Drug use and suicidal ideation in the daily lives of individuals in a dialectical behavior therapy program.

OBJECTIVES: Substance use disorders and borderline personality disorders (BPD) often co-occur and may be concurrently treated by Dialectical Behavior Therapy (DBT). However, there is limited information on how drug use and suicidal ideation may interact in the daily lives of individuals receiving DBT treatment. METHODS: This study examined the DBT diary cards of 47 individuals in a community mental health center's partial hospital and intensive outpatient program. Multilevel modeling techniques were used to examine the moderating effects of BPD symptom severity on the relationship between same day, 1-, 2-, and 3-day lagged drug use and suicidal ideation. RESULTS: Results indicated a significant relationship between same-day, 1-day lagged, 2-day lagged drug use and suicidal ideation. BPD was a moderator for the relationship between 1-day lagged drug use and suicidal ideation. CONCLUSION: Limitations of the study include the measure for BPD symptom severity was only collected pretreatment and the results are likely limited to the effects of cannabis use on suicidal ideation. Clinicians may need to consider the prolonged effects of drug use on suicidal ideation when conducting chain analyses on suicidal behaviors.

Dialectical Behavior Therapy Skills and Urges to Use Alcohol and Substances: An Examination of Diary Cards.

Background: Skills learned in Dialectical Behavior Therapy (DBT) are a proposed mechanism that prompts behavior change. Few studies have examined the effects of DBT skills on treatment outcomes. No published studies have examined the effects of DBT skills on alcohol and substance use outcomes. Objectives: This study examined 48 individuals in a community mental health facility that delivers DBT-adherent treatment. Utilizing intake data and diary cards, multilevel model analyses were conducted to examine the effects each DBT skills domain had on urges for participants that entered treatment with varying frequencies of alcohol and substance use. Results: Emotion regulation and mindfulness skills domains were related to decreased urges for individuals that entered treatment with high frequencies of alcohol and substance use. Previous-day distress tolerance skills were associated with decreased urges and previous-day interpersonal effectiveness skills were associated with decreased urges for individuals that entered treatment with high frequencies of substance use. Conclusions: DBT skills may be a helpful mechanism to decrease urges for individuals that use alcohol and other substances. However, more research on why certain skills domains may be more effective is needed.

Latent profiles of cannabis use, protective behavioral strategies, and health beliefs in college students.

College student cannabis use is prevalent and heterogeneous, with some students experiencing cannabis-related problems. Cannabis protective behavioral strategies (PBS) are cognitive-behavioral strategies associated with reduced cannabis use and problems. There is a need for theory-informed and person-centered research to better understand cannabis PBS. The current study applied the health belief model (HBM) and latent profile analysis to discern patterns of cannabis use, PBS, and health beliefs among college students. Students (n = 164; Mage = 18.8; 53% female) who endorsed past-month cannabis use completed an online survey between September and November 2017. The 3-profile model best fit the data. Profile 1 (24.3%) represents the "infrequent use/high protection" profile characterized by using cannabis about 1-9 times, high PBS use, high perceived threat and benefits, and moderate perceived barriers. Profile 2 (38.1%) represents the "occasional use/moderate protection" profile characterized by using cannabis about 20-59 times, moderate PBS use, moderate perceived threat and benefits, and low perceived barriers. Profile 3 (37.6%) represents the "frequent use/low protection" profile characterized by using cannabis about 80 or more times, low PBS use, low perceived threat and benefits, and high perceived barriers. Profiles did not differ by age, ethnicity/race, sex, or college year, though varied significantly by age at first cannabis use, cannabis availability, cannabis problems, use frequency, and use context. Results provide preliminary support for distinct patterns of cannabis use, PBS, and health beliefs that align with the HBM. Results highlight the importance of considering how students perceive cannabis PBS and problems and how those beliefs may influence their PBS and cannabis use.

Expectancies that Predict Cannabis Initiation in Response to Legalization.

Background: Recent and prospective changes to nonmedical/recreational cannabis laws in the United States and abroad raise questions about how legalization may influence cannabis use behaviors. Objectives: In the current study, we examined links between legalization, context-specific likelihood of using cannabis, and cannabis expectancies using cross-sectional survey data from 121 college students who had never used or were abstaining from cannabis in a U.S. state where laws prohibit nonmedical cannabis. Results: We found that across scenarios, 61% of students reported they would be more likely to use cannabis if it were legal. Social/sexual facilitation expectancies predicted a higher likelihood of using cannabis after legalization in a social context. Relaxation/tension reduction expectancies predicted a higher likelihood of using in an anxiety relief context. Perceptual/cognitive enhancement expectancies predicted a higher likelihood of using in a pain relief context. Cognitive/behavioral impairment expectancies predicted a lower likelihood of using in social, pain relief, relaxation, and concert contexts. Global negative effects expectancies predicted a lower likelihood of using in relaxation and concert contexts. Conclusions: Our findings suggest that among college students who do not use cannabis, expectancies are linked to cannabis use likelihood in certain contexts if cannabis were legal. This work highlights cannabis expectancies and contexts as possible targets for evidence-based public health education and clinical prevention initiatives related to the potential increase in cannabis use associated with cannabis policy implementation. College students may benefit from initiatives that address cannabis expectancies and enhance harm reduction skills to help them effectively navigate contexts in which cannabis is available to them.

Assessing motivations and gender as factors in college students' views of nonmedical prescription stimulant use.

Introduction: Two prominent motivation categories of college student nonmedical prescription stimulant use (NMUPS) are for academic and recreational purposes. However, little research focuses on these motivations' association with college students' NMUPS views. Further, limited research assesses if user gender influences views. Methods: The current online scenario study implemented a 2 × 2 factorial design assessing 148 college undergraduates' (75% females; Mage = 19.18; SDage = 1.30) NMUPS views based on user motivation and gender. Participants reported their drug use stigmatization, prescription stimulant expectancies (ie, anticipated drug use beliefs and outcomes), and personal substance use. Results and Discussion: Results showed that user gender did not influence participants' NMUPS views; however, participants viewed academic use less negatively compared to recreational use, thus highlighting the need to educate students on the negative consequences of NMUPS, even when use is for academically related tasks. Furthermore, exploratory analyses showed drug use stigmatization and prescription stimulant expectancies predicted participant NMUPS views.Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2021.1942005 .

Associations between parental and adolescent alcohol use: The role of gender and familism support.

INTRODUCTION: This study examined the role of gender and familism support in the associations between parental and adolescent drinking behaviors in a sample of Mexican adolescents. METHOD: Mexican adolescents (49% girls; N = 724) aged 12-19 completed measures assessing familism support, self-reported drinking behaviors, and perceptions of parental drinking behaviors. RESULTS AND CONCLUSION: Findings suggest that both gender and familism support moderate the relationship between parental drinking behaviors and adolescent drinking behaviors. For instance, the association between mothers' alcohol use frequency and adolescent binge drinking was stronger for girls. In contrast, the association between fathers' amount per drinking day and adolescent binge drinking was stronger for boys. Mother's amount per drinking day was associated with less alcohol use per drinking day among adolescents reporting high familism support. The current study expands our understanding of parental modeling on Mexican adolescent drinking behavior.

Impulsivity traits associated with disordered eating and binge drinking among female college students.

Objective: Disordered eating and problematic alcohol use may negatively impact women's health, and the two issues frequently occur together. We assessed the interaction between negative urgency and disordered eating variables on binge drinking frequency. We also examined impulsivity facets in relation to binge eating, purging, and restrictive eating using multiple linear regression. Methods: Undergraduate women (M age 19.02; SD 1.51; n 262) from a mid-sized southeastern university, reported quantity and frequency of alcohol use over the past 90 days, disordered eating measured by the Multifactorial Assessment of Eating Disorder Symptoms (MAEDS), and impulsivity on the UPPS-P. Results: Negative urgency was the best impulsivity predictor of binge eating and restrictive eating. Negative urgency was a significant predictor of binge drinking frequency (negative binomial regression, p values < .01), but no interaction was found. Conclusions: To reduce these behaviors, college students may benefit from campus programs offering adaptive strategies to cope with negative affect.

Alcohol and other substance use by faculty, staff, and students in a university community during two hurricanes: Lessons for preventing risky misuse.

Communities commonly warn against heavy alcohol and other substance use during natural disasters like hurricanes, because such use may produce risk for individuals and communities, with studies showing deleterious effects persisting months or even years. Examining patterns and emotional correlates of use in the immediate presence of hurricanes may identify useful risk prevention targets. We assessed self-reported substance use and emotions in a university community (faculty, staff, and students) having the unlucky fate of experiencing hurricanes in early September 2 years in a row. Participants (403 in 2018, 76.0% female; M age 28.82; SD = 12.36 and 292 in 2019, 72.6% female; M age 30.63; SD = 13.96) reported typical weekly substance use and emotions and then the same data during each hurricane day. Results showed elevated use of alcohol, caffeine and tobacco before and during each hurricane, but a rapid drop-off of alcohol and caffeine (but not tobacco) use immediately after-although anxiety remained high. Findings are interpreted using both tension-reduction and stress-coping models and suggestions are made for future risk mitigation.

Women's Drinking Decisions in Heterosocial Situations: Development and Validation of Scenarios to Assess Influence of Attraction and Risk-Awareness.

These three related studies created a set of ecologically valid scenarios for assessing relative associations of both attraction and sexual coercion risk-recognition in college women's heterosocial situational drinking decisions. The first study constructed nine scenarios using input from heterosexual drinking women in the age cohort (18-30) most likely to experience alcohol-related sexual coercion. In the second study, 50 female undergraduates (ages 18-25) assessed the salience of three important dimensions (attraction, risk, and realism) in these scenarios. The third study was a factor analysis (and a follow-up confirmatory factor analysis) of the elements of coercion-risk as perceived by the target group with two female samples recruited 1 year apart (Sample 1: N = 157, ages 18-29); Sample 2: N = 157, ages 18-30). Results confirmed that the scenarios could be a useful vehicle for assessing how women balance out risk and attraction to make in-the moment heterosocial drinking decisions. The factor analysis showed participants perceived two types of situations, based on whether the male character was "Familiar" or "Just Met" and perceived themselves as happier and more excited with Familiar males. However, in contrast to HIV risk studies, Familiar males were perceived as higher risk for unwanted sex. Future research will use the six scenarios that emerged from the factor analysis to study how attraction and risk perception differentially affect young adult women's social drinking decisions.

What Do Women Want? A Qualitative Study of Dating.

Many approaches to decrease unwanted sex for women emphasize enhanced risk recognition. However, women often remain in risky situations despite recognition; so we need to understand the attractions of normative dating and sex. In this focus group study, 45 young adult women discussed their attractions to men, dating, and sex. Themes emerged describing conflicts between what they wanted, dating realities, desire for "traditional" behavior from the man, alcohol use, sexual arousal (hers and his), indirect communication about sex, feeling "obligated," and enhanced self-esteem. Results suggest improving risk-recognition programs by examining and clarifying women's goals for dating and putting positive emphasis on "have fun, achieve your goals, but try to avoid harm in the process."

Women's drinking decisions in sexually risky situations: Effects of a low level of intoxication.

INTRODUCTION: Alcohol administration studies assessing alcohol's deleterious effects on women's threat perception and response in potential sexual assault situations usually employ a moderate to high dose (.07% BAC or more) and measure alcohol's effects specifically on women's sexual decisions. The current study used a low dose (.03%, equivalent to about 1-2 drinks) to assess women's projected decisions on a different risky behavior: decisions to continue drinking and to drink higher amounts in a series of ecologically-valid sexual risk situations. METHODS: Young adult women (n=17; M age=21.8, SD=1.3, range 21-25) participated in a three-session double-blind within subjects 2 (type of scenario)×3( beverage) experiment, responding each time to 6 vignettes with an attractive man who was either Familiar or had Just Met her. In each session participants consumed a beverage (alcohol, placebo or water, random order) and projected emotional reactions and drinking decisions (likelihood and amount) in each of the 6 scenarios. RESULTS: Regardless of beverage, women predicted greater happiness, drinking likelihood, and drinking amount with "Familiar" men. However, there was also an interaction: they projected increased subsequent amounts in the .03% BAC (vs. water and placebo) condition differentially in the "Familiar" scenarios. CONCLUSION: When the woman is Familiar with the man in a risky sexual situation, just one drink may increase subsequent projected alcohol amount over that originally intended. Implications include a low dose as a possible prime for more drinking, increasing sexual assault risk.

Do angry women choose alcohol?

Women's alcohol treatment usually includes anger management, predicated on the hypothesis that anger increases their drinking. Studies show strong association between anger and drinking but to date there is no laboratory support for this hypothesis. We examined effects of a "female-specific" anger provocation on young adult women's drinking behavior by randomly assigning 30 women (age 21-30) to one of two conditions: Provocation (n=15) or Non-Provocation (n=15). In the Provocation condition, a female confederate was both annoying and condescending to the participant for 8min. A manipulation check showed heightened anger and hostility (but not anxiety or depression) in the Provocation participants. In a subsequent taste-task, all participants could drink placebo "beer" and ginger ale. When the data analysis controlled for participants' baseline negative emotions, Provocation participants consumed more "beer" (M=172.33ml, SD=78.90) than did Non-Provocation participants (M=118.60ml, SD=75.74) (p<.04), with no differences in ginger ale consumption. Results support a causal relationship between young women's anger and their specific choice to drink alcohol.

Modeling the severity of drinking consequences in first-year college women: an item response theory analysis of the Rutgers Alcohol Problem Index.

OBJECTIVE: The present study examined the latent continuum of alcohol-related negative consequences among first-year college women using methods from item response theory and classical test theory. METHOD: Participants (N = 315) were college women in their freshman year who reported consuming any alcohol in the past 90 days and who completed assessments of alcohol consumption and alcohol-related negative consequences using the Rutgers Alcohol Problem Index. RESULTS: Item response theory analyses showed poor model fit for five items identified in the Rutgers Alcohol Problem Index. Two-parameter item response theory logistic models were applied to the remaining 18 items to examine estimates of item difficulty (i.e., severity) and discrimination parameters. The item difficulty parameters ranged from 0.591 to 2.031, and the discrimination parameters ranged from 0.321 to 2.371. Classical test theory analyses indicated that the omission of the five misfit items did not significantly alter the psychometric properties of the construct. CONCLUSIONS: Findings suggest that those consequences that had greater severity and discrimination parameters may be used as screening items to identify female problem drinkers at risk for an alcohol use disorder.

A comparison of African-American versus Caucasian men screened for an alcohol administration laboratory study: recruitment and representation implications.

African-Americans are under-represented in alcohol research, especially alcohol administration laboratory studies. Specific recruitment of African-Americans into laboratory studies, however, may also inadvertently affect the generalizability of the findings. In the current study, we compared all African-American young adult men (n=53) who volunteered and met criteria for an alcohol administration study to a sample (n=50) of Caucasian men recruited for the same study. Groups were compared on variables including demographics, quantity and frequency of alcohol consumption and other substance use, consequences of use and psychopathology. Compared to their Caucasian counterparts, African-American men reported less drinking frequency and quantity, less use of other substances and fewer negative consequences, but their alcohol and drug use was more likely to be associated with various measures of psychopathology. Results suggest that even when recruiting participants using criteria that should minimize differences (i.e. all participants were "social drinkers"), differences on key variables were evident. These differences may have important implications for alcohol research.

Collateral informant assessment in alcohol use research involving college students.

OBJECTIVE: This study examined the associations between college students' self-reported alcohol use and corresponding collateral reports and identified factors that influence agreement between both sets of reports. PARTICIPANTS/METHODS: Subject-collateral pairs (N = 300) were recruited from undergraduate psychology courses. RESULTS: Data yielded moderate correlations between subject-collateral pairs for all alcohol use measures, whereas discrepancy analyses revealed a tendency for subjects to report greater alcohol use relative to collateral reports. Greater subject-collateral agreement regarding frequency of subject alcohol use was predicted by a greater frequency of shared drinking occasions between the dyads, lower subject self-reported drug use, and lower levels of collateral guessing, whereas greater correspondence for quantity of alcohol consumed was predicted by fewer subject self-reported alcohol-related negative consequences, lower levels of subject self-reported drug use, and lower levels of alcohol ingestion among collaterals. CONCLUSIONS: College students appear to provide reasonably accurate self-reports of their alcohol use.

Assessing acceptance of violence toward women: a factor analysis of Burt's Acceptance of Interpersonal Violence Scale.

The Acceptance of Interpersonal Violence Scale (AIV) is a self-report inventory assessing beliefs about violence toward women. This study's purpose was to test the multidimensionality of the AIV. Exploratory factor analysis (EFA) was conducted on half a sample of 772 male participants and confirmatory factor analysis (CFA) on the other half. EFA indicated a two-factor solution. Factors were labeled Intimate Partner Violence and Sexual Violence. The CFA showed this model provided a good fit and was superior to the original one-factor model. Potential problems when using the single sum score and the applicability of the derived factor structure to violence research are discussed.

The effects of alcohol and cue salience on young men's acceptance of sexual aggression.

Research suggests that alcohol intoxication may increase a young man's likelihood of sexual aggression. This laboratory analogue experiment tested a disinhibition versus alcohol myopia explanation of alcohol's role by investigating effects of acute alcohol administration, expectations and individual differences drawn from Malamuth's Confluence Model of Sexual Aggression (i.e., Acceptance of Interpersonal Violence: AIV, Need for Sexual Dominance: NSD) on young men's acceptance of sexual aggression. Young adult heterosexual men (n=334) attended two laboratory sessions each. In the first, they completed screening and individual differences measures. In the second, they were assigned randomly to consume one of four beverages: Control, Placebo, Low Dose Alcohol (0.33 ml alcohol/kg body weight) or Moderate Dose Alcohol (0.75 ml/kg) and view one of two video-delivered scenario conditions: "Anti-Force Cues" (scenario of a couple on a date with embedded explicit cues mitigating against forced sex) or "No Cues" (Identical scenario with no Anti-Force cues). Participants then judged 1) should the man continue to force the woman to have sex? 2) would they force the woman? and 3) who was responsible for the outcome? Results supported a disinhibition versus alcohol myopia model. Consuming alcohol increased acceptance of sexual aggression. Further, higher NSD and AIV scores were associated with acceptance of forced sex, but only after alcohol consumption. Overall, findings showed that key individual difference factors from Malamuth's Confluence Model enhance precision of predicting sexual aggression risk by young men under the influence of alcohol.

Development and validation of videotaped scenarios: a method for targeting specific participant groups.

Researchers using scenarios often neglect to validate perceived content and salience of embedded stimuli specifically with intended participants, even when such meaning is integral to the study. For example, sex and aggression stimuli are heavily influenced by culture, so participants may not perceive what researchers intended in sexual aggression scenarios. Using four studies, the authors describe the method of scenario validation to produce two videos assessing alcohol-related sexual aggression. Both videos are identical except for the presence in one video of antiforce cues that are extremely salient to the young heterosexual men. Focus groups and questionnaires validate these men's perceptions that (a) the woman was sexually interested, (b) the sexual cues were salient, (c) the antiforce cues were salient (antiaggression video only), and (e) these antiforce cues inhibited acceptance of forced sex. Results show the value of carefully selecting and validating content when assessing socially volatile variables and provide a useful template for developing culturally valid scenarios.

Social norms theory-based interventions: testing the feasibility of a purported mechanism of action.

UNLABELLED: Social norms-based interventions targeting college student drinking behaviors have become increasingly popular. Such interventions purportedly modify student misperceptions of fellow student drinking behaviors, which leads to changes in individual drinking behavior. Despite claims of successful interventions, research demonstrating that social norms-based interventions modify student perceptions is lacking. OBJECTIVE: The authors conducted a laboratory experiment examining the feasibility of this mechanism of action and aimed to determine the validity of the campus-specific drinking norms hypothesis. PARTICIPANTS AND METHODS: The authors randomly assigned 60 students to 1 of 3 research conditions: Alcohol 101 (national drinking norms), a didactic presentation of campus specific drinking norms, or a control condition. RESULTS: Both intervention groups modified student misperceptions regarding peer alcohol use, and these changes were sustained 1 week later. CONCLUSIONS: Social norms-based interventions can contribute to more accurate drinking perceptions among college students.

Rape blame as a function of alcohol presence and resistance type.

Attributions of rape blame may be related to variables such as alcohol presence and resistance type used during a sexual assault. The current study sought to assess participants' attributions of responsibility for a sexual assault based on these two variables through the use of several written scenarios. Two hundred and thirteen male and female college students participated in the study. Results indicated that responsibility ratings given to the victim varied by the presence of alcohol but not by resistance type. If the female target had been drinking, she was judged as being more responsible for the assault than if she had not been drinking. However, how she resisted the assault did not affect ratings of her responsibility. Additionally, participant gender was found to not be an important factor for attributing blame to the woman target. Future research should focus on two important factors: 1) how participants' judgments of blame may change during actual alcohol administration and 2) how the use of video, rather than written vignettes, may produce stronger effects.