Kristen P. Lindgren

Examining the relationship between typical drinking behavior and 21st birthday drinking behavior among college students: implications for event-specific prevention

AIMS The purpose of this research was to: (i) compare 21st birthday drinking with typical drinking; (ii) assess the prevalence of negative consequences and risk behaviors experienced during the 21st birthday week; and (iii) examine the role of typical drinking and 21st birthday drinking in explaining 21st birthday week negative consequences and risk behaviors. SETTING AND PARTICIPANTS Participants (n = 306; 50% male) included college students turning 21 at a Midwestern public university in the United States. DESIGN AND MEASUREMENT Approximately 1 week prior to their 21st birthday, students completed measures of typical past 3-month alcohol consumption via a web-based survey. Following their birthday, students (n = 296; 50% male) completed measures of 21st birthday week drinking as well as negative consequences and risk behaviors. FINDINGS Findings indicated that students consumed considerably larger amounts of alcohol during the week of their 21st birthdays in comparison to typical weekly consumption. Additionally, students experienced a variety of negative consequences and risk behaviors during the week of their 21st birthday, including hangovers, vomiting and not remembering part of the previous evening. Negative binomial regression results indicated that those most likely to experience more negative consequences and risk behaviors associated with 21st birthday drinking were those who consumed heavy amounts of alcohol the week of their birthday, but who did not typically drink excessively. CONCLUSIONS Findings underscore the need to develop event-specific prevention approaches for occasions associated with extreme drinking and provide direction for considering who may be at greatest risk for problems associated with celebratory drinking.

Implicit drinking identity: Drinker+me associations predict college student drinking consistently

Predicting hazardous drinking in college students continues to be a serious priority. Emerging evidence suggests that implicit measures may offer additional insight in predicting unique variance in alcohol outcomes. Implicit drinking identity, in particular, may be a powerful predictor of alcohol use. The current study examined the predictive validity of three alcohol-related associations (e.g., drinking identity, alcohol approach, and alcohol cope) using adaptations of the Implicit Association Test (IAT) in a sample of 243 undergraduates. Confirming previous findings, drinking identity associations were the most consistent predictor of alcohol consumption and alcohol problems. They were the only associations that were unique predictors of alcohol use after controlling for other implicit associations. In comparison, alcohol cope and alcohol approach associations were weak but consistent predictors of alcohol consumption and alcohol problems. Although positively correlated with all drinking outcomes, neither set of associations predicted unique variance in the drinking outcomes when all implicit associations were included in the same model. Collectively, these results extend previous findings that implicit drinking identity may be a powerful tool for predicting alcohol outcomes and a potential target for clinical intervention and prevention efforts.

GENDER DIFFERENCES IN PERCEPTIONS OF SEXUAL INTENT: A QUALITATIVE REVIEW AND INTEGRATION

Men appear to interpret peoples behaviors more sexually than do women. This finding, which has been replicated in scores of studies using a variety of methodological approaches, has been linked to important social concerns, including sexual assault and sexual harassment. This article provides a critical review of the published literature on gender differences in sexual intent perception, using selective examples to illustrate and summarize the fields major constructs, methodologies, and empirical findings. Theoretical explanations for gender differences in sexual intent perceptions are reviewed. Finally, we highlight the fields remaining issues and make several recommendations for future research directions.

A randomized controlled trial of mental health interventions for survivors of systematic violence in Kurdistan, Northern Iraq

BackgroundExperiencing systematic violence and trauma increases the risk of poor mental health outcomes; few interventions for these types of exposures have been evaluated in low resource contexts. The objective of this randomized controlled trial was to assess the effectiveness of two psychotherapeutic interventions, Behavioral Activation Treatment for Depression (BATD) and Cognitive Processing Therapy (CPT), in reducing depression symptoms using a locally adapted and validated version of the Hopkins Symptom Checklist and dysfunction measured with a locally developed scale. Secondary outcomes included posttraumatic stress, anxiety, and traumatic grief symptoms.MethodsTwenty community mental health workers, working in rural health clinics, were randomly assigned to training in one of the two interventions. The community mental health workers conducted baseline assessments, enrolled survivors of systematic violence based on severity of depression symptoms, and randomly assigned them to treatment or waitlist-control. Blinded community mental health workers conducted post-intervention assessments on average five months later.ResultsAdult survivors of systematic violence were screened (N = 732) with 281 enrolled in the trial; 215 randomized to an intervention (114 to BATD; 101 to CPT) and 66 to waitlist-control (33 to BATD; 33 to CPT). Nearly 70% (n = 149) of the intervention participants completed treatment and post-intervention assessments; 53 (80%) waitlist-controls completed post-intervention assessments. Estimated effect sizes for depression and dysfunction were 0.60 and 0.55 respectively, comparing BATD participants to all controls and 0.84 and 0.79 respectively, compared to BATD controls only. Estimated effect sizes for depression and dysfunction were 0.70 and 0.90 respectively comparing CPT participants to all controls and 0.44 and 0.63 respectively compared to CPT controls only. Using a permutation-based hypothesis test that is robust to the model assumptions implicit in regression models, BATD had significant effects on depression (p = .003) and dysfunction (p = .007), while CPT had a significant effect on dysfunction only (p = .004).ConclusionsBoth interventions showed moderate to strong effects on most outcomes. This study demonstrates effectiveness of these interventions in low resource environments by mental health workers with limited prior experience.Trial RegistrationClinicalTrials.Gov NCT00925262. Registered June 3, 2009.

Coping motives as a mediator of the relationship between sexual coercion and problem drinking in college students

Sexually coercive experiences, heavy alcohol use, and alcohol-related problems occur at relatively high base rates in college populations. As suggested by the self-medication hypothesis, alcohol consumption may be a means by which one can reduce negative affect or stress related to experiences of sexual coercion. However, few studies have directly tested the hypothesis that coping motives for drinking mediate the relation between sexual assault and problem drinking behaviors, and no published studies have tested this in men. The current study tested this hypothesis using structural equation modeling in a sample of 780 male and female undergraduates. Results revealed that coping motives partially mediated the relation between sexual coercion and drinking and alcohol-related negative consequences. In addition, direct and indirect paths between sexual coercion and drinking were found for men whereas only indirect paths were found for women. Results provide support for self-medication models of drinking and suggest the importance of exploring gender differences in mechanisms for drinking.

Community-based mental health treatments for survivors of torture and militant attacks in Southern Iraq: a randomized control trial

BackgroundSystematic violence is a long-standing problem in Iraq. Research indicates that survivors often experience multiple mental health problems, and that there is a need for more rigorous research that targets symptoms beyond post-traumatic stress (PTS). Our objective was to test the effectiveness of two counseling therapies in Southern Iraq in addressing multiple mental health problems among survivors of systematic violence: (1) a transdiagnostic intervention (Common Elements Treatment Approach or CETA); and (2) cognitive processing therapy (CPT). The therapies were provided by non-specialized health workers since few MH professionals are available to provide therapy in Iraq.MethodsThis was a randomized, parallel, two site, two-arm (1:1 allocation), single-blinded, wait-list controlled (WLC) trial of CETA in one site (99 CETA, 50 WLC), and CPT in a second site (129 CPT, 64 WLC). Eligibility criteria were elevated trauma symptoms and experience of systematic violence. The primary and secondary outcomes were trauma symptoms and dysfunction, respectively, with additional assessment of depression and anxiety symptoms. Non-specialized health workers (community mental health worker, CMHW) provided the interventions in government-run primary health centers. Treatment effects were determined using longitudinal, multilevel models with CMHW and client as random effects, and a time by group interaction with robust variance estimation, to test for the net difference in mean score for each outcome between the baseline and follow up interview. Multiple imputation techniques were used to account for missingness at the item level and the participant level. All analyses were conducted using Stata 12.ResultsThe CETA intervention showed large effect sizes for all outcomes. The CPT intervention showed moderate effects sizes for trauma and depression, with small to no effect for anxiety or dysfunction, respectively.ConclusionsBoth CETA and CPT appear to benefit survivors of systematic violence in Southern Iraq by reducing multiple mental health symptoms, with CETA providing a very large benefit across a range of symptoms. Non-specialized health workers were able to treat comorbid symptoms of trauma, depression and anxiety, and dysfunction among survivors of systematic violence who have limited access to mental health professionals. The trial further supports the use of evidence-based therapies in lower-resource settings.Trial registration and protocolThis trial was registered at ClinicalTrials.gov on 16 July 2010 with an identifier of NCT01177072 as the Study of Effectiveness of Mental Health Interventions among Torture Survivors in Southern Iraq.The study protocol can be downloaded from the following website: http://tinyurl.com/CETA-Iraq-Protocol. In the protocol, the CETA intervention is given a different name: components-based intervention or CBI.

Short CommunicationImplicit drinking identity: Drinker + me associations predict college student drinking consistently

Predicting hazardous drinking in college students continues to be a serious priority. Emerging evidence suggests that implicit measures may offer additional insight in predicting unique variance in alcohol outcomes. Implicit drinking identity, in particular, may be a powerful predictor of alcohol use. The current study examined the predictive validity of three alcohol-related associations (e.g., drinking identity, alcohol approach, and alcohol cope) using adaptations of the Implicit Association Test (IAT) in a sample of 243 undergraduates. Confirming previous findings, drinking identity associations were the most consistent predictor of alcohol consumption and alcohol problems. They were the only associations that were unique predictors of alcohol use after controlling for other implicit associations. In comparison, alcohol cope and alcohol approach associations were weak but consistent predictors of alcohol consumption and alcohol problems. Although positively correlated with all drinking outcomes, neither set of associations predicted unique variance in the drinking outcomes when all implicit associations were included in the same model. Collectively, these results extend previous findings that implicit drinking identity may be a powerful tool for predicting alcohol outcomes and a potential target for clinical intervention and prevention efforts.

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.

Attempted training of alcohol approach and drinking identity associations in US undergraduate drinkers: null results from two studies

There is preliminary evidence that approach avoid training can shift implicit alcohol associations and improve treatment outcomes. We sought to replicate and extend those findings in US undergraduate social drinkers (Study 1) and at-risk drinkers (Study 2). Three adaptations of the approach avoid task (AAT) were tested. The first adaptation – the approach avoid training – was a replication and targeted implicit alcohol approach associations. The remaining two adaptations – the general identity and personalized identity trainings – targeted implicit drinking identity associations, which are robust predictors of hazardous drinking in US undergraduates. Study 1 included 300 undergraduate social drinkers. They were randomly assigned to real or sham training conditions for one of the three training adaptations, and completed two training sessions, spaced one week apart. Study 2 included 288 undergraduates at risk for alcohol use disorders. The same training procedures were used, but the two training sessions occurred within a single week. Results were not as expected. Across both studies, the approach avoid training yielded no evidence of training effects on implicit alcohol associations or alcohol outcomes. The general identity training also yielded no evidence of training effects on implicit alcohol associations or alcohol outcomes with one exception; individuals who completed real training demonstrated no changes in drinking refusal self-efficacy whereas individuals who completed sham training had reductions in self-efficacy. Finally, across both studies, the personalized identity training yielded no evidence of training effects on implicit alcohol associations or alcohol outcomes. Despite having relatively large samples and using a well-validated training task, study results indicated all three training adaptations were ineffective at this dose in US undergraduates. These findings are important because training studies are costly and labor-intensive. Future research may benefit from focusing on more severe populations, pairing training with other interventions, increasing training dose, and increasing gamification of training tasks.

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.