Alcohol use is highly prevalent among college students, and collegiate student-athletes, in particular, are considered an at-risk group due to their tendency to consume greater quantities of alcohol per drinking occasion and experience adverse outcomes. Prior studies indicated that athletes engage in alcohol consumption for various reasons, including positive/negative reinforcement following performance results, relief from physical pain, and the pursuit of group identification, with sports-related anxiety and diminished psychological well-being being associated with alcohol abuse. However, existing studies have predominantly focused on binge drinking behaviors and have not sufficiently examined the differences in the risk for alcohol use disorder (AUD) between collegiate student-athletes and non-athletes, nor the moderating effect of psychological well-being on this relationship. To fill this gap, the present study aims to assess differences in high-risk AUD status between these groups while analyzing the moderating role of psychological well-being in this association.
The study utilized self-reported data from the ACHA-NCHA survey conducted from Fall 2019 to Fall 2022, comprising a final sample of 220,798 college students who reported their varsity student-athlete status and completed the ASSIST tool to determine an alcohol Substance Specific Involvement Score (SSIS). Data were gathered through online or paper-and-pencil questionnaires, with the primary outcome being high-risk alcohol use disorder (AUD), as defined by the SSIS cutoff. The collected data were analyzed using a multiple logistic regression model to assess the relationship between student-athlete status and the risk of AUD.
The study revealed that although student-athletes comprised only 4.86% of the sample, they exhibited notable differences when compared to non-athletes. Specifically, a distinct trend emerged indicating that lower psychological well-being was associated with an increased risk of developing alcohol use disorder (AUD) among student-athletes relative to their non-athlete counterparts. For instance, when the well-being score was low (a Diener score of 10), student-athletes were approximately twice as likely to be at high risk for AUD (adjusted odds ratio, AOR = 2.06). As the well-being score improved to 30, the risk decreased to 1.54, and at a score of 50, the difference in risk was no longer statistically significant (aOR = 1.15). These findings were further corroborated by additional analyses employing various measures of AUD risk and comparing data from before and after the COVID-19 pandemic. Overall, the results underscore a significant correlation between lower psychological well-being and an elevated likelihood of AUD among college student-athletes.
Takeaway: Lower psychological well-being is significantly associated with an increased likelihood of high-risk AUD among student-athletes in comparison to non-athletes, with the risk decreasing as psychological well-being improves.