Exploring the role of positive and negative consequences in understanding perceptions and evaluations of individual drinking events

College students' perceptions of positive and negative drinking-related sexual experiences

Objective: During young adulthood, drinking and sexual behaviors are both normative and inextricably linked. While this association is well documented, little is known about how students define positive and negative drinking-related sexual experiences. Methods: Thirty-five undergraduates participated in a focus group about sexual experiences in the context of drinking. Thematic analysis was utilized to identify themes in the data. Results: Students' descriptions of positive drinking-related sexual encounters included having a good time, feeling safe, maintaining control over alcohol, as well as feeling safe in drinking contexts where sexual partners are located. Students' perceptions of negative experiences included specific consequences such as a damaged reputation, loss of control due to alcohol, and concern of engagement in sex when they or a partner was too intoxicated to consent. Conclusion: Gaining a better understanding of how college students view positive and negative drinking-related sexual experiences could inform interventions aimed at promoting student well-being.

Development and Validation of the Positive Outcomes of Cannabis Use Scale (POCUS) Among Predominantly White Adults in the United States

Operant conditioning and social learning theories suggest that positive cannabis use-related outcomes are a primary contributor to maintained use and risk for dependence. However, currently there does not exist a reliable, validated measure of positive cannabis-related outcomes. This study sought to develop and psychometrically evaluate the Positive Outcomes of Cannabis Use Scale (POCUS). We collected three samples, college students (N = 883), community adults (N = 214), and college students (N = 615), of predominantly White adults in the United States who completed an online survey. Exploratory and confirmatory factor analyses evaluated scale structure and identified four factors: social enhancement, mood enhancement, cognitive enhancement, and sexual enhancement. Positive outcomes were positively associated with recent use, controlling for expectancies and negative outcomes. Positive outcomes were also differentiated from positive expectancies and more influential in predicting typical use frequency. Findings indicate that the POCUS is psychometrically sound and clinically useful for measuring positive cannabis use-related outcomes among predominantly White adults in the United States.

STI-protective self-efficacy and binge drinking in a sample of university students in the United Kingdom

OBJECTIVE

Alcohol use has consistently been shown to be related to sexual risk-taking behaviours. To assess what factors may contribute to the sexual risk decision-making process, this study examined the relationships among alcohol use (frequency, quantity, and binge drinking), cognitive appraisals of sexual risk taking, sex-related alcohol expectancies, and STI-protective self-efficacy.

METHOD

138 sexually-active university students who drink alcohol completed scales measuring alcohol consumption, appraisals of consequences, sex-related alcohol expectancies, and items regarding STI-protective self-efficacy.

RESULTS

Increasing levels of binge drinking were negatively associated with STI-protective self-efficacy. A moderated mediation analysis revealed that for binge drinkers, stronger appraisals of the positive consequences for having sexual intercourse while intoxicated predicted lower STI-protective self-efficacy indirectly through increasing rates of sex-related alcohol risk expectancies.

CONCLUSION

Findings provide evidence of a need to target binge drinkers and increase their STI-protective self-efficacy by shifting their focus from positive consequences to negative risk consequences of engaging in sexual intercourse while intoxicated.

Subjective evaluations of alcohol-related consequences among college students: Experience with consequences matters

OBJECTIVE

Research suggests college students rate some alcohol-related consequences less negatively than others, yet it is unclear how or when these differences in perception develop. The current study compared college students' subjective evaluations of alcohol-related consequences that they had and had not experienced in order to test the hypothesis that students become desensitized to the consequences they experience.

PARTICIPANTS

Participants were 269 undergraduate students enrolled at a large, public, Midwestern university.

METHODS

Participants completed measures of drinking behaviors, consequences experienced, and subjective evaluations of consequences via an online survey.

RESULTS

Participants rated the consequences they had personally experienced more positively than those they had not experienced. Similarly, individuals who reported experiencing consequences rated them as significantly more positive than those who had not experienced the same consequences.

CONCLUSIONS

Experience with consequences is associated with more positive evaluations of those consequences. Therefore, it may be important to consider individuals' experiences with, and evaluations of, alcohol-related consequences in college student drinking interventions.

When do college students have less favorable views of drinking? Evaluations of alcohol experiences and positive and negative consequences

College students experience numerous positive and negative consequences from drinking alcohol, although the extent to which these consequences influence perceptions of their drinking experiences is poorly understood. A better understanding of the impact of experiencing specific consequences, and how they are evaluated, on college students' perceptions of the overall drinking experience and subsequent alcohol use is crucial for advancing intervention efforts. The current study used daily data to examine (a) whether experiencing specific consequences and (b) whether ratings of the most favorable and most aversive consequences predicted overall evaluations of the drinking experience and perceptions that drinking was worth it; and (c) whether overall evaluations and perceptions that drinking was worth it predicted next-day drinking. College student drinkers (N = 349, 53.3% female) completed daily reports on drinking, consequences, evaluations of consequences, and evaluations of the drinking experience during four 2-week periods across 1 year. Findings from generalized estimating equations demonstrated that experiencing any of the positive consequences predicted more favorable overall evaluations and perceptions that drinking was worth it, whereas the majority of the negative consequences predicted less favorable overall evaluations. Ratings of the most favorable positive consequence and the most aversive negative consequence were also associated with overall evaluations. Perceiving that drinking was more worth it was associated with an increased likelihood of next-day drinking. Current findings reinforce the need to address the experience of both positive and negative consequences in interventions, while simultaneously considering the extent to which students perceived the negative consequences as aversive. (PsycINFO Database Record

Development of risk perception and substance use of tobacco, alcohol and cannabis among adolescents and emerging adults: evidence of directional influences

BACKGROUND

While several studies have investigated the relationship between risk perception and substance use, surprisingly little is known about mutual influences between both variables over time.

OBJECTIVES

The present study aimed to explore two different hypotheses separately for tobacco, alcohol and cannabis: influences from risk perception on behavior (motivational hypothesis) and influences from behavior on risk perception (risk reappraisal hypothesis).

METHODS

A prospective and longitudinal cross-lagged panel design was used with substance use and risk perception measured five times over the course of 10 years. Participants were 318 German youths aged 14-15 at the beginning of the study. Risk perception and substance use frequency were measured using self-reports.

RESULTS

Structural equation modeling indicated significant influences of risk perception on substance use behavior for all substances, which supports the motivational hypothesis. Changes in risk perception predict changes in future substance use of tobacco, alcohol and cannabis. Specifically for cannabis, influences of substance use on risk perception can also be shown, thus, supporting the risk reappraisal hypothesis.

CONCLUSIONS

While there is support for the rationale behind adequate risk perception as a goal of preventive interventions, the possibility of risk reappraisal should not be neglected, especially regarding illicit substances.

How much does one more drink matter? Examining effects of event-level alcohol use and previous sexual victimization on sex-related consequences

OBJECTIVE

The first semester of college has been associated with increased drinking and sexual risk. However, it remains unclear why some drinking occasions result in experiencing negative sexual consequences whereas others do not. The current study used a diary-based approach to assess the event-level effect of alcohol use and previous adult/adolescent sexual victimization (PSV) on experiencing negative sex-related consequences in first-year college women.

METHOD

Participants (N=120) provided repeated measures of weekend drinking and sex-related consequences on the Friday and Saturday nights of six different weekends over the course of their first semester, resulting in 12 measured drinking occasions. A multilevel model was used to assess both between- and within-person effects of alcohol use and between-person effects of PSV on the likelihood of experiencing negative alcohol-related sexual consequences.

RESULTS

Findings revealed an important within-person association, such that every drink consumed above one's mean was associated with a 13% increase in the likelihood of experiencing negative consequences. In addition, PSV had a significant main effect on experiencing negative sex-related consequences. Individuals with PSV experienced nearly 2.5 times more sexual consequences than individuals without PSV.

CONCLUSIONS

These results yield important implications for prevention, particularly with respect to limiting "above average" alcohol consumption among women with a history of sexual victimization.

Use of drinking protective behavioral strategies and sexual perceptions and behaviors in U.S. college students

Alcohol use among college students is linked to an increased likelihood of engaging in risky sexual behaviors, including casual sex and unprotected sex. These behaviors increase college students' risks for negative social and health-related consequences. This study examined the relationship between drinking behaviors and protective behavioral strategies (PBS), expectancies and perceptions of sexual risk, and actual alcohol-related sexual behaviors and consequences. Sexually active college students completed Web-based self-report measures of drinking behaviors and use of PBS, alcohol expectancies and perceptions of risk, and sexual behaviors and related consequences (n = 524; 57.1% women). Findings indicated that PBS were related to lower expectancies of sexual risk and sexual disinhibition, and among lighter drinkers, lower expectancies of sexual enhancement from alcohol. PBS were also related to decreased perceptions of sexual-related risks, some alcohol-related sexual behaviors, including number of drinks before/during sex, and number of sexual consequences, but were not related to abstaining during sex, frequency of alcohol-related sexual behaviors, or general condom use. These findings demonstrate a disconnect between perceived and actual risks among college students, such that decreased perceptions of risk may not be associated with protective behaviors. Prevention and intervention implications are discussed.

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.

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.

Alcohol drinking among college students: college responsibility for personal troubles

Background

One young adult in two has entered university education in Western countries. Many of these young students will be exposed, during this transitional period, to substantial changes in living arrangements, socialisation groups, and social activities. This kind of transition is often associated with risky behaviour such as excessive alcohol consumption. So far, however, there is little evidence about the social determinants of alcohol consumption among college students. We set out to explore how college environmental factors shape college students' drinking behaviour.

Methods

In May 2010 a web questionnaire was sent to all bachelor and master students registered with an important Belgian university; 7,015 students participated (participation = 39%). The survey looked at drinking behaviour, social involvement, college environmental factors, drinking norms, and positive drinking consequences.

Results

On average each student had 1.7 drinks a day and 2.8 episodes of abusive drinking a month. We found that the more a student was exposed to college environmental factors, the greater the risk of heavy, frequent, and abusive drinking. Alcohol consumption increased for students living on campus, living in a dormitory with a higher number of room-mates, and having been in the University for a long spell. Most such environmental factors were explained by social involvement, such as participation to the student folklore, pre-partying, and normative expectations.

Conclusions

Educational and college authorities need to acknowledge universities’ responsibility in relation to their students’ drinking behaviour and to commit themselves to support an environment of responsible drinking.

Predictors and consequences of pregaming using day- and week-level measurements

Drinking before going to a social event is common in adolescents and young adults and is associated with harmful outcomes, but information collected at the daily level is needed to better examine individual and contextual factors associated with pregaming. The purpose of this study was to investigate the prevalence of pregaming in a diverse sample of college students; demographic differences in rates of pregaming; the degree to which pregaming is associated with higher volume drinking, intoxication, and consequences; and the importance of time-of-year and day-of-week. College students (N = 750) at three colleges completed past-week surveys throughout their freshman and sophomore years. Pregaming was reported by 3 out of 4 drinkers and occurred on 31% of 12,361 drinking days. Compared with nonpregaming days, participants drank approximately 2 more drinks on pregaming days; this increase accounted for a .040 higher estimated blood alcohol concentration. Using generalized estimating equations, we established that women, racial/ethnic minority students, and first-year students were more likely to pregame on a drinking day than males, non-Hispanic White students, and sophomore students, respectively. Men became more intoxicated on pregaming days and sophomores consumed more alcohol. Pregaming predicted higher positive and higher negative consequences, even after controlling for the number of drinks consumed. Pregaming was more common in the fall semester, in the early weeks of each semester, and on weekends. Prevention efforts targeting first-year students, the early weeks of the semester, and the hours before traditional party times may be effective at reducing this hazardous practice.

Drinking consequence types in the first college semester differentially predict drinking the following year

The objectives of the present study were to examine the utility of distinguishing among negative consequence types when seeking to predict drinking later in college, to understand which consequences in particular were associated with future drinking, and to determine the direction of those associations. We also examined whether there were differences in the types of drinking outcomes (quantity, frequency, binge) predicted by unique consequences. Finally, we tested whether the link between consequences and future drinking was different for men versus for women. Incoming first year college students (n=997; 65% female) completed an online assessment in September of the first college year, and again at the same time the following year. Results of structural equation model tests offered support for the utility of distinguishing among different consequence types, as specific consequences experienced during the first semester of college were associated differently with drinking at the beginning of the second school year. Gender differences also were observed. For both men and women, social consequences were associated with increases in drinking over time. Blackout drinking also evidenced prospective prediction, but differentially for men and women. For men, these consequences were associated with later increases in drinking, whereas for women, they were associated with a diminution in drinking the next year. For men, only consequences associated with self-care (impairment in physical activity, physical appearance, less time to pursue recreation) predicted decreases in drinking at Year 2. Prediction was generally similar across drinking outcomes. Results suggest that whether negative consequences result in downward titration, escalation, or no change at all in later drinking depends on the type of consequence experienced, and who experiences it.

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

Heavy alcohol use and related consequences are common during the college years and are associated with deleterious outcomes for both the students themselves and the college community. Some college students make self-initiated changes to their drinking to avoid such outcomes, but little is known about how such adjustments occur, or characteristics that are associated with making these adjustments. Based on Social Learning Theory (SLT), one cognitive factor that may predict within-person changes in drinking is the subjective evaluations of alcohol consequences (i.e., the extent to which consequences are perceived as negative, aversive, or severe). The aim of the present study was to investigate whether subjective evaluations of recently experienced consequences influence within-person changes in drinking behavior. In 10 weekly, web-based surveys, regularly drinking college students (N = 96, 50 female) reported on their previous week alcohol use and experience of 24 alcohol-related consequences, as well as their subjective evaluations of those consequences. Results demonstrated that evaluations across the consequences varied, and that in addition to differing from one another, students' evaluations of consequences differed at the within-person level over time. Most important, hierarchical linear model tests revealed that students drank less and experienced fewer consequences following weeks in which they rated their consequences as more negative (relative to their own typical subjective evaluations), suggesting that viewing one's recent consequences as aversive prompts self-initiated behavior change. Findings of the present study have potential to inform interventions for college drinking, particularly those that target how individuals think about their behavior and its consequences.

Positive drinking consequences among hazardous drinking college students

Negative drinking consequences in college students have been well studied, but emerging evidence points to a role for positive drinking consequences in predicting alcohol related problems. Positive drinking consequences appear to be distinct from other drinking constructs such as drinking expectancies and drinking motives. However, no work has evaluated the role of positive drinking consequences in hazardous drinking college students, a population at high risk for alcohol related problems. The goal of the current study was to examine the effect of positive drinking consequences on problem drinking and alcohol problem recognition in a hazardous drinking college sample. Participants (N=222) were hazardous drinking undergraduate students completing a battery of self-report measures about alcohol use. Findings indicated that positive drinking consequences predicted problem drinking above and beyond other related constructs including positive drinking motives (i.e. enhancement and social). However, positive drinking consequences did not appear to play a significant role in alcohol problem recognition. Future research directions and implications for interventions with hazardous drinking college students are discussed.

Personal experiences of drinking and alcohol-related risk perceptions: The importance of the subjective dimension

Aims

To explore the association between subjective experiences of drinking and alcohol-related risk perceptions.

Methods

The data Is based on a questionnaire with questions about beliefs, use habits and experiences of alcohol and tobacco sent to a random sample of 3,000 Swedes aged 18 to 70 years (response rate= 1,623 Individuals, or 54%). In this study, those respondents who had ever been drinking alcohol were Included (1,536 individuals). The data were analysed statistically by cross tabs and multiple logistic regression.

Results

With some exceptions, the results generally showed that differences In subjective experiences of drinking were related to risk perceptions of alcohol consumption. In particular, those who had more negative than positive subjective experiences of alcohol consumption had substantially higher risk perceptions than those who had more positive than negative experiences, controlling for alcohol consumption and potential confounders. There were also several significant differences between Individuals differently involved in alcohol consumption, net of subjective experiences.

Conclusions

Subjective experiences of alcohol consumption appear to be an important construct in relation to alcohol-related risk perceptions. To understand the link between personal experiences and risk perceptions pertaining to alcohol consumption, both objective measures of personal experiences and subjective measures should be considered.

Rose-colored beer goggles: the relation between experiencing alcohol consequences and perceived likelihood and valence

Although experiencing alcohol-related consequences has some influence on future drinking, this effect may be stronger based on the degree to which the consequence is viewed as positive versus negative, either by the individual or predefined by researchers. This study explored the relationship between experiencing positive and negative alcohol-related consequences and college students' perceptions of how likely those consequences were to occur in the future (i.e., likelihood), and their view of how positive or negative experiencing those consequences would be if they did experience them as a result of drinking (i.e., valence). Data were collected from 491 college students (mean age = 19.26; 56.4% female; 55.0% Caucasian; 33.2% Asian/Pacific Islander) through a computerized survey. Results indicated that experiencing more positive consequences in the past year was associated with viewing those consequences as both more likely to occur and more positive, while experiencing more negative consequences was associated with viewing them as less negative and no more likely to occur, except for those who had experienced the highest levels of negative consequences. These findings suggest that finding ways to reduce both perceptions as well as consequences themselves may be effective intervention tools.