Associations Between Alcohol and Cannabis Use and Pain Among College Student-Athletes.

Background: Pain motivates alcohol and cannabis use, with evidence that pain catastrophizing (i.e., ruminative exaggeration of pain) mediates these associations. Student-athletes represent a unique population who engage in riskier substance use, experience more substance-related consequences, and are more likely to develop chronic pain compared to non-athletes. Objectives: This study examined relationships between pain, catastrophizing, alcohol and cannabis use and consequences. Student-athletes from two Division I universities (N = 549; 51% female) completed a cross-sectional survey. Moderated mediation tested the conditional indirect effect of pain catastrophizing on associations between pain and alcohol- and cannabis- use and consequences, separately, with sex moderating the a and b paths. Results: There was a significant direct effect between pain and alcohol-related consequences (b = 0.11, p = .008). Pain and pain catastrophizing were positively associated in all four models (bs = 0.68-0.72, ps <.001), and this relationship was stronger among female than male athletes. No other direct or conditional indirect effects were observed. Conclusions: Student-athletes experiencing pain report more alcohol-related consequences, and pain catastrophizing may be particularly relevant for student-athletes with greater pain. Future research should examine other factors proposed by theoretical models, such as negative affect, while focusing on athletes with more significant pain (e.g., injured athletes).

Expectancies for and Pleasure from Simultaneous Alcohol and E-Cigarette Use among Young Adults.

Background: Young adults' use of alcohol and e-cigarettes are of public health concern, as they report among the highest prevalence for use of both substances. Many young adults use alcohol and e-cigarettes simultaneously (i.e., at the same time with overlapping effects) despite heightened risk for adverse effects. Objectives: This study assessed simultaneous use expectancies and changes in pleasure from e-cigarettes as a function of alcohol consumption and simultaneous use frequency. Participants (N = 408; Mage = 23.64 years; 52.7% female) recruited through Amazon MTurk completed measures of alcohol and e-cigarette use, and expectancies, pleasure and frequency of simultaneous use. Results: Separate linear regression models revealed that alcohol consumption was positively associated with expectancies for simultaneous use of e-cigarettes/alcohol and pleasure from simultaneous use (ps ≤ .015). As individuals engaged in simultaneous use more frequently, they also reported greater expectancies for, and increased pleasure from, simultaneous use (ps < .001). Conclusions/Importance: Expectancies for simultaneous use may be greatest among young adults who consume more alcohol and engage in simultaneous use more frequently. Increased pleasure from e-cigarettes while drinking suggests that positive reinforcement may be implicated in simultaneous use patterns. Future research should examine the role of pleasure in simultaneous use trajectories.

Sport-Related and Psychosocial Factors Associated With Motives and Consequences Of Alcohol and Cannabis Use Among NCAA Athletes: A Systematic Review.

AIMS: To review differences in alcohol- and cannabis-related motives and consequences among National Collegiate Athletic Association (NCAA) athletes as a function of athlete characteristics (e.g. gender and competition season status). METHODS: Procedures followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, PsycINFO and manual reference list review were used to identify studies that reported alcohol- or cannabis-related motives and consequences among NCAA athletes as a function of gender, race, season status, division level or sport-type through December 2019. Relevant findings and any reported psychosocial correlates were extracted by two independent reviewers. RESULTS: The majority of studies (K = 15) focused on alcohol-related motives or consequences, with one examining cannabis-related motives, and no studies examined cannabis-related consequences. Social drinking motives were strongest among men and White NCAA athletes, and athlete-specific motives were most salient for men and in-season athletes. Cannabis use motives for positive reinforcement (e.g. enhancement) and coping were also strongest during the in-season. Negative alcohol-related consequences were greatest among men, athletes of color and out-of-season athletes, although women and in-season athletes experienced more consequences in athletic performance. Our exploratory aim revealed two studies that examined psychosocial correlates, and the results indicate that sensation-seeking, stress and negative affect were associated with more alcohol-related consequences. CONCLUSION: NCAA athletes are a heterogenous population, and their motives and consequences of use appear to vary across multiple athlete factors (e.g., gender). This review highlights the gaps in the literature and suggests future research directions to identify the risk and protective factors for substance use among NCAA athletes.

Examining Sex Differences in Associations between Pain and Alcohol Use among College Student-Athletes.

Background: College student-athletes are a high-risk population for both pain and alcohol use. Although a growing literature indicates that pain motivates alcohol consumption, no studies have tested associations between pain and alcohol in college student-athletes. Methods and Results: Among National Collegiate Athletic Association Division I student-athletes at a large public university (N = 65; 48% Female), nearly all student-athletes (97%) reported alcohol use and 65% reported pain due to an athletic injury. Pain intensity was positively associated with greater motivation to reduce drinking prior to receiving a brief alcohol intervention. Among females, pain intensity was associated with lower self-reported alcohol consumption. Among male athletes, pain-related interference was associated with greater alcohol-related problems and lower perceived ability to deal with alcohol-related situations. Conclusion: Results provide initial evidence that pain may be important to consider when addressing alcohol use among student-athletes.

Comparison of Pregaming Alcohol Use and Consequences by Season Status and Sex in College Student Athletes.

As student athletes exhibit unique alcohol use patterns based on being in- versus out-of-season and biological sex, we aimed to explore student athlete (N = 442) alcohol use, pregaming behaviors, and associated negative outcomes. Results suggest being out-of-season and male are positively associated with negative alcohol-related consequences, and male athletes report greater numbers of pregame specific alcohol-related consequences than female athletes (p < .05). Female athletes indicated significantly higher estimated blood alcohol concentrations than male athletes on pregaming nights. No differences emerged between in- and out-of-season athletes on pregame consequences. Results suggest that further emphasis on the role season status and sex has on pregaming behaviors and experiencing negative outcomes may be an important next step toward enhancing prevention and intervention approaches.

Initial testing of a computer-based simulation training module to support clinicians' acquisition of CBT skills for substance use disorder treatment.

Cognitive behavioral therapy (CBT) is one of the most common and effective treatments for substance use disorders (SUD); however, effective delivery of CBT depends on a wide variety of nuanced skills that require practice to master. We created a computer-based simulation training system to support the development of necessary skills for student trainees to be able to apply CBT effectively for clients with SUDs. CBT: Introducing Cognitive Behavioral Therapy is an interactive, role-play simulation that provides opportunities for clinician trainees to hone their skills through repeated practice and real-time feedback before application in a clinical setting. This is the first study that tests whether such a simulation improves trainee skills for the treatment of clients with SUDs. Graduate students (N = 65; social work, clinical psychology) completed standardized patient (SP) interviews, were randomized to the simulation training program or manual comparison condition (Project MATCH manual), and completed SP interviews three months post-baseline. Using general linear models, results indicated a significant time x group effect, with students assigned to the simulation training program showing greater improvement in "extensiveness" and "skillfulness" ratings across three skill categories: general agenda setting (p = .03), explaining CBT concepts (p = .007), and understanding of CBT concepts (p = .001). However, manual comparison participants showed greater improvement than simulation trainees in "assessing primary drug use" (prange = .013-.024). No changes in extensiveness or skillfulness of motivational interviewing (MI) style were observed. This pilot test of CBT: Introducing Cognitive Behavioral Therapy offers support for use of this novel technology as a potential approach to scale up CBT training for students, and perhaps clinicians, counseling people with SUDs.