The Relationship Between Social Anxiety and Alcohol and Marijuana Use Outcomes Among Concurrent Users: A Motivational Model of Substance Use

Background: College students with more social anxiety symptoms are particularly vulnerable to problematic alcohol and marijuana use given their susceptibility for elevated anxiety symptoms in social settings combined with the normative nature of substance use. Existing research has established substance use as coping motivated for these students when examining alcohol and marijuana use problems separately. The next step is to determine whether students with more social anxiety who use both substances do so for similar or different reasons. The current study tested a comprehensive (i.e., all variables in the same model) motivational model of alcohol/marijuana use in a sample of college students from 10 universities across the United States who endorsed both past-month alcohol and marijuana use. Methods: College students were recruited through psychology department participant pools and completed an online survey assessing mental health symptoms, substance use motives, and substances use behaviors. Current sample comprised concurrent alcohol/marijuana users (n = 2,034), 29.6% of whom endorsed clinically indicated levels of social anxiety and nearly one-fourth exceeded the cutoff for hazardous drinking (23.2%) and hazardous marijuana use (21.9%). Results: Across both substances, coping motives significantly mediated the positive relationship between social anxiety symptoms and substance use problems. Unique to alcohol, conformity motives mediated the association between social anxiety symptoms and alcohol-related problems. Conclusions: Taken together, students with more social anxiety who are focused on anxiety management may use either alcohol or marijuana; however, these students may experience more alcohol-related problems when drinking to fit in with peers

College Student Mental Health: An Evaluation of the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure

© 2018 American Psychological Association. The DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure was developed to aid in clinical decision-making for clients seeking psychiatric services and to facilitate empirical investigation of the dimensional nature of mental health issues. Preliminary evidence supports its utility with clinical samples. However, the brief, yet comprehensive structure of the DSM-5 Level 1 measure may benefit a high-risk population that is less likely to seek treatment. College students have high rates of hazardous substance use and co-occurring mental health symptoms, yet rarely seek treatment. Therefore, the current study evaluated the psychometric properties (i.e., construct and criterion-related validity) of the DSM-5 Level 1 measure with a large, diverse sample of non-treatment-seeking college/university students. Data from 7,217 college students recruited from 10 universities in 10 different states across the United States evidenced psychometric validation of the DSM-5 Level 1 measure. Specifically, we found acceptable internal consistency across multi-item DSM-5 domains and moderate to strong correlations among domains (internal validity). Further, several DSM-5 domains were positively associated with longer, validated measures of the same mental health construct and had similar strengths of associations with substance use outcomes compared to longer measures of the same construct (convergent validity). Finally, all DSM-5 domains were negatively associated with self-esteem and positively associated with other theoretically relevant constructs, such as posttraumatic stress (criterion-related validity). Taken together, the DSM-5 Level 1 measure appears to be a viable tool for evaluating psychopathology in college students. Several opportunities for clinical application and empirical investigation of the DSM-5 Level 1 measure are discussed

A Latent Profile Analysis of Social Anxiety and Alcohol Use Among College Students

Background The social, normative nature of alcohol use may make college students with social anxiety vulnerable to problematic alcohol use. Yet, social anxiety is typically unrelated to drinking quantity or frequency. One potential explanation is that researchers primarily use a variable-centered approach to examine alcohol use among students with social anxiety, which assumes population homogeneity. Methods The current study utilized a person-centered approach to identify distinct classes among 674 college students (69.6% female) based on social anxiety characteristics and alcohol use behaviors, and tested how these classes differed in their experience of adverse outcomes. Results Latent profile analysis resulted in six distinct classes of students – two classes with low levels of social anxiety and non-problematic drinking behaviors that differed based on frequency of alcohol use, three classes with moderate levels of social anxiety that differed based on quantity, frequency, and extent of problematic drinking behaviors, and one class with high levels of social anxiety and low, frequent problematic drinking behaviors. Two classes – moderate levels of social anxiety and heavy, problematic drinking behaviors or high levels of social anxiety and light, problematic drinking behaviors – appeared to have riskier profiles due to endorsing more social anxiety-specific beliefs about social impressions while drinking and more emotional distress. Conclusions Current findings offer clarity surrounding the role of alcohol use in the association between social anxiety and problematic alcohol use. Although preliminary, findings demonstrate that comorbid social anxiety and alcohol use disorder symptoms appear to place students at greater risk for adverse outcomes

The Integration of Science and Practice: Unique Perspectives From Counseling Psychology Students

Counseling psychology training programs predominately subscribe to the scientist–practitioner training model, which emphasizes the mutual integration of science and practice. There has been extensive debate surrounding the applicability of the scientist–practitioner training model to the field of counseling psychology, and existing commentary from both trainers and trainees has documented the potential challenges to adequately integrating science and practice. In the current article, three counseling psychology doctoral students outline their experiences in a program that adheres to the scientist–practitioner training model. In particular, they describe their involvement in both clinical and scholarly related activities, their experiences with the integration of science and practice, and how the scientist–practitioner model has influenced their overall professional development. Specific examples of how the scientist–practitioner model can shape the perspectives and career goals of psychologists-in-training are reviewed

Examining the Role of Positive Drinking Consequences On the Relationship Between Social Anxiety and Negative Drinking Consequences

Positive drinking consequences are gaining more attention in the college student drinking literature due to their degree of saliency in predicting hazardous drinking. However, the research is limited on the relationship between psychological constructs, such as social anxiety, and positive drinking consequences. The current study explored the moderating role of positive drinking consequences on the relationship between social anxiety and negative drinking consequences in a sample of hazardous drinking college students. A sample of 222 hazardous drinking undergraduate students completed measures of social anxiety and positive and negative drinking consequences. As predicted, social anxiety and positive consequences were positively related to negative consequences. Contrary to our predictions, interaction results revealed that students with more social anxiety reported more negative consequences when they reported fewer rather than more positive consequences. Thus, students with more social anxiety may not obtain the social benefits from drinking, which appears to be contributing to their experience of negative drinking consequences. Briefly, alcohol intervention clinicians should consider how to incorporate discussions of positive drinking consequences for these students to facilitate ways to foster social engagement while minimizing alcohol-related harm

Are There Social Benefits? Exploring the Role of Positive Consequences in the Relationship Between Social Anxiety Symptoms and Negative Drinking Consequences

Research has shown that college students with social anxiety experience more alcohol-related negative consequences, regardless of the amount of alcohol they consume. To better understand this relationship, it is important to examine social anxiety as a multidimensional construct, as well as explore the positive outcomes these students experience from drinking. The current study sought to examine the impact of positive drinking consequences on the relationship between behavioral (i.e. interaction and performance-type) and cognitive (i.e. fear of negative evaluation) social anxiety symptoms and alcohol-related negative consequences. Participants were 544 traditional age college students who reported consuming alcohol in the past month and completed measures of social anxiety symptoms, positive drinking consequences, and alcohol-related negative consequences. Positive drinking consequences moderated the relationship between social anxiety and alcohol-related negative consequences, such that students with more fear of negative evaluation and that experienced more positive drinking consequences reported more negative drinking consequences. Future directions and implications are discussed

Evaluating the Validity of the Client Evaluation of Motivational Interviewing Scale in a Brief Motivational Intervention for College Student Drinkers

The Client Evaluation of Motivational Interviewing scale (CEMI) is a measure for assessing client perceptions of clinicians\u27 use of motivational interviewing (MI). This study explored the factorial, convergent and predictive validity of the CEMI with a sample of 137 college students who completed a brief motivational intervention for alcohol harm reduction. A two factor structure was confirmed, supporting previous findings of relational and technical subscales. The CEMI technical subscale partially mediated an increase in readiness to change drinking, while the relational subscale did not. Higher scores on CEMI technical subscale predicted higher scores on the tasks, bond and goals subscales of the Working Alliance Inventory while higher scores on the CEMI relationship subscale predicted an increase in the goals subscale. Finally, the correlations between the CEMI subscales and observer-rated MI spirit score and MI adherent and non-adherent behavioral counts were in the expected directions but did not reach statistical significance. Further revision and evaluation of the CEMI is recommended. Clinical, training and research implications are provided

Depressive Symptoms and Drinking Outcomes: The Mediating Role of Drinking Motives and Protective Behavioral Strategies Among College Students

Background: College students with depressive symptoms tend to engage in more hazardous drinking and experience more alcohol-related consequences to cope with their symptoms. Given the perceived tension reducing effects of alcohol among these students, it is important to explore how protective factors, such as protective behavioral strategies, account for the relationships among depressive symptoms, drinking motives, and alcohol-related outcomes. Objective: To examine the mediating role of drinking motives and protective behavioral strategies on the associations that depressive symptoms have with typical weekly alcohol consumption, hazardous drinking, and alcohol-related negative consequences in a sample of college student drinkers. Methods: Traditional age college students (n = 566, 73% women; 58% White, non-Hispanic) completed measures of depression, drinking motives, protective behavioral strategies, weekly alcohol use, hazardous drinking, and alcohol-related negative consequences. Results: Coping with depression motives and controlled consumption PBS explained the association between depression and weekly alcohol consumption and hazardous drinking whereas coping with depression motives and serious harm reduction PBS explained the depression-negative consequences relationship. Conformity motives and serious harm reduction PBS explained the association between depression and hazardous drinking and alcohol-related negative consequences. Conclusions: Findings suggest that students with more depressive symptoms would benefit from clinical interventions tailored to address negative reinforcement drinking motives and, by extension, increase student utilization of PBS related to minimizing harm. Clinical and research implications are provided

Thinking While Drinking: Fear of Negative Evaluation Predicts Drinking Behaviors of Students With Social Anxiety

College students with social anxiety disorder experience more alcohol-related negative consequences, regardless of the amount of alcohol they consume. Social anxiety refers to psychological distress and physiological arousal in social situations due to an excessive fear of negative evaluation by others. The current study examined within-group differences in alcohol-related negative consequences of students who met or exceeded clinically-indicated social anxiety symptoms. In particular, we tested a sequential mediation model of the cognitive (i.e., fear of negative evaluation) and behavioral (protective behavioral strategies) mechanisms for the link between social anxiety disorder subtypes (i.e., interaction and performance-type) and alcohol-related negative consequences. Participants were 412 traditional-age college student drinkers who met or exceeded the clinically-indicated threshold for social anxiety disorder and completed measures of fear of negative evaluation, protective behavioral strategies (controlled consumption and serious harm reduction), and alcohol-related negative consequences. Fear of negative evaluation and serious harm reduction strategies sequentially accounted for the relationship between interaction social anxiety disorder and alcohol-related negative consequences, such that students with more severe interaction social anxiety symptoms reported more fear of negative evaluation, which was related to more serious harm reduction strategies, which predicted fewer alcohol-related negative consequences. Future directions and implications are discussed

Drinking Motives and Alcohol Use Behaviors Among African American College Students: The Mediating Role of Protective Behavioral Strategies

Drinking motives are robust predictors of alcohol use behaviors among college students. However, less is known about the link between drinking motives and alcohol use behaviors among African American college students. This study explored the associations between drinking motives and alcohol use behaviors in a sample of 215 African American college students. The study also assessed whether protective behavioral strategies mediated the associations between drinking motives and alcohol use behaviors. A direct relationship emerged between enhancement motives and alcohol consumption, harmful drinking and alcohol-related negative consequences. Protective behavioral strategies mediated each of these relationships. Clinical and research implications are discussed