Understanding Drinking Game Behaviors: A Consideration of Alcohol Expectancies and Motives to Play and Drink

Comparing Drinking Game Motives, Behaviors, and Consequences Among Varsity Athletes, Recreational Athletes, and Non-Student-Athletes: A Multisite University Study

OBJECTIVE

Among college students, student-athletes are at increased risk for heavy alcohol consumption, participation in risky drinking practices (e.g., playing drinking games [DG]), and adverse alcohol-related consequences relative to non-student-athletes. Within the student-athlete population, level of sports participation (e.g., recreational or varsity sports) can affect alcohol use behaviors and consequences, but our understanding of the extent to which level of sports participation influences engagement in DG is limited. Thus, in the present study, we examined differences in frequency of participation in DG, typical drink consumption while playing DG, negative DG consequences, and motives for playing DG among varsity, recreational, and non-student-athletes.

METHOD

College students (n = 7,901 across 12 U.S. colleges/universities) completed questionnaires on alcohol use attitudes, behaviors, and consequences.

RESULTS

Student-athletes (recreational or varsity sports) were more likely to have participated in DG within the past month than non-student-athletes. Among students who reported past-month DG play, recreational athletes played more often and endorsed more enhancement/thrills motives for playing DG than non-student-athletes, and student-athletes (recreational or varsity) endorsed higher levels of competition motives for playing DG than non-student-athletes.

CONCLUSIONS

These findings shed light on some risky drinking patterns and motives of recreational athletes who are often overlooked and under-resourced in health research and clinical practice. Recreational and varsity student-athletes could benefit from alcohol screening and prevention efforts, which can include provision of competitive and alcohol-free social activities and promotion of alcohol protective behavioral strategies to help reduce recreational athletes' risk for harm while playing DG.

A confirmatory factor analysis of a revised motives for playing drinking games (MPDG-33) scale among university students in the United States

AIM

Participating in a drinking game (DG) is common practice among university students and can increase students' risk for heavy drinking. Given the theoretical link between motivations to drink and alcohol use, careful consideration should be given to students' motivations to play DGs. In this study, we examined the factor structure, internal consistency, and concurrent validity of a revised version of the motives for playing drinking games (MPDG) scale, the MPDG-33.

METHODS

University students (n = 3345, Mage = 19.77 years, SDage = 1.53; 68.8% = women; 59.6% = White) from 12 U.S. universities completed a confidential online self-report survey that included the MPDG-33 and questions regarding their frequency of DG participation and typical drink consumption while playing DGs.

RESULTS

Confirmatory factor analysis indicated the 7-factor model fit the data adequately, and all items had statistically significant factor loadings on their predicted factor. All subscales had adequate to excellent internal consistency and were positively correlated with the frequency of DG participation and the typical number of drinks consumed while playing DGs (though the correlations were small).

CONCLUSION

Findings suggest that the MPDG-33 can be reliably used in research and clinical settings to assess U.S. university students' motives for playing DGs.

College Student Alcohol Use: Understanding the Role of Alcohol Expectancies, Social Anxiety, Social Connectedness, and Need to Belong

ObjectiveCollege students consume more alcohol and engage in binge drinking more frequently than their non-college attending peers, and prevalence of alcohol-related consequences (e.g., drinking and driving; taking avoidable risks) has not decreased proportionally with decreases in consumption. Social anxiety and alcohol expectancies, or beliefs about the effects of alcohol, have been found to be significantly related to alcohol use and account for significant variance in alcohol use and related consequences. Few studies, however, have examined how other social variables such as need to belong and social connectedness may fit into existing models of increased and risky alcohol use. Methods: Students at a large state university (n = 1,278) completed an online survey measuring alcohol expectancies, need to belong, social anxiety, and social connectedness. Mean age of participants was 19.65 years, and 59.5% self-identified as female, 39.8% male, and 0.7% identified as transgender. Structural equation modeling supported hypothesized relationships between need to belong, social anxiety, social connectedness, alcohol expectancies, and alcohol use, a mean centered variable that included binge drinking, drinking frequency, and amount of consumption. Results: Positive alcohol expectancies related to tension reduction, sociability, and sexuality, were positively related to drinking, such that increased alcohol expectancies were associated with increased drinking. Alcohol expectancies mediated the relationship between need to belong and increased alcohol use, as well as social connectedness and increased alcohol use. Similarly, social anxiety also mediated these relationships. No direct relationships were found between need to belong or social connectedness and alcohol use, suggesting previous research exploring these relationships may have excluded control variables (e.g., biological sex, race/ethnicity) that better explain the impact of need to belong and social connectedness on alcohol use. Conclusion: Prevention and intervention efforts might be more effective in reducing alcohol use if social factors are more broadly targeted.

Risky business: an examination of drinking games in college settings and their impact: a systematic review

This systematic review explores the prevalence and impact of Drinking Games (DG) among college students. DGs involve social drinking with the goal of heavy alcohol consumption and are associated with risky behaviours. The review aims to quantify the relationship between DG participation, alcohol consumption, and negative outcomes. It also investigates gender moderation and unexplored motivational factors for DG engagement. Following PRISMA guidelines, 34 studies were included after screening 317 records. The studies comprised n = 34,197 participants and were analysed for various variables, including gender dynamics, motivations, and associated negative consequences. Gender convergence in DG participation was noted, emphasizing the importance of gender-specific interventions. Participants were aware of risks but often perceived negative outcomes as a badge of honour. Motivations for DGs were linked to social interaction and a sense of belonging. Personality traits like sensation seeking and identification with college drinking culture played significant roles in DG engagement and outcomes. The review underscores the need for targeted interventions to address shifting perceptions of negative consequences and consider personality traits when designing preventive measures. It also highlights the significance of gender-specific strategies. However, variations in DG measurement and possible selection bias among heavy drinkers participating in DGs remain limitations. This systematic review provides insights into DG prevalence and its link to negative outcomes among college students. The findings stress the importance of tailored interventions and further research to mitigate risk factors and promote healthier drinking behaviours in this demographic.

Investigating the Relation between Anxiety Sensitivity and Substance Use: What Are the Roles of Social Anxiety and Outcome Expectancies?

Objective: Research on the association between anxiety sensitivity (AS) and substance use is mixed, with some studies showing a positive association and others showing no association. Other relevant variables, such as social anxiety and outcome expectancies, may help us understand how and for whom AS is linked to substance use. This study tested (a) the associations between AS and alcohol use, cannabis use, and drinking games and pregaming behaviors among young adults, and (b) the mediating role of social anxiety and moderating role of outcome expectancies in these associations. Method: Participants (N = 199, 69% women) were young adults (19 to 25 years) who completed a 30-minute online self-report questionnaire on their substance use. Results: Results revealed significant negative associations between AS and drinking game and pregaming participation. AS was not directly associated with other substance use outcomes. The association between AS and hazardous cannabis use was moderated by relaxation and tension reduction expectancies, but outcome expectancies did not moderate any of the other associations between AS and substance use outcomes. Social anxiety mediated the associations between AS and hazardous cannabis use and both drinking game and pregaming participation. Conclusions: Findings highlight the complex association between AS and different substance use outcomes. Outcome expectancies and social anxiety may help explain how AS is associated with hazardous cannabis use and drinking game/pregaming participation, respectively. More effective interventions can be developed by understanding the relation between AS and substance use.

Longitudinal examination of high-risk drinking contexts: Daytime drinking, pregaming, and drinking games linked to high-risk alcohol use and negative consequences in young adults

BACKGROUND

The contexts in which young adults drink alcohol play a salient role in alcohol-related outcomes and negative consequences at an event-level, but less is known about longitudinal risks. We collected longitudinal monthly data across 2 years on (a) daytime drinking, (b) pregaming/pre-partying, and (c) playing drinking games. We then examined associations between drinking in these contexts and within-person variability in alcohol consumption, consequences, and simultaneous alcohol and marijuana (SAM) use in a given month. We also examined the extent to which drinking in these contexts predicted hazardous drinking (using Alcohol Use Disorders Identification Test (AUDIT) scores) at a distal follow-up timepoint, controlling for baseline AUDIT scores.

METHOD

A community sample of 759 young adults (Mage  = 21.1 years; 56.4% female) completed monthly surveys for 24 consecutive months and a distal 30-month follow-up. Multilevel models estimated within- and between-person associations between drinking context frequencies (daytime drinking, pregaming, drinking games) and alcohol-related outcomes (weekly consumption, consequences, SAM use). A single-level negative binomial regression tested associations between drinking context frequency averages across a two-year period and changes in AUDIT scores from baseline to a follow-up 2.5 years later.

RESULTS

Over 75% of the sample of non-abstaining young adults reported drinking in each of the three contexts at least once during the 24-month period. Within-persons, young adults reported greater consumption, more negative consequences, and increased likelihood of SAM use during months that they drank in these contexts more often than usual. Each context was associated with negative consequences, even when controlling for alcohol use frequency. More frequent daytime drinking and pregaming, but not drinking games, were associated with increases in AUDIT scores at the 30-month follow-up, suggesting that there are potential long-term risks of drinking in these contexts.

CONCLUSIONS

Findings suggest that daytime drinking, pregaming, and playing drinking games are high-risk contexts in terms of month-to-month and long-term risks. Additional research is needed on the various contexts in which young adults drink alcohol and the extent to which contextual factors interact with one another to amplify/reduce risks and harms.

What pandemic? A multisite study of drinking motives and drinking games participation among college students during a pandemic (COVID-19) academic year

A drinking game (DG) is a widely practiced social activity that tends to encourage rapid alcohol consumption. While social restrictions during the pandemic (COVID-19) academic year were implemented as a health measure across many colleges/universities, the extent to which college student drinkers continued to play DGs in-person is not well understood. Because theory and research suggest that drinking motives are proximal correlates of drinking behaviors, we examined which drinking motives increased the likelihood of playing DGs in-person, and playing DGs in-person in a group of 10 + people during the 2020-21 pandemic academic year. College students (past-year drinkers) from 12 universities completed an online survey (N = 900; M_age = 19.42, Range = 18-25; SD_age = 1.45, White = 73.1%, 69.2% female). Of the students surveyed, 590 students played DGs, with 460 students only playing DGs in-person. Of the students who played DGs in-person, 274 students reported that the maximum number of people they played DGs with in-person exceeded the CDC's recommended guidelines (10 + people). Accounting for demographics, general alcohol use, and perceived COVID-19 threat, social drinking motives were positively associated with an increased likelihood of playing DGs in-person; the inverse was found for coping motives. Drinking motives were not associated with the likelihood of playing DGs with 10 + people but greater alcohol use and lower perceived threat of COVID-19 were. Given that the pandemic did not deter many student drinkers from playing DGs in-person, further investment in targeted intervention and public health initiatives aimed at substance-free alternatives promoting engagement and enhancement of social activities may be needed.

The role of eating expectancies and eating motives in the association between mood and loss-of-control eating: A national sample daily diary study

Loss-of-control eating (LOCE, the subjective inability to refrain from eating or cease eating), is highly mood-driven. Mood-related eating motives and eating expectancies have been identified as contributors to binge eating. However, little is known about how these factors relate to LOCE, much less their relationship with daily-level LOCE. This study assessed the impact of trait eating expectancies and daily eating motives on the relationship between daily affective states and LOCE. United States adults (n = 109) reporting recent LOCE participated in a ten-day diary study, completing two surveys per day regarding eating behaviors, mood, and motives. Data were analyzed at the within- and between-subject levels utilizing a Bayesian approach to examine pathways from mood to LOCE, mediated by eating motives and accounting for a moderating impact of baseline eating expectancies on the path leg between mood and motives. Negative mood was associated with LOCE at both the within- and between-subjects level by way of coping motives, and directly at the within-subjects level. Negative affect (NA) reduction expectancies did not moderate the indirect pathway. Positive mood was only associated with LOCE at the within-subjects level, via pleasure motives. This relationship was potentiated via reward expectancies. Therefore, although negative mood appears be a robust predictor of LOCE regardless of trait NA reduction expectancies, positive mood appears to have a specific set of conditions under which individuals are at increased likelihood of LOCE at the within-subjects level. These findings suggest that eating expectancies and motives for eating may be meaningful targets in LOCE interventions.

Social Anxiety and Pre-Party Motives Are Associated With Alcohol-Related Negative Consequences During College Students' Most Recent Pre-Party Occasion

OBJECTIVE

Engaging in hazardous drinking behaviors, such as playing drinking games or pre-partying, is associated with excessive drinking and negative consequences among college students. Pre-partying or playing drinking games often occurs in anticipation of or during social situations. College students with elevated social anxiety who drink to cope with social anxiety symptoms in social settings may be especially vulnerable to drinking more heavily in these contexts and, in turn, experiencing more negative consequences. However, little is known about specific psychosocial factors that may inform the decision of socially anxious individuals to engage in hazardous drinking behaviors.

METHOD

The current study used cross-sectional data to test whether social anxiety symptoms and past-year pre-party motives were associated with (a) a greater likelihood of playing drinking games while pre-partying, (b) total alcohol consumption, and (c) consequences during students' most recent drinking occasion during which they pre-partied.

RESULTS

Participants were 981 college students (63.5% women, 67.9% White, mean age = 20.1 years, SD = 1.3) who reported on their most recent pre-party drinking occasion. Greater social anxiety symptoms were related to higher past-year interpersonal enhancement and intimate pursuit motives, which in turn were associated with greater alcohol consumption and more negative consequences during the most recent pre-party event.

CONCLUSIONS

Although preliminary, results highlight the importance of considering pre-party motives associated with social anxiety and negative drinking consequences among college students.

Latent class analysis of drinking game consequences among college drinkers

Participation in drinking games has been identified as one specific alcohol-related context linked to increased risk for heavier alcohol consumption and negative consequences among college students. Despite advances in drinking game research, questions remain about the different types of individuals at risk from participating. The current study utilized latent class analysis to classify individuals based on their endorsement of eight negative drinking game consequences from the Hazardous Drinking Games Measure. Analyses included identification of classes among 656 college students, followed by covariate analyses regressing class membership on motives for playing drinking games, general drinking motives, impulsivity facets, general problematic alcohol use, and specific drinking game behaviors. A total of three classes were identified, including a class with the fewest number of problems, a class with higher rates of hangovers and becoming sick, and a class with relatively higher rates of a majority of the other consequences. Classes differed in endorsement of motives, impulsivity facets, general problematic consumption, and drinking game behaviors. Generally, coping, conformity, and social general drinking motives; conformity and enhancement and thrills motives for playing drinking games; the impulsivity facet of negative urgency; the number of drinks consumed while playing drinking games; playing consumption type drinking games; and general problematic alcohol use were associated with more problematic class membership. Results highlight distinct classes of individuals at risk from drinking game participation. Recommendations for future studies and potential prevention and intervention efforts are also discussed.

Drinking games among university students in five countries: Participation rates, game type, contexts, and motives to play

Most published studies, regarding students' participation in drinking games (DGs), originate from the United States of America (USA). This study extends research to the United Kingdom (UK) and countries of mainland Europe. University students from five countries completed an anonymous online questionnaire which included measures of the frequency of DG participation, along with types, contexts and motives for participation. Responses are compared by the gender, and country of domicile of the participants. The study is based on the results of the questionnaire administered to 306 Social Work students from five universities/countries of which 72.2% are females, with a mean age of 22.6 years. This included students in Austria, Germany, the Netherlands, the UK and the USA. A high proportion of students, irrespective of gender, or country of domicile, stated that they participated in DGs. To 'meet people' and 'to get drunk' are the most important reasons stated for DG participation. Less benign motives, to 'control others' or 'get other people drunk', are reported as 'not important'. The most common types of DGs were consumption and team DGs. The pre-partying involved in DGs and associated consequences show important targets in alcohol harm minimization interventions. Harm minimization/public health messages regarding safer drinking need to recognize that younger students often feel they are immortal and do not fully appreciate risks and adverse effects of DGs and drink to have fun and be sociable.

Fun/intoxication pre-drinking motives lead indirectly to more alcohol-related consequences via increased alcohol consumption on a given night

INTRODUCTION

Pre-drinking increases alcohol use on drinking nights, which is associated with various adverse alcohol-related consequences but what motivates people to do so, i.e. the role of pre-drinking motives (PDM) in this link, is unclear. The current study examined a) the association of three PDM factors (fun/intoxication, facilitation, and conviviality) with average night-level alcohol use, b) whether PDM are associated with adverse alcohol-related consequences (hangover, drunk driving, blackout, risky sex, injury, and fights) and c) whether PDM mediates the link between night-level alcohol use and negative consequences.

METHODS

A sample of 204 young adult nightlife goers (48.8% males, M_age = 19 SD = 2.4) from Switzerland reported PDM at baseline, and subsequently participated in a 2-month event-level study. Regressions models assessed direct and mediated associations.

RESULTS

Fun/intoxication PDM predicted alcohol use in subsequent drinking nights (11.3 nights per participant on average), but not the two other PDM. No direct link between PDM and consequences was found. However, fun/intoxication PDM lead indirectly to more adverse consequences through higher alcohol use.

CONCLUSION

This study shows that predominantly 'fun/intoxication' predrinkers are at increased risk for alcohol consumption and consequences, but not those who predrink for conviviality or facilitation motives. The outcomes thus suggest the importance of specific PDM in preventing alcohol use for instance by tailoring interventions based on individuals' PDM in order to curb drinking and its associated consequences among young adults on weekend nights out.

Relations among Externalizing Behaviors, Alcohol Expectancies and Alcohol Use Problems in a Multi-Ethnic Sample of Middle and High School Students

BACKGROUND

Alcohol expectancies and externalizing behaviors, that is, aggression and rule-breaking behaviors, are associated with underage alcohol use. The interactive influence of these risk factors on problem alcohol use among minority adolescents is investigated in the present study.

OBJECTIVES

This study examined the unique and interactive influences of alcohol expectancies and externalizing problems on specific measures of adolescents' (a) past three-month binge drinking episodes and (b) negative consequences of alcohol use.

METHODS

Cross-sectional self-report data were collected in 2014 via tablet-based computerized assessments from a predominantly minority sample of 762 (404 females, Mage = 13.73 years, SDage =1.59) 6th, 8th, and 10th grade students recruited from public middle and high schools in Miami-Dade County, FL and Prince George's County, MD. Students completed surveys on tablets in school settings regarding alcohol expectancies, expectancy valuations, externalizing problem behaviors, past 3-month binge drinking episodes, and experiences of alcohol-related negative consequences.

RESULTS

Zero-inflated negative binomial regressions indicated: (1) older adolescents were more likely to report binge drinking; and (2) a significant main effect for externalizing problem behaviors on binge use. Logistic regressions indicated (1) older adolescents were more likely to endorse an alcohol-related negative consequence and (2) the interaction between positive alcohol expectancies and externalizing behaviors was associated with endorsing an alcohol-related negative consequence.

CONCLUSIONS

Engaging adolescents who exhibit serious externalizing behaviors and report positive alcohol expectancies via developmentally appropriate, tailored interventions is one feasible strategy to address escalation of binge alcohol use and related negative consequences among minority youth.

Test-Retest Reliability of the 7-Factor Motives for Playing Drinking Games Scale and its Associations With Drinking Game Behaviors Among Female College Athletes

Drinking games (DGs) participation is prevalent among college-attending emerging adults. Research also suggests that student-athletes play DGs more frequently than non student-athletes, but what motivates student-athletes to participate in DGs is not well understood. Using data from a larger longitudinal study with Division III female athletes, we examined the test-retest reliability and minimal detectable change of the revised 7-factor Motives for Playing Drinking Games (MPDG) measure, and explored how its subscales were related to DGs behavior across two annual timepoints (n = 49). Results indicated that the MPDG shows adequate test-retest reliability over a one year period among student-athletes. Controlling for age and general alcohol consumption, conformity motives were positively associated with DG consumption at timepoint 1, whereas the DG motives of enhancement/thrills and boredom were positively related to DG consumption at timepoint 2. Implications for future research directions on motives for playing DGs and DGs behavior among student-athletes are discussed.

Secondary effects of myPlaybook on college athletes' avoidance of drinking games or pregaming as a protective behavior strategy: A multisite randomized controlled study

RATIONALE

Student-athletes are at risk for engaging in drinking games and pregaming. Research suggests that brief motivational and alcohol education intervention approaches designed to reduce harmful drinking behaviors may not be effective in lowering students' participation in drinking games or pregaming.

METHOD

We evaluated the effects of myPlaybook (a student-athlete-specific web-based alcohol intervention) on student-athletes' avoidance of drinking games and pregaming over a 4-month period. Seventy-three NCAA member institutions were randomly assigned to the treatment condition or a no-intervention control. Student-athletes at these schools (N = 2449) completed assessments at baseline, 1-, and 4-months post-intervention. At each assessment, participants indicated how often they used each of several harm prevention strategies when they drank in the past month including "avoided drinking games" and "avoided drinking before going out (i.e., pregaming or pre-drinking)."

RESULTS

Controlling for gender and race/ethnicity, treatment condition was not associated with change in avoidance of drinking games and pregaming between baseline and either follow-up. Athletic season did not moderate treatment effects on avoidance of either behavior. We found no evidence that myPlaybook, a general alcohol-reduction intervention, is efficacious in influencing student-athletes' avoidance of drinking games or pregaming as a protective strategy.

CONCLUSIONS

Findings from the present study as well as other research suggest that general alcohol-focused interventions may not have secondary effects on reducing students' participation in drinking games and pregaming and as such, more specific targeted interventions should be investigated.

Social anxiety and drinking game behaviors among Australian university students

INTRODUCTION

The relationship of social anxiety with alcohol use/problems has been examined among college student samples, but the relevance of findings to drinking game (DG) consumption/gaming consequences is not well understood due to a paucity of research.

METHODS

A cross-sectional sample of 224 Australian university students aged 18-25 years (M_age = 20.7 years; 63% female) was utilized for analysis. Participants completed an online questionnaire which included measures of social anxiety, DG consumption, DG consequences, and motives for playing drinking games.

RESULTS

Social anxiety was positively associated with DG consequences, but not DG consumption. However, after controlling for DG motives, social anxiety was no longer associated with DG consequences. Rather, an indirect effect of social anxiety on DG consequences via conformity DG motives was identified.

CONCLUSIONS

Our findings highlight the vulnerability of socially anxious students to experiencing greater drinking game consequences, but the importance of considering motives specific to playing DGs when examining these relationships.