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...on Substance Use and the College Campus

www.ProjectCork.org

Fall 2002

Alcohol-related sexual assault: A common problem among college students.

Abbey A. Journal of Studies on Alcohol (Supplement): 118-128, 2002. (63 refs.)
Objective: This article summarizes research on the role of alcohol in college students' sexual assault experiences, Sexual assault is extremely common among college students. At least half of these sexual assaults involve alcohol consumption by the perpetrator, the victim or both. Method: Two research literatures were reviewed: the sexual assault literature and the literature that examines alcohol's effects on aggressive and sexual behavior. Results: Research suggests that alcohol consumption by the perpetrator and/or the victim increases the likelihood of acquaintance sexual assault occurring through multiple pathways, Alcohol's psychological, cognitive and motor effects contribute to sexual assault. Conclusions: Although existing research addresses some important questions, there are many gaps. Methodological limitations of past research are noted, and suggestions are made for future research. In addition, recommendations are made for college prevention programs and policy initiatives.

College student heavy drinking in social contexts versus alone.

Christiansen M; Vik PW; Jarchow A. Addictive Behaviors 27(3): 393-404, 2002. (33 refs.)
Heavy drinking is common among college students and typically occurs in social contexts. Heavy drinking when alone, however, is less common. The present study hypothesized that students who drink heavily when alone (HD-Alone) would differ from college students who only drink heavily in social contexts (Social HD). Forty-nine HD- Alone students (at least one heavy-drinking episode when alone), 213 Social HDs, and 63 non-heavy drinkers (Non-HDs) were compared on alcohol-related consequences, drinking milestones, alcohol-outcome expectancies, and symptoms of depression. HD-Alone students reported more negative drinking consequences, earlier onset of regular drinking, more alcohol expectancies, less self-efficacy and motivation to reduce drinking, and higher depression scores than Social HDs and Non-HDs. Findings imply individual differences among heavy-drinking college students according to their drinking context.

Identification, prevention and treatment: A review of individual-focused strategies to reduce problematic alcohol consumption by college students.

Larimer ME; Cronce JM. Journal of Studies on Alcohol (Supplement): 148-163, 2002. (96 refs.)
Objective: The purpose of this article is to review and assess the existing body of literature on individually focused prevention and treatment approaches for college student drinking. Method: Studies that evaluate the overall efficacy of an approach by measuring behavioral outcome, such as reductions in alcohol use and associated negative consequences were included. All studies discussed utilized at least one outcome measure focused on behavioral change and included a control or comparison condition: however, not all trials were randomized. Results: Consistent with the results of previous reviews, little evidence exists for the utility of educational or awareness programs. Cognitive behavioral skills-based interventions and brief motivational feedback (including mailed graphic feedback) have consistently yielded greater Support for their efficacy than have informational intervention. Conclusions: There is mixed support for values clarification and normative reeducation approaches. Much of the research suffers from serious methodological limitations. The evidence from this review suggests that campuses would best serve the student population by implementing brief motivational or skills- based interventions, targeting high-risk students identified either through brief screening in health care centers or other campus settings or through membership in an identified risk group (e.g.. freshmen, Greek Organization members, athletes. Mandated students). More research is needed to determine effective strategies for identifying, recruiting and retaining students in efficacious individually focused prevention services, and research on mandated student prevention services is an urgent priority. Integration between campus policies and individually oriented prevention approaches is recommended.

Magnitude of alcohol-related mortality and morbidity among US college students ages 18-24.

Hingson RW; Heeren T; Zakocs RC; Kopstein A; Wechsler H. Journal of Studies on Alcohol 63(2): 136-144, 2002. (32 refs.)
Objective This report estimates the numbers of 18-24 year old United State, college students who annually experience alcohol-related deaths, injuries and other health problems. Method: we examined traffic and unintentional injury deaths in 1998 reported by the National Highway Traffic Safety Administration and the Centers for Disease Control (CDU) We also examined results of national coroner studies, Department of Education college enrollment data, the National Household Survey on Drug Abuse (NHSDA), the CDC National College Health Risk Behavior Survey and the Harvard School of Public Health College Alcohol Survey; (CAS), All surrey participants were ages 18-24: 8,30 college and 12,394 noncollege respondents in the NHSDA Survey: 3,077 college students in the CDC survey and 12,217 full-time 4-year college students in the CAS. Based on the number and proportion of 18-24 year enrolled in college, data on alcohol involvement in injury deaths among 18-24 year olds and survey responses, we calculated the number of 18-24 year old alcohol- related injury deaths and other health problems Results: we estimate that over 1.400 students aged 18-24 and enrolled in 2- and 4-year colleges died in 1998 from alcohol-related unintentional injuries, including motor vehicle crashes. According, to surveys conducted in 1999, in the preceding year, about 2 million of the 8 million college students in the United States drove under the influence of alcohol and 3 million rode with a drinking driver. Over 500,000 full-time 4-year college students were unintentionally injured under the influence of alcohol and over 600,000 were hit or assaulted by another student who had been drinking, Conclusions : There is an urgent need for expanding prevention and treatment programs to reduce alcohol-related harm among U,S. college students and other young adults.

Results of a heart disease risk-factor screening among traditional college students.

Spencer L. Journal of American College Health 50(6): 291-296, 2002. (42 refs.)
The author collected data on serum cholesterol, blood pressure, and self-reported health behavior in 226 college students aged 18 to 26 years. Twenty-nine percent had undesirable total cholesterol levels, 10% had high cholesterol, 10% had high systolic blood pressure, and 11 % had high diastolic blood pressure. Half or more of the participants consumed a diet high in saturated fats, engaged in binge. drinking, had a parental risk for high cholesterol or blood pressure, or reported they experienced elevated stress levels. Men had higher risk-factor levels than women. Findings from a regression analysis revealed that smoking, binge drinking, lack of cardiovascular exercise, and eating a high saturated-fat diet were predictive of undesirable cholesterol levels. Study limitations included self-selection of participants and single measurements of blood pressure and cholesterol. Trained students served as screeners in the program for providing an effective, low-cost screening intervention.

Social norms and the prevention of alcohol misuse in collegiate contexts.

Perkins HW. Journal of Studies on Alcohol (Supplement): 164-172, 2002. (75 refs.)
Objective. This article provides a review of conceptual and empirical studies on the role of social norms in college student alcohol use and in prevention strategies to counter misuse. The normative influences of various constituencies serving as reference groups for students are examined as possible factors influencing students' drinking behavior. Method. A review of English language studies was conducted. Results. Parental norms hake only modest impact on students once they enter college beyond the residual effects of previously instilled drinking attitudes and religious traditions. Faculty could theoretically provide a positive influence on student drinking behavior. but there is little evidence in the literature that faculty norms, and expectations about avoiding alcohol misuse are effectively communicated to students. Although the norms of resident advisers (RAs) should ideally prod restraint on student alcohol misuse, the positive influence of RAs is limited by their negotiated compromises with student, whom them oversee and by their misperceptions of student norms. Research reveals student peer norms to be the strongest influence on students' personal drinking behavior, with the more socially integrated students typically drinking most heavily. The widespread prevalence among students of dramatic misperceptions of peer norms regarding drinking attitudes and behaviors is also a consistent finding. Permissiveness and problem behaviors among peers are overestimated, even in environments where problem drinking rates are relatively high in actually. These misperceived norms, in turn, have a significant negative effect promoting and exacerbating problem drinking. Conclusions: Interventions to reduce these misperceptions have revealed a substantial positive effect in several pilot studies and campus experiments.

Student factors: Understanding individual variation in college drinking. (review).

Baer JS. Journal of Studies on Alcohol (Supplement): 40-53, 2002. (105 refs.)
Objective: Research on individual differences in drinking rates and associated problems among college students is reviewed. Method: Studies are included if completed within U.S, college and university samples and found in published scientific literature as identified by several searches of national databases. Results. The resulting review suggests first that the extant literature is large and varied in quality, as most studies use questionnaire responses from samples of convenience in cross-sectional designs. Evidence from studies of college samples does consistently suggest that alcohol is consumed for several different purposes for different psychological effects in different contexts. A pattern of impulsivity sensation seeking is strongly related to increased drinking among students. This pattern is supported by research into personality, drinking motives, alcohol expectancies anti drinking contexts. A second pattern of drinking associated with negative emotional states is also documented. Some long-term consequences of this second pattern have been described. Social processes appear especially important for drinking in many college venues and may contribute to individual differences in drinking more than enduring personality differences, Conclusions. Future research efforts should test interactive and mediating models of multiple risk factors and address developmental processes.

Modeling effects in student drinking and smoking: Revisited after 24 years.

Standing LG. Social Behavior and Personality 30(5): 435-442, 2002. (11 refs.)
A systematic replication is reported of a campus survey carried out in 1978. The present data (N = 100) indicate increased peer modeling effects for drinking, in which a respondent's intake of alcohol and drunkenness are both best predicted from the drinking of his/her friends. Smoking, however, today shows no correlation with the smoking of either friends or parents, unlike the previous survey. Alcohol consumption, measured as drinks per week, has remained constant over 24 years for female students, but has doubled for males, reaching four times the female level. The frequency of drinking "to excess" also increased greatly over this interval. Smoking has decreased to minimal levels, and now shows no sign of modeling effects, but self-serving bias now occurs, since respondents today report themselves as smoking fewer cigarettes than their friends.

The adolescent brain and the college drinker: Biological basis of propensity to use and misuse alcohol.

Spear LP. Journal of Studies on Alcohol (Supplement): 71-81, 2002. (144 refs.)
Objective: This article reviews the literature on adolescent brain development and considers the impact of these neural alterations on the propensity to use and misuse alcohol. Method. Neural, behavioral and hormonal I characteristics of adolescents across a variety of species were examined, along with a review of the ontogeny of ethanol responsiveness, tolerance development and stress, alcohol interactions. Results: The adolescent brain is a brain in transition. Prominent among the brain regions undergoing developmental change during adolescence in a variety of species are the prefrontal cortex and other forebrain dopamine projection regions, stressor-sensitive areas that form part of the neural circuitry modulating the motivational value of alcohol and other reinforcing stimuli. Along with these characteristic brain features, adolescents also exhibit increased stressor responsivity and an altered sensitivity to a variety of ethanol effects. Findings are mixed to date as to whether exposure to ethanol during this time of rapid brain development alters neurocognitive function and later propensity for problematic ethanol use, Conclusions. Developmental transformations of the adolescent brain may have been evolutionarily advantageous in promoting behavioral adaptations to avoid inbreeding and to facilitate the transition to independence, These brain transformations may also alter sensitivity of adolescents to a number of alcohol effects, leading perhaps in some cases to higher intakes to attain reinforcing effects. These features of the adolescent brain may also increase the sensitivity of adolescents to stressors, further escalating their propensity to initiate alcohol use. Additional investigations are needed to resolve whether ethanol use during adolescence disrupts maturational processes in ethanol-sensitive brain regions.

A developmental perspective on alcohol use and heavy drinking during adolescence and the transition to young adulthood. (review).

Schulenberg JE; Maggs JL. Journal of Studies on Alcohol (Supplement): 54-70, 2002. (186 refs.)
Objective. This article offers a developmental perspective on college drinking by focusing on broad developmental themes during adolescence and the transition to young adulthood. Method. A literature review was conducted. Results: The transition to college involves major individual and contextual change in emery domain of lifer at the same time, heavy drinking and associated problems increase during this transition, A developmental contextual perspective encourages the examination of alcohol use and heavy drinking in relation to normative developmental tasks and transitions and in the context of students' changing lives, focusing on interindividual variation in the course and consequences of drinking and on a wide range of proximal and distal influences. Links between developmental transitions and alcohol use and other health risks are discussed in light of five conceptual models: Overload. Developmental Mismatch. Increased Heterogeneity, Transition Catalyst and Heightened Vulnerability to Chance Events. We review normative developmental transitions of adolescence and young adulthood, focusing on the domains of physical and cognitive development, identity, affiliation and achievement. Conclusions: As shown in a selective review of empirical studies, these transitions offer important vantage points for examining increasing (and decreasing) alcohol and other drug use during adolescence and young adulthood, we conclude with a consideration of research and intervention implications.

Alcohol abuse and dependence among US college students.

Knight JR; Wechsler H; Kuo MC; Seibring M; Weitzman ER; Schuckit MA. Journal of Studies on Alcohol 63(3): 263-270, 2002. (27 refs.)
Objective: To estimate the prevalence of alcohol abuse and dependence among U.S. college students, and to identify characteristics associated with these diagnoses. Method: More than 14,000 Students at 1194-year U.S. colleges completed a questionnaire that included items corresponding to DSM-IV diagnostic criteria for alcohol abuse and dependence. Frequencies were computed, and correlations used to identify demographic, drinking and other variables associated with these diagnoses. Results: 31% percent of students endorsed criteria for an alcohol abuse diagnosis and 6% for a dependence diagnosis in the past 12 months. More than two of every five students reported at least one symptom of abuse or dependence. Students who were heavy episodic drinkers were more likely than those who were not to have an alcohol disorder. Students who were frequent heavy episodic drinkers had 13 times greater odds for abuse and 19 times greater odds for dependence. One of every five heavy episodic drinkers was classified with dependence. Few reported seeking treatment since coming to college. Students from heavy drinking college environments were more likely to have abuse and dependence diagnoses. Conclusions: Many college students report behaviors and symptoms that meet the diagnostic standard for alcohol abuse or dependence. In addition to strengthening prevention programs, colleges should implement new strategies for screening and early identification of high risk student drinkers and ensure that treatment is readily available for those with alcohol disorders.

Comprehensive community interventions to promote health: Implications for college-age drinking problems.

Hingson RW; Howland J. Journal of Studies on Alcohol (Supplement): 226-240, 2002. (38 refs.)
Objective. This article reviews comprehensive community interventions that sought to reduce ( I) cardiovascular disease risks: (2) smoking: (3) alcohol use disorders, alcohol-related injury and illicit drug use: or (4) sexual risk taking that could lead to HIV infection, sexually transmitted disease and pregnancy. Method. Comprehensive community programs typically involve multiple city government agencies as well as private citizens and organizations and use multiple intervention strategies such as school-based and public education programs. media advocacy. community organizing, environmental policy changes and heightened enforcement of existing policies. This review focused on English-language papers published over the past several decades. Results: Some programs in each of the four problem areas achieved their behavioral and health goals. The most consistent benefits were found in programs targeting behaviors with immediate health consequences such as alcohol misuse or sexual risk taking. Results were less consistent when consequences of targeted behaviors were more distant in time such as cardiovascular risks and smoking. Also, programs that targeted youth to prevent them from starting new health-compromising behaviors tended to be more successful than programs aimed at modifying preexisting habits among adults. Programs that combined environmental and institutional policy change with theory-based education programs were the most likely to be successful. Finally, programs tailored to local conditions by the communities themselves tended to achieve more behavior change than programs imported from the outside. Conclusions: Comprehensive community intervention approaches may have considerable potential to reduce college-age drinking problems, especially given the success of these programs in reducing alcohol-related problems and in presenting health-compromising behaviors among youth.

Effects of minimum drinking age laws: Review and analyses of the literature from 1960 to 2000. (review).

Wagenaar AC; Toomey TL. Journal of Studies on Alcohol (Supplement): 206-225, 2002. (149 refs.)
Objective: The goal of this article is to review critically the extant minimum legal drinking age (MLDA) research literature and summarize the current state of knowledge regarding the effectiveness of this policy. Method: Comprehensive searches of four databases were conducted to identify empirical studies of the MLDA published from 1960 to 1999, Three variables were coded for each study regarding methodological quality: (1) sampling design. (2) study design and (3) presence or absence of comparison group. Results: We identified 241 empirical analyses of the MLDA. Fifty-six percent of the analyses met our criteria for high methodological quality. Of the 33 higher quality studies of MLDA and alcohol consumption. 11 (33%) found an inverse relationship; only I found the opposite. Similarly, of the 79 higher quality analyses of MLDA and traffic crashes, 46 (58%) found a higher MLDA related to decreased traffic crashes: none found the opposite. Eight of the 23 analyses of other problems found a higher MLDA associated with reduced problems; none found the opposite. Only 6 of the 64 college-specific studies (9%) were of high quality; none found a significant relationship between the MLDA and outcome measures. Conclusions: The preponderance of evidence indicates there is an inverse relationship between the MLDA and two outcome measures: alcohol consumption and traffic crashes. The quality of the studies of specific populations such as college students is poor, preventing any conclusions that the effects of MLDA might differ for such special populations.

Marking the transition from high school to college: The role of alcohol-related social influence factors in student's drinking.

Read JP; Wood MD; Davidoff OJ; McLarken J; Campbell JF. Substance Abuse 23(1): 53-65, 2002. (33 refs.)
Using a sample of entering college freshmen (N=311), the purposes of this study were to examine 1) whether perceived norms for college student alcohol use and problems differed by gender and level of intended Greek involvement (Greek intent); 2) associations between perceived norms, Greek intent, and alcohol use and problems; and 3) whether relations between perceived norms, Greek intent, and alcohol use and problems were moderated by gender. Perceived norms demonstrated consistent, significant association with both alcohol use and problems, while Greek intent demonstrated significant associations only with alcohol problems. Examinations of gender effects in associations between perceived norms, Greek intent, and alcohol use and problems revealed a number of differences in these relations. Specifically, Greek intent was significantly associated with measures of alcohol use and problems for men , but not for women. Finally, although perceived norms were a significant predictor of heavy drinking for both men and women, the association was much stronger among male students. These finding s suggest that alcohol prevention interventions may benefit from specifically targeting perceived norms among incoming students who are at highest risk (i.e. male pledges.)

Secondhand effects of student alcohol use reported by neighbors of colleges: The role of alcohol outlets.

Wechsler H; Lee JE; Hall J; Wagenaar AC; Lee H. Social Science & Medicine 55(3): 425-435, 2002. (62 refs.)
This is a study of the secondhand effects of student alcohol use experienced by residents of neighborhoods near college campuses. We examined the relationship of a college's level of binge drinking and the number of alcohol outlets in the immediate area, to lowered quality of neighborhood life through such secondhand effects. Adults from 4661 households in the United States were interviewed through a stratified list-assisted random digit dialing telephone survey. The interview schedule included questions about residents' experiences of secondhand effects of alcohol use such as noise, vandalism or public disturbances. Reports about the quality of neighborhood life provided by respondents residing near colleges were compared with those of respondents who did not live near colleges; and reports of neighbors of colleges with high rates of binge drinking were compared with those of neighbors of colleges with lower rates. The presence of alcohol outlets in these areas was also compared. Residents near colleges and particularly near colleges with heavy episodic drinking reported the presence of more alcohol outlets within a mile. Those neighborhoods were characterized by lower socioeconomic status. Neighbors living near college campuses were more likely to report a lowered quality of neighborhood life through such secondhand effects of heavy alcohol use as noise and disturbances, vandalism, drunkenness, vomiting and urination. A path analysis indicated that the number of nearby alcohol outlets was an important factor mediating the relationship between colleges, especially those with high rates of binge drinking, and such secondhand effects. The results suggest that neighborhood disruptions around colleges due to heavy alcohol use may be reduced by limiting the presence of alcohol outlets in those areas, and the marketing practices that this engenders.

The impact of current residence and high school drinking on alcohol problems among college students.

Harford TC; Wechsler H; Muthen BO. Journal of Studies on Alcohol 63(3): 271-279, 2002. (33 refs.)
Objective: This study examines relationships between type of (current) residence, heavy episodic drinking in high school and alcohol-related problems among college students. Method: The study participants were respondents in the 1993, 1997 and 1999 Harvard School of Public Health College Alcohol Study (CAS) surveys of students attending 119 4-year U.S. colleges. Based on responses from 6,525 (55.6% female) students in the 1993 CAS, an exploratory factor analysis of the alcohol problem items was specified in a confirmatory factor analysis framework based on a four-factor solution, and related to study variables. The 1993 data were cross-validated with the 1997 and 1999 surveys. Results: When compared with students living in single-gender dormitories, students living off campus with parents reported lower alcohol-related problem consequences and a higher probability of drinking/driving. Students residing off campus without parents, compared with students in single-gender dorms, reported a higher probability of drinking/driving. Associations between off-campus residence and probabilities for drinking/driving were mediated by frequency of driving. Students living in coed dormitories, when compared with students in single-gender dorms, incurred more problem consequences related to drinking but reported significantly lower probabilities associated with designated driving and drinking/driving. Heavy episodic drinking in high school was related to higher probabilities of problems on all outcome measures. Conclusions: The presence of direct and independent effects for both heavy drinking prior to college and high-risk environmental factors in collegiate drinking practices support targeted and diverse strategies for prevention activities.

Mass media, social norms, and health promotion efforts: A longitudinal study of media effects on youth binge drinking. (review).

Yanovitzky I; Stryker J. Communication Research 28(2): 208-21A239, 2001. (113 refs.)
This study examines the validity of a norm-reinforcement approach as a complementary model to direct media effects on health behavior change. Focusing on news coverage effects on youth binge drinking between 1978 and 1996, it was hypothesized that the media may have contributed to the reduction in this behavior by increasing perceptions of social disapproval. The predictive power of this approach was then compared with that of other plausible models (namely, a direct effect model and a model proposing media effects that are mediated by policy actions). The findings from two separate tests (a time-series regression and the ideo-dynamic method) suggest that although a direct route of media effects on binge-drinking behavior produced evidence of null effects, there was evidence that the impact of news stories on this behavior was mediated by policy actions as well as by changes in the social acceptability of this behavior. Implications of this approach to the study of media effects on health behavior change are discussed.

The role of mass media campaigns in reducing high-risk drinking among college students.

DeJong W. Journal of Studies on Alcohol (Supplement): 182-192, 2002. (34 refs.)
Objective. This article categorizes and describes current media campaigns to reduce college student drinking. reviews key principles of campaign design and outlines recommendations for future campaigns. Method: The article describes three types of media campaigns on student drinking: information, social norms marketing, and advocacy. Key principles of campaign design are derived from work in commercial marketing, advertising, and public relations and from evaluations of past public health campaigns. Results. Information campaigns on the dangers of high-risk drinking are common, but none has been rigorously evaluated. Quasi-experimental studies suggest that social norms marketing campaigns, which correct misperceptions of campus drinking norms may be effective, but more rigorous research is needed. As of this writing. only one major media campaign has focused on policy advocacy to reduce college student drinking, but it is still being evaluated. Lessons for campaign design are organized as a series of steps for campaign development, implementation and assessment: launch a strategic planning process, select a strategic objective, select the target audience, develop a staged approach, define the key premise, avoid fear appeals, select the right message source, select a mix of media channels, maximize media exposure, conduct formative research, and conduct process and outcome evaluations. Conclusions: Future campaigns should integrate information, social norms marketing, and advocacy approaches to create a climate of support for institutional, community and policy changes that will alter the environment in which student make decisions about their alcohol consumption.

Alcohol misuse among college athletes: Self-medication for psychiatric symptoms?

Miller BE; Miller MN; Verhegge R; Linville HH; Pumariega AJ. Journal of Drug Education 32(1): 41-52, 2002. (32 refs.)
A collegiate athlete population was surveyed for alcohol abuse as well as self-reported depression, anxiety, and other psychiatric symptoms. This study revealed that in a group of 262 athletes there were 21 percent who reported high alcohol use and problems associated with its use. Significant correlations were found between reported alcohol abuse and self-reported symptoms of depression and general psychiatric symptoms. Subjects with positive depression and psychiatric symptom ratings in the "severe" range had a significantly higher rate of alcohol abuse than subjects who had low depression and low or mild symptom ratings. Conversely, subjects reporting higher rates of alcohol misuse had more psychiatric symptoms. These findings suggest a possible causal link between psychopathology and serious alcohol abuse among college athletes. They also point to the need for routine depression and anxiety screening in college students who are typically beginning a significant exposure to alcohol.