Article

Drinking games, tailgating, and pregaming: Precollege predictors of risky college drinking

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Abstract

Background: The transition from high school to college is a critical period for developing college drinking habits. Hazardous alcohol consumption increases during this period, as well as participation in drinking games, pregaming, and tailgating. All of these risky drinking practices are associated with higher levels of intoxication as well as an increased risk of alcohol-related problems. Objective: The current study aimed to evaluate pre-college predictors (personality, social norms, and beliefs reflecting the internalization of the college drinking culture [ICDC]) of estimated peak BAC (pBAC) reached during drinking games, pregaming, and tailgating, as well as pBAC and alcohol-related problems during the first 30 days of college. Methods: Participants (n = 936) were incoming freshmen at a large university who completed a baseline assessment prior to college matriculation and a follow-up assessment after they had been on campus for 30 days. Results: Using path analysis, ICDC was significantly associated with pBAC reached during the three risky drinking practices. ICDC had an indirect effect on both pBAC and alcohol-related problems via pBAC from drinking games, pregaming, and tailgating. Hopelessness and sensation seeking were significantly related to alcohol use outcomes. Conclusion: Precollege perceptions of the college drinking culture are a stronger predictor of subsequent alcohol use than social norms. Interventions that target these beliefs may reduce peak intoxication and associated harms experienced during the first 30 days of college.

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... Además, en la muestra total (i.e., todos los países), la probabilidad de reportar conducta de previa (en el último año) fue mayor entre los 16 y los 20 años (Ferris et al., 2019). Distintos estudios indican que la previa se asocia al consumo de grandes cantidades de alcohol (Pedersen y LaBrie, 2007), a altas concentraciones de alcohol en sangre (Merrill et al., 2013;Moser et al., 2014) o en aliento (Santos, Paes, Sanudo, y Sanchez, 2015), a mayor ocurrencia de episodios de ebriedad (Barnett et al., 2013;Miller et al., 2016) y al uso de alcohol combinado con otras sustancias como las bebidas energizantes (Linden-Carmichael y Lau-Barraco, 2017) o la marihuana (Davis et al., 2020). Debido a esto, la previa se asocia a una mayor cantidad de consecuencias negativas del uso de alcohol, tales como los epi-Relación de la impulsividad y las normas sociales descriptivas con la práctica de tomar alcohol antes de salir sodios de amnesia, las peleas y las conductas sexuales riesgosas (LaBrie et al., 2016;Pilatti et al., 2018;Wahl et al., 2013). ...
... A su vez, la falta de perseverancia es la dimensión más relacionada con la cantidad consumida, la falta de premeditación y la urgencia negativa se asocian particularmente con trastornos por dependencia al alcohol, ambas urgencias (positiva y negativa) están más bien vinculadas con consecuencias negativas del consumo, y la búsqueda de sensaciones, con el CEEA. Otros resultados, incluso en muestras de adolescentes, evidencian que los rasgos impulsivos de la personalidad se asocian con prácticas de consumo excesivo como los juegos de tomar alcohol Moser et al., 2014;Zamboanga et al., 2016) y el co-uso de sustancias durante la previa (Davis et al., 2020). Por ejemplo, un estudio reciente encontró que en los jóvenes que presentaron niveles altos de búsqueda de sensaciones y urgencia positiva, mayores puntajes en ansiedad social se asociaron con una elevada cantidad de marihuana consumida durante la previa (donde también se consumió alcohol; Davis et al., 2020). ...
... Estas prácticas pueden implicar la ingesta de una cantidad muy elevada de alcohol en un periodo muy corto de tiempo Zamboanga et al., 2021). Estos, y otros resultados (Barnett et al., 2013;Merrill et al., 2013;Miller et al., 2016;Moser et al., 2014), destacan el riesgo que presentan los adolescentes a experimentar consecuencias negativas a corto (e.g., relaciones sexuales no planificadas o sin protección y peleas físicas; Keough et al., 2016;Pilatti et al., 2016) y largo plazo (Harding et al., 2016) cuando se involucran Relación de la impulsividad y las normas sociales descriptivas con la práctica de tomar alcohol antes de salir en estas prácticas de consumo excesivo de alcohol. Ilustrando este punto, la frecuencia de previa, controlando por el volumen de alcohol consumido y por la presencia de CEEA, fue un importante predictor de la cantidad y la severidad de consecuencias negativas del uso de alcohol experimentadas un año después por estudiantes universitarios (LaBrie et al., 2016). ...
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Introducción. La previa (i.e., consumir alcohol antes de salir) es una práctica de consumo de alcohol caracterizada por la ingesta de cantidades elevadas de alcohol en un periodo corto de tiempo. En Argentina, sin embargo, los estudios sobre la previa son escasos. Objetivo. Se examinó la conducta de previa en adolescentes del Área Metropolitana de Buenos Aires y su relación con la impulsividad y las normas sociales descriptivas específicas de la previa. Material y Métodos. Participaron 427 adolescentes de 13 a 18 años que respondieron cuestionarios auto-administrados. Resultados. Casi la mitad reportó al menos un episodio de previa en el último mes y una media de cuatro medidas de alcohol por previa. Quienes hicieron previa, comparados con quienes tomaron alcohol en otros contextos, reportaron significativamente mayor consumo de alcohol. La edad de los participantes, tres dimensiones de la impulsividad (i.e., la urgencia negativa, la falta de perseverancia y la falta de premeditación) y la percepción de una mayor conducta de previa en los pares se asociaron significativamente con la conducta de previa. Conclusiones. La impulsividad y las normas sociales descriptivas podrían ser útiles para identificar adolescentes con mayor vulnerabilidad a involucrarse en esta práctica de consumo excesivo de alcohol. Consumo de alcohol, Prácticas de consumo excesivo de alcohol, Impulsividad, Normas sociales, Adolescentes.
... 1,[26][27][28] Other recent research also has demonstrated that CABs are a robust predictor, mediator, and moderator of important alcohol outcomes and consequences among college students. 27,[29][30][31][32][33][34] When examined in relation to other predictors of college student drinking such as such as sensation seeking, impulsivity, positive and negative urgency, and hopelessness and anxiety sensitivity, CABs have been more strongly associated with experiencing alcohol consequences in college freshmen, [31][32][33] and comparably associated among mandated students. 35 It is particularly noteworthy that CABs have been found to have stronger associations with drinking consequences when pitted against both descriptive and injunctive norms. ...
... 1,[26][27][28] Other recent research also has demonstrated that CABs are a robust predictor, mediator, and moderator of important alcohol outcomes and consequences among college students. 27,[29][30][31][32][33][34] When examined in relation to other predictors of college student drinking such as such as sensation seeking, impulsivity, positive and negative urgency, and hopelessness and anxiety sensitivity, CABs have been more strongly associated with experiencing alcohol consequences in college freshmen, [31][32][33] and comparably associated among mandated students. 35 It is particularly noteworthy that CABs have been found to have stronger associations with drinking consequences when pitted against both descriptive and injunctive norms. ...
... 35 It is particularly noteworthy that CABs have been found to have stronger associations with drinking consequences when pitted against both descriptive and injunctive norms. 26,28,[31][32][33]35 Similarly, the association between CABs and consequences have been stronger than that found between positive alcohol expectancies and consequences. 26,28 Thus, CABs have been found to be more strongly associated with alcohol consequences than norms and expectancies, two common targets of college alcohol interventions. ...
Article
Objective: We explored the potential mediating role of willingness to experience drinking consequences and other traditional alcohol outcome predictors (descriptive norms, injunctive norms, positive alcohol expectancies) in explaining the association between college alcohol beliefs 1 (CABs) and the actual experience of drinking consequences among college students. Participants: The sample consisted of 415 college students tested in October 2014. Methods: Participants responded to an online survey. Results: When compared to both types of norms and positive alcohol expectancies, CABs demonstrated the strongest associations to both willingness to experience drinking consequences and actual drinking consequences among college students. A multiple mediation analysis revealed that the impact of CABs on students' actual drinking consequences was mediated only through their willingness to experience drinking consequences. Conclusions: Students' college alcohol beliefs and their corresponding willingness to experience drinking consequences should be targeted in prevention and intervention programs designed to address the problem of college student drinking.
... Other researchers recently have found that CABs are a robust predictor, mediator, and moderator of important alcohol outcomes and consequences among college students (Boyle, LaBrie, Froidevaux, & Witkovic, 2016;Hustad, Mastroleo, Urwin, Zeman, LaSalle, & Borsari, 2014;Hustad, Pearson, Neighbors, & Borsari, 2014;LaBrie, Kenney, Napper, & Miller, 2014;Moser, Pearson, Hustad, & Borsari, 2014;Qi, Pearson, & Hustad, 2014). Hustad et al. found CABs to be "a particularly robust predictor of outcomes and mediator of the effects of personality traits, including sensation seeking and impulsivity on alcohol outcomes. ...
... level. Moser et al., 2014;Osberg et al., 2010Osberg et al., , 2011Osberg et al., , 2012Qi et al., 2014). The present study explored the relative impact of college alcohol beliefs, descriptive norms, injunctive norms, positive alcohol expectancies, and sensation seeking on college students' risk for engaging in regretted sexual encounters. ...
... College students who engage in risky forms of drinking such as pregaming and tailgating more strongly endorse CABs (Hustad, Mastroleo, Urwin, Zeman, LaSalle, & Borsari, 2014). Moreover, CABs have been found to be a stronger predictor of subsequent alcohol use than social norms, and they were found to have an indirect effect on both peak BAC and alcohol problems via peak BAC from drinking games, pregaming, and tailgating (Moser, Pearson, Hustad, & Borsari, 2014). CABs also have been found to be linked to poorer motivation to change among mandated college students and thus are an important target to address in college drinking interventions (Qi, Pearson, & Hustad, 2014). ...
Article
This study explored the relative impact of college alcohol beliefs (CABs; i.e., the extent to which the student views alcohol as part of the fabric of college life), descriptive norms, injunctive norms, positive alcohol expectancies, and sensation seeking on college students' (N = 415) risk for engaging in regretted sexual encounters (RSE). Overall, 12% of our sample reported having experienced RSE within the past 30 days. When pitted against the other traditional predictors of college student drinking and its consequences, such as positive alcohol expectancies, descriptive and injunctive norms, and sensation seeking, CABs emerged as the strongest correlate of RSE other than drinking itself, and explained significant additional variance in RSE beyond these other predictors. Mediation analyses revealed that CABs had a significant indirect effect on RSE through typical weekly drinking. This pattern of findings indicates that college alcohol beliefs are, from a public health perspective, dangerous beliefs, that warrant serious consideration in the development of new approaches to college student drinking and its consequences.
... [18] With regards alcohol consumption within the general population, there has been a gradual decline such that between 2005 and 2012 the proportion of men who had drank alcohol in the week before being interviewed fell from 72% to 64%, and the proportion of women fell from 57% to 52% [19]. Young people (those aged [16][17][18][19][20][21][22][23][24] were more likely to have binged on alcohol at least once during the week, with a similar proportion for men (26%) and women (28%) [19]. ...
... However, this proportion has more than doubled (19%) when looking at the age subgroup of 16-24 year-olds. This has risen from 8% of 16-59 year olds and 16% of [16][17][18][19][20][21][22][23][24] year-olds when compared to the previous year. The use of cocaine, ecstasy, LSD, ketamine and New Psychoactive Substances (NPS) (also known as 'Legal Highs') had particularly increased. ...
... This prevalence has increased since becoming undergraduates, and 53.9% of males and 46.2% of females admitted that they drunk less alcohol before starting their studies. These results are unsurprising as undergraduate students are now at a legal age to purchase alcohol, and in addition, the culture of being a university student is likely to have a role [24]. These figures support the study carried out in 2008 [5]. ...
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The aim of this study was determine the prevalence of tobacco, alcohol and illicit substance use among dental undergraduates at one UK university in 2015. A cross-sectional survey of all 344 dental undergraduates using an anonymous self-report questionnaire was carried out. The response rate was 77%, of which 29% were male and 71% female. Tobacco smoking was reported by 23.6% of males and 12.2% of females, with only 1.6% of females reporting to smoke ≥10 cigarettes per day. Alcohol consumption was reported by 85.5% of males and 84% of females, and reported levels of alcohol consumption increased since becoming undergraduates. Binge drinking was reported by 35.3% of males and 41% of female students. Only 2.6% of males and 0.5% of females reported to be current regular users of cannabis. The vast majority of respondents claimed to have never used any illicit substance. The only other reported regularly used substances by males was Ecstasy (1.3%) and by females were LSD (0.5%), Ecstasy (1.5%), Cocaine (0.5%), Inhalants (0.5%) and Ketamine (0.5%). These results are encouraging. Fewer students reported smoking than in the general population, levels of binge drinking were considerably lower than previously reported figures, as were the numbers of regular users of cannabis and other illicit substances.
... For instance, Memetovic et al. (2016) discovered that all personality traits (i.e., sensation seeking, hopelessness, impulsivity) except for anxiety sensitivity were independently associated with an increased risk of smoking cigarettes in adolescents. Similarly, another study found that anxiety sensitivity was not a significant risk factor of substance misuse in early adolescence (Krank et al., 2011), and that anxiety sensitivity had significant negative associations with levels of substance use in incoming undergraduate students (Moser et al., 2014) and in adolescents (M. Krank et al., 2011). ...
... Conrod et al. (2000) found that individuals high in sensation seeking were at an increased risk of alcohol-related problems. As well as being associated with alcohol use in both adolescents and young adults (Malmberg et al., 2010;Moser et al., 2014;Schlauch et al., 2015), Krank et al. (2011) found evidence that sensation-seeking as measured by the Substance Use Risk Profile Scale is also predictive of hallucinogen use in a longitudinal study of adolescents. ...
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Article
Aims Much research indicates that an individual’s personality impacts the initiation and escalation of substance use and problems in youth. The acquired-preparedness model suggests that personality influences substance use by modifying learning about substances, which then affects substance use. The current study used longitudinal data to test whether automatic cannabis-related cognitions (memory associations and outcome expectancy liking) mediate the relationship between four personality traits with later cannabis use. Methods: The study focused on initiation of use in a sample of adolescents who had not previously used (n = 670). Results: A structural equation model supported a full mediation effect and the hypothesis that personality affects cannabis use in youth by influencing automatic memory associations and outcome expectancy liking. Further findings from the same model also indicated a mediation effect of these cognitions in the relationship between age and cannabis use. Conclusion: The findings of the study support the acquired-preparedness model where personality influences automatic associations in the context of dual-processing theories of substance use.
... College alcohol beliefs have been found to be robust predictors of college drinking outcomes and have outperformed the most common targets of college alcohol interventions -descriptive and injunctive norms, as well as positive alcohol expectancies -in accounting for these outcomes (Hustad et al., 2014; LaBrie et Moser et al., 2014;Osberg et al., 2011Osberg et al., , 2012Osberg & Boyer, 2016Qi et al., 2014). Yet, current interventions do not target these beliefs. ...
... Collectively, these findings indicate students feel that persuasive messages featuring arguments focused on academics and career, and the potential damage to these, are among the best ways to dissuade others from buying into the college drinking culture. Thus, the present findings are consistent with calls by some researchers that college alcohol beliefs should be targeted by "interventions that increase the perceived importance of academic achievement" (Moser et al., 2014) and by "deemphasizing the integral role of alcohol on campus and promoting other important aspects of the college experience (e.g. academic achievement and sense of community)" (Lui et al., 2020). ...
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Article
Objective College alcohol beliefs (e.g. “College is a time for experimentation with alcohol”) are highly predictive of heavy drinking and its consequences. Yet, current college alcohol interventions do not address this belief system even though researchers have recommended that these beliefs be targeted. Method Using a mixed methods approach, we conducted two studies to generate arguments against the college drinking culture and to evaluate the effectiveness of such arguments. Results In Study 1, freshman students (N = 104, 65% women) wrote an essay to a fictitious roommate presenting arguments against the college drinking culture. Responses were reliably coded into a 19-category scheme. The most common arguments included that (1) one’s focus should be on academics, (2) drinking will lead to academic consequences, and (3) drinking is not a rite of passage in college. In Study 2, college students (N = 488) rated the effectiveness of prototype arguments drawn from each Study 1 category. According to their ratings, the most effective arguments were that (1) one’s focus should be on academics, (2) drinking could have a negative impact on one’s career, and (3) one could do potential harm to others. Conclusions The student-generated arguments against the college drinking culture identified in his research have inherent ecological validity and will help inform the development of new interventions to counter such beliefs. We offer suggestions for translating our findings into clinical interventions. The problem of college student drinking has been long-standing (Kilmer et al., 2014 Kilmer, J. R., Cronce, J. M., & Larimer, M. E. (2014). College student drinking research from the 1940s to the future: Where we have been and where we are going. Journal of Studies on Alcohol and Drugs. Supplement, 75(Suppl 17), 26–35. https://www.ncbi.nlm.nih.gov/pubmed/24565309 https://doi.org/10.15288/jsads.2014.s17.26[Crossref], [PubMed] , [Google Scholar]) and remains a significant public health issue today (Hingson et al., 2017 Hingson, R. W., Zha, W., & White, A. M. (2017). Drinking beyond the binge threshold: Predictors, consequences, and changes in the U.S. American Journal of Preventive Medicine, 52(6), 717–727. https://doi.org/10.1016/j.amepre.2017.02.014[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). Decades of research on college student drinking and its consequences have identified key cognitive factors that underlie drinking and its consequences, such as the misperception of norms for drinking (Borsari & Carey, 2003 Borsari, B., & Carey, K. B. (2003). Descriptive and injunctive norms in college drinking: A meta-analytic integration. Journal of Studies on Alcohol, 64(3), 331–341. https://doi.org/10.15288/jsa.2003.64.331[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) and the positive expectancies students hold about the effects of drinking (Jones et al., 2001 Jones, B. T., Corbin, W., & Fromme, K. (2001). A review of expectancy theory and alcohol consumption. Addiction (Abingdon, England), 96(1), 57–72. https://doi.org/10.1046/j.1360-0443.2001.961575.x[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Monk & Heim, 2013 Monk, R. L., & Heim, D. (2013). A critical systematic review of alcohol-related outcome expectancies. Substance Use & Misuse, 48(7), 539–557. https://doi.org/10.3109/10826084.2013.787097[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]). The robust relationships between these cognitive variables and alcohol consumption among college students have led to the development of interventions that target these variables. Social norms marketing campaigns (DeJong et al., 2006 DeJong, W., Schneider, S. K., Towvim, L. G., Murphy, M. J., Doerr, E. E., Simonsen, N. R., Mason, K. E., & Scribner, R. A. (2006). A multisite randomized trial of social norms marketing campaigns to reduce college student drinking. Journal of Studies on Alcohol, 67(6), 868–879. https://doi.org/10.15288/jsa.2006.67.868[Crossref], [PubMed] , [Google Scholar]), personalized normative feedback (Lewis & Neighbors, 2006 Lewis, M. A., & Neighbors, C. (2006). Social norms approaches using descriptive drinking norms education: A review of the research on personalized normative feedback. Journal of American College Health, 54(4), 213–218. https://doi.org/10.3200/JACH.54.4.213-218[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]), and expectancy challenge techniques (Scott-Sheldon et al., 2012 Scott-Sheldon, L. A., Terry, D. L., Carey, K. B., Garey, L., & Carey, M. P. (2012). Efficacy of expectancy challenge interventions to reduce college student drinking: A meta-analytic review. Psychology of Addictive Behaviors, 26(3), 393–405. https://doi.org/10.1037/a0027565[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) have been a part of interventions designed to correct students’ misperceptions about the percentage of and amount students drink and the effects that alcohol has on their functioning in social situations. Reviews of the literature have demonstrated that interventions containing these components are effective for first year students (Scott-Sheldon et al., 2014 Scott-Sheldon, L. A., Carey, K. B., Elliott, J. C., Garey, L., & Carey, M. P. (2014). Efficacy of alcohol interventions for first-year college students: A meta-analytic review of randomized controlled trials. Journal of Consulting and Clinical Psychology, 82(2), 177–188. https://doi.org/10.1037/a0035192[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) and mandated students (Carey et al., 2016 Carey, K. B., Scott-Sheldon, L. A., Garey, L., Elliott, J. C., & Carey, M. P. (2016). Alcohol interventions for mandated college students: A meta-analytic review. Journal of Consulting and Clinical Psychology, 84(7), 619–632. https://doi.org/10.1037/a0040275[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]), except for interventions targeting student members of Greek letter organizations (Scott-Sheldon et al., 2016 Scott-Sheldon, L. A. J., Carey, K. B., Kaiser, T. S., Knight, J. M., & Carey, M. P. (2016). Alcohol interventions for Greek letter organizations: A systematic review and meta-analysis, 1987 to 2014. Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association, 35(7), 670–684. https://doi.org/10.1037/hea0000357[Crossref], [Web of Science ®] , [Google Scholar]). Effect sizes in most interventions across freshman and mandated students tend to be modest and not very durable in the long-term (Carey et al., 2016 Carey, K. B., Scott-Sheldon, L. A., Garey, L., Elliott, J. C., & Carey, M. P. (2016). Alcohol interventions for mandated college students: A meta-analytic review. Journal of Consulting and Clinical Psychology, 84(7), 619–632. https://doi.org/10.1037/a0040275[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Scott-Sheldon et al., 2014 Scott-Sheldon, L. A., Carey, K. B., Elliott, J. C., Garey, L., & Carey, M. P. (2014). Efficacy of alcohol interventions for first-year college students: A meta-analytic review of randomized controlled trials. 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Aside from social norms and positive alcohol expectancies, another cognitive variable has been found to be a very robust predictor, mediator, and moderator of college student drinking and its consequences – college alcohol beliefs (Crawford & Novak, 2006 Crawford, L. A., & Novak, K. B. (2006). Alcohol abuse as a rite of passage: The effect of beliefs about alcohol and the college experience on undergraduates’ drinking behaviors. Journal of Drug Education, 36(3), 193–212. http://www.ncbi.nlm.nih.gov/pubmed/17345914 https://doi.org/10.2190/F0X7-H765-6221-G742[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Osberg et al., 2010 Osberg, T. M., Atkins, L., Buchholz, L., Shirshova, V., Swiantek, A., Whitley, J., Hartman, S., & Oquendo, N. (2010). Development and validation of the College Life Alcohol Salience Scale: A measure of beliefs about the role of alcohol in college life. 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... This risk was even greater for adolescents who started using cannabis before the age of 15 (Gobbi et al., 2019). Depressive symptoms, such as low mood and anhedonia, and hopelessness, have been widely recognized as transdiagnostic variables in mental health, and hopelessness a risk factor for substance abuse (Moser et al., 2014). In relation to cannabis use, Malmberg et al. (2010) found that adolescents with high levels of hopelessness were more likely to have used cannabis compared to adolescents with lower levels of hopelessness. ...
... In this study we found that hopelessness is a predictor of cannabis use. This variable is considered a risk factor for substance use (Moser et al., 2014), with high levels of hopelessness associated with earlier onset of substance use (Malmberg et al., 2010). Hopelessness can be considered as a transdiagnostic factor, since it is observed in different psychopathological disorders and behaviors, such as depression or suicidal attempt (Ribeiro et al., 2018). ...
Article
Introduction: Cannabis is the most widely used psychoactive substance among adolescents worldwide, and the age at which consumption begins to decrease. Cannabis use in adolescents is associated with a wide range of adverse consequences in adulthood including increased vulnerability to psychosis and other mental disorders, as well as suicidal ideation and attempt. The aim of this study is to extend understanding of the link between cannabis use and mental illness by examining whether cannabis use at early ages predicts transdiagnostic variables that are precursors to severe clinical diagnoses. Methods: A descriptive cross-sectional study was conducted. The sample was made up of 605 adolescents from 7th to 9th grades, with a mean age of 13.2 years (SD = 1.0, 47% girls). The variables evaluated were: anomalous perception of reality, intolerance of uncertainty, rumination, suicide attempt, hopelessness, and symptoms of depression and anxiety. The administration of the questionnaires was carried out in groups of 20 participants under the supervision of a researcher in a unique session of 1 hour. Results: Adolescent cannabis users scored higher on all variables assessed: anomalous perception of reality (Cohen's d = .60), rumination (d = .48), intolerance of uncertainty (d = .11), suicidal attempt (affirmative answer: 25.9% of users vs 7.7% of non-users), hopelessness (d = .85), symptoms of depression (d = .80), and anxiety (d = .39). A binary logistic regression showed that the only variable uniquely related to cannabis use was hopelessness (Wald = 4.560, OR: 1.159, p = .033). Conclusions: Among some mental health risk factors, hopelessness appears uniquely related to cannabis use. Adolescents may use cannabis as a coping strategy for negative thoughts and emotions, or it may be a consequence of cannabis use. Future prevention programs should focus on preventing/treating modifiable factors such as hopelessness, and delaying cannabis use in specific subgroups of adolescents who experience pathologies such as depression or suicide attempts.
... Osberg et al. (2010) introduced a construct of alcohol perceptions about the role of drinking in the college experience, or internalization of college drinking culture, as assessed by the College Life Alcohol Salience Scale (CLASS). These perceptions regarding the relative importance of drinking in college appear to be correlated with personal alcohol use and negative consequences crosssectionally (Osberg et al., 2010;Osberg, Insana, Eggert, & Billingsley, 2011) and prospectively (Moser, Pearson, Hustad, & Borsari, 2014;Osberg, Billingsley, Eggert, & Insana, 2012). Collectively, these findings suggest that this construct holds promise as a potential intervention target in alcohol use research. ...
... Longitudinal/experimental studies are needed to better understand the relations among these variables. Previous research indicates that alcohol descriptive norms are drastically elevated before college (e.g., Hustad et al., 2014) and internalization of college drinking culture before college are positively related to drinking in college (Moser et al., 2014). Thus, future prospective studies are needed to investigate the relation between marijuana use norms and internalization of college marijuana use culture prior to college and their effects on marijuana use during college. ...
Article
Based on the high prevalence of marijuana use among college students, we examined distal and proximal antecedents to marijuana-related outcomes in this population. Specifically, we examined three marijuana-related perceptions (descriptive norms, injunctive norms, and internalization of college marijuana use culture) as potential mediators of the associations between four personality traits (impulsivity, sensation seeking, hopelessness, and anxiety sensitivity) and marijuana-related outcomes (marijuana use, negative marijuana-related consequences). In a large sample of college student marijuana users (n=2129), our path analysis revealed marijuana-related perceptions to significantly mediate the associations between personality and marijuana-related outcomes. Specifically, internalization of college marijuana use culture mediated the effects of both impulsivity and sensation seeking on marijuana-related outcomes. Not only do our findings suggest the importance of distinct types of marijuana-related norms in predicting marijuana involvement, but also the possibility that such normative beliefs could be targeted as part of personality-tailored interventions.
... Thus, impulsivity does not appear to be associated with whether high schoolers report current DG participation; rather, impulsivity relates to negative consequences. With regard to incoming college students, one study found that, after controlling for alcohol indices and other psychosocial variables, higher levels of sensation seeking (but not impulsivity) were associated with higher peak blood alcohol concentrations while playing DGs (Moser, Pearson, Hustad, & Borsari, 2014). Thus, in light of the novelty and excitement inherent in the first few weeks of college, students high in sensation seeking may be especially vulnerable for DG participation. ...
... For instance, one study found that incoming college students were more likely to endorse drinking while playing DGs in the context of a small gathering of friends compared with less controlled contexts involving heckling (i.e., where players being made fun of, perhaps because of performing poorly; Anderson, Duncan, Buras, Packard, & Kennedy, 2013). In addition, Moser et al. (2014) recently examined the cultural adjustment that takes place when students transition into college; those who internalized the college drinking culture (e.g., ''college is a time for experimentation with alcohol'') had higher BAC estimates during DG participation. ...
... Thus, impulsivity does not appear to be associated with whether high schoolers report current DG participation; rather, impulsivity relates to negative consequences. With regard to incoming college students, one study found that, after controlling for alcohol indices and other psychosocial variables, higher levels of sensation seeking (but not impulsivity) were associated with higher peak blood alcohol concentrations while playing DGs (Moser, Pearson, Hustad, & Borsari, 2014). Thus, in light of the novelty and excitement inherent in the first few weeks of college, students high in sensation seeking may be especially vulnerable for DG participation. ...
... For instance, one study found that incoming college students were more likely to endorse drinking while playing DGs in the context of a small gathering of friends compared with less controlled contexts involving heckling (i.e., where players being made fun of, perhaps because of performing poorly; Anderson, Duncan, Buras, Packard, & Kennedy, 2013). In addition, Moser et al. (2014) recently examined the cultural adjustment that takes place when students transition into college; those who internalized the college drinking culture (e.g., ''college is a time for experimentation with alcohol'') had higher BAC estimates during DG participation. ...
Article
The transition from high school to college has been characterized as a potentially vulnerable period because of decreased parental supervision and increased autonomy. This transition can increase risk for participation in high-risk behaviors such as drinking games (DGs), which are a social drinking activity that encourages intoxication and are associated with negative alcohol-related consequences. To date, there has not been a narrative review of DG research that examines this activity among high schoolers and incoming college students specifically, and thus, the current review bridges this gap. Findings indicate that DG participation is consistently linked to negative consequences (e.g., passing out, becoming sick) and other high-risk behaviors, such as prepartying (drinking before going to a social event). In addition, DG participation is linked to demographic (e.g., age, gender), psychological (e.g., personality, alcohol cognitions), and contextual/cultural factors (e.g., the college drinking culture). These findings have implications for current prevention and intervention efforts and suggest promising directions for future research.
... While reflective of overall demographics of the university, it is likely not generalizable to American college students as a whole, especially considering nonethnic college students have higher incidences of alcohol use compared to their counterparts. 60 Second, data were self-reported, so some reported answers could be over-or underreported. It is important to note, however, self-report data can accurately reflect a respondent's true cognitions and behaviors when settings and conditions are designed to maximize response accuracy (e.g., anonymity), such as those used in this study. ...
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Article
Objective: College campuses report alcohol and other drug policy violations as the most frequent reason students receive disciplinary referrals and, thus, are mandated to programming. This study sought to determine predictors of mandated students’ alcohol use frequency, and the likelihood of early-onset alcohol using college students enrolled in mandated programming engaging in current polysubstance use. Methods and participants: Employing a purposive sampling method, n = 822 participants were recruited from a pool of students who violated their university’s alcohol policy between October 2019 and July 2021. Results: Data analysis revealed early-onset alcohol use (p < .001), gender ID (p < .01), Greek Affiliation (p < .001), ethnicity (p < .05), and perceived norms (p < .001) significantly predicted alcohol frequency. Analysis also revealed engaging in early-onset alcohol use significantly predicted current participation in polysubstance use (p < 0.01), outside of controls. Conclusions: University programs should consider exploring polysubstance use targeted interventions to mitigate these harmful behaviors and associated negative consequences.
... In support of this possibility, impulsivity is associated with feeling more stimulant alcohol effects (e.g., elated, excited; Berey et al., 2019;Leeman et al., 2014;Waddell et al., 2021c, and stimulant alcohol effects are associated with drinking in physically stimulating and social contexts (Corbin et al., 2015;Fairbairn & Sayette, 2013;Kirkpatrick & De Wit, 2013;Sayette et al., 2012). In addition, contexts that are inherently high arousal/exciting, such as those that include drinking games and pregaming, are related to heavier drinking (Cox et al., 2019;Moser et al., 2014), and meta-analytic findings suggest that heavier drinking is more likely in large group contexts (Stanesby et al., 2019). Taken together, these studies suggest that impulsive individuals may be particularly vulnerable to the reward/excitability associated with highly arousing drinking contexts, which may then predict heavier drinking. ...
Article
Objective: Research suggests that impulsivity is a risk factor for problem drinking, but prior studies have yet to examine typical drinking context as a potential moderator of relations between impulsivity and drinking outcomes. Guided by Person-Environment Transactions Theory, the current study tested whether five facets of impulsivity (negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking) interacted with typical drinking context to prospectively predict drinking quantity. Method: Young adult participants (N = 448; mean age = 22.27) were recruited from a southwestern university and the surrounding community. Data from a baseline survey (Time [T] 1) and a 1-year follow-up (T2) were used for the current analyses. Impulsivity (UPPS-P Impulsive Behavior Scale), typical drinking context, and typical drinking quantity were assessed at T1, and typical drinking quantity at T2. Results: Context items were loaded onto latent factors comprising high-arousal (e.g., at a tailgate, large house party) and low-arousal (e.g., at a restaurant, on a date) drinking contexts. In univariate (separated by UPPS-P facet) and multivariate (UPPS-P facets together) models, lack of premeditation and positive urgency interacted with high-arousal drinking contexts to predict T2 drinking, such that individuals at high/mean levels of impulsivity drank more heavily the more frequently they drank in high-arousal contexts. Only interactions in univariate models remained significant after a false discovery correction, although effect sizes were very similar across univariate and multivariate models. Conclusions: Individuals high in positive urgency and lack of premeditation may be particularly vulnerable to riskier drinking behavior in high-arousal environments. Findings advance the literature on context-specific cues that may be important intervention targets, particularly for individuals high in positive urgency and lack of premeditation.
... It is especially noteworthy that CAB have been found to have stronger associations with drinking consequences when pitted against both descriptive and injunctive norms. 17,18,[20][21][22][23] In a similar vein, the association between CAB and consequences have been stronger than that found between positive alcohol expectancies and consequences. 17,18 Thus, it can be concluded that CAB are more strongly associated with alcohol consequences than norms and expectancies, two common targets of college alcohol interventions. ...
Article
Objective Non-adherence to COVID-19 guidelines is a major public health issue. This study explored factors that explain college student party behavior (PB; defined as attending a college party wherein COVID-19 guidelines, including masks and social distancing were ignored) during the pandemic. Method Freshmen students at a northeastern university (N = 207; 72% women) responded to an online Fall 2020 semester survey. Results The percentage of students who participated in on-campus partying during past month was 11.6%, with 20.3% participating in off-campus partying. Living on campus and higher perceived norms for partying were associated with higher levels of on-campus PB, whereas higher perceived norms for partying, stronger college alcohol beliefs, and a more conservative political ideology accounted for significant variance in off-campus PB. Conclusions Efforts to reduce party behavior should target misperception of party behavior norms as well as college alcohol beliefs, and take into account students’ residence and political ideology.
... Conversely, the use of other nonrestrictive terms may hold greater ecological merit dependent on the context and/or geographical location. For instance, the terms pre-gaming and pre-partying are commonly used by interest groups in the United States of America/South America (LaBrie et al., 2012;Moser et al., 2014;Pedersen & LaBrie, 2007;Pilatti & Read, 2018). Researchers from these locations may prefer to use these terms instead of pre-loading to mitigate confusion in their research methodologies and foster culturally consistent terminology among participants/their target audience. ...
Article
Background: Pre-loading of alcohol and other drugs has become a prevalent start to nights out in many countries. Studies into pre-loading have been using different operational definitions and descriptions, leading to confusion and debate in the research literature. Purpose/Objective: We wish to propose a full taxonomy so that research into preloading, of any substances, can be spe- cific and standardized. Methods: We address this problem by analyzing (1) terminology used throughout the literature, (2) the evolving nature of this phenomenon, and (3) the operational components comprising this substance use practice. Additionally, we provide a context and ration- ale for how we view pre-loading in relation to the broader event-level session. Results: Our results propose a full operational definition and taxonomy of pre-loading to be used, and built upon, by researchers. We also provide a visual representation of pre-loading within an event-level session and provide a method to facilitate consistency across cultures. Conclusions: We propose that this system will lead to greater specificity and higher reliability in the interpretation of research results.
... Furthermore, the transition to college is a challenging time in which students are adjusting to new academic tasks and social networks, which can lead to experimentation with substances and other maladaptive behaviors. 24,25 Several studies have used theoretical frameworks to gain an understanding of mechanisms that influence college students' NMUPD. 26,27 The Theory of Reasoned Action (TRA) was among the first theories to propose specific individual and social characteristics can influence substance use. ...
Article
Objectives: This study assesses students' non-medical use of prescription drugs (NMUPD) from college entrance to graduation, and examines factors that predict NMUPD. Participants: The study was conducted between May 2011 and September 2015 with 338 students. Methods: Longitudinal cohort study design was used to examine NMUPD across time, and NMUPD-related attitudes and subjective norms. Five yearly interviews were conducted to collect data. Cox proportional hazards regression analysis was used to examine time to NMUPD. Results: Thirty-five percent of study participants reported NMUPD; the majority of those initiated non-medical use before their third year in college. Analyses indicated that more positive attitudes towards NMUPD (HR = 1.73, p < 0.001), increased subjective norms regarding NMUPD (HR = 1.01, p < 0.01), and gender (male) (HR= 1.89, p < 0.001) were significantly associated with sooner NMUPD. Conclusions: Findings suggest that NMUPD prevention efforts that target mutable factors such as attitudes and subjective norms should be implemented early during students' college careers.
... Existing research examining sensation seeking and impulsivity in adolescence typically focuses on average (i.e., variable-centered) levels and developmental trends of the constructs. Although the traits are moderately correlated at the group level ( Collado et al., 2014;Lydon-Staley & Geier, 2017;Moser, Pearson, Hustad, & Borsari, 2014;Shulman et al., 2016;Zuckerman, 1994), neither levels nor developmental patterns of sensation seeking and impulsivity are necessarily similar across all individuals. That is, some individuals may be low in both traits or high in both traits, whereas other individuals may be high in one, but not the other. ...
Article
Introduction High levels of sensation seeking and impulsivity in adolescence are typically associated with risky behaviours; limited research has examined the relation of these traits to positive outcomes. Given that adolescence is a sensitive developmental period that can impact success later in life, we adopt the Positive Youth Development Framework to better understand how the development of self-reported sensation seeking and impulsivity may be differentially related to positive markers of early adulthood. Method Data are from the Victoria Healthy Youth Survey (T1 N = 662; 52% female), a six-wave longitudinal cohort study of Canadian youth. Parallel process latent class growth analysis estimated trajectories of sensation seeking and impulsivity identifying classes of youth (ages 14–28). Controlling for baseline age, sex, and socio-economic status, linear regression analyses examined how longitudinal patterns (classes) of sensation seeking and impulsivity were related to positive markers of early adulthood. Results Three classes of youth were identified. These varied in levels and trajectories of change in sensation seeking (Ss) and impulsivity (I): LowSs-LowI, 26%; HighSs-HighI, 35%; ModerateSs-LowI, 38%. In young adulthood (T6; ages 22–29), youth in the LowSs-LowI and ModerateSs-LowI classes had significantly higher educational and occupational achievement, and lower financial strain, compared to youth in the HighSs-HighI class. Further, the ModerateSs-LowI class was associated with the highest levels of income and well-being. Conclusions Findings identified differential trajectories of sensation seeking and impulsivity, with youth in the ModerateSs-LowI class, followed by the LowSs-LowI class, reporting the most positive outcomes in young adulthood.
... While some studies found AS reduces drinking (Woicik et al., 2009), others found no effect MacNevin et al., 2017). Similarly, hopelessness was found to be a risk factor for alcohol-related problems in one study (Moser, Pearson, Hustad, & Borsari, 2014), but other studies found no relationship between hopelessness and drinking outcomes in emerging adulthood Loxton, Bunker, Dingle, & Wong, 2015;MacNevin et al., 2017;Woicik et al., 2009). ...
Article
Personality traits provide one way of understanding differential susceptibility to drinking. However, the relationship between trait neuroticism and drinking is unclear. This exploratory study aimed to clarify this relationship by examining whether: (1) existing measures of neuroticism (based on prominent personality models) assess similar or different constructs; (2) social anxiety moderated the relationship between the resulting neuroticism factors and problematic drinking. Emerging adults (N = 757; Mage = 20.71; 72% female) completed an online survey assessing problematic drinking, six facets of neuroticism, and social anxiety. Factor analyses of the neuroticism scales yielded a four-factor solution comprising emotional instability (EI), behavioural inhibition system (BIS), fight-flight-freeze system, and hopelessness. Regression analyses revealed a positive main effect of EI and a significant interaction between BIS and social anxiety on problematic drinking (B = −0.009, p =.008). The BIS was associated with reduced problematic drinking when participants were high in social anxiety (B = −0.177, p =.032) and unrelated to problematic drinking when participants were low in social anxiety (B = 0.091, p =.220). Emerging adults with elevated EI are a vulnerable group which may benefit from personality-targeted interventions. High BIS is associated with reduced problem drinking in socially anxious emerging adults.
... Exhibiting sensation seeking personality traits is significantly associated with overall and heavy alcohol consumption (Stautz & Cooper, 2013), participation in drinking games (Diulio, Silvestri, & Correia, 2014; Johnson & Cropsey, 2000) and peak blood alcohol content (BAC) (Moser, Pearson, Hustad, and Borsari, 2014). Risky drinking patterns, such as participation in drinking games, mediate the relationship between sensation seeking and negative alcohol consequences (Jones, Chryssanthakis, & Groom, 2014), and alcohol-related consequences may be more prevalent among sensation seeking females compared to sensation seeking males (Turchik, Garske, Probst, & Irvin, 2010). ...
Article
Background: The alcohol industry recognizes children and pregnant women as population sub-groups vulnerable to the effects of alcohol marketing. Research indicates that heavy alcohol users are also potentially vulnerable to alcohol marketing. The purpose of the current study is to determine if sub-groups defined by psychological characteristics should be classified as potentially vulnerable as well. Methods: College students (n = 326) from two northeast schools were recruited to complete a survey containing questions on demographics, alcohol use, and psychological characteristics (alcohol expectancies, alcohol dependence, sensation seeking traits, and past delinquent behaviors). Additionally, after viewing each of five alcohol ads (4 television and 1 magazine), participants answered questions about their perceptions of alcohol consumption, responsible drinking, excessive drinking, and appeal of the ads. Main effects were assessed using hierarchical linear modeling, with adjustment for age, sex, race, ethnicity, and AUDIT score. Results: Alcohol expectancies (p < .001), particularly the social and physical pleasure and social expressiveness sub-scales, and sensation seeking traits (p = .002) were positively associated with alcohol ad appeal. Alcohol dependence symptoms, specifically impaired control and tolerance, were positively associated with perceptions of responsible drinking (p = .035), even though mean perceived number of drinks consumed met the definition of binge drinking. Conclusions: Individuals with positive alcohol expectancies, sensation seeking traits, and alcohol dependence may be vulnerable to alcohol advertising and marketing. Because alcohol advertising often contains content that can serve as a cue or reinforce to drink, specific regulations may be needed to prevent alcohol-related harm from occurring in these sub-populations.
... However, given the focus of our study was an evaluation of the SURPS, we refrain from providing specific assessment recommendations. Indeed, although other work suggests the construct of anxiety sensitivity is a correlate of alcohol-related outcomes in some populations when using alternative measures (e.g., Stewart, Zvolensky, & Eifert, 2001), the lack of evidence for criterion validity for AS in the current study and others (e.g., Malmberg et al., 2010;Moser et al., 2014; seminal work regarding the psychometric properties of the SURPS; Woicik et al., 2009), raises the broader question: What is the utility of simultaneously assessing these constructs, as indexed by the SURPS, to predict substance-related outcomes? ...
Article
The Substance Use Risk Profile Scale (SURPS), a widely used self-report questionnaire, assesses four personality traits which predict risk for substance use (i.e., anxiety sensitivity, hopelessness, impulsivity, and sensation seeking). Given its use in research and clinical settings, as well as potential utility, this study aimed to provide a comprehensive psychometric evaluation of the SURPS. Undergraduate participants (N = 718; 69% White; 26% Hispanic, aged 18-25 years, M = 19.00, SD = 1.33) completed a battery of measures, including the SURPS. Tests of measurement invariance, convergent and criterion validity, and internal consistency were conducted, as well as item response theory analyses and a treatment assignment simulation. Several items were removed before partial measurement invariance across gender was established with little information lost. Despite removing several SURPS items, the proposed factor structure was not empirically supported. More work is necessary to determine the predictive utility of assessing these personality traits to predict substance-related outcomes.
... Our findings indicated that alcohol use and partying had a direct and indirect influence on the sexual selves that participants discussed for their first semester in college. Previous research on first-semester students' alcohol use has indicated that a greater internalization of a perceived drinking script in college and increased perceptions of peer drinking behavior are associated with several alcohol-related behaviors (e.g., partying; Jun, Agley, Huang, & Gassman, 2016;Moser, Pearson, Hustad, & Borsari, 2014). Findings from our study indicated a similar script as participants reported they were planning to engage in alcohol consumption during their first semester in college because it was perceived as socially normative; however, many of these same participants discussed concerns about alcohol leading them to engage in behaviors or outcomes they hoped to avoid during the first semester. ...
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Article
According to the possible selves theory, individuals have possible selves that they hope to attain, or feared selves they hope to avoid, in the proximal future. In addition, individuals may have strategies they use to help them attain these possible selves or avoid their feared selves. Recent work has applied this theory to the realm of sexuality (i.e., sexual possible selves; SPS) in the developmental period of emerging adulthood, as this period is considered a time of increased sexual identity development. The purpose of this study was to extend this research by conducting semi-structured qualitative interviews with a sample of first-semester college-attending emerging adults (N = 35) at a 4-year university. We examined the developmental influences on expected and feared SPS to better understand why various internalized expectations develop. Interviews were conducted during the first four weeks of the fall 2016 semester and were analyzed using Applied Thematic Analysis. Prominent themes that emerged within the expected SPS included: sex and commitment, taking a passive approach, delaying sex and relationships, plans for hooking up, and abstinence. Feared SPS themes that emerged included: non-committed sexual avoidance, sexual assault/coercion, reputation, and sexual health. Prominent influences on participants’ SPS included: family, alcohol and parties, peers/friends, past experiences, changes in expectations, college culture, and religion. Implications for sexuality research, education and intervention are discussed.
... Effort to continually be aware of one's drinking (e.g., counting drinks) or financial concerns were listed as obstacles for using PBS. Although an interventionist may warn against dangers of "pregaming" (Moser, Pearson, Hustad, & Borsari, 2014), drinking cheap drinks at home prior to going out to a venue with expensive drinks may be economically advantageous. Additionally, participants reported that PBS use was counterintuitive when the goal of their alcohol consumption was to get drunk or experience the effects of alcohol intoxication. ...
Article
Background: Alcohol protective behavioral strategies (PBS) are behaviors engaged in immediately prior to, during, after, or instead of drinking with the explicit goal of reducing alcohol use, intoxication, and/or alcohol-related harms. Despite the quantitative support for alcohol PBS as a protective factor among college student drinkers, we know of no qualitative research aimed at determining college student drinkers' perceptions regarding the advantages and disadvantages of using PBS. Objectives: In the style of a decisional balance exercise, we asked college student drinkers (analytic n = 113) to identify 5 reasons they would not use PBS (cons) and 5 reasons they would use PBS (pros). Method: Participants (majority female, 77.0%) were recruited from a psychology department participant pool at a large, southeastern university in the United States. Within our analytic sample, participants on average consumed 6.38 (SD = 8.16) drinks per typical week of drinking and reported consuming alcohol on average 7.5 days (SD = 5.83) in the last 30 days. Results: Using a descriptive phenomenological approach, we identified 2 themes for pros (prevention of specific negative alcohol-related consequences and general safety) and 4 themes for cons (goal conflict, ineffectiveness, difficulty of implementation, and negative peer/social repercussions). Overall, participants reported more pros than cons and this discrepancy (i.e., number of PBS pros minus number of PBS cons) was positively related to self-reported frequency of PBS use. Conclusions/Importance: Taken together, we hope that clinicians/researchers will probe individual's reasons for choosing to use (or not use) PBS in order to tailor or improve existing PBS-based interventions.
... This may make a difference. Moser, Pearson, and Borsari (2014) found that students' perception of the college drinking culture was a stronger predictor of subsequent alcohol use than social norms. They suggested that addressing these perceptions would reduce drinking during the first month at college. ...
... Other names for this drinking practice include pre-partying, pre-drinking, or pre-loading (Foster & Ferguson, 2014;Reed et al., 2011). Pregaming is a specific type of risky drinking that has been the focus of recent empirical attention (Ahmed, Hustad, LaSalle, & Borsari, 2014;Barnett, Orchowski, Read, & Kahler, 2013;Hustad et al., 2014;Moser, Pearson, Hustad, & Borsari, 2014;Wells, Graham, & Purcell, 2009). Pregaming is considered to be a hazardous behavior in part because heavier drinkers tend to do it (e.g., DeJong, DeRicco, & Schneider, 2010;Haas, Smith, Kagan, & Jacob, 2012) and because it is linked to higher levels of intoxication (Barry, Stellefson, Piazza-Garnder, Chaney, & Dodd, 2013;Borsari et al., 2007;Fairlie, Maggs, & Lanza, 2015) and negative consequences (Barnett et al., 2013;Labhart, Graham, Wells, & Kuntsche, 2013;LaBrie & Pedersen, 2008;Merrill, Vermont, Bachrach, & Read, 2013). ...
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Article
Background: College students with trauma exposure and PTSD are at risk for problem drinking. This may include more specific hazardous drinking practices such as pregaming (drinking prior to a social event), which is linked to increased alcohol-related consequences. Objectives: The present study examined the association between pregaming and alcohol consequences and the role of trauma exposure and PTSD in predicting pregaming and alcohol-related consequences in a sample of college students using Multilevel Structural Equation Modeling (MSEM). We also assessed specific risk associated with PTSD relative to trauma exposure alone in relation to our outcomes. Methods: Participants were categorized into groups based on trauma exposure and PTSD symptoms via diagnostic interview: (1) No Trauma, those who had not experienced a Criterion A trauma; (2) Trauma Only, those who experienced a Criterion A trauma but did not currently have PTSD; and (3) PTSD, those with current full or partial PTSD related to a Criterion A trauma. Alcohol consumption and related consequences also were measured via interview (TLFB, B-YAACQ). Results: For all participants, nearly 50% more consequences were reported on pregaming days compared to nonpregaming drinking days. Those with PTSD were significantly more likely to pregame than those in the Trauma Only and No Trauma groups. Moreover, students with PTSD reported more consequences on pregaming days relative to the other two groups. In all analyses, the No Trauma and Trauma Only groups did not differ. Conclusions: PTSD may confer risk both for pregaming and experiencing harmful consequences on pregaming days.
... For example, those who have high positive expectancies with regard to alcohol consumption (e.g., it would make it easier to talk with people) are more likely to preparty and play drinking games than those with lower expectancies (Zamboanga, Schwartz, Ham, Borsari, & Van Tyne, 2010). Also, students who preparty are more likely to report that the reason they drink is to get intoxicated (Reed et al., 2011;Wahl, Sonntag, Roehrig, Kriston, & Berner, 2013) and that they agree with statements reflecting the stereotypical college-drinking culture, like "college is a time for experimentation with alcohol" (Moser, Pearson, Hustad, & Borsari, 2014). Regarding personality traits, those who preparty tend to display a greater propensity to seek out immediate reward and positive feelings (Haas et al., 2013). ...
Full-text available
Article
Background: Prepartying, or drinking before an event where more alcohol may or may not be consumed, has been positioned in the literature as a behavior engaged in by heavy drinkers. However, recent findings suggest that prepartying may confer distinct risks, potentially causing students to become heavier drinkers over time. Objectives: The goals of this study were to disentangle the longitudinal relationships between prepartying, general and episodic alcohol consumption, and alcohol-related consequences by investigating (1) whether prepartying is associated with future consequences above and beyond current alcohol consumption habits and (2) whether augmentations in approval for alcohol and related increases in drinking mediate this relationship. Methods: One-hundred and ninety-five undergraduates completed online questionnaires at baseline, 6 months, and 12 months later. Results: Prepartying frequency was more strongly related to alcohol-related consequences one year later than was overall or episodic drinking. In addition, a path mediation model confirmed our hypothesis that this relationship is due to gradual increases in drinking which occur as a result of more approving attitudes toward alcohol brought on by exposure to prepartying. Conclusion/Importance: Findings suggest a new model for conceptualizing the relationship between prepartying, drinking, and consequences whereby students who get involved in prepartying may witness slow increases in their approval for alcohol use and, as a result, consumption. Importantly, results suggest that the increases in drinking displayed by prepartiers over the course of a year may account for the strong relationship between prepartying and later consequences. Prevention and intervention initiatives may benefit from directly targeting prepartying as a means of tempering risky alcohol use trajectories during one's college tenure.
... A serious limitation of this approach is that it leaves researchers unable to determine when these negative consequences are occurring with reference to alcohol use. For example, although Wechsler and colleagues have focused largely on average level of drinking or the number of binge-drinking episodes [4,36], several investigators have demonstrated the incremental validity of peak or heaviest drinking measures in the prediction of negative consequences [37,38]. Researchers have assumed that more negative consequences are occurring on peak drinking days relative to 'typical' drinking days, but this assumption cannot be tested with retrospective data. ...
Article
Background and aims: The terms 'binge drinking' and 'heavy drinking' are both operationalized typically as 4+/5+ standard drinks per occasion for women/men, and are used commonly as a proxy for non-problematic (<4/<5) versus problematic (4+/5+) drinking in multiple research contexts. The Food and Drug Administration in the United States recently proposed the 4+/5+ criterion as a primary efficacy end-point in their guidance for trials examining new medications for alcohol use disorders (AUDs). Internationally, similar cut-offs have been proposed, with the European Medicines Agency having identified reductions in the number of heavy drinking days (defined as 40/60 g pure alcohol in women/men) as a primary end-point for efficacy trials with a harm reduction goal. Analysis and evidence: We question the validity of the 4+/5+ cut-off (and other similar cut-offs) on multiple accounts. The 4+/5+ cut-off has not been shown to have unique predictive validity or clinical utility. The cut-off has been created based on retrospective self-reports and its use demonstrates ecological bias. Given strong evidence that the relationship between alcohol consumption and problems related to drinking is at least monotonic, if not linear, there is little existing evidence to support the 4+/5+ cut-off as a valid marker of problematic alcohol use. Conclusions: There is little empirical evidence for the 4+/5+ standard drinks per occasion threshold for 'binge' or 'heavy' drinking in indexing treatment efficacy. Further consideration of an appropriate threshold seems to be warranted.
Article
The present study examined occasion-level associations between cognitions (willingness to drink, descriptive norms, and injunctive norms) and situational factors (familiarity with people and locations) with playing drinking games (DGs) among adolescents and young adults. Further, this study tested the associations between playing DGs, the number of drinks consumed, and the negative consequences experienced at the occasion level. Participants were 15-25-year-olds (N = 688; 43% male, 47% White, Non-Hispanic, Mean age = 21.18) who were part of a longitudinal ecological momentary assessment (EMA) study on cognitions and alcohol use. The study design consisted of a 3-week EMA burst design (8 surveys per week) that was repeated quarterly over the 12-month study (up to 2x/day) per participant. Multilevel models showed that occasion-level risks (higher willingness, higher descriptive norms, and less familiarity with people) were associated with playing DGs. When examining the within-person associations between DGs and number of drinks, results showed that playing DGs was associated with consuming more drinks. For consequences, DGs were not uniquely predictive of experiencing more consequences and riding in a vehicle with a driver who had been drinking. This study contributes to the literature by examining associations between cognitions and situational factors with DGs and the role DGs play in experiencing negative consequences among a diverse sample of adolescents and young adults.
Article
Participation in drinking games has been identified as one specific alcohol-related context linked to increased risk for heavier alcohol consumption and negative consequences among college students. Despite advances in drinking game research, questions remain about the different types of individuals at risk from participating. The current study utilized latent class analysis to classify individuals based on their endorsement of eight negative drinking game consequences from the Hazardous Drinking Games Measure. Analyses included identification of classes among 656 college students, followed by covariate analyses regressing class membership on motives for playing drinking games, general drinking motives, impulsivity facets, general problematic alcohol use, and specific drinking game behaviors. A total of three classes were identified, including a class with the fewest number of problems, a class with higher rates of hangovers and becoming sick, and a class with relatively higher rates of a majority of the other consequences. Classes differed in endorsement of motives, impulsivity facets, general problematic consumption, and drinking game behaviors. Generally, coping, conformity, and social general drinking motives; conformity and enhancement and thrills motives for playing drinking games; the impulsivity facet of negative urgency; the number of drinks consumed while playing drinking games; playing consumption type drinking games; and general problematic alcohol use were associated with more problematic class membership. Results highlight distinct classes of individuals at risk from drinking game participation. Recommendations for future studies and potential prevention and intervention efforts are also discussed.
Article
Objective: Posttraumatic stress disorder (PTSD) and hazardous alcohol use are prevalent among trauma survivors. Despite higher rates of both PTSD and hazardous alcohol use among military combat veterans than civilians, scant research has examined whether military combat experience is associated with drinking alcohol to cope with PTSD symptoms. This study tested the hypothesis that compared to trauma-exposed men without combat experience, men with military combat experience would be more likely to endorse drinking alcohol to cope with their PTSD symptoms. Methods: Interview data from N = 11,474 men who reported at least one lifetime traumatic experience were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a face-to-face interview study that recruited a nationally representative sample of adults living in the United States between 2004-2005. Results: Among men endorsing lifetime trauma exposure, men with military combat experience (n = 1,386) were more likely than men without combat experience (n = 10,088) to report drinking alcohol to cope (7.22% vs. 2.61% in unweighted analyses, 6.46% vs. 2.37% in weighted analyses). Total number of lifetime trauma types, lifetime PTSD severity, and lifetime alcohol abuse/dependence were significantly associated with drinking to cope in bivariate and multivariate analyses. Military combat experience was significantly associated with drinking to cope in multivariate analyses adjusting for lifetime PTSD diagnosis. Military combat experience was not significantly associated with drinking to cope in multivariate analyses adjusting for lifetime PTSD symptom count. Conclusions: Although military combat experience was significantly associated with drinking to cope in bivariate analyses, multivariate analyses yielded mixed findings: combat experience was significantly associated with drinking to cope in models adjusting for PTSD diagnosis, but not in models adjusting for PTSD symptom count. Findings highlight the importance of assessing and targeting PTSD symptom-related alcohol use, even in the absence of alcohol abuse/dependence. Results from this preliminary study could inform future research on drinking to cope with PTSD symptoms among military combat veterans and other trauma survivors.
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College alcohol beliefs (CABs; i.e., beliefs that alcohol use is an integral feature of college life) have been shown to be positively associated with negative alcohol-related consequences among college students. Given this information, the present study examined restricted eating before consuming alcohol to increase intoxication as one drinking behavior mechanism through which CABs relate to negative alcohol-related consequences. Additionally, we examined whether the indirect association of CABs and negative alcohol-related consequences through restricted eating differed as a function of enhancement drinking motives, specifically the CABs—restricted eating association (i.e., first-stage moderated mediation). Participants included college students (n = 1347) across 10 states/universities who consumed alcohol in the last month. The majority of participants identified as being White, non-Hispanic (69.0%), female (70.1%), and reported a mean age of 20.92 (Median=20.00; SD = 4.60) years. As hypothesized, restricted eating mediated the association between CABs and negative alcohol-related consequences. Further, the indirect effect of CABs on negative alcohol-related consequences through restricted eating was stronger in students who endorsed high levels of enhancement motives, compared to students with low or average levels. Our findings suggest that college students with high levels of enhancement motives are at a relatively higher risk of experiencing negative alcohol-related consequences related to CABs via restricted eating, compared to those with average or low levels. Future research is needed to examine additional drinking-related factors that may influence the pathways between CABs and negative alcohol-related consequences among college students.
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Anxiety sensitivity (AS) refers to a dispositional tendency to respond to one's anxiety sensations with fear. Longstanding theoretical accounts implicate AS in alcohol misuse; however, the relationship between AS and alcohol misuse remains unclear. We addressed this by testing whether AS is a risk factor for, and/or complication of, alcohol misuse by conducting a rigorous meta-analysis using random effect models. Our literature search yielded 15 studies (N = 9459). Studies were included if they used a longitudinal design, assessed AS and alcohol misuse at baseline, and assessed alcohol misuse and/or AS at follow-up. Results failed to support AS as a risk factor for, or complication of, alcohol misuse. Researchers are encouraged to test if the link between AS and alcohol misuse emerges under specific conditions (e.g., elevated state anxiety).
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Tailgating drinking prior to a football game is a type of event-specific drinking associated with increased alcohol use and related problems. Personalized drinking feedback interventions (PFI) are efficacious in reducing alcohol use and problems. The current study aimed to advance understanding of event-specific interventions by examining: (1) the efficacy of an event-specific, text message PFI on tailgating alcohol outcomes, and (2) the extent to which intervention effects generalize to "typical" alcohol outcomes at 1-month follow-up. College students (N = 130; 71% female; 92% white) who reported tailgating within the past 30 days and binge drinking when tailgating in the past year completed assessments on tailgating and typical alcohol use. They were randomly assigned to one of two text message conditions delivered on the morning of a home football game: event-specific PFI (TXT PFI) or a control condition. Multilevel modeling examined the association of treatment condition on tailgating and 1-month alcohol outcomes. When tailgating, participants in TXT PFI reported lower estimated peak blood alcohol concentration (eBAC) and consumed less drinks than the control condition. At the 1-month "typical" drinking follow-up, participants in TXT PFI reported lower peak eBAC and fewer alcohol-related problems than the control condition. Perceived tailgating drinking norms were found to statistically mediate the relationship between condition and alcohol outcome at tailgating and 1-month follow-ups. Findings provide preliminary support for the efficacy of an event-specific, text message PFI in reducing both tailgating and typical drinking alcohol outcomes. Event-specific TXT PFI can be used for prevention/intervention of alcohol misuse.
Article
Anxiety sensitivity (AS) refers to a dispositional tendency to respond to one’s anxiety sensations with fear. Longstanding theoretical accounts implicate AS in alcohol misuse; however, the relationship between AS and alcohol misuse remains unclear. We addressed this by testing whether AS is a risk factor for, and/or complication of, alcohol misuse by conducting a rigorous meta-analysis using random effect models. Our literature search yielded 15 studies (N = 9,459). Studies were included if they used a longitudinal design, assessed AS and alcohol misuse at baseline, and assessed alcohol misuse and/or AS at follow-up. Results failed to support AS as a risk factor for, or complication of, alcohol misuse. Researchers are encouraged to test if the link between AS and alcohol misuse emerges under specific conditions (e.g., elevated state anxiety).
Article
Introduction: Heavy alcohol and illicit drug use has been documented amongst medical and dental professionals and educational programs have been developed to attempt to reduce such behaviour in clinical undergraduates. This pilot study aims to investigate the legal and moral perceptions of substance use in clinical and non-clinical undergraduates. Method: A cross-sectional self-report questionnaire was administered to 107 clinical and non-clinical undergraduates to investigate their moral and legal perceptions of alcohol and illicit substance use. Results: More clinical (72.5%) than non-clinical students (66.0%) drink alcohol regularly. Both groups perceive ecstasy, cocaine and ketamine as ‘high risk’ drugs. A third of both clinical (34%) and non-clinical (36%) students support the legalisation of illicit drugs. Forty seven percent of non-clinical students would consider changing their behaviour if illicit substances were legalised compared to 32% of clinical students. Clinical students believe the legal punishment for Class A drugs is appropriate, but disagree with that for Class C drug use. Personal values of clinical students differ regarding some immoral activities. Social perceptions of illicit substance users are similar for both clinical and non-clinical students with those who use heroin perceived most negatively by 86.5% of all undergraduates. Conclusion: Individual substance use behaviours may be influenced by legal perceptions of illicit substance use. Personal values and social norms are also likely to be important. Further research is required to investigate how these perceptions affect a clinical student’s decision to participate in excessive alcohol and illicit substance use behaviours.
Article
Drinking games are high-risk, social drinking activities comprised of rules that promote participants’ intoxication and determine when and how much alcohol should be consumed. Despite the negative consequences associated with drinking games, this high-risk activity is common among college students, with participation rates reported at nearly 50% in some studies. Empirical research examining drinking games participation in college student populations has increased (i.e. over 40 peer-reviewed articles were published in the past decade) in response to the health risks associated with gaming and its prevalence among college students. This Special Issue of The American Journal of Drug and Alcohol Abuse seeks to advance the college drinking games literature even further by addressing understudied, innovative factors associated with the study of drinking games, including the negative consequences associated with drinking games participation; contextual, cultural, and psychological factors that may influence gaming; methodological concerns in drinking games research; and recommendations for intervention strategies. This Prologue introduces readers to each article topic-by-topic and underscores the importance of the continued study of drinking games participation among college students.
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This conclusion reviews the critical issues raised by the papers in this Special Issue on Drinking Games, with an eye toward directions for future research and the development of palliative interventions. In particular, this conclusion highlights the significance of individual-level characteristics that are associated with drinking game risk, the social context in which these games take place, and methodological considerations for studying both the individual and the context as they unfold as part of drinking game practices. Given both the ubiquity of these games in North American college drinking life, and the substantial hazards with which these games are associated, interventions that may reduce harmful outcomes are needed but have not yet been developed. Issues relevant to the development of such interventions are considered.
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Objective: Pregaming (drinking before a social occasion) predicts alcohol consequences between persons; people who pregame report greater consequences than those who do not. The present study examined within-person associations between pregaming and daily consequences. Method: Participants were college students (N = 44; 50% female) reporting past-month pregaming. Daily drinks consumed (during pregaming and across the entire drinking episode) and alcohol consequences were assessed with a 30-day Timeline Followback interview. Results: Within individuals, engaging in pregaming predicted consequences experienced on a given day above and beyond the number of drinks consumed across the drinking episode and typical drinking level. Furthermore, there was a trend toward pregaming placing women at more risk for consequences than men. Conclusions: Findings support a context-specific risk for consequences that is conferred by pregaming and that is independent of how much drinking occurs across the drinking episode. Results highlight pregaming as a target for future interventions.
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Drinking before going to a social event is common in adolescents and young adults and is associated with harmful outcomes, but information collected at the daily level is needed to better examine individual and contextual factors associated with pregaming. The purpose of this study was to investigate the prevalence of pregaming in a diverse sample of college students; demographic differences in rates of pregaming; the degree to which pregaming is associated with higher volume drinking, intoxication, and consequences; and the importance of time-of-year and day-of-week. College students (N = 750) at three colleges completed past-week surveys throughout their freshman and sophomore years. Pregaming was reported by 3 out of 4 drinkers and occurred on 31% of 12,361 drinking days. Compared with nonpregaming days, participants drank approximately 2 more drinks on pregaming days; this increase accounted for a .040 higher estimated blood alcohol concentration. Using generalized estimating equations, we established that women, racial/ethnic minority students, and first-year students were more likely to pregame on a drinking day than males, non-Hispanic White students, and sophomore students, respectively. Men became more intoxicated on pregaming days and sophomores consumed more alcohol. Pregaming predicted higher positive and higher negative consequences, even after controlling for the number of drinks consumed. Pregaming was more common in the fall semester, in the early weeks of each semester, and on weekends. Prevention efforts targeting first-year students, the early weeks of the semester, and the hours before traditional party times may be effective at reducing this hazardous practice. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
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Objective: Many students pregame (ie, drink before drinking), but there are scant data evaluating changes following college entry. The authors examined pregaming across the fall quarter and identified predictors of change and initiation in college. Participants: Freshmen (N = 708; 53% female, 100% drinkers) were recruited during university orientation (baseline). Methods: Self-report data were collected at baseline and end of fall quarter for 3 cohorts (the 2008-2010 academic years) and included demographics, alcohol use, problems, pregaming, personality, and expectancies. Results: Pregaming increased from 61.7% (baseline) to 79.9% (follow-up), with students pregaming twice as often and attaining higher blood alcohol concentration at follow-up. Many (54%) baseline non-pregamers initiated by follow-up. Initiation was associated with increased overall drinking (including heavy episodic drinking), positive expectancies, and greater behavioral activation sensitivity. Conclusions: Pregaming rapidly escalates upon college entry and students who initiate in college may be at higher risk for alcohol-related problems. Campus prevention and intervention efforts should consider including pregaming in their prevention programming.
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Personalized drinking feedback is an evidence-based and increasingly common way of intervening with high-risk college drinking. This article extends an earlier review by Walters and Neighbors (S. T. Walters & C. Neighbors, 2005, Feedback interventions for college alcohol misuse: What, why, and for whom? Addictive Behaviors, 30, 1168-1182) by reviewing the literature of published studies using personalized feedback as an intervention for heavy drinking among college students. This article updates and extends the original review with a more comprehensive and recent set of 41 studies, most of which were not included in the original article. This article also examines within-subject effect sizes for personalized feedback interventions (PFIs) for high-risk alcohol use and examines the content of PFIs more closely to provide insight on the most essential components that will guide the future development of feedback-based interventions. In general, PFIs appear to be reliably effective at reducing harmful alcohol misuse among college students. Some components are almost universally included (i.e., drinking profile and normative comparison), precluding inferences regarding their unique contribution. Significantly larger effect sizes were observed for interventions that included decisional balance, practical costs, and strategies to limit risks. The present research provides an important empirical foundation for determining the relative contribution of individual components and facets in the efficacy of PFIs. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
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Depression is common among college students and higher levels of depression are associated with greater alcohol-related problems. However, depression is frequently not found to be directly associated with more alcohol use. This study examined whether various aspects of impulsivity (negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and delay discounting) and drinking to cope with negative affect help to account for the relationship between depression and alcohol problems among emerging adult college drinkers who reported at least a minimal level of depressive symptoms. In this cross-sectional study, 143 emerging adult (between 18 and 25 years old) female (69.9%, n = 100) and male (30.1%, n = 43) college drinkers with at least minimal depressive symptoms completed measures of depression, alcohol use and problems, drinking to cope, and impulsivity. A multiple mediation analysis revealed that only negative urgency and drinking to cope partially mediated the depression-alcohol problems relationship. Moderated mediation analyses revealed that impulsivity-related constructs did not significantly interact with drinking to cope to increase alcohol problems. It appears that alcohol use is particularly problematic for students with elevated depression, and this is partly attributable to depression's association with negative urgency, in addition to its association with drinking to cope. Our findings suggest that students who suffer from depression may engage in problematic drinking behavior in part because negative affect is detrimental to their short-term impulse control and decision making, independent of maladaptive attempts to regulate affect through drinking to cope.
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Pregaming is the practice of consuming alcohol prior to going out to a social event. Although pregaming has begun to receive research attention in the college setting, very little is known about this risky drinking behavior in high school students. As pregaming has health implications for both students who are college bound and those who are not, we examined the prevalence of this behavior in a sample of high school students who reported current alcohol use and completed pregaming measures (n = 233). The present study examined the associations of gender, age, alcohol expectancies, motivations for drinking (e.g., social, enhancement, and coping), and engagement in other risky drinking practices (i.e., general hazardous use and drinking game participation) with pregaming. Results indicate that pregaming was significantly associated with being older, being a male, having high levels of hazardous alcohol use, and participating in drinking games frequently. Pregaming also occurred most often before parties and sporting events and it was associated positively with frequency of attendance at parties where alcohol is available, the tendency to use alcohol at these parties, and the amount of alcohol consumed at these parties. We discuss the findings in the context of pregaming research that has been conducted with college students, and make suggestions regarding prevention and intervention efforts focused on this risky drinking practice.
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This article reports the development and validation of the College Life Alcohol Salience Scale (CLASS), which assesses college students' beliefs about the centrality of alcohol to the college experience. Developed using procedures designed to increase its ecological validity, the CLASS was administered to three samples of college students (total N = 571). Its unidimensional factor structure was first established via exploratory factor analysis and parallel analysis on one sample and then verified via confirmatory factor analysis on a separate sample. Scores on the CLASS were predictably related to a nomological network of drinking and personality variables and it provided incremental validity in accounting for drinking frequency and amount, when added to drinking motive scores. The importance of assessing and developing interventions to target the types of beliefs measured by the CLASS is discussed.
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Prepartying and drinking game playing are associated with excessive alcohol consumption and alcohol-related negative consequences in college populations; however, research exploring the prevalence of these high risk drinking contexts among high school students, and how such engagement may impact both high school and subsequent college drinking risk, is lacking. The current study, which is the first study to assess prepartying during high school, examined how engaging in either prepartying or drinking game playing during high school was associated with risky high school drinking as well as alcohol use and consequences during the transitional first month of college. The study involved 477 first-year college students, the majority of whom were 18 years old (94%), female (66%), and Caucasian (59%). Prepartying was found to be highly prevalent in high school (45%). Further, students who prepartied or played drinking games during high school drank significantly more in high school than students who did not engage in these high risk activities. Finally, prepartying and game playing during high school were associated with greater collegiate alcohol consumption (controlling for high school drinking) and consequences (controlling for both high school and college drinking). This study establishes prepartying and drinking games as common high risk activities among both high school and incoming first-year college students, and addresses implications for prevention and targeted interventions.
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Interventions for college student drinking often incorporate interpersonal factors such as descriptive and/or injunctive norms to correct misperceptions about campus drinking (e.g., BASICS [Brief Alcohol Screening and Intervention for College Students] and social-norms campaigns). Some interventions also focus on intra-personal factors of alcohol consumption, which can be considered as one's own perception of drinking, one's attitude toward drinking, and one's intended outcome related to drinking. The current study sought to extend previous work by examining relationships between both inter- and intrapersonal perceptions of drinking and reported drinking behavior. College students (N=303) completed questionnaires assessing drinking behaviors, perceptions of other students' attitudes toward drinking (i.e., injunctive norms), their perception of the quantity and frequency of student/friend drinking (i.e., descriptive norms), and their attitudes and perceptions toward their own alcohol consumption (i.e., intrapersonal factors). Multiple regressions were used to analyze the unique influence between inter- and intrapersonal drinking perceptions and drinking behavior. Among the interpersonal perceptions of drinking, only closest friend's drinking significantly predicted alcohol consumption, whereas all three intrapersonal factors significantly predicted alcohol consumption. Suggestions for enhancing college student drinking interventions are discussed.
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This research evaluated the importance of reference groups in the relationships between injunctive norms and alcohol consumption for college student drinkers. First-year students (N = 811; 58% women) completed online assessments of their drinking behavior, as well as their perceptions of the approval (injunctive norms) and prevalence (descriptive norms) of drinking by others. Injunctive norms were evaluated with respect to typical students, typical same-sex students, friends, and parents. Descriptive norms were evaluated with respect to typical students and typical same-sex students. Results suggested that for injunctive norms, only perceptions of proximal reference groups (friends and parents) are positively associated with drinking behavior. However, when considered in the context of multiple referents and norms, injunctive norms for more distal groups (typical students/same-sex students) were negatively associated with personal drinking, whereas descriptive norms for distal referents remained positively associated with drinking. Results suggest that injunctive norms are more complex than descriptive norms and these complexities warrant important consideration in the development of intervention strategies.
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Although young adulthood is often characterized by rapid intellectual and social development, college-aged individuals are also commonly exposed to circumstances that place them at risk for psychiatric disorders. To assess the 12-month prevalence of psychiatric disorders, sociodemographic correlates, and rates of treatment among individuals attending college and their non-college-attending peers in the United States. Face-to-face interviews were conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43,093). Analyses were done for the subsample of college-aged individuals, defined as those aged 19 to 25 years who were both attending (n = 2188) and not attending (n = 2904) college in the previous year. Sociodemographic correlates and prevalence of 12-month DSM-IV psychiatric disorders, substance use, and treatment seeking among college-attending individuals and their non-college-attending peers. Almost half of college-aged individuals had a psychiatric disorder in the past year. The overall rate of psychiatric disorders was not different between college-attending individuals and their non-college-attending peers. The unadjusted risk of alcohol use disorders was significantly greater for college students than for their non-college-attending peers (odds ratio = 1.25; 95% confidence interval, 1.04-1.50), although not after adjusting for background sociodemographic characteristics (adjusted odds ratio = 1.19; 95% confidence interval, 0.98-1.44). College students were significantly less likely (unadjusted and adjusted) to have a diagnosis of drug use disorder or nicotine dependence or to have used tobacco than their non-college-attending peers. Bipolar disorder was less common in individuals attending college. College students were significantly less likely to receive past-year treatment for alcohol or drug use disorders than their non-college-attending peers. Psychiatric disorders, particularly alcohol use disorders, are common in the college-aged population. Although treatment rates varied across disorders, overall fewer than 25% of individuals with a mental disorder sought treatment in the year prior to the survey. These findings underscore the importance of treatment and prevention interventions among college-aged individuals.
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The final, common pathway to alcohol use is motivational. A person decides consciously or unconsciously to consume or not to consume any particular drink of alcohol according to whether or not he or she expects that the positive affective consequences of drinking will outweigh those of not drinking. Various factors (e.g., past experiences with drinking, current life situation) help to form expectations of affective change from drinking, these factors always modulated by a person’s neurochemical reactivity to alcohol. Such major influences include the person’s current nonchemical incentives and the prospect of acquiring new positive incentives and removing current negative incentives. Our motivational counseling technique uses nonchemical goals and incentives to help the alcoholic develop a satisfying life without the necessity of alcohol. The technique first assesses the alcoholic’s motivational structure and then seeks to modify it through a multicomponent counseling procedure. The counseling technique is one example of the heuristic value of the motivational model.
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Data drawn from a comprehensive survey of alcohol use in a college student community (N = 1, 116) show most students holding a moderate personal attitude regarding alcohol use while misperceiving their peer environment as being much more liberal. Drinking behavior is significantly related to gender, type of living unit, personal attitudes toward drinking, and also the degree of consistency/discrepancy between the individual's own attitude and his or her perception of the campus norm regarding drinking. Students who saw the campus norm to be similar to their own attitude were found to drink more heavily, and in more public settings, than students with discrepant attitudes and perceptions. Implications of findings for alcohol abuse prevention programs on college campuses are discussed.
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Drinking games are associated with excess alcohol use and alcohol-related problems, yet it is unclear whether they are unique to the college environment or whether students come to college familiar with such games. The authors queried 1,252 students attending voluntary summer orientation programs about their experiences with drinking games. A majority (63%) indicated they had played drinking games and viewed them as a means to get drunk quickly and to socialize, control others, or get someone else drunk. Logistic regression analyses revealed that familiarity with drinking situations was associated with a greater likelihood of playing drinking games. Students who reported drinking more frequently and consuming greater quantities of alcohol than others, having lifetime marijuana use, and initiating alcohol consumption between the ages of 14 and 16 years were significantly more likely to have participated in drinking games. These findings demonstrate the importance of considering students' participation in drinking games when campus officials address alcohol use.
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The purpose of this study is to determine the accuracy of retrospective estimated blood alcohol concentrations (eBACs) for re-creating intoxication resulting from a naturally occurring drinking event. This study identified five eBAC equations, applied them to self-report data and compared the results to actual blood alcohol concentration obtained by a breath test. A convenience sample of 109 drinkers was recruited near drinking establishments and asked to provide breath alcohol concentration (BrAC) samples. Participants were contacted by telephone on the next waking day to gather data required for five algorithms that determine eBAC. BrAC and eBAC obtained from each equation were compared to determine the level of agreement between the two approaches. eBACs correlated highly with each other (r > or = 0.99); R2 for all algorithms ranged from 0.54 to 0.55 with BrAC as the criterion. On average, eBAC equations overestimated BrAC. Regression analysis identified the amount of time spent drinking, number of standard drinks, weight and year in school as factors related to discrepancy. These data indicate that, although all equations produce eBACs that are highly related, their relationship to BrAC does vary across equations. Using the best fitting equation, eBAC is more strongly correlated with BrAC when intoxication is less than 0.08 g/210 L of breath, and the magnitude of the relationship decreases as intoxication rises.
Article
Objective: The purpose of this study is to determine the accuracy of retrospective estimated blood alcohol concentrations (eBACs) for re-creating intoxication resulting from a naturally occurring drinking event. This study identified five eBAC equations, applied them to self-report data and compared the results to actual blood alcohol concentration obtained by a breath test. Method: A convenience sample of 109 drinkers was recruited near drinking establishments and asked to provide breath alcohol concentration (BrAC) samples. Participants were contacted by telephone on the next waking day to gather data required for five algorithms that determine eBAC. BrAC and eBAC obtained from each equation were compared to determine the level of agreement between the two approaches. Results: eBACs correlated highly with each other (r >= 0.99); R-2 for all algorithms ranged from 0.54 to 0.55 with BrAC as the criterion. On average, eBAC equations overestimated BrAC. Regression analysis identified the amount of time spent drinking, number of standard drinks, weight and year in school as factors related to discrepancy. Conclusions: These data indicate that, although all equations produce eBACs that are highly related, their relationship to BrAC does vary across equations. Using the best fitting equation, eBAC is more strongly correlated with BrAC when intoxication is less than 0.08 g/210 L of breath, and the magnitude of the relationship decreases as intoxication rises.
Article
The Substance Use Risk Profile Scale (SURPS) is based on a model of personality risk for substance abuse in which four personality dimensions (hopelessness, anxiety sensitivity, impulsivity, and sensation seeking) are hypothesized to differentially relate to specific patterns of substance use. The current series of studies is a preliminary exploration of the psychometric properties of the SURPS in two populations (undergraduate and high school students). In study 1, an analysis of the internal structure of two versions of the SURPS shows that the abbreviated version best reflects the 4-factor structure. Concurrent, discriminant, and incremental validity of the SURPS is supported by convergent/divergent relationships between the SURPS subscales and other theoretically relevant personality and drug use criterion measures. In Study 2, the factorial structure of the SURPS is confirmed and evidence is provided for its test–retest reliability and validity with respect to measuring personality vulnerability to reinforcement-specific substance use patterns. In Study 3, the SURPS was administered in a more youthful population to test its sensitivity in identifying younger problematic drinkers. The results from the current series of studies demonstrate support for the reliability and construct validity of the SURPS, and suggest that four personality dimensions may be linked to substance-related behavior through different reinforcement processes. This brief assessment tool may have important implications for clinicians and future research.
Article
The purpose of present study was to understand factors that are related to a desire or motivation to change (MTC) alcohol use in a sample of college students mandated to receive an alcohol intervention. We examined characteristics of and reactions to the referral event, typical alcohol use involvement, and alcohol beliefs about the perceived importance of drinking in college assessed by the College Life Alcohol Salience Scale (CLASS; Osberg et al., 2010) as predictors of MTC following referral to an alcohol intervention. College students (N = 932) who presented for a mandatory alcohol intervention following a referral event (e.g., citation for underage drinking, medical attention for an alcohol-related incident, or driving under the influence) completed an assessment prior to receiving an alcohol intervention. Higher perceived aversiveness of the referral event and higher personal responsibility one felt for the occurrence of the event were positively related to higher MTC. Although alcohol beliefs about the role of drinking in college were not significantly related to either event aversiveness or responsibility, it was negatively related to MTC even after controlling for alcohol use involvement variables. Alcohol beliefs about the role of drinking in college represent an important construct that is related to increased alcohol use and alcohol-related problems and decreased MTC in a sample of college students. Interventions aimed at reducing alcohol beliefs about the role of drinking in college may be an effective strategy to reduce alcohol use and alcohol-related problems by college students. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Article
The present study examined three alcohol-perception variables (descriptive norms, injunctive norms, and college-related alcohol beliefs) as mediators of the predictive effects of four personality traits (impulsivity, sensation seeking, anxiety sensitivity, and hopelessness) on alcohol use and alcohol-related consequences in a sample of mandated college students (n=875). Our findings replicated several findings of a previous study of incoming freshman college students (Hustad et al., in press) in that impulsivity and hopelessness had direct effects on alcohol-related problems, sensation seeking and impulsivity had indirect effects on alcohol-related outcomes via college-related alcohol beliefs, and college-related alcohol beliefs predicted both alcohol use and alcohol-related problems. We discuss the implications of our findings for global college student interventions as well as personality-targeted interventions.
Article
After high school, college students escalate their drinking at a faster rate than their noncollege-attending peers, and alcohol use in high school is one of the strongest predictors of alcohol use in college. Therefore, an improved understanding of the role of predictors of alcohol use during the critical developmental period when individuals transition to college has direct clinical implications to reduce alcohol-related harms. We used path analysis in the present study to examine the predictive effects of personality (e.g., impulsivity, sensation seeking, hopelessness, and anxiety sensitivity) and three measures of alcohol perception: descriptive norms, injunctive norms, and perceptions regarding the perceived role of drinking in college on alcohol-related outcomes. Participants were 490 incoming freshmen college students. Results indicated that descriptive norms, injunctive norms, and the role of drinking largely mediated the effects of personality on alcohol outcomes. In contrast, both impulsivity and hopelessness exhibited direct effects on alcohol-related problems. The perceived role of drinking was a particularly robust predictor of outcomes and mediator of the effects of personality traits, including sensation seeking and impulsivity on alcohol outcomes. The intertwined relationships observed in this study between personality factors, descriptive norms, injunctive norms, and the role of drinking highlight the importance of investigating these predictors simultaneously. Findings support the implementation of interventions that target these specific perceptions about the role of drinking in college. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Article
Objective: Alcohol use established during the first-year of college can result in adverse consequences during the college years and beyond. In this meta-analysis, we evaluated the efficacy of interventions to prevent alcohol misuse by first-year college students. Method: Studies were included if the study reported an individual- or group-level intervention using a randomized controlled trial, targeted 1st-year college students, and assessed alcohol use. Forty-one studies with 62 separate interventions (N = 24,294; 57% women; 77% White) were included. Independent raters coded sample, design, methodological features, and intervention content. Weighted mean effect sizes, using fixed- and random-effects models, were calculated. Potential moderators, determined a priori, were examined to explain variability in effect sizes. Results: Relative to controls, students receiving an intervention reported lower quantity and frequency of drinking and fewer problems (d(+)s = 0.07-0.14). These results were more pronounced when the interventions were compared with an assessment-only control group (d(+)s = 0.11-0.19). Intervention content (e.g., personalized feedback) moderated the efficacy of the intervention. Conclusions: Behavioral interventions for 1st-year college students reduce alcohol consumption and alcohol-related problems. Interventions that include personalized feedback, moderation strategies, expectancy challenge, identification of risky situations, and goal-setting optimize efficacy. Strategies to prevent alcohol misuse among first-year students are recommended.
Article
Research indicates that pregaming (drinking before a social event) and tailgating (drinking before a sporting event) are two culturally ingrained alcohol use behaviors by college students. We examined the prevalence of these two activities in a sample of college students (N = 354) who violated campus alcohol policy and were mandated to receive an alcohol intervention in fall 2010. Results indicated that alcohol consumption and other risk factors were related to pregaming and tailgating. These findings are discussed in the context of clinical implications and future directions for research. This study was funded in part by the National Institutes of Health.
Article
Participants (N = 202) were students at a college in the northeastern United States who participated in the 2010 Core Alcohol and Drug survey. Data were collected on prepartying behavior, preparty social norms, and individual-difference variables. Using multivariate logistic and least-squares regression, it was found that descriptive social norms were associated with prepartying in women and injunctive social norms were associated with prepartying in men. Prepartying also was found to be negatively related to underage status and GPA in women and positively related to Greek membership and athlete status in men. Implications for social-norms interventions and suggestions for future social-norms research are discussed.
Article
Pregaming (consuming several alcoholic drinks prior to going to a bar or party) has become a common practice on many college campuses. We propose that students often rely on descriptive norms when making decisions about pregaming. In Study 1, we provided undergraduate students with norm information indicating that relatively few college students regularly engage in pregaming behavior. Female students receiving this information engaged in pregaming significantly less often the following week than female students who received no norm information. The rate of pregaming among male students was not affected by the norm information. The effect of norm information on pregaming was replicated in Study 2 using only female students. In addition, providing information about gender-specific norms had a greater impact on pregaming behavior than presenting norm data for the general student body only. The findings indicate that descriptive norms play an important role in pregaming behavior and suggest avenues for intervention programs.
Chapter
Statistics is a subject of many uses and surprisingly few effective practitioners. The traditional road to statistical knowledge is blocked, for most, by a formidable wall of mathematics. The approach in An Introduction to the Bootstrap avoids that wall. It arms scientists and engineers, as well as statisticians, with the computational techniques they need to analyze and understand complicated data sets.
Article
Osberg et al. (2010) recently developed the College Life Alcohol Salience Scale (CLASS), which assesses the extent to which students identify with the college drinking culture. Using a prospective design, we explored the incremental and predictive validity of the new measure in a sample of 479 college freshmen. Scores obtained on the new measure at Time 1 demonstrated strong positive associations with concurrently assessed drinking patterns and alcohol consequences, as well as those collected at Time 2 1 month later. The college alcohol beliefs measured by the CLASS also explained significant additional variance in drinking and its consequences at Time 2 beyond that accounted for by gender, perceived descriptive and injunctive norms, and positive and negative alcohol expectancies. Moreover, CLASS scores predicted typical drinking levels and alcohol consequences at Time 2, even when baseline levels of these drinking indices were controlled. Potential future lines of research with the CLASS are discussed.
Article
Two computer programs for estimating blood alcohol concentration (BAC) are described. BACTAB generates individualized tables for BAC estimation based upon a client's sex, body weight, amount of consumption, and drinking rate. ALCOMP convertes data from client self-monitoring cards into weekly summary statistics and plots a table for each individual client showing BAC estimates at each half-hour interval throughout the week. Various applications of these programs in controlled drinking therapies and in treatment outcome research are discussed.
Article
Individual drinking patterns and the perceived typical drinking patterns of close friends and reference groups were assessed in two different studies with college students. In both studies virtually all students reported that their friends drank more than they did. These effects were found across different levels of individual drinking, within different types of samples, across gender of subjects and with different types of questionnaire assessment. In addition, students' estimates of typical or average drinking within their own social living groups were significantly higher than average drinking within the group estimated from self-reports. Because of the consistent, asymmetrical pattern of reports of self and other drinking, it was interpreted that reports of others' drinking were exaggerated. These biases were particularly evident within organized social groups (i.e., fraternities and sororities) but were minimal in reference to "students in general" or "people in general." Results are discussed in terms of cognitive and motivational factors that potentially could promote or excuse excessive drinking practices among college students.
Article
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. Studies that evaluate the overall efficacy of an approach by measuring behavioral outcomes 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. 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 interventions. 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.
Article
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. Results revealed no differences in levels of perceived norms for alcohol use and problems as a function of gender or intention to affiliate with a Greek letter organization. Perceived norms demonstrated consistent, significant associations with both alcohol use and problems, while Greek intent demonstrated significant associations only with alcohol problems. Examination 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. Likewise, the association between perceived norms and alcohol use and problems were significant 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 findings suggest that alcohol prevention interventions may benefit from specifically targeting perceived norms among incoming students who are at highest risk (i.e., male pledges).
Article
Many college students overestimate both the drinking behaviors (descriptive norms) and the approval of drinking (injunctive norms) of their peers. As a result, consistent self-other discrepancies (SODs) have been observed, in which self-perceptions of drinking behaviors and approval of drinking usually are lower than comparable judgments of others. These SODs form the foundation of the currently popular "social norms approach" to alcohol abuse prevention, which conveys to students the actual campus norms regarding drinking behaviors and approval of alcohol use. However, little attention has been paid to the factors that can influence the magnitude of SODs. This research was conducted to address these issues. This meta-analytic integration of 23 studies evaluated the influence of five predictors of SODs: norm type (injunctive or descriptive), gender, reference group, question specificity and campus size. These studies rendered 102 separate tests of SODs in descriptive and injunctive forms, representing the responses of 53,825 participants. All five predictors were significantly related to self-other differences in the perception of norms. Greater SODs were evident for injunctive norms, estimates by women, distal reference groups and nonspecific questions, as well as on smaller campuses. More systematic attention should be given to how norms are assessed. In particular, SODs can be maximized or minimized, depending on the specificity of the behaviors/attitudes evaluated and the reference groups chosen for comparison.
Article
Although a number of measures of alcohol problems in college students have been studied, the psychometric development and validation of these scales have been limited, for the most part, to methods based on classical test theory. In this study, we conducted analyses based on item response theory to select a set of items for measuring the alcohol problem severity continuum in college students that balances comprehensiveness and efficiency and is free from significant gender bias. We conducted Rasch model analyses of responses to the 48-item Young Adult Alcohol Consequences Questionnaire by 164 male and 176 female college students who drank on at least a weekly basis. An iterative process using item fit statistics, item severities, item discrimination parameters, model residuals, and analysis of differential item functioning by gender was used to pare the items down to those that best fit a Rasch model and that were most efficient in discriminating among levels of alcohol problems in the sample. The process of iterative Rasch model analyses resulted in a final 24-item scale with the data fitting the unidimensional Rasch model very well. The scale showed excellent distributional properties, had items adequately matched to the severity of alcohol problems in the sample, covered a full range of problem severity, and appeared highly efficient in retaining all of the meaningful variance captured by the original set of 48 items. The use of Rasch model analyses to inform item selection produced a final scale that, in both its comprehensiveness and its efficiency, should be a useful tool for researchers studying alcohol problems in college students. To aid interpretation of raw scores, examples of the types of alcohol problems that are likely to be experienced across a range of selected scores are provided.
Article
The first year of college is a unique transition period, in which the student establishes a college identity and social network. Alcohol use is often part of this process, and many first-year college students develop a pattern of heavy drinking that puts them at risk for adverse consequences during their college years and into young adulthood. To better understand the development of risky alcohol use during this transition, we reviewed the literature on influences on college drinking and identified moderators and mediators that were particularly relevant for first-year alcohol use. As the transition from high school to college presents a unique opportunity for intervention, we discuss how these moderators and mediators can inform alcohol abuse prevention programs. We also identify approaches aimed at changing the culture of alcohol use on campus. Limitations of the reviewed research are highlighted in the context of promising directions for future research.
Article
Pregaming, the practice of consuming alcohol before attending a social function, has not received as much research attention as drinking games among college students. This study investigated the prevalence of both pregaming and drinking game participation in a sample of mandated students (N=334) who had been referred for an alcohol violation. Approximately one-third (31%) of the sample reported pregaming on the night of their referral event. Pregaming was associated with higher estimated blood alcohol content on that night, along with a greater history of pregaming and taking greater responsibility for the incident. A higher proportion of the students (49%) reported playing drinking games on the event night and reported the event to be less aversive than non-players. Neither drinking games nor pregaming was consistently related to recent alcohol consumption or problems, nor did they frequently occur together on the event night. Pregaming was a unique predictor of intoxication on the night of the referral, and drinking games were not. Therefore, pregaming and drinking games appear to be distinct activities. This research suggests methods of prevention for both activities as well as promising research directions for future research.
Article
In the collegiate context, misperceptions of student drinking norms are among the most salient predictors of heavy drinking. Despite overall overestimations of peer alcohol use, misperceptions of context-specific behaviors have been infrequently studied. The present study examines students' perceptions of the high-risk behaviors of prepartying and drinking games and investigates the relationship between perceived and actual behaviors. A sample of 524 college students completed an online assessment of actual and perceived alcohol use related to prepartying and drinking games. Quantity and frequency of overall drinking, prepartying, and drinking games were assessed for perceptions of all students at the university, as well as for male and female students separately. Questions also assessed participants' overall drinking, prepartying, and drinking game behaviors. Participants significantly overestimated the prepartying and drinking game behaviors of all students, male students, and female students at their university. For men, perceptions of same-sex prepartying quantity and drinking game frequency and quantity were associated with actual behavior. For women, perceptions of both same-sex and other-sex prepartying quantity were associated with actual behavior. These findings provide preliminary support for the association between context-specific perceived norms and actual prepartying and drinking game behaviors. Addressing these same-sex and opposite-sex norms during interventions may help students reduce their own engagement in these risky behaviors.
Today’s first-year students and alcohol. Task Force on College Drinking
  • M Upcraft
Upcraft M. Today's first-year students and alcohol. Task Force on College Drinking, National Advisory Council on Alcohol Abuse and Alcoholism, Bethesda, MD; 2002.
The role of alcohol beliefs on motivation to change college student drinking habits
  • D Qi
  • M Pearson
  • Jtp Hustad
Qi D, Pearson M, Hustad JTP. The role of alcohol beliefs on motivation to change college student drinking habits. Psychol Addict Behav 2014;28:524-531.