A daily diary study examining alcohol-induced blackouts among college students using alcohol sensors - ABSTRACT
College drinking continues to be a major public health concern in the United States and a priority area within
NIAAA. About 1 in 3 students report heavy episodic drinking (HED; 4+/5+ females/males) and 1 in 10 engage
in high-intensity drinking (HID; 8+/10+ females/males). Students who engage in risky drinking behaviors (HED
or HID) are at risk for experiencing alcohol-induced blackouts (AIBs; i.e., absence of memory for all or part of a
drinking episode). AIBs are critical to reducing harm because they are associated with experiencing higher
numbers of consequences and more severe consequences, even after controlling for drinking. A secondary
data analysis of ~800 student drinkers over 18 weekends showed that on nights when AIBs occurred, students
experienced ~3.5 more consequences than on non-AIB nights. At least one of these additional consequences
were considered to be severe. AIBs also occur at a high frequency to warrant their examination. Our pilot data
showed risky drinking students experienced AIBs on 1 out of every 3 drinking days. Although AIBs are
associated with risky drinking, there are many unanswered questions about why and when AIBs occur (which
events result in an AIB). The overall goal of the proposed research is to extend the field by using objective
transdermal alcohol concentration (TAC) sensors to increase our understanding of why and when AIBs occur.
The proposed study will utilize a comprehensive theoretical model which includes psychosocial variables (e.g.,
willingness to drink and experience AIBs, drinking/AIB attitudes/subjective evaluations, expectancies, and
norms), behavioral constructs (e.g., self-report drink counts, protective behaviors), and a novel biometric
assessment (i.e., TAC sensors) to examine the associations between risky drinking and AIBs. TAC sensors
assess alcohol use in near real time measuring features of intoxication repeatedly to provide a curve of
biological alcohol intoxication for every drinking day. Prior research suggests that the manner individuals
consume drinks (via TAC sensors) may differ when reporting the same number of drinks (e.g., speed of
drinking, time spent drinking). I served as a Co-I on a small pilot study (n=33) using similar methods to support
the proposed research. Students wore TAC sensors and completed 12 event-level drinking surveys over 4
weekends (Thurs, Fri, Sat). The preliminary findings included: 1) high compliance to study protocols (91%
retention/TAC use/event survey completion); and 2) 70% reported at least 1 AIB during the 12-weekend day
period, and 55% reported multiple AIBs at a rate of 1 out of every 3 drinking days. These findings are
encouraging and demonstrate my ability to carry out the proposed study. The aims are as follows: Aim 1
utilizes a comprehensive theoretical model to examine why and when AIBs occur (which events result in an
AIB); and Aim 2 examines trait constructs (self-regulation and sensation-seeking) and sex as moderators for
the associations between psychosocial constructs, TAC drink features, and AIBs.
