Trajectories of College Alcohol Involvement and Their Associations with Later Alcohol Use Disorder Symptoms

  • Mark A. Prince
  • Jennifer P. Read
  • Craig R. Colder


Little is known about what differentiates individuals whose drinking patterns escalate into problematic use following the transition out of college compared to those who learn to drink in a way that is consistent with independent adult roles. Patterns of alcohol use and problems during college may pre-sage progression toward problem drinking in adulthood. The present study sought to examine such patterns in an effort to delineate those at greatest risk. Research has not yet elucidated whether, when, and how these groups diverge. Our results indicate that students who report AUD symptoms one year following graduation reported greater alcohol involvement from the first semester and escalated their involvement with alcohol at a more rapid pace. We observed marked and measurable differences in drinking patterns between those who go on to exhibit AUD symptoms following college and those who do not. A close inspection of these differences reveals that relatively small absolute differences in alcohol consumption add up to large differences in alcohol-related consequences. Thus, markers of longer-term risk are present early in college, and greater escalation of drinking across college is an indicator that intervention is needed. Brief Motivational Interventions could help students to anticipate some of the challenges ahead as they transition from the college environment, as well as the potential deleterious effects of immoderate alcohol use on making a successful transition into adult roles. In addition to the beginning of college, our findings also point to critical periods during which screening and brief intervention may be optimally timed.


College student drinking Transition out of college Joinpoint analysis Alcohol use disorder 



This work was supported by the National Institute on Drug Abuse, Grant #Z R01DA018993 & Administrative Supplement: 3R01DA018993-05S1: Read, PI. Mark A. Prince is supported by the National Institute on Alcohol Abuse and Alcoholism Training Grant T32-AA007583.

Compliance with Ethical Standards

Conflicts of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual study participants.


  1. Bachrach, R. L., & Read, J. P. (2012). The role of posttraumatic stress and problem alcohol involvement in university academic performance. Journal of Clinical Psychology, 68, 843–859.CrossRefGoogle Scholar
  2. Barnett, N. P., Goldstein, A. L., Murphy, J. G., Colby, S. M., & Monti, P. M. (2006). “I’ll never drink like that again”: Characteristics of alcohol-related incidents and predictors of motivation to change in college students. Journal of Studies on Alcohol, 67, 754–763.CrossRefGoogle Scholar
  3. Carey, K. B., & Hustad, J. T. (2002). Are retrospectively reconstructed blood alcohol concentrations accurate? Preliminary results from a field study. Journal of Studies on Alcohol, 63, 762–766.CrossRefGoogle Scholar
  4. Carter, A. C., Brandon, K. O., & Goldman, M. S. (2010). The college and noncollege experience: A review of the factors that influence drinking behavior in young adulthood. Journal of Studies on Alcohol and Drugs, 71, 742–750.CrossRefGoogle Scholar
  5. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (Vol. 2). Hillsdale: Lawrence Earlbaum Associates.Google Scholar
  6. Collins, R. L., Parks, G. A., & Marlatt, G. A. (1985). Social determinants of alcohol consumption: The effects of social interaction and model status on the self-administration of alcohol. Journal of Consulting and Clinical Psychology, 53, 189–200.CrossRefGoogle Scholar
  7. Davis, C. M., & Clifford, P. R. (2016). Ascertaining the relationships between the trajectories of specific categories of alcohol-related negative consequences and subsequent drinking behavior. Psychology of Addictive Behaviors. Advance online publication.
  8. Dawson, D. A., Grant, B. F., Stinson, F. S., & Chou, S. P. (2004). Another look at heavy episodic drinking and alcohol use disorders among college and noncollege youth. Journal of Studies on Alcohol, 65, 477–488 Scholar
  9. Dimeff, L. A. (1999). Brief alcohol screening and intervention for college students (BASICS): A harm reduction approach. New York: Guilford Press.Google Scholar
  10. Hasin, D., Paykin, A., & Endicott, J. (2001). Course of DSM-IV alcohol dependence in a community sample: Effects of parental history and binge drinking. Alcoholism: Clinical and Experimental Research, 25, 411–414.CrossRefGoogle Scholar
  11. Hustad, J. T. P., & Carey, K. B. (2005). Using calculations to estimate blood alcohol concentrations for naturally occurring drinking episodes: A validity study. Journal of Studies on Alcohol, 66, 130–138.CrossRefGoogle Scholar
  12. Jackson, K. M. (2008). Heavy episodic drinking: Determining the predictive utility of five or more drinks. Psychology of Addictive Behaviors, 22, 68–77.CrossRefGoogle Scholar
  13. Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). Monitoring the future national survey results on drug use, 1975–2011. Volume II: College students and adults ages 19–50. Ann Arbor: Institute for Social Research, The University of Michigan.Google Scholar
  14. Kim, H. J., Fay, M. P., Feuer, E. J., & Midthune, D. N. (2000). Permutation tests for joinpoint regression with applications to cancer rates. Statistics in Medicine, 19, 335–351 (correction: 2001;20:655).CrossRefGoogle Scholar
  15. Kim, H. J., Fay, M. P., Yu, B., Barrett, M. J., & Feuer, E. J. (2004). Comparability of segmented line regression models. Biometrics, 1005–1014.Google Scholar
  16. Lee, M. R., Chassin, L., & MacKinnon, D. P. (2015a). Role transitions and young adult maturing out of heavy drinking: Evidence for larger effects of marriage among more severe premarriage problem drinkers. Alcoholism: Clinical and Experimental Research, 39, 1064–1074.CrossRefGoogle Scholar
  17. Lee, M. R., Ellingson, J. M., & Sher, K. J. (2015b). Integrating social-contextual and intrapersonal mechanisms of “maturing out”: Joint influences of familial-role transitions and personality maturation on problem-drinking reductions. Alcoholism: Clinical and Experimental Research, 39, 1775–1787.CrossRefGoogle Scholar
  18. Littlefield, A. K., Sher, K. J., & Wood, P. K. (2009). Is “maturing out” of problematic alcohol involvement related to personality change? Journal of Abnormal Psychology, 118, 360–374.CrossRefGoogle Scholar
  19. Littlefield, A. K., Sher, K. J., & Wood, P. K. (2010). A personality-based description of maturing out of alcohol problems: Extension with a five-factor model and robustness to modeling challenges. Addictive Behaviors, 35(11), 948–954.Google Scholar
  20. Maggs, J. L., Schulenberg, J., & Hurrelmann, K. (1997). Developmental transitions during adolescence: Health promotion implications. In J. Schulenberg, J. L. Maggs, & K. Hurrelmann (Eds.), Health risks and developmental transitions during adolescence (pp. 522–546). New York: Cambridge University Press.Google Scholar
  21. Maisto, S. A., Conigliaro, J. C., Gordon, A. J., McGinnis, K. A., & Justice, A. C. (2008). An experimental study of the agreement of self-administration and telephone administration of the timeline followback interview. Journal of Studies on Alcohol and Drugs, 69, 468–471.CrossRefGoogle Scholar
  22. Mallett, K. A., Lee, C. M., Neighbors, C., Larimer, M. E., & Turrisi, R. (2006). Do we learn from our mistakes? An examination of the impact of negative alcohol-related consequences on college students’ drinking patterns and perceptions. Journal of Studies on Alcohol, 67, 269–276.CrossRefGoogle Scholar
  23. Mallett, K. A., Varvil-Weld, L., Borsari, B., Read, J. P., Neighbors, C., & White, H. R. (2013). An update of research examining college student alcohol-related consequences: New perspectives and implications for interventions. Alcoholism: Clinical and Experimental Research, 37, 709–716.CrossRefGoogle Scholar
  24. Merrill, J. E., Read, J. P., & Barnett, N. P. (2013). The way one thinks affects the way one drinks: Subjective evaluations of alcohol consequences predict subsequent change in drinking behavior. Psychology of Addictive Behaviors, 27, 42–51.CrossRefGoogle Scholar
  25. Patrick, M. E., & Schulenberg, J. E. (2011). How trajectories of reasons for alcohol use relate to trajectories of binge drinking: National panel data spanning late adolescence to early adulthood. Developmental Psychology, 47, 311.CrossRefGoogle Scholar
  26. Patrick, M. E., Terry‐McElrath, Y. M., Kloska, D. D., & Schulenberg, J. E. (2016). High‐intensity drinking among young adults in the United States: Prevalence, frequency, and developmental change. Alcoholism: clinical and experimental research, 40(9), 1905–1912.Google Scholar
  27. Polak, M. A., & Conner, T. S. (2012). Impairments in daily functioning after heavy and extreme episodic drinking in university students. Drug and Alcohol Review, 31, 763–769.CrossRefGoogle Scholar
  28. Prince, M. A., & Maisto, S. A. (2013). The clinical course of alcohol use disorders: Using joinpoint analysis to aid in interpretation of growth mixture models. Drug and Alcohol Dependence, 133, 433–439.CrossRefGoogle Scholar
  29. Prince, M. A., Pearson, M. R., Bravo, A. J., & Montes, K. S. (2018). A quantification of the alcohol use-consequences association in college student and clinical populations: A large, multi-sample study. The American Journal on Addictions, 27, 116–123.CrossRefGoogle Scholar
  30. Read, J. P., Kahler, C. W., Strong, D. R., & Colder, C. R. (2006). Development and preliminary validation of the young adult alcohol consequences questionnaire. Journal of Studies on Alcohol, 67, 169–177.CrossRefGoogle Scholar
  31. Read, J. P., Merrill, J. E., Kahler, C. W., & Strong, D. R. (2007). Predicting functional outcomes among college drinkers: Reliability and predictive validity of the Young Adult Alcohol Consequences Questionnaire. Addictive Behaviors, 32, 2597–2610.CrossRefGoogle Scholar
  32. Read, J. P., Beattie, M., Chamberlain, R., & Merrill, J. E. (2008). Beyond the “binge” threshold: Heavy drinking patterns and their association with alcohol involvement indices in college students. Addictive Behaviors, 33, 225–234.CrossRefGoogle Scholar
  33. Read, J. P., Ouimette, P., White, J., Colder, C., & Farrow, S. (2011). Rates of DSM-IV—TR trauma exposure and posttraumatic stress disorder among newly matriculated college students. Psychological Trauma: Theory, Research, Practice, and Policy, 3, 148–157.CrossRefGoogle Scholar
  34. Read, J. P., Colder, C. R., Merrill, J. E., Ouimette, P., White, J., & Swartout, A. (2012). Trauma and posttraumatic stress symptoms predict alcohol and other drug consequence trajectories in the first year of college. Journal of Consulting and Clinical Psychology, 80, 426–439.CrossRefGoogle Scholar
  35. Read, J. P., Wardell, J. D., & Bachrach, R. L. (2013). Drinking consequence types in the first college semester differentially predict drinking the following year. Addictive Behaviors, 38, 1464–1471.CrossRefGoogle Scholar
  36. Schulenberg, J. E., & Maggs, J. L. (2002). A developmental perspective on alcohol use and heavy drinking during adolescence and the transition to young adulthood. Journal of Studies on Alcohol, Supplement, 14, 54–70.CrossRefGoogle Scholar
  37. Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini-International Neuropsychiatric Interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.PubMedGoogle Scholar
  38. Slutske, W. S. (2005). Alcohol use disorders among US college students and their non-college-attending peers. Archives of General Psychiatry, 62, 321–327.CrossRefGoogle Scholar
  39. The Century Council (2003) Alcohol 101 plus [computer software]. Retrieved from
  40. Vergés, A., Haeny, A. M., Jackson, K. M., Bucholz, K. K., Grant, J. D., Trull, T. J., Wood, P. K., & Sher, K. J. (2013). Refining the notion of maturing out: Results from the national epidemiologic survey on alcohol and related conditions. American Journal of Public Health, 103, e67–e73.CrossRefGoogle Scholar
  41. Wechsler, H., Davenport, A., Dowdall, G., Moeykens, B., & Castillo, S. (1994). Health and behavioral consequences of binge drinking: A national survey of students at 140 campuses. JAMA, 272, 1672–1677.CrossRefGoogle Scholar
  42. Wechsler, H., Dowdall, G. W., Davenport, A., & Rimm, E. B. (1995). A gender-specific measure of binge drinking among college students. American Journal of Public Health, 85, 982–985.CrossRefGoogle Scholar
  43. White, A. M., Kraus, C. L., & Swartzwelder, H. S. (2006). Many college freshmen drink at levels far beyond the binge threshold. Alcoholism: Clinical and Experimental Research, 30, 1006–1010.CrossRefGoogle Scholar
  44. Wood, M. D., Read, J. P., Palfai, T. P., & Stevenson, J. F. (2001). Social influence processes and college student drinking: The mediational role of alcohol outcome expectancies. Journal of Studies on Alcohol, 62, 32–43.CrossRefGoogle Scholar
  45. Yu, B., Barrett, M., Kim, H.-J., & Feuer, E. J. (2007). Estimating joinpoints in continuous time scale for multiple change-point models. Computational Statistics and Data Analysis, 51, 2420–2427.CrossRefGoogle Scholar

Copyright information

© Society for Prevention Research 2019

Authors and Affiliations

  1. 1.Department of PsychologyColorado State UniversityFort CollinsUSA
  2. 2.Department of PsychologyUniversity at BuffaloBuffaloUSA

Personalised recommendations