substance use. Existing research has established substance use as coping motivated for these students when examining alcohol and marijuana use problems separately. The next step is to determine whether students with more social anxiety who use both substances do so for similar or different reasons. The current study tested a comprehensive (i.e., all variables in the same model) motivational model of alcohol/marijuana use in a sample of college students from 10 universities across the United States who endorsed both past-month alcohol and marijuana use.

METHODS

College students were recruited through psychology department participant pools and completed an online survey assessing mental health symptoms, substance use motives, and substances use behaviors. Current sample comprised concurrent alcohol/marijuana users (n = 2,034), 29.6% of whom endorsed clinically indicated levels of social anxiety and nearly one-fourth exceeded the cutoff for hazardous drinking (23.2%) and hazardous marijuana use (21.9%).

RESULTS

Across both substances, coping motives significantly mediated the positive relationship between social anxiety symptoms and substance use problems. Unique to alcohol, conformity motives mediated the association between social anxiety symptoms and alcohol-related problems.

CONCLUSIONS

Taken together, students with more social anxiety who are focused on anxiety management may use either alcohol or marijuana; however, these students may experience more alcohol-related problems when drinking to fit in with peers.

Predictors of Adverse Alcohol Use Consequences Among Tertiary Students

BACKGROUND

The alcohol consumption patterns of young adults are of concern. Critically, tertiary students consume greater quantities of alcohol, are at increased risk of injury/harm, and have higher rates of alcohol use disorders as compared to their nonuniversity enrolled peers. The Brief Young Adult Alcohol Consequences Questionnaire (BYAACQ) is one of several tools utilized to explore adverse alcohol-related outcomes among tertiary students. Alcohol intake behavior, assessed via retrospective summary measures, has been linked to BYAACQ score. It is unclear, however, how drinking assessed in real time, in conjunction with variables such as age of drinking onset, might predict severity of adverse alcohol consequences as captured by the BYAACQ.

METHODS

The psychometric properties of the BYAACQ were explored using a large Australian sample of tertiary students (N = 893). A subsample (n = 504) provided alcohol intake information in real time (21 days; event and notification contingent) via a smartphone app (CNLab-A) plus details related to age of drinking onset, drug use, parental alcohol/drug use, and anxiety/depression symptomology.

RESULTS

Average BYAACQ score was 7.53 (SD = 5.37). Classical and item response theory analyses revealed inconsistencies related to dimensionality, progressive item severity, and male/female differential item functioning. Current drinking-namely, frequency of intake and quantity per drinking occasion-plus age of drinking onset predicted BYAACQ score after controlling for age, other drug use, and depression symptomology.

CONCLUSIONS

The BYAACQ is a sound tool for use with Australian samples. Information related to current drinking, age of drinking onset, and drug use is useful for predicting severity of alcohol use consequences. These markers might enable tertiary institutions to better target students who could benefit from prevention/intervention programs.

Cross-cultural examination of negative alcohol-related consequences: Measurement invariance of the Young Adult Alcohol Consequences Questionnaire in Spain, Argentina, and USA

The present study examined measurement invariance of the 48-item, 8-factor, Young Adult Alcohol Consequences Questionnaire (YAACQ) across nationality in college students from the United States, Spain, and Argentina. We also compared latent mean differences and criterion-related validity (i.e., correlation with other alcohol-related outcomes) across countries. Last month drinkers (1,511) from the United States (n = 774, 70.5% female), Argentina (n = 439, 50.6% female), and Spain (n = 298, 72.1% female) completed an online survey measuring alcohol use, drinking motives, college alcohol beliefs, and negative alcohol-related consequences. Multigroup confirmatory factor analyses supported configural and scalar invariance of a 47-item, 8-factor YAACQ across countries. Overall, the correlation analysis supported criterion-related validity (i.e., strong bivariate correlations between the 8 subscales and alcohol consumption, drinking motives and college alcohol beliefs) across countries. Some nonsignificant bivariate correlations and differences in the magnitude of the correlations across countries are discussed. Our findings expand previous work, mostly focused on U.S. samples, by supporting the YAACQ as an adequate measure to assess alcohol-related consequences in youths across countries marked by unique cultural traditions, attitudes, and policies pertaining to alcohol. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Posttraumatic stress disorder symptoms and problematic alcohol use in college students: The moderating role of alcohol protective behavioral strategies and gender

OBJECTIVE

The present study evaluated the moderating role of alcohol protective behavioral strategy subtypes (alcohol PBS; serious harm reduction, manner of drinking, limiting/stopping drinking) and gender on the relationship between posttraumatic stress disorder (PTSD) symptoms and alcohol-related negative consequences.

METHOD

Participants were 2,138 traditional college students (i.e., age between 18 and 25 years old) recruited from 10 universities in the United States who reported drinking in the past month. All participants reported their gender and completed measures of PTSD symptoms, alcohol PBS use, alcohol consumption, and alcohol-related negative consequences through an online survey.

RESULTS

Experiencing greater PTSD symptoms was associated with increased alcohol-related negative consequences and all alcohol PBS subtypes were independently associated with fewer alcohol-related negative consequences. Gender had a moderating effect such that the relationship between manner of drinking and alcohol-related negative consequences was weaker among men. Further, we found significant three-way interactions such that the associations between PTSD symptoms and alcohol-related negative consequences were weaker at higher levels of serious harm reduction and limiting/stopping drinking, but only among women.

CONCLUSIONS

Although alcohol PBS appear beneficial for all college student drinkers, these findings highlight the additional protective value of certain alcohol PBS for college women experiencing PTSD symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A Combination of Impulsivity Subdomains Predict Alcohol Intoxication Frequency

BACKGROUND

Impulsivity, broadly characterized as the tendency to act prematurely without foresight, is linked to alcohol misuse in college students. However, impulsivity is a multidimensional construct and different subdomains likely underlie different patterns of alcohol misuse. Here, we quantified the association between alcohol intoxication frequency and alcohol consumption frequency and choice, action, cognitive, and trait domains of impulsivity.

METHODS

University student drinkers (n = 106) completed a battery of demographic and alcohol-related items, as well as self-report and task-based measures indexing different facets of impulsivity. Two orthogonal latent factors, intoxication frequency and alcohol consumption frequency, were generated. Their validity was demonstrated with respect to adverse consequences of alcohol use. Machine learning with penalized regression and feature selection was then utilized to predict intoxication and alcohol consumption frequency using all impulsivity subdomains. Out-of-sample validation was used to quantify model performance.

RESULTS

Impulsivity measures alone were significant predictors of intoxication frequency, but not consumption frequency. Propensity for increased intoxication frequency was characterized by increased trait impulsivity, including the Disinhibition subscale of the Sensation Seeking Scale, Attentional and Non-planning subscales of the Barratt Impulsiveness Scale, increased task-based cognitive impulsivity (response time variability), and increased choice impulsivity (steeper delay discounting on a delay discounting questionnaire). A model combining impulsivity domains with other risk factors (gender; nicotine, cannabis, and other drug use; executive functioning; and learning processes) was also significant but did not outperform the model comprising of impulsivity alone.

CONCLUSIONS

Intoxication frequency, but not consumption frequency, was characterized by a number of impulsivity subdomains.