A Randomized Pilot Trial of a Mobile-Delivered Alcohol-Impaired Driving Brief Intervention with College Students

Alcohol-Impaired Driving (AI-Driving) among college students remains a significant public health concern. Counselor delivered and web based Brief Alcohol Interventions (BAIs) have been shown to reduce AI-driving among college students, but to date no study has selected students on the basis of recent AI-driving and evaluated the efficacy of a mobile-based BAI specific to AI-driving. The present study examined whether a mobile-based, AI-diriving specific BAI would significantly decrease AI-driving among college students compared to an informational control. Participants were 82 college students who endorsed driving after drinking two or more drinks at least twice in the past three months. After completing baseline measure, participants were randomly assigned to receive either: a) alcohol information or b) an AI-driving specific personalized feedback intervention. Participants in the personalized feedback condition received a personalized feedback document via text containing personalized feedback related to alcohol use and AI-driving. Students randomized to the information condition received standard information about alcohol and AI-driving via a link to a secure website included in text message and/or email. Participants completed outcome measures at three-month follow-up. Repeated measures mixed modeling analyses revealed that students receiving the AI-driving interventions reported significantly greater reductions in driving after drinking than students in the information condition at three-month follow-up. However, differential group differences were not found for estimated BAC prior to driving and alcohol use as both groups reduced on these outcomes at three-month follow-up. The findings of this study provide preliminary support for the efficacy of a mobile-based brief intervention for reducing alcohol-impaired driving among college students

Behavioral Economic Predictors of Substance-Impaired Driving among College Substance Users

Substance-impaired driving among college students represents a significant public health concern yet little is known about specific theoretical risk factors for driving after substance use among heavy drinking college students. The present study evaluated the hypothesis that substance users with elevated substance demand and steeper delay discounting would be more likely to report driving after substance use. Participants were 419 college students who reported at least one day of past month alcohol or marijuana use. Participants completed two Alcohol Purchase Tasks (APT), a Marijuana Purchase Task, a Delayed Discounting task, and a series of questions regarding driving after substance use. In binary logistic regression models that controlled for a number of covariates, participants who reported higher alcohol demand were more likely to report driving after drinking. Additionally, in a series of ANCOVAs, DD+ participants reported significantly less of a reduction in demand as a function of the driving scenario

The behavioral economics of driving after drinking among college drinkers

Background: Driving after drinking (DAD) among college students is a significant public health concern, yet little is known about specific theoretical risk factors for DAD, beyond drinking level, among college student drinkers. This study had the following aims: (i) to examine the associations between elevated alcohol demand and DAD, (ii) to determine whether demand decreases in response to a hypothetical driving scenario, (iii) to determine whether drivers who report DAD in the past 3 months would show less of a reduction in demand in response to the hypothetical driving scenario, and (iv) to determine whether delayed reward discounting (DRD) is associated with DAD. Method: Participants were 419 college students who reported at least 1 day of past-month alcohol use. Participants completed 2 alcohol purchase tasks (APTs) that assessed hypothetical alcohol consumption across 17 drink prices with and without a driving scenario, a delay-discounting task, and a series of questions regarding DAD. Results: In logistic regression models that controlled for drinking level, demographics, and sensation seeking, participants reporting higher demand intensity (95% confidence interval [95% CI] [1.04, 2.34]), breakpoint (95% CI [1.23, 2.28]), Omax (95% CI [1.03, 1.53]), and lower elasticity (95% CI [0.15, 1.02]) were more likely to report DAD. Additionally, in analyses of covariance, DAD+ participants exhibited significantly less of a reduction in demand between the standard and the driving APT (intensity, p \u3c 0.01, breakpoint, p = 0.05, and Omax, p \u3c 0.01). A binary logistic regression model with identical covariates revealed that DRD is not associated with DAD. Conclusions: DAD is associated with elevated/inelastic demand and less sensitivity to a hypothetical driving scenario. Drinkers with elevated demand should be prioritized for DAD intervention efforts

A mobile phone–based brief intervention with personalized feedback and text messaging is associated with reductions in driving after drinking among college drinkers

Objective: Driving after drinking (DAD) among college students remains a significant public health concern and is perhaps the single riskiest drinking-related behavior. Counselor-delivered and web-based Brief Alcohol Interventions (BAIs) have been shown to reduce DAD among college students, but to date no study has evaluated the efficacy of a single-session mobile phone–based BAI specific to DAD. The present study examined whether a driving-specific BAI delivered via mobile phone would significantly decrease DAD among college students compared to an informational control. Method: Participants were 84 college students (67.1% women; average age = 23; 52.4% White) who endorsed driving after drinking two or more drinks at least twice in the past 3 months. After completing baseline measures, participants were randomly assigned to receive either (a) DAD information or (b) DAD mobile BAI that included personalized feedback and interactive text messaging. Participants completed outcome measures at 3-month follow-up. Results: Repeated-measures mixed modeling analyses revealed that students receiving the mobile phone–based BAI reported significantly greater reductions in likelihood of DAD (three or more drinks) and the number of drinks consumed before driving than students in the information condition at 3-month follow-up. Conclusions: These fi ndings provide preliminary support for the short-term efficacy of a mobile phone–based BAI for reducing DAD among college students

Brief motivational interventions are associated with reductions in alcohol-impaired driving among college drinkers

Objective: Alcohol-impaired (AI) driving among college students remains a significant public health concern and may be the single most risky drinking outcome among young adults. Brief motivational interventions (BMIs) have been shown to reduce alcohol use and problems, but their specific efficacy for decreasing AI driving among college students is unknown. The present study analyzed data from three randomized controlled trials of BMI (Murphy et al., 2010: n = 74; Borsari et al., 2012: n = 530; and Martens et al., 2013: n = 365) to evaluate whether BMIs are associated with reductions in AI driving among college student drinkers. Method: Participants in all three studies were randomized to BMI or control conditions. Participants reported whether they had driven under the influence (yes/no) following the BMI over the follow-up period. Results: Separate binary logistic regression analyses were conducted for each study. For Studies 1 and 2, these analyses revealed that a BMI was significantly associated with reductions in AI driving at the final (6-month and 9-month, respectively) follow-up compared with the control condition. For Study 3, analyses revealed that a single-component BMI focused on the correction of misperceptions of descriptive norms was significantly associated with reductions in AI driving compared with the control group at the final (6-month) followup, whereas a single-component BMI focused on the use of protective behavioral strategies was not. Change in drinking level did not mediate the relationship between the condition and the change in AI driving. Conclusions: Counselor-administered BMIs that include descriptive normative feedback are associated with significant reductions in AI driving compared with control

Brief Motivational Interventions Are Associated With Reductions in Alcohol-Impaired Driving Among College Drinkers

OBJECTIVE: Alcohol-impaired (AI) driving among college students remains a significant public health concern and may be the single most risky drinking outcome among young adults. Brief motivational interventions (BMIs) have been shown to reduce alcohol use and problems, but their specific efficacy for decreasing AI driving among college students is unknown. The present study analyzed data from three randomized controlled trials of BMI (Murphy et al., 2010: n = 74; Borsari et al., 2012: n = 530; and Martens et al., 2013: n = 365) to evaluate whether BMIs are associated with reductions in AI driving among college student drinkers. METHOD: Participants in all three studies were randomized to BMI or control conditions. Participants reported whether they had driven under the influence (yes/no) following the BMI over the follow-up period. RESULTS: Separate binary logistic regression analyses were conducted for each study. For Studies 1 and 2, these analyses revealed that a BMI was significantly associated with reductions in AI driving at the final (6-month and 9-month, respectively) follow-up compared with the control condition. For Study 3, analyses revealed that a single-component BMI focused on the correction of misperceptions of descriptive norms was significantly associated with reductions in AI driving compared with the control group at the final (6-month) follow-up, whereas a single-component BMI focused on the use of protective behavioral strategies was not. Change in drinking level did not mediate the relationship between the condition and the change in AI driving. CONCLUSIONS: Counselor-administered BMIs that include descriptive normative feedback are associated with significant reductions in AI driving compared with control

Elevated Demand and Proportionate Substance-related Reinforcement are Associated with Driving after Cannabis Use

Objective:Cannabis is the most prevalent illicit drug detected among drug-impaired drivers and the most frequently used illicit drug on college campuses. Behavioural economic variables, such as demand and proportionate substance-related reinforcement, have been identified as risk factors for driving after substance use. Though driving after cannabis use (DACU) represents a significant public health concern, no previous research has investigated behavioural economic predictors of DACU among college cannabis users. The present study evaluated the hypothesis that elevated cannabis demand and proportionate substance-related reinforcement would be associated with DACU among college cannabis users.Method:Participants were 132 college students who reported cannabis use on 4 or more days in the past month. Participants completed a Marijuana Purchase Task that assessed hypothetical cannabis consumption across 20 prices, the Adolescent Reinforcement Survey Schedule-Substance Use Version to measure past-month activity participation and enjoyment from substance-related and substance-free activities, and questions regarding DACU.Results:In ordinal logistic regression models that controlled for past-month cannabis use frequency, gender, age, and ethnicity, cannabis demand (intensity) and substance-related reinforcement were both significantly associated with DACU.Conclusions:These results provide evidence that demand and substance-related reinforcement are associated with DACU. Intervention approaches aiming to reduce DACU among college students should target demand and engagement in substance-free activities

A Longitudinal Behavioral Economic Analysis of Non-medical Prescription Opioid Use Among College Students

Despite the growing opioid epidemic in the US, few studies have identified theoretically based risk factors for non-medical prescription opioid (NMPO) use among young adults. The goal of the current study was to evaluate the behavioral economic hypotheses that NMPO use would be associated with lower levels of reinforcement from substance-free activities and future time orientation. Participants were 71 undergraduate students (62% women, 52.1% Caucasian, 35.2% African American) who either reported past-year NMPO use or demographically similar control participants with no past-year drug use. Participants provided information on alcohol and drug use, completed three measures of substance-free reinforcement (time allocation to exercise and academic activities, hedonic response to substance-free pleasant images, and self-report anhedonia), and a measure of future orientation, at baseline, 6-month, and 12-month follow-up. Consistent with nationwide trends, most NMPO users also reported use of marijuana (94%) and alcohol (80%). Compared to no drug use, NMPO use was associated with lower time allocation to academic activities, lower hedonic response to pleasant images, greater self-reported anhedonia, and lower future orientation across the 12-month study period. Among NMPO users, greater positive hedonic response to substance-free pleasant images predicted less alcohol use at 12-month follow-up, and greater baseline future orientation predicted less marijuana and NMPO use at 12-month follow-up. These findings provide partial support for behavioral economic models that link substance misuse to diminished levels of substance-free reinforcement and lower consideration of the future

Posttraumatic Stress Disorder: Overview of Evidence-Based Assessment and Treatment

Posttraumatic stress disorder (PTSD) is a chronic psychological disorder that can develop after exposure to a traumatic event. This review summarizes the literature on the epidemiology, assessment, and treatment of PTSD. We provide a review of the characteristics of PTSD along with associated risk factors, and describe brief, evidence-based measures that can be used to screen for PTSD and monitor symptom changes over time. In regard to treatment, we highlight commonly used, evidence-based psychotherapies and pharmacotherapies for PTSD. Among psychotherapeutic approaches, evidence-based approaches include cognitive-behavioral therapies (e.g., Prolonged Exposure and Cognitive Processing Therapy) and Eye Movement Desensitization and Reprocessing. A wide variety of pharmacotherapies have received some level of research support for PTSD symptom alleviation, although selective serotonin reuptake inhibitors have the largest evidence base to date. However, relapse may occur after the discontinuation of pharmacotherapy, whereas PTSD symptoms typically remain stable or continue to improve after completion of evidence-based psychotherapy. After reviewing treatment recommendations, we conclude by describing critical areas for future research

The Moderating Effect of Gender on the Relation Between Expectancies and Gambling Frequency Among College Students

Compared to college females, college males are more likely to report frequent gambling. Research on gambling outcome expectancies has shown that expectations about gambling influence gambling behavior and that endorsement of particular expectancies differs by gender. Knowledge regarding the differential predictive utility of specific gambling expectancies based on gender would help to determine how beliefs about gambling may be fundamentally different for men and women. The present study explored whether gender moderates the relation between gambling expectancy and gambling frequency in a college sample. 421 college students completed an online survey that included questions about their demographics, gambling frequency, and gambling expectancies. Hierarchical regression analyses indicated that gender moderated the relations between the expectancies of social consequences, material gain, and gambling frequency. For females, greater endorsement of social consequences predicted less frequent gambling. For both males and females, greater endorsement of material gain predicted more frequent gambling. The current findings can help inform prevention and intervention efforts by identifying gambling expectations that are differentially related to college student gambling behavior choices