Social Networks and Sexual and Gender Minority Disparities in Alcohol Use and Consequences Among First-Year College Students.

Purpose: In this work, we investigate the association between social relationships and alcohol use and the related consequences of sexual and gender minority (SGM) college students, and we highlight the importance of SGM social networks as a potential protective factor among SGM college students. Methods: The study used data from 1340 students (47.2% White and non-Hispanic, 55.4% assigned female at birth, 16.3% SGM), which were collected during the 2016 fall semester of the first year of college at one university. The study collected information about alcohol use and related consequences and about the social networks of participants through a peer nomination survey. Results: Regardless of SGM status, students who nominated at least one SGM peer reported significantly lower drinks per week (ß = -0.69, p = 0.04) and heavy drinking frequency (ß = -0.38, p = 0.02) after adjusting for relevant covariates including peer drinking. SGM participants showed a significantly stronger negative association between having an SGM peer and heavy drinking frequency and alcohol-related consequences than their cisgender heterosexual counterparts (ß = -0.90, p = 0.04; ß = -1.32, p = 0.03). Conclusion: These findings highlight the importance of SGM social networks as a potential protective factor for reducing alcohol use and related consequences among SGM college students. College campuses should identify ways to support connections among SGM students. Clinical trials registration number is NCT02895984.

Identification and Description of Potentially Influential Social Network Members using the Strategic Player Approach.

Background: Diffusion of innovations theory posits that ideas and behaviors can be spread through social network ties. In intervention work, intervening upon certain network members may lead to intervention effects "diffusing" into the network to affect the behavior of network members who did not receive the intervention. The strategic players (SP) method, an extension of Borgatti's Key Players approach, is used to balance the (sometimes) opposing goals of spreading the intervention to as many members of the target group as possible, while preventing the spread of the intervention to others. Objectives: We sought to test whether members of the SP set have network position and non-network differences (such as demographic, attitudinal, or behavioral differences) compared to the remaining members of the target group (non-SPs). Methods: A first-year class at a private residential university (N = 1342) completed network and non-network measures. Analyses were restricted only to heavy drinkers, leading to a final analytic sample of 529. Results: SPs and non-SPs differed on multiple network variables, but did not differ on most demographic, attitudinal, and behavior variables. Conclusions: As designed, the SP program identified participants who were distinguished by their network position. The fact that they did not also differ on other characteristics shows the SPs are not significantly different than heavy drinkers who were not selected.

Rx for addiction and medication safety: An evaluation of teen education for opioid misuse prevention.

BACKGROUND: Rhode Island (RI) ninth graders report lifetime nonmedical use of prescription opioids (NMUPO) of 8.9%. NMUPO is associated with transition to heroin use, opioid overdose, and death. OBJECTIVES: Measure changes in 9th grade students' knowledge, confidence, perceptions of opioid use disorder prevention, overdose response with naloxone, treatment, and recovery, following the delivery of an interactive substance use disorder curriculum. METHODS: Eight RI public high schools were recruited to participate. Freshman in each school were administered identical surveys that collected demographic data, substance use and misuse knowledge, students' perceptions of substance misuse harm, reported drug use, and risk and protective behaviors before and after the curriculum. RESULTS: Among 969 pre-intervention survey respondents, 19% reported use of marijuana, 3% heroin use, and 21% nonmedical use of prescription opioids. Between the pre-intervention to the post-intervention survey, significantly more students identified that addiction is a chronic brain disease (79%-83%, p = 0.05), drug users are not responsible for their addiction (81%-88%, p = 0.001), and that non-medical use of a prescription medication is use without a prescription (81%-88%, p = 0.001). Improved confidence was also reported in identifying opioid withdrawal symptoms (26%-45%, p < 0.0001), identifying signs of an opioid overdose from 29% to 46% (p < 0.0001), and knowing when to administer naloxone (17%-45%, p < 0.0001). Confidence to refer someone to treatment improved from 31% to 45% (p < 0.0001). Logistic regression showed associations between mental health, peer use, parental affection, and academic performance factors as related to NMUPO. CONCLUSIONS: Students reported significant NMUPO prevalence. Ninth grade students' knowledge and confidence of opioid misuse, overdose response, and recovery resources increased following the delivery of a multi-modal interactive substance use disorder curriculum. Community, school, and student-level interventions are needed to reduce NMUPO.

Enrollment and assessment of a first-year college class social network for a controlled trial of the indirect effect of a brief motivational intervention.

Heavy drinking and its consequences among college students represent a serious public health problem, and peer social networks are a robust predictor of drinking-related risk behaviors. In a recent trial, we administered a Brief Motivational Intervention (BMI) to a small number of first-year college students to assess the indirect effects of the intervention on peers not receiving the intervention. OBJECTIVES: To present the research design, describe the methods used to successfully enroll a high proportion of a first-year college class network, and document participant characteristics. METHODS: Prior to study enrollment, we consulted with a student advisory group and campus stakeholders to aid in the development of study-related procedures. Enrollment and baseline procedures were completed in the first six weeks of the academic semester. Surveys assessed demographics, alcohol use, and social network ties. Individuals were assigned to a BMI or control group according to their dormitory location. RESULTS: The majority of incoming first-year students (1342/1660; 81%) were enrolled (55% female, 52% nonwhite, mean age 18.6 [SD = 0.51]). Differences between the intervention and control group were noted in alcohol use, but were in large part a function of there being more substance-free dormitory floors in the control group. CONCLUSIONS: The current study was successful in enrolling a large proportion of a first-year college class and can serve as a template for social network investigations.

U.S. College Students' Social Network Characteristics and Perceived Social Exclusion: A Comparison Between Drinkers and Nondrinkers Based on Past-Month Alcohol Use.

OBJECTIVE: There is a general perception on college campuses that alcohol use is normative. However, nondrinking students account for 40% of the U.S. college population. With much of the literature focusing on intervening among drinkers, there has been less of a focus on understanding the nondrinker college experience. The current study has two aims: to describe the social network differences between nondrinkers and drinkers in a college setting, and to assess perceived social exclusion among nondrinkers. METHOD: First-year U.S. college students (n = 1,342; 55.3% female; 47.7% non-Hispanic White) were participants in a larger study examining a social network of one college class and network associations with alcohol use. Alcohol use, sociocentric and egocentric network ties were assessed, as were experiences of social exclusion related to nondrinking. RESULTS: Drinking homophily based on past-month use was found; students tended to associate with others with a similar drinking status. Compared with drinkers, nondrinkers received fewer network nominations within the first-year network and made more nominations outside the first-year network. Nondrinkers' perceived social exclusion was positively related to the number of drinkers in their social networks, such that those with more drinkers in their network reported more social exclusion. CONCLUSIONS: College students' past-month drinking status in the first semester of college is related to their network position and perception of social exclusion. Nondrinking students who are part of a nondrinking community are less likely to feel socially excluded. Improving our understanding of the nondrinker college experience should improve support services for these students.

Relationships between social network characteristics, alcohol use, and alcohol-related consequences in a large network of first-year college students: How do peer drinking norms fit in?

A burgeoning area of research is using social network analysis to investigate college students' substance use behaviors. However, little research has incorporated students' perceived peer drinking norms into these analyses. The present study investigated the association between social network characteristics, alcohol use, and alcohol-related consequences among first-year college students (N = 1,342; 81% of the first-year class) at one university. The moderating role of descriptive norms was also examined. Network characteristics and descriptive norms were derived from participants' nominations of up to 10 other students who were important to them; individual network characteristics included popularity (indegree), network expansiveness (outdegree), relationship reciprocity, and network density. Descriptive norms were defined as participants' average perceived binge drinking frequency among their nominated peers. Network autocorrelation models revealed that indegree and descriptive norms were positively associated with participants' average number of drinks per week, binge drinking frequency, and alcohol-related consequences. Indegree and outdegree interacted with descriptive norms, such that when participants perceived less frequent binge drinking among their peers, outdegree was associated with less alcohol consumption but not consequences. When participants perceived more frequent binge drinking among their peers, indegree and outdegree were associated with more alcohol consumption but not consequences. The present results suggest that being popular and believing that heavy episodic drinking is normative among one's peers are associated with greater alcohol risk. Further, alcohol risks associated with nominating more peers may be enhanced or lessened depending on students' peer drinking norms. Implications for future research and interventions are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Initiation of vaporizing cannabis: Individual and social network predictors in a longitudinal study of young adults.

BACKGROUND: A trend has recently emerged of individuals using electronic nicotine delivery systems (ENDS) or similar devices to vaporize cannabis, either in the form of high-potency THC concentrates or cannabis plant material. Peer use is central to the adoption of substance use behaviors in young adulthood, but little is known about peer influence for initiating cannabis vaping. METHODS: A longitudinal investigation of first-year college students (N = 1313) using social network methods was conducted to determine the prevalence of vaping cannabis, differences in networks between individuals who initiate vaping cannabis, and predictors of initiation of vaping cannabis across two time points. The surveys were available for two weeks beginning in the sixth week of each semester. RESULTS: We found that 9.4% vaped in their lifetime but not since the first survey, 7.5% vaped in their lifetime and since the first survey, and 5.9% reported vaping cannabis at the second survey. Lifetime cannabis use, lifetime ENDS use, and number of peers who initiated vaping cannabis from Time 1 to Time 2 were significantly associated with increased odds of the initiation of vaping cannabis; the number of any-cannabis-using or any-ENDS-using peers was not associated with increased odds of initiating vaping cannabis. CONCLUSIONS: Individuals with the greatest risk of initiation of vaping cannabis during the first year of college are those with a prior history of other cannabis use and ENDS use and who have peers in their network who initiate cannabis vaping.

Poor mental health, peer drinking norms, and alcohol risk in a social network of first-year college students.

OBJECTIVE: College students with anxiety and depressive symptomatology face escalated risk for alcohol-related negative consequences. While it is well-established that normative perceptions of proximal peers' drinking behaviors influence students' own drinking behaviors, it is not clear how mental health status impacts this association. In the current study, we examined cross-sectional relationships between anxiety and depressed mood, perceived drinking behaviors and attitudes of important peers, and past month alcohol consumption and related problems in a first-semester college student social network. METHOD: Participants (N = 1254, 55% female, 47% non-Hispanic White) were first-year students residing on campus at a single university who completed a web-based survey assessing alcohol use, mental health, and social connections among first-year student peers. Network autocorrelation models were used to examine the independent and interactive associations between mental health and perceptions of close peers' drinking on drinking outcomes, controlling for important variables. RESULTS: Mental health interacted with perceptions to predict past-month drinking outcomes, such that higher anxiety and higher perceptions that peers drink heavily was associated with more drinks consumed and consequences, and higher depression and perceptions was associated with more drinks consumed, heavy drinking frequency, and consequences. Attitudes that peers approve of heavy drinking were associated with more drinks consumed and heavy drinking frequency among students with lower (vs. higher) depressed mood. CONCLUSIONS: This study provides strong evidence that perceiving that close peers drink heavily is particularly risk-enhancing for anxious and depressed college students, and offers implications about alcohol intervention targeted at these subgroups.

An event- and network-level analysis of college students' maximum drinking day.

BACKGROUND: Heavy episodic drinking is common among college students and remains a serious public health issue. Previous event-level research among college students has examined behaviors and individual-level characteristics that drive consumption and related consequences but often ignores the social network of people with whom these heavy drinking episodes occur. The main aim of the current study was to investigate the network of social connections between drinkers on their heaviest drinking occasions. METHODS: Sociocentric network methods were used to collect information from individuals in the first-year class (N=1342) at one university. Past-month drinkers (N=972) reported on the characteristics of their heaviest drinking occasion in the past month and indicated who else among their network connections was present during this occasion. RESULTS: Average max drinking day indegree, or the total number of times a participant was nominated as being present on another students' heaviest drinking occasion, was 2.50 (SD=2.05). Network autocorrelation models indicated that max drinking day indegree (e.g., popularity on heaviest drinking occassions) and peers' number of drinks on their own maximum drinking occasions were significantly associated with participant maximum number of drinks, after controlling for demographic variables, pregaming, and global network indegree (e.g., popularity in the entire first-year class). CONCLUSION: Being present at other peers' heaviest drinking occasions is associated with greater drinking quantities on one's own heaviest drinking occasion. These findings suggest the potential for interventions that target peer influences within close social networks of drinkers.

Resistance to peer influence moderates the relationship between perceived (but not actual) peer norms and binge drinking in a college student social network.

INTRODUCTION: Adolescent and young adult binge drinking is strongly associated with perceived social norms and the drinking behavior that occurs within peer networks. The extent to which an individual is influenced by the behavior of others may depend upon that individual's resistance to peer influence (RPI). METHODS: Students in their first semester of college (N=1323; 54.7% female, 57% White, 15.1% Hispanic) reported on their own binge drinking, and the perceived binge drinking of up to 10 important peers in the first-year class. Using network autocorrelation models, we investigated cross-sectional relationships between participant's binge drinking frequency and the perceived and actual binge drinking frequency of important peers. We then tested the moderating role of RPI, expecting that greater RPI would weaken the relationship between perceived and actual peer binge drinking on participant binge drinking. RESULTS: Perceived and actual peer binge drinking were statistically significant predictors of participant binge drinking frequency in the past month, after controlling for covariates. RPI significantly moderated the association between perceptions of peer binge drinking and participant's own binge drinking; this association was weaker among participants with higher RPI compared to those with lower RPI. RPI did not interact with the actual binge drinking behavior of network peers. CONCLUSIONS: RPI may function to protect individuals from the effect of their perceptions about the binge drinking of peers, but not from the effect of the actual binge drinking of peers.

Abstinence-induced withdrawal severity among adolescent smokers with and without ADHD: disentangling effects of nicotine and smoking reinstatement.

RATIONALE: Individuals with attention deficit hyperactivity disorder (ADHD) start smoking earlier, are more likely to progress to nicotine dependence, and have a more difficult time quitting smoking compared to their non-ADHD peers. Little is known about the underlying behavioral mechanisms associated with this increased risk, particularly at the adolescent stage. OBJECTIVE: This study aimed to assess the effects of overnight nicotine abstinence and smoking reinstatement on subjective withdrawal states in adolescent smokers with and without ADHD. METHODS: Adolescent daily smokers (27 with ADHD and 17 without ADHD) completed three experimental sessions: (1) a placebo patch followed by smoking a nicotine cigarette, (2) placebo patch followed by smoking a nicotine-free cigarette, and (3) nicotine patch followed by smoking a nicotine-free cigarette. Subjects abstained overnight before each session, and patches were administered 45 min before smoking. The primary outcome measure was a smoking withdrawal symptom questionnaire. RESULTS: ADHD smokers experienced greater difficulty concentrating and impatience/restlessness during abstinence than non-ADHD smokers. Smoking a cigarette improved abstinence-induced difficulty concentrating and restlessness, regardless of its nicotine content, and regardless of whether transdermal nicotine was received or not. CONCLUSIONS: Thus, sensorimotor aspects of smoking, rather than nicotine itself, appeared to relieve withdrawal. Although ADHD smokers report greater withdrawal symptoms than non-ADHD smokers, they responded strongly to the sensorimotor aspects of smoking during withdrawal. These findings suggest that even lighter, adolescent smokers with ADHD are vulnerable to smoking progression through altered smoking abstinence and withdrawal relief processes.

Efficacy of the College Drinkers Check-Up for Student Drinkers Living Off Campus.

OBJECTIVE: Students living in off-campus housing consume more alcohol and experience more alcohol-related consequences than those living on campus, yet prevention efforts have not targeted this high-risk group specifically. The present study evaluated the efficacy of a brief, computer-delivered, alcohol intervention (the College Drinkers Check-Up [CDCU]) in reducing alcohol use and related consequences in a sample of college students living off campus. METHOD: Students who lived off campus and reported at least one heavy drinking episode (4+/5+ drinks for females/males in one occasion) in the past 30 days completed the CDCU or assessment only during the first month of the school year (n = 326; 61% female). Participants in both conditions completed follow-up assessments at 1, 3, and 6 months. We hypothesized that participants who completed the CDCU would report fewer drinks per week and heavy drinking episodes, lower peak drinking quantities, and fewer alcohol-related consequences than those in the control group. RESULTS: Hierarchical linear modeling was used to examine changes in drinking outcomes across groups from baseline to 1-, 3-, and 6-month follow-ups. Significant effects of time indicated less drinking and fewer consequences at each follow-up relative to baseline. Compared with those in the control group, participants who received the CDCU reported significantly fewer heavy drinking episodes at 1 month, lower peak drinking quantities at 3 months, and fewer alcohol-related consequences at 1 and 3 months. Neither sex nor baseline drinking severity moderated intervention effects. CONCLUSIONS: The brief, online CDCU reduces heavy drinking and alcohol consequences in the short term among atrisk college students living off campus.

Off-Campus Residence as a Risk Factor for Heavy Drinking Among College Students.

BACKGROUND: College student alcohol use is a public health problem. OBJECTIVES: The aim of this study was to examine associations between residence and drinking behaviors among college students. We hypothesized that living off-campus independently or with peers would be associated with riskier drinking than living on-campus, and living with parents would be associated with less risky drinking than living on-campus. METHODS: We analyzed data from two separate studies conducted at two four-year universities in the Northeast. Study 1 examined data from 1286 students (57% female) attending a private university. In Study 2, analyses were replicated and extended with 2408 students (67% female) from a public university. We conducted regression analyses that controlled for age, race, gender, and class year to determine the unique association of residence on typical and peak drinking, frequency of heavy drinking, and alcohol-related consequences. RESULTS: In both samples, students living off-campus without parents reported more frequent alcohol consumption, larger drinking quantities, more frequent heavy drinking, and a greater number of alcohol-related consequences than students living on-campus (ps <.001). In Study 2, students living off-campus with their parents exhibited significantly fewer risky drinking behaviors than those living on-campus (ps <.001). CONCLUSIONS: Living off-campus - either independently or with peers - is a risk factor for heavy drinking and consequences. This group exhibits more risky drinking behaviors and alcohol-related consequences than students living on-campus, independent of age and class year. Therefore, students moving off-campus may be appropriate targets for alcohol misuse prevention programs.

Do my peers approve? Interest in injunctive norms feedback delivered online to college student drinkers.

Injunctive norms feedback is promising but understudied as a component of college drinking interventions. The aim of the present study was to demonstrate acceptability of injunctive norms feedback delivered to college drinkers via the web. We examined subjective interest in information reflecting peer approval of four sets of drinking behaviors and outcomes, and correlates of interest in the normative feedback. A sample of 221 young adults enrolled in a 2- or 4-year college or university (ages 18-25 years; 52% female) completed online surveys in which they were asked to rate their interest in each of 11 injunctive norms statements. Participants were randomly assigned to one of four sets of statements regarding peer approval of (a) intoxicated behaviors, (b) safe drinking strategies, (c) drinking-related consequences, and (d) drinking behaviors of potential partners. All items were framed to reflect disapproval of risky behaviors and approval of protective behaviors. Across norm sets, participants found the items to be moderately interesting and interest ratings did not differ across sets. Higher scores on the Alcohol Use Disorders Identification Test (AUDIT), stronger perceived approval of drinking in general (injunctive norms), stronger perceptions of drinking among peers (descriptive norms), and female gender were bivariately correlated with more interest. In a multiple regression, female gender, higher AUDIT (consequence subscale), and stronger general drinking injunctive norms remained significantly associated with interest in the pro-moderation statements. An important future direction is to determine whether the presentation of specific types of injunctive norms feedback can result in downward changes in drinking behavior.