Reduce Alcohol Use Research Articles

Impact of Longitudinal Alcohol Use Patterns on Long-Term Risk of Cirrhosis Among US Veterans With Steatotic Liver Disease

Background & AimsConflicting data exists on impact of alcohol use on risk of liver disease progression in patients with steatotic liver disease. We aim to evaluate the effect of longitudinal alcohol use on risk of cirrhosis among Veterans with steatotic liver disease. MethodsU.S. Veterans with steatotic liver disease were identified from January 2010 to December 2022. Alcohol use was assessed using documented AUDIT-C scores and categorized as no alcohol (AUDIT-C = 0), low-risk alcohol use (AUDIT-C 1-2 for women and 1-3 for men), high-risk alcohol (AUDIT-C > 3 for women and > 4 for men). Incidence of cirrhosis was evaluated with competing risks Nelson-Aalen methods. Adjusted multivariable regression models evaluated risks of cirrhosis associated with baseline alcohol use and changes in alcohol use during follow up. Results1,156,189 Veterans with steatotic liver disease were identified (54.2% no alcohol, 34.6% low-risk alcohol, 11.2% high-risk alcohol). Veterans with steatotic liver disease and high-risk alcohol have 43% higher incidence of cirrhosis compared to patients reporting no alcohol use. Compared to patients with baseline high-risk alcohol who reported no change in alcohol use, those who decreased their alcohol use during follow up experienced a 39% reduction in long-term risk of cirrhosis (HR 0.61, 95% CI 0.45-0.83, p< 0.01). ConclusionsOne in nine Veterans with steatotic liver disease report concurrent high-risk alcohol use, which is associated with 43% greater risk of cirrhosis compared to no alcohol use. However, reducing alcohol use lowers risk of cirrhosis, emphasizing the importance of timely alcohol use assessment and early interventions to address high-risk alcohol use in steatotic liver disease.

Longitudinal examination of alcohol use motives, item-level protective behavioral strategies, and alcohol-related consequences.

Alcohol misuse among college students is a public health concern. Protective behavioral strategies (PBS) can be used before, during, after, or instead of drinking to reduce alcohol use and negative consequences, but findings on their utility at the aggregate level are mixed. Although recent work has provided important information on the performance of individual PBS items, it is limited by research designs that are cross-sectional, do not examine consequences, or do not examine other important correlates, such as drinking motives. This study examines both the association between item-level PBS and alcohol-related negative consequences and the moderating effect of drinking motives longitudinally. College students from two universities (n = 200, 62.5% female, Mage = 20.16) completed the Drinking Motives Questionnaire-Revised, Protective Behavioral Strategies Survey, the Rutgers Alcohol Problem Index, and a measure of the quantity of alcohol use at baseline and 3-month follow-up. Generalized linear models were conducted to assess direct effects of item-level PBS on alcohol-related consequences and the moderating effects of drinking motives. Two PBS items were associated with fewer alcohol-related consequences at follow-up, and two items were associated with greater alcohol-related consequences at follow-up. Drinking motives differentially moderated associations between item-level PBS and alcohol-related consequences for a proportion in the sample. Enhancement motives moderated the greatest number of associations, followed by coping, conformity, and social motives. Certain PBS (e.g., drink slowly, rather than gulp or chug) were moderated by several drinking motives, whereas other PBS items were not moderated by any motives. Consistent with previous research, some item-level PBS were associated longitudinally with increased negative consequences, and some were associated with decreased negative consequences. Drinking motives, particularly enhancement, moderated several item-level PBS and consequence associations, suggesting that reasons for drinking may be important for understanding the associations between PBS strategies and alcohol-related consequences.

Physical and Social Drinking Contexts Changes Due to the Lockdown During the COVID-19 Pandemic Modified Alcohol Consumption in a Sample of Argentine College Students

Alcohol consumption is highly prevalent in college students, being important to identify risk factors for alcohol consumption. Thus, this work explored students' alcohol consumption and the influence of drinking contexts and how the lockdown modified drinking contexts and its influence on alcohol consumption. Argentinean college students ( N = 1762; 74.8% women; Mean age = 23.25 ± 2.64) completed a survey that assessed alcohol consumption and related contexts before and during the lockdown. Latent Class Analysis identified 5 context-classes that showed different alcohol consumption patterns. A high percent of students drink alcohol in various contexts, but especially those related with social encounters with peers. Moreover, students who consume alcohol at social events with peers tend to have higher consumption rates per occasion and on a monthly basis. The confinement measures could have an effect on reducing alcohol use in college students, probably by modifying the drinking context of some students. college students consume alcohol extensively, which is worrying considering the health disturbances that it produces. Moreover, it is important to consider special situations such as the lockdown -that could modify contexts and its influence on consumption-to devise intervention strategies to reduce alcohol consumption.

Look away now! Defensive processing and unrealistic optimism by level of alcohol consumption

Objective Health risk information is insufficient as a means of reducing alcohol use, particularly when it evokes negative emotional states amongst those for whom it is most personally relevant. Appraisal biases, or ‘defensive processing’, may be employed to mitigate the psychological discomfort posed by such information. Few studies have evaluated the role of defensive processing in people with different levels of alcohol consumption. Design Online participants (n = 597) completed measures of defensive processing of a health risk infographic, perceived susceptibility and severity of alcohol use, efficacy for resisting alcohol use, unrealistic optimism, the Alcohol Use Disorder Identification Test – Consumption (AUDIT-C) and demographics. Results AUDIT-C scores were positively and linearly associated with all defensive processing measures (Pearson’s correlation r from.16 to .36), threat and susceptibility (r = .16) and unrealistic optimism (r = .50). AUDIT-C scores were also negatively associated with efficacy for controlling alcohol use (r = −0.48). Conclusion People with alcohol use disorder (AUD) engaged in much more defensive processing of alcohol-related messages, offering an explanation for why such messages are limited at eliciting behaviour change. High levels of unrealistic optimism in people with alcohol use disorder may reflect low problem recognition in order to maintain a problem-free drinking identity.

Nicotine Vaping Expectancies: Organization and Activation in Memory Based on Vaping Use Patterns.

The prevalence of smoking combustible cigarettes has decreased, but rates of nicotine vaping among adolescents and young adults have increased dramatically. Vaping is associated with acute health problems and exposes users to toxic metals with unknown long-term consequences. Research on factors influencing vaping is needed to inform the development of effective prevention and intervention methods. Nicotine vaping expectancies, or expected effects related to vaping, may be an important target as they can predict vaping behaviors. The purpose of this study was to examine nicotine expectancy activation patterns with corresponding nicotine vaping behaviors. Using methods from alcohol expectancy research, we applied a memory model approach to identifying nicotine vaping expectancies and modeling organization and activation patterns concerning the frequency of nicotine vaping. We created a memory model-based nicotine expectancy measure based on information from 200 adolescents in 8th and 12th grades, and college students. Our expectancy measure was completed by a second sample of 862 college students. We mapped expectancies into network format using Individual Differences Scaling (INDSCAL) and we modeled likely paths of expectancy activation using Preference Mapping (PREFMAP). Nonusers primarily emphasized a positive-negative expectancy dimension and were more likely to activate expectancies of negative internal experiences about vaping. Students who vaped nicotine daily or almost daily primarily emphasized an external appearance-internal experience expectancy dimension and were more likely to activate expectancies of negative affect reduction and withdrawal relief. Our results identify specific targets for expectancy-based prevention and intervention methods that have the potential to be as effective as similar approaches to preventing and reducing alcohol use.

Couples motivational interviewing with mobile breathalysers to reduce alcohol use in South Africa: a pilot randomised controlled trial of Masibambisane

IntroductionHeavy alcohol use among people living with HIV in sub-Saharan Africa can hinder the success of HIV treatment programmes, impacting progress towards United Nations Programme on HIV/AIDS goals. Primary partners...

Mental Imagery to Reduce Alcohol-related harm in patients with alcohol use disorder and alcohol-related liver damaGE: the MIRAGE randomised pilot trial results

ObjectiveThe healthcare burden of alcohol-related liver disease (ARLD) is increasing. ARLD and alcohol use disorder (AUD) is best managed by reduction or cessation of alcohol use, but effective treatments are...

Intertribal Talking Circle for the prevention of alcohol and drug use among Native American youth.

The purpose of this study was to examine the impact of a culturally based intervention, the Intertribal Talking Circle program, compared to a standard alcohol and drug abuse education, the Be A Winner program. Community-based participatory research was used to implement a two-condition, quasi-experimental study. The sample included 540 Native American youth ages 10-12 years old from three tribal areas in the United States. Data were collected at baseline, 6 and 12-months post-intervention for both the intervention and control groups using demographic, cultural identity, alcohol use, and drug use questionnaires. Regression models evaluated participants' improvement in decreasing alcohol and drug use and increasing cultural identity. Findings revealed that alcohol and drug use decreased more significantly among youth who participated in the Intertribal Talking Circle (ITC) intervention program than youth who participated in a standard alcohol and drug abuse education Be A Winner (BAW) program. Cultural identity also increased more significantly among participants who completed the Talking Circle intervention program. Native American youth ages 10-12 years old respond positively to a culturally based intervention for the reduction of alcohol and drug use. The findings highlight the importance of cultural values and identity and their significance in preventing and reducing alcohol and drug use among Native American youth.

Integrative Treatment for Substance Use Disorders: Improving Outcomes Through Evidence-based Practice of Yoga-derived Breathwork and Meditation.

Among 20.4 million US adults diagnosed with substance use disorders (SUDs), up to 60% return to use despite treatment or attempted abstinence. Standard care for SUDs is pharmacotherapy and/or behavioral interventions in either an inpatient or outpatient setting. Both national and international epidemiological data suggest this approach to treatment is insufficient and use of an integrative protocol can better promote recovery. To determine the efficacy of integrating yoga-derived breathwork and meditation into substance use treatment with emphasis on a specific practice, Sudarshan Kriya yoga (SKY). Literature review conducted in PubMed, OVID, and SCOPUS. The initial search term was " Sudarshan Kriya" alone. Subsequent searches combined the search term " Sudarshan Kriya" with a series of substance use-related terms using AND to link the terms. SKY practice impacts quality of life, well-being, functioning, and substance use behavior. In patients with alcohol use disorder, SKY contributes to significant reduction in depressive symptoms, stress biomarkers, and alcohol use up to 6 months after treatment completion. SKY practitioners engaging in opioid partial agonist therapy may experience buprenorphine potentiation such that concurrent nonprescribed opioid use is eliminated. SKY practitioners can achieve tobacco cessation at a rate comparable to bupropion pharmacotherapy. SKY has established efficacy in the treatment of anxiety, depression, and posttraumatic stress disorder. Currently available evidence also supports integration of SKY into the management of SUDs, and expanded SKY research can ensure optimal use of this promising intervention within this clinical subspecialty.

Experiences of alcohol use during pregnancy: A qualitative study of pregnant women at risk of acquiring HIV in Cape Town, South Africa

In South Africa, alcohol use during pregnancy is prevalent and associated with increased HIV risk. Developing locally sensitive and contextually appropriate evidence-based interventions to address alcohol use among pregnant and breastfeeding women in South Africa requires comprehensive understanding of the context of perinatal alcohol use and how relationships and lived environments may serve as barriers or supports for alcohol reduction. We conducted twenty in-depth qualitative interviews with isiXhosa speaking women who reported alcohol use during their recent pregnancy and/or recent intimate partner violence in Cape Town, South Africa between September and November 2022. We describe patterns and drivers of ongoing alcohol use during pregnancy and map them onto levels of the socioecological model. Data were analyzed utilizing the interpretivist paradigm and interpretive thematic analysis. Eight women reported alcohol use during pregnancy, sixteen reported experiencing recent IPV, and four women reported both alcohol use during pregnancy and recent IPV. In interviews, commonly cited reasons for continued alcohol use in pregnancy included stress (e.g., due to financial concerns), peer pressure, the central role of alcohol use in socialization and the persistence of misconceptions regarding the safety of alcohol use in pregnancy. Still, despite women reporting social norms that supported continued alcohol use in pregnancy, many altered who they drank with due to fear of judgement from close friends and family, leaving them isolated from their social support system. Interventions aimed at increasing interpersonal support, such as the use of peer mentors, could prove beneficial. Although the clinic provides messaging around the harms of alcohol use in pregnancy, these messages conflict with messaging received from their peers, limiting their impact on behavior. Locally sensitive tailored, relevant programming that intervenes on barriers to reducing alcohol use in pregnancy at multiple levels of the socioeconomic model are vital to effectively addressing this public health issue.

Effectiveness of The Seven Challenges® for adults: It’s not just because of self-disclosure

ABSTRACT This study examined the longer-term effectiveness of The Seven Challenges® Program, a comprehensive counseling program that incorporates work on drug and co-occurring problems. This study also examined the role of self-disclosure in achieving positive outcomes for adult drug court clients. Results indicated that The Seven Challenges Program elicited more self-disclosure and was more effective than standard cognitive-behavioral treatment in sustained reduction of alcohol use, mental distress, emotional problems, and behavioral issues to 6 months post-intake. Additionally, The Seven Challenges Program was effective at reducing criminal activity. Greater self-disclosure among The Seven Challenges clients accounted for their greater perceived impact of treatment, but not for the effectiveness of The Seven Challenges relative to standard cognitive-behavioral treatment. These findings strengthen the existing evidence base of the effectiveness of The Seven Challenges.

Engagement of adolescents with ADHD in a narrative-centered game-based behavior change environment to reduce alcohol use

BackgroundAttention deficit hyperactivity disorder (ADHD) affects about 13% of adolescents and is associated with substance use-related morbidity and mortality. While evidence on effective interventions to reduce alcohol use among adolescents with ADHD is limited, parent-teen communication about alcohol use has been found to be protective. Other approaches, such as educational interventions, hold promise to reduce alcohol-related harms in adolescents with ADHD. Digital technology offers an innovative approach to health behavior change, expanding access to services and may promote learning for neurodiverse youth, including teens with ADHD. INSPIRE, a narrative-centered game-based behavior change environment designed to promote self-regulation and self-efficacy to prevent risky alcohol use has been found to engage a general adolescent population. The goals of this pilot study are (1) to examine the engagement of youth with ADHD in INSPIRE; and (2) to examine if INSPIRE fosters parent-teen communication.MethodAdolescents diagnosed with ADHD aged 14–16 were recruited from developmental medicine clinics and invited to a focus group offered via Zoom. Participants completed a pre-survey, interacted with the INSPIRE game, and answered a post-survey as well as open-ended questions about their gaming experience during the focus group. Engagement was measured through both self-report using subscales from the User Engagement Scale and computer data; survey and qualitative data collected information on parent-teen communication. Univariate statistics described adolescent characteristics, Rank-sum and Fisher’s exact tests examined relationships among variables, and qualitative analysis identified themes in open-ended questions.ResultsOf adolescent participants (N = 40), 45% identified as female, 17.5% Black, 7.5%, Hispanic, and 62.5% White. Post-survey mean engagement subscales of Usability (on a 5-point scale) was 3.67 (SD = 0.74), and Satisfaction was 3.63 (SD = 0.75). Computer data indicated that participants played the game for a median of 24 min. Adolescents shared that playing the game strengthened refusal skills and their ability to navigate social gatherings with alcohol. Post-survey, 63% planned to share information from INSPIRE with a parent.ConclusionFindings suggest that INSPIRE may support facilitating youth with ADHD to learn the developmental competencies needed to mitigate risk and thrive. INSPIRE warrants further testing to explore its impact on alcohol use in youth with ADHD.

A prevention program for binge drinking among students based on mindfulness and implementation intention (ALCOMEDIIT): a randomized controlled trial

BackgroundThe emergence of new problematic alcohol consumption practices among young people requires new dynamics in prevention strategies. In this context, the ADUC project (Alcohol and Drugs at the University of Caen) aims to develop a better understanding of alcohol consumption, and in particular the practice of binge drinking (BD) in students, in order to develop relevant and adapted prevention tools. The ALCOMEDIIT study (Rin Normandie and IRESP funding; Agreement 20II31-00 - ADUC part 3) is a randomized controlled trial that focuses on the specific determinant of impulsivity. The main objective of this experiment is to assess a program for the prevention of BD practices based on motivational interviewing (MI) associated with implementation intention (II) and mindfulness meditation (MBM) in a student environment.MethodsThis study will include 170 healthy subjects who will be students at the university, alcohol users, with a BD score > 1 in the month preceding the inclusion but not presenting any specific disorder. The trial will be proposed by e-mail and students who meet the inclusion criteria will join either a control group which will benefit from a MI or an experimental group which will additionally benefit from an initiation to MBM with II (initial visit T0). In order to measure the effectiveness of the prevention program in terms of BD decrease, a follow-up at 1 month (T1) as well as a follow-up at 6 months (T6; exploratory) will be proposed to all participants. The total duration of this research protocol is 21 months.DiscussionThe purpose of this study is to evaluate the interest of associating mindfulness meditation practices and implementation of self-regulation strategies to optimize their use, with a motivational interview in an innovative prevention program aiming at reducing alcohol use and BD practice in the student population.Trial registrationClinicalTrials.gov Identifier: NCT05565989, September 30, 2022.https://clinicaltrials.gov/study/NCT05565989Protocol version 2.0 (September 2022)No. ID-RCB : 2022-A00983-40

Emotion differentiation among individuals in a randomized clinical trial for alcohol use disorder: Within- and between-person associations with affect, craving, and alcohol use in daily life

Emotion differentiation refers to cognitively distinguishing among discrete, same-valenced emotions. Negative emotion differentiation (NED) is a transdiagnostic indicator of emotional functioning. The role of positive emotion differentiation (PED) in clinical disorders, including alcohol use disorder (AUD), is less understood. Further, despite consensus that emotions are highly variable, little is known about within-person fluctuations in NED/PED. The current study leveraged 84 consecutive daily smartphone surveys from participants (N = 181) in a clinical trial of cognitive behavioral therapy for AUD to investigate whether between-person differences in overall NED/PED, or within-person variability in daily NED/PED, were associated with affect intensity, craving, drinking, and heavy drinking in daily life. Subsequent analyses explored whether associations were moderated by baseline alexithymia. At the between-persons level, greater average PED, but not NED, was associated with lower heavy drinking odds. At the within-persons level, higher-than-usual PED was associated with lower negative affect and odds of any drinking. Individuals with baseline alexithymia had stronger negative within-person associations between daily NED and both any and heavy drinking. PED is a skill linked to less alcohol use between- and within-persons irrespective of baseline alexithymia, whereas greater daily NED appears especially important for reduced alcohol use among individuals with co-morbid AUD and alexithymia.

Evaluating the Sick Quitting Hypothesis for Frailty Status and Reducing Alcohol Use Among People With HIV in a Longitudinal Clinical Cohort Study.

Evaluating the Sick Quitting Hypothesis for Frailty Status and Reducing Alcohol Use Among People With HIV in a Longitudinal Clinical Cohort Study.

Evaluating the Sick Quitting Hypothesis for Frailty Status and Reducing Alcohol Use Among People With HIV in a Longitudinal Clinical Cohort Study.

"Sick quitting," a phenomenon describing reductions in alcohol consumption following poor health, may explain observations that alcohol appears protective for frailty risk. We examined associations between frailty and reductions in drinking frequency among people with HIV (PWH). At six Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) sites between January 2012 and August 2021, we assessed whether frailty, measured through validated modified frailty phenotype, precedes reductions in drinking frequency. We associated time-updated frailty with quitting and reducing frequency of any drinking and heavy episodic drinking (HED), adjusted for demographic and clinical characteristics in Cox models. Among 5,654 PWH reporting drinking, 60% reported >monthly drinking and 18% reported ≥monthly HED. Over an average of 5.4 years, frail PWH had greater probabilities of quitting (HR: 1.56, 95% confidence interval [95% CI] [1.13-2.15]) and reducing (HR: 1.35, 95% CI [1.13-1.62]) drinking frequency, as well as reducing HED frequency (HR: 1.58, 95% CI [1.20-2.09]) versus robust PWH. Sick quitting likely confounds the association between alcohol use and frailty risk, requiring investigation for control.

Child Incarceration and Maternal Alcohol Use: Disentangling Within- and Between-Person Processes

Having a child incarcerated can take a toll on the physical, psychological, and financial well-being of mothers. These factors could, in turn, affect behavioral outcomes of mothers, such as alcohol use patterns. Some mothers might drink to cope with the experience of having a child incarcerated, but others may reduce alcohol use for various reasons. Given these uncertainties, the authors examined the association between child incarceration and maternal alcohol consumption (i.e., any use, frequency, quantity, and binge drinking). Eight waves of nationally representative data from the National Longitudinal Survey of Youth 1979 cohort were linked with the National Longitudinal Survey Children and Young Adults ( n = 3,837 mothers; 678 had children incarcerated). Multilevel generalized linear regression models showed that compared with mothers with no child incarceration, mothers of ever-incarcerated children were more likely to binge drink and consume more drinks when drinking (between-person effects). In contrast, following child incarceration, women consumed alcohol less frequently and were less likely to binge drink than they were prior to experiencing child incarceration (within-person effects). Additional research should focus on mechanisms that explain these opposing associations to identify protective factors and institutional supports for women whose children have been incarcerated.

Disease burden and related risk factors of esophageal cancer in China and globally from 1990 to 2021, with forecast to 2035: An analysis and comparison.

In this study we estimate the burden of esophageal cancer (EC) in China and globally from 1990 to 2021, with a forecast to 2035, using Global Burden of Disease (GBD) data. We also analyze the related risk factors to investigate burden trends. Mortality, disability-adjusted life years (DALYs), crude rates, and age-standardized rates of EC were analyzed in China and globally from 1990 to 2035, utilizing GBD open data as a secondary dataset analysis of GBD data. Temporal change trends of EC risk factors were analyzed from 1990 to 2021. Joinpoint regression determined average annual percentage change (AAPC) of age-standardized rates. Descriptive analysis compared mortality and DALYs by age groups. Bayesian age-period-cohort (BAPC) predicted age-standardized mortality and DALYs rates for the next 14 years. The ASMR and ASDR fluctuations in EC were significant in China, showing an overall downward trend. Globally, although there was also a downward trend, the fluctuations were relatively mild. The number of deaths and DALYs related to EC in China and globally showed a significant upward trend. Age-specific burden trends in China for EC indicated that the age group with the peak number of EC deaths shifted to the 70-74 years age group in 2021, while DALYs peaked in the 65-69 years age group. The crude mortality rate (CMR) peaked consistently in 1990 and 2021, both within the 90-94 years age range, while the crude DALY rate (CDR) shifted to the 85-89 years age group. Overall, the burden of EC deaths and DALYs in the population aged <40 years was relatively low, increasing rapidly after the age of 40 years, reaching a peak and gradually declining, and reaching a lower level after the age of 85 years. The predictive results of the BAPC model indicated that over the next 14 years, both ASMR and ASDR for EC in China and globally would show a slight overall increase. The GBD 2021 study identified smoking, high alcohol use, chewing tobacco, and diet low in vegetables as the main risk factors affecting EC mortality rate and DALYs. Among these, smoking and alcohol use were the most significant risk factors, with a higher impact on EC in China compared to the global level. From 1990 to 2021, the overall changes in ASMR and ASDR indicate a decreasing trend in the impact of these four risk factors on EC mortality rate and DALYs. The burden of EC is expected to steadily increase in China and globally until 2035, posing a significant challenge. Targeted prevention and control policies, such as calling on people to quit smoking and reduce alcohol use, may help curb this upward trend.

CANNABIS USE TRENDS AND INTENTIONS AMONG OLDER PEOPLE WHO INJECT DRUGS IN LOS ANGELES, CA, AND DENVER, CO, 2021–2022

Abstract One potential benefit of drug legalization is that it might lead to substitution of legal products for criminalized substances. This is particularly true in the case of legal cannabis use by the subpopulation of people who inject drugs (PWID) and thus face substantial risk of physical harm, infectious diseases transmission, and even death especially in criminalized environments. Should substitution occur among older PWID, where other comorbid conditions are more common, the benefits could be even greater. To describe substance use patterns among older people who inject drugs and to examine if older PWID are more likely to use cannabis as a substitute for other substances. We analyze data from quantitative, health surveys collected from 429 community-recruited PWID during 2021/22. Descriptive statistics were used to characterize the drug use patterns among older (50 years of age or more) PWID and multivariate regression to examine if older participants were more likely to substitute cannabis for any other substance. Results: Among the 429 participants, 110 (or 26%) were 50 years of age or older. Older participants reported being significantly less likely than younger participants to use of methamphetamine, fentanyl and cannabis. In terms of cannabis substitution, older participants were significantly more likely to report using cannabis to reduce alcohol use. Risk and benefits of cannabis use vary among subpopulations. Older PWID might benefit from improved access to cannabis when trying to reduce alcohol use. Given the negative consequences of alcohol use, cannabis substitution might have additional benefits for this subpopulation.

College Student Alcohol Use: Understanding the Role of Alcohol Expectancies, Social Anxiety, Social Connectedness, and Need to Belong

Objective College students consume more alcohol and engage in binge drinking more frequently than their non-college attending peers, and prevalence of alcohol-related consequences (e.g., drinking and driving; taking avoidable risks) has not decreased proportionally with decreases in consumption. Social anxiety and alcohol expectancies, or beliefs about the effects of alcohol, have been found to be significantly related to alcohol use and account for significant variance in alcohol use and related consequences. Few studies, however, have examined how other social variables such as need to belong and social connectedness may fit into existing models of increased and risky alcohol use. Methods: Students at a large state university (n = 1,278) completed an online survey measuring alcohol expectancies, need to belong, social anxiety, and social connectedness. Mean age of participants was 19.65 years, and 59.5% self-identified as female, 39.8% male, and 0.7% identified as transgender. Structural equation modeling supported hypothesized relationships between need to belong, social anxiety, social connectedness, alcohol expectancies, and alcohol use, a mean centered variable that included binge drinking, drinking frequency, and amount of consumption. Results: Positive alcohol expectancies related to tension reduction, sociability, and sexuality, were positively related to drinking, such that increased alcohol expectancies were associated with increased drinking. Alcohol expectancies mediated the relationship between need to belong and increased alcohol use, as well as social connectedness and increased alcohol use. Similarly, social anxiety also mediated these relationships. No direct relationships were found between need to belong or social connectedness and alcohol use, suggesting previous research exploring these relationships may have excluded control variables (e.g., biological sex, race/ethnicity) that better explain the impact of need to belong and social connectedness on alcohol use. Conclusion: Prevention and intervention efforts might be more effective in reducing alcohol use if social factors are more broadly targeted.