About

Kate B. Carey is a Professor of Behavioral and Social Sciences and serves as the Director of the Behavioral and Social Health Sciences PhD Program at Brown University. She earned her PhD in clinical psychology from Vanderbilt University in 1985 and completed a post-doctoral fellowship in addiction and behavioral medicine at the Miriam Hospital/Brown University. Her research focuses on motivation to change substance use, the application of screening and brief intervention models for at-risk drinkers, the influence of social norms on drinking behavior, and the contribution of alcohol intoxication to sexual risk behavior. Her work aims to develop and evaluate interventions to reduce alcohol misuse and associated risky behaviors, particularly among college students and young adults. Through her extensive research, she has contributed to understanding the behavioral and social factors influencing substance use and sexual health, and she has been involved in developing innovative approaches such as motivational interviewing, normative feedback, and digital health interventions to promote healthier behaviors.

Research topics

• Chemistry
• Medicine
• Organic chemistry
• Toxicology
• Internal medicine
• Biology
• Environmental health
• Clinical psychology
• Psychology
• Developmental psychology
• Psychiatry
• Food science

Selected publications

• Efficacy of counter-attitudinal advocacy and personalized feedback for heavy-drinking college students.

  Journal of Consulting and Clinical Psychology · 2025-03-13 · 4 citations

  articleOpen access1st authorCorresponding

  OBJECTIVE: Young adults in college engage in risky drinking that results in alcohol-related harms. Most evidence-based prevention interventions recommended for this population rely on correcting exaggerated drinking norms via personalized normative feedback (PNF). Informed by an extensive literature linking alcohol attitudes and drinking behavior, we adapted a brief counter-attitudinal advocacy (CAA) task to the alcohol prevention context. The goal of this study is to evaluate the ability of CAA in changing drinking and related consequences and to explore the comparative efficacy of CAA versus PNF. METHOD: This two-site randomized controlled trial had two experimental conditions (CAA and PNF) and an assessment-only control condition. Participants were 585 students who reported heavy episodic drinking and ≥ 2 alcohol-related negative consequences. Alcohol outcomes were assessed at 1-, 3-, and 6-month follow-ups to test hypotheses that the CAA and PNF manipulations will decrease drinks per week, typical drinks per day, peak blood alcohol concentration, and alcohol consequences, relative to control. RESULTS: Participants reported reductions in drinks per week, typical drinks, and alcohol consequences. Those who received PNF reported significantly fewer drinks per week than controls, whereas those who received CAA reported significantly fewer consequences than controls. The CAA and PNF conditions did not differ from one another. CONCLUSIONS: This study demonstrates an application of attitude change theory and CAA methods to the alcohol prevention context, across demographically different settings. The novel CAA task had a harm reduction effect on consequences but not consumption. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

  PublisherDOI

• Technology-Based Substance Use Interventions for Young Adults and College students: A Systematic Review and Meta-Analysis

  Drug and Alcohol Dependence · 2025-02-01

  review
  PublisherDOI

• An Examination of predictors of prospective changes in self-reported drinker identity and changes in drinker identity as a predictor of changes in alcohol use and associated consequences

  Addictive Behaviors · 2025-01-13 · 1 citations

  articleOpen accessSenior author

  PURPOSE: Self-reported drinker identity, the extent to which one views oneself as a drinker, is associated with alcohol consumption and related harms in young adults. The current study examined changes in self-reported drinker identity, theoretically relevant factors associated with drinker identity development, and drinker identity's association with changes in drinking and alcohol-related consequences. We hypothesized that drinker identity would increase over time; theoretically relevant factors would be significantly and positively associated with that increase, and increases in drinking identity would be associated with elevated drinking and related consequences. METHOD: = 19.87, from two universities) reporting recent heavy episodic drinking and experiencing alcohol-related consequences in the previous month. Students completed baseline and follow-up assessments at 1-, 3-, and 6-months related to theoretically relevant factors, drinker identity, and drinking/related consequences. RESULTS: Using parallel process latent growth curve modeling, we examined changes in drinker identity as a function of initial levels and changes in theoretically relevant factors. We also examined changes in alcohol use and related consequences as a function of changes in drinker identity. Results indicated that a more favorable initial attitude toward heavy drinking and an increase in favorable attitude toward heavy drinking were associated with an increase in drinker identity. Overall, alcohol use and associated consequences diminished over time, but increases in drinker identity were associated with smaller reductions in alcohol outcomes. CONCLUSIONS: The study highlights the importance of attitudes as a potential contributing factor to drinker identity development, particularly among college students who drink heavily. This work further demonstrates a link between changes in drinker identity and changes in drinking and associated consequences. This work can inform future interventions aimed at targeting drinking identity.

  PublisherDOI

• Prior-night sleep as an event-level predictor of alcohol-induced memory loss

  SLEEP · 2025-12-20

  articleOpen access

  STUDY OBJECTIVES: Alcohol-induced memory loss (also known as "blackout") is prevalent and confers risk for other adverse drinking outcomes. Sleep health is implicated in memory and cognitive functioning broadly, but proximal impacts of sleep on next-day memory loss are understudied. We hypothesized that worse sleep health the night before drinking (fewer hours, misaligned timing, worse sleep quality, greater sleepiness) would (a) increase the odds of next-day memory loss and (b) moderate day-level associations between estimated blood alcohol concentration (eBAC) and blackouts, such that lower eBACs would be required to experience memory loss following nights of worse sleep. METHODS: Heavy-drinking young adults (N = 203, 57 per cent female) in the United States completed baseline self-report measures, followed by 28 days of ecological momentary assessments. RESULTS: Memory loss was reported on 15.4 per cent (n = 366) of drinking days (n = 2380). Multilevel models, controlling for eBAC, indicated that fewer hours of sleep (OR = 0.84 [95% CI: 0.76, 0.92], p < .001), more deviation than usual from mid-sleep timing (OR = 1.43 [1.25, 1.65], p < .001), and worse sleep quality (OR = 0.72 [0.60, 0.85], p < .001) on the night before drinking significantly increased the odds of next-day memory loss. Sleepiness at the start of drinking events was unrelated to memory loss [OR = 0.91 (0.81, 1.03), p = .13]. Sleep parameters did not significantly moderate associations between eBAC and memory loss (p ≥ .08). CONCLUSIONS: Prior-night sleep health increases risk for alcohol-induced memory loss. These behavioral data extend experimental findings to young adults' real-time drinking outcomes. We encourage prevention and intervention efforts highlighting poor sleep as a potential contributor to alcohol-induced memory impairment.

  PublisherOA PDFDOI

• Mixed-Method Evaluation of the Impact of a “Healthcare Exploration Through Patient Care” Course on Undergraduate Students

  Medical Science Educator · 2025-11-08

  articleOpen access

  Introduction: Students in undergraduate degree programs often do not gain exposure to clinical work until late in their studies or even after graduation. The Healthcare Explorers (HCE) program provides an introduction to healthcare careers via a course series that combines seminar speakers and paid internships for students as patient care assistants. The purpose of this study was to evaluate the effectiveness of the gateway course in the HCE series using student feedback and reflection data. Methods: Mixed-method data were collected from students through feedback surveys and written reflection assignments. Descriptive statistical analyses described frequencies for the quantitative survey items. Inductive qualitative analyses identified themes that describe the impact of the course over time on students' perceptions, understanding, and decisions regarding future careers in healthcare, as well as areas of program improvement. Results: Quantitative results demonstrated consistently high satisfaction throughout the semester and between semesters. Several themes characterized students' self-reflexivity in the written reflection data: feelings of inspiration and relief, consideration of personal and professional goals, self-confidence in skills and character, awareness of career options, and key lessons learned. Discussion: Introducing students to patient care, clinical team roles, and career options early in their education prepares them to pursue the training and work experiences they need to achieve their individual goals. Formal programming such as the HCE program that combines a supportive course framework with a clinical internship provides students with critical experiences that encourage self-reflection and informed decision-making. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-025-02545-y.

  PublisherOA PDFDOI

• Longitudinal analysis for between‐ and within‐person influences of descriptive alcohol drinking norms and attitudes on drinking outcomes

  Alcohol Clinical and Experimental Research · 2025-03-27 · 1 citations

  articleOpen accessSenior author

  BACKGROUND: The study aimed to expand on existing research related to the theory of planned behavior (TPB) by exploring both between-person and within-person effects of descriptive norms and attitudes toward moderate and heavy drinking on drinking outcomes, including drinks per week, blackouts, and alcohol-related consequences. While previous studies focus on between-person effects, this study uniquely investigates both between-person effects as well as within-person changes over time, using longitudinal data collected at six points over 12 months. METHODS: = 0.758; 55.6% male). Participants completed measures of descriptive drinking norms, attitude toward moderate and heavy drinking, drinking intentions, and drinking outcomes, including drinks per week, blackout, and alcohol-related consequences. Multilevel models were run to examine the unique between-and within-person effects of descriptive drinking norms and attitude toward moderate and heavy drinking on drinking outcomes. RESULTS: Overall, the results from the multilevel models showed that at the between-person level, descriptive norms were associated with drinks per week, and a more favorable attitude toward heavy drinking was associated with higher weekly alcohol consumption and related consequences. At the within-person level, within-person fluctuations in descriptive norms and attitude toward heavy drinking were associated with higher weekly drinking, blackout, and alcohol-related consequences, while favorable attitude toward moderate drinking were associated with lower odds of blackouts and fewer alcohol-related consequences. CONCLUSIONS: Attitudes toward drinking, particularly heavy drinking, at both between-person and within-person levels, are strong predictors of alcohol use and its consequences. Furthermore, attitude toward moderate drinking are protective. Interventions promoting a moderate drinking attitude and reducing heavy drinking attitude and descriptive drinking norms will likely be effective in reducing alcohol-related harm.

  PublisherOA PDFDOI

• Capturing meaningful change: Initiation and maintenance of reductions in World Health Organization risk drinking levels among mandated college students.

  Psychology of Addictive Behaviors · 2025-09-15

  articleOpen access

  OBJECTIVE: Reductions in World Health Organization (WHO) risk drinking levels have been used to capture nonabstinent reductions in drinking in the general population and in clinical trials. We examined mandated college students' reductions in WHO risk drinking levels 1 month postintervention, whether reductions were maintained at 5- to 6- and 12-month follow-ups and whether maintenance to 12 months predicted better alcohol-related outcomes. We also explored sex differences throughout. METHOD: = 816). Sex-specific WHO risk levels were calculated from drinks per drinking day at baseline and follow-ups. Additional measures of alcohol use and consequences were assessed at baseline and 12-month follow-up. RESULTS: Most participants (61%) did not initiate reductions in drinking risk level by 1 month follow-up. Of those who achieved at least a one-level reduction, approximately 60% maintained this change at 5-6 and 12 months. Further evidencing maintenance, 1-month reductions predicted an approximately 500% increase in the odds of at least a one-level reduction at each follow-up. Finally, those who failed to maintain at least a one-level reduction to 12 months and those who successfully maintained change were generally similar at baseline. However, by 12 months, those who failed to maintain reduced drinking drank more and experienced more consequences than those who maintained changes. There were few sex differences across all results. CONCLUSIONS: Reductions in WHO risk drinking levels hold promise for quantifying meaningful, individual-level initiation and maintenance of reduced drinking among mandated students. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

  PublisherDOI

• Factors that increase risk for alcohol‐induced blackouts in high‐intensity drinking young adults

  Alcohol Clinical and Experimental Research · 2025-05-20

  articleOpen access

  BACKGROUND: Alcohol-induced blackouts are prospectively associated with negative drinking outcomes. While typically requiring heavy drinking, blackouts are not reported on all heavy drinking events or by all individuals who drink heavily. This study extends previous research by identifying the young adults most likely to experience blackouts assessed prospectively. Hypotheses focused on previously supported (female sex, White race, younger age, family history of alcohol problems, lower subjective response to alcohol, and higher tolerance) and novel predictors (possible traumatic brain injury; TBI) of alcohol-induced blackouts. METHODS: = 22.07) recruited for high-intensity drinking (8/10+ drinks/occasion for females/males) completed a baseline survey and a 28-day ecological momentary assessment protocol. Hierarchical linear modeling was used to test between-person predictors of fragmentary (temporary) or en bloc (permanent) blackout likelihood during the 28 days, and moderators of the effect of day-level estimated blood alcohol concentration (eBAC) on blackout likelihood. RESULTS: Controlling for event-level and average eBAC, both types of blackouts were more likely among those with higher subjective response to alcohol. Fragmentary blackouts were more likely among younger participants and those with possible prior TBI. Day-level eBAC was more strongly associated with both types of blackouts among non-Hispanic White participants and those with lower mean eBACs. Day-level eBAC was most strongly associated with fragmentary blackouts among those with a first-order family history of alcohol problems. CONCLUSIONS: Younger age and greater sensitivity to alcohol may confer risk for blackouts above and beyond intoxication levels. Future work is needed to understand mechanisms that explain why these factors confer risk for blackouts.

  PublisherOA PDFDOI

• Mechanisms of change for two brief alcohol interventions: Testing theoretical mediators for counter attitudinal advocacy and personalized feedback intervention effects

  Alcohol Clinical and Experimental Research · 2025-12-04 · 1 citations

  articleOpen accessSenior author

  BACKGROUND: Given the importance of identifying mechanisms of action for the development and dissemination of alcohol interventions, this study tests theory-based mechanisms of change for two brief alcohol interventions. METHODS: We conducted a secondary analysis of data from an efficacy trial that compared a novel intervention based on Counter Attitudinal Advocacy (CAA) to an evidence-based intervention using Personalized Normative Feedback (PNF) and an assessment-only control. Participants consisted of 585 heavy-drinking college students who reported experiencing alcohol-related consequences. Hypothesized mediators were linked to the theoretical underpinning of each intervention: perceived descriptive norms (PNF), dissonance (PNF and CAA), attitudes (CAA), and protective behavioral strategies (CAA). Negative binomial multilevel mediation analyses included data from baseline, posttest, and 1-, 3-, and 6-month follow-up assessments. RESULTS: Mediation analyses indicated that, with respect to drinks per week, PNF significantly reduced perceived norms compared to both the control and CAA conditions, which in turn were associated with decreased alcohol consumption. Similarly, CAA significantly reduced dissonance relative to both control and PNF, which was also associated with reduced drinking. Conversely, PNF increased dissonance relative to control, leading to greater alcohol consumption. Parallel patterns emerged for alcohol-related consequences: PNF reduced norms and CAA reduced dissonance, each associated with fewer consequences, whereas PNF increased dissonance contributing to greater alcohol-related consequences. CONCLUSIONS: Overall, these findings demonstrate that PNF and CAA operate through distinct mechanisms, emphasizing the complexity inherent in intervention effects. They further highlight the importance of empirically identifying and examining the processes underlying the efficacy of alcohol-related interventions.

  PublisherDOI

• Measuring what happens when bystanders help in drinking situations: The bystanders to alcohol risk scales–positive and negative consequences.

  Psychology of Addictive Behaviors · 2025-07-14

  articleOpen access

  OBJECTIVE: Understanding the consequences that occur when bystanders intervene to address problematic alcohol use in others is of utmost importance because the consequences that bystanders experience can influence their behavior in future situations. Consequences are defined as the effects of attempting to help another person and may be positive and/or negative. Given the dearth of measurement scales for alcohol-related bystander intervention, the present study aimed to develop two valid and reliable measures of consequences following alcohol-related bystander intervention: one assessing positive consequences and one assessing negative consequences. METHOD: = 345) completed a 2-week follow-up to evaluate test-retest reliability. Exploratory and confirmatory factor analysis and item response theory were used to examine model fit and reduce the number of items. Correlations with established measures were used to evaluate validity. RESULTS: One-factor solutions demonstrated the best fit for both measures. Both measures demonstrated strong internal consistency, test-retest reliability, and evidence of convergent validity. CONCLUSIONS: The newly developed Bystanders to Alcohol Risk Scale-Positive Consequence and Bystanders to Alcohol Risk Scale-Negative Consequence are valid and reliable measures of the consequence bystanders experience when they intervene during alcohol-related situations. These measures might be used for surveillance of consequences among bystanders or as a measure of outcomes following bystander intervention training. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

  PublisherDOI

Recent grants

• Correcting Exaggerated Drinking Norms with a Mobile Message Delivery System

  NIH · $416k · 2017–2019

• NIH Grant K02AA015574

  NIH · $931k · 2010

• NIH Grant R01DA010010

  NIH · $826k · 2002

• NIH Grant R01AA012518

  NIH · $5.1M · 2017

• NIH Grant K02DA000426

  NIH · $504k · 2004

Frequent coauthors

• Michael P. Carey

  Brown University

  346 shared

• Jennifer E. Merrill

  145 shared

• Angelo M. DiBello

  Rutgers, The State University of New Jersey

  115 shared

• Mary Beth Miller

  University of Missouri

  104 shared

• Lori A. J. Scott‐Sheldon

  National Institute of Mental Health

  98 shared

• Brian Borsari

  79 shared

• Stephen A. Maisto

  Syracuse University

  67 shared

• Peter A. Vanable

  Syracuse University

  65 shared

Labs

• Kate Carey's LabPI

  N/A

Education

• Ph.D., Clinical Psychology

  Vanderbilt University

  1985

• Other, Addiction and Behavioral Medicine

  Miriam Hospital/Brown University