Highlights • Sexual orientation disparities in substance use among adolescents were examined. • Minority stress and social norms were tested to understand substance use disparities. • Descriptive and ...injunctive social norms accounted for disparities in substance use.
Summary
Two out of three adults seeking treatment for alcohol or other substance use disorders report co‐occurring symptoms of insomnia. This study compared the feasibility, acceptability, and ...preliminary efficacy of cognitive behavioural therapy for insomnia (CBT‐I) among adults seeking and not seeking treatment for substance use. Adults with alcohol or other substance use disorders (n = 22, 32% female, 82% White; Mage = 39.5) completed assessments at baseline, post‐treatment, and at 6 week follow‐up. Of those, 11 were and 11 were not enrolled in substance use treatment. All received CBT‐I. Multiple imputation was used for missing data. Data were analysed using repeated measures analyses of variance. In the substance use treatment group, 6/11 completed post and 5/11 completed follow‐up. In the non‐treatment group, 9/11 completed post and 7/11 completed follow‐up. Participants in both groups reported improvements in insomnia severity, sleep onset latency, and dysfunctional beliefs about sleep, with most effects evident at post and follow‐up. There was a marginal group‐by‐time interaction in the change in frequency of substance use, with only participants not in substance use treatment reporting decreases at follow‐up. Participants in substance use treatment reported significant reductions in substance‐related problems and symptoms of post‐traumatic stress disorder over time; however, they also reported more symptoms at baseline. CBT‐I produces similar reductions in insomnia but is relatively less feasible among individuals in (versus not in) treatment for substance use disorder. This may be due to the more complex logistics of accessing CBT‐I among those in treatment. We speculate that integrating CBT‐I into treatment for addictions may improve feasibility in this population. clinicaltrials.gov NCT04198311.
Theory and evidence indicate that affirming the value of the self before exposure to a threatening message fosters more open-minded appraisal of message content. We predicted that college students ...mandated to a computer-delivered personalized feedback intervention (PFI) and who engaged in a self-affirmation (SA) exercise would demonstrate reduce drinking and consequences relative to those who received an attention control.
Participants were 484 undergraduates (age 18-24, 56% male, 78% White) mandated to participate in an alcohol intervention following a first-time alcohol policy violation. After a baseline assessment, each was randomized to SA (
= 256) or attention control (
= 227) prior to a computer-delivered PFI intervention. Posttest measures included an affirmation manipulation check; primary outcomes (past month weekly quantity, peak drinks, binge frequency, consequences) were assessed at 1-, 3-, 6-, 9-, and 12-month follow-ups. We used latent growth curve modeling to test study hypotheses.
The SA exercise increased positive self-evaluation at posttest (
< .001). Overall reductions in drinking and consequences were observed at early follow-up (all
< .05), but the SA manipulation was not associated with intercept or slope factor differences in the models. Engaging in assessments during COVID restrictions was generally associated with reduced drinking and consequences.
The SA exercise did not differentially affect trajectories of alcohol use and consequences, despite evidence that the exercise had the predicted effect on participant's self-evaluations. The lack of SA effects could be attributed to a nonthreatening PFI intervention that is generally accepted among mandated students. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
•Protective behavioral strategies predict past-month alcohol-related blackout.•Manner of drinking and limiting/stopping drinking were significant predictors.•Use of serious harm reduction strategies ...was unrelated to alcohol-related blackout.•Avoidance of blackouts is facilitated by only some protective behavioral strategies.
Alcohol-induced blackouts are experienced by approximately half of college students who drink. People who use protective behavioral strategies (PBS) tend to experience fewer alcohol-related consequences of drinking, but the relationship between PBS and blackouts is unknown. This study examines the associations among the use of protective behavioral strategies and blacking out.
Participants were 484 college students, aged 18–22 (56% male, 51% first-year), who were mandated to complete alcohol education following an alcohol violation. Before the intervention, participants completed questionnaires that included questions about past month peak consumption, alcohol-related consequences, marijuana use frequency, and frequency of PBS use. Logistic regression analyses were conducted to evaluate how use of PBS was related to the odds of experiencing a blackout, controlling for consumption and other risk factors.
Participants endorsing greater overall use of PBS had decreased odds of having experienced a blackout. However, this association depended on the type of PBS being used. Participants endorsing greater use of PBS regarding manner of drinking and stopping/limiting drinking had decreased odds of having experienced a blackout, but those who endorsed greater use of PBS relating to serious harm reduction did not.
This study adds nuance to the idea that PBS protect against adverse alcohol-related consequences. Only PBS that serve to limit or slow consumption appear to be protective against experiencing blackouts. Research on specific associations between types of PBS and consequences may lead to improved outcomes in interventions that incorporate PBS.
Social cognitive factors such as perceived norms and personal attitudes toward alcohol consumption are reliable predictors of alcohol use and related problems. The current study aimed to evaluate the ...relative importance of one's attitude toward alcohol use as a unique and important predictor of drinking related outcomes when directly compared to perceived descriptive and injunctive norms. Participants were mandated students (n=568; 28% female) who violated a campus alcohol policy and received a Brief Motivational Intervention. Analyses included the use of linear regression for prospective predictions to evaluate the relative importance of predictors which included perceived descriptive norms and injunctive norms, and attitudes toward moderate and heavy alcohol use. Overall, the results indicate that one's attitude toward heavy alcohol use is a stronger predictor of drinks per week, binge frequency, as well as alcohol related problems when directly compared to norms. Thus, the findings of the current study provide a compelling rationale for incorporating attitudes in the development and refinement of intervention strategies.
•Attitude toward heavy consumption is positively associated with problems over time.•Attitude toward moderate consumption is negatively associated with drinking over time.•Attitude toward heavy consumption is a stronger predictor than norms.
•One-third of heavy-drinking young adults screened positive for insomnia.•Individuals with insomnia reported more alcohol-related consequences.•Drinking had a weaker association with blackout in the ...context of insomnia.•Drinking had lower odds of physiological consequences in the context of insomnia.•We speculate that insomnia may heighten sensitivity to acute effects of alcohol.
Alcohol-induced blackout is associated concurrently and prospectively with alcohol-related harm, including emergency room visits and sexual coercion. Although sleep has not been linked empirically to blackout, symptoms of insomnia have also been linked to memory impairment, in which case insomnia symptoms may compound alcohol’s negative effects on memory. This study tested insomnia symptoms as a moderator of the association between heavy drinking and alcohol-induced blackout.
Heavy-drinking young adults in college (N = 461, 69% female) completed assessments online from remote locations. Hierarchical linear regression was used to test a moderation model predicting blackout frequency. Logistic regression was used to test post hoc hypotheses.
In contrast to our main hypothesis, heavy drinking was more weakly (not more strongly) associated with blackout in the context of more severe insomnia. Post hoc analyses tested insomnia symptoms as a unique moderator of the association between heavy drinking and likelihood of acute physiological consequences of alcohol use (blackout, passing out, nausea/throwing up, and hangover). Insomnia severity at least marginally moderated the association between heavy drinking and 4 out of 5 physiological consequences of alcohol use, and only moderated the association between drinking and 1 of 19 remaining consequences.
Symptoms of insomnia are associated with alcohol-related harm, but may buffer associations between drinking and acute physiological consequences of alcohol. Additional research is needed to determine if alcohol heightens sensitivity to the acute physiological effects of alcohol, in which case less alcohol may be required for young adults with insomnia to experience these effects.
Studies report mixed findings on the effect of the COVID-19 pandemic on college student alcohol consumption. However, the impact of pandemic restrictions on students referred to an intervention ...following a campus alcohol violation has not yet been studied. The current study examined alcohol use behaviors and perceived drinking norms among mandated student cohorts enrolled in the pre-COVID-19 era (fall 2019) and COVID-19 era (fall 2020).
Participants (
= 228) completed measures focused on alcohol use and associated behaviors. Analytic models controlled for participant age and entailed negative binomial regressions for count outcomes and analyses of covariance for normally distributed continuous outcomes.
COVID-era cohort students reported fewer drinks, pregaming occasions (i.e., drinking before a social occasion such as a sports event), and drinks while pregaming. Frequency of heavy episodic drinking (HED) remained consistent between groups; however, the peak number of drinks during HED was significantly lower in the COVID-era group, as were Alcohol Use Disorders Identification Test scores and alcohol-related consequences. Perceived peer norms for frequency and quantity were significantly higher in the COVID-era group. Regression confirmed a significant impact of norms on both frequency and quantity of alcohol use in both cohorts.
Mandated college students during the COVID-19 pandemic consumed less alcohol, engaged in less pregaming, consumed fewer drinks while pregaming, and reported fewer negative alcohol consequences than a cohort from the previous year. In this campus case study of residential students who violate campus alcohol policy, COVID restrictions were associated with reduced overall quantity and risky practices.
Abstract Introduction The present study examined self-affirmation theory, cigarette smoking, and health-related images depicting adverse effects of smoking. Previous research examining ...self-affirmation and negative health-related images has shown that individuals who engage in a self-affirmation activity are more receptive to messages when compared to those who do not affirm. We were interested in examining the extent to which self-affirmation would reduce defensive responding to negative health images related to cigarette smoking. Methods Participants included 203 daily smokers who were undergraduate students at a large southern university. Participants completed a battery of questionnaires and were then randomly assigned to one of four conditions (non-smoking image control, smoking image control, low affirmation, and high affirmation). Analyses evaluated the effectiveness of affirmation condition as it related to defensive responding. Results Results indicated that both affirmation conditions were effective in reducing defensive responding for those at greatest risk (heavier smokers) and those more resistant to health benefits associated with quitting. Conclusions Findings are discussed in terms of potential public health implications as well as the role defensive responding plays in the evaluation and processing of negative health messages.
College alcohol beliefs and personal attitudes about alcohol use are important predictors of alcohol use and related problems both cross-sectionally and over time. However, little work has examined ...these constructs together and how they may influence one another in predicting various alcohol related outcomes over time. The current study aimed to evaluate one's attitude toward heavy drinking as a mediator of the association between college alcohol beliefs and drinking related outcomes over a 12-month period of time. Participants were mandated students (n = 568; 28% female) who violated campus alcohol policy and received a Brief Motivational Intervention. Analyses included the use of linear regression for prospective predictions as well as PROCESS to evaluate the proposed mediation models. Overall, the results indicate that one's attitude toward heavy drinking significantly mediates the association between college alcohol beliefs and drinks per week, binge frequency, as well as alcohol-related problems over 12 months. These findings provide a compelling rationale for incorporating both college alcohol beliefs and attitudes in the development and refinement of intervention strategies.
•College alcohol beliefs are positively associated with attitudes toward heavy drinking.•Attitude toward heavy drinking mediates the college alcohol belief – alcohol use association.•Attitude toward heavy drinking mediates the college alcohol belief – alcohol problem association.
Personal attitudes toward alcohol consumption are reliable predictors of alcohol use and related problems, with emerging work suggesting that one's favorable attitude toward limited drinking (i.e., ...at levels below the threshold for heavy episodic drinking) is a buffer against alcohol use and binge drinking. However, little work has examined the specific mechanism(s) through which one's personal attitude toward limited drinking is associated with alcohol use and related problems. One such mechanism may be an individual's self-efficacy to limit their alcohol use. The current study aimed to evaluate whether self-efficacy to limit one's alcohol use mediates the association between one's personal attitude toward limited drinking and actual alcohol use and related problems over time. Participants were mandated students (n = 568; 28% female) who violated campus alcohol policy and received a brief motivational intervention. Mediation models were used to test (a) self-efficacy to limit one's alcohol use as a traditional mediator of the attitudes-drinking quantity association and (b) self-efficacy and drinking quantity as serial mediators of the attitudes-alcohol-problems link. Favorable attitudes toward limiting drinking at baseline were positively associated with self-efficacy to limit drinking at 1 month, which was associated with a reduction in drinking quantity at 3 months; this, in turn, was associated with a reduction in alcohol-related problems at 5 months. These findings provide a rationale for incorporating attitudes and self-efficacy in the development and refinement of intervention strategies.
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