Aesoon Park

Risky Drinking in College Changes as Fraternity/Sorority Affiliation Changes: A Person-Environment Perspective

This study aimed to resolve the direction of the relation between Greek affiliation and substance use by taking advantage of the quasi-experimental nature of change in college fraternity/sorority affiliation. Precollege individual differences and college substance use were examined as a function of time-varying Greek status to characterize self-selection (by which heavy substance users opt into Greek systems) and socialization (by which Greek systems foster heavy substance use). Prospective data on continuously enrolled college students (N=2,376), assessed at precollege and in the first 6 semesters of college, were used. Latent class analysis indicated 4 discrete groups of status: constant Greek members (30%), constant nonmembers (64%), late joiners (2%), and droppers (4%). Random coefficient models demonstrated disaffiliation with Greek systems is associated with decreases in risky drinking and alcohol-conducive environmental factors (peer norms and alcohol availability), whereas affiliation is associated with increases, indicating Greek socialization via sociocognitive and physical environments. Future Greeks differed from nonmembers in diverse individual characteristics and heavier substance use at precollege, suggesting multiple selection paths into Greek systems. Findings suggest a reciprocal relation between Greek environment and individuals in determining the trajectories of college drinking and heterogeneity in drinking as functions of changes in Greek affiliation.

21st Birthday Drinking : Extremely Extreme

Despite public recognition of the hazards of 21st birthday drinking, there is little empirical information concerning its prevalence, severity, and risk factors. Data from a sample of 2,518 college students suggest that 21st birthday drinking poses an extreme danger: (a) 4 of every 5 participants (83%) reported drinking to celebrate, (b) birthday drinkers indicated high levels of consumption, (c) 12% of birthday drinkers (men and women) reported consuming 21 drinks, and (d) about half of birthday drinkers exceeded their prior maximum number of drinks. Current problematic alcohol involvement and its typical correlates strongly predicted both the occurrence and severity of 21st birthday drinking. It is imperative that investigators consider a variety of potential interventions to minimize the harm associated with this rite of passage.

Dual mechanisms underlying accentuation of risky drinking via fraternity/sorority affiliation: The role of personality, peer norms, and alcohol availability.

Heavy drinkers prior to college have been shown to increase their drinking in college via their self-selection into the Greek societies and subsequent Greek influence on their drinking. This study characterized the dual mechanisms underlying these processes: (a) the Greek selection on the basis of personality and precollege drinking and (b) the Greek influence through alcohol-conducive environmental factors. Prospective data obtained in the summer prior to college and over the first 6 semesters of college (N = 3,099) indicated strong precollege drinking-based selection, strong initial influence immediately after college entrance, and sustained influence afterward. Impulsivity/novelty seeking was associated with Greek affiliation both directly and indirectly via precollege drinking, whereas extraversion and neuroticism were associated with Greek affiliation largely independent of precollege drinking. Greek affiliation was related to higher levels of drinking norms immediately after college entrance and alcohol availability by the sophomore year, but not afterward, after controlling for prior drinking. Findings highlight the diverse mechanisms underlying accentuation of risky drinking over the transition to college and during the college years, through dynamic interplay between individuals and high-risk environments.

Personality disorder symptoms, drinking motives, and alcohol use and consequences: cross-sectional and prospective mediation.

Research shows high comorbidity between Cluster B personality disorders (PDs) and alcohol use disorders (AUDs). Studies on personality traits and alcohol use have identified coping and enhancement drinking motives as mediators in the relations among impulsivity, affective instability, and alcohol use. To the extent that PDs reflect extreme expression of these traits, drinking motives should mediate the relation between PD symptoms and alcohol involvement. This was tested using path models estimating the extent to which coping and enhancement drinking motives mediated the relation between Cluster B symptom counts and alcohol use and problems both concurrently and at a 5-year follow-up. Three hundred fifty-two adults participated in a multiwave study of risk for alcoholism (average age = 29 years at Wave 1). Enhancement motives mediated (a) the cross-sectional relation between Cluster B symptoms and drinking quantity/frequency, heavy drinking, total drinking consequences, dependence features, and AUD diagnosis and (b) the prospective relation to AUDs. Although coping motives mediated the relation between Cluster B symptoms and drinking consequences and dependence features cross-sectionally, prospective effects were limited to indirect effects through Time 1.

Selection and Socialization of Risky Drinking During the College Transition: The Importance of Microenvironments Associated With Specific Living Units

Risky drinking among college students differs as a function of living types, with living at Greek houses as a major risk factor. Both self-selection based on prior drinking and socialization through living environments have been shown to account for this association. However, it is not clear whether selection and socialization processes occur as a function of specific living units within living types. Multilevel models using a prospective sample of incoming college students (N = 2,392) demonstrated that (1) precollege drinking based selection into specific living units occurred within both fraternity houses and residence halls (beyond selection into the Greek system in general) and (2) socialization of extremely risky drinking among certain fraternity houses was greater than other houses (beyond greater socialization of living at fraternity houses than residence halls in general). Living unit-level precollege correlates (i.e., college attendance motives and cigarette use) and college correlates (i.e., peer drinking norms and alcohol availability) accounted for most of the selection and socialization effects. These findings highlight the importance of micro-environments associated with specific living units in risky drinking during the college transition.

Cigarette Smoking Predicts Differential Benefit from Naltrexone for Alcohol Dependence

BACKGROUND Identifying factors that modify responsiveness to pharmacotherapies for alcohol dependence is important for treatment planning. Cigarette smoking predicts more severe alcohol dependence and poorer treatment response in general. Nevertheless, there is limited research on cigarette smoking as a potential predictor of differential response to pharmacological treatment of alcoholism. METHODS We examined the association between cigarette smoking and drinking outcomes in the COMBINE (Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence) study, a randomized, double-blind placebo-controlled 16-week trial comparing combinations of medications (i.e., acamprosate and naltrexone) and behavioral interventions (i.e., medical management, combined behavioral therapy) in 1383 alcohol-dependent individuals. RESULTS Smokers (i.e., more than one half the sample) significantly differed from nonsmokers on several demographic and drinking-related variables at baseline and generally had poorer treatment outcomes than nonsmokers. However, smokers who received naltrexone had better drinking outcomes than smokers who received placebo, whereas alcohol use among nonsmokers did not vary by naltrexone assignment. This pattern of findings occurred independent of whether patients received combined behavioral intervention or medical management and remained after controlling for alcoholism typology and baseline demographic differences. Approximately 9% of smokers quit smoking, and an additional 10% reduced their cigarette intake during treatment. Reductions in smoking did not vary by treatment assignment. CONCLUSIONS These results suggest that naltrexone might be particularly beneficial for improving alcohol use outcomes in alcohol-dependent smokers.

Interaction between the DRD4 VNTR Polymorphism and Proximal and Distal Environments in Alcohol Dependence during Emerging and Young Adulthood

The manifestation of alcohol dependence at different developmental stages may be associated with different genetic and environmental factors. Taking a developmental approach, we characterized interaction between the dopamine receptor 4 variable number tandem repeat (DRD4 VNTR) polymorphism and developmentally specific environmental factors (childhood adversity, college/Greek organization involvement, and delayed adult role transition) on alcohol dependence during emerging and young adulthood. Prospective data were obtained from a cohort of 234 White individuals (56% women, 44% men) who were followed up at ages 18 through 34. A longitudinal hierarchical factor model was estimated to model a traitlike persistent alcohol dependence factor throughout emerging and young adulthood and 2 residual statelike alcohol dependence factors limited to emerging adulthood and young adulthood, respectively. We accounted for those alcohol dependence factors by modeling 3 two-way interaction effects between the DRD4 VNTR polymorphism and the 3 developmentally specific environment factors. Carriers of the DRD4 long allele showed greater susceptibility to environmental effects; they showed more persistent symptoms of alcohol dependence as childhood adversity increased and more alcohol dependence symptoms limited to emerging adulthood as college/Greek organization involvement increased. Alcohol dependence among noncarriers of the long allele, however, did not differ as a function of those environments. Although replication is necessary, these findings highlight the importance of repeated phenotypic assessments across development and modeling both distal and proximal environments and their interaction with genetic susceptibility at specific developmental stages.

Associations Between Sleep Hygiene and Insomnia Severity in College Students: Cross-Sectional and Prospective Analyses

Although a small number of studies characterized cross-sectional associations between sleep hygiene and insomnia severity, no prior study has examined their relationships prospectively. Further, the relationship between sleep hygiene and insomnia severity among college students has rarely been examined. This study examined the prevalence of diverse sleep hygiene behaviors and their associations with insomnia severity in two independent samples of college students from a cross-sectional (N=548; mean age=19; 59% female; 71% White) and a two-wave short-term prospective (N=157; mean age=19; 71% female; 76% White) study. A total of 12% to 13% of students reported clinically significant insomnia. On average, students reported frequent engagement in inconsistent sleep-wake schedules and lounging and worrying/thinking about important matters in the bed. Improper sleep scheduling, behaviors that promote arousal near bedtime, and uncomfortable sleeping environments were positively associated with cross-sectional insomnia severity. After controlling for other well-established risk factors, only improper sleep scheduling remained significant. Prospectively, baseline improper sleep scheduling predicted insomnia severity at a 2-month follow-up after controlling for baseline insomnia severity and other well-established risk factors. Together, findings suggest a potential unique role of improper sleep scheduling in insomnia among college students.

DRINKING MOTIVES AS MEDIATORS IN THE RELATION BETWEEN PERSONALITY DISORDER SYMPTOMS AND ALCOHOL USE DISORDER

Research shows high comorbidity between Cluster B Personality Disorders (PDs) and Alcohol Use Disorders (AUDs). Studies of personality traits and alcohol use have identified coping and enhancement drinking motives as mediators of the relation among impulsivity, negative affectivity or affectivity instability, and alcohol use. To the extent that certain PDs reflect extreme expression of these traits, drinking motives were hypothesized to mediate the relation between PD symptoms and presence/absence of an alcohol use disorder (AUD). This hypothesis was tested using a series of cross-sectional and prospective path models estimating the extent that coping and enhancement drinking motives mediated the relation between cluster A, B, and C PD symptom counts and AUD diagnosis among a sample of 168 young adults between ages 18 and 21. Enhancement motives mediated the cross-sectional relation between Cluster B symptoms and AUD. Prospectively, enhancement motives partially mediated the relation between Cluster B personality symptoms and AUD through the stability of Year 1 AUD to Year 3 AUD. Results suggest that enhancement motives may be especially important in understanding the relation between Cluster B personality disorders and AUDs.

Short-Term Prospective Effects of Impulsivity on Binge Drinking: Mediation by Positive and Negative Drinking Consequences

Abstract. Objective: Although the association of impulsivity with diverse alcohol outcomes has been documented, the mechanisms by which impulsivity predicts drinking over time remain to be fully characterized. The authors examined whether positive drinking consequences, but not negative drinking consequences, mediated the association between impulsivity and subsequent binge drinking, over and above prior binge drinking. Participants: Participants were 171 college students. Methods: Participants completed 2 online surveys with an average interval of 68 days between assessments at Time 1 (September to October 2012) and Time 2 (November to December 2012). Results: Path analysis showed that, among 5 facets of impulsivity, the effect of sensation seeking on subsequent binge drinking was completely mediated by prior positive consequences. No mediating effects of negative consequences were found. Conclusions: Prior experience of positive drinking consequences may serve as one of the risk pathways by which sensation seeking shapes binge drinking over time. Personalized intervention strategies may utilize information about students’ impulsivity facets to address their binge drinking and alcohol-related consequences.