Unhealthy behavior clustering and mental health status in United States college students

Abstract

Objective: Examine the association of health risk behavior clusters with mental health status among US college students. Participants: 105,781?US college students who completed the Spring 2011 National College Health Assessment. Methods: We utilized the latent class analysis to determine clustering of health risk behaviors (alcohol binge drinking, cigarette/marijuana use, insufficient physical activity, and fruit/vegetable consumption), and chi-square and ANOVA analyses to examine associations between the class membership and mental health (mental health diagnoses, psychological symptoms, and self-injurious thoughts/behaviors). Results: Three classes were identified with differing rates of binge drinking, substance use, and insufficient physical activity but similar rates of insufficient fruit/vegetable consumption. Students classified with the highest rates of binge drinking and cigarette/marijuana use had the highest rates across all mental health variables compared to other classes. Conclusions: Students who reported engaging in multiple health risk behaviors, especially high alcohol and cigarette/marijuana use, were also more likely to report poorer mental health.     

Condom Use in Heavy Drinking College Students: The Importance of Always Using Condoms

Abstract

Objective: The authors examined whether alcohol use decreased condom use. Participants: The subjects were heavy-drinking students on 5 different college campuses. Methods: A face-to-face interview, administered between November of 2004 and February of 2007, gathered information about condom use, alcohol use, and other behaviors. Multivariate logistic regression was used to assess predictors of condom use. Results: Of the 1715 participants, 64% reported that they did not always use condoms. Male students who drank heavily were less likely to always use condoms (adjusted odds ratio [AOR] 0.61). Participants with more sexual partners used condoms less when drinking (AOR 1.93 for men, 1.45 for women). Conclusions: Many students do not use condoms consistently, especially those who drink heavily or have multiple sexual partners. Clinicians at student health need to encourage all students to use condoms every time they have intercourse.     

Toward Understanding the Adjustment Problems of Foreign Families in the College Community: The Case of Japanese Wives at the Harvard University Health Services

Abstract

Four hundred fifty-six undergraduates at a Scottish university completed the Core Alcohol and Drug Survey, an instrument widely used in the United States to examine the nature, scope, and consequences of alcohol and other drug use on college campuses. The Scottish students were found to drink more frequently, consume more alcohol, and engage in binge drinking more often than their American counterparts. The Scottish students also demonstrated higher rates of hangovers, missed classes, and blackouts than the Americans, but the percentage of American students who had driven while intoxicated was greater than that of the Scots. Focus groups of students in Scotland and interviews with student affairs personnel and local officials indicated that student drinking is not generally viewed as a problem because extensive alcohol use appears to be part of Scottish culture and is readily accepted. Students reported that their drinking, other than in pubs, was spread out over time and was associated with eating and social activities. At student social events where alcohol was served, there was little evidence of loud, inappropriate, aggressive, or otherwise rowdy behavior; drinking appeared to be handled in a more controlled, safe, and responsible way than among US college students.     

The Role of Positive Alcohol Expectancies in Underage Binge Drinking Among College Students

Abstract

Objective: This study explored associations between positive alcohol expectancies, and demographics, as well as academic status and binge drinking among underage college students. Participants: A sample of 1,553 underage college students at 3 public universities and 1 college in the Southeast who completed the Core Alcohol and Drug Survey in the Spring 2013 semester. Methods: A series of bivariate analyses and logistic regression models were used to examine associations between demographic and academic status variables as well as positive alcohol expectancies with self-reported binge drinking. Positive alcohol expectancies were examined in multivariable models via 2 factors derived from principal component analyses. Results: Students who endorsed higher agreement of these 2 emergent factors (sociability, sexuality) were more likely to report an occurrence of binge drinking in the past 2 weeks. Conclusions: Study results document associations between positive alcohol expectancies and binge drinking among underage students; implications for prevention and treatment are discussed.     

Alcohol Use in Students Seeking Primary Care Treatment at University Health Services

Abstract

Objective: Given the high rate of at-risk drinking in college students, the authors examined drinking behaviors and associated factors in students being seen in student health services for primary care visits from October 30, 2004, to February 15, 2007. Methods: Analyses were based on a Health Screening Survey completed by 10,234 college students seeking general medical treatment. Results: Alcohol use was similar to other studies with 57% (n = 5,840) meeting the National Institute on Alcohol Abuse and Alcoholism criteria for at-risk drinking. Twenty-six percent of the students reported smoking at least once in the last 3 months. Risk factors for at-risk drinking included young age, white males, drinking at a fraternity/sorority house, and use of tobacco. Conclusions: These findings support the widespread implementation of alcohol screening and intervention in university health services.     

Social Norms Theory-Based Interventions: Testing the Feasibility of a Purported Mechanism of Action

Social norms-based interventions targeting college student drinking behaviors have become increasingly popular. Such interventions purportedly modify student misperceptions of fellow student drinking behaviors, which leads to changes in individual drinking behavior. Despite claims of successful interventions, research demonstrating that social norms-based interventions modify student perceptions is lacking. Objective: The authors conducted a laboratory experiment examining the feasibility of this mechanism of action and aimed to determine the validity of the campus-specific drinking norms hypothesis. Participants and Methods: The authors randomly assigned 60 students to 1 of 3 research conditions: Alcohol 101 (national drinking norms), a didactic presentation of campus specific drinking norms, or a control condition. Results: Both intervention groups modified student misperceptions regarding peer alcohol use, and these changes were sustained 1 week later. Conclusions: Social norms-based interventions can contribute to more accurate drinking perceptions among college students.     

The State of the Union: Sexual Health Disparities in a National Sample of US College Students

Abstract

Objective: To examine sexual health disparities between blacks and whites in a national sample of US college students. Participants and Method Summary: Analyses utilized secondary data from 44,165 nonmarried undergraduates (aged 18–24; M = 20.1) responding to the Spring 2007 American College Health Association–National College Health Assessment; 64% were female and 94.7% were white. Results: Whites reported more experience in oral and anal sex, were less likely to use condoms for oral, anal, and vaginal sex, and less likely to have been tested for HIV (human immunodeficiency virus) compared with blacks. However, blacks reported more sex partners, lower use of hormonal contraceptives, and higher rates of adverse sexual health outcomes, such as sexually transmitted infections (STIs) and unintended pregnancy. Sexual behaviors and outcomes also varied across gender. Conclusions: This study highlights a need to increase access to hormonal contraceptives and early STI screening/treatment among blacks, improve HIV testing among whites, and increase condom use promotion for all students.     

Moderators of the Relationship Between Physical Activity and Alcohol Consumption in College Students

Abstract

Objective: Among college students, several studies have found a positive relationship between physical activity and alcohol use. The current study tested gender, Greek status, and ethnicity as potential moderators of the physical activity-alcohol use relationship. Participants: Participants were college freshmen (n = 310) endorsing alcohol/drug use. Methods: Students completed questionnaires assessing a number of health behaviors. Results: Results indicated that gender and Greek status were significant moderators of the relationship between physical activity and alcohol consumption. There was a positive relationship between physical activity and alcohol use for men and Greeks, but not for females and non-Greeks. Conclusions: These findings suggest that exercise does not serve as a protective factor for any of the subgroups of college students studied and is positively associated with drinking among college students who are men and/or involved with the Greek system.     

Peer,social media,and alcohol marketing influences on college student drinking

Objective: To investigate how alcohol marketing and peers may promote college students' alcohol use through social media. Participants: College students (N = 682) aged 18 to 22 years from a large Southern university completed paper surveys in April 2014. Methods: Structural equation modeling was used to investigate relationships among variables as well as moderation by gender and race. Results: Drinking behavior was directly related to perceived norms and attitudes toward alcohol that develop, in part, from direct and indirect interactions with their online and offline peers, as well as engagement with alcohol-related content on social media. Gender and ethnicity moderated some effects. Conclusions: College student drinking is influenced by friends' alcohol-related content posted on social networking sites and by greater engagement with traditional and online alcohol marketing. College campus alcohol misuse interventions should include components to counter peer influences and alcohol marketing on social media.     

Comparing American college and noncollege young adults on e-cigarette use patterns including polysubstance use and reasons for using e-cigarettes

Abstract

Objective: Existing literature on young adults’ e-cigarette and polysubstance use focused on college students. This study examined the differences between college and noncollege groups on prevalence and patterns of e-cigarette and other substance use using data from a national survey. Participants: Adults aged 18–24 from the 2013–2014 Population Assessment of Tobacco and Health Study (n?=?6,608). Methods: Independent sample t-tests and Chi-square tests were conducted to examine group differences. Results: Noncollege young adults had higher prevalence of cigarette, e-cigarette, and marijuana use; college students had higher prevalence of alcohol use. Among current e-cigarette users, college students had higher prevalence of polysubstance use of alcohol and marijuana. College students used e-cigarettes for socializing purposes more. Conclusions: Differences in prevalence and patterns of e-cigarette and other substance use between college and noncollege groups exist. Future interventions should target the social context of college life and reach out to noncollege young adults in workplaces.     

Perceptions About Residence Hall Wingmates and Alcohol-Related Secondhand Effects Among College Freshmen

Objective: The authors examined the secondhand effects among college freshmen of others' alcohol use and related student characteristics, and perceptions about residence hallmates.

Participants: The authors surveyed 509 incoming freshmen residing in predominantly freshman residence halls.

Methods: The authors administered a Web-based survey 2 months into the 2006 fall academic semester.

Results: Most (80%) students experienced at least 1 secondhand effect. Participants' perceptions of wingmates' acceptance and expectation of alcohol use and participants' perceived inability to protect themselves against alcohol problems were related to experiencing secondhand effects, as were being a female and a drinker.

Conclusions: Incoming college freshmen frequently experienced secondhand effects of alcohol use. Involving residence halls in norms-based interventions aimed at reducing secondhand effects warrants evaluation. Further research is also needed to examine skill building among college students to avoid and intervene into others' drinking and to examine resident advisor roles as both engenderers of trust and cooperation as well as enforcers of alcohol rules.     

Examining the role of racism in the risky alcohol use behaviors of black female college students

Objective: This study explores the impact racism has on the drinking behaviors of Black college women. Little is known about Black college women's experience of racism and the impact racism has on their psychological wellbeing and drinking behaviors. The current study fills a gap in our understanding of the role racism plays in the risky drinking behavior of Black college women. Participants: 469 Black college women ages 18–29 were sampled from 8 colleges and universities across the US, in 3 waves from December 2014-August 2017. Results: Findings suggest that general life stress and perceived racism are significantly associated with alcohol use among Black college women. However, only increased experiences of racism increase Black college women's engagement in risky drinking. Conclusions: The findings of this study serve as an entry point for a more nuanced assessment of stressors among Black college women that may inform drinking behaviors in this population.     

Patterns of alcohol use and marijuana use among students at 2- and 4-year institutions

Objective: The objective of this study was to understand substance use patterns of alcohol, marijuana, and simultaneous alcohol and marijuana (SAM) use among 2- and 4-year college students. Participants: Participants were 526 young adults aged 18–23 (n?=?355 4-year students; n?=?171 2-year students) recruited from February 2015 to January 2016 who were participating in a larger longitudinal study. Methods: Latent class analysis (LCA) was used to identify past-month classes of alcohol, marijuana, and SAM use. Results: Among both 2- and 4-year students, a four-class solution yielded the best-fitting model, with 2-year classes tending to include greater marijuana use and less alcohol use and 4-year classes tending to include heavy alcohol use. Demographic characteristics were largely similar across classes. Conclusions: Classes of alcohol, marijuana, and SAM use differed by education status. Screening and prevention efforts for 4-year students may need to be tailored for the needs of 2-year students.     

The Impact of Living in Co-ed Resident Halls on Risk-taking Among College Students

Abstract

Objective: Although previous research has suggested that college housing impacts student behavior and outcomes, recent research linking college housing to risk-taking has been limited. In this study, we investigate if patterns of risk behavior differ based on the type of college housing environment students reside in. Participants: This study utilizes 510 college students living in on-campus college housing. Methods: Students were recruited from 5 college sites across the United States. Participants responded to survey items online that measured current risk-taking behaviors such as binge drinking and sexual activity. Results: After controlling for an assortment of demographic and psychological variables, results indicated that students living in co-ed housing were more likely than students living in gender-specific housing to binge drink and consume alcohol, have more permissive sexual attitudes, and have more recent sexual partners. Conclusions: On-campus housing environments impact college student risk behaviors. Implications are discussed in light of the decline of in loco parentis on most college campuses.     

Binge Drinking Among Undergraduate College Students in the United States: Implications for Other Substance Use

Abstract

The authors examined the relationship between binge drinking and other substance use among US college students, using nationally representative data from the 1995 National College Health Risk Behavior Survey implemented by the Centers for Disease Control and Prevention. Compared with nonbinge drinkers, current binge drinkers were significantly more likely to report “ever” using and current use of cigarettes, marijuana, cocaine, and other illegal drugs. The researchers also found that the more often students binge drank, the more likely they were to have ever used cigarettes, marijuana, cocaine, and other drugs, and the more likely they were to report current use of cigarettes and marijuana. Those who design programs to prevent binge drinking and use of other substances should take into account the reality that many students use more than one substance and that the more frequently students report binge drinking, the more likely they are to be using other substances as well.     

Heavy Episodic Drinking in College Students: Associations With Features of Psychopathy and Antisocial Personality Disorder

Abstract

Objective: This study extends the college heavy episodic drinking literature by examining the associations between features of psychopathy and antisocial personality disorder (ASPD), on the one hand, and heavy episodic drinking and associated problem behaviors, on the other. Participants: Participants were 159 (85 male, 74 female) undergraduates from a private university. Methods: Participants completed self-report measures assessing alcohol use, frequency, and consequences of heavy episodic drinking, and personality pathology. Results: It was found that psychopathy, independent of ASPD, was related to the prediction of heavy episodic drinking frequency and problems associated with alcohol use. It was also found that the relation between traits of psychopathy and heavy episodic drinking are limited largely to the impulsive and antisocial aspects of this condition. Conclusion: These findings point to the need for further investigation of the association between psychopathy and ASPD traits and heavy episodic drinking behaviors in college students.     

Contingent Gambling-Drinking Patterns and Problem Drinking Severity Moderate Implicit Gambling-Alcohol Associations in Problem Gamblers

Although problem gambling and problem drinking often co-occur, the processes underlying this association are not well understood. This study investigated the effects of contingent gambling-drinking patterns and problem drinking severity on implicit gambling-alcohol associations. Participants were 144 (34 female) problem gamblers. The South Oaks Gambling Screen (SOGS) measured severity of problem gambling. The Brief Michigan Alcohol Screening Test (BMAST) measured severity of problem drinking. The Implicit Association Test (Greenwald, McGhee, & Schwartz, 1998, Journal of Personality and Social Psychology, 74, 1464–1480) measured gambling-alcohol associations. Participants who reported drinking when they won displayed faster response time (i.e., priming) on trials where alcohol words were paired with gambling win (e.g., jackpot) vs. gambling loss (e.g., forfeit) words. The tendency to drink in response to losses did not influence the priming effect of win cues or moderate the effects of Win-Drinking Pattern on priming. Severity of problem drinking on the BMAST also correlated positively the priming effects of win cues. These findings indicate that a tendency to drink in response to gambling wins and more severe alcohol problems each coincide with stronger associations between gambling win and alcohol concepts in memory. Such associations can promote drinking and its attendant effects (e.g., poor decision-making) in problem gamblers, and thus, may contribute to co-morbid gambling and alcohol use disorders.     

Protective Effects of Parent–College Student Communication During the First Semester of College

Abstract

Objective: Recent studies suggest that parents maintain influence as their adolescents transition into college. Advances in communication technology make frequent communication between parents and college students easy and affordable. This study examines the protective effect of parent–college student communication on student drinking behaviors, estimated peak blood alcohol concentration (eBAC), and serious negative consequences of drinking. Participants: Participants were 746 first-year, first-time, full-time students at a large university in the United States Methods: Participants completed a baseline and 14 daily Web-based surveys. Results: The amount of time spent communicating with parents on weekend days predicted the number of drinks consumed, heavy drinking, and peak eBAC, consistent with a protective within-person effect. No association between communication and serious negative consequences was observed. Conclusions: Encouraging parents to communicate with their college students, particularly on weekend days, could be a relatively simple, easily implemented protective process to reduce dangerous drinking behaviors.     

Low Self-Control and Co-occurrence of Gambling with Substance Use and Delinquency Among Chinese Adolescents

Relatively little is known about gambling co-morbidity in Asian youth populations. The role of trait self-control in co-morbidity also remains under-explored in the gambling literature. This study examined the association between gambling, substance use and delinquency among Chinese adolescents, and the extent to which these forms of risk behavior are commonly predicted by low self-control. Data from a cross-sectional questionnaire survey of a stratified, random sample of 4,734 high school students aged 12–23 years in Hong Kong were analyzed. The prevalence of gambling pathology, frequency and attitudes showed statistically significant, positive and consistent relationships with tobacco use, alcohol use, and delinquent acts at the p < .001 level. Further analyses revealed that low self-control significantly (p < .001) predicts at-risk/probable pathological gambling, frequent gambling, strong permissiveness toward gambling, heavy use of tobacco and alcohol, and delinquent involvement, even after controlling for the potential shared correlates of socioeconomic characteristics, parental monitoring and peer delinquency. Hence, the concept that gambling problems and strong receptivity to gambling are likely to be part of a general problem behavior syndrome is evinced cross-culturally among young people in a Chinese context. It may also be cost-effective to increase intervention efforts to improve the self-control deficit in adolescents, as this should reduce their gambling and concurrent problem behavior.     

An examination of the impact of maladaptive coping on the association between stressor type and alcohol use in college

Objective: Examine the impact of maladaptive coping style on the association between source of stress (academic, interpersonal, intrapersonal, environmental) and alcohol use (consumption, heavy episodic drinking, driving under the influence) among college students. Participants: 1,027 college students completed an online survey in April 2014. Methods: To test the mediating effects of maladaptive coping on the association between academic stress and alcohol use variables, indirect effects were examined using the PROCESS analytical framework for SPSS. Results: Maladaptive coping and academic stress were associated with alcohol use outcomes. Moreover, maladaptive coping mediated the relationship between academic stress and two of three alcohol use outcomes (consumption, heavy episodic drinking). Conclusions: Among college students, the association between academic stress and alcohol use may be driven by maladaptive coping. College students may benefit from interventions that seek to improve coping skills, potentially alleviating the burden of academic stress and decreasing problematic alcohol use.