Showing papers in "Journal of Studies on Alcohol and Drugs in 2006"
TL;DR: The development and initial validation of a measure designed to capture a broad range of alcohol-related consequences experienced by male and female college students is described, which may serve as an aid in both the description of and intervention for heavy drinking in college.
Abstract: OBJECTIVE: A substantial proportion of U.S. college students drink alcoholic beverages and report significant deleterious effects. The present study describes the development and initial validation of a measure designed to capture a broad range of alcohol-related consequences experienced by male and female college students. METHOD: College students (N=340, 176 women) completed a self-report questionnaire battery consisting of information about demographic characteristics, drinking behaviors, and drinking consequences. Drinking consequences were assessed with a composite measure based on the Drinker Inventory of Consequences, the Young Adult Alcohol Problem Screening Test (YAAPST) and items developed by the researchers. To assess concurrent validity, a subset of the total sample (n=126) also completed the Rutgers Alcohol Problem Index (RAPI). RESULTS: Confirmatory factor analyses supported an eight-factor solution (Social-Interpersonal Consequences, Impaired Control, Self-Perception, Self-Care, Risk Behaviors, Academic/Occupational Consequences, Physical Dependence, and Blackout Drinking), with all factors loading on a single, higher-order factor. YAACQ total scores correlated with alcohol quantity and frequency, and the RAPI. Gender comparisons suggest that the YAACQ assesses constructs of interest equally well for women and men. CONCLUSIONS: These results offer preliminary support for this measure. Research and clinical applications include the potential to predict future problems by specific type of consequence and to offer detailed feedback about drinking consequences to students as part of a preventive intervention. As such, the YAACQ may serve as an aid in both the description of and intervention for heavy drinking in college.
506 citations
TL;DR: To prevent increases in substance use in emerging adulthood, interventions should concentrate on strengthening prosocial involvement and parental monitoring during high school and youths with high sensation seeking might be targeted for added intervention.
Abstract: Objective: This study examined the effects of leaving home and going to college on changes in the frequency of alcohol use, heavy episodic drinking, and marijuana use shortly after leaving high school. We also examined how protective factors in late adolescence predict post-high school substance use and moderate the effects of leaving home and going to college. Method: Data came from subjects (N = 319; 53% male) interviewed at the end of 12th grade and again approximately 6 months later, as part of the Raising Healthy Children project. Results: Leaving home and going to college were significantly related to increases in the frequency of alcohol use and heavy episodic drinking from high school to emerging adulthood but not to changes in marijuana use. Having fewer friends who used each substance protected against increases in the frequency of alcohol use, heavy episodic drinking, and marijuana use. Higher religiosity protected against increases in alcohol-and marijuana-use frequency. Higher parental monitoring protected against increases in heavy episodic drinking and moderated the effect of going to college on marijuana use. Lower sensation seeking lessened the effect of going to college on increases in alcohol use and heavy episodic drinking. Conclusions: To prevent increases in substance use in emerging adulthood, interventions should concentrate on strengthening prosocial involvement and parental monitoring during high school. In addition, youths with high sensation seeking might be targeted for added intervention. Language: en
422 citations
TL;DR: Simultaneous polydrug use was more prevalent among undergraduate students who were male, were white, and reported early initiation of alcohol use, and collegiate prevention efforts aimed at reducing substance abuse should clearly focus on co-ingestion of alcohol and prescription drugs.
Abstract: Objective: In this study, we sought to examine the prevalence, correlates, and consequences associated with simultaneous polydrug use and concurrent polydrug use of alcohol and prescription drugs. For purposes of this investigation, simultaneous polydrug use referred to the co-ingestion of different drugs at the same time, and concurrent polydrug use referred to the use of different drugs on separate occasions within the past 12 months. Method: Undergraduate students attending a large public midwestern university in the United States were randomly selected to self-administer a Web survey. The sample consisted of 4,580 undergraduate students, with a mean (SD) age of 19.9 (2.0) years; the sample consisted of 50% women, and the racial breakdown was 65% white, 13% Asian, 7% black, 5% Hispanic, and 10% other race/ethnicity. The survey assessed simultaneous polydrug use and concurrent polydrug use of alcohol and four classes of prescription drugs: (1) pain medication, (2) stimulant medication, (3) sedative medi...
285 citations
TL;DR: The present findings suggest that normative misperceptions are stable, at least over a relatively short time period, and support a mutual influence model of the relationship between perceived norms and drinking quantity but are more strongly associated with conformity explanations for the relationship to drinking frequency.
Abstract: Descriptive social norms have been pervasively incorporated in adolescent and college student alcohol interventions based on two key relationships; (1) perceived norms are typically higher than actual norms, and (2) perceived norms are positively correlated with drinking. With few exceptions (Marks et al 1992; Read el al., 2005), most studies have been cross-sectional or have examined only how perceived norms are associated with later drinking, rather than how drinking relates to later perceived norms (Kahler et al., 2003; Larimer et al., 2004; Read el al., 2002). The present research was designed to evaluate the stability of normative misperceptions, perceived norms, and drinking. In addition, the ability of perceived norms to predict future drinking is compared with the ability of drinking to predict future perceived norms.
As a general term, “social norm” usually refers to what is considered to be normal within a given population of people. Terminology used in empirical investigations related to social norms is discordant and varied but can perhaps best be understood by considering two dimensions: injunctive versus descriptive norms and perceived versus actual norms. The “injunctive versus descriptive” distinction was suggested by Cialdini and colleagues (1990). “Injunctive norms” refer to the extent to which some population approves or disapproves of a given behavior. “Descriptive norms” refer to the frequency or quantity of a given behavior within some population. The present research focuses on descriptive norms. The “perceived versus actual” distinction is important because people often do not know the extent to which others approve, disapprove, or engage in a particular behavior. It is usually the perception of others’ attitudes or behaviors that is directly influential on the individual rather than others’ actual attitudes or behaviors (Lewin, 1943).
Past research has shown that college students overestimate the prevalence of peers’ drinking (Borsari and Carey, 2003). Moreover, the magnitude of overestimation is associated with more problematic drinking (Baer and Carney, 1993; Baer et al 1991; Lewis and Neighbors. 2004; Perkins and Berkowitz, 1986). Perceived approval and prevalence of peer drinking is associated with one’s own drinking (Borsari and Carey, 2001; Lewis and Neighbors, 2004; Perkins, 2002; Prentice and Miller, 1993). It is clear from previous studies that perceived norms and behaviors go hand in hand: the reason for this, however, is less clear. Several explanations have been offered regarding normative misperceptions, including pluralistic ignorance (Miller and Prentice, 1996; Prentice and Miller, 1993), false consensus (Ross et al., 1977; Marks and Miller, 1987), and false uniqueness (Suls et al., 1988). The temporal relationship between perceived norms and drinking remains unclear.
In theory, perceived norms about drinking will influence people’s behavior to the extent that they are motivated to be seen as similar to the group. If individuals are afraid to be viewed as deviants, they will behave in accordance with what they believe the group norm to be. These ideas are supported by classic research on conformity (Asch, 1951; Deutsch and Gerard, 1955; Sherif, 1936), as well as by a host of literature related to social comparison theory (Festinger, 1954), social impact theory (Latane, 1981), and social identity and self-categorization theories (Tajfel and Turner, 1986; Turner et al., 1987). Empirical support for the notion that perceived norms temporally precede drinking can be derived indirectly from intervention studies incorporating normative feedback. Perceived norms are experimentally manipulated by providing feedback that highlights the discrepancies between one’s own drinking, one’s perceptions of peer drinking, and peers’ actual drinking. A number of studies have found provision of normative feedback to result in drinking reductions (Agostinelli et al., 1995; Collins et al., 2002; Walters and Neighbors, 2005; Walters et al., 2000). Other studies have shown that reductions in perceived norms mediate drinking reductions (Borsari and Carey, 2000; Mattern and Neighbors, 2004; Neighbors et al., in press).
In contrast to the notion that perceived norms temporally precede drinking, at least two phenomena—projection and social selection—suggest the opposite. Students may base their estimates of others’ drinking on their own behavior This idea is consistent with false consensus (Marks and Miller, 1987; Ross et al., 1977) and false uniqueness (Suls et al., 1988) effects. An alternative is that heavier drinkers may choose to associate with heavier-drinking peers, which may influence both their perceived norms and subsequent drinking. Previous research suggests that social or peer selection has a clear impact on student drinking (Bullers et al., 2001; Kahler et al., 2003; Read et al., 2005).
In sum, previous research and theory suggest three possibilities: perceived norms will be better predictors of later drinking, drinking will be a better predictor of later perceived norms, or both will be equally predictive of the other. The present study was designed to examine mean differences in, and correlations between, perceived and actual drinking norms among college students over time.
280 citations
TL;DR: This study is the most rigorous evaluation of SNM campaigns conducted to date and revealed that students attending institutions that implemented an SNM campaign had a lower relative risk of alcohol consumption than students attending control group institutions.
Abstract: Objective: An 18-site randomized trial was conducted to determine the effectiveness of social norms marketing (SNM) campaigns in reducing college student drinking. The SNM campaigns are intended to correct misperceptions of subjective drinking norms and thereby drive down alcohol consumption. Method: Institutions of higher education were randomly assigned to treatment and control groups. At the treatment group institutions, SNM campaigns delivered school-specific, data-driven messages through a mix of campus media venues. Cross-sectional student surveys were conducted by mail at baseline (n = 2,771) and at posttest 3 years later (n = 2,939). Hierarchical linear modeling was applied to examine multiple drinking outcomes, taking intraclass correlation into account. Results: Controlling for other predictors, having an SNM campaign was significantly associated with lower perceptions of student drinking levels and lower alcohol consumption, as measured by a composite drinking scale, recent maximum consumption,...
267 citations
TL;DR: This study provides the first evidence for an association between exposure to movie alcohol use and early-onset teen drinking, with a statistically significant linear and quadratic effect, and suggesting a higher dose-effect relationship at lower movie alcohol exposure levels compared to higher levels.
Abstract: Objective: Little is known about the impact of viewing depictions of alcohol in entertainment media on adolescent drinking behavior. Our aims were to assess drinking in a sample of popular contemporary movies and to examine the association of movie alcohol exposure with early-onset drinking in an adolescent sample. Method: We conducted a school-based cross-sectional survey (N=4655) with longitudinal follow-up of never-drinkers (N=2406) involving adolescents ages 10-14 years and recruited from 15 New Hampshire and Vermont schools. Screen depictions of alcohol use were timed for each of 601 popular contemporary movies. Each adolescent was asked if he/she had seen a unique list of 50 movie titles, randomly selected from the larger pool. Movie alcohol use was summed for movies the adolescent had seen, adjusted to reflect exposure to the larger pool and modeled as a continuous variable. Results: Ninety-two percent of the movies in the sample depicted drinking; median screen time for movie alcohol use was 2.5 m...
233 citations
TL;DR: Despite management's responsibility for the development and enforcement of such policies, managers report elevated rates of consuming alcohol during the workday, working under the influence of alcohol, and working with a hangover.
Abstract: Objective: Although much research has explored overall alcohol use in the workforce, little research has explored the extent of alcohol use and impairment in the workplace. This study explored the overall prevalence, frequency, and distribution of alcohol use and impairment during the workday. Method: Data were collected from a national probability sample of 2805 employed adults using a random digit dialing telephone survey. Alcohol use within 2 hours of reporting to work, alcohol use during the workday, working under the influence of alcohol, and working with a hangover were assessed for the 12 months preceding the interview. Results: Workplace alcohol use and impairment directly affect an estimated 15% of the U.S. workforce (19.2 million workers). Specifically, an estimated 1.83% (2.3 million workers) drink before work, 7.06% (8.9 million workers) drink during the workday, 1.68% (2.1 million workers) work under the influence of alcohol, and 9.23% (11.6 million workers) work with a hangover. The results ...
203 citations
TL;DR: This social norms intervention was highly effective in reducing alcohol misuse in this high-risk collegiate subpopulation by intensively delivering data-based messages about actual peer norms through multiple communication venues.
Abstract: Objective: This study examines the impact of a social norms intervention to reduce alcohol misuse among student-athletes. The intervention was designed to reduce harmful misperceptions of peer norms and, in turn, reduce personal risk. Method: A comprehensive set of interventions communicating accurate local norms regarding alcohol use targeted student-athletes at an undergraduate college. An anonymous survey of all student-athletes was conducted annually for 3 years (2001: n = 414, 86% response; 2002: n = 373, 85% response; and 2003: n = 353, 79% response). A pre/post comparison of student-athletes was conducted separately for new and ongoing athletes at each time point to isolate any general time period effects from intervention effects. A cross-sectional analysis of student-athletes with varying degrees of program exposure was also performed. Results: The intervention substantially reduced misperceptions of frequent alcohol consumption and high-quantity social drinking as the norm among student-athlete ...
189 citations
TL;DR: The findings show that older adults, women, and married adults were more likely to have quit using alcohol, and two of the individual components of enculturation had significantly positive effects on alcohol cessation.
Abstract: Objective: The detrimental effects of alcohol misuse and dependence are well documented as an important public-health issue among American Indian adults. This preponderance of problem-centered research, however, has eclipsed some important resilience factors associated with life course patterns of American Indian alcohol use. In this study, we investigate the influence of enculturation, and each of the three component dimensions (traditional practices, traditional spirituality, and cultural identity) to provide a stringent evaluation of the specific mechanisms through which traditional culture affects alcohol cessation among American Indians. Method: These data were collected as part of a 3-year lagged sequential study currently underway on four American Indian reservations in the upper Midwest and five Canadian First Nation reserves. The sample consisted of 980 Native American adults, with 71% women and 29% men who are parents or guardians of youth ages 10-12 years old. Logistic regression was used to as...
179 citations
TL;DR: The magnitude and costs of problems resulting from underage drinking by category-traffic crashes, violence, property crime, suicide, burns, drownings, fetal alcohol syndrome, high-risk sex, poisonings, psychoses, and dependency treatment-and compared those costs with associated alcohol sales are estimated.
Abstract: Objective: Despite minimum-purchase-age laws, young people regularly drink alcohol. This study estimated the magnitude and costs of problems resulting from underage drinking by category-traffic crashes, violence, property crime, suicide, burns, drownings, fetal alcohol syndrome, high-risk sex, poisonings, psychoses, and dependency treatment-and compared those costs with associated alcohol sales. Previous studies did not break out costs of alcohol problems by age. Method: For each category of alcohol-related problems, we estimated fatal and nonfatal cases attributable to underage alcohol use. We multiplied alcohol-attributable cases by estimated costs per case to obtain total costs for each problem. Results: Underage drinking accounted for at least 16% of alcohol sales in 2001. It led to 3,170 deaths and 2.6 million other harmful events. The estimated $61.9 billion bill (relative SE = 18.5%) included $5.4 billion in medical costs, $14.9 billion in work loss and other resource costs, and $41.6 billion in lost quality of life. Quality-of-life costs, which accounted for 67% of total costs, required challenging indirect measurement. Alcohol-attributable violence and traffic crashes dominated the costs. Leaving aside quality of life, the societal harm of $1 per drink consumed by an underage drinker exceeded the average purchase price of $0.90 or the associated $0.10 in tax revenues. Conclusions: Recent attention has focused on problems resulting from youth use of illicit drugs and tobacco. In light of the associated substantial injuries, deaths, and high costs to society, youth drinking behaviors merit the same kind of serious attention. (J. Stud. Alcohol 67: 519-528, 2006). Language: en
161 citations
TL;DR: Given the relationship between norm misperception and behavior with marijuana use, future research could explore the impact of targeting misperceived norms through prevention and intervention efforts.
Abstract: Objective: This study investigates the relationship between marijuana use, perceived norms of use by friends and students in general, and negative experiences or problems from alcohol and drug use. It was hypothesized that students would overestimate the marijuana use of students in general and that perceptions about the prevalence of marijuana use would be related to drug-related consequences. Method: In this study, 5,990 participants provided information on the perceptions and consequences of drug use via an online survey or via a paper-based survey. Results: Although two thirds of participants reported no marijuana use, 98% of respondents incorrectly predicted that students in general use marijuana at least once per year. Perceptions of use by friends and students in general accounted for variance in drug use and related problems or experiences. Conclusions: Given the relationship between norm misperception and behavior with marijuana use, future research could explore the impact of targeting mispercei...
TL;DR: Alcohol problems in perpetrators and their partners contributed directly to physical abuse and indirectly via psychological aggression, even after perpetrator antisociality, perpetrator trait anger, perpetrator relationship discord, and perpetrator and partner psychological and physical aggression were included in the model.
Abstract: Objective: There is a paucity of research developing and testing conceptual models of intimate partner violence, particularly for female perpetrators of aggression Several theorists' conceptual frameworks hypothesize that distal factors-such as personality traits, drinking patterns, and marital discord-influence each other and work together to increase the likelihood of physical aggression The purpose of the present study was to investigate these variables in a relatively large sample of men and women arrested for domestic violence and court-referred to violence intervention programs Method: We recruited 409 participants (272 men and 137 women) who were arrested for domestic violence We assessed perpetrator alcohol problems, antisociality, trait anger, relationship discord, psychological aggression, and physical abuse We also assessed the alcohol problems, psychological aggression, and physical abuse of their relationship partners We used structural equation modeling to examine the interrelationship
TL;DR: Transitional life events demonstrate many effects on recovery, including both direct effects consistent with role socialization and associations more reflective of selectivity than causation, and taken as a whole, these events appear to contribute to the high rates of recovery from alcohol dependence that have been observed even in the absence of treatment.
Abstract: Objective: The purpose of this study was to investigate the effects of transitional life events related to education, employment, and family formation on the likelihood of recovery from alcohol dependence as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), distinguishing the short- and long-term effects of these events and potential effect modification by treatment history, gender, and severity of dependence. Method: This analysis is based on data from the Wave 1 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a cross-sectional, retrospective survey of a nationally representative sample of U.S. adults 18 years of age and older. The analytic sample consisted of 4,422 individuals with prior-to-past-year (PPY) onset of DSM-IV alcohol dependence. Time-dependent proportional hazards models were used to estimate the effects of completing school, starting full-time work, getting married, becoming separated/divorced/widowed, and bec...
TL;DR: This article evaluated two brief personal feedback substance-use interventions for students mandated to the Rutgers University Alcohol and Other Drug Assistance Program for Students (ADAPS): (1) a brief motivational interview (BMI) intervention and (2) a written feedback-only (WF) intervention.
Abstract: Objective: This study evaluated two brief personal feedback substance-use interventions for students mandated to the Rutgers University Alcohol and Other Drug Assistance Program for Students (ADAPS): (1) a brief motivational interview (BMI) intervention and (2) a written feedback-only (WF) intervention. A key question addressed by this study was whether there is a need for face-to-face feedback in the context of motivational interviewing to affect changes in substance-use behaviors or whether a written personal feedback profile is enough of an intervention to motivate students to change their substance use. Method: The sample consisted of 222 students who were mandated to ADAPS, were eligible for the study, and completed the 3-month follow-up assessment. Eligible students completed a baseline assessment from which a personal feedback profile was created. They were then randomly assigned to the BMI or WF condition. Students were followed 3 months later. Results: Students in both interventions reduced their...
TL;DR: Embedded in a health-risk questionnaire in primary-care settings, the AUDIT is a reliable and valid screening instrument to identify at-risk drinkers and patients with an AUD and the findings strongly suggest a lowering of the recommended cut-off value of eight points.
Abstract: Objective: Our goal was to analyze the retest reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a primary-care setting and recommend a cut-off value for the different alcohol-related diagnoses.Method: Participants recruited from general practices (GPs) in two northern German cities received the AUDIT, which was embedded in a health-risk questionnaire. In total, 10,803 screenings were conducted. The retest reliability was tested on a subsample of 99 patients, with an intertest interval of 30 days. Sensitivity and specificity at a number of different cut-off values were estimated for the sample of alcohol consumers (n = 8,237). For this study, 1,109 screen-positive patients received a diagnostic interview. Individuals who scored less than five points in the AUDIT and also tested negative in a second alcohol-related screen were defined as “negative” (n = 6,003). This definition was supported by diagnostic interviews of 99 screen-negative patients from which no false negativ...
TL;DR: The differences that exist within college drinkers identified as high-risk drinkers are demonstrated, and a broad range of problematic drinkers grouped together within the category "heavy drinking," which is defined by a single episode.
Abstract: OBJECTIVE: This study demonstrates the differences that exist within college drinkers identified as high-risk drinkers. METHOD: The study looked at alcohol and other drug (AOD) use patterns of the entire U.S. college student body, using a cross-section of institutions (public, private, 2-year, and 4-year) and students that reflected the enrollment patterns within geographic regions of the country. A survey that focused on safety and violence on college campuses, in addition to more traditional questions regarding the prevalence of alcohol and other drug use and negative consequences, was mailed to a stratified random sample. The final sample consisted of students from 96 institutions of higher education (N = 17,821; 45.3% males, 54.7% females) and was weighted to ensure an accurate representation of the student population in the United States. RESULTS: We found there to be a broad range of problematic drinkers grouped together within the category "heavy drinking," which is defined by a single episode (five or more drinks on one occasion). The seriously problematic drinkers can be differentiated from those less problematic by the inclusion of frequency in the criteria. Comparing heavy drinkers with "heavy and frequent drinkers," we found rates of negative consequences to be almost three times higher for the heavy and frequent drinkers. In addition, the heavy and frequent drinkers account for nearly half of all negative consequences reported by all drinkers. CONCLUSIONS: Greater specificity in classification is a necessary component of alcohol research and intervention.
TL;DR: There is some evidence that being enrolled in college appears to be a protective factor for young adult and adult heavy drinkers, whereas nonenrolled individuals not drinking heavily during high school or college ages are at increased risk for adult heavy drinking.
Abstract: Objective: The purpose of this study was to illustrate the use of latent class analysis to examine change in behavior over time. Patterns of heavy drinking from ages 18 to 30 were explored in a national sample; the relationship between college enrollment and pathways of heavy drinking, particularly those leading to adult heavy drinking, was explored. Method: Latent class analysis for repeated measures is used to estimate common pathways through a stage-sequential process. Common patterns of development in a categorical variable (presence or absence of heavy drinking) are estimated and college enrollment is a grouping variable. Data were from the National Longitudinal Survey of Youth (N = 1,265). Results: Eight patterns of heavy drinking were identified: no heavy drinking (53.7%); young adulthood only (3.7%); young adulthood and adulthood (3.7%); college age only (2.6%); college age, young adulthood, and adulthood (8.7%); high school and college age (4.4%); high school, college age, and young adulthood (6....
TL;DR: How this genetic risk factor interacts with marital status, another factor previously shown to be associated with the risk for alcohol dependence, is explored to illustrate the complex pathways by which genotype and environmental risk factors act and interact to influence alcohol dependence and challenge traditional conceptualizations of "environmental" risk factors.
Abstract: Objective: The gene GABRA2 has been associated with the risk for alcohol dependence in independent samples. This article explores how this genetic risk factor interacts with marital status, another factor previously shown to be associated with the risk for alcohol dependence. Method: Data from more than 1,900 male and female subjects from the Collaborative Study of the Genetics of Alcoholism (COGA) sample were analyzed. Subjects were recruited based on membership in a family with multiple individuals with alcoholism. A series of analyses was performed to evaluate the relationship between the following: (1) GABRA2 and alcohol dependence, (2) marital status and alcohol dependence, (3) GABRA2 and marital status, and (4) interactions between GABRA2 and marital status on the development of alcohol dependence in the high-risk COGA sample. Additional analyses were carried out in a sample of approximately 900 individuals from control families to test the generalizability of results. Results: Both GABRA2 and marit...
TL;DR: Estimating whether students overestimate norms in these specific contexts, as they do more generally, is evaluated to lay the foundation for developing personalized normative feedback interventions for 21st birthday celebratory drinking and tailgating drinking.
Abstract: OBJECTIVE: Negative alcohol-related consequences often occur during specific events and in specific contexts (e.g., 21st birthday celebrations and tailgating [pregaming] parties). A lack of available event- and context-specific interventions suggests the need to better understand factors associated with heavy drinking in these contexts, with an eye toward developing specific interventions. The purpose of this research was to lay the foundation for developing personalized normative feedback interventions for 21st birthday celebratory drinking and tailgating drinking by evaluating whether students overestimate norms in these specific contexts, as they do more generally. METHOD: Perceived descriptive norms and alcohol consumption were assessed at event- and context-specific levels in two studies. Study 1 included 119 students turning 21 years old who reported their 21st birthday drinking behavior and estimated the typical number of drinks consumed by students celebrating their 21st birthday. Study 2 included 140 undergraduates drawn from a stratified random sample who reported their behavior regarding drinking and tailgating and their perceived norms for typical drinking and tailgating behavior. RESULTS: Results from Study 1 revealed that students overestimated peer drinking during 21 st birthday celebrations, and this overestimation was associated with heavier drinking on one's own 21st birthday. In Study 2, students underestimated the percentage of tailgaters who drank but overestimated typical consumption. Overestimation was consistently associated with heavier drinking during tailgating. CONCLUSIONS: Successful correction of general normative misperceptions has been shown to reduce drinking in other research. Documentation of normative misperceptions for specific events and contexts provided by these results represents an important step in developing event- and context-specific interventions utilizing specific normative feedback.
TL;DR: This was the first large-scale, brief intervention trial that included development and testing of computerized, highly tailored interventions with injured drinkers in the ED to positively impact risky drinking practices.
Abstract: Objective: This study used a randomized controlled trial design to compare the effectiveness of four interventions at reducing alcohol consumption, consequences, and heavy episodic drinking among injured, at-risk drinkers in the emergency department (ED). Method: Injured patients (n = 4,476) completed a computerized survey; 575 at- risk drinkers were randomly assigned to one of four intervention conditions: tailored message booklet with brief advice, tailored message booklet only, generic message booklet with brief advice, and generic message booklet only. Regression models using the generalized estimating equation approach were constructed comparing the intervention conditions at baseline, 3-month follow-up, and 12-month follow-up. Gender and age were entered in models along with their interaction. Results: Each of the intervention groups significantly decreased their alcohol consumption from baseline to 12-month follow-up; subjects in the tailored message booklet with brief advice group significantly decreased their average weekly alcohol consumption by 48.5% (p < .0001). Those in the brief advice conditions (tailored or generic) significantly decreased their average consumption during the 12 months of the study compared with the no brief advice conditions. Younger adult women (ages 19-22) who received some brief advice were the most likely to decrease their heavy episodic drinking. Conclusions: This was the first large-scale, brief intervention trial that included development and testing of computerized, highly tailored interventions with injured drinkers in the ED. ED-based interventions for alcohol problems would benefit from computerized screening, brief advice, and booklets to positively impact risky drinking practices. Language: en
TL;DR: The results suggest that prevention efforts should focus on both identifying bars that typically have more intoxicated patrons and reducing the intoxication levels of patrons across bars generally, and that greater attention needs to be paid to group dynamics in alcohol-related aggression.
Abstract: OBJECTIVE: The purpose of this study was to assess the relationship between level of intoxication and the frequency and severity of aggression at the person, incident, visit, and bar level for aggressive incidents observed in bars or clubs. METHOD: Hierarchical Linear Modeling (HLM) analysis of 1025 incidents of aggression documented by trained observers during 1334 nights of observation in 118 bars and clubs in Toronto, Canada, was conducted. RESULTS: Both level of intoxication of the crowd during the visit as well as mean level of intoxication at the bar level significantly predicted frequency of aggression. There was a positive association between level of intoxication and severity of aggression at both the incident and person level except for the highest level of intoxication at the person level, where severity of aggression was less than for moderate intoxication. A person-incident level interaction between intoxication and severity of aggression was also found. CONCLUSIONS: These results suggest that prevention efforts should focus on both identifying bars that typically have more intoxicated patrons and reducing the intoxication levels of patrons across bars generally. The results also showed a strong positive relationship between level of intoxication and severity of aggression (except at the highest levels), indicating that intoxication increases risk in terms of both frequency and severity of aggression. The significant interaction between person- and visit-level intoxication suggests that greater attention needs to be paid to group dynamics in alcohol-related aggression. Language: en
TL;DR: In patients who are treated for alcohol-use disorders, a positive therapeutic alliance may counteract the negative impact of a low baseline self-efficacy.
Abstract: Objective: High abstinence self-efficacy reliably predicts better treatment outcomes for patients with alcohol use disorders, but little is known about aspects of treatment that may be particularly beneficial for patients who enter treatment with low self-efficacy. This study examines whether the relationship between self-efficacy and treatment outcomes is influenced by the quality of the therapeutic alliance in Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity), a multisite clinical trial of three treatments for alcohol use disorders. Method: Information on 785 patients in the outpatient sample of Project MATCH was used to test for an interaction between baseline self-efficacy and therapeutic alliance in relation to 1-year alcohol use outcomes. Results: A significant interaction was found between self-efficacy and the therapists& perception of the therapeutic alliance predicting 1-year drinking outcomes. Patients with low self-efficacy who established a strong treatment alliance, as j...
TL;DR: The findings suggest that young people's substance use and aggressive behaviors may be related to their frequent exposure to music containing references to substanceUse and violence.
Abstract: Objective:This study investigated whether young people's substance use and aggressive behaviors are related to their listening to music containing messages of substance use and violence.Method: Using self-administered questionnaires, data were collected from a sample of community-college students, ages 15-25 years (N = 1,056; 57% female). A structural equation model (maximum likelihood method) was used to simultaneously assess the associations between listening to various genres of music and student's alcohol use, illicit-drug use, and aggressive behaviors. Respondent's age, gender, race/ethnicity, and level of sensation seeking were included in the analyses as control variables. Results: Listening to rap music was significantly and positively associated with alcohol use, problematic alcohol use, illicit-drug use, and aggressive behaviors when all other variables were controlled. In addition, alcohol and illicit-drug use were positively associated with listening to musical genres of techno and reggae. Control variables (e.g., sensation seeking, age, gender and race/ethnicity) were significantly related to substance use and aggressive behaviors. Conclusions: The findings suggest that young people&s substance use and aggressive behaviors may be related to their frequent exposure to music containing references to substance use and violence. Music listening preference, conversely, may reflect some personal predispositions or lifestyle preferences. There is also the possibility that substance use, aggression, and music preference are independent constructs that share common "third factors." Language: en
TL;DR: There is a clear need for accessible substance-use treatment and prevention services in rural areas of the United States, including services that can address MA, cocaine, polydrug use, and mental health needs for polydrug users.
Abstract: Objective: Use and production of methamphetamine (MA) has dramatically increased in the United States, especially in rural areas, with concomitant burdens on the treatment and criminal justice systems. However, cocaine is also widely used in many rural areas. The purpose of this article is to contrast MA and cocaine users in three geographically distinct rural areas of the United States. Method: Participants were recent not-in-treatment adult cocaine and MA users living in rural Ohio, Arkansas, and Kentucky, who were recruited by a referral recruitment method for sampling hidden community populations. Participants were interviewed for demographics, drug and alcohol use, criminal justice involvement, and psychological distress (Brief Symptom Inventory). Results: The sample of 706 comprised 29% nonwhite and 38% female participants; the average age was 32.6 years; 58% had a high school education or higher, and 32% were employed. In the past 6 months, they had used either MA only (13%), cocaine only (52%), or...
TL;DR: Results suggest that heavier-drinking students do not learn from their mistakes but instead overestimate the amount of alcohol they can consume without experiencing negative consequences.
Abstract: OBJECTIVE: Little research has examined antecedents of specific drinking consequences (vomiting, regretted sex, hangover, blackouts) among college students. This research examined how students' experiences of past consequences relate to their beliefs of experiencing similar consequences in the future and how these beliefs relate to current drinking patterns. METHOD: Self-reported past drinking behavior and resulting consequences associated with specific occasions were assessed among 303 (66% women) college students. Students also estimated number of drinks associated with risk of experiencing future similar consequences. RESULTS: Paired-samples t tests indicated that students significantly overestimated the number of drinks it would take to vomit, have unwanted sexual experiences, experience hangovers, and black out in comparison with the actual self-reported number of drinks consumed the last time identical consequences were experienced. In addition, a series of multiple-regression analyses revealed that greater misperceptions between the perceived and actual number of drinks associated with each type of consequence were consistently associated with heavier drinking. CONCLUSIONS: Results suggest that heavier-drinking students do not learn from their mistakes but instead overestimate the amount of alcohol they can consume without experiencing negative consequences. Clinical implications of these findings are discussed in terms of augmenting brief interventions aimed at heavy-drinking college students.
TL;DR: An explanatory model based on both psychosocial and behavioral protective and risk factors was effective in accounting for variation in college-student heavy episodic drinking.
Abstract: Objective: A theory-based protection/risk model was applied to explain variation in college students' heavy episodic drinking. Key aims were (1) to establish that psychosocial and behavioral protective factors and risk factors can account for cross-sectional and developmental variation in heavy episodic drinking, and (2) to examine whether protection moderates the impact of risk on heavy episodic drinking. Method: Random- and fixed-effects maximum likelihood regression analyses were used to examine data from a three-wave longitudinal study. Data were collected in fall of 2002, spring of 2003, and spring of 2004 from college students (N=975; 548 men) who were first-semester freshmen at Wave 1. Results: Psychosocial and behavioral protective and risk factors accounted for substantial variation in college-student heavy episodic drinking, and protection moderated the impact of risk. Findings held for both genders and were consistent across the three separate waves of data. Key predictors of heavy episodic dri...
TL;DR: Web-based surveys versus telephone interviews can be an effective and more cost-efficient means for collecting data on alcohol use and related negative consequences, particularly victimization, and some evidence that women may be more forthcoming when responding to a Web-based survey as compared with an interviewer-administered telephone survey is found.
Abstract: Objective: Traditionally, personal contact with an expe- rienced interviewer has been thought to facilitate collection of data on alcohol use and victimization experiences. Recent studies indicate that Web-based surveys may be an efficient alternative for gathering these sensitive data. To date, telephone interviewing and Web-based collec- tion of data on alcohol-related negative consequences, particularly vic- timization, have not been compared. This study was designed to compare data from an interviewer-administered and Web-based survey on alco- hol use and alcohol-related negative consequences in a sample of col- lege women. Method: Seven hundred women from a second semester freshmen college class were randomly selected to participate in either the telephone interview or Web-based modes of survey administration. Results: Fifty-three percent of invited women (N = 370) completed the survey. Completion rates were higher, and estimated dollar costs were significantly lower, for the Web-based survey. There were no differences in reported rates of alcohol or drug use by survey method; however, there were differences in several specific alcohol-related negative conse- quences. Conclusions: These findings suggest that, for college women, Web-based surveys versus telephone interviews can be an effective and more cost-efficient means for collecting data on alcohol use and related negative consequences, particularly victimization. In addition, we found some evidence that women may be more forthcoming when respond- ing to a Web-based survey as compared with an interviewer-adminis- tered telephone survey. (J. Stud. Alcohol 67: 318-323, 2006)
TL;DR: 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.
Abstract: 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...
TL;DR: Although alcohol use increased overall for study participants between ages 18.5 and 22.5, participants in lower-level alcohol-use latent classes were more likely to remain in low-level latent classes over time, and participants in moderate- and high-levelLatent transition analysis identified unique multidimensional classes of alcohol use and examined individuals' movement among these classes during emerging adulthood.
Abstract: Objective: Longitudinal analyses identified unique multidimensional classes of alcohol use and examined individuals' movement among these classes during emerging adulthood. Method: Latent transition analysis was used to identify a developmental model of alcohol use incorporating four aspects of use: use in the past year, frequency of use, quantity of use, and heavy episodic drinking. Participants were drawn from the Reducing Risk in Young Adult Transitions study (N = 1,143). Participants' alcohol use was assessed at mean ages of 18.5, 20.5, and 22.5 years. Results: Through exploratory analysis, a five-class developmental model was identified as the best description of participants' alcohol use between ages 18.5 and 22.5 years. This model consisted of five multidimensional alcohol-use latent variables: no use, occasional low use, occasional high use, frequent high use, and frequent high use with heavy episodic drinking. Analyses provided information regarding the proportion of participants in each latent c...
TL;DR: The results suggest that the "U"-shaped association between alcohol consumption and depressive symptoms previously identified in Western countries is present in young people from a variety of cultural backgrounds and is not secondary to variations in health status, socioeconomic background, age, and gender.
Abstract: Objective: The objective of this study was to determine whether the nonlinear association between alcohol and depressive symptoms observed in middle-aged and older men and women is present in young adults and is independent of culture, socioeconomic position, and health status. Method: Data were from the International Health and Behaviour Survey, involving 6,932 male and 8,816 female university students ages 17-30 years from 20 countries. Alcohol consumption was assessed in terms of number of drinks per week and number of drinks per episode, and the Beck Depression Inventory (BDI) was administered. Analyses were adjusted for clustering by country. Results: The proportion of respondents with elevated BDI scores was 19.3%, 16.3%, and 20.0% for nondrinkers, moderate drinkers, and heavy drinkers, respectively. The odds of elevated BDI scores for nondrinkers compared with moderate drinkers were 1.22 (95% confidence interval [CI]: 1.06-1.42) after adjusting for age, gender, living arrangements, socioeconomic st...