1. Melissa A. Lewis, Ph.D. Department of Psychiatry & Behavioral Sciences Center for the Study Health & Risk Behaviors University of Washington Assessing recognition of alcohol poisoning symptoms in college students turning 21: Implications for important next steps

2. Medical Amnesty Policies  Eliminate or reduce judicial consequences for students involved in alcohol-related emergencies  Research is limited  Medical amnesty policies assume that students: 1.can identify symptoms of alcohol poisoning 2.understand the risk associated with alcohol poisoning 3.are currently not seeking help due to fear of getting in trouble Lewis & Marchell, 2006; Oster-Aaland & Eighmy, in press

3. Implications for Prevention Interventions - Friends   Determining if, when, and how college students help individuals with alcohol poisoning may have important implications for prevention interventions.

4. Present Research  This study sought to determine if students could identify and understand the risk associated with symptoms of alcohol poisoning.  We expected that showing concern for and observing symptoms of alcohol poisoning would be associated with helping behavior.

5. Present Research  An additional purpose of this research was to assess sources in which students seek help. Friends Friends Parents Parents RAs RAs Police Police ER ER  Finally, this study assessed why students might be reluctant to seek help. Not concerned Not concerned Too drunk Too drunk Don’t know how to seek help Don’t know how to seek help Thought somebody else was helping Thought somebody else was helping Scared of getting in trouble Scared of getting in trouble

6. Method  Students from an ongoing longitudinal intervention study N = 306 (50% male) N = 306 (50% male) Participants were 95.8% Caucasian, and 4.2% other Participants were 95.8% Caucasian, and 4.2% other  Web-based assessment Students were asked to complete two 50 minute assessments during the week prior to their 21st birthday and after their 21 st birthday Students were asked to complete two 50 minute assessments during the week prior to their 21st birthday and after their 21 st birthday Paid $50 for participation at each assessment Paid $50 for participation at each assessment Current data include baseline responses prior to turning 21 Current data include baseline responses prior to turning 21

7. Measures  Typical Drinks per Week & Drinking Frequency Daily Drinking Questionnaire (Collins, Parks, Marlatt, 1988) Daily Drinking Questionnaire (Collins, Parks, Marlatt, 1988)  Alcohol-Related Negative Consequences Young Adult Alcohol Problems Screening Test (Hurlbut and Sher, 1992) Young Adult Alcohol Problems Screening Test (Hurlbut and Sher, 1992) 0 (No, never) to 1 (Yes, at least once) scale (α =.87) 0 (No, never) to 1 (Yes, at least once) scale (α =.87)  Concern 1 (not at all concerned) to 4 (extremely concerned) scale (α =.86) 1 (not at all concerned) to 4 (extremely concerned) scale (α =.86)  Observations 0 (never) to 1 (1 or more times) scale (α =.80) 0 (never) to 1 (1 or more times) scale (α =.80)  Helping Behaviors 0 (never) to 1 (1 or more times) scale (α =.80) 0 (never) to 1 (1 or more times) scale (α =.80)  Sources of Help  Reasons You have Never Helped 1 (strongly disagree) to 4 (strongly agree) 1 (strongly disagree) to 4 (strongly agree)

8. Results: Descriptive Information VariableMeanSD Drinks per Week7.318.89 Drinking Frequency3.252.31 Negative Consequences4.934.11 Concern3.05.53 Observe3.502.21 Helping Behavior1.741.52 Note. N = 306.  Concern for symptoms of alcohol poisoning? YES  Observe symptoms of alcohol poisoning? YES

9. Predictor BSE B βΔR2ΔR2 d Step 1Sex.08.17.03.01.05 Step 2Drinks per Week.01.06.20***.08 Drinking Frequency.11.06.16 †.21 Negative Consequences.10.03.27***.41 Step 3Concern.19.15.07.01.14 Step 4Observe.32.03.46***.18***1.09 Note. N = 306. *** p <.001. † p <.10.  Relate to helping behaviors? YES Results: Helping Behavior

10. Results: Sources of Help Source% Another Student44% Parent14% Hospital/Clinic/ER9% Resident Advisor3% Off-Campus Police2% Campus Police<1% Note. N = 263. “I once googled alcohol poisoning for the symptoms just to make sure my friend didn't have it” “I may use the internet for signs or symptom help” “it has not been severe enough to need outside help, just watch them, help them and get some water or something like that.”

11. Results: Reasons Not to Seek Help ReasonMeanSD No need to help, no risk3.481.17 Note. N = 43. “Never was in a situation where my friend was really bad where I had to contact a hospital!” “I have never been in a situation where the people who I was with were drunk enough to need help. They had only had a couple drinks” “I have not witnessed any of these problems therefore I have not helped!!” “My friends do not drink nor do I.”.

12. Results: Reasons Not to Seek Help ReasonMeanSD Someone else was helping2.841.19 Was not sure what to do2.311.08 Others were not concerned2.20.85 Afraid friend would be in trouble2.10.99 Assumed someone else would help2.00.90 Others discouraged me from helping1.93.86 Afraid self would be in trouble1.90.83 Too busy, in a hurry1.70.71 Note. N = 43.

13. Implications  Most students have helped another student with symptoms of alcohol poisoning, and demonstrate concern for these symptoms.  By and large, students do not help because situations in which they perceive the need to help tend to be relatively rare.  Heavier drinkers report being more likely to help largely because they are more likely to be in situations in which someone might need help.

14. Implications  When students do help others Most likely to seek help from other students and parents Most likely to seek help from other students and parents  Demonstrates the potential importance of incorporating students/friends/parents in prevention interventions, as well as making sure students/friends/parents are able to identify symptoms and how to intervene.  Examine other sources of help Internet Internet

15. This research was supported, in part, by National Institute on Alcohol Abuse and Alcoholism Grants U18AA015885, U01AA014742, T32AA07455.