Peer influences on college drinking: a review of the research

Trajectories and determinants of alcohol use among LGB young adults and their heterosexual peers: results from a prospective study

Lesbians, gays, and bisexuals (LGBs) are at increased risk for alcohol use during young adulthood, but the mechanisms remain inadequately understood. The aim of the present study was to examine the trajectories and determinants of alcohol use among LGB young adults who were sampled prospectively. The sample included 111 LGB individuals (47 women and 64 men) and 2,109 heterosexuals (1,279 women and 830 men), who were assessed at three time points: during the summer after their senior year of high school and during the fall and spring of their freshman year of college. Hierarchical linear modeling analyses indicated that lesbians consumed more alcohol than their heterosexual peers during high school, whereas gay men increased their alcohol use at greater rates than heterosexual men during the initial transition to college. Positive alcohol expectancies and social norms mediated this relation for both men and women. The results extend the generalizability of these processes and highlight the importance of considering normative social-cognitive influences in the development of alcohol use among LGB young adults.

Sensation seeking, attitudes toward drug use, and actual use among adolescents: testing a model for alcohol and ecstacy use

The use of ecstasy (MDMA), one of the most popular substances among young people in the context of many leisure and fun activities, is moving from party and recreation circuits to high schools and college dorms, in many cases in combination with alcohol consumption. Bearing in mind the concurrent use of the two drugs and the "gateway" thesis of a progression from legal drugs to illegal ones, a causal(1) model of linkages among sensation seeking, attitudes toward alcohol and ecstasy consumption, and frequency of use was tested using structural equation modeling (SEM). The data were obtained from a sample of 450 high school students ranging in age from 14 to 18 (47% male, 53% female). An additional moderator analysis was performed in order to examine a possible moderating role of sensation seeking in the relationship between attitudes toward consumption and frequency of use of both alcohol and ecstasy. Results were consistent with the hypothesis that positive attitudes toward consumption mediate the effects of sensation seeking on drug use. In addition, whereas our results were coherent with the existence of direct effects of sensation seeking on drug use, these were only found in the case of alcohol consumption. However, a moderating effect of this same variable was observed in the relationship between positive attitudes toward ecstasy consumption and its frequency of use. General and specific clinical implications and limitations of these findings are discussed and future lines of research suggested. .

Evaluating personal alcohol feedback as a selective prevention for college students with depressed mood

OBJECTIVE

This research evaluated a brief mailed intervention for alcohol use as an adjunct to a brief treatment for college students with depression symptoms. The intervention aimed to correct normative misperceptions and reduce students' drinking and related consequences.

METHOD

One hundred seventy seven college students (70% Female) with elevated scores on the Beck Depression Inventory were randomly assigned to intervention or control group. Participants in the intervention were mailed feedback and information detailing their reported alcohol use, moderation strategies, and accurate normative information regarding student drinking.

RESULTS

Results indicated no main effects of the intervention on drinking or related problems but students receiving feedback showed significant reductions in their perception of drinking norms compared to the control group. Furthermore, students whose normative perceptions reduced showed significant reductions in total drinks per week and total alcohol related problems compared to those whose norms did not reduce.

CONCLUSIONS

Results support the importance of correcting normative perceptions and provide direction for selective prevention of alcohol use and related problems among college students with depressed mood.

Fraternity and sorority involvement, social influences, and alcohol use among college students: a prospective examination

This study used latent growth curve modeling to investigate whether the effects of gender and Greek involvement on alcohol use and problems over the first 2 years of college are best characterized by selection, socialization, or reciprocal influence processes. Three social influences (alcohol offers, social modeling, and perceived norms) were examined as potential mediators of these effects. Undergraduate participants (N = 388) completed self-report measures prior to enrollment and in the spring of their freshmen and sophomore years. Male gender and involvement in the Greek system were associated with greater alcohol use and problems prior to college. Both gender and Greek involvement significantly predicted increases in alcohol use and problems over the first 2 years of college. Cross-domain analyses provided strong support for a mediational role of each of the social influence constructs on alcohol use and problems prior to matriculation, and prematriculation social modeling and alcohol offers mediated relations between Greek involvement and changes in alcohol use over time. Findings suggest that students, particularly men, who affiliate with Greek organizations constitute an at-risk group prior to entering college, suggesting the need for selected interventions with this population, which should take place before or during the pledging process.

Social norms and alcohol consumption among intercollegiate athletes: the role of athlete and nonathlete reference groups

The relationship between perceived alcohol use among peers and personal alcohol use was assessed in a sample of collegiate athletes. Data were collected on 109 intercollegiate athletes during the competitive season and 119 athletes during the off-season at a large, state university in the Northeastern United States. Participants were asked to estimate the normative alcohol use of four reference groups (closest athlete friend, closest nonathlete friend, typical athlete, and typical nonathlete). Results of both in-season and off-season analyses indicated that athletes estimated that others consumed more drinks per week than they did, and perceptions of these social norms predicted personal use. Although the typical athlete norm emerged as the strongest predictor of personal alcohol use, the relative strength of the relationships between individual behavior and the athlete and nonathlete norms varied according to seasonal status. Results have implications for the content and timing of prevention and intervention programs aimed at reducing high-risk alcohol use among intercollegiate athletes.

Misperceptions of peer drinking norms in Canada: another look at the "reign of error" and its consequences among college students

OBJECTIVE

Much research has documented extensive misperceptions of drinking norms and their negative effects in U.S. student populations. This study provides extensive research evidence documenting this phenomenon in Canadian higher education.

METHODS

Data were collected in a 2003-2004 survey of students (N=5280) attending 11 institutions across Canada. Surveys were administered either to a random sample of students through the mail or to students attending a diverse selection of classes.

RESULTS

Regardless of the actual drinking norm on each campus, students most commonly overestimated the alcohol consumption norms (both quantity and frequency levels) in every instance. Students' perception of their campus drinking norm was the strongest predictor of the amount of alcohol personally consumed in comparison with the influence of all demographic variables. Perception of the norm was also a much stronger predictor of personal use than the actual campus norm for consumption on each campus or the actual norm for compliance with campus regulations. Among students who personally abstain or consume lightly, misperceptions of the student drinking norms contribute to alienation from campus life.

CONCLUSION

The data presented here on Canadian students extends the evidence that peer drinking norms are grossly misperceived and that these misperceptions produce a highly detrimental "reign of error" in the lives of college students. The data suggest that a broad range of students--abstainers and light drinkers as well as moderate and heavy drinkers--may benefit from implementing intervention strategies that can correct or reduce these misperceptions.

Indicated prevention for incoming freshmen: personalized normative feedback and high-risk drinking

This research evaluated the efficacy of a computerized, freshmen-specific personalized normative feedback (PNF) intervention on reducing alcohol consumption among high-risk drinking freshmen. Students (N=316; 53.8% female) completed measures of perceived drinking norms and drinking behavior. After completing the baseline assessment, students were randomly assigned to receive either freshmen-specific PNF that was gender-specific or gender-neutral, or to assessment only control. Findings demonstrated that students exhibited normative misperceptions for typical freshmen drinking behavior and that perceptions of typical same-sex freshmen drinking were positively associated with riskier drinking behavior. At follow-up, students randomly assigned to receive PNF reduced perceptions of typical freshmen drinking behavior and personal drinking behavior relative to those who did not receive PNF. Findings extend previous evaluations of computer-based PNF and suggest that computer-based PNF for incoming freshmen utilizing freshmen-specific norms that are gender-specific may constitute a promising prevention strategy.

Event-Specific Prevention: addressing college student drinking during known windows of risk

The unique drinking patterns of college students call for Event-Specific Prevention (ESP) strategies that address college student drinking associated with peak times and events. Despite limited research evaluating ESP, many college campuses are currently implementing programming for specific events. The present paper provides a review of existing literature related to ESP and offers practical guidance for research and practice. The prevention typology proposed by DeJong and Langford [DeJong, W. & Langford, L. M. (2002). A typology for campus-based alcohol prevention: Moving toward environmental management strategies. Journal of Studies on Alcohol, 140-147.] provides a framework for strategic planning, suggesting that programs and policies should address problems at the individual, group, institution, community, state, and society level, and that these interventions should focus on knowledge change, environmental change, health protection, and intervention and treatment services. From this typology, specific examples are provided for comprehensive program planning related to orientation/beginning of school year, homecoming, 21st birthday celebrations, spring break, and graduation. In addition, the University of Connecticut's efforts to address problems resulting from its annual Spring Weekend are described as an illustration of how advance planning by campus and community partners can produce a successful ESP effort.

Frequency of heavy drinking and perceived peer alcohol involvement: comparison of influence and selection mechanisms from a developmental perspective

The present study investigated social influence and selection explanations for the association between frequency of heavy drinking and perceived peer alcohol involvement in emerging and early adulthood. Participants were 489 young adults recruited from a university setting who were taking part in an 11-year longitudinal study, which includes 6 waves of data. Piecewise latent growth curve analyses indicated that patterns of change from ages 18 to 30 for both frequency of heavy drinking and perceived peer alcohol involvement are best represented by two distinct developmental periods (i.e., college and post-college years). Several models were compared to identify a framework that yielded the best estimates of influence and selection effects. Evidence suggests that selection mechanisms may best account for the relation between frequency of heavy drinking and perceived peer alcohol involvement especially during the post-college years.

Predictors of alcohol use during the first year of college: implications for prevention

The first year of college is a unique transition period, in which the student establishes a college identity and social network. Alcohol use is often part of this process, and many first-year college students develop a pattern of heavy drinking that puts them at risk for adverse consequences during their college years and into young adulthood. To better understand the development of risky alcohol use during this transition, we reviewed the literature on influences on college drinking and identified moderators and mediators that were particularly relevant for first-year alcohol use. As the transition from high school to college presents a unique opportunity for intervention, we discuss how these moderators and mediators can inform alcohol abuse prevention programs. We also identify approaches aimed at changing the culture of alcohol use on campus. Limitations of the reviewed research are highlighted in the context of promising directions for future research.

Are social norms the best predictor of outcomes among heavy-drinking college students?

OBJECTIVE

This research was designed to evaluate the relative contribution of social norms, demographics, drinking motives, and alcohol expectancies in predicting alcohol consumption and related problems among heavy-drinking college students.

METHOD

Participants included 818 (57.6% women) first-year undergraduates who reported at least one heavy-drinking episode in the previous month. In addition to providing demographic information (gender and fraternity/sorority membership) participants completed Web-based assessments of social norms (perceived descriptive norms regarding typical student drinking, injunctive norms regarding friends' and parents' approval), motives (social, enhancement, coping, and conformity), and expectancies and evaluations of positive and negative alcohol effects.

RESULTS

Regression results indicated that descriptive and injunctive norms were among the best predictors of college student drinking. With respect to alcohol problems, results indicated that coping motives accounted for the largest proportion of unique variance. Finally, results revealed that alcohol consumption mediated the relationships between predictors and problems for social norms, whereas coping motives, negative expectancies, and evaluation of negative effects were directly associated with alcohol problems despite having relatively weak or null unique associations with consumption.

CONCLUSIONS

The results of this study substantiate social norms as being among the best predictors of alcohol consumption in this population and suggest that drinking to cope is a better predictor of problems. The findings are discussed in terms of practical prevention and treatment implications.

Injunctive norms and problem gambling among college students

Two studies examined the relationships among injunctive norms and college student gambling. In study 1 we evaluated the accuracy of perceptions of other students' approval of gambling and the relationship between perceived approval and gambling behavior. In study 2 we evaluated gambling behavior as a function of perceptions of approval of other students, friends, and family. In study 1, which included 2524 college students, perceptions of other students' approval of gambling were found to be overestimated and were negatively associated with gambling behavior. The results of study 2, which included 565 college students, replicated the findings of study 1 and revealed positive associations between gambling behavior and perceived approval of friends and family. Results highlight the complexity of injunctive norms and the importance of considering the reference group (e.g., peers, friends, family members) in their evaluation. Results also encourage caution in considering the incorporation of injunctive norms in prevention and intervention approaches.

Long-Term Effects of Brief Substance Use Interventions for Mandated College Students: Sleeper Effects of an In-Person Personal Feedback Intervention

BACKGROUND

It is known that brief interventions for mandated college students decrease alcohol use and/or related problems in the short term. However, none of the existing studies has followed students' past 6 months. Therefore, we compared the long-term efficacy of 2 brief substance use feedback interventions for mandated college students.

METHODS

We followed up mandated students (N=348) who were randomly assigned to either a brief motivational interview (BMI; n=180) or a written feedback-only (WF; n=168) intervention at 4 months and 15 months postintervention.

RESULTS

Long-term follow-up data revealed that students, at the aggregate level, decreased their peak blood alcohol concentration (BAC) levels, number of drinks per week, and number of alcohol-related problems at 15 months postintervention compared with their baseline levels. With the exception of peak BAC, the observed long-term reduction was mainly due to the positive change among students who received the BMI intervention. Students in the BMI intervention showed significantly lower levels of alcohol-related problems at 15 months than those in the WF intervention. The BMI intervention more effectively reduced within-individual alcohol-related problems during the initial 4 months, and more successfully curbed the subsequent increase in alcohol use frequency and number of drinks per week during the 11 months between the 2 follow-up assessments.

CONCLUSIONS

The results suggest that brief substance use interventions reduce the riskiest type of alcohol use (e.g., peak BAC) among mandated college students over the long term, and that sleeper effects of in-person personal feedback interventions (PFIs) exist. In-person PFIs in the context of a motivational interview may be more efficacious in the long term than written feedback-only interventions for mandated students. Future studies comparing interventions for college students should extend follow-up for longer periods of time.

Event-Specific Prevention: addressing college student drinking during known windows of risk

The unique drinking patterns of college students call for Event-Specific Prevention (ESP) strategies that address college student drinking associated with peak times and events. Despite limited research evaluating ESP, many college campuses are currently implementing programming for specific events. The present paper provides a review of existing literature related to ESP and offers practical guidance for research and practice. The prevention typology proposed by DeJong and Langford [DeJong, W. & Langford, L. M. (2002). A typology for campus-based alcohol prevention: Moving toward environmental management strategies. Journal of Studies on Alcohol, 140-147.] provides a framework for strategic planning, suggesting that programs and policies should address problems at the individual, group, institution, community, state, and society level, and that these interventions should focus on knowledge change, environmental change, health protection, and intervention and treatment services. From this typology, specific examples are provided for comprehensive program planning related to orientation/beginning of school year, homecoming, 21st birthday celebrations, spring break, and graduation. In addition, the University of Connecticut's efforts to address problems resulting from its annual Spring Weekend are described as an illustration of how advance planning by campus and community partners can produce a successful ESP effort.

Peer crowds in a commuter college sample: the relation between self-reported alcohol use and perceived peer crowd norms

The author studied peer crowds on a college commuter campus and examined the relation between self-reported alcohol use and perceived peer crowd norms for alcohol use. College students (N = 271) completed questionnaires to determine their peer crowd affiliation and frequency and amount of alcohol use. The author assessed perceived peer-crowd affiliation norms with a series of vignettes describing the typical student that would be associated with each peer crowd. Analyses revealed identifiable peer crowds among college students that represent different patterns of alcohol use both in self-reported alcohol use among students in a peer crowd and in the perceived norms for alcohol use in each peer crowd. The author described the relation between self-reported use and the perceived use by members of one's peer crowd.

Theory-based processes that promote the remission of substance use disorders

Four related theories about the personal and social resources that shield individuals from developing substance use disorders and foster the process of remission from these disorders are described. These theories are social control theory, behavioral economics and behavioral choice theory, social learning theory, and stress and coping theory. Next, the social processes specified by these theories are highlighted, including the provision of support, goal direction, and monitoring; engagement in rewarding activities other than substance use, exposure to abstinence-oriented norms and models, and attempts to build self-efficacy and coping skills. Then, a review of the literature considers evidence about the association between the personal and social resources specified by the four theories and remission from substance use disorders. The discussion highlights several issues that need to be addressed to enhance our understanding of the protective resources involved in stable remission, such as how to develop integrated measures of the key resources and specify their associations with substance use outcomes, the extent to which the resources amplify or compensate for the influence of treatment, and how treatment and continuing care can be tailored to strengthen the protective resources that promote remission.

Peer enhancement of a brief motivational intervention with mandated college students

In this pilot study, the authors evaluated whether incorporating a peer in a brief motivational intervention would lead to significant reductions in alcohol use and problems in students mandated to receive treatment after violating campus alcohol policy. Thirty-six participant-peer dyads (66% male) were randomly assigned to receive either two 45-min sessions of an individual motivational intervention (IMI, n = 18) or a peer-enhanced motivational intervention (PMI, n = 18). The IMI included exploration of motivation to change alcohol use, perceived positive and negative effects of drinking, personalized feedback, and goals for changing alcohol consumption and related behaviors. The PMI included all elements of the IMI plus the presence of a supportive peer of the participant during both sessions. Although both groups significantly reduced number of drinking days and heavy drinking days at 1-month follow-up, the magnitude of within-group reductions in alcohol use and problems was 3 times larger on average for the PMI group than for the IMI group, based on effect-size calculations. Peers and participants endorsed high satisfaction ratings on the PMI. Findings indicate the promise of including peers in brief motivational interventions for mandated students.

Theory-based active ingredients of effective treatments for substance use disorders

This paper describes four related theories that specify common social processes that protect individuals from developing substance use disorders and may underlie effective psychosocial treatments for these disorders: social control theory, behavioral economics and behavioral choice theory, social learning theory, and stress and coping theory. It then provides an overview of the rationale and evidence for four effective psychosocial treatments for substance use disorders: motivational interviewing and motivational enhancement therapy, 12-step facilitation treatment, cognitive-behavioral treatment and behavioral family counseling, and contingency management and community reinforcement approaches. The presumed active ingredients of these treatments are described in terms of how they exemplify the social processes highlighted by the four theories. The identified common components of effective treatment include support, goal direction, and structure; an emphasis on rewards that compete with substance use, a focus on abstinence-oriented norms and models, and attempts to develop self-efficacy and coping skills. Several issues that need to be addressed to enhance our understanding of the active ingredients involved in effective treatment are discussed, including how to develop measures of these ingredients, how well the ingredients predict outcomes and influence conceptually comparable aspects of clients' life contexts, and how much their influence varies depending upon clients' demographic and personal characteristics.

Optimizing personalized normative feedback: the use of gender-specific referents

OBJECTIVE

Many brief interventions include personalized normative feedback (PNF) using gender-specific or gender-neutral referents. Several theories suggest that information pertaining to more socially proximal referents should have greater influence on one's behavior compared with more socially distal referents. The current research evaluated whether gender specificity of the normative referent employed in PNF related to intervention efficacy.

METHOD

Following baseline assessment, 185 college students (45.2% women) were randomly assigned to one of three intervention conditions: gender-specific feedback, gender-neutral feedback, or assessment-only control. Immediately after completing measures of perceived norms, alcohol consumption, and gender identity, participants in the gender-neutral and gender-specific intervention conditions were provided with computerized information detailing their own drinking behavior, their perceptions of student drinking, and actual student drinking.

RESULTS

After a 1-month follow-up, the results indicated that normative feedback was effective in changing perceived norms and reducing alcohol consumption for both intervention groups for women and men. The results provide support, however, for changes in perceived gender-specific norms as a mediator of the effects of normative feedback on reduced drinking behavior for women only. Additionally, gender-specific feedback was found to be more effective for women higher in gender identity, relative to the gender-neutral feedback. A post-assessment follow-up telephone survey administered to assess potential demand characteristics corroborated the intervention effects.

CONCLUSIONS

Results extend previous research documenting efficacy of computer delivered PNF. Gender specificity and gender identity appear to be important elements to consider for PNF intervention efficacy for women.

Patterns and importance of self-other differences in college drinking norms

College students overestimate other students' drinking behavior (descriptive norms) and attitudes (injunctive norms). This study explored the effects of demographics, norm type, and reference group on the magnitude of self- other differences (SODs). Participants (N = 1,611; 64% women) completed surveys assessing demographics, drinking patterns, and perceived norms. A subset of 122 students provided consumption data 1 month later to test predictors of changes in drinking. Overall, women and non-Greeks (Greek = member of fraternity or sorority) reported larger SODs for both norm types compared with men and Greeks. Heavier drinkers reported smaller SODs. Gender x Reference Group interactions revealed that women had larger SODs for reference groups increasingly distal to them; for men, the largest SODs occur for close friends versus more distal groups. Larger SODs for descriptive norms predicted increases in drinking, consistent with social norms theory.

Being controlled by normative influences: self-determination as a moderator of a normative feedback alcohol intervention

The objectives of this research were to evaluate the efficacy of computer-delivered personalized normative feedback among heavy drinking college students and to evaluate controlled orientation as a moderator of intervention efficacy. Participants (N = 217) included primarily freshman and sophomore, heavy drinking students who were randomly assigned to receive or not to receive personalized normative feedback immediately following baseline assessment. Perceived norms, number of drinks per week, and alcohol-related problems were the main outcome measures. Controlled orientation was specified as a moderator. At 2-month follow-up, students who received normative feedback reported drinking fewer drinks per week than did students who did not receive feedback, and this reduction was mediated by changes in perceived norms. The intervention also reduced alcohol-related negative consequences among students who were higher in controlled orientation. These results provide further support for computer-delivered personalized normative feedback as an empirically supported brief intervention for heavy drinking college students, and they enhance the understanding of why and for whom normative feedback is effective.

Alcohol use among college students: a comparison of athletes and nonathletes

This study examines alcohol use among college students, focusing on variation in binge drinking based on involvement in athletics. Prior research indicates that college students who participate in athletics are more likely to report binge drinking than are students who are not involved in athletics. However, existing research has not offered an explanation why college athletes are at a greater risk for binge drinking. Using data from the 1999 Harvard School of Public Health College Alcohol Study, a national study examining substance use and other health risk behaviors of college students in the United States, the current research examines social norms as a possible source of the elevated levels of binge drinking among college athletes. Findings indicate that athletes are more likely to report binge drinking, in part, because they view alcohol use as being more normative. The limitations of the study are noted.

The role of group orientation and descriptive norms on water conservation attitudes and behaviors

Social norms have been shown to impact behaviors, but with mixed results. The theory of normative social behavior delineates factors that moderate the relationship between descriptive norms and behaviors, and it addresses the attributes of behaviors that make them susceptible to normative influence. This study tests whether group orientation moderates the impact of descriptive norms on water conservation attitudes and behavioral intentions. Findings indicate a consistent pattern of interactions for descriptive norms and group orientation on both attitudes and behavioral intent. Implications for normative theory and campaign design are addressed.

Alcohol use and partner expectations among newly married couples

The objective of this work was to determine if a spouse's expectations about a married person's drinking patterns affected his/her partner's alcohol use and alcohol use-related problems. Alcohol use and problems were assessed in a U.S. urban sample of 634 couples at the time they applied for their marriage license (1996-1999) and at their first and second anniversaries. Husbands' expectations about married women's alcohol use, as well as wives' expectations about married men's alcohol use, were assessed at each wave using a three-item scale. Linear regression models were used to identify the longitudinal association between a person's expectations of married individuals' drinking patterns and his/her spouse's alcohol use the following year. Evidence was found to support the relation between one spouse's expectations and his/her partner's alcohol use. However, wives' expectations appeared more influential compared to husbands and this influence is not present at the start of marriage, but rather develops slightly later. The study's limitations are noted.

Peer contagion of aggression and health risk behavior among adolescent males: an experimental investigation of effects on public conduct and private attitudes

Peer contagion of adolescent males' aggressive/health risk behaviors was examined using a computerized "chat room" experimental paradigm. Forty-three 11th-grade White adolescents (16-17 years old) were led to believe that they were interacting with other students (i.e., "e-confederates"), who endorsed aggressive/health risk behaviors and whose ostensible peer status was experimentally manipulated. Adolescents displayed greater public conformity, more internalization of aggressive/health risk attitudes, and a higher frequency of actual exclusionary behavior when the e-confederates were high in peer status than low. Participants' level of social anxiety moderated peer contagion. Nonsocially anxious participants conformed only to high-status peers, whereas socially anxious participants were equally influenced by low- and high-status peers. The role of status-maintenance motivations in aggression and risk behavior, and implications for preventive intervention, are discussed.

Social networks and college drinking: probing processes of social influence and selection

This study used a three-wave panel design (N = 119 complete cases for all waves) to test for social influence and selection in the relation of college students' heavy drinking and that of their social networks. Evidence emerged for both social influence and selection, leading the authors to probe more specialized issues related to each. Results regarding social influence revealed, further, that greater presence in the network of individuals that the focal respondent considered "drinking buddies" was predictive of one's own later drinking, controlling for potential confounds. Network demographic characteristics associated with a "risky" (i.e., heavy-drinking) network also were documented. An additional finding, important for selection, was that wave-to-wave change in average network drinking appeared to result primarily from network members with different drinking levels being added to and dropped from the network. Findings are discussed in the context of the recent renaissance in social-network research.

Agent-based modeling of drinking behavior: a preliminary model and potential applications to theory and practice

OBJECTIVES

We developed a preliminary agent-based simulation model designed to examine agent-environment interactions that support the development and maintenance of drinking behavior at the population level.

METHODS

The model was defined on a 1-dimensional lattice along which agents might move left or right in single steps at each iteration. Agents could exchange information about their drinking with each other. In the second generation of the model, a "bar" was added to the lattice to attract drinkers.

RESULTS

The model showed that changes in drinking status propagated through the agent population as a function of probabilities of conversion, rates of contact, and contact time. There was a critical speed of population mixing beyond which the conversion rate of susceptible nondrinkers was saturated, and the bar both enhanced and buffered the rate of propagation, changing the model dynamics.

CONCLUSIONS

The models demonstrate that the basic dynamics underlying social influences on drinking behavior are shaped by contacts between drinkers and focused by characteristics of drinking environments.

Adolescent alcohol and cannabis use in relation to peer and school factors. Results of multilevel analyses

The present study used a multilevel approach with multiple informants to determine whether, at individual level, association with substance-using peer groups, and, at class level, incidences of intoxicated students in school premises, are related to students' own substance use. Additionally, it tested the hypothesis that such school incidences affect the closeness of the relation between association with substance-using peers and students' own substance use. Multilevel regression models were estimated separately for drunkenness and cannabis use on the basis of cross-sectional data from 3,925 students of eighth and ninth grades in Switzerland (mean age 15.3, S.D. 0.9) and their teachers (N=220). For both drunkenness and cannabis use, the results confirmed that association with substance-using peers is strongly related to individual substance-use. A higher level of students' own cannabis use and a closer relation between association with cannabis-using peers and the students' own cannabis use were found in classes where students saw others coming cannabis-intoxicated to school or taking cannabis in school premises. Such relations were not found for alcohol. It appears that cannabis use at school or shortly before arriving at school creates an atmosphere that favors cannabis use whether or not students are associated with cannabis-using peers. Establishing an overarching environment of disapproval appears to be an effective means of preventing cannabis use by adolescents.

The changing influences of self-worth and peer deviance on drinking problems in urban American Indian adolescents

This study explored the changing relations among self-worth, peer deviance, and alcohol-related problems in a sample of 224 urban-dwelling, American Indian adolescents. Data were collected annually at 7 time points to test a proposed mediational model. As expected, peer deviance mediated the relation between low self-worth and alcohol-related problems in younger adolescents; however, this relation did not hold as participants became older. In older adolescents, low self-worth and peer deviance directly and independently contributed to alcohol problems. Possible explanations for and implications of these findings are discussed in terms of developmental changes during adolescence.

How the quality of peer relationships influences college alcohol use

Peer relationships are consistently linked to alcohol use in college students. However, this disparate literature often reveals contradictory findings regarding the precise mechanisms of peer influence. In this review, we use an organisational framework based on social learning theory (SLT) to demonstrate how the quality of peer relationships may influence personal alcohol use. We propose that the quality of peer relationships enhance the influence of social reinforcement, modelling and cognitive processes on personal alcohol use. Research indicates that the quality of peer relationships influences drinking via three pathways: the lack or breakdown of quality peer relationships, alcohol use being an integral part of peer interactions, and if peers disapprove of alcohol use or do not drink. This conceptualisation of peer influence informs the consistent finding of gender differences in college student drinking. Limitations of the reviewed research include reliance on cross-sectional surveys, self-report and homogeneous populations. Future directions for research on quality peer relationships involve detailed longitudinal assessment and the application of advanced statistical methods.

Normative processes and adolescents’ smoking behaviour in Norway: A multilevel analysis

Currently, smoking prevalence is still high among adolescents. This is of major concern for public health organizations. Factors that influence adolescent smoking behaviour need to be identified and addressed. Research in this area has identified attitudes, subjective norms and perceived behavioural control as some of the contributing factors, but subjective norms have often been the weakest predictor of smoking behaviour. This could be due to inadequate measurement. The current paper suggests that examining different types of norms and their relationship with smoking behaviour could help increase the contribution of norms. The paper set out to identify other normative concepts, such as the subjective estimate of smoking prevalence, and descriptive and desired societal norms that are not captured by subjective norms but that could be related to adolescents' smoking behaviour. Data were collected from 15-year-old students from Norway (n = 1670 in 89 grade 10 school classes). Multilevel logistic regression analysis was used to determine how the various concepts of norms relate to each other and their relationship with adolescent smoking behaviour. The findings of the study showed that an individual's opinion of societal norms, and the expectations of significant others as well as their behaviour all seem significantly related to adolescent smoking behaviour, either as an individual or as a school class predictor. Hence, rather than playing down the role of norms, the addition of a subjective estimate of smoking prevalence, and descriptive and desired societal norms could extend the normative concept as well as increase its predictive power. Future intervention could address different types of norms as well as the effect of shared context to help prevent adolescents from smoking.

Moving beyond the keg party: a daily process study of college student drinking motivations

Theoretical models of alcohol consumption assert that young adults endorse multiple drinking motives, including drinking to cope with negative experiences and to enhance positive experiences. Social contacts may be important to both pathways. This study applied daily process methodology to determine the relationship between college student drinking in different contexts and daily social contacts and moods. Each afternoon for 3 weeks, 122 undergraduates (43% men, 57% women) logged onto a secure Web site during specified hours to report daily activities, moods, and contacts. Hierarchical linear modeling analyses provided support for motivational models and the context-specific nature of motivated drinking. Individual differences were revealed for each motivation. These findings highlight the importance of studying within-person processes using daily process designs.

The utility of collateral informant assessment in college alcohol research: results from a longitudinal prevention trial

OBJECTIVE

Collateral informants have been used to assess independently the validity of college student self-report data. However, it is unclear under what conditions collateral reports might be valid and useful in college research. We present two studies that examine aspects of these issues using data from 1,264 college student participants in a brief intervention prevention trial conducted at a public university.

METHOD

The first study describes the characteristics and predictors of agreement on reports of alcohol use and problems from 219 student-collateral informant pairs. The second study investigates potential "pipeline effects"; that is, whether collateral verification resulted in changes in student self-reports on two subsequent survey assessments over 1 year using longitudinal data from 1,264 students.

RESULTS

Little support was found for the assumption that nondependent college drinkers underreport drinking behaviors and consequences. Collaterals who reported more occasions of drinking together, higher confidence in the report and a close relationship with the participant provided reports that were more consistent with participant drinking reports. No evidence was found that pipeline effects of collateral verification improve the accuracy of college student self-reports at future assessments.

CONCLUSIONS

The results from this study are consistent with much of the published literature showing that using collateral reports to verify the self-reports of college students (and adults) may result in increased, not decreased, misclassification error. These findings suggest that the time and expense required to collect collateral data in the college setting has limited utility and may be better spent on establishing the proper assessment conditions that will foster accurate and honest self-reporting.

Life events and peer substance use and their relation to substance use problems in college students

Substance use disorders among college students are not well understood, and the present study examined the relationship of two environmental factors to alcohol and drug use problems in 616 (316 women) college students. Participants completed measures assessing substance use problems, life events, and substance use among peers. Alcohol use problems were significantly associated with higher drug use problems and regular use of illicit drugs among friends. Drug use problems were significantly associated with male gender, higher alcohol use problems, regular use of alcohol and drugs among friends, illicit drug use among romantic partners, and higher numbers of negative life events. Results extend previous research and suggest that college students who experience multiple negative life events and/or affiliate with substance using friends and romantic partners may be at risk for developing a substance use problem.

Substance use by college students: The role of intrinsic versus extrinsic motivation for athletic involvement

Certain types of athletic involvement may confer risk for substance use by college students. This study investigated whether motivational factors play a role in the relationship between athletic involvement and substance use. Intercollegiate athletes (n=98) and exercisers (n=120) were surveyed about substance use and motivation for athletic involvement. Athletes and exercisers who were extrinsically motivated had significantly higher rates of alcohol use than their intrinsically motivated counterparts. Results suggest that college students who are extrinsically motivated for involvement in physical activity/athletics--particularly those involved in team sports--may be in need of targeted prevention efforts.

Perceived alcohol use among friends and alcohol consumption among college athletes

Intercollegiate athletes have been identified as an at-risk group for heavy alcohol consumption (e.g., T. F. Nelson & H. Wechsler, 2001). The purpose of this study was to assess the relationship between descriptive drinking norms among one's closest friends and personal alcohol consumption among athletes. Specifically, the authors sought to determine whether perceptions of alcohol consumption among one's closest friend who was an athlete (athlete norms) demonstrated a stronger relationship with personal alcohol use than normative perceptions among one's closest friend who was not an athlete (nonathlete norms). Data were collected on 165 athletes competing at the National Collegiate Athletic Association Division I level. Results indicated that the athlete norms demonstrated a stronger main effect with personal alcohol use than the nonathlete norms, although both norms demonstrated strong effects. However, an interaction effect indicated that the athlete norms demonstrated a stronger relationship with personal consumption among men, whereas the nonathlete norms demonstrated a stronger relationship among women. Implications for alcohol prevention programs among college athletes are discussed.

What is worse? A hierarchy of family-related risk factors predicting alcohol use in adolescence

The aim of the present study was to determine if family structure, perception of excessive drinking in the family, and family bonding hold a graduated importance in predicting adolescent alcohol use and their association with peers who drink excessively. Three nested linear structural models were calculated separately for frequent and excessive drinking, based on a sample of 3,127 eighth and ninth graders in Switzerland (mean age 15.3, SD 0.8) surveyed in spring 2002 in the context of the "Health Behavior in School-Aged Children (HBSC)" study. The results confirm that the perception of excessive drinking in the family is more closely related to both frequent and excessive drinking than family structure, and family bonding is more closely related than drinking perception. Adjusting for both socio-demographic variables and the association with peers who drink excessively only slightly changed the results. To predict an association with the latter, family structure was more important than the perception of drinking, but family bonding remained the predominant predictor. The results stress the graduated importance of family-related risk factors: by listening to their children's worries, by spending their free time with them, and by providing help when needed, parents might have the possibility to actively minimize the risk of frequent and excessive drinking regardless of whether they are frequent excessive drinkers or live without a partner.

Evaluating the believability and effectiveness of the social norms message "most students drink 0 to 4 drinks when they party"

In an effort to reduce dangerous drinking levels among college students, university health educators have initiated social norms campaigns based on the rationale that students will be more likely to reduce their own drinking behaviors if they think that most students on campus are not heavy or binge drinkers. Within the framework of social comparisons theory, this study reports the findings of a survey of 277 college students and explores the correlates of accuracy and bias in students' estimates of whether or not most other students think that binge drinking on campus is a problem and whether or not most other students believe the campaign message. The overwhelming majority (72.6%) of students did not believe the norms message that most students on campus drink "0 to 4" drinks when they party, and 52.7% reported drinking "5 or more" drinks in a sitting. The social norms campaign was effective in motivating 61% of the respondents to think about binge drinking as a problem. For the most part, group or social network norms were more influential on students' own drinking behavior than were their estimates of the campus drinking norm. The findings also clarify that accuracy in estimating the campus social norm in and of itself does not necessarily lead to an increase or reduction in alcohol consumption. The social comparisons approach underscores the complex and social nature of human interaction and reinforces the need for the development of multiple approaches to alcohol education with messages that are designed to target the specific needs of students based on their orientations toward alcohol consumption.

Social norms approaches using descriptive drinking norms education: a review of the research on personalized normative feedback

College students have been shown to consistently overestimate the drinking of their peers. As a result, social norms approaches are effective in correcting these misperceived norms to reduce alcohol consumption and alcohol-related problems. In this review of literature, the authors critically evaluated the effectiveness of personalized normative feedback. In addition, the authors reviewed personalized normative feedback interventions and provided suggestions for increasing the efficacy of these interventions by making better use of salient referent group data.

False consensus and adolescent peer contagion: examining discrepancies between perceptions and actual reported levels of friends' deviant and health risk behaviors

Adolescents' perceptions of their friends' behavior strongly predict adolescents' own behavior, however, these perceptions often are erroneous. This study examined correlates of discrepancies between adolescents' perceptions and friends' reports of behavior. A total of 120 11th-grade adolescents provided data regarding their engagement in deviant and health risk behaviors, as well as their perceptions of the behavior of their best friend, as identified through sociometric assessment. Data from friends' own report were used to calculate discrepancy measures of adolescents' overestimations and estimation errors (absolute value of discrepancies) of friends' behavior. Adolescents also completed a measure of friendship quality, and a sociometric assessment yielding measures of peer acceptance/rejection and aggression. Findings revealed that adolescents' peer rejection and aggression were associated with greater overestimations of friends' behavior. This effect was partially mediated by adolescents' own behavior, consistent with a false consensus effect. Low levels of positive friendship quality were significantly associated with estimation errors, but not overestimations specifically.

Do popular students smoke? The association between popularity and smoking among middle school students

BACKGROUND

Several studies have shown an association between popularity and behavior, indicating that popular people tend to reflect the norms of their group. Among adolescents, it has been hypothesized that popular students are more likely to smoke, especially in schools with high smoking prevalence.

METHODS

Data were collected on friendship patterns and smoking from 1,486 sixth and seventh graders in 16 middle schools in southern California. Susceptibility to smoke was measured as not stating a commitment not to smoke in the future, and smoking as ever taken a puff or smoked a whole cigarette. We measured popularity as the number of times a student was chosen as a friend. Multivariate logistic regression was used to correlate popularity with susceptibility to smoke and smoking at follow-up controlling for baseline outcomes, demographic characteristics, and clustering within schools.

RESULTS

Popularity was associated with increased susceptibility to smoke (Adjusted Odds Ratio [AOR] = 5.64, p < .001) and smoking (AOR = 5.09, p < .05) over the 1-year interval between surveys. Although the association was strongest for non-White boys, we did not find evidence of interactions between popularity and gender or ethnicity.

CONCLUSIONS

Popular middle school students were more likely to become smokers compared to their less popular peers. Although there seems some difference in the association by gender and ethnicity, the evidence does not suggest subgroup effects in this population. Implications for the study of adolescent smoking and prevention programming are discussed.

Feedback interventions for college alcohol misuse: what, why and for whom?

In response to the persistent problem of college drinking, universities have instituted a range of alcohol intervention programs for students. Motivational feedback is one intervention that has garnered support in the literature and been adopted on college campuses. This article reviews published outcome studies that have utilized feedback as a major component of an alcohol intervention for college students. Overall, 11 of the 13 reviewed studies (77%) found a significant reduction in drinking as compared to a control or comparison group. While the studies varied widely in terms of population, follow-up period, and feedback content, it appears that feedback can be effective whether delivered by mail, the Internet, or via a face-to-face motivational interview. Feedback seems to change normative perceptions of drinking and may be more effective among students who drink for social reasons. The addition of a group or individual counseling session does not appear to increase the short-term impact of the feedback.

Drinking patterns, drinking contexts and alcohol-related aggression among late adolescent and young adult drinkers

AIMS

The main objectives of this study were to determine: (1) the relative roles of heavy episodic drinking (HED), drinking frequency and drinking volume in explaining alcohol-related aggression and (2) whether drinking context variables (i.e. usual drinking locations, typical drinking companions and extent of peer drinking) confound or modify the relationship between HED and alcohol-related aggression or whether they predict alcohol-related aggression independently.

DESIGN

A secondary analysis of the US National Longitudinal Survey of Youth was conducted. Alcohol-related aggression (denoted fights after drinking) was measured based on self-reports of arguments or fights that occurred during or after drinking in the previous 12 months.

PARTICIPANTS

A composite sample of drinkers, ages 17-21, from the 1994, 1996 and 1998 Young Adult surveys (n = 738) was used.

FINDINGS

Frequency of drinking and drinking volume largely confounded the association between HED and fights after drinking. Usually drinking in public locations away from home versus private locations was found to be significantly associated with a greater likelihood of fights after drinking among females. Among males, usual drinking location modified the relationship between drinking frequency and alcohol-related aggression, with the greatest risk of aggression for males who drank frequently and usually drank in public locations away from home.

CONCLUSIONS

Programs designed to reduce drinking frequency in this population and to increase the safety of drinking locations in public places away from home may prove to be beneficial in reducing alcohol-related aggression.

Developmental considerations for substance use interventions from middle school through college

This article summarizes a symposium organized by Dr. Elizabeth D'Amico and presented at the 2004 Annual Meeting of the Research Society on Alcoholism in Vancouver, Canada. The four presentations illustrate the importance of creating substance use interventions that are developmentally appropriate for youth. They represent innovative approaches to working with preteens, teenagers, and young adults. Dr. D'Amico's paper describes her research on the development of a voluntary brief intervention targeting alcohol use among middle school students. Findings indicated that by using school and community input, she was able to obtain a diverse a sample of youth across grades, sex, ethnicity, and substance use status. Dr. Ellickson's paper describes her research on Project ALERT, a school-based prevention program for middle school youth. Her findings indicate that Project ALERT worked for students at all levels of risk (low, moderate, and high) and for all students combined. Dr. Wagner's Teen Intervention Project was a randomized clinical trial to test the efficacy of a standardized Student Assistance Program for treating middle and high school students with alcohol and other drug problems. The study provided a unique opportunity to begin to examine how development may impact response to an alcohol or other drug intervention. Dr. Turrisi's paper examined processes underlying the nature of the effects of a parent intervention on college student drinking tendencies. Findings suggested that the parent intervention seems to have its impact on student drinking by reducing the influence of negative communications and decreasing the susceptibility of influences from closest friends. Dr. Kim Fromme provided concluding remarks.

Iatrogenic effects of psychosocial interventions for substance use disorders: prevalence, predictors, prevention

AIMS

To examine the prevalence and personal and intervention-related predictors of potential iatrogenic effects associated with psychosocial interventions for substance use disorders and provide a conceptual framework to guide further research on such effects.

METHOD

A review of relevant studies focuses on the prevalence and predictors of potential iatrogenic effects of psychosocial treatment and prevention programs for substance use disorders.

RESULTS

Between 7% and 15% of patients who participate in psychosocial treatment for substance use disorders may be worse off subsequent to treatment than before. In addition, several controlled trials of substance use prevention have shown some apparent iatrogenic effects, including more positive expectations about substance use and a rise in alcohol use and alcohol-related problems. Probable person-related predictors of deterioration associated with treatment include younger age and unmarried status, more serious current diagnoses and substance use problems and more psychiatric and interpersonal problems. Probable intervention-related predictors of deterioration include lack of bonding; lack of monitoring; confrontation, criticism and high emotional arousal; deviancy modeling; and stigma, low or inappropriate expectations and lack of challenge.

CONCLUSION

A significant minority of individuals with substance use problems appear to deteriorate during or shortly after participation in treatment or prevention programs. Safety standards and monitoring procedures are needed to routinely identify potential adverse consequences of intervention programs; research is needed to clarify whether deterioration is due to iatrogenic effects of interventions and to identify new approaches to counteract any such effects.

Prevention of heavy drinking and associated negative consequences among mandated and voluntary college students

The Lifestyle Management Class (LMC) was evaluated as a universal and targeted alcohol prevention program among voluntary and mandated college students. The relative efficacy of peer- and professional-led group interventions was also tested in this randomized, controlled design. LMC participants showed decreases in driving after drinking relative to control participants. Changes in heavy drinking varied as a function of treatment condition, readiness to change, and gender, with a trend toward larger decreases among voluntary LMC participants high in readiness to change and a comparable though nonsignificant advantage for male LMC participants in the mandated sample. The LMC was comparably effective for mandated and voluntary students, with no clear advantage for peer- or professional-led groups.

The epidemiology of college alcohol and gambling policies

Background

This article reports the first national assessment of patterns of drinking and gambling-related rulemaking on college campuses (e.g., punitive versus recovery oriented). Analyses relating school policies to known school rates of drinking or gambling identified potentially influential policies. These results can inform and encourage the development of guidelines, or "best practices," upon which schools can base future policy.

Methods

The college policy information was collected from handbooks, Web sites and supplemental materials of 119 scientifically selected colleges included in the fourth (2001) Harvard School of Public Health College Alcohol Study (CAS). A coding instrument of 40 items measured the scope and focus of school alcohol and gambling policies. This instrument included items to measure the presence of specific policies and establish whether the policies were punitive or rehabilitative. A total of 11 coders followed a process of information extraction, coding and arbitration used successfully in other published studies to codify policy information.

Results

Although all schools had a student alcohol use policy, only 26 schools (22%) had a gambling policy. Punitive and restrictive alcohol policies were most prevalent; recovery-oriented policies were present at fewer than 30% of schools. Certain alcohol and gambling policies had significant relationships with student binge drinking rates.

Conclusions

The relative lack of college recovery-oriented policies suggests that schools might be overlooking the value of rehabilitative measures in reducing addictive behaviors among students. Since there are few college gambling-related policies, schools might be missing an opportunity to inform students about the dangers of excessive gambling.

Gender differences in predicting high-risk drinking among undergraduate students

The purpose of this study was to examine gender differences in college students' high-risk drinking as measured by an estimated blood alcohol concentration (eBAC) based on gender, height, weight, self-reported number of drinks, and hours spent drinking. Using a developmental/contextual framework, high-risk drinking is conceptualized as a function of relevant individual characteristics, interpersonal factors, and contextual factors regularly mentioned in the college drinking literature. Individual characteristics include race, gender, and age; interpersonal characteristics include number of sexual partners and having experienced forced sexual contact. Finally, contextual factors include Greek membership, living off-campus, and perception of peer drinking behavior. This study is a secondary data analysis of 1,422 students at a large university in the Southeast. Data were gathered from a probability sample of students through a mail survey. A three-step hierarchical logistic regression analysis showed gender differences in the pathway for high-risk drinking. For men, high-risk drinking was predicted by a combination of individual characteristics and contextual factors. For women, interpersonal factors, along with individual characteristics and contextual factors, predicted high-risk drinking, highlighting the importance of understanding female sexual relationships and raising questions about women's risk-taking behavior. Implications for prevention and assessment are discussed.