Correcting exaggerated drinking norms with a mobile message delivery system: Selective prevention with heavy-drinking first-year college students.
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ABSTRACT:
SUBMITTER: Carey KB
PROVIDER: S-EPMC7148196 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BACKGROUND:Heavy drinking among college students is a significant public health concern that can lead to profound social and health consequences, including alcohol use disorder. Behavioral economics posits that low future orientation and high valuation of alcohol (alcohol demand) combined with deficits in alternative reinforcement increase the likelihood of alcohol misuse. Despite this, no study has examined the incremental utility of all 3 variables simultaneously in a comprehensive model. METHODS:This study uses structural equation modeling to test the associations between behavioral economic variables-alcohol demand (latent), future orientation (measured with a delay discounting task and the Consideration of Future Consequences [CFC] scale), and proportionate substance-related reinforcement-and alcohol consumption and problems among 393 heavy drinking college students. Two models are tested as follows: (i) an iteration of the reinforcer pathology model that includes an interaction between future orientation and alcohol demand; and (ii) an alternative model evaluating the interconnectedness of behavioral economic variables in predicting problematic alcohol use. RESULTS:The interaction effects in Model 1 were nonsignificant. Model 2 suggests that greater alcohol demand and proportionate substance-related reinforcement are associated with greater alcohol consumption and problems. Furthermore, CFC was associated with alcohol-related problems and lower proportionate substance-related reinforcement but was not significantly associated with alcohol consumption or alcohol demand. Finally, greater proportionate substance-related reinforcement was associated with greater alcohol demand. CONCLUSIONS:Our results support the validity of the behavioral economic reinforcer pathology model as applied to young adult heavy drinking.
| S-EPMC6028289 | biostudies-other
Project description:BackgroundPregaming is a high-drink context popular among college students that often leads to elevated blood alcohol levels and negative consequences. Over 15 years of research studies have demonstrated that pregaming represents one of the riskiest known behaviors among college students, yet no pregaming-specific interventions have been developed to help prevent this behavior. General brief interventions for students do not reduce pregaming behavior and may not be appropriate, as they do not help students develop skills unique to the pregaming context that could help them drink less. We developed a brief, mobile-based intervention that is proposed to prevent heavy drinking during pregaming for college students, with the ultimate goal that behavioral reductions in this risky practice will ultimately affect global drinking and prevent consequences.Methods/designThe intervention, Pregaming Awareness in College Environments (PACE), was developed by combining two innovations to facilitate behavior change: (1) a mobile-based application that increases accessibility, is easy and engaging to use, and broadens the reach of the intervention content and (2) personalized pregaming-specific intervention content with harm reduction and cognitive behavioral skills proven to be mechanisms preventing and reducing heavy drinking among college students. After a develop and beta-test phase, we propose to test the efficacy of PACE in a preliminary randomized controlled trial with 500 college students who pregame at least once per week. Pregaming, general drinking, and alcohol-related consequences outcomes will be examined in the immediate (2 weeks post-intervention) and short-terms (six and 14-week post-intervention). We will also evaluate moderator effects for age, sex, and heaviness of drinking to allow for more refined information for a planned larger test of the intervention to follow this initial trial of PACE.DiscussionThis pregaming intervention clinical trial, if found to be efficacious, will culminate with an easily-disseminated mobile-based intervention for college student drinkers. It has the potential to reach millions of college students, perhaps as a clinical tool used by college counseling centers as an adjunct to formal care or as a preventive tool for first-year students or other high-risk groups on campus.Trial registrationClinicalTrials.gov Identifier NCT04016766.
| S-EPMC9206220 | biostudies-literature
Project description:BACKGROUND:Emerging adults have the highest prevalence of heavy drinking as compared to all other age groups. Given the negative consequences associated with such drinking, additional research efforts focused on at-risk consumption are warranted. The current study sought to identify patterns of situational antecedents to drinking and to examine their associations with drinking motivations, alcohol involvement, and mental health functioning in a sample of heavy drinking college students. METHOD:Participants were 549 (65.8% women) college student drinkers. RESULTS:Latent profile analysis identified three classes based on likelihood of heavy drinking across eight situational precipitants. The "High Situational Endorsement" group reported the greatest likelihood of heavy drinking in most situations assessed. This class experienced the greatest level of alcohol-related harms as compared to the "Low Situational Endorsement" and "Moderate Situational Endorsement" groups. The Low Situational Endorsement class was characterized by the lowest likelihood of heavy drinking across all situational antecedents and they experienced the fewest alcohol-related harms, relative to the other classes. Class membership was related to drinking motivations with the "High Situational Endorsement" class endorsing the highest coping- and conformity-motivated drinking. The "High Situational Endorsement" class also reported experiencing more mental health symptoms than other groups. CONCLUSIONS:The current study contributed to the larger drinking literature by identifying profiles that may signify a particularly risky drinking style. Findings may help guide intervention work with college heavy drinkers.
| S-EPMC5283858 | biostudies-literature
Project description:There are limited findings on mental health prevalence and service utilization rates among community college (CC) students. Utilizing a heavy drinking CC sample, the current study examined: 1) prevalence of mental health symptoms, 2) mental health service utilization and perceived unmet service need, and 3) barriers to service utilization. Participants were 142 CC students who were heavy alcohol users (70% female; 59% White) from three public CCs in the Pacific Northwest who were participating in a larger study designed to adapt a brief intervention for high-risk alcohol use. Findings of the current study revealed that 32% of CC students had a positive screen for depression; 25% had a positive screen for anxiety; a total of 28% received mental health services in the past 12 months; a total of 41% reported a perceived unmet need for mental health services at some point in the past 12 months (i.e., needing mental health services but not receiving it). Students with mental health symptoms reported more barriers to receiving services, and were more likely to not receive services due to cost, compared to students without mental health symptoms. There were differences in type of barrier as a function of alcohol use severity, although there was no difference in number of barriers. Campuses may benefit from understanding mental health service utilization barriers their students report and to effectively advertise the services offered. Training of student services personnel staff and faculty in screening for mental health or substance use may be a worthwhile and cost-effective endeavor.
| S-EPMC6709858 | biostudies-literature
Project description:Alcohol use disorder (AUD) is debilitating and costly. Identification and better understanding of risk factors influencing the development of AUD remain a research priority. Although early life exposure to trauma increases the risk of adulthood psychiatric disorders, including AUD, many individuals exposed to early life trauma do not develop psychopathology. Underlying genetic factors may contribute to differential sensitivity to trauma experienced in childhood. The hypothalamic-pituitary-adrenal (HPA) axis is susceptible to long-lasting changes in function following childhood trauma. Functional genetic variation within FKBP5, a gene encoding a modulator of HPA axis function, is associated with the development of psychiatric symptoms in adulthood, particularly among individuals exposed to trauma early in life. In the current study, we examined interactions between self-reported early life trauma, past-year life stress, past-year trauma, and a single nucleotide polymorphism (rs1360780) in FKBP5 on heavy alcohol consumption in a sample of 1,845 college students from two university settings. Although we found no effect of early life trauma on heavy drinking in rs1360780*T-allele carriers, rs1360780*C homozygotes exposed to early life trauma had a lower probability of heavy drinking compared to rs1360780*C homozygotes not exposed to early life trauma (P?<?0.01). The absence of an interaction between either current life stress or past-year trauma, and FKBP5 genotype on heavy drinking suggests that there exists a developmental period of susceptibility to stress that is moderated by FKBP5 genotype. These findings implicate interactive effects of early life trauma and FKBP5 genetic variation on heavy drinking. © 2016 Wiley Periodicals, Inc.
| S-EPMC5045724 | biostudies-literature
Project description:Heavy episodic drinking (HED) is highly prevalent in college students. In Argentina, there is a notable lack of longitudinal studies examining drinking trajectories. The present study identified HED trajectories in Argentinean college students during the first 3 years of college (seven waves) and examined the association between risk factors for alcohol use and HED trajectories. The sample was composed of 1,240 college students [63.1% women, aged 18-25 years (M = 19.1 ± 1.7)] who completed at least three waves (the first data collection and ?2 follow-ups). For 3 years, participants completed seven surveys that measured HED frequency, age of drinking onset, drunkenness occurrence, trait impulsivity, family history of alcohol abuse, stressful life events, and perceived peer's drinking. Latent Class Growth Analysis (LCGA) and Multinomial Logistic Regression (MLR) were used to identify the pattern and number of HED trajectories and to explore which risk factors better distinguished between the trajectories, respectively. Six HED trajectories were identified: Heavy Stable Frequency, Moderate Stable Frequency, Moderate Decreasing Frequency, Stable Infrequent, Decreasing Infrequent, and No-HED. Younger age of drinking onset, alcohol intoxication, greater perception of peer drinking frequency and higher levels of impulsivity (i.e., sensation seeking, lack of premeditation, and positive urgency) increased the probability of belonging to the trajectories with more frequent HED. These trajectories partially coincide with those identified in studies from other cultures. Unlike previous studies, we did not find a trajectory with increasing/ascending HED frequency. This may be related to contextual/cultural variables unique to Argentina, like differences in the age when the peak in alcohol consumption is reached or the legal minimum age to buy alcoholic beverages in this country, and the idiosyncratic elements that characterize college life in Argentina. This work represents a step forward in the identification of risk factors differentiating between different HED trajectories, and help understand changes in alcohol use during college, in an understudied population.
| S-EPMC7311794 | biostudies-literature
Project description:OBJECTIVE:College students with anxiety and depressive symptomatology face escalated risk for alcohol-related negative consequences. While it is well-established that normative perceptions of proximal peers' drinking behaviors influence students' own drinking behaviors, it is not clear how mental health status impacts this association. In the current study, we examined cross-sectional relationships between anxiety and depressed mood, perceived drinking behaviors and attitudes of important peers, and past month alcohol consumption and related problems in a first-semester college student social network. METHOD:Participants (N?=?1254, 55% female, 47% non-Hispanic White) were first-year students residing on campus at a single university who completed a web-based survey assessing alcohol use, mental health, and social connections among first-year student peers. Network autocorrelation models were used to examine the independent and interactive associations between mental health and perceptions of close peers' drinking on drinking outcomes, controlling for important variables. RESULTS:Mental health interacted with perceptions to predict past-month drinking outcomes, such that higher anxiety and higher perceptions that peers drink heavily was associated with more drinks consumed and consequences, and higher depression and perceptions was associated with more drinks consumed, heavy drinking frequency, and consequences. Attitudes that peers approve of heavy drinking were associated with more drinks consumed and heavy drinking frequency among students with lower (vs. higher) depressed mood. CONCLUSIONS:This study provides strong evidence that perceiving that close peers drink heavily is particularly risk-enhancing for anxious and depressed college students, and offers implications about alcohol intervention targeted at these subgroups.
| S-EPMC5975188 | biostudies-literature
Project description:BackgroundAlcohol-induced blackouts, a form of anterograde amnesia that restricts the encoding of short-term memories into long-term ones, are among the most severe alcohol-related consequences. College students are at high risk of experiencing alcohol-induced blackouts, and there is a need to determine whether alcohol interventions can effectively reduce blackouts in this population. The current study uses data from 3 randomized clinical trials to examine the effect of various intervention approaches on alcohol-induced blackouts.MethodsFour interventions were compared over 3 studies: (i) a computerized feedback intervention (electronic Check-Up To Go [e-Chug]; Study 1); (ii) a single-session brief motivational intervention (BMI; Study 1); (iii) a BMI plus behavioral economic session focused on increasing substance-free activities (BMI + Substance-Free Activity Session [SFAS]; Studies 2 and 3); and (iv) a BMI plus supplemental Relaxation Training session (BMI + Relaxation Training; Studies 2 and 3). Studies 1 and 3 also included an assessment-only control condition. For each study, participants reported whether they had experienced an alcohol-induced blackout at each time point; binary logistic regressions examined differential likelihood of experiencing an alcohol-induced blackout over time.ResultsNeither the single-session BMI nor e-Chug reduced alcohol-induced blackouts over assessment only; however, participants in the BMI + SFAS or BMI + Relaxation Training condition were significantly less likely to experience an alcohol-induced blackout compared to assessment only at 1-month (Wald = 4.77, odds ratio [OR] = 0.53, p = 0.03) and 6-month follow-ups (Wald = 5.72, OR = 0.52, p = 0.02). Study 2 also revealed a larger effect for the BMI + SFAS over the BMI + Relaxation Training condition at 6 months (Wald = 4.11 OR = 0.22, p = 0.043), although this was not replicated in Study 3. The effects for the 2-session BMIs lasted 6 months, at which point maturation effects diminished differences between assessment-only and intervention conditions.ConclusionsTwo sessions of BMI are a substantial enough dose to result in reductions in alcohol-induced blackouts among college student heavy drinkers.
| S-EPMC6502647 | biostudies-literature
Project description:High levels of 3 behavioral economic indices (delay discounting, alcohol demand, and proportionate substance-related reinforcement) are consistently associated with greater alcohol misuse and alcohol-related problems. However, it is unclear whether and how these variables jointly increase the risk for alcohol-related outcomes among college students who engage in heavy episodic drinking (HED; 4/5+ drinks for women/men, respectively). The current study used a person-centered approach to identify similar patterns of behavioral economic domains among heavy-drinking college students and investigate the relationship between these empirically derived classes and alcohol-related outcomes. A sample of 393 college students (60.8% female, 78.9% White/Caucasian) reporting at least 2 heavy drinking episodes in the previous month completed measures of alcohol use and problems, demographics, delay discounting, and alcohol reward value (alcohol demand and proportionate substance-related reinforcement). Latent profile analyses revealed that a 3-class solution provided the best fit to the data: a low reward value, high discounting (LRHD) class (n = 53), a moderate reward value, low discounting (MRLD) class (n = 214), and a high reward value, high discounting (HRHD) class (n = 126). Members of the HRHD class reported significantly greater alcohol consumption, past-month HED episodes, alcohol-related problems, and symptoms of alcohol use disorder than those in the MRLD and LRHD classes. The results suggest that there are 3 constellations of behavioral economic processes and that, consistent with the reinforcer pathology model, students who overvalue alcohol-related reward and discount the future more steeply are at the greatest risk for alcohol misuse and alcohol-related problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
| S-EPMC8409244 | biostudies-literature
Project description:An increasing number of mobile app interventions have been developed for problem drinking among college students; however, few studies have examined the integration of a mobile app with continuous physiological monitoring and alerting of affective states related to drinking behaviors.The aim of this paper was to evaluate the acceptability and feasibility of Mind the Moment (MtM), a theoretically based intervention for female college students with problem drinking that combines brief, in-person counseling with ecological momentary intervention (EMI) on a mobile app integrated with a wearable sensorband.We recruited 10 non-treatment seeking, female undergraduates from a university health clinic who scored a 3 or higher on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) to participate in this pilot study. Study activities involved an in-person baseline intake and 1 follow-up assessment, 2 in-person alcohol brief intervention counseling sessions, and use of MtM technology components (sensorband and EMI on a mobile app) for approximately 3-4 weeks. The intervention used motivational interviewing (MI) and cognitive behavioral therapy (CBT) strategies for reducing risks associated with drinking. We used both qualitative and quantitative assessments to measure acceptability of the intervention and feasibility of delivery. Use patterns of the sensorband and mobile app were also collected.Quantitative and qualitative data indicated high levels of acceptability for the MtM intervention. Altogether, participants made reports on the app on 26.7% (78/292) the days the technology was available to them and completed a total of 325 reports with wide variation between participants. Qualitative findings indicated that sensorband-elicited alerts promoted an increase in awareness of thoughts, feelings, and behaviors related to current environmental stressors and drinking behaviors in theoretically meaningful ways. Specific challenges related to functionality and form of the sensorband were identified.Delivering intervention material "just-in-time," at the moment participants need to use behavioral strategies has great potential to individualize behavioral interventions for reducing problem drinking and other health behaviors. These findings provide initial evidence for the promise of wearable sensors for increasing potency of theoretically grounded mobile health interventions and point to directions for future research and uptake of these technologies.
| S-EPMC5522582 | biostudies-other