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1.
Psychol Addict Behav ; 38(3): 255-268, 2024 May.
Article in English | MEDLINE | ID: mdl-38271079

ABSTRACT

OBJECTIVE: Cannabis use is increasing among college students and commonly co-occurs with anxiety symptoms in this age group. Interventions that reduce anxiety may also reduce cannabis use. Behavioral economic theory suggests that substance use reductions are most likely when there is an increase in substance-free reinforcement. This randomized pilot trial evaluated the efficacy of a brief motivational intervention (BMI) for cannabis supplemented by either a substance-free activity session (SFAS) or a relaxation training (RT) session for reducing cannabis use, problems, craving, and anxiety symptoms. METHOD: One hundred thirty-two college students (Mage = 19.9; 54% female; 67% White, 31% Black) who reported five or more past-month cannabis use days were randomized to: (a) assessment-only (AO); (b) BMI plus SFAS; or (c) BMI plus RT. Participants in the BMI conditions received two individual counselor-administered sessions plus a brief phone booster session. Outcomes were evaluated 1- and 6-months postintervention. RESULTS: Relative to assessment, both BMI + SFAS and BMI + RT were associated with significant reductions in cannabis problems and craving at 1-month follow-up, and significant reductions in anxiety at 6-month follow-up. Relative to AO, BMI + RT was associated with significant reductions in cannabis use at 1-month follow-up. There were no differences between BMI conditions. CONCLUSIONS: This pilot trial was not adequately powered to conclusively evaluate relative efficacy but provides preliminary support for the short-term efficacy of both two-session interventions for reducing anxiety and cannabis-related risk among nontreatment seeking emerging adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Subject(s)
Anxiety , Relaxation Therapy , Students , Humans , Female , Male , Pilot Projects , Young Adult , Relaxation Therapy/methods , Anxiety/therapy , Adult , Marijuana Use/therapy , Motivational Interviewing/methods , Adolescent , Craving , Psychotherapy, Brief/methods , Treatment Outcome , Universities
2.
Alcohol Clin Exp Res ; 46(8): 1525-1538, 2022 08.
Article in English | MEDLINE | ID: mdl-35707989

ABSTRACT

BACKGROUND: The association between behavioral economic demand and various alcohol use outcomes is well established. However, few studies have examined whether changes in demand occur following a brief alcohol intervention (BAI), and whether this change predicts alcohol outcomes over the long term. METHODS: Parallel process piecewise latent growth curve models were examined in a sample of 393 heavy drinking emerging adults (60.8% women; 85.2% white; Mage  = 18.77). In these models, two linear slopes represented rates of change in alcohol use, heavy drinking episodes, alcohol-related problems, and demand (intensity and highest expenditure across all price points or Omax ) from baseline to 1 month (slope 1) and 1 month to 16 months (slope 2). Mediation analyses were conducted to estimate the effect of a BAI on 16-month alcohol outcomes through slope 1 demand. RESULTS: A two-session BAI predicted significant reductions in all five outcomes from baseline to 1-month follow-up. Although no further reduction was observed from the 1-month to the 16-month follow-up, there was no regression to baseline levels. Slope 1 demand intensity, but not Omax , significantly mediated the association between BAI and both outcomes-heavy drinking episodes (Est. = -0.23, SE = 0.08, p < 0.01) and alcohol-related problems (Est. = -0.15, SE = 0.07, p < 0.05)-at the 16-month follow-up. CONCLUSIONS: Reducing high valuation of alcohol among heavy drinking emerging adults within the first month following BAI is critical for the long-term efficacy of the intervention. A two-session BAI was associated with enduring reductions in alcohol demand, and the change in demand intensity, but not Omax , was associated with sustained reductions in heavy drinking and alcohol-related problems.


Subject(s)
Alcohol Drinking , Crisis Intervention , Adolescent , Adult , Alcohol Drinking/epidemiology , Alcohol Drinking/therapy , Economics, Behavioral , Ethanol , Female , Humans , Male
3.
Psychol Addict Behav ; 36(6): 710-723, 2022 Sep.
Article in English | MEDLINE | ID: mdl-34766785

ABSTRACT

OBJECTIVE: Innovative strategies are needed to reduce young adult drinking. Real-time feedback via mobile health (mHealth) technology (e.g., smartphone devices/apps) may facilitate moderate drinking, yet requires evidence of feasibility, acceptability, and usability. METHOD: Young adults reporting frequent heavy drinking (N = 99, Mage = 23, 51% male) participated in a manualized, brief, motivational interview on recent typical and peak blood alcohol concentration (BAC), then were randomized to use 1 of the 3 forms of technology: (a) smartphone breathalyzer device/app; (b) app that estimates BAC based on factors including sex, weight, number/types of drinks over time; or (c) self-text messaging after each drink. Technologies were tested initially in small-group laboratory alcohol self-administration sessions. Participants then completed a 2-week field test wherein they had free access to all three technologies. Participants reported on usability and acceptability. RESULTS: Laboratory alcohol self-administration did not differ significantly by technology condition. The smartphone breathalyzer and BAC estimator app had favorable acceptability and usability. Participants used at least one form of technology on 67% of drinking days in the field period. In exploratory analyses, alcohol use during the field period was significantly lower than the baseline including a decrease of nearly one drink per drinking day. CONCLUSIONS: These findings support the feasibility of research combining lab and field methods to test moderate drinking technologies in young adults. Findings further support the acceptability and usability of these technologies, along with young adults' openness to using them. Exploratory results suggest potential efficacy of combined mobile technology intervention to be tested in subsequent controlled studies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
Mobile Applications , Motivational Interviewing , Adult , Alcohol Drinking , Blood Alcohol Content , Ethanol , Female , Humans , Male , Motivational Interviewing/methods , Smartphone , Young Adult
4.
Alcohol Clin Exp Res ; 45(10): 2147-2159, 2021 10.
Article in English | MEDLINE | ID: mdl-34342015

ABSTRACT

BACKGROUND: Behavioral economic theory predicts that low access to environmental reward is a risk factor for alcohol use disorder (AUD). The Substance-Free Activity Session (SFAS) is a behavioral economic supplement to standard brief alcohol interventions that attempts to increase environmental reward and may therefore have beneficial effects, particularly for individuals with low levels of environmental reward. METHODS: Participants were 393 college students who reported at least 2 heavy-drinking episodes in the past month. Participants were randomly assigned to 1 of 3 conditions following a baseline assessment: a standard alcohol-focused brief motivational intervention plus relaxation training session (BMI + RT), BMI plus Substance-Free Activity Session (BMI + SFAS), or an assessment-only control condition (AO). In a secondary analysis of the data from this study, we used person-centered statistical techniques to describe trajectories of alcohol severity and environmental reward over a 16-month follow-up and examined whether environmental reward levels moderated the effectiveness of the interventions. RESULTS: Piecewise growth mixture modeling identified 2 trajectories of reward availability: low increasing (LR; n = 120) and high stable (HR; n = 273). Depressive symptoms, cannabis use, sensation seeking, and low life satisfaction were associated with a greater probability of classification in the LR trajectory. Alcohol severity was greater in the LR trajectory than the HR trajectory. For students in the LR trajectory, at 1, 6, and 12 months, BMI + SFAS led to greater increases in reward availability and reduced levels of alcohol severity compared with the BMI + RT and AO conditions and at 16 months compared with AO. CONCLUSIONS: Young adults with low levels of environmental reward are at heightened risk for greater alcohol severity and may show greater benefit from brief alcohol interventions that focus on increasing substance-free reward than individuals who are not deficient in reward availability.


Subject(s)
Alcohol Drinking in College/psychology , Alcoholism/psychology , Alcoholism/therapy , Crisis Intervention/statistics & numerical data , Reward , Severity of Illness Index , Adolescent , Alcohol-Related Disorders/epidemiology , Alcoholism/epidemiology , Depression/epidemiology , Ethnicity , Female , Humans , Male , Marijuana Abuse , Motivation , Young Adult
5.
Psychol Addict Behav ; 35(4): 444-457, 2021 Jun.
Article in English | MEDLINE | ID: mdl-33956473

ABSTRACT

OBJECTIVE: Recent studies have examined the extent to which alcohol dependence (AD) criteria prospectively predict the course of AD. Critically, these studies have lacked a developmental perspective. However, the differential performance of criteria by age might indicate overendorsement in younger individuals. The current study examined AD criteria in terms of persistence and prediction of AD course and alcohol use by age in order to identify criteria that are likely to be overly endorsed by younger individuals. METHOD: The current study used longitudinal data from the National Epidemiologic Survey on Alcohol and Related Conditions to depict age differences in rates of new onset, recurrence, and persistence for each AD criterion, thereby showing how these three factors contribute to the overall age-prevalence curve of each criterion. Additionally, we tested age moderation of the predictive association between each criterion at baseline and new onset, recurrence, and persistence of syndromal AD. RESULTS: Some criteria (particularly, persistent desire or unsuccessful efforts to cut down or control drinking, and drinking despite physical/psychological problems) are both less persistent and less predictive of AD course among younger adults compared to older adults. CONCLUSIONS: These findings raise the possibility of elevated rates of false-positive AD among younger adults and suggest ways to improve the assessment of AD criteria. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
Alcohol Drinking/psychology , Alcoholism/psychology , Ethanol/adverse effects , Adolescent , Adult , Age Factors , Alcoholism/diagnosis , Female , Humans , Longitudinal Studies , Male , Middle Aged , Prevalence , Prognosis , Recurrence , Young Adult
6.
Exp Clin Psychopharmacol ; 29(2): 191-202, 2021 Apr.
Article in English | MEDLINE | ID: mdl-32730058

ABSTRACT

High levels of 3 behavioral economic indices (delay discounting, alcohol demand, and proportionate substance-related reinforcement) are consistently associated with greater alcohol misuse and alcohol-related problems. However, it is unclear whether and how these variables jointly increase the risk for alcohol-related outcomes among college students who engage in heavy episodic drinking (HED; 4/5+ drinks for women/men, respectively). The current study used a person-centered approach to identify similar patterns of behavioral economic domains among heavy-drinking college students and investigate the relationship between these empirically derived classes and alcohol-related outcomes. A sample of 393 college students (60.8% female, 78.9% White/Caucasian) reporting at least 2 heavy drinking episodes in the previous month completed measures of alcohol use and problems, demographics, delay discounting, and alcohol reward value (alcohol demand and proportionate substance-related reinforcement). Latent profile analyses revealed that a 3-class solution provided the best fit to the data: a low reward value, high discounting (LRHD) class (n = 53), a moderate reward value, low discounting (MRLD) class (n = 214), and a high reward value, high discounting (HRHD) class (n = 126). Members of the HRHD class reported significantly greater alcohol consumption, past-month HED episodes, alcohol-related problems, and symptoms of alcohol use disorder than those in the MRLD and LRHD classes. The results suggest that there are 3 constellations of behavioral economic processes and that, consistent with the reinforcer pathology model, students who overvalue alcohol-related reward and discount the future more steeply are at the greatest risk for alcohol misuse and alcohol-related problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
Alcohol Drinking in College , Alcohol Drinking/epidemiology , Alcohol-Related Disorders/epidemiology , Economics, Behavioral , Adolescent , Alcoholism/epidemiology , Female , Humans , Male , Reinforcement, Psychology , Reward , Students/statistics & numerical data , Universities , Young Adult
7.
Alcohol Clin Exp Res ; 43(12): 2607-2619, 2019 12.
Article in English | MEDLINE | ID: mdl-31661166

ABSTRACT

INTRODUCTION: Behavioral economic theory views addiction as a reinforcer pathology characterized by excessive demand for drugs relative to alternatives. Complementary to this theory, Lamb and Ginsburg (Pharmacology Biochemistry and Behavior, 164, 2018, 62) describe addiction as a behavioral allocation disorder and predict that decisions to drink under increasingly stringent constraints are a central indicator of addiction. This study used a modified demand-curve paradigm to examine alcohol demand in the context of a next-day contingency (high opportunity cost demand) as a specific indicator of a severe pattern of alcohol problems. METHODS: Participants were 370 undergraduates (61.1% female, 86.5% white, Mage  = 18.8) reporting multiple past-month heavy drinking episodes (5/4 drinks per occasion for men/women) who completed 2 versions of an alcohol purchase task (APT), along with measures of past-month alcohol use and problems. In 1 APT (low opportunity cost), students imagined they had no next-day responsibilities, and in the other APT (high opportunity cost), they imagined having a 10:00 am test the next day. Item-response theory analyses were used to determine mild and severe alcohol problems from the Young Adult Alcohol Consequences Questionnaire (Journal of Studies on Alcohol, 67, 2006, 169), and the most and least severe binge drinking days throughout the week. RESULTS: Low opportunity cost demand (ß = 0.15, p = 0.02) significantly predicted beyond high opportunity cost demand for the least severe problems, and high opportunity cost demand (ß = 0.17, p = 0.009) significantly predicted beyond low opportunity cost demand for the most severe problems. Similarly, low opportunity cost demand (ß = 0.26, p < 0.001) was more highly associated with weekend drinking, whereas high opportunity cost demand (ß = 0.21, p = 0.001) was more highly associated with weekday drinking. CONCLUSIONS: The current results suggest high opportunity cost alcohol demand is a distinct marker of severe alcohol problems among college student heavy drinkers.


Subject(s)
Alcohol Drinking in College/psychology , Cost-Benefit Analysis , Adolescent , Female , Humans , Male , Psychological Theory , Young Adult
8.
Psychol Addict Behav ; 33(7): 603-615, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31448930

ABSTRACT

Alcohol use is highly comorbid with depression, especially among college students, whose rates of both phenomena are higher than in the general population. The self-medication hypothesis (i.e., alcohol use is negatively reinforced via the alleviation of negative affect) has dominated explanatory models of comorbidity. However, self-regulation has also demonstrated cross-sectional relationships with both depression and alcohol problems and may contribute to the development of alternative comorbidity models. Self-regulation introduces three alternative models that can be tested empirically: (a) a depressed regulation model, (b) a central nervous system depressant model, and (c) a self-regulatory failure model. The purpose of this study was to test the utility of these models (in addition to the self-medication hypothesis) by examining the temporal precedence in the relations between self-regulation, depressive symptoms, and alcohol problems among heavy-drinking college students (N = 393) over 5 assessment points (baseline, 1 month, 6 months, 12 months, and 16 months) using an autoregressive cross-lagged model. Lower self-regulation, and higher alcohol problems and depressive symptoms, prospectively predicted higher depressive symptoms. Higher alcohol problems and lower self-regulation prospectively predicted higher alcohol problems. Only self-regulation prospectively predicted self-regulation. These results were consistent across multiple time points. Findings are consistent with a self-regulatory failure model of depressive symptoms and alcohol problems. Therefore, self-regulation may be an important etiological variable and potential intervention target to reduce both alcohol problems and depressive symptoms among college students. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Subject(s)
Alcohol Drinking in College , Alcohol-Related Disorders/epidemiology , Depression/epidemiology , Self-Control , Adolescent , Adult , Comorbidity , Cross-Sectional Studies , Female , Humans , Male , Young Adult
9.
J Consult Clin Psychol ; 87(7): 657-669, 2019 Jul.
Article in English | MEDLINE | ID: mdl-31070386

ABSTRACT

OBJECTIVE: Behavioral economic theory suggests that a reduction in alcohol use is most likely when there is an increase in rewarding substance-free activities. Anxiety has also been linked to heavy drinking, and strategies to reduce anxiety may enhance alcohol interventions. The goal of this 2-site randomized controlled clinical trial was to evaluate the efficacy of a brief alcohol intervention that was supplemented with either a behavioral economic substance-free activity session (SFAS) or a relaxation training (Relaxation training [RT]) session. METHOD: Participants were 393 college students (61% female, mean age = 18.77 years) who reported 2 or more past-month heavy drinking episodes. Participants were randomized to 1 of 3 conditions: (a) assessment; (b) alcohol brief motivational intervention (BMI) plus SFAS; or (c) BMI plus RT. Both treatment conditions included 2 in-person sessions plus a phone booster session. Outcomes were evaluated 1-, 6-, 12-, and 16-months postintervention. RESULTS: Generalized linear mixed models indicated that the combination of a BMI plus either the SFAS or RT was associated with significant reductions in alcohol use and problems across the 16-month follow-up compared with assessment only. There were no significant differences between the two active treatment conditions. Changes in proportional reinforcement from substance-related activities, and protective behavioral strategies mediated treatment effects. CONCLUSION: Two-session (plus booster) interventions that combine BMI and either substance-free activity enhancement or RT can result in enduring reductions in alcohol misuse among college drinkers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Subject(s)
Alcohol Drinking in College/psychology , Binge Drinking/therapy , Motivational Interviewing , Relaxation Therapy , Adolescent , Binge Drinking/psychology , Counseling , Economics, Behavioral , Female , Humans , Male , Reinforcement, Psychology , Treatment Outcome , Young Adult
10.
Alcohol Clin Exp Res ; 43(5): 988-996, 2019 05.
Article in English | MEDLINE | ID: mdl-30973651

ABSTRACT

BACKGROUND: Alcohol-induced blackouts, a form of anterograde amnesia that restricts the encoding of short-term memories into long-term ones, are among the most severe alcohol-related consequences. College students are at high risk of experiencing alcohol-induced blackouts, and there is a need to determine whether alcohol interventions can effectively reduce blackouts in this population. The current study uses data from 3 randomized clinical trials to examine the effect of various intervention approaches on alcohol-induced blackouts. METHODS: Four interventions were compared over 3 studies: (i) a computerized feedback intervention (electronic Check-Up To Go [e-Chug]; Study 1); (ii) a single-session brief motivational intervention (BMI; Study 1); (iii) a BMI plus behavioral economic session focused on increasing substance-free activities (BMI + Substance-Free Activity Session [SFAS]; Studies 2 and 3); and (iv) a BMI plus supplemental Relaxation Training session (BMI + Relaxation Training; Studies 2 and 3). Studies 1 and 3 also included an assessment-only control condition. For each study, participants reported whether they had experienced an alcohol-induced blackout at each time point; binary logistic regressions examined differential likelihood of experiencing an alcohol-induced blackout over time. RESULTS: Neither the single-session BMI nor e-Chug reduced alcohol-induced blackouts over assessment only; however, participants in the BMI + SFAS or BMI + Relaxation Training condition were significantly less likely to experience an alcohol-induced blackout compared to assessment only at 1-month (Wald = 4.77, odds ratio [OR] = 0.53, p = 0.03) and 6-month follow-ups (Wald = 5.72, OR = 0.52, p = 0.02). Study 2 also revealed a larger effect for the BMI + SFAS over the BMI + Relaxation Training condition at 6 months (Wald = 4.11 OR = 0.22, p = 0.043), although this was not replicated in Study 3. The effects for the 2-session BMIs lasted 6 months, at which point maturation effects diminished differences between assessment-only and intervention conditions. CONCLUSIONS: Two sessions of BMI are a substantial enough dose to result in reductions in alcohol-induced blackouts among college student heavy drinkers.


Subject(s)
Alcohol Drinking in College/psychology , Alcoholic Intoxication/psychology , Alcoholic Intoxication/therapy , Motivational Interviewing/trends , Adolescent , Alcoholic Intoxication/epidemiology , Amnesia, Anterograde/epidemiology , Amnesia, Anterograde/prevention & control , Amnesia, Anterograde/psychology , Female , Follow-Up Studies , Humans , Male , Motivation/physiology , Motivational Interviewing/methods , Randomized Controlled Trials as Topic/methods , Young Adult
11.
Prev Sci ; 20(6): 873-883, 2019 08.
Article in English | MEDLINE | ID: mdl-30054777

ABSTRACT

Tailgating drinking prior to a football game is a type of event-specific drinking associated with increased alcohol use and related problems. Personalized drinking feedback interventions (PFI) are efficacious in reducing alcohol use and problems. The current study aimed to advance understanding of event-specific interventions by examining: (1) the efficacy of an event-specific, text message PFI on tailgating alcohol outcomes, and (2) the extent to which intervention effects generalize to "typical" alcohol outcomes at 1-month follow-up. College students (N = 130; 71% female; 92% white) who reported tailgating within the past 30 days and binge drinking when tailgating in the past year completed assessments on tailgating and typical alcohol use. They were randomly assigned to one of two text message conditions delivered on the morning of a home football game: event-specific PFI (TXT PFI) or a control condition. Multilevel modeling examined the association of treatment condition on tailgating and 1-month alcohol outcomes. When tailgating, participants in TXT PFI reported lower estimated peak blood alcohol concentration (eBAC) and consumed less drinks than the control condition. At the 1-month "typical" drinking follow-up, participants in TXT PFI reported lower peak eBAC and fewer alcohol-related problems than the control condition. Perceived tailgating drinking norms were found to statistically mediate the relationship between condition and alcohol outcome at tailgating and 1-month follow-ups. Findings provide preliminary support for the efficacy of an event-specific, text message PFI in reducing both tailgating and typical drinking alcohol outcomes. Event-specific TXT PFI can be used for prevention/intervention of alcohol misuse.


Subject(s)
Binge Drinking/prevention & control , Health Promotion , Students , Text Messaging , Adolescent , Feedback, Psychological , Female , Humans , Male , Program Evaluation , Universities , Young Adult
12.
Exp Clin Psychopharmacol ; 26(4): 347-353, 2018 08.
Article in English | MEDLINE | ID: mdl-29952619

ABSTRACT

Behavioral economic theory suggests that increased engagement in constructive, substance-free activities that are in the service of long-term goals (e.g., college graduation, career development, health) can decrease alcohol use and related problems. However, engaging in activities such as these in the high-risk college environment requires the ability to self-regulate by avoiding rewarding but risky behaviors (e.g., drinking) while also effectively organizing behavior in the pursuit of delayed academic and career-related rewards. The current secondary data analyses evaluated self-regulation as a potential mechanism of behavior change in an alcohol intervention trial that compared a standard alcohol-focused brief motivational intervention (BMI) plus a behavioral economic substance-free activity session (SFAS) with an alcohol BMI plus relaxation training (reaction time [RT]) session (Murphy et al., 2012). Participants were 82 first-year undergraduate students (50% women; Mage = 18.5, SD = .71) who reported 2 or more past-month heavy drinking episodes. After completing a baseline assessment and an individual alcohol-focused BMI, participants were randomized to either the SFAS or the RT session. The BMI + SFAS condition reported greater mean self-regulation at 1 month compared with BMI + RT. Furthermore, self-regulation at 1 month significantly mediated the relation between condition and alcohol-related outcomes at 6-month follow-up. Although preliminary, these results suggest that brief behavioral economic intervention elements that an attempt to increase future goal pursuit and substance-free activities can enhance the short-term efficacy of standard alcohol BMIs and that this effect may be due in part to increases in self-regulation. (PsycINFO Database Record


Subject(s)
Alcohol Drinking in College/psychology , Economics, Behavioral , Reward , Self-Control/psychology , Students/psychology , Adolescent , Female , Follow-Up Studies , Humans , Male , Motivation , Risk-Taking , Treatment Outcome , Universities , Young Adult
13.
Exp Clin Psychopharmacol ; 26(1): 58-64, 2018 02.
Article in English | MEDLINE | ID: mdl-29323504

ABSTRACT

Behavioral economic measures of alcohol reward value and future orientation have received support as predictors of alcohol consumption, alcohol-related problems, and response to intervention. Protective behavioral strategies (PBS) have been shown to be a significant mediator between a variety of risk factors and alcohol-related problems. The current article examines direct and mediating associations between measures of alcohol reward value (proportionate substance-related activity participation and enjoyment) and future orientation, use of PBS, and alcohol-related problems. Participants were 393 undergraduates (39.2% male, 78.9% Caucasian) who reported at least 2 past-month binge drinking episodes (5 and 4 drinks for men and women, respectively). This study is a secondary analysis of data collected previously as part of a brief intervention study. Alcohol reward value and future orientation were significantly associated with both protective behavioral strategies and alcohol problems. PBS was a significant partial mediator between these variables and alcohol-related problems after controlling for gender, level of alcohol consumption, and sensation seeking. This study provides support for the hypothesis that high levels of reinforcement from alcohol relative to alternatives and low consideration of the future may lead to patterns of dysregulated drinking with few harm-reduction strategies that increase risk for alcohol problems. In addition to directly targeting PBS, brief alcohol interventions for college students should attempt to increase future orientation and substance-free activities. (PsycINFO Database Record


Subject(s)
Alcohol Drinking in College/psychology , Alcohol-Related Disorders/psychology , Ethanol/pharmacology , Protective Factors , Reward , Adolescent , Alcohol-Related Disorders/economics , Ethanol/economics , Female , Humans , Male , Risk Factors , Young Adult
14.
Exp Clin Psychopharmacol ; 25(5): 412-421, 2017 10.
Article in English | MEDLINE | ID: mdl-28910128

ABSTRACT

College student drinking is a major public health concern and can result in a range of negative consequences, from acute health risks to decreased academic performance and drop out. Harm reduction interventions have been developed to reduce problems associated with drinking but there is a need to identify specific risk/protective factors related to academic performance among college drinkers. Behavioral economics suggests that chronic alcohol misuse reflects a dysregulated behavioral process or reinforcer pathology-alcohol is overvalued and the value of prosocial rewards are sharply discounted due, in part, to their delay. This study examined delay discounting, consideration of future consequences (CFC) and protective behavioral strategies (PBS) as predictors of academic success (grade point average; GPA) and engagement (time devoted to academic activities) among 393 college drinkers (61% female). In multivariate models, PBS were associated with greater academic engagement, but were not with academic success. Lower discounting of delayed rewards and greater CFC were associated with both academic success and engagement among drinkers. Previous research suggests that future time orientation is malleable, and the current results provide support for efforts to enhance future time orientation as part of alcohol harm-reduction approaches. (PsycINFO Database Record


Subject(s)
Alcohol Drinking in College/psychology , Alcohol Drinking/epidemiology , Delay Discounting , Students/statistics & numerical data , Academic Performance , Adolescent , Adult , Alcoholism/epidemiology , Female , Harm Reduction , Humans , Male , Reward , Universities , Young Adult
15.
Addict Behav ; 70: 54-60, 2017 07.
Article in English | MEDLINE | ID: mdl-28214434

ABSTRACT

INTRODUCTION: Compared to the general population, veterans of the wars in Afghanistan and Iraq (OEF/OIF) are more likely to engage in hazardous alcohol use and meet criteria for mental health disorders including Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder. Less is known how distinct profiles of alcohol use behavior relate to mental health symptoms. METHOD: The current study examined the extent that indicators of alcohol use (i.e., drinks per week, peak blood alcohol concentration, and alcohol-related problems) are categorized into different alcohol risk profiles utilizing a person-centered approach. We also examined how mental health symptoms (i.e., PTSD, depression, and anxiety-related symptoms) were associated with the alcohol risk profiles. Participants were 252 Veterans who reported consuming alcohol within the past month. RESULTS: Latent profile analysis indicated a four-class solution yielded the best-fitting model, and profiles were named based on their respective levels and patterns of alcohol use. Mental health symptoms were significantly different among the four profiles. Profiles of veterans who endorsed more alcohol-related problems (i.e., the "Severe alcohol behavior" and "Steady drinkers with functional impairment") also reported comorbid clinical symptoms of PTSD, depression, and anxiety. The "Binge drinkers with no functional impairment" and "Mild alcohol behavior" profiles reported the lowest levels of mental health symptoms. DISCUSSION: Findings highlight the unique relationship between distinct alcohol risk profiles and mental health outcomes. Targeted interventions and treatment options based on unique alcohol risk profiles may be helpful in tailoring prevention and intervention efforts in detecting co-occurring mental health symptoms among OEF/OIF veterans.


Subject(s)
Alcoholism/epidemiology , Alcoholism/psychology , Mental Disorders/epidemiology , Mental Disorders/psychology , Veterans/psychology , Veterans/statistics & numerical data , Adult , Afghan Campaign 2001- , Comorbidity , Female , Humans , Iraq War, 2003-2011 , Male , Risk , Severity of Illness Index , United States/epidemiology
16.
Am J Orthopsychiatry ; 87(2): 166-175, 2017.
Article in English | MEDLINE | ID: mdl-28206804

ABSTRACT

Many returning OIF/OEF/OND Veterans are seeking higher education in an effort to develop a meaningful career and financial stability. Evidence suggests that student service members/veterans (SSM/Vs) are experiencing less academic success than other students. The purpose of this review is to identify the unique challenges of SSM/Vs and evaluate current campus efforts to facilitate their retention and academic performance. With a focus on SSM/Vs attending colleges and universities, we obtained 57 peer-reviewed and 73 gray literature records published between 2001 and 2015. The current SSM/V literature contains an abundance of gray literature, and the empirical research tends to be limited by cross-sectional design and small sample sizes. SSM/Vs encounter significant personal and environmental challenges when transitioning from the military to college campuses. A variety of services have been developed to address the needs of the SSM/V population, but the efficacy of these services remains largely unknown. In conclusion, there is a clear need to provide education to faculty, students, and staff regarding the experiences of SSM/Vs. Efforts to enhance screening for, availability of, and SSM/V engagement in mental health services would also be beneficial, as would improved availability of and SSM/V access to academic support. All future programs designed to address the unique challenges of SSM/Vs in the academic environment should also be systematically implemented and evaluated. (PsycINFO Database Record


Subject(s)
Military Personnel/psychology , Social Adjustment , Students/psychology , Universities , Veterans/psychology , Humans , Mental Health Services/statistics & numerical data
17.
J Ethn Subst Abuse ; 16(3): 263-275, 2017.
Article in English | MEDLINE | ID: mdl-27294691

ABSTRACT

Drinking behaviors and alcohol use consequences can have a major effect on well-being in college student populations. Little research has addressed how the unique acculturative stress experiences of international students may affect their alcohol use and consequences. This study examined acculturative stress as a moderator of the relationship between international student drinking behaviors and alcohol use consequences. Data were collected from 175 international students and analyzed using hierarchal regression analysis to assess the moderating effect of acculturative stress. Acculturative stress moderated the relationship between alcohol use and related consequences such that the relationship was stronger among those with higher levels of acculturative stress. Efforts to alleviate acculturative stress experiences of this population may help decrease alcohol use consequences.


Subject(s)
Acculturation , Alcohol Drinking in College/psychology , Stress, Psychological/psychology , Students/psychology , Adult , Female , Humans , Male , Universities , Young Adult
18.
Alcohol Clin Exp Res ; 40(12): 2685-2691, 2016 12.
Article in English | MEDLINE | ID: mdl-27805267

ABSTRACT

BACKGROUND: Reward deprivation has been implicated in major depressive disorder and severe substance abuse, but its potential relation to alcohol use disorder (AUD) symptoms in non-treatment-seeking young adult drinkers is less clear. Depression is often comorbid with alcohol misuse, so relations of AUD with reward deprivation might be due in part to the presence of depressive symptoms in young adults. Behavioral economic theory views addiction as a state that is related in part to deficits in drug-free rewards, and therefore requires an investigation into whether reward deprivation has a direct relation to alcohol misuse that is, at least partially, independent of mood. METHODS: This study evaluates the contribution of 2 facets of reward deprivation (reward availability and experience) to alcohol use, AUD symptoms, and depression in a sample of young adult heavy episodic drinkers. Data were collected from 392 undergraduates (60.4% female, 85.1% Caucasian) who reported recent heavy drinking (83.7% with at least 1 AUD symptom). RESULTS: Low reward availability (environmental suppression) was significantly associated with both DSM-5 AUD symptoms and alcohol-related problems after controlling for age, gender, depressive symptomatology, and drinking level. CONCLUSIONS: This study provides support for behavioral economic models that emphasize reward deprivation as a unique risk factor for AUD that is independent of mood and drinking level. Limited access to natural rewards may be a risk and/or maintaining factor for AUD symptoms in college student drinkers.


Subject(s)
Alcohol Drinking in College/psychology , Alcohol-Related Disorders/psychology , Depression/psychology , Reward , Adolescent , Alcohol-Related Disorders/complications , Depression/complications , Economics, Behavioral , Female , Humans , Male
19.
Addict Behav ; 60: 18-23, 2016 09.
Article in English | MEDLINE | ID: mdl-27082264

ABSTRACT

Research suggests that high school athletes are at greater risk for heavy alcohol use and alcohol-related problems than their non-athlete peers. Drinking motives unique to the athletic experience may contribute to elevated use. The Athlete Drinking Scale (ADS) was designed to assess sport-related motives for alcohol use, but has not yet been validated among high school athletes. The purpose of this study was to examine the psychometric properties of the ADS among a sample of high school athletes. Participants were 216 high school student-athlete drinkers who completed anonymous self-report surveys. A confirmatory factor analysis resulted in a revised three-factor solution with a satisfactory overall model fit. Path analyses indicated that the Positive Reinforcement motives subscale was the only ADS subscale that was significantly associated with alcohol use and alcohol-related problems when controlling for the effects of the other factors (i.e., age and gender) in this population. The ADS may be a valuable assessment tool for researchers and clinicians involved in alcohol prevention efforts for high school athletes.


Subject(s)
Alcohol Drinking/epidemiology , Alcohol Drinking/psychology , Athletes/psychology , Athletes/statistics & numerical data , Motivation , Adolescent , Factor Analysis, Statistical , Female , Humans , Male , Psychometrics , Risk Factors , Students/psychology , Students/statistics & numerical data
20.
Health Psychol ; 35(6): 604-13, 2016 Jun.
Article in English | MEDLINE | ID: mdl-26914646

ABSTRACT

OBJECTIVE: Drinking remains a problem across college campuses. Changing this behavior requires interventions that can be easily and widely dispersed. Several theories place intentions as a proximal predictor of behavior change. The current study examines the effects of a Web-based Deviance Regulation Theory (DRT) intervention on (1) intentions to use alcohol protective behavior strategies (PBS) and (2) associations between these intentions and actual behavior. METHOD: Participants (n = 76) completed a 6-week, Web-based study examining drinking behaviors. Participants were randomly assigned to receive a positive frame about individuals who use PBS or a negative frame about individuals who do not. They also reported normative perceptions of PBS use among college students. They subsequently logged onto a secure server each week to report on alcohol involvement, use of 3 types of PBS (Manner of Drinking, Stopping/Limiting, and Serious Harm Reduction), and intentions to use these PBS the following week. RESULTS: Consistent with DRT, negative frames resulted in higher PBS use intentions if individuals held high normative beliefs about PBS use. Positive frames resulted in higher Manner of Drinking PBS use intentions if individuals held low normative beliefs about PBS use, but only if individuals endorsed a high belief in the frame. In addition, there was a DRT consistent increase in intention-action associations, but only for Stopping/Limiting PBS. DISCUSSION: A brief Web-based DRT intervention was effective at increasing PBS intentions and increasing PBS intention-action associations. DRT may provide a mechanism to additively or synergistically improve other Web-based interventions for college drinking. (PsycINFO Database Record


Subject(s)
Alcohol Drinking/prevention & control , Alcohol Drinking/psychology , Harm Reduction , Intention , Social Behavior , Students/psychology , Adolescent , Adult , Female , Humans , Internet/statistics & numerical data , Male , Random Allocation , Universities , Young Adult
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