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CORK Bibliography: Binge Drinking

69 citations. January 2010 to present

Prepared: December 2011

Baiocco R; D'Alessio M; Laghi F. Binge drinking among gay, and lesbian youths: The role of internalized sexual stigma, self-disclosure, and individuals' sense of connectedness to the gay community. Addictive Behaviors 35(10): 896-899, 2010. (26 refs.)

We examined the prevalence of binge drinking among lesbian and gay (LG) youths, and evaluated whether experiences such as internalized sexual stigma, the experience of "coming out" to family and friends, and the individuals' sense of "connectedness" to the gay community could be associated with alcohol abuse. The research involved 119 gay (58.9%) and 83 lesbian (41.1%) Italian youths (18 to 24 years old). According to previous research, youths were categorized in non-drinkers, social, binge and heavy drinkers. Results showed that the estimated percentage of binge drinking among gay and lesbian youths is 43.6%. The survey revealed that social, binge, and heavy drinkers differ in terms of some drinking variables, internalized sexual stigma, family and peer self-disclosure, and connectedness gay community. Implications for the prevention of binge drinking in LG youths are currently under discussion even if further investigation is urgently needed.

Brassai L; Piko BF; Steger MF. Meaning in life: Is it a protective factor for adolescents' psychological health? International Journal of Behavioral Medicine 18(1): 44- 51, 2011. (43 refs.)

Background: Searching for a coherent meaning in life has long been proposed to be a protective factor in adolescent development. Purpose: The present study aimed to examine meaning in life as a protective factor in a largely unstudied population: Romanian adolescents. Additionally, we sought to provide a novel, multidimensional assessment of several health-related variables (substance abuse, health risk behaviors, psychological health). Potential gender differences were explored regarding the role of life meaning in adolescent health. Method Data were collected in 2006 from students enrolled in the secondary schools of the Middle Transylvanian Region, Romania (n=1,977). Self-administered questionnaires were used as a method of data collection including items of life meaning and psychological health. Results: Meaning in life played a protective role with regard to health risk behaviors except smoking and binge drinking. Among males, meaning in life was found to be correlated only to illicit drug and sedative use, whereas among females, meaning in life was associated with binge drinking, unsafe sex, and lack of exercise and diet control. Psychological health was strongly related to meaning in life. Conclusion: In Romanian adolescents, meaning in life is a protective factor against health risk behaviors and poor psychological health.

Carey MG; Al-Zaiti SS; Dean GE; Sessanna L; Finnell DS. Sleep problems, depression, substance use, social bonding, and quality of life in professional firefighters. Journal of Occupational and Environmental Medicine 53(8): 928-933, 2011. (31 refs.)

Objective: Little attention has been given to factors contributing to firefighters' psychosomatic well-being. The purpose of this descriptive study was to examine such contributing factors in a sample of professional firefighters. Methods: Measures assessing sleep, depression, substance use, social bonding, and quality of life were examined in 112 firefighters. Results: Overall, many firefighters reported sleep deprivation (59%), binge drinking behavior (58%), poor mental well-being (21%), current nicotine use (20%), hazardous drinking behavior (14%), depression (11%), poor physical well-being (8%), caffeine overuse (5%), or poor social bonding (4%). Conclusions: Small-to-medium correlations were identified between sleep deprivation, depression, physical/mental well-being, and drinking behaviors. High-risk behaviors that impact psychosomatic well-being are prevalent in professional firefighters, which require environmental and individual-based health promotion interventions. The inter-correlation relationships between such behaviors, therefore, need to be explored in further details.

Charles J; Valenti L; Miller G. Binge drinking. (editorial). Australian Family Physician 40(8): 569-569, 2011. (1 refs.)

Chavez PR; Nelson DE; Naimi TS; Brewer RD. Impact of a new gender-specific definition for binge drinking on prevalence estimates for women. American Journal of Preventive Medicine 40(4): 468-471, 2011. (19 refs.)

Background: Binge drinking accounts for more than half of the 79,000 deaths due to excessive drinking in the U.S. each year. In 2006, the Behavioral Risk Factor Surveillance System (BRFSS) lowered the threshold for defining binge drinking among women from >= 5 drinks to >= 4 drinks per occasion, in accordance with national recommendations. Purpose: To assess changes in binge-drinking prevalence among women. Methods: The relative and absolute change in binge drinking among U.S. adult women was assessed using pooled BRFSS data from the 2 years before (2004-2005) and after (2006-2007) the implementation of the new gender-specific definition. Analyses were conducted in 2008-2009. Results: Binge-drinking prevalence among women increased 2.6 percentage points (from 7.3% in 2004-2005 to 9.9% in 2006-2007), a 35.6% relative increase. The percentage of women who reported consuming exactly 4 drinks in 2006 (3.6%) was similar to the increase in the prevalence of binge drinking among women that was observed from 2005 to 2006 (absolute change=2.9 percentage points). Conclusions: The new gender-specific definition of binge drinking significantly increased the identification of women drinking at dangerous levels. The change in prevalence among women was primarily due to the change in the definition and not to actual changes in drinking behavior. The new gender-specific definition of binge drinking can increase the usefulness of this measure for public health surveillance and support the planning and implementation of effective prevention strategies (e.g., increasing alcohol excise taxes).

Chen WY; Rosner B; Hankinson SE; Colditz GA; Willett WC. Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. Journal of the American Medical Association 306(17): 1884-1890, 2011. (44 refs.)

Context: Multiple studies have linked alcohol consumption to breast cancer risk, but the risk of lower levels of consumption has not been well quantified. In addition, the role of drinking patterns (ie, frequency of drinking and "binge" drinking) and consumption at different times of adult life are not well understood. Objective: To evaluate the association of breast cancer with alcohol consumption during adult life, including quantity, frequency, and age at consumption. Design, Setting, and Participants: Prospective observational study of 105 986 women enrolled in the Nurses' Health Study followed up from 1980 until 2008 with an early adult alcohol assessment and 8 updated alcohol assessments. Main Outcome Measures Relative risks of developing invasive breast cancer. Results During 2.4 million person-years of follow-up, 7690 cases of invasive breast cancer were diagnosed. Increasing alcohol consumption was associated with increased breast cancer risk that was statistically significant at levels as low as 5.0 to 9.9 g per day, equivalent to 3 to 6 drinks per week (relative risk, 1.15; 95% CI, 1.06-1.24; 333 cases/100 000 person-years). Binge drinking, but not frequency of drinking, was associated with breast cancer risk after controlling for cumulative alcohol intake. Alcohol intake both earlier and later in adult life was independently associated with risk. Conclusions: Low levels of alcohol consumption were associated with a small increase in breast cancer risk, with the most consistent measure being cumulative alcohol intake throughout adult life. Alcohol intake both earlier and later in adult life was independently associated with risk.

Chou KL; Liang K; Mackenzie CS. Binge drinking and axis I psychiatric disorders in community-dwelling middle-aged and older adults: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Journal of Clinical Psychiatry 72(5): 640-647, 2011. (60 refs.)

Objective: The aims of this study were to document the sociodemographic correlates of binge drinking in middle-aged and older adults and to test the association of binge drinking with the occurrence of DSM-IV mood, anxiety, and alcohol use disorders; smoking; and the use of illicit drugs independently of sociodemographic variables and lifetime diagnosis of the disorder in question. Method: We conducted secondary data analyses based on a subsample of a 3-year prospective, population-based study, the National Epidemiologic Survey on Alcohol and Related Conditions, which consisted of a nationally representative sample of 13,489 American community-dwelling adults aged 50 years and above, interviewed in both 2001-2002 and 2004-2005. This survey assessed the occurrence of 11 DSM-IV mood, anxiety, and alcohol use disorders; nicotine dependence; and the use of illicit drugs during the 3-year follow-up period by using the National Institute on Alcohol Abuse and Alcoholism's Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version. Results: We found that, among persons aged 50 years and above, 15.6% of men and 5.7% of women reported binge drinking in the year prior to baseline assessment in 2001-2002. After adjustment was made for covariates, both men who were occasional binge drinkers and men who were frequent binge drinkers were significantly more likely than current male drinkers without binge drinking to have alcohol abuse disorder (adjusted odds ratio [AOR] = 2.90 [95% CI, 1.82-4.62] and AOR = 5.68 [95% CI, 3.79-8.51], respectively) and alcohol dependence disorder (AOR = 3.69 [95% CI, 1.75-7.75] and AOR = 9.21 [95% CI, 5.59-15.18], respectively). Similarly, after adjustment was made for covariates, both women who were occasional binge drinkers and women who were frequent binge drinkers were significantly more likely than current female drinkers without binge drinking to have alcohol abuse disorder (AOR = 4.43 [95% CI, 1.85-10.60] and AOR = 3.49 [95% CI, 1.64-7.43], respectively) and alcohol dependence disorder (AOR = 5.20 [95% CI, 1.56-17.33] and AOR = 19.47 [95% CI, 7.59-49.98], respectively). In addition, in female subjects, occasional binge drinking was associated with an increased risk of panic disorder without agoraphobia (AOR = 2.23; 95% CI, 1.01-4.91) and post-traumatic stress disorder (AOR = 2.67; 95% CI, 1.05-6.84). Conclusions: Binge drinking is strongly associated with a higher risk of alcohol use disorder in middle-aged and older adults in the United States. Results provide valuable information on the risks associated with binge drinking and suggest targets for prevention strategies for mental health in middle and old age.

Ciesla JA; Dickson KS; Anderson NL; Neal DJ. Negative repetitive thought and college drinking: Angry rumination, depressive rumination, co-rumination, and worry. Cognitive Therapy and Research 35(2): 142-150, 2011. (28 refs.)

Alcohol abuse among college students continues to be a large societal problem in need of further study. This project investigated the influence of different types of negative repetitive thought (NRT) on alcohol use and binging behavior among undergraduates. Specifically, angry rumination, depressive rumination, co-rumination, and worry were examined. An initial exploratory factor analysis supported the distinctiveness of these four forms of NRT. With respect to quantity of weekly drinking, worry was significantly associated with less alcohol use among drinkers whereas angry rumination was associated with greater weekly usage. The effect of co-rumination was moderated by sex such that higher levels of co-rumination was associated with less weekly drinking in men but more weekly drinking in women. The tendency to co-ruminate was also significantly associated with of being a binge drinker, and demonstrated similar gender moderation. Higher levels of worry were associated with less binge drinking among women, but no association between worry and binging was present among men. The implications for these findings in the study of NRT and alcohol use are discussed.

Cooke R; French DP; Sniehotta FF. Wide variation in understanding about what constitutes 'binge-drinking'18. Drugs: Education, Prevention and Policy 17(6): 762-775, 2010. (18 refs.)

Two studies investigated undergraduates' knowledge of the UK government recommendations about binge drinking and sensible drinking, and also examined how labelling oneself as a binge drinker is associated with binge drinking perceptions. In Study 1, 325 undergraduates reported how many units constitute binge drinking, and labelled themselves as a 'binge drinker' or 'non-binge drinker'. Participants overestimated how many units constitute binge drinking relative to the UK government recommendations. Also, 59% labelled themselves as 'non-binge drinkers' and gave significantly higher estimates compared with 'binge drinkers'. In Study 2, 386 undergraduates defined binge drinking and reported how many units constitute sensible drinking. Only 13% of undergraduates defined binge drinking in terms of units of alcohol, and undergraduates overestimated how many units constitute sensible drinking. This research found wide variation in personal understanding of the term binge drinking and suggests a review of how to communicate recommendations about alcohol consumption to young people is needed.

Courtney KE; Polich J. Binge drinking effects on EEG in young adult humans. International Journal of Environmental Research and Public Health 7(5): 2325-2336, 2010. (42 refs.)

Young adult (N=96) university students who varied in their binge drinking history were assessed by electroencephalography (EEG) recording during passive viewing. Groups consisted of male and female non-binge drinkers (>1 to 5/4 drinks/ounces in under two hours), low-binge drinkers (5/4-7/6 drinks/ounces in under two hours), and high-binge drinkers (=10 drinks/ounces in under two hours), who had been drinking alcohol at their respective levels for an average of 3 years. The non- and low-binge drinkers exhibited less spectral power than the high-binge drinkers in the delta (0-4 Hz) and fast-beta (20-35 Hz) bands. Binge drinking appears to be associated with a specific pattern of brain electrical activity in young adults that may reflect the future development of alcoholism.

Crego A; Rodriguez-Holguin S; Parada M; Mota N; Corral M; Cadaveira F. Reduced anterior prefrontal cortex activation in young binge drinkers during a visual working memory task. Drug and Alcohol Dependence 109(1-3): 45-56, 2010. (125 refs.)

Working memory (WM) is a major cognitive function that is altered by chronic alcohol consumption. This impairment has been linked to alterations in the hippocampus and prefrontal cortex (PFC). Animal and human studies have shown that the adolescent brain is more sensitive to the neurotoxic effects of alcohol than the adult brain, particularly those structures that mature late on in development, such as the hippocampus and prefrontal brain. The aim of the present study was to assess visual working memory and its neural correlates in young university students who partake in intermittent consumption of large amounts of alcohol (binge drinkers). A sample of 42 binge drinkers and 53 corresponding control subjects performed an identical pairs continuous performance task (IP-CPT) in a combined event-related potential (ERP) and exact low-resolution brain electromagnetic tomography. (eLORETA) study. The results revealed that, despite adequate performance, binge drinkers showed a smaller late positive component (LPC) associated with hypoactivation of the right anterior prefrontal cortex (aPEC) for matching stimuli, in comparison with control subjects. These findings may reveal binge drinking-related functional alteration in recognition working memory processes and suggest that impaired prefrontal cortex function may occur at an early age in binge drinkers.

Cucciare MA; Darrow M; Weingardt KR. Characterizing binge drinking among U.S. military veterans receiving a brief alcohol intervention. Addictive Behaviors 36(4): 362-367, 2011. (28 refs.)

Background: Brief web-based alcohol interventions (BAIs) are effective for reducing binge drinking in college students and civilian adults, and are increasingly being applied to U.S. military populations. However, little is known about factors associated with binge drinking in Veteran populations and therefore some concern remains on the generalizability of studies supporting BAIs for addressing binge drinking in this population. This study sought to better understand the characteristics (e.g., demographic, coping related mental health factors, prior exposure to traumatic events, and factors assessing motivation to change alcohol use) of a predominantly male sample of binge drinking Veterans receiving a BAI from a VA provider. Methods: A primarily male (93.5%) sample (N = 554) of Veterans completed a BAI consisting of brief assessment and personalized feedback. Results: We found that Veterans who were younger, used drugs/alcohol to cope with symptoms of PTSD and depression (e.g., nightmares and flashbacks and sleep difficulties), and had experienced sexual assault, had higher self-reported peak blood alcohol concentration and a higher likelihood for a binge drinking episode in the last 90 days. Conclusions: BAIs may be a promising approach for addressing binge drinking in Veterans. However, binge drinking among a sample of mostly male Veterans receiving a BAI may be associated with a complex set of factors that are less prevalent in the college student population and thus studies demonstrating the efficacy of BAIs with Veterans are needed.

Cunningham RM; Walton MA; Harrison SR; Resko SM; Stanley R; Zimmerman M et al. Past-year intentional and unintentional injury among teens treated in an inner-city emergency department. Journal of Emergency Medicine 41(4): 418-426, 2011. (45 refs.)

An inner-city emergency department (ED) visit provides an opportunity for contact with high-risk adolescents to promote injury prevention. Objectives: To identify the prevalence of injuries sustained over the past year by teens presenting to an inner-city ED, and to identify factors associated with recent injury to inform future ED-based injury prevention initiatives. Methods: Over 1 year, 7 days a week, from 1:00-11:00 p.m., patients aged 14-18 years presenting to the ED participated in a survey regarding past-year risk behaviors and injuries. Results: Of the entire group of teens presenting to the ED (n = 1128) who completed the survey (83.8% response rate), 46% were male, and 58% were African-American. Past-year injuries were reported by 768 (68.1%) of the teens; 475 (61.8%) of those reported an unintentional injury and 293 (38.1%) reported an intentional injury. One-third of all youth seeking care reported a past-year sports-related injury (34.5%) or an injury related to driving or riding in a car (12.3%), and 8.2% reported a gun-related injury. Logistic regression found that binge drinking (adjusted odds ratio [AOR] 1.95) and illicit weapon carrying (AOR 2.31) predicted a past-year intentional injury. African-American youth (AOR 0.56) and those receiving public assistance (AOR 0.73) were less likely to report past-year unintentional injuries. Conclusions: Adolescents seeking care in an inner-city ED, regardless of the reason for seeking care, report an elevated prevalence of recent injury, including violence. Future injury screening and prevention efforts should consider universal screening of all youth seeking ED care.

Daeppen JB; Bertholet N; Gaume J; Fortini C; Faouzi M; Gmel G. Efficacy of brief motivational intervention in reducing binge drinking in young men: A randomized controlled trial. Drug and Alcohol Dependence 113(1): 69-75, 2011. (34 refs.)

Background: Brief motivational intervention (BMI) is one of the few effective strategies targeting alcohol consumption, but has not been tested in young men in the community. We evaluated the efficacy of BMI in reducing alcohol use and related problems among binge drinkers and in maintaining low-risk drinking among non-bingers. Methods: A random sample of a census of men included during army conscription (which is mandatory for 20-year-old males in Switzerland) was randomized to receive a single face-to-face BMI session (N = 199) or no intervention (N = 219). A six-month follow-up rate was obtained for 88.7% of the subjects. Results: Among binge drinkers, there was 20% less drinking in the BMI group versus the control group (incidence rate ratio = 0.80, confidence interval 0.66-0.98, p = 0.03): the BMI group showed a weekly reduction of 1.5 drinks compared to an increase of 0.8 drinks weekly in the control group. Among subjects who experienced one or more alcohol-related consequences over the last 12 months, there was 19% less drinking in the BMI group compared to the control group (incidence rate ratio = 0.81; confidence interval 0.67-0.97, p = 0.04). Among non-bingers, BMI did not contribute to the maintenance of low-risk drinking. Conclusion: BMI reduced the alcohol use of binge drinkers, particularly among those who experienced certain alcohol-related adverse consequences. No preventive effect of BMI was observed among non-bingers. BMI is a plausible secondary preventive option for young binge drinkers.

Danielsson AK; Romelsjo A; Tengstrom A. Heavy episodic drinking in early adolescence: Gender-specific risk and protective factors. Substance Use & Misuse 46(5): 633-643, 2011. (54 refs.)

This longitudinal study examined possible gender differences regarding risk and protective factors for heavy episodic drinking among 1,222 seventh-grade students (aged 13) in the City of Stockholm, Sweden, with follow-up 2 years later. Logistic regression analyses showed that several factors predicted heavy episodic drinking. The strongest predictors for boys' heavy episodic drinking in the ninth grade were heavy episodic drinking (odds ratio [OR] = 5.30) and smoking in the seventh grade (OR = 5.80). Drinking peers (OR = 2.47) and smoking (OR = 2.44) in the seventh grade showed the strongest association for girls. Furthermore, high parental monitoring and having a secure attachment to parents may have a protective effect when risk factors are present. Our results lend support to prevention initiatives to strengthen the parent-child relation and focus on adolescents' ability to resist peer pressure and of limiting parental provision of alcohol. The study's limitations are noted.

Dingwall KM; Maruff P; Cairney S. Similar profile of cognitive impairment and recovery for Aboriginal Australians in treatment for episodic or chronic alcohol use. Addiction 106(8): 1419-1426, 2011. (49 refs.)

Aims: The cognitive impairment and recovery associated with chronic alcohol abuse and subsequent abstinence is well understood. However, the recovery profile following heavy episodic or 'binge' use, which is common among some Australian Aboriginal users, has not been investigated thoroughly and no empirical studies have examined chronic use in this population. The aim of this study was to identify and compare cognitive impairment and recovery associated with chronic and episodic alcohol use among Aboriginal Australians. Design Longitudinal case-control design. Setting Residential alcohol treatment programmes in northern Australia. Participants Forty chronic alcohol users, 24 episodic users and 41 healthy controls [mean age = 34.24; standard deviation (SD) = 9.73]. Measurements: Cognitive assessments of visual motor, attention, memory, learning and executive functions at baseline (start of treatment), then 4 weeks and 8 weeks later. Reassessment of 31% of participants an average of 11 months later (SD = 4.4) comparing those who remained abstinent (n = 5), those who relapsed (n = 11) and healthy controls (n = 19). Findings At baseline, chronic and episodic alcohol users showed impaired visual motor, learning, memory and executive functions. With the exception of visual motor impairment, all deficits had improved to normal levels within 4 weeks. Visual motor deficits had normalized within 11 months. Performances did not differ at any time between chronic and episodic alcohol groups. Conclusions: In Aboriginal Australians, episodic drinking is associated with similar patterns of impairment and recovery as chronic alcohol use. Most cognitive deficits appear to recover within the first month of abstinence, while persisting visual motor problems recover within 1 year.

du Toit MM; Smith M; Odendaal HJ. The role of prenatal alcohol exposure in abruptio placentae. South African Medical Journal 100(12): 832-835, 2010. (25 refs.)

Objective. To investigate the association between preconception and prenatal alcohol use and abruptio placentae. Methods. A case-control study of women with the clinical diagnosis of abruptio placentae, 65 cases and 66 controls, at Tygerberg Academic Hospital, Western Cape, South Africa. Women in whom a retroplacental blood clot, covering at least 15% of the placental surface, was found at delivery at 24 weeks' gestation or later were asked to complete a timeline follow-back questionnaire to determine their alcohol intake 12 and 3 months before and during pregnancy. The same questionnaire was administered to a control group of high-risk women who had no antepartum haemorrhage. Outcome. Women who drank alcohol 12 months before conception were more than 4 times more likely to develop abruptio placentae than the control group (odds ratio (OR) 4.49, p=0.00009). Women who drank alcohol 3 months prior to conception were 3 times more likely to develop abruptio placentae than the control group (OR 3.06, p=0.003). Drinking alcoholic beverages during pregnancy carried a more than 3 times greater risk of developing abruptio placentae (OR 3.52, p=0.0006). In the study group, women consumed a mean of 13.6, 12.0 and 11.2 standard drinks in a typical week at 12 and 3 months before and during pregnancy, respectively. The study group demonstrated a binge-drinking pattern, with two to four sessions per month. Conclusion. An association was found between preconception and prenatal consumption of alcohol and abruptio placentae.

Elliott MA; Ainsworth K. Predicting university undergraduates' binge-drinking behavior: A comparative test of the one- and two-component theories of planned behavior. Addictive Behaviors 37(1): 92-101, 2012. (87 refs.)

This study provides a comparative test of the one- and two-component theories of planned behavior (TPB) in the context of university undergraduates' binge-drinking. Participants (N=120) self-completed questionnaire measures of all TPB constructs at time 1 and subsequent binge-drinking at time 2 (two-weeks later). The data were analyzed using a combination of path analyses and bootstrapping procedures. Both models accounted for a substantial proportion of the variation in behavior. However, the two-component TPB provided a significantly better fit to the data, with the total direct and indirect effects accounting for 90% of the variance. Intention was the only direct predictor of behavior. Instrumental attitude, affective attitude and self-efficacy had indirect effects. Although health interventions could usefully target these cognitive antecedents, simulation analyses, modeling the effects of cognition change on behavior, showed that only large-sized (0.8 SD) changes to affective attitude, or moderate-sized changes to all of these cognitions in combination were sufficient to reduce binge-drinking.

Foxcroft DR; Tsertsvadze A. Universal school-based prevention programs for alcohol misuse in young people. (review). Cochrane Database of Systematic Reviews 5: CD009113, 2011. (156 refs.)

Background: Alcohol misuse in young people is cause of concern for health services, policy makers, prevention workers, criminal justice system, youth workers, teachers, parents. This is one of three reviews examining the effectiveness of (1) school-based, (2) family-based, and (3) multi-component prevention programs. Objectives: To review evidence on the effectiveness of universal school-based prevention programs in preventing alcohol misuse in school-aged children up to 18 years of age. Search strategy Relevant evidence (up to 2002) was selected from the previous Cochrane review. Later studies, to July 2010, were identified from MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, Project CORK, and PsycINFO. Selection criteria: Randomized trials evaluating universal school-based prevention programs and reporting outcomes for alcohol use in students 18 years of age or younger were included. Two reviewers screened titles/abstracts and full text of identified records. Data collection and analysis Two reviewers extracted relevant data independently using an a priori defined extraction form. Risk of bias was assessed. Main results: 53 trials were included, most of which were cluster-randomised. The reporting quality of trials was poor, only 3.8% of them reporting adequate method of randomisation and program allocation concealment. Incomplete data was adequately addressed in 23% of the trials. Due to extensive heterogeneity across interventions, populations, and outcomes, the results were summarized only qualitatively. Six of the 11 trials evaluating alcohol-specific interventions showed some evidence of effectiveness compared to a standard curriculum. In 14 of the 39 trials evaluating generic interventions, the program interventions demonstrated significantly greater reductions in alcohol use either through a main or subgroup effect. Gender, baseline alcohol use, and ethnicity modified the effects of interventions. Results from the remaining 3 trials with interventions targeting cannabis, alcohol, and/or tobacco were inconsistent. Authors' conclusions: This review identified studies that showed no effects of preventive interventions, as well as studies that demonstrated statistically significant effects. There was no easily discernible pattern in characteristics that would distinguish trials with positive results from those with no effects. Most commonly observed positive effects across programs were for drunkenness and binge drinking. Current evidence suggests that certain generic psychosocial and developmental prevention programs can be effective and could be considered as policy and practice options. These include the Life Skills Training Program, the Unplugged program, and the Good Behaviour Game. A stronger focus of future research on intervention program content and delivery context is warranted. PLAIN LANGUAGE SUMMARY: Psychosocial and Development Alcohol Misuse Prevention in Schools can be effective We conducted a Cochrane systematic review of 53 well-designed experimental studies that examined the effectiveness of school-based universal programs for the prevention of alcohol misuse in young people. The studies were divided into two major groups based on the nature of the prevention program: 1) programs targeting specifically prevention or reduction of alcohol misuse and 2) generic programs with wider focus for prevention (e. g., other drug use/abuse, antisocial behavior). In the review we found studies that showed no effects of the preventive program, as well as studies that demonstrated statistically significant effects. There was no easily discernible pattern in program characteristics that would distinguish studies with positive results from those with no effects. Most commonly observed positive effects across programs were for drunkenness and binge drinking. In conclusion, current evidence suggests that certain generic psychosocial and developmental prevention programs can be effective and could be considered as policy and practice options. These include the Life Skills Training Program, the Unplugged Program, and the Good Behaviour Game.

Hadland SE; Marshall BDL; Kerr T; Zhang R; Montaner JS; Wood E. A comparison of drug use and risk behavior profiles among younger and older street youth. Substance Use & Misuse 46(12): 1486-1494, 2011. (48 refs.)

Among 559 street youth recruited between 2005 and 2007 in Vancouver, Canada, young drug users (<21 years of age) were compared with older drug users (>= 21 years) with regard to recent drug use and sexual practices using multiple logistic regression. Older youth were more likely to be male and of Aboriginal ancestry, to have more significant depressive symptoms, to have recently engaged in crack smoking, and to have had a recent history of injection drug use. Young drug users, by contrast, were more likely to have engaged in recent binge alcohol use. Efforts to reduce drug use-related harm among street youth may be improved by considering the highly prevalent use of "harder" drugs and risk for depression among older youth.

Hakansson A; Schlyter F; Berglund M. Associations between polysubstance use and psychiatric problems in a criminal justice population in Sweden. Drug and Alcohol Dependence 118(1): 5-11, 2011. (44 refs.)

Background: Polysubstance use is common in substance users, and may complicate their clinical course. This study, in a criminal justice setting in Sweden, examines the association between the number of concurrently used substance types and psychiatric symptoms during 30 days before incarceration, while controlling for background variables such as family history (drug and alcohol problems, psychiatric problems, criminality), demographic data and history of emotional, physical or sexual abuse. Methods: The data material comprised 5659 criminal justice clients reporting a substance use problem, examined with the Addiction Severity Index. Variables were compared in a multinomial regression analysis, comparing clients reporting one (n = 1877), two (n = 1408), three (n = 956), four (n = 443) and five or more (it = 167) substance types. Results: The 30-day prevalence of most psychiatric symptoms included in the study (depression, anxiety, cognitive problems, hallucinations, difficulty controlling violent behaviour, suicidal ideation, suicide attempts) was higher in individuals with a higher number of concurrent substance types used. In multinomial regression analysis, while controlling for background variables, these associations remained for concurrent suicidal ideation, cognitive problems, hallucinations and violent behaviour, with the latter two being associated with the higher numbers of substance types. Binge alcohol drinking, tranquilizers, opioids and the number of substance types reported were associated with several of the psychiatric symptoms. Conclusions: In the present criminal justice setting in Sweden, the use of multiple substance types and concurrent psychiatric symptoms appear to be associated, and a sub-group reporting particularly high numbers of concurrent substance types are particularly likely to report potentially severe psychiatric problems.

Heffernan T; Clark R; Bartholomew J; Ling J; Stephens S. Does binge drinking in teenagers affect their everyday prospective memory? Drug and Alcohol Dependence 109(1-3): 73-78, 2010. (41 refs.)

Aims: To examine whether teenage binge drinking has an adverse effect upon everyday prospective memory (PM). Design: The study utilised an existing-groups design, with alcohol group: binge drinkers vs non-binge drinkers as the independent factor, and scores on the two PM memory subscales of the Prospective and Retrospective Memory Questionnaire (PRMQ) and the score on the Prospective Remembering Video Procedure (PRVP) as the dependent factors. Age, anxiety and depression scores, last alcohol use (in hours) and how many years spent drinking, were measured and analysed between the groups. Setting: Each participant was tested in a laboratory setting. Participants: An opportunity sample of 21 'binge drinkers' (those drinking above 6 units for females and 8 units for males on 2 or more occasions per week) and 29 non-bingers were compared. Measurements: Self-reported everyday PM lapses were measured using the PRMQ. The PRVP was used as an objective measure of PM. Alcohol and other drug use were assessed by the University of East London Recreational Drug Use Questionnaire. The Hospital Anxiety and Depression Scale gauged self-reported levels of anxiety and depression. Findings: After controlling for age, anxiety and depression scores, last alcohol use and how many years spent drinking, there were no significant between-group differences on either the self-reported long-term or short-term PM lapses. However, binge drinkers recalled significantly fewer location-action combinations on the PRVP than non-binge drinkers. Conclusions: The results Of the present study suggest that binge drinking in the teenage years leads to impairments in everyday PM.

Howland J; Rohsenow DJ; Greece JA; Littlefield CA; Almeida A; Heeren T et al. The effects of binge drinking on college students' next-day academic test-taking performance and mood state. Addiction 105(4): 655-665, 2010. (74 refs.)

Aim: To assess the effects of binge drinking on students' next-day academic test-taking performance. Design: A placebo-controlled cross-over design with randomly assigned order of conditions. Participants were randomized to either alcoholic beverage [mean = 0.12 g% breath alcohol concentration (BrAC)] or placebo on the first night and then received the other beverage a week later. The next day, participants were assessed on test-taking, neurocognitive performance and mood state. Participants: A total of 196 college students (>= 21 years) recruited from greater Boston. Setting: The trial was conducted at the General Clinical Research Center at the Boston Medical Center. Measurements: The Graduate Record Examinations(C) (GREs) and a quiz on a lecture presented the previous day measured test-taking performance; the Neurobehavioral Evaluation System (NES3) and the Psychomotor Vigilance Test (PVT) measured neurocognitive performance; and the Profile of Mood States (POMS) measured mood. Findings: Test-taking performance was not affected on the morning after alcohol administration, but mood state and attention/reaction-time were affected. Conclusion: Drinking to a level of 0.12 g% BrAC does not affect next-day test-taking performance, but does affect some neurocognitive measures and mood state.

Hughes T; Szalacha LA; McNair R. Substance abuse and mental health disparities: Comparisons across sexual identity groups in a national sample of young Australian women. Social Science & Medicine 71(4): 824-831, 2010. (46 refs.)

A growing body of research amply documents health disparities related to substance abuse among sexual minority women. However, relatively little research has examined risk factors or predictors of substance use in this population and even less has explored differences among sexual minority subgroups. Using data from 8850 women aged 25-30 years in the 2003 survey of the Australian Longitudinal Study on Women's Health Survey (ALSWH) we compared rates of substance use (alcohol, marijuana and other illicit drugs) and potential predictors (e.g., depression, anxiety, perceived stress, lower levels of social support) across four sexual identity groups exclusively heterosexual, mainly heterosexual, bisexual and lesbian. Using statistical weighting of the sample and controlling for demographic characteristics we fitted logistic regression models to estimate adjusted odds ratios for substance use. Compared with exclusively heterosexual women sexual minority women reported significantly higher levels of substance use but there was notable variation among the three sexual minority subgroups. Women who identified as mainly heterosexual were significantly more likely than exclusively heterosexual women to report at-risk drinking and those who identified as bisexual were more likely to report marijuana use. Mainly heterosexual and bisexual women were also more likely to report binge drinking. Findings implicate stress as an important predictor of substance use and emphasize the need for research that more systematically examines the relationships between minority stress and substance use in sexual minority women. Findings of variations in risk across sexual minority subgroups suggest prevention and intervention strategies aimed at reducing health disparities should be targeted toward specific sexual minority subgroups.

Jenkins KR; Zucker RA. The prospective relationship between binge drinking and physician visits among older adults. Journal of Aging and Health 22(8): 1099-1113, 2010. (44 refs.)

Objectives: The objectives are to (a) determine if binge drinking is related to physician visits and (b) estimate the degree to which the relationship between binge drinking and physician visits can be explained by other health characteristics. Method: Data on a sample of 4,960 older adults (70+ years of age in 2002) from the Health and Retirement Study (HRS) were used. Three linear regression models estimated the impact of binge drinking on physician visits. Results: In the fully adjusted models, binge drinking did have an effect on the number of physician visits by older adults, with more frequent binge drinkers having fewer physician visits. This negative relationship exists even when demographic as well as other current health characteristics are controlled. Discussion: The implications of these results are discussed in terms of more broadly communicating the risks associated with binge drinking and more effectively targeting interventions to older binge drinkers.

Kanny D; Liu Y; Brewer RD; Garvin W; Balluz L. Vital Signs: Binge drinking among high school students and adults --- United States, 2009. MMWR. Morbidity and Mortality Weekly Review 59(39): 1274-1279, 2010. (11 refs.)

Background: Binge drinking was responsible for more than half of the estimated 79,000 deaths and two thirds of the estimated 2.3 million years of potential life lost as a result of excessive drinking each year in the United States during 2001--2005. Methods: CDC analyzed data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) on the prevalence of binge drinking (defined as consuming four or more alcoholic drinks per occasion for women and five or more for men during the past 30 days) among U.S. adults aged �18 years who responded to the BRFSS survey by landline or cellular telephone. Data also were analyzed from the 2009 National Youth Risk Behavior Survey (YRBS) on the prevalence of current alcohol use (consuming at least one alcoholic drink during the 30 days before the survey), and binge drinking (consuming five or more alcoholic drinks within a couple of hours during the 30 days before the survey) among U.S. high school students, and on the prevalence of binge drinking among high school students who reported current alcohol use. Results: Among U.S. adults, the prevalence of reported binge drinking was 15.2% among landline respondents. Binge drinking was more common among men (20.7%), persons aged 18--24 years (25.6%) and 25?34 years (22.5%), whites (16.0%), and persons with annual household incomes of $75,000 or more (19.3%). Among cellular telephone respondents, the overall prevalence of binge drinking (20.6%) was higher than among landline respondents, although the demographic patterns of binge drinking were similar. Prevalence among high school students was 41.8% for current alcohol use, 24.2% for binge drinking, and 60.9% for binge drinking among students who reported current alcohol use. Conclusions: Binge drinking is common among U.S. adults, particularly those with higher household incomes, and among high school students. Binge drinking estimates for adults were higher in the cellular telephone sample than in the landline sample. Most youths who reported current alcohol use also reported binge drinking.

Public Domain

Kelly-Weeder S. Binge drinking and disordered eating in college students. Journal of The American Academy of Nurse Practitioners 23(1): 33-41, 2011. (59 refs.)

Purpose: To explore the co-occurrence of binge drinking and disordered eating behaviors in college-aged students. Data sources: Data were collected from 211 college-aged students (mean age 20.7 years) at a private university in the northeastern United States using a web-based survey. Gender-specific binge drinking rates (five drinks per occasion for men and four drinks per occasion for women) were ascertained. Disordered eating behaviors included measures of binge eating as well as unhealthy weight loss behaviors (skipping meals, fasting, diet pills, laxatives, and self-induced vomiting). Conclusions: Binge drinking rates were high (63% of female, 83% of male students). Binge eating was reported by 48% of students and was correlated with healthy and unhealthy weight loss behaviors. Female students were more likely to endorse the use of skipping meals, fasting, use of diet pills, laxatives, and self-induced vomiting. Implications for practice: Binge drinking and disordered eating behaviors are practiced by both male and female students and are common occurrences on college campuses. Nurse practitioners need to be aware of these behaviors, their co-occurrence, and the need to assess and intervene with students who are at risk for the negative health outcomes associated with the use of these behaviors.

King AC; de Wit H; McNamara PJ; Cao D. Rewarding, stimulant, and sedative alcohol responses and relationship to future binge drinking. Archives of General Psychiatry 68(4): 389-399, 2011. (93 refs.)

Context: Excessive consumption of alcohol is a major problem in the United States and abroad. Despite many years of study, it is unclear why some individuals drink alcohol excessively while others do not. It has been postulated that either lower or greater acute responses to alcohol, or both, depending on the limb of the breath alcohol concentration curve, contribute to propensity for alcohol misuse. Objective: To prospectively assess the relationship of acute alcohol responses to future binge drinking. Design: Within-subject, double-blind, placebo-controlled, multidose laboratory alcohol challenge study with intensive follow-up. Each participant completed 3 randomized sessions examining responses to a high (0.8 g/kg) and low (0.4 g/kg) alcohol dose and placebo, followed by quarterly assessments for 2 years examining drinking behaviors and alcohol diagnoses. Setting: Participants recruited from the community. Participants: High-risk heavy social drinkers aged 21 to 35 years who habitually engage in weekly binge drinking (n = 104) and light drinker controls (n = 86). Intervention: We conducted 570 laboratory sessions with a subsequent 99.1% follow-up (1506 of 1520). Main Outcome Measures: Biphasic Alcohol Effects Scale, Drug Effects Questionnaire, cortisol response, Time-line Follow-Back, Drinker Inventory of Consequences-Recent, and DSM-IV alcohol abuse and dependence. Results: Alcohol produced greater stimulant and rewarding (liking and wanting) responses and lower sedative and cortisol responses in heavy vs light drinkers. Among the heavy drinkers, greater positive effects and lower sedative effects after alcohol consumption predicted increased binge drinking frequency during follow-up. In turn, greater frequency of binge drinking during follow-up was associated with greater likelihood of meeting diagnostic criteria for alcohol abuse and dependence. Conclusions: The widely held low level response theory and differentiator model should be revised: in high-risk drinkers, stimulant and rewarding alcohol responses even at peak breath alcohol concentrations are important predictors of future alcohol problems.

Lammers J; Goossens F; Lokman S; Monshouwer K; Lemmers L; Conrod P et al. Evaluating a selective prevention programme for binge drinking among young adolescents: Study protocol of a randomized controlled trial. BMC Public Health 11: article 126, 2011. (60 refs.)

Background: In comparison to other Europe countries, Dutch adolescents are at the top in drinking frequency and binge drinking. A total of 75% of the Dutch 12 to 16 year olds who drink alcohol also engage in binge drinking. A prevention programme called Preventure was developed in Canada to prevent adolescents from binge drinking. This article describes a study that aims to assess the effects of this selective school-based prevention programme in the Netherlands. Methods: A randomized controlled trial is being conducted among 13 to 15-year-old adolescents in secondary schools. Schools were randomly assigned to the intervention and control conditions. The intervention condition consisted of two 90 minute group sessions, carried out at the participants' schools and provided by a qualified counsellor and a co-facilitator. The intervention targeted young adolescents who demonstrated personality risk for alcohol abuse. The group sessions were adapted to four personality profiles. The control condition received no further intervention above the standard substance use education sessions provided in the Dutch national curriculum. The primary outcomes will be the percentage reduction in binge drinking, weekly drinking and drinking-related problems after three specified time periods. A screening survey collected data by means of an Internet questionnaire. Students have completed, or will complete, a post-treatment survey after 2, 6, and 12 months, also by means of an online questionnaire. Discussion: This study protocol presents the design and current implementation of a randomized controlled trial to evaluate the effectiveness of a selective alcohol prevention programme. We expect that a significantly lower number of adolescents will binge drink, drink weekly, and have drinking-related problems in the intervention condition compared to the control condition, as a result of this intervention.

Laranjeira R; Pinsky I; Sanches M; Zaleski M; Caetano R. Alcohol use patterns among Brazilian adults. Revista Brasileira de Psiquiatria 32(3): 231-241, 2010. (31 refs.)

Objective: To describe patterns of alcohol consumption in the adult Brazilian population Method Multicluster random sample of 2 346 subjects 18 years of age or older selected nationwide Interviews were conducted in respondents homes between November 2005 and April 2006. Results: About 48% of the sample had not drunk alcoholic beverages in the past year with variations by gender age marital status, education income and region of the country. Among drinkers 29% reported drinking 5 or more drinks per occasion (men 38%) Sociodemographic variables are associated with the frequency and amount of drinking alcohol problems and alcohol abuse and dependence Among the whole sample (including drinkers and non drinkers) 28% reported binge drinking 25% reported at least one kind of alcohol related problem, 3% were alcohol abusers and another 9% were alcohol dependent Discussion: Abstinence is high in the Brazilian population. However elevated proportions of those who drink consume alcohol in a high risk pattern (binge drinking), report a high level of alcohol problems, alcohol abuse and dependence. National public policies must consider these factors as well as the regional Brazilian differences

Lin DH; Li XM; Fan XH; Fang XY. Child sexual abuse and its relationship with health risk behaviors among rural children and adolescents in Hunan, China. Child Abuse & Neglect 35(9): 680-687, 2011. (40 refs.)

Objective: The current study was designed to explore the prevalence of child sexual abuse (CSA) and its association with health risk behaviors (i.e., smoking, alcohol use, binge drinking, suicidal ideation, and suicide attempt) among rural children and adolescents in China. Methods: A sample of 683 rural children and adolescents (8 to 18 years of age) completed an anonymous questionnaire which assessed experiences of CSA and 5 health risk behaviors. Data on several potential confounding factors were also collected. Results: A total of 123(18%) respondents reported experiencing at least 1 kind of CSA before 16 years of age, with more boys reporting CSA than girls (21.5% vs. 14.2%). In addition, attending non-boarding schools, lower levels of self-esteem, and higher levels of perceived peer pressure for engagement in health risk behaviors were associated with higher rates of CSA. Multivariate logistic regression analyses revealed that CSA experience was significantly associated with cigarette smoking (aOR = 2.14), binge drinking (aOR = 2.68), suicidal ideation (aOR = 1.69), and suicide attempt (aOR = 2.69) after controlling for several demographic and psychological factors. Conclusion: More attention should be paid to the issues of CSA among rural children and adolescents in China. Effective CSA prevention intervention needs to address the vulnerabilities of the population, increase children's and parents' awareness of CSA and ability of self-protection.

McCauley JL; Calhoun KS; Gidycz CA. Binge drinking and rape: A prospective examination of college women with a history of previous sexual victimization. Journal of Interpersonal Violence 25(9): 1655-1668, 2010. (26 refs.)

The current study prospectively examined the longitudinal relationships between binge drinking behavior and rape experiences among a multisite sample of college women with a history of prior attempted or completed rape (N = 228). Rates of binge drinking among this high-risk sample were high. Prospective analyses indicated that binge drinking significantly increased risk for subsequent rape. Monthly binge drinkers were significantly more likely to experience alcohol-involved rape than forcible rape at follow-up. Only prior binge drinking, and not type of rape experience, predicted subsequent binge drinking. Findings have direct implications for targeted programming addressing combined risks for binge drinking and rape among college women.

McCoy SL; Nieland MNS. Are drinking habits really changing? A cross-generational test of the 'new' phenomenon of 'binge-drinking'. Drugs: Education, Prevention and Policy 18(5): 333-339, 2011. (40 refs.)

Aims: To investigate whether 'binge-drinking' is new by comparing the behaviour and attitudes of two generations at the same age and of one generation at different ages. Methods: Fifty-six student/parent pairs completed questionnaires partially based on the Adolescent version of the Alcohol Expectancy Questionnaire (Brown, S. A., Christiansen, B. A., & Goldman, M. S. (1987). The alcohol expectancy questionnaire: An instrument for the assessment of adolescent and adult alcohol expectancies. Journal of Studies on Alcohol, 48, 483-491). Students' reports of their behaviour and attitudes were compared to their parents' memories of their behaviour and attitudes at 18. Parents' memories were compared to their current behaviour and attitudes to explore possible lifespan effects. Data regarding the groups' attachment to aspects of society were drawn on as a possible explanation of differences between generations. Findings: Parents recalled consuming more alcohol more frequently, having more favourable attitudes towards alcohol and having fewer ties with their communities when they were 18 than their children. They drank less and had a less favourable attitude towards alcohol at the time of the research than in their youth. Conclusions: Despite contrary 'evidence', it may be that today's young people are less prone to 'binge-drinking' than previous generations. Whilst it is recognized that data may be contaminated by parents' 'forgetting', the study highlights the possibility that the 'binge-drinking' crisis is merely media hype, spurious, or both.

McGee R; Williams S; Kypri K. College students' readiness to reduce binge drinking: Criterion validity of a brief measure. Drug and Alcohol Dependence 109(1-3): 236-238, 2010. (17 refs.)

We assessed the criterion-related validity of a contemplation ladder used to determine college students' readiness to reduce binge drinking. 1356 students in halls of residence in Dunedin, New Zealand completed a self-report survey including the contemplation ladder, AUDIT questionnaire, and other alcohol-related measures. Two groups of binge drinkers were identified, one reporting bingeing more than twice per week (n=645), and one bingeing 1-2 times per week (n=237). A third group did not report binge drinking (n=474). A higher readiness to change binge drinking was associated with more frequent bingeing, more interpersonal and academic problems with alcohol, less frequent use of cannabis, and living in a hall with a norm of binge drinking. The contemplation ladder for alcohol was sensitive to other alcohol-related behaviours, and may be useful in surveys of drinking where a brief measure of readiness to change is needed.

Mellor JM; Freeborn BA. Religious participation and risky health behaviors among adolescents. Health Economics 20(10): 1226-1240, 2011. (26 refs.)

Previous studies have shown that adolescent religious participation is negatively associated with risky health behaviors such as cigarette smoking, alcohol consumption, and illicit drug use. One explanation for these findings is that religion directly reduces risky behaviors because churches provide youths with moral guidance or with strong social networks that reinforce social norms. An alternative explanation is that both religious participation and risky health behaviors are driven by some common unobserved individual trait. We use data from the National Longitudinal Study of Adolescent Health and implement an instrumental variables approach to identify the effect of religious participation on smoking, binge drinking, and marijuana use. Following Gruber (2005), we use a county-level measure of religious market density as an instrument. We find that religious market density has a strong positive association with adolescent religious participation, but not with secular measures of social capital. Upon accounting for unobserved heterogeneity, we find that religious participation continues to have a significant negative effect on illicit drug use. On the contrary, the estimated effects of attendance in instrumental variables models of binge drinking and smoking are statistically imprecise.

Meyer-Leu Y; Lemola S; Daeppen JB; Deriaz O; Gerber S. Association of moderate alcohol use and binge drinking during pregnancy with neonatal health. Alcoholism: Clinical and Experimental Research 35(9): 1669-1677, 2011. (52 refs.)

Background: Heavy drinking and smoking during pregnancy are known to have a negative impact on the unborn child. However, the impact of low-to-moderate alcohol consumption and binge drinking has been debated recently. The aim of this study was to examine the relationship of moderate prenatal drinking and binge drinking with birthweight, being small for gestational age (SGA) at birth, preterm birth, and neonatal asphyxia. Methods: Moderate alcohol drinking, binge drinking, and several possible confounders were assessed in 1,258 pregnant women; information on neonatal health was obtained at birth. Results: Results indicate that 30.8% of the women drank at low levels (< 2 glasses/wk), 7.9% drank moderately (2 to 4 glasses/wk), and 0.9% showed higher levels of drinking (>= 5 glasses/wk); 4.7% reported binge drinking (defined as >= 3 glasses/occasion). 6.4% of the children were SGA (< 10th percentile of birthweight adjusted for gestational age), 4.6% were preterm (< 37th week of gestation), and 13.0% showed asphyxia (arterial cord pH < 7.10 and/or arterial cord lactate > 6.35 mmol and/or Apgar score < 7 at 5 minutes). When controlling for maternal age, citizenship, occupational status, parity, smoking, use of prescription/over-the-counter drugs, illicit drug use, and child gender moderate drinking was related to lower birthweight (p < 0.01), and moderate drinking and binge drinking were associated with neonatal asphyxia at trend level (p = 0.06 and p = 0.09). Moderate drinking and binge drinking were not related to length of gestation. Conclusions: In contrast to recent reviews in the field, our results assume that moderate drinking and binge drinking are risk factors for neonatal health.

Muckle G; Laflamme D; Gagnon J; Boucher O; Jacobson JL; Jacobson SW. Alcohol, smoking, and drug use among Inuit women of childbearing age during pregnancy and the risk to children. Alcoholism: Clinical and Experimental Research 35(6): 1081- 1091, 2011. (62 refs.)

Background: Alcohol consumption during pregnancy, a known teratogen often associated with drug use and smoking is a well-known public health concern. Aim: This study provides prevalence data for alcohol, smoking, and illicit drug use before, during, and after pregnancy among Inuit. Factors associated with alcohol use are also identified. Methods: Two hundred and eight Inuit women from Arctic Quebec were interviewed at mid-pregnancy, and at 1 and 11 months postpartum to provide descriptive data on smoking, alcohol, and drug use during pregnancy, and the year before and after pregnancy. Sociodemographic and family characteristics potentially associated with alcohol use were documented. Results: Ninety-two percent of the women reported smoking and 61% reported drinking during pregnancy. Episodes of binging during pregnancy were reported by 62% of the alcohol users, which correspond to 38% of pregnant women. Thirty-six percent of the participants reported using marijuana during pregnancy. Alcohol use and binge drinking during pregnancy were more likely to be reported by women who lived in less crowded houses, had a better knowledge of a second language, drank alcohol more often and in larger amounts prior to pregnancy, and used illicit drugs. Binge drinkers were more likely to be single women and to have had fewer previous pregnancies. Postpartum distress and violence were more likely to be experienced by women who used alcohol during pregnancy. Binge drinking during pregnancy was best predicted by drinking habits before pregnancy, maternal symptoms of depression, the use of illicit drugs during pregnancy, and the number of young children living with the mother. Conclusions: These results confirm that alcohol is a major risk factor to maternal and child health in this population, underscoring the need for culturally relevant and effective prevention programs.

Mumford EA; Kelley-Baker T; Romano E. Sexual assault histories and evening drinking among young american men in a high-risk drinking environment. Journal of Sex Research 48(1): 53-61, 2011. (36 refs.)

This study surveyed young American men traveling to Tijuana, Mexico from San Diego, California for a weekend night out, collecting responses both southbound at the outset of the evening and northbound upon return at the end of the evening. Among 650 males, we examined the relationship between sexual histories and attitudes and alcohol use, both historically and on their night in Tijuana. Respondents with a history of coercing sex drank more in Tijuana and were more likely to binge drink. Although estimating sexual assaults committed by these males on the evening in question was not possible, this research establishes the link between a history of sexual assault and the blood alcohol concentration of young men resulting from an evening in a timeout environment.

Naimi TS; Nelson DE; Brewer RD. The intensity of binge alcohol consumption among US adults. American Journal of Preventive Medicine 38(2): 201-207, 2010. (25 refs.)

Background: Binge drinking (consuming five or more drinks during, a drinking occasion) is responsible for more than half of the 79,000 annual deaths due to excessive drinking in the U.S. Although studies show a strong close-response relationship between the intensity of binge drinking (i.e., the number of drinks consumed per binge episode) and adverse outcomes, there are no population-based Studies assessing this measure. Purpose: This study aims to analyze population-based data from a module of questions on binge drinking among U.S. adults to assess the number of drinks consumed by binge drinkers and the associated independent risk factors for consuming more drinks Methods: Data were analyzed from 14,143 adult binge drinkers who responded to the Behavioral Risk Factor Surveillance System binge drinking module in 2003 and 2004 Total drinks were calculated by summing the total number of beer, wine, and liquor-containing drinks consumed during a respondents' most recent binge drinking episode Results: Binge drinkers consumed an average of 8.0 drinks (median 6) during their most recent binge drinking episode, 70.0% of binge drinkers consumed six or more drinks, and 38.4% consumed eight or more drinks. Men consumed more drinks during their last binge episode than women (M =8.3 vs 7.0, median=7 vs 6), and those aged 18-34 years consumed more drinks than those aged >34 years for both men and women. Independent risk factors for consuming eight or more drinks included being male, being aged <35 years; being other than white race/ethnicity; having less education, not being married, binge drinking three or more times in the past 30 days; and drinking mostly beer Conclusions: Most adult binge drinkers drink in excess of the five-drink threshold defining this risky behavior. The intensity of binge drinking should be monitored regularly by health agencies to improve surveillance and to better assess the impact of interventions designed to reduce binge drinking and its consequences.

Nazareth I; Walker C; Ridolfi A; Aluoja A; Bellon J; Geerlings M et al. Heavy episodic drinking in Europe: A cross section study in primary care in six European countries. Alcohol and Alcoholism 46(5): 600-606, 2011. (41 refs.)

Aims: We examined the prevalence of heavy episodic drinking in general practice attenders who were non-hazardous drinkers, the associated risk factors and the outcome over 6 months. Methods: Consecutive attenders aged 18-75 were recruited from the UK, Spain, Slovenia, Estonia, the Netherlands and Portugal and followed up after 6 months. Data were collected on alcohol use using the Alcohol Use Disorder Identification test (at recruitment and 6 months) and risk factors for heavy episodic alcohol use at recruitment. Results: The prevalence of heavy episodic drinking in non-hazardous drinkers was 4.5% across Europe [lowest in Portugal (1.5%); highest Netherlands (8.4%)]. It was less frequent in Spain, Slovenia, Estonia and Portugal compared with the UK and Netherlands. It was higher in men [odd ratio (OR) 4.4, 95% confidence interval (CI) 3.3, 5.9], people between 18 and 29 years of age, those employed (OR 1.8, 95% CI 1.3, 2.6) and those using recreational drugs (OR 2.1, 95% CI 1.4, 3.3). It was lower in people with existing DSM-IV major depression (OR 0.54, 95% CI 0.31, 0.96). Heavy episodic drinkers were more likely to become hazardous drinkers at 6 months (male: OR 7.2, 95% CI 4.1, 12.7; female: OR 9.4, 95% CI 4.3, 20.6). Conclusion: Women and men in the UK, men in the Netherlands and younger people in all countries are at the greatest risk of exhibiting heavy episodic drinking behaviours even in the absence of hazardous alcohol use. There is hence an urgent need for general practitioners to consider early detection and management of heavy episodic drinking behaviour in this population.

Neumark Y; Bar-Hamburger R. Volatile substance misuse among youth in Israel: Results of a national school survey. Substance Use & Misuse 46(Supplement 1): 21-26, 2011. (33 refs.)

Volatile substance misuse (VSM) among Israeli youth has been identified as widespread and growing. Using data from the 2009 National School Survey of 12-18 year olds (N = 7,166), this study describes VSM prevalence among Jews and Arabs, examining relationships between past-month VSM and sociodemographic, behavioral, psychological, and interpersonal characteristics. Past-month VSM, reported by 7.5%% of respondents, was significantly associated with other risky behaviors including past-month illicit drug use (Adjusted odds ratios (AOR) = 5.41, 95%% CI: 3.5-8.1), Internet gambling (AOR = 2.12, 95%% CI: 1.5-3.1), smoking, binge drinking, and truancy. National drug policy must address VSM and develop strategies to reduce demand and supply. Potential study limitations are noted.

Norman P. The theory of planned behavior and binge drinking among undergraduate students: Assessing the impact of habit strength. Addictive Behaviors 36(5): 502-507, 2011. (55 refs.)

The present study sought to apply the theory of planned behavior (TPB) to the prediction of binge drinking intentions and behavior among undergraduate students and to test whether habit strength explains additional variance in binge drinking behavior. Undergraduate students (N = 137) completed measures of the TPB (i.e., attitude, subjective norm, self-efficacy, perceived control, and intention) and habit strength (Self-Report Habit Index) in relation to binge drinking. Frequency of binge drinking was assessed one month later (n = 109). The TPB explained 75% of the variance in binge drinking intentions, with attitude and self-efficacy making significant contributions, and 35% of the variance in binge drinking behavior at one-month follow-up, with only intention making a significant contribution. Habit strength explained additional variance in binge drinking behavior (Delta R-2 = .06), although intention remained as a significant predictor. The results suggest that binge drinking among undergraduate students is under the control of both intentional and habitual processes. Interventions to reduce binge drinking should therefore focus on the motivational determinants (e.g., perceived positive and negative consequences) of binge drinking as well as the environmental factors (i.e., contextual cues) that promote binge drinking.

Northcote J. Young adults' decision making surrounding heavy drinking: A multi-staged model of planned behaviour. Social Science & Medicine 72(12): 2020-2025, 2011. (30 refs.)

This paper examines the real life contexts in which decisions surrounding heavy drinking are made by young adults (that is, on occasions when five or more alcoholic drinks are consumed within a few hours). It presents a conceptual model that views such decision making as a multi-faceted and multi-staged process. The mixed method study draws on purposive data gathered through direct observation of eight social networks consisting of 81 young adults aged between 18 and 25 years in Perth, Western Australia, including in-depth interviews with 31 participants. Qualitative and some basic quantitative data were gathered using participant observation and in-depth interviews undertaken over an eighteen month period. Participants explained their decision to engage in heavy drinking as based on a variety of factors. These elements relate to socio-cultural norms and expectancies that are best explained by the theory of planned behaviour. A framework is proposed that characterises heavy drinking as taking place in a multi-staged manner, with young adults having: 1. A generalised orientation to the value of heavy drinking shaped by wider influences and norms; 2. A short-term orientation shaped by situational factors that determines drinking intentions for specific events; and 3. An evaluative orientation shaped by moderating factors. The value of qualitative studies of decision making in real life contexts is advanced to complement the mostly quantitative research that dominates research on alcohol decision making.

Novik MG; Howard DE; Boekeloo BO. Drinking motivations and experiences of unwanted sexual advances among undergraduate students. Journal of Interpersonal Violence 26(1): 34-49, 2011. (25 refs.)

This study examined the relationship between drinking motivations and college students' experiences with unwanted sexual advances. Undergraduates, from a public university in the mid-Atlantic region, who reported recent (30 day) alcohol use (n = 289) completed an online survey midway through the spring 2007 academic semester. Experiencing an unwanted sexual advance was the outcome of interest for the present study. The independent variables included sociodemographics and a three-factor (social ease, social image or reputation, emotional distress) drinking motivation measure. Prevalence estimates as well as unadjusted and adjusted odds ratios (OR) were produced. A strong relationship was found between having an unwanted sexual advance and recent binge drinking as well as drinking to remove emotional distress (OR = 3.40 and 2.73, respectively, for the total sample; OR = 7.27 and 2.82 for females). Findings suggest that experiencing an unwanted sexual advance is associated with specific drinking motivations and more likely to occur among females. Further research is needed to fully understand pathways and implications.

Olthuis JV; Zamboanga BL; Ham LS; Van Tyne K. The utility of a gender-specific definition of binge drinking on the AUDIT. Journal of American College Health 59(4): 239-245, 2011. (26 refs.)

Objective: Although binge drinking is commonly defined as the consumption of at least 5 drinks in 1 sitting for men and 4 for women, the Alcohol Use Disorders Identification Test (AUDIT) defines binge drinking as the consumption of 6 or more drinks in 1 sitting for both men and women. This study examined the effect of using gender-specific binge drinking definitions on overall AUDIT scores. Participants: Participants were 331 college men and 1224 college women. Methods: Participants completed a self-report questionnaire, which included the AUDIT. Results: Findings showed that defining binge drinking as 4 or more drinks for women, rather than 6 or more, does impact their AUDIT scores and could affect the percentage of women classified as hazardous users. Among men, AUDIT scores were unaffected by the use of a gender-specific definition of binge drinking. Conclusions: Results suggest that the AUDIT might be underidentifying hazardous users among college women.

Paljarvi T; Suominen S; Car J; Makela P; Koskenvuo M. Subjective measures of binge drinking, suboptimal subjective health and alcohol-specific hospitalizations among working-aged adults: A prospective cohort study. Alcohol and Alcoholism 46(5): 607-613, 2011. (35 refs.)

Aims: The purpose of this prospective study was to determine how subjective measures of binge drinking predict suboptimal subjective health. In order to contribute to the understanding of potential causal mechanisms, we also aimed to determine the factors through which subjective health predicts alcohol-specific hospitalizations. Methods: A total of 16,111 alcohol-drinking men and women, aged 20-54 years, participated in the Health and Social Support baseline postal survey in 1998, and also responded to the repeated measurement 5 years later in 2003 (T2). Suboptimal subjective health was defined as self-reported overall health status being fair, rather poor or poor. Subjective measures of binge drinking were frequency of subjective intoxications/drunkenness, frequency of hangovers and frequency of alcohol-induced pass-outs. Results: Frequency of intoxications, hangovers and alcohol-induced pass-outs, all predicted suboptimal subjective health regardless of several potential confounders, including beverage-specific total intake. Those reporting suboptimal subjective health at baseline had a 5-fold odds ratio (5.08, 95% confidence interval: 3.43, 6.48) for alcohol-related hospitalizations, compared with those rating their health above fair, when gender and age were controlled. Binge drinking, together with concurrent symptoms of depression, explained over 50% of this relationship, and when additionally taking into account smoking, over two-thirds of this relation was explained. Conclusion: Mental health is an important mediating factor between binge drinking, suboptimal subjective health and alcohol-specific hospitalizations, and symptoms of depression should therefore be taken into account in prevention of alcohol-related adverse health outcomes.

Patrick ME; Morgan N; Maggs JL; Lefkowitz ES. "I got your back": Friends' understandings regarding college student spring break behavior. Journal of Youth and Adolescence 40(1): 108-120, 2011. (50 refs.)

Behaviors that pose threats to safety and health, including binge drinking and unprotected sex, increase during a week-long break from university. Understandings with peers regarding these behaviors may be important for predicting behavior and related harms. College students (N = 651; 48% men) reported having understandings with their friends regarding alcohol use (59%) and sexual behavior (45%) during Spring Break. These understandings were to engage in behaviors characterized by risk (e. g., get drunk [23.5%], have sex with someone new [5.2%]) and protection (e. g., drink without getting drunk [17.8%], use condoms [15.8%]). After controlling for previous semester behavior and going on a Spring Break trip, Get Drunk Understandings predicted a greater likelihood of binge drinking and alcohol-related consequences; No/Safe Sex Understandings predicted condom use; and Sex Understandings predicted not using condoms. Understandings with friends regarding Spring Break behavior may be important proximal predictors of risk behaviors and represent potential targets for event-specific prevention.

Patrick ME; Schulenberg JE. How trajectories of reasons for alcohol use relate to trajectories of binge drinking: National panel data spanning late adolescence to early adulthood. Developmental Psychology 47(2): 311-317, 2011. (42 refs.)

Developmental changes in both alcohol use behaviors and self-reported reasons for alcohol use were investigated. Participants were surveyed every 2 years from ages 18 to 30 as part of the Monitoring the Future national study (analytic weighted sample size N = 9,308; 53% women, 40% college attenders). Latent growth models were used to examine correlations between trajectories of binge drinking and trajectories of self-reported reasons for alcohol use across young adulthood. Results revealed developmental changes in masons for use and correlations between the patterns of within-person change in frequency of binge drinking and within-person change in reasons for use. In particular, an increase in binge drinking between ages 18 and 22 was most positively correlated with slopes of using alcohol to get high and because of boredom. Continued binge drinking between ages 22 and 30 was most strongly correlated with using alcohol to get away from problems. Almost no moderation by gender, race, college attendance, employment, or marital status was found. Binge drinking and masons for alcohol use traveled together, illustrating the ongoing and dynamic connections between changes in binge drinking and changes in reasons for use across late adolescence and early adulthood.

Paul LA; Grubaugh AL; Frueh BC; Ellis C; Egede LE. Associations between binge and heavy drinking and health behaviors in a nationally representative sample. Addictive Behaviors 36(12): 1240-1245, 2011. (33 refs.)

Background: Binge and heavy drinking are noted in the literature for their relatively high prevalence and adverse health-related effects. Design and participants: We used data from the 2006 Behavioral Risk Factor Surveillance Survey (BRFSS) to determine the associations between binge and heavy drinking and a wide range of health-related variables, including positive and negative health behaviors, preventive care practices, and quality of life indices in a nationally representative sample of 344,793 adults. Results: Rates of binge and heavy drinking in the current sample were 15% and 5%, respectively. Binge and heavy drinking were more common among men, younger adults, and individuals with higher incomes and at least some college education. After controlling for relevant demographic variables, binge and heavy drinking were associated with a number of adverse health-related and preventive care behaviors (e.g., smoking, failing to receive a mammogram), as well as less life satisfaction and a greater number of poor mental health days than those who did not engage in these drinking behaviors. Interestingly, binge and heavy drinking were also associated with some positive health-related variables (e.g., recent physical activity, positive perceptions of one's own health). Conclusions: The current study findings provide additional information regarding the relations between health-related attitudes and behaviors and binge and heavy drinking in the U.S. population. Implications of study findings are discussed.

Phillips-Howard PA; Bellis MA; Briant LB; Jones H; Downing J; Kelly IE et al. Wellbeing, alcohol use and sexual activity in young teenagers: Findings from a cross-sectional survey in school children in North West England. Substance Abuse Treatment, Prevention and Policy 5: e-article 27, 2010. (29 refs.)

Background: Adolescent health is a growing concern. High rates of binge drinking and teenage pregnancies, documented in the UK, are two measures defining poor wellbeing. Improving wellbeing through schools is a priority but information on the impact of wellbeing on alcohol use, and on sexual activity among schoolchildren is limited. Methods: A cross-sectional survey using self-completed questionnaires was conducted among 3,641 schoolchildren aged 11-14 years due to participate in a sex and relationships education pilot programme in 15 high schools in North West England. Bivariate and multivariate analyses were conducted to examine the relationship between wellbeing and alcohol use, and wellbeing and sexual activity. Results: A third of 11 year olds, rising to two-thirds of 14 year olds, had drunk alcohol. Children with positive school wellbeing had lower odds of ever drinking alcohol, drinking often, engaging in any sexual activity, and of having sex. General wellbeing had a smaller effect. The strength of the association between alcohol use and the prevalence of sexual activity in 13-14 year olds, increased incrementally with the higher frequency of alcohol use. Children drinking once a week or more had 12-fold higher odds of any sexual activity, and 10-fold higher odds of having sex. Rare and occasional drinkers had a significantly higher odds compared with non-drinkers. Conclusions: The relationship between wellbeing and alcohol use, and wellbeing and sexual activity reinforces the importance of initiatives that enhance positive wellbeing in schoolchildren. The association between alcohol use and sexual activity highlights the need for integrated public health programmes. Policies restricting alcohol use may help reduce sexual exposure among young teenagers.

Ramadoss J; Jobe SO; Magness RR. Alcohol and maternal uterine vascular adaptations during pregnancy. Part I: Effects of chronic in vitro binge-like alcohol on uterine endothelial nitric oxide system and function. Alcoholism: Clinical and Experimental Research 35(9): 1686-1693, 2011. (68 refs.)

Background: Pregnancy-induced utero-placental growth, angiogenic remodeling, and enhanced vasodilation are all partly regulated by estradiol-17 beta-mediated activation of endothelial nitric oxide synthase (eNOS) and nitric oxide (NO) production. However, very little is known about the effects of alcohol on these maternal utero-placental vascular adaptations during pregnancy and its potential role in the pathogenesis of fetal alcohol spectrum disorders (FASDs). In this study, we hypothesized that in vitro chronic binge-like alcohol will decrease uterine arterial endothelial eNOS expression and alter its multisite phosphorylation activity state via disruption of AKT signaling. To study the direct effects of alcohol on uterine vascular adaptations, we further investigated the effects of alcohol on estradiol-17 beta-induced uterine angiogenesis in vitro. Methods: Uterine artery endothelial cells were isolated from pregnant ewes (gestational day 120 to 130; term = 147), fluorescence-activated cell sorted, validated, and maintained in culture to passage 4. To mimic maternal binge drinking patterns, cells were cultured in the absence or presence of a lower (LD) or higher dose (HD) of alcohol in a compensating sealed humidified chamber system equilibrated with aqueous alcohol for 3 hours on 3 consecutive days. Immunoblotting was performed to assess expression of NO system-associated proteins and eNOS multisite phosphorylation. Following this treatment paradigm, control and binge alcohol-treated cells were passaged, grown for 2 days, and then treated with increasing concentrations of estradiol-17 beta (0.1, 1, 10, 100 nM) in the absence or presence of LD or HD alcohol to evaluate estradiol-17 beta-induced angiogenesis index using BrdU proliferation assay. Results: LD and HD binge-like alcohol decreased uterine arterial eNOS expression (p = 0.009). eNOS multisite phosphorylation activation state was altered: P-635 eNOS was decreased (p = 0.017), P-1177 eNOS was not altered, and P-495 eNOS exhibited an inverse U-shaped dose-dependent relationship with alcohol. LD and HD alcohol decreased the major eNOS-associated protein cav-1 (p < 0.001). However, the commonly implicated AKT pathway did not correlate with eNOS posttranslational modifications. Assessment of uterine vascular adaptation via angiogenesis demonstrated that alcohol abrogated the dose-dependent proliferative effects of estradiol-17 beta and thus blunted angiogenesis. Conclusions: Thus, the maternal uterine vasculature during pregnancy may be vulnerable to chronic binge-like alcohol. Altered eNOS multisite phosphorylation also suggests that alcohol produces specific effects at the level of posttranslational modifications critical for pregnancy-induced uterine vascular adaptations. Finally, the alcohol and estradiol-17 beta data suggest a negative impact of alcohol on estrogen actions on the uterine vasculature.

Rasul JW; Rommel RG; Jacquez GM; Fitzpatrick BG; Ackleh AS; Simonsen N et al. Heavy episodic drinking on college campuses: Does changing the legal drinking age make a difference? Journal of Studies on Alcohol and Drugs 72(1): 15-23, 2011. (20 refs.)

Objective: This article extends the compartmental model previously developed by Scribner et al. in the context of college drinking to a mathematical model of the consequences of lowering the legal drinking age. Method: Using data available from 32 U.S. campuses, the analyses separate underage and legal age drinking groups into an eight-compartment model with different alcohol availability (wetness) for the underage and legal age groups. The model evaluates the likelihood that underage students will incorrectly perceive normative drinking levels to be higher than they actually are (i.e., misperception) and adjust their drinking accordingly by varying the interaction between underage students in social and heavy episodic drinking compartments. Results: The results evaluate the total heavy episodic drinker population and its dependence on the difference in misperception, as well as its dependence on underage wetness, legal age wetness, and drinking age. Conclusions: Results suggest that an unrealistically extreme combination of high wetness and low enforcement would be needed for the policies related to lowering the drinking age to be effective.

Rolland B; Karila L; Guardia D; Cottencin O. Pharmacological approaches of binge drinking. (review). Current Pharmaceutical Design 17(14): 1333-1342, 2011. (123 refs.)

Binge Drinking (BD) is often considered to be recurrent alcohol abuse amongst adolescents and young adults. However, the close link between adolescence and impulsivity has led many authors to define BD as intoxication-seeking behaviour. Medications may sometimes be justified because of the major short-term and long-term risks that underlie the most severe BD-related behaviours. The most common consequences in the long run are the occurrence of alcohol dependence, psycho-and neurodevelopmental disruptions and alcohol liver disease. To understand the specificities of BD among other forms of alcohol addiction, this article is based on a two-headed conception of alcohol dependence: on one hand, psychological dependence, which refers to the behavioural habituation of alcohol intake, clinically results in craving and is neurobiologically supported by the reward system, particularly the dopaminergic mesolimbic pathway (MLP); on the other hand, physical dependence, which refers to the pharmacological tolerance induced by chronic alcohol intake, results in Alcohol Withdrawal Syndrome (AWS) and is neurobiologically supported by the imbalance between GABA and Glutamate-NMDA neurotransmission. Medications for psychological dependence include anticraving drugs, which all act by regulating MLP. Medications for physical dependence on alcohol include GABA-A and perhaps GABA-B agonists and some NMDA antagonists. In practice, many alcohol-dependence treatments seem to have a dual action. This article proposes an attempt to classify current and forthcoming medications for alcohol addiction based on this two-headed approach to treating alcohol dependence. Drawing from this classification, specific therapeutic schemes for treating BD are proposed, with currently approved alcohol medications and possible future treatments. These schemes are justified by recent literature on the subject and propose to prioritize pure anticraving medications, taking into account the clinical specificities of BD. Furthermore, these schemes also mention harm-reductive neuroprotective and hepatoprotective strategies, which could be included in the arsenal of possible medications for BD in the near future.

Rooke SE; Hine DW. A dual process account of adolescent and adult binge drinking. Addictive Behaviors 36(4): 341-346, 2011. (50 refs.)

This study adopted a dual process perspective to investigate the relative contributions of implicit and explicit cognitions to predicting binge drinking in adolescents and adults. Two hundred and seventy-two participants (136 teen-parent pairs) completed measures of alcohol memory associations (reflecting implicit cognition), expectancies about potential costs and benefits of alcohol use (reflecting explicit cognition), and self-reported binge drinking. Adolescents had stronger alcohol memory associations and perceived drinking benefits to be more probable than did adults. In turn, higher scores on the memory association and expected benefit measures were both associated with significantly higher levels of binge drinking. Moderation analyses revealed that alcohol memory associations and expected benefits of drinking were stronger predictors of binge drinking for adolescents than for adults. The findings suggest that both implicit and explicit cognitions may play important roles in alcohol use decisions, and these roles may differ for adolescents and adults.

Ruidavets JB; Ducimetiere P; Evans A; Montaye M; Haas B; Bingham A et al. Patterns of alcohol consumption and ischaemic heart disease in culturally divergent countries: the Prospective Epidemiological Study of Myocardial Infarction (PRIME). British Medical Journal 341: e-article 6077, 2010. (47 refs.)

Objective: To investigate the effect of alcohol intake patterns on ischaemic heart disease in two countries with contrasting lifestyles, Northern Ireland and France. Design Cohort data from the Prospective Epidemiological Study of Myocardial Infarction (PRIME) were analysed. Weekly alcohol consumption, incidence of binge drinking (alcohol >50 g on at least one day a week), incidence of regular drinking (at least one day a week, and alcohol <50 g if on only one occasion), volume of alcohol intake, frequency of consumption, and types of beverage consumed were assessed once at inclusion. All coronary events that occurred during the 10 year follow-up were prospectively registered. The relation between baseline characteristics and incidence of hard coronary events and angina events was assessed by Cox's proportional hazards regression analysis. Setting One centre in Northern Ireland (Belfast) and three centres in France (Lille, Strasbourg, and Toulouse). Participants 9778 men aged 50-59 free of ischaemic heart disease at baseline, who were recruited between 1991 and 1994. Main outcome measures Incident myocardial infarction and coronary death ("hard" coronary events), and incident angina pectoris. Results: A total of 2405 men from Belfast and 7373 men from the French centres were included in the analyses, 1456 (60.5%) and 6679 (90.6%) of whom reported drinking alcohol at least once a week, respectively. Among drinkers, 12% (173/1456) of men in Belfast drank alcohol every day compared with 75% (5008/6679) of men in France. Mean alcohol consumption was 22.1 g/day in Belfast and 32.8 g/day in France. Binge drinkers comprised 9.4% (227/2405) and 0.5% (33/7373) of the Belfast and France samples, respectively. A total of 683 (7.0%) of the 9778 participants experienced ischaemic heart disease events during the 10 year follow-up: 322 (3.3%) hard coronary events and 361 (3.7%) angina events. Annual incidence of hard coronary events per 1000 person years was 5.63 (95% confidence interval 4.69 to 6.69) in Belfast and 2.78 (95% CI 2.41 to 3.20) in France. After multivariate adjustment for classic cardiovascular risk factors and centre, the hazard ratio for hard coronary events compared with regular drinkers was 1.97 (95% CI 1.21 to 3.22) for binge drinkers, 2.03 (95% CI 1.41 to 2.94) for never drinkers, and 1.57 (95% CI 1.11 to 2.21) for former drinkers for the entire cohort. The hazard ratio for hard coronary events in Belfast compared with in France was 1.76 (95% CI 1.37 to 2.67) before adjustment, and 1.09 (95% CI 0.79 to 1.50) after adjustment for alcohol patterns and wine drinking. Only wine drinking was associated with a lower risk of hard coronary events, irrespective of the country. Conclusions: Regular and moderate alcohol intake throughout the week, the typical pattern in middle aged men in France, is associated with a low risk of ischaemic heart disease, whereas the binge drinking pattern more prevalent in Belfast confers a higher risk.

Ruthig JC; Marrone S; Hladkyj S; Robinson-Epp N. Changes in college student health: Implications for academic performance. Journal of College Student Development 52(3): 307- 320, 2011. (52 refs.)

This study investigated the longitudinal associations of health perceptions and behaviors with subsequent academic performance among college students. Multiple health perceptions and behaviors were assessed for 203 college students both at the beginning and end of an academic year. Students' academic performance was also measured at the end of the year. Separate regression analyses were conducted for men and women to examine changes in health perceptions and behaviors as predictors of year-end performance. Significant gender differences were found for initial health symptoms, perceived stress, exercise, and nutrition. After controlling for prior achievement, increased binge drinking negatively predicted female students' academic performance and feelings of success; increased tobacco use negatively predicted male students' performance. Male and female college students appear to differ in the ways that their health changes over an academic year as well as how such changes impact their later academic performance. Implications for devising health promotion programs that specifically target male and female college students' health risks are discussed.

Spijkerman R; Roek MAE; Vermulst A; Lemmers L; Huiberts A; Engels RCME. Effectiveness of a web-based brief alcohol intervention and added value of normative feedback in reducing underage drinking: A randomized controlled trial. Journal of Medical Internet Research 12(5): e-article 65, 2010. (55 refs.)

Background: Current insights indicate that Web-based delivery may enhance the implementation of brief alcohol interventions. Previous research showed that electronically delivered brief alcohol interventions decreased alcohol use in college students and adult problem drinkers. To date, no study has investigated the effectiveness of Web-based brief alcohol interventions in reducing alcohol use in younger populations. Objective: The present study tested 2 main hypotheses, that is, whether an online multicomponent brief alcohol intervention was effective in reducing alcohol use among 15- to 20-year-old binge drinkers and whether inclusion of normative feedback would increase the effectiveness of this intervention. In additional analyses, we examined possible moderation effects of participant's sex, which we had not a priori hypothesized. Method: A total of 575 online panel members (aged 15 to 20 years) who were screened as binge drinkers were randomly assigned to (1) a Web-based brief alcohol intervention without normative feedback, (2) a Web-based brief alcohol intervention with normative feedback, or (3) a control group (no intervention). Alcohol use and moderate drinking were assessed at baseline, 1 month, and 3 months after the intervention. Separate analyses were conducted for participants in the original sample (n = 575) and those who completed both posttests (n = 278). Missing values in the original sample were imputed by using the multiple imputation procedure of PASW Statistics 18. Results: Main effects of the intervention were found only in the multiple imputed dataset for the original sample suggesting that the intervention without normative feedback reduced weekly drinking in the total group both 1 and 3 months after the intervention (n = 575, at the 1-month follow-up, beta = -.24, P = .05; at the 3-month follow-up, beta = -.25, P = .04). Furthermore, the intervention with normative feedback reduced weekly drinking only at 1 month after the intervention (n=575, beta = -.24, P = .008). There was also a marginally significant trend of the intervention without normative feedback on responsible drinking at the 3-month follow-up (n = 575, beta = .40, P = .07) implying a small increase in moderate drinking at the 3-month follow-up. Additional analyses on both datasets testing our post hoc hypothesis about a possible differential intervention effect for males and females revealed that this was the case for the impact of the intervention without normative feedback on weekly drinking and moderate drinking at the 1-month follow-up (weekly drinking for n = 278, beta = -.80, P = .01, and for n = 575, beta = -.69, P = .009; moderate drinking for n = 278, odds ratio [OR] = 3.76, confidence interval [CI] 1.05 - 13.49, P = .04, and for n = 575, OR = 3.00, CI = 0.89 - 10.12, P = .08) and at the 3-month follow-up (weekly drinking for n = 278, beta = -. 58, P = .05, and for n = 575, beta = -. 75, P = .004; moderate drinking for n = 278, OR = 4.34, CI = 1.18 - 15.95, P = .04, and for n = 575, OR = 3.65, CI = 1.44 - 9.25, P = .006). Furthermore, both datasets showed an interaction effect between the intervention with normative feedback and participant's sex on weekly alcohol use at the 1-month follow-up (for n = 278, beta = -. 74, P = .02, and for n = 575, beta = -. 64, P =. 01) and for moderate drinking at the 3-month follow-up (for n = 278, OR = 3.10, CI = 0.81 - 11.85, P = .07, and for n = 575, OR = 3.00, CI = 1.23 - 7.27, P = .01). Post hoc probing indicated that males who received the intervention showed less weekly drinking and were more likely to drink moderately at 1 month and at 3 months following the intervention. For females, the interventions yielded no effects: the intervention without normative feedback even showed a small unfavorable effect at the 1-month follow-up. Conclusion: The present study demonstrated that exposure to a Web-based brief alcohol intervention generated a decrease in weekly drinking among 15- to 20-year-old binge drinkers but did not encourage moderate drinking in the total sample. Additional analyses revealed that intervention effects were most prominent in males resulting in less weekly alcohol use and higher levels of moderate drinking among 15- to 20-year-old males over a period of 1 to 3 months.

Squeglia LM; Schweinsburg AD; Pulido C; Tapert SF. Adolescent binge drinking linked to abnormal spatial working memory brain activation: Differential gender effects. Alcoholism: Clinical and Experimental Research 35(10): 1831-1841, 2011. (72 refs.)

Background: Binge drinking is prevalent during adolescence, and its effect on neurocognitive development is of concern. In adult and adolescent populations, heavy substance use has been associated with decrements in cognitive functioning, particularly on tasks of spatial working memory (SWM). Characterizing the gender-specific influences of heavy episodic drinking on SWM may help elucidate the early functional consequences of drinking on adolescent brain functioning. Methods: Forty binge drinkers (13 females, 27 males) and 55 controls (24 females, 31 males), aged 16 to 19 years, completed neuropsychological testing, substance use interviews, and an SWM task during functional magnetic resonance imaging. Results: Significant binge drinking status x gender interactions were found (p < 0.05) in 8 brain regions spanning bilateral frontal, anterior cingulate, temporal, and cerebellar cortices. In all regions, female binge drinkers showed less SWM activation than female controls, while male bingers exhibited greater SWM response than male controls. For female binge drinkers, less activation was associated with poorer sustained attention and working memory performances (p < 0.025). For male binge drinkers, greater activation was linked to better spatial performance (p < 0.025). Conclusion: Binge drinking during adolescence is associated with gender-specific differences in frontal, temporal, and cerebellar brain activation during an SWM task, which in turn relate to cognitive performance. Activation correlates with neuropsychological performance, strengthening the argument that blood oxygen level-dependent activation is affected by alcohol use and is an important indicator of behavioral functioning. Females may be more vulnerable to the neurotoxic effects of heavy alcohol use during adolescence, while males may be more resilient to the deleterious effects of binge drinking. Future longitudinal research will examine the significance of SWM brain activation as an early neurocognitive marker of alcohol impact to the brain on future behaviors, such as driving safety, academic performance, and neuropsychological performance.

Srivastava P. Does bingeing affect earnings? Economic Record 86(275): 578-595, 2010. (47 refs.)

Both anecdotal and empirical lines of evidence have pointed out that frequent binge drinking has far more serious consequences than occasional bingeing. As a result, a lower penalty for heavy drinking will be estimated by combining the heavy bingers with individuals who binge on rare occasions and are not necessarily less productive. This article explores the drinking-earnings relationship based on a finer distinction between frequent and occasional bingeing, and an extension to female subjects. It finds that frequent bingers experience reduced earnings whereas non-bingers and occasional bingers earn a positive premium over abstainers.

Stevens-Watkins D; Rostosky S. Binge drinking in African American males from adolescence to young adulthood: The protective influence of religiosity, family connectedness, and close friends' substance use. Substance Use & Misuse 45(10): 1435-1451, 2010. (72 refs.)

We examined the contribution of culturally relevant protective factors (i.e., adolescent religiosity, family connectedness, and perceived close friends' substance use) to the probability of young adult binge drinking among African American males. Participants (n = 1,599) drawn from the National Longitudinal Study of Adolescent Health were high school age adolescents (14-18 years, M=16) at Wave 1 and young adults (18-26, M = 22) at Wave 3. Adolescent binge drinking was associated with all three protective factors. Perceived close friends' substance use in adolescence was a protective factor in later binge drinking during young adulthood, and was moderated by age such that the effect was stronger for younger adolescents. Implications for culturally relevant research and prevention are discussed.

Stevens-Watkins D; Rostosky SStevens-Watkins D; Rostosky SZhao GZ; Wu CX; Houston RJ; Creager W. The effects of binge drinking and socio-economic status on sober driving behavior. Traffic Injury Prevention 11(4): 342-352, 2010. (65 refs.)

Objective: Drinking and driving is a primary cause of traffic fatalities and it has been suggested that binge drinkers comprise a major portion of those drivers involved in drinking and driving accidents. Although several experimental studies have investigated the driving behavior of binge drinkers (particularly college students and/or young adults) under the influence of alcohol, few studies have focused on a comparison of sober driving behavior of the general population between binge and non-binge drinkers with a consideration of drivers' income levels. In addition, these studies have not taken other potentially influential factors into account such as socio economic status. Methods: A driving simulator study was conducted with a 2 x 2 factorial design (binge vs. non-binge drinker; low vs. high income). Sixty-two participants who were not under the influence of alcohol or drugs were asked to operate a driving simulator following traffic rules. Multiple aspects of participants' driving behaviors were measured in a sober driving situation. To control the potential effects of confounding factors, factors (e.g., age, gender, etc.) that were significantly correlated to the driving behavior were all entered into the multivariate analysis of variance (MANOVA) as covariates. Results: Significant interaction effects were found between effects of binge drinking and income levels. Analyses indicated that binge drinkersindependent of their income levelsexhibited more speeding exceedances and longer speeding duration than those of non-binge drinkers with a high income. Individuals characterized as non-binge drinkers with a low income also exhibited more speeding behaviors. Conclusion: Cognitive deficits and problems in vehicle control resulting from chronic alcohol consumption may impact binge drinkers' abilities to perform adequately, even in a sober driving situation. In addition, non-binge drinkers with a low income were more prone to make unsafe choices compared to non-binge drinkers with a high income. Further implications of the results in transportation safety and alcohol addiction were also discussed.

Stickley A; Pridemore WA. The effects of binge drinking and social capital on violent victimisation: Findings from Moscow. Journal of Epidemiology and Community Health 64(10): 902-907, 2010. (49 refs.)

Background: Rates of violence in Russia are among the highest in the world, and violent victimisation represents a major public health threat in the country. As yet, however, little research has been undertaken on what factors are associated with non-lethal violent victimisation in this setting. This study used data from the Moscow Health Survey 2004 to examine the effects of binge drinking and social capital on individuals' risk of non-fatal violent victimisation. Methods: A stratified random sampling strategy was used across Moscow's 125 municipal districts to collect data from 1190 individuals aged 18+ years. Respondents reported if they had been a victim of physical violence in the previous 12 months. Data were also collected on binge drinking (defined for men as consuming >= 80 g of pure alcohol, and for women >= 60 g of pure alcohol, at least once per month) and social capital (frequency of interaction with relatives, friends and acquaintances). Results: Overall, 8.7% of the respondents had been a victim of violence in the past 12 months. Men who binge drink were more than twice as likely to have been a victim of non-lethal violence (OR 2.19, CI 1.23 to 3.92), while greater levels of social capital acted as a protective factor against male victimisation (OR 0.82, CI 0.69 to 0.97). Neither binge drinking nor social capital was associated with violent victimisation among women. Conclusion: Urgent public health measures are now needed to reduce excessive alcohol consumption and detrimental drinking patterns to bring down the high levels of violent victimisation in Russia.

Svensson M; Hagquist C. Adolescents alcohol-use and economic conditions: A multilevel analysis of data from a period with big economic changes. European Journal of Health Economics 11(6): 533-541, 2010. (27 refs.)

This paper examines how the unemployment rate is related to adolescent alcohol use and experience of binge drinking during a time period characterized by big societal changes. The paper uses repeated cross-sectional adolescent survey data from a Swedish region, collected in 1988, 1991, 1995, 1998, 2002 and 2005, and merges this with data on local unemployment rates for the same time periods. Individual level frequency of alcohol use as well as experience of binge drinking is connected to local level unemployment rate to estimate the relationship using multilevel modeling. The model includes municipality effects controlling for time-invariant differences between municipalities as well as year fixed effects controlling for municipality-invariant changes over time in alcohol use. The results show that the unemployment rate is negatively associated with adolescents' alcohol use and the experience of binge drinking. When the unemployment rate increases, more adolescents do not drink at all. Regular drinking (twice per month or more) is, on the other hand, unrelated to the unemployment rate. Examining gender-differences in the relationship, it is shown that the results are driven by behavior in girls, whereas drinking among boys does not show any significant relationship with changes in the unemployment rate.

Temple JR; Freeman DH. Dating violence and substance use among ethnically diverse adolescents. Journal of Interpersonal Violence 26(4): 701-718, 2011. (61 refs.)

Teen dating violence is a serious public health concern with numerous and long-lasting consequences. Although alcohol and drug use have been associated with dating violence, little is known about the role of specific substances, especially the use of club drugs and the nonmedical use of prescription drugs. Thus, the authors examined the association between dating violence victimization and the use of a variety of licit and illicit substances among 1,565 ethnically diverse and economically disadvantaged high school students in southeast Texas. Past year dating violence victimization was reported by 14.1% of boys and 11.3% of girls. Compared to their nonabused counterparts, youth who experienced dating violence were more likely to smoke cigarettes, drink alcohol, binge drink alcohol, sniff glue to get high, use marijuana, use ecstasy, use Vicodin, and use Xanax. However, with the exception of alcohol and cigarettes, all substances were reduced to nonsignificance in multivariate analyses. No differences were found in the rate of dating violence between African American, White, and Hispanic adolescents.

Todd J; Mullan B. Using the theory of planned behaviour and prototype willingness model to target binge drinking in female undergraduate university students. Addictive Behaviors 36(10): 980-986, 2011. (52 refs.)

The current study investigated whether binge drinking in female undergraduates could be reduced by the mere measurement effect (MME), and by altering binge drinker prototypes from the prototype willingness model (PWM). Whether willingness added to the theory of planned behaviour (TPB) was also explored. Female undergraduates aged 17-25 (N = 122) were randomly allocated to a prototype manipulation, mere measurement, or control group, and completed two online questionnaires separated by 14-21 days. Controlling for past behaviour, MME group consumed less alcohol than the control group, and this effect was more extreme for those who previously consumed more alcohol. However, the prototype manipulation had no effect. The TPB variables were predictive of intentions and behaviour, but willingness was not. Despite limitations, the MME could be utilised to reduce binge drinking in female undergraduates. The TPB appears to model binge drinking in female undergraduates better than the PWM, implying that binge drinking can be a reasoned behaviour.

Walton MA; Resko S; Whiteside L; Chermack ST; Zimmerman M; Cunningham RM. Sexual risk behaviors among teens at an urban emergency department: Relationship with violent behaviors and substance use. Journal of Adolescent Health 48(3): 303-305, 2011. (10 refs.)

Purpose: Data regarding sexual risk behaviors among adolescent patients presenting to urban emergency departments (EDs) are lacking. This article describes rates and correlates of sexual risk behaviors among adolescents screened in an urban ED. Methods: During a period of 1-year, a total of 1,576 patients aged 14-18 years, self-administered a computerized survey (57.6% female, 59.3% African American). Results: Among sexually active adolescents (60%), 12% reported four or more partners; of those, 45.3% reported using a condom all the time and 14.7% reported using substances before sex. Regression analyses examined correlates of sexual risk behaviors on the basis of demographics, violence, and substance use. Males and younger teens were more likely to report condom use than females and older teens. Participants with poor grades were more likely to have had sex and used substances before sex, and were less likely to report condom use. Participants reporting dating violence were more likely to have had sex and less likely to have used condoms, whereas participants reporting peer violence and weapon carriage were more likely to report substance use before sex. Binge drinking and marijuana use were associated with all sex risk behaviors. Conclusions: The visit to an urban ED may provide an opportunity to deliver interventions to address sexual risk behaviors among adolescents.

Wells BE; Kelly BC; Golub SA; Grov C; Parsons JT. Patterns of alcohol consumption and sexual behavior among young adults in nightclubs. American Journal of Drug and Alcohol Abuse 36(1): 39-45, 2010. (29 refs.)

Background: Alcohol consumption has been linked to a variety of sexual risk behaviors. However, much research addresses this connection among college students, ignoring other social contexts in which this association may be prevalent, such as club settings. Objectives: As such, this study assessed patterns of drinking and sexual activity among young adults who frequent nightclubs. Methods: Using time-space sampling, we surveyed 308 young adults (ages 18-29) in New York City clubs. Results: Participants reported binge drinking on 52% of drinking days. Roughly, 62% reported recent sex under the influence, and 29% of them reported being less safe in sexual situations as a result of their drinking. Men reported more days of drinking and binge drinking than women, and were more likely to report recent sex under the influence. Younger participants were more likely to report being less safe sexually while intoxicated. Recent binge drinking was associated with sex after drinking. Conclusions and Scientific Significance: These data suggest the need for targeted intervention and prevention efforts at nightclubs.

Wu J; Witkiewitz K; McMahon RJ; Dodge KA. A parallel process growth mixture model of conduct problems and substance use with risky sexual behavior. Drug and Alcohol Dependence 111(3): 207-214, 2010. (53 refs.)

Conduct problems substance use and risky sexual behavior have been shown to coexist among adolescents which may lead to significant health problems The current study was designed to examine relations among these problem behaviors in a community sample of children at high risk for conduct disorder. A latent growth model of childhood conduct problems showed a decreasing trend from grades K to 5. During adolescence four concurrent conduct problem and substance use trajectory classes were identified (high conduct problems and high substance use increasing conduct problems and increasing substance use minimal conduct problems and increasing substance use and minimal conduct problems and minimal substance use) using a parallel process growth mixture model. Across all substances (tobacco binge drinking and marijuana use) higher levels of childhood conduct problems during kindergarten predicted a greater probability of classification into more problematic adolescent trajectory classes relative to less problematic classes. For tobacco and binge drinking models Increases in childhood conduct problems over time also predicted a greater probability of classification into more problematic classes. For all models individuals classified into more problematic classes showed higher proportions of early sexual intercourse infrequent condom use receiving money for sexual services and ever contracting an STD. Specifically tobacco use and binge drinking during early adolescence predicted higher levels of sexual risk taking into late adolescence. Results highlight the importance of studying the conjoint relations among conduct problems substance use and risky sexual behavior in a unified model.

Yang ARST; Liu Juan; Yi Heon S; Warnock KT; Wang M; June HL Jr et al. Binge drinking: In search of its molecular target via the GABA(A) receptor. Frontiers In Neuroscience 5: e-123, 2011

Binge drinking, frequently referred to clinically as problem or hazardous drinking, is a pattern of excessive alcohol intake characterized by blood alcohol levels >0.08g% within a 2-h period. Here, we show that overexpression of alpha1 subunits of the GABA(A) receptor contributes to binge drinking, and further document that this involvement is related to the neuroanatomical localization of alpha1 receptor subunits. Using a herpes simplex virus amplicon vector to deliver small interference RNA (siRNA), we showed that siRNA specific for the alpha1 subunit (pHSVsiLA1) caused profound, long-term, and selective reduction of gene expression, receptor density, and binge drinking in high-alcohol drinking rats when delivered into the ventral pallidum (VP). Scrambled siRNA (pHSVsiNC) delivered similarly into the VP failed to alter gene expression, receptor density, or binge drinking. Silencing of the alpha1 gene in the VP, however, failed to alter binge sucrose or water intake. These results, along with our prior research, provide compelling evidence that the alpha1-containing GABA(A) receptor subunits are critical in the regulation of binge-like patterns of excessive drinking. Collectively, these data may be useful in the development of gene-based and novel pharmacological approaches for the treatment of excessive drinking.