Showing papers in "Journal of Studies on Alcohol and Drugs in 2007"

Are social norms the best predictor of outcomes among heavy-drinking college students?

Abstract: Objective: This research was designed to evaluate the relative contribution of social norms, demographics, drinking motives, and alcohol expectancies in predicting alcohol consumption and related problems among heavy-drinking college students. Method: Participants included 818 (57.6% women) first-year undergraduates who reported at least one heavy-drinking episode in the previous month. In addition to providing demographic information (gender and fraternity/sorority membership) participants completed Web-based assessments of social norms (perceived descriptive norms regarding typical student drinking, injunctive norms regarding friends' and parents' approval), motives (social, enhancement, coping, and conformity), and expectancies and evaluations of positive and negative alcohol effects. Results: Regression results indicated that descriptive and injunctive norms were among the best predictors of college student drinking. With respect to alcohol problems, results indicated that coping motives accounted for the largest proportion of unique variance. Finally, results revealed that alcohol consumption mediated the relationships between predictors and problems for social norms, whereas coping motives, negative expectancies, and evaluation of negative effects were directly associated with alcohol problems despite having relatively weak or null unique associations with consumption. Conclusions: The results of this study substantiate social norms as being among the best predictors of alcohol consumption in this population and suggest that drinking to cope is a better predictor of problems. The findings are discussed in terms of practical prevention and treatment implications. Language: en

A prospective study of the effects of age of initiation of alcohol and drug use on young adult substance dependence.

Abstract: Objective: Previous cross-sectional research has disagreed about whether an adolescent's age of onset of alcohol use is a unique predictor of later alcohol dependence or whether it is merely a correlate of those factors that produce alcohol dependence. The current study tests this question in a longitudinal sample, and extends the literature by testing whether age of onset of alcohol and drug use predicts alcohol and drug dependence. Method: Data from an ongoing study of children of alcoholics and matched controls (n = 395) were collected during three annual interviews during adolescence and two 5-year follow-ups in young adulthood. Results: Taking a first drink of alcohol at or before age 13 was unrelated to the odds of alcohol and drug dependence when the adolescent did not also participate in early drug use or when correlated risk factors were taken into account. On the other hand, early drug use elevated the odds of drug dependence by young adulthood, even while controlling for shared risk factors. Co...

Long-term effects of child abuse and neglect on alcohol use and excessive drinking in middle adulthood.

Abstract: Objective: The purpose of this study was to determine the long-term effects of child abuse and neglect on alcohol use in middle adulthood. Method: Individuals with documented cases of childhood physical and sexual abuse and/or neglect (n = 500) and matched controls (n = 396) from a metropolitan county in the Midwest were followed and interviewed in middle adulthood. Outcomes were Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, diagnoses of alcohol abuse or dependence in young adulthood (age 29) and excessive drinking in middle adulthood (age 40). Results: Women with documented histories of child abuse or neglect reported higher past-year typical quantity (p < .01) and past-month number of days drinking eight or more drinks (p < .05) than nonabused/nonneglected women. Controlling for parental alcohol/drug problems, the effect of child maltreatment on excessive drinking in middle adulthood was not significant for women. For women, the final structural equation model revealed a...

Optimizing personalized normative feedback: the use of gender-specific referents.

Abstract: Objective: Many brief interventions include personalized normative feedback (PNF) using gender-specific or gender-neutral referents. Several theories suggest that information pertaining to more socially proximal referents should have greater influence on one's behavior compared with more socially distal referents. The current research evaluated whether gender specificity of the normative referent employed in PNF related to intervention efficacy. Method: Following baseline assessment, 185 college students (45.2% women) were randomly assigned to one of three intervention conditions: gender-specific feedback, gender-neutral feedback, or assessment-only control. Immediately after completing measures of perceived norms, alcohol consumption, and gender identity, participants in the gender-neutral and gender-specific intervention conditions were provided with computerized information detailing their own drinking behavior, their perceptions of student drinking, and actual student drinking. Results: After a 1-mont...

Alcohol and environmental justice: the density of liquor stores and bars in urban neighborhoods in the United States

Abstract: Objective: This study had two purposes: (1) to characterize the density of liquor stores and bars that individuals face according to race, economic status, and age in the urban United States and (2) to assess alternative measures of retailer density based on the road network and population. Method: We used census data on business counts and sociodemographic characteristics to compute the densities facing individuals in 9,361 urban zip codes. Results: Blacks face higher densities of liquor stores than do whites. The density of liquor stores is greater among nonwhites in lower-income areas than among whites in lower- and higher-income areas and nonwhites in higher-income areas. Nonwhite youths face higher densities of liquor stores than white youths. The density of liquor stores and bars is lower in higher-income areas, especially for nonwhites. Conclusions: Mismatches between alcohol demand and the supply of liquor stores within urban neighborhoods constitute an environmental injustice for minorities and l...

Environmental Policies to Reduce College Drinking: An Update of Research Findings*

Abstract: Objective: We provide an overview of environmental strategies that may reduce college drinking. The identified environmental strategies fall into three categories: (1) reducing alcohol use and related problems among underage college students, (2) reducing risky alcohol use and related problems among all college students, and (3) de-emphasizing the role of alcohol and creating positive expectations on campus. At the time of our 2002 review, few studies had assessed environmental policies and strategies in the context of college student alcohol use and related problems. The present article summarizes recent research on the effects of environmental policies and strategies affecting college students. Method: We updated our previous literature searches to identify peer-reviewed research studies evaluating the effects of environmental strategies on college and general populations. Results: We identified 110 new studies addressing environmental strategies published between 1999 and 2006. Thirty-six of these studies focused on the college population. The extant research indicates that many environmental strategies are promising for reducing alcohol-related problems among the general population. Several recent studies suggest that these strategies, particularly combined strategies, also may be effective in decreasing alcohol-related problems among college populations. Conclusions: Further research is needed to continue expanding our understanding of environmental strategies to identify the most effective individual and combined strategies. Language: en

The costs of alcohol, illegal drugs, and tobacco in Canada, 2002

Abstract: Objective: The aim of this study was to estimate costs attributable to substance use and misuse in Canada in 2002. Method: Based on information about prevalence of exposure and risk relations for more than 80 disease categories, deaths, years of life lost, and hospitalizations attributable to substance use and misuse were estimated. In addition, substance-attributable fractions for criminal justice expenditures were derived. Indirect costs were estimated using a modified human capital approach. Results: Costs of substance use and misuse totaled almost Can. $40 billion in 2002. The total cost per capita for substance use and misuse was about Can. $1,267: Can. $463 for alcohol, Can. $262 for illegal drugs, and Can. $541 for tobacco. Legal substances accounted for the vast majority of these costs (tobacco: almost 43% of total costs; alcohol: 37%). Indirect costs or productivity losses were the largest cost category (61%), followed by health care (22%) and law enforcement costs (14%). More than 40,000 people died in Canada in 2002 because of substance use and misuse: 37,209 deaths were attributable to tobacco, 4,258 were attributable to alcohol, and 1,695 were attributable to illegal drugs. A total of about 3.8 million hospital days were attributable to substance use and misuse, again mainly to tobacco. Conclusions: Substance use and misuse imposes a considerable economic toll on Canadian society and requires more preventive efforts.

Social motives and the interaction between descriptive and injunctive norms in college student drinking.

Abstract: Objective: Social norms are a key determinant of young adult drinking, yet little research has evaluated potential interactive effects among different types of norms. The present research was designed to evaluate perceptions of friends' approval of drinking (i.e., injunctive norms) as a moderator of the relationship between perceived prevalence of friends' drinking (i.e., descriptive norms) and personal alcohol consumption. We also evaluated whether social drinking motives further influence this relationship. Method: Participants included 1,400 first-year college students (61% women) who completed Web-based assessments of descriptive and injunctive norms, personal drinking, and social drinking motives. Results: Results revealed that both descriptive and injunctive norms regarding close friends were uniquely and positively associated with drinking behavior. The relationship between perceived descriptive norms and personal alcohol consumption was stronger among those who also perceived their friends as bein...

Alcohol Initiation Experiences and Family History of Alcoholism as Predictors of Problem-Drinking Trajectories

Abstract: Objective: The purpose of this study was to identify developmental trajectories of problem drinking from adolescence into young adulthood and to determine if alcohol use initiation experiences and family history of alcoholism, as well as their interactions, would predict trajectory group membership. Method: Five waves of data were collected from respondents who were 12 years old at the time of recruitment to the Rutgers Health and Human Development Project and followed until age 31 (n = 438). A standardized measure of problem drinking (Rutgers Alcohol Problem Index) was used to develop trajectories with growth-mixture modeling. Differences across groups in first- use experience (age of onset, pleasantness of the experience, and feeling intoxicated), a family history of alcoholism, and gender were analyzed with chi-square and analysis of variance tests, and logistic regression analyses were used to estimate the odds of group membership. Results: Three trajectory groups of drinkers were identified: no or lo...

Alcohol's Effects on Sexual Decision Making: An Integration of Alcohol Myopia and Individual Differences

Abstract: Objective: We conducted an experiment to test the applicability of integrating individual perceptions of unprotected sex consequences with alcohol's myopic effects as an explanatory framework for risky sexual decision making in young heterosexual men and women. Method: Male and female participants (N = 61) rated their perceptions of unprotected sex consequences, received alcoholic (target breath alcohol concentration = .10%) or nonalcoholic drinks, and completed a risky sexual decision-making task that included a quantitative measure of sexual decision-making cue attention. Results: Intoxicated participants were more attentive to impelling cues and reported greater sexual risk intentions than sober participants. Mediational analyses indicated that attention to cues fully mediated the alcohol-sexual risk intention relationship. Moderational analyses revealed that alcohol's focusing effect acts in conjunction with pre-existing individual perceptions to influence cue salience directly and sexual risk intenti...

Six-month changes in spirituality, religiousness, and heavy drinking in a treatment-seeking sample

Abstract: Objective: This descriptive and exploratory study investigated change in alcoholics' spirituality and/or religiousness (S/R) from treatment entry to 6 months later and whether those changes were associated with drinking outcomes. Method: Longitudinal survey data were collected from 123 outpatients with alcohol use disorders (66% male; mean age = 39; 83% white) on 10 measures of S/R, covering behaviors, beliefs, and experiences, including the Daily Spiritual Experiences and Purpose in Life scales. Drinking behaviors were assessed with the Timeline Followback interview. Alcoholics Anonymous (AA) participation and attendance were also measured. Results: Over 6 months, there were statistically significant increases in half of the S/R measures, specifically the Daily Spiritual Experiences scale, the Purpose in Life scale, S/R practices scale, Forgiveness scale, and the Positive Religious Coping scale. There were also clinically and statistically significant decreases in alcohol use. Multiple logistic regressio...

Drinking Motives as Mediators of the Link Between Alcohol Expectancies and Alcohol Use Among Adolescents

Abstract: Objective: The purpose of this study was to test whether the link between alcohol expectancies and alcohol use (drinking fre- quency, usual quantity, five-plus drinking) is mediated by drinking mo- tives. Method: Linear structural equation models were estimated based on a nationally representative sample of 5,616 8th, 9th, and 10th grad- ers in Switzerland (51% female; mean (SD) age = 15.1 (1.0) years). Re- sults: In most cases, a perfect mediation occurred. Although all expectancy and motive dimensions were related to all alcohol-use mea- sures in multivariate models, the expectancy link in multiple multivari- ate models was reduced to zero, whereas the motive link remained basically the same. One exception was the Tension Reduction Expect- ancy scale, which included aspects other than problem coping that were still related to alcohol consumption, even when coping motives were con- trolled for. Conclusions: Given the consistency of the results across dif- ferent alcohol expectancies, drinking motives, and alcohol-use measures, the present study provides evidence to support one basic assumption of the motivational model of alcohol use: Drinking motives are the most proximate factor that precedes alcohol use. They are the gateway through which more distal influences (e.g., alcohol expectancies) are mediated. (J. Stud. Alcohol Drugs 68: 76-85, 2007)

Multidimensional assessment of impulsivity in undergraduate hazardous drinkers and controls.

Abstract: Objective: Alcohol misuse in college students represents a significant public health problem Toward improving the understanding of determinants of collegiate alcohol misuse, the current study examined several dimensions of impulsivity in relation to hazardous drinking in college students Method: A one-way, two-group, cross-sectional design was used to compare hazardous drinkers (HZD) with social drinkers (SOC) HZD drinkers were required to score 6 or more on the Alcohol Use Disorders Identification Test (AUDIT); SOC drinkers were required to score 1–5 on the AUDIT The sample comprised 93 participants (56% HZD; 76% male) who were recruited from a mediumsized public university Participants were assessed under neutral conditions using the Eysenck Impulsivity Questionnaire (EIQ), Delay Discounting Task (DDT), and Stanford Time Perspective Inventory (STPI) Results: Consistent with predictions, HZD participants exhibited significantly greater impulsivity on the EIQ-Impulsivity subscale (p < 001), the STP

The Alcohol Use Disorders Identification Test for Detecting At-Risk Drinking: A Systematic Review and Meta-Analysis

Abstract: Objective: The purpose of this study was to perform a systematic review of the diagnostic accuracy of the Alcohol Use Disorders Identification Test (AUDIT) for detecting at-risk drinking. Method: The MEDLINE, PsycINFO, Science Citation Index Expanded, BIOSIS Previews, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDION, and Cochrane Library databases were searched for relevant studies. The criteria for inclusion were a valid reference standard, AUDIT consisting of 10 items, avoiding bias that may result from how the reference standard was obtained, and when and how many participants were tested. Data were extracted independently by two reviewers. Data synthesis was performed by applying direct pooling of proportions and random effects model for likelihood ratios and diagnostic odds ratio. Results: Twenty-three studies were included in the systematic review, 19 of which were included in the meta-analysis. With a cutoff of 8 points, sensitivity ranged from .31 to .89 and specificity ra...

Do Protective Behavioral Strategies Mediate the Relationship Between Drinking Motives and Alcohol Use in College Students

Abstract: Objective: Heavy alcohol use among college students represents a public health problem on American college campuses Use of protective behavioral strategies (PBS) has been shown to be related to reduced alcohol use and fewer alcohol-related problems, but the relationship of PBS to other alcohol-related constructs is unclear The purpose of this study was to determine whether the use of PBS mediated the relationship between positively and negatively reinforcing drinking motives and both alcohol use and alcohol-related problems Method: Data were collected on 254 undergraduate students at a large, public university in the northeast region of the United States Approximately one third (n = 90) of the participants were volunteers, whereas the remaining individuals enrolled in the study as an option for satisfying an alcohol-related campus judicial sanction Results: Structural equation modeling analyses indicated that use of PBS partially mediated the relationships between positively reinforcing (ie, social

The Impact of Partner Alcohol Problems on Women's Physical and Mental Health

Abstract: Objective: The purpose of this study was to examine the association between partner alcohol problems and selected physical and mental health outcomes among married or cohabiting women, before and after adjusting for potential confounders, and to compare these associations with those reflecting the impact of the women's own alcohol-use disorders (AUDs). 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 11,683 married or cohabiting women. Classification of their own AUDs was based on self-report of symptoms operationalizing the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria for alcohol abuse or dependence. Current partner alcohol problems were identified by the women after an explanation that recapitulated the essence of these c...

Using Wireless Handheld Computers and Tailored Text Messaging to Reduce Negative Consequences of Drinking Alcohol

Abstract: Objective: The purpose of this trial was to investigate the feasibility and short-term outcomes of a tailored intervention, delivered via text messages to wireless handheld computers, to reduce alcohol-related consequences among college students. Method: Forty college students were randomly assigned to one of two study groups. In the control group, participants used handheld computers to complete daily surveys about their drinking behavior and related variables. In the treatment group, participants used the handheld computers to complete daily surveys and to receive individually tailored messages on the units. The tailored messages addressed consequences of alcohol use and were tailored to respondents' reported behavior, self-efficacy, and outcome expectancies regarding alcohol-related consequences. Results: All treatment group participants reported receiving messages on their handheld computers; most students were sent messages on 12-14 days. Controlling for baseline differences, participants in the treatment group reported drinking significantly fewer drinks per drinking day than participants in the control group during the study period. At follow-up, participants in the treatment group had lower expectancies that they would get in trouble as a result of alcohol consumption than did control group participants. Participants provided both positive and negative feedback about the messages. Conclusions: This study demonstrated the feasibility of delivering tailored messages via wireless handheld computers. Tailored messages about avoiding negative consequences of alcohol use delivered via handheld computers had small but positive effects on alcohol-related attitudes and behaviors. Future research should replicate these findings with a larger, more diverse sample, during a longer period, and with other audiences. Language: en

Recall Bias for Seven-Day Recall Measurement of Alcohol Consumption Among Emergency Department Patients: Implications for Case-Crossover Designs*

Abstract: Objective: The purpose of this study was to estimate biases in recalling alcohol consumption over short periods. Method: Patients (n = 918) attending the surgical ward of the emergency department (ED) of the Lausanne University Hospital in Switzerland participated in a brief intervention study. Inclusion criteria were an average alcohol consumption exceeding 14 drinks per week for men or 7 drinks per week for women, or the consumption at least once monthly of 5 or more drinks for men or 4 or more drinks for women. Alcohol consumption was measured by means of a retrospective 7-day diary. Results: Recalled alcohol consumption decreased with the length of the recall period. Consumption was 0.9 drinks lower for a recall of 7 days compared with a recall of 1 day. Biases were apparent for every day of the week, but the bias was highest for consumption to be recalled for Fridays and Saturdays. Recall bias was significant only for sporadic drinkers (those drinking less than 4 days a week) but not for regular drin...

Reasons for drinking in the college student context: the differential role and risk of the social motivator.

Abstract: Objective: The present study examines the relationships among reasons for drinking, alcohol consumption, and alcohol-related consequences in two college-aged samples. Personal motivators such as mood enhancement and coping (tension reduction) have consistently been shown to predict problematic alcohol use, but because of the salient nature of social drinking in college, we hypothesized that social reasons for drinking would be most frequently endorsed and, in turn, predict negative consequences. Method: T w o distinct samples—119 coed adjudicated students sanctioned by the university for violating campus alcohol policy and 106 coed volunteer students—completed measures assessing alcohol consumption, reasons for drinking, and consequences. Differential effects between genders were examined. Results: Social camaraderie (SC) was the most frequently endorsed reason for drinking. Regression analyses controlling for previous drinking revealed that social reasons for drinking predicted alcohol-related problems a...

Normative beliefs, misperceptions, and heavy episodic drinking in a British student sample.

Abstract: OBJECTIVE: Numerous studies have demonstrated the existence and effect of normative misperceptions on heavy episodic drinking behavior. However, there has been little work on these processes or application of normative-belief interventions outside the U.S. college system. The aim of the current study, therefore, was to investigate heavy episodic drinking and normative misperceptions in a U.K. university setting. METHOD: An email containing a link to a survey Web site was distributed to all current undergraduate students at the University of Paisley, Scotland. In addition to age and gender questions, the survey contained items on students' personal behavior and perception of the level of that behavior in three groups of increasing social distance: close friends, other students of the same age, and other people of the same age in U.K. society in general. RESULTS: Completed surveys from 500 respondents were returned. In keeping with previous research, significant correlations were found between the respondents' behavior and the perception of that behavior in others, with beliefs about the most proximal individuals being the most strongly correlated. The majority of respondents were also found to overestimate alcohol consumption in other students. An age effect was noted, in which misperceptions appeared to decrease with age but did not vary between genders. CONCLUSIONS: The findings of the study indicate that the normative-belief alcohol consumption processes that have been found on U.S. college campuses also operate in U.K. university settings. This raises the possibility of applying social-norms interventions from the United States to the United Kingdom and potentially elsewhere in the world. Furthermore, the study noted apparent age effects in the degree of misperception, the implications of which are discussed.

The factor structure of a dichotomously scored Rutgers Alcohol Problem Index.

Abstract: Objective: Heavy college-student alcohol use and its resulting negative consequences represent a public-health problem on American college campuses. The Rutgers Alcohol Problem Index (RAPI) is a commonly used measure of alcohol problems among college students, but the psychometric properties of this measure never have been comprehensively assessed with the college-student population. The purpose of this research was to conduct reliability and validity analyses, particularly exploratory and confirmatory factor analysis, on a dichotomously scored version of the measure. Method: Data were collected on 4,686 undergraduate students at a large, public university in the Northwest region of the United States and 438 students at a large, public university in the Northeast. Results: Exploratory factor analysis suggested that a three-factor model provided the best fit to the data. This finding was replicated via confirmatory factor analyses in two separate samples. The three factors were labeled Abuse/Dependence Sym...

Outdoor alcohol advertising near schools: what does it advertise and how is it related to intentions and use of alcohol among young adolescents?

Abstract: OBJECTIVE: The objectives of this study were to (1) document and describe all outdoor alcohol advertisements surrounding schools and (2) examine the association between exposure to alcohol advertising in sixth grade and youth alcohol use, intentions, norms, and attitudes in eighth grade. METHOD: All outdoor alcohol advertisements within 1,500 feet of 63 Chicago school sites were documented and coded for content and theme. Longitudinal mixed-effects regression analysis was used to determine the association between number of alcohol advertisements around a school in sixth grade and student alcohol behaviors, intentions, norms, and attitudes at the end of eighth grade, 2 years later. Participants included 2,586 sixth-grade students in the 2002-2003 school year. The sample was 37% black, 33% Hispanic, and 15% white. Gender was evenly distributed, and the average age was 12.2 at the end of sixth grade. RESULTS: A total of 931 alcohol advertisements were found within 1,500 feet of the 63 school sites. Exposure to alcohol advertising around schools at the end of sixth grade was found to predict alcohol intentions at the end of eighth grade. This finding held true even for those students who were nonusers of alcohol in sixth grade. CONCLUSIONS: Exposure to outdoor alcohol advertising around schools is associated with subsequent youth intentions to use alcohol. The association between exposure to alcohol advertising and youth alcohol-use intentions was found even among sixth-grade nonusers of alcohol, suggesting that even those who have not used alcohol are still influenced by alcohol advertising. These findings suggest that restrictions in alcohol advertising near schools may be warranted. Language: en

Military culture and drinking behavior among U.S. Navy careerists.

Abstract: Objective: This study builds on research linking work culture and drinking behavior to examine the influence of the military work environment, especially deployment and liberty, on heavy and heavy episodic drinking among career enlistees and officers. Method: Both quantitative (self-administered cross-sectional survey data collected from 2,380 respondents) and qualitative (home-base and shipboard observations and ethnographic interviews with 81 enlisted and officer personnel) methods provided data. Linear regression analyses were used to examine the relationship between occupational factors (enforcement of alcohol policy, work problems, work-related stress, and length of deployment) and positive normative beliefs for heavy drinking during deployment liberty. Logistic regression analyses were used to examine the relationship between positive normative beliefs and four drinking-related outcomes (past 12-month Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV], alcohol abuse and f...

Collegiate alcohol consumption and academic performance.

Abstract: Objective: Although studies consistently have found a negative bivariate association between alcohol use and academic performance among college students, some research suggests that this association largely results from student differences at matriculation. The present study examines this relationship while controlling for key background factors. Method: Personal interview surveys were conducted for four consecutive semesters with random samples of students at a small, liberal arts college, resulting in a combined sample of 754 (392 women). The interviews measured alcohol consumption, gender, race, athletic status, academic class, parents' education and income, and frequency of attending off-campus parties; and 94% of the sample granted permission to obtain grade point average (GPA), high school class rank, and Scholastic Aptitude Test (SAT) scores from official college records. Results: The amount of alcohol consumed correlated significantly with GPA (r = −.26). Ordinary least squares regressions showed ...

Alcohol Treatment Research Assessment Exposure Subject Reactivity Effects: Part I. Alcohol Use and Related Consequences

Abstract: Objective: There has been increasing recognition among alcohol treatment researchers that research assessment exposure subject reactivity effects can contribute to clinical outcomes, decrease study design sensitivity, and confound research findings. The present study is an experimental investigation of two of the more salient components of the research assessment interview (i.e., frequency and comprehensiveness) and their effects on clinical outcomes (Part I: Alcohol Use and Related Consequences) and treatment participation (Part II: Treatment Engagement and Involvement). Method: The study design was a 2 (Frequency of Assessment) × 2 (Comprehensiveness of Assessment) completely randomized factorial, and study participants were randomly assigned, using an urn randomization procedure, to one of the resulting four experimental research assessment exposure conditions: (1) frequent-comprehensive, (2) frequent-brief, (3) infrequent-comprehensive, and (4) infrequent-brief. Study participants were recruited from ...

Six-month treatment outcomes of cocaine-dependent patients with and without PTSD in a multisite national trial.

Abstract: Objective: This study examined 6-month treatment outcomes among 428 cocaine-dependent outpatients with (n = 34) and without (n = 394) posttraumatic stress disorder (PTSD) in a randomized controlled multisite clinical trial of manual-based psychotherapies for substance use disorder (SUD). Method: Assessments were completed at baseline and monthly during the 6-month treatment. With longitudinal mixed-effects models, we compared outcomes between SUD-PTSD and SUD-only patients and also examined rates of within-group change. Results: Results indicated a highly consistent pattern: the SUD-PTSD patients were more impaired to begin with and remained so across time compared with SUD-only patients (with the exception of substance use and addiction-related legal and employment problems, which did not differ between groups). Also, the SUD-PTSD patients improved less than SUD-only patients in alcohol use and the majority of addiction-related psychosocial problems. However, the two groups did not differ significantly i...

The factor structure of the Alcohol Use Disorders Identification Test (AUDIT).

Abstract: Objective: Past research assessing the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) with various exploratory and confirmatory factor analytic techniques has identified one-, two-, and three-factor solutions. Because different factor analytic procedures may result in dissimilar findings, we examined the factor structure of the AUDIT using the same factor analytic technique on two new large clinical samples and on archival data from six samples studied in previous reports. Method: Responses to the AUDIT were obtained from participants who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria for alcohol dependence in two large randomized clinical trials: the COMBINE (Combining Medications and Behavioral Interventions) Study (N = 1,337; 69% men) and Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity; N = 1,711; 76% men). Supplementary analyses involved six correlation matrices of AUDIT data obtained from five previously pu...

Alcohol Use and Protective Sexual Behaviors Among High-Risk Adolescents

Abstract: Objective: This study seeks to advance our understanding of moderating influences on the relationship between alcohol and condom use by examining their association at both the global and event levels of analysis using a prospective approach within a sample of high-risk adolescents. The following potential moderators were examined: sex-related alcohol expectancies, gender, relationship type, level of alcohol use, and impulsive sensation seeking. Method: Criminally involved adolescents (N = 300) completed measures of alcohol use, condom use, personality, and alcohol expectancies; 267 (89%) participants completed a behavioral assessment 6 months later. Results: At the global level of analysis, there was a significant moderating effect of alcohol-related sexual-enhancement expectancies, such that the relationship between alcohol and condom use was negative and significant only among individuals with higher sexual-enhancement expectancies. At the time-limited global level, impulsive sensation seeking at baseli...

Attitudes and perceived approval of drinking as mediators of the relationship between the importance of religion and alcohol use.

Abstract: Objective: Previous research has consistently demonstrated that religiosity and personal importance of religion are associated with lower levels of alcohol use among both adolescents and college students Although a number of different mechanisms have been proposed to account for this, few studies have empirically examined potential mediators of this relationship Given the extensive literature on the impact of social norms on the drinking behavior of college students, the present study evaluates the role of perceived drinking norms as a mediator of the relationship between the importance of religion and alcohol use Specifically, we examined both personal attitudes and perceived injunctive norms with regard to reference groups that vary in their proximity to students (ie, close friends and typical college students) Method: Participants were 1,400 undergraduate students (606% women) who were assessed using self-report measures of alcohol consumption, importance of religion, attitudes, and perceived no

Cocaine craving as a predictor of treatment attrition and outcomes after residential treatment for cocaine dependence.

Abstract: Objective: Whether craving (urge to use) actually predicts drug-use outcomes has had little investigation despite its central role in theories. Pretreatment predictors of within-treatment cocaine urges were investigated, and the urge reports were used as predictors of treatment attrition and outcome while controlling for correlated variables. In addition, urge to use in the patients' first relapse situations was compared with urge reports in the same patients' close-call situations without relapse. Method: Cocaine-dependent patients (N = 163) in residential treatment were assessed during the first week of treatment for pretreatment substance use and for urge to use cocaine in simulated high-risk situations. Substance use was assessed at follow-up with urine-confirmed self-reports (n = 119 at 3 months, n = 114 at 6 months). Mood and urge ratings just before relapse and in close calls without relapse were assessed. Results: Urge to use cocaine was unrelated to demographics, other substance use, years used, ...