Neither a problem nor my problem: Risk factors for underage drinking disengagement among college students.

OBJECTIVE: Underage drinking disengagement (UDD; cognitive restructuring/minimizing agency) measures attitudes about the acceptability and responsibility of drinking. We examined demographic correlates of UDD, as well as the moderating effects of legal drinking status on the association between UDD and drinking. PARTICIPANTS: College student drinkers (n = 893; Mage = 19.48, range = 18-25; White = 74.1%; female = 68.1%) from a multi-site study. METHODS: An online confidential survey included the UDD Scale for College Students and the AUDIT-C. RESULTS: White and multiracial, underage students, or those living with others endorsed greater cognitive restructuring disengagement than Hispanic students, legal-age students, or those living alone or with parents, respectively. Greek membership and greater "party school" perceptions were related to more cognitive restructuring and minimizing agency. The associations between UDD and alcohol use were not moderated by legal drinking age status. CONCLUSION: Identifying and educating students at risk for UDD on the ramifications associated with underage drinking could combat drinking.

Passive recruitment reach of a lifestyle management program to address obesity in the deep south during the COVID-19 pandemic.

Obesity is a significant public health concern, especially in the Deep South and in Mississippi where prevalence is among the worst in the nation paired, with other poor health outcomes and socioeconomic conditions. Lifestyle management programs that address modifiable risk factors, such as nutrition and physical activity, can be effective mitigation strategies to halt weight accumulation patterns and ameliorate metabolic risk factors for some populations. However, there is limited evidence regarding the implementation of effective practice models to address obesity risk in underserved and underrepresented populations, such as African Americans, and people in the stage of earlier adulthood. Furthermore, there is growing evidence supporting the impact of the COVID-19 pandemic on lifestyle management programs that should be considered in these populations. The purpose of this manuscript was to describe the development and telehealth implementation of a weight management program during the COVID-19 pandemic and provide a preliminary examination of recruitment strategies and baseline characteristics for enrolled participants. Passive recruitment (social media, web, email, and other media advertisements) resulted in 157 screening initiations, and 79 of those participants met the study inclusion criteria. Further, of the 79 eligible participants, 38 completed all study enrollment requirements and presented with metabolic abnormalities. The study findings add to the emerging body of evidence for how the pandemic may have impacted lifestyle management programs and is representative of an understudied and underrepresented population.

Multidimensional Evaluation of Screening Brief Intervention and Referral to Treatment Training for Medical Students.

OBJECTIVE: Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach to identifying and addressing alcohol use in non-specialty settings. Many medical schools teach SBIRT, but most published evaluations of these efforts exclude rigorous skill assessments and teaching methods. METHODS: During the 2017-2018 academic year, 146 third-year medical students received classroom-based learning on SBIRT and motivational interviewing (MI) and at least two SBIRT practices with feedback as part of a 4-week psychiatry clerkship. The objective of this curriculum was to improve SBIRT knowledge, attitudes, and confidence and enable learners to skillfully deliver SBIRT. Outcomes evaluated included satisfaction, knowledge, attitudes and confidence, and clinical skill in delivering SBIRT to a standardized patient (rated by the actor, as well as an expert). RESULTS: Results indicated acceptable satisfaction at post-curriculum and significant improvements in attitudes and knowledge from pre- to post-curriculum. On the clinical skills exam, all students were rated as having mastered at least 80% of SBIRT elements by standardized patients and 91.8% were rated at this level by a faculty expert. Student attitudes and knowledge were unrelated to expert ratings, and standardized patient ratings had limited associations with expert ratings. CONCLUSIONS: These results suggest curriculum objectives were achieved and provide unique contributions to the SBIRT curricular outcome research for healthcare trainees. Other findings included that trainee knowledge and confidence may not relate to skill, and standardized patient feedback provides different information on SBIRT and MI skill than expert ratings.

What pandemic? A multisite study of drinking motives and drinking games participation among college students during a pandemic (COVID-19) academic year.

A drinking game (DG) is a widely practiced social activity that tends to encourage rapid alcohol consumption. While social restrictions during the pandemic (COVID-19) academic year were implemented as a health measure across many colleges/universities, the extent to which college student drinkers continued to play DGs in-person is not well understood. Because theory and research suggest that drinking motives are proximal correlates of drinking behaviors, we examined which drinking motives increased the likelihood of playing DGs in-person, and playing DGs in-person in a group of 10 + people during the 2020-21 pandemic academic year. College students (past-year drinkers) from 12 universities completed an online survey (N = 900; Mage = 19.42, Range = 18-25; SDage = 1.45, White = 73.1%, 69.2% female). Of the students surveyed, 590 students played DGs, with 460 students only playing DGs in-person. Of the students who played DGs in-person, 274 students reported that the maximum number of people they played DGs with in-person exceeded the CDC's recommended guidelines (10 + people). Accounting for demographics, general alcohol use, and perceived COVID-19 threat, social drinking motives were positively associated with an increased likelihood of playing DGs in-person; the inverse was found for coping motives. Drinking motives were not associated with the likelihood of playing DGs with 10 + people but greater alcohol use and lower perceived threat of COVID-19 were. Given that the pandemic did not deter many student drinkers from playing DGs in-person, further investment in targeted intervention and public health initiatives aimed at substance-free alternatives promoting engagement and enhancement of social activities may be needed.

Ethnic/Racial Differences in Alcohol Use: Does Drinking Refusal Self-Efficacy Matter?

Introduction: College students-including those of Hispanic backgrounds-are at risk for hazardous drinking. Research has shown robust group differences between Hispanic and White individuals in alcohol use outcomes. The ability to resist alcohol consumption can be leveraged to reduce hazardous drinking; however, little research has examined Hispanic-White differences and whether drinking refusal self-efficacy accounts for group differences in hazardous drinking. Considering Hispanic individuals make up the largest ethnic/racial minority group in the United States, it is important to identify malleable psychological factors that prevent and reduce drinking problems. Method: Hispanic and White college students at two predominantly White institutions (N = 389; 58.6% women, Mage= 20.22) completed measures assessing drinking refusal self-efficacy, hazardous drinking, and negative drinking consequences. Results: Hispanic students reported lower levels of hazardous drinking, alcohol-related problems, and drinking refusal self-efficacy than White students. Drinking refusal self-efficacy was found to partially explain Hispanic-White differences in the levels of hazardous drinking and drinking-related problems. Specifically, drinking refusal self-efficacy was associated with alcohol use outcomes only among White students and not Hispanic students. Conclusion: The correspondence between drinking refusal self-efficacy and actual behaviors to turn down drinks, ethnic/racial distinctiveness in ratings of self-efficacy and cultural orientations, and situational contexts that surround drinking should be examined in future research.

Mississippi INBRE Outreach Scholars program: adapting a summer scholars program to the virtual world amidst the COVID-19 pandemic.

The Mississippi IDeA Networks of Biomedical Research Excellence (INBRE) supported by the National Institute of General Medical Sciences (Grant P20GM103476) launched the new Mississippi INBRE Outreach Scholars (MIOS) summer research program in 2019. The program was designed to offer students community outreach and research experiences related to the study of behavioral and health disparities life sciences. The program was adapted in early 2020 to offer the program in a fully online format in the summer of 2020. This article details the program adaptations and discusses program evaluation data related to scholars' perceptions of program benefits and expectations and their confidence in research-related skills. The program evaluation was a mixed-method approach that included a qualitative postprogram survey and a pre-post quantitative survey. Scholars identified technical and communication skill building and resilience as areas of personal growth. Overall, the program met scholars' expectations for the program and significantly improved their confidence on 8 of the 19 (with confidence interval estimated differences from 0.3 to 2.56, where a difference of 1 is an improvement across 1 anchor on a Likert-type scale) various research-related tasks/skills after completion of the program. The analyses presented demonstrated that a combined qualitative and quantitative analysis approach is useful for examining the extent to which programs such as Mississippi INBRE are meeting goals of providing a rich research experience in health disparities for a diverse student body. Future longitudinal data may be examined to explore the long-term impact of MIOS on career preparation and choices and graduate education.NEW & NOTEWORTHY The Mississippi INBRE Outreach Scholars program is a summer research program for Mississippi college students that was successfully adapted to a fully online environment amidst the coronavirus-19 pandemic.

Key Focus Group Themes to Inform Weight Management Interventions in Deep South African Americans.

OBJECTIVE: To understand African Americans' perceptions, barriers, and facilitators to recruitment, enrollment, adoption, maintenance, and retention in a nutrition and physical activity promotion program. DESIGN: Four focus groups were conducted. SETTING: Two community settings located in Jackson and Hattiesburg, Mississippi. PARTICIPANTS: Participants (n = 28) were aged 18-50 years. MAIN OUTCOME MEASURE(S): Barriers and facilitators associated with healthy eating, physical activity, achieving a healthy weight, and participation in a health behavior change program. ANALYSIS: A conventional thematic content analysis approach includes data familiarization, initial code generation, initial theme generation, themes review, and team review for finalization of themes. RESULTS: Major themes related to health behaviors and participation in a behavior change program were identified by participants, including time constraints, costs, social support, consistency and self-efficacy, motivation for longevity and disease prevention, physical appearance, fear of injury/pain, social norms/stigma associated with outdoor physical activity, body criticism from family members, and having empathic and validating program staff support. CONCLUSIONS AND IMPLICATIONS: Several social determinants of health were identified as essential considerations for promoting healthy nutrition and physical activity behaviors among African American adult Mississippians. Cultural and spiritual implications were also identified. Study insights inform policy approaches for designing culturally appropriate health behavior change programs in the Deep South.

Evaluating the Protective Behavioral Strategies for Marijuana Scale (PBSM) short-form: Support for a two-factor structure and measurement invariance.

BACKGROUND: The present study evaluated the two-factor structure of the Protective Behavioral Strategies for Marijuana Scale (PBSM-SF) Short-Form, a 13-item measure of harm reduction behaviors related to cannabis use. Additionally, the PBSM was evaluated for measurement invariance based on sex and state cannabis legalization status. METHOD: Participants were 1,048 college students (Mage = 19.00) reporting past 30-day cannabis use who primarily identified as White (75.5%) females (64.9%) recruited from 11 universities in 11 states representative of the United States. All participants provided demographic information and completed the PBSM-SF, Marijuana Use Grid assessing cannabis use frequency, Cannabis Use Disorder Identification Test-Revised assessing hazardous cannabis use, and Brief Marijuana Consequences Questionnaire evaluating negative consequences. RESULTS: The two-factor structure (i.e., Quantity and Context) of the PBSM-SF identified in Mian et al. (2021) was supported in the present study. Additionally, analyses demonstrated evidence of convergent and concurrent validity. Finally, the two-factor PBSM-SF demonstrated some degree of invariance by sex and state legalization status. CONCLUSIONS: This study provides additional support for a two-factor model of PBSM-SF (i.e., Quantity and Context) that functions similarly for men and women college students as well as for students from states without legalized cannabis use and states with legalized cannabis use.

Mental Health Risk Profiles and Related Substance Use During Coronavirus Pandemic Among College Students Who Use Substances.

College students have shown elevated mental distress during the coronavirus disease of 2019 (COVID-19). The extent and persistence of mental distress as COVID-19 restrictions have continued is unclear. This study used latent profile analysis to identify student mental health risk subgroups and to evaluate subgroups in relation with substance use. A four-profile solution was supported with a sample of 930 college students (69.6% female, 58.1% White) from 11 US-based institutions. Students were characterized by slight mental health symptoms, mild mental health symptoms, moderate-to-severe mental health symptoms with mild psychosis/substance use, and severe mental health symptoms. The severe profile comprised more ethnoracial or sexual minorities and students impacted from COVID-19. Whereas the severe profile had more alcohol-related consequences, the slight profile had fewer cannabis-related consequences. COVID-19 has exacerbated college student risks for psychiatric disorders. Students of diverse backgrounds and more impacted by COVID-19 show disproportionately more mental distress and related substance use.

The Status of SBIRT Training in Health Professions Education: A Cross-Discipline Review and Evaluation of SBIRT Curricula and Educational Research.

PURPOSE: To assess the quality of curricular research on the Screening Brief Intervention and Referral to Treatment (SBIRT) approach and determine the presence of useful training modalities, particularly motivational interviewing (MI) training, across health care training curricula. METHOD: The authors conducted a systematic review of published, peer-reviewed studies in PubMed, ERIC, CINAHL, Ovid HealthSTAR, and PsycINFO databases through March 2021 for English-language studies describing SBIRT, a curriculum for health care trainees, and curricular intervention outcomes. After the records were independently assessed, data were extracted and 20% of the studies were double-coded for interrater reliability. RESULTS: Of 1,856 studies, 95 were included in the review; 22 had overlapping samples and were consolidated into 10 nested studies, leaving 83 total. Interrater reliability ranged from moderate (κ = .74, P < .001) to strong (κ = .91, P < .001) agreement. SBIRT training was delivered to trainees across many professions, including nursing (n = 34, 41%), medical residency (n = 28, 34%), and social work (n = 24, 29%). Nearly every study described SBIRT training methods (n = 80, 96%), and most reported training in MI (n = 54, 65%). On average, studies reported 4.06 (SD = 1.64) different SBIRT training methods and 3.31 (SD = 1.59) MI training methods. Their mean design score was 1.92 (SD = 0.84) and mean measurement score was 1.89 (SD = 1.05). A minority of studies measured SBIRT/MI skill (n = 23, 28%), and 4 studies (5%) set a priori benchmarks for their curricula. CONCLUSIONS: SBIRT training has been delivered to a wide range of health care trainees and often includes MI. Rigor scores for the studies were generally low due to limited research designs and infrequent use of objective skill measurement. Future work should include predefined training benchmarks and validated skills measurement.

The Brief Young Adult Alcohol Consequences Questionnaire: A cross-country examination among university students in Australia, New Zealand, Canada, Argentina, and the United States.

BACKGROUND: The Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ) was designed to measure alcohol consequences and identify at-risk students. It was developed and originally validated among university students in the United States (U.S.), yet it is widely used in both the U.S. and abroad. Using the alignment method, we tested whether the B-YAACQ measures alcohol consequences similarly across university students in several countries where heavy alcohol use and related outcomes are prevalent. METHODS: The sample consisted of 1473 university students (ages 18-30) from five university sites: Australia (n = 315), New Zealand (n = 270), Canada (n = 276), Argentina (n = 232), and the U.S. (n = 380). Participants completed a confidential, online alcohol use survey which included the B-YAACQ. RESULTS: Overall, 12 of the 24 B-YAACQ items had invariant factor loading and threshold parameters, suggesting that these items exhibited similar reliability and difficulty among university students across the five countries. Of the 24 B-YAACQ items, 21 exhibited comparable reliability across the five countries; the remaining 3 items were slightly less reliable indicators of alcohol consequences among U.S. students. Thus, several items on the B-YAACQ may be particularly informative for identifying students who are experiencing high levels of drinking harm across multiple countries. CONCLUSIONS: The present study is an important step toward (a) validating the B-YAACQ among university students in New Zealand and Canada, and (b) furthering our understanding of the psychometric properties of the B-YAACQ among university students in Australia, Argentina, and the U.S.

Psychometric validation of the Protective Drinking Practices Scale in college students across the United States.

The present study tested the psychometric properties of a new 20-item alcohol protective behavioral strategies (PBS) measure, the Protective Drinking Practices Scale (PDPS). Specifically, we evaluated measurement invariance of the PDPS in a sample of college students recruited nationally, tested the factor structure, evaluated construct validity, and explored potential short-form versions. Participants were 684 college student drinkers from throughout the United States (50.3% male; 65.6% White) obtained using Amazon's Mechanical Turk (MTurk) who completed measures of PBS use, hazardous drinking, alcohol-related negative consequences, alcohol use disorder (AUD) screening criteria, and depression. A differential item functioning analysis found that the PDPS items functioned similarly in the present sample and the original validation sample. Further, a unidimensional item response theory analysis confirmed the single PDPS factor structure identified in the original study. The PDPS demonstrated evidence of convergent validity with measures of hazardous drinking and alcohol-related negative consequences. Finally, five potential three-item PDPS short-form versions were generated, which all had strong correlations with the 20-item PDPS. Overall, these results suggest the PDPS functioned similarly in a United States college student sample with geographical diversity relative to a sample from a single Southeastern United States university, which has implications for future research and clinical work with college students. Future research should continue assessing the psychometric properties of the PDPS among diverse samples of college students and further elucidate an optimal PDPS short form for use in clinical screening and research contexts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Color Coding the "Labyrinth": How Staff Perceived a Two-Part Intervention to Improve Wayfinding in an Adult Emergency Department.

OBJECTIVES, PURPOSE, OR AIM: We report a two-part wayfinding intervention, considering four quality criteria (visibility, usability, efficiency and overall effectiveness) from staff perspectives. BACKGROUND: Few studies to date have explored wayfinding in the Emergency Department (ED). Yet, as ED usage continues to grow, effective wayfinding in these high-stress, fast-paced environments is likely to become increasingly important. At an adult ED located in the U.S. Southeast, wayfinding has been a persistent problem. We subsequently developed a two-part wayfinding intervention: colored routes to key destinations in the ED and corresponding visitor badges. METHODS: Quality criteria were formulated using the Donabedian model: visibility (structure), usability (process), efficiency (process), and overall effectiveness (outcome). Assessments consisted of staff surveys, which were distributed from March to early April 2019. RESULTS: The strong ratings across quality criteria, added to affirmative comments from staff, provide evidence that the color coding system made a positive impact on wayfinding. CONCLUSIONS: While the results should be generalized with caution, the two-part intervention may be highly portable to other contexts. Future studies might examine the effect of colored routes alone. They might illuminate relations between structure, process, and outcomes as they relate to the assessment of wayfinding. They might also expand wayfinding quality criteria. Ultimately, such studies should improve not only the productivity but also the accessibility and user experience of the ED.

Protective Behavioral Strategies Mediate the Relationship between Overparenting and Alcohol-Related Consequences among College Students.

BACKGROUND: The negative consequences associated with alcohol misuse remain a concern on college campuses nationwide. Alcohol protective behavioral strategies are important factors in mitigating college students' experiences of alcohol-related negative consequences. Overparenting, or "helicopter parenting," is a form of over-involved parenting which has been associated with a range of substance use concerns in college students. The mechanism by which overparenting is associated with alcohol use and/or consequences is unclear; however, it may be partially explained by failure to engage in the use of protective behavioral strategies. Purpose/objectives: The current study explored the degree to which alcohol protective behavioral strategies mediated the relationship between overparenting and alcohol-related negative consequences when accounting for alcohol consumption and if these associations were invariant across race and gender. Methods: Participants were 625 traditional age college students who consumed alcohol within the 30 days prior to completing measures of alcohol consumption, overparenting, alcohol-related negative consequences, and alcohol protective behavioral strategies. Results: Alcohol protective behavioral strategies, specifically manner of drinking, partially mediated the relationship between overparenting and alcohol-related negative consequences when accounting for alcohol misuse. There were no differences noted across gender, but the models were found to be invariant across White and African American participants in relation to the protective value of alcohol protective behavioral strategies. Conclusion/Importance: Overparenting may relate to negative alcohol outcomes in part through less use of harm reduction strategies. More investigation into the value of alcohol protective behavioral strategies across race is needed.

Making sense of design thinking: A primer for medical teachers.

An increasing number of medical teachers have taken an interest in design thinking, which has been used for years in business, law, and technology sectors. Yet, what does design thinking mean, and how has it been applied in medical education? This commentary discusses design thinking from multiple perspectives. First, it overviews, briefly, the historical development of design thinking, which medical education literature has seldom addressed in detail. Second, it synthesizes three current understandings of design thinking across disciplines: design thinking as a cognitive style, as a process of creativity and innovation, and as an organizational attribute. Third, it presents a 'roundup' of design thinking initiatives that have been applied at preclinical and clinical levels, including programs, courses, workshops, and hackathons. To conclude, the commentary suggests future directions for medical teachers interested in design thinking. Although design thinking is showing promise in medical education, there is substantial work to be done theoretically and practically.

Practice and Dissemination of Motivational Interviewing: A Psychology Internship Curriculum.

Sufficient training in substance use issues has been identified as a common gap in professional psychology graduate training. Satisfactory training in evidence-based practices has also been identified as a common gap for providers who care for individuals with substance use problems. The "practice and dissemination" curriculum we developed seeks to address both of these gaps during the predoctoral internship training year by first training psychology interns to competently deliver motivational interviewing (MI) to individuals with substance use problems and then train community providers and volunteers to do so. From 2012-2013, a total of 55 community providers and volunteers from a homeless shelter, a substance use treatment facility, and a community mental health facility received training in MI through this curriculum by attending continuing education events delivered by 17 psychology interns. Evaluation of the dissemination portion of the curriculum as part of an exempt educational research project revealed that community providers were able to achieve significant increases in MI knowledge, readiness to implement MI, and MI skill as assessed with a video analogue measure by the end of the workshop. They also reported satisfaction with the workshop. These evaluation findings provide preliminary support for the curriculum as a novel and efficacious way to disseminate MI to community providers. Research is necessary to determine long-term outcomes of such training and to identify strategies to overcome potential barriers such as the substantial faculty effort necessary to implement the intensive curriculum.

Coping Styles Mediate the Association between Posttraumatic Stress Disorder Symptoms and Alcohol Outcomes in College Students.

BACKGROUND: College students report high rates of alcohol consumption and Criterion A traumatic events, which puts them at higher risk for dangerous alcohol-related negative consequences when compared to the general population. The self-medication theory suggests coping as the potential link between substance use and psychological distress, and it has been found that ineffective coping styles are related to increased PTSD symptom severity and harmful drinking behaviors. Purpose: This study evaluated the mediating role of coping styles (i.e. problem-solving and avoidance coping) on the relationship between posttraumatic stress disorder (PTSD) symptoms and alcohol outcomes (i.e. hazardous drinking and alcohol-related negative consequences [ARNC]). Methods: A national sample of 672 traditional age (i.e. 18-25 years old; M = 22.35, SD = 1.97) college students who reported alcohol consumption in the past month were recruited via Amazon's Mechanical Turk website. Participants were 55.1% male and 60.9% White and completed measures of PTSD symptoms, coping styles, hazardous drinking, and ARNC. Results: Problem-solving coping mediated the positive relationship between PTSD symptoms and hazardous drinking such that PTSD symptoms were negatively associated with problem-solving coping, which was negatively associated with hazardous drinking. Avoidance coping mediated the positive relationship between PTSD symptoms and ARNC through a positive association between PTSD symptoms and avoidance coping. Conclusions: These novel findings highlight the importance of adaptive coping styles as a protective factor for college students experiencing co-occurring PTSD symptoms and harmful alcohol use.

Motivational interviewing quality assurance: A systematic review of assessment tools across research contexts.

The need for sustained skill development and quality assurance when executing behavioral interventions is best demonstrated in the empirical evolution of Motivational Interviewing (MI). As a brief behavioral intervention that identifies the therapeutic process as an active treatment ingredient, it is critical for researchers, trainers, and administrators to use psychometrically sound and theoretically congruent tools to evaluate provider skills and fidelity when executing MI. Yet, no prior work has evaluated the breadth of MI tools employed across research contexts. Therefore, this review identified MI fidelity and skill development tools across measurement, training and efficacy/effectiveness studies and evaluated their psychometric strength and fit with current MI theory. We identified 199 empirical studies that employed an MI fidelity/skill tool and we found 21 tools with varying degrees of empirical support and theoretical congruence. Specifically, we identified five observer-, two trainee- and one client-rated tool with strong empirical support, and nine observer- and two client-rated tools with preliminary empirical support. We detailed the empirical strength, including the extent to which tools were linked to trainee/client outcomes across research contexts and offer recommendations on which MI tools to use in training, efficacy, and effectiveness trials.

College Alcohol Beliefs and Alcohol Outcomes: The Mediating Effects of Alcohol Protective Behavioral Strategies.

BACKGROUND: The present study examined the mediating role of alcohol protective behavioral strategies (i.e. serious harm reduction [PBS-SHR], manner of drinking [PBS-MOD], stopping/limiting drinking [PBS-SLD]) on the relationships between college alcohol beliefs and alcohol outcomes (i.e. hazardous drinking and alcohol-related negative consequences) in an attempt to replicate recent findings in the early stages of college alcohol belief and PBS research. Methods: Participants were 625 traditional age undergraduate college students (M = 19.00, SD = 1.72; 63.7% White; 80.7% female) recruited from a southeastern United States university who reported past 30-day alcohol consumption. All participants completed measures of college alcohol beliefs, alcohol PBS use, hazardous drinking, and alcohol-related negative consequences through an online survey. Results: Higher college alcohol beliefs were associated with greater hazardous drinking and alcohol-related negative consequences. Further, PBS-MOD mediated the positive relationship college alcohol beliefs had with hazardous drinking, such that higher college alcohol beliefs predicted less PBS-MOD use which was associated with greater hazardous drinking. Discussion: These findings provide further evidence to support previous findings highlighting the additional protective value of certain alcohol PBS especially for college students with high college alcohol beliefs.

Screening for alcohol use disorders in college student drinkers with the AUDIT and the USAUDIT: a receiver operating characteristic curve analysis.

Background: The Alcohol Use Disorders Identification Test (AUDIT) and its consumption subscale (AUDIT-C) are international gold standard screeners for identifying at-risk drinkers. Items have been modified to reflect United States low-risk drinking guidelines in the USAUDIT and USAUDIT-C, which also perform well in identifying at-risk drinkers. The USAUDIT may also be used to screen for potential AUD, an important first step to identify individuals needing diagnostic testing and treatment referrals. Objectives: The present study sought to evaluate the sensitivity and specificity of each measure in predicting potential AUDs via diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition in a college sample. Methods: Participants were 382 college student drinkers (Mage = 20.2, SD = 1.5; 68.7% female) who completed online surveys assessing alcohol use, at-risk drinking, and AUD symptom endorsement. Receiver operating curves provide optimal cutoff scores for each measure in overall, male, and female samples. Results: Results indicated the AUDIT and USAUDIT are equally superior in detecting potential AUD in the current sample. Recommended cutoff scores for detecting likely AUD with the USAUDIT are 12 for males (sensitivity = 62.0%, specificity = 86.6%) and 8 for females (sensitivity = 65.3%, specificity = 87.7%). Conclusions: Whereas prior work supports the USAUDIT-C in detecting at-risk drinking, the current study supports the AUDIT and USAUDIT in detecting potential AUD. Based on prior work, and in an effort to be consistent with standard US drinking guidelines, we recommend using the USAUDIT in screening and brief interventions across college campuses.