In light of increasing numbers of controlled studies evaluating alcohol abuse prevention interventions for college drinkers, we conducted a meta-analysis to summarize the current status of the literature. The meta-analysis includes 62 studies, published between 1985 to early 2007, with 13750 participants and 98 intervention conditions. All studies were content coded for study descriptors, participant characteristics, and intervention components. We derived weighted mean effect sizes for alcohol interventions versus comparison conditions for consumption variables and alcohol-related problems, over four measurement intervals. Over follow-up intervals lasting up to 6 months, participants in risk reduction interventions drank significantly less relative to controls. Students receiving interventions also reported fewer alcohol-related problems over longer intervals. Moderator analyses suggest that individual, face-to-face interventions using motivational interviewing and personalized normative feedback predict greater reductions in alcohol-related problems. Implications for future research include attention to maintenance of effects, and developing more efficacious interventions for at-risk college drinkers.

The screening and brief intervention (SBI) modality of treatment for at-risk college drinking is becoming increasingly popular. A key to effective implementation is use of validated screening tools. While the Alcohol Use Disorder Identification Test (AUDIT) has been validated in adult samples and is often used with college students, research has not yet established optimal cut-off scores to screen for at-risk drinking. A total of 401 current drinkers completed computerized assessments of demographics, family history of alcohol use disorders, alcohol use history, alcoholrelated problems, and general health. Of the 401 drinkers, 207 met criteria for at-risk drinking. Receiver-operating characteristic (ROC) curve analysis revealed that the AUROC of the AUDIT was 0.86 (95% CI = 0.83-0.90). The AUDIT-C (AUROC = 0.89, 95% CI = 0.86--.92) performed significantly better than the AUDIT in the detection of at-risk drinking in the whole sample, and specifically for females. Gender differences emerged in the optimal cut-off scores for the AUDIT-C. A total score of 7 should be used for males and a score of 5 should be used for females. These empirical guidelines may enhance identification of at-risk drinkers in college settings. Keywordsalcohol screening; at-risk drinking; gender; college drinking; ROC Optimizing the Use of the AUDIT for Alcohol Screening in College StudentsExcessive rates of alcohol consumption on college campuses continue to pose a public health challenge. Approximately 70% of college students report alcohol use in the past month (O'Malley & Johnston, 2002). Heavy episodic drinking, defined as five or more drinks on one occasion for a male and four or more drinks on one occasion for a female, is commonplace. Nearly half of all college students reporting at least one heavy drinking episode in the past two weeks or month (Substance Abuse and Mental Health Services Administration [SAMHSA], 2006;Wechsler et al., 2002). Importantly, it is these heavy drinking episodes that are linked with alcohol consequences (e.g., Park, 2004). In college samples, heavy drinking episodes (sometimes referred to as binge episodes) are related to academic, relational, and legal problems (Park, 2004), as well as physical injury and unprotected sex (Hingson, Zha, & Weitzman, 2009).Despite these high rates of heavy alcohol use, college students often do not seek specialty treatment for alcohol problems. Results from the National Epidemiologic Study on AlcoholCorrespondence concerning this article should be addressed to Kelly S. DeMartini, Ph.D., Yale University School of Medicine, Division of Substance Abuse, 1 Long Wharf Dr., Box 18, New Haven CT 06511; kelly.demartini@yale.edu. Author Note: At the time of the study, both authors were affiliated with the Department of Psychology and Center for Health and Behavior, Syracuse University. Kelly S. DeMartini is now at the Department of Psychiatry, Division of Substance Abuse, Yale University School of Medicine; Kate B. Carey is now at the Department of Behavioral and Social Scie...

Self-reported impulsivity confers risk factor for substance abuse. However, the psychometric properties of many self-report impulsivity measures have been questioned, thereby undermining the interpretability of study findings using these measures. To better understand these measurement limitations and to suggest a path to assessing self-reported impulsivity with greater psychometric stability, we conducted a comprehensive psychometric evaluation of the Barratt Impulsiveness Scale-11 (BIS-11), the Behavioral Inhibition and Activation Scales (BIS/BAS), and the Brief Self Control Scale (BSCS) using data from 1,449 individuals who participated in substance use research. For each measure, we evaluated: 1) latent factor structure, 2) measurement invariance, 3) test-criterion relationships between the measures, and 4) test-criterion relations with drinking and smoking outcomes. Notably, we could not replicate the originally published latent structure for the BIS, BIS/BAS, or BSCS or any previously published alternative factor structures (English language). Using exploratory and confirmatory factor analysis, we identified psychometrically improved, abbreviated versions of each measure (i.e., 8-item, 2 factor BIS-11 [RMSEA = .06, CFI = .95]; 13-item, 4 factor BIS/BAS [RMSEA = .04, CFI = .96]; 7-item, 2 factor BSCS [RMSEA = .05, CFI = .96]). These versions evidenced: 1) stable, replicable factor structures, 2) scalar measurement invariance, ensuring our ability to make statistically interpretable comparisons across subgroups of interest (e.g., sex, race, drinking/smoking status), and 3) test-criterion relationships with each other and with drinking/smoking. This study provides strong support for using these psychometrically improved impulsivity measures, which improve data quality directly through better scale properties and indirectly through reducing response burden.

Aims College students who violate alcohol policies are often mandated to participate in alcohol-related interventions. This study investigated (a) whether such interventions reduced drinking beyond the sanction alone, (b) whether a brief motivational intervention (BMI) was more efficacious than two computer-delivered interventions (CDIs), and (c) whether intervention response differed by gender. Design Randomized controlled trial with four conditions (BMI, Alcohol 101 Plus™, Alcohol Edu for Sanctions, delayed control) and four assessments (baseline, 1, 6, and 12 months). Setting Private residential university in the USA. Participants Students (n = 677; 64% male) who had violated campus alcohol policies and were sanctioned to participate in a risk reduction program. Measurements Consumption (drinks per heaviest and typical week, heavy drinking frequency, peak and typical blood alcohol concentration), alcohol problems, and recidivism. Findings Piecewise latent growth models characterized short-term (1-month) and longer-term (1–12 months) change. Female but not male students reduced drinking and problems in the control condition. Males reduced drinking and problems after all interventions relative to control, but did not maintain these gains. Females reduced drinking to a greater extent after a BMI than after either CDI, and maintained reductions relative to baseline across the follow-up year. No differences in recidivism were found. Conclusions Male and female students responded differently to sanctions for alcohol violations and to risk reduction interventions. BMIs optimized outcomes for both genders. Male students improved after all interventions, but female students improved less after CDIs than after BMI. Intervention effects decayed over time, especially for males.