E-Book, Englisch, 99 Seiten
Winograd / Sher Binge Drinking and Alcohol Misuse Among College Students and Young Adults
1., 2015
ISBN: 978-1-61334-403-3
Verlag: Hogrefe Publishing
Format: EPUB
Kopierschutz: 6 - ePub Watermark
E-Book, Englisch, 99 Seiten
Reihe: Advances in Psychotherapy - Evidence-Based Practice
ISBN: 978-1-61334-403-3
Verlag: Hogrefe Publishing
Format: EPUB
Kopierschutz: 6 - ePub Watermark
This book provides clear guidance about effective, evidence-based approaches to treating alcohol misuse in young adults.
Heavy drinking – and its associated problems – are an integral part of many college students’ and other young adults’ lives. Though some young drinkers are able to consume alcohol without incident, many face significant negative fallout from their excessive consumption.
This volume in the series Advances in Psychotherapy: Evidence-Based Practice describes the nature of alcohol misuse, its epidemiology, its causes, and methods for treatment, specifically as they pertain to college students and other young adults. It provides practitioners and trainees with a range of evidence-based treatment approaches to help clients change their alcohol use habits. The information presented is both thorough and concise and will help readers with varied backgrounds and experience improve their understanding of the many nuanced factors involved in assessing and treating problematic drinking in young adults.
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[1]1 Description of Young-Adult Alcohol Misuse Alcohol misuse is common in North America and throughout much of the industrialized and developing world. In most Western countries, alcohol problems are especially pronounced in late adolescence and early adulthood – particularly during the college years – and represent a significant public health problem. In this book, we describe the nature of alcohol misuse, its epidemiology, its causes, and methods for treatment. Fundamental to this discussion is a consideration of the basic terminology of relevant alcohol-related concepts because there are many facets of alcohol misuse, and, despite some commonalities, not all of these facets can be viewed as interchangeable from a clinical or public health perspective. 1.1 Terminology and Definitions We use the terms alcohol misuse and alcohol problems to refer to a range of phenotypic behaviors and conditions. These terms are used by clinicians, public health workers, and researchers to describe different types of consumptive behaviors and consequences. 1.1.1 Consumption AUD diagnostic criteria do not include measures of consumption, such as how much or how often someone drinks Perhaps the most basic concept in characterizing alcohol involvement is alcohol consumption. At a fundamental level, though people can be classified as drinkers or abstainers, the classification of drinkers represents a large and highly diverse group that includes those who drink in moderation and those whose drinking patterns put them at risk for a range of consequences. It is important to note that current diagnostic criteria for alcohol-related disorders – alcohol use disorders (AUDs), according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5; American Psychiatric Association, 2013), and alcohol dependence and hazardous use, according to the International Statistical Classification of Diseases and Related Health Problems, 10th Edition (ICD-10; World Health Organization (WHO), 2008) – both described below – fail to include direct measures of alcohol consumption despite the health-relevance of excessive alcohol consumption. Although not presenting formal diagnostic criteria, the US government has published safedrinking guidelines as part of their 2010 Dietary Guidelines for Americans[2] (US Departments of Agriculture and of Health and Human Services, 2010). Moderate consumption of alcohol is defined as = 2 drinks a day for men and = 1 drink a day for women. Drinking = 15 drinks a week for men and = 8 drinks a week for women, or = 5 drinks in a given day for men or = 3 drinks in a given day for women is considered high-risk drinking, based on epidemiological data documenting increased health-related risks that occur at those consumption levels. One study found that almost one half of men and one third of women drinkers in the United States exceed these safe-drinking levels (Dawson, Grant, & Li, 2005). Healthy drinking limits according to the National Institutes of Health: Men: No more than 14 drinks per week or four drinks per occasion Women: No more than seven drinks per week or three drinks per occasion NIAAA definition of binge drinking: five or more drinks (for men) or four or more drinks (for women) within a 2-hr period In addition, there has been increasing concern in recent years over drinking patterns associated with high levels of consumption on drinking days (i.e., binge drinking). The US National Institute of Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as “a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 g/dL or above. For the typical adult, this pattern corresponds to consuming 5 or more drinks (male), or 4 or more drinks (female), in about 2 hours” (NIAAA, 2011). Such patterns represent significant risk for the drinker and for society. It is important to note that the five/four binge drinking definition can be a problem, as not everyone in this 2-hr time period will exceed a 0.08 g/dL BAC. Conversely, some drinkers who drink less than the five/four binge drinking threshold might achieve a BAC greater than 0.08 g/dL. The reason for such variability is related to the wide variation among men and among women in their body masses, stomach contents at the time of drinking, individual differences in alcohol metabolism rates (pharmacokinetics), and other individual factors that can vary substantially from one person to another (e.g., Cederbaum, 2012). In addition, it is possible that a different threshold might be better for identifying individuals likely to have alcohol-related difficulties. Despite any problems with a five/four threshold definition, it represents a useful metric to convey to the public what is considered a risky level of consumption and for amassing statistics on rates of heavy alcohol consumption. Note that use of the term binge drinking to describe this phenomenon is controversial (see Wechsler & Nelson, 2001), with some researchers arguing against its use because the term has historically been used to denote a more extreme drinking phenomenon sometimes observed in individuals with severe alcohol dependence (i.e., a “bender,” a period of continuous intoxication lasting a day or more). Consequently, sometimes in the research literature the term heavy episodic drinking is used to describe binge drinking, with those who binge more than once a week being classified as frequent heavy drinkers. Extreme Consumption and Heavy Drinking Events Drinking patterns among heavy drinking college students and young adults tend to be highly patterned as a function of day of the week, major holidays, academic breaks, and personal milestones. Studies of daily drinking over the course of the calendar year indicate that college students often engage in weekend-like drinking during the week (e.g., “Thirsty Thursdays”; Wood, Sher, & Rutledge, 2007) and that some holidays and events are strongly associated with particularly high spikes in alcohol consumption (Neighbors et al., 2011). These include traditional holidays (e.g., New Year’s Day, Fourth of July), regional holidays with strong drinking traditions, sporting events (e.g., Super[3] Bowl), and traditional drinking rites of passage (e.g., 21st birthday, Spring Break). Moreover, college students and young adults are known for their methods of drinking that facilitate extremely heavy consumption, such as drinking heavily before leaving for a party (“prepartying”) and playing drinking games. Day of the Week One aspect of college-age drinking that sets it apart from the typical drinking patterns of older adults is the frequent heavy drinking that occurs on Thursday nights, in addition to the usual Friday and Saturday night drinking. Often called “Thirsty Thursday” (Wood, Sher, & Rutledge, 2007), Thursday night drinking can be just as heavy as weekend drinking, and does not have the same repercussions as Monday, Tuesday, or Wednesday night drinking, because many college campuses offer fewer classes on Fridays, essentially separating it from the typical academic week. In fact, researchers have found that students who did not take Friday classes drank twice as much as students with Friday early morning classes (Wood, Sher, & Rutledge, 2007), and a NIAAA committee has suggested that administrators consider increasing the number of Friday morning classes to curtail excessive Thursday night drinking (Malloy, Goldman, & Kington, 2002). Twenty-First Birthday Celebrations Perhaps epitomizing the extremes that characterize some drinking during this stage of life is the phenomenon of 21st birthday drinking, when many young adults attempt to drink “21 for 21” (i.e., a drink for each year of the person’s life). Although not all young drinkers attempt to accomplish this particular drinking milestone, for almost half of those drinking to celebrate their 21st birthday, this one occasion will represent the heaviest drinking event of their life to date (Rutledge, Park, & Sher, 2008). Although many young adults intend to consume large quantities of alcohol on that occasion, on average, celebrants drink more than intended, especially if they drink quickly, drink shots, and engage in various 21st birthday rituals. Given the high levels of consumption, it is not surprising that these celebrations are associated with a range of negative acute risks from drinking, including high rates of vomiting, blackouts, hangovers, physical impairment, and engaging in sexually provocative behavior. Recently, Neighbors et al. (2011) estimated the mean blood alcohol concentrationf (BAC) experienced by a sample of college undergraduates in the year they turned 21 years of age, across a range of different drinking events. Twenty-first birthday celebrations led the list, with estimated BACs of 0.19 g/dL (more than twice the legal limit for driving while intoxicated). Several other events are also associated with mean BACs over 0.08 g/dL (e.g., New Year’s Eve and Day, Super Bowl, Mardi Gras, St. Patrick’s Day, Spring Break, Cinco de Mayo, graduation, and Fourth of July). Not surprisingly, these events have been targeted for event-specific, preventive interventions (e.g., Neighbors et al., 2012). Spring Break Though 21st birthday celebrations may represent the extreme of heavy drinking events, there are a number of events that have been associated with very heavy drinking during the college years, such as Spring Break for students. Spring Break drinking resembles weekend drinking, and each day of...
