Anne M. Fairlie

Brief motivational and parent interventions for college students: A randomized factorial study

OBJECTIVE Using a randomized factorial design, we examined the efficacy of a brief motivational intervention (BMI) and a parent-based intervention (PBI) as universal preventive interventions to reduce alcohol use among incoming college students. METHOD Participants (N = 1,014) were assessed prior to matriculation and at 10 months and 22 months postbaseline. Two-part latent growth modeling was used to simultaneously examine initiation and growth in heavy episodic drinking and alcohol-related consequences. RESULTS This study retained 90.8% (n = 921) of randomized students at the 10-month follow-up and 84.0% (n = 852) of randomized students at the 22-month follow-up. BMI participants were significantly less likely than non-BMI participants to initiate heavy episodic drinking and to begin experiencing alcohol-related consequences. Effect sizes were minimal at 10 months (Cohens h ranged from 0.02 to 0.07) and were small at 22 months (hs ranged from 0.15 to 0.22). A significant BMI x PBI interaction revealed that students receiving both the BMI and the PBI were significantly less likely to report the onset of consequences beyond the sum of the individual intervention effects (h = 0.08 at 10 months, and h = 0.21 at 22 months). Hypothesized direct BMI effects for reductions in heavy episodic drinking and consequences were not observed. Significant mediated effects via changes in descriptive norms were present for both growth and initiation of heavy episodic drinking and consequences. CONCLUSIONS To our knowledge, the current study is the first to provide support for BMI as a universal preventive intervention for incoming college students. Although hypothesized PBI main effects were not found, mediation analyses suggest future refinements could enhance PBI effectiveness.

Prospective protective effect of parents on peer influences and college alcohol involvement.

This prospective study used a conceptually based risk and protective framework to investigate whether parental influences exert a protective effect on the robust association between peer influences and college alcohol involvement. Participants were incoming freshmen in the control condition of a randomized clinical trial, N = 256, 57.0% female, baseline age: M = 18.36 years (SD = 0.41). Participants completed telephone surveys in the summer before matriculation (baseline) and in the spring of the freshman (10-month) and sophomore years (22-month) with 85.6% retention at 22-months. Latent growth models were estimated for heavy episodic drinking and alcohol-related consequences. Descriptive norms and social modeling among peers were positively associated with initial heavy drinking and consequences; parental drinking permissiveness was positively associated with initial heavy drinking. Greater social modeling among peers was associated with less growth in consequences. Parental monitoring was not significantly associated with alcohol involvement. Prematriculation social modeling exhibited a weaker positive association with initial heavy drinking and consequences at low prematriculation parental drinking permissiveness compared to high. Similarly, prematriculation descriptive norms exhibited a weaker positive association with initial heavy drinking at low prematriculation parental drinking permissiveness compared to high. Prematriculation descriptive norms were not significantly associated with growth in heavy drinking at low parental drinking permissiveness; in contrast, higher prematriculation descriptive norms were associated with less growth in heavy drinking at high parental drinking permissiveness. Findings provide support for a protective parental influence on peer-alcohol relations extending into college. Parental drinking permissiveness may be an important target for parent-based interventions.

Sociodemographic, behavioral, and cognitive predictors of alcohol-impaired driving in a sample of U.S. College students

Alcohol-impaired driving continues to be a major public health concern, particularly among college students. The current study examined whether sociodemographic, behavioral, and cognitive variables predicted alcohol-impaired driving in a sample of college students. Data were collected via telephone interviews from a random sample of undergraduates, ages 18–25 years old, stratified by sex and class in school. Using hierarchical logistic regression analyses (n = 330), results revealed that higher levels of weekly alcohol use, being age 21 or older, and perceived difficulty in obtaining alternative transportation were associated with a greater likelihood of drinking and driving. In addition, perceived likelihood of drinking and driving-related consequences was associated with a lower likelihood of drinking and driving. Knowledge of the .08% per se and zero tolerance laws did not predict alcohol-impaired driving. Findings are discussed in terms of their implications for college media campaigns designed to reduce alcohol-impaired driving.

The Significance of Marijuana Use Among Alcohol-using Adolescent Emergency Department Patients

OBJECTIVES The objective was to determine if adolescents presenting to a pediatric emergency department (PED) for an alcohol-related event requiring medical care differ in terms of substance use, behavioral and mental health problems, peer relationships, and parental monitoring based on their history of marijuana use. METHODS This was a cross-sectional comparison of adolescents 13-17 years old, with evidence of recent alcohol use, presenting to a PED with a self-reported history of marijuana use. Assessment tools included the Adolescent Drinking Inventory, Adolescent Drinking Questionnaire, Young Adult Drinking and Driving Questionnaire, Center for Epidemiologic Studies Depression Scale, Behavioral Assessment System for Children, and Peer Substance Use and Tolerance of Substance Use Scale. RESULTS Compared to adolescents using alcohol only (AO), adolescents who use alcohol and marijuana (A+M) have higher rates of smoking (F = 23.62) and binge drinking (F = 11.56), consume more drinks per sitting (F = 9.03), have more externalizing behavior problems (F = 12.53), and report both greater peer tolerance of substance use (F = 12.99) and lower parental monitoring (F = 7.12). CONCLUSIONS Adolescents who use A+M report greater substance use and more risk factors for substance abuse than AO-using adolescents. Screening for a history of marijuana use may be important when treating adolescents presenting with an alcohol-related event. A+M co-use may identify a high-risk population, which may have important implications for ED clinicians in the care of these patients, providing parental guidance, and planning follow-up care.

Prepartying, Drinking Games, and Extreme Drinking among College Students: A Daily-Level Investigation

INTRODUCTION Daily data collected over 14 consecutive days were used to examine whether extreme drinking was more likely on days college students reported prepartying (i.e., drinking before going out) or playing drinking games in a multi-ethnic sample of college seniors (analysis subsample: N=399; 57% women; M age=21.48years, SD=.40). METHODS Multilevel modeling with drinking occasions at Level 1 (1265 drinking days) nested within persons at Level 2 (399 drinkers) was used to predict four extreme drinking behavior outcomes at the daily level: consuming at least 8/10 (women/men) drinks, reaching an estimated blood alcohol concentration (eBAC) of .16% or greater, drinking enough to stumble, and drinking enough to pass out. RESULTS Prepartying only (29% of drinking days) was more common than playing drinking games only (10%) or engaging in both behaviors on the same day (13%). Odds of extreme drinking were greater among students who frequently engaged in prepartying (ORs: 1.86-2.58) and drinking games (ORs: 1.95-4.16), except prepartying frequency did not predict drinking enough to pass out. On days students prepartied (ORs: 1.58-2.02) and on days they played drinking games (ORs: 1.68-1.78), odds of extreme drinking were elevated, except drinking games did not predict eBAC of .16% or greater. CONCLUSIONS Extreme drinking is attributable to both person-level characteristics (e.g., preparty frequency) and specific drinking behaviors on a given day. Prepartying and drinking games confer elevated risk of extreme drinking and are important targets in alcohol interventions for college seniors.

Fraternity and Sorority Leaders and Members: A Comparison of Alcohol Use, Attitudes, and Policy Awareness

Background: Studies have documented that members of college fraternities and sororities (i.e., Greeks) drink more heavily and experience more alcohol-related consequences than other students. Few studies have examined the role of Greek leaders in the socialization of Greek members. Objectives: The present study investigated how alcohol-related attitudes and behaviors among Greek leaders differ from the attitudes and behaviors of members. Methods: At a single university, two anonymous surveys were conducted in 2006 and 2007 (N = 726 and 757, respectively) at fraternity and sorority chapter meetings. All individuals present at the meetings were invited to participate. One-way analyses of covariance (ANCOVAs), controlling for age and sex, were conducted to examine the effect of leadership status on alcohol-related attitudes and behaviors. Zero-inflated negative binomial regression was used to analyze the effect of leadership status on alcohol-impaired driving. Results: Few differences were found between Greek leaders and members. In both years, leaders perceived alcohol control policies as stricter than did members. Notably, leaders and members did not significantly differ in reports of alcohol use or consequences. Conclusion: With this additional study, the literature suggests that alcohol-related attitude and behavioral differences between Greek leaders and members may be highly variable across college and university campuses. Scientific Significance: The socialization process among Greek leaders and members warrants further investigation. The current findings suggest that future research should examine the roles that campus climate and on-campus initiatives may play in the Greek socialization process.

Day-to-day variations in high-intensity drinking, expectancies, and positive and negative alcohol-related consequences

High-intensity drinking (i.e., women/men consuming 8+/10+ drinks in a day) is prevalent and associated with negative consequences. Occasions of high-intensity drinking have markedly high risk; however, previous research has not examined the predictors of these high-risk drinking days. The current study was designed to examine to what extent positive and negative alcohol expectancies predict high-intensity drinking and whether high-intensity drinking on a given day was associated with drinking consequences and their evaluations that day. Frequently drinking college students (N=342) participated in an intensive longitudinal study of drinking behaviors (N=4645 drinking days). Days with greater positive and negative expectancies were associated with high-intensity drinking. Days with high-intensity drinking were associated with reporting more positive and negative consequences and with evaluating positive consequences more favorably and evaluating negative consequences less favorably, compared to drinking days without high-intensity drinking. Given this, prevention and intervention efforts may consider specifically targeting high-intensity drinking events as a unique phenomenon.

Alcohol Use History Differentiates Adolescents Treated in the Emergency Department After an Alcohol-Related Incident

Objectives: The current study compared 3 groups of adolescents identified in an emergency department (ED) following an alcohol-related event: (1) alcohol-positive adolescents scoring at or above the clinical cutoff on a measure of problematic drinking, the Adolescent Drinking Inventory (ADI) (n = 45); (2) alcohol-positive adolescents scoring below the clinical cutoff on the ADI (n = 68), and (3) alcohol-negative adolescents (n = 64). We examined whether these 3 groups of adolescents differed on measures of substance use as well as psychosocial factors. Methods: Participants were recruited as part of a larger clinical trial. Alcohol-positive adolescents were recruited from a level I regional trauma center for treatment related to an alcohol-related incident. Alcohol-negative adolescents were recruited from the ED and the community. The data reported here were from the baseline adolescent and parent assessments. Before completing assessments, adolescents were required to pass a brief mental status examination. Results: Adolescents in the alcohol-positive, high-ADI group reported significantly more substance use, peer substance use, and peer tolerance of substance use than adolescents in the alcohol-positive, low-ADI group followed by adolescents in the alcohol-negative group. Adolescents in the alcohol-positive, high-ADI group reported significantly less parental supervision than adolescents in the other 2 groups. Conclusions: These findings underscore that alcohol-positive adolescents being treated in an ED are a heterogeneous group with respect to substance use as well as parent and peer risk factors. Physicians need to consider relevant background factors when making individualized discharge recommendations.

Adolescent Perceptions of a Suicide Prevention Group on an Inpatient Unit

The purpose of this study was to present a psychoeducational suicide prevention group for psychiatrically hospitalized suicidal adolescents, and explore participant perceptions of the strengths and weaknesses of this group therapy experience using archival data. Over the course of approximately three years, 250 adolescents admitted to a psychiatric inpatient unit attended the suicide prevention group. Almost all adolescents indicated that they learned something helpful in the group that would keep them from attempting suicide in the future. The creation of a “Reasons To Live List” was reported as most helpful by adolescents while the creation of a “Safety List” was deemed least helpful. However, some differences did emerge as a function of history of prior suicidal behavior. Recommendations for future treatment research with suicidal adolescent psychiatric inpatients are offered.

Descriptive and Prospective Analysis of Young Adult Alcohol Use and Romantic Relationships: Disentangling between- and within-Person Associations Using Monthly Assessments

ABSTRACT Background: Prior research on romantic relationships and alcohol use among young adults has not distinguished between differences in patterns of relationship status over extended periods of time and within-person changes in status that only occur for some individuals. Objectives: This study captured between-person differences in relationship patterns, assessed associations between relationship patterns and alcohol use, and examined within-person associations between alcohol use and relationship status changes. In addition, age and sex differences in between- and within-person associations were tested. Methods: We used multilevel modeling of monthly data collected over one year on alcohol use and romantic relationship status from a Seattle area community sample of 620 young adults (ages 18–24). Results: Participants were coded into six relationship pattern groups: (1) single-not-dating (16%), (2) stable-in-a-relationship (30%), (3) single-dating (10%), (4) ended-a-relationship (14%), (5) started-a-relationship (13%), and (6) ended-and-started-a-relationship (18%). Single-not-dating and stable-in-a-relationship groups reported the least drinking across the entire year; the single-dating, ended-a-relationship, and ended-and-started-a-relationship groups reported higher levels of drinking. Examining within-person changes in groups 3–6 revealed increases in drinking associated with months of dating among the single-dating group, months postbreakup among the ended-a-relationship group, and months of breaking up and starting a new relationship among the ended-and-started-a-relationship group. Few differences by age or sex were found for between- or within-person associations. Conclusions: The findings point to heterogeneity in patterns of relationship status over time, differences in relationship patterns associated with variations in drinking, and particular time points of elevated risk for young adults who experience changes in status.