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. 2024 Jan;85(1):73-83.
doi: 10.15288/jsad.23-00063. Epub 2023 Sep 28.

A Dual-Process Decision-Making Model Examining the Longitudinal Associations Between Alcohol-Induced Blackouts and Alcohol Use Disorder Risk Among College Student Drinkers

Shannon D Glenn  1   2 , Robert J Turrisi  1   2 , Veronica L Richards  2 , Michael A Russell  1   2 , Kimberly A Mallett  2
Affiliations

A Dual-Process Decision-Making Model Examining the Longitudinal Associations Between Alcohol-Induced Blackouts and Alcohol Use Disorder Risk Among College Student Drinkers

Shannon D Glenn et al. J Stud Alcohol Drugs. 2024 Jan.

Abstract

Objective: The purpose of this study was to use a dual-process decision-making model to examine the longitudinal associations between alcohol-induced blackouts (blackouts) and alcohol use disorder (AUD) risk symptoms among college student drinkers.

Method: Undergraduate drinkers (N = 2,024; 56% female; 87% White; 5% Hispanic) at a large northeastern university completed online surveys each semester during their first (Time [T] 1, T2), second (T3, T4), third (T5, T6), and fourth (T7, T8) years of college (87% retention across the study). Path analyses were examined testing the longitudinal associations between T1 willingness to experience a blackout, T1 intentions to avoid a blackout, T2-T8 drinking, T2-T8 blackouts, and T8 AUD risk symptoms. Hypotheses 1 and 2 tested the associations between T1 willingness, T1 intentions, T2-T8 drinking, and T2-T8 blackouts. Hypothesis 3 tested the associations between T2-T8 drinking, T2-T8 blackouts, and T8 AUD risk symptoms.

Results: Students experienced an average of 8 (SD = 8) blackouts during college. Approximately 1,514 (88.8%) participants reported experiencing 1 of 8 AUD risk symptoms. T1 willingness was positively associated with T2-T8 blackouts. T2-T8 drinking and T2-T8 blackouts were positively associated with T8 AUD risk symptoms. T1 willingness significantly indirectly affected T8 AUD risk symptoms through its association with T2-T8 blackouts.

Conclusions: Results estimated that, on average, college student drinkers experienced eight blackouts across 4 years of college, and 88% of participants reported experiencing at least one symptom of AUD in the last semester of college. Willingness to experience a blackout influenced students' AUD risk symptoms through the number of blackouts they experienced throughout college.

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Figures

Figure 1.
Figure 1.
Theoretical model. DDQ = Daily Drinking Questionnaire; AUD = alcohol use disorder.
Figure 2.
Figure 2.
Path model. DDQ = Daily Drinking Questionnaire; AUD = alcohol use disorder. Unstandardized beta values and asymmetrical 95% confidence intervals reported. Bold values are significant.
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