A confirmatory factor analysis of a revised motives for playing drinking games (MPDG-33) scale among university students in the United States.

AIM: Participating in a drinking game (DG) is common practice among university students and can increase students' risk for heavy drinking. Given the theoretical link between motivations to drink and alcohol use, careful consideration should be given to students' motivations to play DGs. In this study, we examined the factor structure, internal consistency, and concurrent validity of a revised version of the motives for playing drinking games (MPDG) scale, the MPDG-33. METHODS: University students (n = 3345, Mage = 19.77 years, SDage = 1.53; 68.8% = women; 59.6% = White) from 12 U.S. universities completed a confidential online self-report survey that included the MPDG-33 and questions regarding their frequency of DG participation and typical drink consumption while playing DGs. RESULTS: Confirmatory factor analysis indicated the 7-factor model fit the data adequately, and all items had statistically significant factor loadings on their predicted factor. All subscales had adequate to excellent internal consistency and were positively correlated with the frequency of DG participation and the typical number of drinks consumed while playing DGs (though the correlations were small). CONCLUSION: Findings suggest that the MPDG-33 can be reliably used in research and clinical settings to assess U.S. university students' motives for playing DGs.

Increasing access to mental health supports for 12-17-year-old Indigenous youth with the JoyPop mobile mental health app: study protocol for a randomized controlled trial.

BACKGROUND: Indigenous youth in Northwestern Ontario who need mental health supports experience longer waits than non-Indigenous youth within the region and when compared to youth in urban areas. Limited access and extended waits can exacerbate symptoms, prolong distress, and increase risk for adverse outcomes. Innovative approaches are urgently needed to provide support for Indigenous youth in Northwestern Ontario. Using a randomized controlled trial design, the primary objective of this study is to determine the effectiveness of the JoyPop app compared to usual practice (UP; monitoring) in improving emotion regulation among Indigenous youth (12-17 years) who are awaiting mental health services. The secondary objectives are to (1) assess change in mental health difficulties and treatment readiness between youth in each condition to better understand the app's broader impact as a waitlist tool and (2) conduct an economic analysis to determine whether receiving the app while waiting for mental health services reduces other health service use and associated costs. METHODS: A pragmatic, parallel arm randomized controlled superiority trial will be used. Participants will be randomly allocated in a 1:1 ratio to the control (UP) or intervention (UP + JoyPop) condition. Stratified block randomization will be used to randomly assign participants to each condition. All participants will be monitored through existing waitlist practices, which involve regular phone calls to check in and assess functioning. Participants in the intervention condition will receive access to the JoyPop app for 4 weeks and will be asked to use it at least twice daily. All participants will be asked to complete outcome measures at baseline, after 2 weeks, and after 4 weeks. DISCUSSION: This trial will evaluate the effectiveness of the JoyPop app as a tool to support Indigenous youth waiting for mental health services. Should findings show that using the JoyPop app is beneficial, there may be support from partners and other organizations to integrate it into usual care pathways. TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT05898516 [registered on June 1, 2023].

Clarifying the pathway from anxiety sensitivity to binge eating: The mediating role of depressive symptoms in a 3-week, 3-wave longitudinal study of undergraduates.

Anxiety sensitivity (AS) - characterized by a persistent fear that arousal-related bodily sensations will lead to serious cognitive, physical, and/or social consequences - is associated with various psychopathologies, including depressive symptoms and binge eating. This 3-week, 3-wave longitudinal study examined the relation between AS (including its global AS factor and lower-order AS cognitive, physical, and social concern dimensions), depressive symptoms, and binge eating among 410 undergraduates from two universities. Using generalized estimating equation models, we found that global AS, AS social concerns, and depressive symptoms predicted binge eating during any given week. Mediation analyses showed that global AS (as a latent variable with its lower-order AS dimensions as indicators), AS cognitive concerns, and AS physical concerns at Wave 1 predicted subsequent increases in depressive symptoms at Wave 2, which, in turn, led to increases in binge eating at Wave 3. Findings contribute to a better understanding of the interplay between AS, depressive symptoms, and binge eating, highlighting the role of binge eating as a potential coping mechanism for individuals with high AS, particularly in managing depressive symptoms. This study underscores the importance of AS-targeted intervention and prevention efforts in addressing depressive symptoms and binge eating.

Comparing Drinking Game Motives, Behaviors, and Consequences Among Varsity Athletes, Recreational Athletes, and Non-Student-Athletes: A Multisite University Study.

OBJECTIVE: Among college students, student-athletes are at increased risk for heavy alcohol consumption, participation in risky drinking practices (e.g., playing drinking games [DG]), and adverse alcohol-related consequences relative to non-student-athletes. Within the student-athlete population, level of sports participation (e.g., recreational or varsity sports) can affect alcohol use behaviors and consequences, but our understanding of the extent to which level of sports participation influences engagement in DG is limited. Thus, in the present study, we examined differences in frequency of participation in DG, typical drink consumption while playing DG, negative DG consequences, and motives for playing DG among varsity, recreational, and non-student-athletes. METHOD: College students (n = 7,901 across 12 U.S. colleges/universities) completed questionnaires on alcohol use attitudes, behaviors, and consequences. RESULTS: Student-athletes (recreational or varsity sports) were more likely to have participated in DG within the past month than non-student-athletes. Among students who reported past-month DG play, recreational athletes played more often and endorsed more enhancement/thrills motives for playing DG than non-student-athletes, and student-athletes (recreational or varsity) endorsed higher levels of competition motives for playing DG than non-student-athletes. CONCLUSIONS: These findings shed light on some risky drinking patterns and motives of recreational athletes who are often overlooked and under-resourced in health research and clinical practice. Recreational and varsity student-athletes could benefit from alcohol screening and prevention efforts, which can include provision of competitive and alcohol-free social activities and promotion of alcohol protective behavioral strategies to help reduce recreational athletes' risk for harm while playing DG.

Engaging care partners of persons living with dementia in acceptance and commitment therapy (ACT) programs: a scoping review.

OBJECTIVES: Acceptance and commitment therapy (ACT) is a relatively new type of psychotherapy effective for treating depression and anxiety amongst family care partners of persons living with dementia [PLWD]. However, care partner engagement in mental health services is low and specific guidelines for designing ACT programs for care partners of PLWD do not exist. The purpose of this scoping review was to examine patterns in care partner engagement in ACT programs to identify program factors potentially influencing engagement. METHODS: A comprehensive scoping review according to Arksey and O'Malley's framework was followed. Databases and grey literature were searched for primary studies of ACT programs with care partners of PLWD. Data were charted and synthesized. RESULTS: Ten studies met inclusion criteria and were analyzed. Amongst these, engagement was highest in three ACT programs that were delivered individually, remotely and were therapist-led or supported. Conversely, engagement was the lowest in two ACT programs that were self-directed, web-based and had minimal or no care partner-therapist interaction. Program factors perceived as influencing engagement included tailoring and personalization, mode of delivery and format, therapeutic support and connectedness, program duration and pace. CONCLUSION: Findings from this review suggest that care partners engagement may be promoted by designing ACT programs that focus on the therapeutic client-therapist relationship, are delivered remotely and individually. Future research should focus on evaluation of best implementation practices for engagement and effectiveness.

Female youth and mental health service providers' perspectives on the JoyPop™ app: a qualitative study.

Introduction: Mobile health (mHealth) apps are a promising adjunct to traditional mental health services, especially in underserviced areas. Developed to foster resilience in youth, the JoyPop™ app has a growing evidence base showing improvement in emotion regulation and mental health symptoms among youth. However, whether this novel technology will be accepted among those using or providing mental health services remains unknown. This study aimed to evaluate the JoyPop™ app's acceptance among (a) a clinical sample of youth and (b) mental health service providers. Method: A qualitative descriptive approach involving one-on-one semi-structured interviews was conducted. Interviews were guided by the Technology Acceptance Model and were analyzed using a deductive-inductive content analysis approach. Results: All youth (n = 6 females; Mage = 14.60, range 12-17) found the app easy to learn and use and expressed positive feelings towards using the app. Youth found the app useful because it facilitated accessibility to helpful coping skills (e.g., journaling to express their emotions; breathing exercises to increase calmness) and positive mental health outcomes (e.g., increased relaxation and reduced stress). All service providers (n = 7 females; Mage = 43.75, range 32-60) perceived the app to be useful and easy to use by youth within their services and expressed positive feelings about integrating the app into usual care. Service providers also highlighted various organizational factors affecting the app's acceptance. Youth and service providers raised some concerns about apps in general and provided recommendations to improve the JoyPop™ app. Discussion: Results support youth and service providers' acceptance of the JoyPop™ app and lend support for it as an adjunctive resource to traditional mental health services for youth with emotion regulation difficulties.

A national study on pregaming motives, frequency, consumption, and negative alcohol consequences among university students in the United States.

BACKGROUND: Pregaming, or drinking before going out, is a commonly practiced risky behavior. Drinking motives are well-established predictors of alcohol use and negative alcohol consequences. Given the influence of context on drinking practices, motives specific to pregaming may affect pregaming behaviors and outcomes above and beyond general drinking motives. Thus, we examined how pregaming motives are related to pregaming behaviors and negative alcohol consequences. METHODS: Using data from two national cross-sectional online studies, the current study included undergraduates who pregamed at least once in the past month (n=10,200, Mage=19.9, women=61%, white=73.6%; 119 U.S. universities). Participants completed assessments of demographics, general drinking motives, pregaming motives, pregaming frequency/consumption, and negative alcohol consequences. Data were analyzed using hierarchical linear models accounting for nesting of participants within sites. RESULTS: When controlling for demographic factors and general drinking motives, interpersonal enhancement motives and intimate pursuit motives were positively associated with pregaming frequency, pregaming consumption, and negative alcohol consequences. Situational control motives were negatively associated with pregaming consumption and negative alcohol consequences. Barriers to consumption motives were negatively associated with pregaming frequency but positively associated with negative alcohol consequences. CONCLUSIONS: Students who pregame to make the night more fun or to meet potential dating partners appear to be at particular risk for negative alcohol consequences. Motives may be modifiable, particularly via cognitive/behavioral strategies. Findings suggest that specific motives may be appropriate intervention targets when trying to reduce pregaming behaviors and negative alcohol consequences.

Investigating the Relation between Anxiety Sensitivity and Substance Use: What Are the Roles of Social Anxiety and Outcome Expectancies?

Objective: Research on the association between anxiety sensitivity (AS) and substance use is mixed, with some studies showing a positive association and others showing no association. Other relevant variables, such as social anxiety and outcome expectancies, may help us understand how and for whom AS is linked to substance use. This study tested (a) the associations between AS and alcohol use, cannabis use, and drinking games and pregaming behaviors among young adults, and (b) the mediating role of social anxiety and moderating role of outcome expectancies in these associations. Method: Participants (N = 199, 69% women) were young adults (19 to 25 years) who completed a 30-minute online self-report questionnaire on their substance use. Results: Results revealed significant negative associations between AS and drinking game and pregaming participation. AS was not directly associated with other substance use outcomes. The association between AS and hazardous cannabis use was moderated by relaxation and tension reduction expectancies, but outcome expectancies did not moderate any of the other associations between AS and substance use outcomes. Social anxiety mediated the associations between AS and hazardous cannabis use and both drinking game and pregaming participation. Conclusions: Findings highlight the complex association between AS and different substance use outcomes. Outcome expectancies and social anxiety may help explain how AS is associated with hazardous cannabis use and drinking game/pregaming participation, respectively. More effective interventions can be developed by understanding the relation between AS and substance use.

Paraprofessional delivery of online narrative exposure therapy for firefighters.

Firefighters are at increased risk for developing posttraumatic stress disorder (PTSD) and face numerous barriers to accessing mental health care. Innovative ways to increase access to evidence-based interventions are needed. This study was a case series testing the acceptability, feasibility, and preliminary effectiveness of a paraprofessional-delivered, virtual narrative exposure therapy (eNET) intervention for PTSD. Participants were 21 firefighters who met the criteria for clinical or subclinical probable PTSD and completed 10-12 sessions of eNET via videoconference. Participants completed self-report measures pre- and postintervention and at 2- and 6-month follow-ups as well as a postintervention qualitative interview. Paired samples t tests evidenced statistically significant decreases in PTSD, anxiety, and depressive symptom severity and functional impairment from pre- to postintervention, ds = 1.08-1.33, and in PTSD and anxiety symptom severity and functional impairment from preintervention to 6-month follow-up, ds = 0.69-1.10. The average PTSD symptom severity score fell from above to below the clinical cutoff for probable PTSD at postintervention and follow-ups. Qualitative interviews indicated that paraprofessionals were considered central to participants' success and experience with the intervention. No adverse events or safety concerns were raised. This study is an important step in demonstrating that appropriately trained and supervised paraprofessionals can effectively deliver eNET to firefighters with PTSD.

Exercise and Health Anxiety in Older Women: Exploring the Mediating Role of Anxiety Sensitivity.

Research shows that health anxiety significantly affects older adults' health and quality of life. Although exercise may be associated with lower health anxiety, research on older adults is limited, and the mechanism remains unknown. This study examined the association between exercise and health anxiety in older women and the mediating role of anxiety sensitivity in this association. Participants were 166 women aged 65+ years, without health problems that prevented them from exercising. Participants were recruited via Facebook advertisements. They completed an online self-report questionnaire including measures of health anxiety, physical activity, and anxiety sensitivity. The SPSS PROCESS macro was used to examine the association between exercise and health anxiety, and the role of anxiety sensitivity as a mediator. Results indicated that greater participation in exercise was associated with lower health anxiety, and anxiety sensitivity mediated the association. Findings suggest that exercise-based interventions might prevent health anxiety in older adults.

Do anxiety sensitivity cognitive concerns and/or depression symptoms independently explain sleep disturbances in a high anxiety sensitive treatment-seeking sample?

Cognitive models of insomnia posit a role for anxiety sensitivity (AS) in sleep difficulties. While sleep disturbances have been linked to AS, particularly AS cognitive concerns, prior studies have rarely accounted for the correlated construct of depression. We used pre-treatment intervention trial data from 128 high AS, treatment-seeking adults with a DSM-5 diagnosis of an anxiety, depressive, or posttraumatic stress disorder to determine whether AS cognitive concerns and/or depression are independently associated with sleep impairment domains (e.g., sleep quality, latency, daytime dysfunction). Participants provided data on AS, depressive symptoms, and sleep impairments. AS cognitive concerns (but not other AS dimensions) were correlated with four of five sleep impairment domains; depression was correlated with all five. Multiple regressions revealed four of five sleep impairment domains were predicted by depression with no independent contribution of AS cognitive concerns. In contrast, AS cognitive concerns and depression were independently associated with daytime dysfunction. Results suggest previous findings linking AS cognitive concerns to sleep impairments may have been largely secondary to the overlap of cognitive concerns with depression. Findings demonstrate the importance of incorporating depression into the cognitive model of insomnia. Both AS cognitive concerns and depression may be useful targets for reducing daytime dysfunction.

Mental health and physical activity in SCI: Is anxiety sensitivity important?

Compared to research conducted with nondisabled samples, little is known about the relation between mental health and physical activity (PA) in individuals with a spinal cord injury (SCI). Despite this population being more at risk of experiencing anxiety and depression and less likely to engage in PA, few studies have investigated other factors that may impact this association in this population such as anxiety sensitivity (AS). AS is a fear of physiological arousal sensations, and importantly has been shown to be negatively associated with PA in people without disabilities. It is unknown if the changes to how one experiences physiological sensations after a SCI impacts the relation between AS and PA. OBJECTIVE: This study investigated which forms of PA are predicted by anxiety and depression and whether AS is predictive of PA in this population. RESEARCH METHOD: 98 participants with a SCI (both paraplegia and tetraplegia) completed an online questionnaire that had measures of PA, AS, and anxiety and depression. RESULTS: It was found that symptoms of anxiety were significantly associated with mild-intensity PA. Interestingly AS was positively associated with moderate-intensity PA. CONCLUSIONS: The results of this study show that the relation between mental health and PA in this sample may not mirror what has been found in people without disabilities. More research is needed to replicate these findings as well as to investigate other potential mechanisms that may be relevant for people with a SCI. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Anxiety Sensitivity in the Sexual Context: Links between Sexual Anxiety Sensitivity and Sexual Well-Being.

Anxiety sensitivity, the fear of physiological arousal sensations, has been linked to lower sexual frequency, poorer sexual function, and greater sexual anxiety. The current study assessed whether anxiety sensitivity specific to the sexual context, termed sexual anxiety sensitivity, was linked to a wide range of indicators of sexual well-being over and above associations accounted for by general anxiety sensitivity. As a first step, we developed the Sexual Anxiety Sensitivity Inventory (SASI). Participants were 484 adults aged 19 to 60 years old who completed an on-line survey. To develop the SASI, we constructed parallel items to those on the Anxiety Sensitivity Scale-3 (ASI-3; Taylor et al., 2007). The SASI demonstrated the same three-factor structure as the ASI-3 and showed high internal consistency providing evidence for its reliability. As predicted, sexual anxiety sensitivity was significantly associated with all ten of the markers of the behavioral, cognitive-affective, and functional domains of sexual well-being assessed and six of these associations remained significant after controlling for general anxiety sensitivity. The results provide evidence that sexual anxiety sensitivity is an important construct for understanding individuals' sexual well-being and provide initial evidence that the specificity of the SASI has value as a reliable and valid measure for assessing sex-related anxiety sensitivity. Implications for clinicians and researchers are discussed.

Investigating pathways from anxiety sensitivity to impairment in a treatment-seeking sample.

BACKGROUND: Previous research suggests that high anxiety sensitivity (AS) - a fear of arousal-related body sensations - may have implications not only for mental health symptoms but also for functional impairment. The aim of the present study was to examine whether elevated AS is associated with functional impairment by way of heightened anxiety symptoms and resultant depressive symptoms or unhealthy coping behaviours (i.e., alcohol use, exercise avoidance, sleep problems) in a chained mediation model. METHOD: Participants were 128 treatment-seeking individuals with high AS who qualified for an anxiety, depression, or posttraumatic stress disorder diagnosis. They completed self-report measures of AS, anxiety, depression, and unhealthy coping behaviours as part of a pre-treatment assessment battery for a larger study examining the efficacy of a cognitive behavioural intervention for AS. Data were analyzed using path analysis. RESULTS: Results revealed a direct association between AS and functional impairment that was partially mediated through a chained indirect pathway from AS to anxiety symptoms to depression symptoms to functional impairment. Unhealthy coping behaviours did not serve as mediators. LIMITATIONS: Results are limited by the cross-sectional nature of the data. CONCLUSIONS: The present findings have clinical implications insofar as supporting the relevance of reducing AS and focusing on depressive symptoms when seeking to improve clients' functioning.

Racial, ethnic, and sex differences in heavy drinking and negative alcohol-related consequences in a national sample of NCAA student-athlete drinkers.

Objective: Athletic involvement is linked to increased risk for heavy alcohol use among college students. We examined whether student-athletes from diverse racial/ethnic backgrounds differ with respect to heavy drinking and related consequences. Method: Participants were 15,135 student-athlete drinkers (50.7% female) from 170 NCAA member institutions who participated in an online study. Results: Findings from our hierarchical linear models indicated that being a male student-athlete was associated with an increased likelihood of high intensity drinking (10/8 + drinks/per sitting for males/females) for White, Asian American/Pacific Islander, and Black student-athletes, but not for Hispanic student-athletes. Additionally, being a female student-athlete was associated with higher levels of negative alcohol-related consequences across all racial/ethnic groups. Finally, at similar drink quantities, compared to being a White student-athlete, being an Asian American/Pacific Islander student-athlete was associated with higher levels of alcohol-related consequences. Conclusions: Student-athlete drinkers are not homogeneous with respect to heavy drinking and related consequences.

A National Study on Drinking Game Behaviors and Related Consequences Among NCAA Student-Athletes: Racial/Ethnic and Sex Differences.

OBJECTIVE: Research indicates that college student-athletes report more alcohol use and negative drinking consequences than non-student-athletes. One drinking practice that has been linked to heavy alcohol use and related consequences is playing drinking games. In the present study, we investigated which segment of the student-athlete population is most at risk for frequent drinking game participation, elevated alcohol consumption while playing drinking games, and negative drinking game consequences. We examined sex and racial/ethnic differences in behaviors and consequences associated with drinking games in a national sample of White, Hispanic, Black, and Asian American/Pacific Islander (AAPI) student-athletes. METHOD: A total of 11,839 student-athletes (51.4% women) from 165 National Collegiate Athletic Association (NCAA) member institutions who endorsed lifetime participation in drinking games completed a confidential online survey. RESULTS: Hierarchical linear modeling revealed that being a White (vs. Black or Hispanic) student-athlete was associated with more frequent drinking game participation, and among AAPI and Black (but not White or Hispanic) student-athletes, men played drinking games more frequently than women. Being a Black (vs. White) student-athlete was associated with more drinking game consumption; no sex differences in drinking game consumption were found among Black student-athletes. Among White, AAPI, and Hispanic student-athletes, being a male student-athlete was associated with more drinking game consumption. Finally, female student-athletes had a higher likelihood of experiencing one or more negative consequences from drinking games than did male student-athletes. The association between drinking game participation and negative drinking game consequences was also stronger for women compared with men. CONCLUSIONS: Student-athletes are heterogeneous with regard to drinking game behaviors and related consequences. Knowing who is at greatest risk for drinking game participation and related outcomes is an important first step in developing targeted intervention approaches for student-athletes.

Do anxiety sensitivity and impulsivity interact in predicting exercise involvement in emerging adult drinkers and cannabis users?

Anxiety sensitivity (AS; i.e. fear of arousal-related sensations) and impulsivity (i.e. tendency to act quickly without regard for longer-term consequences) represent risks for low physical activity participation. Theoretically, higher impulsivity may exacerbate the negative exercise behaviours of high AS individuals given the tendency of impulsive individuals to favour immediate (e.g. watching TV) over delayed rewards (e.g. the benefits of exercise). Our goal was to investigate the main and interactive effects of AS and impulsivity on physical activity levels at varying exercise intensities. Participants were 178 emerging adults (Mean age = 21.9; 68.8% women). Higher AS was associated with less engagement in vigorous intensity exercise. Moderator analyses revealed an AS x impulsivity interaction: high AS predicted significantly less engagement in moderate intensity exercise at low impulsivity levels and marginally more engagement in moderate intensity exercise at high impulsivity levels. Finally, higher impulsivity was associated with more time spent walking. Cognitive behavioural therapy for high AS, or teaching individuals with high AS to focus on immediate, external rewards of exercise, may help them engage in more physical activity. Given the wide-ranging physical and mental health benefits of exercise involvement, developing effective strategies to increase such involvement in high AS individuals is vital.

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.

Dimensions of Athletic Identity and their Associations with Drinking Behaviors among a National Sample of University Athletes in the United States.

Although prior studies have indicated athletic identity plays a role in alcohol use among college athletes, this research has largely drawn on a unidimensional conceptualization. Addressing this gap, the current study utilized a sample of 8,550 university athletes (Mage = 19.70 years, SD = 1.33, 50.8% men) from 203 U.S. post-secondary institutions to examine the associations between athletic identity dimensions (i.e., social identification, negative affectivity, and exclusivity) and alcohol use for athletes across gender, sport type, and division. The results indicated that negative affectivity and social identification were associated with higher levels of alcohol use, whereas exclusivity was associated with lower levels of alcohol use. Further, the association between dimensions of athletic identity and alcohol use varied across competitive level (i.e., Division I, II, and III). The findings implicate the need for (a) future research to approach athletic identity as a multidimensional concept when examining its association with alcohol use outcomes, and (b) post-secondary alcohol prevention professionals to integrate dimensions of athletic identity in alcohol prevention approaches.