Detroit Area Study of College Student Lifestyles

While individual difference factors, such as trait self-control and subjective college
student role investment, appear to be important predictors of excessive alcohol consumption
and related problems, these factors are not typically incorporated into indicated prevention
strategies. Indicated prevention usually focuses on groups or individuals who already
express some aspects of a health-related problem (e.g., heavy episodic drinking), or who, at
the very least, exhibit markers of risk (e.g., early age of first drink) associated with the
development of a health-related problem (Gordon, 1987). The primary aim of the current
proposal is to incorporate a personality-informed module into an existing motivational
interviewing framework for alcohol-related harm reduction and test its efficacy compared to
an information-only approach (i.e., informational packet) and a conventional strategy for
indicated prevention (i.e., Brief Alcohol Screening and Intervention for College Students,
BASICS; Dimeff et al., 1999) that has provided evidence for reduced risk of alcohol-related
problems in randomized controlled trials (Borsari & Carey, 2000; 2005).

Motivational interviewing is a common technique used to address ambivalence and/or
resistance to behavioral change. Motivational interviewing is commonly used in the context
of health-related behaviors, such as excessive alcohol consumption, where an individual
might not have experienced any serious consequences (e.g., driving while intoxicated), but
may still be at risk for problems (Miller & Rollnick, 2002). In motivational interviewing, a
tone of collaboration and attentiveness is considered critical to the success of the
interaction. The primary goal is to guide an individual toward increased motivation to
change (and actual behavioral change) by being responsive to the desires and concerns of the
individual as it relates to change, and by having an individual commit to even the most
modest of change goals (e.g., consuming beverages with reduced alcohol by volume in
situations that are known to be high-risk, rather than a favorite, higher alcohol-by-volume
beverage). Motivational interviewing is well-suited to accommodate a personality-informed
module for change due to its emphasis on an individual's unique profile of factors.

In BASICS, a harm reduction approach is used to inform the assessment and content of the
initial assessment session, as well as the follow-up feedback session (Dimeff et al., 1999).
Consistent with research showing there to be a continuum of problems for alcohol and other
externalizing behaviors (Bogg & Finn, 2010; Krueger et al., 2002), the harm reduction
approach emphasizes that any movement toward reduced risk and harm, regardless of its
impact, is positive movement, even if a person might be farther along the continuum of harm
(Marlatt, 1998). The current proposal seeks to test an augmentation of the harm reduction
approach of BASICS with a normative enhancement approach derived from the social investment
hypothesis of the Cumulative Continuity Model of personality development (Roberts & Caspi,
2003).

According to the social investment hypothesis, the process of commitment to normative roles,
such as college student, is ''thought to exact a form of social control through the role
demands embedded in these contexts that call on individuals to act with more responsibility
and probity'' (Roberts & Caspi, 2003; p. 203). To the extent that further commitment,
investment, and involvement in the college student role can be fostered, then a concomitant
increase in trait self-control should be expected as well, independent of harm reduction
effects. As suggested by the findings described above, the effect of increased subjective
college student role investment could be to deflect a risky trajectory for alcohol-related
problems - an effect that could be further amplified by corresponding increases in trait
self-control. This normative enhancement (NE) approach is posited to be particularly useful
for those individuals who do not recognize or are steadfastly resistant to even minor harm
reduction efforts conveyed through the motivational interviewing framework of BASICS. The
strategy of the normative enhancement approach is to capitalize on an individual's goals for
involvement in roles - especially those roles, such as college student, which are nominally
voluntary in nature.

Inclusion Criteria:

- We initially screen anonymously on the telephone for the inclusion/exclusion criteria
(see attached phone screen). The responses obtained from respondents are used only to
determine if they meet study criteria. Their names and responses are not recorded and
the information they provide is shredded when the screen is completed.

- be currently enrolled in full-time university coursework

- be between the ages of 18 and 23 years

- understand and be able to respond to screening questions in English

- be able to read at a Grade 6 level

- have consumed at least 4 (for women) or 5 (for men) standard drinks at least two
times in the past 30 days OR typically consume at least 3 (for women) or 4 (for
men) standard drinks on a drinking occasion

- meet at least one of the DSM-IV diagnostic criteria for alcohol dependence OR
score 8 or greater on the Alcohol Use Disorders Identification Test (AUDIT

Exclusion Criteria:

- not have major cognitive impairments (i.e., assessed by whether they can understand
and respond adequately to all screening questions)

- not have any history of traumatic brain injury. Subjects also are excluded if they
report a history of any serious head injury.

- not have a history of psychotic symptoms or Bipolar Disorder

- not be taking medications for cancer, AIDS treatment, or epilepsy

- not be taking other medications that will affect behavior, such as major
tranquilizers or antipsychotics

- not currently receiving voluntary or mandated counseling or treatment for substance
use