The Interaction of Cannabis Consumption with Heavy Episodic Drinking and Alcohol-induced Blackouts in Relation to Cannabis Use Consequences Among Recent Undergraduate College Cannabis Users.

Introduction: Risky alcohol use patterns, characterized by heavy episodic drinking (HED) and alcohol-induced blackout, are prevalent in college students. However, it is not clear if experiencing HED and blackout among college-attending cannabis users heightens risk for adverse cannabis use consequences. The purpose of this study was to examine whether heavy episodic drinking and blackout episodes moderate the relationship between cannabis consumption and cannabis use consequences among college students. Methods: Undergraduate college students (n = 4331) were recruited from a Midwest University in 2021. This analysis used a subset of data from past 6-month cannabis users (n= 772; 17.8% of the full sample). Among cannabis users, 64.5% identified as female and 87.8% were White with an average age of 19.99 (SD=2.88). A linear regression was conducted with two two-way interactions of cannabis consumption and HED frequency as well as cannabis consumption and alcohol-induced blackout episodes. Results: Results showed a statistically significant positive association between cannabis consumption and cannabis use consequences (B=0.73, p<.001), adjusting for the other variables in the model. Blackout, but not HED, was a significant moderator (B=0.19, p=.003). Discussion: The findings of this study indicate that blackout experiences amplify the relationship between cannabis use and cannabis-related consequences among college students. This underscores that blackouts not only signal a risk of problematic drinking but also exacerbate the association between cannabis use and its negative consequences. Conclusion: Findings may inform college campus interventions targeting cannabis and alcohol concurrent-users who experience alcohol-induced blackouts to reduce their additional risk for cannabis-related consequences.

Alcohol's Role in Sexual Decision Making in First-Year College Women: An Event-Level Assessment.

Sexual decision making is often grounded in social scripts that can be detrimental to women's healthy relationship and sexual development during the transition to college. Little is known about the malleable decision-making processes and drinking behaviors that influence sexual behaviors from day-to-day. We examined whether women were more likely to engage in sexual behaviors on days they had higher intentions and willingness to engage in sex or drink alcohol. We also explored interactions between sex- and alcohol-related decision constructs. Eighty-two first-year college women completed 14-days of ecological momentary assessment, reporting on alcohol- and sex-related intentions and willingness (3x daily) and daily drinking and sexual behaviors. We found partial support for our hypotheses: intentions and willingness to have sex were positively associated with sex behaviors, but willingness to drink was negatively associated with sex behaviors. Heavy drinking was associated with sexual behavior, even when women indicated no prior willingness to engage in sexual behavior on those days. Findings highlight the need to address event-level variability in sexual decision making, with a particular focus on how alcohol impacts these processes. Further, the robust association between sexual intentions and behavior suggests intention setting may be a particularly useful sexual empowerment education tool.

Associations among sexual assault history, alcohol use, blackouts, and blackout intentions among college women.

Background: Links between alcohol-induced blackouts and sexual assault (SA) are understudied. We tested whether: (1) history of blackouts, past 30-day blackouts, and past 30-day blackout intentions would be higher among women with histories of SA relative to women without; (2) baseline history of blackouts, past 30-day blackouts, and blackout intentions would predict an increase in SA severity (i.e., a continuous variable that considers SA tactic type and assault frequency) at a one-year follow-up. Methods: 1721 undergraduate women completed a baseline survey and 313 completed the follow-up. Results: Women with SA history had 2.10 higher odds of history of blackouts, 1.47 higher odds of past 30-day blackout during "one" drinking episode, 1.78 higher odds of blackout during a "few" drinking episodes, 3.21 higher odds of blackout during "most/all" drinking episodes, and 1.54 higher odds of blackout intentions in the last 30-days. Longitudinally, history of blackouts and past 30-day blackouts at baseline were associated with an increase in SA severity at follow-up, when peak drinks were not controlled. Conclusion: Longitudinal findings provide some evidence that lifetime history of blackouts and past 30-day blackouts are significant predictors of an increase in SA severity at follow-up and therefore an essential target for interventions.

Tracking Changes in the Endorsement of Injunctive Drinking Norms in Response to the COVID-19 Pandemic Using Longitudinal Alignment Analysis.

The onset of the pandemic saw shifts in messaging around the acceptability of alcohol consumption at different times and contexts. A psychometric analysis of responses to injunctive norms may reveal important differences in specific aspects of norms that were influenced by the pandemic. Study 1 used alignment analysis to evaluate measurement invariance in low- and high-risk injunctive norms across samples of Midwestern college students from 2019 to 2021. Study 2 used an alignment-within-confirmatory factor analysis (CFA) approach to replicate the solution from Study 1 in an independent longitudinal sample (N = 1,148) who responded between 2019 and 2021. For Study 1, the latent mean for high-risk norms was significantly higher in 2021, and the endorsement of four specific norms also differed. In Study 2, increases in latent means for low- and high-risk norms were observed across 2020 and 2021, and differential endorsement emerged for one high-risk norm item. Examining scale-level changes in injunctive drinking norms provides insight into how college students' perceptions changed in response to the COVID-19 pandemic.

Do you 'like' problems? The linkage between college students' interactions with alcohol-related content on social media and their alcohol-related problems.

INTRODUCTION: Alcohol-related content (ARC) on social media and drinking motives impact college students' drinking. Most studies have examined peer-generated ARC on drinking outcomes but have yet to extend this relationship to other sources of influence. The current study explores the link between drinking motives, alcohol company ARC, celebrity ARC, and alcohol-related problems among college students. METHODS: Students (N = 454) from two US universities completed a cross-sectional online survey assessing demographics; drinking motives (Drinking Motives Questionnaire-Revised; Cooper, Psychol Assess. 1994;6:117-28); following/awareness of alcohol company ARC; engagement with celebrity ARC; peak drinks (most drinks consumed on one occasion); and alcohol-related problems (e.g., passed out). RESULTS: Greater celebrity ARC was linked to coping, enhancement, and conformity motives, and peak drinks. Frequent engagement with celebrity ARC was associated with higher problems. Positive indirect effects were observed from celebrity ARC to problems through coping and conformity motives, and peak drinks. After having adjusted for the influence of celebrity ARC, no significant pathways were found between alcohol company ARC and any of the drinking motives, peak drinks or problems, nor were there any indirect effects between alcohol company ARC and problems. DISCUSSION AND CONCLUSIONS: Results revealed that a possible explanation for why students who engaged with celebrity ARC experience problems was due to coping and conformity motives as well as peak drinks. Interventions targeting alcohol cognitions might assess engagement with and exposure to different sources of ARC given their potential to influence problems.

Examining Alcohol-Related Blackouts and Drinking Motives Over Time Among College Women.

OBJECTIVE: Excessive alcohol consumption and its consequences among college women continues despite prevention efforts. One common consequence, alcohol-related blackouts (ARBs), are periods of alcohol-activated anterograde amnesia. The purpose of the current project is to extend the ARB and drinking motive literature by examining their relationship over time. METHOD: A sample of 424 women (88.9% White) completed online surveys assessing their ARBs and drinking motives weekly for 10 weeks. A series of hierarchical generalized linear models were estimated to examine the between-person and within-person effects of each drinking motive on repeated measures of experiencing a blackout across the time points. RESULTS: Women who report higher levels of drinking motives compared with others were more likely to report having blackout experiences. College women who reported higher levels of conformity motives did not have increased odds of experiencing a blackout. In weeks when they reported elevated levels of drinking motives, they were also more likely to experience an ARB. CONCLUSIONS: In general, college women who reported higher levels of social, coping, or enhancement motives experienced more blackouts than students who reported lower levels of these motives. Women who were underage were more likely to experience a blackout compared with women who were 21 or older. In a given week, 52.6% to 70.7% of the students consumed alcohol, and among women who drank in a given week, the prevalence of blackouts ranged from 8.5% to 14.6%. The results suggest that changes in motivational levels might provide a possible intervention point for ARBs risk.

Following social media influencers who share alcohol-related content is associated with college drinking.

INTRODUCTION: Frequent exposure to peer-shared alcohol-related content (ARC) on social media is associated with greater alcohol consumption and related consequences among undergraduates. Social media influencers also share ARC; yet, the effect of exposure to influencer-shared ARC on alcohol outcomes has not been examined. The current study examined whether following influencers who share ARC and the frequency of sharing were associated with alcohol outcomes, and associations between influencer type (e.g., actors) and alcohol outcomes. METHODS: Undergraduates (N = 528) from two universities in the United States completed an online survey assessing demographics, social media use, alcohol use and related consequences. They listed up to five influencers they followed and viewed the most content from. A series of linear regression models were conducted. RESULTS: Having a larger proportion of influencers sharing ARC was associated with greater quantity, frequency and peak drinks, but not consequences. Frequency of influencers sharing ARC was associated with greater quantity and peak drinks, but not frequency or consequences. Findings remained significant, even after controlling for peer ARC. Actor ARC, everyday person ARC and 'other' type influencer ARC were associated with several alcohol outcomes. DISCUSSION AND CONCLUSIONS: This study added to the literature by examining how following influencers who share ARC, and sharing frequency, were associated with drinking outcomes over and above exposure to peer ARC. It also examined whether ARC content from specific types of influencers was associated with alcohol outcomes. Findings highlight that the source of ARC is relevant when studying the effects of ARC exposure on college drinking.

Alcohol demand in college students: The roles of athletic involvement and gender.

College student-athletes represent a high-risk group for heavy alcohol consumption and negative alcohol-related consequences. Although college drinking correlates with access to low-cost alcohol, no study has examined demand, or the relationship between price and consumption, in student-athletes. Furthermore, the prevalence of anxiety, depression, and drinking to cope motives in student-athletes suggest athlete-specific risks of alcohol consumption that have not yet been examined in conjunction with demand. Therefore, the present study examined gender differences in alcohol demand, alcohol consumption, and anxiety and depressive symptoms in student-athletes (n = 118) and nonathletes (n = 78) at three colleges/universities. Participants completed the Alcohol Purchase Task and measures of alcohol-related behaviors and mental health. Observed demand indices including intensity (i.e., consumption at zero price), Omax (i.e., maximum expenditure), Pmax (i.e., price associated with Omax), and breakpoint-1, or BP1 (i.e., highest price of nonzero consumption) were calculated at the individual level. The rate of change in demand elasticity (i.e., decrease in consumption relative to price increases) was calculated at the group level. Overall, students reported lower alcohol consumption at higher alcohol prices, but men reported higher alcohol consumption and demand intensity than women, student-athletes reported higher Omax than nonathletes, and student-athletes reported lower depressive symptoms than nonathletes. These findings support reducing access to low-cost alcohol in college drinking environments as a harm-reduction strategy, particularly for high-risk student populations, such as men and those involved in athletics. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sexual minority status and food and alcohol disturbance among college students: The moderating role of body esteem.

Food and alcohol disturbance (FAD; restricting caloric intake before, during, or after drinking to either offset calories or to increase intoxication) is common among college students and poses a threat to students' health. In conjunction, sexual minority (SM; i.e., not exclusively heterosexual) college students may be at increased risk of engaging in alcohol misuse and disordered eating compared to their heterosexual peers due to exposure to minority stress. However, little research has examined whether engagement in FAD differs by SM status. Body esteem (BE) is an important resilience factor among SMs that may influence SM students' risk of participating in FAD. Therefore, the aim of the present study was to understand the association between SM status and FAD with additional interest in BE as a moderating factor. Participants were 459 college students who engaged in past 30-day binge drinking. Most participants identified as White (66.7 %), female (78.4 %), heterosexual (69.3 %), with a mean age of 19.60 (SD = 1.54) years. Participants completed two surveys (3 weeks apart) over the course of an academic semester. Analyses revealed a significant interaction between SM status and BE, such that SMs with lower BE (T1) reported more engagement in FAD-intoxication (T2), whereas SMs with higher BE (T1) reported less engagement in FAD-calories (T2) and FAD-intoxication (T2) than their heterosexual peers. Stressors associated with body esteem may contribute to increased FAD engagement among SM students. Consequently, BE may be an especially important target for interventions aimed at reducing FAD among SM college students.

The relationship between drunkorexia, alcohol, and blackouts among college students: An exploratory study.

College drinkers commonly report blacking out (i.e., alcohol-induced amnesia), and those who drink with the intention to blackout are at risk for harmful consequences. Drunkorexia (i.e., restriction of calories on planned drinking days) is a high-risk behavior potentially associated with blacking out. Informed by the Theory of Planned Behavior (TPB), this study explores blackout experiences and intentions to blackout association with drunkorexia. College students (n = 2335) who primarily identified as female and White participated via an online survey. Participants received a $3 coupon for completion of the study. Consistent with the literature, 40% and 60.7% of participants reported experiencing blackouts and drunkorexia, respectively, in the last year. Informed by the TPB, a structural equation model assessed whether more frequent blackout experiences (IV) were related to drunkorexia behaviors (DV1) and alcohol behaviors (DV2), and whether there was a significant indirect effect through blackout intention. The model fit the data well (CFI = .98, TLI = .95), which suggests that more frequent blackout experiences relate to more drunkorexia experiences (R2 = .04) and higher levels of alcohol consumption (R2 = .44). In addition, the relationship between blackout experiences and drunkorexia flows through intentions to blackout (i.e., a significant indirect effect). Findings are consistent with TPB, which suggests that intentions predict health behavior. Future interventions should consider modifying intentions and other possible TPB constructs to minimize high-risk alcohol consumption and drunkorexia behaviors.

International and Domestic College Students: A Comparison of Campus Sexual Assault Victimization.

Campus sexual assault (CSA) research predominately focuses on the victimization experiences of domestic college students. Therefore, there is little knowledge on, and understanding of, international student's CSA victimization experiences. The present study analyzed results from a campus climate survey conducted in 2018 at a midsized Midwestern university. Twenty-three percent of international women and 18% of international men reported being a CSA victim. A series of analyses then compared CSA victimizations in relation to international victims vs. international nonvictims and international victims vs. domestic victims. Results showed international victims vs. international nonvictims were more likely to be a sexual minority and be a member of a sorority or fraternity. Compared with domestic women, international women were more likely to report being non-victims. Compared with domestic men, international men were more likely to report being CSA victims. Results are discussed in relation to research on CSA and propose future directions of study.

Posting alcohol-related content on social media: Comparing college student posters and non-posters.

Social networking sites (SNSs) are popular among college-aged adults. The defining characteristic of SNSs is that they are a platform to electronically share content. Most students report posting alcohol-related content (ARC) on SNSs. Little is known concerning these students who consume both alcohol and ARC yet choose not to generate ARC. OBJECTIVE: The purpose of the current study was to compare key characteristics of posters and non-posters and develop a measure assessing reasons for not posting ARC. METHOD: The researchers recruited a diverse sample of 1063 college students from two universities for an online study. RESULTS: Relative to posters of ARC, non-posters tend to drink less, have fewer alcohol-related problems, and report fewer reasons for drinking. Non-posters also report viewing several positive and negative consequences of drinking on SNSs, but at lower levels than ARC posters. The Reasons Not to Post ARC Scale was correlated with common alcohol measures (drinking motives, drinking problems) and self-monitoring. The scale was not correlated with some other measures (posting and sharing alcohol-related content). CONCLUSIONS: Given the dominant echo chamber effects of ARC on SNSs, examining non-posters can provide insight into the cognitions that might prevent others from joining the ARC social media culture.

Examining alcohol-related social norms among international and domestic students in the United States.

OBJECTIVES: The purpose of the current study is to examine college student status (international vs. domestic) across alcohol social norms perception. METHODS: Undergraduates (n = 3081) were recruited for the study. Most participants were female (69.9%) and White (98.2%), with the average age of participants was 19.97 (SD = 1.61). Approximately 17.3% (n = 534) of the students were international (i.e., nonresident alien who are in the US for a bachelor's degree). It is a cross-sectional study. RESULTS: International students reported significantly lower social norms than domestic students. International students in later college years reported norms closer to domestic students. International women endorsed social norms at a higher level than international men. CONCLUSIONS: Assimilation into U.S. drinking culture may be linked with increased support of drinking norms among International students. This study shows the importance of incorporating drinking norms prevention strategy and cultural diversity awareness training to increase international students' knowledge and prevent misconceptions. International students' social norms should be examined for future drinking interventions. Interventions for college drinking should target specific events and context with short-term increase in hazardous drinking behavior but long-lasting effects.

The alcohol self-presentation model: Using thematic qualitative analysis to elucidate how college students self-present via alcohol-related social media posts.

INTRODUCTION: Posting and viewing of alcohol-related content to social media is prevalent among college students and is related to problematic drinking. However, the cognitive self-presentation and self-monitoring processes behind users' alcohol-related content posts to different platforms are largely unknown. METHODS: Through in-depth, qualitative interviews with college students (n = 15) who drink heavily and post alcohol-related content regularly, we developed the Alcohol Self-Presentation Model. RESULTS: Using a multi-step thematic analysis approach, the themes of protectiveness and acquisitiveness emerged; these themes served as the basis of our model. In total, three protectiveness (perceived permanence of the content, privacy and reputation concerns) factors and four acquisitiveness (provocative, impulsive, high-status, maintaining relevance and connections) factors were derived. DISCUSSION AND CONCLUSIONS: Our model delineated the alcohol self-presentations which allowed participants to demonstrate disparate versions of themselves to certain social media audiences. Our results illuminated that what people identify as being alcohol-related content, and what motivates the individual to post alcohol-related content, are essential to better comprehending how their alcohol-related content uniquely contributes to their drinking. Understanding students' alcohol self-presentations is important since their alcohol-related content may be putting themselves, and others, at-risk by perpetuating patterns of frequent posting and heavy drinking within the network. Our model may inform future behavioural interventions targeting the reduction of drinking among young people who are active on social media.

Intuitive Eating and Biomarkers Related to Cardiovascular Disease in Older Adults.

OBJECTIVE: Examine whether exercise and diet motivation are associated with 4 biomarkers related to cardiovascular disease. DESIGN: Cross-sectional analysis. Data collection involved questionnaires, blood draws, body composition assessments, and accelerometry. SETTING: Small, midwestern college town. PARTICIPANTS: Community older adults (≥ 58 years of age; n = 79) recruited through convenience sampling; the sample was representative of the population of interest for some demographic characteristics (eg, age and sex) but not representative of other characteristics (eg, level of activity). VARIABLES MEASURED: Independent variables comprised self-reported intrinsic exercise motivation (Behavioral Regulation for Exercise Questionnaire-3) and intuitive eating (Intuitive Eating Scale-2). Dependent variables included inflammatory proteins (C-reactive protein and interleukin-6) and lipid levels (low-density lipoprotein/high-density lipoprotein and triglycerides) quantified from blood samples. Covariates included age, body mass index, sex, and objective physical activity measured by accelerometers worn for 7 days. ANALYSIS: Multiple linear regression was used to assess the association between diet and exercise motivation and biomarker outcomes; we analyzed 4 regression models (1 for each biomarker). Significance level P < 0.05. RESULTS: Greater intuitive eating was associated with a lower low-density lipoprotein/high-density lipoprotein ratio (ß = -0.45, P = 0.001) and lower triglycerides (ß = -0.37, P = 0.003). Intrinsic exercise motivation was not associated with the biomarkers. CONCLUSIONS AND IMPLICATIONS: Intuitive eating may be a key determinant of certain biomarkers and could be a viable target for interventions to help decrease the risk of cardiovascular disease among older adults.

Likelihood of Posting Alcohol-Related Content on Social Networking Sites - Measurement Development and Initial Validation.

Background: The vast majority of adolescents and young adults are active on social networking sites (SNSs). SNSs are influential, risk-conducive environments for alcohol use among adolescents and young adults. Specifically, posting or sharing alcohol-related content (ARC) is associated with higher levels of alcohol use. However, it is unknown if sharing different types of ARC associates differentially with alcohol use and consequences. Objective: The goal of the current project was to develop a measure of the likelihood of posting key types of ARC posted by adolescents and young adults and to examine their associations with SNS use patterns and actual alcohol-related behavior. Method: Participants were 15-20 years of age (n = 306; 46.7% male; 56.6% Caucasian/White; 27.0% Asian) who completed a battery of self-report measures. Results: Results from an exploratory factor analysis revealed four types of ARC: (1) self and friend consumption, (2) memes and viral photos, (3) status updates: others' drinking and consequences, and (4) pictures: others' drinking and consequences. Conclusions: Participants' likelihood of posting self and Friend Consumption was significantly associated with heightened Snapchat use, typical drinks per week, peak drinking, and negative drinking consequences. Whereas youth appear to share more readily alcohol-related viral posts and memes, it seems that the sharing of ARC that is specifically related to the participants' own use or friends' use is salient concerning alcohol use and problems. Therefore, interventions might consider sending targeted prevention messages to individuals who share certain types of ARC which are more associated with problematic alcohol behaviors.

Drunkorexia and trait mindfulness among college students.

Objective: Combined alcohol and disordered eating (drunkorexia) are alcohol fueled weight management behaviors. Mindfulness negatively relates to both disordered eating and alcohol use. Participants: Participants (n = 344, average age 20) were primarily female (85.2%, n = 293), and Caucasian (82.6%, n = 284). Methods: Students reported drunkorexia and mindfulness. Results: Drunkorexia behaviors were negatively correlated with Acting with Awareness (AA; full attention to a present moment; r = -.21, p < .001) and Nonjudgment (NJ; understanding and leniency toward oneself; r = -.22, p < .001). Drunkorexia motivations are significantly correlated with AA (r = -.13, p = .01) and NJ (r = -.18, p = .001). Structural equation modeling revealed higher levels of NJ related to higher levels of drunkorexia. Conclusion: The objective was to determine a potential relationship between drunkorexia behaviors and motivations, and trait mindfulness. Findings suggest a nonjudgmental disposition relates to lower levels of drunkorexia.

The Relationship Between Sexual Assault, Intimate Partner Violence, and Eating Disorder Symptomatology Among College Students.

This study examined the interrelationship of intimate partner violence (IPV), sexual assault (SA), and eating disorder (ED) symptomatology among a sample of college students (n = 1,580). Students reporting a history of SA were 2.5 times more likely to screen positively for further ED assessment. A history of IPV also increased odds of having a positive ED screener. The model showed that 6% of the variance in ED symptomatology was explained by IPV and SA. Results did not differ based on gender. This study furthers our understanding of the relationship between IPV, SA, and ED to guide future prevention and treatment efforts. Specifically, the use of trauma-informed ED treatment could assist with full ED recovery and other comorbid mental health conditions.

College students' patterns of electronic nicotine delivery system use and other substance use.

Objective: Electronic nicotine delivery system (ENDS) use on college campuses increased dramatically in recent years. Little is known about how ENDS use among college students relates to other substance use. Participants: Undergraduates (n = 3,917) at a mid-sized Midwestern public university in the United States. Methods: Cross-sectional survey data and latent class analysis of ENDS, cigarettes, alcohol, marijuana, and non-medical use of attention-deficit/hyperactivity disorder (ADHD) medication. Results: Over 95% of ENDS users fit into one of two classes comprising a minority of college students engaged in multiple and often problematic substance use behaviors. Only 4% of ENDS users were grouped into a class comprising 85% of the sample and characterized by either little/no substance use or moderate alcohol consumption. Conclusions: ENDS use in this sample was not indicative of general exploration with substances, nor was it indicative of isolated tobacco use, but rather more heavy and problematic substance use.

When are alcohol-related blackout Tweets written in the United States?

BACKGROUND: Alcohol use varies throughout the year and often peaks on weekends or during celebrations (e.g., New Year's). There is not a perfect correlation between alcohol use and negative consequences, and the extent to which one particularly risky consequence-an alcohol-related blackout-is more common during certain times of the year is unknown. Identifying when blackouts occur may help identify which periods are associated with more risk and be critical in designing public health campaigns. Thus, we examined Twitter data to ascertain whether alcohol-related blackouts occur more during certain holidays/celebrations than typical weekends and whether they differed in timing from general alcohol-related Tweets. METHODS: We used a Twitter-sponsored platform to access unique Tweets written in the United States referencing blackouts (e.g., "blackout") and alcohol generally (e.g., "drunk"). RESULTS: The final dataset included 3.5 million blackout Tweets and 591 million alcohol Tweets (written between 2009 and 2020). Both blackout and alcohol Tweets were written in the late evening, on weekends, and during certain holidays (New Years, St. Patrick's). However, relative to typical weekends, only blackout Tweets were more common during Thanksgiving and only general alcohol-related Tweets were more common during Cinco de Mayo. CONCLUSION: While blackout and alcohol-related Tweets were similar in time of day (peaking in the evening) and day of week (peaking on weekends), they differed during certain celebrations/holidays, suggesting that while alcohol use may be more common during some celebrations, others are more associated with serious harms.