Alcohol consumption and abuse among college students: alarming rates among the best and the brightest.
Participants: Two hundred eighty eight college students at two different universities in the U.S were surveyed from February to April of 2013.
Methods: Students were recruited through the head coaches of sports teams, the presidents of Greek organizations, and through the psychology departments, and emailed a Survey Monkey link.
Results: Eighty five students reported alcohol dependence (severe alcohol abuse disorder in DSM 5), 43 reported alcohol abuse (moderate alcohol abuse in DSM 5), and 68 reported problematic drinking (mild alcohol abuse in DSM 5).
Conclusions: "Dry" policies do not diminish problematic alcohol consumption and abuse, but are associated with substantial decreases in the onset of alcohol dependence.
Within the Diagnostic and Statistical Manual of Mental Disorders (DSM), alcohol is one of the most prevalent substances used in the United States, along with nicotine, cannabis and caffeine 1. DSM-5 estimates that 40% of individuals have experienced some type of adverse event related directly to alcohol consumption. (1) There are many risks and problems that result in the consumption of copious amounts of alcohol, most prominently nights when binging occurs. The most commonly reported adverse events of excessive drinking involve health and/or social problems including: motor-vehicle accidents, violence (physical and sexual), hypertension, acute myocardial infarction, the contraction of sexually transmitted diseases, and unwanted and/or unplanned pregnancies. (2) Those are troubling consequences, and even more troubling is that a recent NLAAA sponsored study estimated that approximately 1,700-college students die per year from unintentional alcohol-related injuries (mostly through motor vehicle accidents). Furthermore, approximately 5% of female college students reported having been victims of sexual assault and 75% of that 5% reported that they were under the influence of alcohol at the time of their assault. 3 Within those statistics, the age range that has the highest rate of alcohol consumption and adverse events are college students and individuals aged 18-24. (3)
In 1993, Harvard University's School of Public Health published the results of their first College Alcohol Study. (4) This study and the three subsequent studies conducted by the Harvard University School of Public Health examined alcohol consumption via the rates of binge drinking by college students. Binge drinking is defined by both the DSM-IV-TR and Wechsler and Isaac (5) as having 5 or more drinks in a single sitting for males and 4 or more drinks in a single sitting for females. Binge drinking has always thought to have been a problem, and these studies unveiled the magnitude of the problem. The Harvard College Alcohol Studies found that 40% (2 out of every 5) of students reported binge drinking within the last two weeks of taking the survey. Since that study, more time, research, and money has been spent studying and examining these startling trends. The Centers for Disease Control and Prevention released their findings from 2010-2011 and found that alcoholic binge drinking accounted for more than 50% of the alcohol consumed by adults and 90% of the alcohol consumed by adolescents. (6) As startling as the high prevalence rate of binge drinking are the increasing prevalence rates of diagnosable alcohol abuse and dependence for college students. (7,8) Weschsler et al (4) reported that approximately 32% of college students meet the DSM-IV-TR criteria for alcohol abuse, and 6% meet the criteria for alcohol dependence. The results of this study indicate that alcohol consumption research among college students needs to include rates of abuse and dependence, as well rates of binge drinking.
In the current survey study, we explored if athletes and members of fraternities and/or sororities would report significantly different rates of alcohol consumption in comparison to unaffiliated students. We also collected data at two different universities (one a "dry" urban campus, where alcohol is not allowed on the campus in residence halls, and the other a "wet" rural campus, where alcohol is allowed on the campus in residence halls) and examined if differences in policies regarding alcohol consumption policy at these two universities would yield significant differences in alcohol consumption.
The total number of respondents was 350, but only 288 were utilized in the data analysis due to missing data. Participants had to be at least 18 years old and full-time undergraduates. Students were recruited through the head coaches of sports teams, the presidents of Greek organizations, and through the psychology research pool at both institutions. The students who were interested were emailed a Survey Monkey link through email. After consenting to participate, they completed the survey online. IRB approval was obtained at both institutions where data were collected.
A thirty-seven-item questionnaire was developed that included demographics, college campus information, personal and familial psychiatric histories, alcohol related questions concerning alcohol consumption, and student identification information. The questions concerning alcohol consumption were taken directly from the DSM-IV-TR. (9) A third category was created for alcohol consumption: problematic drinking used if a participant did not meet diagnosable criteria for either alcohol abuse or alcohol dependence but met one or two criteria of the seven criteria named for alcohol dependence. We also utilized the DSM-IV-TR criteria for alcoholic binges so that participants were aware of what a clinician would use to evaluate binge drinking (4+ drinks in a single night for women and 5+ drinks in a single night for men). Participants were told in the questionnaire that a single drink would be a standard 12 oz. beer, 4 oz. glass of wine, or a 1.5 oz. shot of hard alcohol (e.g., rum, vodka, etc.). Students responded to a question asking if they took an Alcohol Education class (10) before beginning their ffeshman year. The results from the data collected show that nearly all students took AlcoholEdu and/or Alcohol Education Class before their freshman year.
Seventy (24%) of the respondents were male and 218 female (76%). Two hundred and thirty of the respondents stated they are white/Caucasian (80%), 19 identified as African American/Black (7%), 13 Hispanic/Latino (5%), and 12 as Asian (4%), nine as other (3%), five did not disclose ethnicity (1%). In terms of age, 92 of the respondents were 18 (31.9%), 54 were 19 (18.8%), 56 were 20 (19.4%), 62 were 21 (21.5%), nine were 22 (3.1%), and 15 were 23 or older (5.2%). One hundred and eight of the respondents were freshman (38%), 48 (17%) sophomores, 68 (24%) juniors, 64 (22%) seniors. Fifty eight (20%) of respondents were Greek Organization members, 56 (20%) members of NCAA varsity sports teams, and 174 (60%) stated they were unaffiliated students and not members of either a varsity sport or a Greek Organization.
In terms of medical history, 47 (16%) of the respondents stated they had been diagnosed by a clinician with an Axis I Mental Disorder (i.e. Anxiety, Depression, Dysthymia), and 17 (17%) stated they have been diagnosed by a clinician with an Axis II Mental Disorder (i.e. a personality disorder). One respondent reported that he/she had been diagnosed by a clinician with an alcohol disorder (either alcohol abuse or alcohol dependence). 87 (30%) of the respondents stated that they have a family history of alcohol disorders, while 35 (12%) stated that they were not 100% sure if their families had a history of alcohol related problems. There were no significant differences on drinking behaviors between men and women in the sample.
The results of the analyses presented below can also be found on table 1, which show that 196 of the 288 (i.e., 68%) students who participated in our study reported experiencing one of these three alcohol problems, alcohol abuse, alcohol dependence, or problematic drinking. Twenty nine percent (n=85) reported alcohol dependence, 14% (n=43) reported alcohol abuse, and 23% (n=68) reported problematic drinking. The results indicate that with respect to alcohol abuse, 43 of 288 students, or 14%, reported alcohol abuse, and comparisons between the three groups showed that athletes (24%) reported a higher percentage of abuse than Greeks (13%) and Unaffiliated students (12%). The Pearson chi-square statistic was 5.28 and approached statistical significance (p<.07). With respect to dependence, 85 of 288 students, or 29%, reported dependence of alcohol, and comparisons showed that athletes (40%) reported a higher percentage of dependence than Greeks (31%) and Unaffiliated students (25%). The Pearson chi-square statistic was 4.66 and approached statistical significance (p<.09). With respect to problematic drinking, 68 of 288 students, or 23%, reported problems with drinking, and comparisons showed that Greeks (36%) reported a higher percentage of problems with drinking than athletes (7%) and Unaffiliated students (24%). The Pearson chi-square statistic was 15.80 and was significant (p<.003).
Results also indicate that 14% of students of all students reported alcohol abuse and that rates at the two schools were practically identical (14% for the DUC and 15% at the WRC). Results also indicate that 23% of all students reported problems with drinking and that rates at the two schools were again very similar (22% for the DUC and 24% at the WRC). However, 21% of students at the DUC and 37% of students at the WRC reported dependence on alcohol (the percent overall is 29%). The Pearson chi-square statistic was 8.95 and was significant (p<.003). We were also interested in examining drinking rates among students and their ranks (e.g., freshmen versus seniors). Results indicate that 14% of freshmen, 8% of sophomores, 13% of juniors, and 23% of seniors reported abusing alcohol. Also, 20% of freshmen, 18% of sophomores, 27% of juniors, and 28% of seniors reported problems with drinking alcohol. However, the differences in these percentages do not represent statistical significance. Thirty-five percent of freshmen, 38% of sophomores, 20% of juniors, and 21% of seniors reported dependence on alcohol, and this difference was significant: The Pearson chi-square statistic was 8.27 and was significant (p<.04).
We found that 68% of the students surveyed experienced a problem with alcohol dependence, alcohol abuse, or problematic drinking-an alarming high rate. In the United States to date, 34% of colleges and universities have banned alcohol for all students on-campus, while another 81% of the remaining 66% of schools that are "wet" offered at least some type of "dry" residential housing. (3) Our results indicate that the "wet" campus had a significantly higher rate of alcohol dependence among the college student population, but there was only a marginal difference between the "wet" and the "dry" campuses regarding alcohol abuse and problematic drinking.
Our results also indicate that freshmen and sophomores are more likely to experience alcohol dependence than juniors and seniors, which speaks to their vulnerability and risk as they leave home and experience the transition from high school to college. Although new students are expected to undergo some challenges and difficulties as they transition and adjust to college life, developing dependence on alcohol is certainly out of the ordinary and requires specially targeted and consistent interventions on the part of college administrators to protect them from this harm. Unaffiliated students are also much more likely, significantly so in comparison to athletes and Greek-affiliated students, to engage in problematic drinking. This may be due to the lack of support, the lack of targeted interventions, and perhaps the diminished sense of community that these students may experience in college.
In terms of alcohol abuse, unaffiliated students were also more likely to experience this problem than athletes or Greek-affiliated students, regardless of type of campus or rank. Greek-affiliated students who are sophomores or juniors reported the lowest levels of consumption in our sample. This finding, coupled with the finding of a significantly higher percentage of unaffiliated students endorsing the criteria for problematic drinking, points to the need for targeted and comprehensive interventions for students who are make up the general population of students.
From the results we conclude that dry policies do not diminish incidences of problematic alcohol consumption and abuse, but are associated with substantial decreases in the onset of alcohol dependence. The student most likely to develop alcohol dependence is a freshman or sophomore who is not an athlete or Greek-organization member and who attends a rural campus where alcohol is allowed on campus.
One of the limitations of the current study, and that has been documented in similar research, is the accuracy of reporting alcohol and drug abuse. Researchers have generally been concerned with the under-reporting of alcohol consumption, an unsettling possibility given the high percentages of alcohol consumption in our results. However, the inverse is also possible, and respondents might have over-reported their use-out of error in estimating their consumption, to impress the researcher, or as a cry for help. It is also possible that the current results represent an accurate snapshot of consumption (i.e., not over-reporting) for students acutely aware of their problems with alcohol and who were thus more motivated to participate in the research.
JAIRO N. FUERTES
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Washington DC; 2013.
National Institute of Alcohol Abuse and Alcoholism. Tenth special report to the U.S Congress on alcohol and health. Bethesda, MD: National Institute of Health. 2000.
Wechsler, H., & Nelson, T.F. What We Learned From the Harvard School of Public Health College Alcohol Study: Focusing Attention on College Student Alcohol Consumption and the Environmental Conditions That Promote It. J Stud on Alcohol Drugs. 2008;1-10
Weschler, H., Lee, J.E., Kuo, M., Seibring, M., Nelson, T.S., Lee, H. Trends in college binge drinking during a period of increased prevention efforts: Findings from 4 Harvard School of Public Health College Alcohol Study Surveys: 1993-2001. J Am Coll Health. 2002; 50; 203-217.
Weschler, H., & Isaac, N. "Binge" drinkers at Massachusetts's colleges: Prevalence, drinking style, time trends, and associated problems. JAMA. 1992; 267: 2929-2931.
U.S. Department of Health and Human Services: Centers for Disease Control and Prevention. Vital Signs: Binge Drinking Prevalence, Frequency, and Intensity among Adults-United States. MMWR. 2012; 61:1-7.
Knight, J.R., Wechsler, H., Kuo, M., Seibring, M. Weitzman, E.R., & Schuckit, M.A (2002). Alcohol Abuse and Dependence among U.S. College Students. J Stud Alcohol. 2002;263-270
Mitka, M. (2009). College Binge Drinking Still on the Rise. JAMA. 2009;8: 836-838.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, Washington DC; 2000
Paschall, M.J., Antin, T., Ringwalt, C.L., Saltz, R.F. Effects of AlcoholEdu for College on Alcohol-Related Problems Among Freshman: A Randomized Multicampus Trial. J Stud on Alcohol Drugs. 2011; 642-650
Table 1. Results by Membership, Campus, and Rank (Total N=288) Abuse Dependence Problematic (DSM IV (DSM Drinking TR) IV TR) DSM 5 Alcohol Moderate Severe Mild Use D/O: N=43 N=85 N=68 (14%) (29%) (23%) Membership Athlete 14 23 4 Greek 8 18 21 Unaffiliated 21 44 43 Chi-Square 5.28 4.66 15.80 Significance p<.07 p<.09 p<.003 Campus UDC 22 33 34 RWC 21 52 34 Chi-Square .03 8.95 .27 Significance p<.85 p<.003 p<.87 Rank Freshmen 15 38 22 Sophomore 4 19 9 Junior 9 14 19 Senior 15 14 18 Chi-Square 5.63 8.27 4.89 Significance p<.13 p<.04 p<.55
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|Author:||Fuertes, Jairo N.; Hoffman, Alexander|
|Publication:||College Student Journal|
|Date:||Jun 1, 2016|
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