Nadine Mastroleo - Academia.edu (original) (raw)

Papers by Nadine Mastroleo

Research paper thumbnail of Motivational interviewing with significant other participation: assessing therapeutic alliance and patient satisfaction and engagement

Journal of substance abuse treatment, 2010

Inclusion of concerned significant others (SOs) in alcohol use treatment has demonstrated efficac... more Inclusion of concerned significant others (SOs) in alcohol use treatment has demonstrated efficacy but has not been tested in the context of brief interventions. In this study, individual motivational interviewing (MI) sessions were compared with MI sessions including a significant other on within-treatment outcomes (alliance, fidelity, client satisfaction, and engagement). Participants (N = 382) were adult alcohol users recruited in a Level I trauma center. Perceived alliance did not differ across conditions, but patients and SOs reported higher alliance, satisfaction, and engagement than was perceived by the therapist. The occurrence of MI components, or discussion areas, was consistent across conditions. Higher baseline SO drinking was associated with lower patient engagement, whereas higher baseline SO acceptance of patient drinking was associated with lower SO engagement. Results suggest that individual MI sessions can be adapted to include an SO with minimal impact on patient ...

Research paper thumbnail of Addressing Alcohol Use and Problems in Mandated College Students: A Randomized Clinical Trial Using Stepped Care

Journal of Consulting and Clinical Psychology

Objective: Over the past 2 decades, colleges and universities have seen a large increase in the n... more Objective: Over the past 2 decades, colleges and universities have seen a large increase in the number of students referred to the administration for alcohol policies violations. However, a substantial portion of mandated students may not require extensive treatment. Stepped care may maximize treatment efficiency and greatly reduce the demands on campus alcohol programs. Method: Participants in the study (N = 598) were college students mandated to attend an alcohol program following a campus-based alcohol citation. All participants received Step 1: a 15-min brief advice session that included the provision of a booklet containing advice to reduce drinking. Participants were assessed 6 weeks after receiving the brief advice, and those who continued to exhibit risky alcohol use (n = 405) were randomized to Step 2, a 60- to 90-min brief motivational intervention (n = 211), or an assessment-only control (n = 194). Follow-up assessments were conducted 3, 6, and 9 months after Step 2. Resu...

Research paper thumbnail of Daily co-occurrence of alcohol use and high-risk sexual behavior among heterosexual, heavy drinking emergency department patients

Drug and Alcohol Dependence, 2015

Global association and experimental studies suggest that alcohol use may increase sexual behavior... more Global association and experimental studies suggest that alcohol use may increase sexual behavior that poses risk for exposure to sexually transmitted infections (STI) among heterosexual men and women. However, results from longitudinal and daily recall studies exploring the co-occurrence of alcohol use with various sexual risk outcomes in more naturalistic contexts have been mixed, and the bulk of this research has focused on college students. The current study enrolled heavy-drinking emergency department (ED) patients and used a cross-sectional, 30-day Timeline Followback (TLFB) method to examine the daily co-occurrence between alcohol use and three sexual behavior outcomes: Any sex, unprotected intercourse (UI), and UI with casual partners (versus protected intercourse [PI] with casual partners, or UI/PI with steady partners). Results indicated that increasing levels of alcohol use on a given day increased the odds of engaging in any sexual activity and that heavy drinking (but not very heavy drinking) on a given day was associated with an increased odds of engaging in UI with either steady or casual partners. However, day-level alcohol use was not associated with an increased odds of UI with casual partners. These findings suggest that alcohol may play an important role in increasing risk for HIV/STIs among heterosexuals, and support the continued need to target heavy drinking in sex risk reduction interventions. However, our results also suggest that alcohol may not universally result in unprotected sex with casual partners, a behavior posing perhaps the highest risk for HIV/STI transmission.

Research paper thumbnail of The Impact of Defensiveness and Incident Reactions on Post-Sanction Drinking Behaviors among Mandated Students

Addictive Behaviors, 2015

Prior studies with mandated students (students referred for an intervention following violation o... more Prior studies with mandated students (students referred for an intervention following violation of a campus alcohol policy) have suggested that decreases in drinking behaviors may occur before clinical intervention. Others studies have suggested that greater reductions were associated with lower defensiveness and stronger incident reactions, such as responsibility and aversiveness. The current study sought to integrate these findings and examine the influence of pre-sanction drinking and perceptions on mandated students' post-sanction drinking levels prior to attending a brief intervention. Data were collected as part of a longitudinal study of brief interventions in a mandated student sample (N=61, 43% female, 97% White). Participants completed demographic measures, scales measuring incident reactions and defensiveness, and a Time Line Follow Back assessing drinking quantity and frequency both pre- and post-sanction. Analyses revealed significant post-sanction decreases in quantity (average total drinks per month) and frequency (number of monthly drinking days). Pre-sanction drinking quantity and frequency significantly predicted post-sanction quantity and frequency, respectively. Interaction effects suggest higher post-sanction quantities among moderate and heavier drinkers with higher defensiveness and lower aversiveness perceptions, while perceptions did not influence outcomes among light drinkers. None of the interactions involving blame or responsibility, or predicting post-sanction frequency, were significant. These findings suggest a complex relationship between pre-sanction drinking and student reactions. Implications for mandated student interactions and future research directions are discussed.

Research paper thumbnail of A pilot study of two supervision approaches for peer-led alcohol interventions with mandated college students

Journal of studies on alcohol and drugs, 2014

Despite the increasing need to identify and implement effective interventions to reduce drinking ... more Despite the increasing need to identify and implement effective interventions to reduce drinking with mandated college students, peer-led brief alcohol interventions have received minimal research attention. The current pilot study tested whether enhanced supervision (evidence-based application approach [EAA; group plus individual]) would improve peer counseling skills beyond those acquired by a common practice approach (CPA; group only). Following initial peer counselor skill evaluation, drinking outcomes after intervention were compared between supervision groups with a mandated college student sample (N = 82; 65 men). The relationship between acquired motivational interviewing skills and subsequent drinking behaviors was also assessed. EAA peer counselors showed higher motivational interviewing skill acquisition than CPA peer counselors. Despite differences in counselor skill demonstration, mandated clients in both intervention groups significantly reduced drinking behaviors. Fur...

Research paper thumbnail of Assessing Sexual Motives for Drinking Alcohol Among HIV-Positive Men Who Have Sex With Men

Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, Jan 18, 2014

Individuals who drink alcohol for the explicit motive of facilitating or enhancing sex may be mor... more Individuals who drink alcohol for the explicit motive of facilitating or enhancing sex may be more likely to engage in risky sexual behavior, including having sex under the influence of alcohol. However, efforts to assess sexual motives for drinking (SMDs) have been very limited to date. We examined the psychometric properties of a 5-item measure of SMDs in a sample of HIV-positive heavy drinking men who have sex with men. Findings provided excellent support for the scale's internal consistency and concurrent validity with a well-established measure of sexual alcohol expectancies (SAEs). Good discriminant validity was also established, as SMDs were correlated with other drinking motives but uniquely predicted the proportion of sex acts occurring under the influence of alcohol and other drugs, over and above other drinking motives and SAEs. SMDs were not significantly associated with unprotected anal intercourse. Adjusting for alcohol problem severity, higher SMDs were associated...

Research paper thumbnail of Contents List

Research paper thumbnail of Individual versus significant-other-enhanced brief motivational intervention for alcohol in emergency care

Journal of Consulting and Clinical Psychology, 2014

Effects of brief motivational interventions (BMIs) for heavy drinkers identified by alcohol-relat... more Effects of brief motivational interventions (BMIs) for heavy drinkers identified by alcohol-related emergency department (ED) visits are mixed. The successes of including significant others (SOs) in behavioral treatment suggest that involving SOs in ED-delivered BMI might prove beneficial. This study investigated the relative efficacy of an SO-enhanced motivational intervention (SOMI) compared with an individual motivational intervention (IMI) to address heavy drinking in emergency care settings. ED (n = 317) or trauma unit (n = 89) patients were randomly assigned to receive either an IMI or an SOMI and were reassessed at 6 and 12 months for alcohol consumption, alcohol-related consequences, and perceived alcohol-specific SO support. Generalized estimating equation analyses showed consistent reductions over time for both alcohol consumption and consequences. At 1-year follow-up, the average reduction in total drinks consumed per week was greater for patients in the SOMI condition than the IMI condition. In SOMI, 9.4% more patients moved to within the national guidelines for weekly drinking than did IMI patients. Frequency of heavy drinking and negative alcohol consequences showed no differential effects of intervention. Emergence of a modest treatment effect at 12 months suggests that SO involvement in the SOMI condition may have led to more sustained positive influence on patient drinking than in the IMI condition. Implications and limitations regarding SO involvement in brief treatment are discussed.

Research paper thumbnail of Behavioral Economic Decision Making and Alcohol-related Sexual Risk Behavior

AIDS and Behavior, 2014

The discipline of behavioral economics integrates principles from psychology and economics to sys... more The discipline of behavioral economics integrates principles from psychology and economics to systematically characterize decision-making preferences. Two forms of behavioral economic decision making are of relevance to HIV risk behavior: delay discounting, reflecting preferences for immediate small rewards relative to larger delayed rewards (i.e., immediate gratification), and probability discounting, reflecting preferences for larger probabilistic rewards relative to smaller guaranteed rewards (i.e., risk sensitivity). This study examined questionnaire-based indices of both types of discounting in relation to sexual risk taking in an emergency department sample of hazardous drinkers who engage in risky sexual behavior. More impulsive delay discounting was significantly associated with increased sexual risk-taking during a drinking episode, but not general sexual risk-taking. Probability discounting was not associated with either form of sexual risk-taking. These findings implicate impulsive delay discounting with sexual risk taking during alcohol intoxication and provide further support for applying this approach to HIV risk behavior.

Research paper thumbnail of College Students' Social Reactions to the Victim in a Hypothetical Sexual Assault Scenario: The Role of Victim and Perpetrator Alcohol Use

Violence and Victims, 2012

College students' responses to a hypothetical sexual assa... more College students' responses to a hypothetical sexual assault scenario involving alcohol use by the victim and/or perpetrator were examined (N = 295). Participants reported on victim/perpetrator responsibility, the extent to which the scenario would be considered rape, and their likelihood of providing positive or negative responses to the victim. Compared to women, men indicated that they would provide more negative and less positive social reactions to the victim, were less likely to identify the scenario as rape, and endorsed less perpetrator responsibility. When the victim was drinking, participants endorsed greater victim responsibility and lower perpetrator responsibility for the assault. Participants indicated that they would provide the victim with less emotional support when only the perpetrator was drinking, compared to when both the individuals were drinking.

Research paper thumbnail of The comparative effectiveness of individual and group brief motivational interventions for mandated college students

Psychology of Addictive Behaviors, 2014

Individual brief motivational intervention (iBMI) is an efficacious strategy to reduce heavy drin... more Individual brief motivational intervention (iBMI) is an efficacious strategy to reduce heavy drinking by students who are mandated to receive an alcohol intervention following an alcohol-related event. However, despite the strong empirical support for iBMI, it is unknown if the results from rigorously controlled research on iBMI translate to real-world settings. Furthermore, many colleges lack the resources to provide iBMI to mandated students. Therefore, group-delivered BMI (gBMI) might be a cost-effective alternative that can be delivered to a large number of individuals. The purpose of this study was to conduct a comparative effectiveness evaluation of iBMI and gBMI as delivered by staff at a university health services center. Participants (N ϭ 278) were college students who were mandated to receive an alcohol intervention following an alcohol-related incident. Participants were randomized to receive an individual (iBMI; n ϭ 133) or a Group BMI (gBMI; n ϭ 145). Results indicated that both iBMI and gBMI participants reduced their peak estimated blood alcohol concentration (BAC) and the number of negative alcohol-related consequences at 1-, 3-, and 6-months postintervention. The iBMI and gBMI conditions were not significantly different at follow-up. These findings provide preliminary support for the use of iBMI and gBMIs for college students in real-world settings.

Research paper thumbnail of Incident-specific and individual-level moderators of brief intervention effects with mandated college students

Psychology of Addictive Behaviors, 2011

Brief Motivational Interventions (BMI) and Computer-delivered interventions (CDI) have been succe... more Brief Motivational Interventions (BMI) and Computer-delivered interventions (CDI) have been successful in reducing drinking behaviors with mandated college students. However, research examining moderators of intervention effects have found mixed results. The current study sought to replicate and extend the research on moderators of intervention efficacy with mandated students. Baseline alcohol-related problems, readiness to change, gender, incident consequences, and participant responses to the event (personal attributions about the incident, aversiveness of the incident) were examined as moderators of intervention and booster condition efficacy on alcohol use and problems. Mandated students (N = 225) were randomized to complete either a BMI or CDI (Alcohol 101; Century Council, 1998), with or without a 1-month booster session, following a campus alcohol sanction. Outcomes were measured 3 months after baseline. Attributions moderated intervention condition such that participants low in personal attributions for their incident showed significantly less drinking following a CDI than a BMI. Men and individuals who reported low incident aversiveness showed higher drinks per occasion after receiving a booster, while individuals high in alcohol-related problems reported fewer heavy drinking days after completing a booster session. Findings suggest that identifying specific characteristics related to the precipitating event may inform intervention approaches in this high-risk population, however additional research is needed to offer concrete guidance to practitioners in the field.

Research paper thumbnail of Examination of the mediational influences of peer norms, environmental influences, and parent communications on heavy drinking in athletes and nonathletes

Psychology of Addictive Behaviors, 2007

The present study used perspectives from the general literature on college alcohol consumption to... more The present study used perspectives from the general literature on college alcohol consumption to examine mediational influences of peer, environmental, and parental variables on heavy drinking for student athlete and nonathlete samples. Eight hundred thirty-five freshmen who differed in organized sports involvement were compared on heavy drinking outcomes, peer norms, environmental influences, and parental communication. College athletes reported significantly more heavy drinking experiences than nonathletes. Peer norms, environmental influences, and parental communication were all significant mediators of the athlete-heavy drinking relationship. Athletes reported a higher perception of peer drinking, peer approval of drinking, higher alcohol availability, and direct drink offers, which, in turn, were related to higher rates of heavy drinking. Parental communication mediated the athlete-heavy drinking relationship differently, depending on the specific topic of conversation. Discussion surrounding the importance of incorporating a variety of interventions aimed at reducing collegiate athlete drinking on the basis of the peer, environmental, and parental influences observed in the present analyses are presented. Limitations and directions for future research are also noted.

Research paper thumbnail of Substance use patterns among first-year college students: Secondary effects of a combined alcohol intervention

Journal of Substance Abuse Treatment, 2010

The current study explored secondary effects of a multi-site randomized alcohol prevention trial ... more The current study explored secondary effects of a multi-site randomized alcohol prevention trial on tobacco, marijuana and other illicit drug use among a sample of incoming college students who participated in high school athletics. Students (N = 1275) completed a series of web-administered measures at baseline during the summer before starting college and ten months later. Students were randomized to one of four conditions: a parent-delivered intervention, a brief motivation enhancement intervention (BASICS), a condition combining the parent intervention and BASICS, and assessment only control. A series of ANOVAs evaluating drug use outcomes at the 10-month follow up assessment revealed significant reductions in marijuana use among students who received the combined intervention compared to the BASICS-only and control groups. No other significant differences between treatment conditions were found for tobacco or other illicit drug use. Our findings suggest the potential utility of targeting both alcohol and marijuana use when developing peer and parent-based interventions for students transitioning to college. Clinical implications and future research directions are considered.

Research paper thumbnail of Examination of posttraining supervision of peer counselors in a motivational enhancement intervention to reduce drinking in a sample of heavy-drinking college students

Journal of Substance Abuse Treatment, 2010

Importance of peer counselor posttraining supervision on motivational interviewing (MI) microskil... more Importance of peer counselor posttraining supervision on motivational interviewing (MI) microskills and postintervention drinking outcomes were evaluated in a sample of heavy-drinking undergraduate students completing Brief Alcohol Screening and Intervention for College Students (BASICS; L.A. Dimeff, J.S. Baer, D.R. Kivlahan, & G.A. Marlatt, 1999). Two peer counselor groups were trained using identical protocols. Posttraining, one group was randomized to receive supervision, whereas the other received no supervision. Groups were subsequently compared on MI microskills. College students (n = 122) were randomly assigned to either assessment-only control, supervision, or no supervision groups and completed a BASICS intervention. Postintervention drinking outcomes were examined. Results suggested supervision aided peer counselors in reducing use of closed-ended questions. Both treatment groups reduced total drinks per week and heavydrinking behaviors compared to control. No differences on peak blood alcohol concentration (BAC) or alcohol-related consequences were observed. Differences in supervision did not influence drinking outcomes; however, posttraining supervision for peer counselors deficient in MI microskills may be needed to improve BASICS fidelity.

Research paper thumbnail of Phone-delivered brief motivational interventions for mandated college students delivered during the summer months

Journal of Substance Abuse Treatment, 2014

Across the United States, tens of thousands of college students are mandated to receive an alcoho... more Across the United States, tens of thousands of college students are mandated to receive an alcohol intervention following an alcohol policy violation. Telephone interventions may be an efficient method to provide mandated students with an intervention, especially when they are away from campus during summer vacation. However, little is known about the utility of telephone-delivered brief motivational interventions. Participants in the study (N=57) were college students mandated to attend an alcohol program following a campus-based alcohol citation. Participants were randomized to a brief motivational phone intervention (pBMI) (n=36) or assessment only (n=21). Ten participants (27.8%) randomized to the pBMI did not complete the intervention. Follow-up assessments were conducted 3, 6, and 9 months post-intervention. Results indicated the pBMI significantly reduced the number of alcohol-related problems compared to the assessment-only group. Participants who did not complete the pBMI appeared to be lighter drinkers at baseline and randomization, suggesting the presence of alternate influences on alcohol-related problems. Phone BMIs may be an efficient and cost-effective method to reduce harms associated with alcohol use by heavy-drinking mandated students during the summer months.

Research paper thumbnail of Heavy Drinking in College Students: Who Is at Risk and What Is Being Done About It?

The Journal of General Psychology, 2006

Problem drinking and related consequences are a major social issue plaguing college campuses acro... more Problem drinking and related consequences are a major social issue plaguing college campuses across the United States. Each year, alcohol is responsible for fatalities, assaults, serious injuries, and arrests that occur among college students. The authors review and discuss the risk factors, drinking patterns, and consequences that are relevant to the general student population. In addition, the authors highlight individuals at an increased risk of experiencing alcohol-related problems, such as Greek-letter social organization members and student athletes. The authors also discuss the interventions that attempt to reduce risky drinking and related problems in these subgroups as well as the future directions for research.

Research paper thumbnail of Clinical Considerations in the Treatment of Substance Use Disorders with Veterans

Journal of Contemporary Psychotherapy, 2011

This article addresses issues associated with the treatment of substance use disorders (SUD) in t... more This article addresses issues associated with the treatment of substance use disorders (SUD) in the U.S. veteran population. First, we examine special considerations regarding the assessment of alcohol and drug use in veterans. Second, we discuss current treatment approaches that have demonstrated efficacy in this population, with special consideration the issue of co-morbidity (especially SUD and Posttraumatic Stress Disorder). Third, we discuss two strategies to coordinate treatment of SUD: stepped care as a way to implement these treatments for SUD alone, and integrated treatment for SUD and co-morbid disorders. Finally, we discuss promising future directions for the treatment of SUD in the veteran population, including examination of mechanisms of behavior change, formal involvement of the veteran's family in treatment, and use of existing datasets.

Research paper thumbnail of The Process of Delivering Peer-Based Alcohol Intervention Programs in College Settings

Journal of College Student Development, 2008

Research paper thumbnail of A Comparison of 2 Brief Intervention Approaches to Reduce Indoor Tanning Behavior in Young Women Who Indoor Tan Very Frequently

Archives of Dermatology, 2008

Case-control studies have found evidence linking UV radiation exposure through indoor artificial ... more Case-control studies have found evidence linking UV radiation exposure through indoor artificial UV tanning to all forms of skin cancer, and these risks increase exponentially for those who indoor tan more than 10 times a year. 1,2 Compounding the problem are the high rates of indoor UV tanning among young women, who engage in significantly more indoor tanning than men. 3,4 Despite these risks, few prevention efforts have been developed specifically targeting indoor tanners who tan very frequently.

Research paper thumbnail of Motivational interviewing with significant other participation: assessing therapeutic alliance and patient satisfaction and engagement

Journal of substance abuse treatment, 2010

Inclusion of concerned significant others (SOs) in alcohol use treatment has demonstrated efficac... more Inclusion of concerned significant others (SOs) in alcohol use treatment has demonstrated efficacy but has not been tested in the context of brief interventions. In this study, individual motivational interviewing (MI) sessions were compared with MI sessions including a significant other on within-treatment outcomes (alliance, fidelity, client satisfaction, and engagement). Participants (N = 382) were adult alcohol users recruited in a Level I trauma center. Perceived alliance did not differ across conditions, but patients and SOs reported higher alliance, satisfaction, and engagement than was perceived by the therapist. The occurrence of MI components, or discussion areas, was consistent across conditions. Higher baseline SO drinking was associated with lower patient engagement, whereas higher baseline SO acceptance of patient drinking was associated with lower SO engagement. Results suggest that individual MI sessions can be adapted to include an SO with minimal impact on patient ...

Research paper thumbnail of Addressing Alcohol Use and Problems in Mandated College Students: A Randomized Clinical Trial Using Stepped Care

Journal of Consulting and Clinical Psychology

Objective: Over the past 2 decades, colleges and universities have seen a large increase in the n... more Objective: Over the past 2 decades, colleges and universities have seen a large increase in the number of students referred to the administration for alcohol policies violations. However, a substantial portion of mandated students may not require extensive treatment. Stepped care may maximize treatment efficiency and greatly reduce the demands on campus alcohol programs. Method: Participants in the study (N = 598) were college students mandated to attend an alcohol program following a campus-based alcohol citation. All participants received Step 1: a 15-min brief advice session that included the provision of a booklet containing advice to reduce drinking. Participants were assessed 6 weeks after receiving the brief advice, and those who continued to exhibit risky alcohol use (n = 405) were randomized to Step 2, a 60- to 90-min brief motivational intervention (n = 211), or an assessment-only control (n = 194). Follow-up assessments were conducted 3, 6, and 9 months after Step 2. Resu...

Research paper thumbnail of Daily co-occurrence of alcohol use and high-risk sexual behavior among heterosexual, heavy drinking emergency department patients

Drug and Alcohol Dependence, 2015

Global association and experimental studies suggest that alcohol use may increase sexual behavior... more Global association and experimental studies suggest that alcohol use may increase sexual behavior that poses risk for exposure to sexually transmitted infections (STI) among heterosexual men and women. However, results from longitudinal and daily recall studies exploring the co-occurrence of alcohol use with various sexual risk outcomes in more naturalistic contexts have been mixed, and the bulk of this research has focused on college students. The current study enrolled heavy-drinking emergency department (ED) patients and used a cross-sectional, 30-day Timeline Followback (TLFB) method to examine the daily co-occurrence between alcohol use and three sexual behavior outcomes: Any sex, unprotected intercourse (UI), and UI with casual partners (versus protected intercourse [PI] with casual partners, or UI/PI with steady partners). Results indicated that increasing levels of alcohol use on a given day increased the odds of engaging in any sexual activity and that heavy drinking (but not very heavy drinking) on a given day was associated with an increased odds of engaging in UI with either steady or casual partners. However, day-level alcohol use was not associated with an increased odds of UI with casual partners. These findings suggest that alcohol may play an important role in increasing risk for HIV/STIs among heterosexuals, and support the continued need to target heavy drinking in sex risk reduction interventions. However, our results also suggest that alcohol may not universally result in unprotected sex with casual partners, a behavior posing perhaps the highest risk for HIV/STI transmission.

Research paper thumbnail of The Impact of Defensiveness and Incident Reactions on Post-Sanction Drinking Behaviors among Mandated Students

Addictive Behaviors, 2015

Prior studies with mandated students (students referred for an intervention following violation o... more Prior studies with mandated students (students referred for an intervention following violation of a campus alcohol policy) have suggested that decreases in drinking behaviors may occur before clinical intervention. Others studies have suggested that greater reductions were associated with lower defensiveness and stronger incident reactions, such as responsibility and aversiveness. The current study sought to integrate these findings and examine the influence of pre-sanction drinking and perceptions on mandated students' post-sanction drinking levels prior to attending a brief intervention. Data were collected as part of a longitudinal study of brief interventions in a mandated student sample (N=61, 43% female, 97% White). Participants completed demographic measures, scales measuring incident reactions and defensiveness, and a Time Line Follow Back assessing drinking quantity and frequency both pre- and post-sanction. Analyses revealed significant post-sanction decreases in quantity (average total drinks per month) and frequency (number of monthly drinking days). Pre-sanction drinking quantity and frequency significantly predicted post-sanction quantity and frequency, respectively. Interaction effects suggest higher post-sanction quantities among moderate and heavier drinkers with higher defensiveness and lower aversiveness perceptions, while perceptions did not influence outcomes among light drinkers. None of the interactions involving blame or responsibility, or predicting post-sanction frequency, were significant. These findings suggest a complex relationship between pre-sanction drinking and student reactions. Implications for mandated student interactions and future research directions are discussed.

Research paper thumbnail of A pilot study of two supervision approaches for peer-led alcohol interventions with mandated college students

Journal of studies on alcohol and drugs, 2014

Despite the increasing need to identify and implement effective interventions to reduce drinking ... more Despite the increasing need to identify and implement effective interventions to reduce drinking with mandated college students, peer-led brief alcohol interventions have received minimal research attention. The current pilot study tested whether enhanced supervision (evidence-based application approach [EAA; group plus individual]) would improve peer counseling skills beyond those acquired by a common practice approach (CPA; group only). Following initial peer counselor skill evaluation, drinking outcomes after intervention were compared between supervision groups with a mandated college student sample (N = 82; 65 men). The relationship between acquired motivational interviewing skills and subsequent drinking behaviors was also assessed. EAA peer counselors showed higher motivational interviewing skill acquisition than CPA peer counselors. Despite differences in counselor skill demonstration, mandated clients in both intervention groups significantly reduced drinking behaviors. Fur...

Research paper thumbnail of Assessing Sexual Motives for Drinking Alcohol Among HIV-Positive Men Who Have Sex With Men

Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, Jan 18, 2014

Individuals who drink alcohol for the explicit motive of facilitating or enhancing sex may be mor... more Individuals who drink alcohol for the explicit motive of facilitating or enhancing sex may be more likely to engage in risky sexual behavior, including having sex under the influence of alcohol. However, efforts to assess sexual motives for drinking (SMDs) have been very limited to date. We examined the psychometric properties of a 5-item measure of SMDs in a sample of HIV-positive heavy drinking men who have sex with men. Findings provided excellent support for the scale's internal consistency and concurrent validity with a well-established measure of sexual alcohol expectancies (SAEs). Good discriminant validity was also established, as SMDs were correlated with other drinking motives but uniquely predicted the proportion of sex acts occurring under the influence of alcohol and other drugs, over and above other drinking motives and SAEs. SMDs were not significantly associated with unprotected anal intercourse. Adjusting for alcohol problem severity, higher SMDs were associated...

Research paper thumbnail of Contents List

Research paper thumbnail of Individual versus significant-other-enhanced brief motivational intervention for alcohol in emergency care

Journal of Consulting and Clinical Psychology, 2014

Effects of brief motivational interventions (BMIs) for heavy drinkers identified by alcohol-relat... more Effects of brief motivational interventions (BMIs) for heavy drinkers identified by alcohol-related emergency department (ED) visits are mixed. The successes of including significant others (SOs) in behavioral treatment suggest that involving SOs in ED-delivered BMI might prove beneficial. This study investigated the relative efficacy of an SO-enhanced motivational intervention (SOMI) compared with an individual motivational intervention (IMI) to address heavy drinking in emergency care settings. ED (n = 317) or trauma unit (n = 89) patients were randomly assigned to receive either an IMI or an SOMI and were reassessed at 6 and 12 months for alcohol consumption, alcohol-related consequences, and perceived alcohol-specific SO support. Generalized estimating equation analyses showed consistent reductions over time for both alcohol consumption and consequences. At 1-year follow-up, the average reduction in total drinks consumed per week was greater for patients in the SOMI condition than the IMI condition. In SOMI, 9.4% more patients moved to within the national guidelines for weekly drinking than did IMI patients. Frequency of heavy drinking and negative alcohol consequences showed no differential effects of intervention. Emergence of a modest treatment effect at 12 months suggests that SO involvement in the SOMI condition may have led to more sustained positive influence on patient drinking than in the IMI condition. Implications and limitations regarding SO involvement in brief treatment are discussed.

Research paper thumbnail of Behavioral Economic Decision Making and Alcohol-related Sexual Risk Behavior

AIDS and Behavior, 2014

The discipline of behavioral economics integrates principles from psychology and economics to sys... more The discipline of behavioral economics integrates principles from psychology and economics to systematically characterize decision-making preferences. Two forms of behavioral economic decision making are of relevance to HIV risk behavior: delay discounting, reflecting preferences for immediate small rewards relative to larger delayed rewards (i.e., immediate gratification), and probability discounting, reflecting preferences for larger probabilistic rewards relative to smaller guaranteed rewards (i.e., risk sensitivity). This study examined questionnaire-based indices of both types of discounting in relation to sexual risk taking in an emergency department sample of hazardous drinkers who engage in risky sexual behavior. More impulsive delay discounting was significantly associated with increased sexual risk-taking during a drinking episode, but not general sexual risk-taking. Probability discounting was not associated with either form of sexual risk-taking. These findings implicate impulsive delay discounting with sexual risk taking during alcohol intoxication and provide further support for applying this approach to HIV risk behavior.

Research paper thumbnail of College Students' Social Reactions to the Victim in a Hypothetical Sexual Assault Scenario: The Role of Victim and Perpetrator Alcohol Use

Violence and Victims, 2012

College students' responses to a hypothetical sexual assa... more College students' responses to a hypothetical sexual assault scenario involving alcohol use by the victim and/or perpetrator were examined (N = 295). Participants reported on victim/perpetrator responsibility, the extent to which the scenario would be considered rape, and their likelihood of providing positive or negative responses to the victim. Compared to women, men indicated that they would provide more negative and less positive social reactions to the victim, were less likely to identify the scenario as rape, and endorsed less perpetrator responsibility. When the victim was drinking, participants endorsed greater victim responsibility and lower perpetrator responsibility for the assault. Participants indicated that they would provide the victim with less emotional support when only the perpetrator was drinking, compared to when both the individuals were drinking.

Research paper thumbnail of The comparative effectiveness of individual and group brief motivational interventions for mandated college students

Psychology of Addictive Behaviors, 2014

Individual brief motivational intervention (iBMI) is an efficacious strategy to reduce heavy drin... more Individual brief motivational intervention (iBMI) is an efficacious strategy to reduce heavy drinking by students who are mandated to receive an alcohol intervention following an alcohol-related event. However, despite the strong empirical support for iBMI, it is unknown if the results from rigorously controlled research on iBMI translate to real-world settings. Furthermore, many colleges lack the resources to provide iBMI to mandated students. Therefore, group-delivered BMI (gBMI) might be a cost-effective alternative that can be delivered to a large number of individuals. The purpose of this study was to conduct a comparative effectiveness evaluation of iBMI and gBMI as delivered by staff at a university health services center. Participants (N ϭ 278) were college students who were mandated to receive an alcohol intervention following an alcohol-related incident. Participants were randomized to receive an individual (iBMI; n ϭ 133) or a Group BMI (gBMI; n ϭ 145). Results indicated that both iBMI and gBMI participants reduced their peak estimated blood alcohol concentration (BAC) and the number of negative alcohol-related consequences at 1-, 3-, and 6-months postintervention. The iBMI and gBMI conditions were not significantly different at follow-up. These findings provide preliminary support for the use of iBMI and gBMIs for college students in real-world settings.

Research paper thumbnail of Incident-specific and individual-level moderators of brief intervention effects with mandated college students

Psychology of Addictive Behaviors, 2011

Brief Motivational Interventions (BMI) and Computer-delivered interventions (CDI) have been succe... more Brief Motivational Interventions (BMI) and Computer-delivered interventions (CDI) have been successful in reducing drinking behaviors with mandated college students. However, research examining moderators of intervention effects have found mixed results. The current study sought to replicate and extend the research on moderators of intervention efficacy with mandated students. Baseline alcohol-related problems, readiness to change, gender, incident consequences, and participant responses to the event (personal attributions about the incident, aversiveness of the incident) were examined as moderators of intervention and booster condition efficacy on alcohol use and problems. Mandated students (N = 225) were randomized to complete either a BMI or CDI (Alcohol 101; Century Council, 1998), with or without a 1-month booster session, following a campus alcohol sanction. Outcomes were measured 3 months after baseline. Attributions moderated intervention condition such that participants low in personal attributions for their incident showed significantly less drinking following a CDI than a BMI. Men and individuals who reported low incident aversiveness showed higher drinks per occasion after receiving a booster, while individuals high in alcohol-related problems reported fewer heavy drinking days after completing a booster session. Findings suggest that identifying specific characteristics related to the precipitating event may inform intervention approaches in this high-risk population, however additional research is needed to offer concrete guidance to practitioners in the field.

Research paper thumbnail of Examination of the mediational influences of peer norms, environmental influences, and parent communications on heavy drinking in athletes and nonathletes

Psychology of Addictive Behaviors, 2007

The present study used perspectives from the general literature on college alcohol consumption to... more The present study used perspectives from the general literature on college alcohol consumption to examine mediational influences of peer, environmental, and parental variables on heavy drinking for student athlete and nonathlete samples. Eight hundred thirty-five freshmen who differed in organized sports involvement were compared on heavy drinking outcomes, peer norms, environmental influences, and parental communication. College athletes reported significantly more heavy drinking experiences than nonathletes. Peer norms, environmental influences, and parental communication were all significant mediators of the athlete-heavy drinking relationship. Athletes reported a higher perception of peer drinking, peer approval of drinking, higher alcohol availability, and direct drink offers, which, in turn, were related to higher rates of heavy drinking. Parental communication mediated the athlete-heavy drinking relationship differently, depending on the specific topic of conversation. Discussion surrounding the importance of incorporating a variety of interventions aimed at reducing collegiate athlete drinking on the basis of the peer, environmental, and parental influences observed in the present analyses are presented. Limitations and directions for future research are also noted.

Research paper thumbnail of Substance use patterns among first-year college students: Secondary effects of a combined alcohol intervention

Journal of Substance Abuse Treatment, 2010

The current study explored secondary effects of a multi-site randomized alcohol prevention trial ... more The current study explored secondary effects of a multi-site randomized alcohol prevention trial on tobacco, marijuana and other illicit drug use among a sample of incoming college students who participated in high school athletics. Students (N = 1275) completed a series of web-administered measures at baseline during the summer before starting college and ten months later. Students were randomized to one of four conditions: a parent-delivered intervention, a brief motivation enhancement intervention (BASICS), a condition combining the parent intervention and BASICS, and assessment only control. A series of ANOVAs evaluating drug use outcomes at the 10-month follow up assessment revealed significant reductions in marijuana use among students who received the combined intervention compared to the BASICS-only and control groups. No other significant differences between treatment conditions were found for tobacco or other illicit drug use. Our findings suggest the potential utility of targeting both alcohol and marijuana use when developing peer and parent-based interventions for students transitioning to college. Clinical implications and future research directions are considered.

Research paper thumbnail of Examination of posttraining supervision of peer counselors in a motivational enhancement intervention to reduce drinking in a sample of heavy-drinking college students

Journal of Substance Abuse Treatment, 2010

Importance of peer counselor posttraining supervision on motivational interviewing (MI) microskil... more Importance of peer counselor posttraining supervision on motivational interviewing (MI) microskills and postintervention drinking outcomes were evaluated in a sample of heavy-drinking undergraduate students completing Brief Alcohol Screening and Intervention for College Students (BASICS; L.A. Dimeff, J.S. Baer, D.R. Kivlahan, & G.A. Marlatt, 1999). Two peer counselor groups were trained using identical protocols. Posttraining, one group was randomized to receive supervision, whereas the other received no supervision. Groups were subsequently compared on MI microskills. College students (n = 122) were randomly assigned to either assessment-only control, supervision, or no supervision groups and completed a BASICS intervention. Postintervention drinking outcomes were examined. Results suggested supervision aided peer counselors in reducing use of closed-ended questions. Both treatment groups reduced total drinks per week and heavydrinking behaviors compared to control. No differences on peak blood alcohol concentration (BAC) or alcohol-related consequences were observed. Differences in supervision did not influence drinking outcomes; however, posttraining supervision for peer counselors deficient in MI microskills may be needed to improve BASICS fidelity.

Research paper thumbnail of Phone-delivered brief motivational interventions for mandated college students delivered during the summer months

Journal of Substance Abuse Treatment, 2014

Across the United States, tens of thousands of college students are mandated to receive an alcoho... more Across the United States, tens of thousands of college students are mandated to receive an alcohol intervention following an alcohol policy violation. Telephone interventions may be an efficient method to provide mandated students with an intervention, especially when they are away from campus during summer vacation. However, little is known about the utility of telephone-delivered brief motivational interventions. Participants in the study (N=57) were college students mandated to attend an alcohol program following a campus-based alcohol citation. Participants were randomized to a brief motivational phone intervention (pBMI) (n=36) or assessment only (n=21). Ten participants (27.8%) randomized to the pBMI did not complete the intervention. Follow-up assessments were conducted 3, 6, and 9 months post-intervention. Results indicated the pBMI significantly reduced the number of alcohol-related problems compared to the assessment-only group. Participants who did not complete the pBMI appeared to be lighter drinkers at baseline and randomization, suggesting the presence of alternate influences on alcohol-related problems. Phone BMIs may be an efficient and cost-effective method to reduce harms associated with alcohol use by heavy-drinking mandated students during the summer months.

Research paper thumbnail of Heavy Drinking in College Students: Who Is at Risk and What Is Being Done About It?

The Journal of General Psychology, 2006

Problem drinking and related consequences are a major social issue plaguing college campuses acro... more Problem drinking and related consequences are a major social issue plaguing college campuses across the United States. Each year, alcohol is responsible for fatalities, assaults, serious injuries, and arrests that occur among college students. The authors review and discuss the risk factors, drinking patterns, and consequences that are relevant to the general student population. In addition, the authors highlight individuals at an increased risk of experiencing alcohol-related problems, such as Greek-letter social organization members and student athletes. The authors also discuss the interventions that attempt to reduce risky drinking and related problems in these subgroups as well as the future directions for research.

Research paper thumbnail of Clinical Considerations in the Treatment of Substance Use Disorders with Veterans

Journal of Contemporary Psychotherapy, 2011

This article addresses issues associated with the treatment of substance use disorders (SUD) in t... more This article addresses issues associated with the treatment of substance use disorders (SUD) in the U.S. veteran population. First, we examine special considerations regarding the assessment of alcohol and drug use in veterans. Second, we discuss current treatment approaches that have demonstrated efficacy in this population, with special consideration the issue of co-morbidity (especially SUD and Posttraumatic Stress Disorder). Third, we discuss two strategies to coordinate treatment of SUD: stepped care as a way to implement these treatments for SUD alone, and integrated treatment for SUD and co-morbid disorders. Finally, we discuss promising future directions for the treatment of SUD in the veteran population, including examination of mechanisms of behavior change, formal involvement of the veteran's family in treatment, and use of existing datasets.

Research paper thumbnail of The Process of Delivering Peer-Based Alcohol Intervention Programs in College Settings

Journal of College Student Development, 2008

Research paper thumbnail of A Comparison of 2 Brief Intervention Approaches to Reduce Indoor Tanning Behavior in Young Women Who Indoor Tan Very Frequently

Archives of Dermatology, 2008

Case-control studies have found evidence linking UV radiation exposure through indoor artificial ... more Case-control studies have found evidence linking UV radiation exposure through indoor artificial UV tanning to all forms of skin cancer, and these risks increase exponentially for those who indoor tan more than 10 times a year. 1,2 Compounding the problem are the high rates of indoor UV tanning among young women, who engage in significantly more indoor tanning than men. 3,4 Despite these risks, few prevention efforts have been developed specifically targeting indoor tanners who tan very frequently.