Anne E. Ray

Social???cognitive correlates of protective drinking behaviors and alcohol-related consequences in college students

Although heavy episodic drinkers are at risk to experience alcohol-related consequences, studies show that a large percentage of student drinkers do not experience problems as a result of their drinking. The present study was a more in-depth examination of factors beyond just drinking quantity and frequency to explain why students experience consequences. The current research examined the relationship between the use of protective behaviors, alcohol use, and alcohol related consequences, as well as the relationship between attitudinal and cognitive predictors of engaging in protective behaviors when drinking. We hypothesized there would be a significant direct effect of protective behaviors on consequences after taking into account the effect of alcohol use and that cognitive predictors, including perceived self-efficacy, perceived effectiveness, and subjective norm, would be associated with the attitude and frequency of engaging in protective behaviors. Results supported both hypotheses, indicating good model fit for all models and significant paths between constructs (ps<.05). These findings extend the literature on protective behaviors by providing insight as to their utility in preventing harm and why students choose to engage in these behaviors. Implications for interventions are also discussed.

Transitions in first-year college student drinking behaviors: does pre-college drinking moderate the effects of parent- and peer-based intervention components?

This study used Latent Transition Analysis (LTA) to examine a stage-sequential model of alcohol use among a sample of high-risk matriculating college students (N=1,275). Measures of alcohol use were collected via web-administered surveys during the summer before entering college and followed-up during the fall semester of college. Seven indicators of alcohol use were used in the LTA models, including temporal measures of typical drinking throughout the week. The results indicated that four latent statuses characterized patterns of drinking at both times, though the proportion of students in each status changed during the transition to college: (a) nondrinkers; (b) weekend nonbingers; (c) weekend bingers; and (d) heavy drinkers. Heavy drinkers were distinguished by heavy episodic drinking (HED), and increased likelihood of drinking throughout the week, especially on Thursdays. Covariates were added to the LTA model to examine the main and interaction effects of parent- and peer-based intervention components. Results indicated that participants in the parent and peer conditions were least likely to transition to the heavy drinkers status. Results also indicated that the parent condition was most effective at preventing baseline nondrinkers from transitioning to heavy drinkers whereas the peer condition was most effective at preventing escalation of use among weekend nonbingers. The results underscore the value of considering multiple dimensions of alcohol use within a person-centered approach. Differential treatment effects were found across baseline drinking class, suggesting the benefit for tailored intervention programs to reduce high-risk drinking among college students.

Sustained parenting and college drinking in first-year students

Research indicates that for many students excessive drinking in college is a continuation of high school drinking tendencies. However, there have been limited theory-driven, systematic interventions targeting students so as to prevent alcohol misuse in their transition to college. Almost all current prevention approaches tend to be focused on younger populations and college-drinking interventions are typically delivered to students when they are already on campus. These analyses draw from a novel program of research involving parents of college freshmen based on the work of Turrisi et al. [Turrisi et al. [2001] Psychology of Addictive Behaviors, 15(4), 366-372; Turrisi, et al. [2009] Journal of Applied Social Psychology, 7, 315-326] and focuses on examining: (1) the relationship between parenting and student drinking tendencies during the transitional period between high school and college and into the first year of college, and (2) the mediation process by which sustained parenting throughout the first year is related to college-drinking outcomes and consequences so as to inform future intervention efforts. The empirical evidence from this study suggests that sustained parental efforts have a beneficial effect on reducing high-risk drinking and preventing harm even at this late stage of late adolescent/early adult development.

Substance use patterns among first-year college students: secondary effects of a combined alcohol intervention.

This study explored secondary effects of a multisite randomized alcohol prevention trial on tobacco, marijuana, and other illicit drug use among a sample of incoming college students who participated in high school athletics. Students (n = 1,275) completed a series of Web-administered measures at baseline during the summer before starting college and 10 months later. Students were randomized to one of four conditions: a parent-delivered intervention, a brief motivation enhancement intervention (Brief Alcohol Screening and Intervention for College Students [BASICS]), a condition combining the parent intervention and BASICS, and assessment-only control. A series of analyses of variance evaluating drug use outcomes at the 10-month follow-up assessment revealed significant reductions in marijuana use among students who received the combined intervention compared to the BASICS-only and control groups. No other significant differences between treatment conditions were found for tobacco or other illicit drug use. Our findings suggest the potential utility of targeting both alcohol and marijuana use when developing peer- and parent-based interventions for students transitioning to college. Clinical implications and future research directions are considered.

Examination of posttraining supervision of peer counselors in a motivational enhancement intervention to reduce drinking in a sample of heavy-drinking college students

Importance of peer counselor posttraining supervision on motivational interviewing (MI) microskills and postintervention drinking outcomes were evaluated in a sample of heavy-drinking undergraduate students completing Brief Alcohol Screening and Intervention for College Students (BASICS; L.A. Dimeff, J.S. Baer, D.R. Kivlahan, & G.A. Marlatt, 1999). Two peer counselor groups were trained using identical protocols. Posttraining, one group was randomized to receive supervision, whereas the other received no supervision. Groups were subsequently compared on MI microskills. College students (n = 122) were randomly assigned to either assessment-only control, supervision, or no supervision groups and completed a BASICS intervention. Postintervention drinking outcomes were examined. Results suggested supervision aided peer counselors in reducing use of closed-ended questions. Both treatment groups reduced total drinks per week and heavy-drinking behaviors compared to control. No differences on peak blood alcohol concentration (BAC) or alcohol-related consequences were observed. Differences in supervision did not influence drinking outcomes; however, posttraining supervision for peer counselors deficient in MI microskills may be needed to improve BASICS fidelity.

Age of drinking onset as a moderator of the efficacy of parent-based, brief motivational, and combined intervention approaches to reduce drinking and consequences among college students.

BACKGROUND The current study tested age of onset as a moderator of intervention efficacy on drinking and consequence outcomes among a high-risk population of college students (i.e., former high school athletes). METHODS Students were randomized to one of four conditions: assessment only control, combined parent-based intervention (PBI) and brief motivational intervention (BMI), PBI alone, and BMI alone. Participants (n = 1,275) completed web-administered measures at baseline (summer before starting college) and 10-month follow-up. RESULTS Overall, the combined intervention demonstrated the strongest and most consistent reductions across all outcomes, particularly with the youngest initiators. Participants who initiated drinking at the youngest ages had significantly lower peak drinking, typical weekly drinking, and reported consequences at follow-up when they received the combined intervention when compared to the control group. The BMI and PBI groups, when examined independently, demonstrated significant effects across outcomes but were inconsistent across the different age groups. CONCLUSION Results suggest the combination of a PBI and a peer-delivered BMI is an appropriate and efficacious way to reduce drinking and related consequences among individuals who initiated drinking earlier in adolescence and are at an increased risk of experiencing alcohol problems.

Patterns of drinking-related protective and risk behaviors in college student drinkers

Drinking-related protective (e.g., pacing consumption) and risk (e.g., participating in drinking games) behaviors influence both the amount of alcohol consumed and the consequences experienced by college students. Previous studies of these behaviors have typically examined use and predictors of these constructs separately. In the current study, latent profile analysis (LPA) was used to identify latent subgroups of drinkers with distinct patterns of use of both drinking-related protective and risk behaviors in a sample of college students. A random sample of first year student drinkers (N=229, 59.4% female) at a large, public university in the Northeastern United States completed a web-based assessment of drinking-related protective and risk behaviors, alcohol use, and related consequences. Three patterns of use were identified, including: 1) students who used protective behaviors frequently and seldom engaged in risk behaviors (10%), 2) students who used risk behaviors more frequently and used protective behaviors less often (30%), and 3) students who used both risk and protective behaviors at similar frequencies (60%). Significant differences in the distribution of profiles were observed when considering gender, age of onset of alcohol use, and recent drinking outcomes including weekend alcohol use, heavy-episodic drinking, and alcohol-related problems. Prevention and intervention programs may benefit from a focus on not only increasing protective actions, but on also reducing risk behaviors beyond that of quantity and frequency of alcohol use alone.

The Relationship Between Baseline Drinking Status, Peer Motivational Interviewing Microskills, and Drinking Outcomes in a Brief Alcohol Intervention for Matriculating College Students: A Replication ☆

The purpose of this study was to replicate and extend previous findings (Tollison et al., 2008) on the association between peer facilitator adherence to motivational interviewing (MI) microskills and college student drinking behavior. This study used a larger sample size, multiple follow-up time-points, and latent variable analyses allowing for more complex models to be tested in a sample with different characteristics than Tollison et al. Matriculating students who participated in high school sports (N=327) took part in a Brief Alcohol Screening and Intervention for College Students led by peer facilitators trained in motivational interviewing (MI). Participants were assessed pre- and immediately postintervention on contemplation to change, as well as pre-, 5months, and 10months postintervention on drinking quantity. Independent coders used the Motivational Interviewing Treatment Integrity scale (Moyers, Martin, Manuel, & Miller, 2003) to evaluate therapist MI adherence. Contrary to our previous study, results indicated that a higher number of open questions was positively related to increases in drinking, especially for heavier drinkers. Congruent with the previous study, more simple reflections was positively related to increases in drinking. Finally, this study revealed that heavier baseline drinking was associated with more simple reflections. There were no significant results found for changes in contemplation. Results corroborate previous findings that the excessive use of simple reflections may be indicative of countertherapeutic outcomes while raising questions about the relationship between the frequency of open questions and therapeutic outcomes.

Project INTEGRATE: An integrative study of brief alcohol interventions for college students

This article provides an overview of a study that synthesizes multiple, independently collected alcohol intervention studies for college students into a single, multisite longitudinal data set. This research embraced innovative analytic strategies (i.e., integrative data analysis or meta-analysis using individual participant-level data), with the overall goal of answering research questions that are difficult to address in individual studies such as moderation analysis, while providing a built-in replication for the reported efficacy of brief motivational interventions for college students. Data were pooled across 24 intervention studies, of which 21 included a comparison or control condition and all included one or more treatment conditions. This yielded a sample of 12,630 participants (42% men; 58% first-year or incoming students). The majority of the sample identified as White (74%), with 12% Asian, 7% Hispanic, 2% Black, and 5% other/mixed ethnic groups. Participants were assessed 2 or more times from baseline up to 12 months, with varying assessment schedules across studies. This article describes how we combined individual participant-level data from multiple studies, and discusses the steps taken to develop commensurate measures across studies via harmonization and newly developed Markov chain Monte Carlo (MCMC) algorithms for 2-parameter logistic item response theory models and a generalized partial credit model. This innovative approach has intriguing promises, but significant barriers exist. To lower the barriers, there is a need to increase overlap in measures and timing of follow-up assessments across studies, better define treatment and control groups, and improve transparency and documentation in future single intervention studies.

Combining alcohol and energy drinks: An examination of psychosocial constructs and alcohol outcomes among college students using a longitudinal design

Combining alcohol and energy drinks (e.g., Red Bull and vodka) is a significant problem on college campuses. To date, few studies have examined psychosocial constructs specific to alcohol-energy drink cocktail (AmED) consumption that could be amenable to change via prevention efforts targeting this population. The aim of the current study was to examine differences in AmED-specific attitudes, beliefs, normative perceptions among students who report AmED use compared to college student drinkers who consume alcohol only. In addition, these two groups were compared on their intentions to consume AmEDs, actual AmED use, and other drinking outcomes using a longitudinal design. Participants (N  =  386, 59% female) completed a web-based survey in the spring of their first year of college and fall of their second year assessing alcohol-energy drink cocktail use, psychosocial decision-making constructs, heavy drinking, and alcohol-related consequences. Findings revealed that combiners of alcohol and energy drinks had more positive attitudes and beliefs about AmED use, higher perceived peer norms, and stronger intentions toward future use. Accordingly, at Time 2, this group reported significantly higher AmED use, along with high-risk drinking and related consequences. The findings reinforce that AmED use is associated with risky drinking practices, and suggest potential targets for change for future prevention efforts.