An Application of the Stressor-Vulnerability Model of Drinking in College Student Drinkers.

Background: The stressor vulnerability model provides theoretical support for conditions under which drinking to cope (DTC) is likely to occur (i.e., decreased adaptive coping, increased positive alcohol expectancies). However, research has only tested this model in a college sample reporting trauma. Generalizability to a non-trauma-specific sample college drinkers would support applications of the model and inferences about coping-related drinking across a broader group of young adults. Objectives: Our sample included 565 college student drinkers (Mage = 20.3 years; SDage = 2.0 years; 77.0% female; 54.2% White) from a large southeastern university. Mediation analyses examined DTC as a mediator between negative affect and alcohol-related outcomes (i.e., drinking quantity, drinking frequency, binge drinking frequency, and alcohol-related consequences). Moderated mediation models tested the influence of tension reduction expectancies and cognitive reappraisal on mediation pathways. Results: Drinking to cope was found to be a full mediator for associations between negative affect and drinking-related outcomes. For associations between negative affect and alcohol-related consequences, DTC was a partial mediator. For all alcohol outcomes, results indicated the mediation between negative affect and outcomes through DTC is strongest for individuals with greater cognitive reappraisal use. Positive alcohol expectancies did not moderate any indirect effects. Conclusions: Although cognitive reappraisal is typically considered an adaptive emotion regulation technique, our results suggest that this may not always be the case with drinking outcomes. Given our findings, further research is needed to discern the conditions wherein cognitive reappraisal may and may not be adaptive. This could be useful in informing interventions to reduce harmful DTC behaviors.

Normative Perceptions of Peer Drinking Distinguish High-Intensity Drinkers from Other Drinking Groups.

Background: High-intensity drinking (HID), or drinking that doubles the binge threshold (i.e., 8+/10+ drinks for women/men), is associated with more negative consequences than binge-only drinking. However, research focusing on HID and factors that may delineate HID from other drinking behaviors is lacking. The present study evaluated if perceived norms for peer drinking behavior (i.e., descriptive norms for alcohol quantity and frequency and injunctive norms) differentiated high-intensity drinkers from other drinker statuses. Further, we evaluated the role of perceived norms on odds of HID engagement and HID frequency. Finally, college status, sex, and underage drinker status were evaluated as moderators of the association between perceived norms and HID status/frequency. Methods: Participants were 623 emerging adult drinkers recruited via Craigslist (68.7% male; 69.0% White). Participants completed an online survey on their drinking behaviors and related social factors. Results: Each domain of perceived norms positively associated with drinker status. Higher perceived norms were associated with greater odds of HID and predicted HID frequency. The association between quantity and frequency descriptive norms and HID engagement was stronger for nonstudents and was only significant for males. Underage drinker status did not moderate associations between perceived norms and HID engagement. Conclusions: Findings provided evidence that perceptions of peer drinking behaviors are strong indicators of HID risk and may be especially useful for identifying high-intensity drinking males and nonstudents. The utility of perceived peer norms to differentiate this group of particularly risky drinkers suggests that social-influence-focused intervention approaches, including norms correction, may be efficacious in targeting HID among emerging adults.

Simultaneous Substance Use With Alcohol in a Community-Based Sample of Young Adults.

Objective: Simultaneous substance use is associated with worse outcomes than concurrent use. Further investigations into simultaneous use are warranted because there is limited knowledge about the co-use of substances other than alcohol and cannabis. Study aims were to examine: (1) the prevalence of simultaneous use of substances with alcohol, (2) the extent to which use patterns are related to key correlates (i.e., psychological functioning, sensation seeking), and (3) differences by college status. Methods: Participants were 623 young adult drinkers who were recruited online to complete a one-time survey. Results: Cannabis (54.3%), tobacco (53.7%), and stimulants (46.5%) were most frequently used with alcohol. Moderation analyses showed the positive association between simultaneous use and psychological distress was stronger for students whereas the positive association with sensation seeking was stronger for nonstudents. Conclusions: Results highlight the need for future research and intervention efforts that consider the link between simultaneous use and psychological wellbeing while acknowledging that educational attainment may differentially influence these factors.

Daily Positive Alcohol Expectancies and Alcohol Use Outcomes among College Students.

Expectancy theory supports alcohol expectancies, or the expected effects of drinking, as an important factor in alcohol use behaviors. Recent research supports that alcohol expectancies fluctuate daily, but scant research has examined specific types of expectancies and their associations with alcohol use at the daily level. Consequently, the present study examined (1) the daily association between select expectancies (i.e., sociability, tension reduction, liquid courage) and likelihood of drinking, and (2) whether daily expectancies predict alcohol use outcomes (i.e., alcohol-related problems, heavy drinking) on drinking days. Participants (N = 221; 79.2% women) were primarily White (48.4%) and Black (29.7%) university students. Participants completed daily measures of expectancies, alcohol use, and alcohol-related problems each day for 14 days. Results from multilevel models revealed daily sociability as the only expectancy subscale linked with increased odds of drinking. Daily expectancies did not predict heavy drinking or alcohol-related problems on drinking days. At the between-person level, average levels of sociability and tension reduction expectancies were associated with a greater likelihood of engaging in heavy drinking and experiencing a problem. Findings highlight that fluctuations in sociability expectancies may be proximally linked to likelihood of alcohol use, which may inform just-in-time intervention efforts targeting alcohol expectancies.

Differential Pathways of Risky Drinking via Coping Motives in College and Noncollege Young Adults.

The current study tested a mediation model of psychological functioning (i.e., perceived stressors, psychological distress, and self-regulation) and risky drinking through a drinking to cope pathway comparing college and noncollege young adults. Participants were 623 young adult drinkers (M age = 21.46) who completed an online survey. Multigroup analyses examined the proposed mediation model for college students and nonstudents. For nonstudents, the indirect effects of psychological distress to alcohol use outcomes (i.e., alcohol quantity, binge drinking frequency, and alcohol-related problems) via coping motives was significant. Further, coping motives significantly mediated the positive effects of self-regulation on alcohol quantity, binge drinking frequency, and alcohol-related problems. For students, greater psychological distress was associated with greater coping motives, which in turn, related to greater alcohol-related problems. Coping motives significantly mediated the positive effect of self-regulation on binge drinking frequency. Findings highlight the different pathways that may result in risky drinking and alcohol problems based on young adult's educational attainment. These results have important clinical implications, particularly for those who have not attended college.

Alcohol, cannabis, and tobacco polysubstance use: A latent profile analysis of age of onset.

BACKGROUND: Despite understanding the long-term risks associated with early substance use, less is known about the specific patterns of the age of onset (AO) across multiple substances and whether these patterns of early exposure are linked to substance use later in young adulthood. Consequently, the present study sought to (1) identify distinct classes regarding AO for alcohol, cannabis, and tobacco and (2) compare these classes on patterns of individual and simultaneous alcohol, cannabis, and tobacco use, other substance use, and mental health symptoms. METHODS: Participants were 510 emerging adults (Mage = 21.35; 88.6% men) who reported past-year use of alcohol, cannabis, and tobacco. RESULTS: Latent profile analysis was used to identify classes based on three indicators: AO for alcohol, cannabis, and tobacco. Results revealed that four classes best fit the data: Earliest AO for Alcohol (19.8%); Latest AO for Substances (6.5%); Late AO for Substances (67.8%); Earliest AO for Cannabis and Tobacco (5.9%). Classes varied on current patterns of individual substance use, co-use of substances, other illicit drug use, and mental health symptomology. The Latest AO of Substances class reported the lowest alcohol use, cannabis use, other illicit drug use, and mental health symptomology than the other classes. The Earliest AO for Alcohol and the Late AO of Substances reported a lower frequency of tobacco compared to the other classes. The Late AO of Substance class reported the highest past-year frequency of simultaneous alcohol and cannabis use. CONCLUSIONS: The current study contributed to the larger polysubstance literature by identifying profiles that may signify risky patterns of use. Findings may help guide prevention and intervention work with adolescents and young adults.

Sex and Racial Differences in Patterns of Disordered Eating and Alcohol Use.

The present study aimed to determine how young adults' use of disordered eating behaviors (DEBs) and alcohol uniquely cluster with one another, how these clusters differ by sex and race, and map onto health-related correlates. As a part of a cross-sectional study assessing college student health and experiences, female (n = 1,026), male (n = 336), White (n = 640), and Black (n = 561) young adult college students at three universities (Mage = 20.54, SD = 1.80) completed measures assessing DEBs and alcohol use, and physical and mental health. Multigroup mixture modeling was used to identify subgroups of female, male, White, and Black young adults that are characterized by different levels of DEBs (fasting, food avoidance, loss of control eating, overeating) and alcohol use (binge drinking, drinking quantity). Whether group membership relates to theoretically and clinically relevant health correlates (stress, depressive symptoms, sleep health) was examined via auxiliary analyses. Qualitative and quantitative differences were identified in the best-fitting mixture models for female (four groups), male (four groups), White (five groups), and Black (three groups) participants that suggest sex and racial variations exist in patterns of DEBs and alcohol use severity. Generally, classification in groups characterized by moderate to high probabilities of DEBs only, or the combination of moderate to high DEBs and alcohol use, was associated with worse affective concerns across sexes and races. Targeting young adults' DEBs and alcohol use via diversity-informed treatments focused on coping skill development may help promote health and well-being.

Descriptive Norms but not Harm Reduction Strategies as a Mediator of Personalized Boosters After a Computerized College Drinking Intervention.

BACKGROUND: Computer-delivered programs to reduce college drinking have strong appeal but are sometimes less efficacious than their in-person counterparts. Boosters may be an ideal way to strengthen and extend the effects of computerized interventions while maintaining low cost and easy dissemination. However, little is known about how they work. Consequently, the current study aimed to explore descriptive perceived drinking norms and use of protective behavioral strategies (PBS) as potential mediators of booster effects. We also examined norms and PBS as mediators of the main intervention. The present study was a follow-up analysis of data from a randomized controlled trial (Alcohol Clin Exp Res 42, 2018, 1735) testing the efficacy of emailed boosters containing personalized feedback after a computerized alcohol intervention. METHODS: Participants were 537 (67.4% women) emerging adult college drinkers (M age = 19.65, SD = 1.67). They were randomly assigned to one of 3 conditions: general health education, alcohol intervention only, or alcohol intervention plus booster email. Participants completed assessments at baseline and follow-ups through 9 months. RESULTS: Descriptive norms were a mediator of booster efficacy where receiving the booster yielded stronger reductions in alcohol use through reduced concurrent norms; however, fully longitudinal models did not reach significance. There was also an indirect effect for the intervention where those who received the intervention experienced an increase in drinking through increased concurrent norms. However, a stronger direct effect was found where those who received the intervention experienced a stronger decrease in drinking after controlling for norms. There was no support for PBS as a mediator of booster or intervention efficacy. CONCLUSIONS: The present study was the first, to our knowledge, to demonstrate a potential mechanism of change in booster interventions. A simple, succinct reminder via email led to reductions in perceptions of how much peers drink, and this led to reductions in alcohol consumption. Our findings support the promise of utilizing brief and easily implemented targeted messaging to enhance the potency of computerized interventions for college drinkers.

A daily diary investigation of self-reported alcohol-related direct and indirect aggression.

Research supports the relationship between alcohol use and direct aggression, however, scant research has examined the association between alcohol use and indirectly aggressive behavior. Further, extant research has relied on retrospective reporting of behaviors, which may be subject to recall bias. The daily diary methodology enables the assessment of both the between- and within-subject variation, as well as reduces the likelihood of biased reporting. Consequently, the current study utilized a daily diary design to examine (a) associations between daily alcohol use and alcohol-related aggressive behaviors (i.e., direct and indirect); and (b) the co-occurrence of alcohol-related direct and indirect aggression. Participants were 105 (80% female) college student drinkers. Students completed baseline questionnaires and up to 14 consecutive, daily surveys regarding their previous day alcohol use, alcohol-related direct aggression, and alcohol-related indirect aggression. Findings revealed that alcohol use was associated with same day alcohol-related direct and indirect aggression, after controlling for baseline alcohol use. Self-reported alcohol-related direct aggression was more likely to occur on days in which self-reported alcohol-related indirect aggression occurred, after controlling for dispositional aggression, trait self-control, and baseline alcohol use. Results of the study suggest that, similar to alcohol-related direct aggression, alcohol use is associated with an increased likelihood of alcohol-related indirect aggression. Further, the co-occurrence of alcohol-related indirect and direct aggression supports that individuals may be engaging in multiple types of aggressive behaviors. Findings extend previous cross-sectional and qualitative research suggesting that indirect aggression may co-occur, perhaps increasing in severity.

A Daily Diary Study of Drinking and Nondrinking Days in Nonstudent Alcohol Users.

BACKGROUND: Emerging adults with lower educational attainment are at higher long-term risk for problematic drinking and alcohol use disorders. Efforts to gain a more in-depth understanding of the drinking habits of nonstudent emerging adults are critical to reduce disparities and to shed light on targets of intervention for this vulnerable group. OBJECTIVES: The current investigation aimed to: (1) provide a description of the daily drinking habits of nonstudent emerging adult drinkers using a 14-day diary method, and (2) examine nondrinking days by assessing their reasons for not drinking as well as strategies used to avoid drinking. METHODS: Participants were 27 (55.5% women) emerging adult drinkers recruited from the community. RESULTS: On drinking days, multilevel results indicated that heavier alcohol use was positively associated with level of subjective intoxication and alcohol-related problems. Men reported higher alcohol use outcomes than women across all alcohol use indicators. Regarding nonconsumptive days, the most frequently endorsed reasons for not drinking largely reflected an internal motivation, while the least endorsed reasons were related to external constraints. Pertaining to strategies used to avoid drinking, the most frequently endorsed response related to choosing alternative enjoyable activities. Diary compliance with the 14-day protocol was 90.9% for at least one daily survey. Conclusion/Importance: The present investigation represents one of the first to examine drinking behaviors using a daily diary approach with nonstudent emerging adult drinkers. Study findings filled an important gap regarding our understanding of the context of drinking of an at-risk and understudied group of drinkers.

Simultaneous Use of Alcohol and Marijuana: Patterns and Individual Differences.

Background: Simultaneous alcohol and marijuana (SAM) use, or using alcohol and marijuana in such a way that their effects overlap, is associated with negative health and behavioral outcomes. Objectives: Our study sought to fill gaps in our knowledge on this emerging public health concern by comparing SAM users and alcohol-only users on individual-level factors and substance use outcomes as well as examining associations of SAM use frequency, within users. Methods: Participants were recruited through online postings. Our analytic sample consisted of 1017 young adults (18-25 years) who reported past-month alcohol use. Most were male (67.8%), Caucasian (71.5%), and had attended at least some college (74.8%). Results: Past-year SAM users reported higher levels of sensation seeking and greater perceptions of their close friends' drinking behavior in comparison to alcohol-only users. SAM users reported heavier and more frequent alcohol use than alcohol-only users. Within past-year SAM users, 70% reported SAM use at least weekly. More frequent SAM use was associated with all alcohol use outcomes (e.g., weekly quantity, frequency, alcohol-related problems) and marijuana use outcomes (e.g., quantity, frequency, peak use) and higher drinking norms. Conclusions/Importance: It is clear that SAM users are a vulnerable sub-population of young adult drinkers. SAM users are differentiated from alcohol-only users in terms of their personality characteristics and perceptions of peer groups' drinking. SAM users and more frequent users are also at heightened risk for substance use outcomes. Prevention and intervention efforts targeting high-risk drinking may benefit from also assessing whether they simultaneously use alcohol and marijuana.

The Influence of a Brief Alcohol Intervention on Alcohol Use Trajectories in Nonstudent Emerging Adult Drinkers.

Background: This study sought to inform research with noncollege-attending emerging adults, an at-risk, and understudied population, by identifying patterns of response following a brief alcohol intervention. This study was a reanalysis of data from a randomized controlled intervention trial testing a brief, personalized feedback alcohol intervention targeting nonstudent emerging adult drinkers. Objectives: The study aims were to (1) model intervention response by identifying subgroups characterized by changes in heavy drinking (i.e. peak use, number of binges during a typical week, proportion of binge days, peak estimated blood alcohol concentration [eBAC]) following the alcohol intervention, and (2) distinguish subgroups on factors related to intervention response (i.e. perceived norms regarding how much peers drink, alcohol use severity, mental health symptoms, and readiness to change). Methods: Participants were 81 (64.2% men) nonstudent heavy drinkers between ages 18-25 years (average age = 22.04) recruited from the community. Results: Findings revealed two latent subgroups that exhibited differential response to the intervention (i.e. intervention "responders" and "nonresponders"). Further, responders reported higher pre-intervention descriptive normative perceptions and alcohol use severity. Conclusions/Importance: The current investigation contributed to knowledge regarding for whom brief alcohol interventions work in the short term within nonstudent emerging adults and could inform future research to facilitate behavior change in those unresponsive to intervention efforts.

Testing Daily Associations between Impulsivity, Affect, and Alcohol Outcomes: A Pilot Study.

BACKGROUND: Considerable research has examined impulsivity between individuals, but less research has focused on whether impulsivity fluctuates within a person. Although previous research supports trait levels of impulsivity as a risk factor for increased alcohol involvement, it is unclear whether daily (i.e., state) fluctuations in impulsivity coincide with same-day drinking behaviors. The present pilot study tested (1) the extent to which impulsivity fluctuates within-person; (2) the influence of daily impulsivity on alcohol use outcomes across all days (i.e., whether drinking occurred, the number of drinks consumed, and intentions to drink) and on drinking days only (i.e., whether heavy episodic drinking occurred and the number of problems experienced); and (3) daily affect as moderators of these relationships. METHOD: Participants were 24 young adult drinkers without postsecondary education who completed a baseline plus 14 follow-up daily surveys. Each day, participants reported their impulsivity, affect, and drinking behavior. RESULTS: Multilevel modeling revealed that 42.5% of the variability in daily impulsivity was due to within-person differences. Impulsivity was related to greater odds of heavy episodic drinking and more alcohol-related problems on drinking days. Positive affect moderated the relationship between impulsivity and alcohol-related problems, and the relationship between impulsivity and drinking intentions. CONCLUSIONS: Findings suggest that changes in positive affect and impulsivity may be a risk factor for alcohol problems in a daily context. Future research examining within-person impulsivity and negative outcomes may benefit from considering positive affect.

Personalized Boosters After a Computerized Intervention Targeting College Drinking: A Randomized Controlled Trial.

BACKGROUND: Problematic drinking among emerging adult college students is extensive. Computer-delivered interventions (CDIs) have strong appeal because they can be quickly delivered to large numbers of students. Although they are efficacious in the short term, CDIs are not as efficacious as in-person interventions longer term. This study examined the utility of emailed boosters containing personalized feedback after a CDI to enhance and extend reductions among emerging adult college drinkers. Sex and age were explored as potential moderators. METHODS: Participants were 537 college students (67.4% female) aged 18 to 24 years (M age = 19.65, SD = 1.67) who consumed at least 1 alcoholic drink in the past 2 weeks. They were randomly assigned to CDI-only, CDI + booster email, or an assessment-only control condition, and were assessed up to 9 months postintervention. A booster email with personalized feedback was sent to the CDI + booster email group 2 weeks after completion of the CDI. RESULTS: Moderation findings for age revealed that the booster may be an effective means to strengthen and extend intervention effects for emerging adults who are of legal drinking age. However, effects were negligible for underage drinkers. Although the booster effect for the overall sample demonstrated a trend in the expected direction, it failed to reach significance. Booster effects were not significantly moderated by sex. Intervention effects were not moderated by either age or sex. CONCLUSIONS: The present investigation contributes to a limited body of research on boosters to augment main intervention effects in college drinkers. Our study demonstrated that a brief CDI plus a simple email booster with personalized feedback resulted in significant reductions in drinking outcomes for emerging adults of legal drinking age. Efforts to further develop and refine intervention booster strategies represent a promising future direction to minimize harmful drinking among college students.

A Randomized Trial of a Personalized Feedback Intervention for Nonstudent Emerging Adult At-Risk Drinkers.

BACKGROUND: Emerging adulthood is a period of heightened vulnerability for problematic alcohol use. Considerable research has been devoted to reducing alcohol risks in college student populations, although far less effort has focused on their noncollege-attending peers. Research targeting nonstudent emerging adults is critical as this group is at risk of experiencing alcohol-related harms. Consequently, the main objective of the present randomized study was to examine the preliminary efficacy of a brief personalized feedback intervention (PFI) tailored for nonstudent at-risk drinkers. We also examined the influence of gender on intervention outcomes. Finally, we explored participant acceptability of the intervention. METHODS: Participants were 164 (65.9% men) emerging adults (M age = 21.98, SD = 2.02) recruited from the community. They were randomly assigned to either a 50-minute, in-person PFI or an assessment-only control group and were assessed over 9 months postintervention. RESULTS: Results showed that for short-term change (1 month), the PFI condition reduced drinking significantly more than controls. For longer-term change (1 to 9 months), both conditions continued to show gradual decline in consumption. The groups did not differ in alcohol-related problems, and the intervention was equally effective for both women and men. Regarding acceptability, participants were extremely satisfied with the intervention, perceived the information to be personally relevant, and thought it provided them a new way of looking at their own drinking. CONCLUSIONS: Overall, the present research advanced knowledge regarding an understudied and at-risk group of drinkers. This is among one of the first randomized studies to evaluate a brief intervention tailored to the needs of nonstudent emerging adults based on prior formative research with this group. Our data support PFI as a promising intervention approach for nonstudent drinkers in the community. Ultimately, this line of research aims to reduce alcohol-related health disparities associated with inequities in education.

Mediators and Moderators of a Personalized Feedback Alcohol Intervention for Nonstudent Emerging Adult Drinkers.

BACKGROUND: The main objective of this study was to test proposed mediators and moderators of a personalized feedback alcohol intervention (PFI) on alcohol use. Data for the current investigation came from an earlier randomized controlled trial of a PFI targeted for nonstudent heavy drinkers between 18 and 25 years. METHODS: Participants were 164 (65.9% men) drinkers recruited from the community. They were randomly assigned to either a single-session PFI or an assessment-only (AO) control group. Follow-up assessments at 1 and 3 months were included for analysis. RESULTS: Perceived drinking norms mediated the intervention effect on quantity, frequency, and peak drinking; 2 dimensions of protective behavioral strategies (PBS) mediated the intervention effect on peak drinking; and drinking to cope motives did not mediate any drinking outcomes. Of the moderating factors examined (i.e., norms, PBS, drink to cope motives, age, gender), only PBS related to serious harm reduction moderated intervention impact. Specifically, for those high in serious harm reduction PBS at baseline, postintervention reductions in drinking were stronger for the PFI group compared to AO. CONCLUSIONS: Overall, findings highlight the importance of correcting misperceived drinking norms and addressing the use of specific PBS in brief interventions. The knowledge gained from this study represents an important step toward minimizing drinking-related harms that are disproportionately experienced by those with lower educational attainment.

Sexual Coercion, Drinking to Cope Motives, and Alcohol-Related Consequences among Self-Identified Bisexual Women.

BACKGROUND: Given higher sexual victimization and greater alcohol use among bisexual women, a critical public health challenge is to understand within-group variation that may heighten or explain these associations in bisexual women. OBJECTIVES: The present study tested a moderated-mediation model in which sexual coercion was hypothesized to be associated with alcohol-related consequences via drinking to cope motives in self-identified bisexual women who reported at least occasional binge drinking. Negative affect was hypothesized to moderate the sexual coercion-drinking to cope motives association. METHODS: Participants were a community sample of 107 self-identified bisexual women (age M = 20.97, SD = 2.11) who completed an online survey and reported at least one binge drinking episode as well as engaging in sexual activity in the past 30 days. RESULTS: Of these participants, 57 (53.3%) reported one or more experiences of sexual coercion in the past 30 days. Sexual coercion was associated with negative alcohol-related consequences via drinking to cope motives. Negative affect moderated the association between sexual coercion and drinking to cope motives such that the association was stronger among women with greater negative affect. Conclusions/Importance: Methods of addressing vulnerability to sexual coercion and educating young bisexual women about the association between sexual coercion and potentially problematic affective coping through alcohol use are needed.

Alcohol Mixed with Energy Drinks: Daily Context of Use.

BACKGROUND: The link between use of alcohol mixed with energy drinks (AmEDs) and alcohol-related harms is well established, but limited research has examined the context in which AmEDs are consumed. Identifying the social and environmental characteristics of use may illuminate whether AmEDs are used in settings that could increase the likelihood of engaging in risky behaviors or experiencing harms. This study used a 2-week daily diary assessment to compare days in which AmEDs were consumed ("AmED days") and days where other types of alcohol were used ("non-AmED days") on where, when, and with whom drinking occurred. METHODS: Participants were 122 (90 women) heavy drinking college students who reported mixing caffeine with alcohol at least once in the past week. Data were collected across 389 drinking days; 40 of these days involved AmED use. RESULTS: Multilevel modeling findings revealed that odds of drinking AmEDs were higher on days where individuals drank at a bar or club and drank at home relative to other locations. In addition, odds of pregaming were higher on AmED days as compared to non-AmED days. AmED use was linked with lower odds of drinking game behavior. CONCLUSIONS: Overall, AmEDs appear to be consumed in potentially risky contexts. In combination with prior findings that AmED days are linked with heavier alcohol use and more harms experienced, these findings support the unique nature of AmED consumption in terms of the factors that may predict or maintain potentially hazardous drinking patterns.

Motivations and Consequences of Alcohol Use among Heavy Drinking Nonstudent Emerging Adults.

Research suggests that nonstudent emerging adults may be at elevated risk for alcohol-related problems in adulthood. The present study utilized a qualitative approach to broaden our understanding of the drinking-related perceptions and experiences of heavy drinking nonstudents, with the ultimate goal of generating meaningful knowledge that could aid intervention planning. Research aims were to identify nonstudent (1) drinking motivations and (2) drinking consequences. Eleven focus groups were conducted (n = 64 participants). Data analytic techniques were used to code transcripts and generate themes emerging from the group data. Analyses revealed three main themes emerged regarding nonstudent reasons for drinking (i.e., emotional, social, enhanced experiences). Four prominent themes were identified for drinking consequences (i.e., physical health, psychological health, risk-taking, life functioning). Our findings underscore several considerations related to intervening with this at-risk and understudied population.

An Examination of the Most Recent Episode of Molly Use among College Students.

OBJECTIVE: The current study examined event-level characteristics (e.g., contextual factors, risk behaviors) during the most recent episode of Molly use among a sample of college students who reported previously using Molly. PARTICIPANTS: Participants (N = 151; 66.7% female) were drinkers aged 18 to 25. Data were collected from October to November 2014, February to April 2015, and September to November 2015. METHOD: Participants completed measures regarding typical Molly use and items related to context and behaviors during their most recent episode of Molly use. RESULTS: Findings revealed that our sample most commonly reported using Molly earlier in the evening while hanging out with friends or at a party. Additionally, sexual and other drug use behaviors commonly occurred when using Molly. CONCLUSIONS: Findings provide preliminary information in guiding future work exploring Molly use and potential substance-related issues associated with the context of when and how Molly is consumed.