Is the deliberate self-induction of alcohol tolerance associated with negative alcohol outcomes?

Research indicates 10% of college student drinkers report deliberately training to increase alcohol tolerance (a diagnostic criterion for alcohol use disorder) to avoid passing out early or to keep up with peers. Given that tolerance training may be considered a harm reduction technique designed to reduce acute aversive consequences, we examined the associations between tolerance training and the use of protective behavioral strategies (PBS) more generally. A cross-sectional survey of 1080 lifetime drinkers was conducted at a large Midwestern university. Of this sample, 5.6% (n=60) reported training to increase their tolerance. Drinkers who endorsed having trained to increase tolerance reported notably more alcohol-related problems than those who reported never training (Madj=51.80 versus Madj=39.30; p<0.0001). Further, participants who endorsed tolerance training reported utilizing significantly fewer PBS (e.g., avoid drinking games) on the Protective Behavioral Strategies Scale (PBSS, Martens et al., 2005) than participants who had never trained (Madj=16.89 versus Madj=18.90; p<0.01). An exception was that drinkers who trained to avoid passing out early used significantly more PBS (e.g., using a designated driver, knowing where your drink is at all times). Despite this, these trainers consumed more alcohol and experienced more alcohol-related harms. The present findings support previous research demonstrating that trainers consume more alcohol than non-trainers, and provide further evidence that deliberately training to increase tolerance is indicative of problematic drinking behavior. Prevention efforts might aim to inform drinkers of the problems associated with deliberately inducing alcohol tolerance, and focus on developing alternative strategies for minimizing acute harm from drinking.

A confirmatory factor analysis of the Protective Behavioral Strategies Scale among OEF/OIF veterans.

INTRODUCTION: Military veterans of the wars in Afghanistan and Iraq (OEF/OIF/OND) are at-risk for increased alcohol consumption and alcohol-related consequences. The Protective Behavioral Strategies Scale (PBSS) has been shown to be a reliable and valid measure of assessing strategies to facilitate more responsible drinking and to reduce alcohol-related harm among college student populations. The purpose of this study was to examine the psychometric properties of the PBSS among the OEF/OIF veteran population. METHOD: Participants were 251 veterans (94% male; 83% White; M age=31.77years) who were participating in a larger alcohol intervention trial and reported consuming alcohol within the past 30days. RESULTS: Confirmatory Factor Analyses indicated the model fit of the PBSS was similar to college student samples. Although a confirmatory three-factor model best fits the data, model fit indices were slightly below commonly accepted guidelines. All PBSS subscales were negatively correlated with alcohol outcomes. Greater use of Manner of Drinking (MOD) and Stopping/Limiting Drinking (SLD) strategies were associated with less alcohol consumption and lower peak BAC. Greater use of MOD strategies was associated with less alcohol-related problems. CONCLUSIONS: Findings provide initial support for use of the PBSS among OEF/OIF veterans. Strategies aimed at Stopping/Limiting Drinking and the Manner of Drinking may be more effective with a veteran sample. Additional studies examining the external validity of this measure are encouraged.

Personalized drinking feedback: A meta-analysis of in-person versus computer-delivered interventions.

OBJECTIVE: Alcohol misuse is a significant public health concern. Personalized feedback interventions (PFIs) involve the use of personalized information about one's drinking behaviors and can be delivered in person or via computer. The relative efficacy of these delivery methods remains an unanswered question. The primary aim of the current meta-analysis was to identify and directly compare randomized clinical trials of in-person PFIs and computer-delivered PFIs. METHOD: A total of 14 intervention comparisons from 13 manuscripts, of which 9 were college samples, were examined: in-person PFIs (N = 1,240; 49% female; 74% White) and computer-delivered PFIs (N = 1,201; 53% female; 73% White). Independent coders rated sample characteristics, study information, study design, intervention content, and study outcomes. RESULTS: Weighted mean effect sizes were calculated using random-effects models. At short follow-up (≤4 months), there were no differences between in-person PFIs and computer-delivered PFIs on any alcohol use variable or alcohol-related problems. At long follow-up (>4 months), in-person PFIs were more effective than computer-delivered PFIs at impacting overall drinking quantity (d = .18) and drinks per week (d = .19). These effects were not moderated by sample characteristics. CONCLUSIONS: For assessing alcohol outcomes at shorter follow-ups, there were no differences between delivery modality. At longer follow-ups, in-person PFIs demonstrated some advantages over computer-delivered PFIs. We encourage researchers to continue to examine direct comparisons between these delivery modalities and to further examine the efficacy of in-person PFIs at longer follow-ups. (PsycINFO Database Record

A computer-based feedback only intervention with and without a moderation skills component.

Research on the efficacy of computer-delivered feedback-only interventions (FOIs) for college alcohol misuse has been mixed. Limitations to these FOIs include participant engagement and variation in the use of a moderation skills component. The current investigation sought to address these limitations using a novel computer-delivered FOI, the Drinkers Assessment and Feedback Tool for College Students (DrAFT-CS). Heavy drinking college students (N=176) were randomly assigned to DrAFT-CS, DrAFT-CS plus moderation skills (DrAFT-CS+), moderation skills only (MSO), or assessment only (AO) group, and were assessed at 1-month follow-up (N=157). Participants in the DrAFT-CS and DrAFT-CS+groups reported significantly lower estimated blood alcohol concentrations (eBACs) on typical heaviest drinking day than participants in the AO group. The data also supported the incorporation of a moderation skills component within FOIs, such that participants in DrAFT-CS+group reported significantly fewer drinks per week and drinks per heaviest drinking occasion than participants in the AO group.

Sport-related achievement motivation and alcohol outcomes: an athlete-specific risk factor among intercollegiate athletes.

Intercollegiate athletes report greater alcohol consumption and more alcohol-related problems than their non-athlete peers. Although college athletes share many of the same problems faced by non-athletes, there are some consequences that are unique to athletes. Studies have demonstrated that alcohol negatively affects athletic performance including increased dehydration, impeded muscle recovery, and increased risk for injury. Beyond risk factors for alcohol misuse that may affect college students in general, research has begun to examine risk factors that are unique to collegiate athletes. For example, research has found that off-season status, the leadership role, and athlete-specific drinking motives are associated with increased alcohol use. Given these findings, it is possible that other athlete-specific variables influence alcohol misuse. One such variable may be sport achievement orientation. The purpose of the current study was to examine the relationship between sport achievement orientation and alcohol outcomes. Given previous research regarding seasonal status and gender, these variables were examined as moderators. Varsity athletes (n=263) completed the Sport Orientation Questionnaire, which assesses sport-related achievement orientation on three scales (Competitiveness, Win Orientation, and Goal Orientation). In addition, participants completed measures of alcohol use and alcohol-related problems. Results indicated that Competitiveness, Win Orientation, and Goal Orientation were all significantly associated with alcohol use, but not alcohol-related problems. Moreover, these relationships were moderated by seasonal status and gender. These interactions, clinical implications, and limitations are discussed.

Do protective behavioral strategies moderate the relationship between negative urgency and alcohol-related outcomes among intercollegiate athletes?

OBJECTIVE: The purpose of this study was to examine the moderating effect of protective behavioral strategies on the relationship between negative urgency and alcohol outcomes. METHOD: Participants were college students who endorsed participating in club/intramural or varsity athletics. The students (N = 234; 73.9% female) completed measures of negative urgency, protective behavioral strategies, alcohol use, and alcohol-related problems. Separate hierarchical multiple regression analyses were conducted for each subscale of the Protective Behavioral Strategies Scale to test for moderation. RESULTS: Results indicated that protective behavioral strategies aimed at serious harm reduction moderated the relationship between negative urgency and alcohol use, whereas strategies aimed at avoiding excessive or rapid drinking moderated the relationship between negative urgency and alcohol-related problems. Strategies that involved planning drinking activities in advance did not moderate the relationship between negative urgency and alcohol outcomes. CONCLUSIONS: The current investigation provides further evidence for the role of protective behavioral strategies against known risk factors for alcohol use and related problems. Further, the paper suggests that type of strategy used matters when attempting to mitigate the relationship between negative urgency and alcohol outcomes. Limitations and future directions are discussed.

Randomized trial comparing computer-delivered and face-to-face personalized feedback interventions for high-risk drinking among college students.

This study evaluated the efficacy of two brief personalized feedback interventions (PFIs) using identical feedback and motivational interviewing strategies aimed at reducing alcohol consumption and alcohol-related problems to two control conditions among a sample of high-risk drinking college students. Students (N = 152) were randomly assigned to a computer-delivered PFI with a video interviewer, a face-to-face PFI with a live interviewer, a comprehensive assessment condition, or a minimal assessment-only condition. At 10 weeks posttreatment, the face-to-face PFI significantly reduced weekly drinking quantity and peak and typical blood alcohol concentration compared with the comprehensive assessment and minimal assessment-only conditions (d values ranged from 0.32 to 0.61). No significant between-group differences were evidenced for the computer-delivered PFI condition, although effect sizes were comparable to other college drinking studies using computer-delivered interventions (d values ranged from 0.20 to 0.27). Results provide further support for the use of a face-to-face PFI to help reduce college students' alcohol consumption and suggest that a video interviewer in the context of a computer-delivered PFI is likely a helpful but not necessarily a complete substitute for a live interviewer.

The effect of chewing gum flavor on the negative affect associated with tobacco abstinence among dependent cigarette smokers.

Many smokers relapse during cessation attempts due to increases in negative affect. Previous research has shown that chewing confectionary chewing gum appears to lessen the severity of acute nicotine withdrawal symptoms and help individuals who are trying to reduce smoking in part due to the flavor of the gum chewed. The current study compared the effects of three flavored gums to a No Gum Control during 48-hour cessation periods for young dependent smokers. Forty-nine smokers participated in three experimental conditions (peppermint, vanilla, and baked apple cardamom flavored gum) as well as a No Gum Control across four weeks while abstaining from smoking for 48-hours each week. Compared to the No Gum Control, participants in the Gum conditions reported lower levels of anxiety, dysphoria, and tension. Vanilla and baked apple cardamom flavored gum resulted in lower levels of negative affect while peppermint flavored gum was not different from the No Gum Control. These findings indicate that some flavors of gum are effective in reducing the negative affect associated with nicotine withdrawal and may serve as a valuable tool in helping smokers quit.