Liquid Courage: The Role of Alcohol in Women's Transition to College.

Author:Gibson, Sandy
 
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INTRODUCTION

Adolescence is a developmental period characterized by substantial changes in brain structure, systems and neural connectivity (Melon, Wray, Moore, & Boehm, 2013; Kaarre et al., 2016). Due to such dramatic changes during this period, concurrent alcohol use can stunt maturation and potentially increase susceptibility to later substance abuse and dependence (Melon et al., 2013; Witt, 2010), as evidenced by the established link between the age of first drink and the rate of alcohol dependence (Dawson, Goldstein, Chou, Ruan, & Grant, 2008; Melon et al., 2013; Moore, Mariani, Linsenbardt, Melon, and Boehm, 2010). Furthermore, adolescents continue gray matter synaptic pruning in the cerebella region of their brains until their mid-twenties (Lenroot & Giedd, 2006), and maturation of white matter until the early thirties (Jernigan & Gamst, 2005). The grey matter includes regions of the brain involved in muscle control, sensory perception, such as seeing and hearing, memory, emotions, speech, decision-making and self-control, while the white matter is the passageway for messages between different areas of gray matter within the nervous system (Miller & Alston, 2008). Recent studies suggest that adolescent binge drinkers, compared to light drinkers, had significantly reduced white matter quality in several brain regions (McQuceny, et al., 2009; Silveri, Dager. Cohen-Gilbert & Sneider; 2016) including one study using brain MRI images of binge drinking and non-binge-drinking adolescents (Lisdahl, Thayer, Squcglia, McQueeny, & Tapert, 2013), which revealed that a higher number of drinks in the past 3 months predicted smaller cerebellar volumes, for both gray and white matter with a range of binge-drinking exposure for both males and females. As research continues to build support that increased overall use of alcohol during the past year is significantly related to smaller cerebellar volumes (Medina, Nagel & Tapert, 2010), it suggests that increased alcohol use and recent binge drinking are indeed associated with structural brain changes in adolescents.

In addition to the neurological damage associated with adolescent alcohol use, abuse of alcohol by adolescents also increases the risk of motor vehicle crashes (Marcotte, Bekman, Meyer & Brown, 2012), risky sexual behaviors (Oshri, Tubman, Morgan-Lopex, Saavedra, & Csizmadia, 2013), unwanted pregnancy, crime (Popovici, Homer, Fang, & French, 2012), violence (Whiteside, et al., 2013), non-suicidal self-injuries (Jarvi & Swenson, 2016), personal injuries (Olsen, Hertz, Shults, Hamburger, & Lowry, 2011) and suicide, (Danielsson, Romelsjo & Tengrstrom, 2010; Mahalik et al., 2013; Zeigler et al., 2005), all risk factors that commonly follow adolescents into their college drinking experiences (Park, K.im & Sori, 2013).

Binge Drinking

Researchers are recognizing that as time goes on, binge drinking is being seen as more normative in society and is more accepted now than in the past (Dalton, Hoy & Lyons, 2006; Motluk, 2004; Jun, Agley, Huang & Gassman, 2016; Utpala-Kumar & Deane, 2012). The prevalence of excessive drinking increases upon an adolescent's transition to college; approximately 40 percent of college students report binge drinking (defined as four or more drinks in a row) (Johnston, O'Malley, Bachman & Schulenberg, 2012; NIAAA, 2013; Prince & Carey, 2010), a rate higher than non-college-attending peers (Kypri, Cronin, & Wright, 2005; Paschall, 2003). College freshman students also drink more alcoholic drinks and engage in heavy drinking episodes more frequently in comparison to upperclassmen (Turrisi, Padella, & Wiermsa, 2000), and all college students are significantly less likely to seek treatment for their alcohol use than their non-college-attending peers (DeMartini & Carey, 2012).

The earlier adolescents start drinking, the more likely it is that they will abuse alcohol in the future (Anderson, Angus, de Bruijn, Gordon & Hastings, 2009; Danielsson, Romelsjo, & Tengstrom, 2011), with students drinking heavily in high school being three times more likely to binge drink in college (SAMHSA, 2012; Lindsay, 2006). Grucaz, Norberg & Bierut (2009) evaluated trends in the prevalence of binge drinking among youths and young adults in the United States using three decades of NHSDA/NSDUH data and concluded that although there are national trends towards diminishing rates of binge drinking among adolescents, these decreasing trends do not exist on college campuses, where male binge drinking remains constant and female binge drinking continues to rise.

Gender

The 2012 National Household Survey on Drugs Use (NHSDU) shows that underage females are drinking as frequently as males (Danielsson, et al., 2011 ; SAMHSA, 2012), while consuming even higher amounts of alcohol (Koebler, 2013). A recent analysis of this trend revealed that this may be primarily due to small geographic trends being overly-generalized, and a national decrease in male drinking, rather than a national increase in female drinking (Roberts, 2012). Whether there is an increase in female alcohol use or a decrease in male alcohol use, the reality remains that females are not experiencing the same downward trend in alcohol use as males. The physiological dangers of drinking are increased for females, as their bodies metabolize alcohol differently than males, with less alcohol required for intoxication due to different stomach enzymes, different body fat to water ratio and different alcohol absorption rates. These factors make women more vulnerable to the development of liver, heart, nerve and brain damage after shorter periods of drinking compared to men drinking the same amount (Agabio, Campesi, Pisanu, Gessa & Franconi, 2016; Alfonso-Loeches, Pascual & Gucrri, 2013; Alvanzo et al., 2011). As a result of this, alcohol dependence progresses more quickly in women than in men, a process called the "telescoping effect" (Keyes, Phil, Martins, Blanco & Hasin, 2010).

Transition to college

The transition from high school to college can be a significant stressor for many young people (Wemm et al., 2013), with research suggesting that female college students in particular being more susceptible to using alcohol as a coping mechanism during the transition to college than males (LaBrie, Ehret, Hummer, & Prenovost, 2012; Norberg, Norton, Olivier, & Zvolensky, 2010; Wemm, et al., 2013). Understanding the perceived benefits of increased alcohol use during this transition to college can help both parents and high school counselors better prepare students for the transition, as well as allow college counselors to better manage the transition by offering non-alcohol-related opportunities to meet these needs that alcohol appears to relieve during this time. As more than half of all students who leave college do so in the first 6 weeks (Mattanhan et al., 2010), ignoring how women manage this transition may only perpetuate the trend of increased alcohol use for women during this time.

Perceived Benefits

An important determinant of alcohol use among college students is what they perceive to be the benefits of such use, known as positive alcohol expectancies (Baer, 2002; LaBrie, Grant & Hummer, 2011). When college students have positive alcohol expectancies, they are more likely to drink higher quantities of alcohol more frequently and develop alcohol-related problems (LaBrie et al., 2011; McBride, Barrett, Moore & Schonfeld, 2014; Park & Grant, 2005). As having such positive expectancies (i.e. perceived benefits) of alcohol use leads to increased alcohol use and associated consequences, it is important for high school counselors and college alcohol programs to understand these specific 'perceived benefits' in order to intervene in ways that specifically target such expectancies.

Purpose

The purpose of this study is to explore the perceived benefits of drinking alcohol among freshmen women as they relate to the college transition, and learn which of these perceived benefits are significantly associated with increased usage of alcohol, and more specifically, binge drinking. Literature is lacking in identifying such perceived benefits for increased alcohol use, particularly by college freshmen women. Limited existing research suggests that variable-centered approaches to drinking motives may be a better alternative to understanding this problem and suggest this course of study in future research (Littlefield, Verge, Rosinski, Steinley, & Sher, 2013). We propose that the reasons identified by college women freshmen for increased alcohol use will likely be internally motivated factors associated with the college transition rather than results of their new environment or relationships. This research supports the proposition of Pirkle & Richter (2006) that understanding the risk profiles of girls and young women who engage in specific forms of substance use can facilitate the identification of those at risk and the development of more targeted and effective prevention programs and interventions.

METHODS

Procedures

Participants in this study were students from a moderate-sized suburban public college in the mid-Atlantic region of the United States. Approximately 95% of all incoming freshmen are housed on campus. All incoming freshmen are recruited annually to participate in a Check-Up to Go (e-Chug) alcohol prevention course and incorporated survey. This universal sample of incoming freshmen receives an e-mail invitation to participate in e-Chug two weeks before the start of the fall academic semester. Students are informed that participation is voluntary, and they are not reimbursed for their participation. This e-Chug survey is again sent to these same students two weeks after their arrival to campus for the purpose of assessing behavioral and/or cognitive changes in students' relationships with alcohol after transitioning to college. The data collection window at time 2 was open for two weeks, allowing students to...

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