Brief intervention in college settings.

It is well established that college students have high rates of alcohol use and misuse and suffer the negative consequences of this behavior. Research evaluating the results of brief interventions with high-risk college students has shown these approaches to be successful in reducing alcohol consumption and/or related consequences. Several screening tools have been developed to detect the presence of problematic alcohol use and associated disorders, and some are designed specifically for use in a college student population. College campuses offer several opportunities to implement screening and interventions, including universal or large-scale assessments; health services, counseling centers, or local emergency rooms; or via established judicial or grievance systems set up to deal with students who violate campus alcohol policies. Issues to consider when implementing screening and brief interventions in college populations include who should deliver the interventions-peer or professional counselors-and how students should be encouraged to participate in the interventions. Regardless of how the measures are implemented, the content and process of the brief interventions should be based on the available scientific evidence regarding established efficacious interventions. KEY WORDS: undergraduate student; alcohol abuse; binge drinking; heavy drinking; AODD (alcohol and other drug use disorder); identification and screening; interview; motivational interviewing; CAGE Questionnaire; Michigan Alcoholism Screening Test (MAST); Young Adult Alcohol Problems Screening Test (YAAPST); brief intervention; peer counseling; professional counseling; literature review This article briefly summarizes the literature on college student drinking, the factors that can place students at risk for harmful consequences from their drinking, screening instruments and brief interventions shown to be effective with college students, and considerations and limitations in implementing such interventions. It concludes with clinical and research recommendations for further study of brief interventions in college populations. EPIDEMIOLOGY OF ALCOHOL USE BY COLLEGE STUDENTS The use and misuse of alcohol by young adult college students and the resulting negative consequences have been widely documented in the alcohol literature (see O'Malley and Johnston 2002 and Perkins 2002 for reviews). Several longitudinal and cross-sectional national studies have been tracking the use of alcohol among the nation's youth and college students. In the 2003 Monitoring the Future (MTF) report, 86 percent of college students reported drinking alcohol at least once in their lifetime, and 66 percent reported drinking alcohol in the last month (Johnston et al. 2004). The prevalence of college student drinking has been fairly stable over the past two decades, although tobacco and illegal drug use mainly have declined (Johnston et al. 2004). The pattern of alcohol use among college students is a serious cause for concern because many engage in heavy episodic, or binge, drinking, traditionally defined as having five or more drinks in a row1 (Johnston et al. 2004; Wechsler et al. 2002). Approximately 39 to 44 percent of college students reported binge drinking at least once in the 2 weeks prior to filling out the survey (Johnston et al. 2004; Wechsler et al. 2002). Additionally, according to one study, nearly one-third of college students met the criteria for alcohol abuse specified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and 6 percent met its criteria for alcohol dependence (Knight et al. 2002). Perkins (2002) provides a review of the negative physical, behavioral, legal, interpersonal, and institutional effects associated with alcohol use by college students. For example, many students who drink alcohol experience consequences such as physical illness (e.g., hangovers, nausea), academic impairment (e. …