College Student Alcohol Abuse E-Book

Christopher J. Correia

• Herausgeber: John Wiley & Sons
• Kategorie: Bildung
• Sprache: Englisch

Seitenzahl: 844

Veröffentlichungsjahr: 2012

Beschreibung

Essential evidence-based strategies for the prevention and reduction of alcohol abuse among college students With contributions from notable substance abuse researchers, this practical guide presents clear strategies for prevention of and interventions for alcohol abuse in the college-age population. Ranging from community-based prevention programs to individual, motivational, and interview-based approaches, College Student Alcohol Abuse explores: * The leading theories used to conceptualize college student drinking and related problems, with an emphasis on the clinical implications of each perspective * Epidemiology of student drug use--including illicit drugs and nonmedical use of prescription drugs * The spectrum of empirically supported prevention programs with a focus on best practices and materials * How to conduct assessments and create intervention programs for students with substance abuse problems A must-have resource for every college administrator, resident staff member, and addiction counselor who works with this unique population, College Student Alcohol Abuse translates the latest research findings and interventions into clear and evidence-based strategies for assessing and treating college students who are abusing alcohol.

Leseprobe

Contents

Cover

Title Page

Copyright

Preface

Contributors

Part I: Epidemiology, Consequences, and Risk Factors

Chapter 1: Prevalence and Consequences of College Student Alcohol Use

HEAVY DRINKING AT COLLEGE

ALCOHOL-RELATED CONSEQUENCES

ACADEMIC PERFORMANCE

ALCOHOL BLACKOUTS

ALCOHOL AND ADOLESCENT NEUROCOGNITIVE DEVELOPMENT

ALCOHOL AND DRUG USE AMONG COLLEGE STUDENTS

ALCOHOL OVERDOSES

STUDENTS AT HIGH RISK

INTERVENTIONS TO REDUCE COLLEGE DRINKING

CONCLUSIONS

REFERENCES

Chapter 2: College Student Drug Use

PREVALENCE AND CONSEQUENCES

AT-RISK GROUPS

SUMMARY

REFERENCES

Chapter 3: Windows of Risk

EVENTS ASSOCIATED WITH EXTREME DRINKING

CONTEXTS ASSOCIATED WITH HIGH-RISK DRINKING

CONCLUSIONS

REFERENCES

Chapter 4: Theories of College Student Drinking

THEORIES OF COLLEGE STUDENT DRINKING AND THEIR ROLE

PREVALENCE OF COLLEGE STUDENT DRINKING AND ALCOHOL-RELATED NEGATIVE CONSEQUENCES

MAJOR THEORIES OF AND APPLIED TO COLLEGE STUDENT DRINKING

THEORIES OF DRINKING AMONG COLLEGE STUDENTS

PERSONALITY CORRELATES OF COLLEGE DRINKING

SUMMARY OF THE EMPIRICAL EVIDENCE FOR THEORIES OF DRINKING AMONG COLLEGE STUDENTS

ANALYSIS AND CONCLUSIONS

WHERE DO THEORIES OF DRINKING AMONG COLLEGE STUDENTS GO FROM HERE?

CONCLUSIONS

REFERENCES

Part II: Assessment, Intervention and Prevention Strategies

Chapter 5: Review of Clinical Assessment Tools

RELIABILITY AND VALIDITY OF SELF-REPORT

CONCEPTUALIZING ALCOHOL-RELATED PROBLEMS AMONG COLLEGE STUDENTS

SPECIFIC CLINICAL ASSESSMENTS

FUTURE DIRECTIONS/SUMMARY

REFERENCES

Chapter 6: Applying Harm-Reduction Strategies on College Campuses

COLLEGE STUDENT ALCOHOL USE AND RELATED CONSEQUENCES

HARM-REDUCTION APPROACHES

INFORMATION ON FACTORS CONTRIBUTING TO HARM THAT CAN BE INCLUDED IN HARM-REDUCTION INTERVENTIONS

HARM-REDUCTION STRATEGIES

POLICY AS A FORM OF HARM REDUCTION

OPPORTUNITIES FOR APPLICATION

FUTURE DIRECTIONS

REFERENCES

Chapter 7: Campus and Community Interventions to Reduce Alcohol Use, Abuse,and Consequences

OVERVIEW AND INTRODUCTION

CURRENT EVIDENCE ON ENVIRONMENTAL STRATEGIES

RECOMMENDATIONS AND CONSIDERATIONS FOR CAMPUS AND COMMUNITY ADMINISTRATORS

ADDRESSING BARRIERS TO ENVIRONMENTAL PREVENTION EFFORTS

CONCLUSIONS

REFERENCES

Chapter 8: Stepped Care in the College Setting

THE PROBLEM: ALCOHOL USE IN COLLEGE

“ONE SIZE DOES NOT FIT ALL”

STEPPED CARE—THEORY AND PRACTICE

WHAT GOES WHEN?

INTERVENTIONS IMPLEMENTED WITH COLLEGE STUDENTS TO ADDRESS ALCOHOL USE

CASE EXAMPLE OF STEPPED CARE IN THE COLLEGE SETTING

CONSIDERATIONS FOR IMPLEMENTING A STEPPED CARE PROGRAM

FUTURE DIRECTIONS

CONCLUSION

REFERENCES

Chapter 9: Brief Motivational Interventions

ORIGINS

EVOLUTION AND DIVERSIFICATION OF BMIs

EMPIRICAL SUPPORT FOR BMIs

SUGGESTIONS FOR CONDUCTING A BRIEF MOTIVATIONAL INTERVENTION

CONCLUSIONS

REFERENCES

Chapter 10: Computerized Interventions

INTRODUCTION

CDI MECHANISMS

COMMERCIALLY AVAILABLE CDIs: PROGRAM DESCRIPTIONS

EVIDENCE FOR USING CDIs WITH SPECIFIC POPULATIONS

COMMERCIALLY AVAILABLE CDIs: SUMMARY OF EMPIRICAL FINDINGS

FACTORS RELEVANT TO THE IMPLEMENTATION OF CDIs

FUTURE DIRECTIONS

REFERENCES

Chapter 11: Treating Comorbid Disorders

WHAT IS COMORBIDITY AND WHY DOES IT OCCUR?

COMORBIDITY OF ALCOHOL USE AND MENTAL HEALTH SYMPTOMS

PROBLEMATIC OUTCOMES OF COMORBID ALCOHOL USE AND MENTAL HEALTH SYMPTOMS

ASSESSMENT OF COMORBID ALCOHOL AND PSYCHOLOGICAL DISORDERS

TREATMENT OF COMORBID ALCOHOL AND PSYCHOLOGICAL DISORDERS: MODELS FROM THE NONCOLLEGE LITERATURE

FUTURE DIRECTIONS IN RESEARCH AND TREATMENT

SUMMARY AND CONCLUSIONS

REFERENCES

Chapter 12: Treating Drug Abuse

EDUCATION BASED DRUG PREVENTION

EDUCATION-BASED DRUG TREATMENT FOR MANDATED STUDENTS

BRIEF MOTIVATIONAL INTERVENTIONS (BMI)

BRIEF ALCOHOL SCREENING AND INTERVENTION FOR COLLEGE STUDENTS (BASICS)

BMI FOR DRUG USE AMONG YOUNG ADULTS

WEB-BASED INTERVENTIONS

INTERVENTIONS THAT WARRANT EVALUATION FOR TREATING COLLEGE DRUG USE

COMMUNITY DRUG TREATMENT REFERRALS

CONSIDERATIONS AND RECOMMENDATIONS WHEN WORKING WITH COLLEGE STUDENTS

CONCLUDING REMARKS

REFERENCES

Chapter 13: The Role of Training and Supervision in Delivering Empirically Supported Treatments for College Student Drinkers

INTERVENTION APPROACHES WITH COLLEGE STUDENT DRINKERS

APPROACHES TO COUNSELOR TRAINING AND SUPERVISION

WHAT DOES COUNSELOR TRAINING LOOK LIKE?

COUNSELOR SUPERVISION

INTERVENTION FIDELITY

CONCLUSION

REFERENCES

Chapter 14: Future Directions in College Student Alcohol Abuse Research and Prevention

SUGGESTIONS FOR FUTURE RESEARCH

REFERENCES

About the Editors

Author Index

Subject Index

This book is printed on acid-free paper.

Copyright © 2012 by John Wiley & Sons, Inc. All rights reserved. Published by John Wiley & Sons, Inc., Hoboken, New Jersey.

Published simultaneously in Canada.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, [phone], fax [phone], or on the Web at www.copyright.com. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, [phone], fax [phone].

Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor author shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering professional services. If legal, accounting, medical, psychological or any other expert assistance is required, the services of a competent professional person should be sought.

Designations used by companies to distinguish their products are often claimed as trademarks. In all instances where John Wiley & Sons, Inc. is aware of a claim, the product names appear in initial capital or all capital letters. Readers, however, should contact the appropriate companies for more complete information regarding trademarks and registration.

For general information on our other products and services, please contact our Customer Care Department within the United States at [phone], outside the United States at [phone] or fax [phone].

Wiley publishes in a variety of print and electronic formats and by print-on-demand. Some material included with standard print versions of this book may not be included in e-books or in print-on-demand. If this book refers to media such as a CD or DVD that is not included in the version you purchased, you may download this material at http://booksupport.wiley.com. For more information about Wiley products, visit www.wiley.com.

Library of Congress Cataloging-in-Publication Data:

College student alcohol abuse : a guide to assessment, intervention, and prevention / [edited by] Christopher J. Correia, James G. Murphy, Nancy P. Barnett. p. cm. Includes index. ISBN 978‐1‐118‐03819‐2 (pbk.) 1. College students–Alcohol use. 2. Alcoholism–Prevention. I. Correia, Christopher J. II. Murphy, James G. III. Barnett, Nancy P. HV5135.C65 2012 362.292084′2—dc23 2012010598

Preface

According to the U.S. Surgeon General and the U.S. Department of Health and Human Services, heavy episodic drinking among college students represents a “major national health problem” (USDHHS, 2000). A number of sources have also noted recent increases in the use of drugs like marijuana and nonmedical use of prescription medications. Misuse of alcohol and other drugs can lead to many well-documented negative outcomes, including injuries and fatalities, social and interpersonal difficulties, and problems related to academic performance. Substance misuse also results in increased violence, property destruction, sexual assaults, and other problems that affect the entire college community. Recent reports by the Task Force of the National Advisory Council on Alcohol Abuse and Alcoholism (NIAAA, 2002, 2007) noted that widespread heavy drinking and associated consequences on campuses place colleges and universities in the challenging position of developing programs and policies that will adequately protect students from harm.

The impetus for this book was our shared recognition of the need for a comprehensive resource on how to address substance use among college students. Our primary goal was to bring together experts from across the United States to create a thought-provoking, hands-on, and user-friendly book that practitioners, administrators, and researchers will find valuable in their day-to-day work with college students. The book is useful to a variety of professions and professionals in training who work primarily with college students and young adults, including psychologists, counselors, and other mental health practitioners; physicians and nurses; those involved in higher education administration; researchers with an interest in substance abuse or clinical interventions; and students who aspire to join one of these exciting professions.

The text is divided into two major sections. Part I, “Epidemiology, Consequences, and Risk Factors,” consists of four chapters that provide a primer on substance use among college students. The initial chapters give readers a firm understanding of the prevalence of alcohol and drug use and associated negative consequences, the populations (e.g., Greek members, student athletes), and activities and events (e.g., spring break, drinking games) associated with increased risk of misuse, and the latest theories used to explain substance use among college students.

In Part II, “Assessment, Intervention, and Prevention Strategies,” 10 chapters translate the latest theories and research findings related to college student substance abuse into clear and evidence-based strategies for assessing and treating college students who are abusing alcohol and other drugs. Consistent with a public health approach to college drinking prevention, the book covers a continuum of prevention and intervention modalities, ranging from campus-wide and community-based prevention programs, to brief and easily disseminated computerized and web-based interventions, to more intensive small group and individual approaches utilizing both peer and professional counselors. Each chapter provides clear suggestions about how to implement the strategies and interventions that have been shown to be most effective.

Many people contributed to making this book a reality. We would like to thank all of the authors for their excellent contributions. We would also like to thank our colleagues and students, too many to name individually, who continue to challenge and excite us with new perspectives. Finally, we thank the people of Wiley for supporting this project, with special acknowledgment to Marquita Flemming and Sherry Wasserman for seeing us through from start to finish.

REFERENCES

National Institute on Alcohol Abuse and Alcoholism. (2002). High-risk drinking in college:What we know and what we need to learn. Final report on the panel on contexts and consequences. National Advisory Council on Alcohol Abuse and Alcoholism Task Force on College Drinking. USDHHS.

National Institute on Alcohol Abuse and Alcoholism. (2007). What colleges need to know now: An update on college drinking research. National Advisory Council on Alcohol Abuse and Alcoholism Task Force on College Drinking. USDHHS.

U.S. Department of Health and Human Services. (2000). Healthy people 2010 (conference ed., Vol. II, pp. 26–29). Washington, DC: author.

Contributors

Brooke J. Arterberry, MS University of MissouriColumbia, MO

Rachel L. Bachrach, MS University at Buffalo, The State University of New YorkBuffalo, NY

Nancy P. Barnett, PhD Brown UniversityProvidence, RI

Todd M. Bishop, MS Syracuse UniversitySyracuse, NY

Brian Borsari, PhD Department of Veterans Affairs Medical CenterProvidence, RI

Julia D. Buckner, PhD Louisiana State UniversityBaton Rouge, LA

Jennifer M. Cadigan, BA University of MissouriColumbia, MO

William Campbell, MS The University of New MexicoAlbuquerque, NM

Kate B. Carey, PhD Brown UniversityProvidence, RI

Amy L. Copeland, PhD Louisiana State UniversityBaton Rouge, LA

Christopher J. Correia, PhD Auburn UniversityAuburn, AL

Anthony H. Ecker, BS Louisiana State UniversityBaton Rouge, LA

Darin J. Erickson, PhD University of MinnesotaMinneapolis, MN

Anne M. Fairlie, MA University of Rhode IslandKingston, RI

Nicole Fossos, BS University of HoustonHouston, TX

Dawn W. Foster, MPH University of HoustonHouston, TX

Raluca M. Gaher, PhD University of South DakotaVermillion, SD

Eliza J. Hart, BA Syracuse UniversitySyracuse, NY

Reid K. Hester, PhD Behavior Therapy Associates, LLPAlbuquerque, NM

Ralph W. Hingson, ScD, MPH National Institute on Alcohol Abuse and AlcoholismBethesda, MD

Jason R. Kilmer, PhD University of WashingtonSeattle, WA

Melissa A. Lewis, PhD University of WashingtonSeattle, WA

Diane E. Logan, MS University of WashingtonSeattle, WA

Stephen A. Maisto, PhD Syracuse UniversitySyracuse, NY

Matthew P. Martens, PhD University of MissouriColumbia, MO

Nadine R. Mastroleo, PhD Brown UniversityProvidence, RI

James G. Murphy, PhD University of MemphisMemphis, TN

Clayton Neighbors, PhD University of HoustonHouston, TX

Jennifer P. Read, PhD University at Buffalo, The State University of New YorkBuffalo, NY

Ryan N. Reed, BS University of South DakotaVermillion, SD

Erica Eaton Short, MA Brown UniversityProvidence, RI

Jeffrey S. Simons, PhD University of South DakotaVermillion, SD

Ashley E. Smith, MA University of MissouriColumbia, MO

Meredith A. Terlecki, PhD Louisiana State UniversityBaton Rouge, LA

Aaron M. White, PhD National Institute on Alcohol Abuse and AlcoholismBethesda, MD

Mark D. Wood, PhD University of Rhode IslandKingston, RI

Tyler B. Wray, MS University of South DakotaVermillion, SD

PART I

Epidemiology, Consequences, and Risk Factors

1

Prevalence and Consequences of College Student Alcohol Use

Ralph W. Hingson and Aaron M. White

Since 1976, when the National Institute on Alcohol Abuse and Alcoholism (NIAAA) issued its first report on abusive drinking by college students, research advances have transformed our understanding of alcohol abuse and related problems among college students. Several national surveys indicate that about 80% of college students drink alcohol each year. Many first-year students come to college with an established pattern of drinking developed in high school and even middle school. Further, we now know that a broad array of factors affect college student drinking behaviors and the consequences that follow. These factors include an individual's genetic susceptibility to the positive and negative effects of alcohol, campus norms related to drinking, expectations regarding the benefits and detrimental effects of drinking, penalties for underage drinking, parental attitudes about drinking while at college, whether one is member of a Greek organization, and conditions within the larger community that determine how accessible and affordable alcohol is. Together, these influences and others contribute to a culture of drinking that, in the end, can be more damaging and deadly than previously recognized.

HEAVY DRINKING AT COLLEGE

Research suggests that a large percentage of college students who drink do so to excess. National surveys indicate that from 1999 to 2007 (Substance Abuse and Mental Health Services Administration, 2000, 2002, 2006, 2008) the percent of 18- to 24-year-old college students who drank five or more drinks on an occasion in the previous 30 days increased from 41.7% to 43.8%, a significant 5% proportional increase. Among 18- to 24-year-olds not in college, the percent increased from 36.5% to 40.7%, a significant 12% proportional increase.

For the majority of drinkers, five drinks in a 2-hour period, often referred to as heavy episodic or binge drinking, would produce a blood alcohol concentration (BAC) at or above 0.08%, a level at which driving-related abilities are markedly impaired, decision making and impulse control are dulled, and memory starts to fail. This is the legal limit of intoxication for adults in all 50 states. The odds of a fatal car crash are elevated significantly here, as are the chances of suffering from alcohol blackouts, being sexual assaulted, physically injured, and suffering various other harms (Hingson & White, 2010).

A greater percentage of 18- to 24-year-old college students compared with noncollege respondents engage in binge drinking. However, because only 36% of 18- to 24-year-olds are in college, the number not in college who consumed five or more drinks on an occasion in 2007 exceeded the number of college students who did so by a large number (7,705,578 vs. 4,564,861). From 1999 to 2007, among 18- to 24-year-olds, the proportion of college students who drove under the influence of alcohol decreased slightly from 26.1% to 25.2%. Among those in the same age-group who are not in college, the proportion increased significantly from 19.8% to 21.0%.

Those old enough to drink legally drink more heavily and are more likely to drink and drive than students who are underage based on current law (i.e., < 21 years old). The largest increase in binge drinking occurred among 21- to 24-year-olds (43% in 1999 and 48% in 2007), not 18- to 20-year-olds (38% in 1998 and 39% in 2007), who currently are prohibited from drinking legally. Similarly, the percentages of those who drove under the influence were highest in the 21- to 24-year-old group at 30% in both 1999 and 2007. In the 18- to 20-year-old group, the percent declined from 24% to 21% during those years.

Concerns have been raised that the legal drinking age of 21 drives drinking by underage persons into unsupervised settings where very heavy drinking is apt to occur. Analyses of the National Longitudinal Alcohol Epidemiologic Study (NLAES) and National Epidemiologic Study on Alcohol and Related Conditions (NESARC) national surveys conducted 10 years apart in 1991 to 1992 and 2001 to 2002 reveal increases in consuming 10 or more drinks or 21 or more drinks, the latter being the equivalent of one fifth of distilled spirits, occurred among 21- to 24-year-olds, particularly those in college, not 18- to 20-year-olds (see Figure 1.1). Among 21- to 24-year-old college students, the percentages consuming 10 or more drinks on an occasion rose from 27% to 40%, and the percent consuming 21 or more drinks on an occasion rose from 8% to 15%.

Figure 1.1 Consumption of 10+ Drinks or More or 21+ Drinks on an Occasion in Past Year by U.S. 18- to 20-year-olds and 21- to 24-year-olds, 1991–1992 versus 2001–2002

ALCOHOL-RELATED CONSEQUENCES

Drinking to intoxication leads to widespread impairments in cognitive abilities, such as decision making and impulse control, and impairments in motor skills, such as balance and hand-eye coordination, thereby increasing the risk of injuries and various other harms. Among 18- to 24-year-old college students, deaths from all alcohol-related unintentional injuries, including traffic and other unintentional injuries, increased from 1,442 in 1998 to 1,870 in 2007, corresponding to a 1% increase in rates of death among students per 100,000 from 18.5 to 18.6. Among all 18- to 24-year-olds, alcohol-related unintentional injury deaths increased from 4,809 in 1998 to 5,502 in 2007. Most of the injury deaths resulted from traffic crashes involving alcohol (1,395 among college students ages 18 to 24 and 4,103 among all individuals in that age group) in 2007. Alcohol-related traffic deaths involving college students increased from 1,135 to 1,395 and from 3,783 to 4,103 among all 18- to 24-year-olds. Nontraffic unintentional injury deaths increased from 308 to 531 among 18- to 24-year-old college students and from 1,026 to 1,562 among all persons that age. Most of that increase resulted from increases in poisoning deaths involving alcohol, up from 62 to 262 among college students and from 207 to 770 among all 18- to 24-year-olds from 1998 to 2007.