Frances K. Del Boca

Up Close and Personal: Temporal Variability in the Drinking of Individual College Students During Their First Year.

Surveys have documented excessive drinking among college students and tracked annual changes in consumption over time. This study extended previous work by examining drinking changes during the freshman year, using latent growth curve (LGC) analysis to model individual change, and relating risk factors for heavy drinking to growth factors in the model. Retrospective monthly assessments of daily drinking were used to generate weekly estimates. Drinking varied considerably by week, apparently as a function of academic requirements and holidays. A 4-factor LGC model adequately fit the data. In univariate analyses, gender, race/ethnicity, alcohol expectancies, sensation seeking, residence, and data completeness predicted growth factors (ps <.05); gender, expectancies, residence, and data completeness remained significant when covariates were tested simultaneously. Substantive, methodological, and policy implications are discussed.

A validation study of the problem-oriented screening instrument for teenagers (POSIT)

The Problem-Oriented Screening Instrument for Teenagers (POSIT) is a 139-item questionnaire designed to identify substance abuse and related problems. The reliability and validity of the POSIT were studied in adolescents referred to an assessment service for evaluation of substance use problems. Convergent and divergent validity were examined using the Personal Experience Inventory, the Diagnostic Interview for Children and Adolescents, and the Adolescent Diagnostic Interview. Scales measuring problems assessed by both the POSIT and the criterion measures were moderately to highly correlated. Those measuring dissimilar domains were slightly correlated or were not significantly related. The findings highlight the strengths and limitations of the POSIT, and suggest the need for further research on screening tests designed specifically for substance-involved youth.

Variation in the drinking trajectories of freshmen college students

F. K. Del Boca, J. Darkes, P. E. Greenbaum, and M. S. Goldman (2004) examined temporal variations in drinking during the freshmen college year and the relationship of several risk factors to these variations. Here, using the same data, the authors investigate whether a single growth curve adequately characterizes the variability in individual drinking trajectories. Latent growth mixture modeling identified 5 drinking trajectory classes: light-stable, light-stable plus high holiday, medium-increasing, highdecreasing, and heavy-stable. In multivariate predictor analyses, gender (i.e., more women) and lower alcohol expectancies distinguished the light-stable class from other trajectories; only expectancies differentiated the high-decreasing from the heavy-stable and medium-increasing classes. These findings allow for improved identification of individuals at risk for developing problematic trajectories and for development of interventions tailored to specific drinker classes.

Binge Drinking and Alcohol-Related Problems Among Community College Students: Implications for Prevention Policy

Binge drinking and alcohol-related problems among students at traditional 4-year universities have been well documented. However, little is known about the frequency of their such behaviors and its consequences among community college students, who comprise roughly 44% of all undergraduate students in the United States. The present study examined binge drinking and alcohol-related problems in 762 (61% female) ethnically diverse (65% Caucasian, 20% Hispanic, 9% African American) community college students (mean age = 26.23, SD = 7.81). Based on gender-specific criteria, 25% engaged in binge drinking. As compared to nonbingers and current abstainers, bingers had higher rates of drinking-related problems. The implications of these findings for research and for prevention/intervention programs are discussed.

Adverse effects limit the usefulness of fluvoxamine for the treatment of alcoholism

Open-label and placebo-controlled trials of fluvoxamine, a selective, serotonergic antidepressant, were conducted as an adjunct to relapse prevention psychotherapy in alcoholics. In the open trial, 16 inpatient alcoholics began a 12-week treatment program, with 10 patients dropping out during the first 4 weeks of treatment. In the controlled trial, 8 of 10 patients on fluvoxamine dropped out during the first 4 weeks of treatment, compared with only 1 of 9 patients on placebo. Baseline patient characteristics did not appear to explain the differential attrition in the controlled trial, although the placebo-treated patients were more alcohol dependent. In both trials, patients on fluvoxamine complained of a variety of adverse effects, which they often identified as the basis for early termination of treatment. These adverse effects appear to limit the usefulness of the medication for the treatment of alcoholism.

Toward a Social Psychology of Female–Male Relations

Vive la difference The battle of the sexes Women and children first Its a mans world The mating game

The SBIRT program matrix: a conceptual framework for program implementation and evaluation

BACKGROUND AND AIMS Screening, Brief Intervention and Referral to Treatment (SBIRT) is a comprehensive, integrated, public health approach to the delivery of services to those at risk for the adverse consequences of alcohol and other drug use, and for those with probable substance use disorders. Research on successful SBIRT implementation has lagged behind studies of efficacy and effectiveness. This paper (1) outlines a conceptual framework, the SBIRT Program Matrix, to guide implementation research and program evaluation and (2) specifies potential implementation outcomes. METHODS Overview and narrative description of the SBIRT Program Matrix. RESULTS The SBIRT Program Matrix has five components, each of which includes multiple elements: SBIRT services; performance sites; provider attributes; patient/client populations; and management structure and activities. Implementation outcomes include program adoption, acceptability, appropriateness, feasibility, fidelity, costs, penetration, sustainability, service provision and grant compliance. CONCLUSIONS The Screening, Brief Intervention and Referral to Treatment Program Matrix provides a template for identifying, classifying and organizing the naturally occurring commonalities and variations within and across SBIRT programs, and for investigating which variables are associated with implementation success and, ultimately, with treatment outcomes and other impacts.

Items as context: Effects of item order and ambiguity on factor structure

Based on previous work (Darkes, Greenbaum, & Goldman, 1998), we evaluated the effects of item order and ambiguity on factor structure using items from the Disinhibition subscale of the Sensation Seeking Scales Form V (Zuckerman, 1979). Participants completed the items with order of item-group (alcohol, sex, ambiguous) presentation manipulated between respondents. The factor structure varied as a function of item-group order. In addition, factor covariances varied across the 3 item orders as a function of item-group order. Apparently, ambiguous items were interpreted differently (as related either to alcohol use or to sexual behavior) depending on the content of items that preceded them. Results suggest that item order and ambiguity are important considerations in assessment.

Sex, Gender, and Alcoholic Typologiesa

Classification systems for subtyping alcoholics have a long history in alcohol research. The typological approach promises parsimonious theoretical explanations for the etiology of alcoholism in the large and diverse population of affected individuals. Moreover, the prospect of treatment-matching effects, that is, improved outcomes as a result of matching subsets of clients to appropriate types and intensities of care, is another potential benefit. Although less frequently mentioned, an enhanced understanding of the different pathways that lead to alcoholism may promote the development of prevention and intervention efforts tailored to particular subgroups with different vulnerabilities for the development of alcohol problems. Although females have been understudied in alcohol research, sex and gender have been explicitly or implicitly implicated in typological schemes since investigators began to conceptualize alcoholics in these terms. The present paper selectively reviews research findings that may be relevant to understanding the role of sex and gender in alcoholic subtyping and offers a heuristic framework for integrating existing findings and guiding future research. Although the topics of sex and gender concern males as well as females, research that pertains more directly to the development of alcohol-related problems in women is emphasized. New data analyses are reported; however, the major aims of this paper are to highlight issues and to formulate hypotheses. Particular attention is focused on research methods and analytic procedures that are appropriate for addressing the questions and hypotheses presented.

Developments in alcoholism treatment research: Patient-treatment matching

This article describes patient-treatment matching, a recent advance in alcoholism treatment research. A general description of the concept is presented and the challenges patient-treatment matching poses for investigators and for treatment providers are described. Project MATCH, a multisite clinical trial designed to test the matching hypothesis is used to illustrate approaches to addressing the research challenge. Two additional avenues of promising patient-treatment matching research, one relating to patient characteristics and the other to pharmacological treatments, are also summarized. The article concludes with a brief prescription for individual providers to implement and test treatment matching strategies in their own clinical practice.