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Inland recreational swimming sites provide significant social value globally. This study focused on public recreational swimming sites across the Murrumbidgee River and its tributaries in the Australian Capital Territory (ACT) throughout the swimming season (September-April) from 2009 to 2020 to determine whether high intestinal enterococci concentrations could be predicted with flow exceedance and routinely monitored physical and chemical parameters of water quality. Enterococci concentrations were positively correlated with the turbidity associated with high-flow conditions. The predictive accuracy of high enterococci levels during high-flow conditions was good (mean percentage correctly classified, 60%). The prediction of high enterococci levels at low flows was significantly less reliable (mean percentage correctly classified, 12-15%). As the ACT is expected to experience decreases in rainfall overall but increases in extreme rainfall events due to climate change, understanding the drivers of elevated intestinal enterococci under extreme flow conditions remains important from a public health perspective. [ABSTRACT FROM AUTHOR]

Substance use and mental health problems are associated with academic difficulties among high school and undergraduate students, but little research has been conducted on these relationships among graduate students. The sample consisted of 2683 graduate students attending two large, public universities. Standard measures were used to collect data on demographic and program characteristics, mental health, substance use, advisor satisfaction, and burnout (i.e., exhaustion, cynicism, and inefficacy). Linear regression models evaluated the relationships between each mental health and substance use variable with burnout, as well as the moderating role of advisor satisfaction. Students with a greater number of substance use and mental health problems had higher levels of exhaustion, cynicism, and inefficacy. No statistically significant relationships between substance use and burnout were found. High levels of stress, moderate or severe anxiety symptoms, and moderate or severe depressive symptoms were associated with increased levels of burnout. Advisor support moderated the relationships between stress and both cynicism and inefficacy such that the effects of stress on these dimensions of burnout were lower among those who were satisfied with their advisor. Graduate students with mental health problems might be at increased risk for burnout; however, having a supportive advisor might buffer this association. [ABSTRACT FROM AUTHOR]

This study evaluated variation in substance use and mental health among graduate student subgroups. A sample of 2,683 master's and doctoral students completed an online survey in October 2017. Subgroup variation in behavioral health by demographic and program characteristics, particularly degree type and academic discipline, was explored. Compared with academic doctoral students (ie, PhD students), professional doctoral students (ie, MD, JD, etc.) were significantly more likely to report high stress levels and moderate or severe anxiety symptoms. Master's students were more likely to report moderate or severe anxiety symptoms and use marijuana than academic doctoral students. Students in the behavioral and social sciences, social work, and arts and humanities disciplines were more likely to use substances and report mental health problems than engineering and business students. These findings highlight graduate student subgroups who might require closer attention with respect to access to behavioral health services. [ABSTRACT FROM AUTHOR]

Nonmedical use of prescription stimulants (NMPS) has increased on college campuses during the past two decades. NMPS is primarily driven by academic enhancement motives, and normative misperceptions exist as well. However, large, nationwide studies have not yet been conducted to generalize findings more broadly and gain a deeper understanding of the relationship between NMPS and other substance use (e.g. alcohol use, marijuana, etc.). The present study was conducted to lay the foundation for prevention efforts related to NMPS by establishing NMPS prevalence, practices surrounding NMPS, and other substance use. N = 2,989 students from seven universities around the U.S. completed a web-based survey assessing NMPS practices and related behaviors. Prevalence and factors associated with NMPS were explored. Analyses revealed a 17% past-year prevalence of NMPS with associated widespread misperceptions of peer use. NMPS was significantly related to alcohol use, binge drinking, and marijuana use, as well as skipped classes and affiliation with Greek life. Although most college students do not report NMPS, those who do also are more likely to report alcohol use, binge drinking, and marijuana use, and NMPS could be a "red flag" for other risk behaviors worth exploring. Implications for prevention and intervention are discussed. [ABSTRACT FROM AUTHOR]

Background: There are high levels of stress among graduate students, and stress is associated with multiple negative outcomes among student populations, including academic burnout. Sleep could play an important role in explaining the association between stress and burnout, but these relationships have not been explored among the graduate student population. The current study assessed whether or not sleep duration and quality moderated the relationship between stress and burnout (i.e., exhaustion, cynicism, and inefficacy) among graduate students. Methods: A sample of 2683 master's, doctoral, and professional graduate students from two large, public universities completed an online survey. Linear regression models with interaction terms were developed to evaluate the relationships between stress and burnout while examining moderation by sleep duration and quality. Results: Participants slept an average of 6.4 h per night, with 62% indicating good sleep quality. Stress had significant, positive relationships with exhaustion, cynicism, and inefficacy. The relationship between stress and exhaustion lessened as sleep duration increased, and the relationship between stress and exhaustion was weaker among students with good sleep quality when compared with those with poor sleep quality. Neither sleep duration nor sleep quality moderated the relationships between stress and cynicism or stress and inefficacy. Conclusions: Improving sleep habits has the potential to lessen the negative association between stress and graduate student functioning. Future research utilizing longitudinal designs is needed to understand the temporality of these associations and the influence of possible co-factors like individual propensity for mental health problems and social support. [ABSTRACT FROM AUTHOR]

Objective: This study examines the prospective relationship between substance use during college and two outcomes: having definite plans to attend graduate school; and, among individuals with plans, enrolling in graduate school upon college graduation. Participants:n = 980 were originally enrolled as first-time, first-year college students in an ongoing longitudinal study (August 2004 to present). Methods: Measures from personal interviews included demographics, GPA, alcohol use, alcohol abuse/dependence, and other drug use during college. Results: Fifty-four percent had definite plans to attend graduate school, and 47% of students with definite plans enrolled in graduate school. Alcohol dependence was significantly associated with reduced likelihood of having graduate school plans. Among students with plans to attend graduate school, alcohol abuse and alcohol dependence during college were associated with decreased likelihood of enrolling in graduate school. Conclusions: Substance use during college might impact graduate school enrollment, and early intervention efforts could help students achieve their educational goals. [ABSTRACT FROM AUTHOR]

Background: Drug use among college students is associated with adverse academic and health outcomes and risks to personal safety.Objectives: This study utilized data from a longitudinal study to estimate annual prevalence, cumulative lifetime prevalence, and incidence of ten types of drug use during the eight years after college entry and the average age of onset of each drug used.Methods: Participants (N = 1,253; 52% female) were young adults who were originally enrolled as first-time, first-year students at a university in the mid-Atlantic US. Annual personal interviews gathered data about the use of seven illicit drugs and three prescription drugs used nonmedically. Annual follow-up rates ranged from 76 to 91%.Results: Marijuana was the most commonly used drug in every year of the study, with the highest annual prevalence estimates in Year 3 (47%wt). In Year 8, when the modal age of participants was 25, 29%wt used marijuana during the past year. Nonmedical use of prescription drugs was more prevalent during college than in the later years of the study. Although the prevalence of cocaine and ecstasy use was low (cumulative prevalence estimates of 17%wt and 13%wt, respectively), incidence for these drugs was particularly high in the later years of the study.Conclusion: Drug use is prevalent among college students, and drug use persists among young adults, even after many have graduated college. More attention should be directed at identifying and intervening with students at risk for drug use to mitigate possible academic, health, and safety consequences. [ABSTRACT FROM AUTHOR]

Background Highly caffeinated 'energy drinks' ( ED) are commonly consumed and sometimes mixed with alcohol. Associations between ED consumption, risk-taking, and alcohol-related problems have been observed. This study examines the relationship between ED consumption-both with and without alcohol-and drunk driving. Methods Data were derived from a longitudinal study of college students assessed annually via personal interviews. In Year 6 (modal age 23; n = 1,000), participants self-reported their past-year frequency of drunk driving, ED consumption patterns (frequency of drinking alcohol mixed with energy drinks [AmED] and drinking energy drinks without alcohol [ED]), alcohol use (frequency, quantity), and other caffeine consumption. Earlier assessments captured suspected risk factors for drunk driving. Structural equation modeling was used to develop an explanatory model for the association between ED consumption patterns and drunk driving frequency while accounting for other suspected risk factors. Results More than half (57%) consumed ED at least once during the past year. Among ED consumers, 71% drank Am ED and 85% drank ED alone; many (56%) engaged in both styles of ED consumption while others specialized in one or the other (29% drank ED alone exclusively, while, 15% drank Am ED exclusively). After accounting for other risk factors, ED consumption was associated with drunk driving frequency in 2 ways. First, a direct path existed from ED frequency (without alcohol) to drunk driving frequency. Second, an indirect path existed from Am ED frequency through alcohol quantity to drunk driving frequency. Conclusions Among this sample, ED consumption with and without alcohol was common, and both styles of ED consumption contributed independently to drunk driving frequency. Results call for increased attention to the impact of different patterns of ED consumption on alcohol-related consequences, such as drunk driving. [ABSTRACT FROM AUTHOR]

Background College students who engage in high-risk drinking patterns are thought to 'mature out' of these patterns as they transition to adult roles. College graduation is an important milestone demarcating this transition. We examine longitudinal changes in quantity and frequency of alcohol consumption between the college years and the 4 years after graduation and explore variation in these changes by gender and race/ethnicity. Methods Participants were 1,128 college graduates enrolled in a longitudinal prospective study of health-risk behaviors. Standard measures of alcohol consumption were gathered during 8 annual personal interviews (76 to 91% annual follow-up). Graduation dates were culled from administrative data and self-report. Spline models, in which separate trajectories were modeled before and after the 'knot' of college graduation, were fit to 8 annual observations of past-year alcohol use frequency and quantity (typical number of drinks/drinking day). Results Frequency increased linearly pregraduation, slightly decreased postgraduation, and then rebounded to pregraduation levels. Pregraduation frequency increased more steeply among individuals who drank more heavily at college entry. Quantity decreased linearly during college, followed by quadratic decreases after graduation. Conclusions Results suggest that the postcollege 'maturing-out' phenomenon might be attributable to decreases in alcohol quantity but not frequency. High-frequency drinking patterns that develop during college appear to persist several years postgraduation. [ABSTRACT FROM AUTHOR]

Sales of energy drinks have increased rapidly since their introduction to the marketplace in the 1990s. Despite the health concerns raised about these beverages, which are often highly caffeinated, surprisingly little data are available to estimate the prevalence of their use. This review presents the results of secondary data analyses of a nationally representative data set of schoolchildren in the United States and reviews the available research on the association between energy drink use and risk-taking behaviors. Approximately one-third of the students surveyed were recent users of energy drinks, with substantial variation by age, sex, and race/ethnicity. Among the health and safety concerns related to energy drinks and their consumption is the possible potentiation of risk-taking behaviors. The review of available research reveals that, although there does appear to be a strong and consistent positive association between the use of energy drinks and risk-taking behavior, all but one of the available studies used cross-sectional designs, thereby limiting the ability to make inferences about the temporal nature of the association. Thus, more research is needed to understand the nature of this association and how energy drinks, particularly those containing caffeine, might impact adolescent health and safety, especially given the high prevalence of their use among youth. [ABSTRACT FROM AUTHOR]

Background Many underage drinkers obtain alcohol from legal-age family, friends, and acquaintances. This study aimed to understand the attitudes and behaviors of young adults related to providing alcohol to underage drinkers. Methods Participants were 755 current or recent college students of legal drinking age (ages 22 to 26) who were approached by a minor to provide alcohol at least once since turning 21. Interviewers assessed frequency of providing alcohol, relationship to the recipients, and general attitudes about providing alcohol to minors. Separate questions asked about younger (under 18) and older (18 to 20) minors. Correlates and predictors of provision and frequency of provision were examined via logistic regression and Poisson regression, focusing on demographics, sensation-seeking, behavioral dysregulation, age at first drink, parental history of alcohol problems, fraternity/sorority involvement, attitudes about provision, violations, peer drinking norms, and alcohol use disorder ( AUD) risk during and post-college. Results Most participants (84.6%) provided alcohol to minors at least once. Provision to older minors was more prevalent (82.8%) than to younger minors (20.7%); it was also more frequent. Few (2.4%) were ever caught providing alcohol. Recipients were more commonly friends or family members rather than acquaintances or strangers. Legal concerns about providing alcohol (82.5 and 53.7% for younger and older minors, respectively) were more prevalent than health concerns (55.7 and 9.5%). Legal concerns consistently predicted lower likelihood of provision, independent of demographics. Health concerns and lower post-college AUD risk scores also independently predicted lower likelihood of provision, but only to older minors. Fraternity/sorority involvement and higher peer drinking norms were associated with higher provision frequency, whereas legal concerns and college violations were associated with lower provision frequency. Conclusions Young adults who have recently turned 21 could represent an important target for prevention strategies to reduce underage drinking on college campuses. More research is needed to understand the motivations of young adults who provide alcohol to underage drinkers. [ABSTRACT FROM AUTHOR]

Background It is well known that using false identification ( ID) is a common method by which underage youth in the United States obtain alcohol. While false ID use is associated with high-risk drinking patterns, its association with alcohol use disorder ( AUD), independent of other risk factors, has not been firmly established. Methods Participants were 1,015 college students recruited from 1 university and assessed annually during their first 4 years of college. Latent variable growth curve modeling was used to identify significant predictors of false ID use and test the hypothesis that false ID use increased the risk for AUD, by increasing the frequency and/or quantity of alcohol use. Several other hypothesized risk factors for AUD were accounted for, including demographics (sex, race, living situation, religiosity, socioeconomic status), individual characteristics (childhood conduct problems, sensation-seeking, age at first drink), high school behaviors (high school drinking frequency, drug use), family factors (parental monitoring, parental alcohol problems), perception of peer drinking norms, and other factors related to false ID use. Results False IDs were used by almost two-thirds (66.1%) of the sample. False ID use frequency was positively associated with baseline quantity and frequency of alcohol use, independent of all other factors tested. False ID use was not directly related to AUD risk, but indirectly predicted increases in AUD risk over time through its association with greater increases in alcohol use frequency over time. Several predictors of false ID use frequency were also identified. Conclusions False ID use may contribute to AUD risk by facilitating more frequent drinking. If replicated, these findings highlight the potential public health significance of policies that enforce sanctions against false ID use. Students who use false IDs represent an important target population for alcohol prevention activities. [ABSTRACT FROM AUTHOR]

Objective: This study examined the prospective relationship of substance use and mental health problems with risk of discontinuous enrollment in college. Methods: Participants were 1,145 students at a large public university who were interviewed annually for four years beginning at college entry in 2004 (year 1). Discontinuous enrollment was defined as a gap in enrollment of one or more semesters during the first two years (early discontinuity) or the second two years (late discontinuity) versus continuous enrollment throughout all four years. Explanatory variables measured in year 1 were scores on the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory, childhood conduct problems, cannabis use, number of illicit drugs used, and alcohol consumption. In years 3 and 4, participants reported lifetime history of clinically diagnosed attentiondeficit hyperactivity disorder, depression, and anxiety, including age at diagnosis. Multinomial logistic regression models were developed to evaluate the association between the independent variables and discontinuous enrollment while holding constant background characteristics. Results: Higher BDI scores predicted early discontinuity but not late discontinuity, whereas cannabis and alcohol use predicted only late discontinuity. Receiving a depression diagnosis during college was associated with both early and late discontinuity. Self-reported precollege diagnoses were not related to discontinuous enrollment once background characteristics were taken into account. Conclusions: Students who experience depressive symptoms or seek treatment for depression during college might be at risk of interruptions in their college enrollment. Cannabis use and heavy drinking appear to add to this risk. Students entering college with preexisting psychiatric diagnoses are not necessarily at risk of enrollment interruptions. [ABSTRACT FROM AUTHOR]

Background: Previous research has suggested important contextual factors that can differentiate problem and nonproblem drinkers. Objectives: To evaluate the strength of the prospective association between social contexts of drinking and subsequent alcohol use disorder and drunk driving 2-3 years later. Methods: The sample consisted of 652 individuals who were originally recruited at college entry, had complete data on at least one social context subscale, met the minimum criteria for Year 1 drinking, and had nonmissing data on at least one of the outcome variables in Years 3 and/or 4. Social contexts of drinking were assessed in Year 1 by using previously validated scales measuring six different situational and motivational contexts in which alcohol is consumed. DSM-IV criteria for alcohol abuse and dependence and drunk driving were assessed annually. Results: Holding constant gender, race/ethnicity, and baseline drinking frequency, the frequency of drinking in a context of social facilitation, sex-seeking, or in a motor vehicle during Year 1 was significantly related to a greater likelihood of alcohol abuse, alcohol dependence, and drunk driving in Years 3 and/or 4. Drinking in a context of emotional pain was related to alcohol dependence and drunk driving but not to alcohol abuse. Conclusions: The Social Context of Drinking Scales have utility for identifying students who are at risk for developing alcohol-related problems. Scientific Significance: Identifying college students who might develop alcohol dependence requires an assessment of both situational and motivational factors that influence drinking, especially drinking in a motor vehicle. [ABSTRACT FROM AUTHOR]

Prevalence and correlates of HIV testing were examined in a sample of 957 unmarried recent college students in the United States. Participants were asked about HIV testing, past-six-months sexual activities, lifetime treatment for sexually transmitted infections (STI), past-year health service utilization, and DSM-IV criteria for alcohol and other drug (AOD) dependence during the 2008-2009 academic year. Two in five (41.9%wt) were ever tested for HIV. Holding constant demographics, HIV testing was positively related to AOD dependence, frequency of unprotected sex, number of sex partners, having a physical exam by a medical professional, number of visits to a health provider for physical health problems, and lifetime STI treatment. Women were more likely than men to be tested for HIV despite similar levels of risky sex. Results demonstrate the feasibility of achieving high HIV testing rates in a college population. [ABSTRACT FROM AUTHOR]

Introduction: Light and intermittent patterns of cigarette smoking are prevalent among U.S. college-aged individuals. It is unclear whether intermittent smokers maintain their use over time or are transitioning to daily use or nonuse, and whether they experience more adverse health outcomes than nonsmokers. Methods: This study examined the trajectories of tobacco cigarette smoking, their predictors, and health outcomes among students (N = 1,253) assessed during their first year of college (Y1) and annually thereafter (Y2, Y3, and Y4). Results: In Y1, 3.4% smoked daily and 4.1% exhibited signs of dependence (first cigarette within 30 min of waking). Growth curve modeling identified five distinct smoking trajectories. After stable nonsmokers (71.5%wt), the low-stable smoking trajectory was the most common (13.3%wt), outnumbering both low-increasing (6.5%wt) and high-stable smokers (5.5%wt) by 2:1 and high-decreasing smokers (3.2%wt) by 4:1. The likelihood of maintaining a low level of smoking over time was inversely related to Y1 smoking frequency. Few demographic, smoking, and alcohol use characteristics measured in Y1 distinguished low-increasers from low-stable smokers or high-decreasers from high-stable smokers. By Y4, high-stable smokers rated their health significantly worse than all others except low-increasers. High-stable smokers had the most Y4 health problems (i.e., provider visits for health problems and days of illness-related impairment), but only among nonWhites. Conclusions: Many college students smoke, but few smoke daily or are nicotine dependent. Intermittent smoking patterns are often stable throughout college and are associated with adverse health outcomes. Prevention strategies should be designed to mitigate the possible long-term health consequences of light and intermittent smoking. [ABSTRACT FROM PUBLISHER]

Longitudinal studies are often considered to be a gold standard for research, but the operational management of such studies is not often discussed in detail; this paper describes strategies used to track and maintain high levels of participation in a longitudinal study involving annual personal interviews with a cohort of 1,253 undergraduates (first-time, first-year students at time of enrollment) at a large public mid-Atlantic university. [ABSTRACT FROM AUTHOR]

Longitudinal studies are often considered to be a gold standard for research, but the operational management of such studies is not often discussed in detail; this paper describes strategies used to track and maintain high levels of participation in a longitudinal study involving annual personal interviews with a cohort of 1,253 undergraduates (first-time, first-year students at time of enrollment) at a large public mid-Atlantic university. [ABSTRACT FROM AUTHOR]

Marijuana is the most prevalent illicit drug used by adolescents and young adults, yet marijuana initiation is rarely studied past adolescence. The present study sought to advance our understanding of parent and peer influences on marijuana exposure opportunity and incident use during college. A sample of 1,253 students was assessed annually for 4 years starting with the summer prior to college entry. More than one-third (38%) of students had already used marijuana at least once prior to college entry; another 25% initiated use after starting college. Of the 360 students who did not use marijuana prior to college, 74% were offered marijuana during college; of these individuals, 54% initiated marijuana use. Both low levels of parental monitoring during the last year of high school and a high percentage of marijuana-using peers independently predicted marijuana exposure opportunity during college, holding constant demographics and other factors ( AOR = 0.92, 95% CI = 0.88-0.96, p < .001 and AOR = 1.11, 95% CI = 1.08-1.14, p < .001, respectively). Among individuals with exposure opportunity, peer marijuana use ( AOR = 1.04, 95% CI = 1.03-1.05, p < .001), but not parental monitoring, was associated with marijuana initiation. Results underscore that peer influences operate well into late adolescence and young adulthood and thus suggest the need for innovative peer-focused prevention strategies. Parental monitoring during high school appears to influence exposure opportunity in college; thus, parents should be encouraged to sustain rule-setting and communication about adolescent activities and friend selection throughout high school. [ABSTRACT FROM AUTHOR]

Early conduct problems have been linked to early marijuana use in adolescence. The present study examines this association in a sample of 1,076 college students that was divided into three groups: (1) early marijuana users (began marijuana use prior to age 15; N = 126), (2) late marijuana users (began marijuana use at or after age 15; N = 607), and (3) nonusers (never used marijuana; N = 343). A conduct problem inventory used in previous studies was adapted for use in the present study. Early conduct problems were associated with early marijuana use but not with late marijuana use, holding constant other risk factors. Results suggest that early conduct problems are a risk factor for early marijuana use even among academically achieving college-bound students. [ABSTRACT FROM AUTHOR]

To understand the extent to which medication adherence was related to diversion of prescription analgesics. Cross-sectional analyses of data from the College Life Study, a prospective study of young adults. Participants were originally sampled as incoming first-time first-year college students from one large public university in the Mid-Atlantic United States. One hundred ninety-two young adults aged 21-26 who were prescribed an analgesic to treat acute pain in the past year. Diversion of prescription analgesics. The study tested two competing hypotheses: 1) individuals who skip doses (under-users) are at greatest risk for diversion because they have leftover medication; and 2) individuals who over-use their prescriptions (over-users) are at greatest risk for diversion, perhaps because of a general propensity to engage in deviant behavior. Fifty-eight percent followed physician's instructions regarding their prescription analgesic medication; 27% under-used their prescribed medication and 16% over-used their prescribed medication. Twenty-seven percent of the total sample diverted their medication, with over-users being the most likely to divert (63%). Holding constant demographic characteristics and perceived harmfulness of nonmedical use, over-users were almost five times as likely as adherent users to divert analgesic medications ( P < 0.05). Further research is needed to better understand the relationship between adherence and diversion. If these findings are replicated, physicians who are involved in pain management for acute conditions among young adults should take steps to monitor adherence and reduce diversion of prescription analgesics. [ABSTRACT FROM AUTHOR]

Energy drinks are highly caffeinated beverages that are increasingly consumed by young adults. Prior research has established associations between energy drink use and heavier drinking and alcohol-related problems among college students. This study investigated the extent to which energy drink use might pose additional risk for alcohol dependence over and above that from known risk factors. Data were collected via personal interview from 1,097 fourth-year college students sampled from 1 large public university as part of an ongoing longitudinal study. Alcohol dependence was assessed according to DSM-IV criteria. After adjustment for the sampling design, 51.3% of students were classified as 'low-frequency' energy drink users (1 to 51 days in the past year) and 10.1% as 'high-frequency' users (≥52 days). Typical caffeine consumption varied widely depending on the brand consumed. Compared to the low-frequency group, high-frequency users drank alcohol more frequently (141.6 vs. 103.1 days) and in higher quantities (6.15 vs. 4.64 drinks/typical drinking day). High-frequency users were at significantly greater risk for alcohol dependence relative to both nonusers (AOR = 2.40, 95% CI = 1.27 to 4.56, p = 0.007) and low-frequency users (AOR = 1.86, 95% CI = 1.10, 3.14, p = 0.020), even after holding constant demographics, typical alcohol consumption, fraternity/sorority involvement, depressive symptoms, parental history of alcohol/drug problems, and childhood conduct problems. Low-frequency energy drink users did not differ from nonusers on their risk for alcohol dependence. Weekly or daily energy drink consumption is strongly associated with alcohol dependence. Further research is warranted to understand the possible mechanisms underlying this association. College students who frequently consume energy drinks represent an important target population for alcohol prevention. [ABSTRACT FROM AUTHOR]

Background: Alcohol-impaired driving is a major public health problem. National studies indicate that about 25% of college students have driven while intoxicated in the past month and an even greater percentage drive after drinking any alcohol and/or ride with an intoxicated driver. The purpose of this investigation was to examine the change in these various alcohol-related traffic risk behaviors as students progressed through their college experience. Methods: A cohort of 1,253 first-time first-year students attending a large, mid-Atlantic university were interviewed annually for 4 years. Repeated measures analyses were performed using generalized estimating equations to evaluate age-related changes in prevalence and frequency of each behavior (i.e., ages 19 to 22). Results: At age 19, 17%wt of students drove while intoxicated, 42%wt drove after drinking any alcohol, and 38%wt rode with an intoxicated driver. For all 3 driving behaviors, prevalence and frequency increased significantly at age 21. Males were more likely to engage in these behaviors than females. To understand the possible relationship of these behaviors to changes in drinking patterns, a post hoc analysis was conducted and revealed that while drinking frequency increased every year, frequency of drunkenness was stable for females, but increased for males. Conclusions: Alcohol-related traffic risk behaviors are quite common among college students and take a significant upturn when students reach the age of 21. Prevention strategies targeted to the college population are needed to prevent serious consequences of these alcohol-related traffic risk behaviors. [ABSTRACT FROM AUTHOR]

Aims: To: (1) estimate the proportion of students exposed to specific types of information regarding the positive and negative effects of ecstasy, (2) test models that quantified the relationship between exposure to these messages and subsequent ecstasy use, controlling for peer drug use and sensation-seeking. Methods: As part of the College Life Study, 447 students, aged 17–20 years, from a university in the mid-Atlantic region of the US completed an in person interview plus three follow-up assessments. Findings: Individuals who had heard a greater number of negative messages were significantly more likely to use ecstasy, even controlling for positive messages, prior ecstasy use, peer ecstasy use, perceived harm, sensation-seeking, sex and race. Some messages were significant at the bivariate level. Conclusions: Ecstasy use may have been influenced more by the content of the messages than by the quantity or diversity of messages. Interventions should be designed to address both positive and negative perceptions about a particular drug, rather than focusing exclusively on the negative information. Future evaluations should focus on the effectiveness of multi-pronged sustainable prevention programs in reducing adolescent drug use risk. [ABSTRACT FROM AUTHOR]

Background: Research has linked heavy alcohol use with nonmedical prescription analgesic use, but no studies have focused on concurrent use. Objectives: To understand the extent to which alcohol use and nonmedical prescription analgesic use co-occur among college students. Methods: The Timeline Followback method was used to split the sample (n = 1,118) into three groups based on their alcohol and nonmedical prescription analgesic use. Results: Of all nonmedical prescription analgesic users, 58% (n = 90) were concurrent users. Concurrent users consumed more drinks per drinking day (7.5) than non-concurrent (5.8) and alcohol-only users (5.2), and drank more often (74.4% of days in the past six months, vs. 45.7% and 36.8%, respectively). Conclusions and Scientific Significance: Concurrent alcohol and analgesic use is prevalent among nonmedical users of prescription analgesics. Findings suggest a need for heightened awareness and increased research of the risks of coingestion. [ABSTRACT FROM AUTHOR]

Background: Heavy drinking and illicit drug use among college students has been a longstanding public health concern. Current methods to screen and identify college students at-risk for the development of substance use disorders (SUD) are somewhat limited. Objectives: This study aimed to cross-validate the work by Kirisci et al. (1), who developed the Transmissible Liability Index (TLI), by deriving a set of items that would be potentially useful for characterizing SUD risk across multiple dimensions among college students. We examined: 1) variations in the TLI-College Version (TLI-CV) by race, sex, SES, religiosity, and family history of substance use problems; 2) the association between the TLI-CV and alcohol and/or marijuana dependence, both cross-sectionally and prospectively, by race and sex; and, 3) the sensitivity and specificity of the TLI-CV for identifying cases of marijuana and/or alcohol dependence. Methods: Data from an ongoing longitudinal study of college students (n = 1,253) was used to conduct item response theory (IRT) analyses; the resulting TLI-CV consisted of 33 items. Results: The TLI-CV was significantly associated with baseline dependence and significantly higher for non-dependent individuals who later became dependent during the subsequent three years of college. These associations were observed for both sexes, Whites, Blacks/African-Americans, Asians, and other racial minorities. The sensitivity and specificity were suboptimal. Conclusions and Scientific Significance: The TLI-CV advances prior research to identify college students at risk for SUD. This approach holds potential promise to identify and ultimately modify the trajectories of college students who may be at risk for the development of SUD. [ABSTRACT FROM AUTHOR]

This study describes the level of perceived harmfulness of nonmedical prescription stimulant and analgesic use in a sample of college students, and examines the prospective relationship between perceived harmfulness and subsequent nonmedical use. In addition, we explore whether the association between perceived harmfulness and nonmedical use varies by level of sensation-seeking. Personal interviews, including questions on sensation-seeking and drug use, were conducted with 1,253 first-year college students. Participants were then followed-up twice at 6-month intervals. Perceived harmfulness of nonmedical use of prescription drugs was assessed at 6 months via a web-based survey. At the 12-month follow-up interview, drug use was again assessed. Students who never had the opportunity to use prescription drugs nonmedically were excluded from all analyses. Results revealed that one in four students perceived a great risk of harm from occasional nonmedical use of prescription stimulants (25.2%) and analgesics (27.8%). As expected, low perceived harmfulness and high sensation-seeking were independently associated with increased risk of nonmedical use, holding constant demographic characteristics. The protective effect of high perceived harmfulness could be seen at all levels of sensation-seeking with one important exception: Among high sensation-seekers, perceived harmfulness was not related to nonmedical use of prescription analgesics. Perceived harmfulness appears to distinguish nonmedical users from non-users, given the opportunity to use. Increasing perceived harmfulness may be a viable prevention strategy for most students, but alternative approaches might need to be developed that are tailored to high sensation-seekers. [ABSTRACT FROM AUTHOR]

Objective: To examine how social contexts of drinking are related to alcohol use disorders, other alcohol-related problems, and depression among college students. Methods: Logistic regressian models controlling for drinking frequency measured the association between social context and problems, among 728 current drinkers. Results: Drinking for social facilitation was associated with drinking and driving and housing violations. Drinking in the context of motor vehicles was associated with alcohol abuse/ dependence. Drinking in a context of emotional pain was associated with clinical depression. Conclusions: Alcohol-free programming that fulfills needs for conviviality and addresses early signs of depression might reduce alcohol problems among college students. [ABSTRACT FROM AUTHOR]

Study Objective. To define, among a sample of college students, the nature and extent of nonmedical use of prescription stimulants (NPS), including both overuse and use of someone else's drug, for attention-deficit-hyperactivity disorder (ADHD); to characterize NPS among individuals not medically using a prescription stimulant for ADHD; and to determine whether NPS and overuse of a medically prescribed stimulant for ADHD were independently associated with an increased risk of other illicit drug use and dependence on alcohol and marijuana. Design. Cross-sectional analysis of personal interview data. Setting. Large public university in the mid-Atlantic region. Participants. A cohort of 1253 first-year college students aged 17-20 years. Measurements and Main Results. All students completed a 2-hour personal interview to ascertain medical use and overuse of prescription stimulants, NPS, nonmedical use of other prescription drugs and illicit drug use, and dependence on alcohol and marijuana. Comparisons were made among nonusers, nonmedical users, and medical users of prescription stimulants for ADHD (ADHD+), some of whom overused their drug. Of 1208 students who were not using prescription stimulants medically for ADHD (ADHD-), 218 (18.0%) engaged in NPS. Of 45 ADHD+ students, 12 (26.7%) overused their ADHD drug at least once in their lifetime, and seven (15.6%) nonmedically used someone else's prescription stimulants at least once in their lifetime. Among 225 nonmedical users, NPS was infrequent and mainly associated with studying, although 35 (15.6%) used prescription stimulants to party or to get high. Lifetime NPS was associated with past-year other drug use. Both NPS and overuse of prescribed stimulants for ADHD were independently associated with past-year use of five drugs, holding constant sociodemographic characteristics; NPS was also associated with alcohol and marijuana dependence. Conclusions. Physicians should be vigilant for possible overuse and/or diversion of prescription stimulants for ADHD among college students who are medical users of these drugs, as well as the occurrence of illicit drug use with NPS. Initiation of comprehensive drug prevention activities that involve parents as well as college personnel is encouraged to raise awareness of NPS and its association with illicit drug use. [ABSTRACT FROM AUTHOR]

Background: College drinking is a significant public health problem. Although parental monitoring and supervision reduces the risk for alcohol consumption among younger adolescents, few studies have investigated the impact of earlier parental monitoring on later college drinking. This study examined whether parental monitoring indirectly exerts a protective effect on college drinking by reducing high school alcohol consumption. Methods: A longitudinal cohort of 1,253 male and female students, ages 17 to 19, attending a large, public, mid-Atlantic university was studied at two time points. First, data on high school parental monitoring and alcohol consumption were gathered via questionnaire during the summer prior to college entry. Second, during the first year of college, past-year alcohol consumption was measured via a personal interview. Multiple regression models tested the relationship between parental monitoring and past year alcohol use (i.e., number of drinks per drinking day). Results: Holding constant demographics, SAT score, and religiosity, parental monitoring had a significant protective effect on both high school and college drinking level. However, the association between parental monitoring and college drinking level became non-significant once high school drinking level was held constant. Conclusion: While parental monitoring did not directly influence college alcohol consumption, evidence for mediation was observed, whereby parental monitoring had an indirect influence on college drinking through reductions in high school drinking. Initiatives that promote effective parenting might be an important strategy to curb high-risk drinking among older adolescents. More research is needed to understand the nature and degree of parent-child communication that is necessary to extend the protective influence of parents into the college years. [ABSTRACT FROM AUTHOR]

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