Modafinil Modulates Resting-State Functional Network Connectivity and Cognitive Control in Alcohol-Dependent Patients

Chronic alcohol abuse is associated with deficits in cognitive control functions. Cognitive control is likely to be mediated through the interaction between intrinsic large-scale brain networks involved in externally oriented executive functioning and internally focused thought processing. Improving the interaction between these functional brain networks could be an important target for treatment.

Therefore, the current study aimed to investigate the effects of the cognitive enhancer modafinil on within-network and between-network resting-state functional connectivity and cognitive control functions in alcohol-dependent patients.

In a double-blind, placebo-controlled cross-over design, resting-state functional magnetic resonance imaging and a Stroop task were employed in alcohol-dependent patients (n = 15) and healthy control subjects (n = 16). Within-network and between-network functional connectivity was calculated using a combination of independent component analysis and functional network connectivity analysis.

Modafinil significantly increased the negative coupling between executive networks and the default mode network, which was associated with modafinil-induced improvement in cognitive control in alcohol-dependent patients.

These findings demonstrate that modafinil at least partly exerts its effects by targeting intrinsic functional relationships between large-scale brain systems underlying cognitive control. The current study therefore provides a neurobiological rationale for implementing modafinil as an adjunct in the treatment of alcohol dependence, although clinical studies are needed to substantiate this promise.


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This is the Southern African Alcohol Policy Alliance

In November 2012, delegates from civil society organisations working in various capacities on alcohol met in Johannesburg to build a platform for collaboration on alcohol-related issues. The delegates represented civil society organizations from seven countries in the region, as well as NGOs from Kenya, Sierra Leone, Sweden and Norway.

The Forum allowed delegates to exchange experiences from policy and prevention work and to discuss a closer regional collaboration. These discussions led to the formation of the Southern African Alcohol Policy Alliance, which is affiliated to the Global Alcohol Policy Alliance (GAPA).    > > > >  Read More

Interoceptive Awareness, Tension Reduction Expectancies and Self-Reported Drinking Behavior

Recent accounts have suggested the involvement of interoceptive processes in consumption behavior for alcohol and other drugs. However, there is a paucity of empirical support for a direct association with physiologically assessed individual differences in interoceptive awareness (IA). The current research explored this postulated link and examined the interplay with positive outcome expectancies of alcohol consumption.

IA of alcohol-dependent adult in- and outpatients was measured with an objective electrocardiogram heart rate tracking task. Tension reduction expectancies (TRE) and drinking compulsions/obsessions were assessed with self-report questionnaires.

No direct associations of IA with drinking compulsions/obsessions were found. However, IA and TRE interacted as predictors of drinking compulsions and drinking obsessions.

The results corroborate the suggestion that neglect of bodily feedback might be a maintaining factor for drinking behavior.          



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Editorial - What neuroimaging has and has not yet added to our

 

 

Neuroscientists have collected valuable information on neurofunctional and neurostructural characteristics accompanying addiction. This editorial argues for three
prerequisites to making neuroimaging practically relevant for addiction medicine: the integration of imaging findings, the identification of concrete neuroimaging risk factors for the individual and the ability to inform the development of treatment regimens.


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Characteristics, circumstances and toxicology of sudden or unnatural deaths involving very high range alcohol concentrations

To characterise sudden or unnatural deaths with very high range blood alcohol concentrations (BACs) presenting to the Department of Forensic Medicine (DOFM) in Sydney between 1/1/1997-31/12/2011.

 

Case series.

 

Sydney, Australia.

 

263 cases of sudden or unnatural death with a BAC of ≥0.300g/100ml.

 

Case characteristics, circumstances of death, quantitative toxicology, major autopsy findings and serology.

 

The mean age of decedents was 46.7 yrs and 74.5% were male. Pre-existing alcohol problems were noted in 78.7%. Deaths were due to alcohol toxicity/chronic alcoholism (34.6%), combined alcohol/other drug toxicity (14.8%), accidents (18.7%), natural disease (13.4%), suicide (11.0%), homicide (6.9%) and one case was undetermined. Alcohol was a direct, or contributory, cause of death in 84.4% of cases. The overwhelming majority (81.4%) occurred in a home environment, and deaths did not vary by day or month. The mean BAC was 0.371g/100ml (range 0.300-0.820g/100ml), being highest in alcohol toxicity/chronic alcoholism cases (0.410g/100ml). The most frequently detected substances, other than alcohol, were benzodiazepines (31.9%) and opioids (12.9%). Alcohol-related disease was diagnosed in 62.9% of cases. Alcohol-related pathology was prevalent across all categories of death: severe steatosis (35.3%), cirrhosis (22.5%), chronic pancreatitis (15.3%), cardiomyopathy (9.4%), cerebellar atrophy (9.0%).

 

Unnatural deaths with very high range alcohol concentrations extend well beyond direct toxicity, and alcohol is causal in most cases. Those at greatest risk are middle aged males, with long histories of alcohol problems.


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Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism and its implication in executive functions in adult offspring of alcohol-dependent probands

Impairment of executive functions (EFs) mediated by the prefrontal lobe is regarded as a cognitive endophenotype of alcohol dependence, being observed both in probands and in healthy offspring. Given its impact on the anatomy of the prefrontal cortex, the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism may well be involved in this specific endophenotype.

Forty-six healthy adult children of alcoholics (HACA) and 82 healthy controls (HC) took part in the study. All the participants were assessed with the Diagnostic Interview for Genetic Studies, and their family histories of alcohol and substance use were assessed with the Family Informant Schedule and Criteria. The Trail Making Test, Arithmetic Switching Task, Stroop Color-Word Test and Wisconsin Card Sorting Test were administered to assess EFs. An overall executive factor score was calculated using factorial analyses. Genotyping of the BDNF Val66Met polymorphism was performed using the TaqMan^® allelic discrimination assay.

HACA had significantly lower EFs performance than HC. Genetic analysis showed that BDNF genotype distributions were in Hardy–Weinberg equilibrium in the HACA and HC. Genotype and allele distributions did not differ significantly between the two groups. Participants with the Met allele performed significantly more poorly than participants with the Val allele, and a group by allele interaction was observed, the BDNF Met allele being associated with a poorer executive factor score in the HACA group.

These results suggest that the BDNF Val66Met polymorphism may contribute to alcohol dependence vulnerability via lower EFs performance.


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Extending the Treatment Options in Alcohol Dependence: A Randomized Controlled Study of As-Needed Nalmefene

There is a large treatment gap in alcohol dependence, and current treatments are only moderately effective in preventing relapse. New treatment modalities, allowing for reduction of alcohol consumption as a treatment goal are needed. This study evaluated the efficacy of as-needed use of the opioid system modulator nalmefene in reducing alcohol consumption in patients with alcohol dependence.

Six hundred and four patients (placebo = 298; nalmefene = 306),≥18 years of age, with a diagnosis of alcohol dependence,≥6 heavy drinking days, and average alcohol consumption≥World Health Organization medium drinking risk level in the 4 weeks preceding screening, were randomized (1:1) to 24 weeks of as-needed placebo or nalmefene 18 mg.

Patients taking placebo (n = 289) and patients taking nalmefene (n = 290) were included in the efficacy analyses. At Month 6, there was a significant effect of nalmefene compared with placebo in reducing the number of heavy drinking days (−2.3 days [95% confidence interval:−3.8 to−.8]; p = .0021) and total alcohol consumption (−11.0 g/day [95% confidence interval:−16.8 to−5.1]; p = .0003). Improvements in Clinical Global Impression and liver enzymes were larger in the nalmefene group compared with placebo at Week 24. Adverse events (most mild or moderate) and dropouts due to adverse events were more common with nalmefene than placebo. The number of patients with serious adverse events was similar in the two groups.

Nalmefene provides clinical benefit, constitutes a potential new pharmacological treatment paradigm in terms of the treatment goal and dosing regimen, and provides a method to address the unmet medical need in patients with alcohol dependence that need to reduce their alcohol consumption.


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Request Reprint E-Mail:     karl.mann@zi-mannheim.de

Using Public Health and Community Partnerships to Reduce Density of Alcohol Outlets

Excessive alcohol use causes approximately 80,000 deaths in the United States each year. The Guide to Community Preventive Services recommends reducing the density of alcohol outlets — the number of physical locations in which alcoholic beverages are available for purchase either per area or per population — through the use of regulatory authority as an effective strategy for reducing excessive alcohol consumption and related harms.

We briefly review the research on density of alcohol outlets and public health and describe the powers localities have to influence alcohol outlet density. We summarize Regulating Alcohol Outlet Density: An Action Guide, which describes steps that local communities can take to reduce outlet density and the key competencies and resources of state and local health departments. These include expertise in public health surveillance and evaluation methods, identification and tracking of outcome measures, geographic information systems (GIS) mapping, community planning and development of multisector efforts, and education of community leaders and policy makers. We illustrate the potential for partnerships between public health agencies and local communities by presenting a contemporary case study from Omaha, Nebraska.
Public health agencies have a vital and necessary role to play in efforts to reduce alcohol outlet density. They are often unaware of the potential of this strategy and have strong potential partners in the thousands of community coalitions nationwide that are focused on reducing alcohol-related problems.


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Effects of naltrexone plus topiramate on ethanol self-administration and tyrosine hydroxylase gene expression changes

The purpose of this study was to evaluate the effects of naltrexone (0.7 mg/kg) and/or topiramate (25 mg/kg) on ethanol consumption and the motivation to drink in an oral-operant conditioning paradigm in C57BL/6 mice. Subsequent real-time polymerase chain reaction (PCR) experiments were performed to analyze gene expression changes in tyrosine hydroxylase (TH) in the ventral tegmental area (VTA).

The administration of naltrexone significantly reduced ethanol consumption and the motivation to drink during the different stages of the experiment, whereas the treatment with topiramate resulted in a much lower effect. Interestingly, the administration of naltrexone plus topiramate reduced ethanol consumption markedly compared with single-drug treatment.

The water self-administration paradigm was also performed using the same drugs and no differences were found between treatment groups. Real-time PCR analyses revealed that naltrexone significantly normalized the increase of TH gene expression in the VTA induced by ethanol, whereas the administration of topiramate did not produce any significant effect. In the ethanol self-administration procedure, the combination of both drugs further reduced TH gene expression, reaching statistical significance compared with the vehicle, naltrexone or topiramate groups.

Taken together, these findings indicate that the administration of naltrexone plus topiramate further reduced ethanol consumption and the motivation to drink in comparison with single-drug treatment. This action may be due, at least in part, to a greater decrease in TH gene expression in the VTA.

These results suggest that the combination of both drugs deserves further exploration for the treatment of problems related to alcohol consumption.


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An infernal spark: drink, addiction and disease

Our Research Manager, James Nicholls, recently gave a public lecture at the Museum of London on the history of alcohol and addiction in the UK. The full presentation (45 minutes) can now be viewed here.

Peri-Adolescent Ethanol Vapor Exposure Produces Reductions in Hippocampal Volume that are Correlated with Deficits in Prepulse Inhibition of the Startle

Epidemiological studies suggest that excessive alcohol consumption is prevalent among adolescents and may have lasting neurobehavioral consequences. The use of animal models allows for the separation of the effects of adolescent ethanol (EtOH) exposure from genetic background and other environmental insults. In this study, the effects of moderate EtOH vapor exposure, during adolescence, on structural diffusion tensor imaging (DTI) and behavioral measures were evaluated in adulthood.

 

A total of 53 Wistar rats were received at postnatal day (PD) 21 and were randomly assigned to EtOH vapor (14 hours on/10 hours off/day) or air exposure for 35 days from PD 23 to 58 (average blood ethanol concentration: 169 mg%). Animals were received in 2 groups that were subsequently sacrificed at 2 time points following withdrawal from EtOH vapor: (i) at 72 days of age, 2 weeks following withdrawal or (ii) at day 128, 10 weeks following withdrawal. In the second group, behavior in the light/dark box and prepulse inhibition (PPI) of the startle was also evaluated. Fifteen animals in each group were scanned, postmortem, for structural DTI.

 

There were no significant differences in body weight between EtOH and control animals. Volumetric data demonstrated that total brain, hippocampal, corpus callosum but not ventricular volume were significantly larger in the 128-day-sacrificed animals as compared to the 72 day animals. The hippocampus was smaller and the ventricles larger at 128 days as compared to 72 days, in the EtOH-exposed animals, leading to a significant group × time effect. EtOH-exposed animals sacrificed at 128 days also had diminished PPI, and more rears in the light box were significantly correlated with hippocampal size.

 

These studies demonstrate that DTI volumetric measures of hippocampus are significantly impacted by age and peri-adolescent EtOH exposure and withdrawal in Wistar rats.


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Request Reprint E-Mail:     cindye@scripps.edu

Multidimensionality in Impulsivity and Alcohol Use: A Meta-Analysis Using the UPPS Model of Impulsivity

Although there is considerable support for the relationship between impulsivity and alcohol use, the use of multidimensional conceptualizations of impulsivity and alcohol use has lead to varying relationship sizes across studies. The aims of the current meta-analysis are to (i) examine variability in the magnitude of the bivariate relationship between impulsivity and alcohol use across studies and (ii) describe the pattern of effects between specific impulsivity traits and alcohol use variables, using the UPPS model of impulsivity.

Ninety-six studies were meta-analyzed using a random effects model to examine the relationship between general impulsivity and alcohol use, as well as the relationships among separate impulsivity traits based in the UPPS model of impulsivity and specific alcohol use outcomes.

 

Results indicate that, in general, impulsivity and alcohol use are related (r = 0.28); however, this effect size varied significantly across studies (from −0.05 to 1.02). Drinking quantity was most strongly predicted by lack of perseverance (r = 0.32), whereas all traits equally predicted drinking frequency. Drinking problems were most highly related to negative (r = 0.35) and positive (r = 0.34) urgency, and alcohol dependence was most highly related to negative urgency (r = 0.38) and lack of planning (r = 0.37).

 

Effect sizes between impulsivity and alcohol use vary significantly by UPPS trait used in each study; thus, findings suggest and further reinforce the view in the literature that specific impulsivity-related constructs differentially relate to specific alcohol use outcomes.


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Request Reprint E-Mail:     mcyders@iupui.edu
 

Mice Bred for Severity of Acute Alcohol Withdrawal Respond Differently in a Go/No-Go Task

Mice selectively bred for high or low withdrawal to acute alcohol differ on a number of traits, including consumption of alcohol, conditioned place preference for alcohol, and sensitivity to alcohol-induced locomotor activity. One trait that has not been examined in these mice is behavioral inhibition.

 

High and low alcohol withdrawal mice (second replicate: high and low acute alcohol withdrawal [HAW-2/LAW-2]) were trained and tested in a Go/No-go task. Mice were administered 0.0, 0.5, 1.0, and 1.5 g/kg ethanol (EtOH) on 3 occasions according to an incomplete Latin Square. A separate cohort of C57BL/6J (B6) and DBA/2J (D2) mice (the progenitor strains for HAW-2/LAW-2 mice) underwent the same protocol, using the same EtOH doses.

 

HAW-2 and LAW-2 mice did not differ in behavioral inhibition at baseline, although LAW-2 mice did have higher overall levels of responding in the task. EtOH did not alter behavioral inhibition in these mice. However, it did decrease responses to the Go cue, and this effect was greater in HAW-2 mice than in LAW-2 mice. D2 mice had lower behavioral inhibition than B6 mice at baseline, and EtOH slightly decreased behavioral inhibition in both strains.

 

The findings with D2 and B6 mice generally fit with the existing literature. However, the lack of a difference in behavioral inhibition between HAW-2 and LAW-2 mice was unexpected, as well as the absence of any effect of these doses of EtOH on behavioral inhibition in these mice. Nonetheless, the findings do suggest that selectively breeding for high or low withdrawal to acute alcohol can lead to differences in operant behavior in the Go/No-go task.


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Request Reprint E-Mail:    mitchesu@ohsu.edu

Utility of established cardiovascular disease risk score models for the 10-year prediction of disease outcomes in women

 

Cardiovascular disease (CVD) is a major cause of mortality globally. In absolute numbers, more women die from CVD than men do. CVD mortality risk differs between genders, reflecting the different distribution of modifiable risk factors and severity of CVD outcomes.

This study reviews six established risk score models and their applicability to the female population. These models are assessed against two criteria: discrimination and calibration. Sensitivity, specificity and positive- and negative-predictive values are also examined.

The risk score models are found to be limited in applicability, requiring recalibration beyond their study population.

Relevant risk factors to predict CVD mortality for women, such as measures of obesity, physical activity, alcohol consumption, use of antihypertensive medication, chronic kidney disease and coronary artery calcium are generally not incorporated in these models.


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Request Reprint E-Mail:   P.Della@curtin.edu.au

Liver Transplantation in Alcoholic Patients: Impact of an Alcohol Addiction Unit Within a Liver Transplant Center

Many concerns about liver transplantation in alcoholic patients are related to the risk of alcohol recidivism. Starting from 2002, an Alcohol Addiction Unit (AAU) was formed within the liver transplant center for the management of alcoholic patients affected by end-stage liver disease and included in the waiting list for transplantation. We evaluated retrospectively the impact of the AAU on alcohol recidivism after transplantation. The relationship between alcohol recidivism and the duration of alcohol abstinence before transplant was evaluated as well.

 

Between 1995 and 2010, 92 cirrhotic alcoholic patients underwent liver transplantation. Clinical evaluation and management of alcohol use in these patients was provided by psychiatrists with expertise in addiction medicine not affiliated to the liver transplant center before 2002; group A), or by the clinical staff of the AAU within the liver transplant center starting from 2002 .

 

Group B, as compared with group A, showed a significantly lower prevalence of alcohol recidivism  and a significantly lower mortality  Furthermore, an analysis of group B patients with either greater than 6 or less than 6 months of alcohol abstinence before transplantation showed no difference in the rate of alcohol recidivism. 

 

The presence of an AAU within a liver transplant center reduces the risk of alcohol recidivism after transplantation. A pretransplant abstinence period greater than 6 months might be considered, at least in selected patients managed by an AAU.


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Request Reprint E-Mail:    g.addolorato@rm.unicatt.it

Alcohol Tax Policy in Relation to Hospitalization from Alcohol-Attributed Diseases in Taiwan: A Nationwide Population Analysis of Data from 1996 to 2010

The effects of alcohol taxes and prices on drinking and mortality are well established, but the effects of alcohol taxes on measures of alcohol-related morbidity from noninjury health outcomes have not been fully elucidated. We assess the 2 opposing effects of alcohol tax policy interventions (tax rate increase in 2002 and decrease in 2009) on alcohol-attributed diseases (AADs) in Taiwan.

Admissions data from 1996 to 2010 were retrieved from the National Health Insurance Research Database (NHIRD) claims file and analyzed in this study. Data on 430,388 men and 34,874 women aged 15 or above who had an admission due to an AAD were collected. An interrupted time series analysis examining the effects of the implementation of alcohol tax policy on quarterly age- and sex-specific incidence rates of hospitalization for AADs was employed. The same method was also used to analyze hospitalizations for alcoholic liver disease.

The teen/adult groups all showed significant (p < 0.05) changes in the adjusted incidence rate of hospitalization (AIRH) for AADs and alcoholic liver disease in 2002. Men aged 15 to 64 years showed an abrupt decline in the rate of AADs (9.1%) and in the rate of alcoholic liver disease (10.3%). A 16% reduction in the AAD rate was found in teen/adult women after the alcohol tax increase. In contrast, a 17.4% increase in the same rate was seen in the first quarter of 2010 for this group. A similar pattern was presented for the AIRH for alcoholic liver disease among women. The effect of tax intervention was not significant among the elderly.

This study provides evidence that alcohol taxation in
response to international trade liberalization has resulted in an immediate reduction of AADs in Taiwan. The policy of increasing alcohol tax rates may have favorable influences on the time trend for the rate of AADs, most notably among young and middle-aged men and women.

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Request Reprint E-Mail:  cmlin@mail.mcu.edu.tw

Long-term ethanol exposure-induced hepatocellular carcinoma cell migration and invasion through lysyl oxidase activation are attenuated by combined treatment with pterostilbene and curcumin analogs

Ethanol consumption induces hepatocellular carcinoma (HCC) cell metastasis by changing the extracellular matrix (ECM). Lysyl oxidase (LOX) catalyzes the cross-linkage of collagen or elastin in the ECM.

LOX protein and mRNA overexpression (>21-fold compared with controls, n=6) was detected in cirrhotic HCC patients with a history of alcoholism. LOX protein expression was induced in HCC cells after long-term treatment with ethanol (10 mM) for 20 to 40 passages (denoted as E20-E40 cells). Pterostilbene (PSB, 1 υM) displayed significant potency to reduce LOX-mediated activity in E40 cells when combined with curcumin and its analogs. The ability of E40 cells to form colonies in soft agar was reduced by both genetic depletion of LOX and by chemical inhibitors of LOX expression.
This study suggests that targeting LOX expression with food components such as PSB and curcumin may be a novel strategy to overcome ethanol-induced HCC cell metastasis in liver cancer patients.


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Request Reprint E-Mail:   hoyuansn@tmu.edu.tw

Chronic tolerance to ethanol-induced sedation: Implication for age-related differences in locomotor sensitization

The adolescent brain has been suggested to be particularly sensitive to ethanol-induced neuroadaptations, which in turn could increase the risk of youths for alcohol abuse and dependence. Sensitization to the locomotor stimulant effects of ethanol has often been used as an animal model of ethanol-induced neuroadaptations. Previously, we showed that young mice were more sensitive than adults to the locomotor sensitization induced by high ethanol doses. However, this effect could be due to age-related differences in chronic tolerance to the sedative effects of ethanol.

The aim of the present study is to assess chronic tolerance to the sedative effects of ethanol in weaning 21-day-old (P21), adolescent 35-day-old (P35) and adult 63-day-old (P63) female Swiss mice.

After a daily injection of saline or 4 g/kg ethanol during 6 consecutive days, all P21, P35 and P63 mice were injected with 4 g/kg ethanol and submitted to the loss of righting reflex procedure.

Our results confirm that the sensitivity to the acute sedative effects of ethanol gradually increases with age. Although this schedule of ethanol injections induces significant age-related differences in ethanol sensitization, it did not reveal significant differences between P21, P35 and P63 mice in the development of a chronic ethanol tolerance to its sedative effects.
The present results show that age-related differences in the development of ethanol sensitization cannot be explained by differences in chronic ethanol tolerance to its sedative effects. More broadly, they do not support the idea that ethanol-induced sensitization is a by-product of chronic ethanol tolerance.


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Request Reprint E-Mail:    equertemont@ulg.ac.be

Diffusion Tensor Imaging Correlates of Saccadic Reaction Time in Children with Fetal Alcohol Spectrum Disorder

Eye movement tasks provide a simple method for inferring structural or functional brain deficits in neurodevelopmental disorders. Oculomotor control is impaired in children with fetal alcohol spectrum disorder (FASD), yet the neuroanatomical substrates underlying this are not known. Regions of white matter have been shown by diffusion tensor imaging (DTI) to be different in FASD and thus may play a role in the delayed saccadic eye movements. The objective of this study was to correlate oculomotor performance with regional measures of DTI-derived white matter anisotropy in children with FASD.

 

Fourteen children (8 to 13 years) with FASD were recruited for oculomotor assessment and DTI. Eye movement control was evaluated using the pro- and antisaccade tasks, in which subjects look at (prosaccade) or away from (antisaccade) a peripheral target. Saccadic reaction time (SRT; time for subjects to move their eyes after the target appears) and direction errors (saccades made in the incorrect direction relative to the instruction) were measured and correlated to fractional anisotropy (FA) on a voxel-by-voxel basis across the whole brain white matter.

 

A significant positive correlation was observed between antisaccade SRT and FA in a large cluster containing anterior and posterior sections of the corpus callosum just to the right of the midline; prosaccade SRT and FA correlated positively in the genu of the corpus callosum and the right inferior longitudinal fasciculus (ILF), and correlated negatively in the left cerebellum.

 

The negative correlation for prosaccade SRT and cerebellum demonstrated that individuals with slower reaction times had lower FA values relative to their faster responding counterparts, a finding that implicates cerebellar dysfunction as a significant contributor to deficits in oculomotor control. The higher FA in the corpus callosum and ILF corresponding to longer reaction times for both pro- and antisaccade was opposite to what was expected, but nonetheless implies that altered brain structure in these regions underlies deficits in oculomotor control.


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Request Reprint E-Mail:    jnr@queensu.ca

Moderation of a Parent-Based Intervention on Transitions in Drinking: Examining the Role of Normative Perceptions and Attitudes Among High- and Low-Risk First-Year College Students

Parent-based interventions (PBIs) are an effective strategy to reduce problematic drinking among first-year college students. The current study examined the extent to which student-based characteristics, derived from the Theory of Planned Behavior, moderated 3 PBI conditions: (i) prior to college matriculation (PCM); (ii) PCM with a booster during the fall semester; and (iii) after college matriculation. The moderator variables included injunctive and descriptive peer norms about alcohol use and attitudes toward alcohol use.

 

Using data from a randomized control trial delivered to 1,900 incoming college students, we examined differential treatment effects within 4 types of baseline student drinkers: (i) nondrinkers; (ii) weekend light drinkers (WLD); (iii) weekend heavy episodic drinkers; and (iv) heavy drinkers. The outcome variable was based on the transitions in drinking that occurred between the summer prior to college enrollment and the end of the first fall semester and distinguished between students who transitioned to 1 of the 2 risky drinking classes.

 

The results indicated that injunctive norms (but not descriptive norms or attitudes) moderated the differential effects of the PBI with strongest effects for students whose parents received the booster. Differential effects also depended on baseline drinking class and were most pronounced among WLDs who were deemed “high-risk” in terms of injunctive peer norms.

 

Parental influence can remain strong for young adults who are transitioning to college environments, even among students with relatively high peer influence to drink alcohol. Thus, the PBI represents an effective tool to prevent escalation of alcohol use during the first year of college, when risk is highest and patterns of alcohol use are e
established.


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Request Rerprint E-Mail:      mcleveland@psu.edu