Study helps identify college drinkers at risk for adult alcohol abuse

Mar 24 2009

College students who are problem drinkers using alcohol to cope with personal problems and boost self-confidence are more likely to continue excessive drinking into adulthood, a recent study suggests.

The Ohio State University survey results suggest that adults who are still high-risk drinkers by age 34 may have inadvertently used alcohol to blunt the social and cognitive development that typically occurs during college, including the ability to handle alcohol.

Binge drinking involves consuming five or more drinks for men and four or more drinks for women in a single sitting, as previously described by Harvard researchers. The Ohio State study categorized high-risk drinkers based on their scores on a National Institute for Alcohol Abuse and Alcoholism questionnaire. In all cases, this drinking puts people at risk for serious consequences ranging from fatal injuries and sexual abuse to academic or mental problems and alcohol dependence.

High-risk drinkers in the survey who stopped problem drinking after college typically reduced their alcohol use during school - a sign in itself that their social development was closer to what is considered normal and on track.

If the subset of students most likely to continue problem drinking in adulthood can be identified during college, they might benefit from counseling or programming that specifically aims to lower long-term high-risk drinking, the researchers say. And the junior year might be the best time to introduce the intervention.

"We saw clear differences that, if they could be identified during college, could potentially lead to interventions that would make a difference in the long term," said Ada Demb, associate professor of educational policy and leadership at Ohio State and senior author of the study.

Demb completed this exploratory study with Corbin Campbell, a former master's student in Ohio State's higher education and student affairs program now pursuing a Ph.D. at the University of Maryland. The research is published in a recent issue of the Journal of College Student Development .

Demb and Campbell surveyed graduates of a large Midwestern university about their current drinking habits as well as their alcohol use during college. They received responses from 4,428 alumni who graduated between 1983 and 1993.

The researchers reported the basic survey results in an earlier paper published in the Journal of Alcohol & Drug Education. For this later study, they looked at those results through what they call a developmental lens.

Plenty of research has described the typical psychosocial and cognitive development that college students experience. Generally, development for young adults involves establishing an identity separate from parents and peers, sharpening judgment, developing interpersonal relationships and even mastering the use of alcohol.

Demb and Campbell compared the drinking survey results with typical college student development trends and found that high-risk college drinkers, depending on whether they grew out of the behavior or continued drinking into adulthood, appeared to have used alcohol for different purposes and in different quantities, which may have affected the rate of their social development during school.

The survey confirmed a long-standing statistic associated with college student drinking. For more than two decades, about 40 percent of college student drinkers have been considered high-risk users of alcohol, according to a number of studies. In this survey, 46 percent of the respondents reported they engaged in high-risk drinking during college.

Among high-risk drinkers, about 80 percent will grow out of that behavior. But 20 percent become what the researchers call "adult persistent" drinkers who maintain high-risk alcohol use well into adulthood. In this study, the results were very close to the national trend, with 78.9 percent of respondents scoring as "time limited" drinkers and 21.1 percent scoring as adult persisters whose current drinking behavior could cause them harm.

"We took that 21 percent and asked if there was anything about their behavior during college that could help us identify those who may be able to benefit from a different kind of intervention," Demb said.

One likely visible sign by the junior year would be a consistent drinking pattern throughout the college years, rather than the reduction seen among those who grow out of problem drinking, the study suggests. Student affairs professionals, especially those working in residence halls, are considered the most likely personnel to recognize problems, Campbell and Demb said.

The researchers used a well-known survey designed by the National Institute of Alcohol Abuse and Alcoholism that categorizes different kinds of drinkers. They questioned the adults about their current drinking behavior, and then added a second component, asking the alumni to answer the same questions about how they drank during college.

The reasons for drinking in college were strong indicators for differences between adults who grew out of problem drinking and those who persisted with high-risk alcohol use.

Adult persistent high-risk drinkers were more likely than others to use alcohol for developmental needs beyond the desire for the effect of alcohol and for help with social coping, common reasons for alcohol use among all high-risk college drinkers. The 21 percent of drinkers in the adult persistent group reported they had been more likely to use alcohol for self-confidence and to cope with personal problems during college.

"These students appeared to use alcohol to cope with or avoid developmental tasks," Campbell said. "So then we're asking if, in essence, they're drinking instead of developing along other lines."

Adult persistent drinkers also drank more alcohol during college than did the high-risk drinkers who eventually grew out of the behavior, indicating the time-limited group appeared to learn how to handle alcohol as they developed socially and cognitively while the adult persisters did not.

And even though adult persistent drinkers were more likely than others to say they thought they had had a drinking problem in college, they were ambivalent about whether they wanted to change their current drinking behavior.

"They had an inkling that something was not quite right, but they weren't quite ready to make a change," Campbell said.

"That's not to say any of the drinking in the high-risk group was normal," she said. "About 60 percent of college students are not high-risk drinkers and they are able to master these development tasks. They're able to develop autonomy, master the peer influence piece, manage emotions, develop interdependence with other people - all typical development tasks during college."

Many college-based alcohol intervention programs emphasize prevention and safety and are targeted toward first-year students. Demb and Campbell suggest that specialized programming for potential adult persistent drinkers would ideally focus on future consequences associated with continued excessive drinking, as well as assistance with developmental tasks such as introspective skill-building or developing social competencies outside of alcohol use.

The researchers also noted that family history of alcohol-related disease could be a strong influence on high-risk drinking behavior in college and beyond.

"I don't think there's a silver bullet here," Demb said. "We're not going to get all 20 percent of long-term high-risk drinkers with one kind of program.

"It's also not just a college and university job to take care of all of this, but it is an opportunity. One step we can take is to equip the student affairs professionals who work with students day in and day out with more of this information so they might be more aware of differentiation of students."