Effects of within- and between-person assessments of alcohol expectancies and valuations on use and consequences moderated by sex.

BACKGROUND: Alcohol expectancies (AE; beliefs about the likelihood of outcomes) and valuations (beliefs about the desirability of outcomes) may help explain alcohol use by young adults. However, it remains unclear how variability in AE and valuations over time are related to alcohol-related outcomes, and whether these associations are moderated by sex. The current study addressed these gaps in knowledge by examining within-person variability among positive and negative AEs, valuations, and alcohol-related outcomes over a 12-month period. METHODS: Data were collected from 433 college students (Mage  = 20.06; 59.81% women) who completed surveys at 4 timepoints: at baseline and 3-month, 6-month, and 12-month follow-up. RESULTS: We found substantial within-person variability in both AE and valuations (intraclass correlation coefficients ranged from 50% to 66%), and differences in variability by sex, with women showing more variability than men. Multilevel models revealed that weekly drinking was significantly higher at timepoints in which participants held relatively greater AE for sociability, sexuality, and risk/aggression, but lower when participants expected greater effects on self-perception. Weekly drinking was also higher when participants reported more favorable valuation of risk/aggression. Participants experienced significantly more negative consequences at timepoints in which they held relatively greater AE for sexuality and self-perception. No AEs were associated with a reduced likelihood of negative consequences. Participants experienced more negative consequences at timepoints in which they reported more favorable valuation of self-perception No valuations were associated with fewer consequences. Several between- and within-person associations were moderated by sex. CONCLUSIONS: These findings suggest that AE and valuations are dynamic, that young adults' beliefs about the effects of alcohol varied over time, and that both negative and positive AE and valuations may be important correlates of alcohol use and consequences. These findings have implications for interventions designed to challenge expectancies and valuations with the goal of reducing alcohol use and associated consequences.

Doing It for the Money: The Relationship Between Gambling and Money Attitudes Among College Students.

Today's college students have grown up with legalized gambling and access to a variety of gambling venues. Compared to the general adult population, rates of disordered gambling among college students are nearly double. Previous research suggests that the desire to win money is a strong motivator to gamble (Neighbors et al. in J Gambl Stud 18:361-370, 2002a); however, there is a dearth of literature on attitudes towards money in relation to gambling behavior. The current study evaluated the association between the four subscales of the Money Attitude Scale (Yamauchi and Templer in J Pers Assess 46:522-528, 1982) and four gambling outcomes (frequency, quantity, consequences and problem severity) in a sample of college students (ages 18-25; N = 2534) using hurdle negative binomial regression model analyses. Results suggest that college students who hold high Power-Prestige or Anxiety attitudes toward money were more likely to gamble and experience greater consequences related to their gambling. Distrust attitudes were negatively associated with gambling behaviors. Retention-Time attitudes were not significantly associated with gambling behaviors and may not be directly relevant to college students, given their often limited fiscal circumstances. These findings suggest that money attitudes may be potential targets for prevention programs in this population.

Exploring the Relationship Between Stimulant Use and Gambling in College Students.

Both gambling and stimulant use are common and can lead to problems on college campuses with consequences that impact the financial, emotional, academic and physical well-being of students. Yet few studies have been conducted to understand the co-occurrence of these conditions and the increased risk factors if any that may exist for gambling and related problems. The present study is among the first to document the co-occurrence of these behaviors in both a random sample of students (N = 4640), and then to explore to what extent stimulant use impacts subsequent gambling and related problems 12 months later in an at-risk sample (N = 199). Results revealed a three-fold higher rate of recent problem gambling for those who used stimulants versus those who had not (11 vs. 4 %). For those already gambling, stimulant use predicted an increased frequency in gambling 12 months later. Implications for prevention and screening are discussed.

Gambling-Related Problems as a Mediator Between Treatment and Mental Health with At-Risk College Student Gamblers.

Disordered gambling has been linked to increased negative affect, and some promising treatments have been shown to be effective at reducing gambling behaviors and related problems (Larimer et al. in Addiction 107:1148-1158, 2012). The current study seeks to expand upon the findings of Larimer et al. (Addiction 107:1148-1158, 2012) by examining the relationship between gambling-related problems and mental health symptoms in college students. Specifically, the three-group design tested the effects of two brief interventions for gambling­an individual, in-person personalized feedback intervention (PFI) delivered using motivational interviewing and group-based cognitive behavioral therapy, versus assessment only on mood outcomes. The mediating effect of gambling-related problems on mood was also explored. Participants (N = 141; 65% men; 60% Caucasian, 28% Asian) were at-risk college student gamblers [South Oaks Gambling Screen (Lesieur and Blume in Am J Psychiatry 144:1184-1188, 1987) ≥3], assessed at baseline and 6-month follow-up. Gambling problems were assessed using the Gambling Problems Index (Neighbors et al. in J Gamb Stud 18:339-360, 2002). Mental health symptoms were assessed using the depression, anxiety, and hostility subscales of the Brief Symptom Inventory (Derogatis in Brief Symptom Inventory (BSI): administration, scoring, and procedures manual, National Computer Systems, Inc., Minneapolis, 1993). Results revealed that the PFI condition differentially reduced negative mood, and that reductions in gambling-related problems partially mediated this effect. Implications for intervention for comorbid mood and gambling disorders are discussed.

The use of protective behaviors in relation to gambling among college students.

The purpose of the current study was to evaluate a measure of gambling protective behaviors and examine the relationship between indices of gambling behavior, including frequency, quantity and problem severity, and the use of gambling protective behaviors. Undergraduates from a large public university (N = 4,014) completed a web-based screening survey comprising measures of gambling and health behaviors, from which those who gambled within the past 6-months (n = 1,922, 48 % of the entire sample) were invited to complete the baseline assessment, including the Gambling Protective Behavior Scale (GPBS). The GPBS was determined to have two subscales, primarily consisting of harm reduction strategies that reduce the money or time spent on gambling, or avoidance strategies that help to minimize engagement in gambling activities. Hierarchical multiple regressions found participants' sex moderated the relationship between use of protective behavioral strategies and gambling outcomes. However, effects were in the opposite direction to those hypothesized. Specifically, because women gambled less, had lower gambling problem severity, and reported more frequent use of gambling avoidance protective behaviors, the relationship between use of gambling protective behaviors and gambling outcomes was stronger for men than women. Men who used more avoidance strategies gambled less frequently compared to men who used fewer avoidance strategies. Similarly, men who used more harm reduction strategies spent fewer dollars on gambling and had lower scores on gambling problem severity compared to men using fewer harm reduction strategies for women these relationships were less pronounced. Implications of incorporating specific gambling protective behavioral strategies into prevention and treatment programs are discussed.

Predictors of hooking up sexual behaviors and emotional reactions among U.S. college students.

The present study examined factors associated with engaging in oral and vaginal sex and condom use during the most recent hookup, a term that refers to a range of physically intimate behaviors outside of a committed relationship, among college students. In addition, this research aimed to evaluate factors associated with experiencing positive and negative affect resulting from the most recent hookup. A random sample (N = 1,468) of undergraduates (56.4% female) completed a Web-based survey that was comprised of measures of drinking and sexual behavior. Participants (n = 824; 56.1%) who indicated they had ever hooked up were included in data analysis. Findings indicated that sex, partner type, alcohol use, attitudes towards hooking up, and attitudes towards sexual activity during hookups explained significant variance for oral sex, vaginal sex, condom use, and positive and negative affect related to the most recent hookup experience. Clinical implications regarding the role of situational stressors, such as the impact on affect following a hookup, and ways to reduce risks associated with stressors are discussed.

Gender, Alcohol Consumption Patterns, and Engagement in Sexually Intimate Behaviors Among Adolescents and Young Adults in Nha Trang, Viet Nam.

A randomly selected cross-sectional survey was conducted with 880 youth (16 to 24 years) in Nha Trang City to assess relationships between alcohol consumption and sexual behaviors. A timeline followback method was employed. Chi-square, generalized logit modeling and logistic regression analyses were performed. Of the sample, 78.2% male and 56.1% female respondents ever consumed alcohol. Males reporting sexual behaviors (vaginal, anal, oral sex) had a significantly higher calculated peak BAC of 0.151 compared to 0.082 for males reporting no sexual intimacy (p < .0001). Females reporting sexual behaviors had a peak BAC of 0.072 compared to 0.027 for those reporting no sexual intimacy (p = .016). Fifty percent of (33/66) males and 30.4% (7/23) females report event specific drinking and engagement in sexual behaviors. Males reporting 11+ drinks in 30 days had more sexual partners than those reporting 1 to 10 drinks (p = .037). Data suggest different physical and psychosocial mediators between alcohol consumption and sexual behaviors by gender.

Crossover Effects of Protective Behavioural Strategies for Drinking on Gambling Consequences Among College Gamblers with Alcohol or Drug Abuse.

Protective behavioural strategies (PBS) for drinking are behaviours that individuals engage in to reduce the amount they drink and drinking-related consequences. To date, little is known about associations that PBS might have with other risky behaviours that frequently coincide with drinking, such as gambling. The goal of this study was to examine the associations between three subscales of the Protective Behavioral Strategies Scale (PBSS) and gambling consequences in a college sample of gamblers who also met criteria for alcohol or drug abuse. We hypothesized that engaging in more drinking PBS would be associated with lower levels of gambling consequences. A sample of 316 students (55% female) completed an online survey and met criteria for problematic gambling behaviour (3 or more on the South Oaks Gambling Screen and 1 or more consequences on the Gambling Problem Index). Those endorsing a higher score on the Serious Harm Reduction subscale (but not the Stopping or Limiting Drinking or Manner of Drinking subscales) showed a lower level of lifetime gambling consequences, suggesting a crossover effect. Strategies to reduce serious harm represent a treatment target that could potentially reduce negative consequences associated with both drinking and gambling.

Personalized mailed feedback for college drinking prevention: a randomized clinical trial.

The current study was designed to evaluate the efficacy of a mailed feedback and tips intervention as a universal prevention strategy for college drinking. Participants (N = 1,488) were randomly assigned to feedback or assessment-only control conditions. Results indicated that the mailed feedback intervention had a preventive effect on drinking rates overall, with participants in the feedback condition consuming less alcohol at follow-up in comparison with controls. In addition, abstainers in the feedback condition were twice as likely to remain abstinent from alcohol at follow-up in comparison with control participants (odds ratio = 2.02), and feedback participants were significantly more likely to refrain from heavy episodic drinking (odds ratio = 1.43). Neither gender nor severity of baseline drinking moderated the efficacy of the intervention in these analyses, but more conservative analyses utilizing last-observation carryforward suggested women and abstainers benefited more from this prevention approach. Protective behaviors mediated intervention efficacy, with participants who received the intervention being more likely to use strategies such as setting limits and alternating alcohol with nonalcoholic beverages. Implications of these findings for universal prevention of college drinking are discussed.

Injunctive norms and problem gambling among college students.

Two studies examined the relationships among injunctive norms and college student gambling. In study 1 we evaluated the accuracy of perceptions of other students' approval of gambling and the relationship between perceived approval and gambling behavior. In study 2 we evaluated gambling behavior as a function of perceptions of approval of other students, friends, and family. In study 1, which included 2524 college students, perceptions of other students' approval of gambling were found to be overestimated and were negatively associated with gambling behavior. The results of study 2, which included 565 college students, replicated the findings of study 1 and revealed positive associations between gambling behavior and perceived approval of friends and family. Results highlight the complexity of injunctive norms and the importance of considering the reference group (e.g., peers, friends, family members) in their evaluation. Results also encourage caution in considering the incorporation of injunctive norms in prevention and intervention approaches.

Cognitive Processing Therapy for Acute Stress Disorder Resulting From an Anti-Gay Assault.

This case study describes Cognitive Processing Therapy (CPT) with a 30-year-old gay man with symptoms of acute stress disorder (ASD) following a recent homophobic assault. Treatment addressed assault-related posttraumatic stress disorder symptoms and depressive symptoms. Also addressed were low self-esteem, helplessness, and high degrees of internalized homophobia. Client symptomatology was tracked using the PTSD Symptom Scale and the Beck Depression Inventory over the course of 12 sessions and for a 3-month posttermination session. Symptoms were significantly reduced by the end of the 12-week therapy and were maintained at 3-month follow-up. This case highlights the utility of this therapy in targeting both ASD symptoms and internalized homophobia relating to experiencing a hate crime-related assault. The authors elaborate on theoretical and applied issues in adapting a structured cognitive-behavioral intervention to the treatment of ASD symptoms associated with experiencing a hate crime.

Beliefs about drinking behavior predict drinking consequences.

Cognitions about drinking, such as positive expectancies and self-efficacy, have been found to profoundly influence drinking behavior. Although the relationship of self-efficacy and positive expectancies with drinking consumption has been established, the relationship of self-efficacy and alcohol expectancies with the number of reported drinking related consequences has not been examined. One hundred thirteen participants who met criteria for alcohol abuse or dependence were administered the Situational Confidence Questionnaire, the Alcohol Expectancies Questionnaire, the Drinker Inventory of Consequences-Recent, and the Losses of Significance Self-report Questionnaire-Revised. As predicted, lower self-efficacy and greater positive alcohol expectancies predicted greater recent drinking consequences beyond those accounted for by alcohol consumption alone. Greater numbers of positive alcohol expectancies also predicted greater numbers of recent important alcohol related losses. Correcting errant assumptions about alcohol expectancies and strategies designed to increase self-efficacy may reduce harmful drinking consequences even if a client is unwilling to reduce consumption.

Brief motivational feedback and cognitive behavioral interventions for prevention of disordered gambling: a randomized clinical trial.

AIMS: The purpose of the current study was to evaluate feasibility and efficacy of two promising approaches to indicated prevention of disordered gambling in a college population. DESIGN: Randomized clinical trial with assignment to a personalized feedback intervention (PFI), cognitive-behavioral intervention (CBI) or assessment-only control (AOC). PFI was delivered individually in a single session and included feedback regarding gambling behavior, norms, consequences and risk-reduction tips, delivered in a motivational interviewing style. CBI was delivered in small groups over four to six sessions and included functional analysis and brief cognitive correction, as well as identification of and alternatives for responding to gambling triggers. SETTING: College campus. PARTICIPANTS: At-risk or probable pathological gamblers (n = 147; 65.3% male; group assignment: PFI, n = 52; CBI, n = 44; AOC, n = 51). MEASUREMENTS: Self-reported gambling quantity, frequency, consequences, psychopathology, normative perceptions and beliefs. FINDINGS: Relative to control, results at 6-month follow-up indicated reductions in both interventions for gambling consequences (PFI d = 0.48; CBI d = 0.39) and DSM-IV criteria (PFI d = 0.60; CBI d = 0.48), reductions in frequency for PFI (d = 0.48). CBI was associated with reduced illusions of control, whereas PFI was associated with reduced perceptions of gambling frequency norms. Reductions in perceived gambling frequency norms mediated effects of PFI on gambling frequency. CONCLUSIONS: A single-session personalized feedback intervention and a multi-session cognitive-behavioral intervention may be helpful in reducing disordered gambling in US college students.

They drink how much and where? Normative perceptions by drinking contexts and their association to college students' alcohol consumption.

OBJECTIVE: Prior research has shown that normative perceptions of others' drinking behavior strongly relates to one's own drinking behavior. Most research examining the perceived drinking of others has generally focused on specificity of the normative referent (i.e., gender, ethnicity). The present study expands the research literature on social norms by examining normative perceptions by various drinking contexts. Specifically, this research aimed to determine if college students overestimate peer drinking by several drinking contexts (i.e., bar, fraternity/sorority party, non-fraternity/sorority party, sporting event) and to examine whether normative perceptions for drinking by contexts relate to one's own drinking behavior specific to these contexts. METHOD: Students (N = 1,468; 56.4% female) participated in a web-based survey by completing measures assessing drinking behavior and perceived descriptive drinking norms for various contexts. RESULTS: Findings demonstrated that students consistently overestimated the drinking behavior for the typical same-sex student in various drinking contexts, with the most prominent being fraternity/sorority parties. In addition, results indicated that same-sex normative perceptions for drinking by contexts were associated with personal drinking behavior within these contexts. CONCLUSIONS: Results stress the importance of specificity of social norms beyond those related to the normative referent. Clinical implications are discussed in terms of preventions and intervention efforts as well as risks associated with drinking in a novel context.

A randomized clinical trial evaluating a combined alcohol intervention for high-risk college students.

OBJECTIVE: The current study is a multisite randomized alcohol prevention trial to evaluate the efficacy of both a parenting handbook intervention and the Brief Alcohol Screening and Intervention for College Students (BASICS) intervention, alone and in combination, in reducing alcohol use and consequences among a high-risk population of matriculating college students (i.e., former high school athletes). METHOD: Students (n = 1,275) completed a series of Web-administered measures at baseline (in the summer before starting college) and follow-up (after 10 months). Students were randomized to one of four conditions: parent intervention only, BASICS only, combined (parent and BASICS), and assessment-only control. Intervention efficacy was tested on a number of outcome measures, including peak blood alcohol concentration, weekly and weekend drinking, and negative consequences. Hypothesized mediators and moderators of intervention effect were tested. RESULTS: The overall results revealed that the combined-intervention group had significantly lower alcohol consumption, high-risk drinking, and consequences at 10-month follow-up, compared with the control group, with changes in descriptive and injunctive peer norms mediating intervention effects. CONCLUSIONS: The findings of the present study suggest that the parent intervention delivered to students before they begin college serves to enhance the efficacy of the BASICS intervention, potentially priming students to respond to the subsequent BASICS session.

Harm reduction and individually focused alcohol prevention.

This paper provides a brief overview of harm reduction and individually focused alcohol prevention strategies. Universal, selective, and indicated prevention strategies are described for several populations including elementary and secondary schools, colleges, and medical settings. This paper primarily reviews individually focused alcohol prevention efforts in the United States (US), where harm reduction has been less well received in comparison to many European countries, Canada, and Australia. Zero-tolerance approaches continue to be the norm in individually focused prevention efforts in the US, especially amongst adolescents, despite research suggesting that harm reduction approaches can be effective. Moreover, existing evidence supports that harm reduction approaches show considerable promise in universal prevention and have become best practices in selective and indicated prevention contexts.

Exploring college student gambling motivation.

The present research combined qualitative and quantitative approaches in examining gambling motives among college student gamblers. A comprehensive set of 16 gambling motives was identified by categorizing 762 open-ended reasons for gambling, provided by 184 college student gamblers. Results revealed that most college students gamble to win money, for fun, for social reasons, for excitement, or just to have something to do. Overall, the results suggest the need for an eclectic biopsychosocial approach with regard to etiology of college student gambling.

Measuring gambling outcomes among college students.

The present research describes the proposal and validation of three gambling outcome measures, the Gambling Quantity and Perceived Norms Scale (GQPN), the Gambling Problem Index (GPI), and the Gambling Readiness to Change Questionnaire (GRTC). The study consisted of 560 undergraduate college students who completed a survey including the newly constructed measures and other measures designed to assess convergent validity. Results confirmed good reliability and convergent validity of all three measures. Implications for evaluating efficacy of treatment and prevention interventions are detailed.