Refining measurement in the study of social anxiety and student drinking: Who you are and why you drink determines your outcomes.

This study investigated inconsistencies in the literature regarding social anxiety and problematic drinking among college students. One hundred eighteen students (61% women) who experience anxiety in social or performance situations completed measures of social anxiety and a modified Timeline Followback that assessed the psychological context of drinking episodes and alcohol-related consequences. Results suggest that men who experience severe social anxiety drink less alcohol than men with lower levels of anxiety, whereas women high in social anxiety are likely to experience more alcohol-related consequences per drinking episode than women low in social anxiety, despite drinking similar amounts of alcohol. In addition, women with high social anxiety were found to experience more alcohol-related consequences than men with high social anxiety. These findings suggest that the inconsistencies noted in the literature on drinking to cope with social anxiety and alcohol-related consequences may reflect methodological differences and the failure to consider gender. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fitting in and feeling fine: Conformity and coping motives as mediators of the relationship between social anxiety and problematic drinking.

The present research was conducted to clarify the relationships among social anxiety, alcohol consumption, alcohol-related problems, and negative-reinforcement drinking motives among college students. Heavy drinking students (N = 316, 53.80% female) completed self-report measures of social anxiety, alcohol consumption, alcohol-related problems, and drinking motives. Findings indicated that students higher in social anxiety consumed less alcohol but experienced more negative consequences. Moreover, the relationship between social anxiety and negative consequences was mediated by coping and conformity drinking motives in addition to alcohol consumption. In the context of social anxiety, the current research demonstrates the importance of examining problematic drinking as distinct constructs: alcohol consumption and negative consequences. Findings are also discussed in terms of implications for interventions with socially anxious students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Protective behavioral strategies and the relationship between depressive symptoms and alcohol-related negative consequences among college students.

Approximately 40% of college students reported engaging in heavy episodic or "binge" drinking in the 2 weeks prior to being surveyed. Research indicates that college students suffering from depression are more likely to report experiencing negative consequences related to their drinking than other students are. The reasons for this relationship have not been well-studied. Hence, the purpose of this study was to determine whether use of protective behavioral strategies (PBS), defined as cognitive-behavioral strategies an individual can use when drinking alcohol that limit both consumption and alcohol-related problems, mediated the relationship between depressive symptoms and alcohol-related negative consequences among college students. Data were obtained from 686 participants from a large, public university who were referred to an alcohol intervention as a result of violating on-campus alcohol policies. Results from structural equation modeling analyses indicated that use of PBS partially mediated the relationship between depressive symptoms and alcohol-related negative consequences. Implications for clinicians treating college students who report experiencing depressive symptoms or consuming alcohol are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The social norms of alcohol-related negative consequences.

Social norms for alcohol use are important influences on individual college student drinking. The present study extends social norms research by examining alcohol-related consequences and, in particular, whether similar misperceptions exist regarding the frequency and evaluation of these consequences over time. College student drinkers (N = 624) participating in a longitudinal study completed Web-based surveys assessing alcohol use and related consequences, as well as their beliefs about frequency and evaluation of consequences for the typical college student. Findings suggest that students overestimated how often typical college students experience negative consequences and underestimated how negatively other students evaluated those consequences. Finally, results support a bidirectional model for alcohol-related consequences, possibly indicating a reciprocal, mutually influential feed-forward loop of norms and consequences that promotes maintenance of college student drinking and consequences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining the associations among severity of injunctive drinking norms, alcohol consumption, and alcohol-related negative consequences: The moderating roles of alcohol consumption and identity.

This study examined a range of injunctive norms for alcohol use and related consequences from less severe behaviors (e.g., drinking with friends) to more severe behaviors (e.g., drinking enough alcohol to pass out), and their relationship with alcohol consumption and alcohol-related negative consequences among college students. In addition, this research aimed to determine whether these relationships between injunctive norms and consequences were moderated by alcohol consumption and level of identification with the typical same-gender college student. A random sample (N = 1,002) of undergraduates (56.9% women) completed a Web-based survey that was comprised of measures of drinking behavior, perceived approval of drinking behaviors that ranged in severity (i.e., injunctive norms), and level of identification with the typical same-gender college student. Results suggest that the association between negative consequences and injunctive drinking norms depend on one's own drinking behavior, identification with other students, and the severity of the alcohol use and related consequences for which injunctive norms are assessed. Findings are discussed in terms of false consensus and false uniqueness effects, and deviance regulation perspectives. Implications for preventive interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Executive cognitive function and heavy drinking behavior among college students.

Executive cognitive functions (ECFs) seem important for motivating change and self-regulation of problem drinking. Evidence for executive cognitive deficits have been found among heavy-drinking college students. Although college students who abuse alcohol often experience a variety of negative consequences related to their drinking behavior, executive cognitive dysfunction may interfere with recognizing consequences and responding skillfully to avoid future harm. Fifty college students with drinking problems completed assessments of ECFs. Greater negative drinking consequences and short-term memory function significantly predicted greater awareness of drinking problems. ECF may be an important factor for motivation to change drinking behavior among college students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Help-seeking for alcohol-related problems in college students: Correlates and preferred resources.

Despite the development of a variety of efficacious alcohol intervention approaches for college students, few student drinkers seek help. The present study assessed students' history of help-seeking for alcohol problems, as well as their estimates of how likely they would be to use various help-seeking resources, should they wish to change their drinking. Participants were 197 college students who reported recent heavy drinking (46% male, 68.5% White, 27.4% African-American). Participants completed measures related to their drinking and their use (both past use and likelihood of future use) of 14 different alcohol help-seeking options. Repeated-measures analyses of variance revealed that students preferred informal help-seeking (e.g., talking to friends and family) over formal (e.g., talking with a counselor or medical provider) and anonymous resources (e.g., internet- or computer-based programs). Higher self-ideal discrepancy, greater depressive symptoms, and more alcohol-related consequences were positively associated with actual past help-seeking. Alcohol-related problems and normative discrepancy were negatively associated with hypothetical likelihood of utilizing all three help-seeking resources. These results suggest that heavy drinking college students prefer low-threshold intervention options including peer, family, computerized, and brief motivational interventions. Only 36 participants (18.3% of the sample) reported that they had utilized any of the help-seeking options queried, suggesting that campus prevention efforts should include both promoting low-threshold interventions and attempting to increase the salience of alcohol-related risk and the potential utility of changing drinking patterns. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

College student drinking and meaning in the pursuit of life goals.

The current study was designed to examine the association between risky alcohol use and life goals among college students. Introductory psychology students completed a questionnaire that included measures of typical life goals and alcohol use behavior. Students listed their 5 most typical life goals and rated them each on a series of dimensions from which 2 factors were derived (i.e., Goal Meaning, Goal Efficacy). Hierarchical regression analyses showed that the lower levels of goal meaning were associated with more heavy episodic use of alcohol and alcohol-related negative consequences. Results are consistent with motivational models of drinking that depict alcohol use as a function of satisfaction from other life goals. Findings support the importance of understanding college student drinking within the broader context of life goal appraisal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluations and expectancies of alcohol and marijuana problems among college students.

Two studies examined the associations between evaluations (good-bad) and expected likelihood (likely-unlikely) of alcohol- and marijuana-related problems and hazardous consumption and problems among college students. Participants provided data on alcohol use, alcohol-related problems, and expectancies and evaluations of alcohol problems; marijuana use indices, marijuana-related problems, marijuana effect expectancies, and likelihood and evaluations of marijuana problems. Evaluations of alcohol problems were positively related to the number of binge drinking occasions and alcohol-related problems. The interaction between evaluations and expectancies was significant in predicting the number of binge drinking occasions. Expectancies demonstrated a curvilinear relationship with binge drinking and alcohol-related problems. Marijuana users evaluated marijuana-related problems as less negative and less likely to occur than did nonusers. Expectancies, but not evaluations, of negative consequences were significantly associated with marijuana use intensity. Expectancies of problems demonstrated a curvilinear relationship with marijuana-use intensity and marijuana problems. Men evaluated alcohol and marijuana problems less negatively than did women. In summary, the expected likelihood of alcohol-marijuana problems and the evaluation of such problems represent a vulnerability factor associated with increased liability for hazardous alcohol and marijuana use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical relevance of heavy drinking during the college years: Cross-sectional and prospective perspectives.

This study investigated the clinical relevance of heavy drinking during the college years and beyond on concurrent and prospective alcohol-related problems in a high-risk sample (N?=?377). Measures of heavy drinking and alcohol-related problems were significantly correlated cross-sectionally over the study frame, regardless of how these constructs were operationalized. However, the magnitude of the association between heavy drinking and alcohol-related problems declined substantially over time, with the most pronounced decrease following the college years. Despite this cross-sectional decrease in the association between heavy drinking and alcohol-related problems over time, heavy drinking during the college years significantly and substantially predicted alcohol-use disorders up to 10 years later. Implications for assessment of heavy drinking as well as prevention of problematic alcohol use in college students are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring alcohol-related protective behavioral strategies among college students: Further examination of the Protective Behavioral Strategies Scale.

Heavy drinking among college students has been recognized as a public health problem on American college campuses (e.g., R. Hingson, T. Heeren, M. Winter, & H. Wechsler, 2005). Recently, protective behavioral strategies, or cognitive-behavioral strategies that can be implemented when using alcohol to reduce consumption and resulting negative consequences, have been shown to be associated with less alcohol use and fewer alcohol-related problems (e.g., S. L. Benton et al., 2004; M. P. Martens et al., 2005). The purpose of the present study was to conduct additional psychometric work on a measure designed to assess the use of such strategies: the Protective Behavioral Strategies Scale (PBSS; M. P. Martens et al., 2005). Data were collected on 505 undergraduate students from 2 universities who reported having consumed alcohol at least once in the past 30 days. Results of a confirmatory factor analysis supported the hypothesized 3-factor version of the PBSS, and scores on each subscale were correlated in the expected direction with both alcohol use and alcohol-related problems. Thus, the PBSS appears to be reliable and valid for use among college student drinkers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of college students' use of protective behavioral strategies in the relation between binge drinking and alcohol-related problems.

Previous research has examined protective behavioral strategies (PBS), or cognitive-behavioral strategies that may be employed when using alcohol to reduce consumption and related problems, as an important predictor of alcohol use and alcohol-related problems. More recently, studies have explored the mediating and moderating role of PBS on the relationships between key alcohol-related risk factors (i.e., drinking motives, depressive symptoms, binge drinking) and alcohol problems; however, current research examining PBS as a moderator of the relationship between alcohol use and related problems has methodological limitations. The purpose of the present study was to extend previous literature to examine the moderating effect of PBS on the relationship between binge drinking and alcohol-related problems. Data were collected and analyzed from 4,154 students at 13 midwestern universities. Findings indicated that PBS moderated the binge drinking-alcohol problems relationship for each of the four measures of binge drinking. However, effects were strongest when binge drinking was measured dichotomously versus continuously. Implications and future directions are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Using focus group interviews to identify salient issues concerning college students' alcohol abuse

Despite extensive efforts to decrease alcohol abuse among college students, prevention approaches have had limited success. This study attempted to clarify reasons for this limited success and to identify directions for future interventions by directly interviewing college students on this topic. Five issues were discussed in the focus group interviews: (1) reasons for drinking alcohol, (2) reasons for not drinking alcohol, (3) circumstances surrounding overconsumption of alcohol, (4) topics and methods for prevention, and (5) gender differences in drinking patterns. The focus group interviews were found to be a valid tool for elucidating sensitive aspects of these issues and the relative importance of these issues to each other. The students revealed how susceptible they are to societal pressures to drink alcohol and how the limitations of their intrapersonal skills affect their alcohol consumption, most notably regarding sexuality issues. The authors contend that improving intrapersonal skills should be a major focus of programs to prevent alcohol abuse.     

Acute alcohol tolerance on subjective intoxication and simulated driving performance in binge drinkers.

High rates of binge drinking and alcohol-related problems, including drinking and driving, occur among college students. Underlying reasons for the heightened impaired driving rates in this demographic group are not known. The authors hypothesized that acute tolerance to the interoceptive cues of intoxication may contribute to these maladaptive decisions to drive in binge drinkers. Groups of binge-drinking and non-binge-drinking college students (N = 28) attended sessions during which they received a moderate dose of alcohol (0.65 g/kg) or a placebo. The development of acute tolerance to subjective ratings of intoxication and simulated driving performance was assessed by comparing measures taken during the ascending phase and descending phases of the blood alcohol curve. Compared with placebo, alcohol increased ratings of intoxication and impaired multiple aspects of simulated driving performance in both binge and non-binge drinkers. During the descending phase of the blood alcohol curve, binge drinkers showed acute tolerance to alcohol’s effect on subjective intoxication, and this effect was accompanied by an increased rating of willingness to drive. By contrast, non-binge drinkers showed no acute tolerance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two brief alcohol interventions for mandated college students.

Encouraging but limited research indicates that brief motivational interventions may be an effective way to reduce heavy episodic drinking in college students. At 2 campuses, students (83% male) mandated to a substance use prevention program were randomly assigned to 1 of 2 individually administered conditions: (a) a brief motivational interview (BMI; n = 34) or (b) an alcohol education session (AE; n = 30). Students in the BMI condition reported fewer alcohol-related problems than the AE students at 3-and 6-month assessments. Trends toward reductions in number of binge drinking episodes and typical blood alcohol levels were seen in both groups. Process measures confirmed the integrity of both interventions. The findings demonstrate that mandated BMIs can reduce alcohol problems in students referred for alcohol violations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pathology of sudden death in the young

Demographic trends reveal the elderly to be the fastest growing segment of the population. Physicians can therefore anticipate encountering increasing numbers of older patients with alcohol-related problems. These problems include liver disease, dementia, confusion (masquerading as dementia), peripheral neuropathy, insomnia, late-onset seizure disorder, poor nutrition, incontinence, diarrhea, myopathy, inadequate self-care, macrocytosis, depression, fractures, and adverse reactions to medications. Despite the prevalence of alcohol use in older people, their risks and problems are often unrecognized. We reviewed published literature on the determinants and consequences of alcohol-related problems in persons aged 65 years and older and the usefulness of available screening measures. Thirteen of 25 eligible studies on determinants and consequences met quality criteria and were reviewed. Nine additional studies on screening tests were also evaluated. Determinants include history of alcohol use and abuse, social isolation, and reduced mobility; consequences consist of risks of hip fracture from falls, neoplasms, and psychiatric illness. Currently accessible screening tests focus on high levels of alcoholic beverage use and abuse and dependence. They are not useful in screening for hazardous consumption that may result from relatively low levels of alcohol use alone or in combination with medications, medical illness, or preexisting diminished physical, emotional, or social function. Research is needed on the consequences of lower levels of alcohol consumption on the physical and psychosocial health of older individuals and on methods for distinguishing alcohol-related from age-related problems. Existing screening tests should be expanded or new screening methods developed in anticipation of a growing public health problem.     

Alcohol-related infractions among college students: Associations with subsequent drinking as a function of sensitivity to punishment.

Problematic alcohol use on college campuses is a significant concern. Violations of campus alcohol policies can lead to disciplinary action from the university. These and other alcohol-related legal infractions may be a sign of significant alcohol-related problems. However, few studies have focused on determining predictors of alcohol-related infractions among college students. Likewise, the role of infractions in reducing future use is unclear. In the present study, we tested whether alcohol-related infractions were associated with decreased alcohol use, and whether the effect of the infraction varied as a function of initial drinking levels, sensitivity to punishment (SP), and sensitivity to reward (SR) in a 6-month prospective design. Alcohol use, grade point average, and SR were significantly associated with receiving an alcohol-related infraction. For heavier drinkers, receiving an infraction was associated with decreased drinking at follow-up, and this decrease was most pronounced among those with higher sensitivity to punishment. SP appeared to increase responsiveness to the infraction, resulting in greater attenuation of drinking at follow-up. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Reliability and validity of a demand curve measure of alcohol reinforcement.

Recent clinical research suggests that several self-report behavioral economic measures of relative reinforcing efficacy (RRE) may show utility as indices of substance abuse problem severity. The goal of the present study was to evaluate the reliability and validity of the Alcohol Purchase Task (APT), a RRE measure that uses hypothetical choices regarding alcohol purchases at varying prices (demand curves) to generate several indices of alcohol-related reinforcement. Participants were 38 college students who reported recent alcohol consumption. Both the raw alcohol purchase/consumption values and several of the computed reinforcement parameters (intensity & Omax) showed good to excellent 2-week test–retest reliability. Reinforcement parameters derived from both a linear-elasticity (Hursh, Raslear, Bauman, & Black, 1989) and an exponential (Hursh & Silberberg, 2008) demand curve equation were generally less reliable, despite the fact that both equations provided a good fit to participants’ reported consumption data. The APT measures of demand intensity (number of drinks consumed when price = 0), Omax (maximum expenditure), and elasticity (α) were correlated with weekly drinking, alcohol-related problems, and other self-report RRE measures (relative discretionary monetary expenditures toward alcohol and/or relative substance-related activity participation and enjoyment). Demand intensity was uniquely associated with problem drinking in a regression model that controlled for weekly consumption. These results provide support for the reliability and validity of the RRE indices generated with the APT. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preliminary examination of Spring Break alcohol use and related consequences.

The authors examined the extent to which college student drinkers are at risk for experiencing negative alcohol-related consequences during Spring Break. A sample of first-year college student drinkers (N = 726) participated by completing an online survey assessing typical drinking, as well as Spring Break drinking and related consequences. Findings suggest Spring Break drinking was positively associated with alcohol-related consequences during Spring Break, even after controlling for sex and typical drinking. Furthermore, results indicated that typical drinking moderated the relationship between Spring Break drinking and expected zero-values (i.e., not reporting any Spring Break consequences), such that the association between Spring Break drinking and the likelihood of being a zero-score was less evident for those who are typically lighter drinkers. Identifying and examining temporal and contextually relevant events and associated drinking is critical for understanding and ultimately preventing extreme drinking and associated consequences associated with specific events like Spring Break, which place many students at high risk for experiencing acute harm. (PsycINFO Database Record (c) 2010 APA, all rights reserved)