Previous studies have shown that college students' perceptions of the quantity and frequency of peer alcohol consumption are biased. Most students report that their social referents drink more than they themselves do. In the current study members of two fraternities and two sororities (N = 252) were asked to make two types of ratings of alcohol-related consequences across four target individuals. The ratings were: (1) the frequency of occurrence of predefined alcohol-related negative consequences and (2) the degree to which certain alcohol-related consequences are considered "problems." The targets were: themselves, their best friend, a typical member of their fraternity or sorority and a typical student at the university. Estimates of frequency of problem behaviors for typical member of the residence and typical student at the university were significantly higher than ratings for self (p < .001). Data from ratings of behavioral definitions of alcohol problems for the same four targets replicated the bias, although to a lesser degree. Correlational analyses suggest that biased perceptions of problems were unrelated to personal levels of alcohol consumption. Results are discussed in terms of the cognitive and motivational factors that could result in this misrepresentation of peer behavior.
Grounded in current best practices, this book offers flexible, readily applicable guidelines for assessing and working with college drinkers. Provided is a wealth of practical advice on interacting with students in a range of contexts, from brief conversations in medical settings to motivational counseling sessions and group interventions. Also described are effective ways to weave alcohol prevention and intervention services into the fabric of campus life. Over a dozen appendices feature reproducible assessment instruments and other indispensable tools, in a large-size format for ease of photocopying and use. For optimal utility, supplemental materials for use in workshops, seminars, and other educational and training events are available online as PowerPoint slides (www.guilford.com/walters2).
This study investigated the clinical significance of previously reported statistically significant mean reductions in drinking and related problems among college students in a randomized trial of a brief indicated preventive intervention (G. A. Marlatt et al., 1998). Data were analyzed over a 2-year follow-up for participants from a high-risk intervention group (n = 153), a high-risk control group (n = 160), and a functional comparison group (n = 77). A risk cutpoint for each dependent measure was based on the functional comparison group distribution. Compared with the high-risk controls, more individuals in the high-risk intervention group improved and fewer worsened, especially on alcohol-related problems and, to a lesser extent, on drinking pattern variables. These data from a prevention context clarify the magnitude and direction of individual change obscured by group means.
Unhealthy alcohol use is common among Operations Enduring and Iraqi Freedom (OEF/OIF) veterans, yet barriers discourage treatment-seeking. Mobile applications (apps) that deliver alcohol interventions have potential to address these barriers and increase treatment receipt. Few studies have qualitatively assessed users' experiences with apps to manage alcohol use. We assessed OEF/OIF veterans' experiences with Step Away, an app to reduce alcohol-related risks, to identify factors that may influence engagement. This single-arm pilot study recruited OEF/OIF veterans with positive alcohol screens nationwide using mail/telephone. Veterans aged 18-55 who exceeded drinking guidelines and owned an iPhone were eligible. Twenty-one (16 men, 5 women) of 55 participants completed interviews. Interviews were analyzed using thematic analysis. Participants found Step Away easy to use, although setup was time consuming. Participants reported increased awareness of alcohol use, highlighting daily assessment, weekly feedback, goal setting, and high-risk notification features as helpful and associated awareness with an intent to decrease use. Participants described Step Away as informative, with over half reporting they would use it outside of the study and most recommending it. Suggestions for improvement included greater personalization and control over features. Step Away features appear to influence engagement and increase users' awareness about alcohol consumed and factors associated with drinking, as well as intent to change. Assessment, feedback, and customization features of apps may facilitate app engagement. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
The short-term results of a randomized trial testing a brief feedback and motivational intervention for substance use among homeless adolescents are presented. Homeless adolescents ages 14-19 (N = 285) recruited from drop-in centers at agencies and from street intercept were randomly assigned to either a brief motivational enhancement (ME) group or 1 of 2 control groups. The 1-session motivational intervention presented personal feedback about patterns of risks related to alcohol or substance use in a style consistent with motivational interviewing. Follow-up interviews were conducted at 1 and 3 months postintervention. Youths who received the motivational intervention reported reduced illicit drug use other than marijuana at 1-month follow-up compared with youths in the control groups. Treatment effects were not found with respect to alcohol or marijuana. Post hoc analyses within the ME group suggested that those who were rated as more engaged and more likely to benefit showed greater drug use reduction than did those rated as less engaged. Limitations of the study are discussed as are implications for development of future substance use interventions for this high-risk group.
Background: Proficient delivery of motivational interviewing (MI) is often determined by global rating of relational elements or cumulative tallies of technical elements. Yet limited empirical evidence exists to clarify how relational and technical elements are associated, or if rates of skill indices and their constituent technical elements vary within a clinical encounter. Aims: This study sought to document temporal variance in rates of MI skill indices and their constituent technical elements during brief clinical encounters with a standardized patient wherein delivery was “MI-proficient”, and to distinguish those temporal patterns from those observed in encounters with “MI-inconsistent” delivery. Method: Data were accessed from a large MI training trial wherein relational and technical elements of MI delivery were scored for 503 recordings of a simulated 20-minute clinical encounter. Notably, independent raters tallied technical elements in 5-minute segments, allowing evaluation of potential variance among the encounter's quartile intervals. Global ratings of MI spirit identified subsets of recordings with MI-proficient ( n = 49) and MI-inconsistent ( n = 43) delivery for stratified analyses. Results: Analyses contrast temporal trajectories of technical aspects of MI-proficient and MI-inconsistent delivery, with the former characterized by: 1) elicitation and reflective listening as primary opening strategies; 2) increased depth of reflective listening as a predominant strategy in subsequent, focused therapeutic discussion; and 3) increased use of elicitation and information provision in change planning as the encounter approached conclusion. Conclusions: Findings are generally consistent with seminal descriptions of MI (Miller and Rollnick, 1991, 2002), and document temporal aspects of skilful MI delivery in brief encounters.
Different types of "relapse crises" and associated coping responses were associated with the resumption of smoking using a prospective design. One hundred and two previously heavy smokers (M = 23.9 cigarettes a day) who achieved initial abstinence through a smoking cessation program were interviewed by telephone at 1, 2, and 3 months posttreatment. At each assessment, subjects described relapse crises, situations in which they were tempted to smoke or actually smoked but resumed abstinence (lapsed). Prospective analyses indicated that any smoking lapse is strongly related to subsequent relapse. Situational characteristics of relapse crises and the number of cognitive and behavioral coping responses reported during crises were only modestly consistent over time and were unrelated to later relapse. Confidence ratings and situational attributions about the relapse crises were also not prospectively associated with eventual relapse. Subanalyses suggested that lapses associated with urges and emotional (guilt) responses and lapses occurring in frequent situations are more likely to result in relapse.
A self-selected sample of 4695 university and college students participated in a short-term evaluation of an interactive CD-ROM addressing harm reduction for alcohol use. The CD-ROM (Alcohol 101) uses a mix of video, text, music, graphics, and animation elements to present behavioral change strategies for safe and responsible use of alcohol. Student learning about alcohol as measured by self-report was generally in the desired direction and supportive of the impact of the CD-ROM on understanding of the physiological impact of alcohol and the range of behavioral options for pacing consumption and helping friends in potential peril.
