Targeting Misperceptions of Descriptive Drinking Norms: Efficacy of a Computer-Delivered Personalized Normative Feedback Intervention.

The authors evaluated the efficacy of a computer-delivered personalized normative feedback intervention in reducing alcohol consumption among heavy-drinking college students. Participants included 252 students who were randomly assigned to an intervention or control group following a baseline assessment. Immediately after completing measures of reasons for drinking, perceived norms, and drinking behavior, participants in the intervention condition were provided with computerized information detailing their own drinking behavior, their perceptions of typical student drinking, and actual typical student drinking. Results indicated that normative feedback was effective in changing perceived norms and alcohol consumption at 3- and 6-month follow-up assessments. In addition, the intervention was somewhat more effective at 3-month follow-up among participants who drank more for social reasons. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group-based motivational interviewing for alcohol use among college students: An exploratory study.

How can practicing psychologists help reduce excessive alcohol consumption among college students? Over 80% of college students consume alcohol, and a significant percentage drinks excessively with myriad problems. Brief interventions based on motivational interviewing (MI) have been identified for use with college populations. The authors randomly assigned 91 freshman students to a brief, classroom-based MI intervention or an assessment control condition. At the end of the semester, MI group participants reported fewer drinks per occasion and fewer episodes of intoxication compared to controls. A classroom-based, MI-style intervention might be an efficient, sustainable, and effective means of reducing heavy drinking among college students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What makes group MET work? A randomized controlled trial of college student drinkers in mandated alcohol diversion.

Nationally, college drinkers exhibit the highest rates of alcohol consumption and represent the largest percentage of problem drinkers. Group motivational enhancement therapy (GMET) has been found to catalyze problem drinking reductions among college student samples. Although research supporting the use of single-session GMET in college samples (general and mandated) is emergent, no studies have evaluated a comprehensive model of the potential active ingredients of this group intervention. College students (N = 206; 88% White; 63% men; M age = 18.6) mandated to a university alcohol diversion program were randomly assigned to 1 of 3 conditions: the standard-of-care 2-session “Focus on Alcohol Concerns” education group (FAC), a single GMET, or a single alcohol information-only control group (AI) to evaluate the role of 5 putative mediators: readiness to change, self-efficacy, perceived risk, norm estimates, and positive drinking expectancies. At 3- and 6-month follow-ups, GMET students demonstrated greater reductions in problem drinking outcomes (drinks per drinking day, hazardous drinking symptoms, and alcohol-related problems). Of the 5 mediators proposed, only self-efficacy emerged as a significant mediator. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of drinking protective behavioral strategies in association to sex-related alcohol negative consequences: The mediating role of alcohol consumption.

Alcohol use has been implicated as a risk factor for sexual negative consequences, such as unprotected sexual intercourse. The present research was conducted to examine the relationship between drinking protective behavioral strategies and consensual sex-related alcohol negative consequences, and whether this relationship varied by gender. Additionally, typical number of drinks during sexual behavior was evaluated as a potential mediator of this association. Heavy drinking, sexually active college students (N = 297, 50.2% women) completed self-report measures of drinking protective behavioral strategies, alcohol consumption, and sex-related alcohol negative consequences. Findings indicated that women who used drinking protective behavioral strategies more frequently were less likely to experience sex-related alcohol negative consequences whereas this relationship was not significant for men. For women, this relationship was mediated by the typical number of drinks consumed during sexual behavior. The current research demonstrates that use of drinking protective behavioral strategies is related to a reduction in women's sex-related risks when drinking. Findings are discussed in terms of alcohol myopia theory. Implications for interventions aimed to reduce higher risk sexual behavior among college students are discussed. (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 effect of drink price and next-day responsibilities on college student drinking: A behavioral economic analysis.

More than [3/4] of U.S. college students report a heavy drinking episode (HDE; 5 (for men) and 4 (for women) drinks during an occasion) in the previous 90 days. This pattern of drinking is associated with various risks and social problems for both the heavy drinkers and the larger college community. According to behavioral economics, college student drinking is a contextually bound phenomenon that is impacted by contingencies such as price and competing alternative reinforcers, including next-day responsibilities such as college classes. This study systematically examines the role of these variables by using hypothetical alcohol purchase tasks to analyze alcohol consumption and expenditures among college students who reported recent heavy drinking (N = 207, 53.1% women). The impact of gender and the personality risk factor sensation seeking (SS) were also assessed. Students were asked how many drinks they would purchase and consume across 17 drink prices and 3 next-day responsibility scenarios. Mean levels of hypothetical consumption were highly sensitive to both drink price and next-day responsibility, with the lowest drinking levels associated with high drink prices and a next-day test. Men and participants with greater levels of SS reported more demand overall (greater consumption and expenditures) than women and students with low SS personality. Contrary to our hypotheses women appeared to be less sensitive to increases in price than men. The results suggest that increasing drink prices and morning academic requirements may be useful in preventing heavy drinking among college students. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Which heavy drinking college students benefit from a brief motivational intervention?

Heavy drinking among college students is common and is often harmful. A previously reported randomized trial revealed that a brief motivational intervention (BMI) reduced the alcohol consumption of heavy drinking college students (K. B. Carey, M. P. Carey, S. A. Maisto, & J. M. Henson, 2006). For this study, the researchers conducted supplemental analyses of hypothesized predictors of change using the same sample (N = 495). Greater readiness to change, higher levels of self-regulation, and less engagement in social comparison all independently predicted reductions in drinking outcomes. Furthermore, self-regulation, social comparison, and future time perspective interacted with BMI and predicted drinks per week. As expected, greater self-regulation skills enhanced response to the BMI; the remaining interaction effects were unexpected. Overall, these findings suggest that BMIs produce relatively robust effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Being controlled by normative influences: Self-determination as a moderator of a normative feedback alcohol intervention.

The objectives of this research were to evaluate the efficacy of computer-delivered personalized normative feedback among heavy drinking college students and to evaluate controlled orientation as a moderator of intervention efficacy. Participants (N = 217) included primarily freshman and sophomore, heavy drinking students who were randomly assigned to receive or not to receive personalized normative feedback immediately following baseline assessment. Perceived norms, number of drinks per week, and alcohol-related problems were the main outcome measures. Controlled orientation was specified as a moderator. At 2-month follow-up, students who received normative feedback reported drinking fewer drinks per week than did students who did not receive feedback, and this reduction was mediated by changes in perceived norms. The intervention also reduced alcohol-related negative consequences among students who were higher in controlled orientation. These results provide further support for computer-delivered personalized normative feedback as an empirically supported brief intervention for heavy drinking college students, and they enhance the understanding of why and for whom normative feedback is effective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief motivational interventions for heavy college drinkers: A randomized controlled trial.

In this randomized controlled trial, the authors evaluated brief motivational interventions (BMIs) for at-risk college drinkers. Heavy drinking students (N = 509; 65% women, 35% men) were randomized into 1 of 6 intervention conditions formed by crossing the baseline Timeline Followback (TLFB) interview (present versus absent) and intervention type (basic BMI, BMI enhanced with a decisional balance module, or none). Assessments completed at baseline, 1, 6, and 12 months measured typical and risky drinking as well as drinking-related problems. Relative to controls, the TLFB interview reduced consumption but not problems at 1 month. The basic BMI improved all drinking outcomes beyond the effects of the TLFB interview at 1 month, whereas the enhanced BMI did not. Risk reduction achieved by brief interventions maintained throughout the follow-up year. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pregaming in high school students: Relevance to risky drinking practices, alcohol cognitions, and the social drinking context.

Pregaming is the practice of consuming alcohol prior to going out to a social event. Although pregaming has begun to receive research attention in the college setting, very little is known about this risky drinking behavior in high school students. As pregaming has health implications for both students who are college bound and those who are not, we examined the prevalence of this behavior in a sample of high school students who reported current alcohol use and completed pregaming measures (n = 233). The present study examined the associations of gender, age, alcohol expectancies, motivations for drinking (e.g., social, enhancement, and coping), and engagement in other risky drinking practices (i.e., general hazardous use and drinking game participation) with pregaming. Results indicate that pregaming was significantly associated with being older, being a male, having high levels of hazardous alcohol use, and participating in drinking games frequently. Pregaming also occurred most often before parties and sporting events and it was associated positively with frequency of attendance at parties where alcohol is available, the tendency to use alcohol at these parties, and the amount of alcohol consumed at these parties. We discuss the findings in the context of pregaming research that has been conducted with college students, and make suggestions regarding prevention and intervention efforts focused on this risky drinking practice. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Peer enhancement of a brief motivational intervention with mandated college students.

In this pilot study, the authors evaluated whether incorporating a peer in a brief motivational intervention would lead to significant reductions in alcohol use and problems in students mandated to receive treatment after violating campus alcohol policy. Thirty-six participant-peer dyads (66% male) were randomly assigned to receive either two 45-min sessions of an individual motivational intervention (IMI, n = 18) or a peer-enhanced motivational intervention (PMI, n = 18). The IMI included exploration of motivation to change alcohol use, perceived positive and negative effects of drinking, personalized feedback, and goals for changing alcohol consumption and related behaviors. The PMI included all elements of the IMI plus the presence of a supportive peer of the participant during both sessions. Although both groups significantly reduced number of drinking days and heavy drinking days at 1-month follow-up, the magnitude of within-group reductions in alcohol use and problems was 3 times larger on average for the PMI group than for the IMI group, based on effect-size calculations. Peers and participants endorsed high satisfaction ratings on the PMI. Findings indicate the promise of including peers in brief motivational interventions for mandated students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of a brief motivational intervention with college student drinkers.

This study consisted of a randomized controlled trial of a 1-session motivational intervention for college student binge drinkers. Sixty students who reported binge drinking 2 or more times in the past 30 days were randomly assigned to either a no-treatment control or a brief intervention group. The intervention provided students with feedback regarding personal consumption, perceived drinking norms, alcohol-related problems, situations associated with heavy drinking, and alcohol expectancies. At 6-week follow-up, the brief intervention group exhibited significant reductions on number of drinks consumed per week, number of times drinking alcohol in the past month, and frequency of binge drinking in the past month. Estimates of typical student drinking mediated these reductions. This study replicates earlier research on the efficacy of brief interventions with college students and extends previous work regarding potential mechanisms of change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Heavy episodic drinking: Determining the predictive utility of five or more drinks.

Although the heavy episodic drinking (HED) measure of 5+ drinks (sometimes 4+ for women) is used extensively, there is no empirical basis for the designation of 5 drinks as the threshold (vs. another threshold that may perform equally). The present study sought to determine the threshold for HED that maximally predicts proximal and distal adverse-drinking-related outcomes. Participants included 115 young adults (57% female; 96% Caucasian) who partook in an 8-week Internet survey that assessed daily drinking as well as next-day hangover; 10 months later, adverse outcomes (problem drinking, alcohol-related problems, maximum number of drinks, and drug use) were surveyed. Thresholds were computed, with a range from 1+ drinks to 15+ drinks, and outcomes were predicted from each threshold. Findings for hangover measures showed relatively good convergence across multiple indicators, with greatest prediction occurring at a threshold of 10+ drinks per occasion. Different thresholds were observed for long-term outcomes, with higher thresholds indicative of outcomes with greater severity. Although alternatives to HED, such as subjective effects and blood alcohol concentration, can indicate risky drinking, a threshold measure of HED may have advantages in terms of prevention and of intervention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

21st birthday drinking: Extremely extreme.

Despite public recognition of the hazards of 21st birthday drinking, there is little empirical information concerning its prevalence, severity, and risk factors. Data from a sample of 2,518 college students suggest that 21st birthday drinking poses an extreme danger: (a) 4 of every 5 participants (83%) reported drinking to celebrate, (b) birthday drinkers indicated high levels of consumption, (c) 12% of birthday drinkers (men and women) reported consuming 21 drinks, and (d) about half of birthday drinkers exceeded their prior maximum number of drinks. Current problematic alcohol involvement and its typical correlates strongly predicted both the occurrence and severity of 21st birthday drinking. It is imperative that investigators consider a variety of potential interventions to minimize the harm associated with this rite of passage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Finding common ground for effective campus-based prevention.

This commentary reviews the controversy over use of the term binge drinking to describe college student alcohol consumption, argues for abandoning the term, and explains how doing so will help unify and reinvigorate campus-based prevention work. Binge drinking has been defined for men as 5 or more drinks in a row at least once in the previous 2 weeks and as 4 or more drinks for women. There is no scientific basis for focusing on this measure to the exclusion of other consumption measures; neither is there justification for labeling such consumption binge drinking, which reinforces an exaggerated view of student drinking. To build support for environmental management strategies to reduce alcohol-related problems, campus officials should avoid terminology that demonizes students and instead embrace the responsible majority of college students as an essential part of the solution. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol use among college students as a function of their typical social drinking context.

This study investigated the relations among frequency of drinking in different social contexts; alcohol consumption, expectancies, and problems; and psychosocial characteristics among college students. Social drinking contexts were defined by the size and gender composition of social groups. Participants were 98 men and 98 women who endorsed current alcohol use. The results showed that typical social drinking contexts were associated with men's average daily number of drinks and frequency of drunkenness but were not associated with women's alcohol consumption. Controlling for alcohol expectancies and personality factors did not obscure significant social context effects for men's alcohol consumption or problems, supporting the importance of considering social context variables in studies of drinking. Future research with regard to alcohol education, intervention, and prevention strategies is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivational pathways to unique types of alcohol consequences.

Individuals consume alcohol for a variety of reasons (motives), and these reasons may be differentially associated with the types of drinking outcomes that result. The present study examined whether specific affect-relevant motivations for alcohol use (i.e., coping, enhancement) are associated with distinct types of consequences, and whether such associations occur directly, or only as a function of increased alcohol use. It was hypothesized that enhancement motives would be associated with distinct problem types only through alcohol use, whereas coping motives would be linked directly to hypothesized problem types. Regularly drinking undergraduates (N = 192, 93 female) completed self-report measures of drinking motives and alcohol involvement. Using structural equation modeling, we tested direct associations between coping motives and indirect associations between enhancement motives and eight unique alcohol problem domains: risky behaviors, blackout drinking, physiological dependence, academic/occupational problems, poor self-care, diminished self-perception, social/interpersonal problems, and impaired control. We observed direct effects of coping motives on three unique problem domains (academic/occupational problems, risky behaviors, and poor self-care). Both coping and enhancement motives were indirectly associated (through use) with several problem types. Unhypothesized associations between conformity motives and unique consequence types also were observed. Findings suggest specificity in the consequences experienced by individuals who drink to cope with negative affect versus to enhance positive affect, and may have intervention implications. Findings depict the coping motivated student as one who is struggling across multiple domains, regardless of levels of drinking. Such students may need to be prioritized for interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Computer versus in-person intervention for students violating campus alcohol policy.

In this study, the authors evaluated the efficacy of a brief motivational intervention (BMI) and a computerized program for reducing drinking and related problems among college students sanctioned for alcohol violations. Referred students (N = 198, 46% women), stratified by gender, were randomly assigned to a BMI or to the Alcohol 101 Plus computer program. Data obtained at baseline, 1, 6, and 12 months were used to evaluate intervention efficacy. Planned analyses revealed 3 primary findings. First, women who received the BMI reduced drinking more than did women who received the computer intervention; in contrast, men's drinking reductions did not differ by condition. Second, readiness to change and hazardous drinking status predicted drinking reductions at 1 month postintervention, regardless of intervention. Third, by 1 year, drinking returned to presanction (baseline) levels, with no differences in recidivism between groups. Exploratory analyses revealed an overall mean reduction in drinking immediately after the sanction event and before taking part in an intervention. Furthermore, after the self-initiated reductions prompted by the sanction were accounted for, participation in the BMI but not the computer intervention was found to produce additional reduction in drinking and related consequences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Standardized measures of alcohol-related problems: A review of their use among college students.

College students' alcohol consumption has received considerable attention in the scientific literature and the media for its impact on students and the college community. Misuse of alcohol can lead to a wide range of consequences, the most severe being alcohol abuse, dependence, and death. Researchers have struggled to develop effective methods to assess problems related to alcohol, and the literature on college drinking lacks a strong theoretical framework for such assessment. The authors contend that measures of alcohol-related problems for college students should assess specific dimensions pertaining to 3 main domains: alcohol abuse, alcohol dependence, and what the authors define as risky drinking. The authors examined how existing measures fit into this model. In a comprehensive review of the college literature, the authors identified 9 measures (and their revised versions) assessing alcohol-related problems. Their analysis revealed that most measures do not assess comprehensively the domains outlined, and instead provide only partial assessments of the potential consequences of drinking for college students. The authors include directions for future research so that measurement of drinking consequences for college students can be refined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Association between DNA cleavage during apoptosis and regions of chromatin replication

This randomized controlled trial evaluated the efficacy of a brief intervention designed to reduce the harmful consequences of heavy drinking among high-risk college students. Students screened for risk while in their senior year of high school (188 women and 160 men) were randomly assigned to receive an individualized motivational brief intervention in their freshman year of college or to a no-treatment control condition. A normative group selected from the entire screening pool provided a natural history comparison. Follow-up assessments over a 2-year period showed significant reductions in both drinking rates and harmful consequences, favoring students receiving the intervention. Although high-risk students continued to experience more alcohol problems than the natural history comparison group over the 2-year period, most showed a decline in problems over time, suggesting a developmental maturational effect.