Library Watch - On Substance Abuse and the College Campus

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Last Update: 28.12.07

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...on substance abuse and the college campus

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Winter 2008

Alcohol consumption and females' recognition in response to date rape risk: The role of sex-related alcohol expectancies.

Pumphrey-Gordon JE; Gross AM. Journal of Family Violence 22(6): 475-485, 2007. (41 refs.)
This study examined the pharmacological and psychological effects of alcohol on women's recognition of and response to dating sexual aggression. Female participants completed measures of prior sexual victimization experiences, sex related alcohol expectancies, general alcohol expectancies, and drinking habits. Using a 2 (alcohol)x2 (expectancy) balanced placebo research design, women were exposed to an audiotape date rape vignette and asked to press a button when the man's sexual advances had gone to far. Upon pressing the button, the tape was stopped and participants were instructed to imagine themselves in the same situation and generate a response describing what they would say and/or do at that point. Results indicated that although alcohol and expectancy were not related to risk perception, individuals who consumed alcohol displayed significantly less resistant role play refusals. A significant interaction between expectancy set and pre-existing sex-related alcohol expectancies was observed indicating participants believing alcohol affects sexual behavior generated less resistant refusal responses when they expected to receive alcohol. Moreover, for those who expected to receive alcohol, stronger pre-existing sex-related alcohol expectancies predicted less resistant refusal responses over above the effects of blood alcohol level and general alcohol expectancies. The implications of these findings are discussed.

Alcohol-use disorders and nonmedical use, of prescription drugs among US college students.

McCabe SE; West BT; Wechsler H. Journal of Studies on Alcohol and Drugs 68(4): 543-547, 2007. (26 refs.)
Objective: The purpose of this study was to examine the association between Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), alcohol-use disorders (AUDs) and nonmedical use of prescription drugs (NMPD) among U.S. college students. A secondary aim of this study was to identify individual-level and college-level characteristics associated with the co-occurrence of AUDs and NMPD. Method: Data were collected from self-administered mail surveys, sent to a random sample of approximately 14,000 college students from a nationally representative sample of 119 U.S. colleges and universities. Results: Among U.S. college students, those with AUDs represented approximately 75% of nonmedical users of prescription drugs. Multivariate logistic regression analyses indicated that college students with past-year DSM-IV alcohol abuse only (adjusted odds ratio [AOR] = 4.46, 95% confidence interval [CI] = 3.59-5.55) and students with past-year DSM-IV alcohol dependence (AOR = 9.17, 95% Cl = 7.05-11.93) had significantly increased odds of NMPD in the past year compared with students without AUDs. The co-occurrence of AUDs and NMPD was more likely among college students who were male, white, earned lower grade point averages, and attended co-ed colleges and institutions located in Southern or Northeastern U.S. regions. Conclusions: The findings provide evidence that NMPD is more prevalent among those college students with AUDs, especially individuals with past-year DSM-IV alcohol dependence. The assessment and treatment of AUDs among college students should account for other forms of drug use such as NMPD.

Are drinking games sports? College athlete participation in drinking games and alcohol-related problems.

Grossbard J; Geisner IM; Neighbors C; Kilmer JR; Larimer ME. Journal of Studies on Alcohol and Drugs 68(1): 97-105, 2007. (31 refs.)
Objective: Studies indicate greater heavy episodic drinking and related consequences for college student-athletes compared with nonathletes. Surprisingly, little research has examined college athletes' participation in drinking games, a context associated with excessive alcohol consumption and negative alcohol-related consequences in college students. Method: We examined how drinking game participation contributes to alcohol consumption and alcohol-related consequences among college-level intramural and intercollegiate athletes compared with nonathletes in two independent samples. Study I consisted of 1,395 randomly selected students, (61% women) at a West Coast college campus. including 335 students who reported intramural athletic participation. Study 2 consisted of 6,055 randomly selected college students (63% women) from three college campuses, including 1,439 intramural athletes and 3 17 intercollegiate athletes. Results: Results of Study I indicated that intramural athletes consumed significantly more drinks per week, had significantly higher typical and peak blood alcohol concentration levels, and reported more negative consequences than nonathletes. Drinking game participation mediated the relationship between intramural athlete status and measures of consumption and consequences. Results of Study 2, including both intramural and intercollegiate athletes, were consistent with those of Study 1, revealing drinking game participation as a mediator of the relationships between athlete status and alcohol consumption and consequences. Conclusions: Drinking games represent contexts for college athletes to engage in heavy episodic drinking, and participation in drinking games mediates the relationship between alcohol consumption and negative consequences in athletes. Interventions targeted at college athletes should consider the impact of drinking game participation.

Characteristics of a collegiate recovery community: Maintaining recovery in an abstinence-hostile environment.

Cleveland HH; Harris KS; Baker AK; Herbert R; Dean LR. Journal of Substance Abuse Treatment 33(1): 13-23, 2007. (22 refs.)
As adolescents have entered substance abuse treatment programs in greater numbers than ever before [Substance Abuse Mental Health Services Administration, 2004. Substance abuse treatment by primary substance of abuse. (http: www.oas. samhsa.gov/ dasis.htm#teds2). Retrieved September 20041, increasing numbers of young adults are beginning college in 12-step recovery. Unfortunately, with social contexts organized around excessive alcohol consumption, colleges may be the most difficult place through which to control drinking behaviors, let alone remain abstinent. This study used data collected during 2004 and 2005 to describe members of the largest collegiate recovery community in the United States. Included in this study are the following: a description of the program that supports the community, the methods and measurements used to collect data, and results describing the substance use history and characteristics of the community members (N = K). Collected at a large southwestern university, the data provide drug and alcohol counselors, treatment providers, school administrators, and researchers with the first description of a large collegiate recovery community.

College women and sexual assault: The role of sex-related alcohol expectancies.

Benson BJ; Gohm CL; Gross AM. Journal of Family Violence 22(6): 341-351, 2007. (45 refs.)
This study examined the relationship between alcohol, sex-related alcohol expectancies, and sexual assaults among women college students. Participants completed measures of sexual behaviors, sexual victimization experiences, sex related alcohol expectancies, and drinking habits. Based on participants' responses women were categorized as having experienced no assault, unwanted sexual contact, sexual coercion, attempted rape, and rape. It was observed across groups that relative to controls, women reporting attempted rape and rape consumed higher levels of alcohol. Within group comparisons revealed that relative to controls, victimized women endorsed higher levels of sex-related alcohol expectancies. In the prediction of severity of sexual victimization, regression analyses revealed an interaction between alcohol consumption and expectancy of vulnerability to sexual coercion. At higher levels of alcohol consumption women endorsing high vulnerability to sexual coercion experienced more severe victimatization. Implications of the findings are discussed.

Efficacy of counselor vs. computer-delivered intervention with mandated college students.

Barnett NP; Murphy JG; Colb SM; Monti PM. Addictive Behaviors 32(11): 2529-2548, 2007. (76 refs.)
The purpose of this study was to evaluate the efficacy of two brief interventions and the inclusion of a 1-month booster session with college students who were referred to attend alcohol education following an alcohol-related incident. Participants (N= 225; 48.9% male) were randomly assigned to receive one session of a Brief Motivational Interview (BMI) or computer-delivered intervention (CDI) with the Alcohol 10 1 CD-ROM. Participants were also randomly assigned to booster/no booster. At 3-month follow up, participants in BMI reported greater help seeking and use of behavioral strategies to moderate drinking. At 12-month follow up, BMI participants were drinking more frequently and CDI participants were consuming a greater number of drinks per occasion than at baseline. Mediation analyses showed that the use of specific behavioral strategies mediated the effect of the BMI condition on drinking volume. There was no intervention effect on alcohol problems, and the booster condition did not significantly affect outcomes. Promoting specific behaviors in the context of in-person brief interventions may be a promising approach to reducing drinking volume among identified at-risk students.

Individual-level interventions to reduce college student drinking: A meta-analytic review. (review).

Carey KB; Scott-Sheldon LAJ; Carey MP; DeMartini KS. Addictive Behaviors 32(11): 2469-2494, 2007. (102 refs.)
In light of increasing numbers of controlled studies evaluating alcohol abuse prevention interventions for college drinkers, we conducted a meta-analysis to summarize the current status of the literature. The meta-analysis includes 62 studies, published between 1985 to early 2007, with 13,750 participants and 98 intervention conditions. All studies were content coded for study descriptors, participant characteristics, and intervention components. We derived weighted mean effect sizes for alcohol interventions versus comparison conditions for consumption variables and alcohol-related problems, over four measurement intervals. Over follow-up intervals lasting up to 6 months, participants in risk reduction interventions drank significantly less relative to controls. Students receiving interventions also reported fewer alcohol-related problems over longer intervals. Moderator analyses suggest that individual, face-to-face interventions using motivational interviewing and personalized normative feedback predict greater reductions in alcohol-related problems. Implications for future research include attention to maintenance of effects, and developing more efficacious interventions for at-risk college drinkers.

Intimate partner violence perpetration and problem drinking among college students: The roles of expectancies and subjective evaluations of alcohol aggression.

Fossos N; Neighbors C; Kaysen D; Hove MC. Journal of Studies on Alcohol and Drugs 68(5): 706-713, 2007. (48 refs.)
Objective: The present research examined the effect of alcohol aggression expectancies and subjective evaluations of alcohol's effects on aggression in intimate partner violence (IPV) perpetration among college students. We were interested in determining the extent to which these relationships differed across gender. Method: A total of 780 (57.3% female) incoming heavy drinking college freshmen who were between the ages of 18 and 25 years completed self-reported measures of IPV perpetration, alcohol use and problems, and alcohol aggression expectancies and subjective evaluations of those expectancies as part of the baseline assessment for a larger social norms alcohol intervention study. Analyses evaluated the effect of alcohol aggression expectancies and subjective evaluations of those expectancies on IPV perpetration. Results: Results indicated that problem drinking was positively associated with IPV perpetration for those who were lower (beta=.32, p <.001) versus those who were higher (beta=.07, p = NS) in alcohol aggression expectancies. Among men, there was a significantly stronger relationship between problem drinking and IPV perpetration among those who evaluated alcohol's effects on aggression more favorably (beta=.41, p <.00 1) versus less favorably (beta=. 11, P = NS). Among women, there was not a significantly stronger relationship between problem drinking and IPV perpetration at less favorable (beta=.17, p <.05) versus more favorable (beta= 11, p <.06) evaluations of alcohol's effects on aggression. Conclusions: Findings suggest that, in understanding IPV perpetration, it may not be sufficient to evaluate expected alcohol effects without also including whether those effects are viewed as good or bad. Findings also suggest that the relationship between alcohol problems and IPV perpetration may be stronger and more straightforward for men than for women.

Alcohol involvement and participation in residential learning communities among first-year college students.

McCabe SE; Boyd CJ; Cranford JA; Slayden J; Lange JE; Reed MB et al. Journal of Studies on Alcohol and Drugs 68(5): 722-726, 2007. (31 refs.)
Objective: Residential learning communities (RLCs) on U.S. college campuses are assumed to build connections between formal learning opportunities and students' living environment. The objective of this longitudinal study was to examine the association between living in RLCs and alcohol misuse among first-year undergraduate students. Method: A Web-based survey was self-administered to a stratified random sample of 923 first-year undergraduate students (52.7% women) attending a large Midwestern research university. The sample included 342 students who lived and participated in RLCs (termed RLC) and 581 students who did not participate in RLCs (termed non-RLC). First-year students were asked about their drinking behaviors before college, during their first semester, and approximately 6 months later during their second semester. Results: RLC students reported lower rates of drinking than non-RLC students before college. RLC students reported lower rates of drinking and fewer alcohol-related consequences than non-RLC students during the first and second semesters. Maximum drinks in I day increased from precollege to first semester, and this increase was larger among non-RLC students than RLC students. The number of drinks per occasion and alcohol-related consequences increased between first semester and second semester for all students regardless of RLC status. Conclusions: Lower rates of alcohol misuse among RLC students predate their entrance into college, and the increase in drinking from precollege to first semester is lower in magnitude among RLC students. RLCs' influence involves selection and socialization processes. These findings have implications for prevention and intervention efforts aimed at incoming first-year undergraduate students.

Long-term effects of brief substance use interventions for mandated college students: Sleeper effects of an in-person personal feedback intervention.

White HR; Mun EY; Pugh L; Morgan TJ. Alcoholism: Clinical and Experimental Research 31(8): 1380-1391, 2007. (44 refs.)
Background: It is known that brief interventions for mandated college students decrease alcohol use and/or related problems in the short term. However, none of the existing studies has followed students' past 6 months. Therefore, we compared the long-term efficacy of 2 brief substance use feedback interventions for mandated college students. Methods: We followed up mandated students (N=348) who were randomly assigned to either a brief motivational interview (BMI; n=180) or a written feedback-only (WF; n=168) intervention at 4 months and 15 months postintervention. Results: Long-term follow-up data revealed that students, at the aggregate level, decreased their peak blood alcohol concentration (BAC) levels, number of drinks per week, and number of alcohol-related problems at 15 months postintervention compared with their baseline levels. With the exception of peak BAC, the observed long-term reduction was mainly due to the positive change among students who received the BMI intervention. Students in the BMI intervention showed significantly lower levels of alcohol-related problems at 15 months than those in the WF intervention. The BMI intervention more effectively reduced within-individual alcohol-related problems during the initial 4 months, and more successfully curbed the subsequent increase in alcohol use frequency and number of drinks per week during the 11 months between the 2 follow-up assessments. Conclusions: The results suggest that brief substance use interventions reduce the riskiest type of alcohol use (e.g., peak BAC) among mandated college students over the long term, and that sleeper effects of in-person personal feedback interventions (PFIs) exist. In-person PFIs in the context of a motivational interview may be more efficacious in the long term than written feedback-only interventions for mandated students. Future studies comparing interventions for college students should extend follow-up for longer periods of time.

Smoking, but not smokers: Identity among college students who smoke cigarettes.

Levinson AH; Campo S; Gascoigne J; Jolly O; Zakharyan A; Tran ZV. Nicotine & Tobacco Research 9(8): 845-852, 2007. (30 refs.)
Cigarette smoking in college is often described as social smoking, but the term lacks definition and implicitly discounts dependence. We report on college students' use of the terms social smoker and smoker. Students who currently smoked cigarettes were asked whether they considered themselves smokers, and whether they smoked because they were social smokers. The survey was conducted during 1999-2004 at eight colleges; analysis was limited to 1,401 students aged 18-24 years. More than half of students (56.3%) denied being smokers ("deny-ers'') despite current smoking behavior. Half of deniers, and fewer than half of admitters, called themselves social smokers. Deniers were highly likely to smoke infrequently, to say they were not addicted to cigarettes, to have mostly nonsmokers as close friends, to prefer dating nonsmokers, and to smoke for reasons other than stress relief. In contrast, social-smoker identity was associated only weakly with any attitude, behavior, or belief. Smoker and social-smoker identities were not significantly correlated with each other. Regardless of identity, more than half of the respondents wanted to quit smoking by graduation. Results suggest that denying being a smoker may be a widespread dissonance among college students who smoke. The possibility should be evaluated using population-level research, because it has potentially undermining implications for smoking cessation campaigns. Campus health centers should avoid using "smoker'' self-assessment items on pre-exam questionnaires. Further research is needed to explore the psychosocial mechanisms involved with deny-er identity, to clarify the implications for public health communications, and to develop appropriate intervention strategies.

The relationship between alcohol use and cigarette smoking in a sample of undergraduate college students.

Reed MB; Wang R; Shillington AM; Clapp JD; Lange JE. Addictive Behaviors 32(3): 449-464, 2007. (55 refs.)
During the decade of the 1990s, smoking prevalence increased nearly 30% in the college student population. Although most college students initiate smoking before the age of 18, recent evidence suggests a sizable minority of undergraduates report starting smoking while in college. This study examined the concurrent use of alcohol and tobacco as well as the relationship between alcohol use and smoking initiation among a sample of undergraduate students attending a large public university in the southwestern United States. We defined three categories of smoking status for this study: never smokers (n = 777), experimenters (n = 15 8), and smokers (n = 178). Both experimenters and smokers reported consuming significantly more drinks per occasion in the past 28 days and more drinks on one occasion in the past 2 weeks compared to never smokers; however, there was no significant difference between experimenters and smokers on either of these measures of consumption. The results of two multinomial logistic regression models showed that measures of alcohol consumption and drinking frequency were significantly associated with being an experimenter or smoker after controlling for demographic and other drug use covariates. Results of a logistic regression analysis revealed a significant relationship between past year drinking frequency and smoking initiation among respondents who reported that they were not smoking at all 12 months prior to their survey participation. The influence of alcohol consumption on smoking initiation among college students is discussed.

The relationship between drinking control strategies and college student alcohol use.

Sugarman DE; Carey KB. Psychology of Addictive Behaviors 21(3): 338-345, 2007. (24 refs.)
Interventions designed to reduce heavy drinking among college students often contain suggestions for drinking control strategies. However, little is known about the relationship between the use of these strategies and alcohol consumption. The authors developed a measure of drinking control strategies and investigated its psychometric properties in a sample of 250 college drinkers. Strategies clustered into three factors: selective avoidance of heavy drinking activities and situations, strategies used while drinking, and alternatives to drinking. These three types of strategies were independently associated with alcohol use; however, the first and last types were negatively associated with alcohol consumption, whereas the second type was positively associated with alcohol use. The findings from this study suggest that the type of strategy recommended may be important when the goal is alcohol reduction.

Bad luck or bad decisions: College students' perceptions of the reasons for and consequences of their alcohol overdose.

Reis J. Journal of Drug Education 17(9): 71-81, 2007. (32 refs.)
Reasons for and immediate consequences of an alcohol overdose were explored for 217 undergraduate students requiring a medical emergency transport because of excessive alcohol consumption. The sample was categorized into 26 students attributing their overdose solely to bad luck and 191 students citing bad decision making as an explanation. A discriminant analysis portrayed the bad luck students as more likely to change the type of alcohol consumed, worrying more about problems with friends, less likely to change how much they drink and less likely to feel that they learned something about themselves. Friends were not named as being involved, but lapses in knowing how to pace consumption were frequently cited. Design of preventive educational programs for underage drinkers with the aim of avoiding an overdose is discussed.

Which heavy drinking college students benefit from a brief motivational intervention?

Carey KB; Henson JA; Carey MP; Maisto SA. Journal of Consulting and Clinical Psychology 75(4): 663-669, 2007. (22 refs.)
Heavy drinking among college students is common and is often harmful. A previously reported randomized trial revealed that a brief motivational intervention (BMI) reduced the alcohol consumption of heavy drinking college students (K. B. Carey, M. P. Carey, S. A. Maisto, & J. M. Henson, 2006). For this study, the reseachers conducted supplemental analyses of hypothesized predictors of change using the same sample (N = 495). Greater readiness to change, higher levels of self-regulation, and less engagement in social comparison all independently predicted reductions in drinking outcomes. Furthermore, self-regulation, social comparison, and future time perspective interacted with BMI and predicted drinks per week. As expected, greater self-regulation skills enhanced response to the BMI; the remaining interaction effects were unexpected. Overall, these findings suggest that BMIs produce relatively robust effects.

Trends in non-medical use of anabolic steroids by US college students: Results from four national surveys.

McCabe SE; Brower KJ; West BT; Nelson TF; Wechsler H. Drug and Alcohol Dependence 90(2/3): 243-251, 2007. (77 refs.)
This study assessed the prevalence, trends, and student- and college-level characteristics associated with the non-medical use of anabolic steroids (NMAS) among U.S. college students. Data were collected through self-administered mail surveys, from 15,282, 14,428, 13,953, and 10,904 randomly selected college students at the same 119 nationally representative colleges in 1993, 1997, 1999 and 200 1, respectively. The prevalence of lifetime, past-year and past-month NMAS was 1% or less and generally did not change significantly between 1993 and 200 1, with one exception: past-year WAS increased significantly among men from 1993 (0.36%) to 2001 (0.90%). Multiple logistic regression analyses revealed that lifetime and past-year NMAS were associated with student-level characteristics such as being male and participation in intercollegiate athletics. Lifetime and past-year NMAS were also positively associated with several risky behaviors, including cigarette smoking, illicit drug use, drinking and driving, and DSM-IV alcohol use disorders. Nearly 7 out of every 10 lifetime non-medical users of anabolic steroids met past-year criteria for a DSM-IV alcohol use disorder. Although the overall prevalence of NMAS remained low between 1993 and 2001, findings suggest that continued monitoring is necessary because male student-athletes are at heightened risk for NMAS and this behavior is associated with a wide range of risky health behaviors. The characteristics associated with NMAS have important implications for future practice and research.