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)     

An alcohol expectancy-challenge prevention program for at risk college women.

Alcohol expectancy-challenge programs are effective in changing expectancies and reducing drinking in college men (J. Darker & M. S. Goldman. 1993. 1998); however, recent evidence suggests this protocol might not be effective for women (M. E. Dunn, C. Lau, & I. Y. Cruz, 2000). This study was designed to reevaluate the effectiveness of a social/sexual expectancy-challenge intervention in college women reporting moderate to heavy alcohol use. Forty-six undergraduate women were randomly assigned to the prevention or control condition. Participants reported alcohol expectancies at pre- and posttest and monitored their drinking patterns daily for 6 weeks. The program was effective in changing some expectancies but did not reduce drinking. This further confirms differences in the mechanisms by which expectancy-challenge programs function for men and women. (PsycINFO Database Record (c) 2010 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)     

A multisite randomized effectiveness trial of motivational enhancement therapy for Spanish-speaking substance users.

Hispanic individuals are underrepresented in clinical and research populations and are often excluded from clinical trials in the United States. Hence, there are few data on the effectiveness of most empirically validated therapies for Hispanic substance users. The authors conducted a multisite randomized trial comparing the effectiveness of 3 individual sessions of motivational enhancement therapy with that of 3 individual sessions of counseling as usual on treatment retention and frequency of substance use; all assessment and treatment sessions were conducted in Spanish among 405 individuals seeking treatment for any type of current substance use. Treatment exposure was good, with 66% of participants completing all 3 protocol sessions. Although both interventions resulted in reductions in substance use during the 4-week therapy phase, there were no significant Treatment Condition × Time interactions nor Site × Treatment Condition interactions. Results suggest that the individual treatments delivered in Spanish were both attractive to and effective with this heterogeneous group of Hispanic adults, but the differential effectiveness of motivational enhancement therapy may be limited to those whose primary substance use problem is alcohol and may be fairly modest in magnitude. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A motivational factor in conformity.

"Two groups of women college students were placed in a judgmental conformity situation… to test the hypothesis that persons with high social-approval and low self-approval motivation would yield to a unanimous, but erring, majority in judgment of length of lines more frequently than would persons with the opposite motivational profile… . The results were in accord with the major hypothesis." 17 references. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dismantling motivational interviewing and feedback for college drinkers: A randomized clinical trial.

Motivational interviewing (MI) is a counseling style that has been shown to reduce heavy drinking among college students. To date, all studies of MI among college students have used a format that includes a feedback profile delivered in an MI style. This study was a dismantling trial of MI and feedback among heavy-drinking college students. After an initial screen, 279 heavy-drinking students were randomized to (a) Web feedback only, (b) a single MI session without feedback, (c) a single MI session with feedback, or (d) assessment only. At 6 months, MI with feedback significantly reduced drinking, as compared with assessment only (effect size = .54), MI without feedback (effect size = .63), and feedback alone (effect size = .48). Neither MI alone nor feedback alone differed from assessment only. Neither sex, race or ethnicity, nor baseline severity of drinking moderated the effect of the intervention. Norm perceptions mediated the effect of the intervention on drinking. MI with feedback appears to be a robust intervention for reducing drinking and may be mediated by changes in normative perceptions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adapted motivational interviewing for women with binge eating disorder: A randomized controlled trial.

In this randomized controlled trial, 108 women with binge-eating disorder (BED) recruited from the community were assigned to either an adapted motivational interviewing (AMI) group (1 individual AMI session + self-help handbook) or control group (handbook only). They were phoned 4, 8, and 16 weeks following the initial session to assess binge eating and associated symptoms (depression, self-esteem, quality of life). Postintervention, the AMI group participants were more confident than those in the control group in their ability to change binge eating. Although both groups reported improved binge eating, mood, self-esteem, and general quality of life 16 weeks following the intervention, the AMI group improved to a greater extent. A greater proportion of women in the AMI group abstained from binge eating (27.8% vs. 11.1%) and no longer met the binge frequency criterion of the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) for BED (87.0% vs. 57.4%). AMI may constitute a brief, effective intervention for BED and associated symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relative efficacy of a brief motivational intervention for college student drinkers.

The authors evaluated the efficacy of Brief Alcohol Screening and Intervention for College Students (BASICS; L. A. Dimeff, J. S. Baer, D. R. Kivlahan, & G. A. Marlatt, 1999), a single session of drinking-related feedback intended to reduce heavy drinking and related harm. 84 college student drinkers (N?=?99) were assigned to BASICS, an educational intervention, or an assessment-only control group. At 3 months post-intervention, there were no overall significant group differences, but heavier drinking BASICS participants showed greater reductions in weekly alcohol consumption and binge drinking than did heavier drinking control and education participants. At 9 months, heavier drinking BASICS participants again showed the largest effect sizes. BASICS participants evaluated the intervention more favorably than did education participants. This study suggests that BASICS may be more efficacious than educational interventions for heavier drinking college students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining the role of drinking motives in college student alcohol use and problems.

A motivational model of alcohol involvement (M. L. Cooper, M. R. Frone, M. Russell, & P. Mudar, 1995) was replicated and extended by incorporating social antecedents and motives and by testing this model cross-sectionally and longitudinally in a sample of college students. Participants (N = 388) completed a questionnaire battery assessing alcohol use and problems, alcohol expectancies, sensation seeking, negative affect, social influences, and drinking motives. Associations among psychosocial antecedents, drinking motives, and alcohol involvement differed from those found by M. L. Cooper et al. (1995). These findings point to the importance of social influences and of positive reinforcement motives but not to the centrality of drinking motives in this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The alliance in motivational enhancement therapy and counseling as usual for substance use problems.

Data from a community-based multicenter study of motivational enhancement therapy (MET) and counseling as usual (CAU) for outpatient substance users were used to examine questions about the role of the alliance in MET and CAU. Most (94%) of the sample met diagnostic criteria for abuse or dependence (primarily alcohol and/or cocaine). Sixteen therapists for CAU and 14 for MET participated. No reliable differences in patient ratings (n = 319) on the Helping Alliance Questionnaire–II (HAq-II) were evident for MET compared to CAU, but significant differences between therapists were found within each condition in mean patient-rated HAq-II scores. Overall, average levels of alliance were high. The between-therapists component of the alliance, but not the within-therapist component, was significantly associated with self-reported days of primary substance use during the follow-up period from Week 4 to Week 16 (Cohen’s d = 0 .39; n = 257). Therapists with either low or very high alliances had relatively poorer average outcomes (quadratic effect, d = 0.44). For therapists in both MET and CAU, increased use of MET fundamental techniques and MET advanced techniques during treatment sessions was associated with higher levels of alliance. Implications of the findings for conceptualization of the alliance and for training of therapists are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between drinking control strategies and college student alcohol use.

Interventions designed to reduce heavy drinking among college students often contain suggestions for drinking control strategies. However, little is known about the relationship between the use of these strategies and alcohol consumption. The authors developed a measure of drinking control strategies and investigated its psychometric properties in a sample of 250 college drinkers. Strategies clustered into three factors: selective avoidance of heavy drinking activities and situations, strategies used while drinking, and alternatives to drinking. These three types of strategies were independently associated with alcohol use; however, the first and last types were negatively associated with alcohol consumption, whereas the second type was positively associated with alcohol use. The findings from this study suggest that the type of strategy recommended may be important when the goal is alcohol reduction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A motivational interviewing and common factors approach to change in working with alcohol use and abuse in college students.

The authors describe an approach for intervening with college students who present for self-referred or mandated treatment for alcohol or other drug issues. The authors offer a conceptual framework for working with such clients that is influenced by the evidence-based motivational interviewing literature and the evidence-based common factors approach to psychotherapy in general. Implications for practice are elaborated on and exemplified through a case study that includes motivational interviewing's guiding principles. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fake ID ownership and heavy drinking in underage college students: Prospective findings.

The authors examined the ownership of false identification (fake ID) for the purpose of obtaining alcohol and the relation of fake ID ownership to heavy drinking in a longitudinal sample of college students under 21 years of age. A sample of 3,720 undergraduates was assessed the summer prior to college entrance and during the 4 semesters comprising freshman and sophomore years. Regression analyses were used to estimate bidirectional relations between consumption and fake ID ownership. Sex, Greek membership, and prior drinking were controlled. Results showed that fake ID ownership increased over time (12.5% precollege to 32.2% fourth semester) and that Greek members were more likely than others to own fake IDs. Fake ID ownership predicted concurrent and next-semester heavy drinking with increasing strength over time. Also, the acquisition (onset) of fake ID ownership at each time point was predicted by previous-semester consumption. When traditional, robust risk factors of consumption are controlled, fake ID ownership meaningfully relates to heavy drinking in college. It thus presents a significant public health problem, addressable through training for alcohol servers and retailers, punitive measures toward fake ID owners, and other possible interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Thirty-month follow-up of drinking moderation training for women: A randomized clinical trial.

This study examined the durability of a group-based drinking moderation training for heavily drinking women reporting low physical dependence on alcohol. A 30-month follow-up of participants was conducted based on a previous study of 144 women randomly assigned to treatment conditions (G. J. Connors & K. S. Walitzer, 2001). Thirty-month follow-up results indicated that women who at baseline were relatively heavier drinkers had significantly greater benefit from the drinking moderation training when exposed to intervention enhancements entailing life skills training and booster sessions. Further, the initial improvements in drinking, relative to baseline levels, did not statistically deteriorate over the 30-month follow-up. The findings support the application of treatment enhancements among women in this population who at baseline are relatively heavier drinkers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personalized mailed feedback for college drinking prevention: A randomized clinical trial.

The current study was designed to evaluate the efficacy of a mailed feedback and tips intervention as a universal prevention strategy for college drinking. Participants (N = 1,488) were randomly assigned to feedback or assessment-only control conditions. Results indicated that the mailed feedback intervention had a preventive effect on drinking rates overall, with participants in the feedback condition consuming less alcohol at follow-up in comparison with controls. In addition, abstainers in the feedback condition were twice as likely to remain abstinent from alcohol at follow-up in comparison with control participants (odds ratio = 2.02), and feedback participants were significantly more likely to refrain from heavy episodic drinking (odds ratio = 1.43). Neither gender nor severity of baseline drinking moderated the efficacy of the intervention in these analyses, but more conservative analyses utilizing last-observation carryforward suggested women and abstainers benefited more from this prevention approach. Protective behaviors mediated intervention efficacy, with participants who received the intervention being more likely to use strategies such as setting limits and alternating alcohol with nonalcoholic beverages. Implications of these findings for universal prevention of college drinking are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Computerized versus motivational interviewing alcohol interventions: Impact on discrepancy, motivation, and drinking.

The authors conducted two randomized clinical trials with ethnically diverse samples of college student drinkers in order to determine (a) the relative efficacy of two popular computerized interventions versus a more comprehensive motivational interview approach (BASICS) and (b) the mechanisms of change associated with these interventions. In Study 1, heavy drinking participants recruited from a student health center (N = 74, 59% women, 23% African American) were randomly assigned to receive BASICS or the Alcohol 101 CD-ROM program. BASICS was associated with greater post-session motivation to change and self-ideal and normative discrepancy relative to Alcohol 101, but there were no group differences in the primary drinking outcomes at 1-month follow-up. Pre to post session increases in motivation predicted lower follow-up drinking across both conditions. In Study 2, heavy drinking freshman recruited from a core university course (N = 133, 50% women, 30% African American) were randomly assigned to BASICS, a web-based feedback program (e-CHUG), or assessment-only. BASICS was associated with greater post-session self-ideal discrepancy than e-CHUG, but there were no differences in motivation or normative discrepancy. There was a significant treatment effect on typical weekly and heavy drinking, with participants in BASICS reporting significantly lower follow-up drinking relative to assessment only participants. In Study 2, change in the motivation or discrepancy did not predict drinking outcomes. Across both studies, African American students assigned to BASICS reported medium effect size reductions in drinking whereas African American students assigned to Alcohol 101, e-CHUG, or assessment did not reduce their drinking. (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)     

Differential utility of three indexes of risky drinking for predicting alcohol problems in college students.

This study evaluated the relationship between alcohol-related problems and 3 indexes of risky drinking in college student drinkers: number of drinks consumed per week, frequency of binge drinking, and estimated blood alcohol levels (BALs). Use of 2 independent samples (N??=?204, N??=?181) allowed a cross-validation of obtained associations. Results indicated that neither binge drinking frequency nor BAL were more highly related to alcohol-related problems than was weekly drinking. Furthermore, BAL did not provide unique explanatory power in accounting for alcohol-related problems; mixed results were obtained regarding the relationship of binge drinking estimates with problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting Alcohol Patterns in First-Year College Students Through Motivational Systems and Reasons for Drinking.

In the present study, a typological approach was used to identify patterns of alcohol use in a sample of 533 college freshmen students (