An examination of heavy drinking, depressed mood, drinking related constructs, and consequences among high-risk college students using a person-centered approach.

INTRODUCTION: Research has identified college students who experience depressed mood and consume alcohol are at an increased risk for experiencing alcohol problems. The present study identified profiles of differential alcohol use, depression, key psychosocial indicators of drinking (e.g., normative perceptions) and examined the relationship between these profiles and alcohol-related consequences. METHOD: Students with a history of risky drinking and elevated depressed mood (n=311; 62.4% female) completed a web-based survey assessing typical and peak drinking, depressive symptoms, descriptive norms, drinking to cope motives, protective behavioral strategies, and alcohol-related consequences. RESULTS: Latent profile analysis was used to classify participants into distinct profiles focusing on alcohol use patterns and level of depressed mood and drinking related constructs. Profiles were then compared based on their association with reported rates of alcohol-related consequences. Four profiles emerged: 1) Mild Depression, Heavy Drinkers; 2) Mild Depression, Severe Drinkers; 3) Moderate Depression, Heavy Drinkers; and 4) Moderate Depression, Severe Drinkers. Findings revealed significant differences between the four profiles on both risky drinking and alcohol-related consequences. CONCLUSION: These findings suggest the importance of assessing and addressing depressive symptoms among college students in order to reduce rates of risky drinking and alcohol-related consequences.

A Dual-Process Examination of Alcohol-Related Consequences Among First-Year College Students.

OBJECTIVE: Despite showing reductions in college student drinking, interventions have shown some inconsistency in their ability to successfully decrease consequences. With the goal of improving prevention efforts, the purpose of this study was to examine the role of consequence-specific constructs, in addition to drinking, that influence students' experiences with alcohol-related problems. The study examined how drinking and protective behaviors mediated the relationships between students' willingness to experience consequences, intentions to avoid them, and four categories of alcohol-related problems (physiological, social, sexual, and academic). METHOD: First-year college student drinkers (n = 2,024) at a large northeastern university completed surveys during the fall and spring of their freshman year. RESULTS: As expected, different patterns of associations emerged for physiological and nonphysiological consequences. When physiological consequences (e.g., hangover, vomiting) were examined, drinking significantly mediated the effect of willingness on the consequences. Drinking-specific protective behaviors indirectly influenced consequences through drinking behaviors whereas general protective behaviors did not. When nonphysiological (e.g., social, sexual, academic) consequences were examined, drinking and general protective behaviors emerged as significant mediators of the effects of willingness and intentions on the consequences, whereas drinking-specific protective behaviors did not. CONCLUSIONS: The results suggest that prevention efforts (e.g., personalized feedback) could be tailored to address specific types of protective behaviors as well as specific types of consequences frequently experienced by college students.

Brief web-based intervention for college students with comorbid risky alcohol use and depressed mood: does it work and for whom?

UNLABELLED: College is a time of increased risk for problematic alcohol use and depressed mood. The comorbidity of these conditions is well documented, but is less well understood, with few interventions designed to prevent or reduce the related consequences. The current study evaluated a web-based personalized intervention for students (N=311) who reported an AUDIT score of 8 or more, a BDI-II score of 14 or more, and reported drinking four (women) or five (men) or more drinks on at least one occasion in the past month. METHOD: Invited participants were randomly selected from all enrolled undergraduates at a large, public, Pacific Northwestern University. Participants completed a screening and baseline assessment, and those who met study eligibility criteria were randomized to one of four conditions (alcohol only, depressed mood only, integrated, and referral-only control). Follow-up occurred one-month post-intervention. RESULTS: While no main effects for the interventions were found, there were moderation effects, such that students in the alcohol only and integrated conditions who had lower levels of depressed mood or alcohol-related problems at baseline showed greater reductions in alcohol-related problems at follow-up compared to students in the control condition. Implications for interventions are discussed.

Maternal and peer influences on drinking among Latino college students.

Previous research on college drinking has paid little attention to Latino students. Social development models (Catalano, Hawkins, & Miller, 1992) suggest that protective influences in one domain (e.g., mothers) can offset negative influences from other domains (e.g., peers) though this possibility has not been explored with respect to Latino college student drinking. The present study had two aims: 1) to determine whether four specific maternal influences (monitoring, positive communication, permissiveness, and modeling) and peer descriptive norms were associated with college drinking and consequences among Latino students, and 2) to determine whether maternal influences moderated the effect of peer norms on college drinking and consequences. A sample of 362 first-year students (69.9% female) completed an online assessment regarding their mothers' monitoring, positive communication, permissiveness, and modeling, peer descriptive norms, and drinking and related consequences. Main effects and two-way interactions (mother×peer) were assessed using separate hierarchical regression models for three separate outcomes: peak drinking, weekly drinking, and alcohol-related consequences. Maternal permissiveness and peer descriptive norms were positively associated with drinking and consequences. Maternal communication was negatively associated with consequences. Findings indicate that previously identified maternal and peer influences are also relevant for Latino students and highlight future directions that would address the dearth of research in this area.

Optimizing timing and dosage: does parent type moderate the effects of variations of a parent-based intervention to reduce college student drinking?

Research on parent-based interventions (PBIs) to reduce college student drinking has explored the optimal timing of delivery and dosage. The present study extended this work by examining the effectiveness of three different PBI conditions on student drinking outcomes as a function of parenting types and students' pre-college drinking patterns. Four hypotheses were evaluated (early intervention, increased dosage, invariant, and treatment matching risk). A random sample of 1,900 college students and their parents was randomized to four conditions: (1) pre-college matriculation, (2) pre-college matriculation plus booster, (3) post-college matriculation, or (4) control, and was assessed at baseline (summer prior to college) and 5-month follow-up. Baseline parent type was assessed using latent profile analysis (positive, pro-alcohol, positive, anti-alcohol, negative mother, and negative father). Student drinking patterns were classified at baseline and follow-up and included: non-drinker, weekend light drinker, weekend heavy episodic drinker, and heavy drinker. Consistent with the treatment matching risk hypothesis, results indicated parent type moderated the effects of intervention condition such that receiving the intervention prior to college was associated with lower likelihood of being in a higher-risk drinking pattern at follow-up for students with positive, anti-alcohol, or negative father parent types. The findings are discussed with respect to optimal delivery and dosage of parent-based interventions for college student drinking.

Hurting, helping, or neutral? The effects of parental permissiveness toward adolescent drinking on college student alcohol use and problems.

To enhance prevention efforts to reduce college drinking, parents have been identified as an important source of influence that can be modified with brief interventions. Research suggests parental permissiveness toward drinking in adolescence is positively related to college student drinking, though existing studies have not comprehensively accounted for potential confounders (e.g., parental drinking). The present study used propensity modeling to estimate the effects of pre-college parental permissiveness on college student drinking and consequences while accounting for an inclusive range of confounders. A random sample of 1,518 incoming students at a large university completed baseline measures of parental permissiveness and a list of confounders (e.g., parental drinking, family history). At follow-up 15 months later, participants reported on their drinking and alcohol-related consequences. To control for potential confounders, individuals were weighted based on their propensity scores to obtain less biased estimates of the effects of parental permissiveness on drinking and consequences. Analyses revealed parental permissiveness was consistently and positively associated with college drinking and consequences when the confounders were not accounted for, but these effects were attenuated after weighting. Parents' allowance of drinking was not related to college drinking or consequences after weighting. Students' perceived parental limits for consumption were related to drinking and consequences in the weighted models. Prevention efforts may benefit from targeting parents' communication of acceptable limits for alcohol consumption.

Are certain college students prone to experiencing excessive alcohol-related consequences? Predicting membership in a high-risk subgroup using pre-college profiles.

OBJECTIVE: Previous research identified a high-risk subgroup of students who experience high levels of multiple and repeated alcohol-related consequences (MRC group). Although they consist of 20% of the population and account for nearly 50% of the consequences, the MRC group has not been the focus of etiological or prevention research. The present study identified pre-college profiles of psychosocial and behavioral characteristics and examined the association between these profiles and membership in the MRC group. METHOD: The sample consisted of 370 first-year college students (57% female) recruited in the summer before college. Participants reported on typical drinking, alcohol-related risky and protective drinking behaviors, alcohol beliefs, descriptive and injunctive norms, and alcohol-related consequences at three time points over 15 months. RESULTS: Latent profile analysis identified four baseline student profiles: extreme-consequence drinkers, high-risk drinkers, protective drinkers, and nondrinkers. Logistic regression revealed that, when the high-risk drinkers were used as the reference group, both the protective drinkers and the nondrinkers were significantly less likely to be members of the MRC group, whereas the extreme-consequence drinkers were at increased odds of being in the MRC group, even after first-year drinking was controlled for. Student profiles and previously identified parental profiles both had unique main effects on MRC group membership, but there was no significant interaction between parental and student profiles. CONCLUSIONS: Findings suggest ways that brief interventions can be tailored for students and parents in relation to the MRC group.

Moderation of a parent-based intervention on transitions in drinking: examining the role of normative perceptions and attitudes among high- and low-risk first-year college students.

BACKGROUND: Parent-based interventions (PBIs) are an effective strategy to reduce problematic drinking among first-year college students. The current study examined the extent to which student-based characteristics, derived from the Theory of Planned Behavior, moderated 3 PBI conditions: (i) prior to college matriculation (PCM); (ii) PCM with a booster during the fall semester; and (iii) after college matriculation. The moderator variables included injunctive and descriptive peer norms about alcohol use and attitudes toward alcohol use. METHODS: Using data from a randomized control trial delivered to 1,900 incoming college students, we examined differential treatment effects within 4 types of baseline student drinkers: (i) nondrinkers; (ii) weekend light drinkers (WLD); (iii) weekend heavy episodic drinkers; and (iv) heavy drinkers. The outcome variable was based on the transitions in drinking that occurred between the summer prior to college enrollment and the end of the first fall semester and distinguished between students who transitioned to 1 of the 2 risky drinking classes. RESULTS: The results indicated that injunctive norms (but not descriptive norms or attitudes) moderated the differential effects of the PBI with strongest effects for students whose parents received the booster. Differential effects also depended on baseline drinking class and were most pronounced among WLDs who were deemed "high-risk" in terms of injunctive peer norms. CONCLUSIONS: Parental influence can remain strong for young adults who are transitioning to college environments, even among students with relatively high peer influence to drink alcohol. Thus, the PBI represents an effective tool to prevent escalation of alcohol use during the first year of college, when risk is highest and patterns of alcohol use are established.

Examining the relationship between alcohol-energy drink risk profiles and high-risk drinking behaviors.

BACKGROUND: The mixing of alcohol and energy drinks (AMEDs) is a trend among college students associated with higher rates of heavy episodic drinking and negative alcohol-related consequences. The goals of this study were to take a person-centered approach to identify distinct risk profiles of college students based on AMED-specific constructs (expectancies, attitudes, and norms) and examine longitudinal associations between AMED use, drinking, and consequences. METHODS: A random sample of incoming freshmen (n = 387, 59% female) completed measures of AMED use, AMED-specific expectancies, attitudes, and normative beliefs, and drinking quantity and alcohol-related consequences. Data were collected at 2 occasions: spring semester of freshmen year and fall semester of sophomore year. RESULTS: Latent profile analysis identified 4 subgroups of individuals: occasional AMED, anti-AMED, pro-AMED, and strong peer influence. Individuals in the pro-AMED group reported the most AMED use, drinking, and consequences. There was a unique association between profile membership and AMED use, even after controlling for drinking. CONCLUSIONS: Findings highlighted the importance of AMED-specific expectancies, attitudes, and norms. The unique association between AMED risk profiles and AMED use suggests AMED use is a distinct behavior that could be targeted by AMED-specific messages included in existing brief interventions for alcohol use.

An update of research examining college student alcohol-related consequences: new perspectives and implications for interventions.

The objective of this review is to provide an update on existing research examining alcohol-related consequences among college students with relevance for individual-based interventions. While alcohol-related consequences have been a focus of study for several decades, the literature has evolved into an increasingly nuanced understanding of individual and environmental circumstances that contribute to risk of experiencing consequences. A number of risk factors for experiencing alcohol-related consequences have been identified, including belonging to specific student subgroups (e.g., Greek organizations) or drinking during high-risk periods, such as spring break. In addition, the relationship between students' evaluations of both negative and positive consequences and their future drinking behavior has become a focus of research. The current review provides an overview of high-risk student subpopulations, high-risk windows and activities, and college students' subjective evaluations of alcohol-related consequences. Future directions for research are discussed and include determining how students' orientations toward consequences change over time, identifying predictors of membership in high-risk consequence subgroups and refining existing measures of consequences to address evolving research questions.

Parents' and students' reports of parenting: which are more reliably associated with college student drinking?

Recent efforts to reduce college student heavy episodic drinking have examined parental influences, with the goal of continually refining parent-based interventions (PBIs). This research has primarily relied on student-reported data, which is often cited as a methodological limitation although the degree to which parent- and student-reported data on parenting behaviors correspond is unknown. The goals of the present study were to assess the level of consistency between parent- and student-reported data for commonly examined parenting constructs and compare their associations with college student drinking. Data were collected from a sample of 145 parent-student dyads using a longitudinal design. At baseline, parents and students reported on parental monitoring, approval of light and moderate/heavy drinking, and permissiveness. At a 10-month follow up, students reported on their typical weekly drinking and consequences. Parents' and students' reports of parenting behavior at baseline were compared and their associations with student drinking and consequences at follow up were assessed. Agreement between parents' and students' reports of parenting was fair to moderate, with intraclass correlation coefficients ranging from .34 to .61. Student-reported data were more reliably associated with student drinking at follow up. Studies examining parent influences on college student drinking, including research on PBIs, do not appear to be limited by using student-reported data. Implications for future research are discussed.

Evaluation of timing and dosage of a parent-based intervention to minimize college students' alcohol consumption.

OBJECTIVE: The study evaluated the timing and dosage of a parent-based intervention to minimize alcohol consumption for students with varying drinking histories. METHOD: First-year students (N = 1,900) completed Web assessments during the summer before college (baseline) and two follow-ups (fall of first and second years). Students were randomized to one of four conditions (pre-college matriculation [PCM], pre-college matriculation plus boosters [PCM+B], after college matriculation [ACM], and control conditions). Seven indicators of drinking (drink in past month, been drunk in past month, weekday [Sunday to Wednesday] drinking, Thursday drinking, weekend [Friday, Saturday] drinking, heavy episodic drinking in past 2 weeks, and peak blood alcohol concentration <.08) were used in a latent transition analysis (LTA) to examine a stage-sequential model of drinking. LTA models with dummy-coded intervention variables were used to examine the effects of the intervention conditions on changes in drinking patterns. RESULTS: Results indicated that four patterns of drinking were present at all waves: (a) nondrinkers, (b) weekend light drinkers, (c) weekend heavy episodic drinkers, and (d) heavy drinkers. Results indicated that the PCM condition was most effective at influencing baseline heavy drinkers' transition out of this pattern to lower risk patterns at first follow-up, whereas the ACM condition was not effective at preventing drinking escalation for baseline nondrinkers at first follow-up. No decay of effects was observed at long-term follow-up for the PCM condition. Finally, the results also indicated that increased dosage of the parental intervention was not significantly associated with either reduction or escalation of use. CONCLUSIONS: The results underscore the value of pre-college parental interventions and targeted efforts to reduce high-risk drinking among college students.

Using parental profiles to predict membership in a subset of college students experiencing excessive alcohol consequences: findings from a longitudinal study.

OBJECTIVE: Previous research identified a high-risk subset of college students experiencing a disproportionate number of alcohol-related consequences at the end of their first year. With the goal of identifying pre-college predictors of membership in this high-risk subset, the present study used a prospective design to identify latent profiles of student-reported maternal and paternal parenting styles and alcohol-specific behaviors and to determine whether these profiles were associated with membership in the high-risk consequences subset. METHOD: A sample of randomly selected 370 incoming first-year students at a large public university reported on their mothers' and fathers' communication quality, monitoring, approval of alcohol use, and modeling of drinking behaviors and on consequences experienced across the first year of college. RESULTS: Students in the high-risk subset comprised 15.5% of the sample but accounted for almost half (46.6%) of the total consequences reported by the entire sample. Latent profile analyses identified four parental profiles: positive pro-alcohol, positive anti-alcohol, negative mother, and negative father. Logistic regression analyses revealed that students in the negative-father profile were at greatest odds of being in the high-risk consequences subset at a follow-up assessment 1 year later, even after drinking at baseline was controlled for. Students in the positive pro-alcohol profile also were at increased odds of being in the high-risk subset, although this association was attenuated after baseline drinking was controlled for. CONCLUSIONS: These findings have important implications for the improvement of existing parent- and individual-based college student drinking interventions designed to reduce alcohol-related consequences.

One-time or repeat offenders? An examination of the patterns of alcohol-related consequences experienced by college students across the freshman year.

Recent studies have examined alcohol-related consequences in college students as an independent outcome variable, rather than as a result of heavy drinking. The present study examined the patterns of consequences experienced by first-year college students (n=169). Specifically, the number of distinct consequences and the frequency of repeated consequences were evaluated as well as the combination of the two. Results revealed that 80% of participants reported experiencing multiple consequences, with over 34% of students reporting 6 or more unique consequences over the course of their freshmen year. In addition, nearly 50% of the sample reported experiencing 3 or more consequences repeatedly. Further, 23% of the sample reported experiencing 5 or more repeated consequences and 6 or more multiple consequences. These individuals experienced 38% of the multiple consequences and 54% of the repeated consequences reported by the entire sample, suggesting individuals who endorsed experiencing multiple consequences repeatedly also experienced a disproportionate number of the total consequences reported by the sample. The findings suggest there are specific high-risk patterns of alcohol-related consequences and demonstrate a need for further examination of additional variables that predict consequences.

An examination of college students' willingness to experience consequences as a unique predictor of alcohol problems.

The focus of the study was to examine (1) the unique variance between willingness to experience specific consequences (e.g., vomit) and reported experience of the consequence after controlling for drinking, and (2) the relationships between consequence specific constructs (attitudes and norms) and willingness to experience specific consequences in the context of a structural equation model. Freshmen students (n = 167) from a large northeastern university were randomly selected to participate. Results indicated willingness to experience consequences accounted for significant variance across consequence outcomes controlling for drinking. Significant relationships were observed between consequence specific constructs (attitudes and norms) and students' willingness to experience consequences. Findings provide empirical support that alcohol-related consequences have multiple determinants and are not only a function of alcohol consumption. Prevention efforts may benefit from a more comprehensive approach that includes both drinking and consequence-specific constructs as targets of change.