Self-Compassion and Self-Forgiveness in Alcohol Risk, Treatment and Recovery: A Systematic Review.

INTRODUCTION: Self-compassion and self-forgiveness are two self-focused, positive coping approaches that may reduce risk of problem drinking and/or aid in treatment/recovery from alcohol use disorder. The present systematic review aimed to evaluate support for the unique and complementary roles of self-compassion and self-forgiveness in alcohol outcomes. METHODS: A systematic literature search yielded 18 studies examining self-compassion, 18 studies examining self-forgiveness and 1 study examining both constructs in alcohol outcomes. RESULTS: Findings suggest greater self-compassion and self-forgiveness relate to lower likelihood of problem drinking. Self-forgiveness was considerably more researched in treatment/recovery outcomes than self-compassion; self-forgiveness-based interventions appear able to improve drinking-adjacent outcomes, and self-forgiveness may increase across various alcohol treatments. Finally, research suggests that associations of self-compassion and/or self-forgiveness with alcohol outcomes could be driven by numerous factors, including coping-motivated drinking, depression, psychache, social support perceptions, mental health status and/or psychiatric distress. CONCLUSIONS: Self-compassion and self-forgiveness both appear protective against harmful alcohol outcomes. Nevertheless, many questions remain about the role of self-forgiveness and, particularly, self-compassion in alcohol treatment and recovery outcomes. Future research should examine whether targeted interventions and/or adjunctive therapeutic supports designed to increase self-compassion or self-forgiveness can reduce alcohol use disorder symptoms to facilitate alcohol treatment and recovery success.

Prospective Pathways from Affect to Drug Outcomes: Refusal Self-Efficacy in the Context of Peer Influences.

Objective: Non-alcohol drug (NAD) use and its associated consequences remain a prevalent problem among young adults. Both positive and negative affect play etiological roles in NAD. The perception of one's ability to refuse a drug in different situations (drug refusal self-efficacy) could be an important mediator between such affect and NAD outcomes (use and consequences). This study examined mediational pathways from affect to NAD use and NAD-related consequences via drug refusal self-efficacy. We also examined the moderating role of normative perceptions of peer NAD involvement. Method: Across three time points (September, February, April) of their first college year, students (N = 355) completed an online self-report questionnaire to assess affect, refusal self-efficacy, NAD use frequency, NAD-related problems, and peer norms. Data were analyzed using longitudinal structural path models. Results: Refusal of self-efficacy for situations involving negative affect significantly mediated the relationship between negative affect and NAD use but not consequences, supporting a negative reinforcement pathway. Greater perceptions of peer drug use moderated the mediated negative reinforcement pathway. No significant pathways were found for the refusal self-efficacy positive reinforcement pathways. Conclusions: This study provides support for a negative reinforcement pathway to NAD use in which refusal self-efficacy plays an important mechanistic role. These findings may have implications for intervention, as targeting refusal self-efficacy for those with NAD use and addressing peer influences could be helpful in reducing NAD risk. Replication of these findings and extension using daily assessment and more fine-grained assessment of individual NAD types will be important next steps.

Utility of the Brief Young Adult Alcohol Consequences Questionnaire to Identify College Students At-Risk for Alcohol Related Problems: Relative Operating Characteristics across Seven Countries.

Background: It is important to identify students who would benefit from early interventions to reduce harmful drinking patterns and associated consequences. the Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ) could be particularly useful as a screening tool in university settings. Objectives. The present study examined the utility of the B-YAACQ to distinguish among students at-risk for problematic alcohol use as measured by the AUDIT. Objectives: The present study examined the utility of the B-YAACQ to distinguish among students at-risk for problematic alcohol use as measured by the AUDIT. Methods: A sample of 6382 students (mean age=20.28, SD=3.75, 72.2% females) from seven countries (i.e., U.S., Canada, South-Africa, Spain, Argentina, Uruguay, England) completed the B-YAACQ, the AUDIT and different measures of alcohol use. Results: ROC analyses suggested that a cutoff score of 5 maximized the YAACQ's discrimination utility to differentiate between students at low versus moderate/high risk in the total sample and across countries (except in Canada, where the cutoff was 4). In addition, a cutoff of 7 differentiated between students at low/moderate versus high risk in the total sample, while cutoffs of 10, 9, 8 and 7 differentiate between students at low/moderate versus high risk in Uruguay, U.S and Spain (10), Argentina (9), England (8), and Canada and South-Africa (7), respectively. Students classified at the three risk levels (i.e., low, moderate and high) differed in age (i.e., a younger age was associated with higher risk) and drinking patters (i.e., higher drinking frequency, quantity, binge drinking and AUDIT and B-YAACQ scores in the higher risk groups). Conclusions: This study suggest that the B-YAACQ is a useful tool to identify college students at-risk for experiencing problematic patterns of alcohol use.

Development and Initial Testing of a Brief, Integrated Intervention Aimed at Reducing Heavy Alcohol Use and PTSD among Military Veterans in Primary Care.

There is a need for integrated treatment approaches that address heavy alcohol use and posttraumatic stress disorder (PTSD) concurrently among Veterans as interactions between heavy drinking and PTSD are frequent. Veteran engagement in specialty mental health services after referral is limited with poorer outcomes following empirically-supported, exposure-based PTSD treatments that do not explicitly address alcohol use. The current project aimed to incorporate two evidenced-based interventions: Brief Motivational Intervention (BMI) with Prolonged Exposure for Primary Care (PE-PC) for Veterans with heavy drinking and PTSD. Delphi methodology was applied to adapt an intervention protocol using subject matter expert (SME) feedback to guide the refinement of a preliminary treatment manual. The newly developed brief intervention (PC-TIME) was then tested in an open trial (n=9) to gather Veteran participant feedback to modify the treatment manual.Two rounds of SME feedback resulted in 80% agreement that manual content was "acceptable as-is" across all intervention domains. The resulting protocol is a five-session, integrated intervention with session 1 primarily focused on alcohol use reduction and sessions 2-5 consisting of narrative exposure and in-vivo exercises for PTSD symptoms with brief alcohol use check-ins. Open trial results indicated high Veteran acceptance of PC-TIME structure and content, and reductions in heavy drinking and PTSD symptoms. Preliminary data suggest PC-TIME to be a promising approach for treatment of heavy alcohol use and PTSD. A pilot randomized controlled trial is necessary to demonstrate the intervention's efficacy with Veterans in a PC setting.

Coping Flexibility and Alcohol-Related Outcomes: Examining Coping Motives as Mediators.

Background: Coping has been implicated in the etiology and treatment of problem drinking. Traditional, static measurement of coping styles (e.g., approach, avoidance, social support) may fail to capture how adaptive a given coping style may be. Coping flexibility is an emerging construct, associated with psychological health, and one that may shed light on coping's role in drinking risk. Coping flexibility includes (1) discontinuation of an ineffective coping strategy ("Discontinuation") and (2) production of an alternative strategy ("Implementation"). This study is the first to our knowledge to examine its association to drinking outcomes. Further, because coping deficits are theorized to lead to drinking through coping motives, we also examined mediated pathways from coping flexibility to alcohol outcomes via coping motives. Methods: College students (N = 528) completed an online assessment. Data were analyzed using path analysis. Control variables included sex and coping styles. Results: In path analytic models, Implementation was negatively associated with alcohol use and, indirectly via coping motives, negatively associated with alcohol consequences. The direct effect on alcohol use remained when controlling for coping styles and sex, but the mediational pathway was no longer significant. Conclusions: This study provides some evidence for the protective role of coping flexibility in alcohol use behavior, which may have implications for how best to address coping skills in alcohol interventions. The direct effect of Implementation on drinking suggests that there may be utility in teaching clients a flexible approach to coping in treatment. Replication, particularly with longitudinal designs, is needed.

Testing alternative cascades from internalizing and externalizing symptoms to adolescent alcohol use and alcohol use disorder through co-occurring symptoms and peer delinquency.

Given the equivocal literature on the relationship between internalizing symptoms and early adolescent alcohol use (AU) and AU disorder (AUD), the present study took a developmental perspective to understand how internalizing and externalizing symptoms may operate together in the etiology of AU and AUD. We pit the delayed onset and rapid escalation hypothesis (Hussong et al., 2011) against a synthesis of the dual failure model and the stable co-occurring hypothesis (Capaldi, 1992; Colder et al., 2013, 2018) to test competing developmental pathways to adolescent AU and AUD involving problem behavior, peer delinquency, and early initiation of AU. A latent transactional and mediational framework was used to test pathways to AUD spanning developmental periods before AU initiation (Mage = 11) to early and high risk for AUD (Mage = 14-15 and Mage = 17-18). The results supported three pathways to AUD. The first started with "pure" externalizing symptoms in early childhood and involved multiple mediators, including the subsequent development of co-occurring symptoms and peer delinquency. The second pathway involved stable co-occurring symptoms. Interestingly, chronically elevated pure internalizing symptoms did not figure prominently in pathways to AUD. Selection and socialization effects between early AU and peer delinquency constituted a third pathway.

Resilience to mental health problems and the role of deployment status among U.S. Army Reserve and National Guard Soldiers.

PURPOSE: Research suggests that interpersonal and intrapersonal resiliency factors protect against poor post-deployment mental health outcomes among Reserve/Guard soldiers who have been deployed. There is increasing awareness that never-deployed soldiers are also at risk. The purpose of this study was to examine the relationships between resiliency factors and a range of mental health outcomes among a sample of United States Army Reserve and National Guard (USAR/NG) soldiers who have and have not experienced deployment. METHODS: A subset of data was drawn from Operation: SAFETY (N = 360), an ongoing study examining the health and well-being of USAR/NG soldiers. We used a multivariate path analysis approach to examine the simultaneous effects of unit support, marital satisfaction, and psychological hardiness on the following mental health outcomes, concurrently: anger, anxiety, depression, and posttraumatic stress disorder (PTSD) symptomatology. We also examined interaction effects between resiliency factors and deployment status on mental health outcomes. RESULTS: Greater unit support (ps < 0.01), marital satisfaction (ps < 0.001), and psychological hardiness (ps < 0.001) were associated with less anger, anxiety, depression, and PTSD symptomatology. Psychological hardiness had significant interactions with deployment status on anxiety, depression, and PTSD, such that the protective effects of psychological hardiness were even stronger among never-deployed soldiers than previously deployed solders. CONCLUSION: Resiliency factors can be targeted for intervention to prevent poor mental health outcomes among USAR/NG soldiers, regardless of deployment status. Further, psychological hardiness may be an even more important protective factor among soldiers who have never been deployed.

Parents' Cannabis-Related Attitudes and Emerging Adult Offspring Cannabis Use: Testing the Mediating Effect of Perceived Parental Approval.

Background: Contrary to parental alcohol use and expectancies work, little is known about how parent's cannabis use (CU) and expectancies influence offspring CU. This is a notable gap in the literature given increasing acceptability and use of cannabis, especially among emerging adults (EA). Moreover, limited work has tested mechanisms of transmission of risk from these parent factors. This study addresses these gaps by testing prospective associations of parental CU and expectancies with offspring CU and CU problems, and perceived parental approval of offspring CU as a potential mediator. Method: A community sample of 314 EA and caregiver dyads completed three annual assessments (mean age = 19.13). The sample was 54% female and majority White/non-Hispanic (76%). Caregivers reported on their cannabis expectancies and use, and EA reported on their CU, CU-related problems, and perceived parental approval of CU. Results: Longitudinal structural equation modeling supported a mediated pathway such that high parental positive cannabis expectancies were associated with perceived parental approval of CU, which in turn, predicted increases in EA CU and CU problems. Parental negative expectancies had a significant indirect effect but in the opposite direction. Indirect effects were found above and beyond parental CU, which was not associated with offspring CU. Conclusions: This is the first study to test prospective indirect effects of parental cannabis expectancies on offspring CU. Findings suggest parents' attitudes, even in the absence of parental use, confer risk for offspring use by shaping perceived acceptance of CU, suggesting parental expectancies as targets for parent-based CU interventions.

Drinking Motives as Moderators of In-the-Moment Drinking Risks in Response to Trauma-Related Distress.

BACKGROUND: Trauma exposure and posttraumatic stress disorder (PTSD) symptomatology are linked to increased risk for problematic drinking, yet the factors that increase such risk remain largely unknown. Theoretical models suggest that affectively oriented drinking motives may be central to trauma-related drinking. Specifically, individual-level motivations to drink to regulate affect may be important for moderating drinking urges that occur acutely in response to trauma cues. Further, elevated distress associated with PTSD symptomatology may increase any affectively motivated, momentary drinking risks. However, research has yet to examine these dynamic affective processes. In a large experimental sample, the current study tested whether affective (i.e., coping and enhancement) drinking motives and PTSD symptomatology moderated individuals' drinking urge in response to a trauma cue in a laboratory cue reactivity paradigm. METHODS: College drinkers (n = 611, 53% female) were recruited and selected across levels of trauma exposure and PTSD symptomatology by a structured clinical interview. Participants were randomized to a personalized trauma or neutral cue, reporting on their urge to drink alcohol before and after cue exposure. Drinking motives were assessed at the end of the experimental session. RESULTS: Trauma cue associations with drinking urge were moderated by coping, but not enhancement, motives. Specifically, stronger coping motives were associated with increases in urge to drink alcohol following exposure to a trauma but not neutral cue. PTSD classification did not significantly moderate these associations. CONCLUSIONS: Coping motives may increase drinking urge immediately following exposure to trauma cues and may differentiate individuals most at risk for problematic drinking during trauma-associated distress. Findings support momentary negative affect processes driving dynamic, immediate trauma-related drinking risks.

Does Cannabis Use Predict More Severe Types of Alcohol Consequences? Longitudinal Associations in a 3-Year Study of College Students.

BACKGROUND: Prior research shows that negative drinking outcomes among young adults may be exacerbated by cannabis use. However, to date, there have been few longitudinal studies of associations between cannabis use and negative alcohol-related consequences. This study examined longitudinal within-person associations between cannabis use and several domains of negative alcohol consequences among young adults and explored the moderating role of sex. METHOD: We analyzed data from N = 997 students assessed 4 times per year over the first 3 years of university. At each time point, participants completed measures of past-month cannabis use frequency, typical weekly number of drinks, and 8 domains of negative alcohol consequences. Longitudinal associations were examined in multilevel models. RESULTS: Within-person changes in frequency of cannabis use were not uniquely associated with changes in total alcohol consequences aggregated across several alcohol consequence domains. However, when examining alcohol consequence domains separately, within-person increases in cannabis use frequency were specifically associated with increases in some (but not all) of the more severe types of alcohol consequences, including risky behaviors, poor self-care, and alcohol dependence symptoms. No support was observed for the moderating role of sex in the longitudinal within-person associations between cannabis use and alcohol consequence domains. CONCLUSIONS: Findings suggest that within-person changes in cannabis use frequency among young adults are associated with corresponding changes in some domains of alcohol consequences (but not others) when examined over the course of several years. Results may inform targeted harm reduction interventions for young adult drinkers who use cannabis, although future research is needed to clarify the mechanisms of the observed associations.

Distress-Related Internalizing Symptoms Interact With Externalizing Symptoms to Predict Alcohol Problems in an Inpatient Adolescent Sample.

BACKGROUND AND OBJECTIVES: Previous research has yielded equivocal findings regarding whether internalizing symptoms are risk factors for adolescent hazardous alcohol use (AU), specifically in the presence of externalizing symptoms. This may be due to the type of internalizing symptoms examined (ie, distress vs fear), and the use of primarily normative rather than clinical samples. Thus, we tested internalizing and externalizing symptom interactions as they relate to adolescent hazardous AU in a high-risk, clinical sample of adolescents. METHODS: Adolescents (N = 101; 66% female; Mage = 15) were recruited from an inpatient psychiatric unit and assessed for current symptoms. Hypotheses were tested by running a series of moderation models regressing hazardous AU on a set of internalizing symptoms (ie, depression, generalized anxiety disorder [GAD], social anxiety, separation anxiety, school avoidance, and panic), each interacting with externalizing symptoms. RESULTS: We observed significant interactions between several internalizing symptoms (depression, GAD, and panic symptoms) and externalizing symptoms predicting hazardous AU. These internalizing symptoms were unrelated to AU at low and average levels of externalizing symptoms, but were positively related to AU at high levels of externalizing symptoms. DISCUSSION AND CONCLUSIONS: In this clinical sample, distress-related internalizing symptomatology was associated with risk for, and not protection against, hazardous AU, but only when accompanied by high externalizing symptoms. SCIENTIFIC SIGNIFICANCE: Findings suggest that whether or not internalizing symptoms operate synergistically with externalizing symptoms to predict hazardous AU depends on the subdomain of internalizing symptoms (distress vs fear) and perhaps the type of sample (ie, clinical vs community). (Am J Addict 2019:00:00-00).

Coping trajectories in emerging adulthood: The influence of temperament and gender.

OBJECTIVE: The study of coping has far-reaching implications for understanding psychopathology and resilience, as well as for the treatment of psychological disorders. Developmental work has examined how the ability to cope changes across time in children and adolescents; however, work in emerging adulthood is still lacking. Coping is thought to emerge from basic biological and psychological processes, such as temperament and gender, which may influence the trajectory of coping use over time. METHOD: Using a sample of college students (N = 1,000), our 4-year longitudinal study with yearly assessments sought to (a) examine the trajectory of coping styles in emerging adulthood and to (b) examine the influence of temperament and gender on these coping trajectories. RESULTS: Our findings suggest that young adults' use of avoidance strategies decreased slightly over college, whereas the use of approach strategies and social support seeking remained stable. Temperament (BIS/BAS) and gender were related to certain coping styles at baseline and appeared to have an influence on some of these trajectories over time, though these associations were complex. CONCLUSIONS: This work may inform intervention research attempting to promote adaptive coping because it may help identify young adults most in need of such interventions.

Trajectories of College Alcohol Involvement and Their Associations with Later Alcohol Use Disorder Symptoms.

Little is known about what differentiates individuals whose drinking patterns escalate into problematic use following the transition out of college compared to those who learn to drink in a way that is consistent with independent adult roles. Patterns of alcohol use and problems during college may pre-sage progression toward problem drinking in adulthood. The present study sought to examine such patterns in an effort to delineate those at greatest risk. Research has not yet elucidated whether, when, and how these groups diverge. Our results indicate that students who report AUD symptoms one year following graduation reported greater alcohol involvement from the first semester and escalated their involvement with alcohol at a more rapid pace. We observed marked and measurable differences in drinking patterns between those who go on to exhibit AUD symptoms following college and those who do not. A close inspection of these differences reveals that relatively small absolute differences in alcohol consumption add up to large differences in alcohol-related consequences. Thus, markers of longer-term risk are present early in college, and greater escalation of drinking across college is an indicator that intervention is needed. Brief Motivational Interventions could help students to anticipate some of the challenges ahead as they transition from the college environment, as well as the potential deleterious effects of immoderate alcohol use on making a successful transition into adult roles. In addition to the beginning of college, our findings also point to critical periods during which screening and brief intervention may be optimally timed.

Heterogeneity of Pregamers by Consumption and Reinforcement Reasons: A Latent Profile Analysis.

BACKGROUND: Pregaming is a common, high-risk drinking activity among college students that has been largely unchangeable despite targeted intervention approaches. Therefore, identifying profiles of pregamers could enhance understanding of the risks associated with this practice and inform intervention development. METHODS: This study identified subtypes of pregamers in undergraduates (N = 911; 60% female, 42.9% White) attending 3 U.S. universities in 2012. Self-report data assessed recent alcohol use (overall, heavy, and pregaming), pregaming motives, and demographics. Alcohol-related consequences were assessed via the Young Adult Alcohol Consequences Questionnaire. RESULTS: Latent profile analysis using pregaming-specific indicators assessing motives (e.g., to avoid getting caught) and consumption (e.g., estimated pregaming blood alcohol concentration) yielded 5 unique profiles. Three profiles were characterized by pregaming on 50% or more of all drinking events that differed by pregaming consumption and motives: Instrumental (5.3%; heavy consumption, intoxication-driven motives), Global (16.0%; moderate consumption, indistinct motives), and Risk-averse (18.3%; moderate-to-heavy consumption, negatively reinforcing motives). Two profiles reported lower levels of pregaming: Occasional (32.4%; moderate consumption, indistinct motives) and Infrequent (28.0%; lowest pregaming involvement). Cross-profile differences were then examined for demographics, general drinking and pregaming-specific motives, and alcohol-related consequences. Profile comparisons indicated differences in overall alcohol consumption, ethnicity, gender, current living arrangements, Greek involvement, and a variety of alcohol-related consequences (ps < 0.01). CONCLUSIONS: Overall, pregaming is a very heterogeneous behavior among college students in that some students utilize this drinking practice as a means to mitigate risk and others use it to promote intoxication. Results suggest that distinguishing pregamers by consumption as well as motives can facilitate the development of more tailored intervention approaches for students who engage in this high-risk practice.

The Prospective Association Between Internalizing Symptoms and Adolescent Alcohol Involvement and the Moderating Role of Age and Externalizing Symptoms.

BACKGROUND: As predicted by self-medication theories that drinking is motivated by a desire to ameliorate emotional distress, some studies find internalizing symptoms (e.g., anxiety, depression) increase risk of adolescent drinking; however, such a risk effect has not been supported consistently. Our prior work examined externalizing symptoms as a potential moderator of the association between internalizing symptoms and adolescent alcohol use to explain some of the inconsistencies in the literature. We found that internalizing symptoms were protective against early adolescent alcohol use particularly for youth elevated on externalizing symptoms (a 2-way interaction). Our sample has now been followed for several additional assessments that extend into young adulthood, and the current study tests whether the protective effect of internalizing symptoms may change as youth age into young adulthood, and whether this age-moderating effect varied across different clusters of internalizing symptoms (social anxiety, generalized anxiety, and depression). Internalizing symptoms were hypothesized to shift from a protective factor to a risk factor with age, particularly for youth elevated on externalizing symptoms. METHODS: A community sample of 387 adolescents was followed for 9 annual assessments (mean age = 12.1 years at the first assessment and 55% female). Multilevel cross-lagged 2-part zero-inflated Poisson models were used to test hypotheses. RESULTS: The most robust moderating effects were for levels of alcohol use, such that the protective effect of all internalizing symptom clusters was most evident in the context of moderate to high levels of externalizing problems. A risk effect of internalizing symptoms was evident at low levels of externalizing symptoms. With age, the risk and protective effects of internalizing symptoms were evident at less extreme levels of externalizing behavior. With respect to alcohol-related problems, findings did not support age moderation for generalized anxiety or depression, but it was supported for social anxiety. CONCLUSIONS: Findings highlight the importance of considering the role of emotional distress from a developmental perspective and in the context of externalizing behavior problems.

Drinking and exercise behaviors among college students: between and within-person associations.

Prior work has suggested a paradoxical positive relationship between the risk behavior alcohol use and the health behavior exercise, particularly in young adults. Though seldom tested, different theoretical perspectives exist on the mechanisms that may explain the positive relationship. The aims of this study were to test theorized mechanisms of association, including common causes shared by both behaviors (e.g., personality, motives, affective), compensatory processes such as exercising to compensate for calories from alcohol consumption, and methodological confounds (e.g., between vs. within subject effects) in a college sample (N = 132; 56.3% male; 76% Caucasian; M age = 19.15, SD = 0.99) using a cross-sectional design and time line follow back methods. A positive, between-subjects association between alcohol and exercise was found and explained by exercising to compensate for calories of alcohol consumption, enhancement motives, and physical activity enjoyment. However, we also observed a significant and negative within-subjects association between the two constructs, suggesting that, on a given day, individuals who exercise more tended to drink less. Furthermore, individuals who exercised more during the week tended to have declines in weekend drinking over time. Results suggest a complex relationship between exercise and alcohol use among young adults, and highlight the importance of distinguishing between and within subject processes, as well as the temporal ordering of the two behaviors. Implications are discussed in regard to theory, prevention, and intervention.

Posttraumatic Stress and Problem Drinking at the Transition Out of College.

The objective of the present study was to examine how symptoms of posttraumatic stress disorder (PTSD) may confer drinking risk as students with trauma histories complete college and move toward independent adulthood. Students (N = 283) completed assessments of trauma, posttraumatic stress, and alcohol use and consequences at four time points during the year following their fourth year of college. Some students had transitioned out of the college environment, whereas others had not. We examined how transition status moderated within-person associations between changes in PTSD and corresponding changes in alcohol outcomes over time. Using multilevel modeling, we examined differences in within-person PTSD-alcohol associations comparing students who were (1) continuing as fifth-year seniors, (2) graduated and pursuing graduate education, and (3) graduated and left the university setting. Alcohol use and consequences tended to decline on average from the fourth to fifth year post-matriculation. Yet, within-person increases in posttraumatic stress symptomatology across the fifth year were associated with greater alcohol consequences, but only for those students who had left the university setting. These data suggest that the transition out of college may be an important developmental context that is associated with increased vulnerability for negative consequences from stress-related drinking. Findings may have important implications for campus-based prevention efforts geared toward the facilitation of a successful transition into independent adulthood.

Social Surrogate use in those Exposed to Trauma: I Get by with a Little Help from my (Fictional) Friends.

Traumatic events bring an increased need for social connection but paradoxically can make relationships more difficult. The current research examines the unique role social surrogates such as favorite TV shows, books, and celebrities may play in fulfilling the social needs of people who have experienced trauma. Across two studies we predicted and found that experiencing traumatic events is associated with higher interest in using social surrogates. Furthermore, individuals who have experienced trauma without developing PTSD are able to effectively use social surrogates to combat social isolation. However, perhaps because PTSD symptoms often are associated with impaired social functioning, those with PTSD actually feel worse after social surrogate use. Implications for trauma, PTSD, social surrogates, and social self research are discussed.

Cognitive appraisals of alcohol use in early adolescence: Psychosocial predictors and reciprocal associations with alcohol use.

Early adolescence is a dynamic period for the development of alcohol appraisals (expected outcomes of drinking and subjective evaluations of expected outcomes), yet the literature provides a limited understanding of psychosocial factors that shape these appraisals during this period. This study took a comprehensive view of alcohol appraisals and considered positive and negative alcohol outcome expectancies, as well as subjective evaluations of expected outcomes. Developmental-ecological theory guided examination of individual, peer, family, and neighborhood predictors of cognitive appraisals of alcohol and use. A community sample of 378 adolescents (mean age 11.5 years at Wave 1, 52% female) was assessed annually for 4 years. Longitudinal path analysis suggested that the most robust predictors of alcohol appraisals were peer norms. Furthermore, perceived likelihood of positive and negative alcohol outcomes prospectively predicted increases in drinking. There was limited support for appraisals operating as mediators of psychosocial risk and protective factors.

Addressing Inconsistencies in the Social Norms Drinking Literature: Development of the Injunctive Norms Drinking and Abstaining Behaviors Questionnaire.

BACKGROUND: Informed by inconsistent findings regarding the association between injunctive norms (IN) and drinking behaviors, the current study developed a new measure of IN, the Injunctive Norms Drinking and Abstaining Behaviors Questionnaire (IN-DABQ). This measure addressed several psychometric weaknesses of prior assessment of this construct, specifically, reliance on single-item measures, and assessment of a limited range of drinking behaviors. The new measure also assessed norms for reasons for abstaining from drinking as college students often have simultaneous motives to use and inhibit their drug use. A parallel measure of descriptive norms (DN), the Descriptive Norms Drinking and Abstaining Behaviors Questionnaire (DN-DABQ), was created to allow for a comparison of the relative predictive effects of descriptive and IN in relation to different drinking outcomes. METHODS: A college sample (N = 254, female = 50.42%) was recruited using Amazon's Mechanical Turk. Participants completed an online survey assessing demographic characteristics, social norms for 3 referents, weekly alcohol use, and alcohol-related consequences. RESULTS: Exploratory factor analyses indicated 2 factors for the DN-DABQ and 3 factors for the IN-DABQ. The IN Drinking Behaviors factor consistently predicted weekly consumption and alcohol-related consequences across 3 reference groups (typical college student at your school, friends, and closest friends). CONCLUSIONS: These findings suggest that prior inconsistencies in the relationship between IN and drinking behaviors are likely a function of poor measurement of this construct. Implications for normative feedback interventions are discussed.