Discrimination, drinking to cope, protective behavioral strategies, and alcohol-related consequences among university students.

OBJECTIVE: University students who experience more discrimination typically report more negative consequences from alcohol use. The study aimed to assess whether drinking to cope and protective behavioral strategies for alcohol use would help explain the relationship between everyday discrimination and alcohol-related consequences among university student drinkers. METHOD: Data were collected in Fall 2020 and the sample included 707 undergraduate and graduate students from a large public institution in the northeast who reported consuming alcohol in the past month. Participants identified predominantly as women (71.7%; 24.6% men) and White (65.1%; 7.9% Black/African American; 7.2% Asian/Asian American; 7.1% Hispanic/Latinx). A cross-sectional serial mediation analysis using structural equation modeling was conducted using Mplus. RESULTS: Controlling for alcohol use, results supported a serial partial mediation model. More experiences of discrimination predicted a significant increase in alcohol-related consequences, above and beyond the increase attributed to drinking to cope. More frequent use of protective behavioral strategies significantly increased the odds of reporting no alcohol-related consequences. CONCLUSIONS: Drinking to cope and protective behavioral strategies for alcohol use may help explain why university students who report frequent discrimination are more likely to experience alcohol-related consequences, independent of how much alcohol they consume. Findings can inform clinical and prevention practice, advocacy, and training.

Racial, ethnic, and sex differences in heavy drinking and negative alcohol-related consequences in a national sample of NCAA student-athlete drinkers.

Objective: Athletic involvement is linked to increased risk for heavy alcohol use among college students. We examined whether student-athletes from diverse racial/ethnic backgrounds differ with respect to heavy drinking and related consequences. Method: Participants were 15,135 student-athlete drinkers (50.7% female) from 170 NCAA member institutions who participated in an online study. Results: Findings from our hierarchical linear models indicated that being a male student-athlete was associated with an increased likelihood of high intensity drinking (10/8 + drinks/per sitting for males/females) for White, Asian American/Pacific Islander, and Black student-athletes, but not for Hispanic student-athletes. Additionally, being a female student-athlete was associated with higher levels of negative alcohol-related consequences across all racial/ethnic groups. Finally, at similar drink quantities, compared to being a White student-athlete, being an Asian American/Pacific Islander student-athlete was associated with higher levels of alcohol-related consequences. Conclusions: Student-athlete drinkers are not homogeneous with respect to heavy drinking and related consequences.

Associations between Impulsivity and Exercise Addiction, Disordered Eating, and Alcohol Use Behaviors: A Latent Profile Analysis.

BackgroundDespite the known negative consequences of exercise addiction and preliminary evidence suggesting that it may co-occur with other health risk behaviors, no studies to date have examined exercise addiction among college students in conjunction with disordered eating behaviors and alcohol use. The aim of this study was to describe which college students are most at-risk for co-occurring health risk behaviors to enhance the efficiency of health risk prevention efforts. Method: Guided by multidimensional theories of impulsivity and substance use models of comorbidity, this study used latent profile analysis to examine whether separate, conceptually meaningful profiles of risk for exercise addiction, disordered eating behaviors, and alcohol use would emerge among 503 college students from a large public university. Results: The best-fitting model supported three profiles. MANOVA results revealed significant profile differences based on exercise addiction, binge eating, purging, laxative/pill/diuretic use, exercising longer than 60 minutes, negative urgency, and problematic alcohol use. Profile 3 students (n = 29), labeled the Affect Driven Health Risk-Takers, demonstrated the highest levels of impulsivity (i.e., negative urgency, lack of premeditation, lack of perseverance, and sensation seeking) and the most risk behaviors compared to the other two profiles. Profile membership was associated with distinct levels of negative urgency, exercise addiction, disordered eating behaviors, and problematic alcohol use. A small proportion of undergraduates demonstrated co-occurring exercise addiction, disordered eating behaviors, and problematic alcohol use. Profile membership also predicted the health outcomes of clinically significant exercise addiction and hazardous alcohol use. Conclusions: Findings illuminated how patterns of risk behavior engagement were associated with clinically significant exercise addiction and hazardous alcohol use and will inform prevention efforts and clinical interventions with at-risk college students.

The common-sense model and mental illness outcomes: A meta-analysis.

Psychotherapists can improve their patients' outcomes during and after therapy by improving patients' self-management. Patients who do not effectively manage their mental illness generally have worse outcomes. Leventhal's Common-Sense Model of Self-Regulation theorizes that patients' perceptions of their illness (illness representations) guide their self-management, influencing health outcomes. The present study quantified the relations between illness representations, self-management and outcomes for mental illnesses. We conducted a meta-analysis and included articles if they reported (1) on adults with mental illnesses and (2) the correlation between mental illness representations and mental illness outcomes. Twenty-five articles were included which represented 28 independent samples. The pattern of correlations among illness representations (identity, consequences, timeline, control, coherence and emotional representations), self-management strategies (attendance, engagement and adherence to treatment) and mental illness outcomes (symptom severity and quality of life) was consistent with analyses from previous studies of mental and physical illnesses. The results found threat-related illness representations mostly had a large relationship with worse mental illness outcomes and self-management. Protective illness representations had a small-to-large relationship with better mental illness outcomes and self-management. The results suggest patients' perceptions of their mental illness may be a critical indicator of their mental illness outcomes, including symptom severity and quality of life. This theory-driven meta-analysis supports calls for the inclusion of illness representations in psychotherapy for mental illness.

A National Study on Drinking Game Behaviors and Related Consequences Among NCAA Student-Athletes: Racial/Ethnic and Sex Differences.

OBJECTIVE: Research indicates that college student-athletes report more alcohol use and negative drinking consequences than non-student-athletes. One drinking practice that has been linked to heavy alcohol use and related consequences is playing drinking games. In the present study, we investigated which segment of the student-athlete population is most at risk for frequent drinking game participation, elevated alcohol consumption while playing drinking games, and negative drinking game consequences. We examined sex and racial/ethnic differences in behaviors and consequences associated with drinking games in a national sample of White, Hispanic, Black, and Asian American/Pacific Islander (AAPI) student-athletes. METHOD: A total of 11,839 student-athletes (51.4% women) from 165 National Collegiate Athletic Association (NCAA) member institutions who endorsed lifetime participation in drinking games completed a confidential online survey. RESULTS: Hierarchical linear modeling revealed that being a White (vs. Black or Hispanic) student-athlete was associated with more frequent drinking game participation, and among AAPI and Black (but not White or Hispanic) student-athletes, men played drinking games more frequently than women. Being a Black (vs. White) student-athlete was associated with more drinking game consumption; no sex differences in drinking game consumption were found among Black student-athletes. Among White, AAPI, and Hispanic student-athletes, being a male student-athlete was associated with more drinking game consumption. Finally, female student-athletes had a higher likelihood of experiencing one or more negative consequences from drinking games than did male student-athletes. The association between drinking game participation and negative drinking game consequences was also stronger for women compared with men. CONCLUSIONS: Student-athletes are heterogeneous with regard to drinking game behaviors and related consequences. Knowing who is at greatest risk for drinking game participation and related outcomes is an important first step in developing targeted intervention approaches for student-athletes.

Doctor Recommendations are Related to Patient Interest and Use of Behavioral Treatment for Chronic Pain and Addiction.

The opioid crisis has highlighted the importance of improving patients' access to behavioral treatments for chronic pain and addiction. What is not known is if patients are interested in receiving these treatments. In this cross-sectional study, over 1,000 participants with chronic pain were surveyed using an anonymous online questionnaire on Amazon Mechanical Turk to investigate participants' use of and interest in pharmacological and behavioral treatments for chronic pain and addiction. Participants also indicated whether their doctor had recommended these treatments. The majority of participants reported using medication for their pain (83.19%) and that their doctor recommended medication (85.05%), whereas fewer participants reported using (67.45%) and being recommended to (62.82%) behavioral treatments. We found 63.67% of participants screened positive for possible opioid misuse; those who screened positive were more interested in receiving behavioral treatments than those who did not screen positive. Participants who received treatment recommendations were more likely to be interested in receiving those treatments as compared to participants who did not. The results suggest that recommendations for behavioral treatments and interest in those treatments are related. Results also suggest that patients endorsing behaviors consistent with opioid misuse are interested in behavioral treatments. PERSPECTIVE: This study provides information around chronic pain patients' treatment interests, treatment receipt, and recommendation receipt for behavioral pain management and addiction treatment. This study could help facilitate communication between patients and doctors regarding available treatments for chronic pain and pain treatment-related addiction problems.