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Suicide is the second leading cause of death for American Indian (AI) young adults. Alcohol use is a well-established risk factor for suicide. On average, AIs ages 12 to 20 exhibit the second-highest rate of binge drinking compared to all other ethnic groups. The current study investigated the relation between alcohol use and suicide ideation in an AI sample and examined these relations in the context of the interpersonal theory of suicide (ITS). It was hypothesized that perceived burdensomeness and thwarted belongingness would each significantly moderate the relations between alcohol use and suicide ideation in an AI sample. College students who self-identified as American Indian ( N  = 84) completed measures of alcohol use and associated problems, perceived burdensomeness and thwarted belongingness, and suicidality. Results indicated that perceived burdensomeness significantly moderated the relation between alcohol use and suicide ideation, and this interaction was significant at high levels of perceived burdensomeness. However, thwarted belongingness was not a significant moderator of the relation between alcohol use and suicide ideation. Findings suggest that AI young adults who engage in increased alcohol use may be at increased risk for suicide, especially if they also experience stronger perceptions of being a burden on others. The current study provides support for continued examinations of the relationship between alcohol use and suicide to inform culturally appropriate interventions for AI young adults.

Introduction: Personalized feedback interventions (PFIs) are associated with small but reliable decreases in alcohol consumption among college students. While they often include information regarding protective behavioral strategies (PBS), PFIs do not typically include feedback aimed to modify normative perceptions of PBS. This study aimed to enhance the efficacy of existing PFIs among college students by incorporating normative feedback on participants' use of PBS., Methods: Students enrolled in undergraduate courses (N = 268) completed baseline and 1-month follow-up assessments of past-month use of PBS, normative perceptions of PBS use, alcohol consumption, and alcohol-related consequences. Participants were randomized to one of three conditions: typical feedback on PBS (typical strategies PFI), descriptive normative feedback on PBS (strategy norms PFI), or assessment-only control (AOC). Participants in the typical strategies PFI and strategy norms PFI conditions received web-based personalized feedback profiles., Results: Compared to AOC, both the strategy norms PFI and typical strategies PFI were effective in correcting participants' perceptions of other students' engagement in PBS (p = .01) but did not differ significantly from one another. No statistically significant differences were observed between conditions in terms of actual PBS use, alcohol consumption, or alcohol-related consequences at 1-month follow-up (p > .05)., Discussion: The strategy norms and typical strategies PFIs were both successful in increasing normative perceptions of PBS use, indicating that general (rather than normative) feedback regarding PBS use may be sufficient for changing perceptions of PBS use., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Introduction: Relative to non-waterpipe (WP) smokers, WP smokers are more than twice as likely to use alcohol and frequently consume alcohol before or during smoking sessions. Co-use of alcohol and WP may result in greater toxicant exposure compared to WP smoking alone. To date, no study systematically has investigated the impact of acute alcohol intoxication on WP smoking topography, exposure to tobacco-related toxicants, or abuse liability., Methods: Dyads of current WP smokers and drinkers (N = 42; age = 21-32 years) completed two in-laboratory ad libitum smoking sessions (≤2 hours) following 12-hour nicotine abstinence in a double-blind, randomized crossover design in which they consumed a placebo versus active drink (sustained breath alcohol concentration = .08). Exhaled carbon monoxide (eCO) and plasma nicotine concentration were assessed. Questionnaires assessed smoking experience and smoking urge. Smoking topography was measured continuously throughout each smoking session., Results: The alcohol session was associated with increased inhaled volume, flow rate, and WP session duration compared to placebo. Compared to placebo, participants reported a more positive overall smoking experience following the alcohol session and greater smoking urges pre- and post-smoking session. Although both sessions resulted in significant increases in eCO and plasma nicotine, no significant differences emerged in eCO or nicotine exposure between the active and placebo sessions., Conclusions: Co-use of alcohol and WP may contribute to the maintenance of WP smoking through enhanced smoking experiences, increased urge to smoke, and significant exposure to addictive nicotine. Regulations may be necessary to limit the sale of alcohol in WP smoking lounges and reduce exposure to secondhand smoke., Implications: The findings suggest co-use of alcohol and WP tobacco likely maintain WP use and dependence by enhancing the smoking experience and increasing urges to smoke. These findings have implications for regulations aimed at limiting co-use of alcohol and WP tobacco in WP lounges and limiting exposure to secondhand smoke., Clinical Trials Registration: NCT03096860., (© The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Alcohol-induced amnesia ("blackout") is a reliable predictor of alcohol-related harm. Given its association with other negative consequences, experience of alcohol-induced amnesia may serve as a teachable moment, after which individuals are more likely to respond to intervention. To test this hypothesis, alcohol-induced amnesia was evaluated as a moderator of brief intervention effect on (a) alcohol-related consequences and (b) the proposed intervention mediators, protective behavioral strategies and peak blood alcohol concentration (BAC). Baseline alcohol risk measured using the Alcohol Use Disorders Identification Test (AUDIT) was also evaluated as a moderator to rule out the possibility that amnesia is simply an indicator of more general alcohol risk. College students (N = 198) reporting alcohol use in a typical week completed assessments at baseline and 1-month follow-up as part of a larger intervention trial. Participants were randomized to assessment only (AO; n = 58) or personalized feedback intervention (PFI; n = 140). Hierarchical regression was used to examine direct and indirect intervention effects. A significant group-by-amnesia interaction revealed that only PFI participants who had experienced alcohol-induced amnesia in the past month reported decreases in alcohol consequences at 1-month follow-up. The PFI reduced alcohol-related consequences indirectly through changes in peak BAC, but only among those who had experienced amnesia at baseline. In contrast, baseline alcohol risk (AUDIT) did not moderate intervention effects, and use of protective behavioral strategies did not statistically mediate intervention effects. Findings suggest that loss of memory for drinking events is a unique determinant of young adult response to brief alcohol intervention. Normative feedback interventions may be particularly effective for individuals who have experienced alcohol-induced amnesia in the past 30 days., (Copyright © 2018. Published by Elsevier Ltd.)

Objective: Research suggests college students rate some alcohol-related consequences less negatively than others, yet it is unclear how or when these differences in perception develop. The current study compared college students' subjective evaluations of alcohol-related consequences that they had and had not experienced in order to test the hypothesis that students become desensitized to the consequences they experience., Participants: Participants were 269 undergraduate students enrolled at a large, public, Midwestern university., Methods: Participants completed measures of drinking behaviors, consequences experienced, and subjective evaluations of consequences via an online survey., Results: Participants rated the consequences they had personally experienced more positively than those they had not experienced. Similarly, individuals who reported experiencing consequences rated them as significantly more positive than those who had not experienced the same consequences., Conclusions: Experience with consequences is associated with more positive evaluations of those consequences. Therefore, it may be important to consider individuals' experiences with, and evaluations of, alcohol-related consequences in college student drinking interventions.

Objective: To examine the efficacy of a self-affirmation task in deterring college alcohol misuse and the importance of preexisting beliefs in predicting subsequent behavior change., Participants: Heavy-drinking undergraduates (N = 110) participated during the 2011-2012 academic year., Methods: Participants were randomized to complete an affirmation or control task before reading an alcohol risk message. Alcohol-related beliefs and behaviors were assessed. Participants completed a 2-week online follow-up assessing alcohol-related behaviors., Results: Both groups reported increased perceived problem importance, but neither group displayed changes in personal risk. Follow-up assessment revealed similar, significant declines in peak consumption in both groups, with no significant between-group differences. Preexisting beliefs accounted for 5% to 10% of variance in drinking outcomes., Conclusions: An affirmation task does not seem to decrease defensive processing or alter high-risk drinking behaviors among college students and should not be utilized in lieu of more effective strategies.

Research on the efficacy of computer-delivered feedback-only interventions (FOIs) for college alcohol misuse has been mixed. Limitations to these FOIs include participant engagement and variation in the use of a moderation skills component. The current investigation sought to address these limitations using a novel computer-delivered FOI, the Drinkers Assessment and Feedback Tool for College Students (DrAFT-CS). Heavy drinking college students (N=176) were randomly assigned to DrAFT-CS, DrAFT-CS plus moderation skills (DrAFT-CS+), moderation skills only (MSO), or assessment only (AO) group, and were assessed at 1-month follow-up (N=157). Participants in the DrAFT-CS and DrAFT-CS+groups reported significantly lower estimated blood alcohol concentrations (eBACs) on typical heaviest drinking day than participants in the AO group. The data also supported the incorporation of a moderation skills component within FOIs, such that participants in DrAFT-CS+group reported significantly fewer drinks per week and drinks per heaviest drinking occasion than participants in the AO group., (© 2013.)

Despite major advances and success in finding effective interventions for problematic drinking among college students, personalized feedback interventions (PFIs) continue to include a range of components that vary widely across intervention trials. To facilitate research regarding which feedback components may be most effective, the present research provides preliminary evidence regarding student perceptions of and preferences for different types of feedback components. Undergraduate student drinkers (n = 397, 41% male) rated their affinity for and skepticism of 14 feedback components and identified the feedback components that they most preferred. The majority of students preferred information regarding descriptive normative comparisons and the practical costs of drinking, whereas few reported a desire to learn behavioral strategies to limit risk or didactic information. High-risk drinkers (n = 228) reported lower ratings for all feedback components than did low-risk drinkers, and men (n = 162, 41%) provided significantly lower ratings for all feedback components than did women. This is the first study to document student preferences for the different feedback components included in PFIs. The current study generates hypotheses regarding components that may increase the efficacy of current feedback interventions for high-risk drinking., ((PsycINFO Database Record (c) 2013 APA, all rights reserved).)

Transdermal alcohol sensors continuously collect reliable and valid data on alcohol consumption in vivo over the course of hours to weeks. Transdermal alcohol readings are highly correlated with breath alcohol measurements, but transdermal alcohol levels lag behind breath alcohol levels by one or more hours owing to the longer time required for alcohol to be expelled through perspiration. By providing objective information about alcohol consumption, transdermal alcohol sensors can validate self-report and provide important information not previously available. In this article, we describe the development and evaluation of currently available transdermal alcohol sensors, present the strengths and limitations of the technology, and give examples of recent research using the sensors., (Copyright © 2012 by the Research Society on Alcoholism.)

Previous research has found that individuals who engage in risky health behaviors respond to health risk messages in a self-serving manner, limiting the impact of health messages among targeted individuals. The present study sought to investigate whether alcohol-using college students would respond to risk messages about alcohol use with a similar defensive bias. Both alcohol-using (N=244) and non-using (N=91) college students read a summary of alcohol risk information intended for college students. Participants then reported their attitudes about the seriousness of the problem of college drinking, personal risk, and the scientific credibility of the risk information. Results indicated that high-risk participants responded in a self-serving manner, with significantly lower ratings of problem importance among alcohol-using students and non-significant differences among assessments of personal risk between groups. Further, alcohol-using students were more critical of the scientific merit of the risk information and more skeptical about the empirical claims. Defensively biased responding was more pronounced among more frequent and heavy drinking students than among lighter drinking students. The implications of these findings as well as possible ways to reduce defensive bias are discussed.

The purpose of this study was to develop a new measure of incidental behaviors that put college students at increased risk of legal consequences while using alcohol, the Legal Risk Behaviors while using Alcohol (LRBA) scale. Two hundred and twenty one college students who used alcohol were recruited to complete an online study about their use of alcohol, specific behaviors engaged in while using alcohol, and associated consequences. Analyses revealed that the 19-item LRBA consisted of three factors--"Risky Behaviors," "Protective Behaviors," and "Private Settings." Analyses suggested that the LRBA had adequate test-retest reliability and internal consistency. Initial results indicate that the LRBA may be a useful measure to help us better understand what behaviors college student engage in that increase their risk for experiencing a legal encounter.