Kim Fromme

Behavioral Risks during the Transition from High School to College.

The transition from high school to college is an important developmental milestone that holds the potential for personal growth and behavioral change. A cohort of 2,245 students was recruited during the summer before they matriculated into college and completed Internet-based surveys about their participation in a variety of behavioral risks during the last 3 months of high school and throughout the 1st year of college. Alcohol use, marijuana use, and sex with multiple partners increased during the transition from high school to college, whereas driving after drinking, aggression, and property crimes decreased. Those from rural high schools and those who elected to live in private dormitories in college were at highest risk for heavy drinking and driving after drinking.

Prevention of heavy drinking and associated negative consequences among mandated and voluntary college students.

The Lifestyle Management Class (LMC) was evaluated as a universal and targeted alcohol prevention program among voluntary and mandated college students. The relative efficacy of peer- and professional-led group interventions was also tested in this randomized, controlled design. LMC participants showed decreases in driving after drinking relative to control participants. Changes in heavy drinking varied as a function of treatment condition, readiness to change, and gender, with a trend toward larger decreases among voluntary LMC participants high in readiness to change and a comparable though nonsignificant advantage for male LMC participants in the mandated sample. The LMC was comparably effective for mandated and voluntary students, with no clear advantage for peer- or professional-led groups.

Effects of alcohol intoxication on the perceived consequences of risk taking

In 2 laboratory studies, the authors tested the hypothesis that intoxicated risk taking results from alcohols effects on negative outcome expectancies. Young adults (N = 107) consumed alcohol or no alcohol and made ratings of the likelihood that negative and positive consequences would result from a variety of risky activities. Consistent with study hypotheses, participants rated negative consequences as less likely when they were intoxicated than when sober. Results were replicated in a second study (N = 88), which further showed that alcohol, rather than expectancy set, contributed to these reduced perceptions of risk. Findings provide the first experimental evidence that alcohol intoxication may contribute to risk-taking behavior be altering expectations about negative consequences.

Measuring adolescent alcohol outcome expectancies.

The psychometric properties and construct validity of the Comprehensive Effects of Alcohol (CEOA) questionnaire were compared with those of the Alcohol Expectancy Questionnaire--Adolescent version (AEQ-A) in relation to adolescent alcohol consumption. Both measures of adolescent alcohol expectancies were found to be internally reliable and temporally stable. Alcohol use was significantly associated with subjective evaluations for Cognitive and Behavioral Impairment and Self-Perception on the CEOA and with expected effects for Cognitive and Motor Impairment and Changes in Social Behavior on the AEQ-A. Compared with the AEQ-A, the CEOA explained more variance in quantity (28%) and a similar variance in frequency (15%) for adolescent alcohol use (AEQ-A quantity = 20%, frequency = 15%). Whereas the general content and psychometric properties of the 2 measures are markedly similar, the Likert response format, shorter length, and assessment of both expected effects and subjective evaluations with the CEOA may offer measurement advantages over the AEQ-A.

Effects of Outcome Expectancies and Personality on Young Adults' Illicit Drug Use, Heavy Drinking, and Risky Sexual Behavior

To explain risk-taking behavior, personality theorists typically focus on biologically based predispositions, whereas cognitive psychologists often focus on beliefs and environmental contingencies. The current longitudinal study examined both personality traits and outcome expectancies as explanations for heavy drinking, drug use, and unsafe sexual behavior among 162 college students. Results indicated that (1) personality and past experience contribute to outcome expectancies, (2) outcome expectancies and personality independently predict substance use at 6-month follow-up, and (3) only past experience predicts subsequent risky sexual behavior. The approach taken in this research offers a bridge between personality theorists and cognitive psychologists who seek to understand why people endanger their lives in pursuit of risky activities.

Subjective Response to Alcohol Challenge: A Quantitative Review

BACKGROUND Individual differences in subjective response to alcohol, as measured by laboratory-based alcohol challenge, have been identified as a candidate phenotypic risk factor for the development of alcohol-use disorders (AUDs). Two models have been developed to explain the role of subjective response to alcohol, but predictions from the 2 models are contradictory, and theoretical consensus is lacking. METHODS This investigation used a meta-analytic approach to review the accumulated evidence from alcohol-challenge studies of subjective response as a risk factor. Data from 32 independent samples (total N = 1,314) were aggregated to produce quantitative estimates of the effects of risk-group status (i.e., positive family history of AUDs or heavier alcohol consumption) on subjective response. RESULTS As predicted by the Low Level of Response Model (LLRM), family history-positive groups experienced reduced overall subjective response relative to family history-negative groups. This effect was most evident among men, with family history-positive men responding more than half a standard deviation less than family history-negative men. In contrast, consistent with the Differentiator Model (DM), heavier drinkers of both genders responded 0.4 standard deviations less on measures of sedation than did the lighter drinkers but nearly half a standard deviation more on measures of stimulation, with the stimulation difference appearing most prominent on the ascending limb of the blood alcohol concentration curve. CONCLUSIONS The accumulated results from 3 decades of family history comparisons provide considerable support for the LLRM. In contrast, results from typical consumption comparisons were largely consistent with predictions of the DM. The LLRM and DM may describe 2 distinct sets of phenotypic risk, with importantly different etiologies and predictions for the development of AUDs.

Self-Regulation as a Protective Factor against Risky Drinking and Sexual Behavior

Prior research suggests that high dispositional self-regulation leads to decreased levels of risky drinking and sexual behavior in adolescence and the early years of college. Self-regulation may be especially important when individuals have easy access to alcohol and freedom to pursue sexual opportunities. In the current 1-year longitudinal study, we followed a sample of N = 1,136 college students who had recently reached the legal age to purchase alcohol and enter bars and clubs to test whether self-regulation protected against heavy episodic drinking, alcohol-related problems, and unprotected sex. We tested main effects of self-regulation and interactions among self-regulation and established risk factors (e.g., sensation seeking) on risky drinking and sexual behavior. High self-regulation inversely predicted heavy episodic drinking, alcohol-related problems, and unprotected sex, even when taking into account gender and risk factors. Moreover, in predicting unprotected sex, we found three-way interactions among self-regulation, sensation seeking, and heavy episodic drinking. Self-regulation buffered against risk associated with heavy drinking but only among those low in sensation seeking. The protective effects of self-regulation for risky drinking and sexual behavior make it a promising target for intervention, with the caveat that self-regulation may be less protective among those who are more drawn to socially and emotionally rewarding stimuli.

Trajectories and Determinants of Alcohol Use among LGB Young Adults and Their Heterosexual Peers: Results from a Prospective Study.

Lesbians, gays, and bisexuals (LGBs) are at increased risk for alcohol use during young adulthood, but the mechanisms remain inadequately understood. The aim of the present study was to examine the trajectories and determinants of alcohol use among LGB young adults who were sampled prospectively. The sample included 111 LGB individuals (47 women and 64 men) and 2,109 heterosexuals (1,279 women and 830 men), who were assessed at three time points: during the summer after their senior year of high school and during the fall and spring of their freshman year of college. Hierarchical linear modeling analyses indicated that lesbians consumed more alcohol than their heterosexual peers during high school, whereas gay men increased their alcohol use at greater rates than heterosexual men during the initial transition to college. Positive alcohol expectancies and social norms mediated this relation for both men and women. The results extend the generalizability of these processes and highlight the importance of considering normative social-cognitive influences in the development of alcohol use among LGB young adults.

Alcohol use and serial monogamy as risks for sexually transmitted diseases in young adults.

Alcohol and condom use were assessed using global, situational, and event-level analyses in a sample of young adults (N = 305). Results varied by methodology, event, and partner type; an inverse association between alcohol and condom use was found only at the event level. Participants with strong sex-related expectancies used condoms less frequently when drinking at the time of 1st intercourse with their current partner. For most recent event with a regular partner, alcohol use was unrelated to condom use, but gender, relationship duration, and oral contraceptive use accounted for more than 25% of the variance. Thus, alcohol may increase risky sex early in a relationship, whereas partner familiarity and alternate contraceptive use play a larger role as relationships develop.

Measurement of alcohol-related consequences among high school and college students: application of item response models to the Rutgers Alcohol Problem Index.

The Rutgers Alcohol Problem Index (RAPI; H. R. White & E. W. Labouvie, 1989) is a frequently used measure of alcohol-related consequences in adolescents and college students, but psychometric evaluations of the RAPI are limited and it has not been validated with college students. This study used item response theory (IRT) to examine the RAPI on students (N = 895; 65% female, 35% male) assessed in both high school and college. A series of 2-parameter IRT models were computed, examining differential item functioning across gender and time points. A reduced 18-item measure demonstrating strong clinical utility is proposed, with scores of 8 or greater implying greater need for treatment.