Dipali Venkataraman Rinker

Efficacy of personalized normative feedback as a brief intervention for college student gambling: a randomized controlled trial

OBJECTIVE Social influences on gambling among adolescents and adults have been well documented and may be particularly evident among college students, who have higher rates of problem and pathological gambling relative to the general population. Personalized normative feedback (PNF) is a brief intervention designed to correct misperceptions regarding the prevalence of problematic behavior by showing individuals engaging in such behaviors that their own behavior is atypical with respect to actual norms. The current randomized controlled trial evaluated a computer-delivered PNF intervention for problem gambling college students. METHOD Following a baseline assessment, 252 college student gamblers scoring 2+ on the South Oaks Gambling Screen (SOGS) were randomly assigned to receive PNF or attention-control feedback. Follow-up assessments were completed 3 and 6 months postintervention. RESULTS Results indicated significant intervention effects in reducing perceived norms for quantities lost and won, and in reducing actual quantity lost and gambling problems at the 3-month follow-up. All intervention effects except reduced gambling problems remained at the 6-month follow-up. Mediation results indicated that changes in perceived norms at 3 months mediated the intervention effects. Further, the intervention effects were moderated by self-identification with other student gamblers, suggesting that PNF worked better at reducing gambling for those who more strongly identified with other student gamblers. CONCLUSIONS Results support the use of PNF as a stand-alone brief intervention for at-risk gambling students. Extending this approach more broadly may provide an accessible, empirically supported gambling prevention option for universities and related institutions.

Social influence on temptation: perceived descriptive norms, temptation and restraint, and problem drinking among college students.

Temptation and restraint have long been associated with problematic drinking. Among college students, social norms are one of the strongest predictors of problematic drinking. To date, no studies have examined the association between temptation and restraint and perceived descriptive norms on drinking and alcohol-related problems among college students. The purpose of this study was to examine whether perceived descriptive norms moderated the relationship between temptation and restraint and drinking outcomes among college students. Participants were 1095 college students from a large, public, culturally-diverse, southern university who completed an online survey about drinking behaviors and related attitudes. Drinks per week and alcohol-related problems were examined as a function of perceived descriptive norms, Cognitive Emotional Preoccupation (CEP) (temptation), and Cognitive Behavioral Control (CBC) (restraint). Additionally, drinking outcomes were examined as a function of the two-way interactions between CEP and perceived descriptive norms and CBC and perceived descriptive norms. Results indicated that CEP and perceived descriptive norms were associated with drinking outcomes. CBC was not associated with drinking outcomes. Additionally, perceived descriptive norms moderated the association between CEP and drinks per week and CEP and alcohol-related problems. There was a positive association between CEP and drinks per week and CEP and alcohol-related problems, especially for those higher on perceived descriptive norms. College students who are very tempted to drink may drink more heavily and experience alcohol-related problems more frequently if they have greater perceptions that the typical student at their university/college drinks a lot.

Fake ID ownership in a US sample of incoming first-year college students

OBJECTIVE One way that underage drinkers procure alcohol is by using a fake ID. This study examined demographic characteristics and alcohol-related problems associated with fake ID ownership among incoming first-year college students. METHOD We examined baseline data collected as part of a web-based alcohol education program that had been completed by a large, cross-sectional sample of incoming college freshmen from across the US. RESULTS Only 7.7% of incoming freshmen reported owning a fake ID. Multiple logistic regression indicated that the odds of owning a fake ID were significantly increased by intent to join or current membership in a fraternity or sorority (OR=2.00; 95% CI=1.64,2.44; p<0.0001), having taken the survey after the start of fall classes (OR=1.27; 95% CI=1.01, 1.59; p=0.04), reporting 1 heavy drinking episode in the past two weeks (OR=1.28; 95% CI=0.97,1.68; p=0.01), reporting 2 or more such episodes (OR=2.78; 95% CI=2.10,3.66; p<0.0001), experiencing external harms related to alcohol use (OR=1.28, 95% CI=1.01,1.61; p=0.01), and drinking and driving (OR=1.34; 95% CI=1.03,1.75; p=0.03). CONCLUSIONS Fake ID ownership was associated with intent to join or current membership in a fraternity/sorority and with reports of heavy drinking episodes, alcohol-related problems, and drinking and driving. Fake ID owners and incoming college students seeking fraternity or sorority membership should be targeted for multiple interventions to reduce alcohol-related harms.

Latent Class Analysis of DSM-5 Alcohol Use Disorder Criteria among Heavy-Drinking College Students

The DSM-5 has created significant changes in the definition of alcohol use disorders (AUDs). Limited work has considered the impact of these changes in specific populations, such as heavy-drinking college students. Latent class analysis (LCA) is a person-centered approach that divides a population into mutually exclusive and exhaustive latent classes, based on observable indicator variables. The present research was designed to examine whether there were distinct classes of heavy-drinking college students who met DSM-5 criteria for an AUD and whether gender, perceived social norms, use of protective behavioral strategies (PBS), drinking refusal self-efficacy (DRSE), self-perceptions of drinking identity, psychological distress, and membership in a fraternity/sorority would be associated with class membership. Three-hundred and ninety-four college students who met DSM-5 criteria for an AUD were recruited from three different universities. Two distinct classes emerged: Less Severe (86%), the majority of whom endorsed both drinking more than intended and tolerance, as well as met criteria for a mild AUD; and More Severe (14%), the majority of whom endorsed at least half of the DSM-5 AUD criteria and met criteria for a severe AUD. Relative to the Less Severe class, membership in the More Severe class was negatively associated with DRSE and positively associated with self-identification as a drinker. There is a distinct class of heavy-drinking college students with a more severe AUD and for whom intervention content needs to be more focused and tailored. Clinical implications are discussed.

A multisite randomized trial of normative feedback for heavy drinking: Social comparison versus social comparison plus correction of normative misperceptions.

OBJECTIVE Given widespread alcohol misuse among college students, numerous intervention programs have been developed, including personalized normative feedback (PNF). Most research evaluating PNF assumes that presenting ones own perceived norms is necessary to correct normative misperceptions and thereby reduce drinking. Alternatively, simply providing social comparison information showing that one drinks more than others may be sufficient. The present study evaluated the efficacy of full PNF (ones own drinking, campus drinking rates, and perceived norms) and a partial personalized social comparison feedback (PSCF; ones own drinking and campus drinking rates) in a randomized trial among heavy-drinking college students. METHOD Participants included 623 heavy-drinking students from 3 universities. Assessments occurred at baseline and 3- and 6-months postbaseline. RESULTS Primary analyses examined differences across 4 drinking outcomes (drinks per week, total drinks past month, frequency of past month drinking, and negative alcohol-related consequences) at 3- and 6-month follow-ups controlling for the baseline variable. Results revealed significant reductions across all alcohol consumption outcomes at 3 months in both intervention conditions compared to attention-control. Mediation analyses demonstrated significant indirect effects of the intervention on 6-month drinking through changes in perceived norms at 3 months. Moreover, evidence emerged for changes in drinking at 3 months as a mediator of the association between PSCF and 6-month perceived norms. CONCLUSIONS The present research suggests PNF may not require explicit consideration of ones perceived norms to be effective and that direct social comparison provides an alternative theoretical mechanism for PNF efficacy.

Remote versus in-lab computer-delivered personalized normative feedback interventions for college student drinking.

OBJECTIVE Computer-based interventions aimed at reducing college student drinking have shown positive effects. The authors compare differences in effects of computer-based personalized normative feedback (PNF) interventions based on delivery modality (in-person vs. remotely) across six previously evaluated studies with similar content. METHOD Three studies included evaluations of a computer-based PNF intervention in which baseline and intervention procedures took place inside a laboratory setting; three separate studies included evaluations of the same intervention in which participants completed the procedures remotely over the Web. Thus, we tested for differences in intervention efficacy by delivery modality. Outcomes included drinks per week, drinking-related consequences, and the putative intervention mechanism, perceived drinking norms. RESULTS Evidence from hierarchical linear models indicated that computer-based interventions are less effective at reducing drinking and related consequences when delivered remotely than when delivered in person. CONCLUSION The advantages of interventions delivered remotely are not without cost. Suggestions for why remote computer-based interventions may be less effective are discussed.

Do different types of social identity moderate the association between perceived descriptive norms and drinking among college students

Perceived descriptive norms are one of the strongest predictors of college drinking. Social Identity Theory posits that much of our identity is based on groups with which we affiliate. Prior research suggests that there is an association between perceived descriptive norms and drinking among those who identify more strongly with the normative referent group. However, no studies to date have examined how different facets of social identity affect the relationship between perceived descriptive norms and drinking. The purpose of this study was to examine whether the interaction between perceived descriptive norms and social identity on drinking varied as a function of different dimensions of social identity among college students. Participants were 1095 college students from a large, public, southern university who completed an online survey about drinking behaviors and related attitudes. Drinks per week was examined as a function of norms, the Importance, Commitment, Deference, and Superiority subscales of the Measure of Identification with Groups, as well as the two-way interactions between each dimension of social identity and norms. Results indicated that norms were associated with drinking, but that this relationship varied as a function of identity dimension. The association between norms and drinking was stronger among those who viewed the universitys student body as part of their own identity and were more committed to their fellow students, but weaker among those who reported greater deference to student leaders. This research suggests the importance of examining multiple dimensions of social identity in considering social influences on drinking.

Reasons for not drinking and perceived injunctive norms as predictors of alcohol abstinence among college students

Few studies have examined the association between reasons for not drinking and social norms among abstinent college students. Research suggests that drinking motives are associated with perceived injunctive norms and drinking. Therefore, it seems likely that reasons for not drinking may also be associated with perceived injunctive norms and abstinence. The aim of this study was to examine the relationship between reasons for not drinking and perceived injunctive norms on alcohol abstinence. Participants were 423 light-drinking and abstinent college students from a public northwestern university who completed online surveys at baseline, 3-, and 6-month follow-up. We examined abstinence as a function of all subscales of the Reasons for Not Drinking scale using logistic regression, as well as conducted two mediational analyses indicating: (1) perceived injunctive norms as a mediator of the relationship between reasons for not drinking and abstinence, and (2) reasons for not drinking as a mediator of the relationship between perceived injunctive norms and abstinence. The Disapproval/Lack of Interest subscale was the only subscale of the Reasons for Not Drinking scale that was significantly associated with 6-month abstinence. Further, Disapproval/Lack of Interest both directly predicted abstinence and indirectly predicted abstinence via perceived injunctive norms. Perceived injunctive norms indirectly predicted abstinence via Disapproval/Lack of Interest, but did not directly predict abstinence. Results suggest that self-defining personal values are an important component of keeping abstaining college students abstinent. These results are discussed with regard to implications for interventions designed specifically for maintaining abstinence throughout college.

Drinking games and contextual factors of 21st birthday drinking

Abstract Background: 21st birthday celebrations are among the highest risks for alcohol use throughout emerging adulthood and celebrants often experience a range of alcohol-related consequences. Objectives: The present research considered what happens when drinking games are paired with an already high-risk event (i.e., 21st birthday celebrations) and how drinking games compare with other contextual factors on 21st birthdays. Methods: Approximately four days after turning 21, 1124 college students (55% women) completed an online survey assessing alcohol use and related consequences experienced during their birthday celebrations. Participants were also asked whether drinking games and other contextual factors were associated with their celebrations. Results: Overall, 18% of participants reported playing drinking games during their 21st birthday celebrations. These individuals reported consuming more alcohol, had higher estimated BACs, and experienced more negative consequences than those who did not play drinking games. The association between playing drinking games and alcohol use and negative consequences was stronger for men. The effect of drinking games on negative consequences was mediated through elevated BAC levels. Receiving bar specials, having drinks purchased, playing drinking games, and loud music were uniquely and significantly associated with all alcohol outcomes. Conclusion: Together, these results suggest that drinking games are part of a larger context of risk contributing to extreme drinking on 21st birthdays. Furthermore, these results will help to facilitate interventions that are more individually tailored to target specific contextual risks, behaviors, and events.

Factor analyses of the Allen Barriers to Treatment Instrument in a sample of women seeking outpatient treatment for substance abuse

ObjectiveWomen are less likely than their male counterparts to seek treatment for substance abuse. The Allen Barriers to Treatment Instrument (ABTI) was developed in 1994 to measure barriers to treatment from the perspective of substance-abusing women. The factor structure of the ABTI has not been adequately validated, and the instrument has therefore been underused as a clinical and research tool. The purpose of this study was to replicate and validate the factor structure of the ABTI in a sample of women seeking outpatient substance abuse treatment. MethodsConfirmatory and exploratory factor analyses of the ABTI were conducted in a sample of 77 women completing intake for substance abuse treatment. ResultsThe originally proposed factors could not be replicated in this sample. Item-level analyses revealed 3 distinct factors that seemed to be clinically interpretable and descriptive of “barriers to treatment.” The new factors were labeled “Functional Barriers,” “Relational Barriers,” and “Affective Barriers.” ConclusionsThe ABTI in its current form is not a stable measure, and is therefore limited in its ability to measure barriers to treatment entry. Recommendations for modifying the measure are provided.