Meredith A. Terlecki

The role of social anxiety in a brief alcohol intervention for heavy-drinking college students

The Brief Alcohol Screening and Intervention for College Students (BASICS) reduces alcohol use and alcohol-related problems among undergraduates, yet variability in outcomes exists. Identifying individual difference variables related to outcomes could inform efforts to improve treatment protocols. The current study evaluated the role of social anxiety during BASICS. High socially anxious (HSA; n = 26) and low socially anxious (LSA; n = 44) heavy-drinking undergraduates were randomly assigned to BASICS (n = 38) or an assessment-only control (n = 32). HSA patients reported higher baseline alcohol consumption (typical drinks, weekly quantity, and frequency). BASICS significantly decreased weekly alcohol consumption and alcohol-related problems relative to the control group. Social anxiety moderated outcomes such that in the BASICS condition; HSA patients reported heavier typical drinks at posttest, even after controlling for referral status, baseline typical drinks, and trait anxiety. This was not the case in the control group. HSA patients may benefit from social anxiety-specific interventions during BASICS.

College drinking problems and social anxiety: the importance of drinking context

Social anxiety more than quadruples the risk of developing an alcohol use disorder, yet it is inconsistently linked to heavy alcohol use. Elucidation of the relation between social anxiety and alcohol use is an important next step in treating and preventing risky drinking. College students routinely face potentially anxiety-provoking social situations (e.g., meeting new people) and socially anxious undergraduates are especially vulnerable to alcohol-related impairment. Drinking to cope with social anxiety is thought to reinforce alcohol use, yet research on coping-motivated drinking among socially anxious students has yielded inconsistent findings. Further, undergraduate drinking varies by drinking context, yet the role of context in drinking behaviors among socially anxious individuals remains unclear. The current study sought to examine the relationship of social anxiety and drinking quantity in specific drinking contexts among undergraduates (N = 611). We also evaluated whether relevant drinking contexts mediated the relationship between social anxiety and alcohol-related problems. Clinically elevated social anxiety was related to heavier consumption in negative emotion (e.g., feeling sad or angry) and personal/intimate (e.g., before sexual intercourse) contexts, but not social/convivial contexts (e.g., parties, bars). Quantity of alcohol consumed in negative emotion and personal/intimate contexts mediated the relationship between social anxiety and drinking problem severity. Drinking in personal/intimate contexts demonstrated a unique mediational role. Findings suggest that heavy drinking in particular contexts (especially personal/intimate and negative emotion) may play an important role in drinking problems among socially anxious individuals.

Social Anxiety and Heavy Situational Drinking: Coping and Conformity Motives as Multiple Mediators

INTRODUCTION Individuals with clinically elevated social anxiety are at greater risk for alcohol use disorder, and the relation between social anxiety and drinking problems is at least partially accounted for by drinking more in negative emotional (e.g., feeling sad or angry) and personal/intimate (e.g., before sexual intercourse) situations. Identification of cognitive/motivational factors related to drinking in these high-risk situations could inform the development of treatment and prevention interventions for these high-risk drinkers. METHOD The current cross-sectional study examined the mediating effect of drinking motives on the relationship between social anxiety and drinking these high-risk situations among undergraduates (N=232). RESULTS Clinically elevated social anxiety was associated with greater coping and conformity motives. Both coping and conformity motives mediated the relation between social anxiety and heavier alcohol consumption in negative emotional and personal/intimate contexts. CONCLUSIONS Multiple mediation analyses indicated that these motives work additively to mediate the social anxiety-drinking situations relationship, such that heavy situational drinking among undergraduates with clinically elevated social anxiety can be jointly attributed to desire to cope with negative affect and to avoid social scrutiny.

The relative impact of nicotine dependence, other substance dependence, and gender on Bechara Gambling Task performance

Individuals with substance use disorders (SUDs) tend to focus more on immediate, rather than cumulative, consequences of their actions on measures of decision-making. This type of decision-making may contribute to continued substance use. The present study compared the performance of four groups of individuals on one measure of decision-making, the Bechara Gambling Task (BGT). The groups were (a) heavy smokers with comorbid substance dependence (n = 40), (b) heavy smokers with no history of substance dependence (n = 19), (c) substance dependent never smokers (n = 26), and (d) never smokers with no history of substance dependence (n = 34). Analysis revealed that there were no significant main effects of gender or SUD status. However, a significant gender by SUD status interaction was found, such that men with an SUD performed more poorly on the BGT than men without an SUD history. Women with and without an SUD both performed poorly on this task. Unexpectedly, no differences in BGT performance were found between smokers and nonsmokers. Overall, findings indicate that having an SUD, other than nicotine dependence, is correlated with poor BGT performance in men only. The BGT did not differentiate between women with and without SUDs, and therefore, may not be an appropriate measure of decision-making in women.

Randomized controlled trial of brief alcohol screening and intervention for college students for heavy-drinking mandated and volunteer undergraduates: 12-month outcomes.

This is the first randomized trial testing whether heavy-drinking undergraduates mandated to the Brief Alcohol Screening and Intervention for College Students (BASICS) program following a campus alcohol violation would benefit as much as heavy-drinking volunteers up to 1 year postintervention using control groups with high-risk drinkers to model disciplinary-related and naturalistic changes in drinking. Participants (61% male; 51% mandated; 84% Caucasian; M age = 20.14 years) were screened for heavy drinking and randomized to BASICS (n = 115) or assessment-only control (n = 110). Outcome measures (drinking, alcohol problems) were collected at baseline, 4 weeks, 3, 6, and 12 months postintervention. At 4 weeks postintervention, intent-to-treat multilevel longitudinal models showed that regardless of referral group (mandated or volunteer), BASICS significantly decreased weekly drinking, typical drinks, and peak drinks relative to controls (ds = .41-.92). BASICS had a large effect on decreases in alcohol problems (d = .87). At 12 months postintervention, BASICS participants (regardless of referral group) reported significantly fewer alcohol problems (d = .56) compared with controls. Significant long-term intervention gains for peak and typical drinks were sustained in both referral groups relative to controls (ds = .42; .11). Referral group had no significant main effect and did not interact with intervention condition to predict outcomes. Given that BASICS was associated with less drinking and fewer alcohol problems (even among heavier drinking mandated students up to 1 year postintervention), provision of BASICS-style programs within disciplinary settings may help reduce heavy and problematic drinking among at-risk students. (PsycINFO Database Record

College student smokers' cognitive appraisal of high-risk activities.

Abstract Objective: Students who smoke are more likely to engage in risky behaviors such as binge drinking and unprotected sex (Schnieder and Morris, Environ Behav. 1999; 23:575–591). The goals of the present study were to determine whether smokers assess these behaviors as lower risk than nonsmokers, and if smoking rate influences risk perceptions. Methods: Participants were 303 college students. Cognitive Appraisal of Risky Activities (Fromme et al., Cognit Ther Res. 1997; 21:421–442) and smoking were assessed August–November, 2006. Results: Smokers reported significantly less risk, more benefit, and more involvement in risky behaviors than nonsmokers (p < .01). In hierarchical linear regression, risk perceptions moderated the association between smoking and (a) expected benefit from risky sexual behaviors (β = −1.121, p < .05); and (b) expected involvement with illicit drugs (β = −.313, p < .01). Conclusions: College smokers’ assessment of high-risk behaviors influenced their intended involvement. Risk perception change may therefore alter their involvement in high-risk behaviors.

Development and validation of the Family Health Behavior Scale

OBJECTIVE The purpose of the current study was to develop a psychometrically sound, parent-report measure of family and child behaviors related to obesity in children between 5- and 12-years-old. METHODS Item generation, item selection, and initial exploratory factor analysis yielded a 27-item measure called the Family Health Behavior Scale (FHBS). RESULTS The FHBS contains four subscales measuring health-promoting family behaviors, obesogenic behaviors, meal-time routines, and family physical activity habits. Parent ratings on the FHBS were shown to predict their childs weight classification. The FHBS also demonstrated adequate internal consistency and temporal stability. CONCLUSIONS The results of the study suggest that the FHBS is a promising measure of family eating and physical activity habits related to obesity in children.

Distress Tolerance Among Students Referred for Treatment Following Violation of Campus Cannabis Use Policy Relations to Use, Problems, and Motivation

Students referred to treatment after violating campus drug policies represent a high-risk group. Identification of factors related to these students’ cannabis use could inform prevention and treatment efforts. Distress tolerance (DT) is negatively related to substance-related behaviors and may be related to high-risk cannabis use vulnerability factors that can impact treatment outcome. Thus, the current study tested whether DT was related to cannabis use frequency, cannabis-related problems, and motivation to change cannabis use among 88 students referred for treatment after violating campus cannabis policies. DT was robustly, negatively related to cannabis use and related problems. DT was also significantly, negatively correlated with coping, conformity, and expansion motives. DT was directly and indirectly related to cannabis problems via coping (not conformity or expansion) motives. Motives did not mediate the relation of DT to cannabis use frequency. DT may be an important target in treatment with students who violate campus cannabis policies.

Alcohol-induced risky sexual behavior among socially anxious drinkers

Abstract Heavy college drinking is associated with risky sexual behavior. It is therefore important to identify groups that are especially vulnerable to alcohol-influenced sexual risk (e.g., unplanned/unexpected sex). Undergraduates with elevated social anxiety represent one such vulnerable group given that social anxiety is associated with fear of intimacy and heavier drinking in intimate situations and situations with expected negative affect. Drinking to cope with negative affect induced by fear of intimacy might render socially anxious undergraduates vulnerable to risky sexual behavior, yet no known studies have examined this relationship. The current study tested whether social anxiety was related to alcohol-related sexual behaviors among current (past-month) drinking undergraduates (88.1% female; 77.6% non-Hispanic Caucasian) with higher (i.e., clinically elevated) social anxiety (HSA; n = 40) or lower (more normative) social anxiety (LSA; n = 94). Coping motives were examined as a moderator of the social anxiety-risky sexual behavior relationship. Gender was a covariate. HSA students reported more frequent alcohol-influenced sexual risk including regretted sexual situations, unprotected sex, sex with unwanted partners, unwanted sex, pressured/forced to have sex, and pressured someone to have sex. Coping motives significantly interacted with social anxiety group in the prediction of risky sexual behaviors except regretted sexual situations, such that HSA students with greater coping motives experienced more frequent sexual risk when drinking. Findings indicate that HSA students may be particularly vulnerable to risky sexual behaviors and suggest that coping motivated drinking may be an important target for therapeutic interventions geared toward reducing risky sexual behaviors among this high-risk population.

Randomized Controlled Trial of BASICS for Heavy Drinking Mandated and Volunteer Undergraduates: 12-Month Outcomes

This is the first randomized trial testing whether heavy-drinking undergraduates mandated to the Brief Alcohol Screening and Intervention for College Students (BASICS) program following a campus alcohol violation would benefit as much as heavy-drinking volunteers up to 1 year postintervention using control groups with high-risk drinkers to model disciplinary-related and naturalistic changes in drinking. Participants (61% male; 51% mandated; 84% Caucasian; M age = 20.14 years) were screened for heavy drinking and randomized to BASICS (n = 115) or assessment-only control (n = 110). Outcome measures (drinking, alcohol problems) were collected at baseline, 4 weeks, 3, 6, and 12 months postintervention. At 4 weeks postintervention, intent-to-treat multilevel longitudinal models showed that regardless of referral group (mandated or volunteer), BASICS significantly decreased weekly drinking, typical drinks, and peak drinks relative to controls (ds = .41-.92). BASICS had a large effect on decreases in alcohol problems (d = .87). At 12 months postintervention, BASICS participants (regardless of referral group) reported significantly fewer alcohol problems (d = .56) compared with controls. Significant long-term intervention gains for peak and typical drinks were sustained in both referral groups relative to controls (ds = .42; .11). Referral group had no significant main effect and did not interact with intervention condition to predict outcomes. Given that BASICS was associated with less drinking and fewer alcohol problems (even among heavier drinking mandated students up to 1 year postintervention), provision of BASICS-style programs within disciplinary settings may help reduce heavy and problematic drinking among at-risk students. (PsycINFO Database Record