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BackgroundStudent heavy drinking and associated problems are common at most universities and fluctuate throughout the calendar year, with marked increases during celebrations. Most studies of student drinking are limited to the academic year itself, and relatively few focus specifically on special heavy drinking events. Even fewer studies include drinking during summer break and subsequent school return.MethodsIn the context of an experimental protocol, beginning in January 2014, alcohol-related characteristics were evaluated 8 times over 55 weeks for 462 college freshmen, including periods that incorporated a campus festival, summer, and school return. Baseline predictors of drinking quantities over time included demography, substance use patterns, as well as environmental and attitudinal characteristics. Product-moment correlations evaluated relationships between baseline characteristics and subsequent quantities, and simultaneous entry regression analyses evaluated which characteristics most robustly predicted usual and maximum drinks over time.ResultsMaximum drinks per occasion increased 18% from the early spring (4/8/14 to 5/6/14) to the campus festival period (5/7/14 to 6/3/14), decreased 29% in the summer (7/8/14 to 8/5/14), and increased 31% on school return (10/7/14 to 11/4/14). The most robust predictors of higher quantities in regression analyses included items from each of the 3 major domains with the most consistent results seen for most baseline alcohol-related items and descriptive drinking norms (R(2) = 0.20 to 0.31).ConclusionsThese data demonstrate important changes in students' drinking during the calendar year, including expected large increases during the month of a 1-day festival, large decreases over the summer, and resumption of relatively high quantities upon return to school.

ObjectiveHeavy drinking is common on college campuses, with a marked increase from high school to freshman year. Programs addressing heavy campus drinking often personalize prevention protocols to fit a student's demography and prior drinking characteristics. Few efforts have individualized approaches to address a person's vulnerability through his or her low level of response (low LR) to alcohol.MethodThis article describes the recently completed 55-week outcome in drinking quantities and problems for the >90% of 500 participants in a prevention program at a U.S. university (62% female, mean age = 18 years) who completed a 4-week series of 50-minute videos delivered via the Internet. We evaluated whether, for low LRs, participation in an educational approach that focused on a low LR (the LR-based [LRB] condition) was associated with better outcomes than a state-of-the-art (SOTA) general education or with a no-intervention control condition.ResultsUsing a mixed-design analysis of variance and focusing on the most closely ethnically matched high and low LR pairs, students with low LRs in the LRB condition demonstrated the greatest decreases in usual and maximum drinks over the 55 weeks, especially when compared with closely ethnically matched students with high LRs. Low LR controls showed the highest drinking values over time.ConclusionsThis study underscores the potential importance of targeting a person's specific preexisting vulnerability toward heavy drinking when he or she enters college. The approach can be used in a relatively inexpensive protocol of video education sessions delivered via the Internet.

BackgroundHeavy drinking is common during transitions from high school to college. Optimal programs for diminishing risks for high alcohol consumption often tailor the approach to the specific needs of students. This study describes the results of an Internet-based prevention protocol that tailors the information to the risk associated with a pre-existing phenotype, the Low level of Response (Low LR) to alcohol.MethodsUsing stratified random assignment, 454 freshmen with Low and High LR values were assigned to 2 education groups (LR-based where all examples were given the context of the Low LR model of heavy drinking or a State Of The Art (SOTA) Group where the same lessons were taught but without an emphasis on LR) or a no-intervention Control Group. Individuals in the 2 education groups viewed 50-minute online videos once per week for 4 weeks. Changes in drinking patterns were assessed at Baseline, 4 weeks, and 8 weeks using a 2 (LR status) by 3 (education group) by 3 (time points) analysis of variance, with additional tests for ethnicity and sex.ResultsLow LR participants tended to decrease their usual (p

BackgroundPhysical illnesses frequently co-occur with depression and substance use disorders and may impact their improvement. Physical illness symptoms may overlap with or exacerbate somatic symptoms of depression. Individuals may use substances to cope with symptoms of physical illness.ObjectivesWe examined whether chronic physical health problems moderated changes in depression and substance use among dual diagnosed individuals during and in the year following treatment.MethodsParticipants were recruited from a Veterans Affairs dual diagnosis outpatient program between March 2000 and November 2007 and were randomized to either Integrated Cognitive-Behavioral Therapy or Twelve-Step Facilitation Therapy. A total of 214 veterans with assessment data for the variables of interest were included in analyses. Participants completed quarterly depression, substance use, and health assessments over an 18 month period. We used linear-mixed effects models to analyze patterns of change for depression and substance use.ResultsIndividuals with severe chronic health problems and higher intake depression showed slower improvements in both nonsomatic and somatic depression symptoms. Individuals with severe chronic health problems and higher midtreatment substance use showed less improvement in substance use.ConclusionsAssessing and addressing physical health issues during depression and substance use disorder treatment may improve outcomes.

ObjectiveBehavioral economic theory suggests that a reduction in substance use is most likely when there is an increase in rewarding substance-free activities. The goal of this randomized controlled clinical trial was to evaluate the incremental efficacy of a novel behavioral economic supplement (Substance-Free Activity Session [SFAS]) to a standard alcohol brief motivational interviewing (BMI) session for heavy-drinking college students.MethodParticipants were 82 first-year college students (50% female; 81.7% White/European American; M age = 18.5 years, SD = 0.71) who reported 2 or more past-month heavy drinking episodes. After completing a baseline assessment and an individual alcohol-focused BMI, participants were randomized to either the SFAS or to a Relaxation Training (RT) control session. The SFAS was delivered in an MI style and attempted to increase the salience of delayed academic and career rewards and the patterns of behavior leading to those rewards.ResultsThe combination of an alcohol BMI plus the SFAS was associated with significantly greater reductions in alcohol problems compared with an alcohol BMI plus RT at the 1-month and 6-month follow-up assessments (p = .015, ηp² = .07), an effect that was partially mediated by increases in protective behavioral strategies. BMI + SFAS was also associated with greater reductions in heavy drinking among participants who at baseline reported low levels of substance-free reinforcement or symptoms of depression.ConclusionThese results are consistent with behavioral economic theory and suggest that a single session focused on increasing engagement in alternatives to drinking can enhance the effects of brief alcohol interventions.

Objective: Study abroad students are at risk for increased and problematic drinking behavior. As few efforts have been made to examine this at-risk population, the authors predicted drinking and alcohol-related consequences abroad from predeparture and site-specific factors. Participants: The sample consisted of 339 students completing study abroad programs. Methods: Participants filled out online measures at predeparture, abroad, and at postreturn. Results: The authors found that drinking and consequences abroad were predicted by a number of factors, including demographics (eg, younger age, male sex, Greek affiliation, white ethnicity), student factors (eg, low GPA, major area of study), study abroad site factors (eg, apartment living abroad, study in Europe), predeparture levels of drinking and consequences, sensation seeking, and goals related to social gathering. Conclusions: Findings can be used to inform campus policies for admission to study abroad programs as well as assist in the development of interventions targeted toward preventing risk for students during abroad experiences.