Discrimination, drinking to cope, protective behavioral strategies, and alcohol-related consequences among university students.

OBJECTIVE: University students who experience more discrimination typically report more negative consequences from alcohol use. The study aimed to assess whether drinking to cope and protective behavioral strategies for alcohol use would help explain the relationship between everyday discrimination and alcohol-related consequences among university student drinkers. METHOD: Data were collected in Fall 2020 and the sample included 707 undergraduate and graduate students from a large public institution in the northeast who reported consuming alcohol in the past month. Participants identified predominantly as women (71.7%; 24.6% men) and White (65.1%; 7.9% Black/African American; 7.2% Asian/Asian American; 7.1% Hispanic/Latinx). A cross-sectional serial mediation analysis using structural equation modeling was conducted using Mplus. RESULTS: Controlling for alcohol use, results supported a serial partial mediation model. More experiences of discrimination predicted a significant increase in alcohol-related consequences, above and beyond the increase attributed to drinking to cope. More frequent use of protective behavioral strategies significantly increased the odds of reporting no alcohol-related consequences. CONCLUSIONS: Drinking to cope and protective behavioral strategies for alcohol use may help explain why university students who report frequent discrimination are more likely to experience alcohol-related consequences, independent of how much alcohol they consume. Findings can inform clinical and prevention practice, advocacy, and training.

Promoting uptake of efficacious brief alcohol interventions for young adults within institutions of higher education: Challenges and opportunities.

OBJECTIVE: Despite findings indicating that college students' alcohol use remains a significant problem across institutions of higher education, the support for a strong link between excessive drinking and risk for suicide and other psychiatric comorbidities, and associations between excessive drinking and stopping out or dropping out of college, there continue to be barriers to the routine, consistent, and timely implementation of efficacious brief alcohol interventions by mental health practitioners working in college- and university-based clinical service settings. This commentary will focus on the identification of infrastructure, attitudinal, and training-related barriers to the uptake of evidence-based strategies within higher education clinical intervention settings and opportunities to address them. Barriers discussed include compromises to intervention fidelity, limited staffing and multiple and competing service demands, stigma and a lack of understanding concerning the link between alcohol use and psychiatric symptomology, and scarcity of training, professional development, and funding opportunities specifically aimed at the promotion of evidence-based practices addressing risky and excessive drinking among college students. CONCLUSIONS: Alcohol researchers can play a key role in promoting effective, consistent, and timely implementation of efficacious brief interventions in campus-based clinical service settings through strategic engagement with college and university mental health professionals and senior-level decision-makers using a system-focused lens. Both institutional and national-level collaboration and advocacy for translational research opportunities are critical to encourage dissemination, implementation, and sustainability of efficacious brief intervention practices. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Behavioral Willingness, Descriptive Normative Perceptions, and Prescription Stimulant Misuse among Young Adults 18-20.

Objective: It is critical to gain further understanding of etiologic factors, such as descriptive normative perceptions and behavioral willingness, that are associated with prescription stimulant misuse (PSM) among young adults. Our primary hypotheses were that descriptive normative perceptions for PSM (i.e., perceptions of how much and how often others engage in PSM) and perceived peer willingness (i.e., perceptions of how open others are to PSM under certain circumstances) would be positively associated with higher willingness to engage in PSM, which in turn would account for significant shared variance with self-reported PSM. Method: Data were collected from a U.S. sample of 18-20-year-olds (N = 1,065; 54.5% females; 70.5% White) recruited for a larger study on alcohol-related risky sexual behavior. Results: Findings indicated higher descriptive normative perceptions and higher perceived peer willingness were associated with higher participants' willingness to engage in PSM. Participants' own willingness was positively associated with PSM. Finally, participants' own willingness to use, descriptive normative perceptions, and perceived peer willingness were associated with higher willingness to engage in PSM, which accounted for significant shared variance with self-reported PSM. Conclusions: Findings suggest the potential utility of personalized feedback interventions for PSM that focus on constructs such as descriptive normative perceptions and behavioral willingness.

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.

Perceived academic benefit is associated with nonmedical prescription stimulant use among college students.

INTRODUCTION: College students are at higher than average risk for nonmedical use of prescription stimulants (NPS). A commonly identified motive among students who engage in NPS is to improve grades. Several research studies have observed that NPS most likely does not confer an academic advantage, and is associated with excessive drinking and other drug use. This study documents the proportion of the general college student population who believe that NPS will lead to improvements in academic performance. METHODS: This study gathered online survey data from a large, demographically diverse sample of college students to document the prevalence of perceived academic benefit of NPS for improving grades and to examine the association between such belief and NPS. RESULTS: Overall, 28.6% agreed or strongly agreed that NPS could help students earn higher grades, and an additional 38.0% were unsure. Students with a higher level of perceived academic benefit of NPS and more frequent patterns of drinking and marijuana use were more likely to engage in NPS, even after adjustment for a wide range of covariates. CONCLUSIONS: The results underscore the need for interventions that simultaneously correct misperceptions related to academic benefit and target alcohol and marijuana use to reduce NPS.

Do college students improve their grades by using prescription stimulants nonmedically?

INTRODUCTION: Many college students engage in nonmedical use of prescription stimulants (NPS) because they believe it provides academic benefits, but studies are lacking to support or refute this belief. METHODS: Using a longitudinal design, 898 undergraduates who did not have an ADHD diagnosis were studied. Year 3 GPA (from college records) of four groups was compared: Abstainers (did not engage in NPS either year; 68.8%); Initiators (NPS in Year 3 but not Year 2; 8.7%); Desisters (NPS in Year 2 but not Year 3; 5.8%); and Persisters (NPS in both years; 16.7%). Generalized estimating equations regression was used to estimate the association between NPS and change in GPA, controlling for sex and Year 2 GPA. RESULTS: GPA increased significantly within Abstainers (p<0.05), but did not change significantly within the other groups. Overall, the relationship between NPS pattern group and change in GPA was not statistically significant (p=0.081). NPS was generally infrequent, but Persisters used more frequently than Desisters (11.7 versus 3.4days in Year 2) and Initiators (13.6 versus 4.0days in Year 3, both ps<0.001), controlling for sex and Year 2 GPA. CONCLUSIONS: We cannot rule out the possibility that NPS prevented declines in GPA, but we can conclude that students who engaged in NPS showed no increases in their GPAs and gained no detectable advantages over their peers. The results suggest that prevention and intervention strategies should emphasize that the promise of academic benefits from NPS is likely illusory.

Reducing High-Risk Drinking Among Student-Athletes: The Effects of a Targeted Athlete-Specific Brief Intervention.

OBJECTIVE: This study examined the effects of a single-session motivational interviewing-based in-person brief alcohol intervention that contained student-athlete-specific personalized drinking feedback. PARTICIPANTS: Participants were 170 National Collegiate Athletic Association Division I student-athletes meeting screening criteria for heavy episodic drinking. METHODS: Baseline assessments of alcohol use frequency and quantity, norm perceptions of peers' alcohol use, experiences of negative consequences, and use of protective behaviors were administered to student-athletes prior to a 1-session brief intervention containing personalized feedback highlighting the relationship between alcohol use and athletic performance. Follow-up assessment was conducted 3 months post intervention. RESULTS: Student-athletes participating in the athlete-specific brief intervention showed significant reductions in their alcohol use and alcohol-related negative consequences, increases in use of protective behavioral strategies, and corrections in norm misperceptions at 3 months post intervention relative to a no-treatment comparison group. CONCLUSIONS: Student-athlete-specific brief alcohol interventions show promise in addressing high-risk drinking, reducing associated harms, and supporting health.

Implementing an early intervention program for residential students who present with suicide risk: a case study.

OBJECTIVE: This case study examined the effects of an early intervention program designed to respond to residential college students demonstrating risk for suicide. PARTICIPANTS: Participants were 108 undergraduates at a large northeastern public university referred to an early intervention program subsequent to presenting with risk factors for suicide between Fall 2004 and Spring 2011. METHODS: Data were collected from archival records to examine quality of early intervention services, student retention, and grade point average (GPA) during the semesters prior to, during, and subsequent to the referral incident. RESULTS: Program implementation was timely and responsive to student needs; students successfully completing the early intervention program remained in school and demonstrated small but significant rebounds in GPA the semester subsequent to the incident. CONCLUSIONS: There are benefits associated with the implementation of early intervention programs designed to respond to students manifesting risk for suicide, such as connecting the student to vital services and support networks.

Implementing an audience-specific small-group gatekeeper training program to respond to suicide risk among college students: a case study.

OBJECTIVE: This case study evaluated the effectiveness of an audience-specific, single-session, small-group interactive gatekeeper training program conducted at a large northeastern public university. PARTICIPANTS: Participants were 335 faculty, staff, and students completing gatekeeper training programs tailored to their group needs. METHODS: Baseline assessments of knowledge about suicide, risk factors, resources for assistance, and comfort in intervening with a student in distress were administered to participants prior to the small-group training sessions; posttest assessments of knowledge and comfort in intervening with students in distress were administered upon completion of training and at 3-month follow-up. RESULTS: There was a statistically significant increase in knowledge and comfort upon completion of training for both faculty/staff and student groups, although degradation of training effects at 3-month follow-up was evident. CONCLUSIONS: There are benefits associated with the implementation of audience-specific gatekeeper training programs. Booster training sessions to address skill degradation over time are recommended.

Use of electron microscopy to classify canine perivascular wall tumors.

The histologic classification of canine perivascular wall tumors (PWTs) is controversial. Many PWTs are still classified as hemangiopericytomas (HEPs), and the distinction from peripheral nerve sheath tumors (PNSTs) is still under debate. A recent histologic classification of canine soft tissue sarcomas included most histologic types of PWT but omitted those that were termed undifferentiated. Twelve cases of undifferentiated canine PWTs were evaluated by transmission electron microscopy. The ultrastructural findings supported a perivascular wall origin for all cases with 4 categories of differentiation: myopericytic (n = 4), myofibroblastic (n = 1), fibroblastic (n = 2), and undifferentiated (n = 5). A PNST was considered unlikely in each case based on immunohistochemical expression of desmin and/or the lack of typical ultrastructural features, such as basal lamina. Electron microscopy was pivotal for the subclassification of canine PWTs, and the results support the hypothesis that canine PWTs represent a continuum paralleling the phenotypic plasticity of vascular mural cells. The hypothesis that a subgroup of PWTs could arise from a pluripotent mesenchymal perivascular wall cell was also considered and may explain the diverse differentiation of canine PWTs.

Changes in protective behavioral strategies and alcohol use among college students.

BACKGROUND: Protective behavioral strategies (PBS) are specific cognitive-behavioral strategies designed to reduce alcohol consumption and resulting negative consequences. A host of studies have examined the cross-sectional relationship between such strategies and alcohol use in the high-risk population of United States college students, but prospective studies on the construct are lacking. The primary purposes of this study were to determine if PBS use prospectively predicted subsequent alcohol use/alcohol-related problems and if changes in PBS use were associated with less alcohol use and fewer problems. METHODS: Data were examined from 521 heavy drinking college students (60% male, 84% White, mean age=18.9 years). Participants completed questionnaires assessing alcohol use, alcohol-related problems, and PBS use at baseline, 6-month, and 12-month follow-ups. RESULTS: Analysis of residualized change scores indicated that increases in some PBS across time were associated with less alcohol use and fewer alcohol-related problems at follow-up. Findings regarding the prospective relationship between PBS use and subsequent alcohol use/problems were equivocal. DISCUSSION: Results from the study suggest that PBS may have value in alcohol-related interventions among college students. Clinicians who help clients increase their use of PBS may help those clients increase the probability of drinking less and experiencing fewer alcohol-related problems in the future.

Assessing the effectiveness of peer-facilitated interventions addressing high-risk drinking among judicially mandated college students.

OBJECTIVE: This study examined the effectiveness of three peer-facilitated brief alcohol interventions-small group motivational interviewing, motivationally enhanced peer theater, and an interactive alcohol-education program-with students engaging in high-risk drinking who were referred for alcohol policy violations. METHOD: Undergraduate students referred for alcohol policy violations (N = 695) at a large northeastern public university were randomized to one of the three conditions. Six-month follow-up data were collected on drinking frequency and quantity, negative consequences, use of protective behaviors, and perceptions of peers' drinking norms. RESULTS: There were no statistically significant overall pre-post effects or treatment effects. However, exploratory analyses indicated that decreases in perceived norms and increases in use of protective behavioral strategies were associated with reductions in alcohol use and alcohol-related problems at follow-up (p < .01). CONCLUSIONS: The presence of nonsignificant pre-post or main effects is, in part, consistent with recent research indicating that sanctioned college students may immediately reduce drinking in response to citation and that brief interventions may not contribute to additional behavioral change. The presence of statistically significant correlations between alcohol use and related problems with corrections in norms misperceptions and increased use of protective behaviors at the individual level holds promise for both research and practice. The integration of elements addressing social norms and use of protective behaviors within brief cognitive-behavioral intervention protocols delivered by trained peer facilitators warrants further study using randomized clinical trials.

The co-occurrence of alcohol use and gambling activities in first-year college students.

OBJECTIVE: Both alcohol use and gambling are behaviors that can be problematic for many college students; however, it is not clear whether the relationship between the 2 exists for students who have recently entered college. PARTICIPANTS: The sample included 908 first-year college students who were surveyed in fall 2005, approximately 1 month after entering college. METHODS: Participants completed Web-based surveys on alcohol use and gambling behaviors. RESULTS: Alcohol use and alcohol-related risks were significantly related to both gambling frequency and peak gambling loss. CONCLUSIONS: These findings have implications for researchers and clinicians working in the area of addictive behaviors among college students, suggesting that those presenting with problems in 1 domain may also be at risk for problems in the other.

Conscientiousness, protective behavioral strategies, and alcohol use: testing for mediated effects.

The purpose of this study was to determine if use of protective behavioral strategies mediated the relationship between conscientiousness and alcohol use and alcohol-related problems. Participants were 186 college students at a state university campus in the Northeastern United States participating in a study examining the effectiveness of a brief alcohol intervention. Data were collected during the 2006-2007 academic years. Results indicated that use of protective behavioral strategies mediated the relationship between conscientiousness and both alcohol use and alcohol-related problems. Implications of the findings for researchers and clinicians in the area of preventing high-risk drinking among college students are discussed.

Protective behavioral strategies and the relationship between depressive symptoms and alcohol-related negative consequences among college students.

Approximately 40% of college students reported engaging in heavy episodic or "binge" drinking in the 2 weeks prior to being surveyed. Research indicates that college students suffering from depression are more likely to report experiencing negative consequences related to their drinking than other students are. The reasons for this relationship have not been well-studied. Hence, the purpose of this study was to determine whether use of protective behavioral strategies (PBS), defined as cognitive-behavioral strategies an individual can use when drinking alcohol that limit both consumption and alcohol-related problems, mediated the relationship between depressive symptoms and alcohol-related negative consequences among college students. Data were obtained from 686 participants from a large, public university who were referred to an alcohol intervention as a result of violating on-campus alcohol policies. Results from structural equation modeling analyses indicated that use of PBS partially mediated the relationship between depressive symptoms and alcohol-related negative consequences. Implications for clinicians treating college students who report experiencing depressive symptoms or consuming alcohol are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Measuring alcohol-related protective behavioral strategies among college students: further examination of the Protective Behavioral Strategies Scale.

Heavy drinking among college students has been recognized as a public health problem on American college campuses (e.g., R. Hingson, T. Heeren, M. Winter, & H. Wechsler, 2005). Recently, protective behavioral strategies, or cognitive-behavioral strategies that can be implemented when using alcohol to reduce consumption and resulting negative consequences, have been shown to be associated with less alcohol use and fewer alcohol-related problems (e.g., S. L. Benton et al., 2004; M. P. Martens et al., 2005). The purpose of the present study was to conduct additional psychometric work on a measure designed to assess the use of such strategies: the Protective Behavioral Strategies Scale (PBSS; M. P. Martens et al., 2005). Data were collected on 505 undergraduate students from 2 universities who reported having consumed alcohol at least once in the past 30 days. Results of a confirmatory factor analysis supported the hypothesized 3-factor version of the PBSS, and scores on each subscale were correlated in the expected direction with both alcohol use and alcohol-related problems. Thus, the PBSS appears to be reliable and valid for use among college student drinkers.

Implementing a screening and brief intervention for high-risk drinking in university-based health and mental health care settings: reductions in alcohol use and correlates of success.

The purpose of this study was to assess the efficacy of a screening and brief intervention program for college students in a naturally occurring university-based primary health and mental health care setting. One-hundred seventy five students who met our screening criteria (>8 for men or >7 for women on the Alcohol Use Disorders Identification Test) enrolled in the project, and six-week follow-up data were collected from 120 (69%) of them. Results indicated that after receiving the intervention students reported decreased alcohol use, more accurate perceptions of other students' drinking, and increased use of protective behavioral strategies. Results also indicated that the individual-level changes in alcohol use were positively correlated with changes in the students' perceptions of drinking among their peers. Implications of the findings for clinicians, administrators, and researchers in the college drinking intervention and prevention field are discussed.

Do protective behavioral strategies mediate the relationship between drinking motives and alcohol use in college students?

OBJECTIVE: Heavy alcohol use among college students represents a public health problem on American college campuses. Use of protective behavioral strategies (PBS) has been shown to be related to reduced alcohol use and fewer alcohol-related problems, but the relationship of PBS to other alcohol-related constructs is unclear. The purpose of this study was to determine whether the use of PBS mediated the relationship between positively and negatively reinforcing drinking motives and both alcohol use and alcohol-related problems. METHOD: Data were collected on 254 undergraduate students at a large, public university in the northeast region of the United States. Approximately one third (n = 90) of the participants were volunteers, whereas the remaining individuals enrolled in the study as an option for satisfying an alcohol-related campus judicial sanction. RESULTS: Structural equation modeling analyses indicated that use of PBS partially mediated the relationships between positively reinforcing (i.e., social and enhancement) drinking motives and both alcohol use and alcohol-related problems. Use of PBS did not mediate the relationship between negatively reinforcing (i.e., coping) drinking motives and alcohol use or alcohol-related problems. The theoretical models accounted for 26% of the variance in alcohol use and 24% of the variance in alcohol-related problems. CONCLUSIONS: This study suggests that PBS should be incorporated into theoretical models devoted to understanding college student drinking.

Differences between actual and perceived student norms: an examination of alcohol use, drug use, and sexual behavior.

Researchers in the social norms area have previously focused primarily on alcohol consumption, paying comparatively less attention to drug use and sexual behavior. The major purposes of this study were to (1) compare perceptions of peer norms in the areas of alcohol use, drug use, and sexual behavior with actual behavior and (2) determine if a relationship existed between a student's perceptions of normative behavior and a student's actual behavior. Participants were 833 college students at a large, public university in the Northeast. Study participants overestimated alcohol use, drug use, and sexual behavior among their peers. There was also a positive relationship between actual behavior and perceived peer norms, although the effect sizes for all behaviors were small to moderate. The authors provide further support for the tenets of social norms theory and suggest that social norms interventions are appropriate both campus-wide and to targeted high-risk groups.

Do female college students who purge report greater alcohol use and negative alcohol-related consequences?

OBJECTIVE: There has been little research examining the relative importance of the amount of substance consumed versus consequences of substance use in persons with eating disorders. The current study examined the status of both aspects of alcohol use in persons with problematic eating behavior. METHOD: Twenty-one women who reported purging on the National College Health Assessment were identified from a larger (N = 391) sample. A matched group was also created from the larger sample. These groups were compared on alcohol consumption and negative alcohol-related consequences. RESULTS: Participants who purged reported both more frequent alcohol use and more negative consequences of alcohol use than the comparison group. Some of the negative consequences were severe. DISCUSSION: The current study extends previous research on the association between eating disorders and alcohol use disorders. Because alcohol use and the negative consequences of alcohol use are not identical, they both should be assessed in persons with eating disorders.