The Association Between Ethnic Identity and Non-Medical Prescription Drug Use Among A Sample of College Students: Does a Sense of Ethnic Belonging Matter?

BACKGROUND: National data demonstrate significant differences in non-medical prescription drug (NMPD) use, with Whites seeming to be more likely to use compared to non-Whites. College students also appear to be at an increased risk for NMPD use. OBJECTIVES: This study examines NMPD use using a component of social identity theory. We propose that a stronger sense of ethnic identity may reduce the likelihood of NMPD use among college students due to ethnic identity's ties to self-esteem and self-efficacy. We also propose that the protective power of ethnic identity may vary according to one's race. METHODS: Data for this study were collected from a survey of undergraduate students at a Midwestern university (N = 530). Poisson regression analyses were used to test the relationship between ethnic identity and NMPD use. Of our sample, 135 participants (25.5%) indicated NMPD use over the past year. This percentage is high compared to findings from national college data. RESULTS: Results indicate that a stronger sense of ethnic identity reduced the frequency of NMPD use among young adults. The findings also reveal that the relationship between ethnic identity and NMPD use is moderated by race. Ethnic identity was found to be a protective factor for non-White participants only. CONCLUSIONS: This study suggests that ethnic belonging may act as a protective factor against NMPD use among non-White young adults. These findings build upon our understanding of the relationship between ethnic identity and substance use. We conclude with a discussion of directions for future research and intervention programs.

The association between Food and Alcohol Disturbance (FAD), race, and ethnic identity belonging.

PURPOSE: A growing body of literature has established that food and alcohol disturbance (FAD: decreasing one's caloric intake in preparation for alcohol consumption) is a specific health risk that endangers health and wellbeing. Recent research on trends in FAD has revealed ethno-racial disparities. A sociological analysis is helpful to center race and examine the role of ethnic identity in reproducing health disparities. The current study is guided by theories of socialization into ideal body types by race. METHODS: Study uses data from a cross-sectional survey conducted among college students. The sample includes White and Black American college students, ages 18-25, and uses ordinal logistic regression to test for the impact of race and ethnic identity on engagement in FAD using the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS). RESULTS: FAD prevalence was lower among Black Americans than among White Americans in the sample. Results from ordered logistic regression models indicate that stronger ethnic ties reduce likelihood of FAD among Black Americans but have the opposite effect among White Americans. This modification effect provides evidence that ethnic identity belonging protects against FAD for Black Americans but acts as a risk factor for FAD among White Americans. CONCLUSIONS: Findings shed light on the documented racial disparities in FAD and weight control behavior more broadly. Ethnic identity modifies the relationship between race and FAD in our sample. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

The Association between Heavy Episodic Drinking and Gender Orientation among U.S. College Students: The Significance of Masculinity.

BACKGROUND: Heavy episodic drinking (HED) remains a public health concern among college students. Sex differences are routinely reported in the literature although some evidence of convergence in drinking patterns has been observed. The association between sex and gender-orientation in HED remains unclear because sex and gender are often conflated. OBJECTIVE: We examine the intersection of sex, gender-orientation and HED to determine if gender-orientation alone and/or in conjunction with sex play a role in HED among college students. METHODS: Data were collected using a web-based self-administered survey made available to students enrolled in courses at a mid-sized Midwestern public university during the Fall of 2013 and the Spring of 2014 (N = 793). Multiple logistic regression was used to determine the relationship between HED, sex, and gender orientation (measured using the short-form Bem Sex Role Inventory). RESULTS: Our findings indicate that, regardless of sex, a masculine gender-orientation was positively associated with HED. Those who were found to have a feminine gender-orientation appeared to be at decreased risk for HED. CONCLUSIONS: Our findings indicate that sex and gender-orientation should be taken into account in prevention and intervention protocols at colleges and universities. Future work should examine the role of gender orientation among LGBTQ and ethno-racial minority populations.

Perceived racial discrimination, heavy episodic drinking, and alcohol abstinence among African American and White college students.

Previous research has demonstrated that White college students are more likely to drink alcohol at a greater frequency and quantity compared to their African American counterparts. Examining race-related factors that structure alcohol use among college students remains an important area of research. In this study, we specifically examine perceived discrimination and its association with both heavy episodic drinking (HED) and alcohol abstinence among college students. Items that measured perceived racial discrimination in alcohol use contexts and demographic characteristics were used as independent and control variables. African American students were more likely to abstain from alcohol and less likely to engage in HED compared to their White counterparts. Results also suggest that students who believe their drinking will solicit race-based police bias have lower odds of engaging in HED and greater odds of alcohol abstention. We conclude that unsolicited policing, experienced by African Americans generally, and White Americans on campuses, explains effect sizes.

Nonmedical use of prescription drugs in emerging adulthood: differentiating sex from gender.

Male-female variations in health-behavior continue to be of national and international significance with men generally being more likely to be engaged in behaviors that enhance risk across an array of preventable diseases and injuries as well as premature deaths. The literature has identified non-medical use of prescription drugs (NMUPD) as a developing and particularly dangerous substance use behavior among college students. The literature has reported sex differences (male; female) in NMUPD but has yet to explain how gender-orientation (e.g., masculine, feminine) might impact NMUPD. The purpose of this study is to address this gap by examining the influence of gender-orientation on NMUPD. Using survey data collected during the 2013-2014 academic year from a convenience sample of college students at a mid-sized Midwestern university, we examine the association of gender-orientation with NMUPD (N=796). To do this, we separate masculine and feminine scales from the BEM Sex Role Inventory and use logistic regression to test whether masculine or feminine gender characteristics influence the likelihood of NMUPD (lifetime measure of any use and by category). This analysis shows that self-identified characteristics associated with masculinity increase the odds of NMUPD while femininity is associated with lower odds of NMUPD. Findings from this study increase our knowledge of gender-orientation and sex interactions as factors that might influence NMUPD thus demonstrating the importance of differentiating sex from gender-orientation.

Nonmedical prescription drug use among US college students at a Midwest university: a partial test of social learning theory.

We estimate the prevalence of nonmedical prescription drug (NMPD) use and test social learning theory as an explanation for NMPD use based upon data from a large pilot study. Data were collected from 465 college students at a Midwestern university in the USA using a self-administered questionnaire. The sample was predominantly white (88%), 43% were female and the mean age was 22. Most participants (80%) were not members of social fraternities or sororities. A majority of students did not report NMPD use: 39.4% of respondents reported lifetime NMPD use, 31% reported past-year use, and 14.4% reported past-month use. Multivariate regression results partially supported social learning theory as an explanation for lifetime NMPD use. Limitations and suggestions for future research are suggested.

Are Polydrug Users More Physically and Verbally Aggressive? An Assessment of Aggression Among Mono- Versus Polydrug Users in a University Sample.

Early research has revealed that patterns of aggression and antisocial behavior are present among polydrug users. Often missing from this discourse is the examination of whether polydrug users are quantitatively different from monodrug users in their use of aggression. Theoretical perspectives are often centered on the psychopharmacological effects of substance use on behavior. Consideration of possible poly- versus monodrug use differences and their impact on aggression has not been investigated. Data from this study were derived from a sample of Midwestern university students (N = 793). The relationship between violence, aggression, and concurrent polydrug use in the last year is assessed with a series of multivariate ordinary least squares (OLS) regression models. Results demonstrate that higher incidents of physical and verbal aggression are reported among polydrug users compared to monodrug users and abstainers. When analyses were broken down by polydrug users (those who engaged in alcohol/marijuana and alcohol/NMUPD [nonmedical use of prescription drugs] stimulants), polydrug users reported higher levels of physical aggression compared to monodrug users. Similarly, monodrug users reported higher levels of physical aggression compared to nonusers. This research extends our understanding of aggression among users from two different subcategories: polydrug users in comparison to those who only engage in one form of substance use. Scholars and practitioners who work with violent offenders should consider patterns of drug use behavior when addressing substance use-related aggression.

The gender gap in alcohol consumption during late adolescence and young adulthood: gendered attitudes and adult roles.

We utilize data from the National Longitudinal Survey of Youth young adult sample (N = 1,488) to investigate whether gender role attitudes and the occupation of and transition to three adult roles (i.e., employment, marriage, and parenthood) contribute to the maintenance of the gender gap in the frequency and quantity of alcohol use. Our results indicate that traditional gender role attitudes are related to less frequent drinking for both men and women, but role attitudes are not associated with the number of drinks consumed. We also find that employment and transitions to employment increase the frequency and quantity of drinking, but less so for women compared to men. Furthermore, marriage, parenthood, and transitions to parenthood are related to less frequent drinking for women only. In terms of the number of drinks consumed, only employment and transitions to employment distinguish men and women. Employment is related to increased quantity of drinking for men, but decreased drinking for women, while transitions to employment have no effect on men, but do decrease the amount of drinking for women. Marriage decreases the number of drinks consumed equally for both men and women.

On drinking styles and race: a consideration of the socio-structural determinants of alcohol use behavior.

Often missing from the discourse on alcohol use is that "alcohol-related problems among college students" appears to be a euphemism for "white college men" in that students who experience alcohol-related problems disproportionately tend to be white men. An important aspect of promoting social and behavioral change is to understand race-related mechanisms that structure desire for students to engage in alcohol use. This article presents findings based on undergraduate students attending a Midwest university. The current study contributes to the theoretical literature on alcohol use and race. We use logistic regression models which suggest race and attitudes pertaining to race relations matter in predicting non-binge drinking and abstinence behavior.

Alcohol use disorder in sexual minority adults: Age- and sex- specific prevalence estimates from a national survey, 2015-2017.

BACKGROUND: Alcohol use disorders (AUD) occur frequently in sexual minority (SM) adults (identifying as gay, lesbian or bisexual). Age-specific prevalence estimates, particularly during middle and older ages, remain obscure. With questions for sexual identity recently included in the National Survey of Drug Use and Health (NSDUH), increased precision is possible. This study investigates the age-specific estimate for AUD in sexual minority versus sexual majority adults. METHODS: Analysis of the 2015-2017 NSDUH, ages 18-years-and-older (N = 128,740). We estimate age-specific, 12-month DSM-IV AUD prevalence and adjusted prevalence ratios (via Poisson regression) by sexual identity. Adjusted models control for demographic, social, and mental health variables. Post-hoc analysis included age-specific estimates after redefining SM to include any same-sex attraction. RESULTS: The age-specific estimate showed peak AUD prevalence at age ∼28 for all SMs, compared to age ∼23 for heterosexuals. By subgroup, gay men ages 18-23, had the highest AUD prevalence at 18.8% (CI: 13.5%, 25.5%). Bisexual women ages 24-29 had the highest disparity, a prevalence ratio (reference heterosexual women) of 2.59 (CI: 2.15, 3.13). Above age 50, the definition of SM is salient: in this age group, prevalence of AUD converges for heterosexuals and SMs that include individuals with any same-sex attraction. CONCLUSION: In this largest study to date, SMs have a high prevalence of AUD. A disparity in the age-by-age estimates emerges by age 25 when AUD occurrence declines in heterosexuals but increases in SMs. A prevalence disparity occurs with each successive age strata, but by age 50-and-older, the difference is null.

Utilizing a General Strain Framework to Examine Behavioral Responses to Psychological Intimate Partner Violence: Are Responses Gendered?

We know from the violence literature that a distinct sex disparity exists in the perpetration of other-directed violence (ODV). Some scholars suggest that this disparity is explained in part by gendered reactions to stress, strain, or violence victimization, in which males and females engage in different coping mechanisms, with males more likely to engage in ODV than females. Using a college sample, we investigate the behavioral responses of male and female victims of psychological intimate partner abuse. We find that although there is a sex disparity in the use of ODV as a coping mechanism, there is also a distinct gender orientation disparity. Our results indicate that victims who ascribe to a masculine identity are more likely than those of a feminine identity to engage in ODV, regardless of biological sex. These findings shed light on the impact of gender orientation as both a risk and protective factor in the use of ODV.

Gender orientation and alcohol-related weight control behavior among male and female college students.

OBJECTIVE: We examine weight control behavior used to (a) compensate for caloric content of heavy alcohol use; and (b) enhance the psychoactive effects of alcohol among college students. We evaluate the role of gender orientation and sex. PARTICIPANTS: Participants completed an online survey (N = 651; 59.9% women; 40.1% men). METHOD: Weight control behavior was assessed via the Compensatory-Eating-and-Behaviors-in Response-to-Alcohol-Consumption-Scale. Control variables included sex, race/ethnicity, age, and depressive symptoms. Gender orientation was measured by the Bem Sex Role Inventory. The prevalence and probability of alcohol-related weight control behavior using ordinal logistic regression are reported. RESULTS: Men and women do not significantly differ in compensatory-weight-control-behavior. However, regression models suggest that recent binge drinking, other substance use, and masculine orientation are positively associated with alcohol-related weight control behavior. CONCLUSIONS: Sex was not a robust predictor of weight control behavior. Masculine orientation should be considered a possible risk factor for these behaviors and considered when designing prevention and intervention strategies.

When women tell: intimate partner violence and the factors related to police notification.

We analyze how victim perceptions of mandatory arrest policies, perpetrator substance use, and presence of children are related to decisions to invoke law enforcement assistance. Logistic regression was used on survey responses from women receiving care in domestic violence shelters. Results suggest that as victim support for mandatory arrest increases, the odds of law enforcement notification of the abuse also increase. Accordingly, mandatory arrest may simply be reducing the probability of reporting intimate partner violence (IPV) among those who do not support the policy, instead of reducing IPV. Results also suggest that perpetrator substance use plays a significant role in law enforcement notification.

At the intersection of interpersonal violence, masculinity, and alcohol use: the experiences of heterosexual male perpetrators of intimate partner violence.

This article examines the relationship between violence, masculinity, and alcohol use among heterosexual, economically disadvantaged, and primarily Black men officially identified as batterers. Violence occurred against intimates and strangers. Alcohol use coupled with violence against intimates and violence against others (e.g., strangers) appeared to be used for masculinity construction. The use of alcohol before and during assaultive behavior combined with the use of violence symbolized dominance and control. This occurred in situations where markers of masculinity were largely absent (e.g., steady employment) in instances of both intimate partner violence and stranger violence.

Screening for intimate partner violence in a primary care setting: the validity of "feeling safe at home" and prevalence results.

BACKGROUND: We conducted a study to assess the validity of a screening question commonly used to detect intimate partner violence (IPV) in primary care settings. We also analyzed prevalence and risk factors of IPV. METHODS: We used an embedded domestic violence detection instrument in a general health questionnaire at one family medicine clinic. Questionnaire scales included a modified version of the Conflict Tactics Scale (CTS), depression and alcohol use scales, and a personal safety question ("Do you feel safe at home?"). We assessed the sensitivity, specificity, and predictive value of the personal safety question in our sample using responses to the modified CTS and the personal safety question. Three hundred ninety-nine female patients over the age of 18 completed the survey. RESULTS: CTS results revealed 44.3% of women experienced any violence, 43.5% of women experienced psychological violence in the presence or absence of physical violence, and 10.3% experienced physical violence in the presence or absence of psychological violence in the previous 90 days. The sensitivity of a single question used to detect any violence ("Do you feel safe at home?") was 8.8%; the specificity was 91.2%. Racial identity, marital status, and depression influenced the likelihood of IPV. CONCLUSIONS: These preliminary results call into question the utility of the safety question "Do you feel safe at home" for detecting cases of intimate partner violence in a primary care sample.