Showing papers in "Journal of Studies on Alcohol and Drugs in 2008"
TL;DR: The need to focus on lower drink thresholds, the harms produced at this level of drinking for the drinkers, the secondhand effects experienced by other students and neighborhood residents, the continuing extent of the problem, and the role of the college alcohol environment in promoting heavy drinking by students are reviewed.
Abstract: The Harvard School of Public Health College Alcohol Study surveyed students at a nationally representative sample of 4-year colleges in the United States four times between 1993 and 2001. More than 50,000 students at 120 colleges took part in the study. This article reviews what we have learned about college drinking and the implications for prevention: the need to focus on lower drink thresholds, the harms produced at this level of drinking for the drinkers, the secondhand effects experienced by other students and neighborhood residents, the continuing extent of the problem, and the role of the college alcohol environment in promoting heavy drinking by students. In particular, the roles of campus culture, alcohol control policies, enforcement of policies, access, availability, pricing, marketing, and special promotions of alcohol are highlighted.
507 citations
TL;DR: Examination of social disadvantage as a source of stress and its association with alcohol use and problems in the three largest racial/ethnic groups in the United States shows experiences of disadvantage appear to have similar effects on problem drinking among both racial/ ethnic minorities and whites.
Abstract: Objective: Despite growing evidence of the adverse health effects of social disadvantage on minority populations, few studies have investigated whether such effects extend to alcohol problems. This study examines social disadvantage as a source of stress and analyzes its association with alcohol use and problems in the three largest racial/ethnic groups in the United States. Method: Data on white, black, and Hispanic Americans (n = 6,631) were obtained from the 2005 U.S. National Alcohol Survey, a nationally representative telephone-based survey of adults ages 18 and older. Social disadvantage was measured by poverty level, frequency of unfair treatment, racial/ethnic stigma consciousness, and cumulative disadvantage. Outcomes included drinking status, at-risk drinking, and problem drinking. Results: Blacks and Hispanics reported greater exposure to social disadvantage than whites, including greater poverty, unfair treatment, racial/ethnic stigma, and cumulative disadvantage. In all three racial/ethnic gr...
213 citations
TL;DR: It appears that the DMQ-R is an ideal instrument for inclusion in large cross-national surveys and that programs that target motives as a way to reduce risky drinking may be appropriate for different drinking cultures in different geographical locations.
Abstract: Objective: The aim of this study was to investigate cross- national differences (1) in the four-dimensional factor structure of drink- ing motives; (2) in the mean levels of enhancement, coping, social, and conformity motives; and (3) in the association of these motives with ado- lescent alcohol use, risky single-occasion drinking, and alcohol-related problems. Method: Confirmatory factor analysis, analysis of variance, and structural equation modeling were applied to sample data from Swit- zerland (n = 5,118; mean age = 15.3), Canada (n = 2,557; mean age = 15.7), and the United States (n = 607; mean age = 15.7). Results: The results showed that the four-dimensional factor structure of the Drink- ing Motives Questionnaire Revised (DMQ-R) was structurally invari- ant across the three countries. Although the rank order in mean levels of motive endorsement was the same across countries (i.e., highest for social, followed by enhancement, coping, and conformity), the absolute levels of endorsement were highest in the Canadian sample, followed by the Swiss and then the U.S. sample. In all three countries, enhance- ment and coping motives were positively related to alcohol use and to risky drinking in particular, and coping motives were additionally re- lated to alcohol-related problems. Conclusions: The results indicate that the DMQ-R is a valid and reliable instrument to assess drinking mo- tives across cultures. It appears therefore that the DMQ-R is an ideal instrument for inclusion in large cross-national surveys and that pro- grams that target motives as a way to reduce risky drinking may be appropriate for different drinking cultures in different geographical lo- cations. (J. Stud. Alcohol Drugs 69: 388-396, 2008)
208 citations
TL;DR: The 30-day B-YAACQ seems valid for use with college students who have received an alcohol violation and for use in evaluating changes in alcohol consequences.
Abstract: Objective: The Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ) was developed using item response modeling to provide a brief and readily interpretable measure of negative alcohol consequences over the past year among college students. The purpose of the present study was to extend evaluation of the B-YAACQ by examining its psychometric properties when administered to college students cited for a university alcohol violation using a past 30-day time frame of assessment. Method: The B-YAACQ was administered at baseline and at a 6-week follow-up to 291 students cited for a university alcohol violation. Reliability and validity analyses, in addition to Rasch model analyses, were conducted using these data. Results: Results demonstrated that the B-YAACQ was internally consistent, showed strong unidimensionality and additive properties, displayed minimal item redundancy and minimal floor or ceiling effects, was reliable over a 6-week period, and was sensitive to change in drinking following an alcohol intervention. In addition, the relative severity of items was preserved over time and generally consistent with results from an earlier study. Conclusions: The 30-day B-YAACQ seems valid for use with college students who have received an alcohol violation and for use in evaluating changes in alcohol consequences. Language: en
161 citations
TL;DR: Comparing rates of high-risk and problem drinking in a large sample of Chicago-area lesbians and a national sample of age- and education-matched urban heterosexual women indicates that sexual minority women are likely to have elevated risks of hazardous drinking.
Abstract: Objective: Studies of alcohol use among lesbians have typically used convenience samples with uncertain generalizability or general population samples with small numbers of lesbians. Here we compare rates of high-risk and problem drinking in a large sample of Chicago-area lesbians and a national sample of age- and education-matched urban heterosexual women. Method: Data came from comparable face-to-face interviews with 405 self-identified Chicago-area lesbians and with 548 urban women from a U.S. national sample. Rates of hazardous drinking (heavy episodic drinking, intoxication, drinking-related problems, alcohol-dependence symptoms) were compared for exclusively heterosexual, mostly heterosexual, bisexual, mostly lesbian, and exclusively lesbian subgroups. Results: Exclusively heterosexual women had lower rates than did all other women on all measures of hazardous drinking. Exclusively heterosexual women also reported less childhood sexual abuse, early alcohol use, and depression. Bisexual women reported more hazardous drinking indicators and depression than did exclusively or mostly lesbian women. Conclusions: These results indicate that sexual minority women are likely to have elevated risks of hazardous drinking. The differences between lesbian and bisexual women suggest that more attention is needed to subgroup differences among sexual minority women. Health care providers need to know the sexual identity of their patients and how their sexual identity may affect their risks for hazardous drinking. Higher rates of childhood sexual abuse, early drinking, and depression among sexual minority women suggest that these experiences may be important in assessing and treating problems related to their drinking, and in developing prevention and early intervention strategies. Language: en
155 citations
TL;DR: Prevention and treatment of the negative impact of early child maltreatment may delay and reduce alcohol use among students in a large study of adolescents.
Abstract: Objective: Child maltreatment (CM) is prevalent among U.S. youth and has been associated with subsequent maladaptive behaviors, including substance use. The current study examines the associations between early child maltreatment and (1) preteen alcohol-use initiation and (2) heavy episodic drinking among students in a large study of adolescents. Method: The Youth Violence Survey is a cross-sectional survey of public school students enrolled in Grades 7,9, 11, and 12 in a school district in a high-risk community. The analysis sample was limited to students who provided complete data on all relevant variables (N= 3,559). Fifty-two percent of the analysis sample was female. Early child maltreatment was defined as witnessing domestic violence and experiencing physical and/or sexual abuse before the age of 10 years. Outcome variables include ever drinking alcohol, preteen alcohol-use initiation, and heavy episodic drinking. Results: Witnessing domestic violence, experiencing physical abuse, and experiencing sexual abuse were significantly associated with preteen alcohol-use initiation (adjusted odds ratio [AOR] = 1.55, 95% confidence interval [CI]: 1.26-1.91; AOR = 2.10, 95% CI: 1.69-2.63; AOR = 1.57, 95% CI: 1.16-2.14, respectively). Students who experienced one or more types of maltreatment were 1.5-3 times more likely to report preteen alcohol-use initiation. Heavy episodic drinking was associated only with childhood sexual abuse in boys (AOR = 2.62, 95% CI: 1.52-4.50). Conclusions: Prevention and treatment of the negative impact of early child maltreatment may delay and reduce alcohol use. Language: en
141 citations
TL;DR: Interventions are needed with maltreated girls to recognize and attend to their PTSD symptoms and to assist them in developing coping strategies to deal with stressful life events in an attempt to reduce risk of subsequent substance use and related problems.
Abstract: Objective: This study examined mechanisms that might account for the association between early childhood abuse and neglect, and substance use and related problems in adulthood for women. Method: Women with documented cases of early childhood abuse and/or neglect and matched controls were interviewed in young adulthood (mean age = 29 years) and again in middle adulthood (mean age = 40) (n = 582). We examined the mediating effects of posttraumatic stress disorder (PTSD) symptoms, stressful life events, and delinquent and criminal behavior measured in young adulthood on substance use-related problems and illicit drug use measured in middle adulthood. Results: We found that all three potential mediators mediated the effects of abuse and neglect on substance-use problems and illicit drug use. When all three mediators were considered simultaneously, only stressful life events mediated the effects of child abuse and neglect for substance use-related problems and PTSD mediated for illicit drug use. These relationships were not moderated by race/ethnicity, although the effects of abuse and neglect on the mediators differed for white and non-white women. Conclusions: These findings suggest that interventions are needed with maltreated girls to recognize and attend to their PTSD symptoms and to assist them in developing coping strategies to deal with stressful life events in an attempt to reduce risk of subsequent substance use and related problems. Language: en
108 citations
TL;DR: This study suggests that college students high in negative affect and coping drinking motives are particularly at risk for experiencing problems as a result of their alcohol use, indicating that clinicians should consider screening for these factors when conducting alcohol-related prevention and intervention efforts.
Abstract: Objective: Although studies have consistently indicated that among college students alcohol use and the likelihood of experiencing alcohol-related problems are related, it is possible that additional factors strengthen the magnitude of this relationship. The purpose of the present study was to assess the moderating effect of two such factors: negative affect and coping drinking motives. Method: Data were collected on 316 college students at a midsized, public university in the upper Midwest who reported using alcohol. Results: Findings indicated that both negative affect and coping drinking motives moderated the alcohol use–alcohol problems relationship. The three-way interaction indicated that the strongest relationship between alcohol use and alcohol-related problems existed for individuals high in both negative affect and coping drinking motives. Conclusions: This study suggests that college students high in negative affect and coping drinking motives are particularly at risk for experiencing problems ...
105 citations
TL;DR: Among persons who consumed alcohol and drugs, having ever experienced drug dependence was the strongest predictor of driving under the influence of drugs and motor-vehicle crash involvement because of drug use.
Abstract: Objective: We explored among people who ever consumed alcohol whether early age at drinking onset and alcohol dependence predicted drug use and dependence. We also examined among drinkers who have used drugs whether they also predict driving under the influence of drugs and motor-vehicle crash involvement because of drugs. Method: A U.S. national sample of 42,867 persons age 18 and older was surveyed in 1991-1992 (response rate = 90%). Logistic regression examined these potential associations among 27,616 respondents who ever drank alcohol, controlling for numerous demographic and personal characteristics. Results: Among “ever” drinkers, 22% used drugs, 10% had driven under the influence of drugs, and nearly 1% was in a motor-vehicle crash because of drug use, the equivalent of 1 million people. The younger the age of respondents when they first began drinking and whether they ever experienced alcohol dependence were independently associated with greater odds of ever using drugs and experiencing drug depe...
101 citations
TL;DR: The study identified several plausible mechanisms by which religiousness/spirituality could causally impact alcohol use and problems and provided further support for the motivational model of alcohol use.
Abstract: Objective: Religiousness is known to be inversely related to alcohol use and problems, but few studies have attempted to identify mediators of this relationship. We examined beliefs about alcohol, social influences, well-being, and motives for drinking as potential mediators of the relationship between religiousness/spirituality and alcohol use and problems. Method: Participants were 315 female and 197 male college students who responded to a survey sent to a stratified (by gender and year in school) random sample. We used path analysis to test models specifying hypothesized mediators of the relationship between several religious/spiritual constructs (identified via factor analysis in previous studies) and alcohol use and problems. Models were tested in the full sample and a subsample consisting of alcohol users only. Results: The effect of religious/spiritual involvement on alcohol use was mediated by negative beliefs about alcohol, social influences, and spiritual well-being. The effect of religious str...
96 citations
TL;DR: Models of outcomes among ED patients, ages 19 and older, who participated in a randomized controlled trial of a brief intervention for alcohol misuse suggest that highlighting the alcohol/injury connection in brief, ED-based alcohol interventions can augment their effectiveness.
Abstract: Objective: Prior research supports the effectiveness of brief interventions for reducing alcohol misuse among patients in the emergency department (ED). However, limited information is available regarding the mechanisms of change, which could assist clinicians in streamlining or amplifying these interventions. This article examines moderators of outcomes among ED patients, ages 19 and older, who participated in a randomized controlled trial of a brief intervention for alcohol misuse. Method: Injured patients (N= 4,476) completed a computerized survey; 575 at-risk drinkers were randomly assigned to one of four brief intervention conditions, and 85% were interviewed again at 3-month and 12-month follow-ups. Results: Regression models using the generalized estimating equations approach examined interaction effects between intervention condition (advice/no advice) and hypothesized moderator variables (stage of change, self-efficacy, acute alcohol use, attribution of injury to alcohol) on alcohol outcomes over...
TL;DR: Puerto Ricans and Mexican Americans are at higher risk for abuse, dependence, and the associated consequences than the other two groups of U.S. Hispanics, suggesting that prevention efforts must be guided by these findings.
Abstract: Objective: The primary purpose of this article is to report 12-month prevalence rates and predictors of alcohol abuse and dependence among Mexican Americans, Cuban Americans, Puerto Ricans, and South/Central Americans living in the United States. Method: Using a multistage cluster sample design, a total of 5,224 individuals 18 years of age and older were selected from the household population in five metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey weighted response rate was 76%. Personal interviews lasting an average of 1 hour were conducted in respondents' homes either in English or Spanish. Results: There is considerable heterogeneity in rates of abuse and dependence across these national groups, with Mexican American and Puerto Rican men having higher rates than Cuban American and South/Central American men. The rates of dependence for Mexican American and Puerto Rican men are also higher than those for men in the U.S. general population. Fur...
TL;DR: It is found that heavy teenage alcohol use and disadvantaged social origins combined to diminish male educational attainment, in contrast, heavy alcohol use had little effect on female educational attainment.
Abstract: Objective: Using data from the National Child Development Study, an ongoing longitudinal birth cohort study of British youth born in 1958 (N = 9,107), we investigated the long-term impact of heavy alcohol use at age 16 years on educational qualifications in adulthood Method: We used a propensity score matching approach to examine whether and for whom heavy alcohol use predicted reduced adult educational attainment Because of gender differences in both heavy drinking and adult socioeconomic attainment, we examined the effects of heavy drinking on educational outcomes separately for females and males Results: Heavy drinking in adolescence (measured in 1974) had a direct negative effect on the receipt of postsecondary educational credentials by age 42 years among males but not females, independent of child and adolescent risk factors correlated with both heavy drinking and educational attainment In particular, males from working-class backgrounds were most affected by heavy drinking Conclusions: Drawing
TL;DR: Off-campus, on-premise outlet density is strongly associated with college-drinking outcomes and represents a potential modifiable means of addressing the problem.
Abstract: Objective: The objective of the study is to examine the relationship between the physical availability of off-campus alcohol and drinking outcomes among college students. Method: A multilevel analysis of students (N = 17,051) nested within college campuses (N = 32) was conducted. Four problem-drinking-related outcomes (i.e., average number of drinks when partying, frequency of drunkenness in past 2 weeks, 30-day frequency of drinking, and greatest number of drinks in one sitting) along with individual level covariates of drinking were introduced at the student level. The physical availability of alcohol was assessed as the number of on-premise and off-premise alcohol outlets within 3 miles of campus per 1,000 students enrolled. Results: Higher densities of on-premise alcohol outlets were strongly related to drinking outcomes even after controlling for individual predictors of college drinking. The association indicated that the campus means for the average number of drinks when partying and the number of drinking occasions in the past 30 days were, respectively, 1.13 drinks and 1.32 occasions greater when the outlet density was 2 SDs higher. Conclusions: Off-campus, on-premise outlet density is strongly associated with college-drinking outcomes. Given the limited number of modifiable factors that affect college drinking, on-premise outlet density represents a potential modifiable means of addressing the problem. Language: en
TL;DR: Previous treatment with MM and either CBI or naltrexone, or both, but not acamprosate, was associated with sustained efficacy beyond discontinuation, and reasons for the maintained treatment gains with naltxonone and/or CBI and potential methods to extend them are discussed.
Abstract: Objective: The aim of this study was to examine the efficacy of pharmacological and behavioral interventions across 1 year posttreatment in the COMBINE (Combining Medications and Behavioral Interventions) Study. Method: Alcohol-dependent individuals (N = 1,383; 428 women) recruited at 11 outpatient academic alcoholism-treatment clinics across the United States participated in a randomized, double-blind, placebo-controlled trial. They received 16 weeks of naltrexone (Revia) or acamprosate (Campral) or both medications and/or placebos in combination with medical management (MM), with or without combined behavioral intervention (CBI); one group received CBI without pills or MM. Drinking behavior and clinical status were assessed at the end of treatment (Week 16) and at Weeks 26, 52, and 68. Results: Prior treatment with active naltrexone, without active acamprosate or CBI or with active acamprosate plus CBI, and CBI with double placebo resulted in a significantly higher percentage of days abstinent than doub...
TL;DR: Results suggest that, to decrease consumption among adolescents in Spain, strategies should focus on modifying expectancies, limiting access to alcohol at young ages, and targeting students of higher socioeconomic status and those living away from home.
Abstract: Objective: The purpose of this study was to determine the prevalence of risky consumption (RC) and heavy episodic drinking (HED) in Spanish university students and their associated factors. Method: We conducted a cross-sectional analysis (target N = 2,700) within the framework of a cohort study designed to evaluate the neu-ropsychological and psychophysiological consequences of alcohol consumption. Alcohol consumption was measured with the Alcohol Use Disorders Identification Test (AUDIT). The following independent variables were also collected by questionnaire: gender, place of residence, parents' education, alcohol consumption in the family, age at onset of use, and alcohol expectancies. We constructed logistic regression models using two dichotomous variables: (1) RC, dichotomizing the AUDIT score and (2) HED, dichotomizing the AUDIT question about consumption of six or more drinks on a single occasion. Results: The response rate on enrolled students was 50.7% (99% on students present in class the day of the survey). The prevalence of RC was 37.1%, the prevalence of HED was 12.2%, and the prevalence of abstainers was 12.6%. In relation to RC, the multivariate model showed that high expectancies (odds ratio [OR] = 4.77), early age at onset of use (OR = 4.75), and high maternal educational level (OR = 1.56) constituted risk factors. In contrast, living with parents constituted a protective factor (OR = 0.39). For HED, early age at onset of use (OR = 7.16), high expectancies (OR = 2.89), and being male (OR = 3.41) were risk factors. Conclusions: Results suggest that, to decrease consumption among adolescents in Spain, strategies should focus on modifying expectancies, limiting access to alcohol at young ages, and targeting students of higher socioeconomic status and those living away from home.
TL;DR: Understanding how stressors produce elevations in behavioral problems may provide important insights into understanding how broad environmental risk factors lead to substance dependence and suggests that processes other than affect regulation may operate in the pathway from the experiences of stressors to substance use and disorder.
Abstract: Objective: There is much theory, but sparse empirical evidence, supporting the notion that internalizing symptoms and negative affect are the mechanism by which exposure to stressful life events influence the development of substance-use disorders in adolescence and young adulthood. However, many empirical studies have shown that, in addition to elevations in internalizing symptoms, exposure to stressful life events also produces elevations in externalizing behaviors and conduct problems, which are important risk factors for substance-use disorders. The current study tested adolescent externalizing and internalizing symptoms as competitive mediators of the effects of stressors on young adult drug dependence. Method: Data from an ongoing study of children of alcoholics (n = 223) and matched controls (n = 204) were collected in two annual interviews in adolescence and two follow-ups in young adulthood. Results: Experiencing stressful life events during adolescence led to increases in both externalizing and ...
TL;DR: Preliminary support is provided for the association between context-specific perceived norms and actual prepartying and drinking game behaviors that help students reduce their own engagement in these risky behaviors.
Abstract: Objective: In the collegiate context, misperceptions of student drinking norms are among the most salient predictors of heavy drinking. Despite overall overestimations of peer alcohol use, misperceptions of context-specific behaviors have been infrequently studied. The present study examines students' perceptions of the high-risk behaviors of prepartying and drinking games and investigates the relationship between perceived and actual behaviors. Method: A sample of 524 college students completed an online assessment of actual and perceived alcohol use related to prepartying and drinking games. Quantity and frequency of overall drinking, prepartying, and drinking games were assessed for perceptions of all students at the university, as well as for male and female students separately. Questions also assessed participants' overall drinking, prepartying, and drinking game behaviors. Results: Participants significantly overestimated the prepartying and drinking game behaviors of all students, male students, an...
TL;DR: It is found that coping motives moderated the association between anger and weekly drinking onset, with high DTC individuals showing later drinking onset on high anger weeks.
Abstract: Objective: The purpose of this study was to examine among college students (N = 458; 249 women) whether drinking to cope (DTC) motives moderate the effect of daily negative mood states in predicting the onset of weekly drinking. Method: Using a secure, Internet-based survey across 2 consecutive years, participants first completed measures of drinking motives and then reported on their mood states and alcohol use daily for 30 days. Results: Multilevel discrete-time survival models indicated a significant interaction between DTC motives and anxiety in predicting the onset of drinking each week. As predicted, individuals with stronger DTC motives initiated drinking relatively earlier during high compared with low anxiety weeks. In contrast, individuals with weaker coping motives initiated drinking later during high compared with low anxiety weeks. We also found that coping motives moderated the association between anger and weekly drinking onset, with high DTC individuals showing later drinking onset on high...
TL;DR: Results indicate that Korean ethnicity is a risk factor particularly in the context of low acculturation, and the need to consider ethnic subgroup differences in drinking rates and in risk and protective factors for alcohol use among Asian Americans is illustrated.
Abstract: Objective: Recent evidence suggests increasing rates of alcohol use and related disorders among Asian-American young adults. Relatively little research has focused on this group, and few studies have examined heterogeneity in drinking prevalence and correlates across Asian subgroups. This study examined interactive effects of ethnicity, acculturation, and gender on drinking behavior among Asian-American undergraduates. Method: Participants were 112 Chinese Americans and 108 Korean Americans (mean age = 19.2 years, 61% female) who completed measures of alcohol use, acculturation, and demographic factors. Multivariate analyses examined drinking behavior (defined as quantity, frequency, and duration) as a function of ethnicity, gender, and acculturation. Results: Overall, Korean ethnicity predicted increased drinking, and acculturation predicted decreased drinking. However, acculturation interacted with ethnicity such that its influence was protective for Korean Americans and negligible for Chinese Americans...
TL;DR: Examination of the association between individual, relationship, and partner factors as they relate to changes in the number of drinking buddies in the social network during the first 7 years of marriage found that husbands with higher levels of extroversion and agreeableness had a greater number of Drinking buddies over time.
Abstract: Avariety of factors influence changes in heavy drinking and alcohol problems in individuals across the life span. Among adolescents, a key factor in the initiation, escalation, and de-escalation of alcohol and drug use involves the influence of the peer network (e.g., Musher-Eizenman et al., 2003; Prinstein et al., 2001; van den Bree and Pickworth, 2005). Peer alcohol use has also been shown to be a strong predictor of alcohol use among young adults. For example, Andrews and colleagues (2002) examined the prospective influence of peers on alcohol use in a sample of 19- to 25-year-old adults and found that peer influence was a significant predictor of heavy episodic drinking and problematic substance use. Although peer use was predictive of heavy episodic drinking, it was not associated with lower levels of alcohol use. Peer influence also extends to young adult problematic drinkers. For example, Delucchi and colleagues (2008) found that a larger social network of heavy drinkers was associated with greater levels of heavy episodic drinking but was not related to lower levels of alcohol consumption. Taken together, these results suggest that peer alcohol use is an important factor to consider for heavy episodic alcohol use among adolescents and young adults.
Although much of the previous research has focused on the average drinking of the social network, recently there has been an interest in the potential impact of key network members. For example, Leonard and colleagues (2000) focused on the presence of “drinking buddies” in the social network, defined as someone “that you got together with on a regular basis to do activities that centered around drinking and/or going to bars or nightclubs.” In this study, the average drinking of the peer network differentiated between regular drinkers and light/infrequent drinkers but did not differentiate heavy drinkers from regular drinkers. However, heavy drinkers reported that nearly 75% of their social network consisted of “drinking buddies,” in contrast with regular drinkers who indicated that approximately 30% of their network consisted of “drinking buddies,” a difference that was statistically significant. Reifman and colleagues (2006) examined the importance of “drinking buddies” among college students. Participants were asked to report on the drinking levels of their peers and which members could be characterized as a “drinking buddy.” After controlling for baseline alcohol use by the peer network, the number of drinking buddies was predictive of alcohol misuse 1 year later. Thus, it was more than simply the amount of alcohol use of the peer network but, rather, the presence of other individuals who engaged in drinking as an integral part of the relationship.
Until recently, the majority of research on peer network influences on drinking has focused on either young adults (i.e., college students) or adolescent samples. Leonard and Mudar (2003) examined the role of peer and partner influences in a sample of couples during the transition into marriage. During this transition, influence was found, but it was limited to the influence of the partner. For instance, husbands' drinking before marriage was longitudinally predictive of wives' drinking at the first anniversary, whereas no evidence was found to suggest that the peer network impacted drinking behaviors. It is possible that peer influence was not found because this transition triggers important changes in the peer networks. Kalmijn (2003) found that, among adults, social networks often become smaller, and these changes predominantly occur when people begin dating and at the time of marriage. Similarly, Kearns and Leonard (2004) found that the networks of husbands and wives became more overlapping after marriage than before marriage and that, after marriage, socializing with peers was more likely to include one's spouse than was the case before marriage. In the midst of these reductions and reorganization of the social network, its influence may be substantially reduced. To determine if peer influence were prominent after the transition to marriage, Leonard and Homish (2008) examined the social network of newly married couples during the first 4 years of marriage to determine if the number of drinking buddies were longitudinally predictive of heavy drinking and alcohol problems in men and women after controlling for a variety of individual, relationship, and sociodemographic factors. To allow for changes in the social network membership over time, the number of drinking buddies was modeled as a time-varying predictor. Among husbands and wives, a greater number of drinking buddies was longitudinally predictive of both heavy drinking and alcohol problems over time. Taken together, significant evidence exists in the adolescent and adult populations (both college and married adults) to suggest that the peer network relates to both heavy drinking and alcohol-related problems, with heavier drinking peers and a greater number of drinking buddies associated with more problematic use. The goal of the present study is to identify factors that predict changes in the social network.
TL;DR: Findings suggest that, in comparison with other substances, the prevalence of argileh use is high among college students in the United States.
Abstract: Objective: This study examined the prevalence and pre- dictors of argileh (hookah pipe) use among a sample of nonselected col- lege students. Method: Participants were 602 students (24% male; 43% white; mean age = 22.06) at a large, ethnically diverse, urban univer- sity. All participants completed an online survey designed to assess vari- ous types of substance use. Results: More than 15% of the sample reported having used argileh at least once in their lifetime, exceeding the percentage of students who had tried stimulants, barbiturates, co- caine, Ecstasy, heroin, or psychedelics. Arab ethnicity and cigarette smoking were the strongest predictors of argileh use; however, a sub- stantial percentage of non-Arabs and nonsmokers also had tried argileh. Conclusions: Findings suggest that, in comparison with other sub- stances, the prevalence of argileh use is high among college students in the United States. Physical health implications of these findings are dis- cussed. (J. Stud. Alcohol Drugs 69: 472-475, 2008)
TL;DR: IVR with regular feedback may be an effective therapeutic enhancement to BI and is a feasible technology for behavioral self-monitoring in primary care clinics.
Abstract: Objective: Self-monitoring is recommended following brief alcohol intervention (BI). We have previously demonstrated that self-monitoring with an automated telephone system (interactive voice response; IVR) is associated with a steady reduction in alcohol consumption in the absence of BI. In this study we explore the feasibility and efficacy of IVR as a possible therapeutic enhancement for BI. Method: We updated all providers (N= 112) in 15 primary care clinics about BI and encouraged them to do a BI with their patients whenever appropriate and to invite those patients to participate in the research project. Interested patients (N = 338) were randomized to one of four study conditions including no IVR and three groups who self-monitored for 6 months using an IVR: no feedback, feedback, and feedback plus a monetary calling incentive. Results: The IVR proved to be a feasible method for self-monitoring. Of those invited to use the IVR, 90% initiated use and made 95% of the calls while they remained engaged w...
TL;DR: Findings help clarify the link between alcohol involvement and depression and suggest that harm-reduction strategies may help prevent later mood disorders.
Abstract: Objective: Adolescent alcohol involvement may increase risk for young-adult depression; however, findings are mixed and important questions remain unanswered. Because alcohol involvement among teens is multidimensional, this study examined the extent to which four different adolescent alcohol dimensions (i.e., frequency of alcohol use, quantity of consumption, frequency of heavy episodic drinking, and frequency of problem use) were predictive of young-adult major depressive disorder (MDD). Method: Participants in this prospective longitudinal study, which extended from age 11 to age 22, were 429 rural teens (including 222 girls) and their families. Self-reports of each dimension of adolescent alcohol involvement were obtained at ages 16 and 18. Depression diagnoses were obtained at age 22, using a structured interview. Analyses included adolescent depressed mood, measured via self-report at ages 16 and 18. Data were analyzed using confirmatory factor analysis and structural equation modeling. Results: The multidimensional nature of adolescent alcohol involvement was best represented by a first-order problem-use factor and a second-order alcohol-intake factor comprised of quantity, frequency, and heavy drinking. After controlling for gender and depressed mood, adolescent problem use, but not alcohol intake, was a significant positive predictor of young-adult MDD. Conclusions: Findings help clarify the link between alcohol involvement and depression and suggest that harm-reduction strategies may help prevent later mood disorders. Language: en
TL;DR: This study underscores the diversity of drug use within rural communities, suggesting that living in a very rural area is protective against some forms of drugs use but that livingIn a rural area that includes a medium or large town is not.
Abstract: Objective: This study investigated differences in the development of heavy drinking and marijuana use among students in urban and rural areas and assessed whether any such differences can be accounted for by locality differences in racial/ethnic makeup, social disorganization/low social bonding, feelings of despondency and escapism, and the availability of drugs. Method: Drawn from 62 South Dakota middle schools involved in a drug prevention field trial, participating students were assigned to a locality category based on the location of their seventh-grade school. Schools in metropolitan areas were distinguished from schools in nonmetropolitan areas. Schools in nonmetropolitan areas were further distinguished into those in micropolitan (medium and large towns) and noncore (rural areas without towns and with small towns) areas. We used latent growth curve analysis to model the influence of locality on the development of heavy drinking and marijuana use from ages 13 to 19 and to determine whether differences in development across locality were attributable to location-based differences in race/ethnicity, social disorganization/bonding, feelings of despondency and escapism, and alcohol and marijuana availability. Results: Heavy drinking increased at a faster rate among youth living in micropolitan areas compared with youth living in metropolitan areas. Marijuana use increased at a faster rate among youth living in metropolitan and micropolitan areas compared with youth living in noncore areas. Differences in the rate of change in heavy drinking were attributable to differences in the racial/ethnic composition of metropolitan and micropolitan areas. Differences in the rate of change in marijuana use were attributable to differences in residential instability and marijuana availability. Conclusions: This study underscores the diversity of drug use within rural communities, suggesting that living in a very rural area is protective against some forms of drug use but that living in a rural area that includes a medium or large town is not. Language: en
TL;DR: The group differences found in this study may help explain the equivocal findings from previous neighborhood studies, which may use samples with an unmeasured mix of high- and low-risk adolescents.
Abstract: Objective: There is conflicting evidence regarding the impact of neighborhood socioeconomic status (SES) on adolescent alcohol use. The current study tested whether the prospective effects of neighborhood SES on adolescent alcohol outcomes varied across parental alcoholism subgroups. Method: Data from a group of adolescents (N = 361) from an ongoing longitudinal study of children of alcoholics (COAs) and matched controls were collected at three initial annual assessments. Latent growth models were estimated with a range of related time-invariant and time-varying predictors. Results: Among non-COAs, higher neighborhood SES predicted increased rates in alcohol use and consequences, whereas among COAs, lower neighborhood SES was predictive of increased rates in alcohol use and marginally predicted rates of consequences. There were also time-specific effects of family mobility on alcohol outcomes. Conclusions: The current study provides evidence for differential effects of neighborhood SES on adolescent alcoh...
TL;DR: IDUs who sought care in the emergency department for soft tissue infections were at high risk for subsequent hospitalization and death, and factors associated with increased risk for hospitalization or death included living on the street or in a shelter.
Abstract: Objective: Although soft tissue infections are common among injection drug users (IDUs), little is known about the health outcomes among those who seek care for these infections Emergency department visits are an important point-of-health-care contact for IDUs In this prospective cohort study, we aimed to determine the hospitaliza- tion and mortality rates and factors associated with hospitalization or death among IDUs seeking emergency care for soft tissue infection Method: Participants were English-speaking IDUs, 18 years of age and older, who sought initial care for soft tissue infection in an urban emer- gency department We conducted semistructured interviews, identifi ed hospitalizations from hospital records, and identifi ed deaths using the National Death Index Cox proportional hazards regression was used to investigate associations between baseline characteristics and hospitaliza- tions or death Results: Of 211 eligible patients, 156 (74%) participated (mean age = 42 years) There were 255 subsequent hospitalizations over a mean of 39 years follow-up The hospitalization rate was 42 hospitalizations per 100 person-years (95% confi dence interval (CI): 38-48) The mortality rate was 20 per 100 person-years (95% CI: 11- 37) Factors associated with increased risk for hospitalization or death included living on the street or in a shelter (adjusted odds ratio (AOR) = 175, 95% CI: 110-279), being recently incarcerated (AOR = 190, 95% CI: 105-344), and having insurance (AOR: 198, 95% CI: 122-323) Conclusions: IDUs who sought care in the emergency department for soft tissue infections were at high risk for subsequent hospitalization and death Visits for soft tissue infections represent missed opportunities for preventive care (J Stud Alcohol Drugs 69: 924-932, 2008)
TL;DR: The results illuminate the importance of the perceived benefits of drinking, as well as social influences to drink, in adolescent drinking, and should be incorporated into alcohol prevention programs.
Abstract: Objective: Social influences to drink are important predictors of adolescent drinking. This study explored a social influence model of drinking among inner-city adolescents. We examined the role of family drinking and perceived drinking norms in predicting 1-year follow-up perceived social benefits of drinking and the relationship of perceived social benefits of drinking with 2-year follow-up adolescent drinking. Method: Participants in the present study were from the control schools of a randomized trial investigating the etiology and prevention of adolescent alcohol use. During a class period at baseline in seventh grade, participants completed a questionnaire that measured self-reported alcohol use and potential predictors. The panel sample consisted of 1,318 students from baseline (seventh grade), 1 -year follow-up (eighth grade), and 2-year follow-up (ninth grade). Results: Structural equation modeling found that both family drinking and perceived drinking norms affected the perceived benefits of dri...
TL;DR: Women were more likely than men to report exposure to a partner's drinking, family interpersonal problems, death of someone close, and emotional distress, and men's overall greater drinking reactivity corresponds with their propensity to develop problem drinking.
Abstract: Objective: To explore reasons for gender differences in problem-drinking prevalence and to compare the experiences of problem-drinking women and men, this article examines gender differences in exposure and drinking reactivity to social infl uences and stressors during adulthood. Method: A community sample of 831 older adults (347 women and 484 men; average age = 69), comprising problem and nonproblem drinkers, provided information about their drinking histories. Respondents indicated whether they had experienced particular social infl uences and stressors during adulthood (exposure) and, if so, whether they had increased alcohol consumption in response (reactivity). Results: Overall, women were more likely than men to report exposure to a partner's drinking, family interpersonal problems, death of someone close, and emotional distress. Men reported more exposure to peers' drinking and workplace problems and were more likely to report drinking reactivity to social infl uences and stressors. Among problem ...
TL;DR: The findings across methodological approaches provide support for a CSA-specific risk for alcohol misuse, despite the significant contribution of family background factors to overall risk, but much work remains to be done before a comprehensive model for this association can be proposed.
Abstract: This review describes and evaluates methodological approaches aimed at unraveling the association between childhood sexual abuse (CSA) and later misuse of alcohol, which is complicated by the significant overlap between factors that elevate risk for CSA exposure and those that increase risk for problem alcohol use. We critique methods used to distinguish direct effects of CSA events on alcohol-related outcomes from the effects of risk factors frequently present in families in which CSA exposure occurs (e.g., parental alcohol-related problems). These methods include measurement and adjustment for potentially confounding factors and the use of co-twin designs. The findings across methodological approaches provide support for a CSA-specific risk for alcohol misuse, despite the significant contribution of family background factors to overall risk, but much work remains to be done before a comprehensive model for this association can be proposed. Additional directions for research, including the incorporation of measured genes and the use of longitudinal designs, are proposed to further efforts to model the pathways from CSA to alcohol-related problems.