The influence of groups and alcohol consumption on individual risk-taking

A cross-national study of predrinking motives in Spain and the UK: Cross-sectional associations with risk-taking and alcohol consumption

This study contrasts young people's predrinking in two European cultural contexts: Spain and the UK. Whilst UK predrinking typically occurs amongst small groups of individuals who already know one another, the distinctive Spanish context of the Botellón details a far larger gathering in which participants may be less likely to know each other. As such, predrinking motives which drive consumption and risk-taking may be expected to vary between these cultures. An online questionnaire (N = 397; UK = 167, Spain = 230) was used to examine a variety of drinking behaviours and associated beliefs/motivations including predrinking motivations, drinking behaviour, and risk taking. Path analysis was used to analyse both direct and indirect relationships between the measures with the aim of predicting problem alcohol consumption with the most parsimonious model. Varying (in)direct paths were observed between predrinking motives and alcohol consumption between the cultures. Most notably and pointing towards inconsistency in the drivers of young adults' drinking, fun predrinking motives featured prominently among Spanish respondents and predicted their reported consumption (not so in the UK), while conviviality was a more prevalent predrinking motive in the UK sample and associated with alcohol consumption (not the case in Spain). Further, (personal) risky behaviour and risk-taking predicted consumption in both samples, suggesting the importance of group norms and behaviours in predrinking activity, irrespective of alcohol consumption. These findings highlight the potential importance of the environment in which young people predrink. Given their importance in shaping alcohol consumption and risk taking in young people, cultural differences in predrinking contexts and motives warrant further investigation.

Characteristics of drinking episodes associated with simultaneous alcohol and cannabis use among underage drinkers in the United States

BACKGROUND

Simultaneous alcohol and cannabis (SAC) use is associated with more negative consequences than independent use of alcohol or cannabis. Contextual characteristics of drinking episodes are associated with the quantity of alcohol consumed and related risk. This study examined whether drinking contexts may also be associated with SAC use.

METHODS

National Survey on Drug Use and Health (NSDUH) 2010-2019 data from past 30-day drinkers aged 12-20 (n = 39,456) were used. A weighted multivariable logistic regression model examined associations between contextual characteristics (alcohol source, number of people, drinking location) and SAC use during their most recent drinking occasion. Models adjusted for survey year, heavy episodic drinking, age, sex, race/ethnicity, student status, and metropolitan area status.

RESULTS

More than one-in-five drinkers reported SAC use. Compared to getting alcohol from parents/family, those who took it from a home (OR = 1.51,95 %CI = 1.24,1.84), got it for free another way (OR = 2.30,95 %CI = 2.05,2.59), paid someone else for it (OR = 2.83,95 %CI = 2.46,3.25), or purchased it themselves (OR = 3.12,95 %CI = 2.66,3.67) had higher odds of SAC use. Compared to drinking alone, drinking with more than one person was associated with higher odds of SAC use (OR = 1.36,95 %CI = 1.12,1.66). Compared to drinking in their home, drinking in a bar (OR = 0.51,95 %CI = 0.41,0.64) had lower odds of SAC use, whereas drinking in someone else's home (OR = 1.12,95 %CI = 1.02,1.22), a car (OR = 1.36,95 %CI = 1.04,1.77), or multiple locations (OR = 1.29,95 %CI = 1.09,1.53) had higher odds of SAC use.

CONCLUSIONS

Findings suggest that alcohol-related contextual characteristics are associated with SAC use among underage drinkers. Laws addressing underage alcohol consumption, including social host liability and sales to minors laws, may also decrease simultaneous cannabis use.

Does acute alcohol consumption increase risk-taking while gambling? A systematic review and meta-analysis

AIMS

To estimate the effect of acute alcohol consumption on risk-taking while gambling, examine blood alcohol concentration as a moderator and explore possible moderators of this effect.

DESIGN, SETTING AND PARTICIPANTS

A systematic review and meta-analysis was completed. A Boolean search strategy was used to identify studies that included (a) alcohol consumption as an independent variable; (b) a gambling or risk-taking task; (c) a control or placebo comparison; (d) human participants; and (e) English publications. Descriptive information, sample characteristics and experimental data were extracted from each study. Searched databases included: PsycINFO, Web of Science, Medline, Cochrane Library and ProQuest Dissertations and Theses. Included as participants were experiments that compared the effects of alcohol and non-alcoholic or placebo beverages on risk-taking while gambling.

MEASUREMENT

Comprehensive Meta-Analysis version 3.3.070 was used. Standardized mean differences of risk-taking while gambling between the experimental and control conditions were calculated when studies did not report effect sizes. Random-effects models were used for overall effect and meta-regressions while mixed-effects models were used for subgroup analyses.

FINDINGS

Twenty articles containing 47 alcohol versus control comparisons met inclusion criteria. The overall Hedges'g for the difference between groups consuming alcohol and groups consuming a placebo or non-alcoholic drink control was 0.03, 95% confidence interval (CI) = -0.07, 0.12, p = 0.60, indicating no significant difference. Larger effect sizes were found for studies using non-alcoholic control drinks (Hedges' g = 0.30, 95% CI = 0.01, 0.58) compared to placebo beverages (Hedges' g = -0.03, 95% CI = -0.13, 0.06), Cochran's Q = 4.67, p = 0.03.

CONCLUSIONS

Finding that acute alcohol consumption had no reliable effect on risk-taking while gambling was consistent with existing animal research. No support was found for the relation between alcohol dose and risk-taking. The significantly larger effect size for experiments using non-alcoholic versus placebo beverages suggests the potential role of expectancy effects.

A Systematic Review of the Balloon Analogue Risk Task (BART) in Alcohol Research

Risk-taking propensity has been crucial to the investigation of alcohol use and consequences. One measure, the balloon analogue risk task (BART), has been used consistently over the past two decades. However, it is unclear how this measure is related to alcohol outcomes. This paper systematically reviews the literature on the BART and alcohol outcomes. First, direct associations between the BART and alcohol use are reviewed including correlations, group comparisons, the BART's prediction of alcohol outcomes and BART performance after consuming alcohol. Then, potential moderators that explain when and for whom the BART is related to alcohol outcomes are reviewed. Finally, potential mechanisms that explain how the BART and alcohol outcomes are related are reviewed. This review reveals patterns in the BART suggesting risk-taking propensity may be related to changes in alcohol use over time; however, there is little evidence to suggest BART scores increase after consuming alcohol. Yet, additional research suggests adjusted average pump scores may be too simplistic for the amount of information the BART captures and understanding individual's patterns of responses on the BART is important for investigating its relation to alcohol outcomes. Finally, this review opens up several future directions for research to understand how risk-taking propensity is related to alcohol outcomes.

Experimental tasks of behavioral risk taking in alcohol administration studies: A systematic review

Research on emerging adults shows this population exhibits the highest rates of alcohol use and engages in the riskiest of behaviors (Boyer, 2006; Fromme, Corbin, & Kruse, 2008). Among experimental paradigms, prior reviews have established an increase in behavioral risk taking while under the influence of alcohol (Moskowitz & Robinson, 1988; Martin et al., 2013; Weafer & Fillmore, 2016). Previous research highlighted the importance of alcohol dose on behavioral risk taking and the lack of agreement on which psychometric tools are most accurate in assessing behavioral risk taking (Beulow & Blaine, 2015; King, Toule, De Wit, & Holdstock, 2002). This systematic review of experimental paradigms assessing the effects of the dose of alcohol on various behavioral risk taking tasks suggest that higher alcohol doses (0.6 g/kg and above) produces the most robust increase in behavioral risk taking across tasks, compared to lower doses of alcohol (<0.6 g/kg). Results suggest the BART is the most sensitive behavioral risk task used to detect increases in risk taking in moderate/higher doses compared to lower doses of alcohol. This review also highlights the difficulty in measuring behavioral risk taking, as behavioral risk taking is a complex, multifaceted phenomenon that may involve multiple constructs and means to capture it. Future research is needed to standardize experimental administration protocols, to aid in advancing the field of alcohol administration experiments, and to determine the most accurate measurement of behavioral risk taking. PUBLIC HEALTH SIGNIFICANCE: Past experimental paradigms measuring behavioral risk taking under the influence of alcohol in emerging adults have used various alcohol administration paradigms, experimental protocols, and behavioral risk tasks. Key to examining behavioral risk taking via experimental paradigms should use at higher alcohol doses. Future interventions need to assess for levels of blood alcohol concentration when assessing for at-risk populations for alchol use disorders.

The consumption of alcohol by adolescent schoolchildren: Differences in the triadic relationship pattern between rural and urban environments

OBJECTIVE

Excessive alcohol consumption in adolescents is one of the most significant public health problems currently facing society. Social and geographical contexts contribute to the development of alcohol-related behavior in adolescents. The aim of this research is to analyze the social pattern related to alcohol consumption in adolescents based on their geographical environment.

METHODOLOGY

We designed a descriptive cross-sectional study based on social network analysis. We recruited 196 high school students between 16 and 18 years of age to participate in the study. The methodology applied was social network analysis by means of transitivity and homophily social triads. The data were analyzed using STATA statistical software.

RESULTS AND CONCLUSIONS

A total of 58.48% of rural adolescents consumed alcohol compared to 49.52% of urban adolescents. These results demonstrate that adolescents who live in rural areas exhibit a greater risk of drinking alcohol than those who live in urban areas. The presence of transitive triads increases the probability of sharing sociodemographic attributes in such a way that it may be considered one of the causes of homophily, contributing to adolescents taking greater risks, such as consuming alcohol.

Alcohol-impaired driving in rural and urban road environments: Effect on speeding behaviour and crash probabilities

Speeding behaviour is known to influence crash risk among alcohol-impaired drivers, but this relationship is scarcely explored. The present study investigated the effects of different Blood Alcohol Concentrations (BAC) levels on driving performance with respect to mean speed of drivers and their ability to avoid crashes during sudden events while driving. Eighty-two drivers participated in the simulation driving experiment at four BAC levels (0%, 0.03 %, 0.05 % and 0.08 % BAC) in rural and urban driving scenarios. Two sudden events (pedestrian crossing and road crossing by parked vehicles (a car and a truck) in the perpendicular direction of traffic) were designed to evaluate the crash probabilities in both the driving scenarios. Generalized linear mixed models were developed to analyse the effects of BAC levels and driver attributes (e.g., age, gender) on mean speeds and crash probabilities. Results for mean speed showed that, compared to sober state, drivers drove 3.5 kmph, 5.76 kmph and 8.78 kmph faster at 0.03 %, 0.05 % and 0.08 % BAC respectively in the rural environment and this increment was 3.6 kmph, 3.69 kmph and 4.13 kmph in the urban environment. The model results for crash probabilities revealed that 0.03 %, 0.05 % and 0.08 % BAC levels increased the crash probabilities by 1.9 times, 2 times and 3 times in case of the rural environment and 2 times, 2.3 times and 3.5 times respectively in the urban driving environment.

Understanding the Relation Between Social Behaviors and Daily Fantasy Sports Risk Behavior

In daily fantasy sports (DFS) contests, participants form a roster of athletes scheduled to perform in a pre-determined list of sporting contests or games. Each participant has the opportunity to win cash prizes, depending on the performance of the athletes on their roster and the performances of the athletes on the other participants' rosters. Some contests have higher variances than others (i.e., lower percentages of participants winning and higher payouts versus higher percentages of participants winning and lower payouts) and can be considered riskier propositions. DFS operators have mechanisms for interacting with friends on their servers (e.g., referral programs and incentives, friend lists, private contests). To determine whether use of these mechanisms (i.e., social behavior) was associated with preference for higher variance contests (i.e., risk behavior), we analyzed player records (N = 11,130) from a DFS service. We constructed a measure of risk behavior, player risk score, that is based on DFS contests' entry fees and payout structures. We observed that players referred to the DFS service by a friend and those who had a reciprocal friendship had similar player risk scores. However, those who referred a friend, both generally and among players with reciprocal friendships, were more likely than others to have greater player risk scores, and greater numbers of friend referrals also was associated with higher player risk scores. Although the observed effect sizes were small, the results point to a possible relationship between referring others to play and risk activity. Future research should assess how these small effects interact with other behaviors and motivations associated with DFS play, like playing to escape or playing to earn/win money. It also should examine the temporal relationships between refer-a-friend program participation and risk content choices.

Adolescent Health Risk Behaviors: Convergent, Discriminant and Predictive Validity of Self-Report and Cognitive Measures

Self-report and cognitive tasks of reward sensitivity and self-regulation have influenced several developmental models that may explain the heightened engagement in risk behaviors during adolescence. Despite some inconsistencies across studies, few studies have explored the convergent, discriminant, and predictive validity of self-report and cognitive measures of these psychological characteristics in adolescence. The present study evaluated the convergent and discriminant validity of self-report and cognitive measures of reward sensitivity and self-regulation among 2017 adolescents (age M = 16.8, SD = 1.1; 56% female; 55% White, 22% Black, 8% Hispanic, 15% other race/ethnic; 49% 10th grade and 51% 12th grade). This study compared the predictive validity of an omnibus measure and specific measures of risk engagement. Convergent and discriminant validity from self-report to cognitive tasks were as predicted, although with weak convergent relationships. As hypothesized, compared to cognitive tasks, self-report measures consistently predicted risky behaviors and explained more variance in the models. These results demonstrate that while cognitive tasks can significantly predict certain risk behaviors, they require increased power to find the very small effects, raising questions about their use as implicit proxies for real world risk behavior.

Decision- and feedback-related brain potentials reveal risk processing mechanisms in patients with alcohol use disorder

Individuals with alcohol use disorder (AUD) are aware of the risks of alcohol abuse yet continue risky drinking. Research indicates that dysfunctional decision processes and trait variables such as impulsivity contribute to this awareness-behavior discrepancy. The present study focused on decision-related versus feedback-related processes as potential contributors to decision making in AUD by examining the relationship between decision choices and decision- and feedback-related ERP phenomena in the balloon analogue risk task (BART). N = 39 AUD and n = 35 healthy comparison participants (HC) performed the BART modified for EEG assessment. In each of 100 runs, participants made a series of choices about whether to pump up a virtual balloon, which popped pseudorandomly, ending the run. Alternatively, participants ended the run by pressing a "cash-out" button. Each pump not producing a pop provided .05 €; popping resulted in loss of the run's accumulated gain. Groups made similar choices, though AUD responded more slowly. The decision P3 200-400 ms after decision prompt (balloon) was larger in AUD than in HC, and decision P3 enhancement on high-risk trials predicted choices to pump. Feedback-related negativity (FRN) after loss (relative to cash out) feedback was smaller in AUD than in HC, suggesting indifference to negative feedback. In AUD, high impulsivity was associated with risk-modulated decision P3 but not FRN. Results indicate atypical decision- and feedback-related processes that could contribute to difficulties in engaging with daily challenges effectively.

Brief alcohol intervention for risky drinking in young people aged 14–15 years in secondary schools: the SIPS JR-HIGH RCT

Background

Adverse effects from young people’s alcohol consumption manifest in a range of physical and psychosocial factors, including neurological issues, cognitive impairment and risk-taking behaviours. The SIPS JR-HIGH pilot trial showed alcohol screening and brief intervention (ASBI) to be acceptable to young people and schools in the north-east of England.

Objectives

To conduct a two-arm, individually randomised controlled trial to evaluate the effectiveness and cost-effectiveness of ASBI for risky drinking in young people aged 14–15 years in the school setting, to monitor the fidelity of ASBI and to explore the barriers to, and facilitators of, implementation with staff, young people and parents.

Design

A baseline survey with a 12-month follow-up. Interviews with 30 school staff, 21 learning mentors and nine teachers, and 33 young people and two parents.

Setting

Thirty state schools in four areas of England: north-east, north-west, Kent and London.

Participants

Year 10 school pupils who consented to the study (aged 14–15 years, recruited between November 2015 and June 2016), school-based staff and parents of the young people who took part in the study.

Interventions

Young people who screened positively on a single alcohol screening question and consented were randomised to the intervention or control arm (blinded). The intervention was a 30-minute one-to-one structured brief intervention with a trained learning mentor and an alcohol leaflet. The control group received a healthy lifestyle leaflet (no alcohol information).

Main outcome measures

The primary outcome measure was total alcohol consumed in the last 28 days. Secondary outcomes related to risky drinking, general psychological health, sexual risk-taking, energy drink consumption, age of first smoking, quality of life, quality-adjusted life-years, service utilisation and demographic information.

Results

A total of 4523 young people completed the baseline survey, with 1064 screening positively (24%) and 443 being eligible to take part in the trial. Of those 443, 233 (53%) were randomised to the control arm and 210 were randomised to the intervention arm. Of the 443, 374 (84%) were successfully followed up at 12 months (intervention, n = 178; control, n = 196). The results were that the intervention showed no evidence of benefit for any alcohol-related measure when compared with the control arm. At 12 months we found a reduction from 61.9% to 43.3% using the Alcohol Use Disorders Identification Test cut-off point of 8 and cut-off point of 4 (69.0% to 60.7%). These results were not significant. A cost-effectiveness analysis showed that the average net cost saving of the brief intervention was £2865 (95% confidence interval –£11,272 to £2707) per year compared with usual practice, with the intervention showing a 76% probability of being cost saving compared with usual practice. The interview findings showed that school was an acceptable setting to carry out ASBI among staff and young people.

Limitations

Recruitment of parents to take part in interviews was poor. Only 18 ASBI sessions were recorded, making it difficult to assess internal validity.

Conclusions

Although the intervention was ineffective in reducing risky drinking in young people aged 14–15 years, it was well received by the young people and school staff who participated.

Future work

Uniform reporting of the outcomes used for ASBI would generate more robust conclusions on the effectiveness of ASBI in the future. Pilot feasibility studies should include more than one geographical area. Future work on involving parents is needed.

Trial registration

Current Controlled Trials ISRCTN45691494.

Funding

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 9. See the NIHR Journals Library website for further project information.

The effect of beliefs about alcohol's acute effects on alcohol priming and alcohol-induced impairments of inhibitory control

Acute alcohol administration can lead to a loss of control over drinking. Several models argue that this 'alcohol priming effect' is mediated by the effect of alcohol on inhibitory control. Alternatively, beliefs about how alcohol affects behavioural regulation may also underlie alcohol priming and alcohol-induced inhibitory impairments. Here two studies examine the extent to which the alcohol priming effect and inhibitory impairments are moderated by beliefs regarding the effects of alcohol on the ability to control behaviour. In study 1, following a priming drink (placebo or .5g/kg of alcohol), participants were provided with bogus feedback regarding their performance on a measure of inhibitory control (stop-signal task; SST) suggesting that they had high or average self-control. However, the bogus feedback manipulation was not successful. In study 2, before a SST, participants were exposed to a neutral or experimental message suggesting acute doses of alcohol reduce the urge to drink and consumed a priming drink and this manipulation was successful. In both studies craving was assessed throughout and a bogus taste test which measured ad libitum drinking was completed. Results suggest no effect of beliefs on craving or ad lib consumption within either study. However, within study 2, participants exposed to the experimental message displayed evidence of alcohol-induced impairments of inhibitory control, while those exposed to the neutral message did not. These findings do not suggest beliefs about the effects of alcohol moderate the alcohol priming effect but do suggest beliefs may, in part, underlie the effect of alcohol on inhibitory control.