Evaluations of alcohol consequences moderate social anxiety risk for problematic drinking

The link between social anxiety (SA) and problematic drinking is complex; this seems predominantly true among young adults. Individuals high on SA are thought to be particularly sensitive to the negative effects of alcohol, which should deter them from drinking. Yet, some evidence suggests that those high on SA continue to drink despite experiencing negative alcohol-related consequences (NACs) (Morris, Stewart, & Ham, 2005). Although traditionally, researchers assume NACs are perceived as averse, emerging evidence suggests these are not categorically viewed as negative by undergraduates. The study goal was to test whether evaluations of NACs moderate the effect of SA on problematic drinking. It was hypothesized that high SA would predict elevated alcohol use and number of NACs experienced, but only for those who evaluate NACs as less negative. Undergraduate drinkers (N = 130, 80 women) completed self-reports of social anxiety, NAC evaluations (ratings of how ‘bad’ experiencing each alcohol-related consequence would be), alcohol use, and NACs experienced. Regression analyses revealed that NAC evaluations moderated the effect of SA on number of NACs experienced, but not the effect of SA on weekly alcohol use. Simple slopes analyses showed that high SA was associated with elevated NACs experienced for those with weak negative NAC evaluations, controlling for alcohol use. These findings help explain the mixed SA-problematic drinking literature by identifying perceptions of NACs as an important moderator of SA risk for experiencing NACs. Moreover, clinical interventions aimed at reducing SA risk for undergraduate problematic drinking may benefit from targeting NAC evaluations.     

Adverse consequences of student drinking: the role of sex, social anxiety, drinking motives

This study examined whether biological sex, social anxiety, and drinking motives relate differently to distinct types of alcohol-related consequences using Poisson regression. One hundred eighteen college students completed self-report measures assessing drinking motives and social anxiety and an interview assessing alcohol consumption and consequences. Highly socially anxious women were particularly apt to experience adverse role functioning consequences, while men were particularly apt to experience physical consequences. Although highly socially anxious women reported more personal consequences than did women with low to moderate social anxiety, men with low to moderate social anxiety reported experiencing more social and personal consequences than did women with low to moderate social anxiety. When taking into consideration the above associations, coping motives were statistically associated with social consequences and marginally related to personal consequences, while enhancement motives were significantly associated with physical consequences. Targeting these factors may lead to effective interventions for individuals with co-occurring social anxiety and drinking problems.     

Hazardous drinking and weight-conscious drinking behaviors in a sample of college students and college student athletes

ABSTRACT

Background: “Weight-conscious drinking” refers to behaviors to restrict calories in conjunction with consuming alcohol and is associated with numerous negative consequences. This behavior has been observed in the college student population but has not been examined among college student athletes. Methods: This cross-sectional study assessed drinking, hazardous drinking levels (Alcohol Use Disorders Identification Test—Consumption [AUDIT-C] sum score), and weight-conscious drinking behaviors (for weight loss purposes and for intoxication purposes) using a paper-and-pencil survey that was completed by students at a large, private university in the Southwest United States. The sample for this study included college student nonathletes (n = 482; 212 males and 270 females) who completed the survey in 1 of 34 classes and college student athletes (n = 201; 79 males and 122 females) who completed the survey during practice. These analyses examined whether hazardous drinking level and other personal covariates (gender, race, and athlete status) predicted the 2 weight-conscious drinking behaviors of interest. Results: Among the subsample of students who drank, the same proportion of participants indicated weight-conscious drinking behavior for weight loss and weight-conscious drinking behavior for intoxication (both 24.9%; n = 122). In the multivariate analyses, students with higher hazardous drinking scores and females were significantly more likely to report engaging in both weight-conscious drinking behaviors. In those analyses, neither weight-conscious drinking behavior varied by athlete status. Conclusions: In this sample of college students, hazardous drinking most predicted weight-conscious drinking behavior and superseded gender and athlete status. In response, college health professionals should consider evidenced-based approaches to address hazardous drinking.     

Reliability of college student self-reported drinking behavior

College students represent a unique population among substance users, with developmental needs and motivational factors different from those of other adults with substance abuse problems. As most college-based treatment programs focus on harm reduction, the reliability of self-reported substance use is critical to assessing treatment needs and outcomes. This study examined the reliability of students' self-reported alcohol consumption for the month prior to entering a treatment program at two points in time. It was hypothesized that: (a) students required to attend a drug and alcohol educational program would underreport their history of use when asked about it at intake (Time 1), relative to their self-report of use for the same historical timeframe after attending the program (Time 2); and (b) students would describe these discrepancies as a function of feeling more or less concerned about the impact of their disclosure. Findings supported both hypotheses. Implications for an evaluation of student drinking behaviors are discussed.     

A multisite randomized trial of social norms marketing campaigns to reduce college student drinking

OBJECTIVE: An 18-site randomized trial was conducted to determine the effectiveness of social norms marketing (SNM) campaigns in reducing college student drinking. The SNM campaigns are intended to correct misperceptions of subjective drinking norms and thereby drive down alcohol consumption. METHOD: Institutions of higher education were randomly assigned to treatment and control groups. At the treatment group institutions, SNM campaigns delivered school-specific, data-driven messages through a mix of campus media venues. Cross-sectional student surveys were conducted by mail at baseline (n = 2,771) and at posttest 3 years later (n = 2,939). Hierarchical linear modeling was applied to examine multiple drinking outcomes, taking intraclass correlation into account. RESULTS: Controlling for other predictors, having an SNM campaign was significantly associated with lower perceptions of student drinking levels and lower alcohol consumption, as measured by a composite drinking scale, recent maximum consumption, blood alcohol concentration for recent maximum consumption, drinks consumed when partying, and drinks consumed per week. A moderate mediating effect of normative perceptions on student drinking was demonstrated by an attenuation of the Experimental Group x Time interaction, ranging from 16.4% to 39.5% across measures. Additional models that took into account the intensity of SNM campaign activity at the treatment institutions suggested that there was a dose-response relationship. CONCLUSIONS: This study is the most rigorous evaluation of SNM campaigns conducted to date. Analysis revealed that students attending institutions that implemented an SNM campaign had a lower relative risk of alcohol consumption than students attending control group institutions.     

Measuring college student drinking: illustrating the feasibility of a composite drinking scale.

This study explored the feasibility of a Composite Drinking Scale (CDS) designed to capture fully the phenomenon of problem drinking among college students while allowing easy public understanding. A survey conducted at 32 four-year U.S. colleges included four consumption measures: 30-day frequency; average number of drinks per week; number of drinks usually consumed when partying; and greatest number of drinks in one sitting in the past two weeks. Responses were normalized and added to create a continuous distribution, which was then subdivided into quartiles (CDS/Q1-Q4). The CDS is an easily understood scoring system, but compared to the simplistic "binge drinking" measure, it captures a broader range of relative risks and more clearly establishes the quadratic relationship between consumption and alcohol-related problems. Development of the CDS will require further exploring the best set of questions to include, establishing U.S. norms for the general population, and then transforming those scores to a simple measurement yardstick whose meaning can be easily communicated to the public.     

Behavioral economic approaches to reduce college student drinking

There is a need for novel, theory-based approaches to reduce heavy drinking on college campuses. Behavioral economics has guided basic laboratory research on drug administration for over 30 years and has recently been applied to human substance use in naturalistic and clinical settings. This paper provides an introduction to behavioral economics, reviews applications of behavioral economics to college student drinking, and describes prevention and intervention strategies that are consistent with behavioral economic theory. Behavioral economic theory predicts that college students' decisions about drinking are related to the relative availability and price of alcohol, the relative availability and price of substance-free alternative activities, and the extent to which reinforcement from delayed substance-free outcomes is devalued relative to the immediate reinforcement associated with drinking. Measures of problem severity are based on resource allocation towards alcohol and the relative value of alcohol compared to other reinforcers. Policy and individual level prevention approaches that are consistent with behavioral economic theory are discussed, including strategies for increasing the behavioral and monetary price of alcohol, increasing engagement in rewarding alternatives to substance use, and counteracting student drinkers' tendency to overvalue immediate relative to delayed rewards.     

Family history of alcohol abuse associated with problematic drinking among college students

Studies examining family history of alcohol abuse among college students are not only conflicting, but have suffered various limitations. The current report investigates family history of alcohol abuse (FH+) and its relationship with alcohol expectancies, consumption, and consequences. In the current study, 3753 student participants (35% FH+), completed online assessments. Compared to FH− same-sex peers, FH+ males and FH+ females endorsed greater overall positive expectancies, consumed more drinks per week, and experienced more alcohol-related negative consequences. Further, FH+ females evaluated the negative effects of alcohol to be substantially worse than FH− females. An ANCOVA, controlling for age, GPA, race, and alcohol expectancies, resulted in family history main effects on both drinking and consequences. An interaction also emerged between gender and family history, such that FH+ males were especially vulnerable to high levels of alcohol consumption. Results reveal the scope of FH+ individuals in the college environment and the increased risk for these students, particularly male FH+ students, suggesting a need for researchers and college health personnel to focus attention and resources on this issue.     

An internet-based survey method for college student drinking research

The purpose of this study was to describe and assess the utility of an Internet-based survey method for characterizing the alcohol consumption of college students. After extensive pilot research, a random sample of 1910 students aged 16-29 years was invited to complete a questionnaire, consisting of a series of web-pages linked to a relational database on a secure web-site. A branch structure allowed for tailoring of survey items by age and gender. The students received up to nine contacts, including a pre-notice letter with a token gift and an e-mail invitation (Phase 1), a reminder letter and e-mail message (Phase 2), and then telephone reminders and replacement access codes (Phase 3). Non-computer-users were offered a pen-and-paper alternative, making this a mixed-mode survey. The overall response to the survey was 82% (n = 1564). The median completion time was 16.7 min. Participants' comments showed high levels of satisfaction with the survey. Comparison of web (n = 1501) versus pen-and-paper completions (n = 63) revealed no modality effects. Technical problems addressed during the course of implementation included web-browser-operating system incompatibilities, and periodic network errors, although these resulted in little lost participation. Internet-based surveys are feasible for college student research and with carefully managed recruitment, can yield a high response.     

Using a drinking motivation scale to predict degrees of problematic drinking

Much of the recent interest in the role of cognitive factors in decisions to drink has focused on alcohol beliefs and drinking motivations. In this study, male alcoholics in treatment, untreated problem drinkers and non-problem drinkers were studied using a variation of the Mulford and Miller Definitions of Alcohol Scale, which assesses personal-deficiency and social/celebratory reasons for drinking. The three groups of drinkers differed significantly on their mean level of endorsement of items comprising each drinking motivation subscale. The alcoholics scored highest on both personal-deficiency and social/celebratory reasons for drinking, followed by the problem drinkers and then non-problem drinkers. The problem drinkers and non-problem drinkers, relative to the alcoholics, rated their social/celebratory reasons for drinking stronger than their personal-deficiency reasons. A multiple discriminant analysis yielded a function which was moderately successful in classifying the alcoholics (70% correctly classified) and non-problem drinkers (67%). The problem drinkers were much more difficult to correctly classify (32% were classified as alcoholic, 49% as non-problem drinkers). The findings suggest that potentially important differences exist in drinkers' motivations to consume alcohol, motivations that vary as a function of problem drinking severity. These are results which might productively be used in assessment and treatment endeavors.     

The role of cognitive structure in college student problem drinking

Although motivational models of alcohol use often invoke constructs relevant to affective distress (e.g., depressive symptoms), to date, no study has assessed the potential role of cognitive structures (enduring cognitive belief systems) in promoting problematic drinking behavior. Thus, the current study evaluated the relationship between cognitive structure, specifically dysfunctional attitudes and automatic negative thoughts, and problem-related drinking, while controlling for the influence of alcohol consumption, drinking motives related to affect management, demographic variables, and depressive symptoms. Participants were 182 male and female (80%) college undergraduates, who completed a battery of self-report questionnaires on two occasions, separated by 8 weeks. Initial correlational analyses indicated strong (positive) associations among the cognitive structure variables, depressive symptoms, and problem drinking behavior. Findings from set-wise hierarchical regression analyses demonstrated that dysfunctional attitudes measured at Time 1 (T1) predicted problem drinking eight weeks later at Time 2 (T2) even after controlling for age and sex, alcohol consumption (T2), depressive symptoms (T2), and drinking motives linked to affect regulation (T1). These findings highlight the potential importance of cognitive structure as a risk factor for problem drinking, above and beyond the risk posed by more traditionally studied variables.     

College student heavy drinking in social contexts versus alone

Heavy drinking is common among college students and typically occurs in social contexts. Heavy drinking when alone, however, is less common. The present study hypothesized that students who drink heavily when alone (HD-Alone) would differ from college students who only drink heavily in social contexts (Social HD). Forty-nine HD-Alone students (at least one heavy-drinking episode when alone), 213 Social HDs, and 63 non-heavy drinkers (Non-HDs) were compared on alcohol-related consequences, drinking milestones, alcohol-outcome expectancies, and symptoms of depression. HD-Alone students reported more negative drinking consequences, earlier onset of regular drinking, more alcohol expectancies, less self-efficacy and motivation to reduce drinking, and higher depression scores than Social HDs and Non-HDs. Findings imply individual differences among heavy-drinking college students according to their drinking context.     

A campus-based motivational enhancement group intervention reduces problematic drinking in freshmen male college students

The current study employs an adaptation to Motivational Interviewing (AMI) group intervention with freshmen male undergraduates. The program follows suggestions of the National Institute on Alcohol Abuse and Alcoholism for effective interventions with problematic college student drinking, and combines several empirically validated strategies to prevent drinking problems throughout college. All participants reduced drinking and alcohol-related problems; heavier drinkers and those experiencing the most alcohol-related problems reduced drinking most. Additionally, freshmen who completed the intervention were less likely than their non-intervention freshmen male peers to commit alcohol-related violations of campus policies. In addition to the reductions in problematic drinking, the group AMI has advantages over individual formats because larger numbers of students can benefit with comparable expenditures of time and effort.     

Interest and participation in a college student alcohol intervention study as a function of typical drinking

OBJECTIVE: This research explored the relationship between typical alcohol consumption and interest in participating in a brief alcohol intervention study and between typical consumption and actual participation in the study among students recruited to participate in an intervention study. We predicted a curvilinear relationship as a potential explanation for mixed findings from previous examinations of risk status and participation in alcohol intervention research. That is, we expected an inverted U-shaped relationship, with those at the lowest and highest ends of the drinking spectrum expressing the least interest in participation. We expected the same pattern to hold for likelihood of actual participation among study invitees. METHOD: Self-reported typical consumption and interest in participating in an alcohol intervention study were assessed among 1,115 (59.7% female) college students. A subsample of these students (n = 377) who expressed interest and reported at least one heavy-drinking episode in the previous month were subsequently invited to participate in a brief intervention study. RESULTS: Drinkers were more likely than nondrinkers to report interest in participating, and there was a positive relationship between likelihood of expressing interest and typical consumption. However, the predicted quadratic relationship was evident with those at the lowest and highest ends of the drinking spectrum expressing the least interest in participation. The same pattern was also evident for actual participation among the heavy-drinking subsample invited to participate in the alcohol intervention study. CONCLUSIONS: A nonlinear relationship may account for mixed findings regarding the relationship between risk status and participation in alcohol intervention studies. Results are interpreted in terms of psychological relevance and defensiveness. Findings highlight the need for added effort in recruiting, and/or alternative recruitment strategies for, those at highest risk.     

Perceived social norms and their relation to university student drinking

OBJECTIVE: The aims of this study were to compare university students' perceptions of drinking norms with actual student drinking norms, to examine the relationship between norm misperception and individual drinking status and to investigate the relative importance of three reference groups as potential determinants of individual drinking levels: young people in New Zealand of the same age and gender, local university students of the same age and gender and the closest friends of individual respondents. METHOD: In 2002 a randomly selected representative sample of 1,564 New Zealand university students aged 16-29 years completed an Internet-based survey of their alcohol use (response rate: 82%). Respondents were asked to estimate the incidence of heavy episodic drinking and vomiting in the three reference groups and to rate their own drinking in comparison. Estimates within +/- 10% of actual norms were rated as accurate; estimates above or below actual norms by more than 10% were rated, respectively, as overestimates and underestimates. RESULTS: The vast majority of women (80%) and men (73%) overestimated the incidence of heavy drinking among student peers. The incidence of vomiting was also overestimated, but to a lesser extent. The extents of overestimation for both heavy drinking and vomiting were strongly related to the individual's heavy drinking frequency (p < .001). Only 9% of drinkers believed they drank more than other students. Correlations of perceived norms and self-reported drinking increased with the proximity of the social grouping to the individual and were higher for women than for men. CONCLUSIONS: This New Zealand university sample showed strong evidence of norm misperceptions, consistent with the results of several U.S. studies. Perceived norms are strongly related to individual drinking levels. It is unclear whether norm misperceptions are a cause or effect of heavy drinking. Research in which norm misperceptions are corrected may assist in understanding their importance in the etiology and treatment of heavy drinking.