Transition to College: Α Classification and Regression Tree (CART) analysis of natural reduction of binge drinking

Approximately one in five teens that drank heavily in high school reduces or discontinues consumption while in college. Multiple paths might lead to the common outcome of natural reduction in heavy drinking. Statistical modeling of this complex process of natural reduction is a challenge with standard linear statistics. The purpose of this paper is to use a new statistical procedure, Classification and Regression Tree (CART), to model the equifinality of reduction in drinking by college students who drank heavily as adolescents. An appealing aspect of CART is that the resulting tree model that can easily be interpreted and applied by those who work with adolescents during the important transition from high school to college. Of 201 college students who first binged on alcohol while in high school, 71 (35.3%) denied heavy or binge drinking within the previous three months (Natural Reducers). The final model accurately classified 84.6% of the students as either continued heavy drinkers or natural reducers. Sensitivity was modest (accurate identification of 67.6% of the reducers); however, specificity was strong (correct classification of 93.8% of the continued heavy drinkers). The model revealed four pathways to natural reduction in drinking. Predominant in each path was the influence of social factors that maintain continued drinking (e.g., social facilitation outcome expectancies, perception of friends' drinking) or facilitate natural reduction (e.g., regular church attendance). The results support the application of CART to model health behaviors across the transition from adolescence to young adulthood.

[1]  H. Wechsler,et al.  Changes in binge drinking and related problems among American college students between 1993 and 1997. Results of the Harvard School of Public Health College Alcohol Study. , 1998, Journal of American college health : J of ACH.

[2]  Changes Over One Semester in Drinking Game Playing and Alcohol Use and Problems in a College Student Sample , 1999, Substance abuse.

[3]  P K Wood,et al.  Predicting stability and change in frequency of intoxication from the college years to beyond: individual-difference and role transition variables. , 1997, Journal of abnormal psychology.

[4]  H. Perkins,et al.  Problem drinking among college students: a review of recent research. , 1986, Journal of American college health : J of ACH.

[5]  H. Wechsler,et al.  College Binge Drinking in the 1990s: A Continuing Problem Results of the Harvard School of Public Health 1999 College Alcohol Study , 2000, Journal of American college health : J of ACH.

[6]  P. Vik,et al.  Natural reduction of binge drinking among college students. , 2003, Addictive behaviors.

[7]  L. Johnston,et al.  Getting drunk and growing up: trajectories of frequent binge drinking during the transition to young adulthood. , 1996, Journal of studies on alcohol.

[8]  D. Kivlahan,et al.  Episodic heavy drinking among college students: Methodological issues and longitudinal perspectives. , 1998 .

[9]  S. Tapert,et al.  Psychometric evaluation of the Customary Drinking and Drug Use Record (CDDR): a measure of adolescent alcohol and drug involvement. , 1998, Journal of studies on alcohol.

[10]  R. Aseltine,et al.  Mental Health and Social Adaptation Following the Transition From High School , 1993 .

[11]  L C Sobell,et al.  Natural recovery from alcohol and drug problems: methodological review of the research with suggestions for future directions. , 2000, Addiction.

[12]  T. Smith,et al.  An 8-year follow-up of 450 sons of alcoholic and control subjects. , 1996, Archives of general psychiatry.

[13]  P. Vik,et al.  Progression of consequences among heavy-drinking college students. , 2000, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[14]  M. Goldman,et al.  Expectations of reinforcement from alcohol: their domain and relation to drinking patterns. , 1980, Journal of consulting and clinical psychology.

[15]  K. Sher,et al.  Resolution of Alcohal Problems Without Treatment: Methodological Issues andFuture Directions of Natural recovery Research , 1998 .

[16]  L. Sobell,et al.  Recovery from alcohol problems with and without treatment: prevalence in two population surveys. , 1996, American journal of public health.

[17]  S. Brown,et al.  Characteristics of relapse following adolescent substance abuse treatment. , 1989, Addictive behaviors.

[18]  H Wechsler,et al.  Correlates of college student binge drinking. , 1995, American journal of public health.

[19]  B. Muthén,et al.  The development of heavy drinking and alcohol-related problems from ages 18 to 37 in a U.S. national sample. , 2000, Journal of studies on alcohol.

[20]  F. Grodstein,et al.  Continuation and initiation of alcohol use from the first to the second year of college. , 1994, Journal of studies on alcohol.

[21]  B. McCrady,et al.  Problem drinking from young adulthood to adulthood: patterns, predictors and outcomes. , 1999, Journal of studies on alcohol.

[22]  D. Kivlahan,et al.  Secondary prevention of alcohol abuse with college student populations: A skills-training approach. , 1994 .

[23]  R. Clements Prevalence of alcohol-use disorders and alcohol-related problems in a college student sample. , 1999, Journal of American college health : J of ACH.

[24]  D. McCarthy,et al.  Progression into and out of binge drinking among high school students. , 2001, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[25]  G. Vaillant,et al.  The Natural History of Alcoholism , 1996, Alcohol health and research world.

[26]  P. Nathan,et al.  Hypothesized simple factor structure for the Alcohol Expectancy Questionnaire: confirmatory factor analysis. , 1999, Experimental and clinical psychopharmacology.