Examining the relationship between typical drinking behavior and 21st birthday drinking behavior among college students: implications for event-specific prevention

Aims   The purpose of this research was to: (i) compare 21st birthday drinking with typical drinking; (ii) assess the prevalence of negative consequences and risk behaviors experienced during the 21st birthday week; and (iii) examine the role of typical drinking and 21st birthday drinking in explaining 21st birthday week negative consequences and risk behaviors.
Setting and participants   Participants ( n  = 306; 50% male) included college students turning 21 at a Midwestern public university in the United States.
Design and measurement   Approximately 1 week prior to their 21st birthday, students completed measures of typical past 3-month alcohol consumption via a web-based survey. Following their birthday, students ( n  = 296; 50% male) completed measures of 21st birthday week drinking as well as negative consequences and risk behaviors.
Findings   Findings indicated that students consumed considerably larger amounts of alcohol during the week of their 21st birthdays in comparison to typical weekly consumption. Additionally, students experienced a variety of negative consequences and risk behaviors during the week of their 21st birthday, including hangovers, vomiting and not remembering part of the previous evening. Negative binomial regression results indicated that those most likely to experience more negative consequences and risk behaviors associated with 21st birthday drinking were those who consumed heavy amounts of alcohol the week of their birthday, but who did not typically drink excessively.
Conclusions   Findings underscore the need to develop event-specific prevention approaches for occasions associated with extreme drinking and provide direction for considering who may be at greatest risk for problems associated with celebratory drinking.     

Social anxiety and drinking game participation among university students: the moderating role of drinking to cope

Background: Few studies have examined the relationship of social anxiety with drinking game participation. Drinking games represent a popular form of drinking in university settings. Due to their structure, games may appeal to socially anxious drinkers, particularly among those seeking to fit in or cope with the social setting. Objectives: To examine the relationship of social anxiety with frequency of drinking game participation among a university undergraduate sample and to investigate if drinking motives moderate this association. Method: A total of 227 undergraduate students aged 18–24 years (73% female) who had consumed alcohol in the prior year were included in the current investigation. Hierarchical regression examined the influences of social anxiety and drinking motives on frequency of drinking game participation, as well the interactions of social anxiety with drinking for coping motives and conformity motives. Results: Social anxiety failed to emerge as a significant predictor of frequency of drinking game participation. However, drinking to cope moderated the relationship of social anxiety with frequency of drinking game participation. Socially anxious students who drank to cope were more likely to participate in drinking games on occasions when they consumed alcohol than those who did not endorse this drinking motive. Conclusion: Results demonstrated the influence of drinking to cope in the relationship of social anxiety with frequency of drinking game participation. Future work should examine the relationship with other indicators of drinking game activity. Intervention efforts addressing social anxiety and drinking should consider motives for drinking, as well as drinking patterns.     

Interaction between the ADH1B*3 allele and drinking motives on alcohol use among Black college students

Background: Black young adults have lower rates of alcohol use than other racial groups. Genetic factors may protect against drinking. Specifically, the ADH1B*3 allele is present almost exclusively in Black populations and has been protective against alcohol use and alcohol use disorder. The protective effects of the ADH1B*3 allele, however, may differ as a function of alcohol-promoting cognitions. Objectives: The current study examined whether ADH1B*3 moderated relations of drinking motives with alcohol consumption among Black college drinkers. Methods: Participants were 241 undergraduate students of self-identified Black race (mean age = 20 years; 66% female) who reported consuming alcohol at least once in the past 30 days. Results: ADH1B*3 was not significantly associated with drinking motives or drinking behaviors. However, significant, albeit small, interaction effects of ADH1B*3 with drinking motives on drinking behavior were found; the presence of an ADH1B*3 allele protected against greater drinking quantity among students with high social motives (incidence rate ratio [IRR] = 0.95, 95% CI [0.92, 0.99]) and against frequent drinking among students with low coping motives (IRR = 1.06, 95% CI [1.01, 1.11]). Conclusion: These findings represent a novel demonstration of genetic modulation of alcohol-related cognitions within Black college drinkers, although replication is needed. Results represent an initial step toward better characterizing individual differences in associations of drinking motives with drinking behavior, with potential implications for interventions aimed at motivational processes in alcohol use.     

Cigarette smoking and the risk for alcohol use disorders among adolescent drinkers

BACKGROUND: Cigarette smoking and alcohol use disorders (AUDs) are closely linked, but it is not clear whether higher rates of AUD among smokers are solely attributable to heavier drinking or, alternatively, whether smokers are more vulnerable to alcohol abuse and dependence than nonsmokers who drink comparable quantities. We sought to address this issue using data from a nationally representative U.S. sample of adolescents and young adults. Specifically, we analyzed the relationship between cigarette smoking, drinking, and AUDs. METHODS: Data were from the aggregated 2002 through 2004 U.S. National Survey on Drug Use and Health. Participants were randomly selected, household-dwelling adolescents and young adults (ages 12-20) from the noninstitutionalized, civilian population of the United States (N=74,836). Measurements included current DSM-IV alcohol abuse or dependence, number of drinks in the past 30 days, and past-year cigarette smoking, defined as having smoked more than 100 cigarettes across the lifetime and having smoked during the past year. RESULTS: Past-year smokers (prevalence=16.0%) drank in higher quantities than never-smokers, but were also at elevated risk for AUD when compared with never-smokers who drank equivalent quantities. The effect was observed across age groups, but was more prominent among younger adolescents. After adjusting for drinking quantity and sociodemographic variables, smokers had 4.5-fold higher odds of AUD than never-smokers [95% confidence interval (95% CI), 3.1-6.6]. Youths who reported smoking but did not cross the 100-cigarette threshold were at intermediate risk [odds ratio (OR), 2.3; 95% CI, 1.7-3.3]. Differences in AUD between smokers and never-smokers were most pronounced at lower levels of drinking. CONCLUSIONS: The results are consistent with a higher vulnerability to AUDs among smokers, compared with nonsmokers who drink equivalent quantities.     

UPPS-P facets of impulsivity and alcohol use patterns in college and noncollege emerging adults

Background: Alcohol use and related problems reach a peak in emerging adulthood. Impulsivity is a multifaceted construct known to be involved in emerging adult alcohol use. Few studies have examined impulsivity and alcohol use across both college attending and noncollege attending emerging adults. Objectives: To clarify the multifaceted nature of impulsivity and its links to emerging adult alcohol use, this study investigated whether the five distinct facets of the UPPS-P model of impulsivity were predictive of three different behavioral outcomes: alcohol intake, alcohol related problems and binge drinking. In addition, the moderating effects of college attendance were tested. Methods: A community sample comprising 273 Australian college and noncollege attendees (58.6% women; 41.4% men) aged between 18 and 30 years (M_age = 23.71, SD = 2.81). Results: Multiple regression analyses demonstrated that lack of premeditation predicted alcohol intake and binge drinking behavior, whilst positive and negative urgency predicted alcohol related problems. Moderation analyses revealed that the effects of impulsivity on alcohol patterns were consistent for college and noncollege attending emerging adults. Conclusion: These findings highlight the importance of impulsive urgency (both positive and negative) in emerging adult problematic alcohol use, and support the generalizability of college samples to broader emerging adult populations. Emerging adults may use alcohol to avoid negative mood states and further enhance positive mood states. Improved emotional regulation may help both college and non-college emerging adults reduce their alcohol use.     

Drinking games,tailgating, and pregaming: Precollege predictors of risky college drinking

Background: The transition from high school to college is a critical period for developing college drinking habits. Hazardous alcohol consumption increases during this period, as well as participation in drinking games, pregaming, and tailgating. All of these risky drinking practices are associated with higher levels of intoxication as well as an increased risk of alcohol-related problems. Objective: The current study aimed to evaluate pre-college predictors (personality, social norms, and beliefs reflecting the internalization of the college drinking culture [ICDC]) of estimated peak BAC (pBAC) reached during drinking games, pregaming, and tailgating, as well as pBAC and alcohol-related problems during the first 30 days of college. Methods: Participants (n?=?936) were incoming freshmen at a large university who completed a baseline assessment prior to college matriculation and a follow-up assessment after they had been on campus for 30 days. Results: Using path analysis, ICDC was significantly associated with pBAC reached during the three risky drinking practices. ICDC had an indirect effect on both pBAC and alcohol-related problems via pBAC from drinking games, pregaming, and tailgating. Hopelessness and sensation seeking were significantly related to alcohol use outcomes. Conclusion: Precollege perceptions of the college drinking culture are a stronger predictor of subsequent alcohol use than social norms. Interventions that target these beliefs may reduce peak intoxication and associated harms experienced during the first 30 days of college.     

Adult attachment and drinking context as predictors of alcohol problems and relationship satisfaction in college students

Background: Evidence suggests that for young adults, intimate partners influence each other’s drinking patterns. Therefore, exploration of variables related to intimate partner relationships (such as attachment style) could broaden the current understanding of risk factors for alcohol problems in this demographic. Objectives: The current study examined the role of drinking context in the relationships among insecure attachment, alcohol problems, and relationship satisfaction. A path model was hypothesized where the relationship between insecure attachment and alcohol problems would be explained via two distinct drinking contexts (i.e., drinking with one’s partner and drinking away from one’s partner). It was also hypothesized that the relationship between insecure attachment and relationship satisfaction would be explained via these same two drinking contexts. Methods: Participants were 194 undergraduate students ages 18–25 who reported being in a monogamous intimate partner relationship for at least 90 days and had also consumed alcohol in the past 90 days. The sample was comprised of 76% women and 24% men. Results: The hypothesized direct relationship from anxious attachment to alcohol problems was significant; there were also significant direct paths from both anxious and avoidant attachment to relationship satisfaction. The hypotheses regarding indirect relationships were not supported. Conclusion: The results of this study contribute to the existing literature, in that they suggest that drinking in the context of an intimate relationship may not directly affect relationship satisfaction in this population. However, relationship functioning still appears to be an important variable to consider in the prevention and treatment of alcohol-related problems affecting college students.     

Towards the development of laboratory methods for studying drinking games: Initial findings,methodological considerations,and future directions

Background: Drinking games are prevalent among college students and are associated with increased alcohol use and negative alcohol-related consequences. There has been substantial growth in research on drinking games. However, the majority of published studies rely on retrospective self-reports of behavior and very few studies have made use of laboratory procedures to systematically observe drinking game behavior. Objectives: The current paper draws on the authors’ experiences designing and implementing methods for the study of drinking games in the laboratory. Results: The paper addressed the following key design features: (a) drinking game selection; (b) beverage selection; (c) standardizing game play; (d) selection of dependent and independent variables; and (e) creating a realistic drinking game environment. Conclusions: The goal of this methodological review paper is to encourage other researchers to pursue laboratory research on drinking game behavior. Use of laboratory-based methodologies will facilitate a better understanding of the dynamics of risky drinking and inform prevention and intervention efforts.     

Socio-economic status and problem alcohol use: the positive relationship between income and the DSM-IV alcohol abuse diagnosis

AIMS: Epidemiological evidence indicates a positive relationship between income and the prevalence of alcohol abuse in the general population, but an inverse relationship between income and alcohol dependence. Among those with a diagnosis of alcohol abuse, the most prevalent criterion is hazardous use, which commonly requires sufficient resources to own or access a car. The present study investigated whether the association between income and the prevalence of current alcohol abuse is accounted for by the hazardous use criterion; specifically, the drinking and driving symptoms of the hazardous use criterion. DESIGN: Face-to-face survey conducted in the 2001-02 National Epidemiologic Survey on Alcohol and Related Conditions, interviewed with the Alcohol Use Disorders and Associated Disabilities Interview 4th edition (AUDADIS-IV). SETTING: The United States and District of Columbia, including Alaska and Hawaii. PARTICIPANTS: Household and group-quarters residents aged >18 years. Life-time dependence cases were excluded (n = 4781). MEASUREMENTS: Income was defined as past-year personal income. Outcomes were specific alcohol abuse criteria and symptom questions. Logistic regressions were performed controlling for demographics. The relationship between alcohol abuse severity indicators and income was modeled using polytomous regression. Findings Among the alcohol abuse criteria, hazardous use is the most prevalent and the only criterion to have a significant positive relationship with income (F = 20.3, df = 3, P < 0.0001). Among the hazardous use symptoms, driving after drinking (F = 13.0, df = 3, P < 0.0001) and driving while drinking (F = 9.2, df = 3, P < 0.0001) were related positively to income. CONCLUSIONS: Because hazardous use is the most commonly endorsed criterion of alcohol abuse, the link with income raises questions about whether the current alcohol abuse diagnosis can capture the full range of alcohol abusers in every socio-economic class. While many psychiatric disorders exhibit an inverse relationship with socio-economic status, a selection bias may cause the alcohol abuse diagnosis to have an artificially positive relationship with income due to the necessity for access to a vehicle to be diagnosed.     

Brief alcohol interventions for mandated college students: comparison of face-to-face counseling and computer-delivered interventions

Aims College students who violate alcohol policies are often mandated to participate in alcohol‐related interventions. This study investigated (i) whether such interventions reduced drinking beyond the sanction alone, (ii) whether a brief motivational intervention (BMI) was more efficacious than two computer‐delivered interventions (CDIs) and (iii) whether intervention response differed by gender. Design Randomized controlled trial with four conditions [brief motivation interventions (BMI), Alcohol 101 Plus?, Alcohol Edu for Sanctions^®, delayed control] and four assessments (baseline, 1, 6 and 12 months). Setting Private residential university in the United States. Participants Students (n = 677; 64% male) who had violated campus alcohol policies and were sanctioned to participate in a risk reduction program. Measurements Consumption (drinks per heaviest and typical week, heavy drinking frequency, peak and typical blood alcohol concentration), alcohol problems and recidivism. Findings Piecewise latent growth models characterized short‐term (1‐month) and longer‐term (1–12 months) change. Female but not male students reduced drinking and problems in the control condition. Males reduced drinking and problems after all interventions relative to control, but did not maintain these gains. Females reduced drinking to a greater extent after a BMI than after either CDI, and maintained reductions relative to baseline across the follow‐up year. No differences in recidivism were found. Conclusions Male and female students responded differently to sanctions for alcohol violations and to risk reduction interventions. BMIs optimized outcomes for both genders. Male students improved after all interventions, but female students improved less after CDIs than after BMI. Intervention effects decayed over time, especially for males.     

Preventing heavy alcohol use in adolescents (PAS): cluster randomized trial of a parent and student intervention offered separately and simultaneously

Aims   To evaluate the effectiveness of two preventive interventions to reduce heavy drinking in first- and second-year high school students.
Design and setting   Cluster randomized controlled trial using four conditions for comparing two active interventions with a control group from 152 classes of 19 high schools in the Netherlands.
Participants   A total of 3490 first-year high school students (mean 12.68 years, SD = 0.51) and their parents.
Intervention conditions   (i) Parent intervention (modelled on the Swedish Örebro Prevention Program) aimed at encouraging parental rule-setting concerning their children's alcohol consumption; (ii) student intervention consisting of four digital lessons based on the principles of the theory of planned behaviour and social cognitive theory; (iii) interventions 1 and 2 combined; and (iv) the regular curriculum as control condition.
Main outcome measures   Incidence of (heavy) weekly alcohol use and frequency of monthly drinking at 10 and 22 months after baseline measurement.
Findings   A total of 2937 students were eligible for analyses in this study. At first follow-up, only the combined student–parent intervention showed substantial and statistically significant effects on heavy weekly drinking, weekly drinking and frequency of drinking. At second follow-up these results were replicated, except for the effects of the combined intervention on heavy weekly drinking. These findings were consistent across intention-to-treat and completers-only analyses.
Conclusions   Results suggest that adolescents as well as their parents should be targeted in order to delay the onset of drinking, preferably prior to onset of weekly drinking.