Kate Carey

Kate Carey
Brown University · Center for Alcohol and Addiction Studies

About

378
Publications
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Publications

Publications (378)
Article
Objective: To examine whether sexual assault prospectively predicts unhealthy weight management behaviors in college women. Method: Participants were female college students (N = 483) with monthly assessments across the first year, including the frequency and severity of sexual assault and unhealthy weight management behaviors. Results: Frequency o...
Article
Objective Alcohol-induced blackouts are experienced by approximately half of college students who drink. People who use protective behavioral strategies (PBS) tend to experience fewer alcohol-related consequences of drinking, but the relationship between PBS and blackouts is unknown. This study examines the associations among the use of protective...
Article
Background: Little work has considered the importance of a person's attitude toward heavy drinking when evaluated against other well-known predictors of alcohol use and related harm including drinking motives and drinker identity. The current study aimed to further evaluate the predictive utility of one's favorable attitude toward heavy drinking a...
Article
Objective: There is considerable variation in how college student drinkers evaluate alcohol-related consequences across time and consequence type. Previous qualitative work suggested that students perceive consequences less negatively under certain circumstances (i.e., higher intoxication, when less time has passed, positive mood, after discussing...
Presentation
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Introduction and Aims: For new students, the transition from high school to university is a period associated with significant changes and uncertainty. Unfortunately, the early transition (particularly Orientation Week) is also associated with increased alcohol use and harm. Web-based Interventions (WBIs) and Ecological Momentary Interventions (EMI...
Article
Drinking motives are robustly related to alcohol use behavior from adolescence through young adulthood. Yet, examination of changes in motives during the first year of college, a transitional time associated with both onset of and increases in heavy drinking has been understudied. We examined (a) whether drinking motives change, (b) time-varying ef...
Article
One-third to half of emerging adult drinkers report experiencing alcohol-induced blackouts in the past year, and blackouts increase the risk for negative consequences. Qualitative methods provide valuable tools for scientific inquiry, allowing for in-depth understanding of lived experiences. The goal of the present study was to gain insight into em...
Article
Background As many as 35% of college students report having been drunk in the past month, and greater alcohol use and alcohol-related problems are associated with a positive attitude toward heavy drinking. One serious consequence of heavy drinking is alcohol-induced blackout. When they occur, alcohol-induced blackouts present a unique opportunity t...
Article
Full-text available
Introduction As many as 74% of veterans with alcohol use disorders (AUDS) report symptoms of insomnia. Insomnia represents a barrier to alcohol treatment because insomnia symptoms (1) may lead to relapse among those who use alcohol to help them sleep and may negatively impact (2) executive functions and (3) emotion regulation skills. Cognitive–beha...
Article
Objective: Alcohol-related consequences are most often examined as outcomes of alcohol use. However, it is also possible that experiencing consequences may predict future drinking behavior. The predictive power of consequences on future drinking behavior may involve both objective experiences of consequences and subjective evaluations of those cons...
Article
Background: Much of the prior research addressing risky drinking among young adults has focused on heavy episodic drinking (4+/5+ drinks in a single sitting for females/males). However, one in three young adults engaged in past-year high-intensity drinking (HID, 8+/10+ drinks in a single sitting for females/males). Consuming such large amounts of...
Article
Objective: Heavy episodic drinking (HED) and high-intensity drinking (HID) are common in young adulthood but pose unique risks. Quantitative studies have used the Theory of Planned Behavior (TPB) and the Prototype-Willingness Model (PWM) to understand decision-making processes underlying alcohol misuse. However, our understanding of intentions (pl...
Article
Objective: The present study examined if identification with mainstream American culture (acculturation) and heritage culture (enculturation) are differentially associated with blackouts and other drinking consequences among male and female college students of color. Participants: Participants were college students (N = 150) who self-identified...
Article
Full-text available
The incidence of sexually transmitted infections (STIs) has increased over recent years, particularly among young women. Partner type is believed to influence women’s STI risk. However, researchers often restrict partner type to “casual” versus “committed,” labels that can mask risk variability. Therefore, in this study, we identified and explored...
Article
Objective Students in violation of campus alcohol policy often must participate in an alcohol risk reduction intervention, and some mandated students express overt resistance to change. This study tested a priori hypotheses about psychological variables that might predict receptivity to an online brief alcohol intervention Method Participants were...
Article
Background: Prior research on risky alcohol use points to drinking norms as predictors of drinking behavior. Most research to date has only explored global (versus context-specific) drinking norms as they relate to general drinking behavior. To better understand risky drinking behavior in students, how norms may vary across drinking environments sh...
Article
Full-text available
This exploratory trial determined the feasibility, acceptability, and preliminary efficacy of a brief intervention (BI), supplemented with text messaging and a curated Web site, on alcohol use and sexual risk behavior among young women. Young women seeking care at a reproductive health clinic were screened for alcohol misuse and sexual risk behavio...
Article
Objective Blackouts are associated with other alcohol-related consequences and depression among young adults, but the mechanisms underlying these associations are unclear. Using two separate samples, we tested the hypothesis that blackouts would be linked to symptoms of depression due in part to their association with other alcohol-related conseque...
Article
Blackouts are typically considered a negative consequence of alcohol use. Yet some college students report consuming alcohol with the intention of blacking out. This study examined intentions and motives for blackout drinking among young adults in college. College students with a past-year history of blackout (N = 350, 56% female, 73% White) comple...
Article
Many efficacious interventions designed to reduce college student drinking aim to correct misperceptions of peers' drinking behavior. The present study tested the efficacy of a novel delivery strategy, namely text messages, for promoting promoderation descriptive and injunctive drinking norms. Participants included 121 college students who were ran...
Article
Background: Little is known about whether there are differences in rates of sexual violence and its association with substance use based on women's identities, specifically the intersection of their race/ethnicity and sexual orientation. Method: Women (N = 546; 18 to 29 years of age) recruited from a reproductive healthcare clinic reported their...
Article
Alcohol misuse among college students is a persistent public health problem. Identifying the circumstances which influence alcohol misuse can inform the development of interventions to reduce risk for adverse outcomes in this population. Prior research suggests that people who engage in unplanned drinking report more alcohol-related consequences, a...
Article
Background: This study examined the theory of planned behavior (TPB) as an explanatory model for alcohol-induced blackouts among college students. Blackouts are periods of time wherein individuals continue to function and engage in their social environment but do not remember it as a result of consuming large quantities of alcohol. Social cognitiv...
Article
Background: Prior research identifies a range of potential predictors of blackouts and suggests that blackouts increase risk for additional negative consequences. However, these studies are based on epidemiological work that allows us to draw conclusions about groups of people but not within-person processes. The present study examined within-pers...
Article
Personal attitudes toward alcohol consumption are reliable predictors of alcohol use and related problems, with emerging work suggesting that one’s favorable attitude toward limited drinking (i.e., at levels below the threshold for heavy episodic drinking) is a buffer against alcohol use and binge drinking. However, little work has examined the spe...
Article
Background: Blackouts are common among young adults and predict alcohol-related harm. However, existing measures do not capture the range of alcohol-induced memory impairment involved in blackout experiences and do not differentiate between fragmentary and en bloc blackouts. This study aimed to develop and validate a brief, reliable measure of alc...
Article
Full-text available
Alcohol use and sexual behavior co-occur frequently in young women, increasing risk for HIV and other sexually transmitted infections. To inform preventive interventions, we used qualitative methods to better understand how women think about the contribution of alcohol use to sexual risk-taking. Young women (N = 25; M = 22.8 years; 64% White) were...
Article
Brief motivational interventions (BMIs) are widely used and efficacious interventions that address alcohol misuse in mandated college students. Consistent with motivational interviewing (MI; Miller & Rollnick, 2013) theory, within-therapist improvements in MI-consistent (MICO) skills over time-that is, as a therapist gains skill through repeated pr...
Article
Researchers have argued there are bidirectional associations between heavy alcohol use and sexual assault; however, research in this area is inconclusive due to methodological differences, particularly in study design. The purpose of this study is to clarify the longitudinal associations between heavy alcohol use and incapacitated sexual assault am...
Article
Full-text available
Background To describe sexual risk behavior, alcohol (and other substance) use, and perceived health promotion needs among young adult women seeking care from an urban reproductive health care clinic in the Northeastern United States, and to examine if these needs differ by race and ethnicity. Methods Women 18–29 years old presenting for a routine...
Article
Background: Alcohol consumption is associated with risky sex, which increases the risk of acquiring and transmitting HIV. Objective: To examine the prevalence of, and associations among alcohol, risky sex, and HIV, in Nigeria. Methods: We searched electronic databases and reviewed reference sections of relevant papers to locate studies that sa...
Article
A precollege history of sexual victimization predicts revictimization during college, making it important to understand the mechanisms underlying the victimization-to-revictimization pathway. The study aimed to test whether heavy episodic drinking and personal and peer hookup norms mediate revictimization for two types of unwanted sexual contact: s...
Article
Sexual behavior is associated with increased positive affect and decreased negative affect. However, contextual variables such as partner type, behavior type, and condom use may moderate these associations. The goal of the present research was to examine these contextual moderators using monthly longitudinal data from a sample of young women. Femal...
Article
For new students, university can be a wonderland of opportunity. But the first few weeks of the university experience are also typified by change, stress and uncertainty. From a health promotion perspective, the first few weeks of the university experience present an important yet understudied opportunity for alcohol misuse prevention. In this narr...
Article
Blackouts (periods of alcohol-induced anterograde amnesia) are common among young adults and place individuals at significant risk for alcohol-related harm; thus, researchers have advocated for increased efforts to educate young adults on blackouts. This qualitative study examined college student knowledge of blackouts as well as their ideas for in...
Conference Paper
Full-text available
Motivational Interviewing (MI) is a widely disseminated and effective therapeutic approach for behavioral disorder treatment. Over the past decade, MI research has identified client language as a central mediator between therapist skills and subsequent behavior change. Specifically, in-session client language referred to as change talk (CT; persona...
Article
Objective: Brief motivational interventions (BMIs) reduce drinking in the short term, but these initial effects often decay. We tested the hypothesis that theory-based e-mail boosters would promote maintenance of change after a BMI. Method: Participants were students (N = 568; 72% male) who violated campus alcohol policy and were mandated to par...
Article
Blackouts (i.e., alcohol induced memory impairment) are common among college student drinkers, and they are associated with several additional harms. However, alcohol consequences are not perceived universally as negative by the students who experience them, and little is known regarding students' specific thoughts and feelings about blackouts. We...
Article
Background: Blackouts-or memory loss for all or part of a drinking event-are reliable predictors of alcohol-related consequences. Studies suggest a distinction between en bloc (complete memory loss) and fragmentary (off-and-on memory loss) blackouts; however, research has not consistently differentiated between these 2 forms of blackout. This stud...
Article
College alcohol beliefs and personal attitudes about alcohol use are important predictors of alcohol use and related problems both cross-sectionally and over time. However, little work has examined these constructs together and how they may influence one another in predicting various alcohol related outcomes over time. The current study aimed to ev...
Article
Full-text available
Background: The goal of Orientation Week is to help new students adjust to university life. However, it is a period when many new students engage in excessive alcohol consumption and where problematic drinking patterns may be established. Objective: The objective is to determine whether returning students drink in a similar manner to students in...
Article
Level of drinking in the social network is strongly associated with college students’ alcohol use. However, mechanisms through which networks are associated with personal drinking have been underexplored thus far. The present study examined theoretically derived constructs—sociability outcome expectancies, attitudes toward heavy drinking, self-effi...
Article
Background: Alcohol use among university students is common, and those who drink often choose to drink heavily (ie, 4 or more drinks per session for women or 5 or more for men). Web-based interventions (WBIs), in which students complete assessments and receive personalized feedback about their alcohol use, and ecological momentary interventions (E...
Article
Alcohol use and its consequences have often been associated with depression, particularly among female college students. Interpretation of this association has been challenging due to potential reverse causation. The current study sought to clarify the temporality of these relationships. We examined: (1) the association between alcohol consumption...
Article
College students may subjectively evaluate the consequences of drinking in unexpected ways, rating “negative” consequences as neutral or even positive experiences. We previously gathered qualitative evidence for several contextual factors that may influence one’s subjective evaluations (e.g., social influences, intoxication level, concurrent positi...
Article
Full-text available
Background: We examined whether neighborhood-, friend-, and family- norms and social support for consumption and purchase of fruits and vegetables (F&V) were associated with F&V intake among low-income residents in subsidized housing communities. We examined baseline data from a study ancillary to the Live Well/Viva Bien intervention. Participants...
Article
Background Blackouts – or periods of alcohol‐induced amnesia for all or part of a drinking event – have been identified as independent predictors of alcohol‐related harm that may be used to identify individuals who would benefit from intervention. However, little is known about the prevalence and impact of blackouts among Veterans. This study exami...
Article
In Latin America (LA), HIV prevalence among MSM is estimated at thirty times greater than in the general male population. Little is known about the role of social support or disclosure status in relation to the HIV care continuum among LA MSM. Using multivariable logistic generalized estimation equations, we assessed the impact of social support sa...
Article
Alcohol-induced amnesia (“blackout”) is a reliable predictor of alcohol-related harm. Given its association with other negative consequences, experience of alcohol-induced amnesia may serve as a teachable moment, after which individuals are more likely to respond to intervention. To test this hypothesis, alcohol-induced amnesia was evaluated as a m...
Article
Objective: One in five college women experience unwanted sexual contact while in college, with first-year women being at the greatest risk. Given these data, we investigate how first-semester sexual assault impacts college women's mental health. Participants: 483 female first-year students enrolled in the study during the first month of college....
Article
Twenty-first birthdays are associated with extreme levels of heavy drinking and alcohol-related harm. Effective preventive interventions that are acceptable to young adults are needed. The current study tested the efficacy of a brief text-message intervention for reducing 21st birthday alcohol involvement designed to correct perceived 21st birthday...
Article
The current study tests individual differences in response to a mandated brief motivational intervention (BMI) for college student drinking. Participants consisted of 99 (45% female) students who were referred for violating campus alcohol policy. Within-subject analyses suggest that the BMI led to a significant reduction in frequency of drinking an...
Article
Alcohol misuse and associated negative consequences experienced by college students persists as a public health concern. Quantitative studies demonstrate variability in subjective evaluations of consequences, and how positively or negatively consequences are evaluated is associated with drinking behavior. Lacking is a qualitative exploration of how...
Article
Objective: The current study aimed to evaluate college student residence as a unique risk factor for a range of negative health behaviors. Participants: We examined data from 63,555 students (66% female) from 157 campuses who completed the National College Health Assessment Survey in Spring 2011. Methods: Participants answered questions about the f...
Article
Objective: Technology is continuing to shape the way we collect health data, including data on alcohol use. A number of technologies are being developed to objectively measure intoxication ‘in the wild’ without relying on self-report; the most immediate solution may be the use of personal breathalysers. In this study, we aimed to determine whether...
Article
Background: Health literacy is crucial to develop health-related knowledge, adopt healthy lifestyles, and benefit from health care services. However, research on the association between health literacy and adolescent health outcomes, particularly on their prospective associations, is rare. We assessed health literacy using 3 validated measures, an...
Article
Social cognitive factors such as perceived norms and personal attitudes toward alcohol consumption are reliable predictors of alcohol use and related problems. The current study aimed to evaluate the relative importance of one's attitude toward alcohol use as a unique and important predictor of drinking related outcomes when directly compared to pe...
Article
The persistence of risky drinking among young adults in college calls for continued efforts to prevent alcohol-related harms. This study tested a novel prevention strategy targeting a specific mechanism of change: creating attitude-behavior dissonance. Informed by an extensive literature showing strong and consistent associations between alcohol at...
Article
Objective: Brief motivational interventions (BMIs) are currently the most efficacious individual intervention for mandated college students. However, little is known about how BMIs facilitate client language in relation to subsequent changes in alcohol use and problems in mandated student samples. Method: The current study used the Motivational...
Article
Full-text available
Alcohol use is often reported among people living with HIV/AIDS (PLWHA) and is associated with increased sexual risk and poor medication adherence. This meta-analysis evaluated the efficacy of behavioral interventions addressing alcohol use among PLWHA. Twenty-one studies (N = 8461 PLWHA) that evaluated an individual-level intervention addressing a...
Article
Correcting misperceptions in drinking norms is an established method of reducing college student drinking; however, delivery of accurate norms has typically been limited to a single dose within the confines of an alcohol intervention. The present study tests the feasibility, acceptability, and preliminary efficacy of using text messages to promote...
Article
Objective: Brief motivational interventions (BMIs) reduce problematic drinking for some, but not all, college students. Identifying those students who are less responsive can help to guide intervention refinement. Therefore, we examined demographic, personality, and cognitive factors hypothesized to influence change after a BMI. Method: Students...
Article
Background: Mandated college students (those in violation of a campus alcohol policy) are heterogenous with respect to alcohol consumption. Thus, when universities consider required treatment for mandated students, one promising option is to match treatment intensity according to level of alcohol involvement. The present study evaluates such an ap...
Article
Life satisfaction is linked to premature morbidity and mortality and it may be compromised for individuals living in economically-disadvantaged, urban neighborhoods. The present study explores how behavioral and social-environmental health factors are associated with life satisfaction among a sample of African American young adults. Participants (N...
Article
Introduction: College students report high rates of binge drinking yet they reliably endorse elevated perceptions of drinking by their peers. However, the drinking norms literature offers little insight into how college students think about behaviors exhibited while intoxicated. This study aims to determine (a) if the predicted self-other differen...
Article
Objective: Symptoms of insomnia and heavy alcohol use tend to co-occur among military and veteran samples. The current study examined insomnia as a moderator of the association between alcohol use and related consequences among young adult veterans in an effort to extend and replicate findings observed in samples of civilian young adults. Method:...
Article
Objective: Students living in off-campus housing consume more alcohol and experience more alcohol-related consequences than those living on campus, yet prevention efforts have not targeted this high-risk group specifically. The present study evaluated the efficacy of a brief, computer-delivered, alcohol intervention (the College Drinkers Check-Up...
Article
Adolescents with psychiatric disorders appear to be at increased risk for acquiring HIV and other sexually transmitted infections; however, little is known about the prevalence of behavioral risk factors in this population. This meta-analysis aimed to assess the prevalence of alcohol use and sexual risk behaviors among adolescents with psychiatric...
Article
Background: College student alcohol use is a public health problem. Objectives: The aim of this study was to examine associations between residence and drinking behaviors among college students. We hypothesized that living off-campus independently or with peers would be associated with riskier drinking than living on-campus, and living with pare...
Article
Purpose Prior research has documented associations between mental health and alcohol use, mental health and insomnia, and insomnia and alcohol use. This study examined insomnia severity as a mediator of the association between mental health and alcohol-related outcomes in young adult veterans. Procedures Veterans aged 18 to 34 years (N = 622, 83%...