Young adult's immediate reaction to a personal alcohol overdose

Discussion of alcohol consequences during a brief motivational intervention session: Comparing those who do and do not increase readiness to change

The present study was designed to take an inductive, qualitative approach to understanding how discussion of alcohol-related consequences during brief motivational interventions (BMI) relate to readiness to change (RTC) prior to versus at the end of a session. Participants were thirty-four adults (35% female) recruited from the emergency room and enrolled in a randomized clinical trial of a BMI for risky alcohol use and risky sex. Seventeen participants both began and remained low on RTC over the course of the session. We selected 17 additional participants, matched on demographics, but who increased RTC over the session. Transcripts were qualitatively coded and analyzed separately within groups. Among participants who increased their RTC relative to participants who remained low on RTC by BMI end, evaluation of alcohol consequences as negative was more typical. In both groups, several consequences were neutrally evaluated. Many who remained low on RTC attributed consequences to something other than alcohol and/or minimized consequence severity. Study findings highlight the value for clinicians in eliciting and maximizing the importance of subjectively negative recent consequences to perhaps increase heavy drinkers' readiness to decrease heavy alcohol use.

Predictors of motivation to change in mandated college students following a referral incident

The purpose of present study was to understand factors that are related to a desire or motivation to change (MTC) alcohol use in a sample of college students mandated to receive an alcohol intervention. We examined characteristics of and reactions to the referral event, typical alcohol use involvement, and alcohol beliefs about the perceived importance of drinking in college assessed by the College Life Alcohol Salience Scale (CLASS; Osberg et al., 2010) as predictors of MTC following referral to an alcohol intervention. College students (N = 932) who presented for a mandatory alcohol intervention following a referral event (e.g., citation for underage drinking, medical attention for an alcohol-related incident, or driving under the influence) completed an assessment prior to receiving an alcohol intervention. Higher perceived aversiveness of the referral event and higher personal responsibility one felt for the occurrence of the event were positively related to higher MTC. Although alcohol beliefs about the role of drinking in college were not significantly related to either event aversiveness or responsibility, it was negatively related to MTC even after controlling for alcohol use involvement variables. Alcohol beliefs about the role of drinking in college represent an important construct that is related to increased alcohol use and alcohol-related problems and decreased MTC in a sample of college students. Interventions aimed at reducing alcohol beliefs about the role of drinking in college may be an effective strategy to reduce alcohol use and alcohol-related problems by college students.

The way one thinks affects the way one drinks: subjective evaluations of alcohol consequences predict subsequent change in drinking behavior

Heavy alcohol use and related consequences are common during the college years and are associated with deleterious outcomes for both the students themselves and the college community. Some college students make self-initiated changes to their drinking to avoid such outcomes, but little is known about how such adjustments occur, or characteristics that are associated with making these adjustments. Based on Social Learning Theory (SLT), one cognitive factor that may predict within-person changes in drinking is the subjective evaluations of alcohol consequences (i.e., the extent to which consequences are perceived as negative, aversive, or severe). The aim of the present study was to investigate whether subjective evaluations of recently experienced consequences influence within-person changes in drinking behavior. In 10 weekly, web-based surveys, regularly drinking college students (N = 96, 50 female) reported on their previous week alcohol use and experience of 24 alcohol-related consequences, as well as their subjective evaluations of those consequences. Results demonstrated that evaluations across the consequences varied, and that in addition to differing from one another, students' evaluations of consequences differed at the within-person level over time. Most important, hierarchical linear model tests revealed that students drank less and experienced fewer consequences following weeks in which they rated their consequences as more negative (relative to their own typical subjective evaluations), suggesting that viewing one's recent consequences as aversive prompts self-initiated behavior change. Findings of the present study have potential to inform interventions for college drinking, particularly those that target how individuals think about their behavior and its consequences.

College student drinking and ambulance utilization

OBJECTIVE

Alcohol misuse by college students places resource demands on colleges and universities, including the provision of medical services for intoxicated students. We harvested archival data to document the prevalence of alcohol-related ambulance utilization and to explore factors associated with ambulance use.

METHODS

We reviewed 2 years of university ambulance records and determined which trips were alcohol related and their demographic, descriptive, and medical correlates.

RESULTS

Alcohol use was associated with 17 and 16 percent of all university-based ambulance trips in 2005 and 2006, respectively. When alcohol was involved, patients were more likely to be younger than 21 years, less alert, and more likely to receive advanced life support. Alcohol-related ambulance trips were more likely to occur on weekends, to involve transport from a residence hall, and to a hospital.

CONCLUSION

Alcohol misuse is associated with one out of every six campus-based ambulance runs, a hidden cost of student alcohol misuse.

"I'll never drink like that again": characteristics of alcohol-related incidents and predictors of motivation to change in college students

OBJECTIVE

Alcohol use and its associated behaviors are among the most common reasons for medical treatment and disciplinary infractions among college students. The purpose of this study was to describe the characteristics of students who had recent serious alcohol-related incidents and to identify predictors of motivation to change alcohol use and heavy drinking in particular, with specific attention to gender.

METHOD

Students (N = 227; 52% female) who had been mandated to attend a session of alcohol education following alcohol-related medical treatment and/or a disciplinary infraction were assessed on their alcohol use, alcohol problems, characteristics of their alcohol-related incident, reactions to the incident, attributions about the incident, and motivation to change drinking and heavy drinking. Path and regression analyses were used to identify the individual and incident-related characteristics that were related to motivation to change.

RESULTS

Perceived aversiveness of the incident was directly and positively related to motivation to change drinking and heavy drinking. Alcohol consumption in the month before the incident and past-year alcohol problems were negatively related to motivation to change heavy drinking, and women were more motivated to change heavy drinking than men. The more students consumed in the incident, the more likely they were to feel responsible for it, and the more responsible they felt about the incident, the greater its aversiveness.

CONCLUSIONS

Individual and incident-related characteristics are both directly and indirectly associated with motivation to change following an alcohol-related incident, and therefore have implications for interventions with college drinkers who have experienced an alcohol-related incident.