Jennifer M. Cadigan

Differences in reporting of perceived acute effects of alcohol use, marijuana use, and simultaneous alcohol and marijuana use

BACKGROUNDnAlthough there are serious negative harms associated with simultaneous alcohol and marijuana (SAM) use, little is known about the self-reported acute effects of SAM use and how they may be similar to or different than effects experienced when using alcohol or marijuana only. The current study examines the perceived acute effects of SAM use, compared to using alcohol or marijuana only, as well as demographic and substance use predictors of overall SAM effects.nnnMETHODSnParticipants were a community sample of young adults ages 18-23 participating in a longitudinal study on social role transitions and substance use during young adulthood. Young adults who reported SAM use at least once in their lifetime were selected for the present analyses (N=315; mean age=21.42; 58% female) and reported the effects they experienced from typical alcohol use, marijuana use, and SAM use.nnnRESULTSnThere were significant differences in the extent to which young adults perceived the effects depending on the substances used. Most effects (i.e., clumsy, confused, dizzy, difficulty concentrating) were rated strongest when engaging in SAM use, compared to typical alcohol or marijuana use alone. Feeling high and feeling marijuana effects were rated strongest when engaging in marijuana use alone compared to SAM use, but feeling drunk was greater during SAM use compared to alcohol use alone. Greater alcohol use and increased time spent high during typical SAM use were associated with greater overall SAM effects.nnnCONCLUSIONSnWhen young adults engage in SAM use they report experiencing greater negative physiological and cognitive effects.

An examination of alcohol risk profiles and co-occurring mental health symptoms among OEF/OIF veterans

INTRODUCTIONnCompared to the general population, veterans of the wars in Afghanistan and Iraq (OEF/OIF) are more likely to engage in hazardous alcohol use and meet criteria for mental health disorders including Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder. Less is known how distinct profiles of alcohol use behavior relate to mental health symptoms.nnnMETHODnThe current study examined the extent that indicators of alcohol use (i.e., drinks per week, peak blood alcohol concentration, and alcohol-related problems) are categorized into different alcohol risk profiles utilizing a person-centered approach. We also examined how mental health symptoms (i.e., PTSD, depression, and anxiety-related symptoms) were associated with the alcohol risk profiles. Participants were 252 Veterans who reported consuming alcohol within the past month.nnnRESULTSnLatent profile analysis indicated a four-class solution yielded the best-fitting model, and profiles were named based on their respective levels and patterns of alcohol use. Mental health symptoms were significantly different among the four profiles. Profiles of veterans who endorsed more alcohol-related problems (i.e., the Severe alcohol behavior and Steady drinkers with functional impairment) also reported comorbid clinical symptoms of PTSD, depression, and anxiety. The Binge drinkers with no functional impairment and Mild alcohol behavior profiles reported the lowest levels of mental health symptoms.nnnDISCUSSIONnFindings highlight the unique relationship between distinct alcohol risk profiles and mental health outcomes. Targeted interventions and treatment options based on unique alcohol risk profiles may be helpful in tailoring prevention and intervention efforts in detecting co-occurring mental health symptoms among OEF/OIF veterans.

Young Adult Mental Health: a Prospective Examination of Service Utilization, Perceived Unmet Service Needs, Attitudes, and Barriers to Service Use

Most young adults with mental health symptoms do not receive treatment or access services. It remains important to identify barriers to service utilization to improve access to care. The current study was a prospective analysis examining predictors of (a) mental health service utilization and (b) perceived unmet need for mental health services. Barriers to service utilization were examined by prior depression severity status and college student status. Participants included a subsample of young adults ages 18–23 at time of recruitment who were participating in a longitudinal monthly study who completed both baseline and a 15-month follow-up assessment (Nu2009=u2009622, 80% of larger study). At month 15, 23% of young adults reported receiving mental health services in the past 12xa0months; 26% of young adults reported a perceived unmet need for mental health services at some point in the past 12xa0months. There were differences in demographic and mental health predictors of service utilization and perceived unmet need for services. Women, sexual minorities, those with moderate depression, those with more impairment from depression, and perceived past year poor mental health were associated with greater likelihood of receiving services. Similar demographic characteristics were associated with greater likelihood of perceiving unmet need for services. Barriers to service utilization differed by severity of depression symptoms and student status. Young adults have distinct reasons for not accessing mental health services; addressing these to improve accessibility to care remains critical.

Patterns of alcohol use and marijuana use among students at 2- and 4-year institutions

Abstract Objective: The objective of this study was to understand substance use patterns of alcohol, marijuana, and simultaneous alcohol and marijuana (SAM) use among 2- and 4-year college students. Participants: Participants were 526 young adults aged 18–23 (nu2009=u2009355 4-year students; nu2009=u2009171 2-year students) recruited from February 2015 to January 2016 who were participating in a larger longitudinal study. Methods: Latent class analysis (LCA) was used to identify past-month classes of alcohol, marijuana, and SAM use. Results: Among both 2- and 4-year students, a four-class solution yielded the best-fitting model, with 2-year classes tending to include greater marijuana use and less alcohol use and 4-year classes tending to include heavy alcohol use. Demographic characteristics were largely similar across classes. Conclusions: Classes of alcohol, marijuana, and SAM use differed by education status. Screening and prevention efforts for 4-year students may need to be tailored for the needs of 2-year students.

Sexual identity of drinking companions, drinking motives, and drinking behaviors among young sexual minority women: An analysis of daily data.

Research has indicated that sexual minority women (SMW) drink more than do their heterosexual counterparts. Minority stress theory postulates that this increased drinking is motivated by efforts to modulate distress related to minority status, highlighting the potential importance of coping and enhancement drinking motives. Social learning theory postulates that SMW are motivated to drink more because their social companions model drinking behavior and convey social norms regarding appropriate alcohol consumption, suggesting that socialization and conformity motives may be important. The degree to which different motives for drinking affect SMW’s alcohol consumption may depend in part on whether SMW drink with other sexual minorities, but this has not been investigated. This study examined daily data across 2 separate 14-day bursts to understand associations among daily drinking motives, the sexual identity of drinking companions, and alcohol consumption among 67 young SMW who reported on 553 social drinking days. On days when SMW had higher than typical socialization and enhancement motives, they tended to drink more, and SMW who typically had higher coping motives tended to drink more on any given day. Further, higher than typical enhancement motives were associated with heavier drinking on days when SMW drank with only heterosexual companions, relative to days when they drank with only sexual minority companions or in mixed sexual-identity groups. SMW’s typical conformity motives were more strongly related to drinking on days when SMW drank in mixed sexual-identity groups relative to heterosexual companions only. These results indicate that SMW’s drinking motives and drinking companions may be important targets for future research and intervention.

The Efficacy of an Event-Specific, Text Message, Personalized Drinking Feedback Intervention

Tailgating drinking prior to a football game is a type of event-specific drinking associated with increased alcohol use and related problems. Personalized drinking feedback interventions (PFI) are efficacious in reducing alcohol use and problems. The current study aimed to advance understanding of event-specific interventions by examining: (1) the efficacy of an event-specific, text message PFI on tailgating alcohol outcomes, and (2) the extent to which intervention effects generalize to “typical” alcohol outcomes at 1-month follow-up. College students (Nu2009=u2009130; 71% female; 92% white) who reported tailgating within the past 30xa0days and binge drinking when tailgating in the past year completed assessments on tailgating and typical alcohol use. They were randomly assigned to one of two text message conditions delivered on the morning of a home football game: event-specific PFI (TXT PFI) or a control condition. Multilevel modeling examined the association of treatment condition on tailgating and 1-month alcohol outcomes. When tailgating, participants in TXT PFI reported lower estimated peak blood alcohol concentration (eBAC) and consumed less drinks than the control condition. At the 1-month “typical” drinking follow-up, participants in TXT PFI reported lower peak eBAC and fewer alcohol-related problems than the control condition. Perceived tailgating drinking norms were found to statistically mediate the relationship between condition and alcohol outcome at tailgating and 1-month follow-ups. Findings provide preliminary support for the efficacy of an event-specific, text message PFI in reducing both tailgating and typical drinking alcohol outcomes. Event-specific TXT PFI can be used for prevention/intervention of alcohol misuse.

Social support predicts reductions in PTSD symptoms when substances are not used to cope: A longitudinal study of sexual assault survivors

BACKGROUNDnAfter sexual assault, many college women develop symptoms of posttraumatic stress disorder (PTSD), and those who engage in substance use coping are at heightened risk for this outcome. Positively-perceived social support has been identified as an important protective factor against the development of PTSD, but received social support could involve problematic behaviors-like the encouragement of coping through use of alcohol and/or drugs-that could worsen symptoms.nnnMETHODSnIn the current study, 147 undergraduate women with a lifetime history of sexual assault completed two waves of self-report measures assessing their symptoms. We test main and interaction effects for social support and substance use coping at baseline on PTSD symptoms one month later.nnnRESULTSnResults suggest that social support is longitudinally associated with decreases in PTSD. Although substance use coping did not evidence a direct association with PTSD, the relationship between social support and PTSD was significantly weaker as substance use coping increased. Only support from friends (but not family members or a special person) was associated with later PTSD, and this relationship was moderated by substance use coping.nnnLIMITATIONSnSubstance use coping was assessed via a brief measure, and peer encouragement of coping by using alcohol and/or drugs was not directly assessed.nnnCONCLUSIONSnClinicians should consider ways to increase access to social support from friends in patients with PTSD and evaluate ways that substance use coping may interfere with social supports benefits.

Identifying Barriers to Mental Health Service Utilization Among Heavy Drinking Community College Students

ABSTRACT There are limited findings on mental health prevalence and service utilization rates among community college (CC) students. Utilizing a heavy drinking CC sample, the current study examined: 1) prevalence of mental health symptoms, 2) mental health service utilization and perceived unmet service need, and 3) barriers to service utilization. Participants were 142 CC students who were heavy alcohol users (70% female; 59% White) from three public CCs in the Pacific Northwest who were participating in a larger study designed to adapt a brief intervention for high-risk alcohol use. Findings of the current study revealed that 32% of CC students had a positive screen for depression; 25% had a positive screen for anxiety; a total of 28% received mental health services in the past 12 months; a total of 41% reported a perceived unmet need for mental health srvices at some point in the past 12 months (i.e., needing mental health services but not receiving it). Students with mental health symptoms reported more barriers to receiving services, and were more likely to not receive services due to cost, compared to students without mental health symptoms. There were differences in type of barrier as a function of alcohol use severity, although there was no difference in number of barriers. Campuses may benefit from understanding mental health service utilization barriers their students report and to effectively advertise the services offered. Training of student services personnel staff and faculty in screening for mental health or substance use may be a worthwhile and cost-effective endeavor.

Transitions into young adulthood: Extent to which alcohol use, perceived drinking norms, and consequences vary by education and work statuses among 18–20 year olds

INTRODUCTIONnWith many young adults pursuing post-secondary education and many working, understanding the importance of education and work roles on alcohol use are of developmental and clinical importance. Utilizing a sample of 18-20year-olds transitioning from adolescence to young adulthood, the current study examined how social role statuses in education (i.e., not in school, 2-year students, 4-year students) and work status (i.e., unemployed, employed part-time, employed full-time) were associated with alcohol use, alcohol-related consequences, and perceived drinking norms.nnnMETHODnParticipants were 18-20year old young adults (54% female) participating in a one-time online survey about alcohol use and sexual behavior. Regression models were conducted to examine associations between school status and work status with alcohol related outcomes.nnnRESULTSnIndividuals who were unemployed had a significantly lower likelihood of any heavy episodic drinking (HED) in the past month, consumed fewer drinks per week, and experienced fewer alcohol-related consequences compared to individuals who worked full-time. Individuals who worked part-time consumed fewer drinks per week and had lower perceived drinking norms compared to individuals who worked full-time. No significant associations were found for alcohol use and consequences by education status.nnnDISCUSSIONnWorking full-time is a risk factor for HED, greater weekly drinking and negative alcohol-related consequences when compared to young adults who are unemployed, and to a lesser extent with young adults working part-time. Workplace interventions may be one approach to reach heavy drinking young adults.