College student knowledge of blackouts and implications for alcohol intervention: A qualitative analysis.

Abstract

Objective: Blackouts (periods of alcohol-induced anterograde amnesia) are common among young adults and place individuals at significant risk for alcohol-related harm; thus, researchers have advocated for increased efforts to educate young adults on blackouts. This qualitative study examined college student knowledge of blackouts as well as their ideas for intervening on blackout drinking behavior in order to inform prevention and intervention efforts. Method: College students who had experienced a blackout in the past six months participated in eight focus groups, stratified by gender (N=50, 5–8/group, 56% female). Discussions followed a semi-structured agenda. Audio recordings were transcribed verbatim and coded using applied thematic analysis. Themes related to knowledge were reviewed in comparison to the empirical literature. Empirically-derived risk factors for blackouts included biology (e.g., genetics, biological sex), drinking behavior (i.e., rate of consumption), other drug use, and ‘indirect’ influences (e.g., pregaming, drinking location). Results: Participants’ knowledge of the risk factors for blackout was inconsistent and, in some cases, inaccurate. While participants generally understood the behavioral risk factors for blackouts, they demonstrated less understanding of the role of genetics, biological sex, drinking speed (versus quantity), and other drug use. They also identified dehydration and sleep as perceived risk factors for blackout. They suggested avenues for intervention at the policy (e.g., amnesty policies), peer (e.g., expressing concern), and individual level (e.g., education). Conclusions: College students with a history of blackout have limited understanding of the biological risk factors for blackout. These knowledge gaps represent targets for intervention. Findings indicate promise for blackout-specific interventions.

Social and Situational Party Characteristics Associated With High‐Intensity Alcohol Use Among Youth and Young Adults

“…Having no memory of the drinking event is indicative of alcohol‐induced blackouts, or periods of amnesia that occur in which the individual engages in behaviors, potentially serious acts such as unintended sexual activity, but the brain is unable to create memories for the event. This is particularly alarming among young adults given their incomplete knowledge of blackouts (Miller et al., ,b) and high rates of sexual assault in which alcohol is involved in this age group (Abbey, ). Collectively, this work demonstrates an increased level of risk for individuals and their communities associated with high‐intensity alcohol consumption that warrants strategic attention to reduce such harms.…”

“…It should also be noted that high‐intensity drinking occurred in only 5% of the sample; thus, outliers in this group may have had a disproportionate effect on our results. Finally, more nuanced measures of severe consequences associated with high‐intensity drinking, such as distinguishing complete and fragmentary blackouts (Miller et al., , b), would provide further insight into the etiology of high‐intensity alcohol consumption.…”

Trajectories of alcohol‐induced blackouts in adolescence: early risk factors and alcohol use disorder outcomes in early adulthood

“…That is, adolescent females had increased risk of experiencing increasing blackouts compared to adolescent males at equivalent levels of consumption, but females were not more likely than males to start drinking at an earlier age. Although young people tend to understand the behavioural risk factors for alcohol‐related blackouts, such as rapid consumption of alcohol, they have limited understanding of biological risk factors such as sex [37]. As such, schools should consider educating students and care‐givers about the biological risk factors for blackouts, in addition to blackouts themselves being a risk factor for future harm.…”

Opportunities for reducing college drinking: The roles of drinking attitudes and blackout experience

“…It is worth noting that the intervention did not directly address positive attitudes, nor did it provide specific education or risk sensitization related to blackout drinking. Qualitative research suggests that many heavy drinking students do not understand the role of drinking speed in blackouts and, therefore, may not understand the most effective way to prevent them (Miller et al, 2018b). Thus, the active ingredients of the intervention did not necessarily mitigate these baseline risk factors.…”