Subsequent Alcohol-related Problems Research Articles

Evaluating distress as a moderator of the relationship between drinking identity and hazardous drinking during the post-college transition

Drinking identity (the extent to which one associates the self with drinking alcohol) is a robust predictor of young adult hazardous drinking (HD; heavy drinking and alcohol-related problems), and decreases in drinking identity have been linked to the decline in HD that often occurs following college graduation. Identifying moderators is key to recognizing who is most at risk for continued HD given a drinking identity vulnerability. Using data from a longitudinal study of graduating college students from the U.S., we evaluated distress (depression, anxiety, stress symptoms) as a potential moderator. Between- and within-person components of drinking identity and distress were evaluated to consider both individual differences and variations within a person across time and changing contexts. Study hypotheses and data analysis plan were preregistered. Graduating college students who met HD criteria (N = 422) completed implicit and explicit drinking identity measures (assessed using reaction time and self-report measures, respectively), distress symptom questionnaires, and self-reported alcohol consumption and problems at four-month intervals for 2.5 years. Results supported moderation at the between-person level for alcohol consumption, with higher levels of implicit drinking identity and distress linked to greater subsequent alcohol consumption. Only between-person main effects for (explicit) identity and distress were linked to more subsequent alcohol-related problems. Though moderation findings were mixed, having a stronger drinking identity and/or greater distress was linked to continued HD risk in this sample. Individuals with these risk factors may benefit from enhanced prevention efforts to help graduates transition out of HD post-college.

The Health Belief Model in the Context of Alcohol Protective Behavioral Strategies

Objective: Alcohol use continues to be prevalent and problematic among young adult samples. Protective behavioral strategies (PBS), which are harm reduction strategies utilized while drinking, have been linked to decreased alcohol use and subsequent alcohol-related problems. An individual’s likelihood of adopting PBS and other health behaviors, according to The Health Belief Model (HBM), is dependent on perceived susceptibility to and severity of adverse health outcomes, as well as perceived benefits and barriers related to implementing those behaviors. The present study examined whether the perceived effectiveness of PBS in the context of the HBM leads to an increase in PBS use. Method: The analytic sample (n =694 college students, M age =20.21, SD =4.37, 63.26% female, 72.05% Caucasian) self-reported demographics, weekly alcohol consumption (i.e., frequency, intensity, and quantity), alcohol-related problems, use of PBS, and perceived effectiveness of PBS use. A latent variable model was used to test the effect of perceived PBS effectiveness on PBS use, alcohol consumption, and alcohol-related problems. Results: Perceived PBS effectiveness was associated with a higher likelihood of using PBS subtypes (Manner of Drinking, Stopping/Limiting Drinking, and Serious Harm Reduction), which in turn was associated with reductions in alcohol consumption and problems. Conclusions: These findings suggest that increasing perceptions of PBS effectiveness may lead to more PBS use, decreased alcohol consumption, and fewer alcohol-related problems. Future research could implement longitudinal methodology to assess attempts to increase perceived effectiveness of PBS use and potentially establish a causal link between these perceptions, PBS use, and alcohol-related outcomes.

Risk and Protective Factors for Problematic Drinking in Early Adolescence: A Systematic Approach

Alcohol use during early adolescence is associated with other risk behaviors as well as future health problems. Within the design of a larger prospective research program, a cohort of U.S. inner-city sixth-grade students (N = 1573, mean age = 12.10) were assessed and reassessed in the seventh-grade. Self-reported information was obtained on problems related to alcohol, fixed markers of risk (e.g. sex, age, SES), individual and interpersonal factors (e.g. internalizing and externalizing symptoms) and contextual factors (e.g. substance availability). Alcohol-related problems in seventh grade were foremost predicted by individual and interpersonal factors in the sixth grade including depressive symptoms, conduct problems, a decreased perception of wrongdoing, and affiliation with delinquent peers. In addition, alcohol use in the sixth grade and being of Hispanic or White ethnicity was also associated with subsequent alcohol-related problems. Interventions should be directed towards assessing and treating individual risk factors such as depression and externalizing symptoms.

Military sexual trauma, combat exposure, and negative urgency as independent predictors of PTSD and subsequent alcohol problems among OEF/OIF veterans.

This study tested a path model of relationships between military sexual trauma (MST), combat exposure, negative urgency, posttraumatic stress disorder (PTSD) symptoms, and alcohol use and related problems. The sample consisted of 86 Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans who reported drinking at least one alcoholic beverage per week. PTSD mediated the relationships between MST and alcohol-related problems, negative urgency and alcohol-related problems, and combat exposure and alcohol-related problems. In addition, negative urgency had a direct effect on alcohol problems. These results indicate that MST, combat exposure, and negative urgency independently predict PTSD symptoms and PTSD symptoms mediate their relationship with alcohol-related problems. Findings support previous literature on the effect of combat exposure and negative urgency on PTSD and subsequent alcohol-related problems. The current study also contributes to the limited research regarding the relationship between MST, PSTD, and alcohol use and related problems. Clinical interventions aimed at reducing emotional dysregulation and posttraumatic stress symptomology may subsequently improve alcohol-related outcomes.

A Longitudinal Examination of the Associations Between Shyness, Drinking Motives, Alcohol Use, and Alcohol-Related Problems.

The current study evaluated the roles of drinking motives and shyness in predicting problem alcohol use over 2 years. First-year college student drinkers (n = 818) completed assessments of alcohol use and related problems, shyness, and drinking motives every 6 months over a 2-year period. Generalized linear mixed models indicated that shyness was associated with less drinking, but more alcohol-related problems. Further, shyness was associated with coping, conformity, and enhancement drinking motives, but was not associated with social drinking motives. However, when examining coping motives, moderation analyses revealed that social drinking motives were more strongly associated with coping motives among individuals higher in shyness. In addition, coping, conformity, and enhancement motives, but not social motives, mediated associations between shyness and alcohol-related problems over time. Finally, coping motives mediated the association between the interaction of shyness and social motives and alcohol-related problems. Together, the results suggest that shy individuals may drink to reduce negative affect, increase positive affect, and fit in with others in social situations, which may then contribute to greater risk for subsequent alcohol-related problems.

Childhood Sexual Abuse and Later Alcohol-Related Problems: Investigating the Roles of Revictimization, PTSD, and Drinking Motivations Among College Women

The current study sought to examine whether symptoms of posttraumatic stress disorder (PTSD), adolescent sexual assault (ASA), and drinking motivations (e.g., drinking to regulate emotional experiences) mediate the relationship between a history of childhood sexual abuse (CSA) and subsequent alcohol-related problems among college women. Participants were 579 female students at a Midwestern university. Participants were recruited as part of a larger longitudinal study that investigated risk and resiliency factors related to sexual revictimization. Using a serial mediation model, the current study found that the proposed constructs mediated the relationship between CSA and subsequent alcohol-related problems via two separate paths. In one path, CSA was associated with PTSD, which in turn predicted drinking to regulate emotional experiences, which then was related to alcohol-related problems in adulthood. In the second path, CSA was related to ASA, which in turn predicted drinking to regulate emotional experiences, which then was related to alcohol-related problems in adulthood. These results suggest that individuals with a history of CSA are more likely to experience both revictimization in adolescence and PTSD symptoms in adulthood, which may lead to alcohol-related problems via drinking to regulate emotional experiences. These findings suggest the importance of incorporating skills training in adaptive emotion regulation strategies into treatment for individuals with a history of CSA and ASA.

Motives to Drink or Not to Drink: Longitudinal Relations Among Personality, Motives, and Alcohol Use Across Adolescence and Early Adulthood

Adolescent selective intervention programs for alcohol have focused on the identification of youth at risk as a function of personality and associated alcohol-related cognitions. Research into the role of personality, drinking motivations, and alcohol-related outcomes has generally focused exclusively on motives to drink. We expand on this literature by focusing on both motives to drink and motives not to drink across time from adolescence to early adulthood in a community sample. Using 3 waves of data from 3 cohorts from the Rutgers Health and Human Development Project (n = 1,380; 49.4% women), we modeled the influence of baseline alcohol consumption, disinhibition (DIS), and harm avoidance (ages 15, 18, and 21 years) on drinking motives and motives not to drink 3 years later (ages 18, 21, and 24 years) and alcohol use and drinking-related problems 7 years subsequently (ages 25, 28, and 31 years). Path analytic models were relatively invariant across cohort. Across cohorts, DIS and baseline alcohol consumption related to later positive reinforcement drinking motives, but less consistency was found for the prediction of negative reinforcement motives to drink. While positive reinforcement motives were associated with greater alcohol consumption and problems 7 years later, negative reinforcement motives were generally associated with problems alone. Positive reinforcement motives for drinking mediated relations between baseline consumption and later consumption. However, results were mixed when considering DIS as a predictor and drinking problems as an outcome. Similarly, personality and baseline consumption related to later motives not to drink and such motives predicted subsequent alcohol-related problems. However, mediation was not generally supported for pathways through motives to abstain. The results of this study replicate and extend previous longitudinal findings with youth and add to the growing literature on motivations not to engage in alcohol use.

Validation of the College Alcohol Problem Scale—revised (CAPS-r) for use with non-adjudicated first-year students

First-year students in transition to college are at increased risk for consuming greater amounts of alcohol and are subject to subsequent alcohol-related problems. The 8-item College Alcohol Problem Scale—revised (CAPS-r) has been used to measure alcohol-related problems in adjudicated undergraduates and psychology majors. However, structural validity of the CAPS-r has not been examined in a general first-year student population. Confirmatory factor analysis (CFA) was used to test the structural validity of this two-factor model using LISREL 8.5. The original two-factor measurement model for the 8-item CAPS-r represented acceptable fit to the data ( χ 2 = 37.52, df = 19, p = .007, CFI = .968, SRMR = .0449), supporting its use with first-year college students. Future studies need to examine invariance across ethnic, gender, and geographical groups.

Perceived Cognitive Competence, Depressive Symptoms and the Incidence of Alcohol-Related Problems in Urban School Children

ABSTRACT Objective: This study is to test the hypothesis that poor perceived cognitive competence might signal an increased risk of subsequent alcohol-related problems in children. Method: A prospective epidemiologic study of elementary school students aged 9–13 years in Baltimore, Maryland, was undertaken. Perceived cognitive competence, peer use of alcohol, and other suspected risk characteristics for alcohol-related problems were assessed in 1990, among 1232 children with no prior history of problems associated with drinking alcohol. Occurrences of alcohol-related problems were assessed in subsequent annual interviews through 1994. Results: Four years later, 17.6% of these children are found to have developed one or more alcohol-related problems for the first time during the follow-up. Having depressive symptoms is associated with higher risk of developing alcohol-related problems while perceived cognitive competence is not (estimated Relative Risk (RR) = 1.6, 95% Confidence Interval (CI) 1.1–2.1 for depressive symptoms). The evidence from exploratory analyses suggests a possible interaction between depressive symptoms and perceived cognitive competence. Alcohol-related problems develop earlier for youths reporting both lower perceived cognitive competence and depressive symptoms relative to those with no depressive symptoms and high perceived cognitive competence. Furthermore, among children with at least one depressive symptom, having low or moderate perceived cognitive competence is associated with doubling the risk of developing alcohol-related problems relative to those with high cognitive competence (RR = 2.3, 95%CI 1.1–4.7 for low competence; RR = 2.1, 95%CI 1.2–3.9 for moderate competence). Conclusions: The evidence does not support a strong association between perceived cognitive competence and later alcohol-related problems. However, the exploratory search for interactions disclosed a possibility that depressive symptoms and poor perceived cognitive competence might combine to foster subsequent development of alcohol-related problems.

Civic participation by 18- to 20-year-olds as a predictor of support for alcohol control policies: the Communities Mobilizing for Change on Alcohol project

Evidence is accumulating that federal, state, and local alcohol control policies effectively reduce alcohol consumption and subsequent alcohol-related problems among young adults (Toomey et al., 1993; Wagenaar & Farrell, 1989; Ritson, 1994; Anderson & Lehto, 1994). Increasing the legal age for consumption of alcoholic beverages from 18 years to 21 years has been associated with reduced traffic fatality rates (O'Malley & Wagenaar, 1991) and with a reduction in other problems associated with youthful alcohol use such as suicide and unintentional injury (Jones et al., 1992). Increased taxation of alcohol has been associated with decreased auto fatality rates (Cook, 1981) and with reduced alcohol-related harm (Kendell et al., 1983). Additionally, it has been estimated that car crash fatalities among 18- to 20-year-olds could be markedly reduced if beer taxation were indexed for inflation (Saffer & Grossman, 1987). Public policy development and implementation, however, require public understanding, concern and support (Leedham, 1987; Room et al., 1995; Bang & Bang, 1991; Gordis, 1991). Policies that are widely supported are more likely to be successfully implemented and enforced. Efforts to enact alcohol control policy have been hampered by the alcohol industry (Ross, 1992) and by public perception that the majority of drinkers create few problems for society (Gordis, 1991). Despite these social barriers, increasing public support for alcohol control policy is possible (Room et al., 1995). Wagenaar (1993) documents how dissemination of high-quality research results beyond the scientific community by researchers and members of community organizations influenced public opinion and contributed to many states' decision to raise the minimum legal drinking age during the 1980s. Despite generally low levels of initial support for alcohol control policies in New Zealand, a community action project combined with media attention built increased public support for alcohol control policy (Casswell et al., 1989). Support for alcohol control policies among adults varies according to the specific policy (Wagenaar & Streff, 1990; Schmid et al., 1990). In general, prevention and control efforts that impose the fewest restrictions on the behavior of non-problem drinkers are the most widely supported (Hilton & Kaskutas, 1991). Although Schmid et al. reported generally high levels of support for all alcohol control policies among adults in Minnesota, policies promoting youth protection were the most strongly supported, followed by restrictions and prohibitions such as limiting advertising and then by increased alcohol taxes. Elimination of existing alcohol control measures was the least favored. Jones-Webb et al. (1993) reported ethnic differences in support for alcohol control polices in a large survey of adults in Marin County, California. Latinos were more likely than whites to support restricted sponsorship of sports events by the alcohol industry and server liability legislation. Demographic characteristics, alcohol consumption, and certain attitudes influence support for alcohol control policies. Women are more likely than men to support alcohol control policy (Ahlstrom & Osterberg, 1992); Schmid et al., 1990; Jeffery et al., 1990; Room et al., 1995; Casswell et al., 1989; Jones-Webb et al., 1993). Older age has been associated with higher levels of support for alcohol control policies (Schmid et al., 1990; Jeffery et al., 1990; Casswell et al., 1989), whereas younger age is associated with opposition to policies that restrict alcohol (Room et al., 1995). Light drinkers are more likely than heavier drinkers to support restrictive alcohol policy (Pendleton et al., 1990; Ahlstrom & Osterberg, 1991; Schmid et al.,1990; Room et al., 1995; Jones-Webb et al., 1993). Finally, those reporting higher levels of concern about drunk driving were more supportive of restrictive alcohol policies (Wagenaar & Streff, 1990). …