A confirmatory factor analysis of a revised motives for playing drinking games (MPDG-33) scale among university students in the United States.

AIM: Participating in a drinking game (DG) is common practice among university students and can increase students' risk for heavy drinking. Given the theoretical link between motivations to drink and alcohol use, careful consideration should be given to students' motivations to play DGs. In this study, we examined the factor structure, internal consistency, and concurrent validity of a revised version of the motives for playing drinking games (MPDG) scale, the MPDG-33. METHODS: University students (n = 3345, Mage = 19.77 years, SDage = 1.53; 68.8% = women; 59.6% = White) from 12 U.S. universities completed a confidential online self-report survey that included the MPDG-33 and questions regarding their frequency of DG participation and typical drink consumption while playing DGs. RESULTS: Confirmatory factor analysis indicated the 7-factor model fit the data adequately, and all items had statistically significant factor loadings on their predicted factor. All subscales had adequate to excellent internal consistency and were positively correlated with the frequency of DG participation and the typical number of drinks consumed while playing DGs (though the correlations were small). CONCLUSION: Findings suggest that the MPDG-33 can be reliably used in research and clinical settings to assess U.S. university students' motives for playing DGs.

Sexual assault characteristics and posttraumatic stress symptoms among collegiate women: The role of posttraumatic cognitions.

Although it is well-established that sexual assault is a risk factor for posttraumatic stress symptoms (PTSS) and other negative mental health outcomes, research is needed to help identify which individuals are most likely to experience ongoing distress following sexual assault. Negative cognitions following trauma may be influenced by sexual assault characteristics and have been shown to be associated with PTSS. The present study examined whether sexual assault characteristics were associated with PTSS by way of posttraumatic cognitions in a sample of 475 female college students who had experienced a sexual assault since the age of 14 years. Participants completed an online survey that included questions about sexual assault characteristics (i.e., whether the perpetrator used force, whether they experienced a freeze response), posttraumatic cognitions, and PTSS. Path analysis revealed that survivors who indicated they froze during the assault reported higher levels of PTSS, total effect = .28, p < .001, direct effect = .19, p < .001; posttraumatic cognitions regarding others, indirect effect = .02, p = .047, and other-safety, indirect effect = .05, p = .003, partially accounted for this association. Only the direct effect of perpetrator use of force on PTSS was statistically significant, total effect = .23, p = .090, direct effect = .16, p = .009; none of the indirect effects were statistically significant, ps = .063-.669. The results support that assault characteristics are associated with postassault outcomes and are consistent with the cognitive model of posttraumatic stress disorder.

Going it alone: Examining interpersonal sensitivity and hostility as mediators of the link between perfectionism and social disconnection.

OBJECTIVE: Perfectionism is linked to a variety of mental health conditions in university students. The Perfectionism Social Disconnection Model posits that perfectionistic individuals exhibit off-putting interpersonal behaviors (i.e., rejection sensitivity and hostility), which lead to social disconnection, and in turn contribute to psychological distress. Although several longitudinal studies have found that social disconnection mediates the link between perfectionistic traits and psychological distress, less is known about how perfectionism leads to social disconnection. The present study aimed to address this gap. METHODS: A sample of 877 university students completed one survey a month for three consecutive months. RESULTS: Our random-intercept cross-lagged panel model results showed significant positive associations between the random intercepts of socially prescribed and self-oriented perfectionism with rejection sensitivity, hostility, and loneliness, with stronger associations for socially prescribed perfectionism. In addition, the random intercept of other-oriented perfectionism showed positive associations with hostility but not rejection sensitivity or loneliness. Moreover, almost all cross-lagged paths were nonsignificant. CONCLUSION: Collectively, these findings indicate that although perfectionistic traits may be associated with rejection sensitivity and hostility to varying degrees at the between-person level, these behaviors may not cause social disconnection at the within-person level.

Masculine Drinking Norms and Alcohol Use in a National Sample of NCAA Male Student-Athletes.

Objectives: Participation in sports can increase young adults' risk for heavy alcohol use and related consequences. Among student-athletes, more men report heavy drinking than women. These gender differences may reflect men's expression of masculinity which can encompass excessive consumption. While a growing body of research indicates that general masculine norms are positively associated with alcohol use and consequences among men, the extent to which alcohol-specific masculine norms can increase student-athletes' risk for elevated drinking and related outcomes is not yet known. Thus, we examined how masculine drinking norms are associated with alcohol use and related consequences while accounting for demographics and multiple dimensions of general masculine norms. Methods: 1,825 NCAA student-athletes (White=79%, Mage=20.1/SDage=1.3; 50 colleges/universities) completed a confidential online survey which included questions regarding masculine drinking norms of excess and control and conformity to general masculine norms. Results: We created latent constructs and tested a path model in SEM. Results indicated that, after accounting for demographics and multiple dimensions of general masculine norms, the masculine drinking norm of excess was positively associated with alcohol use and consequences. Conversely, control was negatively related to alcohol use but unrelated to consequences. Compared to control and other dimensions of general masculine norms, excess was most strongly related to alcohol use and consequences. Conclusions: A move from assessing general masculine norms toward alcohol-specific masculine norms can further researchers' and practitioners' knowledge of masculine norms and their link to drinking behaviors, and enhance the application of masculine norms in alcohol intervention and prevention programs.

What's in a Label? The Impact of Media and Sexual Assault Characteristics on Survivor Rape Acknowledgment.

Media coverage of sexual assault has increased since 2017 due to high-profile cases and social media campaigns designed to increase awareness of sexual assault. The purpose of this study was to examine whether media coverage of the Harvey Weinstein allegations and the onset of the 2017 viral #MeToo movement impacted the likelihood of college women acknowledging their own victimization as rape. Participants were 207 female rape survivors who completed an online survey that included assessments of survivor acknowledgment and characteristics of the sexual assault. Some participants completed the study prior to the Harvey Weinstein allegations and onset of the #MeToo movement, and some participants completed the study after these events. The likelihood of survivors labeling their experience as rape did not differ based on when participants completed the study, odds ratios (ORs) = 0.61-3.92, ps = .127-.604. Use of both nonforceful verbal resistance, OR = 2.63, p = .001, and assertive resistance, OR = 3.05, p < .001, were positively associated with the likelihood of survivor acknowledgment. The effects of both perpetrators' use of force and experiencing immobility on survivor acknowledgment were moderated by the timing of study completion, ORs = 4.22 and 0.11, respectively, ps = .023-.040. These findings suggest that media coverage may impact how certain sexual assault characteristics influence how survivors label their victimization experiences.

Coping Motivated Alcohol Use: The Role of Social Anxiety and Dissociation.

Background: Social anxiety has been associated with higher rates of negative alcohol use consequences, and this relationship appears to be accounted for by coping drinking motives. Dissociation is commonly present in anxiety disorders, including social anxiety disorder, and may serve to unconsciously reduce negative emotions when more effortful coping strategies are not effective. Objectives: The present study examined whether the relationship between social anxiety, coping motives, and alcohol consequences was moderated by dissociative symptoms. It was hypothesized that coping motives would mediate the relationship between social anxiety and alcohol consequences, and that dissociation would moderate the relationship between social anxiety and coping motives. Undergraduate students who endorsed alcohol use within the past 30 days (n = 320) were recruited from a large public university. Participants completed measures of social anxiety, dissociation, alcohol motives, and alcohol consequences as part of a larger online questionnaire. Results: Coping motives were found to mediate the relationship between social anxiety and alcohol consequences. Dissociation did not moderate the relationship between social anxiety and coping motives. Dissociation was significantly associated with alcohol consequences via coping motives. Conclusions: Future research should include longitudinal research designs or ecological momentary assessment designs and should examine these relationships in clinical and community samples.

The impact of rape acknowledgment on survivor outcomes: The moderating effects of rape myth acceptance.

OBJECTIVE: Little is known about how rape acknowledgment relates to posttrauma functioning; recent research suggests the effect may depend on additional factors. In the current study, the moderating effect of rape myth acceptance (RMA) on the relationships between rape acknowledgment and mental health outcomes was examined. METHOD: A sample of 181 female rape survivors recruited from a university completed an online survey assessing RMA, rape acknowledgment, depression symptoms, and alcohol use. RESULTS: Generally, the results supported that RMA moderated the influence of rape acknowledgment on depression symptoms and average quantity per drinking episode, but not frequency of alcohol use. The findings demonstrated that when individuals endorsed high levels of RMA, acknowledged rape survivors reported worse outcomes than unacknowledged rape survivors. Among individuals low on RMA, unacknowledged rape survivors reported worse outcomes than acknowledged rape survivors. CONCLUSION: It is recommended that clinicians recognize the role of survivor beliefs, such as RMA, in the relationship between labeling sexual assault experiences and mental health consequences.

The Scarier the Better: Maximizing Exposure Therapy Outcomes for Spider Fear.

BACKGROUND: While exposure therapy effectively reduces anxiety associated with specific phobias, not all individuals respond to treatment and some will experience a return of fear after treatment ceases. AIMS: This study aimed to test the potential benefit of increasing the intensity of exposure therapy by adding an extra step that challenged uncontrollability (Step 15: allowing a spider to walk freely over one's body) to the standard fear hierarchy. METHOD: Fifty-one participants who had a severe fear of spiders completed two 60-min exposure sessions 1 week apart in a context that was either the same or different from the baseline and follow-up assessment context. Participants were categorized into groups based on the last hierarchy step they completed during treatment (Step 14 or fewer, or Step 15). RESULTS: Those who completed Step 15 had greater reductions in fear and beliefs about the probability of harm from baseline to post-treatment than those who completed fewer steps. Although completing Step 15 did not prevent fear from returning after a context change, it allowed people to maintain their ability to tolerate their fear, which earlier steps did not. Despite some fear returning after a context change, individuals who completed Step 15 tended to report greater reductions in fear from baseline to the follow-up assessment than participants who completed 14 or fewer steps. CONCLUSIONS: Overall, these results suggest that more intensive exposure that directly challenges harm beliefs may lead to greater changes in fear and fear beliefs than less intensive exposure.

The Indirect Effect of Child Maltreatment Severity on Adult PTSD Symptoms through Anxiety Sensitivity.

Although the rate of posttraumatic stress disorder (PTSD) among survivors of child maltreatment is high, individuals differ in symptom severity and many do not experience clinically significant levels of psychopathology. The present study tested the indirect effects of child maltreatment severity on adult PTSD, suicidal ideations, and alcohol dependence via anxiety sensitivity. A sample of 336 participants (mean age of 22.81 years, SD = 8.93; 70.2% female) completed an online survey of child abuse and neglect, anxiety sensitivity, PTSD symptom severity, suicidal ideation severity, and alcohol dependence severity. The results revealed significant indirect effects of child maltreatment on PTSD symptom severity through cognitive and social concerns, but not physical concerns. No direct or indirect effects were demonstrated for suicidal ideations or alcohol dependence severity. These findings elucidate mechanisms in the robust relationship between child maltreatment and adult PTSD symptoms and can potentially inform future research on mechanisms of change in psychotherapy.

Gender Minority Stress and Resilience Measure: A Meta-Analysis of the Associations with Mental Health in Transgender and Gender Diverse Individuals.

Transgender and gender diverse (TGD) individuals are more likely to experience mental health difficulties than cisgender individuals due to unique stressors related to their stigmatized gender identity and/or expression. This meta-analysis examined the associations between gender minority stressors and resilience factors, as measured by the Gender Minority Stress and Resilience Measure (GMSR; Testa et al., 2015), and two types of mental health symptoms (i.e., depression and anxiety). A comprehensive literature search and study inclusion process following PRISMA guidelines identified 69 sources, representing 47 unique samples. Mean effect sizes revealed significant positive associations between all GMSR minority stress subscales and anxiety and depression symptoms (rs = .22 to .40) with larger correlations for proximal stressors compared to distal stressors. The GMSR resilience subscales were significantly negatively correlated with anxiety and depression symptoms (rs = -.07 to -.16). These findings highlight the robust relationship between gender minority stressors and mental health symptoms among TGD individuals and indicate a need for addressing these stressors both by reducing exposure to external stressors and by addressing the internalization of those stressors in clinical settings. The small effects for the resilience subscales suggest a need to examine additional resilience factors that may be more pertinent to mental health among TGD individuals.

Neither a problem nor my problem: Risk factors for underage drinking disengagement among college students.

OBJECTIVE: Underage drinking disengagement (UDD; cognitive restructuring/minimizing agency) measures attitudes about the acceptability and responsibility of drinking. We examined demographic correlates of UDD, as well as the moderating effects of legal drinking status on the association between UDD and drinking. PARTICIPANTS: College student drinkers (n = 893; Mage = 19.48, range = 18-25; White = 74.1%; female = 68.1%) from a multi-site study. METHODS: An online confidential survey included the UDD Scale for College Students and the AUDIT-C. RESULTS: White and multiracial, underage students, or those living with others endorsed greater cognitive restructuring disengagement than Hispanic students, legal-age students, or those living alone or with parents, respectively. Greek membership and greater "party school" perceptions were related to more cognitive restructuring and minimizing agency. The associations between UDD and alcohol use were not moderated by legal drinking age status. CONCLUSION: Identifying and educating students at risk for UDD on the ramifications associated with underage drinking could combat drinking.

Comparing Drinking Game Motives, Behaviors, and Consequences Among Varsity Athletes, Recreational Athletes, and Non-Student-Athletes: A Multisite University Study.

OBJECTIVE: Among college students, student-athletes are at increased risk for heavy alcohol consumption, participation in risky drinking practices (e.g., playing drinking games [DG]), and adverse alcohol-related consequences relative to non-student-athletes. Within the student-athlete population, level of sports participation (e.g., recreational or varsity sports) can affect alcohol use behaviors and consequences, but our understanding of the extent to which level of sports participation influences engagement in DG is limited. Thus, in the present study, we examined differences in frequency of participation in DG, typical drink consumption while playing DG, negative DG consequences, and motives for playing DG among varsity, recreational, and non-student-athletes. METHOD: College students (n = 7,901 across 12 U.S. colleges/universities) completed questionnaires on alcohol use attitudes, behaviors, and consequences. RESULTS: Student-athletes (recreational or varsity sports) were more likely to have participated in DG within the past month than non-student-athletes. Among students who reported past-month DG play, recreational athletes played more often and endorsed more enhancement/thrills motives for playing DG than non-student-athletes, and student-athletes (recreational or varsity) endorsed higher levels of competition motives for playing DG than non-student-athletes. CONCLUSIONS: These findings shed light on some risky drinking patterns and motives of recreational athletes who are often overlooked and under-resourced in health research and clinical practice. Recreational and varsity student-athletes could benefit from alcohol screening and prevention efforts, which can include provision of competitive and alcohol-free social activities and promotion of alcohol protective behavioral strategies to help reduce recreational athletes' risk for harm while playing DG.

The Role of Gender, Sexual Assault History, and Sexism in Endorsement of Rape Myths Among College Students.

The present study examined the roles of sexual victimization history, sexism toward women, and sexism toward men in the gender difference in rape myth acceptance. The data were obtained from 2,011 male and female college students who completed an online survey. The results suggested that gender had a significant indirect effect on rape myth acceptance via sexual assault history and several forms of sexist beliefs. The findings supported the importance of considering additional antecedents of rape myths in research, as well as in programming geared toward preventing sexual assault and improving support for survivors.

A national study on pregaming motives, frequency, consumption, and negative alcohol consequences among university students in the United States.

BACKGROUND: Pregaming, or drinking before going out, is a commonly practiced risky behavior. Drinking motives are well-established predictors of alcohol use and negative alcohol consequences. Given the influence of context on drinking practices, motives specific to pregaming may affect pregaming behaviors and outcomes above and beyond general drinking motives. Thus, we examined how pregaming motives are related to pregaming behaviors and negative alcohol consequences. METHODS: Using data from two national cross-sectional online studies, the current study included undergraduates who pregamed at least once in the past month (n=10,200, Mage=19.9, women=61%, white=73.6%; 119 U.S. universities). Participants completed assessments of demographics, general drinking motives, pregaming motives, pregaming frequency/consumption, and negative alcohol consequences. Data were analyzed using hierarchical linear models accounting for nesting of participants within sites. RESULTS: When controlling for demographic factors and general drinking motives, interpersonal enhancement motives and intimate pursuit motives were positively associated with pregaming frequency, pregaming consumption, and negative alcohol consequences. Situational control motives were negatively associated with pregaming consumption and negative alcohol consequences. Barriers to consumption motives were negatively associated with pregaming frequency but positively associated with negative alcohol consequences. CONCLUSIONS: Students who pregame to make the night more fun or to meet potential dating partners appear to be at particular risk for negative alcohol consequences. Motives may be modifiable, particularly via cognitive/behavioral strategies. Findings suggest that specific motives may be appropriate intervention targets when trying to reduce pregaming behaviors and negative alcohol consequences.

Acceptance of rape myths and psychological symptoms: the indirect effect of self-blame.

Objective: The current study examined the influence of rape myth acceptance on self-blame and psychological symptoms following a sexual assault. Participants: The sample included 280 female sexual assault survivors in college. Methods: In an online survey, participants completed the Sexual Experiences Survey - Short Form Victimization, Updated Illinois Rape Myth Acceptance Scale, Posttraumatic Cognitions Inventory, Patient Health Questionnaire - 9 item scale, and PTSD Checklist for DSM-5. Results: A significant indirect effect was found between acceptance of rape myths and PTSD symptoms via self-blame; acceptance of rape myths was positively associated with self-blame, which in turn was positively associated with PTSD symptoms. Conclusions: Clinicians working with survivors of sexual assault should assess for endorsement of rape myths and self-blame, as challenging posttraumatic cognitions has been shown to reduce symptoms of trauma.

The Role of Social Reactions to Disclosures in the Relationship Between Sexual Assault Acknowledgment and Psychological Symptoms.

Following a sexual assault, women experience a host of negative psychological consequences. While some survivors label their sexual assault experience as such (i.e., are acknowledged survivors), other survivors do not. The effect of acknowledgment of sexual assault on postassault outcomes has yielded mixed findings. It was hypothesized that social reactions may account for the relationship between acknowledgment status and psychological symptoms. Results indicated that acknowledged survivors reported more severe posttraumatic stress disorder symptoms, which were partially accounted for by turning against social reactions. Future studies should explore the mechanisms responsible for these relationships and analyze the individual social reactions.

Attitudes Toward Men and Rejection of Rape Myths: The Impact on Survivor Rape Acknowledgment.

Because unacknowledged rape survivors (i.e., those who do not conceptualize their victimization as rape) are less likely to report the crime to police or seek formal services, a better understanding of factors that contribute to rape acknowledgment is a key step to improving access to care and assault reporting on college campuses. To contribute to this line of research, this study examined the indirect effect of sexist attitudes toward men on rape acknowledgment via rejection of rape myths among female rape survivors. The analyzed sample included 250 college female rape survivors (M age = 22.49 years, SD = 7.27) who completed measures of sexual assault history, sexist beliefs toward men, and rejection of rape myths. Among these women, 49.6% were classified as acknowledged rape survivors and 50.4% of the sample was classified as unacknowledged rape survivors. Indirect effects of sexist beliefs on rape acknowledgment via rape myth rejection were supported for four types of sexist beliefs, including resentment of paternalism, compensatory gender differentiation, maternalism, and complementary gender differentiation. Specifically, the findings supported that people with greater levels of these particular types of sexist beliefs toward men rejected rape myths less, and lower rejection of rape myths was associated with increased likelihood of unacknowledged rape. The indirect effects were not supported for the heterosexual hostility or heterosexual intimacy subscales of sexist beliefs. By identifying antecedents of rape acknowledgment, the findings from this study can be used to inform programming geared toward encouraging survivors to seek services, which ultimately improves survivor outcomes.

The Effect of Social Anxiety on the Risk of Sexual Victimization via Assertiveness in an Ethnically Diverse Sample.

Preliminary evidence suggests social anxiety may increase the risk of sexual victimization via decreased sexual assertiveness. A sample of 2,043 undergraduate students completed an online survey. Analyses of moderated indirect effects examined whether gender or ethnicity moderated the indirect effect of social anxiety on sexual victimization via sexual assertiveness. No moderation effects were found, but the indirect effect of social anxiety on sexual victimization via sexual assertiveness was significant for all five types of sexual victimization. Clinically, the findings suggest that sexual assault risk reduction programs may be improved by including assertive resistance strategies and behavioral rehearsals.

After the fall: Responding to the Champlain Towers building collapse.

In June 2021, a condominium in Florida collapsed, with the loss of 98 lives. Search and rescue teams spent 2 weeks, recovering the victims. This study's objective was to assess the presence of psychological symptoms that might emerge in the following months, using the PTSD Checklist for DSM-5 (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder - 7 (GAD-7), Suicide Cognitions Scale-Short (SCS-S), and the Insomnia Severity Index (ISI). A monthly survey conducted for 3 months found that overall, mean scores on these measures did not indicate significant emotional distress. We then compared the scores when the group was divided into responders who recovered human remains and those who did not. Scores were significantly higher among the subgroup that recovered human remains. Fifty-three percent (53%) of this sub-group met the cut-off score for a provisional diagnosis of PTSD, depressive disorder or generalized anxiety disorder-15% met the cut-off score criteria on the PCL-5 for probable PTSD, 36.8% for probable depressive disorder on the PHQ-9, and 26.3% for probable generalized anxiety disorder on the GAD-7. The results are consistent with other investigations examining mental health after mass disasters. Specifically, not all first responders will develop emotional distress but certain recovery activities may put some responders at higher risk, with a percentage displaying psychological distress. The results emphasize the need to assess the impact of these events on the mental health of first responders and to consider strategies to prevent or mitigate the development of impairing psychopathology.

A randomized trial of a brief behavioral health lifestyle program for outpatient cardiology clinics.

Research on lifestyle programs for patients with coronary artery disease (CAD) has largely recruited from hospitals and/or recruited following acute coronary syndrome. By contrast, this study evaluated a 3-session behavioral health program for patients with stable CAD treated in an outpatient cardiology clinic. Thirty-three patients were randomized to the behavioral lifestyle intervention or to Treatment as Usual (TAU). A priori feasibility and acceptability criteria were met, and reliable change analyses revealed that at post-treatment and 30-day follow-up, significantly more intervention participants than TAU participants exhibited increased self-efficacy compared with baseline.