Mark M. Silvestri

Alcohol use, impulsivity, and the non-medical use of prescription stimulants among college students

The non-medical use of prescription drugs (NMUPD) is a growing public health concern. College students have been identified as a particularly at risk population for engagement in NMUPD. Across all prescription drug classes, stimulants show the highest ratio of illicit to medical use and are thus important to examine within this population. Emerging research has suggested a relationship between the non-medical use of prescription stimulants (NMUPS) and alcohol use within the college student population. Finally, the construct of impulsivity may serve as an additional indicator for students who engage in NMUPS as well as those who engage in NMUPS/alcohol co-ingestion. The purpose of this paper is to expand on previous prevalence data collected for the past year NMUPS and NMUPS/alcohol co-ingestion. Additionally, this paper examines whether those who engage in NMUPS or NMUPS/alcohol co-ingestion differ significantly from their non-using counterparts on measures of alcohol use, alcohol related negative consequences, binge drinking, and impulsivity. Finally, binary logistic regression models indicated that increased alcohol use, alcohol related negative consequences, and impulsivity all significantly increase the odds of an individual engaging in NMUPS or NMUPS/alcohol co-ingestion.

Modeling motivations for non-medical use of prescription drugs.

INTRODUCTION Non-medical use of prescription drugs (NMUPD) is a growing problem among college-aged individuals. Motivations for use of a substance have been shown to predict consumption behavior across a variety of substances, but research on motivations for engaging in NMUPD is limited. We hypothesize that Confirmatory Factor Analysis (CFA) would support a two-factor latent structure for motivations (self-treatment and recreational) for NMUPD across three classes of drugs (stimulants, tranquilizers and sedatives, and pain relievers). METHODS Data were collected from 1016 undergraduates attending a large southeastern university via an online survey. Motivations for use were subjected to a CFA for those participants who reported past-year use of each drug class (tranquilizer and sedative use n=138, pain reliever use n=189, and stimulant use n=258). RESULTS Model fit varied across drug class. A two-factor model emerged for both pain relievers and stimulants, and each factor was positively correlated with one another and with frequency of use for both drug classes. A two-factor model was not a good fit for tranquilizers and sedatives. CONCLUSIONS Motives for NMUPD are a relatively understudied construct. Although our initial results suggest that a proposed framework consisting of self-treatment and recreational motives might have some utility in explaining the use of stimulants and pain relievers, more research is needed to characterize motives for tranquilizers and sedatives. Additional research is also needed to develop assessment measures that capture the full range of motives for all three classes of NMUPD.

The role of personality variables in drinking game participation

Drinking games are prevalent among college student and associated with increased risk of experiencing negative alcohol-related consequences. Personality variables, and specifically impulsivity and sensation seeking, have been linked to increased alcohol consumption and related negative consequences, but research on the relationship between personality and drinking game participation is limited. The current study used path analysis to assess the impact of sensation seeking and impulsivity on frequency of drinking game participation and related consequences in a sample of undergraduate college students. Findings suggest that sensation seeking and impulsivity are positively associated with frequency of drinking game participation. Both impulsivity and sensation seeking had a direct effect on negative consequences associated with drinking games, and both had an indirect relationship when controlling for the frequency of drinking game participation. The results are largely consistent with previous studies in suggesting that impulsivity and sensation seeking play a role in predicting risky alcohol use and related negative consequences. Understanding the relationship between personality variables and negative drinking game consequences may better inform the treatment of hazardous drinking among college students.

Towards the development of laboratory methods for studying drinking games: initial findings, methodological considerations, and future directions

Abstract Background: Drinking games are prevalent among college students and are associated with increased alcohol use and negative alcohol-related consequences. There has been substantial growth in research on drinking games. However, the majority of published studies rely on retrospective self-reports of behavior and very few studies have made use of laboratory procedures to systematically observe drinking game behavior. Objectives: The current paper draws on the authors’ experiences designing and implementing methods for the study of drinking games in the laboratory. Results: The paper addressed the following key design features: (a) drinking game selection; (b) beverage selection; (c) standardizing game play; (d) selection of dependent and independent variables; and (e) creating a realistic drinking game environment. Conclusions: The goal of this methodological review paper is to encourage other researchers to pursue laboratory research on drinking game behavior. Use of laboratory-based methodologies will facilitate a better understanding of the dynamics of risky drinking and inform prevention and intervention efforts.

Student perceptions of specific components within a personalized feedback intervention.

Previous research suggests that personalized feedback interventions (PFI) can be an effective tool in reducing risky alcohol use among college students; however, little is known about how students perceive the individual components that are typically used during PFIs. In the current study, participants (N = 219, 63.5% female, 84% Caucasian, undergraduates enrolled in introductory psychology courses) reported their drinking behavior in the past month, and then immediately received a computerized PFI based on their self-reported alcohol use. The PFI was modeled from the Brief Alcohol Screening and Intervention for College Students (BASICS) approach and included 10 separate feedback components presented in random order. Participants provided acceptability ratings on each of the 10 components. Overall, participants found the PFI generally acceptable, with females rating the PFI as more acceptable than males, and binge drinkers (defined as 5 or more drinks on an occasion for males and 4 or more drinks for females) rating the PFI more acceptable than nonbinge drinkers. Differences in acceptability emerged across the 10 components, as participants rated the practical cost components (e.g., money spent on alcohol, calories consumed) as more acceptable than didactic information (e.g., impact of blood alcohol levels) and personal negative consequences. The results are similar to a previous study that examines student reactions to PFIs (Miller & Leffingwell, 2013). Overall, the findings suggest that college students prefer certain feedback components to others. Moreover, the findings indicate that future research is needed to examine the relationship between preferred components and treatment outcomes to determine which components are most effective for reducing risky drinking.

Normative influences on the nonmedical use of prescription stimulants among college students

Recent epidemiological data indicate an increasing trend in the nonmedical use of prescription drugs among college students. The nonmedical use of prescription drugs involves using a prescription medication without a prescription, or using the medication in a manner inconsistent with a health care providers instructions. Among college students, prescription stimulants have the highest ratio of nonmedical to medical use and the highest rate of illicit selling and trading on college campuses. The increased prevalence is accompanied by increased risk, as 18-25-year-olds have the highest rate of emergency department visits for nonmedical use of prescription stimulants (NMUPS). To date, no study has examined the impact of social norms on NMUPS. The social norm theory has accounted for other health related behaviors (e.g., alcohol and marijuana use) and has been utilized in brief interventions targeting risky health behaviors. The current study examined the prevalence of self-reported NMUPS among college students and the impact of perceived social norms on NMUPS. The current study included 959 participants who completed an online survey that assessed for NMUPS, self-approval for NMUPS, and perceived descriptive and injunctive norms for NMUPS. Similar to previous research on alcohol and marijuana use, students overestimated the prevalence of NMUPS and this overestimation was related to past-year NMUPS. Perceived close friend and parental approval of NMUPS was positively related to self-approval and past-year NMUPS. Overall, the study broadens the existing literature on NMUPS and provides a platform for developing brief interventions that target this risky behavior. (PsycINFO Database Record

Beyond risky alcohol use: screening non-medical use of prescription drugs at National Alcohol Screening Day.

INTRODCUTION Recent epidemiological data has indicated an increasing trend in the non-medical use of prescription drugs (NMUPD) among college students. NMUPD has shown a strong relationship with heavy alcohol use and associated negative consequences. Despite the trends and association with other risky behavior, there remain large gaps in the literature regarding this hazardous behavior. To date, no study has examined the prevalence of NMUPD among student attending National Alcohol Screening Day (NASD), and few studies have explored motives contributing to NMUPD, as well as the relationship between motives, NMUPD, and alcohol use. METHODS The current study examined the prevalence and motives for NMUPD among undergraduate students (N=128) attending NASD. RESULTS Overall, 42% of the sample reported NMUPD at least once in their lifetime, 29.7% at least once in the past year, and 18.0% reported simultaneously engaging in alcohol consumption and NMUPD. Pain relievers were the most frequently used drug class for lifetime use, and stimulants were the most frequently reported for past year use. Most students reported NMUPD for functional reasons. Students that engaged in binge drinking were three times more likely to report NMUPD. CONCLUSIONS The findings from the current study suggest that events like NASD may provide a platform for screening and discussing NMUPD, and its associated risk with heavy alcohol use.