"If You Don't Eat, You Can Get Drunk Faster": A Qualitative Investigation of Food and Alcohol Disturbance (FAD) Expectancies.

Background: Food and alcohol disturbance (FAD; i.e., use of any compensatory behavior within the context of a drinking episode to offset alcohol-related calories and/or enhance the effects of alcohol) is prevalent among U.S. college students and associated with negative consequences. Expectancies for anticipated outcomes of alcohol use and thinness/restriction behaviors, which comprise FAD, serve as promising targets of intervention for these behaviors individually; however, no study to date has identified or examined FAD expectancies, specifically. Objectives: The purpose of this study was to qualitatively examine the positive and negative FAD expectancies described by students experienced with FAD. Methods: Semi-structured open-ended interviews were conducted with 22 undergraduates with a lifetime history of FAD behavior (72.7% female, 77.3% white non-Hispanic, Mage=20.14). Results: Positive FAD expectancy themes included: Mood Improvement, Appearance/Weight-related Benefits, Alcohol Enhancement, and Social Approval and Connectedness. Negative FAD expectancy themes included: Reputational and Social Concerns, Negative Physical Consequences, Negative Psychological Consequences, and Cognitive and Behavioral Impairment. Conclusions: Results suggest that while there are many similarities, FAD expectancies are distinct from existing alcohol and thinness/restriction expectancies. Specifically, the Mood Improvement theme conceptualizes mood-related improvement within the context of both positive and negative reinforcement and both the Social Approval and Connectedness and Social and Reputational Consequences themes focus on the ways in which one's peers may view and interact with others. Findings lay the groundwork for identifying expectancies that underlie FAD behaviors and provide directions for future research and intervention efforts.

Use of Both Alcohol and Cannabis Protective Behavioral Strategies is Associated with Fewer Negative Consequences: A Moderation Analysis.

Background: Concurrent alcohol and cannabis (i.e. marijuana) use (CAM; use of both substances within the same specified time frame) is prevalent among college students and associated with increased risk of negative substance-related consequences. Extant research supports the use of protective behavioral strategies (PBS) for reducing negative consequences associated with both alcohol and cannabis use. However, limited research exists regarding the efficacy of PBS among CAM users, and it is unknown whether using PBS for both alcohol and cannabis augments protective effects. The present study tested four moderation models to evaluate the interactive effects of alcohol and cannabis PBS on alcohol and cannabis negative consequences and use frequency. Methods: A multisite sample of college students (N = 1705) reporting past-month CAM use completed questionnaires regarding substance use behaviors, PBS use, and substance-related negative consequences. Results: Alcohol and cannabis PBS were negatively associated with alcohol and cannabis use, respectively. However, two-way interactions between PBS on substance use were not supported, such that negative associations between PBS and same-substance use were not augmented as other-substance PBS use increased. Interactive effects of alcohol and cannabis PBS on negative alcohol and cannabis consequences were supported, such that negative associations between alcohol PBS and consequences were augmented as cannabis PBS increased and vice versa. Conclusions: Findings suggest that using both types of PBS may increase protective effects against negative consequences among CAM users. Accordingly, promoting both types of PBS may enhance extant harm reduction interventions.

Compounding Privilege, Resilience, and Nonmedical Prescription Stimulant Use among College Students.

Background: In this study, we examined why non-Hispanic White cisgender men are more likely than other subgroups to misuse prescription stimulants in college. The objective of the current study was to use a strength-based framework to examine intersectional demographic predictors. Methods: We examined gender and race/ethnicity as predictors of nonmedical prescription stimulant use (NPS) among college students. We also investigated resilience as a moderator. This report uses data from an online multisite study conducted at seven universities with 4,764 undergraduate students (70.1% women and 52.0% People of Color). Results: We found that college students who were cisgender men and non-Hispanic White used NPS significantly more than students who identified as another gender and as People of Color. There was also a buffering effect of resilience between race/ethnicity and NPS, such that resilience predicted lower NPS for People of Color, but not non-Hispanic White people 28% of the time. Conclusions: It may be that Students of Color are more resilient than non-Hispanic White students, and this resilience is protective of NPS use in college. Importantly, a compounding-privilege and/or intersectional approach to identity is crucial to fully understanding behavior (in this case NPS) in a diversity of college students; future studies should continue to use and develop such approaches.

ADHD Symptoms and Sex Moderate the Relation Between Protective Behavioral Strategies and Alcohol Use Among Treatment-Mandated College Students.

College students with attention deficit/hyperactivity disorder are likely to engage in alcohol use and experience alcohol-related problems. Use of protective behavioral strategies is related to fewer alcohol-related consequences. However, this association has not been sufficiently examined in relation to attention deficit/hyperactivity disorder symptoms, which could alter the likelihood of utilizing protective behavioral strategies. This study examined whether attention deficit/hyperactivity disorder symptoms moderate the relationship between protective behavioral strategies and alcohol use, and whether this differs by sex. Participants were 125 treatment-mandated college students (58.6% male; Mage = 19.50 years) who completed measures of attention deficit/hyperactivity disorder symptoms, protective behavioral strategies, and past-2-week drinking. There was a significant 3-way interaction such that drinking was highest when protective behavioral strategy use was low and hyperactivity/impulsivity symptoms were high, but only for women. There was also a significant protective behavioral strategy by inattention interaction, as students with high inattention and low protective behavioral strategy use consumed the most drinks. Interventions to enhance use of protective behavioral strategies may effectively decrease alcohol use for college students with attention deficit/hyperactivity disorder symptoms, particularly women.

Nonmedical prescription stimulant users experience subjective but not objective impairments in attention and impulsivity.

BACKGROUND AND OBJECTIVES: Nonmedical prescription stimulant use is frequently reported by college students to improve academic performance, yet it is unknown whether users truly experience cognitive impairments that may drive use. This research compared students with at least one report of nonmedical prescription stimulant use and nonusers on both self-report and objective measures of inattention and impulsivity. METHODS: Two studies examined inattention (N = 155) and impulsivity (N = 115) among college students. Participants completed self-report questionnaires and cognitive tests, including Digit Span, the Paced Auditory Serial Addition Test, and a Continuous Performance Test to assess inattention, and the Balloon Analogue Risk Task and the Stop Signal Task to assess risk-taking and impulsivity. RESULTS: Self-reports of inattention and impulsive symptoms were significantly higher among users, controlling for gender, GPA, self-reported ADHD, alcohol use, and drug use; however, no objective differences were found. DISCUSSION AND CONCLUSIONS: Nonmedical prescription stimulant users may engage in use to overcome perceived deficits in cognitive abilities despite lack of objective evidence. SCIENTIFIC SIGNIFICANCE: Understanding discrepancies in objective performance and subjective reports may aid in the development of effective interventions for nonmedical prescription stimulant use. (Am J Addict 2018;27:238-244).

Factors that Differentiate Prescription Stimulant Misusers from those At-Risk for Misuse: Expectancies, Perceived Safety, and Diversion.

BACKGROUND: The nonmedical use of prescription stimulants (NMUPS) is one of the most prevalent illicit behaviors on college campuses. While numerous risk factors for NMUPS have been identified, it is unknown how nonusing students who meet several risk factors for NMUPS differ from those who have used, which may inform intervention efforts. We expected that users would evidence greater cognitive enhancement and anxiety/arousal expectancies and intentions to use, and lower guilt/dependence expectancies, perceptions of NMUPS-related harm, and academic self-efficacy. METHODS: Between 2014 and 2016, students (N = 121; 65% female) at two demographically dissimilar colleges in the Northeastern and Midwestern United States who reported lifetime NMUPS or endorsed two or more NMUPS risk factors (i.e., recent marijuana use, recent binge drinking, grade point average <3.5, Greek-life involvement, male gender) reported on their prescription stimulant expectancies; academic self-efficacy; perceived harm of NMUPS; lifetime NMUPS; and intentions for NMUPS in the next six months. RESULTS: A MANCOVA showed that at-risk nonusers had lower cognitive expectancies, higher guilt/dependence expectancies, and higher anxiety/arousal expectancies compared to users. ANCOVAs and Chi-square tests showed that nonusers also perceived NMUPS to be more harmful and were less likely to divert their medication if prescribed. The groups did not differ on academic self-efficacy or total number of risk factors endorsed. However, recent marijuana use was more prevalent in users. CONCLUSIONS: Targeted preventive interventions for NMUPS should focus on students who are using marijuana and should aim to maintain lower positive and higher negative stimulant expectancies and reaffirm potential NMUPS-related harms.

Nonmedical prescription stimulant use for suppressing appetite and controlling body weight is uniquely associated with more severe eating disorder symptomatology.

OBJECTIVE: Nonmedical prescription stimulant use (NPS; i.e., use without a prescription or in ways other than prescribed) to suppress appetite or control weight appears to be associated with eating disorder (ED) symptomatology among college students. However, it remains unknown if this relationship is motive-specific and uniquely related to ED symptomatology. This research examined whether engaging in NPS specifically for appetite/weight-related purposes is associated with ED symptomatology and a unique indicator of more severe symptomatology. METHOD: A nonclinical sample of college students (N = 668; 79% female) reported eating disorder symptoms via the Eating Pathology Symptoms Inventory and Eating Disorder Examination-Questionnaire, and lifetime history of NPS and corresponding motives. RESULTS: Binge eating, body dissatisfaction, negative attitudes towards obesity, restricting, purging, and cognitive restraint were reported more frequently by students who endorsed NPS for weight/appetite-related purposes than by those who used for other purposes or denied lifetime NPS. Additionally, NPS for appetite/weight-related purposes was uniquely associated with ED symptomatology after adjusting for gender, lifetime NPS, and past-month binge eating and purging. DISCUSSION: Engaging in NPS for appetite/weight-related purposes is a unique indicator of ED symptomatology, highlighting the need to query for this behavior among individuals with an ED. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:813-816).

The Role of Anonymity in Determining the Self-Reported Use of Cocaine and Nonmedical Prescription Stimulant Use Among College Students.

BACKGROUND: Nonmedical prescription stimulant use (NPSU) is commonly reported by college students and is on the rise. It is possible that increases in NPSU rates may stem from a lack of stigmatization regarding use, given recent evidence that students do not hold strong negative perceptions related to NPSU. OBJECTIVES: This study aimed to assess NPSU and cocaine use using a conventional method and a method that assures anonymity. As anonymous data collection has typically found higher prevalence rates for stigmatized behaviors compared to conventional techniques, it was expected that cocaine rates would differ between techniques, while NPSU rates would not. METHODS: At a Midwestern university during the Fall 2012 and Spring 2013 terms, groups of college student participants were randomly assigned either to a condition in which the data collection method guaranteed their anonymity (n = 204) or to a condition using a more conventional data collection technique that did not guarantee anonymity (n = 236). Participants responded to self-report measures assessing stimulant use, perception of anonymity of the methods, and demographics. RESULTS: When anonymity was guaranteed, male participants were significantly more likely to report cocaine use. However, no differences in NPSU rates were noted for either sex, regardless of anonymity. CONCLUSIONS: These results suggest that NPSU may not have the same perceived negative social consequences as other more stigmatized stimulant drugs, with young men in particular giving little weight to the potential consequences of NPSU.

Examining the Relation Between Social Anxiety and Cannabis Problems Among College Students Through Coping-Related Expectancies and Motives.

Objective: College students high in social anxiety are at increased risk for cannabis-related problems. This may be particularly true when they hold strong coping-related expectancies and motives for cannabis. However, few studies have examined these constructs together in accordance with the motivational model, which posits that substance use is proximally influenced by motives and more distally influenced by expectancies. Thus, the current study examined whether the relation between social anxiety and cannabis-related problems was indirectly explained through coping-related expectancies, motives, and cannabis use. Method: Past-month cannabis users (N = 660; 71.6% female, 47.3% white non-Hispanic) from seven U.S. universities completed an online survey assessing social anxiety, and cannabis use frequency, problems, expectancies, and motives. A saturated path model examined social anxiety as a predictor of cannabis problems via coping-related expectancies and motives, and cannabis frequency. Results: There was a positive indirect effect of social anxiety on cannabis problems through cognitive and behavioral impairment expectancies, depression coping motives, and cannabis use. Social anxiety also indirectly positively related to cannabis problems via social and sexual facilitation expectancies, social anxiety coping motives, and cannabis use. Further, social anxiety indirectly positively related to cannabis problems through relaxation and tension reduction expectancies, both depression and social anxiety coping motives, and cannabis use. These indirect effects were invariant by sex assigned at birth. Conclusions: Results support using a theory-informed model of coping-related cannabis cognitions to understand the relation between social anxiety and cannabis problems. Interventions that modify coping-related cognitions may reduce cannabis-related problems in college students high in social anxiety.

Expectancy for Adderall influences subjective mood and drug effects regardless of concurrent caffeine ingestion: A randomized controlled trial.

RATIONALE: Nonmedical prescription stimulant use (NPS; use without a prescription or in ways other than prescribed) is common among college students. Despite the potential for negative consequences, students continue engaging in NPS for cognitive enhancement purposes, which may be maintained by expectancy and placebo effects. OBJECTIVES: This study examined if a placebo administered under the guise of Adderall influenced subjective mood/drug effects and cognitive performance. Furthermore, this study examined if concurrent caffeine ingestion incrementally enhanced Adderall-related placebo effects. METHODS: Undergraduate students with features that put them at elevated risk for NPS (N = 121) completed measures of mood and drug effects and cognitive assessments on two separate laboratory visits in this parallel randomized controlled trial. Visit 1 was a baseline control visit, on which no drug was expected or received. On visit 2, subjects were randomized to: (1) expect/receive no drug (control); (2) expect Adderall/receive placebo; or (3) expect Adderall/receive 200 mg caffeine. RESULTS: There were several significant condition × visit interactions for subjective effects, including amphetamine effects, energy and efficiency effects, and feeling high. In most cases, participants who expected Adderall reported greater positive subjective effects on visit 2 compared to controls; however, there were generally not incremental enhancements for those ingesting caffeine compared to placebo. There were no significant effects for any cognitive tests. CONCLUSIONS: Expectation for prescription stimulant effects influenced subjective outcomes in a sample of high-risk college students. These findings may inform expectancy challenge interventions to reduce NPS. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03648684.

Sources for prescription stimulant misuse: A person-centered approach to understanding links to substance use and psychiatric impairment.

Prescription stimulant misuse (PSM) is most prevalent among college students and is associated with numerous negative academic and psychosocial outcomes. A large body of literature has identified predictors of PSM in this population, however few studies have utilized a person-centered approach to examine how the sources from which students procure prescription stimulants are associated with substance-related and psychiatric impairment. We used latent class analysis (LCA) to classify a geographically and racially/ethnically diverse sample of U.S. undergraduates (N = 538) who misused prescription stimulants into groups based on their endorsement of nine sources of medication. We selected a five-group classification from the LCA with classes of peer/dealer, given by friend, own prescription, lower multiple sources (i.e., relatively infrequent endorsement of multiple sources), and any source. Compared to the reference group (given by friend), the own prescription class was less likely to report marijuana use, simultaneous alcohol and marijuana use, alcohol or marijuana consequences, and nonoral routes of administration. On the other hand, the own prescription class was more likely to screen positive for anxiety, anger, and suicidality. Similarly, the lower multiple sources group was more likely to screen positive for depression, anxiety, anger, and suicidality. Prevention and intervention efforts focused on PSM may be tailored differently for students who are misusing their own medication and/or endorsing multiple sources. Specifically, these students may need broader assistance with comorbid psychiatric conditions, particularly suicidality, while students who obtain stimulants from peers or a dealer may benefit more from substance-focused interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Negative Affect Regulation and Marijuana Use in College Students: Evaluating the Mediating Roles of Coping and Sleep Motives.

Negative affect regulation models suggest that marijuana may be used to reduce negative affect. Extant research has provided support for these models, indicating that specific motives for marijuana use, particularly coping motives (i.e., using to alleviate negative affects), mediate relations between affective vulnerabilities and marijuana outcomes. However, sleep motives (i.e., using to promote sleep) have been neglected from such models, despite their theoretical relevance. The present study tested two multiple mediation models in a large sample of marijuana-using college students (N = 1,453) to evaluate the indirect effects of coping and sleep motives in paths from depressive and anxiety symptoms to marijuana outcomes (use, consequences, and cannabis use disorder [CUD] symptoms). Both coping and sleep motives mediated the effects of depressive/anxiety symptoms on each marijuana variable. Moreover, significant double mediated effects were found, such that higher affective symptoms were associated with greater motives; which were associated with more marijuana use; which was related to more negative consequences and CUD symptoms. The findings provide support for sleep motives as a relevant pathway between affective vulnerabilities and marijuana outcomes. Additional research is needed to evaluate the potential benefits of interventions targeting specific marijuana motives.

Who's at greatest risk? Latent profiles of alcohol and cannabis use and related consequences among college students.

BACKGROUND: There is significant heterogeneity in alcohol and cannabis use patterns among college students, with some engaging in use patterns that heighten their risk for adverse consequences. Person-centered approaches can help identify those subgroups of students with riskier use patterns. Latent Profile Analyses (LPA) were conducted to identify subgroups based on alcohol and cannabis use frequency and quantity, to explore demographic covariates and to examine mean differences across subgroups on alcohol- and cannabis-related consequences, simultaneous use, and other substance use. METHODS: Participants were 2,423 college students (Mage = 20.1; 72  % female) recruited from seven US universities who endorsed past-month alcohol and cannabis use and completed an online survey of substance use behaviors. RESULTS: A four-profile solution was the best fitting model. Profile 1 represented "light, infrequent alcohol and cannabis use" (73.8 %), Profile 2 represented "heavy, infrequent alcohol and moderate, frequent cannabis use" (15.9 %), Profile 3 represented "moderate, frequent alcohol and cannabis use" (5.6 %) and Profile 4 represented "very heavy, frequent alcohol and heavy, frequent cannabis use" (4.7 %). Students who identify as male, White non-Hispanic, and/or Greek-affiliated were more likely to be in the heavy alcohol use profiles. Profiles 3 and 4 represent high-risk profiles, with both having a higher likelihood of simultaneous use, Profile 3 endorsing more cannabis consequences, and Profile 4 endorsing more alcohol consequences. CONCLUSION: Results suggest that heavy alcohol or heavy co-use heightens risk for serious adverse consequences.

An examination of the effects of ADHD symptoms and sex on the relation between cannabis protective behavioral strategies and cannabis consequences.

The risk for cannabis-related problems is elevated among young adults with attention-deficit/hyperactivity disorder (ADHD) symptoms. It is unknown whether the use of cannabis protective behavioral strategies (PBS) mitigates this risk for college students with ADHD. Prior research finds that college students who use alcohol and report high levels of ADHD symptoms particularly benefit from employing alcohol PBS, and these relations are strongest for male students. Thus, this study examined the moderating effects of ADHD symptoms and sex assigned at birth on the relation between cannabis PBS use and cannabis-related problems among college students who use cannabis. Participants were 384 college students (66.9% female, 57.8% white non-Hispanic, Mage = 19.29) from 12 United States universities who reported past-month cannabis use. Participants completed measures of demographics, ADHD symptoms, past-month cannabis frequency and related problems, and cannabis PBS use via an online survey. There was a significant interaction of ADHD hyperactive/impulsive symptoms, PBS use, and sex on cannabis-related problems, controlling for cannabis use frequency. The strength of the negative association between PBS use and problems depended on level of ADHD symptoms for females, but not for males. However, there were no interactive effects for ADHD inattentive symptoms. These results supplement the literature base on relations between PBS use and ADHD symptoms in college students, extending support for their use to cannabis users. Importantly, promoting PBS use to female college students who are high in hyperactive/impulsive ADHD symptoms is recommended.

Perceived racial/ethnic discrimination among young adult college students: Prevalence rates and associations with mental health.

Objective/Participants: In a large, diverse sample of college students (N = 2,230), this online study investigated racial/ethnic differences on type of discriminatory event experienced and perceived stress, and whether discrimination-related stress was associated with mental health symptoms. Methods: Prevalence of lifetime/past year discriminatory events was assessed and frequency of discrimination-related stress was compared across racial/ethnic groups. Correlations between discrimination-related stress and mental health symptoms were also examined. Results: All racial/ethnic groups reported experiencing all types of discriminatory events, though prevalence was lowest for White students. Racial/ethnic minority (i.e., Asian, Black, Latinx) students reported greater discrimination-related perceived stress compared to White, non-Hispanics. Across all racial/ethnic groups, discrimination-related stress was positively associated with negative mental health outcomes (e.g., anxiety/depressive symptoms). Conclusions: These results highlight the need to continue efforts to reduce discriminatory experiences of racial/ethnic minority students and to incorporate antiracism interventions in universities to mitigate the pervasive negative experiences of minority students.

Sex-related impelling cues uniquely predict event-level alcohol-related sexual behavior that poses heightened risk for negative consequences among college women.

The occurrence of sexual behavior that poses heightened risk for negative outcomes (e.g., condomless sex, sex with new or unfamiliar partners) often involves drinking alcohol for social and enhancement purposes, with female college students being particularly at-risk for resulting consequences. This study examined whether alcohol use, drinking motives, and sex-related impelling cues (i.e., cues that may impel one toward engaging in sexual activity) could predict sexual behaviors that pose heightened risk for negative consequences among female undergraduates. A total of 251 drinking episodes from 56 female college students (M age = 19.66) were obtained via surveys assessing alcohol use, drinking motives, sex-related impelling cues, and sexual behaviors at the event level. Relationships between variables were examined via main effect and factorial generalized estimating equations for social, enhancement, coping, and conformity drinking motives. In each main effects model, sex-related impelling cues were the only significant predictor. Significant three-way interactions were found in the social and enhancement factorial models, such that sexual behaviors that pose heightened risk for negative consequences occurred 58.81% and 55.81% of the time, respectively, under conditions of high drinks, motives, and sex-related impelling cues. This study provides a more nuanced understanding of the circumstances under which these sexual behaviors are most likely to occur, necessitating the consideration of sex-related impelling cues in addition to previously known predictors (i.e., alcohol use and drinking motives). This knowledge may assist in developing targeted interventions designed to reduce sexual behavior that poses heightened risk for negative consequences and ultimately improve the lives of college women. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Expectation for stimulant type modifies caffeine's effects on mood and cognition among college students.

Caffeine is regularly used by college students to enhance mood and academic performance. Although high doses confer risk for negative consequences, moderate doses of caffeine may lead to acute improvements in mood and cognitive functioning. Notably, the pharmacological effects of caffeine may be enhanced by expectancy effects. College students may also engage in nonmedical prescription stimulant use for similar purposes, as students expect strong cognitive enhancement from prescription stimulants and consider them to be more efficacious than caffeine. The purpose of the current study was to examine whether the pharmacological effects of caffeine on mood/drug effects and cognitive performance are enhanced when expecting a conceivably stronger stimulant (i.e., Adderall) compared to when expecting caffeine. Sixty-five undergraduate students were randomized to condition across two variables: drug ingested (placebo or 200 mg caffeine) and drug expected (caffeine or Adderall). Participants completed self-report measures of mood and drug effects pre- and post-drug, as well as cognitive assessments post-drug. There were significant main effects of drug ingested and drug expected on several post-drug measures. Subjects receiving caffeine reported feeling more high, stimulated, anxious, and motivated than subjects receiving placebo. Further, subjects expecting Adderall reported stronger amphetamine effects and feeling more high, and performed better on a working memory test, than those expecting caffeine. Effects tended to be strongest in participants receiving caffeine and expecting Adderall. Modifying expectancies, in conjunction with the pharmacological properties of caffeine at moderate doses, may be one mechanism by which college students may experience differential effects of caffeine. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A qualitative examination of college students' perceptions of cannabis: insights into the normalization of cannabis use on a college campus.

ObjectiveThis study aimed to qualitatively examine how perceptions of cannabis differ among college students in an effort to better understand the changing landscape of cannabis on college campuses. Participants: Forty-six predominantly male (69.9%; Mage = 23.15, SD = 4.11) college students attending a border state university (i.e., a state that has not yet legalized cannabis but borders a state that has). Methods: Participants engaged in facilitated focus group discussions (N = 5) about cannabis-related issues. Results: Thematic analysis uncovered three primary themes and six subthemes. Main themes included: 1) User Heterogeneity and Identity, 2) Relative Benefits and Harms of Cannabis, and 3) Social Position of Cannabis on Campus Culture. Conclusions: Cannabis has quickly integrated into the college social environment, with social stigmatization and identification with cannabis impacting decisions to use. Findings inform existing college health programs on how to approach conversations about cannabis with students.

Prescription Stimulant Misuse and Diversion Events Among College Students: A Qualitative Study.

Prescription stimulant misuse and diversion are interrelated behaviors: diversion increases the availability of stimulants for misuse, and persons who misuse are also more likely to divert. To date, research has examined these behaviors using a primarily quantitative lens. We led a qualitative investigation to better understand misuse and diversion events. Data are from a diverse southern California campus where we interviewed students who misuse and/or divert prescription stimulants (32 total interviews: 16 interviews with students who had a history of misuse, and 16 different interviews with students who had a history of diversion). We analyzed interview data inductively. We identified the following themes about misuse and diversion events, several of which intersected during interviews: medication surplus, diversion and misuse hubs, ease of behavior performance, academic stress, and other drugs commonly involved. For diversion, altruism and monetary gain were juxtaposed themes. Across themes, friends and family were influential figures. Implications for prevention, intervention, and future research directions are discussed.

Mental Health Risk Profiles and Related Substance Use During Coronavirus Pandemic Among College Students Who Use Substances.

College students have shown elevated mental distress during the coronavirus disease of 2019 (COVID-19). The extent and persistence of mental distress as COVID-19 restrictions have continued is unclear. This study used latent profile analysis to identify student mental health risk subgroups and to evaluate subgroups in relation with substance use. A four-profile solution was supported with a sample of 930 college students (69.6% female, 58.1% White) from 11 US-based institutions. Students were characterized by slight mental health symptoms, mild mental health symptoms, moderate-to-severe mental health symptoms with mild psychosis/substance use, and severe mental health symptoms. The severe profile comprised more ethnoracial or sexual minorities and students impacted from COVID-19. Whereas the severe profile had more alcohol-related consequences, the slight profile had fewer cannabis-related consequences. COVID-19 has exacerbated college student risks for psychiatric disorders. Students of diverse backgrounds and more impacted by COVID-19 show disproportionately more mental distress and related substance use.