Implementation of a computerized tool to address barriers to academic success among college students.

OBJECTIVE: Academic assistance professionals work with college students to address barriers to academic success, although few assessment tools exist. This feasibility study examined the results of implementing a computerized tool for academic assistance professionals to help students. The Measure of Obstacles to Succeeding Academically in College (MOSAIC) is a 31-item risk assessment tool used to characterize academic barriers. It utilizes a tailored computer algorithm on a mobile device to match students with resources to address academic barriers. METHODS: The MOSAIC was customized and administered at seven universities around the United States. Student responses were analyzed in Microsoft Excel. Academic assistance professionals were asked about implementation in unstructured interviews. RESULTS: Stress and study skill concerns were the most reported barriers. The MOSAIC was well received, especially among students experiencing academic difficulties, but integration into routine workflow was an obstacle to sustained implementation. CONCLUSIONS: The MOSAIC holds promise in addressing issues impeding academic success.

Drug and alcohol use disorders among adults with select disabilities: The national survey on drug use and health.

BACKGROUND: Deaths caused by drugs and alcohol have reached high levels in the US, and prior research shows a consistent association between disability status and substance misuse. OBJECTIVE: Using national data, this study quantifies the association between disability status and drug and alcohol use disorders among US adults. METHODS: The most recent pre-pandemic years (2018-2019) of the cross-sectional National Survey on Drug Use and Health (n = 83,439) were used to examine how the presence of any disability, and specific disabilities, were associated with past year drug and alcohol use disorders. Logistic regression was used to estimate adjusted odds ratios (aORs) controlling for potential sociodemographic confounders. RESULTS: Adults with any disability had increased odds of drug (aOR = 2.7; 95% CI = 2.5-3.0), and alcohol use disorder (aOR = 1.8; 95% CI = 1.6-2.0), compared to adults without disability. Examining specific types of disabilities, adults with cognitive limitations only had increased odds of drug (aOR = 3.1; 95% CI = 2.6-3.6), and alcohol use disorders (aOR = 2.2; 95% CI = 1.9-2.5), compared to adults without disability. Smaller associations were observed between vision and complex activity limitations and drug use disorder. Adults with two or more types of limitations had increased odds of drug (aOR = 3.7; 95% CI = 3.3-4.3), and alcohol use disorders (aOR = 2.3; 95% CI = 2.0-2.6). CONCLUSIONS: The presence of disability, especially cognitive limitation only, or two or more types of limitations, is associated with elevated odds of drug and alcohol use disorder among US adults. Additional research should examine the temporal relationship between and mechanisms linking disability and substance misuse.

Improving Campus Alcohol Policies Through Assessment and Scoring.

Excessive alcohol consumption is responsible for more than 1,500 deaths annually among college students, of whom more than one in three report having been drunk during the past 30 days. Campus alcohol policies offer a first line of defense against excessive alcohol use but have received little systematic attention in the research literature. The research team previously developed a taxonomy of campus alcohol policies and sanctions, ranked in order of effectiveness, and assessed the accessibility, clarity, and effectiveness of policies at 15 post-secondary educational institutions. Herein we describe the process of reporting those assessments back to the 15 institutions, providing them with recommendations and technical assistance on how to improve their policies, and then re-assessing school alcohol policies for effectiveness and clarity. Conversations with primary points of contact at each school provided further insight into the process of assessing and improving campus alcohol policies. Of the 15 schools assessed, 11 added more effective policies, and four added more effective consequences during the 2 years following receipt of reports on the assessment. Campuses have control over their own policies, and greater attention to them from researchers and practitioners could better maximize their potential for enhancing student health and safety and supporting student success.

In harm's way: Do college students' beliefs about cannabis put them at risk for use?

Objective: This study describes beliefs held by college students about cannabis use and examines the association between three specific cannabis beliefs and likelihood of use. Participants: 3,720 undergraduate students ages 18 to 25 attending ten colleges in one state. Methods: Data were gathered via online survey. Results: The majority (80%) of the sample was unsure or believed that cannabis was an effective way to reduce stress; 67% were unsure or believed that cannabis was not related to an increased risk for mental health problems; and 62% were unsure or believed that students who use cannabis are not more academically disengaged. Holding these beliefs, which are not supported by scientific evidence, was associated with a greater likelihood of cannabis use, even after statistically adjusting for covariates. Conclusions: These findings suggest that beliefs unsupported by scientific evidence are widespread among college students. Dispelling misinformation about cannabis might hold promise for reducing use.

Graduate student burnout: Substance use, mental health, and the moderating role of advisor satisfaction.

Substance use and mental health problems are associated with academic difficulties among high school and undergraduate students, but little research has been conducted on these relationships among graduate students. The sample consisted of 2,683 graduate students attending two large, public universities. Standard measures were used to collect data on demographic and program characteristics, mental health, substance use, advisor satisfaction, and burnout (i.e., exhaustion, cynicism, and inefficacy). Linear regression models evaluated relationships between each mental health and substance use variable with burnout, as well as the moderating role of advisor satisfaction. Students with a greater number of substance use and mental health problems had higher levels of exhaustion, cynicism, and inefficacy. No statistically significant relationships between substance use and burnout were found. High levels of stress, moderate or severe anxiety symptoms, and moderate or severe depressive symptoms were associated with increased levels of burnout. Advisor support moderated the relationships between stress and both cynicism and inefficacy such that the effects of stress on these dimensions of burnout were lower among those who were satisfied with their advisor. Graduate students with mental health problems might be at increased risk for burnout; however, having a supportive advisor might buffer this association.

Substance use and mental health problems among graduate students: Individual and program-level correlates.

OBJECTIVE: This study evaluated variation in substance use and mental health among graduate student subgroups. PARTICIPANTS: A sample of 2,683 master's and doctoral students completed an online survey in October 2017. METHODS: Subgroup variation in behavioral health by demographic and program characteristics, particularly degree type and academic discipline, was explored. RESULTS: Compared with academic doctoral students (ie, PhD students), professional doctoral students (ie, MD, JD, etc.) were significantly more likely to report high stress levels and moderate or severe anxiety symptoms. Master's students were more likely to report moderate or severe anxiety symptoms and use marijuana than academic doctoral students. Students in the behavioral and social sciences, social work, and arts and humanities disciplines were more likely to use substances and report mental health problems than engineering and business students. CONCLUSIONS: These findings highlight graduate student subgroups who might require closer attention with respect to access to behavioral health services.

Nonmedical Use of Prescription Stimulants as a "Red Flag" for Other Substance Use.

BACKGROUND: Nonmedical use of prescription stimulants (NMPS) has increased on college campuses during the past two decades. NMPS is primarily driven by academic enhancement motives, and normative misperceptions exist as well. However, large, nationwide studies have not yet been conducted to generalize findings more broadly and gain a deeper understanding of the relationship between NMPS and other substance use (e.g. alcohol use, marijuana, etc.). The present study was conducted to lay the foundation for prevention efforts related to NMPS by establishing NMPS prevalence, practices surrounding NMPS, and other substance use. METHODS: N = 2,989 students from seven universities around the U.S. completed a web-based survey assessing NMPS practices and related behaviors. Prevalence and factors associated with NMPS were explored. RESULTS: Analyses revealed a 17% past-year prevalence of NMPS with associated widespread misperceptions of peer use. NMPS was significantly related to alcohol use, binge drinking, and marijuana use, as well as skipped classes and affiliation with Greek life. CONCLUSIONS: Although most college students do not report NMPS, those who do also are more likely to report alcohol use, binge drinking, and marijuana use, and NMPS could be a "red flag" for other risk behaviors worth exploring. Implications for prevention and intervention are discussed.

Utilizing Student Health and Academic Data: A County-Level Demonstration Project.

Students with chronic health conditions miss more school days than their peers and are at increased risk for performing worse on standardized tests and not completing a high school degree. University-based researchers, state government leaders, and a local county school system collaborated to use existing health and academic data to (1) evaluate the strength of the relationship between health status and school performance (absenteeism, grades) and (2) describe the health status of students who are chronically absent. Analyses included descriptive statistics, chi-square tests, negative binomial regression models, and estimated marginal means. The most common health conditions among the 3,663 kindergarten through Grade 12 students were ADD (attention deficit disorder)/ADHD (attention deficit hyperactivity disorder), asthma, migraine headaches, mental health conditions, and eczema/psoriasis/skin disorders. After controlling for covariates, having asthma or a mental health diagnosis was positively associated with absences; and having an ADD/ADHD or mental health diagnosis was negatively associated with GPA (grade point average). Chronically absent students had significantly lower GPAs, and a higher number of health conditions than other students. The success of this demonstration project encourages strengthening existing collaborations and establishing new multidisciplinary partnerships to analyze existing data sources to learn more about the relationship between student health and academic achievement. Moreover, connecting health status to academic achievement might be a chief tactic for advocating for additional resources to improve the care and management of chronic disease conditions among students.

Stress and Burnout Among Graduate Students: Moderation by Sleep Duration and Quality.

BACKGROUND: There are high levels of stress among graduate students, and stress is associated with multiple negative outcomes among student populations, including academic burnout. Sleep could play an important role in explaining the association between stress and burnout, but these relationships have not been explored among the graduate student population. The current study assessed whether or not sleep duration and quality moderated the relationship between stress and burnout (i.e., exhaustion, cynicism, and inefficacy) among graduate students. METHODS: A sample of 2683 master's, doctoral, and professional graduate students from two large, public universities completed an online survey. Linear regression models with interaction terms were developed to evaluate the relationships between stress and burnout while examining moderation by sleep duration and quality. RESULTS: Participants slept an average of 6.4 h per night, with 62% indicating good sleep quality. Stress had significant, positive relationships with exhaustion, cynicism, and inefficacy. The relationship between stress and exhaustion lessened as sleep duration increased, and the relationship between stress and exhaustion was weaker among students with good sleep quality when compared with those with poor sleep quality. Neither sleep duration nor sleep quality moderated the relationships between stress and cynicism or stress and inefficacy. CONCLUSIONS: Improving sleep habits has the potential to lessen the negative association between stress and graduate student functioning. Future research utilizing longitudinal designs is needed to understand the temporality of these associations and the influence of possible co-factors like individual propensity for mental health problems and social support.

Behavior Problems During Early Childhood in Children With Prenatal Methamphetamine Exposure.

BACKGROUND AND OBJECTIVES: The effects of in utero methamphetamine exposure on behavioral problems in school-aged children are unclear. Our objective for this study was to evaluate behavior problems in children at aged 3, 5, and 7.5 years who were prenatally exposed to methamphetamine. METHODS: Subjects were enrolled in the Infant Development, Environment, and Lifestyle study, a longitudinal prospective study of prenatal methamphetamine exposure and child outcomes. Exposed and comparison groups were matched on birth weight, race, education, and health insurance.  At ages 3, 5, and 7.5 years, 339 children (171 exposed) were assessed for behavior problems by using the Child Behavior Checklist. Generalized estimating equations were used to determine the effects of prenatal methamphetamine exposure, age, and the interaction of exposure and age on behavior problems. Caregiver psychological symptoms were assessed by using the Brief Symptom Inventory. RESULTS: Analyses adjusted for covariates revealed that relative to age 3, children at 5 years had less externalizing and aggressive behavior and more internalizing behavior, somatic complaints, and withdrawn behavior.  By age 7.5, aggressive behavior continued to decrease, attention problems increased and withdrawn behavior decreased. There were no main effects for methamphetamine exposure and no interactions of exposure and age.  Caregiver psychological symptoms predicted all behavior problems and the quality of the home predicted externalizing problems and externalizing syndrome scores. CONCLUSIONS: Behavioral effects longitudinally from ages 3 to 7.5 years were not associated with prenatal methamphetamine exposure, whereas caregiver psychological symptoms and the quality of the home were predictors of behavior problems.

Prevalence and Correlates of Caffeine Use Disorder Symptoms Among a United States Sample.

Background: The DSM-5 recognizes caffeine use disorder as a condition for further study, but there is a need to better understand its prevalence and clinical significance among the general population. Methods: A survey was conducted among an online sample of 1006 caffeine-consuming adults using demographic quotas to reflect the U.S. population. Caffeine consumption, DSM-proposed criteria for caffeine use disorder, sleep, substance use, and psychological distress were assessed. Results: Eight percent of the sample fulfilled DSM-proposed criteria for caffeine use disorder. These individuals consumed more caffeine, were younger, and were more likely to be cigarette smokers. Fulfilling caffeine use disorder criteria was associated with caffeine-related functional impairment, poorer sleep, some substance use, as well as greater depression, anxiety, and stress. Conclusions: The prevalence of caffeine use disorder among the present sample suggests that the proposed diagnostic criteria would identify only a modest percentage of the general population, and that identified individuals experience significant caffeine-related distress.

Situational context and motives of alcohol use among graduate student drinkers.

Extensive research has examined alcohol use context and motives among undergraduates, but less is known about where, when, and why graduate students drink. The current study aimed to describe the motives and situational context of graduate student alcohol use, identify demographic and program characteristics associated with alcohol use motives and context, and assess how alcohol use motives and context are associated with alcohol use behavior. A sample of master's and doctoral-level students who drank during the past month (n = 2091; 63% female) completed an online survey. An exploratory factor analysis yielded two situational context factors: drinking in social situations (e.g., with friends, at a bar) and non-social situations (e.g., alone, at home). Graduate students most frequently endorsed social and enhancement drinking motives. Results of multivariate linear regression models showed that age, sex, race/ethnicity, and international student, marital, parental, and employment status were all associated with motives and context. Drinking for enhancement and drinking to cope were the motives most strongly associated with increased alcohol quantity and frequency, respectively. Drinking in social contexts was positively associated with alcohol quantity and frequency, and drinking in non-social contexts was positively associated with alcohol use frequency but inversely related to alcohol quantity. Graduate students who drink for enhancement reasons and in social situations might be at increased risk for higher quantity alcohol use, or graduate students who drink for coping reasons and in non-social situations might be at increased risk for more frequent alcohol use. Future longitudinal research is needed to explore whether drinking in certain contexts and with certain motivations is predictive of alcohol problems during and after graduate school.

Excessive drinking and drug use during college: Prospective associations with graduate school plans and attendance.

Objective: This study examines the prospective relationship between substance use during college and two outcomes: having definite plans to attend graduate school; and, among individuals with plans, enrolling in graduate school upon college graduation. Participants:n = 980 were originally enrolled as first-time, first-year college students in an ongoing longitudinal study (August 2004 to present). Methods: Measures from personal interviews included demographics, GPA, alcohol use, alcohol abuse/dependence, and other drug use during college. Results: Fifty-four percent had definite plans to attend graduate school, and 47% of students with definite plans enrolled in graduate school. Alcohol dependence was significantly associated with reduced likelihood of having graduate school plans. Among students with plans to attend graduate school, alcohol abuse and alcohol dependence during college were associated with decreased likelihood of enrolling in graduate school. Conclusions: Substance use during college might impact graduate school enrollment, and early intervention efforts could help students achieve their educational goals.

Child Maltreatment, Relationship with Father, Peer Substance Use, and Adolescent Marijuana Use.

This longitudinal prospective study examined the relationship between child maltreatment as per reports to child protective services (CPS) and adolescent self-reported marijuana use, and the association between relationships with mothers and fathers and use of marijuana. The association between relationships with parents early in childhood (ages 6-8 years) and during adolescence with adolescent marijuana use were also probed. Another aim examined whether relationships with parents moderated the link between child maltreatment and youth marijuana use. The sample included 702 high risk adolescents from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), a consortium of 5 studies related to maltreatment. Children were recruited at age 4 or 6 years together with their primary caregiver. Some were recruited due to their risk for child maltreatment, others were already involved with CPS, and children in one site had been placed in foster care. Logistic regression analysis was performed using youth self-report of marijuana use as the criterion variable and child maltreatment and the relationships with parents as predictor variables, controlling for youths' perceptions of peer substance use and parental monitoring, parental substance use, race/ethnicity, sex and study site. Approximately half the youth had used marijuana. Most of them described quite positive relationships with their mothers and fathers. Participant marijuana Use was associated with a poorer quality of relationship with mother during adolescence, and with peer and parental substance use. A better relationship with father, but not mother, during adolescence attenuated the connection between Child Maltreatment and youth Marijuana Use.

Risks associated with alcohol and marijuana use among college student athletes: The case for involving athletic personnel in prevention and intervention.

The purpose of this study was to describe alcohol and marijuana use patterns and related consequences among student athletes. A total of 12,510 students (n=1,233 athletes) completed four cross-sectional online annual surveys as part of a multi-site campus initiative. Chi-square tests of independence, t-tests, and regression models evaluated differences in alcohol and marijuana use between athletes and non-athletes. The prevalence of binge drinking and high intensity drinking was significantly higher among student athletes than non-athletes, even after controlling for demographic characteristics. Thirteen percent of student athletes experienced an alcohol-related injury during the past year; this was more common among binge drinkers than non-binge drinkers (20.5% and 2.6%, respectively). Among student athletes, past-month binge drinking and past-year marijuana use were significantly associated with lowered GPA (ps<.01). Skipping class was twice as prevalent among student athletes who used marijuana as compared with athletes who did not use marijuana, but no differences were found related to binge drinking. Components for a training for athletic personnel to reduce risks for alcohol-related injury and academic consequences that are associated with alcohol and marijuana use among student athletes are described. Involving athletic personnel might be an important strategy to identify and intervene with high-risk student athletes.

Timing and chronicity of child neglect and substance use in early adulthood.

BACKGROUND: Neglect is the most common form of child maltreatment with consequences that appear to be as serious as for abuse. Despite this, the problem has received less than its due attention. OBJECTIVE: To examine the relationship between the timing and chronicity of neglect during childhood and substance use in early adulthood. PARTICIPANTS AND SETTING: The sample consisted of a subset of 475 participants from the prospective Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) consortium from five geographic areas around the U.S. METHOD: Neglect was assessed using abstracted information from CPS reports (birth-18) and self-reports of neglect (12-18). Participants completed a follow-up online survey (mean age of 24 years) that probed their use of substances. RESULTS: The prevalence of substance use during the past year was comparable in this high-risk sample to the general population. Latent class analysis supported the presence of three groups related to the presence and timing of neglect: Chronic Neglect, Late Neglect and Limited Neglect. Late Neglect was the pattern most strongly linked to substance use in early adulthood. CONCLUSIONS: High-risk youth experiencing neglect beginning in mid- adolescence are especially vulnerable to later substance use. Those working with such youth and their families can play a valuable role helping ensure their basic needs are adequately met, and recognizing early signs of substance use and abuse.

Assessing Campus Alcohol Policies: Measuring Accessibility, Clarity, and Effectiveness.

BACKGROUND: Excessive alcohol consumption poses significant hazards to health and safety on college campuses. While substantial research exists regarding effective policies for preventing alcohol-related problems in the communities surrounding campuses, on-campus alcohol policies have received far less attention. METHODS: Official campus alcohol policies (CAPs) were retrieved from the websites of the 15 member schools of the Maryland Collaborative to Reduce College Drinking and Related Problems, a voluntary statewide collaborative. CAPs were assessed for accessibility, clarity, and effectiveness. In addition to assessing whether campuses were in compliance with federal regulations for comprehensiveness of policies, a measure of likely policy effectiveness was developed through the use of 2 Delphi panels drawing on alcohol policy researchers and on-campus and community practitioners, respectively. The panels rated 35 potential policies and 13 possible sanctions; lists of policies and sanctions were compiled primarily from what was already in existence at 1 or more member schools. RESULTS: For most campuses, the CAPs could be located within 30 seconds, but tended to be spread across multiple web pages. Language used to communicate the policies tended to be complex and above the reading level of someone with a high school education. At least half of the schools had less than half of the possible policies rated most or somewhat effective by the Delphi panels. Schools were more likely to employ the most effective sanctions, but somewhat and ineffective sanctions were also not uncommon. CONCLUSIONS: CAPs are an important element in reducing negative consequences of alcohol consumption on college campuses. A higher level of research scrutiny is warranted to understand the extent to which CAPs are associated with excessive drinking, but this research describes an evidence- and expert-informed assessment approach that colleges can use to regularly analyze and update their CAPS.

Graduate degree completion: Associations with alcohol and marijuana use before and after enrollment.

Research has shown that alcohol and marijuana use are associated with academic performance difficulties, but the relationship to completion of a graduate degree has not been explored. Undergraduate students (n = 1253) were assessed during their first year of college and annually thereafter until age 29. Among the subset of the original sample who enrolled in graduate school (n = 520), measures of alcohol and marijuana use were averaged separately for the time periods before and after graduate school enrollment. Logistic regression models were developed to examine the associations between these variables and graduate degree completion, adjusting for other factors. In general, a minority of the sample were excessive drinkers or frequent marijuana users. The majority of drinkers (70%) drank an average of twice a week or less each year, and 62% of marijuana users used marijuana once a month or less each year. After adjusting for demographic and program characteristics, marijuana use frequency after graduate school enrollment was negatively associated with odds of graduate degree completion. Alcohol use frequency before graduate school enrollment was positively associated with odds of graduate degree completion. Results add to the growing body of literature on marijuana use and decreased academic achievement, but results should be interpreted with caution given the small, but significant, effect sizes found. The positive association between alcohol use frequency and degree completion might be attributed to engagement in the academic environment. Future studies should examine the potential mechanisms through which alcohol and marijuana use are related to the academic achievement of graduate students.