Do hypothetical evaluations of alcohol related consequences change over time? Examining the influence of past and ongoing consequences.

OBJECTIVE: Despite experiencing alcohol-related consequences, college students continue to drink at high rates. Hypothetical evaluations of alcohol-related consequences (i.e., evaluations of where potential/hypothetical consequences lie on a spectrum from extremely positive to extremely negative) may contribute to the maintenance of drinking patterns among students. The purpose of the present study was to describe hypothetical evaluations in a sample of students mandated to an alcohol intervention, examine changes over time, and investigate the influence of both baseline and time-varying experienced consequences. METHOD: This study was a secondary data analysis from a longitudinal randomized controlled trial. Participants were 474 mandated students (Mage = 18.65; 55.5 % male, 77.6 % White). Students completed an initial baseline assessment of demographics, alcohol use, consequences, and hypothetical evaluations, and 3-month and 9-month follow-up assessments that included hypothetical evaluations and experienced consequences. RESULTS: Hierarchical linear modeling (HLM) analyses revealed significant change in hypothetical evaluations over time such that they became less negative. A piecewise model demonstrated that this change happened between baseline and 3-month, with no additional change between 3-month and 9-month. The experience of consequences at baseline did not significantly moderate changes in either time interval. Time-varying consequences also had no significant effect on same-timepoint hypothetical evaluations. CONCLUSIONS: This study is the first to examine changes in hypothetical evaluations over time among mandated college students. Counter to expectations, hypothetical evaluations became less negative at 3-month follow-up. Though preliminary, findings add to the understanding of hypothetical evaluations of alcohol-related consequences.

World Health Organization Risk Drinking Levels Among Mandated College Students: Associations with Alcohol Use, Mental Health, and Academic Performance.

OBJECTIVE: World Health Organization (WHO) risk drinking levels (i.e., low, moderate, high, or very high risk) have been used as a drinking reduction endpoint in clinical trials. Yet, prior work has not attempted to quantify reductions in WHO risk levels among mandated students, who may also benefit from reduced drinking. We sought to validate WHO risk drinking levels in differentiating students' alcohol-related outcomes, depressive symptoms, and academic performance. Defining risk via typical drinks per drinking day versus drinks per day was compared, and gender differences were examined. METHOD: Baseline data were drawn from three intervention trials for students mandated to intervention and who were not abstinent (N=1436). Sex-specific WHO risk levels were generated and dummy coded, with low risk as the reference. Regression models examined associations of risk levels with positive AUDIT scores, peak drinking, consequences, depressive symptoms, and grade point average. RESULTS: Defining WHO risk via drinks per drinking day evenly dispersed students across categories, whereas drinks per day categorized most as low risk. More women than men were classified as very high risk across definitions. Students classified as low risk differed from those classified as moderate, high, and very high risk in screening positive on the AUDIT, peak drinking, and consequences. WHO risk levels did not differentiate depressive symptoms. Differences in grade point average were inconsistent across risk definitions. CONCLUSIONS: WHO risk drinking levels differentiated alcohol use and consequences and, therefore, hold promise for clinical use and for quantifying drinking reductions among mandated college students.

Does self-affirmation augment the effects of a mandated personalized feedback intervention? A randomized controlled trial with heavy drinking college students.

OBJECTIVE: Theory and evidence indicate that affirming the value of the self before exposure to a threatening message fosters more open-minded appraisal of message content. We predicted that college students mandated to a computer-delivered personalized feedback intervention (PFI) and who engaged in a self-affirmation (SA) exercise would demonstrate reduce drinking and consequences relative to those who received an attention control. METHOD: Participants were 484 undergraduates (age 18-24, 56% male, 78% White) mandated to participate in an alcohol intervention following a first-time alcohol policy violation. After a baseline assessment, each was randomized to SA (n = 256) or attention control (n = 227) prior to a computer-delivered PFI intervention. Posttest measures included an affirmation manipulation check; primary outcomes (past month weekly quantity, peak drinks, binge frequency, consequences) were assessed at 1-, 3-, 6-, 9-, and 12-month follow-ups. We used latent growth curve modeling to test study hypotheses. RESULTS: The SA exercise increased positive self-evaluation at posttest (p < .001). Overall reductions in drinking and consequences were observed at early follow-up (all p < .05), but the SA manipulation was not associated with intercept or slope factor differences in the models. Engaging in assessments during COVID restrictions was generally associated with reduced drinking and consequences. CONCLUSIONS: The SA exercise did not differentially affect trajectories of alcohol use and consequences, despite evidence that the exercise had the predicted effect on participant's self-evaluations. The lack of SA effects could be attributed to a nonthreatening PFI intervention that is generally accepted among mandated students. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

How Do Bystanders Help in Drinking Situations: The Bystanders to Alcohol Risk Scale--Strategies.

OBJECTIVE: Bystander intervention (BI) is a promising approach for promoting collective behavior change that has been applied to several domains, including sexual assault, bullying, and more recently, problematic alcohol use. Accurately measuring the strategies that bystanders use to reduce others' alcohol-related risk is an essential step toward improving bystanders' ability to reduce alcohol-related harm in their communities, but current measures of BI are not easily modifiable and applicable for alcohol-related BI. The current study aimed to develop a valid and reliable measure of the bystander construct most proximal to the reduction of risk: bystander strategies. METHOD: Young adults (N = 1,011) who reported being around someone who showed signs of alcohol intoxication in the past 3 months were recruited via Qualtrics Panels to participate in an online survey; a subsample (n = 345) completed a 2-week follow-up. Psychometric evaluation included exploratory and confirmatory factor analyses, item response theory analyses, convergent validity, and test-retest reliability. RESULTS: An initial set of 52 items was reduced to 17 items, representing two different factors. The first factor, Level 1, reflected strategies used during circumstances of acute risk. The second factor, Level 2, reflected strategies used to reduce risk for more longstanding problems with alcohol. Both factors demonstrated good model fit, strong internal consistency, evidence of convergent validity, and moderate test-retest reliability. CONCLUSIONS: This novel measure can contribute to the production of knowledge about the use and efficacy of peer-focused strategies and the value of BI training for alcohol use.

Characterizing Alcohol Consumption and Positive and Negative Consequences During Simultaneous Alcohol and Cannabis Use Events.

OBJECTIVE: Young adults who engage in simultaneous alcohol and cannabis use report heavy use of both substances. Event-level studies examining differences between consequences experienced on simultaneous use compared with single substance use days have been mixed. Although studies often control for alcohol use levels, few have examined how quantity of alcohol may influence consequences experienced on simultaneous use days. Furthermore, little research has examined the relationship between simultaneous use and positive consequences or explored individual consequences. This study examined differences in consequences experienced on simultaneous use versus single substance use days (alcohol-only, cannabis-only) including endorsement of specific consequences and examined the relationship among simultaneous use, consequences, and alcohol consumption. METHOD: Young adults who engage in simultaneous use (N = 86) completed 30 days of daily surveys reporting substance use and positive and negative consequences. RESULTS: Simultaneous use days were associated with more negative and positive consequences than single substance use (alcohol-only and cannabis-only) days. We also examined endorsement of specific positive and negative consequences on alcohol-only, cannabis-only, and simultaneous use days. The effect of day type (simultaneous use vs. alcohol-only) on consequences was moderated by alcohol quantity. On lighter drinking days, more positive and negative consequences were endorsed if it was a simultaneous use versus alcohol-only day. On heavier drinking days, number of consequences did not differ between simultaneous use and alcohol-only days. CONCLUSIONS: Findings from this study point to simultaneous use as both reinforcing and high risk and highlight the importance of intervening even on lighter drinking simultaneous use occasions to reduce harms.

Measuring Exposure to the Hazardous Drinking of Others and Perceived Opportunity to Intervene as a Bystander.

OBJECTIVE: Excessive alcohol use is very prevalent among young adults, and consequences of drinking are often observed by witnesses. Understanding the circumstances under which witnesses of risky alcohol use help others and whether they perceive these circumstances as an opportunity to engage in bystander intervention are important, but valid measures of these constructs are needed. The current study is a psychometric evaluation of the Exposure to Hazardous Drinking in Others (EHDO) scale and a single-item indicator of Perceived Alcohol-Related Bystander Opportunity (PARBO). METHOD: Young adults (N = 1,011; 46.0% women) who reported being around someone who showed signs of alcohol intoxication in the past 3 months were recruited via Qualtrics Panels. The initial item set for the EHDO was developed through qualitative methods and reflected observed or reported risks or consequences. Factor analyses and Item Response Theory analyses were used to reduce and categorize EHDO items, and construct validity was assessed for the EHDO and the PARBO item. RESULTS: An initial set of 33 EHDO items was reduced to 21, representing two factors: Situational Risk Signs and Problematic Pattern. Both factors demonstrated good model fit, internal consistency, and evidence of convergent validity. The PARBO item showed good construct validity but was distinct from the EHDO. CONCLUSIONS: These instruments are useful for measuring secondhand alcohol risks in a community and are particularly applicable for evaluating bystander intervention for alcohol risk.

Perceived belonging on campus predicts depression among heavy drinkers: A test of three moderators.

Objective: An association exists between perceived belonging and depression among college students. Because a student's sense of belongingness may vary as a function of their social identity, three identities - ethnicity, first-generation college student status, and sex - were investigated as potential moderators of this relationship. Participants: One hundred eighty-seven heavy-drinking college students (63% female; 52% non-Latinx White; M = 20 years of age) were assessed. Methods: Three hierarchical linear regressions were conducted to test whether belonging at baseline predicted depression at six months and whether each identity variable moderated this association. Results: Analyses yielded significant main effects between belonging and depression. Hispanic nor first-generation status interacted with belonging in predicting depression. Sex interacted with belonging where higher belongingness was associated with lower levels of depression only among female students. Conclusion: Mental health providers should consider asking female students about their perceptions of belonging on college campuses to understand their vulnerability to depression.

The complexity of multidisciplinary respiratory care in amyotrophic lateral sclerosis.

Motor neurone disease/amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder with no known cure, where death is usually secondary to progressive respiratory failure. Assisting people with ALS through their disease journey is complex and supported by clinics that provide comprehensive multidisciplinary care (MDC). This review aims to apply both a respiratory and a complexity lens to the key roles and areas of practice within the MDC model in ALS. Models of noninvasive ventilation care, and considerations in the provision of palliative therapy, respiratory support, and speech and language therapy are discussed. The impact on people living with ALS of both inequitable funding models and the complexity of clinical care decisions are illustrated using case vignettes. Considerations of the impact of emerging antisense and gene modifying therapies on MDC challenges are also highlighted. The review seeks to illustrate how MDC members contribute to collective decision-making in ALS, how the sum of the parts is greater than any individual care component or health professional, and that the MDC per se adds value to the person living with ALS. Through this approach we hope to support clinicians to navigate the space between what are minimum, guideline-driven, standards of care and what excellent, person-centred ALS care that fully embraces complexity could be. Educational aims: To highlight the complexities surrounding respiratory care in ALS.To alert clinicians to the risk that complexity of ALS care may modify the effectiveness of any specific, evidence-based therapy for ALS.To describe the importance of person-centred care and shared decision-making in optimising care in ALS.

Low levels of fitting in on campus moderates the relationship between enhancement drinking motives and drinks per week among college students.

The first year of college is often marked by increased levels of alcohol consumption; first-year students also vary in their sense of fitting in on campus. Research has amply documented the links between social and enhancement drinking motives with various alcohol outcomes among college students. However, it is unclear how perceived levels of fitting in on campus potentially buffers or amplifies the relationship between drinking motives and drinking behavior. We explored whether perceptions of fitting in on campus moderated effects of social and/or enhancement drinking motives on drinks per week. A sample of 121 heavy drinking first year college students (50 % female, 58 % non-Latinx White, M = 18 years of age) were assessed twice in their first semester (baseline, 3 months) in the context of an alcohol-specific intervention. Hierarchical linear regressions were conducted to test whether drinking motives (social and enhancement) at baseline prospectively predicted drinks per week at 3 months. We hypothesized a positive association between both drinking motives and drinks per week; whether fitting in moderates these relationships was exploratory. Regression analyses yielded non-significant main effects of social motives, enhancement motives, and feelings of fitting in on drinks per week. There was no significant interaction for social motives, but the interaction between enhancement motives and fitting in was significant. Participants with a low sense of fitting in had a strong positive relationship between enhancement motives and drinks per week. Improving perceptions of fitting in for first-year college students may potentially reduce the association between enhancement drinking motives and drinks per week.

Effect of Cognitive Behavioral Therapy for Insomnia on Alcohol Treatment Outcomes Among US Veterans: A Randomized Clinical Trial.

Importance: Three of 4 adults in treatment for alcohol use disorder (AUD) report symptoms of insomnia. Yet the first-line treatment for insomnia (cognitive behavioral therapy for insomnia, CBT-I) is often delayed until abstinence is established. Objective: To test the feasibility, acceptability, and preliminary efficacy of CBT-I among veterans early in their AUD treatment and to examine improvement in insomnia as a mechanism for improvement in alcohol use outcomes. Design, Setting, and Participants: For this randomized clinical trial, participants were recruited through the Addictions Treatment Program at a Veterans Health Administration hospital between 2019 and 2022. Patients in treatment for AUD were eligible if they met criteria for insomnia disorder and reported alcohol use in the past 2 months at baseline. Follow-up visits occurred posttreatment and at 6 weeks. Interventions: Participants were randomly assigned to receive 5 weekly sessions of CBT-I or a single session about sleep hygiene (control). Participants were asked to complete sleep diaries for 7 days at each assessment. Main Outcomes and Measures: Primary outcomes included posttreatment insomnia severity (assessed using the Insomnia Severity Index) and follow-up frequency of any drinking and heavy drinking (4 drinks for women, ≥5 drinks for men; number of days via Timeline Followback) and alcohol-related problems (Short Inventory of Problems). Posttreatment insomnia severity was tested as a mediator of CBT-I effects on alcohol use outcomes at the 6-week follow-up. Results: The study cohort included 67 veterans with a mean (SD) age of 46.3 years (11.8); 61 (91%) were male and 6 (9%) female. The CBT-I group included 32 participants, and the sleep hygiene control group 35 participants. Of those randomized, 59 (88%) provided posttreatment or follow-up data (31 CBT-I, 28 sleep hygiene). Relative to sleep hygiene, CBT-I participants reported greater decreases in insomnia severity at posttreatment (group × time interaction: -3.70; 95% CI, -6.79 to -0.61) and follow-up (-3.34; 95% CI, -6.46 to -0.23) and greater improvements in sleep efficiency (posttreatment, 8.31; 95% CI, 1.35 to 15.26; follow-up, 18.03; 95% CI, 10.46 to 25.60). They also reported greater decreases in alcohol problems at follow-up (group × time interaction: -0.84; 95% CI, -1.66 to -0.02), and this effect was mediated by posttreatment change in insomnia severity. No group differences emerged for abstinence or heavy-drinking frequency. Conclusions and Relevance: In this randomized clinical trial, CBT-I outperformed sleep hygiene in reducing insomnia symptoms and alcohol-related problems over time but had no effect on frequency of heavy drinking. CBT-I should be considered a first-line treatment for insomnia, regardless of abstinence. Trial Registration: ClinicalTrials.gov Identifier: NCT03806491.

Applying the prototype willingness model to day-level simultaneous alcohol and cannabis use.

OBJECTIVE: The prototype willingness model (PWM) provides a framework for understanding simultaneous alcohol and cannabis use by highlighting important psychosocial (e.g., attitudes, norms) predictors of and pathways (via willingness and/or intentions) to simultaneous use. We examined both the PWM reasoned and social reaction pathways in relation to simultaneous use. METHOD: Eighty-nine young adults self-monitored alcohol, cannabis, and simultaneous use and related constructs for 30 days via daily assessments. RESULTS: Day-level simultaneous use specific attitudes, norms, perceived vulnerability, intentions, and willingness each predicted simultaneous use, while only day-level intentions and willingness predicted number of negative consequences. We observed significant indirect effects for the two social reaction pathways examined (from descriptive norms to willingness to simultaneous use; from perceived vulnerability to willingness to simultaneous use). Only direct effects were seen for the cognitions in the reasoned pathway; injunctive norms predicted simultaneous use, and attitudes predicted simultaneous use with no mediation by intentions. CONCLUSIONS: Findings support applying the PWM to event-level simultaneous use among young adults. Future work should establish if PWM day-level constructs are modifiable targets that may be utilized in intervention work focused on reducing simultaneous use and related harms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining Attitude, Norms, and Intentions as Predictors of Prospective Change in Alcohol-Induced Blackouts.

OBJECTIVE: Alcohol-induced blackouts are a marker of risk such that they are strong independent predictors of experiencing other adverse alcohol-related social and health effects. Existing work informed by the Theory of Planned Behavior suggests that several of the constructs contained within it, such as perceived norms, personal attitudes toward consumption, and drinking intentions, are reliable predictors of alcohol use, related problems, and blackout experiences. However, research to date has not examined these theoretical antecedents as predictors of change in the occurrence of alcohol-induced blackout. The current work aimed to evaluate descriptive (the rate a behavior occurs) and injunctive (the approval of a behavior) norms, attitudes toward heavy drinking, and drinking intentions as predictors of the prospective change in experiencing a blackout. METHOD: Using existing data from two samples (Sample 1: N = 431, 68% male; Sample 2: N = 479, 52% male), students mandated to complete an alcohol intervention completed surveys at baseline and 1- and 3-month follow-ups. Latent growth curve models evaluated perceived norms, positive attitude toward heavy drinking, and drinking intention as prospective predictors of the change in blackout over 3 months. RESULTS: Across both samples, descriptive and injunctive norms and drinking intentions were not significantly predictive of the change in blackout. Only attitude toward heavy drinking significantly predicted prospective change (the slope factor) in blackout in both samples. CONCLUSIONS: Given the strong association between heavy drinking attitudes and change in blackout, attitudes may represent an important and novel target for prevention and intervention efforts.

Religion and drinking: Differences between two campuses.

Levels of religiousness vary by geographic location, but studies of the relationship between religiousness and alcohol are often limited to one region. For our participants (N = 1124; 57.5% female), location was significantly associated with both religiousness and alcohol use. Active religiousness was associated with drinking outcomes. The indirect effects of location on drinks per week through active religiousness were significant. At Campus S, subjective religiousness was associated with more drinks per week, whereas active religiousness was associated with fewer drinks per week. Findings indicate active religiousness is especially relevant when exploring drinking, and location is important when exploring religiousness and alcohol use.

Enhancing distress tolerance to uplift motivation in recovery: Results from an open development trial.

Objective: This open pilot study examines the feasibility, acceptability, and qualitative outcomes of an interactive web- and text message-delivered personalized feedback intervention aimed at cultivating motivation and tolerance of distress for adults initiating outpatient buprenorphine treatment. Methods: Patients (n = 10) initiating buprenorphine within the past 8 weeks first completed a web-based intervention focused on enhancing motivation and providing psychoeducation on distress tolerance skills. Participants then received 8 weeks of daily personalized text messages that provided reminders of salient motivational factors and recommended distress tolerance-oriented coping skills. Participants completed self-report measures to assess intervention satisfaction, perceived usability, and preliminary efficacy. Additional perspectives were captured via qualitative exit interviews. Results: In total, 100% of retained participants (n = 9) engaged with the text messages throughout the entire 8-week period. Mean scores of 27 (SD = 5.05) on the Client Satisfaction Questionnaire at the end of 8-week period indicated a high degree of satisfaction with the text-based intervention. The average rating on the System Usability Scale was 65.3 at the end of the 8-week program, suggesting that the intervention was relatively easy to use. Participants also endorsed positive experiences with the intervention during qualitative interviews. Clinical improvements were observed across the intervention period. Conclusions: Preliminary findings from this pilot suggest that the content and delivery method of this combined web- and text message-based personalized feedback intervention is perceived by patients as feasible and acceptable. Leveraging digital health platforms to augment buprenorphine has potential for high scalability and impact to reduce opioid use, increase adherence/retention to treatment, and prevent future incidence of overdose. Future work will evaluate the efficacy of the intervention in a randomized clinical trial design.

Real-time and next-morning correlates of subjective alcohol consequence evaluations.

OBJECTIVE: There is considerable variation in how college student drinkers evaluate alcohol-related consequences across time and consequence type. Previous qualitative work suggested that students perceive consequences less negatively under certain circumstances (i.e., higher intoxication, when less time has passed, positive mood, after discussing with friends). The present study sought to confirm these patterns, using ecological momentary assessment (EMA) during drinking episodes paired with retrospective next-day assessments. METHOD: For 28 days, heavy-drinking college students (n = 90, 50% female) completed self-reports during drinking episodes and the next morning. Measures included alcohol use, subjective intoxication, mood, negative consequences (e.g., being aggressive) and positive consequences (e.g., new friend), and consequence-specific evaluations. RESULTS: Consistent with hypotheses, multilevel models revealed that during drinking events compared to the next morning, average evaluations of negative and positive consequences were less negative and more positive, respectively. During drinking events, neither subjective intoxication nor estimated blood alcohol concentration (eBAC) was associated with positive or negative evaluations. In morning reports, more positive mood was associated with less negative evaluations of negative consequences and more positive evaluations of positive consequences. Next-day discussion with friends was not significantly associated with consequence evaluations. CONCLUSIONS: This study is the first to assess subjective consequence evaluations in real time as well as retrospectively, for the same events. Findings continue to support the role of context (timing, mood) on subjective consequence evaluations, and suggest that ecological momentary interventions targeting alcohol consequences and related cognitions might best be delivered the morning after drinking, to capitalize on relatively more negative perceptions of one's drinking experiences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Gender, acculturation, and alcohol-related consequences among college students of color.

OBJECTIVE: The present study examined if identification with mainstream American culture (acculturation) and heritage culture (enculturation) are differentially associated with blackouts and other drinking consequences among male and female college students of color. PARTICIPANTS: Participants were college students (N = 150) who self-identified as a racial/ethnic minority and endorsed blackouts in the past year. METHODS: Regression models were used to examine gender-by-acculturation/enculturation interaction effects on alcohol-induced blackout and other alcohol-related consequences. RESULTS: While acculturation was not significantly associated with either drinking outcome, enculturation showed a significant relationship with blackout frequency. Gender moderated this relationship; greater enculturation was associated with increased blackout frequency among male but not female students. CONCLUSIONS: The present findings suggest the importance of considering the interplay between enculturation and gender in understanding alcohol use among college students of color. Men who endorse high levels of enculturation may be at an increased risk of experiencing negative drinking-related consequences.

A qualitative examination of the decision-making process of simultaneous alcohol and cannabis use: Intentions and willingness.

BACKGROUND: Alcohol and cannabis use are common among young adults and most young adults who use both substances have used them simultaneously (i.e., using both substances so their effects overlap). Because simultaneous use is associated with a greater number and severity of consequences than single substance use, research is needed to examine the decision-making process of engaging in this high-risk behavior. We conducted a qualitative examination of intentions (i.e., plans) and willingness (i.e., one's openness to engage in the behavior if an opportunity presents itself) to engage in simultaneous use from the perspective of young adults who frequently report this substance use behavior. METHODS: We recruited 36 young adults who reported simultaneous use and heavy drinking (4+/5+ drinks for women/men; 64% women, ages 18 to 25) to participate in semi-structured interviews. All interviews were double coded for thematic analysis and both novel and a priori themes were found. RESULTS: Young adults distinguished between intending to engage in simultaneous use and being willing to engage in simultaneous use. They reported that intentions and willingness varied from occasion to occasion. They also reported that context and alcohol consumption influenced their willingness to engage in simultaneous use. Peer pressure or offers increased their willingness to use cannabis while drinking and having current or next-day responsibilities decreased their willingness to engage in simultaneous use. Additionally, planned simultaneous use occasions were characterized as being special events where young adults consumed more substances, but were more likely to monitor their use than unplanned occasions. CONCLUSIONS: Intentions and willingness may be important proximal predictors of simultaneous use of alcohol and cannabis. Building off this qualitative work, quantitative research should identify which factors influence the decision-making process to engage in simultaneous use and determine when intentions and willingness are most predictive of risky simultaneous use behavior.

A qualitative examination of positive and negative consequences young adults experience from simultaneous alcohol and cannabis use.

OBJECTIVE: Alcohol and cannabis are two of the most commonly used substances among young adults, and most individuals who use both substances use them simultaneously, that is, on the same occasion such that their effects overlap. Given the high prevalence of simultaneous alcohol and cannabis use, it is important to understand the relationship between simultaneous use and consequences. This study presents a qualitative examination of positive and negative consequences of simultaneous use. METHOD: We conducted individual interviews among 36 young adults who engage in simultaneous use (23 women, 12 men, 1 trans man). Interviews included open-ended questions examining negative and positive consequences of simultaneous use and how simultaneous use differed from single substance use (alcohol only use, cannabis only use). Interviews were analyzed using applied thematic analysis. RESULTS: Young adults reported numerous negative and positive consequences of simultaneous use, many overlapping with single substance use. Yet, they also reported unique combinations of positive consequences not experienced by single substance use. Young adults discussed patterns of use that were sometimes approached intentionally (e.g., quantity of substances used, order) that influenced consequences. CONCLUSIONS: Together these findings provide further insight into young adults' simultaneous use experiences. Next steps should include quantitative exploratory research to identify and determine the frequency of specific consequences experienced during simultaneous use and examine the relationship between simultaneous use consequences and particular patterns of use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A combined web based intervention and ecological momentary intervention for reducing alcohol use among incoming first-year university students: Results from a three-arm randomised controlled trial.

BACKGROUND: The transition from high school to university is associated with increased alcohol use and harm. Web-based interventions (WBIs) and ecological momentary interventions (EMIs) are two methods that have had some success in reducing alcohol use among university students and may be particularly effective if implemented during the transition to university. The aim of the current study was to investigate the effectiveness of a combined WBI and EMI to reduce alcohol use among incoming university students. METHODS: Incoming first-year students (n = 783, in 2018 and 2019) were randomized into either a WBI + EMI, WBI-only, or an assessment-only condition. All participants completed online questionnaires before university, after their first and second semester, and reported their alcohol use fortnightly throughout their first year. Those in the WBI + EMI and WBI conditions received online feedback about their drinking (i.e., the WBI) immediately following the pre-university survey. Those in the WBI + EMI were also sent eight EMI messages to their mobile phones during Orientation Week and six EMI messages across the academic year aimed at reducing alcohol harm. RESULTS: There were no significant differences between the conditions in Orientation Week drinking, academic year drinking (both "typical" semester or fortnightly drinking), or alcohol-related harms. CONCLUSION: A WBI + EMI intervention aimed at the transition to university did not reduce university students' alcohol use. The transition, however, continues to be a period of serious harm where students drink more than any other period.

Where do heavy drinking college students experience alcohol consequences and where are they perceived to be normative?

High levels of alcohol consumption are common among college students and associated with endorsing negative alcohol-related consequences. Research suggests both drinking norms and location are strong predictors of drinking behavior in college students. Yet, normative perceptions of consequences, and whether they are location-specific, are less well-studied. We tested the hypotheses that college students who drink would have the highest levels of descriptive and injunctive norms for negative consequences, and would self-report the greatest number of negative consequences, at large gatherings/parties relative to someone's home/dorm and/or bars/clubs. Additionally, we explored whether specific acute consequences were more likely in some drinking locations versus others. Participants were 96 full-time undergraduate students who engaged in high-risk drinking. At baseline, participants reported descriptive and injunctive norms for negative consequences in three locations (home/dorm, large gathering/party, bar/club). Over a 28-day period, participants self-reported daily experiences of five alcohol-related consequences in these same locations. With repeated measures analyses of variance, we found that participants perceived their peers experienced more negative consequences and were more approving of negative consequences at large gatherings/parties and small gatherings at someone's home/dorm relative to bars/clubs. Likewise, nonparametric analyses demonstrated that the total number of consequences over the 28-day assessment period also differed by location, with participants reporting more consequences at home/dorm and large gathering/party locations than at bars/clubs. Future research is needed to better understand how the impact of norms on behavior differs across drinking location, and whether location-specific intervention content (e.g., normative correction) would be useful.