Determinants of Problem Drinking and Depression among Latino Day Laborers

Little is known about alcohol misuse and depression among Latino day laborers despite the fact that they encounter multiple stressors (e.g., job instability, unsafe work environments). A structural equation model tested the relationships among laborer stress, social support, health status, current alcohol misuse, and depression. A sample of 89 male, urban Latino day laborers completed measures assessing these constructs in 2011. Stress was negatively related to physical health status, which was associated with depression. Findings suggest that stressors specific to being a day laborer resulting from their work and living conditions generate and maintain health disparities in this vulnerable population.     

Depression and Risk for Problem Drinking in Latino Migrant Day Laborers

Background: Given the structural vulnerability of Latino migrant day laborers (LMDLs) to unstable and poorly paying work, harsh living conditions and frequent inability to support or even visit families in country of origin, psychological distress is a common response and one frequently implicated in risky outcomes such as problem drinking. Objectives: The purpose of this study was to examine the relation of three different forms of psychological distress to problem drinking in LMDLs: depression, anxiety, and desesperación, the latter a popular Latino culture-based idiom of psychological distress. Methods: A cross sectional survey of 344 LMDLs was conducted in the San Francisco Bay Area from January to June of 2014. Independent contributions of depression, anxiety, and desesperación in explaining problem drinking as measured by a modified version of the AUDIT, were assessed using multiple linear regression analysis. Results: Depression was significantly associated with risk for problem drinking while other forms of psychological distress were not. Conclusion/Importance: Findings provide stronger empirical support for the association between depression and problem drinking, a long suspected but under-demonstrated relationship in the literature on LMDLs. Implications for preventing problem drinking as well as mitigating psychological distress more generally for LMDLs are discussed.     

Patterns of Drinking Initiation Among Latino Youths: Cognitive and Contextual Explanations of the Immigrant Paradox

ABSTRACT

This study examined the immigrant paradox in drinking initiation among Latino youths and tested contextual (i.e., family, peer) and cognitive (i.e., alcohol expectancies, risk-taking) explanations of this pattern. A sample of 129 first- and second-generation (73%) youths completed the study. The estimated odds of starting to drink were 2.5 (95% confidence interval [CI]: 1.10–5.9) times higher for second-generation teens compared to first-generation youths. Negative expectancy valuations and perceptions of peer substance use simultaneously explained the generational increase in drinking initiation. Addressing these tractable mechanisms represents opportunities to delay initiation and help reduce emerging disparities among Latino youth.     

Vida PURA: A Cultural Adaptation of Screening and Brief Intervention to Reduce Unhealthy Drinking Among Latino Day Laborers

Background: Brief intervention is known to reduce drinking in primary care; however, because health care access is limited for Latino immigrants, traditional brief interventions are unlikely to reach this population. Methods: Using Barrera and Castro's framework, our study aims to culturally adapt a screening and brief intervention program to reduce unhealthy alcohol use among Latino day laborers, a particularly vulnerable group of Latino immigrant men. We conducted 18 interviews with Latino day laborers and 13 interviews with mental health and substance use providers that serve Latino immigrant men. Interviews were conducted until saturation of themes was reached. Themes from interviews were used to identify sources of mismatch between traditional screening and brief intervention in our target population. Results: Unhealthy alcohol use was common, culturally accepted, and helped relieve immigration-related stressors. Men had limited knowledge about how to change their behavior. Men preferred to receive information from trusted providers in Spanish. Men faced significant barriers to accessing health and social services but were open to receiving brief interventions in community settings. Findings were used to design Vida PURA, a preliminary adaptation design of brief intervention for Latino day laborers. Key adaptations include brief intervention at a day labor worker center provided by promotores trained to incorporate the social and cultural context of drinking for Latino immigrant men. Conclusions: Culturally adapted brief intervention may help reduce unhealthy drinking in this underserved population.     

Contextual Influences on Young People's Drinking Rates in Public Drinking Places: An Observational Study

Young people's alcohol consumption is to a large extent concentrated in public drinking places. We assumed that, compared with drinking at home, the social pressure in public drinking places to adapt one's drinking to that of others is stronger and that the atmosphere is more likely to invite one to yield to such pressure. To study which aspects of the context of drinking are related to alcohol consumption we conducted an observational study on young people's (16-25 years) drinking rates (N= 385) in public drinking places.

In the analysis we controlled for sex composition of drinking group.

In most cases groups differing in sex composition did not differ in the relation between context of drinking and drinking rate. Drinking rates tended to be higher in large groups, when the main activity was talking, the next drink was ordered in rounds, a large proportion of the total population of visitors participated in large mixed-sex groups, the music was very loud and the number of visitors varied strongly during the evening. In one case a strong interaction of gender with drinking context on drinking rate was observed. Only young women's drinking rate appeared to be related to the sex-ratio of the total population of visitors.

In the discussion we argue that, with some exceptions, adaptation, rather than selection, explains most of the relations between context and drinking rate.0     

Changing Drinking Styles in Denmark and Finland. Fragmentation of Male and Female Drinking Among Young Adults

A traditional heavy intoxication-oriented drinking style, “heroic drinking,” is a central drinking practice in Denmark and Finland, especially among men. However, it seems that another drinking style leading to intoxication, “playful drinking,” has become more prevalent in Denmark as well as in Finland. Playful drinking is characterized by self-presentations in diverse forms of game situations in which you need to play with different aspects of social and bodily styles. We approach the positions of heroic drinking and playful drinking among young adults (between 17 and 23 years) in Denmark and Finland by analyzing how they discuss these two drinking styles in focus groups (N = 16).     

Comparison of the Quick Drinking Screen and the Alcohol Timeline Followback with Outpatient Alcohol Abusers

Objective: A recent study comparing the Quick Drinking Screen (QDS) with the Timeline Followback (TLFB) found that in a nonclinical population of problem drinkers both measures produced reliable summary measures of drinking. The current study was designed to replicate these findings with a clinical population of alcohol abusers. The data were collected over three years (2004–2006). Method: Participants were 124 alcohol abusers who voluntarily enrolled for outpatient treatment. Over half (52.4%) were female with an average age of almost 40 years. About a third were married, had completed university, and a quarter were unemployed and nonwhite. Participants reported having a drinking problem for an average of 8.3 years, and reported drinking on about 5 days per week, averaging six drinks per drinking day. On two different occasions, they responded to two different sets of questions about their alcohol use. The instruments were: (a) the Quick Drinking Screen (QDS), a summary drinking measure, administered by telephone prior to the assessment; and (2) the TLFB self-administered by computer at the assessment. Results: As in a previous study, this study found that the QDS and the TLFB, two very different drinking measures, collected similar aggregate drinking data for four drinking variables in a clinical sample of alcohol abusers. Conclusions: When it is not necessary or not possible to gather detailed drinking data, the QDS produces reliable brief summary measures of drinking for problem drinkers. Generalization to nonclinical samples awaits further research.     

Assessing the Relationship Between Divergent Drinking and Perceptions of Friendship Quality Between Students

The use of psychoactive drugs appears to have a clear influence on both friendship formation and friendship quality. Differences in the frequency of substance use are particularly likely to influence each friend’s perceptions of their relationship with the other. However, the impact of divergent substance use patterns within a friendship dyad on overall friendship quality remains an underexplored area. Self-reported alcohol use and perceptions of friendship quality data were collected from 2,154 students (mean age = 19.3) in 1,077 friendship dyads. Analyses of variance were conducted to determine (a) if friends who have similar alcohol use patterns perceive greater friendship quality than friends with dissimilar use patterns, and (b) how dissimilarities in drinking behaviors between friends affect individuals’ perceptions of friendship quality. Individuals in dyads comprised of friends with similar drinking patterns were found to experience higher quality relationships than those in friendships with dissimilar drinking patterns. Partners who drank less frequently in dissimilar friendships did not perceive the friendship to be of significantly lower quality than did their more frequently drinking peers. Interestingly, high-rate heavy episodic drinkers reported a significantly higher overall friendship quality when their peer was a low-rate heavy episodic drinker as opposed to a non-heavy episodic drinker. Since high-rate drinkers perceived higher friendship quality to low-frequency drinkers than non-heavy episodic drinkers, they likely place more value in the opinions of low-rate drinkers. Abstinence-based alcohol intervention programs may utilize this information in efforts to decrease early dropout rates.     

An Exploration of the Four-Factor Structure of the Drinking Motives Questionnaire-Revised Among Undergraduate Students in China

Background: College drinking has become a significant health issue in China; the current study addressed the gap that no prior research has investigated drinking motives among Chinese undergraduate students. Objectives: This study aimed to replicate the four-factor structure of the Drinking Motives Questionnaire-Revised (DMQ-R) reported for Western populations. Additionally, the relationships between drinking motives and alcohol use were investigated. Methods: In 2012, 436 participants (mean age = 20.49 and SD = 1.49; 50% male) recruited from a college in China completed a self-administered survey in their classroom setting. Drinking motives were measured by the Chinese version of the DMQ-R; three indicators of alcohol use were assessed. Factor analysis was conducted to examine the factor structure of the DMQ-R, followed by regression analysis to investigate the associations between drinking motives and alcohol-related outcomes. Results: Confirmatory factor analysis failed to replicate the measurement model tested, but exploratory factor analysis identified a similar four-dimensional factor structure. Reliability and convergent and discriminant validity of the four factors were acceptable. The results also showed that social motives were related to alcohol use and heavy drinking; conformity motives were related to alcohol use and alcohol-related problems. Enhancement motives were the strongest correlates of alcohol use; coping motives were the strongest correlates of heavy drinking and alcohol-related problems. Conclusions/Importance: The DMQ-R was a reliable and valid scale measuring four types of drinking motives among Chinese college students. Findings suggested that the motivational model of alcohol use may apply to studying college drinking in China.     

Making the Transition from High School to College: The Role of Alcohol-Related Social Influence Factors in Students' Drinking

Using a sample of entering college freshmen (N = 311), the purposes of this study were to examine 1) whether perceived norms for college student alcohol use and problems differed by gender and level of intended Greek involvement (Greek intent); 2) associations between perceived norms, Greek intent, and alcohol use and problems; and 3) whether relations between perceived norms, Greek intent, and alcohol use and problems were moderated by gender. Results revealed no differences in levels of perceived norms for alcohol use and problems as a function of gender or intention to affiliate with a Greek letter organization. Perceived norms demonstrated consistent, significant associations with both alcohol use and problems, while Greek intent demonstrated significant associations only with alcohol problems. Examination of gender effects in associations between perceived norms, Greek intent, and alcohol use and problems revealed a number of differences in these relations. Specifically, Greek intent was significantly associated with measures of alcohol use and problems for men, but not for women. Likewise, the association between perceived norms and alcohol use and problems were significant for men, but not for women. Finally, although perceived norms were a significant predictor of heavy drinking for both men and women, the association was much stronger among male students. These findings suggest that alcohol prevention interventions may benefit from specifically targeting perceived norms among incoming students who are at highest risk (i.e., male pledges).     

Randomized Controlled Trial on the Effects of a Skills-Based Workshop on Medical Students' Management of Problem Drinking and Alcohol Dependence

The purpose of this study was to determine whether a ski lls-based workshop will improve medical students' management of problem drinking and alcohol dependence in simulated patients. Seventy-six 3rd and 4th year Ontario medical students were randomized to receive a 3-h workshop on either problem drinking and alcohol dependence or depression (control condition). Students then completed eight simulated office visits (OSCE stations) with simulated patients presenting with depression, problem drinking or alcohol dependence. Examiners completed a checklist of the questions asked and advice given by the student, and simulated patients and examiners completed a global rating scale. Four months later, students were sent a survey on their knowledge, attitudes, and behavior towards patients with alcohol problems. The alcohol group received significantly higher assessment and management checklist scores and global rating scores than did the depression group (p < 0.01) and performed better on almost all aspects of clinical management of both problem drinking and alcohol dependence. On the follow-up survey (n = 55) the alcohol group showed a significant increase in beliefs about self-efficacy in managing alcohol problems (p < 0.05) and had greater knowledge of reduced drinking strategies, but the two groups did not differ on other measures. A skills-based workshop causes marked short-term improvements in medical students' management of problem drinking and alcohol dependence, an increase from baseline to postworkshop in self-efficacy beliefs that was sustained through to follow-up, and greater knowledge of reduced drinking strategies. Repeated reinforcement of clinical skills may be required for a long-term impact on clinical behavior.     

Age of Drinking Initiation as a Moderator of the Efficacy of a Brief,Web-Based Personalized Feedback Alcohol Intervention

ABSTRACT

Early initiation of alcohol use is associated with high-risk drinking and an increased risk of adult alcohol dependence. The current study tested age of drinking initiation as a moderator of the efficacy of a brief, Web-based intervention on frequency of drinking and alcohol-related consequences among ninth-grade students (N = 513). At a three-month follow-up, students in the intervention group reported a reduction in drinking frequency and alcohol-related consequences relative to those in the control group. In addition, age of drinking initiation was a significant moderator of intervention efficacy. Intervention effects were greatest among two groups of students—those who reported abstinence at baseline and those who initiated drinking at age 11 or younger. Results support a brief, Web-based intervention as a promising strategy for reducing frequency of drinking and the associated consequences as a prevention strategy for students who report no drinking history and as an intervention strategy for early initiators who are at the highest risk for developing alcohol-related problems.     

Drinking in the Context of Life Stressors: A Multidimensional Coping Strategy Among South African Women

This study explored narratives of drinking as a coping strategy among female drinkers in a South African township. In 2010–2011, we conducted qualitative in-depth interviews with 54 women recruited from 12 alcohol-serving venues. Most women drank heavily and linked their drinking to stressors. They were motivated to use drinking to manage their emotions, facilitate social engagement, and achieve a sense of empowerment, even while recognizing the limitations of this strategy. This study helps to contextualize heavy drinking behavior among women in this setting. Multifaceted interventions that help female drinkers to more effectively manage stressors may aid in reducing hazardous drinking.     

Behavioral and Biochemical Correlates of Alcohol Drinking Preference: Studies on the Selectively Bred P and NP Rats

Abstract: The alcohol-preferring P and alcohol-nonpreferring NP lines of rates have been selectively bred and used to study the behavioral and biochemical correlates of alcohol-seeking behavior. The P rats satisfy all the perceived criteria for an animal model of alcoholism. Specifically, free-fed P rats voluntarily drink alcoholic solutions (10 to 30% v/v) to intoxication; they bar-press to obtain alcohol and self-administer ethanol intragastrically when food and water are available; and they acquire metabolic and neuronal tolerance and develop physical dependence when they drink alcohol chronically in a free-choice situation. The spontaneous motor activity in the P rats, but not in the NP rats, is stimulated acutely by low doses of alcohol. With a single hypnotic dose of ethanol, acute tolerance develops faster and to a greater degree and persists many days longer in the P than in the NP rats. These differences in response to ethanol may explain the disparate alcohol drinking behaviors of the P and NP rats. Biochemically, the P rats exhibit decreased serotonin levels in several brain regions including the nucleus accumbens. Serotonin uptake inhibitors curtail the alcohol drinking of the P rats suggesting a role of serotonin in mediating alcohol preference.     

Effects of the Increased Minimum Drinking Age Law on Drinking and Driving Behavior Among Adolescents

In Minnesota, the minimum drinking age law was raised from 19 to 21, effective September 1, 1986. As anyone born prior to September I, 1967 could legally continue to purchase alcohol, we hypothesized that adolescents born on or after September 1, 1967 would report less drinking and driving than their peers born prior to this date. Participants originally comprised the entire seventh-grade enrollment of four suburban school districts in Minnesota in 1979 and 1980 (N = 7124). Drinking and driving data were collected in 1987 and 1988. Comparing the Younger cohort (born on or after September 1, 1967) in 1988 to the Older cohort in 1987, we observed lower overall drinking and driving prevalence in the Younger cohort. The Younger cohort reported a significantly lower rate of driving after drinking at least two drinks than did the Older cohort, though there was a minimal difference in rates of heavy drinking and driving. The increased drinking age seemed effective in reducing the overall drinking and driving prevalence primarily by deterring from driving subjects who had been drinking one or only a few drinks.     

A confirmatory approach to understanding the four-factor structure of the Adolescent Drinking Index: Evidence for a brief version

The purpose of this study was to examine the psychometric properties of the original version of the Adolescent Drinking Index (ADI), and to examine the fit of a series of confirmatory factor analysis models to arrive at an abbreviated version that can be easily administered in settings with limited time for assessment. These aims were examined in a sample of 740 adolescents (M_age = 15.26; 58.5% males) who completed the ADI during an emergency department visit. Results suggested that the four-domain design did not fit the data adequately. Results, however, demonstrated good fit for an 8-item adapted version with a four-factor structure: interpersonal, social, psychological, and physical indicators. This abbreviated version was also associated with outcomes such as hangover, alcohol withdrawal, and substance use. Findings from this study provide support for the use of an abbreviated version of the ADI for screening adolescents and referring them to appropriate interventions.