Showing papers in "Journal of Studies on Alcohol and Drugs in 2005"

Misperceiving the college drinking norm and related problems: a nationwide study of exposure to prevention information, perceived norms and student alcohol misuse.

Abstract: Objective: This study examined (1) the prevalence of misperceptions of college student drinking norms across campuses nationwide, (2) the importance of perceived norms in predicting high-risk drinking, (3) the association of exposure to alcohol education information with students' perceptions of campus drinking norms and (4) the differences in high-risk drinking rates between schools where exposure to alcohol information is associated with more accurately perceived norms and schools where exposure to information is unrelated to perceptions or is associated with greater misperceptions. Method: Multivariate analyses were used to analyze an aggregate database of the National College Health Assessment survey administered to 76,145 students from 130 colleges and universities nationwide from spring 2000 through spring 2003. Results: Regardless of the actual campus drinking norm, a consistently large percentage of students nationwide overestimated the quantity of alcohol consumed by their peers. Students' percep...

Development of the Protective Behavioral Strategies Survey.

Abstract: Objective: Heavy alcohol use among college students represents a public health problem on American college campuses. A promising area for combating this problem is identifying protective behavioral strategies that may reduce consumption and its resulting negative consequences among students who do choose to use alcohol. The purpose of this study was to develop and conduct initial psychometric analyses on a new scale, which we named the Protective Behavioral Strategies Survey. Method: Data were collected on 437 undergraduate students, who volunteered to participate in the study, at a large, public university in the northeast region of the United States. Results: Results from an exploratory factor analysis yielded three theoretically meaningful factors that we labeled Limiting/Stopping Drinking, Manner of Drinking and Serious Harm Reduction. The three factors were, as a group, significantly associated with both alcohol consumption and alcohol-related problems, but the strongest unique relationship existed b...

Reports of alcohol consumption and alcohol-related problems among homosexual, bisexual and heterosexual respondents: results from the 2000 National Alcohol Survey.

Abstract: Objective: Few population-based studies have explored differences in alcohol consumption by sexual orientation. This study examined the prevalence of abstinence, drinking, heavier drinking, alcohol-related problems, alcohol dependence and help-seeking among homosexual and bisexual women and men compared with heterosexuals. Method: Data are from the 2000 National Alcohol Survey, a national population-based survey of adults (N = 7,612), a Random Digit Dialing telephone survey of all 50 states of the United States and Washington, DC. Four categories of sexual orientation were created using questions on both sexual orientation self-identification and behavior: homosexual identified, bisexual identified, heterosexual identified with same sex partners and exclusively heterosexual. Five alcohol measures (past year) were used in the analyses: (1) mean number of drinks, (2) days consuming five or more drinks on a single occasion, (3) drunkenness, (4) negative social consequences (2 or more) and (5) Diagnostic and ...

Fetal alcohol syndrome epidemiology in a South African community: a second study of a very high prevalence area

Abstract: Objective: The aim of the study was to determine the prevalence and characteristics of fetal alcohol syndrome (FAS) in a second primary school cohort in a community in South Africa. Method: Active case ascertainment, two-tier screening, and Institute of Medicine assessment methodology were employed among 857 first grade pupils, most born in 1993. Characteristics of children with FAS were contrasted with characteristics of a randomly selected control group from the same classrooms. Physical growth and development, dysmorphology and psychological characteristics of the children and measures of maternal alcohol use and smoking were analyzed. Results: The rate of FAS found in this study is the highest yet reported in any overall community in the world, 65.2-74.2 per 1,000 children in the first grade population. These rates are 33-148 times greater than U.S. estimates and higher than in a previous cohort study in this same community (40.5-46.4 per 1,000). Detailed documentation of physical features indicates t...

Quality of life as an outcome measure in alcoholism treatment research.

Abstract: Objective: The present article reviews the literature to date dealing with quality of life (QoL) as it relates to drinking behavior, alcohol use disorders and treatment outcome. Methods: Articles using the term "quality of life" to describe a status or outcome construct for individuals diagnosed with or being treated for alcohol use disorders or that used one or more instruments considered to reflect patients' QoL were identified primarily through Psychological Abstracts, MEDLINE and the National Institute on Alcohol Abuse and Alcoholism's ETOH archival database. Results: Thirty-six studies, published between 1993 and 2004, met these criteria. Twelve different QoL measures were used. Frequent heavy drinking or episodic heavy drinking (e.g., five or more drinks per occasion) patterns were associated with reduced QoL. Alcoholics had lower levels of QoL compared with general population norms or with other chronic health conditions. This relationship appears to be moderated by a number of sociodemographic and...

Alcohol use in South Africa: Findings from the first Demographic and Health Survey (1998)

Abstract: Objective This study formed part of the 1998 South African Demographic and Health Survey, which included questions assessing the extent of alcohol use, risky drinking and alcohol problems among South Africans to obtain up-to-date baseline estimates of consumption and risky drinking and to inform intervention efforts. Method A two-stage random sample of 13,826 persons ages 15 or older (59% women) was included in the survey. Alcohol use was assessed through eight questions, including the CAGE questionnaire. Frequency analyses for different age groups, geographic setting, education level, population group and gender were calculated, as were odds ratios for these variables in relation to symptoms of alcohol problems. Results Current alcohol consumption was reported by 45% of the men and 17% of the women. White men (71%) were most likely and Asian women (9%) least likely to be current drinkers. Urban residents were more likely than nonurban dwellers to report current drinking. One third of the current drinkers reported risky drinking over weekends, and 28% of the men and 10% of the women scored above the cutoff level on the CAGE questionnaire. Symptoms of alcohol problems were significantly associated with lower socioeconomic status, no school education in women and being older than 25 years of age. Conclusions A comprehensive strategy is required to address the high levels of risky drinking and reported symptoms of alcohol problems.

Trauma exposure, posttraumatic stress disorder and problem drinking in sexual assault survivors.

Abstract: Objective: Sexual assault history is associated with higher risk of problem drinking in women, yet little is known about mechanisms linking trauma histories to women's problem drinking. This study examined how trauma histories, alcohol-related cognitive mediators and posttraumatic stress disorder (PTSD) relate to past-year problem drinking in adult female sexual assault survivors. Method: Data from self-report questionnaires completed by a large, diverse sample (N = 865) of community-residing women who had experienced adult sexual assault were analyzed. Structural equation modeling was used to test a theoretical model examining the relationship between trauma exposure, alcohol-related cognitive mediators, PTSD symptoms and past-year problem drinking. Results: These analyses suggested that trauma exposure, drinking to cope with distress and tension-reduction expectancies are the most consistent factors associated with problem drinking, whereas PTSD symptoms are not. Drinking to cope and tension-reduction e...

Adolescent-to-young adulthood heavy drinking trajectories and their prospective predictors

Abstract: Objective: The purpose of this study was to investigate longitudinal trajectories of heavy drinking for males and females from adolescence to young adulthood, across the age span of 16-25 years, and to identify prospective predictors of the trajectory groups identified Method: This study used semiparametric group-based mixture modeling to derive adolescent to young adult longitudinal trajectories of heavy drinking separately for 760 participants (430 females and 330 males) who have been participating in a long-term prospective study of risk factors for the development of heavy drinking and alcohol disorders Results: Four trajectory groups were identified for males and five for females; the trajectories indicated both continuity and change in heavy drinking across time for the trajectory groups identified Major common prospective predictors for the high and very high heavy drinking trajectory groups supported the influences of values and beliefs (eg, religious commitment), stressful life events and su

Alcohol screening and brief intervention in primary care settings: implementation models and predictors.

Abstract: Objective: This study compared two different implementation strategies for Cutting Back, a primary care alcohol screening and brief intervention (SBI) program for hazardous and harmful drinkers. It also identified organizational factors contributing to the success or failure of SBI implementation. Method: Cutting Back was implemented in 10 primary care practices associated with managed care organizations (MCOs) in five states, through a system of planning, training, technical assistance and clinic feedback. Clinics were randomly assigned to one of two brief intervention systems: In the P Model, medical providers were responsible for delivering interventions, whereas in the S Model mid-level professionals (usually nurses) acted as the clinic specialists to provide that service. Data were collected to measure the performance of screening and delivery of interventions in each clinic. Results: The S Model screened a higher percentage of patients than did the P Model during the best month of program operation ...

Assessment of difference in dimensions of sexual orientation: implications for substance use research in a college-age population.

Abstract: In the past two decades, health research has increasingly focused on the relationship between sexual orientation and health. In the past 5 years alone, a number of major publications have signaled the movement of lesbian, gay and bisexual (LGB) health issues from the margins into the mainstream. Examples include the Institute of Medicine’s report. Lesbian Health: Current Assessment and Directions for the Future (Solarz, 1999) and the Substance Abuse and Mental Health Services Administration’s publication, A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals (SAMHSA, 2001). As with any nascent field of inquiry, researchers conducting studies on LGB health must grapple with a number of methodological issues. Of particular importance is the definition and measurement of sexual orientation. Like race/ethnicity and socioeconomic status, sexual orientation is a complex construct that is difficult to measure. Despite a growing consensus that sexual orientation includes behavioral, affective (attraction or desire) and cognitive (identity) dimensions (Diamond, 2000; Hughes, 2005; Hughes and Eliason, 2002; Laumann et al., 1994; Solarz, 1999), researchers and others define and use these terms in an inconsistent manner. The lack of standard definitions and measures makes comparisons across studies difficult. For instance, a strictly behavioral measure of sexual orientation may be associated with different health risks than a measure of sexual identity or sexual attraction. The manner in which sexual orientation is defined and measured has important implications for health research and practice. Alcohol and other drug (AOD) use represents the greatest cause of preventable death and injury among U.S. college students from 18 to 24 years of age (Hingson et al., 2002,Hingson et al., 2005; Perkins, 2002; Wechsler et al., 1994), and researchers recognize that the relationship between sexual orientation and substance use needs much more attention (e.g. Abbey, 2002; Dowdall and Wechsler, 2002; Perkins, 2002). Previous studies suggest that LGB college students are at higher risk than their heterosexual counterparts for substance use (e.g., Boyd et al., 2003; Debord et al., 1998; Eisenberg and Wechsler, 2003; McCabe et al., 2003, 2004; Pope et al., 2001). To date, most college-based research has used a single measure of sexual orientation (sexual identity, sexual attraction or sexual behavior) or has not assessed sexual orientation at all. Although prior research shows a correlation between same-sex attraction, behavior and identity (Laumann et al., 1994: Meyer et al., 2002), findings also suggest different risks or levels of risk between samples recruited or analyzed based on different dimensions of sexual orientation (Chng and Geliga-Vargas, 2000; Gomez et al., 1996; Markovic et al., 2001; Scheer et al., 2003). Such findings emphasize the importance of better understanding the measurement of this construct. A few studies have examined the relationship between sexual behavior and substance use among college students (e.g., Boyd et al., 2003; Eisenberg and Wechsler, 2003; Pope et al., 2001; Teter et al., 2003). For example, Eisenberg and Wechsler (2003) compared substance use in a nationally representative sample of college students based on self-reports of sexual behavior with same-gender, both-gender and other-gender partners. Among sexually active students, 94% reported having sex with other-gender partners only, 4% with both male and female partners and 2% with same-gender partners only. Undergraduate women who reported both male and female sexual partners were significantly more likely than women with only male partners to report heavy episodic drinking, cigarette smoking and marijuana use. Substance use did not differ between female students who reported exclusively same-gender partners and exclusively male partners. Neither male students who reported same-gender partners only nor those who reported both-gender partners were at higher risk for substance use than those with female partners only. In fact, men with only female partners were significantly more likely than those with both female and male partners to report heavy episodic drinking. The relationship between sexual identity and substance use has also been examined in several college-based studies (e.g., Boyd et al., 2003; DeBord et al., 1998; McCabe et al., 2003, 2004). For example, DeBord and colleagues (1998) surveyed a random sample of college students over 4 years and found LGB students had higher levels of alcohol involvement than a matched comparison group of heterosexual students. Measures in Debord et al.’s study included the Negative Alcohol Consequence scale, the Alcohol Dependence Symptoms scale, the quantity and frequency of alcohol intake in the past 30 days and a Heavy Drinking Composite score. Although alcohol use differed between LGB and heterosexual students, no differences were found between the two groups in illicit drug use. In a later study that analyzed findings by gender, McCabe and colleagues (2003) found no differences in alcohol use and heavy episodic drinking rates between college women who identified as lesbian and bisexual, and those who identified as heterosexual. Lesbian and bisexual women were, however, significantly more likely than heterosexual women to smoke cigarettes in the past month and to use marijuana (before college, in the past month and in the past year), ecstasy (past year) and other illicit drugs (past month and past year). Gay and bisexual men were significantly less likely than heterosexual men to report heavy episodic drinking in the past 2 weeks but more likely to report marijuana use in the past year and ecstasy use before college. Compared with research examining either identity-related or behavioral dimensions of sexual orientation, substantially less college-based substance use research has examined the role of sexual attraction among college students. However, Russell et al.’s (2002) study provides useful information about the association between sexual attraction and substance use among adolescents. In this nationally representative sample, substance use was compared in 13- to 18-year-old adolescents, based on reported lifetime romantic attraction (Russell et al., 2002). Adolescent males and females who were attracted to both genders were more likely than those with only other-gender attractions to report cigarette smoking, heavy drinking, alcohol-related problems, and marijuana and other illicit drug use. Adolescent females with same-gender attraction were more likely than females with only other-gender attractions to report getting drunk and using marijuana or other illicit drugs. In contrast, adolescent males with same-gender attraction were not at increased risk for substance use relative to males with only other-gender attractions. A few studies of young women and men not in college have assessed more than one dimension of sexual orientation (e.g., Bontempo and D’Augelli, 2002; Scheer et al., 2003). Scheer and colleagues (2003) found that the AOD use behaviors among heterosexual women with both male and female partners were more similar to those of self-identified bisexuals than to heterosexual women with male partners only. These findings caution against drawing conclusions about sexual behavior based solely on a respondent’s sexual identity or presuming that sexual behavior can be used as a satisfactory proxy for sexual identity. Recent work suggests that all three dimensions of sexual orientation should be assessed whenever possible (Saewyc et al., 2004; Scheer et al., 2003). To date, no college-based studies have compared substance use behaviors across all three measures of sexual orientation. Although data regarding sexual orientation and substance use in noncollege student populations is helpful, research suggests that substance use differs between college students and their same-age peers not attending college (Johnston et al., 2003). To understand better how sexual orientation relates to substance use among college students, various measures of substance use were compared across three dimensions of sexual orientation: sexual identity, sexual attraction and sexual behavior. A large random sample of undergraduate students attending a midwestern public university was randomly selected and surveyed about their sexual orientation and substance use behaviors using a Web-based instrument.

Using calculations to estimate blood alcohol concentrations for naturally occurring drinking episodes: a validity study.

Abstract: Objective: The purpose of this study is to determine the accuracy of retrospective estimated blood alcohol concentrations (eBACs) for re-creating intoxication resulting from a naturally occur- ring drinking event. This study identified five eBAC equations, applied them to self-report data and compared the results to actual blood alco- hol concentration obtained by a breath test. Method: A convenience sample of 109 drinkers was recruited near drinking establishments and asked to provide breath alcohol concentration (BrAC) samples. Partici- pants were contacted by telephone on the next waking day to gather data required for five algorithms that determine eBAC. BrAC and eBAC ob- tained from each equation were compared to determine the level of agreement between the two approaches. Results: eBACs correlated highly with each other (r ≥ 0.99); R 2 for all algorithms ranged from 0.54 to 0.55 with BrAC as the criterion. On average, eBAC equations over- estimated BrAC. Regression analysis identified the amount of time spent drinking, number of standard drinks, weight and year in school as fac- tors related to discrepancy. Conclusions: These data indicate that, al- though all equations produce eBACs that are highly related, their relationship to BrAC does vary across equations. Using the best fitting equation, eBAC is more strongly correlated with BrAC when intoxica- tion is less than 0.08 g/210 L of breath, and the magnitude of the rela- tionship decreases as intoxication rises. (J. Stud. Alcohol 66: 130-138, 2005)

An experience sampling study of associations between affect and alcohol use and problems among college students.

Abstract: Objective: This study used experienced sampling methodology to examine the relationship between affective functioning and alcohol consumption and problems. Method: Fifty-six college students provided baseline data on measures of impulsivity and distress tolerance and provided experience sampling data for 2 weeks on measures of negative affect, positive affect, and alcohol consumption and problems. Women made up 54% of the sample. The sample ranged in age from 21 to 23 (mean [SD] = 21.50 [0.57]); 98% were white and 2% were Asian. Results: As predicted, higher levels of both positive and negative affect during the day were associated with higher rates of consumption that night. In contrast, negative, but not positive, affect was associated with alcohol-related problems after controlling for alcohol consumption. Impulsivity was associated with higher consumption and problems and moderated the relationships between negative affect and problems and also between alcohol consumption and problems. Low distress to...

Processes linking adolescent problems to substance-use problems in late young adulthood.

Abstract: OBJECTIVE: The current study explores three avenues in early young adulthood through which adolescent problems may be linked to later substance use problems: problematic substance use, failure to assume adult roles and responsibilities, and exposure to pro-drug social influences. METHOD: Participants (N = 1,986; 49% female) filled out surveys at ages 18, 23 and 29. Participants were 67% white, 9% black, 10% Hispanic and 8% Asian. Deviance, poor mental health, substance use, alcohol and other drug (AOD) problems, and school dropout were measured at age 18. AOD problems were also measured at age 23, as were role changes (e.g., marriage) and pro-drug social influences (e.g., friends use drugs). Indicators of substance abuse and dependence were measured at age 29. Demographics and family history of AOD were covariates. RESULTS: Reporting more deviant behavior and heavier drinking at age 18 was associated with a higher likelihood of abuse and dependence at age 29. Alcohol use and pro-drug social influences at age 23 appeared to mediate the effects of adolescent substance use; lack of role assumption did not. The effect of poor mental health at age 18 was not mediated by any set of variables but instead appeared to directly predict dependence at age 29. CONCLUSIONS: Findings highlight the importance of early young adult drinking and substance-using peers in continuing patterns of heavy substance use developed during adolescence and also underscore the long-term impact of poor mental health during adolescence on substance use problems in late young adulthood.

Acute tolerance to alcohol effects on inhibitory and activational mechanisms of behavioral control.

Abstract: Objective: Acute alcohol tolerance refers to the observation of reduced impairment at a given blood alcohol concentration (BAC) on the descending versus ascending limb of the blood alcohol curve. Psychomotor performance measures used in human studies of alcohol tolerance provide reliable assessments of tolerance but do not identify specific mechanisms involved in the re-establishment of control, and little is known about how acute tolerance is expressed in terms of changes in fundamental mechanisms that regulate and control behavior. This study examined the expression of acute alcohol tolerance to impaired behavioral control in terms of changes in a drinker's ability to activate and inhibit behavioral responses as BAC ascended and declined following a dose. Method: Twenty social drinkers performed a cued go/no-go task that measured behavioral control after receiving a moderate dose (0.65 g/kg) of alcohol and a placebo. The development of acute tolerance was measured by testing behavioral control twice: on...

Use of heavier drinking contexts among heterosexuals, homosexuals and bisexuals: results from a National Household Probability Survey.

Abstract: Objective: Extensive use of specific social contexts (bars and parties, for instance) by homosexuals and bisexuals is thought to be a factor in the higher rates of drinking among these groups. However, much of the empirical evidence behind these assumptions has been based on studies with methodological or sampling shortcomings. This article examines the epidemiological patterns of alcohol contexts in relation to sexual identity, using a large, national, probability population survey. Method: We used the 2000 National Alcohol Survey for these analyses. The prevalence of spending leisure time in each of two social contexts (bars and parties) that are associated with heavier drinking is examined by sexual orientation (heterosexual, homosexual, bisexual and self-identified heterosexuals with same sex partners). In addition, we compare levels of drinking within these contexts by sexual orientation within these groups. Results: Exclusively heterosexual women spent less time in these two contexts relative to all...

Alcohol use in early adolescence: the effect of changes in risk taking, perceived harm and friends' alcohol use.

Abstract: Objective: Friends' substance use, sensation seeking and low perceived harm are well-established risk factors for substance use, but they are often treated as stable factors that affect adolescents' likelihood of substance use. This study instead explores the effects of changes in risk factors for individual adolescents. Method: Participants in this study were 1,065 male and female students. The students were in sixth or seventh grade at the initial survey and provided survey data on three additional occasions over a period of 2 years. Random-coefficient models were used to assess the intraindividual variability of friends' alcohol use, perceived harm, and risk taking and their effect on alcohol use. Results: As expected, the overall number of alcohol-using friends is correlated with a student's own alcohol use. In addition, there is a dynamic relationship within student; as friends' alcohol use changes over time, it is accompanied by parallel changes in alcohol use by the individual. Two moderating varia...

The Cumulative Effects of Acute Alcohol Consumption, Individual Differences and Situational Perceptions on Sexual Decision Making*

Abstract: Objective: Past alcohol administration research has produced mixed findings regarding the role of acute alcohol consumption on sexual decision making. The purpose of this study was to evaluate a more complex theoretical model that places alcohol's acute effects in context, through the inclusion of background measures as well as affective and cognitive responses to the specific situation. Method: College students (90 men, 90 women) completed a survey that included measures of individual difference characteristics and past experiences; approximately 1 month later, they participated in an alcohol administration study. Participants were randomly assigned to one of three drink conditions (sober, placebo, alcohol), after which they read a story about a couple that wanted to have sex, but had no condoms available. Results: In hierarchical multiple regression analyses, acute alcohol consumption significantly predicted participants' perceived likelihood that they would have sex without a condom in such a situation...

Effects of survey mode on self-reports of adult alcohol consumption: a comparison of mail, web and telephone approaches.

Abstract: Objective: Mail and Web surveys are two possible alternatives for reducing potential nonresponse bias in telephone-based studies of alcohol consumption. Mail surveys have been a staple of epidemiological research, but there is a dearth of similar research on Web surveys. Most studies using Web surveys have been conducted among college students or other specialized populations where Internet penetration is relatively high. The present study examines differences in self-reports of alcohol consumption among adult members of the general public surveyed by mail, Web and telephone. Method: Web and mail versions of the 2003 Behavioral Risk Factor Surveillance System (BRFSS) instrument, traditionally a telephone-only survey, were developed and administered to address-matched households drawn from the random-digit dialed sampling frame used for the BRFSS. Comparisons were made with results from the ongoing telephone-based surveillance. Results: A total of 4,051 interviews (836 mail, 1,143 Web, and 2,072 telephone)...

A multicountry controlled trial of strategies to promote dissemination and implementation of brief alcohol intervention in primary health care: findings of a World Health Organization collaborative study.

Abstract: Objective: This study examines the impact of marketing strategies on the dissemination of a brief alcohol intervention program to general practitioners (GPs). The marketing strategy was tested to determine the most effective way to promote awareness about and consideration of a brief alcohol intervention program. The study also examines the impact of training and support strategies to promote the program's implementation in routine primary care. Method: A pragmatic trial was carried out in Australia, Belgium (Flanders), Denmark, England, New Zealand and Spain (Catalonia) in which GPs were randomly allocated into one of three marketing conditions (direct mail, telemarketing and academic detailing [personal visits]). The GPs who requested a brief intervention program and agreed to use it were stratified by previous marketing condition and randomly allocated into one of three implementation strategy groups: written guidance, outreach training and outreach training plus ongoing telephone support. Results: Acceptance of the brief intervention program was more effective with use of telemarketing (65%) and academic detailing (67%) than with direct mail (32%) for promoting awareness about and consideration of a brief alcohol intervention program. The median proportion of patients screened was higher for trained GPs (6%) and supported GPs (9%) than for control GPs (1%), who received only written guidance on how to conduct brief intervention. Similarly, the median rate for giving advice to at-risk patients was higher for trained GPs (3%) and supported GPs (3%) than for control GPs (0%). Conclusions: The adoption of more direct approaches for disseminating evidence-based intervention programs to GPs is a necessary first step for changing practice behavior. However, outreach training was required to promote actual use of a new procedure in routine practice.

Is alcohol assessment therapeutic? Pretreatment change in drinking among alcohol-dependent women.

Abstract: Objective: Participants in alcohol treatment outcome studies typically undergo extensive assessment protocols to determine eligibility and provide descriptive and predictive data before beginning therapy. Changes in alcohol consumption as a result of reactivity to assessment have generally not been studied; most researchers collapse data across the pretreatment period and compare them with within-treatment and posttreatment periods. Previously we found a reduction in drinking days from 90 days prebaseline to 3 months postbaseline, with no significant additional reduction during the second 3 months of treatment, in a clinical trial of cognitive-behavioral therapy (CBT) for alcohol-dependent women. The current study examined the points at which these participants stopped or reduced their drinking during the pretreatment assessment period. Method: As part of a randomized clinical trial of 6 months of individual or couples CBT for 102 alcoholic women, study participants were assessed briefly via a telephone s...

Racial/Ethnic differences in the association between college attendance and heavy alcohol use: a national study.

Abstract: Objective: This study examined racial/ethnic differences in the association between college attendance and heavy alcohol use and factors that may underlie this relationship. Method: Interview data collected from 12,993 young adults who participated in the National Longitudinal Study of Adolescent Health were analyzed to determine if 4- or 2-year college status is differentially associated with heavy alcohol use for five racial/ethnic groups (white, black, Hispanic, Asian, Other) and to assess the explanatory value of selected social and psychological factors. Results: Four-year college status was positively associated with heavy alcohol use among white young adults but inversely related to heavy drinking among blacks and Asians. Two-year college status also was inversely associated with heavy drinking among blacks, Hispanics and Others. Among whites, the association between 4-year college attendance and heavy drinking was partially explained by living away from parents, friends' heavy drinking and time so...

Latent growth curve analyses of parent influences on drinking progression among early adolescents.

Abstract: Objective: The nature of parent influences on early adolescent substance use was examined. Method: Latent growth curve analyses were used to examine data on a sample of 2,453 adolescents from seven middle schools who were randomized to a problem behavior prevention program or a control condition and were assessed a total of five times during sixth to ninth grade. Results: Whereas the growth in the number of friends who drink was positively associated with adolescent drinking, parental involvement, monitoring and expectations over time provided direct protective effects against drinking progression and indirect effects by limiting increases in the number of friends who drink. Conclusions: The results provide evidence in a sample of early adolescents that parenting behavior--including involvement, monitoring and expectations--protected against progression in drinking directly as well as indirectly by limiting growth in the number of friends who drink.

The utility of collateral informant assessment in college alcohol research: results from a longitudinal prevention trial.

Abstract: Objective: Collateral informants have been used to assess independently the validity of college student self-report data. However, it is unclear under what conditions collateral reports might be valid and useful in college research. We present two studies that examine aspects of these issues using data from 1,264 college student participants in a brief intervention prevention trial conducted at a public university. Method: The first study describes the characteristics and predictors of agreement on reports of alcohol use and problems from 219 student-collateral informant pairs. The second study investigates potential "pipeline effects"; that is, whether collateral verification resulted in changes in student self-reports on two subsequent survey assessments over 1 year using longitudinal data from 1,264 students. Results: Little support was found for the assumption that nondependent college drinkers underreport drinking behaviors and consequences. Collaterals who reported more occasions of drinking togethe...

Moral maturity and delinquency after prenatal alcohol exposure.

Abstract: Objective: Prenatal exposure to alcohol is associated with cognitive, behavioral and social deficits, including delinquency. Although delinquent populations and those with intellectual and behavioral deficits exhibit impaired moral judgment and reasoning, this area remains unexplored in alcohol-exposed individuals. Method: Moral maturity and delinquency were evaluated in 27 participants with prenatal alcohol exposure (ALC group) and 29 nonexposed controls (CON group) matched on age (range: 10-18), gender, handedness, socioeconomic status and ethnicity. Moral maturity was evaluated using the Sociomoral Reflection Measure-Short Form, and delinquency was evaluated with the Conduct Disorder (CD) Questionnaire. Additional measures included social desirability and inhibition. Results: The ALC group performed at a lower level of moral maturity than the CON group. Whereas Verbal IQ primarily predicted this difference, a deficit on the moral value judgment having to do with relationships with others was specific t...

A prospective investigation of relations between social influences and alcohol involvement during the transition into college.

Abstract: Objective: The present study used structural equation modeling to test whether prospective relations between prematriculation social influences and alcohol involvement in college were most consistent with peer selection, peer socialization or reciprocal determinism explanations and to determine if observed relations varied according to measurement interval. We tested the hypotheses that "active" (alcohol offers) and "passive" (social modeling, perceived norms) social influences would be uniquely and reciprocally associated with alcohol use and alcohol-related consequences across two and three waves of assessment. Method: Prospective undergraduates (N = 388) completed self-report assessments in the summer before matriculation (Wave 1), in the spring of their freshman year (Wave 2) and in the spring of their sophomore year (Wave 3). Results: Reciprocal effects were observed between social influences and alcohol use in both two- and three-wave models. Some evidence was observed for reciprocal associations fo...

Diagnostic usefulness of brief versions of Alcohol Use Disorders Identification Test (AUDIT) for detecting hazardous drinkers in primary care settings.

Abstract: Objective: The aim of this study was to evaluate the diagnostic usefulness of the brief versions of the Alcohol Use Disorders Identification Test (AUDIT) for detecting hazardous drinkers and to compare it with that of the full-AUDIT in primary care settings. Method: Five hundred patients were randomly selected in a primary care center. An interview on quantity-frequency was administered for assessment of weekly alcohol intake. The standard used for classification of hazardous drinkers was a weekly alcohol consumption of 280 g for men and 168 g for women. Cut-off points were 8 for the full-AUDIT, 1 for the AUDIT-3 (third item), 3 for the AUDIT-C (items 1, 2 and 3), 5 for the AUDIT-PC (items 1, 2, 4, 5 and 10) and 3 for the modified Fast Alcohol Screening Test (m-FAST; items 3, 5, 8 and 10). Sensitivity, specificity, positive and negative predictive values, and areas under the receiver operating characteristic (AUROC) curves were measured. Results: Diagnostic usefulness of the questionnaires for detecting h...

Overserving at licensed premises in Stockholm: effects of a community action program.

Abstract: Objective: The aim of this research was to study the sustainable effects of a community action program on alcohol service to intoxicated patrons at licensed premises. Method: Since 1996, the hospitality industry and authorities in Stockholm, Sweden, have been cooperating to reduce problems related to alcohol consumption at licensed premises. The intervention has included community mobilization, training in responsible beverage service (RBS) and enforcement. A pretest in 1996 and follow-ups in the 1999 and 2001 designs were used to study licensed premises in Stockholm. Male actors portraying intoxicated patrons visited the licensed premises and attempted to order beer. Observers were present at each visit. At the pretest, 92 licensed premises were visited, 47 in north central Stockholm and 45 in south central Stockholm. In 1999, 103 establishments were visited, 61 in north central Stockholm and 42 in south central Stockholm. At the latest follow-up in 2001, 100 licensed premises were visited, 56 in north c...

Coping motives as a moderator of daily mood-drinking covariation

Abstract: Objective: The current study examines the extent to which college students' reports of drinking to cope (DTC) with negative affect moderate the daily covariation between specific types of negative mood (sadness, fear, hostility, shyness and boredom) and alcohol use. Method: Participants were full-time college students, aged 18-20, attending a large Southeastern university (N = 72; 50% male). These individuals completed an experience-sampling protocol over a 1-month interval, to assess daily mood and alcohol use. Results: A series of Hierarchical General Linear Models found that individuals who reported low motives to cope through drinking showed an expected absence of daily mood and drinking covariation. For those reporting high coping motives, a complex and somewhat counterintuitive series of findings were found; students high in DTC drank less on days in which they experienced greater sadness. Analyses on the quadratic effects of mood revealed that when experiencing moderate to high levels of fear and s...

Collateral Reports in the College Setting: A Meta-Analytic Integration

Abstract: IT WAS ONCE assumed that adults would underreport their drinking out of concern for social or legal consequences, and therefore their self-reports could not be trusted (Babor et al., 1987;Watson et al., 1984). As a result, collateral informants were employed to verify the individuals' self-report of drinking. Research participants nominate collateral informants, usually friends or family members, to provide corroboration for self-reported alcohol use and/or problems. Ideally, the collateral has frequent contact with the participant, especially in drinking situations. Statistically significant positive correlations have been found between collateral estimates of participant self-reported substance use (Babor et al., 1987; O'Farrell and Maisto, 1987), although poor collateral and participant agreement has been found in those with comorbid mental disorders (Stasiewicz et al., 2008). As more research indicates that self-reported drinking is often accurate, the use of collaterals has been discouraged as a way to obtain accurate reports of participant alcohol use (Babor and Del Boca, 1992; Babor et al., 1987, 2000; Maisto et al., 1990). Self-report is the most common method of data collection with college students, and researchers continue to use collateral informants to confirm self-reports of drinking behavior of research participants. As in the adult literature, collaterals are most often used in the context of randomized clinical trials to assess the veracity of the self-report of participants who have received treatment. The primary downside of the use of collaterals is the significant time and effort it takes to recruit, track, and contact them in order to obtain information about the participants' drinking. Therefore it is important to determine the extent to which estimates of drinking provided by collaterals in college drinking research correspond with the self-reported alcohol use of participants. This correspondence can be expressed in a number of ways. In the present effort, we define bias as the mean difference between participant and collateral reports, and we define agreement as the reliability of the estimates that are provided by collaterals and participants (how much their estimates agree). It is important to evaluate both as a sample could exhibit no bias (no mean differences) with little or no agreement between collateral and participant reports. College students are a unique population to collect collateral reports as there may be little motivation for college students to misrepresent their alcohol use. Heavy drinking is perceived by many students to be an integral part of the college culture for many college students (Borsari and Carey, 2001, 2006; Perkins, 2002), and is often highly salient at social functions and sporting events. Therefore it is unlikely that students view their alcohol use as socially undesirable or embarrassing. This is much different for adults and adolescents for whom heavy drinking is more likely to be seen as atypical and problematic. As a result, adults and adolescents may be more motivated to underreport their use (especially in treatment samples) than college students. Indeed, previous research with college collaterals (Laforge et al., 2005) found no evidence of systematic underreport of alcohol use. Furthermore, there was no evidence that the use of a “bogus pipeline” (where the student was told that a collateral would verify his/her self-report, but no verification actually was carried out) enhanced the accuracy of college student's self-reports. There may be situations in which collateral informants would be useful to corroborate self-report in the college setting. For example, students who have received judicial sanctions (Barnett and Read, 2005) or who are going to receive unwanted treatment as a result of their responses (as in stepped care, Borsari and O'Leary Tevyaw, 2005; Sobell and Sobell, 2000) may intentionally underreport their alcohol use. Recent research indicates that mandated students intentionally underreported their alcohol use prior to receiving an intervention due to concerns about how the information would be used (Walker and Cosden, 2007). Given the amount of research conducted with college students, we examined the research literature to further our understanding of the factors associated with collateral and participant correspondence and to determine the situations in which collateral reports can be a valuable option.

Training, supervision and quality monitoring of the COMBINE Study behavioral interventions.

Abstract: Objective: Current standards for clinical trials require that behavioral interventions be thoroughly specified, that clinicians be well trained and closely supervised and that performance be carefully monitored to ensure and document treatment fidelity. This article describes procedures developed and implemented for this purpose in the COMBINE Study, a multisite trial combining medications and behavioral interventions for alcohol dependence. Methods: Two behavioral treatments were tested in COMBINE: a Medical Management (MM) protocol to accompany the delivery of trial medications and a Combined Behavioral Intervention (CBI) designed as a comprehensive and flexible evidence-based psychotherapy. Results: Information is provided concerning (1) screening and qualifications of practitioners, (2) training and certification in the interventions, (3) on-site supervision and coordination of the two treatments, (4) central monitoring and coding of treatment sessions and (5) maintenance and documentation of treatmen...