Prediction of alcohol-related harm from controlled drinking strategies and alcohol consumption trajectories

Aims To establish predictors of age 21 alcohol-related harm from prior drinking patterns, current levels of alcohol consumption and use of controlled drinking strategies.

Participants One thousand, five hundred and ninety-six students recruited from an initial sample of 3300 during their final year of high school in 1993.

Design Longitudinal follow-up across five waves of data collection.

Setting Post high school in Victoria, Australia.

Measurements Self-administered surveys examining a range of health behaviours, including alcohol consumption patterns and related behaviour.

Findings Drinking behaviours at age 21 were found to be strongly predicted by drinking trajectories established through the transition from high school. Multivariate regression analysis revealed that alcohol-related harms at age 21 were reduced where current levels of alcohol use fell within limits recommended in Australian national guidelines. After controlling for this effect it was found that the range of strategies employed by participants to control alcohol use maintained a small protective influence. Post-high-school drinking trajectories continued to demonstrate a significant effect after controlling for current behaviours. Findings revealed that over one quarter of males and females drank alcohol, but on a less-than-weekly basis. This pattern of alcohol use demonstrated considerable stability through the post-school transition and was associated with a low level of subsequent harm at age 21.

Conclusions Future research should investigate whether encouraging more Australian adolescents to drink alcohol on a less-than-weekly basis may be a practical intervention target for reducing alcohol-related harms.

'I don't really care about what someone else's studied' : Drinking guidelines and the government of pleasure

This paper examines data from a Drinkwise Australia funded research project that investigated the cultural drivers of drinking in 14-24 year-old Australians. The research included two studies. In one we conducted interviews and focus groups with administrators and young people in a range of sporting clubs and in the other we interviewed 60 young people aged 20-24 about their drinking biographies. The drinking biographies study is the focus of this paper. At the time of interviewing the draft guidelines on low-risk drinking were released by the NH&MRC and we asked our participants what they knew about them and if they would affect their drinking patterns. The responses to these questions are examined in light of O’Malley and Valverde’s claim that pleasure is silenced and/or deployed strategically in liberal governance discourses about drugs and alcohol (2004: 25). This is despite the fact that research indicates that pleasure is an important motivation for drinking.

Clinical translation of the research article titled "The influence of early drinking contexts on current drinking among adult lesbian and bisexual women"

The article reported on a questionnaire-based study of 94 lesbian and 51 bisexual women that investigated the relationship between current drinking and early alcohol drinking patterns associated with coming out and a variety of social networks. The findings were that there was a “more permissive drinking culture” among lesbian and bisexual women than among heterosexual women. Furthermore, the more exposed women were to this culture through socializing in lesbian/bisexual networks during coming out, the more likely they were to drink heavily later in life. There were no differences in early drinking patterns of bisexual compared with lesbian women. One of the central hypotheses of the study that an earlier age at coming out would increase current problem drinking was not borne out.

The association between implicit alcohol attitudes and drinking behavior is moderated by baseline activation in the lateral prefrontal cortex

OBJECTIVE Intense alcohol consumption is a risk factor for a number of health problems. Dual-process models assume that self-regulatory behavior such as drinking alcohol is guided by both reflective and impulsive processes. Evidence suggests that (a) impulsive processes such as implicit attitudes are more strongly associated with behavior when executive functioning abilities are low, and (b) higher neural baseline activation in the lateral prefrontal cortex (PFC) is associated with better inhibitory control. The present study integrates these 2 strands of research to investigate how individual differences in neural baseline activation in the lateral PFC moderate the association between implicit alcohol attitudes and drinking behavior. METHOD Baseline cortical activation was measured with resting electroencephalography (EEG) in 89 moderate drinkers. In a subsequent behavioral testing session they completed measures of implicit alcohol attitudes and self-reported drinking behavior. RESULTS Implicit alcohol attitudes were related to self-reported alcohol consumption. Most centrally, implicit alcohol attitudes were more strongly associated with drinking behavior in individuals with low as compared with high baseline activation in the right lateral PFC. CONCLUSIONS These findings are in line with predictions made on the basis of dual-process models. They provide further evidence that individual differences in neural baseline activation in the right lateral PFC may contribute to executive functioning abilities such as inhibitory control. Moreover, individuals with strongly positive implicit alcohol attitudes coupled with a low baseline activation in the right lateral PFC may be at greater risk of developing unhealthy drinking patterns than others.

The effects of binge drinking on military readiness: The inability to deploy

The negative outcomes from alcohol misuse have been chronicled for decades in epidemiological studies. Recent research has focused on patterns of drinking. Binge and heavy drinking have been associated with multiple negative outcomes, to include surrogate outcomes designed to measure decrements to military readiness. This study is perhaps the first to examine whether binge or heavy drinking patterns are associated with the U.S. military’s overall inability to deploy rate or the individual reasons unable to deploy. ^ The prevalence of binge and heavy drinking and the inability to deploy rates were assessed from responses to the 2005 Department of Defense Survey of Health Related Behaviors Among Military Personnel. A secondary analysis of extant data resulted in a final sample size of 13,619 respondents who represented 847,253 active-duty military personnel. Multivariate models were fitted to examine the association between patterns of drinking and individual reasons for the inability to deploy. ^ Logistic regression showed no association of binge or heavy drinking to greater inability to deploy. Interestingly, individual reasons for the inability to deploy did show an association to include: Training, Dental Issue, No HIV Test, and Family Situation. There was no association noted for the individual reasons: Injury, Illness, Leave/Temporary Duty, or Other. Binge and heavy drinkers appear to be more susceptible to the psychosocial determinants than physical determinants as reasons for the inability to deploy. ^

Analysis of the drinking driving attitudes of New Hampshire high school students. Second survey. Final report.

National Highway Traffic Safety Administration, Office of Driver and Pedestrian Programs, Washington, D.C.

The complexity of drinking: Interactions between the cognitive and behavioural determinants of alcohol consumption

This study expanded the earlier work conducted by this laboratory ( Hasking, P.A. and Oei, T.P.S. (2002a) . The differential role of alcohol expectancies, drinking refusal self-efficacy and coping resources in predicting alcohol consumption in community and clinical samples. Addiction Research and Theory , 10 , 465-494), by examining the independent and interactive effects of avoidant coping strategies, positive and negative expectancies and self-efficacy, in predicting volume and frequency of alcohol consumption in a sample of community drinkers. Differential relationships were found between the variables when predicting the two consumption measures. Specifically, while self-efficacy, seeking social support for emotional reasons and using drugs or alcohol to cope were independently related to both volume and frequency of drinking, complex interactions with positive and negative alcohol expectancies were also found. These interactions are discussed in terms of the cognitive and behavioural mechanisms thought to underlie drinking behaviour.

Using the theory of planned behaviour to understand binge drinking:the importance of beliefs for developing interventions

Objectives. To elicit students' salient beliefs in relation to binge drinking, and to examine the extent to which individual salient beliefs predict theory of planned behaviour (TPB) constructs in relation to binge drink, and actual drinking behaviour assessed later that evening. Design. Longitudinal, over a single evening. Methods. 192 students were recruited as they entered a campus bar at the beginning of the evening. They completed questionnaires with open-ended questions eliciting beliefs concerning binge drinking, and ratings scales assessing standard TPB constructs in relation to binge drinking. At the end of the evening, 181 completed a second questionnaire and recorded the number of alcoholic drinks they had consumed. Results. Beliefs were reliably coded (all kappas =0.79). Students with higher intentions to binge drink were more likely to believe that their friends approved of binge drinking, and that (lack of) money would make it difficult. Students who reported drinking more alcohol at the end of the evening were more likely to believe that getting drunk is an advantage/what they would like about binge drinking tonight, that their sports teams would approve, and that celebrating, drinking patterns, and environment would make it easy to binge drink. Conclusions. The present study has identified the individually salient beliefs relating to drinking behaviour that the TPB states should be addressed by interventions to alter behaviour, and which that should be assessed as mediators in intervention research. As a whole, these findings highlight the importance of perceived peer norms in binge drinking in this population, and support the idea of interventions to challenge the perception of social pressure to binge drink. ©2011 The British Psychological Society.

Implications of co-twin dependence for twins' social interactions, mental health and alcohol use : A follow-up study of Finnish twins from adolescence to early adulthood

Objective: The aim of the present study was to examine co-twin dependence and its impact on twins' social contacts, leisure-time activities and psycho-emotional well-being. The role of co-twin dependence was also examined as a moderator of genetic and environmental influences on alcohol use in adolescence and in early adulthood. Methods: The present report is based on the Finnish Twin Cohort Study (FinnTwin16), a population-based study of five consecutive birth cohorts of Finnish twins born in the years 1975-1979. Baseline assessments were collected through mailed questionnaires, within two months of the twins' sixteenth birthday yielding replies from 5563 twin individuals. All respondent twins were sent follow-up questionnaires at ages of 17, 18½, and in early adulthood, when twins were 22-27 years old. Measures: The questionnaires included a survey of health habits and attitudes, a symptom checklist and questions about twins' relationships with parents, peers and co-twin. Measures used were twins' self-reports of their own dependence and their co-twin's dependence at age 16, reports of twins' leisure-time activities and social contacts, alcohol use, psychological distress and somatic symptoms both in adolescence and in early adulthood. Results: In the present study 25.6% of twins reported dependence on their co-twin. There were gender and zygosity differences in dependence, females and MZ twins were more likely to report dependence than males and DZ twins. Co-twin dependence can be viewed on one hand as an individual characteristic, but on the other hand as a pattern of dyadic interaction that is mutually regulated and reciprocal. Most of the twins (80.7%) were either concordantly co-twin dependent or concordantly co-twin independent. The associations of co-twin dependence with twins' social interactions and psycho-emotional characteristics were relatively consistent both in adolescence and in early adulthood. Dependence was related to higher contact frequency and a higher proportion of shared leisure-time activities between twin siblings at the baseline and the follow-up. Additionally co-twin dependence was associated with elevated levels of psycho-emotional distress and somatic complaints, especially in adolescence. In the framework of gene-environment interaction, these results suggest that the genetic contribution to individual differences in drinking patterns is dependent on the nature of the pair-wise relationship of twin siblings. Conclusions: The results of this study indicate that co-twin dependence is a genuine feature of the co-twin relationship and shows the importance of studying the impact of various features of co-twin relationships on individual twins' social and psycho-emotional life and well-being. Our study also offers evidence that differences in inter-personal relationships contribute to the effects of genetic propensities.

Alcohol and the affluence paradox: A secondary analysis exploring the health disparities surrounding adolescent alcohol use and alcohol related harm in adulthood

Several studies have shown social differences in alcohol consumption, and social inequalities of harm related to alcohol use and abuse. However, relationships between the position in the socio-economic spectrum, alcohol use, and alcohol-related health problems are not clear cut. While there is some evidence of social gradients or associations between indicators of deprivation and some adolescence outcomes (e.g. externalising behaviour), the evidence regarding associations between socio-economic status and alcohol-related problems in adolescence is more conflicting. A major problem in studying socio-economic inequalities in adolescent health is related to the paucity of measures of socio-economic status in adolescence that are both conceptually and methodologically sound.
The aims of this study were to investigate socio-economic differences in pathways from onset to establishment of drinking patterns in adolescence, assess the consequences of these pathways in terms of alcohol related harm, and to consider the causal mechanisms that may contribute to socio-economic differences in drinking pathways and outcomes

Saúde mental e comportamentos de risco em estudantes universitários

A saúde dos estudantes do ensino superior é uma importante questão de saúde pública, com impacto não só a nível pessoal e social, como também institucional. Nesse sentido, a presente investigação teve como objectivos: 1) caracterizar a saúde mental dos estudantes universitários, ao nível de sintomas depressivos, stress e bem-estar; 2) identificar os seus padrões de consumo de álcool, em termos de quantidade e frequência de consumo, ingestão esporádica excessiva e tipos de bebidas mais ingeridas; 3) conhecer a prevalência de dois comportamentos de risco ligados ao álcool, os comportamentos sexuais de risco e a condução sob o efeito de álcool; 4) analisar a relação entre saúde mental e consumo de álcool no ensino superior. Para esse efeito, realizou-se um estudo transversal com 666 alunos do 1º ciclo da Universidade de Aveiro. Os instrumentos utilizados foram: Ficha de Caracterização Sociodemográfica e Académica; Medida de Saúde Comportamental-20; Inventário da Depressão em Estudantes Universitários; Inventário de Stress em Estudantes Universitários; Questionário de Comportamentos de Risco em Estudantes Universitários. Os resultados mostraram que 32% dos estudantes se encontravam num patamar disfuncional quanto à sua saúde mental, 15% apresentavam sintomatologia depressiva e 26% sofriam de níveis elevados de stress, mas que apenas uma minoria destes alunos estava a receber apoio psicológico profissional. Os níveis de saúde mental foram inferiores nas mulheres, nos alunos do 1º e do 3º ano, da área de Saúde e de estatuto socioeconómico baixo. Para além disso, a maioria dos estudantes consumia álcool e 41% tiveram episódios de ingestão excessiva no último mês. Durante as festas académicas, um quarto dos estudantes ingeriu cinco ou mais bebidas por noite. O consumo de álcool foi superior nos homens, nos estudantes da área de Engenharias, de estatuto socioeconómico elevado e nos deslocados. Quanto a problemas ligados ao álcool, 13% dos estudantes sexualmente activos admitiram ter tido relações sexuais decorrentes do consumo de álcool, no último ano, e 29% praticaram condução sob o efeito de álcool no último mês. Estes comportamentos foram mais frequentes em estudantes do sexo masculino e naqueles que tiveram episódios de ingestão excessiva. Não se encontrou, de um modo geral, uma relação entre saúde mental e consumo de álcool, tendo sido detectadas apenas correlações, fracas, do stress e do bem-estar com o consumo de álcool. Ao contrário do que era esperado, verificou-se que à medida que o consumo de álcool aumentava, o stress diminuía e o bem-estar aumentava ligeiramente. Estes dados salientam a necessidade de as instituições do ensino superior reforçarem a identificação e o tratamento de problemas existentes e apostarem na prevenção, tanto através de estratégias dirigidas a toda a comunidade, no âmbito da educação para a saúde e da literacia em saúde mental, como através de iniciativas destinadas aos grupos de risco aqui identificados.

Contextual determinants of alcohol consumption changes and preventive alcohol policies: a 12-country European study in progress.

Beginning with France in the 1950s, alcohol consumption has decreased in Southern European countries with few or no preventive alcohol policy measures being implemented, while alcohol consumption has been increasing in Northern European countries where historically more restrictive alcohol control policies were in place, even though more recently they were loosened. At the same time, Central and Eastern Europe have shown an intermediate behavior. We propose that country-specific changes in alcohol consumption between 1960 and 2008 are explained by a combination of a number of factors: (1) preventive alcohol policies and (2) social, cultural, economic, and demographic determinants. This article describes the methodology of a research study designed to understand the complex interactions that have occurred throughout Europe over the past five decades. These include changes in alcohol consumption, drinking patterns and alcohol-related harm, and the actual determinants of such changes.

Cinq ans après : trajectoire de consommation et processus de changement dans un échantillon présentant une comorbidité psychiatrique

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

Reactivity to alcohol-related cues: relationship among cue type, motivational processes, and personality

This study examined the relationship between personality traits implicated in the drinking literature (i.e., sensation seeking and anxiety) and reactivity to 2 different alcohol cues. The opportunity to consume alcohol was manipulated, and differences in urge and affective reactivity were assessed. Gray’s (1987) model of impulsive sensation seeking and anxiety was adopted to investigate relationships between personality and responses to the appetitive (consumption) and aversive (no consumption, nonrewarding) alcohol cues in 40 regular social drinkers. The consumption cue produced increases in appetitive motivation and positive correlations with sensation-seeking traits. The no-consumption cue produced increases in aversive motivation and positive correlations with anxiety-related traits. It was concluded that Gray’s model of impulsive sensation seeking and anxiety may provide a useful framework for examining the personality correlates of cue reactivity to different cues.

Youth alcohol and other drug use in the United States and Australia: a cross-national comparison of three state-wide samples

Although youth drug and alcohol harm minimization policies in Australia are often contrasted with the abstinence and zero tolerance policies adopted in the United States, there has been little research directly comparing youth substance use behaviour in the two countries. Three state representative samples in Victoria, Australia (n = 7898) and in the US states of Oregon (n = 15 224) and Maine (n = 16 245) completed a common cross-sectional student survey. Rates of alcohol use (lifetime alcohol use, recent use in the past 30 days), alcohol use exceeding recommended consumption limits (binge drinking: five or more drinks in a session), other licit drug use (tobacco use), and norm-violating substance use (substance use at school, use in the past 30 days of marijuana or other illicit drug use) were compared for males and females at ages 12-17. Rates were lower (odds ratios 0.5-0.8) for youth in Maine and Oregon compared to Victoria for lifetime and recent alcohol use, binge drinking and daily cigarette smoking. However, rates of recent marijuana use and recent use of other illicit drugs were higher in Maine and Oregon, as were reports of being drunk or high at school. In contradiction of harm minimization objectives, Victoria, relative to the US states of Oregon and Maine, demonstrated higher rates of alcohol use exceeding recommended consumption limits and daily tobacco use. However, findings suggested that aspects of norm-violating substance use (substance use at school, marijuana use and other illicit drug use) were higher in the US states compared to Victoria.