Terlecki M.A., Larimer M.E., Copeland A.L.
Journal of Studies on Alcohol and Drugs: 2010, 71(1), p. 54–60.
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Is being caught and disciplined all it takes to get heavy drinkers who violate university drinking rules to cut back? According to this US study, the discipline process does work, but adding brief motivational-style advice makes a worthwhile extra impact.
Summary In the USA where the legal drinking age is 21, dealing with college students who violate university campus alcohol policies (for example, by driving under the influence, public intoxication, or underage possession) is an important issue. Such students are among the heaviest and most problematic drinkers on campus. The featured study set out to test whether among students all of whom are drinking heavily and problematically, being disciplined by the college for a violation has an impact on drinking, and whether that impact is augmented by brief advice.
All the students in the study were selected to be heavy and problematic Monthly drinking and consumed five or more US 14g alcohol standard drinks (for men) or four or more drinks (for women) per occasion in the past month, endorsed at least three alcohol-related problems on three to five occasions in the past three years on a standard questionnaire, and score over six on the AUDIT screening questions for hazardous or harmful drinking. drinkers. On average they were about 20 years old and drinking around 20 US standard drinks a week or 35 UK units. Most the disciplined students were men, the voluntary participants, women.
59 disciplined students referred to the study by college authorities agreed to join the study in lieu of being mandated to attend the usual alcohol education class. Of these, 43 completed baseline and follow-up assessments. They had been randomly assigned to no intervention for the next six weeks (the control A group of people, households, organisations, communities or other units who do not participate in the intervention(s) being evaluated. Instead, they receive no intervention or none relevant to the outcomes being assessed, carry on as usual, or receive an alternative intervention (for the latter the term comparison group may be preferable). Outcome measures taken from the controls form the benchmark against which changes in the intervention group(s) are compared to determine whether the intervention had an impact and whether this is statistically significant. Comparability between control and intervention groups is essential. Normally this is best achieved by randomly allocating research participants to the different groups. Alternatives include sequentially selecting participants for one then the other group(s), or deliberately selecting similar set of participants for each group. group), or to record their drinking for two weeks then participate in a 50-minute advice session based on motivational interviewing principles and conducted according to the BASICS manual, a brief intervention designed to reduce risky alcohol use and related problems which involves feedback on the student's drinking relative to campus norms.
Another set of 41 students were also heavy and problematic drinkers but had not been disciplined by the college. In response to study publicity they had volunteered to join the study and in return received an extra course credit. They too were randomly allocated to no intervention or to the same intervention procedures as the mandated students.
At the end of the six weeks of the study all the students completed follow up assessments of their drinking and related problems. These were compared to the same baseline assessments to determine the impacts of being disciplined and/or being assigned to the advice session.
Overall being assigned to the intervention led to greater reductions in drinking, and these extra reductions were seen both among mandated and voluntary students. Just being disciplined had a modest and statistically insignificant impact except on drink-related problems.
On none of the four measures of drinking did mandated students cut back significantly more than the corresponding set of non-mandated students, though the combination of being mandated and being advised did lead to a significantly greater reduction in drinks per week than receiving neither form of intervention. However, even without advice mandated students did experience greater remission in alcohol-related problems than corresponding volunteer students.
Across all the students, being assigned to advice led to significantly greater reductions in drinks per week (and nearly significant in peak drinks per drinking day) than not being assigned, though typical daily consumption and frequency of drinking were not affected. Reductions too were greater among the mandated students in particular, but on none of the measures did the extra difference made by the advice sessions quite reach statistical significance. Among the voluntary students, one of the four measures (quantity drank per week) did fall significantly more if they had been advised.
Findings suggest that mandated students decrease risky drinking behaviour as a result of the disciplinary process, though the addition of brief advice produced larger decreases in weekly alcohol consumption than disciplinary action alone, consistent with previous research on brief advice among mandated students. The findings validate brief intervention programmes on college campuses for students who violate campus alcohol policies.
Also it appears that heavy drinking college students mandated to advice and those who volunteer for it may benefit similarly from a brief intervention designed to reduce risky drinking and associated problems, though.
These results should be considered preliminary and interpreted with caution because of the small sample and the short follow-up period.
commentary Data from what appears to have been the same study have been used to assess whether the impact of the advice session in the featured study differed for socially anxious students. At its extreme social anxiety is characterised by intense and/or persistent fear or avoidance of social scrutiny. The researchers speculated that these students may be less receptive to the advice because for them drinking helps overcome their anxiety. On the other hand, they may be more receptive because part of the advice would reassure them that they did not have drink heavily in order to 'fit in'. In respect of total weekly drinking and drink-related problems the advice session was as effective among socially anxious students as among the rest. However, it was less effective in reducing typical amount drunk on a drinking day, to the point where on average the reduction was slightly less than among socially anxious students who had not been advised at all.
A further analysis investigated whether this last finding was due to the way socially anxious students responded to the advice session's feedback on how their drinking compares to the average student. It found that these anxious students, overly concerned about how they seemed to others, were less responsive to this information, reducing their assessment of how much the typical student drinks relatively little. It was this effect which accounted for their persisting to drink relatively large amounts on a typical drinking day. Rather than, as speculated in the previous report, responding particularly well to this information, they tended to discount it, and in so far as they did, they continued to drink heavily.
One of these reports also mentions that the lead researcher conducted the intervention. If as seems likely she was also involved in conducting follow-up assessments and analysis of the results, this raises the possibility that students advised by her might have exaggerated the degree to which they had responded to that advice by cutting back. There is also the possibility of the
In several social research areas,1 programme developers and other researchers with an interest in the programme's success have been found to record more positive findings than fully independent researchers. Such overlaps between developers and researchers are endemic2 in drug prevention research.
1. See articles at the following web addresses:
2. See article at the following web address:
http://dx.doi.org/10.1016/j.evalprogplan.2007.06.004 to the intervention affecting the outcomes. It was also unfortunate that the great majority of the mandated students were men, while volunteer students were mainly women. This makes it more difficult to be sure that how students responded to advice was due to whether they were mandated or not rather than to differences between mandated and voluntary students.
Thanks for their comments on this entry in draft to Amy Copeland of Louisiana State University in the USA. Commentators bear no responsibility for the text including the interpretations and any remaining errors.
Last revised 13 June 2013. First uploaded 11 June 2013