Jessica A. Blayney

Underestimating protection and overestimating risk: examining descriptive normative perceptions and their association with drinking and sexual behaviors

Individuals who engage in risky sexual behavior face the possibility of experiencing negative consequences. One tenet of social learning theory is that individuals engage in behaviors partly based on observations or perceptions of others’ engagement in those behaviors. The present study aimed to document these norms–behavior relationships for both risky and protective sexual behaviors, including alcohol-related sexual behavior. Gender was also examined as a possible moderator of the norms–behavior relationship. Undergraduate students (n = 759; 58.0% female) completed a Web-based survey, including various measures of drinking and sexual behavior. Results indicated that students underestimate sexual health-protective behaviors (e.g., condom use and birth control use) and overestimate the risky behaviors (e.g., frequency of drinking prior to sex, typical number of drinks prior to sex, and frequency of casual sex) of their same-sex peers. All norms were positively associated with behavior, with the exception of condom use. Furthermore, no gender differences were found when examining the relationship between normative perceptions and behavior. The present study adds to the existing literature on normative misperceptions as it indicates that college students overestimate risky sexual behavior while underestimating sexual health-protective behaviors. Implications for interventions using the social norm approach and future directions are discussed.

Proximal Relationships Between PTSD Symptoms and Drinking among Female College Students: Results from a Daily Monitoring Study

Self-medication has been theorized to explain comorbidity between posttraumatic stress disorder (PTSD) and drinking, whereupon problem drinking develops in order to modulate negative affect and ameliorate PTSD symptoms. Daily monitoring methodologies may help refine our understanding of proximal relations between PTSD, affect, and alcohol use. One hundred thirty-six female college drinkers with a past history of sexual victimization and 38 female college drinkers with no past trauma history completed electronic monitoring of PTSD symptoms, affect, alcohol use, and alcohol cravings, daily for 4 weeks. A two-part mixed hurdle model was used to examine likelihood of drinking and amount of alcohol consumed on drinking days. We found significant relationships between daily PTSD symptoms, affect, and drinking. On days women experienced more intrusive and behavioral avoidance symptoms of PTSD, they experienced stronger urges to drink and were more likely to drink on that day. On days in which women experienced more negative affect than their average, they experienced stronger urges to drink, whereas on days in which women experienced more of the dysphoric symptoms associated with PTSD than their average, they drank less. On days with higher positive affect, women reported stronger urges to drink and were more likely to drink. Results suggest the need to examine both aspects of affect and specific PTSD symptoms as they may differentially predict drinking behavior. Differences in the ways in which PTSD symptoms and affect influence drinking suggest that interventions more specifically address the function of drinking behaviors in reducing alcohol use among college women.

Randomized controlled trial of a web-delivered personalized normative feedback intervention to reduce alcohol-related risky sexual behavior among college students

OBJECTIVE The purpose of this study was to evaluate the efficacy of personalized normative feedback (PNF) on college student alcohol-related risky sexual behavior (RSB). METHOD In a randomized controlled trial, 480 (57.6% female) sexually active college students were stratified by gender and level of drinking and randomly assigned to an alcohol-only intervention, an alcohol-related RSB-only intervention, a combined alcohol and alcohol-related RSB intervention, or control. All assessment and intervention procedures were Web-based. RESULTS Results indicated a significant reduction in drinking outcomes for the alcohol only and the combined alcohol and alcohol-related RSB interventions relative to control. Findings further demonstrated a significant reduction in alcohol-related RSB outcomes for the alcohol-related RSB only and the combined alcohol and alcohol-related RSB interventions relative to control. There were no significant intervention effects on alcohol-related negative consequences. These findings demonstrate that the combined alcohol and alcohol-related RSB intervention was the only intervention successful at reducing both drinking and alcohol-related RSB outcomes relative to control. There were no significant differences when comparing the combined alcohol and alcohol-related RSB intervention to the alcohol-only intervention or the alcohol-related RSB-only intervention. Finally, results suggested that the intervention effects on high-risk behaviors were mediated by reductions in descriptive normative perceptions. CONCLUSIONS These findings demonstrate that PNF specific to drinking in sexual situations was needed to reduce alcohol-related RSB. Furthermore, this study highlights the potential utility of a brief intervention that can be delivered via the Internet to reduce high-risk drinking and alcohol-related RSB among college students.

Sexual Communication, Sexual Goals, and Students' Transition to College: Implications for Sexual Assault, Decision-Making, and Risky Behaviors

A qualitative study was conducted to understand college students’ experiences and perceptions of sexual communication and sexual goals, and how they were affected by the transition from high school to college. Participants were heterosexual college students (N = 29). Single-sex focus groups were conducted and analyzed for themes. Major themes included gender differences in communication of sexual interest, with men reportedly perceiving more sexualized intentions than women intended to communicate. Gender similarities were observed related to preferring indirect and nonverbal communication and to having more freedom to pursue sexual goals in college. Men focused more intently on casual sex goals, whereas women reported more relationship goals and concerns about reputation.

Do drinking motives mediate the association between sexual assault and problem drinking

Sexual assault and problem drinking are both prevalent in college women and are interrelated. Findings from cross-sectional research indicate that motives to drink to decrease negative affect (coping motives) or to increase positive affect (enhancement motives) are partial mediators of the sexual assault-problem drinking relation. However, no published longitudinal studies have examined these relations. The current study tests a longitudinal model and examines coping and enhancement motives as potential mediators. Participants were 131 female undergraduates who completed baseline measures of self-reported sexual assault victimization and problem drinking. Coping and enhancement motives were measured at three-month follow up; problem drinking was measured at six-month follow-up. Analyses using structural equation modeling (SEM) indicated direct and indirect paths in the sexual assault-problem drinking relation. Zero-order correlations indicated significant, positive relations among drinking motives, sexual assault, and drinking variables. Longitudinally, mediation was evident for coping but not enhancement motives. Ultimately, findings were most consistent with self-medication hypotheses about the sexual assault - problem drinking relation - i.e., drinking in order to gain relief from symptoms or problems.

What Is Hooking Up? Examining Definitions of Hooking Up in Relation to Behavior and Normative Perceptions

Research has demonstrated ambiguity about the definition of hooking up among college students. The current research examined whether there were multiple definitions of hooking up among college students and how different definitions might be associated with the participants own hooking up behavior and normative perceptions of peer hooking up behavior. A random sample (N = 1,468) of undergraduates (56.4% female) completed a Web-based survey composed of measures of drinking and sexual behavior. Open-ended definitions of hooking up were content-coded and analyzed using a mixture model to explore discrete definitions of hooking up among college students. Findings indicated three clusters of student definitions of hooking up: Cluster 1 had the broadest definition, referring to sex in general, not specific sexual acts, and to making out. Cluster 2 placed an emphasis on interpersonal and social aspects. Cluster 3 defined hooking up as sex with notable references to specific sexual acts. Results further indicated that hooking up behavior and normative perceptions differentiated these three groups of definitions. Clinical implications regarding the inconsistency of student definitions of hooking up and how they may impact negative consequences associated with hooking up are discussed.

Impact of Daily Assessments on Distress and PTSD Symptoms in Trauma-Exposed Women:

As more advanced methodologies are developed for symptom assessment in traumatic stress studies, it is important to examine how these methodologies can exacerbate distress or contribute to symptoms among study participants. Using a sample of 202 female college students, we examined the changes in posttraumatic stress disorder (PTSD) symptoms and general psychological symptomatology among groups of trauma-exposed and non-trauma-exposed women randomly assigned to complete 30 days of daily monitoring of traumatic symptoms and substance use behaviors using personal digital assistants (PDAs). These two groups were compared with a trauma-exposed sample of women who did not complete daily monitoring assessments and only completed pre- and post-monitoring online assessments. While trauma-exposed participants in the monitoring group reported more distress from the daily assessments than those in the monitoring group with no history of trauma, this distress level was relatively low. Online surveys delivered pre- and post-monitoring showed a similar pattern. Trauma-exposed participants in monitoring and no-monitoring groups reported a decrease in general psychological symptoms over the 30 days; however, monitoring participants reported increased levels of PTSD severity over time. Closer examination revealed the observed changes were relatively moderate. Participants expressed benefits and risks regarding study participation supporting the findings that repeated assessments of traumatic symptoms using personal handheld devices may lead to small increases in distress and PTSD symptoms, but that these approaches may be generally well tolerated.

Curiosity killed the cocktail? Curiosity, sensation seeking, and alcohol-related problems in college women

Curiosity, composed of two factors: exploration and absorption, has been previously associated with life satisfaction, life meaningfulness, and enhanced positive affect. It also shares some overlap with sensation seeking, which has been linked to alcohol use and other addictive behaviors. The present research explored the association between curiosity and college womens problematic drinking in the context of sensation seeking. Participants (79 women) completed questionnaires measuring curiosity, sensation seeking, alcohol consumption, and consequences related to alcohol consumption. A zero-inflated negative binomial model indicated that curiosity and sensation seeking accounted for unique variance in alcohol-related problems after controlling for drinking. The curiosity factors had opposing relationships to alcohol-related problems: higher scores on absorption were associated with more alcohol-related problems whereas higher scores on exploration were associated with fewer alcohol-related problems. Should findings be replicated, the curiosity factors may represent additional prevention and intervention targets. Future directions for research about curiosity and drinking and for the inclusion of positive psychology constructs in addictive behaviors research are discussed.

The Relationship Between Assault and Physical Health Complaints in a Sample of Female Drinkers Roles of Avoidant Coping and Alcohol Use

Trauma exposure and PTSD are associated with poorer physical health. Psychological and behavioral mechanisms may help account for this relationship. In this study, we tested avoidant coping and alcohol use as mediators of the relationship between trauma exposure, PTSD, and self-reported physical health complaints in female drinkers. In 827 college women, we compared three groups: women with no trauma history, women with a sexual assault but no PTSD, and women with a sexual assault and PTSD, on avoidant coping, alcohol use, and physical health complaints. We found that PTSD was positively associated with alcohol use and that PTSD and trauma exposure were associated with increased avoidant coping. We also found that avoidant coping mediated the relationship between trauma, PTSD, and physical health complaints. Alcohol use did not predict physical health but was associated with PTSD. These results suggest that in female college students, coping may be more critical in the PTSD/physical health relationship than alcohol and have implications for targeting coping in young trauma-exposed women to improve physical health.

Buprenorphine from detox and beyond: preliminary evaluation of a pilot program to increase heroin dependent individuals' engagement in a full continuum of care

Absence of successful transition to post-detoxification treatment leads to high rates of relapse among detoxified heroin users. The present study evaluated a pilot buprenorphine treatment program (BTP). Heroin dependent individuals were inducted onto buprenorphine/naloxone in detox, maintained while transitioning through an intensive inpatient program (IIP), and gradually tapered off medication over 5 months of outpatient (OP) treatment. Compared to programmatic indicators of treatment engagement in the year prior to BTP implementation, referrals from detox to IIP, entry into and completion of IIP and subsequent OP, and days in OP treatment increased substantially. BTP completers, compared to non-completers, viewed abstinence as more difficult and as requiring more assistance to achieve, were less likely to be current cocaine and alcohol users or to have relapsed during the course of treatment. Although preliminary and in need of replication, initial adjunctive use of buprenorphine in an abstinence-based continuum of care may improve post-detoxification treatment entry, engagement, and completion.