Brett T. Hagman

Randomized Trial to Reduce Club Drug Use and HIV Risk Behaviors among Men Who Have Sex with Men.

The authors examined the effectiveness of motivational interviewing (MI) on club drug use and risky sex in non-treatment-seeking men who have sex with men (MSM). MSM (N = 150) were assessed and randomly assigned to 4 sessions of MI or an educational control intervention. Follow-up occurred at quarterly intervals for 1 year. Primary outcomes were days of any club drug use and number of unsafe sex acts. On average, club drug use declined during follow-up. A significant interaction effect showed that MI was associated with less club drug use during follow-up compared with education but only among participants with lower severity of drug dependence (p < .02; small to medium effect size). MI did not result in a significant reduction in risky sex relative to education. The results support the use of MI targeting club drug use in at-risk or mildly dependent users not seeking treatment but not in more severely dependent users. MI does not appear effective in reducing risky sexual behavior in this population.

Social Norms Theory-Based Interventions: Testing the Feasibility of a Purported Mechanism of Action

Social norms-based interventions targeting college student drinking behaviors have become increasingly popular. Such interventions purportedly modify student misperceptions of fellow student drinking behaviors, which leads to changes in individual drinking behavior. Despite claims of successful interventions, research demonstrating that social norms-based interventions modify student perceptions is lacking. Objective: The authors conducted a laboratory experiment examining the feasibility of this mechanism of action and aimed to determine the validity of the campus-specific drinking norms hypothesis. Participants and Methods: The authors randomly assigned 60 students to 1 of 3 research conditions: Alcohol 101 (national drinking norms), a didactic presentation of campus specific drinking norms, or a control condition. Results: Both intervention groups modified student misperceptions regarding peer alcohol use, and these changes were sustained 1 week later. Conclusions: Social norms-based interventions can contribute to more accurate drinking perceptions among college students.

An Item Response Theory (IRT) analysis of the Short Inventory of Problems-Alcohol and Drugs (SIP-AD) among non-treatment seeking men-who-have-sex-with-men: Evidence for a shortened 10-item SIP-AD

The Short Inventory of Problems-Alcohol and Drugs (SIP-AD) is a 15-item measure that assesses concurrently negative consequences associated with alcohol and illicit drug use. Current psychometric evaluation has been limited to classical test theory (CTT) statistics, and it has not been validated among non-treatment seeking men-who-have-sex-with-men (MSM). Methods from Item Response Theory (IRT) can improve upon CTT by providing an in-depth analysis of how each item performs across the underlying latent trait that it is purported to measure. The present study examined the psychometric properties of the SIP-AD using methods from both IRT and CTT among a non-treatment seeking MSM sample (N=469). Participants were recruited from the New York City area and were asked to participate in a series of studies examining club drug use. Results indicated that five items on the SIP-AD demonstrated poor item misfit or significant differential item functioning (DIF) across race/ethnicity and HIV status. These five items were dropped and two-parameter IRT analyses were conducted on the remaining 10 items, which indicated a restricted range of item location parameters (-.15 to -.99) plotted at the lower end of the latent negative consequences severity continuum, and reasonably high discrimination parameters (1.30 to 2.22). Additional CTT statistics were compared between the original 15-item SIP-AD and the refined 10-item SIP-AD and suggest that the differences were negligible with the refined 10-item SIP-AD indicating a high degree of reliability and validity. Findings suggest the SIP-AD can be shortened to 10 items and appears to be a non-biased reliable and valid measure among non-treatment seeking MSM.

Collateral Informant Assessment in Alcohol Use Research Involving College Students

Abstract Objective: This study examined the associations between college students’ self-reported alcohol use and corresponding collateral reports and identified factors that influence agreement between both sets of reports. Participants/Methods: Subject–collateral pairs (N = 300) were recruited from undergraduate psychology courses. Results: Data yielded moderate correlations between subject-collateral pairs for all alcohol use measures, whereas discrepancy analyses revealed a tendency for subjects to report greater alcohol use relative to collateral reports. Greater subject–collateral agreement regarding frequency of subject alcohol use was predicted by a greater frequency of shared drinking occasions between the dyads, lower subject self-reported drug use, and lower levels of collateral guessing, whereas greater correspondence for quantity of alcohol consumed was predicted by fewer subject self-reported alcohol-related negative consequences, lower levels of subject self-reported drug use, and lower levels of alcohol ingestion among collaterals. Conclusions: College students appear to provide reasonably accurate self-reports of their alcohol use.

Toward Efficient Screening for DSM-5 Alcohol Use Disorders in College Students: Performance of the Audit-C

Objectives:The newly implemented Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Alcohol Use Disorder (AUD) criteria may significantly alter how AUDs are identified in our alcohol screening efforts. The Alcohol Use Disorders and Identification Test-Consumption (AUDIT-C) is a 3-item alcohol screening instrument that has been used extensively to identify those at-risk for an AUD. At present, research on the AUDIT-C to screen for AUDs in college students using the new DSM-5 guidelines has received no attention. The present study evaluated the performance of the AUDIT-C in screening for DSM-5 AUDs in college students. Methods and Materials:Participants (N=1697) were past-year drinkers and recruited from 3 universities in the Southeastern, United States. Results:The AUDIT-C performed slightly better in the detection of DSM-5 AUDs [areas under receiving operating characteristic curve (AUROC)=0.764; SE=0.014] in comparison with DSM-IV AUDs (AUROC=0.734; SE=0.014). Alternatively, the AUDIT-C performed most optimally in the detection of heavy binge drinking (AUROC=0.913; SE=0.008) and any binge drinking (AUROC=0.862; SE=0.009) in comparison with the detection of DSM-5 AUDs. Sex differences emerged in the identification of optimal AUDIT-C cut-off scores for detecting DSM-5 AUDs. Conclusions:Overall, preliminary findings indicate that the AUDIT-C provides reasonably good discrimination in the detection of DSM-5 AUDs in college students. Continued research is warranted to ensure the stability of the current study findings.

Using latent variable techniques to understand DSM-IV alcohol use disorder criteria functioning.

OBJECTIVES To use factor analytic and item response theory methods to understand diagnostic Alcohol Use Disorder (AUD) criteria functioning in non-college young adults. METHODS The current study examined data from the 2009 National Survey of Drug Use and Health. Participants were non-college attending young adults (18 to 25) who consumed alcohol in the prior year. Confirmatory factor analysis (CFA) and item response theory (IRT) techniques were used to assess the dimensionality of DSM-IV AUD criteria. RESULTS CFA results indicated a dominant single factor, whereas IRT difficulty parameters revealed that the difficulty (severity) parameter estimates were intermixed across the latent AUD continuum. CONCLUSIONS Findings are consistent with research showing that the DSM-IV alcohol abuse and dependence criteria should be combined into a single disorder.

Can Preoccupation with Alcohol Override the Protective Properties of Mindful Awareness on Problematic Drinking

Objectives:To assess the mediating role of drinking restraint—specifically preoccupation with drinking—on the associations between mindful awareness and alcohol consumption and alcohol-related problems. Methods:A total of 390 heavy-drinking, undergraduate, college students (52% male) were assessed on measures of mindfulness, drinking restraint, alcohol consumption (prior 90 d), and alcohol-related problems through self-report surveys. Results:Mindfulness was negatively associated with alcohol consumption, problems, and both factors of drinking restraint (emotional preoccupation and behavioral constraint). Emotional preoccupation, but not behavioral constraint, statistically mediated these relationships and demonstrated positive associations with both alcohol consumption and related problems. Conclusions:Results replicate previous findings documenting a negative association between mindfulness and alcohol consumption and problems. Statistical mediation models suggest that preoccupation with drinking may be a risk factor that over-rides the health-promoting effects of mindfulness.

Development of the Abbreviated Masculine Gender Role Stress Scale.

Data gathered from 6 independent samples (n = 1,729) that assessed mens masculine gender role stress in college and community males were aggregated used to determine the reliability and validity of an abbreviated version of the Masculine Gender Role Stress (MGRS) Scale. The 15 items with the highest item-to-total scale correlations were used to create an abbreviated MGRS Scale. Psychometric properties of each of the 15 items were examined with item response theory (IRT) analysis, using the discrimination and threshold parameters. IRT results showed that the abbreviated scale may hold promise at capturing the same amount of information as the full 40-item scale. Relative to the 40-item scale, the total score of the abbreviated MGRS Scale demonstrated comparable convergent validity using the measurement domains of masculine identity, hypermasculinity, trait anger, anger expression, and alcohol involvement. An abbreviated MGRS Scale may be recommended for use in clinical practice and research settings to reduce cost, time, and patient/participant burden. Additionally, IRT analyses identified items with higher discrimination and threshold parameters that may be used to screen for problematic gender role stress in men who may be seen in routine clinical or medical practice.

Alcohol use disorders: translational utility of DSM-IV liabilities to the DSM-5 system

Objectives:Young adults have some of the highest rates of problem drinking and alcohol use disorders (AUDs) relative to any other age. However, recent evidence suggests that the DSM-IV hierarchical classification system of AUDs does not validly represent symptoms in the population; instead, it evinces a unitary, dimensional classification scheme. The DSM-5 has been altered to fit this changing, evidence-based conceptualization. Nevertheless, little is understood about the degree to which known risk factors for DSM-IV AUD diagnoses will transfer to the new DSM-5 guidelines in this group of high-risk drinkers. The current study built a coherent model of liabilities for DSM-IV AUDs in young adults and tested for transferability to DSM-5. Methods:College students (N=496) (51.10% male) were assessed on a variety of factors related to AUD risk, including demographics, substance use (past 90 d), and drinking motives. Liability models were created using all variables in Structural Equation Modeling to test direct and indirect effects on DSM diagnostic status. The best model under the DSM-IV was chosen based on fit and parsimony. This model was then applied to the DSM-5 system to test for transferability. Results:The best fitting model for DSM-IV included direct influences of drug use, quantity-frequency of alcohol consumption, and social and coping drinking motives. Improved model fit was found when the DSM-5 system was the outcome. Conclusions:Knowledge of risk factors for AUDs seem to transfer well to the new diagnostic system.

Testing the Conjoint Influence of Impulsivity and Drinking Restraint on Alcohol Use Consequences in College Student Drinkers.

Objectives: Impulsivity and drinking restraint play a role in excessive drinking patterns and related negative consequences. Two domains of drinking restraint include preoccupation with thoughts of drinking (Cognitive and Emotional Preoccupation) and attempts to control drinking (Cognitive and Behavioral Control), which differentially predict varying alcohol use outcomes in clinical and nonclinical samples. However, findings do not replicate across clinical, dependent samples and risky drinking young adults. This study examined the moderating role of dispositional impulsivity on the association between drinking restraint and alcohol consequences among college students to help clarify inconsistencies in the literature. Methods: Data were collected from a sample of college student drinkers (N=393) on drinking behavior in the past 90 days, alcohol-related problems, dispositional impulsivity, and drinking restraint. Results: The association between Cognitive and Behavioral Control and alcohol consequences was significantly stronger for those higher than lower in dispositional impulsivity, after controlling for the effects of alcohol consumption. No such relationship was found for those high in trait temptation. Conclusions: Alcohol consequences are greater among those who attempt to control their drinking and who act rashly and without consideration of future consequences; those who are high on trait temptation show no such relationship.