Does it really matter that I do not remember my night? Consequences related to blacking out among college student drinkers

Background

Alcohol-induced blackouts (AIBs) are experienced frequently by college student drinkers and are more likely to occur on days with high-intensity drinking (HID; 8+ for females/10+ for males) than non-HID days. Research suggests that AIBs are associated with experiencing other alcohol-related consequences (ARCs), including more serious ARCs (SARCs; e.g., legal and sexual consequences), but we do not know whether individuals experience more ARCs and more SARCs on occasions when they black out than when they do not black out. This study examines the associations between AIBs and the total number of both ARCs and SARCs.

Methods

Students (N = 462, 51.7% female, 87.7% White, M_age = 20.1) were assessed across 6 weekends via e-surveys (80%–97% response rate). Multilevel models were used to test for main effects, controlling for drinking (HID or estimated blood alcohol concentration; eBAC) and sex.

Results

Drinking days when an AIB was experienced were associated with more total ARCs (b = 3.54, 95% CI: 3.10, 3.99) and more SARCs (b = 0.77, 95% CI: 0.60, 0.95) per day than non-AIB days. The more frequently a person experienced an AIB, the more total ARCs (b = 5.33, 95% CI: 4.40, 6.25) and SARCs (1.05, 95% CI: 0.80, 1.30) they reported on average.

Conclusion

Alcohol-induced blackout days were associated with higher levels of harm than non-AIB days, even at the same levels of drinking. Interventions that focus on reducing the occurrence of AIBs and factors that contribute to them, in addition to reducing alcohol consumption, may help reduce total harm associated with drinking among college students.     

A multilevel analysis of change in alcohol consumption in Québec, 1993-98

Aims Changes in drinking are subgroup‐specific and vary by dimensions of drinking pattern. This study investigates changes in drinking patterns between 1993 and 1998 within various subgroups of Québec society. Design A multilevel design was used in which respondents (level 1) were nested within demographic groups (level 2). Participants Based on the 1993 and 1998 Québec Health and Social Surveys, 40 598 respondents (level 1) were nested within 220 groups (level 2) based on age, SES status, gender and the year of survey. Measurements The effect of group characteristics were assessed for various dimensions of drinking pattern. Findings A significant part of the variance in drinking pattern is attributed to group membership (ranging from 8.6% to 18.3%). Except for the frequency of heavy drinking episodes, the data revealed a significant increase between 1993 and 1998 on all drinking pattern dimensions, which was more marked for higher SES groups for current drinking status. However, the frequency of heavy drinking decreased among the lower SES groups and remained stable among the higher SES groups. Conclusions These results call for an increase in public health vigilance in monitoring trends in drinking patterns and their potential acute and chronic consequences.     

Clinician Burden and Depression Treatment: Disentangling Patient- and Clinician-Level Effects of Medical Comorbidity

Background  Efforts to improve primary care depression treatment have assessed strategies across heterogeneous groups of patients, but few have examined clinician-level influences on depression treatment. Objective  To examine clinician characteristics that affect depression treatment in primary care settings, using multilevel ordinal regression modeling to disentangle patient- from clinician-level effects. Design  Secondary analysis from the Quality Improvement in Depression Study dataset. Participants  The participants were 1,023 primary care patients with depression who reported on treatment in the 6-month follow-up and whose clinicians (n = 158) had at least 4 patients in the study. Measurements  Primary outcome variable was depression treatment intensity, derived from assessment of concordance with AHCPR depression treatment guidelines based on patient-reported data on their treatment. Primary independent variable was clinical practice burden for treating depression, derived from patient- and clinician-reported composite measures tested for significant association with clinician-reported practice burden. Results  Clinicians who treat patients with more chronic medical comorbidities perceive less burden from treating depressed patients in their practice (Spearman’s rho = −.30, p < .05). Clinicians who treat patients with more chronic medical comorbidities also provide greater intensity of depression treatment (adjusted OR = 1.44, p = .02), even after adjusting for the effects of patient-level chronic medical comorbidities (adjusted OR = 0.95, p = .45). Conclusions  Clinicians who provide more chronic care also provide greater depression treatment intensity, suggesting that clinicians who care for complex patients can integrate depression care into their practice. Targeting interventions to these clinicians to enhance their ability to provide guideline-concordant depression care is a worthwhile endeavor and deserves further investigation. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Towards the development of laboratory methods for studying drinking games: Initial findings,methodological considerations,and future directions

Background: Drinking games are prevalent among college students and are associated with increased alcohol use and negative alcohol-related consequences. There has been substantial growth in research on drinking games. However, the majority of published studies rely on retrospective self-reports of behavior and very few studies have made use of laboratory procedures to systematically observe drinking game behavior. Objectives: The current paper draws on the authors’ experiences designing and implementing methods for the study of drinking games in the laboratory. Results: The paper addressed the following key design features: (a) drinking game selection; (b) beverage selection; (c) standardizing game play; (d) selection of dependent and independent variables; and (e) creating a realistic drinking game environment. Conclusions: The goal of this methodological review paper is to encourage other researchers to pursue laboratory research on drinking game behavior. Use of laboratory-based methodologies will facilitate a better understanding of the dynamics of risky drinking and inform prevention and intervention efforts.     

“Seems I’m not alone at being alone:” Contributing factors and interventions for drinking games in the college setting

Alcohol use among college students is prevalent and sometimes takes the form of drinking games, in which players are required to drink in accordance with a set of pre-defined rules. Drinking games are typically associated with elevated alcohol consumption and risk to the individual. This perspective piece considers the potential role of social anxiety in motivating participation in drinking games, perceived norms surrounding drinking games (including ways they are portrayed and discussed in popular media), and the role of competitiveness. Implications for skills training-based prevention and intervention efforts are discussed.