Monica C. Skewes

Role of Impulsivity in the Relationship Between Depression and Alcohol Problems Among Emerging Adult College Drinkers

Depression is common among college students and higher levels of depression are associated with greater alcohol-related problems. However, depression is frequently not found to be directly associated with more alcohol use. This study examined whether various aspects of impulsivity (negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and delay discounting) and drinking to cope with negative affect help to account for the relationship between depression and alcohol problems among emerging adult college drinkers who reported at least a minimal level of depressive symptoms. In this cross-sectional study, 143 emerging adult (between 18 and 25 years old) female (69.9%, n = 100) and male (30.1%, n = 43) college drinkers with at least minimal depressive symptoms completed measures of depression, alcohol use and problems, drinking to cope, and impulsivity. A multiple mediation analysis revealed that only negative urgency and drinking to cope partially mediated the depression-alcohol problems relationship. Moderated mediation analyses revealed that impulsivity-related constructs did not significantly interact with drinking to cope to increase alcohol problems. It appears that alcohol use is particularly problematic for students with elevated depression, and this is partly attributable to depressions association with negative urgency, in addition to its association with drinking to cope. Our findings suggest that students who suffer from depression may engage in problematic drinking behavior in part because negative affect is detrimental to their short-term impulse control and decision making, independent of maladaptive attempts to regulate affect through drinking to cope.

Solitary heavy drinking, social relationships, and negative mood regulation in college drinkers

In college students, solitary (i.e., while alone) heavy episodic drinking is associated with depression, suicidal ideation, drinking to cope, and having greater alcohol-related problems than heavy drinking only in social contexts. This study explored the possible explanatory factors for solitary heavy drinking. Social (n = 58) and solitary heavy episodic drinking (n = 32) emerging adult college students were compared in regards to: alcohol-related problems and dependence severity, negative affect, social relationship issues, socially related coping skills, and negative mood regulation. Multiple analyses of covariance revealed that solitary heavy drinkers were significantly higher in alcohol-related problems, severity of dependence, suicidal ideation, hopelessness, depression, loneliness, and drinking to cope and were lower in negative mood regulation expectancies and social competence. Heavy drinking groups did not differ in social network size, perceived social support, or in their drinking social network size or satisfaction. Our findings suggest that solitary heavy drinkers are not socially isolated or lacking in social support; however, they do experience greater social discomfort and difficulties with negative mood regulation than social heavy drinkers. Interventions focused on depression, affect regulation, adaptive coping, and alcohol abuse would be helpful with this population to address their related problems.

Energy drink use, problem drinking and drinking motives in a diverse sample of Alaskan college students

Background Recent research has identified the use of caffeinated energy drinks as a common, potentially risky behaviour among college students that is linked to alcohol misuse and consequences. Research also suggests that energy drink consumption is related to other risky behaviours such as tobacco use, marijuana use and risky sexual activity. Objective This research sought to examine the associations between frequency of energy drink consumption and problematic alcohol use, alcohol-related consequences, symptoms of alcohol dependence and drinking motives in an ethnically diverse sample of college students in Alaska. We also sought to examine whether ethnic group moderated these associations in the present sample of White, Alaska Native/American Indian and other ethnic minority college students. Design A paper-and-pencil self-report questionnaire was completed by a sample of 298 college students. Analysis of covariance (ANCOVA) was used to examine the effects of energy drink use, ethnic group and energy drink by ethnic group interactions on alcohol outcomes after controlling for variance attributed to gender, age and frequency of binge drinking. Results Greater energy drink consumption was significantly associated with greater hazardous drinking, alcohol consequences, alcohol dependence symptoms, drinking for enhancement motives and drinking to cope. There were no main effects of ethnic group, and there were no significant energy drink by ethnic group interactions. Conclusion These findings replicate those of other studies examining the associations between energy drink use and alcohol problems, but contrary to previous research we did not find ethnic minority status to be protective. It is possible that energy drink consumption may serve as a marker for other health risk behaviours among students of various ethnic groups.

Traditional living and cultural ways as protective factors against suicide: perceptions of Alaska Native university students

Introduction Native peoples living in Alaska have one of the highest rates of suicide in the world. This represents a significant health disparity for indigenous populations living in Alaska. This research was part of a larger study that explored qualitatively the perceptions of Alaska Native university students from rural communities regarding suicide. This analysis explored the resilience that arose from participants’ experiences of traditional ways, including subsistence activities. Previous research has indicated the importance of traditional ways in preventing suicide and strengthening communities. Method Semi-structured interviews were conducted with 25 university students who had migrated to Fairbanks, Alaska, from rural Alaskan communities. An interview protocol was developed in collaboration with cultural and community advisors. Interviews were audio-recorded and transcribed. Participants were asked specific questions concerning the strengthening of traditional practices towards the prevention of suicide. Transcripts were analysed using the techniques of grounded theory. Findings Participants identified several resilience factors against suicide, including traditional practices and subsistence activities, meaningful community involvement and an active lifestyle. Traditional practices and subsistence activities were perceived to create the context for important relationships, promote healthy living to prevent suicide, contrast with current challenges and transmit important cultural values. Participants considered the strengthening of these traditional ways as important in suicide prevention efforts. However, subsistence and traditional practices were viewed as a diminishing aspect of daily living in rural Alaska. Conclusions Many college students from rural Alaska have been affected by suicide but are strong enough to cope with such tragic events. Subsistence living and traditional practices were perceived as important social and cultural processes with meaningful lifelong benefits for participants. Future research should continue to explore the ways in which traditional practices can contribute towards suicide prevention, as well as the far-reaching benefits of subsistence living.

Umyuangcaryaraq “Reflecting”: Multidimensional Assessment of Reflective Processes on the Consequences of Alcohol Use among Rural Yup’ik Alaska Native Youth

Background and aims: Concerns in some settings regarding the accuracy and ethics of employing direct questions about alcohol use suggest need for alternative assessment approaches with youth. Umyuangcaryaraq is a Yup’ik Alaska Native word meaning “Reflecting.” Objectives: The Reflective Processes Scale was developed as a youth measure tapping awareness and thinking over potential negative consequences of alcohol misuse as a protective factor that includes cultural elements often shared by many other Alaska Native and American Indian cultures. This study assessed multidimensional structure, item functioning, and validity. Methods: Responses from 284 rural Alaska Native youth allowed bifactor analysis to assess structure, estimates of location and discrimination parameters, and convergent and discriminant validity. Results: A bifactor model of the scale items with three content factors provided excellent fit to observed data. Item response theory analysis suggested a binary response format as optimal. Evidence of convergent and discriminant validity was established. Conclusion: The measure provides an assessment of reflective processes about alcohol that Alaska Native youth engage in when thinking about reasons not to drink. Scientific significance: The concept of reflective processes has potential to extend understandings of cultural variation in mindfulness, alcohol expectancies research, and culturally mediated protective factors in Alaska Native and American Indian youth.

Attitudes toward harm reduction and abstinence-only approaches to alcohol misuse among Alaskan college students

Background Harm reduction is a public health approach that aims to guide hazardous drinkers to change unsafe drinking and minimize alcohol-related consequences without requiring abstinence. In contrast, abstinence-based interventions are designed for people with more severe alcohol problems and they aim to eliminate consequences via complete abstinence from alcohol. Current best practices for treating college student alcohol misuse involve harm reduction strategies, but no research has been conducted examining students’ perceptions of these strategies. Objective Understanding attitudes is critical prior to the implementation of an intervention in a new setting, particularly when attitudes may serve as barriers to treatment enrolment and retention. For this reason, we sought to examine attitudes toward contrasting alcohol misuse interventions among college students in two large public universities in the circumpolar north. Design A web-based survey was conducted with 461 students from two public universities in Alaska. Participants completed questionnaires assessing attitudes toward alcohol treatment, current drinking behaviour, and demographic information. Results Findings indicated that emerging adult (18–25 years old) students who would be targets of future interventions (hazardous drinkers) evidenced more positive attitudes toward harm reduction than abstinence-only approaches. Conclusion This research provides support for the implementation of harm reduction intervention strategies for Alaskan college students who misuse alcohol. It is likely that harm reduction will be acceptable in this population.

Readiness to change and post-intervention drinking among Hispanic college students living on the US/Mexico border

OBJECTIVE The purpose of the present study was to examine readiness to change as a predictor of post-intervention alcohol consumption among Hispanic college student drinkers taking part in a brief harm reduction intervention. METHOD Participants of the intervention study were 109 Hispanic college students residing on the US/Mexico border who self-identified as regular drinkers. This manuscript reports findings from a subset of participants who had complete data at 3-month follow-up (N=84). Participants completed the Readiness to Change Questionnaire, the Rutgers Alcohol Problem Index, and the Form-90 Steady Pattern drinking assessment prior to receiving an intervention. RESULTS Hierarchical least-squares regression was used to predict baseline readiness to change scores from alcohol consumption and related consequences, and then to predict 3-month post-intervention drinking from baseline drinking and readiness to change. Alcohol consumption and consequences significantly predicted readiness to change at baseline, and follow-up drinking was significantly predicted from baseline drinking, readiness to change, and an interaction between the two variables. Findings indicated that readiness to change may function differently in people with varying levels of alcohol involvement. CONCLUSIONS Greater readiness to change predicted reduced alcohol consumption only among the heaviest drinkers; among lighter drinkers, greater readiness to change predicted increased alcohol consumption. Possible explanations for this finding are discussed.

Native Transformations in the Pacific Northwest: A strength-based model of protection against substance use disorder.

This paper presents findings from the Native Transformations Project, an exploratory community-based participatory research study that aims to identify sources of strength and protection against substance use disorder in three tribal communities in the coastal Pacific Northwest. Preliminary results from the study describe the specific settings, acts, and behaviors that build strengths and provide protection at the family, community, individual, and spiritual levels within coastal Pacific Northwest local tribal cultures. Findings from this study give voice to stated community preferences for grassroots Native intervention programs based in local cultural knowledge, worldviews, values, and theories of change, that operate at the local level on their own terms.

The Biopsychosocial Model of Addiction

Psychosocial Factors and the Development of Addictive Behaviors 64 Risk Factors in Children 64 Personality and Temperament 64 Classical and Operant Conditioning 64 Outcome Expectancies 65 Self-efficacy 66 Social Influences on Substance Use 66 Families 66 Peers 66 Spouses and Intimate Partners 67 Other Individual Difference Variables that Influence Substance Use 67 Ethnicity and Culture 67 Gender 67 Environmental Influences on Substance Use 67

Symptoms of alcohol dependence predict suicide ideation among Alaskan undergraduates

BACKGROUND Previous research has demonstrated an association between alcohol-related problems and suicidal ideation (SI). AIMS The present study evaluated, simultaneously, alcohol consequences and symptoms of alcohol dependence as predictors of SI after adjusting for depressive symptoms and alcohol consumption. METHOD A sample of 298 Alaskan undergraduates completed survey measures, including the Young Adult Alcohol Consequences Questionnaire, the Short Alcohol Dependence Data Questionnaire, and the Beck Depression Inventory - II. The association between alcohol problems and SI status was evaluated using sequential logistic regression. RESULTS Symptoms of alcohol dependence (OR = 1.88, p < .05), but not alcohol-related consequences (OR = 1.01, p = .95), emerged as an independent predictor of SI status above and beyond depressive symptoms (OR = 2.39, p < .001) and alcohol consumption (OR = 1.08, p = .39). CONCLUSION Alcohol dependence symptoms represented a unique risk for SI relative to alcohol-related consequences and alcohol consumption. Future research should examine the causal mechanism behind the relationship between alcohol dependence and suicidality among university students. Assessing the presence of dependence symptoms may improve the accuracy of identifying students at risk of SI.