Consequences, Motives, and Expectancies of Consumption as Predictors of Binge Drinking in University Women.

The increasing presence of women, especially university women, in risky alcohol consumption such as Binge Drinking (BD), which is associated with gender-specific biopsychosocial problems, makes it necessary to analyze the variables underlying BD in order to adjust possible interventions more in line with their reality. The motives and expectancies of this pattern of consumption, as well as the consequences derived from it, are some of the variables that are shown to have the greatest weight in the prediction of BD. In the present study we analyze, on the one hand, the performance of these variables among college women with alcohol use, and on the other hand, which of these variables allow us to classify BD. A total of 501 female university consumers of alcohol (mean age 19.02 years) were assessed. Specifically, they completed a self-report of alcohol consumption (77.1% engage in BD), the Expectancy Questionnaire (EQ), the Drinking Motives Questionnaire (DMQ-R) and the Alcohol Consumption Consequences Evaluation (ACCE). BD female students scored significantly higher on these instruments, except for compliance motives. The logistic regression analysis carried out to estimate the probability of performing BD using the social and conformity motives, the ACCE and positive expectancies correctly estimated (χ2 8 = 9.149, p < 0.33) 88.6% of the cases and explained 26.2% of the BD. Thus, young women with a level of consequences classified as high risk (>25 in ACCE) have a 3.55-fold increase in the probability of having BD, compared to women classified as low risk by the ACCE. On the other hand, women classified as moderate risk by the ACCE have a 4.77-fold increase in the probability of having BD. In the case of social motives and positive expectancies, their increase multiplies by 1.165 and 1.024, respectively, the probability of having BD. The results of this study highlight the importance of adapting preventive measures to the consequences experienced by BD university students, especially in relation to the social motives and positive expectancies that modulate decision-making when engaging in this pattern of consumption.

Psychometric Properties of the "Alcohol Consumption Consequences Evaluation" (ACCE) Scale for Young Spanish University Students.

Instruments that evaluate alcohol use consequences among young people do not consider the intensive alcohol consumption pattern that is so characteristic during these ages. Some of these instruments are even ineffective in the Spanish population. Hence the interest in developing an instrument more adapted to the reality of our young people. A total of 601 university students (35.9% male and 64.1% female) from 18 to 20 years old were recruited. All of them answered a total of 77 items obtained from the review of both the scientific literature and the different scales used to measure consequences derived from alcohol consumption. In addition, they completed the AUDIT and the Timeline Followback for self-reported consumption. The data were analyzed using factor analysis and a two-parameter logistic model. ROC curve analysis was used to establish cut-off points for different risk levels of alcohol consumption distinguishing between genders. The final 43-item scale Alcohol Consumption Consequences Evaluation (ACCE) (Evaluación de Consecuencias derivadas del Consumo de Alcohol [ECCA]) shows adequate psychometric properties: α = 0.94; unidimensionality through exploratory factor analysis (EFA) (26.25% of explained variance) and confirmatory factor analysis (CFA) (RMSEA = 0.39; TLI and CFI > 0.90). In addition, ROC analyses, both at a global scale and distinguishing between genders, were able to characterize consumers with different levels of risk, obtaining areas under the curve between 0.82 and 0.88. A scale has been obtained that enables the establishment of cut-off points to distinguish between the consequences of low, moderate and high risk alcohol consumption. The clinical utility of the ACCE is highlighted by using one single instrument to perform the screening of a possible alcohol risk consumption as well as identifying the consequences that need to be worked on in the evaluated person's or group's intervention.

Revision of AUDIT Consumption Items to Improve the Screening of Youth Binge Drinking.

This study analyzes the appropriateness of an improved version of one of the most frequently used instruments for the screening of high-risk alcohol consumption. This adaptation was created in accordance with certain limitations recognized by other researchers and in an attempt to adjust the content and scales of some items to a more consensual definition of binge drinking. After revising items 2 and 3, the areas under the ROC curves of the AUDIT and of different abbreviated versions were calculated. A total of 906 minors (468 females) between the ages of 15 and 17 were evaluated. Stratified sampling was conducted on a population of high school students in the city of Valencia (Spain). One school was randomly chosen from each of the city's 16 school districts. Information was collected on sociodemographic aspects, consumption patterns and the AUDIT containing the improved items. The percentage of underage BD reached 36%, regardless of gender or age. BD groups have been differentiated by different intensity levels, both in males and females. Upon comparing the effectiveness of the distinct versions of the AUDIT, it is recommended that researchers and clinics use the combination of the revised items 2 and 3 to ensure a more precise identification of underage BD. A cut-off point of 5 for this test would permit identification of 94% of the underage BD and would notably reduce false positives.

The utility of the alcohol use disorders identification test (Audit) for the analysis of binge drinking in university students / Utilidad del Alcohol Use Disorders Identification Test (AUDIT) en el análisis del binge drinking en estudiantes universitarios

BACKGROUND: The increasingly precise conceptualization of Binge Drinking (BD), along with the rising incidence of this pattern of intake amongst young people, make it necessary to review the usefulness of instruments used to detect it. Little evidence exists regarding effectiveness of the AUDIT, AUDIT-C and AUDIT-3 in the detection of BD. This study evaluates their utility in a sample of university students, revealing the most appropriate cut-off points for each sex. METHODS: All students self-administered the AUDIT and completed a self-report of their alcohol consumption. A Two-step cluster analysis differentiated 5 groups of BD in terms of: the quantity consumed, the frequency of BD over the past six months and gender. A ROC curve adjusted cut-off points for each case. RESULTS: 862 university students (18-19 years-old/59.5% female), 424 (49.2%) from Valencia and 438 (50.8%) from Madrid, had cut-off points of 4 in AUDIT and 3 in AUDIT-C as a better fit. In all cases, the best classifier was AUDIT-C. Neither version properly classifies students with varying degrees of BD. CONCLUSIONS: All versions differentiate BD from non-BD, but none are able to differentiate between types of BD

ANTECEDENTES: la operacionalización cada vez más precisa del Binge Drinking (BD), unido a su elevada prevalencia entre los jóvenes, hace necesario revisar la utilidad de los instrumentos utilizados para detectarlo. Existe poca evidencia de la eficacia del AU-DIT y AUDIT-C en la detección del BD. Este artículo evalúa su utilidad en una muestra de universitarios, identificando los puntos de corte más adecuados, en función del sexo. MÉTODO: se cumplimentó el AUDIT y un autoregistro de consumo de alcohol. Un análisis de conglomerados en dos fases diferenció 5 grupos de BD en función de: cantidad consumida, frecuencia de realización en los últimos seis meses y género. Con curvas ROC se ajustaron los puntos de corte para cada caso. RESULTADOS: 862 universitarios (18-19 años/59,5% mujeres), 424 (49,2%) de Valencia y 438 (50,8%) de Madrid obtuvieron puntos de corte de 4 en AUDIT y 3 en AUDIT-C como mejor ajuste. En todos los casos el mejor clasificador de BD fue el AUDIT-C. Ninguna versión clasifica adecuadamente a estudiantes con diferente intensidad de BD. CONCLUSIONES: ambas versiones diferencian BD de noBD, pero ninguna de ellas permite distinguir entre tipos de BD

The utility of the Alcohol Use Disorders Identification Test (AUDIT)for the analysis of binge drinking in university students.

BACKGROUND: The increasingly precise conceptualization of Binge Drinking (BD), along with the rising incidence of this pattern of intake amongst young people, make it necessary to review the usefulness of instruments used to detect it. Little evidence exists regarding effectiveness of the AUDIT, AUDIT-C and AUDIT-3 in the detection of BD. This study evaluates their utility in a sample of university students, revealing the most appropriate cut-off points for each sex. METHODS: All students self-administered the AUDIT and completed a self-report of their alcohol consumption. A Two-step cluster analysis differentiated 5 groups of BD in terms of: the quantity consumed, the frequency of BD over the past six months and gender. A ROC curve adjusted cut-off points for each case. RESULTS: 862 university students (18-19 years-old/59.5% female), 424 (49.2%) from Valencia and 438 (50.8%) from Madrid, had cut-off points of 4 in AUDIT and 3 in AUDIT-C as a better fit. In all cases, the best classifier was AUDIT-C. Neither version properly classifies students with varying degrees of BD. CONCLUSIONS: All versions differentiate BD from non-BD, but none are able to differentiate between types of BD.

Enactive Approach and Dual-Tasks for the Treatment of Severe Behavioral and Cognitive Impairment in a Person with Acquired Brain Injury: A Case Study.

One of the most important sequela in persons who suffer from acquired brain injury is a behavioral disorder. To date, the primary approaches for the rehabilitation of this sequela are Applied Behavior Analysis, Cognitive-Behavior Therapy, and Comprehensive-Holistic Rehabilitation Programs. Despite this theoretical plurality, none of these approaches focuses on rehabilitating behavioral disorders considering the relation between affordance and environmental adaptation. To introduce this therapeutic view to neurorehabilitation, we apply the theoretical tenets of the enactive paradigm to the rehabilitation of a woman with severe behavioral and cognitive impairment. Over seventeen sessions, her behavioral and cognitive performance was assessed in relation to two seated affordances (seated on a chair and seated on a ball 65 cm in diameter) and the environmental adaptation while she was working on various cognitive tasks. These two seated affordances allowed to incorporate the theoretical assumptions of the enactive approach and to know how the behavior and the cognition were modified based on these two postural settings and the environmental adaptation. The findings indicate that the subject exhibited better behavioral (physical and verbal) and cognitive (matching success and complex task) performances when the woman worked on the therapeutic ball than when the woman was on the chair. The enactive paradigm applied in neurorehabilitation introduces a level of treatment that precedes behavior and cognition. This theoretical consideration allowed the discovery of a better relation between a seated affordance and the environmental adaptation for the improvement behavioral and cognitive performance in our case study.

Different versions of the Alcohol Use Disorders Identification Test (AUDIT) as screening instruments for underage binge drinking.

BACKGROUND: The changes experienced in recent years in the conceptualization of binge drinking (BD) make it necessary to revise the usefulness of the existing instruments for its detection among minors. The AUDIT and its abbreviated versions have shown their utility in different populations and consumption ranges, but there has been little research into their use in the detection of BD among adolescents. This study tests the capacity of the AUDIT, AUDIT-C and AUDIT-3 to identify BD adolescents, indicating the optimal cut-off points for each sex. METHODS: High school students self-administered the AUDIT and completed a weekly self-report of their alcohol intake. BD is classified into different groups according to parameters like the quantity consumed and its frequency in the past six months, adjusting the cut-off points for each case. RESULTS: The results obtained with a sample of 634 adolescents (15-17 years old/52.2% female) indicate that cut-off points of 4 on the AUDIT and 3 on the AUDIT-C show the best fit. Dividing the sample by sexes, the AUDIT and the AUDIT-C would detect BD males with scores of 5 and 4, respectively (with the AUDIT-C being more sensitive), and BD females with a score of 3 on both (the more sensitive being the AUDIT). CONCLUSIONS: All three versions are adequate to classify BD adolescents but none of them made it possible to safely differentiate binge drinkers with different consumption intensities.