Risk For Alcohol-related Problems Research Articles

Friendship-Related Stress and Alcohol Use Among Post-college Emerging Adults

Friendship-related stress is an understudied factor that may explain variation in coping-motivated and socially-motivated drinking among emerging adults. This study examined chronic and episodic friendship stress as predictors of drinking levels and motivations among emerging adults transitioning to post-college life. College drinkers reported drinking motives and alcohol consumption daily for 30 days using an Internet-based diary in college and five years later ( N = 897, 54.2% women, Mage = 24.6 at follow-up, 86.0% White). Post-college, participants completed by phone the UCLA-Life Stress Interview assessing chronic and episodic friendship/social life stress. Chronic friendship/social life stress was positively correlated with mean levels of post-college drinking-to-cope motivation and was negatively related to post-college heavy drinking and social drinking motivation. Emerging adults experiencing friendship stress are more likely to use alcohol as a coping mechanism, elevating their risk for alcohol-related problems. Those with low friendship stress may require public health interventions around the risks of heavy drinking.

Calibrating the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) for detecting alcohol-related problems among Canadian, UK and US soldiers: cross-sectional pre-deployment and post-deployment survey results

ObjectivesExcessive alcohol use can bring about adverse health and work-related consequences in civilian and military populations. Screening for excessive drinking can help identify individuals at risk for alcohol-related problems who...

The Association Between Alcohol-Related Problems and Sleep Quality and Duration Among College Students: a Multicountry Pooled Analysis.

Alcohol consumption and sleep disorders are both prevalent and relevant problems among college students, but the relationship between these conditions is unclear. This study aimed to analyze the association between alcohol-related problems and sleep in first-year college students from Brazil, Chile, and Spain. Cross-sectional analyses were performed with data from three independent studies with first-year college students from each country. The risk of alcohol-related problems (RARP) and sleep quality and duration were self-reported using mixed methods. Pooled odds ratios (p-OR) and 95% confidence intervals (95% CI) of suboptimal sleep quality and of short (< 7 h) and long (> 8 h) sleep duration were estimated according to RARP adjusting for the main confounders. Of the 1830 students included (31.2% Brazilian, 42.2% Chilean, and 26.6% Spanish), 61.6% were female, and the mean age was 20.0 ± 3.6 years. Overall, 25.0% and 9.9% of the students were classified as intermediate and high RARP, respectively. In the combined results for the three countries, intermediate-to-high RARP was associated with a higher likelihood of suboptimal sleep quality (p-OR: 1.24; 95% CI: 1.00 to 1.52; I2 heterogeneity statistics: 43.0%), regardless of sociodemographic and lifestyle covariates and of self-rated health. The frequency of alcohol consumption was not associated with sleep quality or sleep duration. In this multicountry pooled analysis, first-year college students at risk of alcohol-related problems were more likely to report worse sleep quality. The coexistence of alcohol-related problems and sleep disorders could potentiate its adverse health effects among these young adults.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11469-022-00763-8.

Economic evaluations of interventions aimed at the prevention, treatment and/or rehabilitation of alcohol-related disorders: A systematic review.

The aim of this systematic literature review is to identify economic evaluations of programmes or interventions aimed at the prevention, treatment and rehabilitation of alcohol use disorders, as well as to determine those types of programmes, treatments or interventions that are efficient. The systematic literature review was conducted by searching the following databases: National Health Service Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA), MEDLINE Ovid and PubMed. The search terms used were in English. No time restriction was applied. A data extraction form was used to draw information. The systematic review follows the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) on reporting systematic reviews. The interventions were classified into three categories: "A" treatments for people with alcohol use disorders (tertiary prevention); "B" treatments for people at risk for alcohol-related problems (secondary prevention); "C" policy legislation and enforcement interventions (primary prevention). Furthermore, the "A" interventions were subclassified into psychological, pharmacological and combined interventions. The review included 63 papers. In terms of treatments for people with alcohol use disorders, any psychosocial intervention compared to no intervention appeared to be a dominant strategy. In terms of treatments for people at risk of alcohol-related problems, brief intervention appears to be dominant or cost-effective when compared to no intervention. Advertising controls, tax increases, licensing, legal drinking age, and mass media campaigns seem to be dominant or cost-effective strategies compared to no intervention or random breath testing. Previous reviews have been extended by depicting alcohol programmes according to their efficiency. Despite this, the available studies in this regard have heterogeneous approaches and most do not adequately define the costs included in their analyses. Therefore, it is necessary to encourage the evaluation of the efficiency of these types of interventions to aid decision-making in public health.

A Comparison of Chinese Adults Who Consume Homemade versus Commercial Alcohol

Background Little is known about adults in China who drink homemade alcohol, and whether they are at elevated risk of harms relative to those who drink alcohol from commercial sources. Purpose: We describe and contrast adults in China who regularly consume either homemade or commercially available alcohol, or both. Methods: Household-based in-person interviews were conducted in 2018 with adults in Jiangshan and Lanxi. We examined the characteristics of 833 adults who had consumed alcohol within the previous 30 days, comparing those who drank commercial alcohol only with those who drank homemade alcohol only and alcohol from both sources. Results: Regression analyses revealed that drinkers of both homemade and commercial alcohol consumed more drinks and were more likely to report heavy drinking than did drinkers of commercial or homemade alcohol only and were also more likely to meet criteria for alcohol use disorder. We also found that homemade-only alcohol drinkers were at elevated risk for this disorder. Conclusions: Drinkers of both homemade and commercial alcohol in China may be at risk for alcohol-related problems and constitute a little understood population for whom further research is needed. The AB InBev Foundation supported this study.

Enhanced Brief Motivational Intervention for College Student Drinkers With ADHD: Goal-Directed Activation as a Mechanism of Change

College students with attention-deficit/hyperactivity disorder (ADHD) are at risk for alcohol-related problems and disorders relative to their typically developing peers. Despite risk, the optimal therapeutic approach for reducing problem alcohol use in students with ADHD, and mechanisms of change underlying treatment effects in this population, are largely unknown. The current study evaluated putative mechanisms of change in a randomized controlled trial of two harm reduction interventions for college student drinkers with ADHD (N = 113; 49% male): brief motivational intervention plus supportive counseling (BMI + SC) versus brief motivational intervention plus behavioral activation (BMI + BA). Results showed that participants in the BMI + BA condition engaged in more goal-directed activation and less avoidant behavior over the course of treatment compared to those in the BMI + SC condition, in turn predicting reductions in alcohol-related negative consequences. Effects were more robust 1 month following intervention, and diminished by 3 months. Sensitivity analyses revealed a significant indirect effect of treatment condition on alcohol-related negative consequence via reductions in avoidance over treatment. Post hoc moderated mediations showed that BMI + BA engaged target mechanisms more robustly for students with more severe ADHD and depressive symptoms compared to BMI + SC. These findings support the application of BMI + BA intervention, particularly in targeting goal-directed activation and avoidance/rumination in at-risk student drinkers with ADHD.

Exploring patterns of alcohol misuse in treatment-seeking UK veterans: A cross-sectional study

AimsTo explore patterns of alcohol misuse in a sample of treatment-seeking veterans compared to the UK Armed Forces personnel population and the general public. Furthermore, the present study investigated which variables were associated with alcohol misuse in this sample, and in particular what factors were associated with increased or decreased severity of alcohol misuse. MethodThe present study investigated alcohol misuse in treatment-seeking veterans and compared it with the UK Armed Forces and the general public. In addition, it explored associations between sociodemographic, physical health and mental health variables and alcohol misuse. ResultsResults suggested that treatment-seeking veterans report different patterns of alcohol misuse compared to the UK Armed Forces and the general public. This group was more likely to report alcohol dependence and alcohol-related harm. They also reported higher levels of overall alcohol misuse than the general public. Mental health problems including PTSD, anxiety and depression, as well as anger, functional impairment and being single were all related to greater alcohol misuse. Being older and not in work were related to reduced alcohol misuse. ConclusionsThese findings add further weight to the importance of ensuring appropriate support is provided to personnel leaving the Armed Forces. Treatment-seeking veterans have specific patterns of alcohol-related needs that should be addressed. Knowing more about the common alcohol-related problems in this group can help inform and improve mental health interventions. Findings on related variables will help in identifying those individuals who may be at most risk of alcohol-related problems.

Meta-Analysis of the Association of Alcohol-Related Social Media Use with Alcohol Consumption and Alcohol-Related Problems in Adolescents and Young Adults.

Despite the pervasive use of social media by young adults, there is comparatively little known about whether, and how, engagement in social media influences this group's drinking patterns and risk of alcohol-related problems. We examined the relations between young adults' alcohol-related social media engagement (defined as the posting, liking, commenting, and viewing of alcohol-related social media content) and their drinking behavior and problems. We conducted a systematic review and meta-analysis of studies evaluating the association of alcohol consumption and alcohol-related problems with alcohol-related social media engagement. Summary baseline variables regarding the social media platform used (e.g., Facebook and Twitter), social media measures assessed (e.g., number of alcohol photographs posted), alcohol measures (e.g., Alcohol Use Disorders Identification Test and Timeline Follow back Interview), and the number of time points at which data were collected were extracted from each published study. We used the Q statistic to examine heterogeneity in the correlations between alcohol-related social media engagement and both drinking behavior and alcohol-related problems. Because there was significant heterogeneity, we used a random-effects model to evaluate the difference from zero of the weighted aggregate correlations. We used metaregression with study characteristics as moderators to test for moderators of the observed heterogeneity. Following screening, 19 articles met inclusion criteria for the meta-analysis. The primary findings indicated a statistically significant relationship and moderate effect sizes between alcohol-related social media engagement and both alcohol consumption (r=0.36, 95% CI: 0.29 to 0.44, p<0.001) and alcohol-related problems (r=0.37, 95% CI: 0.21 to 0.51, p<0.001). There was significant heterogeneity among studies. Two significant predictors of heterogeneity were (i) whether there was joint measurement of alcohol-related social media engagement and drinking behavior or these were measured on different occasions and (ii) whether measurements were taken by self-report or observation of social media engagement. We found moderate-sized effects across the 19 studies: Greater alcohol-related social media engagement was correlated with both greater self-reported drinking and alcohol-related problems. Further research to determine the causal direction of these associations could provide opportunities for social media-based interventions with young drinkers aimed at reducing alcohol consumption and alcohol-related adverse consequences.

A descriptive analysis of alcohol behaviors across gender subgroups within a sample of transgender adults

ObjectiveTransgender (trans) adults are identified as an at-risk group for problem alcohol use. Descriptive empirical data examining alcohol behaviors among trans adults is limited. The present study investigates alcohol behaviors – quantity, frequency, alcohol-related problems, and drinking to cope motives – across sex assigned at birth, gender expression, and gender identity subgroups within a sample of trans adults. MethodA total of 317 trans participants were recruited to complete a cross-sectional battery of online measures assessing alcohol use behaviors, alcohol-related problems, and drinking to cope. Gender identity was assessed through two methods: (1) an open-ended question in which participants wrote-in their primary gender identity; and (2) participants rated the extent to which they identified with 14 gender identity categories. ResultsThis sample had high rates of alcohol use, alcohol-related problems, and drinking to cope motives relative to the general population. Significant and meaningful differences in drinking frequency, alcohol-related problems and drinking motives were found according to gender expression, but not sex assigned at birth or gender identity. ConclusionsFuture work should examine alcohol behaviors among trans individuals, including investigation of predictors and causal pathways, to inform prevention and intervention work aimed at reducing trans people's risk for alcohol-related problems.

Proportion as a metric of problematic alcohol-energy drink consumption in college students

ABSTRACTBackground: Alcohol mixed with energy drinks (AmED) is linked to deleterious drinking, particularly within college students. However, measurement and methodological concerns complicate a more thorough understanding of how AmED contributes to problematic alcohol consumption. This study examined AmED proportion (i.e., percentage of overall drinking events involving AmED consumption) as a metric for differentiating problematic alcohol use and tested the utility for explaining additional risk of alcohol-related problems beyond overall alcohol involvement. Methods: Self-report data were collected from a diverse sample of AmED consumers from two west-coast U.S. universities (N = 458; 60.1% female; 31.4% White). Participants were divided into three AmED proportion groups: low (25% or less of all drinking events), moderate (about 50%), or high (75% or more), and assessed for overall alcohol use and related consequences. Results: The groups did not differ on demographics or recent alcohol use. However, high proportion users reported significantly more alcohol-related problems than the low and moderate groups, even after controlling for overall alcohol involvement. However, proportion did not differentiate at-risk drinking as measured by cut-scores of the AUDIT. Conclusions: Findings provide support for proportion as metric for differentiating alcohol-related problems within AmED consumers. Implications for future research and interventions were discussed.

Gender and age differences in eating and drinking risk behaviors in Italian high school students

Drunkorexia, limiting food intake before alcohol consumption, increases teenagers and young adults’ risk for negative alcohol-related health consequences.The purpose of the present study is to explore gender and age differences regarding weight management behaviors and alcohol consumption among 3004 students aged 13 to 24 years.The following questionnaires were administered: Eating Disorder Inventory-3 (EDI-3), Alcohol Use Disorders Identification Test (AUDIT) and Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS).EDI-3 showed that 11.3% of the sample met the threshold on the “Drive for Thinness” (DT) scale, 28.9% on the “Bulimia” (B) scale, 17.2% on the “Body Dissatisfaction” (BD) scale. Females presented a higher risk at DT, B and BD scales (P &lt; 0.001), and the risk of bulimia was higher in those aged ≤ 16 years (P = 0.028). AUDIT revealed a greater clinical risk of alcohol-related problems in males (P &lt; 0.001) and in those aged &gt; 16 years (P &lt; 0.001). Drunkorexia was found in 44% of the sample, without significant difference in relation to gender and age.Girls and younger students have more weight concerns, while boys and older students are at greater risk of alcohol use disorders. Therefore, no specific group should be considered risk-free with respect to drunkorexia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Social anxiety and alcohol-related impairment: The mediational impact of solitary drinking

Social anxiety disorder more than quadruples the risk of developing an alcohol use disorder, yet it is inconsistently linked to drinking frequency. Inconsistent findings may be at least partially due to lack of attention to drinking context — it may be that socially anxious individuals are especially vulnerable to drinking more often in specific contexts that increase their risk for alcohol-related problems. For instance, socially anxious persons may drink more often while alone, before social situations for “liquid courage” and/or after social situations to manage negative thoughts about their performance. Among current (past-month) drinkers (N=776), social anxiety was significantly, positively related to solitary drinking frequency and was negatively related to social drinking frequency. Social anxiety was indirectly (via solitary drinking frequency) related to greater past-month drinking frequency and more drinking-related problems. Social anxiety was also indirectly (via social drinking frequency) negatively related to past-month drinking frequency and drinking-related problems. Findings suggest that socially anxious persons may be vulnerable to more frequent drinking in particular contexts (in this case alone) and that this context-specific drinking may play an important role in drinking problems among these high-risk individuals.

Religiosity as a protective factor for hazardous drinking and drug use among sexual minority and heterosexual women: Findings from the National Alcohol Survey

ObjectiveDespite research documenting disparities in risk for alcohol-related problems among sexual minority women, few studies explore potential protective factors within this population. This study examines how religiosity may function as a protective or risk factor for alcohol-problems or other substance use among sexual minorities compared to heterosexuals. MethodData from 11,169 women who responded to sexual identity and sexual behavior questions from three population-based National Alcohol Survey waves (2000, 2005, 2010) were utilized for analyses of religiosity in relation to lifetime drinking, past year hazardous drinking, and past year drug use. ResultsReligiosity was significantly greater among exclusively heterosexual women compared to all sexual minority groups (lesbian, bisexual and heterosexual women who report same sex partners). Lesbians reported the lowest rates of affiliation with religions/denominations discouraging alcohol use. Past year hazardous drinking and use of any illicit drugs were significantly lower among exclusively heterosexual women compared to all sexual minority groups. High religiosity was associated with lifetime alcohol abstention and was found to be protective against hazardous drinking and drug use among both sexual minority and heterosexual women. Reporting religious norms unfavorable to drinking was protective against hazardous drinking among exclusively heterosexual women but not sexual minority women. ConclusionsFindings reveal the importance of considering sexual minority status in evaluation of religion or spirituality as protective among women. Future studies should explore religiosity in the context of other individual and environmental factors, such as positive identity development and community-level acceptance, which may be salient to resiliency among sexual minorities.

Associations among depressive symptoms, drinking motives, and risk for alcohol-related problems in veterinary students.

Hazardous alcohol consumption among medical students appears to occur at a level comparable to the general population; however, among medical students, it has been found that the motivation to use alcohol partially stems from unique stressors related to their professional training. Although veterinary students may also experience psychological distress in association with their training, little work has focused on the way that these students use alcohol to cope with their distress. The current study sought to examine the severity of depressive symptoms and alcohol consumption among veterinary students as well as students' specific motives for drinking alcohol. The majority of our sample reported experiencing at least one depressive symptom, and a significant proportion engaged in high-risk drinking, with men reporting more harmful alcohol use patterns. Drinking motives related to managing internal bodily and emotional states accounted for variance in drinking patterns. Further, drinking to ameliorate negative emotions partially accounted for the relationship between psychological distress and high-risk drinking. The results of this study suggest that depressive symptoms among veterinary students may be related to harmful drinking patterns, due to alcohol being used as a coping mechanism to regulate emotions. The findings from this study can be used to develop targeted interventions to promote psychological well-being among veterinary students.

Genes Associated With Alcohol Outcomes Show Enrichment of Effects With Broad Externalizing and Impulsivity Phenotypes in an Independent Sample

The purpose of this study was to evaluate evidence for association with a panel of genes previously associated with alcohol-related traits in a new sample of adolescent and young adult individuals (N = 2,128; 51% female) collected as part of the Collaborative Study on the Genetics of Alcoholism (COGA). We tested for association with phenotypes related to externalizing behavior, including diagnostic symptom counts for disorders on the externalizing spectrum (alcohol dependence, conduct disorder, adult antisocial personality disorder, and illicit drug dependence), and related behavioral/personality traits (Achenbach Externalizing, NEO Extraversion, NEO Conscientiousness, Zuckerman's Sensation Seeking, and the Barratt Impulsivity Scale) based on the substantial literature suggesting that these behaviors may be alternate manifestations of a shared genetic liability. We tested for overall enrichment of the set of 215 genotyped single-nucleotide polymorphisms (SNPs) for each of the phenotypes. We conducted secondary analyses comparing results for sensation seeking with results for the other phenotypes. For all phenotypes, there was significant enrichment of association results (p < .05) compared with chance expectations. The greatest number of significant results was observed with the phenotype Sensation Seeking. Secondary analyses indicated that the number of SNPs yielding p < .05 with Sensation Seeking was significantly greater than that observed for each of the other phenotypes. We find evidence for enrichment of association results across a spectrum of externalizing phenotypes with a panel of candidate genes/SNPs selected based on previous suggestion of association with alcohol-related outcomes. In particular, we find significant enrichment of effects with sensation seeking, suggesting that this may be a particularly salient behavior associated with risk for alcohol-related problems.

Genes Associated With Alcohol Outcomes Show Enrichment of Effects With Broad Externalizing and Impulsivity Phenotypes in an Independent Sample

Objective: The purpose of this study was to evaluate evidence for association with a panel of genes previously associated with alcohol-related traits in a new sample of adolescent and young adult in- dividuals (N = 2,128; 51% female) collected as part of the Collaborative Study on the Genetics of Alcoholism (COGA). We tested for association with phenotypes related to externalizing behavior, including diagnostic symptom counts for disorders on the externalizing spectrum (alcohol dependence, conduct disorder, adult antisocial personality disorder, and illicit drug dependence), and related behavioral/personality traits (Achenbach Externalizing, NEO Extraversion, NEO Conscientiousness, Zuckerman's Sensation Seeking, and the Barratt Impulsivity Scale) based on the substantial literature suggesting that these behaviors may be alternate manifestations of a shared genetic liability. Method: We tested for overall enrichment of the set of 215 genotyped single-nucleotide polymorphisms (SNPs) for each of the phenotypes. We conducted secondary analyses comparing results for sensation seeking with results for the other phenotypes. Results: For all phenotypes, there was signifi - cant enrichment of association results (p < .05) compared with chance expectations. The greatest number of signifi cant results was observed with the phenotype Sensation Seeking. Secondary analyses indicated that the number of SNPs yielding p < .05 with Sensation Seeking was signifi cantly greater than that observed for each of the other phenotypes. Conclusions: We fi nd evidence for enrichment of association results across a spectrum of externalizing phenotypes with a panel of candidate genes/SNPs selected based on previous suggestion of association with alcohol-related outcomes. In particular, we fisignifi cant enrichment of effects with sensation seeking, suggesting that this may be a particularly salient behavior associated with risk for alcohol-related problems. (J. Stud. Alcohol Drugs, 76, 38-46, 2015)

Sweet-liking is associated with transformation of heavy drinking into alcohol-related problems in young adults with high novelty seeking.

We tested the hypothesis that high novelty seeking (NS) (a trait that promotes experimentation) and sweet-liking (SL) (a phenotype that may reflect processing of hedonic stimuli) act independently and synergistically to increase the risk of having alcohol-related problems in young adults. A sample of 163 young adults, ages 18 to 26, was recruited and balanced for gender and evidence for presence of alcohol problems to yield 150 evaluable participants. NS was evaluated using the Tridimensional Personality Questionnaire. Pleasurable response to sweet taste was tested to identify sweet-likers and sweet-dislikers. Alcohol use and problems were assessed by the Alcohol Use Disorders Identification Test and the Rutgers Alcohol Problem Index. NS, but not SL, was positively and significantly associated with alcohol consumption and alcohol problems; however, the effect of NS on alcohol problems was significantly enhanced in the presence of the SL phenotype, thus showing a strong synergistic interaction. The combination of SL and high NS was associated with increased odds of having alcohol problems -20.64 (95% CI: -89.98, 4.74) compared to those with low NS and sweet-disliking. Other combinations did not produce such odds ratios. SL and low NS showed OR = 1.88 (95% CI 0.44, 7.99), and sweet-dislikers and high novelty seekers had OR = 4.07 (95%, CI 1.01, 16.46). These results support and extend our hypothesis that as clinically distinct phenotypes, high NS and the SL phenotype are associated with risk of alcohol-related problems. High NS is associated with the use of alcohol, and the presence of the SL phenotype appears to bias an individual to alcohol problems once alcohol use is initiated. Understanding the biology and phenomenology of these phenotypes will allow a more complete picture of the processes that lead to alcohol problems.

Age-dependent effects of stress on ethanol-induced motor activity in rats

It is important to study age-related differences that may put adolescents at risk for alcohol-related problems. Adolescents seem less sensitive to the aversive effects of ethanol than adults. Less is known of appetitive effects of ethanol and stress modulation of these effects. This study aims to describe the effects of acute social or restraint stress on ethanol-precipitated locomotor activity (LMA), in adolescent and adult rats. Effects of activation of the kappa system on ethanol-induced LMA were also evaluated. Adolescent or adult rats were restrained for 90min, exposed to social deprivation stress for 90 or 180min or administered with the kappa agonist U62,066E before being given ethanol, and assessed for LMA. Adolescents were significantly more sensitive to the stimulating, and less sensitive to the sedative, effects of ethanol than adults. Basal locomotion was significantly increased by social deprivation stress in adult, but not in adolescent, rats. U62,066E significantly reduced basal and ethanol-induced locomotion in the adolescents. Corticosterone and progesterone levels were significantly higher in adolescents than in adults. Adolescents exhibit greater sensitivity to ethanol-induced LMA and reduced sensitivity to ethanol-induced motor sedation than adult rats. Ethanol's effects on motor activity were not affected by acute stress. Unlike adults, adolescents were insensitive to acute restraint and social deprivation stress but exhibited motor depression after activation of the endogenous kappa opioid receptor system.

Getting “Game”: Pregaming Changes During the First Weeks of College

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.

Early Subjective Response and Acquired Tolerance as Predictors of Alcohol Use and Related Problems in a Clinical Sample

Previous studies have demonstrated that a low subjective response (SR) to alcohol is a risk factor for alcohol use disorders (AUDs), and a recent study suggests that acquired tolerance can be differentiated from initial SR and is also significantly associated with drinking problems. Because the prior study of SR and tolerance focused on a sample of moderate drinkers, the goal of the current study was to examine relations between early SR, acquired tolerance, alcohol use, and alcohol-related problems in a sample of young adults with clinically significant alcohol problems. The current study examined associations between early SR and acquired tolerance and both drinking behavior and alcohol-related problems within a sample of 113 heavy drinking young adults (66.1% male) volunteering for a clinical trial of naltrexone in combination with brief motivational counseling. Consistent with the 1 prior study examining simultaneous effects of early SR and tolerance, both early SR and acquired tolerance were positively associated with typical drinking behavior, although tolerance was a much stronger predictor within this clinical sample. In contrast to the prior study, early SR was inversely associated with risk for alcohol-related problems, and tolerance was not a significant predictor of problems. The results suggested that, controlling for weekly drinking, a low early SR protected against acute negative consequences within a sample of heavy drinkers who had acquired significant tolerance to alcohol effects. It is possible that this protective effect may eventually shift to a risk factor by allowing individuals with a low SR to persist in a pattern of hazardous drinking.