Trends in College Binge Drinking During a Period of Increased Prevention Efforts: Findings from 4 Harvard School of Public Health College Alcohol Study Surveys: 1993–2001

Abstract

The 2001 Harvard School of Public Health College Alcohol Study surveyed students at 119 4-year colleges that participated in the 1993, 1997, and 1999 studies. Responses in the 4 survey years were compared to determine trends in heavy alcohol use, alcohol-related problems, and encounters with college and community prevention efforts. In 2001, approximately 2 in 5 (44.4%) college students reported binge drinking, a rate almost identical to rates in the previous 3 surveys. Very little change in overall binge drinking occurred at the individual college level. The percentages of abstainers and frequent binge drinkers increased, a polarization of drinking behavior first noted in 1997. A sharp rise in frequent binge drinking was noted among students attending all-women's colleges. Other significant changes included increases in immoderate drinking and harm among drinkers. More students lived in substance-free housing and encountered college educational efforts and sanctions resulting from their alcohol use.     

Trends in college binge drinking during a period of increased prevention efforts. Findings from 4 Harvard School of Public Health College Alcohol Study surveys: 1993-2001

The 2001 Harvard School of Public Health College Alcohol Study surveyed students at 119 4-year colleges that participated in the 1993, 1997, and 1999 studies. Responses in the 4 survey years were compared to determine trends in heavy alcohol use, alcohol-related problems, and encounters with college and community prevention efforts. In 2001, approximately 2 in 5 (44.4%) college students reported binge drinking, a rate almost identical to rates in the previous 3 surveys. Very little change in overall binge drinking occurred at the individual college level. The percentages of abstainers and frequent binge drinkers increased, a polarization of drinking behavior first noted in 1997. A sharp rise in frequent binge drinking was noted among students attending all-women's colleges. Other significant changes included increases in immoderate drinking and harm among drinkers. More students lived in substance-free housing and encountered college educational efforts and sanctions resulting from their alcohol use.     

Exploring the relation between maternal mind‐mindedness and children’s symbolic play: A longitudinal study from 6 to 18 months

Relations between mothers’ mind‐mindedness (appropriate attunement to their infants’ internal states) at 6 and 12 months and infants’ early symbolic play during infant–mother pretense at 12 and 18 months were investigated in a sample of 43 mothers and infants. Mothers’ appropriate mind‐related comments were associated with average level, length, complexity, and maturity level of symbolic play. Specific sub‐categories of appropriate mind‐related comments were identified as independent predictors of children's symbolic play. Appropriate comments about desires and cognitions at 6 months were associated with average level and length of episodes, as well as with maturity level of symbolic play at 12 months. Longitudinal stability in the appropriateness and content of mothers’ mind‐related comments was also investigated. The results are discussed in terms of the proposal that attunement to specific types of internal state should vary as a function of infant age in order to index mind‐mindedness.     

“How Could I Have Done This?” Thoughts of Mothers of Children with Fetal Alcohol Syndrome

Biological mothers of children with fetal alcohol syndrome (FAS) must cope with the struggles of parenting a child with special needs with the knowledge that their children’s problems are due to their alcohol use during pregnancy. Qualitative interviews were conducted by telephone with 11 biological mothers of children with FAS. This group of mothers understood their use of alcohol during pregnancy through reliance on the disease model, inaccurate or incomplete knowledge of the consequences of drinking during pregnancy, the advice of others, and a lack of awareness of the pregnancy.     

Concurrent alcohol and cigarette use among school-going adolescents in Korea

BackgroundConrurrent alcohol and tobacco use may increase the risk for substance abuse in adolescents. The aim of this study was to investigate concurrent alcohol and cigarette use and the co-occurrence risks of each substance in school-going adolescents in Korea.MethodsIn a cross-sectional nationally representative survey in 2016, 65,528 students (Mean age = 15.1 years, SE = 0.02) responded to a questionnaire that included measures of substance use and substance use exposure.ResultsIn all, 13.3% of the students were concurrent lifetime smokers and drinkers (19.3% among boys and 6.7% among girls), 25.5% lifetime alcohol users only (24.2% among boys and 26.9% among girls), 3.0% lifetime smokers only (4.7% among boys and 1.1% among girls) and 58.3% never smoked and never used alcohol (52.2% among boys and 47.8% among girls). All measures of more intensive smoking pattern and smoking exposure and more intensive drinking pattern and drinking exposures, respectively, were associated with consistently increased risk of lifetime alcohol use and lifetime smoking, respectively, compared to lifetime never smokers and abstainers. In multinomial logistic regression, compared to students who neither had used alcohol nor tobacco, concurrent lifetime smokers and drinkers were more likely to be male, mixed or boys school, higher school grade, lower paternal and maternal educational level, perceived lower socio-economic status, ever drug user, perceived stress above average, depressive mood, experience of violence victimization, and living in a rural area or medium sized city.ConclusionPrevention and treatment strategies should better incorporate the comorbidity of cigarette smoking and alcohol use in their intervention programmes.     

Prevalence and correlates of alcohol use in a survey of rural elementary school students: the New Hampshire study.

Alcohol use by 1190 fourth, fifth and sixth grade students was assessed in a survey of four rural New Hampshire school districts. Half the students surveyed (596) drank, but not regularly; 5 percent (59) were regular drinkers, and an additional 2 percent (19) were regular drinkers and had been drunk at least once. Reported alcohol use increased with both grade and age, and males drank more than females. The child's attitude toward drinking, perceived family attitudes towards drinking, the number of drinking friends, and self-perceived wrongdoing by the child were four factors strongly related to alcohol use. Increased alcohol use was also associated with experimental and current use of cigarettes, marijuana, and smokeless tobacco.     

Maternal Age,Psychological Maturity,Parenting Cognitions,and Mother–Infant Interaction

In the context of the trend toward delayed childbearing, the aim of this study was to examine relations among maternal age and the quality of maternal interactive behavior at 7 months assessed using sensitivity and mind‐mindedness, while also considering whether age effects were attributable to psychological maturity and parenting cognitions. Participants were 150 Australian mothers (mean age 33‐years) and their firstborn infants who were participating in a prospective study of parenthood. Path analysis showed maternal age had both direct and indirect associations with maternal interactive behavior. Older mothers made more mind‐related comments to their infants. They were also more sensitive; however, this effect was indirect and explained by greater psychological maturity (hardiness) and a more internal locus of control with regard to parenting. Results suggest that older maternal age may confer some benefits in terms of responsive parenting in infancy.     

Patterns of positivity: Positive affect trajectories among infants of mothers with a history of depression

This study examined positive affect (PA) trajectories over the first year of life among infants of mothers with a history of depression (N = 191) as well as predictors (i.e., maternal prenatal and postpartum depression symptoms, maternal parenting behaviors) of those trajectories. Infant PA was observed in play and feeding tasks during laboratory visits at 3, 6, and 12 months of age; parenting behaviors were observed at 3 months. Mothers completed questionnaires regarding their symptoms of depression throughout the prenatal period and during the first 3 months postpartum. Growth curve analyses indicated that infant PA increased across time, and this finding replicated across both the play and feeding tasks, though increases slowed over time. Neither maternal prenatal nor postpartum depression symptoms predicted infants' PA trajectories, but mothers' PA, positive parenting, and disengaged parenting were associated with infant PA during the play task. Our finding that infant PA increased over the first year postpartum suggests PA trajectories among infants of mothers with a history of depression may be indices of resilience, despite risks associated with their mothers' history of depression. Furthermore, this study highlights parenting behaviors that may be important targets of prevention and early intervention efforts to bolster infant PA.     

Self-efficacy for refusal mediated by outcome expectancies in the prediction of alcohol-dependence amongst young adults

The present study examined the relative importance of outcome expectancies and self-efficacy [1] in the prediction of alcohol dependence [2] and alcohol consumption in a sample of young adult drinkers drawn from a milieu previously reported as supportive of risky drinking. In predicting alcohol dependence, outcome expectancies were found to mediate self-efficacy and the same pattern was found for both males and females. This suggests that male and female drinkers may become more similar as they progress along the drinking continuum from risky drinking to dependent drinking. However, in women, in comparison to men, a greater array of expectancies and self-efficacy scales were found to predict heavy drinking, as measured by quantity and frequency. These results suggest that heavy drinking women are particularly at risk of developing drinking related complications and that preventative education needs to take into account gender differences.     

College binge drinking in the 1990s: a continuing problem. Results of the Harvard School of Public Health 1999 College Alcohol Study

In 1999, the Harvard School of Public Health College Alcohol Study resurveyed colleges that participated in the 1993 and 1997 surveys. Responses to mail questionnaires from more than 14,000 students at 119 nationally representative 4-year colleges in 39 states were compared with responses received in 1997 and 1993. Two of 5 students (44%) were binge drinkers in 1999, the same rate as in 1993. However, both abstention and frequent binge-drinking rates increased significantly. In 1999, 19% were abstainers, and 23% were frequent binge drinkers. As before, binge drinkers, and particularly frequent binge drinkers, were more likely than other students to experience alcohol-related problems. At colleges with high binge-drinking rates, students who did not binge drink continued to be at higher risk of encountering the second-hand effects of others' heavy drinking. The continuing high level of binge drinking is discussed in the context of the heightened attention and increased actions at colleges. Although it may take more time for interventions to take effect, the actions college health providers have undertaken thus far may not be a sufficient response.     

Understanding fraternity drinking: five recurring themes in the literature, 1980-1998.

In light of widespread concern about alcohol abuse on college campuses, the authors review the empirical literature concerning fraternity drinking published since 1980. The review is structured according to 5 themes that emerge from the literature: (a) the continuity between high school and college drinking, (b) the self-selection of heavy drinkers into environments that support heavy drinking, (c) the central role of alcohol in fraternity socialization, (d) the misperception of drinking norms, and (e) the enabling environment of the fraternity house. The literature is summarized for the benefit of those who wish to better understand the role of alcohol use in the fraternity system.     

Understanding Fraternity Drinking: Five Recurring Themes in the Literature, 1980–1998

Abstract

In light of widespread concern about alcohol abuse on college campuses, the authors review the empirical literature concerning fraternity drinking published since 1980. The review is structured according to 5 themes that emerge from the literature: (a) the continuity between high school and college drinking, (b) the self-selection of heavy drinkers into environments that support heavy drinking, (c) the central role of alcohol in fraternity socialization, (d) the misperception of drinking norms, and (e) the enabling environment of the fraternity house. The literature is summarized for the benefit of those who wish to better understand the role of alcohol use in the fraternity system.     

High-risk drinking among college fraternity members: a national perspective

This survey, with its 85% response rate, provides an extensive profile of drinking behaviors and predictors of drinking among 3,406 members of one national college fraternity, distributed across 98 chapters in 32 states. Multiple indexes of alcohol consumption measured frequency, quantity, estimated blood alcohol concentration levels (BACs), and related problems. Among all members, 97% were drinkers, 86% binge drinkers, and 64% frequent binge drinkers. On the basis of self-reports concerning the 4 weeks preceding the time of survey, the authors found that members drank on an average of 10.5 days and consumed an average of 81 drinks. Drinkers had an average BAC of 0.10, reaching at least 0.08 on an average of 6 days. These fraternity members appear to be heavier drinkers than previously studied fraternity samples, perhaps because they were more representative and forthright. All 6 preselected demographic attributes of members and 2 chapter characteristics were significantly related to the drinking behaviors and levels of risk, identifying possible targets for preventive interventions.     

College Binge Drinking in the 1990s: A Continuing Problem Results of the Harvard School of Public Health 1999 College Alcohol Study

Abstract

In 1999, the Harvard School of Public Health College Alcohol Study resurveyed colleges that participated in the 1993 and 1997 surveys. Responses to mail questionnaires from more than 14 000 students at 119 nationally representative 4-year colleges in 39 states were compared with responses received in 1997 and 1993. Two of 5 students (44%) were binge drinkers in 1999, the same rate as in 1993. However, both abstention and frequent binge-drinking rates increased significantly. In 1999, 19% were abstainers, and 23% were frequent binge drinkers. As before, binge drinkers, and particularly frequent binge drinkers, were more likely than other students to experience alcohol-related problems. At colleges with high binge-drinking rates, students who did not binge drink continued to be at higher risk of encountering the secondhand effects of others' heavy drinking. The continuing high level of binge drinking is discussed in the context of the heightened attention and increased actions at colleges. Although it may take more time for interventions to take effect, the actions college health providers have undertaken thus far may not be a sufficient response.     

The best and worst of 2020, and hopes and fears for 2021

The highlight of 2020 was celebrating the 50th anniversary of the establishment of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) through events such as a two‐day science symposium. We now know more about how alcohol affects the brain and body across the lifespan than ever before, and we have evidence‐based interventions to prevent and treat alcohol misuse. This work has contributed to a steady decrease in underage drinking over the past two decades, and a greater understanding of the deleterious effects of prenatal alcohol exposure and the biology of alcohol use disorder and alcohol‐associated liver diseases.     

SOCIAL WORK EDUCATION: THE AVAILABILITY OF ALCOHOL‐RELATED COURSE CURRICULUM AND SOCIAL WORKERS' ABILITY TO WORK WITH PROBLEM DRINKERS

An explanatory cross‐sectional investigation was employed to assess how well masters‐level social work (MSW) programs in the State of New York prepare students for practice with problem drinkers. The following areas were explored: (1) the incorporation of alcohol‐related coursework and field placement opportunities within MSW programs; (2) the relationship between students' completion of alcohol‐related courses and field placements and their subsequent ability to diagnose clients with alcohol problems, their willingness to work with problem drinkers, and their levels of alcohol‐related knowledge; and (3) subjects' levels of alcohol‐related knowledge in relation to their diagnostic ability and their willingness to work with problem drinkers. The sample consisted of 89 MSW‐level social work practitioners, who were active members of the New York State Chapter of the National Association of Social Workers (NASW) during the fall of 2005. Fewer than 3% of the sample reported the completion of an alcohol‐related course as a mandatory degree requirement and only 29.5% of the sample acknowledged the completion of an alcohol‐related field placement. These findings suggest that a possible gap exists in what social workers are being taught and what they need to know to successfully work with problem drinkers. The findings indicate that clients with alcohol problems are at risk of going untreated due to social workers' inability to correctly diagnose them as a result of insufficient training in the area of alcohol studies.     

My student body: a high-risk drinking prevention web site for college students

The authors investigated the efficacy of an interactive Web site, MyStudentBody.com: Alcohol (MSB:Alcohol) that offers a brief, tailored intervention to help heavy drinking college students reduce their alcohol use. They conducted a randomized, controlled clinical trial to compare the intervention with an alcohol education Web site at baseline, postintervention, and 3-month follow-up. Students were assessed on various drinking measures and their readiness to change their drinking habits. The intervention was especially effective for women and persistent binge drinkers. Compared with women who used the control Web site, women who used the intervention significantly reduced their peak and total consumption during special occasions and also reported significantly fewer negative consequences related to drinking. In addition, persistent heavy binge drinkers in the experimental group experienced a more rapid decrease in average consumption and peak consumption compared with those in the control group. The authors judged MSB:Alcohol a useful intervention for reaching important subgroups of college binge drinkers.     

Increased exposure to alcohol and cannabis education and changes in use patterns

The introduction of new alcohol and cannabis education programs in Ontario schools was associated with significant increases in reported exposure to alcohol and cannabis education. Significant increases were reported for both sexes, all grade levels, and geographic areas. These were associated with decreases in proportions of drinkers, especially among younger students. Little effect was seen on heavy drinking. The evidence also suggests that reported increased exposure to cannabis education was not associated with reduced cannabis use. The challenge remains to develop alcohol education programs which can reduce heavy drinking and to develop effective cannabis education programs.     

Briefly Noted

Compared to light drinkers, heavy drinkers have brains that have less energy due to decreases in glucose metabolism, researchers at the National Institutes of Health have found. In a study published online last week in Nature Communications, the researchers combined measures of the left brain (activity) and the right brain (glucose consumption) to better understand the effects of alcohol on people. “The brain uses a lot of energy compared to other body organs, and the association between brain activity and energy utilization is an important marker of brain health,” said George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), in a statement accompanying the release of the results. “This study introduces a new way of characterizing how brain activity is related to its consumption of glucose, which could be very useful in understanding how the brain uses energy in health and disease.” The research was led by Ehsan Shokri‐Kojori, Ph.D., and Nora D. Volkow, M.D., both of the NIAAA Laboratory of Neuroimaging. Volkow is also the director of the National Institute on Drug Abuse. “The findings from this study highlight the relevance of energetics for ensuring normal brain function and reveal how it is disrupted by excessive alcohol consumption,” said Volkow. “We measured power by observing to what extent brain regions are active and use energy,” explained Shokri‐Kojori. “We measured cost of brain regions by observing to what extent their energy use exceeds their underlying activity.” Using a group of healthy volunteers, researchers showed that different brain regions have different power and cost. They then looked at the effects of alcohol on these measures by assessing a group that included light and heavy drinkers, and found that both acute and chronic use affected brain power and cost. “In heavy drinkers, we saw less regional power, for example, in the thalamus, the sensory gateway and frontal cortex of the brain, which is important for decision‐making,” said Shokri‐Kojori. “These decreases in power were interpreted to reflect toxic effects of long‐term exposure to alcohol on the brain cells.” There was also a disruption of visual processing during acute alcohol exposure, and significant decreases in cost of activity during alcohol intoxication.     

College alcohol use: a full or empty glass?

Data from the Harvard School of Public Health College Alcohol Study (1993) were used to describe weekly alcohol consumption and its associated problems among a representative national sample of college students. The median number of drinks consumed/week by all students, regardless of drinking status, was 1.5. When students were divided by drinking pattern, the median number of drinks/week was 0.7 for those who did not binge drink and 3.7 for those who did so infrequently. For frequent binge drinkers, the median was considerably higher: 14.5 drinks/week. Nationally, 1 in 5 five college students is a frequent binge drinker. Binge drinkers consumed 68% of all the alcohol that students reported drinking, and they accounted for the majority of alcohol-related problems. The data indicate that behavioral norms for alcohol consumption vary widely among students and across colleges. Therefore, it may not be possible to design an effective "one size fits all" approach to address college alcohol use.