It's Not Just What Parents Say, It's Why They Say It: Students' Perceptions of Parents' Motives for Alcohol Communication.

OBJECTIVE: Previous work has investigated parents' reports of motives for communicating with their young adults about alcohol. While parents' self-reported motives may predict intentions to communicate, young adults' perceptions of their parents' motives may be important for understanding young adults' responses to parent alcohol communication. The present study was conducted to explore college students' perceptions of their parents' motives for alcohol communication and to investigate whether perceptions of these motives predict changes in alcohol consumption and related consequences during the transition to college. METHOD: First-year college students (N = 306) participated in a longitudinal survey study. Baseline measures at pre-matriculation (T1) included assessments of student perceptions of their parents' motives for alcohol communication and covariates (e.g., perceived peer descriptive drinking norms, parental modeling and alcohol communication, and drinking and consequences). At a 1-month follow-up (T2), students reported on their alcohol use and consequences. RESULTS: Controlling for other predictors of college student drinking, results indicate that for each one-unit increase in perceived parental reactive communication motives, the incidence rate of typical weekly drinking increased by 9%, and heavy episodic drinking (HED) increased by 21%. Conversely, the incidence rate of HED decreased by 27% for each one-unit increase in perceived maternal family history communication motives. CONCLUSIONS: These findings suggest that college students' perceptions of their parents' motives for alcohol communication can significantly influence their drinking behavior during the transition to college.

The Relationship Between Men's Sociosexuality, Drinking Intake, and Blackouts.

Background: Sociosexuality-attitudes, behaviors, and desires related to casual sex-partly predicts drinking behavior in both men and women because drinking is thought to facilitate interactions that lead to casual sex. It follows that sociosexuality would predict drinking intake (e.g., quantity consumed)-but perhaps not drinking consequences (e.g., blacking out)-on the premise that drinking large quantities with high frequency (but not to such high degrees/levels of intoxication that negative consequences occur) would facilitate casual sex. Objectives: This set of studies evaluated whether baseline measures of sociosexuality predict drinking intake (i.e., frequency, quantity, and binge drinking) but not experiencing blacking out at follow-up in two samples (Study 1, N = 172; Study 2, N = 1,038) of college-aged men. Results: As predicted, men's sociosexuality prospectively predicted drinking frequency, quantity, and binge drinking. Contrary to our predictions, men's sociosexuality also predicted blacking out. Conclusions: College men's drinking interventions should be tailored to high-risk groups and consider individual differences like sociosexuality.

Long-term impact of familismo and ethnic identity on latinx college student drinking and high-risk consequences.

Familismo, ethnic pride, and ethnic shame were examined as longitudinal predictors of Latinx college student alcohol use and high-risk alcohol-related consequences. Latinx students completed measures during the fall of their first (T1), second (T2), and fourth (T4) year of college. T1 familismo was positively associated with T2 ethnic pride and negatively associated with T2 ethnic shame. T2 ethnic pride was negatively associated with T4 drinking, while T2 ethnic shame was positively associated with T4 drinking. T4 drinking was positively associated with T4 consequences. Results suggest that Latinx ethnic pride and ethnic shame during the second-year of college act as mediators between first-year familismo and fourth-year drinking and consequences.

Negative consequences associated with daily alcohol use as a nonlinear function of number of drinks in a daily diary study.

INTRODUCTION: Drinking intensity among young adults is associated with greater negative alcohol-related consequences, but often studied using categorical drinking thresholds. This study examined how alcohol-related consequences varied as a continuous function of number of drinks consumed, without imposing thresholds, to identify drink ranges for which risk is greatest. METHODS: Analyses included daily surveys from the Young Adult Daily Life study (2019-22) in which individuals reported drinking 1 or more alcoholic drinks (n=5219 days; 832 individuals). Time-varying effect models estimated total number of negative alcohol-related consequences and five individual consequences (hangover, drank more than planned, nausea/vomiting, did something embarrassing, blacked out) as a function of the number of drinks consumed among young adult males and females. RESULTS: Often, increases in the number and prevalence of negative consequences were a nonlinear function of the number of drinks consumed. Females reported few negative consequences on 1-to-3-drink occasions but steep increases in consequences on 4-to-9-drink occasions. Among females, the prevalence of blacking out increased six-fold from 4-drink (3.4%; 95% CI=2.6,4.7) to 9-drink occasions (20.6%; 95% CI=16.1,26.1). Among males, the prevalence of some consequences, while not linear, increased across the full drink range. Blacking out among males increased from 9.6% (95% CI=6.2,14.7) on 10-drink occasions to 23.9% (95% CI=15.0,35.8) on 15-drink occasions. CONCLUSIONS: Substantial heterogeneity is missed when typical drinking categories are used. In particular, variability in consequences across levels of the traditional binge drinking category suggests that important differences in risk may be missed when assessed as a uniform category.

Masculine Drinking Norms and Alcohol Use in a National Sample of NCAA Male Student-Athletes.

Objectives: Participation in sports can increase young adults' risk for heavy alcohol use and related consequences. Among student-athletes, more men report heavy drinking than women. These gender differences may reflect men's expression of masculinity which can encompass excessive consumption. While a growing body of research indicates that general masculine norms are positively associated with alcohol use and consequences among men, the extent to which alcohol-specific masculine norms can increase student-athletes' risk for elevated drinking and related outcomes is not yet known. Thus, we examined how masculine drinking norms are associated with alcohol use and related consequences while accounting for demographics and multiple dimensions of general masculine norms. Methods: 1,825 NCAA student-athletes (White=79%, Mage=20.1/SDage=1.3; 50 colleges/universities) completed a confidential online survey which included questions regarding masculine drinking norms of excess and control and conformity to general masculine norms. Results: We created latent constructs and tested a path model in SEM. Results indicated that, after accounting for demographics and multiple dimensions of general masculine norms, the masculine drinking norm of excess was positively associated with alcohol use and consequences. Conversely, control was negatively related to alcohol use but unrelated to consequences. Compared to control and other dimensions of general masculine norms, excess was most strongly related to alcohol use and consequences. Conclusions: A move from assessing general masculine norms toward alcohol-specific masculine norms can further researchers' and practitioners' knowledge of masculine norms and their link to drinking behaviors, and enhance the application of masculine norms in alcohol intervention and prevention programs.

Daily Relations Among Alcohol and Cannabis Co-Use, Simultaneous Use, and Negative Consequences: A Day-Level Latent Profile Analysis.

Objective: Concurrent and simultaneous cannabis and alcohol co-use confers risk for daily negative alcohol consequences. However, studies often treat co-use as a dichotomy, precluding examination of higher- and lower-risk co-use days. Additionally, little is known about specific alcohol consequences associated with daily co-use. Therefore, the current study 1) differentiated days based upon alcohol consumption, co-use, and simultaneous use, and 2) tested whether certain day-level use patterns conferred risk for daily alcohol consequences. Methods: College student co-users (N=489) completed an online Timeline Followback, reporting daily alcohol consumption, negative alcohol consequences, concurrent cannabis and alcohol co-use, and simultaneous co-use (SAM) on drinking days over the past month. Day-Level Latent Profile Analysis differentiated days based upon drinking quantity, co-use, and simultaneous use, and tested whether patterns of use conferred risk for overall and specific negative alcohol consequences. Results: Four day-level profiles emerged, including moderate consumption of alcohol-only days (57.5%), moderate consumption SAM use days (29.1%), higher consumption alcohol-only days (7.4%), and higher consumption SAM use days (6%). Higher consumption SAM use days were associated with more negative alcohol consequences than all other days; however, higher consumption SAM use days differed from higher consumption alcohol-only days in acute dependence symptoms. Higher consumption alcohol-only days were associated with more negative alcohol consequences than moderate consumption SAM days, particularly those that were action-oriented (i.e., dependence symptoms, blackout drinking, impaired control, risky behavior, social/interpersonal consequences). Conclusions: Findings suggest that there are in fact lower-risk co-use days, and that links with unique negative alcohol consequences depend on levels of alcohol consumption and co-use.

A Cross-Cultural Comparison of Negative Alcohol-Related Consequences in the United States and Sweden: Measurement Invariance of the Rutgers Alcohol Problem Index.

Commensurate measures of alcohol-related consequences across countries and cultures are critical for addressing the global burden of hazardous alcohol use. The Rutgers Alcohol Problem Index (RAPI), developed and validated in the United States, is a popular measure of alcohol problems. This study examined measurement invariance of the RAPI across samples of U.S. and Swedish high school seniors. Latent mean differences in alcohol problems across countries and differences in associations between alcohol problems with alcohol use and protective behavioral strategies (PBS) were also examined. The RAPI was scalar invariant. Swedish students reported fewer problems than U.S. students (latent mean difference = -0.19, p = .047). In both samples, the RAPI was positively correlated with alcohol use frequency and quantity (ps < .001), and negatively correlated with PBS use (ps < .05). Overall, the RAPI demonstrated measurement invariance, and we found evidence for its validity across samples of U.S. and Swedish high school seniors.

The role of effortful control in mitigating negative consequences associated with emerging adult drinking.

BACKGROUND: Identifying factors that protect against alcohol-related negative consequences associated with emerging adult drinking is a critical public health issue. It has been proposed that high levels of self-regulation moderate risks associated with drinking, decreasing alcohol-related negative consequences. Past research testing this possibility is limited by a lack of advanced methodology for testing moderation and failure to consider facets of self-regulation. This study addressed these limitations. METHODS: Three hundred fifty-four community emerging adults (56% female; predominantly non-Hispanic Caucasian (83%) or African American (9%)) were assessed annually for 3 years. Moderational hypotheses were tested using multilevel models and the Johnson-Neyman technique was used to examine simple slopes. Data were organized such that repeated measures (level 1) were nested within participants (level 2) to test cross-sectional associations. Self-regulation was operationalized as effortful control and its facets (attentional, inhibitory, and activation control). RESULTS: We found evidence of moderation. The association between alcohol use during a heavy drinking week and consequences weakened as effortful control increased. This pattern was supported for two facets (attentional and activation control), but not for inhibitory control. Regions of significance results revealed that this protective effect was only evident at very high levels of self-regulation. CONCLUSIONS: The results provide some evidence that very high levels of attentional and activation control protect against alcohol-related negative consequences associated with drinking. Emerging adults who are very high in attentional and activation control are likely better able to control their attention and engage in goal-directed behavior, like leaving a party at a reasonable hour, or attending school and/or work when experiencing the punishing effects of a hangover. Results emphasize the importance of distinguishing facets of self-regulation when testing self-regulation models.

Polysubstance use among young adults and differences in negative alcohol-related sexual experiences.

This study aimed to compare negative alcohol-related sexual experiences among individuals who used (1) alcohol only, (2) alcohol plus marijuana, and (3) alcohol plus marijuana and stimulants. Participants in the analytic sample (N = 1,015; Mean age = 19.16 (SD = 0.79); 45.42% male) completed an online baseline survey as part of an intervention study. A hurdle negative binomial model examined the associations between polysubstance use and negative alcohol-related sexual experiences. Models examined if experiences varied by demographic factors. Compared to participants that only used alcohol, those who used alcohol plus marijuana and stimulants reported a higher likelihood and average number of negative alcohol-related sexual experiences in the past 3 months. Participants that used alcohol plus marijuana had a higher likelihood of having a negative alcohol-related sexual experience in the past 3 months compared to those who only used alcohol. These findings suggest the number and risk for negative alcohol-related sexual experiences increases with the number of substances being used.

Alcohol-related consequences and the intention to seek care in treatment naïve women and men with severe alcohol use disorder.

INTRODUCTION: Research on treatment utilization for alcohol use disorder (AUD) is based primarily on clinical samples and community samples of low AUD severity that may not need formal care. Using a community sample of adults with untreated but severe AUD symptoms, we tested the hypothesis that alcohol-related consequences, but not alcohol consumption levels, are associated with the intention to seek AUD treatment, examined associations of specific types of alcohol-related consequences with intention, and explored sex differences in these associations. METHODS: The sample was recruited using social media ads for a randomized controlled trial to test a brief intervention to promote AUD treatment seeking. This report is based on analysis of baseline data collected prior to treatment intervention. Multiple linear regressions examined associations of measures of alcohol consumption, alcohol-related consequences broadly, and specific alcohol-related consequences with the intention to seek treatment. Moderating effects of sex on associations were explored. RESULTS: Subjects (n = 349) averaged 41 years of age, 48% were female, 6% were Latinx, 80% were white, 15% were Black, and 92% met criteria for severe AUD. Alcohol consumption measures were not associated with intention to seek treatment whereas interpersonal- and intrapersonal- consequences were associated with intention. Sex served as a moderator, with intrapersonal consequences (e.g., sad mood) showing a stronger association with intention in women and social responsibility consequences (particularly financial) associated with intention in men. CONCLUSION: Select alcohol-related consequences may be keys to understanding increased intention to seek AUD treatment including intrapersonal consequences in women and financial consequences in men.

Daily-level analysis of drinking intensity and acute physical consequences.

OBJECTIVE: We examined associations of drinking intensity on a given drinking day with acute physical consequences in a sample of U.S. young adult drinkers. METHODS: Participants were past 30-day drinkers at modal age 18 in the 2018 12th-grade Monitoring the Future study who were followed up as part of a daily study in 2019 (n = 911). Of these participants, n = 489 reported at least one drinking day. At age 19, they reported their alcohol use and consequences for 14 consecutive days (n = 1051 drinking days). Daily data were used to examine within- and between-person associations of drinking intensity (moderate [1-3 drinks for women, 1-4 drinks for men], binge [4-7/5-9], or high-intensity [8+/10+]) with four acute physical consequences: hangover, nausea, blackout, and passing out. RESULTS: At least one acute physical consequence was reported on more than half (59.3%) of high-intensity drinking days compared to 40.7% of binge and 4.9% of moderate drinking days. Blackouts and passing out were reported on 17.1% and 9.2% of high-intensity drinking days, respectively. Compared to binge drinking days, high-intensity drinking days were associated with a greater likelihood of any physical consequences (adjusted odds ratio [aOR] = 4.64; 95% confidence interval [CI] = 2.00,10.75), a greater number of consequences (adjusted incident rate ratio [aIRR = 1.99; 95% CI = 1.16,3.42), and a greater likelihood of hangover (aOR = 3.72; 95% CI = 1.58,8.74). Acute physical consequences were also more likely on high-intensity and binge drinking days versus moderate drinking days. CONCLUSIONS: High-intensity drinking days were associated with a distinctly greater risk for acute physical consequences than binge or moderate drinking days.

Discussion of alcohol consequences during a brief motivational intervention session: Comparing those who do and do not increase readiness to change.

The present study was designed to take an inductive, qualitative approach to understanding how discussion of alcohol-related consequences during brief motivational interventions (BMI) relate to readiness to change (RTC) prior to versus at the end of a session. Participants were thirty-four adults (35% female) recruited from the emergency room and enrolled in a randomized clinical trial of a BMI for risky alcohol use and risky sex. Seventeen participants both began and remained low on RTC over the course of the session. We selected 17 additional participants, matched on demographics, but who increased RTC over the session. Transcripts were qualitatively coded and analyzed separately within groups. Among participants who increased their RTC relative to participants who remained low on RTC by BMI end, evaluation of alcohol consequences as negative was more typical. In both groups, several consequences were neutrally evaluated. Many who remained low on RTC attributed consequences to something other than alcohol and/or minimized consequence severity. Study findings highlight the value for clinicians in eliciting and maximizing the importance of subjectively negative recent consequences to perhaps increase heavy drinkers' readiness to decrease heavy alcohol use.

The role of resilience in alcohol use, drinking motives, and alcohol-related consequences among Hispanic college students.

Background: Hispanic college students experience minority stressors and are therefore at greater risk of experiencing alcohol-related consequences. Resilience may protect against problem drinking and related consequences, yet its relationship to drinking motives remains unexplored. Given that drinking motives precede both alcohol use and its consequences, investigating the role of resilience in such associations may inform interventions to reduce alcohol-related health disparities.Objectives: The current study investigated whether greater resilience predicted fewer drinking motives, lower alcohol consumption, and reduced the negative impact of drinking motives on alcohol consequences among Hispanic college students.Methods: Resilience, drinking motives and alcohol consequences were assessed among 443 students living on the U.S./Mexico border recruited via e-mail (68% female; Mage = 22.6 years, SD = 5.09). Linear regressions assessed whether drinking motives (i.e., coping, conformity, social, enhancement) and resilience predicted alcohol consumption. A linear regression also assessed resilience, drinking motives, and alcohol consumption as potential predictors of alcohol consequences. Lastly, linear regressions tested the moderating effects of resilience between each drinking motive and alcohol consumption as well as alcohol consequences.Results: Greater resilience predicted fewer alcohol-related consequences (ß = -.024, p = .028). Additionally, resilience moderated the relationships social (ß = -.095, p = .050) and enhancement drinking motives (ß = -.084, p = .050) had with alcohol consequences. Higher social and enhancement motives were not associated with alcohol consequences among resilient individuals.Conclusion: Strengthening resilience among Hispanic students whose drinking is motivated by a desire for socialization or mood enhancement may protect against alcohol-related consequences.

Antecedente: Estudiantes universitarios Hispanos pueden presentar condiciones de estrés de minoría y por tanto corren un mayor riesgo de sufrir consecuencias relacionadas con el alcohol. Puede que la resiliencia proteja contra de beber en exceso y consecuencias relacionadas, aún su relación con motivos de beber permanece inexplorada. Dado que motivos para beber preceden el consumo de beber en exceso y sus consecuencias, investigar el rol de resiliencia en estas asocia-ciones puede informar intervenciones para reducir las disparidades de salud relacionadas con el consumo de alcohol. Objetivo: El estudio actual investigo si la resiliencia predecía menos motivos para beber, consumo del alcohol y rebajaba el impacto negativo de los motivos para beber en las consecuencias del alcohol entre los estudiantes universitarios Hispanos. Métodos: Se evaluó la resiliencia, los motivos para beber y las consecuencias del alcohol entre 443 estudiantes universitarios en la frontera entre Estados Unidos y México reclutados por correo electrónico (68% mujeres; Medad = 22.6 años, SD = 5.09). Regresión lineales evaluaron si los motivos para beber (es decir, afrontamiento, aprobación, socialización, mejoramiento) y la resiliencia predecían consumo del alcohol. Una regresión lineal también evaluó la resiliencia, los motivos para beber y consumo del alcohol como posibles predictores de las consecuencias del alcohol. Por último, las regresiones lineales probaron los efectos moderadores de la resiliencia entre cada motivo de beber y el consumo del alcohol, así como las consecuencias del alcohol.

PTSD symptom heterogeneity and alcohol-related outcomes in U.S. military veterans: Indirect associations with coping strategies.

INTRODUCTION: This study investigated the role of coping strategies in mediating the relationship between the 7-factor model of posttraumatic stress disorder (PTSD) symptoms and alcohol misuse in veterans. METHODS: Data were analyzed from 615 veterans from a nationally representative study of U.S. veterans who met criteria for probable full or subthreshold PTSD. Path analyses examined the role of self-sufficient, socially-supported, and avoidant coping strategies in mediating associations between PTSD symptom clusters and alcohol use disorder (AUD), alcohol consumption, and alcohol-related consequences. RESULTS: Negative affect PTSD symptoms were associated with AUD through increased use of avoidant coping. Additionally, dysphoric arousal PTSD symptoms were associated with AUD; avoidant coping was associated with AUD and increased alcohol consumption; self-sufficient coping was associated with reduced AUD likelihood anhedonia symptoms with decreased use of self-sufficient coping; and negative affect with decreased use of socially-supported coping and increased use of avoidant coping. CONCLUSIONS: Results underscore the importance of avoidant coping strategies as potential mediators of the relation between PTSD symptoms and AUD. Interventions designed to mitigate engagement in avoidant coping strategies, and to bolster engagement in self-sufficient and socially-supported strategies may help reduce alcohol misuse in veterans with full or subthreshold PTSD.

Examining changes in drinking motives and their influence on drinking behaviors among heavy drinkers during their first year of college.

Drinking motives are robustly related to alcohol use behavior from adolescence through young adulthood. Yet, examination of changes in motives during the first year of college, a transitional time associated with both onset of and increases in heavy drinking has been understudied. We examined (a) whether drinking motives change, (b) time-varying effects of motives on alcohol use and consequences, and (c) change in the strength of the association between motives and use and motives and consequences over the first year of college. A sample of 121 heavy drinking first-year students (50% female, 58% Caucasian) completed three assessments (baseline, 3 months, 6 months). Endorsement of social motives declined from 0 to 3 months, while endorsement of coping, enhancement, and conformity motives declined from 3 to 6 months. Social motives were positively associated with alcohol use and consequences across assessments. When motive × time interactions were tested in separate models, the strength of effects of coping motives on drinks per week increased from 0 to 3 months. The strength of the effect of coping and conformity motives on consequences increased from 0 to 3 months and then decreased from 3 to 6 months. Identifying how drinking motives evolve and relate to trajectories of alcohol use may help to understand the development of risky drinking behavior and inform intervention efforts.

The Brief Young Adult Alcohol Consequences Questionnaire: A cross-country examination among university students in Australia, New Zealand, Canada, Argentina, and the United States.

BACKGROUND: The Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ) was designed to measure alcohol consequences and identify at-risk students. It was developed and originally validated among university students in the United States (U.S.), yet it is widely used in both the U.S. and abroad. Using the alignment method, we tested whether the B-YAACQ measures alcohol consequences similarly across university students in several countries where heavy alcohol use and related outcomes are prevalent. METHODS: The sample consisted of 1473 university students (ages 18-30) from five university sites: Australia (n = 315), New Zealand (n = 270), Canada (n = 276), Argentina (n = 232), and the U.S. (n = 380). Participants completed a confidential, online alcohol use survey which included the B-YAACQ. RESULTS: Overall, 12 of the 24 B-YAACQ items had invariant factor loading and threshold parameters, suggesting that these items exhibited similar reliability and difficulty among university students across the five countries. Of the 24 B-YAACQ items, 21 exhibited comparable reliability across the five countries; the remaining 3 items were slightly less reliable indicators of alcohol consequences among U.S. students. Thus, several items on the B-YAACQ may be particularly informative for identifying students who are experiencing high levels of drinking harm across multiple countries. CONCLUSIONS: The present study is an important step toward (a) validating the B-YAACQ among university students in New Zealand and Canada, and (b) furthering our understanding of the psychometric properties of the B-YAACQ among university students in Australia, Argentina, and the U.S.

The Prevalence of Binge Drinking and Alcohol-Related Consequences and their Relationship among Japanese College Students.

Binge drinking is a common and risky behavior among college students. In Japan, however, research on the prevalence of binge drinking and alcohol-related consequences, and the relationship between them, is currently scant. The aim of this study is to examine the status of binge drinking and alcohol-related problems, and the relationship between them, among Japanese college students. We conducted a cross-sectional survey of college students who participated in a health seminar or lecture including alcohol-related contents from December 2018 to January 2019. Drinking patterns and alcohol-related consequences were assessed using the Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ) and demographic data. A total of 382 students participated in the seminar, of whom 280 agreed to cooperate in this study and 249 had drinking experience. A total of 88 men (67.7%) and 42 women (32.2%) were classified as binge drinkers. Binge drinkers more significantly experienced various consequences, such as hangover, feeling remorse and embarrassing behavior and some of them were suspected of physical dependence. Furthermore, logistic analysis revealed that among men, the B-YAACQ scores of binge drinkers were 2.01-fold higher those of non-binge drinkers. The findings of this study indicated that binge drinking may cause not only physical consequences but also mental and social problems, especially among men. It is important to tell college students these risks properly not to engage in binge drinking.

Event-Specific Drinking and Protective Behavioral Strategy Use among College Students.

BACKGROUND: Event-specific drinking occasions (e.g. holidays, special occasions, school breaks) have been associated with heavy drinking and negative alcohol-related consequences among college students. The current study extends prior research by examining understudied holidays and changes in protective behavioral strategy use during these event-specific drinking occasions. METHOD: Participants were 537 college students between the ages of 18 and 24 who retrospectively reported drinking in the past two weeks. Several alcohol use variables (e.g., frequency, quantity, heavy episodic drinking frequency), negative alcohol-related consequences, and protective behavioral strategies were assessed for the previous 14 days. Ten event-specific drinking occasions were coded for the 14-day reporting period. A series of Analysis of Covariance models were conducted to examine differences on alcohol use variables, negative consequences, and protective behavioral strategies for weeks that included an event-specific drinking occasion relative to a no holiday reference timeframe. RESULTS: Compared to the no holiday reference group, several event-specific drinking occasions (e.g., Labor Day, Martin Luther King Day) were associated with greater alcohol use, negative consequences, and protective behavioral strategy use. In contrast, other occasions were determined to be low-risk holidays (e.g., Veterans Day) when protective behavioral strategies were less frequently used. Some occasions (e.g., spring break) did not exhibit the expected clear pattern of risk. CONCLUSIONS: College students' alcohol use, negative consequences, and protective behavioral strategy use vary across event-specific drinking occasions. Determining which event-specific drinking occasions are associated with risky alcohol use and the lowest use of harm reduction strategies is important for prevention and intervention programs.

Effects of alcohol sensitivity on alcohol-induced blackouts and passing out: An examination of the alcohol sensitivity questionnaire among underage drinkers.

BACKGROUND: The role of alcohol sensitivity in the experience of blacking out and passing out has not been well established. Here, we examined the relation between individual differences in alcohol sensitivity (i.e., numbers of drinks required to experience various effects of alcohol) and reports of blacking out and passing out in the past year. METHODS: Participants (925 healthy, underage college student drinkers) completed the Alcohol Sensitivity Questionnaire (ASQ) and reported on their past year blacking out and passing out experiences. RESULTS: The fit of the ASQ's 2-factor structure was fair (CFI = 0.90, RMSEA = 0.09) in this sample of underage drinkers. In unadjusted models, higher ASQ scores (i.e., requiring more drinks to experience effects, indicating lower alcohol sensitivity) were associated with experiencing more blackouts (IRR = 1.68 [1.31-2.15]) and passing out (IRR = 2.25 [1.59-3.18]) in the past year. After controlling for typical consumption, however, higher ASQ scores were associated with fewer past-year blackouts (IRR = 0.76 [0.60-0.98]). Total ASQ scores moderated the relationship between typical alcohol consumption and blackout occurrence (interaction IRR = 0.96 [0.93-0.98]), but not passing out occurrence (interaction IRR = 0.95 [0.89-1.01]), with the quantity of alcohol consumed more strongly associated with blackout occurrence among higher-sensitivity than lower-sensitivity drinkers. CONCLUSIONS: These findings are consistent with prior work suggesting that low sensitivity may act as a paradoxical risk factor for certain heavy drinking effects, contributing to higher levels of alcohol consumption and more frequent negative consequences while also conferring protection (relative to high-sensitivity peers) at a given level of alcohol exposure.

How much and how fast: Alcohol consumption patterns, drinking-episode affect, and next-day consequences in the daily life of underage heavy drinkers.

BACKGROUND: Understanding how alcohol consumption patterns are associated with negative and positive outcomes can inform efforts to reduce negative consequences through modification of those patterns. This is important in underage drinkers, many of whom drink heavily despite negative consequences. Most work has focused on the amount of alcohol consumed, but amount provides limited information about consumption patterns compared to rate of consumption, or how fast individuals drink. We therefore examined associations of both amount and rate of consumption with negative and positive outcomes (immediate affective states and next-morning consequences) in daily life. METHOD: Ninety-five college students aged 18-20 years completed ecological momentary assessment over 28 days. Participants reported number of standard drinks consumed and positive and negative affect hourly within drinking episodes. Estimated blood alcohol concentration (eBAC) values were used to create amount and rate of consumption indicators. Each morning after drinking, participants reported negative (e.g., blackout, hangover) and positive (e.g., new friend, making others laugh) consequences. RESULTS: Within drinking episodes, multilevel models showed faster consumption was associated with reduced negative affect and both larger amount and faster consumption were associated with greater positive affect. Further, amount and rate were both associated with greater likelihood of a negative consequence the next morning. Rate, but not amount, was associated with more positive consequences. CONCLUSIONS: Not only how much but also how fast individuals drink may be important for the positive and negative outcomes they experience. Interventions to reduce negative alcohol-related outcomes should consider not only amount, but also rate of consumption.