Food and alcohol disturbance among people who have undergone bariatric surgery.

There have been numerous investigations of aberrant eating and substance abuse among patients who have undergone bariatric surgery, which affects the metabolism and the pharmacokinetics of alcohol. However, there is a dearth of literature considering the complex interplay between changes in post-surgery food and alcohol consumption. Furthermore, despite the increasing recognition of issues surrounding replacing food consumption with alcohol consumption (Food and Alcohol Disturbance [FAD]), most emerging research has focused on young adult populations. This perspective reviews and synthesizes the small but growing body of research on the interplay between food and alcohol consumption, particularly FAD, and considers its application to bariatric surgery in general. There are unique considerations for patients who have undergone bariatric surgery. Patients experience altered gastric anatomy, which affects food and alcohol metabolism, and are advised to abstain from drinking alcohol after surgery. After reviewing the available literature, this perspective highlights future directions for research and practice in bariatric surgery.

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

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

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

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

Development and validation of the alcohol-related content poster prototype scale: Exploring the impact of social media prototypes on college students' drinking.

BACKGROUND: Drinking is a public health concern among college students. Viewing and posting alcohol-related content (ARC) on social media may influence students' favorable prototypes of people who post, thereby impacting their drinking. This study created a measure to explore students' ARC poster prototypes. We validated our measure by examining the prototypes as mediators of the associations between viewing and posting ARC and drinking behaviors. METHODS: Students (N = 8065) were asked to complete measures related to viewing and posting ARC, drinking behaviors, and adjectives that described their perceptions of the prototypical college student who posts ARC on social media. RESULTS: Exploratory and confirmatory factor analysis yielded three prototypical images of students who post ARC on social media: hedonistic, despondent, and sociable. There were significant pathways between viewing and posting ARC and drinking. The sociable prototype emerged as a significant mediator of the association between ARC viewing and posting and drinking. CONCLUSIONS: Understanding the role of students' poster prototypes may be important for informing targeted interventions. Our results indicate that the underlying reason for increased drinking among students with greater ARC engagement is that they perceived other ARC viewers and posters as being more sociable. Future research may focus on modifying these perceptions.

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

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

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

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

Classifying risky cannabis involvement in young adults using the Marijuana Consequences Questionnaire (MACQ).

BACKGROUND: Despite the growing prevalence of cannabis use and associated consequences among U.S. young adults, relatively little is known about precisely what level of marijuana involvement may be problematic. METHOD: With this study we sought to identify empirically-derived cut-scores for the Marijuana Consequences Questionnaire (MACQ) that would distinguish among levels of cannabis risk in a sample of young adult college students (N = 496). We also examined how these levels of cannabis risk corresponded to a variety of indicators of cannabis involvement, including frequency of use, intoxication, other measures of cannabis consequences, and indicators of more severe cannabis involvement (e.g., physiological dependence, loss of control over use, cannabis use disorder). RESULTS: Receiver operating characteristic analyses yielded cutoffs that distinguished among three distinct levels of risk, "Low", "Moderate", and "High". These empirically derived cut scores showed strong overall differentiation among classifications, with good sensitivity and specificity. MACQ-based risk levels were validated across several indices of cannabis involvement. Cutoffs differed across genders. CONCLUSIONS: Findings offer a new application for the MACQ, allowing for the identification of those at greatest risk. As such, this measure may be used to facilitate appropriately targeted intervention.

Self in the Service: Self-Identification Moderates the Association between Perceived Drinking Norms and Own Drinking among Veterans.

PURPOSE: Drinking is common among young adult veterans. Previous research has established that veterans' drinking is more strongly associated with veteran versus civilian drinking norms. The present research extends these findings by examining the influence of self-identification both with other veterans and with civilians as moderators of the association between perceived norms and drinking. METHODS: Veterans aged 18-34 (N = 1015; 88.7% male; M = 28.23, SD = 3.44) were recruited via Facebook to participate. Measures included same-gender veterans/same-gender civilians self-identification, same-gender veterans/same gender-civilians perceived drinking norms, and own drinking. RESULTS: Pairwise comparisons revealed both male and female veterans identified more with other veterans than civilians and perceived drinking to be more prevalent among other veterans than civilians. However, males overestimated male veteran drinking norms to a greater degree than male civilian norms whereas the opposite was true for females. Negative binomial analysis examining a three-way interaction between veteran identification, civilian identification, and civilian norms revealed civilian drinking norms were positively associated with drinking, particularly for veterans who strongly identified with both veterans and civilians. Conversely, civilian drinking norms were also found to be negatively associated with drinking, particularly for those who did not identify strongly with civilians but identified strongly with veterans. IMPLICATIONS: This study represented a preliminary step for understanding how identity plays a role in terms of veterans' drinking. Given that veterans drank at differing levels of identification, it may be important to consider identities that are most salient when designing interventions targeting individual veterans.

Shyness and susceptibility to social influence: Stronger concordance between norms and drinking among shy individuals.

Despite a large body of work exploring associations between perceived norms and drinking and norms-based interventions for drinking, less work has examined moderators of associations between norms and drinking outcomes to determine potential sub-groups that might benefit most from brief norms-based interventions. The present study investigates shyness as a moderator of associations between drinking norms and alcohol use. We hypothesized that shyness would moderate associations between drinking norms and alcohol use such that individuals who are higher in shyness might be more sensitive to social influence and thus show stronger associations between drinking norms and alcohol use. Participants included 250 college students (70% female; 44.5% White/Caucasian) aged 18-26 (M = 21.02, SD = 2.16) who met heavy drinking criteria (4/5 drinks on one or more occasions in the past month for women/men). Participants completed measures of demographics, shyness, alcohol use, alcohol-related problems, and drinking norms remotely at baseline and one-month follow-up (N = 169). Drinking norms were negatively associated with shyness and positively associated with baseline and follow-up drinking. Shyness was negatively associated with baseline drinking but not associated with follow-up drinking. Interaction models tested longitudinal associations between shyness, descriptive drinking norms, and follow-up drinking, controlling for baseline drinking and gender. Results showed that associations between drinking norms and drinks per week were strongest among people who were higher in shyness. Individuals who are shy may be more susceptible to social influence and thus may benefit more from a norms-based drinking intervention. Future work may explore shyness as a moderator of norms-based intervention efficacy.

Double Vision on Social Media: How Self-Generated Alcohol-Related Content Posts Moderate the Link between Viewing Others' Posts and Drinking.

A robust finding is the positive association between self-generated alcohol-related content (SG-ARC) on social media (SM) and drinking among emerging adults; however, the reasons for this relationship are still unclear. A factor that has yet to be explored in combination with SG-ARC is how viewing others' alcohol-related content (ARC) may be impacting young adults' drinking. This cross-sectional study conducted across two universities asked students (N = 780; M = 20.80 years old; SD = 2.29; 67.82% female) to self-report how many SG-ARC posts they posted, to estimate how much they saw others' ARC, and how much they drank weekly. SG-ARC was then evaluated as a moderator of the association between viewing others' ARC and drinking. A negative binomial regression model with robust sandwich estimators was employed. Results revealed that both SG-ARC and viewing others' ARC were positively associated with drinking. A significant two-way interaction between SG-ARC and others' ARC emerged such that viewing others' posts appeared to exert an influence on drinking, particularly for students who did not post as many SG-ARC posts. These findings provide evidence that seeing others' ARC may be socially influencing students to drink, especially if they do not post as much SG-ARC themselves, by altering their internalized drinking norms.

Ethical tipping point: Nurses' presence on social media.

ABSTRACT: This article discusses ethical concerns surrounding social media content posted by nurses; specifically, how these posts may violate public trust. It also summarizes considerations for nurses to contemplate before posting to social media and provides examples of positive uses of social media.

Who cares if college and drinking are synonymous? Identification with typical students moderates the relationship between college life alcohol salience and drinking outcomes.

There is considerable research demonstrating that college life alcohol salience is associated with alcohol use among undergraduates. However, the strength of this association may depend on whether students self-identify with other students on their campus; self-identification with other students may indicate how influential other students are on an individuals' drinking. As such, the current research investigated whether identification with the "typical student" moderated the relationship between college life alcohol salience beliefs and alcohol-related outcomes. Five-hundred and eleven undergraduates reported their alcohol use, how closely they identified with other students, as well as their college life alcohol salience beliefs. Poisson moderated regression models and negative binomial moderation regression models were employed. Results indicated that self-identification with other students was a significant moderator of the association between college life alcohol salience beliefs and frequency of drinking as well as peak number of drinks, but not drinks per week or alcohol-related problems. Findings suggest that it may be important to shift students' perceptions surrounding drinking as being an important part of the college experience, particularly for those who identify with their peers.

My friends, I'm #SOTALLYTOBER: A longitudinal examination of college students' drinking, friends' approval of drinking, and Facebook alcohol-related posts.

BACKGROUND: Literature has consistently shown a positive relationship between young adults' social media alcohol-related posts and drinking outcomes; however, the reasons for this association and the psychosocial influences behind students' posting of alcohol-related content are still unclear. Peer influences have been robustly shown to predict students' drinking such that students' perceptions of their friends' drinking is positively associated with their own drinking. OBJECTIVE: Although research has demonstrated that online and offline peer influences are robust predictors of drinking among college students, perceptions of friends' approval and students' drinking in relation to alcohol-related posting have yet to be explored longitudinally. METHODS: The current multi-site, multi-method study examined students (N=316; 58.7% female) from a Midwest (58.8%) and Northwest university over a 4-year period. All Facebook alcohol-related posts were coded each academic calendar year and perceived friends' approval of drinking and students' alcohol use were assessed annually. A lagged, random coefficients negative binomial model was specified to examine between- and within-person effects. RESULTS: After controlling for perceptions of friends' alcohol-related posts, results revealed that time, drinking more, and perceiving friends as more approving of drinking were significantly and positively associated with posting alcohol-related content at the between-person level. Moreover, a significant interaction of Time X Drinking, with drinking at the between-person level, emerged such that heavier drinkers tended to post less often over time. CONCLUSIONS: Increases in alcohol-related content posts are likely to over-inflate students' drinking norms and their drinking. Thus, it is plausible that social media networks containing more alcohol-related content may contribute to cyclical increases in drinking for individuals within that network.

The buffering effect of social support on the relationship between discrimination and psychological distress among church-going African-American adults.

Discrimination is a pervasive stressor among African-American adults. Social support is an important protective factor for psychological distress, especially among minority populations. Although a number of studies have examined social support in relation to discrimination, little research has examined how social support may serve as an important protective factor against both physical and psychological symptoms related to overall psychological distress within this group. The current study examined social support as a moderator of the relationship between discrimination and overall psychological distress as measured by the Brief Symptom Inventory among a community sample of 122 African-American church-going adults. Results indicated that social support buffered the associations of discrimination and overall psychological distress (p < 0.0001) in expected directions. Findings highlight the importance of cultivating strong social relationships to attenuate the effects of this social determinant on mental health disparities among this group.

Contrasting the effects of harmonious and obsessive passion for religion on stress and drinking: Give me that old time religion and a beer.

Research has established two types of passion (i.e., harmonious and obsessive) for several activities, behaviors, and relationships (Vallerand & Houlfourt, 2003). Harmonious passion is characterized by an autonomous orientation toward an activity, while obsessive passion is characterized by a more controlled orientation toward an activity. Similar but not congruent conceptualizations of approaches to religion have been explored. Moreover, the preponderance of research suggests that religiousness is associated with decreased problematic alcohol use. However, little research has been done into contrasting approaches to religious devotion. We explored harmonious and obsessive passion for religious beliefs and practices and their association with alcohol use and alcohol-related problems. Perceived stress and satisfaction with life were examined as mediators. Participants included 707 undergraduate students (54.8% female) from a large southwestern university who were recruited as a part of a larger alcohol-related intervention trial. Data were collected at three time points: baseline, 3-month follow-up, and 6-month follow-up, and were analyzed prospectively, with passion and mental health at time 1 and time 2 predicting alcohol outcomes at time 2 and time 3. The indirect effects of both obsessive passion and harmonious passion on alcohol problems through perceived stress were significant, and in opposite directions. Additionally, moderation analyses showed that both obsessive and harmonious passion for religion moderated the associations between perceived stress and drinking and between perceived stress and alcohol problems.

Personalized normative feedback for heavy drinking: An application of deviance regulation theory.

Deviance Regulation Theory (DRT) proposes that individuals regulate their behavior to be in line with the behaviors of others. Specifically, individuals desire to stand out in positive way and not stand out in a negative way. DRT has been successfully applied to encourage other health behaviors and offers a unique method to utilize both injunctive norms in combination with descriptive norms in brief alcohol interventions. This randomized controlled trial evaluated a computer-delivered, norms-based personalized feedback intervention which systematically varied the focus on whether specific drinking behaviors were described as common or uncommon (a descriptive norm), whether the drinking behaviors were healthy versus unhealthy, and whether the drinking behaviors were positively or negatively framed (an injunctive norm). Nine-hundred and fifty-nine college drinkers completed baseline, three-month, and six-month follow-up assessments. Results indicated messages focusing on unhealthy drinking behaviors, particularly when described as uncommon, were most effective in reducing drinking and alcohol-related problems over time. This research utilizes deviance regulation theory as a way of improving personalized normative feedback by elucidating how to construct messages for brief interventions based on descriptive characteristics associated with specific target drinking behaviors in combination with perceptions of prevalence and acceptability of such drinking behaviors (an injunctive norm).

Evaluation of Alcohol-Related Personalized Normative Feedback With and Without an Injunctive Message.

OBJECTIVE: Personalized normative feedback (PNF) has been used extensively to reduce alcohol consumption, particularly among heavy drinkers. However, the majority of PNF studies have used only descriptive norms (real or perceived pervasiveness of a given behavior). The purpose of the current study was to explore the efficacy of PNF both with and without an injunctive message indicating approval or disapproval based on the participants' standing relative to other students' drinking levels. This randomized trial evaluated two brief web-based alcohol intervention conditions (descriptive-norms-feedback-only condition versus a descriptive-plus-injunctive-message condition relative to an assessment-only control condition). METHOD: Participants included 176 students who had reported at least one heavy drinking episode in the past month. Participants completed baseline and follow-up assessments of perceived norms and drinking. Follow-up assessments were completed at 2 weeks post-intervention by 165 (94%) participants. RESULTS: Analyses were conducted using zero-inflated negative binomial regression models. As expected, the descriptive-norms-only condition was effective in reducing drinking among heavier baseline drinkers at follow-up relative to the control condition. However, contrary to expectations, the descriptive-plus-injunctive-message condition did not predict less drinking at follow-up. CONCLUSIONS: This study was unique in using an injunctive message as an adjunct to descriptive-norms feedback within the context of drinking. Findings highlight the need for additional research into the role of defensiveness, which may serve as an impediment to using injunctive norms/messages in interventions for problematic substance use and other potentially stigmatizing behaviors.

God, Can I Tell You Something? The Effect of Religious Coping on the Relationship between Anxiety Over Emotional Expression, Anxiety, and Depressive Symptoms.

The current study investigated whether religious coping would moderate the association between ambivalence over emotional expression (AEE) and depressive symptoms and anxiety symptoms such that the positive relationship between AEE and depressive symptoms and anxiety symptoms would be weaker among those higher in religious coping. Three-hundred and fifty-two undergraduates (M age=23.51 years, SD=6.80; 84.4% female) completed study materials. Contrary to expectations, results revealed a significant interaction between religious coping and AEE such that religious coping exacerbated the relationship between higher AEE and distress symptoms. The implications of this study suggest that religious coping may not be an ideal coping mechanism for individuals with high levels of AEE. These results indicate the need to further examine the role of AEE in religious coping, and have potential implications for clinicians, healthcare professionals, and religious mentors who may promote the use of religious coping in treatment.

The Influence of Social Media on Addictive Behaviors in College Students.

Social media has become a primary way for college students to communicate aspects of their daily lives to those within their social network. Such communications often include substance use displays (e.g., selfies of college students drinking). Furthermore, students' substance use displays have been found to robustly predict not only the posters' substance use-related outcomes (e.g., consumption, problems) but also that of their social networking peers. PURPOSE OF REVIEW: The current review summarizes findings of recent literature exploring the intersection between social media and substance use. RECENT FINDINGS: Specifically, we examine how and why such substance use displays might shape college students' internalized norms surrounding substance use and how it impacts their substance use-related behaviors. SUMMARY: Additional social media-related interventions are needed in order to target reduction of consumption among this at-risk group. We discuss the technological and methodological challenges inherent to conducting research and devising interventions in this domain.

General Needs Satisfaction as a Mediator of the Relationship Between Ambivalence Over Emotional Expression and Perceived Social Support.

The detrimental effect of ambivalence over emotional expression (AEE) on social support has been well documented. However, the underlying mechanism of this effect remains unclear. Research has demonstrated that when general needs are not met, negative psychological outcomes occur. Thus, the current study investigated general needs satisfaction (GNS) as a potential mediator of the association between AEE and social support among 352 undergraduates. Results revealed that AEE was negatively associated with autonomy, relatedness, competence, and social support, whereas social support was positively associated with autonomy, competence, and relatedness. Further, GNS and each of its three subscales were all found to significantly mediate the association between AEE and social support. Thus, findings from the present study contribute to our understanding of AEE by illustrating a potential mechanism through which AEE may lead to a lack of perceived social support, namely GNS.