Drinking games and contextual factors of 21st birthday drinking

Background: 21st birthday celebrations are among the highest risks for alcohol use throughout emerging adulthood and celebrants often experience a range of alcohol-related consequences. Objectives: The present research considered what happens when drinking games are paired with an already high-risk event (i.e., 21st birthday celebrations) and how drinking games compare with other contextual factors on 21st birthdays. Methods: Approximately four days after turning 21, 1124 college students (55% women) completed an online survey assessing alcohol use and related consequences experienced during their birthday celebrations. Participants were also asked whether drinking games and other contextual factors were associated with their celebrations. Results: Overall, 18% of participants reported playing drinking games during their 21st birthday celebrations. These individuals reported consuming more alcohol, had higher estimated BACs, and experienced more negative consequences than those who did not play drinking games. The association between playing drinking games and alcohol use and negative consequences was stronger for men. The effect of drinking games on negative consequences was mediated through elevated BAC levels. Receiving bar specials, having drinks purchased, playing drinking games, and loud music were uniquely and significantly associated with all alcohol outcomes. Conclusion: Together, these results suggest that drinking games are part of a larger context of risk contributing to extreme drinking on 21st birthdays. Furthermore, these results will help to facilitate interventions that are more individually tailored to target specific contextual risks, behaviors, and events.     

Drinking game play among first-year college student drinkers: An event-specific analysis of the risk for alcohol use and problems

Background: College students who play drinking games (DGs) more frequently report higher levels of alcohol use and experience more alcohol-related harm. However, the extent to which they are at risk for increased consumption and harm as a result of DG play on a given event after accounting for their typical DG participation, and typical and event drinking, is unclear. Objectives: We examined whether first-year students consumed more alcohol and were more likely to experience consequences on drinking occasions when they played DGs. Methods: Participants (n?=?336) completed up to six web-based surveys following weekend drinking events in their first semester. Alcohol use, DG play, and consequences were reported for the Friday and Saturday prior to each survey. Typical DG tendencies were controlled in all models. Typical and event alcohol use were controlled in models predicting risk for consequences. Results: Participants consumed more alcohol on DG versus non-DG events. All students were more likely to experience blackout drinking consequences when they played DGs. Women were more likely to experience social-interpersonal consequences when they played DGs. Conclusion: DG play is an event-specific risk factor for increased alcohol use among first-year students, regardless of individual DG play tendencies. Further, event DG play signals increased risk for blackout drinking consequences for all students, and social-interpersonal consequences for women, aside from the amount of alcohol consumed on those occasions as well as typical drinking behaviors. Prevention efforts to reduce high-risk drinking may be strengthened by highlighting both event- and person-specific risks of DG play.     

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.     

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.     

Alcohol outlet density and university student drinking: a national study

AIMS: To examine the geographic density of alcohol outlets and associations with drinking levels and related problems among university students. DESIGN: Cross-sectional survey study using geospatial data, with campus-level and individual-level analyses. PARTICIPANTS: A total of 2550 students (mean age 20.2, 60% women) at six university campuses in New Zealand (63% response). MEASUREMENTS: Counts of alcohol outlets within 3 km of each campus were tested for their non-parametric correlation with aggregated campus drinking levels and related problems. Generalized estimating equations were used to model the relation between outlet counts within 1 km and 3 km of student residences and individual drinking levels/problems, with control for gender, age, ethnicity and high school binge drinking frequency, and adjustment for campus-level clustering. FINDINGS: Correlations for campus-level data were 0.77 (P = 0.07) for drinking and personal problems, and 0.31 (P = 0.54) for second-hand effects. There were consistent significant associations of both on- and off-licence outlet densities with all outcomes in student-level adjusted models. Effects were largest for 1 km densities and off-licence outlets. CONCLUSIONS: There are positive associations between alcohol outlet density and individual drinking and related problems. Associations remain after controlling for demographic variables and pre-university drinking, i.e. the associations are unlikely to be due to self-selection effects. Increasing alcohol outlet density, and particularly off-licences, may increase alcohol-related harm among university students.     

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.     

A dose–response perspective on college drinking and related problems

Aims In order to examine the degree to which heavy drinking contributes to risks for problems among college drinkers this paper develops and tests a dose–response model of alcohol use that relates frequencies of drinking specific quantities of alcohol to the incidence of drinking problems. Methods A mathematical model was developed that enabled estimation of dose–response relationships between drinking quantities and drinking problems using self‐report data from 8698 college drinkers across 14 campuses in California, USA. The model assumes that drinking risks are a direct monotone function of the amount consumed per day and additive across drinking days. Drinking problems accumulate across drinking occasions and are the basis for cumulative reports of drinking problems reported by college drinkers. Results Statistical analyses using the model showed that drinking problems were related to every drinking level, but increased fivefold at three drinks and more gradually thereafter. Problems were associated most strongly with occasions on which three drinks were consumed, and more than half of all reported problems were related to occasions on which four or fewer drinks were consumed. There were some important differences in dose–responsiveness between men and women and between different groups of ‘light’, ‘moderate’ and ‘heavier’ drinkers. Conclusion Many problems among college students are associated with drinking relatively small amounts of alcohol (two to four drinks). Programs to reduce college drinking problems should emphasize risks associated with low drinking levels.     

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.     

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.     

The relationship between drinking games and intentions to continue drinking,intentions to drive after drinking,and adverse consequences: Results of a field study

Background: Drinking games have become a nearly universal aspect of excessive drinking on university campuses with 50–62% of college students reporting playing drinking games in the past month. Participation in drinking games has been correlated with numerous negative consequences and increased consumption of alcohol. Objectives: The present study addresses the influence of drinking games on three drinking-related outcomes: problems experienced the night of the drinking event, the intent to keep drinking, and the intent to drive after drinking. Methods: The data collected for the present study were part of a study testing environmental influences of drinking behaviors of young adults. A total of 226 randomly selected parties (representing 1725 partygoers) were selected for study inclusion. Three multilevel logistic regression models tested the relationship between drinking games and the three drinking-related outcomes. Results: Participants who reported playing drinking games were 1.58 times more likely to report continued drinking intentions than participants who did not play drinking games. If drinking games were observed at a party, participants were 2.38 times more likely to plan to drive while intoxicated. Additionally, participants who reported playing drinking games were 1.59 times more likely to report experiencing a drinking-related problem than participants who did not play drinking games. Conclusion: Drinking games have consequences beyond increasing the level of intoxication; they contribute to problematic behavior at individual and environmental levels. Preventing drinking games is warranted.     

A comparison between two retrospective alcohol consumption measures and the daily drinking diary method with university students

Background: There are two main categories of retrospective self-report alcohol consumption measures: summary and daily drinking. Time-efficient summary measures have been criticized for being less able to capture sporadic and unpatterned drinking. A novel retrospective summary measure, the Typical and Atypical Drinking Diary (TADD), may produce more precise estimates of alcohol consumption than the gold-standard daily measure, the Timeline Followback (TLFB). Objective: To establish how accurately the TADD and TLFB retrospectively capture alcohol consumption compared to the Daily Drinking Diary (DDD) method. Method: Forty-three university undergraduates (77% female) concurrently recorded their daily alcohol consumption for 28 consecutive days using daily drinking diaries. Participants then retrospectively estimated their alcohol consumption using both the TADD and TLFB 28 days following completion of the 28-day daily consumption period. Results: When compared against the drinking data obtained from the DDD method, the TADD consistently produced accurate retrospective estimates of total alcohol consumption, number of drinking days, and number of heavy drinking episodes. Contrariwise, the TLFB significantly underestimated all aspects of drinking. Underreporting on the TLFB was hypothesized to be associated with social desirability bias. Conclusion: The TADD is a valid and reliable instrument for retrospectively measuring alcohol consumption and drinking variability in the university student population.     

Topiramate reduces the harm of excessive drinking: implications for public health and primary care

AIMS: Having demonstrated previously the efficacy of topiramate--a sulfamate-substituted fructopyranose derivative-as pharmacotherapy for treating alcohol dependence, promoting abstinence and reducing the harmful psychosocial consequences of drinking, we investigated whether topiramate also promoted 'safe' levels of drinking: < or = 1 and < or = 2 standard drinks/day for women and men, respectively, among alcohol-dependent individuals. DESIGN, SETTING AND PARTICIPANTS: In a double-blind, randomized, controlled, 12-week clinical trial conducted in San Antonio, Texas, 75 alcohol-dependent adults received topiramate and 75 received placebo as an adjunct to weekly standardized medication compliance management. MEASUREMENTS: For this secondary analysis of data from that trial, we calculated, based on self-reports, specific intervals of up to 30 days of continuous 'safe' drinking for each subject. FINDINGS: The average longest 'safe' drinking period was 16.7 days for topiramate recipients versus 8.9 days for placebo recipients. By day 50 of treatment, 44% versus 26.4% had achieved > or = 7 and 30.8% versus 10% had achieved > or = 14 continuous 'safe' drinking days. Similarly, topiramate increased the relative likelihood of continuous 'safe' drinking from 77% for > or = 7 days [relative risk (RR) for achieving continuous 'safe' drinking = 1.77] to threefold for > or = 14 days (RR = 3.37) and fourfold for > or = 28 days (RR = 4.07). Thus, participants who received topiramate were more likely to achieve longer periods of 'safe' drinking compared with those who received placebo. CONCLUSIONS: For alcohol-dependent individuals who drank within an abstinence-oriented treatment program, topiramate promoted 'safe' drinking. Topiramate's potential to decrease the public health consequences of hazardous drinking needs to be established in future long-term studies.     

Association between breakfast consumption frequency and the risk of irritable bowel syndrome among Chinese female college students: A cross-sectional study

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder that affects specific groups of people. The relationship between breakfast consumption frequency and the risk of IBS is unclear. This study aimed to investigate the association between breakfast consumption frequency and the risk of IBS among Chinese female college students.In this cross-sectional study (n = 706) conducted in October 2018, the frequency of breakfast consumption was categorized as 0 to 3 times/week, 4 to 6 times/week, or daily. IBS was diagnosed according to the Rome III criteria and was based on the presence of abdominal pain or discomfort for at least 3 months during the previous 6 months, with at least 2 or more of the following conditions: changes in frequency or form of stool and/or decrease in pain after defecation. We adjusted for confounding factors, including age, only child (yes or no), parents’ educational levels (senior high school or below, college, or postgraduate), parents’ marital status (married, widowed, or divorced), smoking status (smoker or nonsmoker), drinking status (drinker or nondrinker), body mass index, and depressive symptoms. A multiple logistic regression analysis was performed to determine the relationship between breakfast frequency and the risk of IBS.Among 706 participants, 23.7% were the only child in their family, and the proportion of parents divorced or widowed was 18.5%. The proportion of fathers and mothers with high school education or above was 93.3% and 96.3%, respectively. The prevalence of IBS among the participants was 17.3% (122/706). Multivariate logistic regressions analysis showed that breakfast consumption frequency is negatively associated with the risk of IBS after adjusting for confounding factors. The odds ratios (95% confidence intervals) for IBS in the breakfast frequency category of 0 to 3 times/week, 4 to 6 times/week, and daily were 1.00 (reference), 0.96 (0.58, 1.60), and 0.45 (0.26, 0.78), respectively (P = .002).Our data revealed that regular breakfast consumption is associated with a lower risk of IBS among Chinese college students. Future cohort and/or interventional studies should be conducted to further explore the association between breakfast consumption frequency and IBS.     

A controlled study of an integrated prevention program for improving disordered eating and body image among Mexican university students: A 3‐month follow‐up

Obesity and eating disorders are currently two significant health problems in Mexico. The aim of this study was to examine the effects of an integrated prevention program on university students through an exploratory controlled study that targeted specific predisposing factors of disordered eating and obesity related to healthy eating, physical activity, body image satisfaction and perceived pressure to be thin. A total of 388 university students participated (264 females and 124 males) and were assigned either to an intervention condition or one of the two control conditions (study skills vs. nonintervention); each comprised of a total of eight workshops lasting 90 min. The program did not have any effect on the male students. In contrast, there was an interaction effect for time and group in thin‐ideal internalization (η² = 0.04) and in disordered eating attitudes/behaviours (η² = 0.03); both showed improvements over time only among the female sample. Though, the effect size was insignificant, which means that the effectiveness of this integrated prevention program was limited. Integrated prevention approaches to eating and weight‐related problems are still nascent in Mexico, and further research in this field is warranted so as to fine tune future prevention programs.