The way one thinks affects the way one drinks: subjective evaluations of alcohol consequences predict subsequent change in drinking behavior

Drinking Over the Lifespan: Focus on College Ages

Many college students drink heavily and experience myriad associated negative consequences. This review suggests that a developmental perspective can facilitate a better understanding of college drinking. Specifically, using an emerging adulthood framework that considers the ongoing role of parents and neurodevelopmental processes can provide insight into why students drink. Most college students drink and tend to drink more and more heavily than their non-college-attending peers. These drinking patterns are affected by environmental and temporal characteristics specific to the college environment, including residential campus living, the academic week, and the academic year. Additional psychosocial factors are of particular relevance to the drinking behavior of college-age people, and include exaggerated peer norms, the development and use of protective behavioral strategies, and mental health considerations. Understanding the unique interaction of person and environment is key to designing prevention/intervention efforts.

Negative evaluations of negative alcohol consequences lead to subsequent reductions in alcohol use

Alcohol use during young adulthood may reflect a learning process whereby positive and negative alcohol-related experiences and interpretations of those experiences drive subsequent behavior. Understanding the effect of consequences and the evaluation of consequences could be informative for intervention approaches. The objective of this study was to examine the extent to which the number of positive and negative alcohol consequences experienced and the evaluation of those consequences predict subsequent alcohol use and consequences in college students. Students at 3 colleges (N = 679) completed biweekly web-based surveys on alcohol use, positive and negative consequences, and consequence evaluations for 2 academic years. Hierarchical linear modeling tested whether consequences and evaluations in a given week predicted changes in alcohol use and consequences at the next assessment. Moderation by gender and class year were also evaluated. Evaluating past-week negative consequences more negatively than one's average resulted in decreases in alcohol use at the next assessment. More negative evaluation of negative consequences was followed in the subsequent observation by a higher number of positive consequences for females but not for males. A higher number of positive consequences in a given week was followed by a higher number of both positive and negative consequences in the subsequent observation. Number of negative consequences experienced and evaluation of positive consequences had no effect on later behavior. Salient negative consequences may drive naturalistic reductions in alcohol use, suggesting the possible efficacy of programs designed to increase the salience of the negative effects of alcohol.

Longitudinal patterns of alcohol mixed with energy drink use among college students and their associations with risky drinking and problems

OBJECTIVE

The consumption of alcohol mixed with energy drinks (AmEDs) is a form of risky drinking among college students, a population already in danger of heavy drinking and associated consequences. The goals of the current longitudinal study were to (a) identify types of AmED users between the first and second year of college and (b) examine differences among these groups in rates of highrisk drinking and consequences over time.

METHOD

A random sample of college student drinkers (n = 1,710; 57.7% female) completed baseline and 6-month follow-up measures assessing alcohol-related behaviors.

RESULTS

AmED use was endorsed by 40% of participants during the course of the study. As anticipated, four distinct groups of AmED users were identified (nonusers, initiators, discontinuers, and continuous users) and were significantly different from one another on drinking and consequence outcomes. Further, significant Time × Group interaction effects were observed for drinking and overall consequences. Generally, across all outcomes and time points, nonusers reported the lowest rates of drinking and consequences, whereas continuous users consistently reported the highest rates of drinking and consequences. Students who initiated AmED use during the course of the study also reported anabrupt increase in alcohol use and reported consequences.

CONCLUSIONS

Findings suggest students who consistently engage in and initiate AmED use also engage in riskier drinking behaviors and experience higher rates of consequences. Interventions that specifically target AmED use may be warranted and have the potential to reduce alcohol-related consequences.

Alcohol evaluations and acceptability: examining descriptive and injunctive norms among heavy drinkers

OBJECTIVES

This study assessed descriptive and injunctive norms, evaluations of alcohol consequences, and acceptability of drinking.

METHODS

Participants were 248 heavy-drinking undergraduates (81.05% female; Mage=23.45).

RESULTS

Stronger perceptions of descriptive and injunctive norms for drinking and more positive evaluations of alcohol consequences were positively associated with drinking and the number of drinks considered acceptable. Descriptive and injunctive norms interacted, indicating that injunctive norms were linked with number of acceptable drinks among those with higher descriptive norms. Descriptive norms and evaluations of consequences interacted, indicating that descriptive norms were positively linked with number of acceptable drinks among those with negative evaluations of consequences; however, among those with positive evaluations of consequences, descriptive norms were negatively associated with number of acceptable drinks. Injunctive norms and evaluations of consequences interacted, indicating that injunctive norms were positively associated with number of acceptable drinks, particularly among those with positive evaluations of consequences. A three-way interaction emerged between injunctive and descriptive norms and evaluations of consequences, suggesting that injunctive norms and the number of acceptable drinks were positively associated more strongly among those with negative versus positive evaluations of consequences. Those with higher acceptable drinks also had positive evaluations of consequences and were high in injunctive norms.

CONCLUSIONS

Findings supported hypotheses that norms and evaluations of alcohol consequences would interact with respect to drinking and acceptance of drinking. These examinations have practical utility and may inform development and implementation of interventions and programs targeting alcohol misuse among heavy drinking undergraduates.

Control and Alcohol-Problem Recognition Among College Students

OBJECTIVE

This study examined negative control (ie, perceived lack of control over life outcomes) and need for control as predictors of alcohol-problem recognition, evaluations (good/bad), and expectancies (likely/unlikely) among college students. The study also explored the interaction between the need for control and alcohol consumption in alcohol-related outcomes.

PARTICIPANTS

Participants were a convenience sample of 500 college students from a rural Midwest university. Data were collected during the 2009-2010 academic year.

METHODS

Participants completed a survey assessing control and alcohol-problem recognition, evaluations, and expectancies.

RESULTS

Negative control demonstrated a significant positive association with alcohol-problem recognition, evaluations, and expectancies after controlling for gender and alcohol consumption. Need for control did not have a main effect. However, the interaction was significant in that the association between need for control and negative evaluation of alcohol problems was strongest among participants with the highest levels of alcohol consumption.

CONCLUSIONS

These results demonstrate that individuals' differences in sense of control are associated with alcohol-problem recognition, evaluations, and expectancies in young adults.

Differential evaluations of alcohol-related consequences among emerging adults

Personalized feedback interventions (PFIs) to reduce drinking in college students often provide feedback about negative alcohol-related consequences experienced by students to motivate them to drink less. Yet, there is evidence which suggests that not everyone perceives consequences as negative and raises questions regarding the utility of consequence-specific feedback for some individuals. The purpose of the current study was to extend this research to examine salience of consequences among both college and non-college emerging adults, differences in ratings by sex, age, and frequency of experiencing consequences, and the relationship between salience measured in emerging adulthood and drinking patterns in young adulthood. Data were from an accelerated cohort study of males and females (N = 1,308), who were either age 18, 21, or 24 years at the time of consequence evaluation and followed-up 7 years later. Most experienced consequences were rated as at least a little bothersome. Regression analyses indicated that females, older participants, and those who experienced a consequence more often evaluated consequences as more bothersome but there were no differences by college status. Mean ratings of bother did not predict quitting drinking or alcohol problems 7 years later, whereas the number of consequences experienced did. Overall, the results suggest that most consequences are rated similarly by emerging adults regardless of college attendance but that feedback on consequences may be more salient for females and older emerging adults. PFIs may need to differ in the types of feedback they provide depending on demographic characteristics and baseline level of alcohol problems.

Description and predictors of positive and negative alcohol-related consequences in the first year of college

OBJECTIVE

The purpose of this study was to establish the frequency of positive and negative alcohol-related consequences during the first year of college and to evaluate gender, race/ethnicity, time of year, alcohol use, and intoxication as predictors of consequences using frequent assessments.

METHOD

Participants (N = 1,053; 57.5% female) completed biweekly assessments of alcohol use and positive and negative alcohol-related consequences throughout the year.

RESULTS

The majority of drinkers reported both positive and negative consequences. Having a good time and feeling less stressed were the most commonly reported positive consequences. Blackouts and getting physically sick were the most commonly endorsed negative consequences. At the weekly level, number of drinking days, drinks per drinking day, and estimated blood alcohol concentration (eBAC, reflecting intoxication) were significantly related to all consequences after controlling for demographics and time of year. Negative consequences had stronger associations with number of drinks and eBAC than positive consequences did. With each additional drink consumed on a drinking day, the incidence of negative consequences more than doubled (incidence rate ratio [IRR] = 2.34, 95% CI [2.19, 2.50]), whereas the incidence of positive consequences increased by about half (IRR = 1.51, 95% CI [1.47, 1.56]). The consequence with the largest gender difference was regretted sex, with women reporting it more often. Few racial/ethnic differences were found in report of negative consequences. Greater positive and negative consequences were endorsed at the beginning of both academic semesters.

CONCLUSIONS

As number of drinks and eBAC increase, the relative odds of a negative consequence are higher than that of a positive consequence. Alcohol interventions could promote greater awareness of the likelihood of specific consequences and could highlight that positive consequences are associated with lower levels of drinking.

Risky cognitions associated with adolescent alcohol misuse: moral disengagement, alcohol expectancies and perceived self-regulatory efficacy

AIM

To examine the longitudinal associations between moral disengagement, alcohol related expectancies, perceived self-regulatory efficacy and alcohol use amongst adolescents.

DESIGN AND PARTICIPANTS

A total of 367 students (mean age=13.1, SD=0.51; 65% male) from five schools across Sydney, Australia took part in this longitudinal study. Participants completed a self-report questionnaire at four time points across an 18 month period which assessed their alcohol use, levels of moral disengagement, alcohol related expectancies and perceived self-regulatory efficacy to resist peer pressure to engage in transgressive behaviours.

RESULTS

Over time, rates of binge drinking in the past three months significantly increased, but rates of drinking any alcohol in the past three months remained stable. As hypothesised, all three cognitions were independently and consistently associated with adolescent alcohol use and binge drinking over time, with the exception of perceived self-regulatory efficacy which was not associated with an increased risk of drinking any alcohol in the past three months when controlling for moral disengagement, alcohol expectancies, gender and age.

CONCLUSIONS

The current study is the first study to longitudinally map three distinct cognitive factors associated with adolescent alcohol use. Considering the alarming number of adolescents drinking at levels that place them at risk of significant harm, this study has provided important implications about cognitive factors that can be targeted to increase the accuracy of assessment and efficacy of prevention for alcohol misuse amongst adolescents.

The role of behavioral inhibition and behavioral approach systems in the associations between mood and alcohol consequences in college: a longitudinal multilevel analysis

The behavioral inhibition system (BIS) and behavioral approach system (BAS) are thought to influence sensitivity to reinforcement and punishment, making them useful for predicting mood-related drinking outcomes. This study provided the first examination of BIS and BAS as moderators of longitudinal within-person associations between mood and alcohol-related consequences in college student drinkers. Participants (N = 637) at two public U.S. universities completed up to 14 online surveys over the first three years of college assessing past-month general positive and negative moods, as well as past-month alcohol use and consequences. BIS and BAS were assessed at baseline. Using multilevel regression, we found that BIS and BAS moderated the within-person associations between negative mood and alcohol consequences. For students high on BIS only, high on BAS only, or high on both BIS and BAS, within-person increases in negative mood were associated with greater alcohol consequences in the first year of college. However, these negative mood-alcohol consequence associations diminished over time for students high on BIS and low on BAS, but remained strong for students high on both BIS and BAS. Within-person associations between positive mood and alcohol consequences changed from slightly positive to slightly negative over time, but were not moderated by BIS or BAS. Findings suggest that BIS and BAS impact the within-person association between general changes in negative mood and negative alcohol consequences, working jointly to maintain this relationship over time.

Normative perceptions and past-year consequences as predictors of subjective evaluations and weekly drinking behavior

Problem drinking during the college years continues to be an important area of study. Subjective evaluations of consequences have recently been demonstrated to predict future drinking behavior; however, what predicts those evaluations is yet unknown. Social Learning Theory (SLT) provides a guiding framework in this study. Primary aims are to investigate whether individual differences in past experience with alcohol consequences and normative perceptions of alcohol consequences predict subjective evaluations (i.e., the extent to which consequences are perceived as negative, aversive, or severe) and weekly drinking behavior. We also test whether evaluations mediate the influence of past consequences and norms on weekly drinking behavior. Following a baseline assessment, participants (N = 96 regularly drinking college students, 52% female) completed ten weekly web-based surveys on previous week alcohol use, consequences, and subjective evaluations of those consequences. A series of hierarchical linear models were used to test hypotheses. Most mediational pathways were not supported - weekly level evaluations do not appear to fully explain the effect of norms or past experience on weekly level drinking behavior. However, results demonstrated that normative perceptions of and past experience with consequences were associated with both weekly drinking behavior and subjective evaluations, and evaluations remained significant predictors of alcohol use behavior after accounting for these important between-person influences. Findings support the importance placed by SLT on cognition in drinking behavior, and suggest that norms for consequences and subjective evaluations may be appropriate targets of intervention in college students.

An update of research examining college student alcohol-related consequences: new perspectives and implications for interventions

The objective of this review is to provide an update on existing research examining alcohol-related consequences among college students with relevance for individual-based interventions. While alcohol-related consequences have been a focus of study for several decades, the literature has evolved into an increasingly nuanced understanding of individual and environmental circumstances that contribute to risk of experiencing consequences. A number of risk factors for experiencing alcohol-related consequences have been identified, including belonging to specific student subgroups (e.g., Greek organizations) or drinking during high-risk periods, such as spring break. In addition, the relationship between students' evaluations of both negative and positive consequences and their future drinking behavior has become a focus of research. The current review provides an overview of high-risk student subpopulations, high-risk windows and activities, and college students' subjective evaluations of alcohol-related consequences. Future directions for research are discussed and include determining how students' orientations toward consequences change over time, identifying predictors of membership in high-risk consequence subgroups and refining existing measures of consequences to address evolving research questions.