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Alcohol Use and Related Problems among College Students: Implications for Prevention and Treatment. Amelia M. Arria, Ph.D. Kimberly Caldeira, M.S. Kathryn Vincent, M.A. Erin Johnson, B.A. Kevin O’Grady, Ph.D. Eric D. Wish, Ph.D. Center for Substance Abuse Research (CESAR)
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Alcohol Use and Related Problems among College Students: Implications for Prevention and Treatment Amelia M. Arria, Ph.D. Kimberly Caldeira, M.S. Kathryn Vincent, M.A. Erin Johnson, B.A. Kevin O’Grady, Ph.D. Eric D. Wish, Ph.D. Center for Substance Abuse Research (CESAR) University of Maryland For more information, email Dr. Arria at aarria@cesar.umd.edu
Overview Design of the College Life Study (CLS) CLS Measures of Alcohol Use and Suspected Risk Factors Changes in Alcohol Consumption from High School to College Patterns of Consumption in College Alcohol-related problems and dependence Implications for prevention Implications for treatment Future Directions of the College Life Study
The overarching goal of the College Life Study (CLS) is to measure the impact of health-related behaviors, including illicit drug use on student lives — how these behaviors might change a student’s path, or how they might influence choices, opportunities, and experiences over time.
Design of the College Life Study (CLS) • Longitudinal prospective design • Two-stage sampling design • Assessments every six months • Combination of in-person interviews and questionnaires Semi-annual surveys Annual Interviews Screening Prior to College Entry Baseline Interview Six-Month Web-based 12 month Follow-up (1253) 86% of available sampled students ( 897) 72% (1141) 91% (3401) 82% of age-eligible freshmen n Response Rate
How do we measure alcohol consumption? • Age at first opportunity • Age at first drink • Age at first intoxication • Number of Drinks/Day consumed on a drinking day: • (Typical, Minimum, Maximum Drinks and by day using TLFB) • Frequency of Drinking (Past year, past month, and with TLFB) • Other Illicit Substances: Non-medical Use of: • Tobacco Rx Stimulants • Marijuana Rx Analgesics • Inhalants Rx Tranquilizers • Hallucinogens Rx Sedatives • Amphetamines/Methamphetamine, • Cocaine • Heroin • Abuse and Dependence (as measured by DSM-IV) • Other consequences
Lifetime Drug Use and Opportunity to Use, by Substance CLS Baseline Assessment (n=1253 Freshman college students; weighted estimates) 97 100 92 90 Ever Offered 81 80 80 Ever Used 70 60 50 49 50 % of students (weighted) 40 36 34 30 27 23 20 16 13 12 14 14 11 9 10 5 4 5 3 3 3 2 0 Alcohol Tobacco Ecstasy Cocaine Heroin Marijuana Inhalants Rx Stimulants Hallucinogens Rx Analgesics Rx Tranquilizers Amphetamines
Changes in Alcohol Consumption from High School… … to Freshman Year
Alcohol Problems among First-year Students First-Year Class (weighted N = 3,285)
Findings related to Alcohol Dependence • 11% of first-year college students met DSM-IV criteria for alcohol dependence. • We are continuing to follow up these students with respect to their perceived need for treatment and barriers to accessing treatment. • We have preliminary data showing a very strong association between temperament traits and the risk of alcohol dependence, as has been shown in studies of non-college samples.
Preliminary Analyses: A Working Model Family and Social Environment Dependence Anxiety Depression Quantity, Frequency and Duration of Alcohol Use Academic Performance High Risk Sexual Activity Personality Characteristics
Implications for Prevention • Educating about effects of alcohol to raise awareness of • harmfulness and risk for later substance use • Intervening on risk factors that have shown to be involved in the • development of alcohol problems • Increasing parental awareness • Sustaining prevention programming into later years of high school
Future Analyses: Understanding Alcohol in the Context of Developmental Trajectories OUTCOMES (examples) BASELINE CHARACTERISTICS (examples) Academic Performance Graduation? Career? Family? Treatment Utilization? Adverse Health Consequences? Strained Relationships? High School Experiences Family Relationships Experiences with Peers Personality Characteristics Susceptibility to Stress Coping Strategies Academic Goals/Expectations Exposure to the College Environment Cognitive Emotional Development Maturation TIME