Nicole Fossos

The relative impact of injunctive norms on college student drinking: the role of reference group.

This research evaluated the importance of reference groups in the relationships between injunctive norms and alcohol consumption for college student drinkers. First-year students (N = 811; 58% women) completed online assessments of their drinking behavior, as well as their perceptions of the approval (injunctive norms) and prevalence (descriptive norms) of drinking by others. Injunctive norms were evaluated with respect to typical students, typical same-sex students, friends, and parents. Descriptive norms were evaluated with respect to typical students and typical same-sex students. Results suggested that for injunctive norms, only perceptions of proximal reference groups (friends and parents) are positively associated with drinking behavior. However, when considered in the context of multiple referents and norms, injunctive norms for more distal groups (typical students/same-sex students) were negatively associated with personal drinking, whereas descriptive norms for distal referents remained positively associated with drinking. Results suggest that injunctive norms are more complex than descriptive norms and these complexities warrant important consideration in the development of intervention strategies.

Internet-Based Personalized Feedback to Reduce 21st-Birthday Drinking: A Randomized Controlled Trial of an Event-Specific Prevention Intervention

This article presents an initial randomized controlled trial of an event-specific prevention intervention. Participants included 295 college students (41.69% male, 58.31% female) who intended to consume 2 or more drinks on their 21st birthday. Participants completed a screening/baseline assessment approximately 1 week before they turned 21 and were randomly assigned to receive Web-based personalized feedback or assessment only. Feedback included normative information, protective behaviors, and personalized blood alcohol concentration information. A follow-up assessment was completed approximately 1 week after a students birthday. Results indicated a significant intervention effect in reducing estimated blood alcohol concentration (d = 0.33). The intervention effect was moderated by 21st-birthday drinking intentions, and the intervention was primarily effective among those who intended to reach higher levels of intoxication. Results provide some support for normative information as a mediator of intervention efficacy. Overall results provide support for Web-based personalized feedback as an intervention approach for specific events associated with extreme drinking.

Efficacy of Web-Based Personalized Normative Feedback: A Two-Year Randomized Controlled Trial

OBJECTIVE Web-based brief alcohol interventions have the potential to reach a large number of individuals at low cost; however, few controlled evaluations have been conducted to date. The present study was designed to evaluate the efficacy of gender-specific versus gender-nonspecific personalized normative feedback (PNF) with single versus biannual administration in a 2-year randomized controlled trial targeting a large sample of heavy-drinking college students. METHOD Participants included 818 freshmen (57.6% women; 42% non-Caucasian) who reported 1 or more heavy-drinking episodes in the previous month at baseline. Participants were randomly assigned in a 2 (gender-specific vs. gender-nonspecific PNF) × 2 (single vs. biannual administration of PNF) + 1 (attention control) design. Assessments occurred every 6 months for a 2-year period. RESULTS Results from hierarchical generalized linear models provided modest effects on weekly drinking and alcohol-related problems but not on heavy episodic drinking. Relative to control, gender-specific biannual PNF was associated with reductions over time in weekly drinking (d = -0.16, 95% CI [-0.02, -0.31]), and this effect was partially mediated by changes in perceived norms. For women, but not men, gender-specific biannual PNF was associated with reductions over time in alcohol-related problems relative to control (d = -0.29, 95% CI [-0.15, -0.58]). Few other effects were evident. CONCLUSIONS The present research provides modest support for the use of biannually administered web-based gender-specific PNF as an alternative to more costly indicated prevention strategies.

Injunctive Norms and Problem Gambling among College Students

Two studies examined the relationships among injunctive norms and college student gambling. In study 1 we evaluated the accuracy of perceptions of other students’ approval of gambling and the relationship between perceived approval and gambling behavior. In study 2 we evaluated gambling behavior as a function of perceptions of approval of other students, friends, and family. In study 1, which included 2524 college students, perceptions of other students’ approval of gambling were found to be overestimated and were negatively associated with gambling behavior. The results of study 2, which included 565 college students, replicated the findings of study 1 and revealed positive associations between gambling behavior and perceived approval of friends and family. Results highlight the complexity of injunctive norms and the importance of considering the reference group (e.g., peers, friends, family members) in their evaluation. Results also encourage caution in considering the incorporation of injunctive norms in prevention and intervention approaches.

Event-specific drinking among college students.

College represents a period of risk for heavy drinking and experiencing unwanted consequences associated with drinking. Previous research has identified specific events, including holidays (e.g., New Years), school breaks (e.g., Spring Break) and personally relevant events (e.g., 21st birthdays), that are associated with elevated risk of heavy drinking and negative alcohol-related consequences. The systematic evaluation of relative risk offers insights into event-specific drinking and an empirical basis upon which to consider allocation of limited prevention resources. Thus, the purpose of the present study was to provide a comparative index of drinking across a wide range of holidays and compare holiday drinking to 21st birthday drinking. Participants were 1,124 students (55% female) who had turned 21 within the previous three weeks in 2008 and provided 90-day retrospective reports of their drinking using the Timeline Follow-back. Results based on a hurdle mixed model for blood alcohol content revealed several holidays that stand out for elevated drinking, including New Years Eve and July 4th, whereas other holidays appear more similar to weekend drinking, such as Spring Break (approximately last week of March) and graduation (mid-June). Drinking on holidays or special days was substantially lower than drinking on 21st birthdays. Results are discussed in terms of practical applications for targeted intervention efforts on college campuses toward specific events where elevated drinking is known to occur.

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.

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.

Social-norms interventions for light and nondrinking students

Social-norms approaches to alcohol prevention are based on consistent findings that most students overestimate the prevalence of drinking among their peers. Most interventions have been developed for heavy-drinking students, and the applicability of social-norms approaches among abstaining or light-drinking students has yet to be evaluated. The present research aimed to evaluate the impact of two types of online social-norms interventions developed for abstaining or light-drinking students. Identification with other students was evaluated as a moderator. Participants included 423 freshmen and sophomore college students who reported never or rarely drinking at screening. Students were randomly assigned to one of three conditions: (a) personalized-norms feedback, (b) social-norms marketing ads, or (c) attention control. Data were analyzed using generalized linear mixed models. Results provided some support for both interventions but were stronger for social-norms marketing ads, particularly among participants who identified more closely with other students.

Alcohol-involved assault and the course of PTSD in female crime victims

Although alcohol use has been associated with increased risk of victimization, little is known about how victim substance use at the time of assault may affect posttraumatic stress disorder (PTSD) symptom development. The present study is a longitudinal examination of substance use on PTSD symptom severity and course. A community sample of female crime victims (n = 60) were assessed within 5 weeks of sexual or physical assault with 3 and 6 month post-assault follow-ups. Twenty-three participants had consumed alcohol or alcohol/drugs prior to the assault (38%) and 37 had consumed neither alcohol nor drugs. Analyses were conducted using hierarchical linear modeling. Participants who had consumed alcohol had lower initial intrusive symptoms, but their symptoms improved less over time.