Hazardous Drinking College Students Research Articles

Pain severity and anxiety sensitivity interact to predict drinking severity among hazardous drinking college students

ABSTRACT Background: Hazardous alcohol use among college students is a growing problem. Alcohol is commonly used in the context of pain due to acute analgesic effects, although the role of pain among hazardous drinkers has not been examined. Little is known regarding factors that may moderate pain-alcohol relations. One factor is anxiety sensitivity, which reflects the fear of physiological sensations. Pain severity and anxiety sensitivity may interact such that those with high anxiety sensitivity may have stronger pain-alcohol relations.Objectives: The current study examined interactive associations of pain severity and anxiety sensitivity in relation to hazardous drinking severity, alcohol consumption, and alcohol problems among hazardous drinking college students (n = 370; 78.1% female).Methods: Self report measures of alcohol use, pain severity, and anxiety sensitivity were collected and moderation analyses were conducted.Results: There was a significant interaction of pain severity and anxiety sensitivity in relation to hazardous drinking severity (β = 0.25, p = .037); pain severity was significantly related to hazardous drinking for high (β = 0.28, p < .001) but not low (β = 0.09, p = .202) anxiety sensitivity. There was a similar interaction for alcohol consumption (β = 0.35, p = .008). For alcohol problems, there was no significant interaction, but there were unique main effects of both pain severity (β = 0.23, p < .001) and anxiety sensitivity (β = 0.34, p < .001).Conclusions: These findings suggest that drinkers with high anxiety sensitivity may use alcohol hazardously (and in greater quantities) in the context of pain. If replicated with longitudinal samples, the findings may inform clinical practice in terms of screening for and treatment of anxiety sensitivity.

The prevalence and impact of elevated anxiety sensitivity among hazardous drinking college students

Hazardous drinking is prevalent among college students, yet few seek treatment. Anxiety sensitivity AS is one factor with relevance to drinking. Yet, there are no known estimates of the prevalence of elevated AS among hazardous drinkers. The current study sought to estimate the prevalence of elevated AS among hazardous drinking college students and to examine relations between AS and hazardous drinking. Data from 1257 students Mage = 22.08; 80.4 % female; 76.8 % racial/ethnic minorities was employed. Approximately one third (30.7 %) of the sample met criteria for hazardous drinking. Among hazardous drinkers, 77.5 % had clinically elevated AS; similar rates were evidenced across sex and race/ethnicity. Hazardous drinkers reported significantly greater AS scores than moderate drinkers and non-drinkers (p < 0.001; η2 = 0.09). Those with elevated AS were more than three times more likely to be hazardous drinkers (p < 0.001). Among hazardous drinkers, those with elevated AS had more severe drinking levels (p < 0.001; Cohen’s d=0.07) as well as greater likelihood, number, and disturbance related to use of other substances (p’s from <0.001-0.005; Cohen’s d’s from 0.01 to 0.02). Findings from this study suggest that most hazardous drinkers have elevated AS, and that elevated AS is associated with a substantially higher likelihood of being a hazardous drinker. Hazardous drinkers with elevated AS report more severe drinking and other substance use than those with normative AS. There may be practical clinical benefit of implementing focus on AS to reduce hazardous drinking in college settings.

Treatment Seeking among College Students with Comorbid Hazardous Drinking and Elevated Mood/Anxiety Symptoms

ABSTRACTBackground: Hazardous drinking is prevalent among college students and often comorbid with mood and/or anxiety disorders; however, these disorders frequently go untreated. Prior studies have found that individuals with comorbid hazardous drinking are more likely to seek treatment than those with an hazardous drinking alone. Objectives: The current study tested possible psychological and structural explanations to understand these treatment seeking behaviors. Methods: A sample of 222 students identified as hazardous drinkers (AUDIT ≥ 8) participated from September 2010 to April 2011. Behavioral measures designed to mimic actual treatment seeking and self-report measures were used to assess treatment seeking behaviors, and the influence of psychopathology and individual predictors on treatment interest. Results: Students were more interested in treatment for emotional problems than for alcohol problems. Further, treatment seeking interest was significantly higher among individuals with comorbid hazardous drinking. When provided a telephone offer for a free on-campus clinic appointment, no students were interested in receiving treatment for alcohol use problems, but some were interested in an appointment for emotional problems (n = 13). Of those students expressing interest on the phone, seven attended the clinic appointment. Logistic regression analyses revealed that students with anxiety, anxiety sensitivity, and depression were more likely to attend the clinic appointment. Conclusions/Importance: In sum, targeting mood and anxiety disorders may be a viable way to increase treatment seeking rates in hazardous drinking college students.

Examining the role of positive drinking consequences on the relationship between social anxiety and negative drinking consequences

ABSTRACTPositive drinking consequences are gaining more attention in the college student drinking literature due to their degree of saliency in predicting hazardous drinking. However, the research is limited on the relationship between psychological constructs, such as social anxiety, and positive drinking consequences. The current study explored the moderating role of positive drinking consequences on the relationship between social anxiety and negative drinking consequences in a sample of hazardous drinking college students. A sample of 222 hazardous drinking undergraduate students completed measures of social anxiety and positive and negative drinking consequences. As predicted, social anxiety and positive consequences were positively related to negative consequences. Contrary to our predictions, interaction results revealed that students with more social anxiety reported more negative consequences when they reported fewer rather than more positive consequences. Thus, students with more social anxiety may not obtain the social benefits from drinking, which appears to be contributing to their experience of negative drinking consequences. Briefly, alcohol intervention clinicians should consider how to incorporate discussions of positive drinking consequences for these students to facilitate ways to foster social engagement while minimizing alcohol-related harm.

Exercise as an intervention for sedentary hazardous drinking college students: A pilot study

Young adults 18–24 years have the highest rates of problems associated with alcohol use among all age groups, and substance use is inversely related to engagement in substance-free activities. This pilot study investigated the promotion of one specific substance-free activity, exercise, on alcohol use in college students. Thirty-one sedentary college students who engaged in hazardous drinking (Alcohol Use Disorders Identification Test scores ≥8) were randomized to one of two conditions: (a) one 50-min session of motivational enhancement therapy (MET) focused on increasing exercise, or (b) one 50-min session of MET focused on increasing exercise plus 8 weeks of contingency management (CM) for adhering to specific exercise activities. All participants completed evaluations at baseline and post-treatment (2-months later) assessing exercise participation and alcohol use. Results of the pilot study suggest the interventions were well received by participants, the MET + CM condition showed an increased self-reported frequency of exercise in comparison to the MET alone condition, but other indices of exercise, physical fitness, and alcohol use did not differ between the interventions over time. These results suggest that a larger scale trial could better assess efficacy of this well received combined intervention. Investigation in other clinically relevant populations is also warranted.

When wanting to change is not enough: automatic appetitive processes moderate the effects of a brief alcohol intervention in hazardous-drinking college students

BackgroundResearch indicates that brief motivational interventions are efficacious treatments for hazardous drinking. Little is known, however, about the psychological processes that may moderate intervention success. Based on growing evidence that drinking behavior may be influenced by automatic (nonvolitional) mental processes, the current study examined whether automatic alcohol-approach associations moderated the effect of a brief motivational intervention. Specifically, we examined whether the efficacy of a single-session intervention designed to increase motivation to reduce alcohol consumption would be moderated by the strength of participants’ automatic alcohol-approach associations.MethodsEighty-seven undergraduate hazardous drinkers participated for course credit. Participants completed an Implicit Association Test to measure automatic alcohol-approach associations, a baseline measure of readiness to change drinking behavior, and measures of alcohol involvement. Participants were then randomly assigned to either a brief (15-minute) motivational intervention or a control condition. Participants completed a measure of readiness to change drinking at the end of the first session and returned for a follow-up session six weeks later in which they reported on their drinking over the previous month.ResultsCompared with the control group, those in the intervention condition showed higher readiness to change drinking at the end of the baseline session but did not show decreased drinking quantity at follow-up. Automatic alcohol-approach associations moderated the effects of the intervention on change in drinking quantity. Among participants in the intervention group, those with weak automatic alcohol-approach associations showed greater reductions in the amount of alcohol consumed per occasion at follow-up compared with those with strong automatic alcohol-approach associations. Automatic appetitive associations with alcohol were not related with change in amount of alcohol consumed per occasion in control participants. Furthermore, among participants who showed higher readiness to change, those who exhibited weaker alcohol-approach associations showed greater reductions in drinking quantity compared with those who exhibited stronger alcohol-approach associations.ConclusionsThe results support the idea that automatic mental processes may moderate the influence of brief motivational interventions on quantity of alcohol consumed per drinking occasion. The findings suggest that intervention efficacy may be improved by utilizing implicit measures to identify those who may be responsive to brief interventions and by developing intervention elements to address the influence of automatic processes on drinking behavior.

Implicit cognition as a moderator of brief motivational interventions for alcohol

Hazardous alcohol use is a function of implicit cognition, i.e., nonconscious influences on appetitive behavior stemming from memory associations that are automatically activated upon exposure to alcohol cues. Implicit cognition is typically not addressed by alcohol brief intervention (BI), which targets explicit or conscious processes underlying alcohol restraint (e.g., readiness-to-change). The potential role of implicit cognition in BI outcomes has not been well-studied. Eighty-nine hazardous drinking college students (Alcohol Use Disorders Identification Test [AUDIT] score > 8) participated in a general health study for course credit. Students were randomly assigned to one of two conditions: assessment only or a 10-15 minute motivational intervention. Students completed measures of alcohol use and readiness-to-change at baseline and at 6-week follow-up. In addition, they completed an alcohol-specific implicit association test (a response-time measure of alcohol approach). The motivational intervention resulted in a significant increase in readiness-to-change immediately following the intervention. However, the effect of the intervention on change in quantity of alcohol use per drinking occasion at follow-up was significantly moderated by implicit cognition. Simple slopes analyses showed that those with low implicit appetitive responses showed significantly less drinking when exposed to the intervention condition, while those with high implicit cognition did not. Similarly, readiness-to-change scores predicted declines in drinking for those low in implicit cognition but not for those who showed high levels of implicit cognition. These results suggest that the effect of brief motivational intervention may be less effective among those with strong implicit alcohol-approach associations, and that implicit cognition may be important to address in subsequent BI development.

Positive drinking consequences among hazardous drinking college students

Negative drinking consequences in college students have been well studied, but emerging evidence points to a role for positive drinking consequences in predicting alcohol related problems. Positive drinking consequences appear to be distinct from other drinking constructs such as drinking expectancies and drinking motives. However, no work has evaluated the role of positive drinking consequences in hazardous drinking college students, a population at high risk for alcohol related problems. The goal of the current study was to examine the effect of positive drinking consequences on problem drinking and alcohol problem recognition in a hazardous drinking college sample. Participants (N=222) were hazardous drinking undergraduate students completing a battery of self-report measures about alcohol use. Findings indicated that positive drinking consequences predicted problem drinking above and beyond other related constructs including positive drinking motives (i.e. enhancement and social). However, positive drinking consequences did not appear to play a significant role in alcohol problem recognition. Future research directions and implications for interventions with hazardous drinking college students are discussed.

Using personalized feedback to reduce alcohol use among hazardous drinking college students: The moderating effect of alcohol-related negative consequences

Web-based screening and brief interventions that include personalized feedback about their alcohol use have proven to be particularly promising for reducing hazardous drinking among university students. Despite the increasing use of these approaches, there is still relatively little known about how the content of these interventions may influence outcomes and who may benefit most from these approaches. The current study sought to address these issues by examining how individual differences in alcohol consequences influence outcomes of a laboratory-based computerized intervention. Methods One-hundred and nineteen introductory psychology students who either had two episodes of heavy episodic drinking in the past month or scored ≥ 8 on the AUDIT participated in this randomized controlled trial for course credit. Participants were assigned to 1 of 4 conditions in this 2 Intervention (Alcohol Feedback vs. Control) × 2 Assessment (Motivational Assessment vs. No Motivational Assessment) between-subjects design. Quantity of alcohol consumed per week and heavy episodic drinking one month later were the primary dependent variables. Results Controlling for corresponding baseline alcohol measures, hierarchical linear regression analyses showed a significant interaction between intervention condition and baseline alcohol-related consequences. For those who reported more alcohol consequences at baseline, the alcohol intervention resulted in significantly less alcohol use and fewer heavy drinking episodes at follow-up, while no difference was observed between intervention conditions for those with few baseline consequences. Assessment did not moderate intervention effects. Discussion These findings suggest that a feedback-based computerized intervention that includes normative information about alcohol use and consequences may be more effective for hazardous drinking students who are experiencing higher levels of alcohol-related consequences.

A Review of Exercise as Intervention for Sedentary Hazardous Drinking College Students: Rationale and Issues

College students have high rates of alcohol problems despite a number of intervention initiatives designed to reduce alcohol use. Substance use, including heavy drinking, often occurs at the expense of other, substance-free, activities. This review examines the promotion of one specific substance-free activity—exercise—as an intervention for hazardous drinking. Exercise has numerous physical and mental health benefits, and data suggest that students who engage in exercise regularly are less likely to drink heavily. However, the adherence to exercise necessary to achieve these benefits and possibly reduce drinking is poor, and improved exercise adherence interventions are needed. A novel combination of motivational enhancement therapy and contingency management is discussed as a means to address the critical issue of exercise adherence.