Examining the associations among severity of injunctive drinking norms, alcohol consumption, and alcohol-related negative consequences: the moderating roles of alcohol consumption and identity

Alcohol-related Consequences: Factor Structure and Associations With Trait Mindfulness and Drinking Motivations

BACKGROUND

This study aimed to determine if motivations to use alcohol (coping and social motivations) mediate the relationship between trait mindfulness and a variety of alcohol-related consequences and to determine if the relationship between motivations to use alcohol and alcohol-related consequences is moderated by alcohol use. We determined the factor structure of positive and negative consequences of alcohol use and used this structure as outcomes across eight moderated mediation models.

METHODS

Data were obtained from 296 undergraduate students to confirm the alcohol-related consequences factor structure and to test eight moderated-mediation models.

RESULTS

Four alcohol-related consequences scales (romantic/sexual, positive, mild negative, and severe negative consequences) were confirmed. The motive of drinking to cope significantly mediated the relationship between trait mindfulness and all four of the alcohol-related consequences scales. Drinking to socialize did not significantly mediate the relationship between trait mindfulness and all of the alcohol-related consequences scales.

CONCLUSIONS

The identified four-factor structure suggests that alcohol-related consequences should be assessed in a more specific manner. Additionally, different motivations for alcohol use relate differentially to trait mindfulness and different alcohol-related consequences; drinking to cope is particularly problematic for this population. Future research on the usefulness of promoting mindfulness to reduce problematic drinking appears warranted.

Examining alcohol-related social norms among international and domestic students in the United States

OBJECTIVES

The purpose of the current study is to examine college student status (international vs. domestic) across alcohol social norms perception.

METHODS

Undergraduates (n = 3081) were recruited for the study. Most participants were female (69.9%) and White (98.2%), with the average age of participants was 19.97 (SD = 1.61). Approximately 17.3% (n = 534) of the students were international (i.e., nonresident alien who are in the US for a bachelor's degree). It is a cross-sectional study.

RESULTS

International students reported significantly lower social norms than domestic students. International students in later college years reported norms closer to domestic students. International women endorsed social norms at a higher level than international men.

CONCLUSIONS

Assimilation into U.S. drinking culture may be linked with increased support of drinking norms among International students. This study shows the importance of incorporating drinking norms prevention strategy and cultural diversity awareness training to increase international students' knowledge and prevent misconceptions. International students' social norms should be examined for future drinking interventions. Interventions for college drinking should target specific events and context with short-term increase in hazardous drinking behavior but long-lasting effects.

Tracking Changes in the Endorsement of Injunctive Drinking Norms in Response to the COVID-19 Pandemic Using Longitudinal Alignment Analysis

The onset of the pandemic saw shifts in messaging around the acceptability of alcohol consumption at different times and contexts. A psychometric analysis of responses to injunctive norms may reveal important differences in specific aspects of norms that were influenced by the pandemic. Study 1 used alignment analysis to evaluate measurement invariance in low- and high-risk injunctive norms across samples of Midwestern college students from 2019 to 2021. Study 2 used an alignment-within-confirmatory factor analysis (CFA) approach to replicate the solution from Study 1 in an independent longitudinal sample (N = 1,148) who responded between 2019 and 2021. For Study 1, the latent mean for high-risk norms was significantly higher in 2021, and the endorsement of four specific norms also differed. In Study 2, increases in latent means for low- and high-risk norms were observed across 2020 and 2021, and differential endorsement emerged for one high-risk norm item. Examining scale-level changes in injunctive drinking norms provides insight into how college students' perceptions changed in response to the COVID-19 pandemic.

Social identity and health-related behavior: A systematic review and meta-analysis

This paper examined the relationship between social identity and health-related behavior, exploring whether social identities are associated with multiple health-related behaviors or only specific ones, and whether this association varies on the type of social identity, the type of social identity measures or the expected relationship between identity and behavior. In a systematic review and meta-analysis we assessed whether the pattern of findings can be explained by the social identity approach. An extensive literature search was conducted in several databases including EBSCO-host and PubMed, using elaborate search terms related to social identity and health-related behavior. This resulted in 10728 potential articles, with 115 articles (with 248 effect sizes from 133 independent samples, N = 112.112) included in the meta-analysis. We found a small but positive overall association between social identification and health-related behavior, which was present for actual behavior, as well as for intention and attitudes. This association was stronger for health-related social identities, positive health-related behaviors, when the expected relationship was positive and when indirect social identity measures were used. However, not all findings could be explained by the social identity approach, indicating a need for further research to better understand the relationship between social identity and health-related behavior, in order to more effectively incorporate social identity into health interventions.

I did not scream. i could not; i was terrified. i just followed them. . .i blocked my mind. then they all raped me: A narrative inquiry on the onset of tonic immobility among women rape victims in Nigeria

Tonic immobility (TI) is a common uncontrollable autonomic mammalian response to an extremely fearful situation. It is one of the most immediate devastating consequences of rape and remains poorly understood. While controversies over its definition persist among researchers, this also reflects on the care for and support to victims. The study aimed to explore and describe the onset of TI and the meaning attached to the experience among women raped victims in Nigeria. The study design was the qualitative narrative inquiry approach. Criterion and purposive sampling were conducted across four post-rape care facilities in Lagos, Nigeria, to recruit 13 participants. In-depth face-to-face interviews were conducted using a semi-structured interview guide to generate data that were thematically analysed. The findings of the study revealed five themes relating to the onset of TI as follows: the first two focused on the experience of TI: (1) the onset of TI prior to rape due to perceived imminent danger, (2) the onset of TI as a self-protection mechanism from further harm) while the last three relate to the meaning-making of the experience of TI (3) self-loathing as a meaning attached to TI, (4) suicidal ideations as a meaning attached to TI, and (5) divine intervention as a meaning attached to TI. Conclusion: The findings underscore the experiences and meanings that participants attach to TI following rape. There is a strong likelihood that tonic-immobility is not an uncommon experience amongst rape victims, but that in the absence of research, specialized care on the condition, and its associated consequences will haunt many women, affecting their psychological well-being and their entire quality of life. Describing the phenomenon as it is experienced by the participants is critical because understanding the condition is the first step toward effective appropriate management.

Experimental Test of Abstaining-and-Drinking Social Media Content on Adolescent and Young Adult Social Norms and Alcohol Use

OBJECTIVE

Experimental research has demonstrated that when alcohol-related content is viewed on social media, adolescents and young adults tend to have favorable attitudes toward alcohol use. However, limited research focuses on social media norms for abstaining from alcohol use. The current study examined the role of descriptive and injunctive alcohol-abstaining-and-drinking norms via experimentally manipulated social media profiles. Experimental effects on descriptive and injunctive normative perceptions and subsequent behavior were tested.

METHOD

Participants (N = 306; ages 15-20 years) were recruited from the Seattle metropolitan area to complete a baseline survey and view researcher-fabricated social media profiles. Using stratified random assignment (birth sex and age), participants were randomized into one of three conditions: (a) alcohol abstaining and drinking, (b) alcohol abstaining, and (c) attention control.

RESULTS

The alcohol-abstaining-and-drinking condition reported greater drinking descriptive norms compared with participants in either the alcohol-abstaining or the attention-control conditions at post-experiment and 1-month follow-up. The alcohol-abstaining-and-drinking condition reported lower abstaining descriptive norms (i.e., perceiving fewer peers abstain) compared with those in the alcohol-abstaining condition at post-experiment and lower abstaining injunctive norms compared with those in the attention-control condition at 1-month follow-up.

CONCLUSIONS

Exposure to social media profiles containing both alcohol-drinking and alcohol-abstaining messages was respectively associated with individuals perceiving that peers were consuming alcohol more often and that fewer peers were abstaining. The present findings are consistent with prior experimental research that indicates alcohol displays on social media are associated with riskier drinking cognitions.

Development of a Web-Based Alcohol Prevention Program Linking School-Child-Family for Intermediate Elementary Students

Family strongly influences student health behavior. However, alcohol-preventive education programs that link parents and school for intermediate-elementary school students remain scarce. Although online educational programs constitute effective interventions to intentionally improve health behaviors, traditional methods are used to implement alcohol- prevention programs for students. In this study, we aimed to (1) develop an online school-child-family alcohol-prevention program based on the theory of planned behavior and (2) examine the preliminary effects of the program on intention to consume alcohol among intermediate-elementary school students. This single-group, pre- and posttest study enrolled 46 Grade 3 students from a public elementary school in a metropolitan South Korea city and ascertained the preliminary effects of a 5-week online alcohol-prevention program by using the alcohol drinking prevention behavior scale. Attitudes, perceived behavioral control, and intention of alcohol-preventive behaviors significantly improved (p < .05) whereas subjective norms did not. The online alcohol-prevention program based on the theory of planned behavior and school-child-family linkage beneficially influenced intention, attitude, and perceived behavioral control for alcohol-prevention behavior, and the effectiveness and convenience of this program underscores its potential application as an educational intervention to improve health behaviors of intermediate-elementary school students.

Race- and university-specific norms associated with alcohol use among Black college students

Approximately one-third of college students engage in heavy episodic drinking. Although White students drink more than Black students, White individuals are more likely to mature out of heavy drinking, whereas Black individuals drink more as they age and experience disproportionate alcohol-related consequences. Compared to their White counterparts, limited research has examined factors associated with alcohol use among Black college students. Descriptive drinking norms based on the typical college student are strong predictors of college student drinking, but previous research found that this association was weaker for Black college students. Therefore, the current study is a preliminary examination of perceived drinking norms (descriptive) and approval (injunctive) based on race for Black college students. Further, we explored likelihood of excessive drinking around other Black students. The current study included survey responses of 192 Black college students from a large southeastern US university. Results indicated that university and race-specific descriptive norms, but not university and race-specific injunctive norms, were associated with more drinks per week. These findings suggest that descriptive norms with Black students at the participant's university as the normative reference group are associated with alcohol use among Black students. Further, greater likelihood of drinking excessively around peers who share the same racial identity may impact alcohol consumption for this population. Current prevention programs for college student drinking are tailored by gender rather than race; however, preliminary findings from the current study suggests that tailoring by race may be an effective way to prevent alcohol misuse among Black college students.

Maturing Out: Between- and Within-Persons Changes in Social-Network Drinking, Drinking Identity, and Hazardous Drinking Following College Graduation

Many college students reduce hazardous drinking (HD) following graduation without treatment. Identifying cognitive mechanisms facilitating this "natural" reduction in HD during this transition is crucial. We evaluated drinking identity as a potential mechanism and tested whether within-person changes in one's social network's drinking were linked to within-person changes in drinking identity and subsequent within-person changes in HD. A sample of 422 undergraduates reporting HD was followed from six months before until two years after graduation. Their drinking, drinking identity, and social networks were assessed online. Within-person changes in drinking identity did not mediate the relationship between within-person changes in social network drinking and personal HD, though significant positive between-person associations among all constructs were found. Instead, there was some evidence that within-person changes in drinking identity followed changes in HD, suggesting that drinking identity may function as a marker versus mechanism of "natural" HD reduction during transition out of college.

Fluctuation in the sense of belongingness during college moderates within-person associations between perceived injunctive norms and subsequent drinking

OBJECTIVE

Explanations for associations between social norms and drinking often focus on wanting to fit in, gain social approval, and/or avoid social exclusion. From this perspective, students who believe that drinking is strongly linked to social approval should be more motivated to drink, especially if their sense of social approval or belongingness in college is low. To evaluate this hypothesis, we examined changes in drinking as a function of fluctuations in perceived injunctive norms (i.e., perceptions of others' approval of drinking) and belongingness (i.e., one's sense of social belonging in college).

METHOD

Participants included 383 (60% women) nonabstaining students who, beginning in their first or second year of college, completed assessments every 3 months over a 2-year period. Data were analyzed using multilevel mixed-effects negative binomial models followed by marginal tests to evaluate nonlinear interactions.

RESULTS

Within-person results indicated that when individuals believed other students were more approving of alcohol, they subsequently increased their drinking, which is especially true when individuals' sense of belongingness was at or below average. Between-person effects revealed overall positive associations of injunctive norms and belongingness with drinking. In addition, greater alcohol consumption among individuals with higher injunctive norms was less evident among students with lower average levels of belongingness.

CONCLUSIONS

Perceiving others as more approving of drinking corresponds to increased drinking only when personal levels of belongingness are at or below average. Elevated feelings of belongingness may buffer social influences on drinking. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Web-Based Alcohol and Sexual Assault Prevention Program With Tailored Content Based on Gender and Sexual Orientation: Preliminary Outcomes and Usability Study of Positive Change (+Change)

Background

Alcohol use and sexual assault are common on college campuses in the United States, and the rates of occurrence differ based on gender identity and sexual orientation.

Objective

We aimed to provide an assessment of the usability and preliminary outcomes of Positive Change (+Change), a program that provides integrated personalized feedback to target alcohol use, sexual assault victimization, sexual assault perpetration, and bystander intervention among cisgender heterosexual men, cisgender heterosexual women, and sexual minority men and women.

Methods

Participants included 24 undergraduate students from a large university in the Southwestern United States aged between 18 and 25 years who engaged in heavy episodic drinking in the past month. All procedures were conducted on the web, and participants completed a baseline survey, +Change, and a follow-up survey immediately after completing +Change.

Results

Our findings indicated that +Change was acceptable and usable among all participants, despite gender identity or sexual orientation. Furthermore, there were preliminary outcomes indicating the benefit for efficacy testing of +Change.

Conclusions

Importantly, +Change is the first program to target alcohol use, sexual assault victimization, sexual assault perpetration, and bystander intervention within the same program and to provide personalized content based on gender identity and sexual orientation.

Trial Registration

ClinicalTrials.gov NCT04089137; https://clinicaltrials.gov/ct2/show/NCT04089137

Assessing parents' motives for talking about alcohol with their emerging adult children

Past research has explored the content and frequency of alcohol-specific communication between parents and their emerging adult children. The current study aimed to address a gap in the research by examining parents' motivation for discussing alcohol. To accomplish this, we developed a multidimensional Parent Motives for Alcohol Communication Scale (PMACS). A total of 633 parents completed the PMACS along with measures assessing communication frequency, communication content, attitudes toward drinking, relationship quality, and perceptions of child alcohol use. An Exploratory Factor Analysis yielded five core communication motives. Parents were commonly motivated by desires to prevent their child's alcohol use, to respond to their child's heavy drinking, to teach their child how to drink safely, to meet relationship needs or expectations, and by a family history of alcohol problems. After controlling for demographic factors, communication motives predicted frequency of alcohol-specific communication. The patterns of relationship among motives and conceptually related constructs provided preliminary support for the construct validity of the PMACS.

Personality and Alcohol Use across College: Examining Context-Dependent Pathways toward Alcohol Problems

BACKGROUND

College life is characterized by marked increases in alcohol consumption. Extraversion and neuroticism are associated with alcohol use problems in college and throughout adulthood, each with alcohol use patterns consistent with an externalizing and internalizing pathway respectively. Students higher in extraversion drink more frequently and consume more alcohol, while neuroticism is paradoxically not consistently associated with elevated alcohol use.

OBJECTIVE

This study examined whether students higher in neuroticism may drink the day before stressors, namely tests and assignment deadlines.

METHOD

Multilevel generalized linear models were performed using data from a longitudinal study of first-time, first-year undergraduates assessing alcohol use across four years of college, with daily diary bursts each semester.

RESULTS

Students higher in extraversion had heavier alcohol use and greater alcohol use problems in their fourth year of college. Neuroticism was not associated with drinking behaviors or with drinking before a test or assignment, but was associated with greater fourth year alcohol problems. Students lower in extraversion who reduced heavy drinking the day before academic events had fewer alcohol use problems at the fourth year of college relative to students higher in extraversion.

CONCLUSIONS

Students higher in extraversion appear to exhibit a continuity of established alcohol use patterns from adolescence, predisposing them to a more hazardous trajectory of college alcohol use. Characteristics of low extraversion may afford some protection from alcohol-positive college culture. High neuroticism appears associated with a hazardous trajectory of college alcohol use, but continued research into situational factors of alcohol use in high neuroticism is warranted.

Overestimation of alcohol consumption norms as a driver of alcohol consumption: a whole-population network study of men across eight villages in rural, southwestern Uganda

BACKGROUND AND AIMS

Little is known about how perceived norms about alcohol consumption may influence high alcohol consumption rates in Uganda. This study estimated the accuracy of perceived norms about men's alcohol consumption and estimated the association between perceived norms and personal alcohol consumption.

DESIGN

Cross-sectional, whole-population, sociocentric social network study.

SETTING

Eight rural villages in Rwampara District, southwestern Uganda in 2016-18.

PARTICIPANTS

A total of 719 men aged 18 years and older (representing 91% of permanent resident men).

MEASUREMENTS

Self-reported frequent (≥ 4 days per week) and heavy alcohol consumption (six or more drinks on one occasion, more than three occasions of intoxication, or spending an excessive amount on alcohol). Participants also reported whether they thought most other men in their village engaged in frequent and heavy alcohol consumption (perceived norms). Using the network study design, we calculated alcohol consumption behavior within villages and social networks. Perceived norms were compared with aggregated self-reports. Multivariable Poisson regression models were used to estimate the association between perceived norms and individual behavior.

FINDINGS

Throughout villages, frequent and heavy alcohol consumption ranged from 7 to 37%. However, 527 (74%) participants perceived, contrary to fact, that most other men in their villages frequently consumed alcohol, and 576 (81%) perceived that most others heavily consumed alcohol. Overestimation of alcohol consumption by others was pervasive among socio-demographic subgroups and was present irrespective of the actual consumption behavior at the village level and within social networks. Men who misperceived these alcohol consumption behaviors as being common were more likely to engage in frequent [adjusted relative risk (aRR) = 3.98; 95% confidence interval (CI) = 1.69-9.34) and heavy (aRR = 4.75; 95% CI = 2.33-9.69) alcohol consumption themselves.

CONCLUSIONS

Most men in eight rural Ugandan villages incorrectly thought that frequent and heavy alcohol consumption were common among men in their villages. These misperceived norms had a strong positive association with individual drinking behavior.

A novel approach to assess descriptive and injunctive norms for college student marijuana use

Descriptive and injunctive norms are traditionally assessed using different metrics. Following an innovation in the alcohol field, we examined a novel measure of perceived descriptive and injunctive marijuana norms (i.e., Marijuana Norms Grid, MNG) to characterize how these normative perceptions relate to one's own use of marijuana. The present study addressed three research questions: (1) Do college students overestimate descriptive/injunctive marijuana norms of typical college students and close friends? (2) Are descriptive/injunctive norms uniquely related to marijuana frequency and quantity? (3) Are injunctive norms related to marijuana frequency and quantity above and beyond how injunctive norms are traditionally assessed? College students (n = 7000) were recruited from 9 universities throughout the US, including 2077 past month marijuana users. Participants completed an online, cross-sectional survey that included measures assessing marijuana use, marijuana consequences, and descriptive and injunctive marijuana norms using traditional and novel assessments, among other assessments. The results revealed robust self-other discrepancies using the MNG such that participants overestimated how often and how much college students use marijuana. We also found that both descriptive and injunctive norms related uniquely to one's own marijuana use. The MNG injunctive norms explained about 19% of additional variability in marijuana outcomes beyond injunctive norms assessed using the traditional method. The findings of the present study support the utility of the novel assessment of injunctive marijuana norms. Implications for norms-based interventions are discussed.

Understanding perceived usefulness and actual use of protective behavioral strategies: The role of perceived norms for the reasons that young adult drinkers use protective behavioral strategies

INTRODUCTION

The current study examines the norms-behavior link by investigating a novel cognition for protective behavioral strategies (PBS)-descriptive and injunctive norms for close friends' reasons to use PBS (e.g., limit drinking, reduce consequences)-in relation to one's own perception of usefulness and personal use of PBS. Further, we tested whether the association between perceived norms for reasons to use PBS and personal PBS use was mediated by perceived usefulness of PBS.

METHODS

College student drinkers ages 18-24 [N = 301; 53% female, 69% White, mean age = 20.16 years (SD = 1.54)] were recruited for a larger study. Eligible students reported alcohol use 2+ days a week and 1+ occasions of heavy episodic drinking in the last two weeks. Linear regression tested whether descriptive and injunctive norms for reasons to use PBS were associated with perceived usefulness and personal use of PBS; path analysis was used to test mediation. All analyses were conducted by PBS subscale (limiting/stopping, serious harm reduction, manner of drinking).

RESULTS

Descriptive norms for reasons to use PBS (i.e., perceptions that close friends use PBS to reduce drinking/consequences) were positively associated with perceived usefulness and personal PBS use for limiting/stopping and to some extent manner of drinking. For each subscale, the association between descriptive norms for reasons to use PBS and personal PBS use was mediated by perceived usefulness of PBS. Results were not significant for injunctive norms.

CONCLUSIONS

Findings suggest descriptive norms, rather than injunctive norms, for close friends' reasons to use PBS, may be relevant for inclusion in brief interventions.

Perceptions of alcohol misuse among Alaska native health care system stakeholders: A qualitative exploration

Although alcohol misuse is a priority for health care systems serving Alaska Native and American Indian (ANAI) people, stakeholders' perceptions of misuse are understudied. Patients (n = 34), providers (n = 20), and leaders (n = 16) at a Tribally owned and operated health care system reported that alcohol misuse results from the interaction of factors, including colonization, structural factors, social alienation, social norms about overdrinking introduced at the time of colonizing contact, coping with emotions, and beliefs about ANAI people and alcohol. Childhood exposure to alcohol misuse leads some ANAI people to avoid alcohol altogether, shedding light on the high levels of abstinence observed in ANAI communities.

Examining the relationship between social norms, alcohol-induced blackouts, and intentions to blackout among college students

BACKGROUND

Alcohol-induced blackouts are a common high-risk outcome of heavy episodic drinking and are considered a marker of problematic alcohol consumption. One's estimates of the prevalence and peer approval of heavy episodic drinking (i.e., social norm perception, descriptive and injunctive norms, respectively) strongly relate to high-risk alcohol consumption. However, it is unknown whether the intention to blackout and the occurrence of alcohol-induced blackouts also associates with these estimates. Therefore, the purpose of this paper is to explore the relation between participants' social norm perception and alcohol-induced blackout intentions and recent blackout history.

METHOD

A total of 4430 participants completed an online survey with an average age of 19.97 (SD = 1.70) years. A series of ANOVAs and a structural equation model examined the relation between social norm perception, intention to blackout, and recent blackout history.

RESULTS

In the structural equation model, the social norm variables (descriptive and injunctive norms) were associated with higher levels of blackout intentions and recent blackout history. The global fit indices suggest that the data fit the model, χ² (n = 4248, 442) = 7755.90, p < .001, CFI = .96, TLI = .96, RMSEA = .06 (CI90 .061-.064).

CONCLUSIONS

Participants with a higher likelihood of having a past 30-day history of alcohol-induced blackouts and higher blackout intentions believed that many of their peer groups approved of certain alcohol-related behaviors and that their peer groups drink frequently and drink higher quantities. Future interventions may assess the impact of adjusting social norms on both the intention to blackout and experiencing blackouts.

Correcting exaggerated drinking norms with a mobile message delivery system: Selective prevention with heavy-drinking first-year college students

Many efficacious interventions designed to reduce college student drinking aim to correct misperceptions of peers' drinking behavior. The present study tested the efficacy of a novel delivery strategy, namely text messages, for promoting promoderation descriptive and injunctive drinking norms. Participants included 121 college students who were randomly assigned to receive daily text messages containing accurate drinking norms (experimental group, n = 61) or historical facts (control group, n = 60) for 10 weeks following a baseline assessment. Participants completed 3-month postbaseline and 6-month postbaseline follow-up assessments. The 3-month assessment revealed that promoderation text messages were effective for reducing peak consumption and alcohol consequences. Changes in descriptive norms and injunctive norms aligned with these two behavioral outcomes. The intervention group reported perceiving others as drinking less on their heaviest drinking day and perceived others as being less approving of alcohol-related consequences than the control group. The intervention group also reported more peer approval of using protective behavioral strategies. Yet intervention effects were not maintained. None of the outcome measures differed by condition at the 6-month postbaseline assessment. Thus, the intervention had short-term effects on self-reported drinking behavior as well as on perceptions of drinking norms. However, the behavioral changes were not maintained when participants were assessed in the second semester after the daily text messages intervention had stopped. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Examining interactions within the theory of planned behavior in the prediction of intentions to engage in cannabis-related driving behaviors

Objective: As marijuana use becomes more available to college students through increasing legal reform, this paper seeks to examine intentions for driving under the influence of cannabis (DUIC) and riding with a high driver (RWHD) through the lens of the theory of planned behavior (TPB) and assess potential interactions between personal attitudes, subjective norms, perceived behavioral control (PBC), and sex. Participants: Undergraduate college students (N = 311) completed online surveys in September, 2013. Method: Participants self-reported their attitudes toward DUIC, subjective norms, PBC, past DUIC and RWHD, and intentions to DUIC and RWHD. Results: Participants' attitudes toward DUIC, subjective norms, and PBC were strongly associated with intentions to DUIC and RWHD bivariately. In regression models, attitudes and PBC were both positively and significantly related to intentions to DUIC and RWHD. Conclusions: DUIC and RWHD are concerns for college populations. Targeting personal attitudes and perceived behavioral control via interventions may reduce these behaviors.

Effects of Social and Outcome Expectancies on Hazardous Drinking among Chinese University Students: The Mediating Role of Drinking Motivations

Background and Objectives: Based on the theory of reasoned action, the present study investigated the relative effects of drinking outcome expectancies and parental norms, as well as the mediating effect of drinking motivations, on hazardous drinking in Chinese university students. Method: A sample of Chinese university students in Hong Kong and Macao (N = 973, M = 19.82, SD = 1.57, 48.9% males), who reported drinking in the past 3 months, voluntarily completed an anonymous questionnaire. Path analysis was used to test the effects of the variables on hazardous drinking. Results: All the psychosocial variables showed positive correlations with hazardous drinking. In the path model, controlling for sex, parental norms had both direct and indirect effects on hazardous drinking through social and enhancement motivations. Courage had the strongest indirect effect on drinking behavior through social, enhancement, and coping motivations, whereas the relationship between tension reduction and hazardous drinking was mediated by enhancement and coping motivations. Sociality and sexuality only had indirect effect through social and coping motivations respectively. Negative outcome expectancies had no direct nor indirect effects on hazardous drinking. Conclusions: Perceived approval from parents and positive alcohol outcome expectancies may enhance individuals' tendency to engage in hazardous drinking by increasing their motivation to drink to be social, for enjoyment, and to cope with problems. Parents should explicitly show their disapproval of their children's drinking, and education efforts should focus on decreasing positive outcome expectancies and associated motivations for drinking among Chinese university students.

Location-Specific Social Norms and Personal Approval of Alcohol Use are Associated with Drinking Behaviors in College Students

Background: Prior research on risky alcohol use points to drinking norms as predictors of drinking behavior. Most research to date has only explored global (versus context-specific) drinking norms as they relate to general drinking behavior. To better understand risky drinking behavior in students, how norms may vary across drinking environments should be considered. Objectives: We sought to explore differences in drinking norms (descriptive and injunctive), personal approval, and alcohol use across specific drinking locations and how these location-specific predictors combine to best predict alcohol consumption in home/dorm locations, bars, and parties. Methods: College student drinkers (N = 115, 76% female) participated in an anonymous online cross-sectional survey in 2015-2016 assessing personal and perceived drinking experiences and attitudes across various locations. Results: Alcohol use, descriptive norms of alcohol use, and injunctive norms of alcohol use (but not personal approval) varied across location. In addition, location-specific descriptive norms were associated with alcohol use in each drinking location, whereas location specific personal approval was associated with alcohol use only at home/dorm and bar locations. Furthermore, descriptive norms and personal approval of drinking in a given location predicted alcohol use in that same location, while norms or approval for other locations did not. Conclusion/Importance: Results highlight the importance of specificity of perceived drinking norms and personal approval for predicting location-specific alcohol use. These findings have implications for interventions, which may benefit from discussions of students' preferred drinking locations and providing location-specific normative feedback.

Who cares if college and drinking are synonymous? Identification with typical students moderates the relationship between college life alcohol salience and drinking outcomes

There is considerable research demonstrating that college life alcohol salience is associated with alcohol use among undergraduates. However, the strength of this association may depend on whether students self-identify with other students on their campus; self-identification with other students may indicate how influential other students are on an individuals' drinking. As such, the current research investigated whether identification with the "typical student" moderated the relationship between college life alcohol salience beliefs and alcohol-related outcomes. Five-hundred and eleven undergraduates reported their alcohol use, how closely they identified with other students, as well as their college life alcohol salience beliefs. Poisson moderated regression models and negative binomial moderation regression models were employed. Results indicated that self-identification with other students was a significant moderator of the association between college life alcohol salience beliefs and frequency of drinking as well as peak number of drinks, but not drinks per week or alcohol-related problems. Findings suggest that it may be important to shift students' perceptions surrounding drinking as being an important part of the college experience, particularly for those who identify with their peers.

Does participation in voluntary organizations protect against risky alcohol and tobacco use? Findings from the UK panel data

Drawing on the literature that posits heterogeneous influences of social networks on health behaviors, we tested whether different forms of participation in voluntary organizations predicted more or less alcohol and tobacco consumption over time. (Access preregistration at https://osf.io/guzem/) We used panel data from younger (aged 14–29 at baseline), middle-aged (aged 40–50), and older (aged 65–75) UK adults, Ns = 1280–9073, followed from 1991 to 2014. Annual measures of smoking included status and intensity. Frequency of pub attendance was assessed biennially between 1996 and 2008. In 2010 and 2013, more precise measures of alcohol consumption were available. We conducted two-level regression analyses for the outcomes measured more than twice and residual change analyses for other outcomes. Over time (within persons), there were no significant effects on smoking. Activity in voluntary organizations predicted slightly less frequent pub attendance in younger adults. In residual change analyses, activity in voluntary organizations decreased last-week ethanol consumption and risk of heavy episodic drinking in younger women. These effects pertained mainly to service-orientated organizations. In middle-aged adults, membership and attendance at meetings of voluntary organizations predicted slightly more frequent pub attendance. Residual change analyses showed volunteering to reduce the risk of heavy episodic drinking in middle-aged men. In older adults, few significant effects emerged. Between persons, all indicators of participation were associated with less smoking, whereas membership was associated with more and activity with less frequent pub attendance. Thus, most associations between participation in voluntary organizations and substance use reflected interindividual differences.

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Light/moderate drinkers and nonsmokers were civically engaged much more often.

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Volunteering had isolated protective effects against heavy episodic drinking.

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Participation in service-orientated organizations had similar effects.

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There were no protective effects against smoking.

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Few age and sex differences emerged.

Personalized normative feedback for heavy drinking: An application of deviance regulation theory

Deviance Regulation Theory (DRT) proposes that individuals regulate their behavior to be in line with the behaviors of others. Specifically, individuals desire to stand out in positive way and not stand out in a negative way. DRT has been successfully applied to encourage other health behaviors and offers a unique method to utilize both injunctive norms in combination with descriptive norms in brief alcohol interventions. This randomized controlled trial evaluated a computer-delivered, norms-based personalized feedback intervention which systematically varied the focus on whether specific drinking behaviors were described as common or uncommon (a descriptive norm), whether the drinking behaviors were healthy versus unhealthy, and whether the drinking behaviors were positively or negatively framed (an injunctive norm). Nine-hundred and fifty-nine college drinkers completed baseline, three-month, and six-month follow-up assessments. Results indicated messages focusing on unhealthy drinking behaviors, particularly when described as uncommon, were most effective in reducing drinking and alcohol-related problems over time. This research utilizes deviance regulation theory as a way of improving personalized normative feedback by elucidating how to construct messages for brief interventions based on descriptive characteristics associated with specific target drinking behaviors in combination with perceptions of prevalence and acceptability of such drinking behaviors (an injunctive norm).

Harm-reduction and zero-tolerance maternal messages about college alcohol use

Past cross-sectional research suggests that zero-tolerance messaging by parents of college students may be more effective than harm-reduction communication at reducing student alcohol risk. The current study employs longitudinal data to examine whether communication type interacts with student alcohol use to predict subsequent drinking outcomes. U.S. college students reported on their own exposure to zero-tolerance and harm-reduction maternal communication. Approximately seven months later, students completed measures of maternal alcohol approval and their own alcohol behaviors. The relationship between communication and subsequent alcohol behaviors depended on students' baseline drinking. For heavy drinkers, harm-reduction communication was associated with less alcohol use and consequences. For those who drank less than two drinks a week, zero-tolerance communication was associated with fewer negative consequences. Zero-tolerance communication was associated with perceiving mothers as less approving, while harm reduction communication was associated with perceiving mothers as more approving. There were indirect effects of communication on drinking through perceived maternal approval. While overall harm-reduction communication may lead students to perceive mothers as more approving of alcohol use, there may be contexts in which this type of communication is beneficial.

Harnessing centred identity transformation to reduce executive function burden for maintenance of health behaviour change: the Maintain IT model

The inability to produce sustainable lifestyle modifications (e.g., physical activity, healthy diet) remains a major barrier to reducing morbidity and mortality from prevalent, preventable conditions. The objective of this paper is to present a model that builds on and extends foundational theory and research to suggest novel approaches that may help to produce lasting behaviour change. The model aims to integrate factors not typically examined together in order to elucidate potential processes underlying a shift from behaviour initiation to long-term maintenance. The central premise of the Maintain IT model builds on approaches demonstrating that in-tact executive function (EF) is critical for health behaviour initiation, for more complex behaviours beyond initiation, and in unsupportive environments and circumstances, but successful recruitment of EF is effortful and prone to error. Enduring changes are more likely if the underlying cognitive processes can become less effortful (non-conscious, automatic). The Maintain IT model posits that a centred identity transformation is one path leading to less effortful processing and facilitating successful recruitment of EF when necessary over the long term, increasing the sustainability of health behaviour change. A conceptual overview of the literature supporting the utility of this integrative model, future directions, and anticipated challenges are presented.

What "likes" have got to do with it: Exposure to peers' alcohol-related posts and perceptions of injunctive drinking norms

OBJECTIVE

Examine 1) whether observed social reinforcements (i.e., "likes") received by peers' alcohol-related social media posts are related to first-year college students' perceptions of peer approval for risky drinking behaviors; and 2) whether associations are moderated by students' alcohol use status.

PARTICIPANTS

First-year university students (N = 296) completed an online survey in September, 2014.

METHOD

Participants reported their own alcohol use, friends' alcohol use, perceptions of the typical student's approval for risky drinking, and ranked 10 types of social media posts in terms of the relative numbers of "likes" received when posted by peers.

RESULTS

Observed social reinforcement (i.e., "likes") for peers' alcohol-related posts predicted perceptions of peer approval for risky drinking behaviors among non-drinking students, but not drinking students.

CONCLUSIONS

For first-year college students who have not yet initiated drinking, observing peers' alcohol-related posts to receive abundant "likes" may increase perceptions of peer approval for risky drinking.

ELSA 2016 Cohort: Alcohol, Tobacco, and Marijuana Use and Their Association with Age of Drug Use Onset, Risk Perception, and Social Norms in Argentinean College Freshmen

The transition from high school to college is a high-risk stage for the initiation and escalation of substance use. Substance use and its associated risk factors have been thoroughly described in developed countries, such as the United States, but largely neglected in Argentina, a South American country with patterns of a collectivist culture. The present cross-sectional study describes the occurrence of alcohol, tobacco, and marijuana use and the association between these behaviors and the age of onset of substance use and cognitive (i.e., risk perception) and social (i.e., prescriptive) variables in a large sample of Argentinean college freshmen (n = 4083, 40.1% men; mean age = 19.39 ± 2.18 years). The response rate across courses was ≥90% and was similarly distributed across sex. Participants completed a survey that measured substance use (alcohol [with a focus on heavy drinking and binge drinking behaviors], tobacco, and marijuana), age of onset of the use of each substance, perceived risk associated with various substance use behaviors, prescriptive norms associated with substance use, and descriptive norms for alcohol use (AU). The results indicated that AU is nearly normative (90.4 and 80.3% with last year and last month use, respectively) in this population, and heavy drinking is highly prevalent (68.6 and 54.9% with heavy episodic and binge drinking, respectively), especially among those with an early drinking onset (97.8 and 93.6% with last year and last month use and 87.8 and 76.3% with heavy episodic and binge drinking, respectively). The last-year occurrence of tobacco and marijuana use was 36 and 28%, respectively. Early substance use was associated with the greater use of that specific substance. The students overestimated their same-sex friend's AU, and women overestimated the level of AU of their best male friend. At the multivariate level, all of the predictors, with the exception of the parents' prescriptive norms, significantly explained the frequency of marijuana and tobacco use and frequency of hazardous drinking. Overall, despite important cultural and contextual differences between Argentina and the United States, our findings suggest that certain vulnerability factors have a similar influence across these cultural contexts.

The role of perceived injunctive alcohol norms in adolescent drinking behavior

Peers have a major influence on youth during adolescence, and perceptions about peer alcohol use (perceived norms) are often associated with personal drinking behavior among youth. Most of the research on perceived norms among adolescents focuses on perceived descriptive norms only, or perceptions about peers' behavior, and correcting these perceptions are a major focus of many prevention programs with adolescents. In contrast, perceived injunctive norms, which are personal perceptions about peers' attitudes regarding the acceptability of behaviors, have been minimally examined in the adolescent drinking literature. Yet correcting perceptions about these perceived peer attitudes may be an important component to include in prevention programs with youth. Using a sample of 2493 high school-aged youth (mean age=17.3), we assessed drinking behavior (past year use; past month frequency, quantity, and peak drinks), drinking consequences, and perceived descriptive and injunctive norms to examine the relationships of perceived injunctive and descriptive norms on adolescent drinking behavior. Findings indicated that although perceived descriptive norms were associated with some drinking outcomes (past year use; past month frequency; past month quantity; peak drinks), perceived injunctive norms were associated with all drinking outcomes, including outcomes of consequences, even after controlling for perceived descriptive norms. Findings suggest that consideration of perceived injunctive norms may be important in models of adolescent drinking. Prevention programs that do not include injunctive norms feedback may miss an important opportunity to enhance effectiveness of such prevention programs targeting adolescent alcohol use.

An Examination of the Relationship Between Consequence-Specific Normative Belief Patterns and Alcohol-Related Consequences Among College Students

BACKGROUND

Research has previously identified a high-risk subgroup of college students who experience high levels of multiple and repeated alcohol-related consequences (MRC group). The purpose of this study was to examine the association between consequence-specific normative influences and experiencing multiple and repeated drinking-related consequences using a person-centered approach. Normative subgroups were identified using latent profile analysis (LPA), which were then used to predict MRC group status at 6-month follow-up.

METHODS

First-year college student drinkers (N = 2,024) at a large northeastern university completed online surveys during the fall and spring semesters of their freshman year. Retention was high with 92% of invited participants completing T2, of which the MRC group accounted for 27%.

RESULTS

Three student profiles were identified from LPA on T1 data: Nonpermissive Parents (77%), Positive Peer and Parent Norms (21%), and Permissive Parents (3%). Logistic regression revealed that both the Positive Peer and Parent Norms and Permissive Parents profiles had significantly higher odds of MRC group membership at follow-up (1.81 and 2.78 times greater, respectively).

CONCLUSIONS

The results suggest value in prevention efforts that include normative beliefs about alcohol-related consequences. Further, parental norms in particular have the potential to enhance interventions, especially through direct communication of disapproval for experiencing consequences.

How Strong is the "Fake ID Effect?" An Examination Using Propensity Score Matching in Two Samples

BACKGROUND

Underage college students who obtain and use false identification (fake ID) are at risk for negative outcomes. However, it is currently unclear how uniquely the fake ID itself serves as a vehicle to subsequent harm (i.e., the "fake ID effect") over and above general and trait-related risk factors (e.g., deviant peers, low self-control).

METHODS

To investigate whether the "fake ID effect" would hold after accounting for phenotypic risk, we utilized propensity score matching (PSM) in a cross-sectional sample of 1,454 students, and a longitudinal replication sample of 3,720 undergraduates. Individuals with a fake ID were matched with individuals without a fake ID, in terms of a number of trait-based and social risk factors. These matched groups were then compared on 5 problematic outcomes (i.e., frequent binge drinking, alcohol-related problems, arrests, marijuana use, and hard drug use).

RESULTS

Findings showed that "fake ID effects" were substantially-although not fully-diminished following PSM. The "fake ID effect" remained strongest for alcohol-related arrests. This may relate to issues of enforcement and students' willingness to engage in deviant behavior with a fake ID, or it may be a function of combined processes.

CONCLUSIONS

Overall, the findings suggest that interventions should not only be aimed at reducing the fake ID-related alcohol access specifically, but should also be aimed more generally toward at-risk youths' access to alcohol. Future research might examine whether fake IDs have their strongest potency as moderators of the effects of risky traits-such as impulsiveness-on drinking outcomes.

Self-Other Differences in Student Drinking Norms Research: The Role of Impression Management, Self-Deception, and Measurement Methodology

BACKGROUND

Data-driven student drinking norms interventions are based on reported normative overestimation of the extent and approval of an average student's drinking. Self-reported differences between personal and perceived normative drinking behaviors and attitudes are taken at face value as evidence of actual levels of overestimation. This study investigates whether commonly used data collection methods and socially desirable responding (SDR) may inadvertently impede establishing "objective" drinking norms.

METHODS

U.K. students (N = 421; 69% female; mean age 20.22 years [SD = 2.5]) were randomly assigned to 1 of 3 versions of a drinking norms questionnaire: The standard multi-target questionnaire assessed respondents' drinking attitudes and behaviors (frequency of consumption, heavy drinking, units on a typical occasion) as well as drinking attitudes and behaviors for an "average student." Two deconstructed versions of this questionnaire assessed identical behaviors and attitudes for participants themselves or an "average student." The Balanced Inventory of Desirable Responding was also administered.

RESULTS

Students who answered questions about themselves and peers reported more extreme perceived drinking attitudes for the average student compared with those reporting solely on the "average student." Personal and perceived reports of drinking behaviors did not differ between multitarget and single-target versions of the questionnaire. Among those who completed the multitarget questionnaire, after controlling for demographics and weekly drinking, SDR was related positively with the magnitude of difference between students' own reported behaviors/attitudes and those perceived for the average student.

CONCLUSIONS

Standard methodological practices and socially desirable responding may be sources of bias in peer norm overestimation research.

Addressing Inconsistencies in the Social Norms Drinking Literature: Development of the Injunctive Norms Drinking and Abstaining Behaviors Questionnaire

BACKGROUND

Informed by inconsistent findings regarding the association between injunctive norms (IN) and drinking behaviors, the current study developed a new measure of IN, the Injunctive Norms Drinking and Abstaining Behaviors Questionnaire (IN-DABQ). This measure addressed several psychometric weaknesses of prior assessment of this construct, specifically, reliance on single-item measures, and assessment of a limited range of drinking behaviors. The new measure also assessed norms for reasons for abstaining from drinking as college students often have simultaneous motives to use and inhibit their drug use. A parallel measure of descriptive norms (DN), the Descriptive Norms Drinking and Abstaining Behaviors Questionnaire (DN-DABQ), was created to allow for a comparison of the relative predictive effects of descriptive and IN in relation to different drinking outcomes.

METHODS

A college sample (N = 254, female = 50.42%) was recruited using Amazon's Mechanical Turk. Participants completed an online survey assessing demographic characteristics, social norms for 3 referents, weekly alcohol use, and alcohol-related consequences.

RESULTS

Exploratory factor analyses indicated 2 factors for the DN-DABQ and 3 factors for the IN-DABQ. The IN Drinking Behaviors factor consistently predicted weekly consumption and alcohol-related consequences across 3 reference groups (typical college student at your school, friends, and closest friends).

CONCLUSIONS

These findings suggest that prior inconsistencies in the relationship between IN and drinking behaviors are likely a function of poor measurement of this construct. Implications for normative feedback interventions are discussed.

Do as I Say, Not as I Do? An Examination of the Relationship Between Partner Behaviors and Help Seeking for Alcohol Related Issues

BACKGROUND

Although there are a number of risks associated with problematic alcohol use, the proportion of people who seek help for alcohol-related issues is alarmingly low.

OBJECTIVE

This study investigated the potential social influences that are associated with alcohol-related help seeking, including perceived partner support, descriptive and injunctive subjective norms, and marital satisfaction.

METHODS

Participants included 133 individuals (50% female, 48% male, and 2% did not report) recruited nationwide through both print and electronic methods. Data were collected in an online survey in 2013. Respondents were 77% Caucasian, 16% African-American, 2% Asian, 2% American Indian, and 1% Hawaiian/Pacific Islander, with a mean age of 38 years (SD = 11.93). Data were analyzed using hierarchical multiple regression.

RESULTS

Results suggested that when considered independently, perceived partner support, injunctive social norms, and closest friend's level of drinking were significantly associated with help seeking behavior, while marital satisfaction was not. Results further indicated that examining support and norms together accounted for increased variance in help seeking over examining the variables separately. Significant interactions were found between gender and acceptance of drinking behavior, which suggested that acceptance of drinking behavior was important for men's help seeking but not for women's, and between positive support and acceptance, which indicated that the role of support varied by level of acceptance for both genders.

CONCLUSION

Overall, this study suggests that social influences play an important role in a person's decision to seek help for alcohol related issues.

Not the same old thing: Establishing the unique contribution of drinking identity as a predictor of alcohol consumption and problems over time

Drinking identity-how much individuals view themselves as drinkers-is a promising cognitive factor that predicts problem drinking. Implicit and explicit measures of drinking identity have been developed (the former assesses more reflexive/automatic cognitive processes; the latter more reflective/controlled cognitive processes): each predicts unique variance in alcohol consumption and problems. However, implicit and explicit identity's utility and uniqueness as predictors relative to cognitive factors important for problem drinking screening and intervention has not been evaluated. Thus, the current study evaluated implicit and explicit drinking identity as predictors of consumption and problems over time. Baseline measures of drinking identity, social norms, alcohol expectancies, and drinking motives were evaluated as predictors of consumption and problems (evaluated every 3 months over 2 academic years) in a sample of 506 students (57% female) in their first or second year of college. Results found that baseline identity measures predicted unique variance in consumption and problems over time. Further, when compared to each set of cognitive factors, the identity measures predicted unique variance in consumption and problems over time. Findings were more robust for explicit versus implicit identity and in models that did not control for baseline drinking. Drinking identity appears to be a unique predictor of problem drinking relative to social norms, alcohol expectancies, and drinking motives. Intervention and theory could benefit from including and considering drinking identity. (PsycINFO Database Record

Drinking Patterns Across Spring, Summer, and Fall in 462 University Students

BACKGROUND

Student heavy drinking and associated problems are common at most universities and fluctuate throughout the calendar year, with marked increases during celebrations. Most studies of student drinking are limited to the academic year itself, and relatively few focus specifically on special heavy drinking events. Even fewer studies include drinking during summer break and subsequent school return.

METHODS

In the context of an experimental protocol, beginning in January 2014, alcohol-related characteristics were evaluated 8 times over 55 weeks for 462 college freshmen, including periods that incorporated a campus festival, summer, and school return. Baseline predictors of drinking quantities over time included demography, substance use patterns, as well as environmental and attitudinal characteristics. Product-moment correlations evaluated relationships between baseline characteristics and subsequent quantities, and simultaneous entry regression analyses evaluated which characteristics most robustly predicted usual and maximum drinks over time.

RESULTS

Maximum drinks per occasion increased 18% from the early spring (4/8/14 to 5/6/14) to the campus festival period (5/7/14 to 6/3/14), decreased 29% in the summer (7/8/14 to 8/5/14), and increased 31% on school return (10/7/14 to 11/4/14). The most robust predictors of higher quantities in regression analyses included items from each of the 3 major domains with the most consistent results seen for most baseline alcohol-related items and descriptive drinking norms (R(2) = 0.20 to 0.31).

CONCLUSIONS

These data demonstrate important changes in students' drinking during the calendar year, including expected large increases during the month of a 1-day festival, large decreases over the summer, and resumption of relatively high quantities upon return to school.

Effect of appreciation for Indigenous cultures and exposure to racial insults on alcohol and drug use initiation among multiethnic Argentinean youth

OBJECTIVES

This study evaluated the effect of factors reflecting appreciation of Indigenous culture and racial insults on alcohol and drug use initiation among multi-ethnic youth in Jujuy, Argentina.

METHODS

Students were surveyed from 27 secondary schools that were randomly selected to represent the province. A total of 3040 eligible students in 10th grade, age 14 to 18years were surveyed in 2006 and 2660 of these same students completed surveys in 11th grade in 2007. Multivariate logistic regression models assessed the effect of appreciation for Indigenous cultures and reported exposure to racial insults in 10th grade on incident current alcohol drinking in previous 30days, binge drinking (≥5 drinks at one sitting), and lifetime drug use (marijuana, inhalants or cocaine) in 11th grade among students not reporting these behaviors in 2006.

RESULTS

In 2006, 63% of respondents reported high appreciation for Indigenous cultures and 39% had ever experienced racial insults. In 2007, incident current drinking was 24.4%, binge drinking 14.8%, and any drug use initiation was 4.1%. Exposure to racial insults increased the likelihood of binge drinking (OR=1.6; 95% CI 1.2-2.1) but was not significant for any drug use. Appreciation for Indigenous cultures reduced the risk of any drug use initiation (OR=0.5, 95% CI 0.3-0.7) but had no effect for alcohol drinking outcomes. These effects were independent of Indigenous ethnicity.

CONCLUSIONS

Enhancing appreciation for Indigenous cultures and decreasing racial insults are achievable goals that can be incorporated into programs to prevent youth substance use.

Injunctive Norms and Alcohol Consumption: A Revised Conceptualization

BACKGROUND

Injunctive norms have been found to be important predictors of behaviors in many disciplines with the exception of alcohol research. This exception is likely due to a misconceptualization of injunctive norms for alcohol consumption. To address this, we outline and test a new conceptualization of injunctive norms and personal approval for alcohol consumption. Traditionally, injunctive norms have been assessed using Likert scale ratings of approval perceptions, whereas descriptive norms and individual behaviors are typically measured with behavioral estimates (i.e., number of drinks consumed per week, frequency of drinking). This makes comparisons between these constructs difficult because they are not similar conceptualizations of drinking behaviors. The present research evaluated a new representation of injunctive norms with anchors comparable to descriptive norms measures.

METHODS

A study and a replication were conducted including 2,559 and 1,189 undergraduate students from 3 different universities. Participants reported on their alcohol-related consumption behaviors, personal approval of drinking, and descriptive and injunctive norms. Personal approval and injunctive norms were measured using both traditional measures and a new drink-based measure.

RESULTS

Results from both studies indicated that drink-based injunctive norms were uniquely and positively associated with drinking, whereas traditionally assessed injunctive norms were negatively associated with drinking. Analyses also revealed significant unique associations between drink-based injunctive norms and personal approval when controlling for descriptive norms.

CONCLUSIONS

These findings provide support for a modified conceptualization of personal approval and injunctive norms related to alcohol consumption and, importantly, offer an explanation and practical solution for the small and inconsistent findings related to injunctive norms and drinking in past studies.

Study protocol for a web-based personalized normative feedback alcohol intervention for young adult veterans

BACKGROUND

Young adult veterans from the wars in Iraq and Afghanistan represent a population at-risk for heavy and problematic alcohol use. Unfortunately, few seek treatment for alcohol concerns and those that do seek care may drop out from lengthy multicomponent treatments. Additionally, veterans who live in rural areas and those who are not engaged in the Veterans Affairs Healthcare System are often overlooked, difficult to engage in treatment, and may not be actively seeking treatment for heavy patterns of use that may develop into an alcohol use disorder. The objective of this proposed randomized controlled trial is to develop and pilot test a brief, stand-alone Internet-based alcohol intervention with young adult veterans to help them reduce their drinking and prevent the development of problematic alcohol use.

METHODS/DESIGN

Recruitment and intervention is delivered entirely over the Internet to address barriers to seeking care among this at-risk group. The online intervention consists of an assessment followed by a single module of personalized normative feedback (PNF), which provides individuals with accurate information to reduce misperceptions regarding the frequency and acceptability of risky peer behavior. PNF has established efficacy as included within multicomponent interventions targeting military populations or as a stand-alone intervention with young adult college students, but has not yet been empirically supported for the at-risk veteran population. This paper describes the development of the PNF intervention content and details the protocol for the intervention study, which will utilize a sample of 600 young adult veterans to examine the efficacy of the brief PNF intervention targeted toward reducing perceived norms, intentions to drink, actual drinking behavior, and consequences. Specific subpopulations of this veteran population, including those with mental health concerns and those differentiated by level of drinking problems, reasons for drinking, and connection to peers, will be examined to support generalizability of the intervention.

DISCUSSION

This intervention has the potential to improve veteran health care by utilizing a novel approach to increase access to care, assist with drinking reductions, and prevent alcohol-related problems. Trial registration ClinicalTrials.gov Identifier NCT02187887.

A road paved with safe intentions: Increasing intentions to use alcohol protective behavioral strategies via Deviance Regulation Theory

OBJECTIVE

Drinking remains a problem across college campuses. Changing this behavior requires interventions that can be easily and widely dispersed. Several theories place intentions as a proximal predictor of behavior change. The current study examines the effects of a Web-based Deviance Regulation Theory (DRT) intervention on (1) intentions to use alcohol protective behavior strategies (PBS) and (2) associations between these intentions and actual behavior.

METHOD

Participants (n = 76) completed a 6-week, Web-based study examining drinking behaviors. Participants were randomly assigned to receive a positive frame about individuals who use PBS or a negative frame about individuals who do not. They also reported normative perceptions of PBS use among college students. They subsequently logged onto a secure server each week to report on alcohol involvement, use of 3 types of PBS (Manner of Drinking, Stopping/Limiting, and Serious Harm Reduction), and intentions to use these PBS the following week.

RESULTS

Consistent with DRT, negative frames resulted in higher PBS use intentions if individuals held high normative beliefs about PBS use. Positive frames resulted in higher Manner of Drinking PBS use intentions if individuals held low normative beliefs about PBS use, but only if individuals endorsed a high belief in the frame. In addition, there was a DRT consistent increase in intention-action associations, but only for Stopping/Limiting PBS.

DISCUSSION

A brief Web-based DRT intervention was effective at increasing PBS intentions and increasing PBS intention-action associations. DRT may provide a mechanism to additively or synergistically improve other Web-based interventions for college drinking. (PsycINFO Database Record

The influence of drinking motives on hookah use frequency among young multi-substance users

PURPOSE

The present work examined the influence of drinking motives on hookah use frequency among individuals reporting both alcohol and hookah use (multi-substance users). Despite growing documentation of cross-substance effects between motives and substance use, limited research has examined these relationships specifically with respect to hookah use.

METHODS

Participants were 134 (75.37% female) hookah and alcohol users, aged 18-47 years (M = 22.17, SD = 3.66) who completed measures of substance use, drinking motives, and reported demographic information. Structural equation modeling (SEM) was employed to investigate the predictive value of drinking motives on hookah use frequency, age taken into account.

RESULTS

Findings showed that hookah use was negatively associated with age (β = -.22, p ≤ .01). The model regressing hookah use on the four drinking motives provided adequate fit (χ² = 314.31, df = 180, p < .05, CFI = .92, RMSEA = .075 [95% CI, .06-.09]). Hookah use was associated negatively with social motives (β = -.43, p < .001) and positively with conformity motives (β = .24, p ≤ .05).

CONCLUSIONS

These findings are consistent with multi-substance use literature suggesting that drinking motives are associated with the use of other substances, including increased hookah use frequency. Additional examinations of cross-substance cognitive processes are needed, particularly with respect to understanding whether hookah use among multi-substance users may be contingent in part on individual factors including negative affectivity.

A multisite randomized trial of normative feedback for heavy drinking: Social comparison versus social comparison plus correction of normative misperceptions

OBJECTIVE

Given widespread alcohol misuse among college students, numerous intervention programs have been developed, including personalized normative feedback (PNF). Most research evaluating PNF assumes that presenting one's own perceived norms is necessary to correct normative misperceptions and thereby reduce drinking. Alternatively, simply providing social comparison information showing that one drinks more than others may be sufficient. The present study evaluated the efficacy of full PNF (one's own drinking, campus drinking rates, and perceived norms) and a partial personalized social comparison feedback (PSCF; one's own drinking and campus drinking rates) in a randomized trial among heavy-drinking college students.

METHOD

Participants included 623 heavy-drinking students from 3 universities. Assessments occurred at baseline and 3- and 6-months postbaseline.

RESULTS

Primary analyses examined differences across 4 drinking outcomes (drinks per week, total drinks past month, frequency of past month drinking, and negative alcohol-related consequences) at 3- and 6-month follow-ups controlling for the baseline variable. Results revealed significant reductions across all alcohol consumption outcomes at 3 months in both intervention conditions compared to attention-control. Mediation analyses demonstrated significant indirect effects of the intervention on 6-month drinking through changes in perceived norms at 3 months. Moreover, evidence emerged for changes in drinking at 3 months as a mediator of the association between PSCF and 6-month perceived norms.

CONCLUSIONS

The present research suggests PNF may not require explicit consideration of one's perceived norms to be effective and that direct social comparison provides an alternative theoretical mechanism for PNF efficacy.

The role of social drinking factors in the relationship between incapacitated sexual assault and drinking before sexual activity

White House Council on Women and Girls (2014) highlighted sexual assault prevention as a high priority issue in need of immediate attention. A risk factor associated with sexual assault victimization and revictimization is drinking before sexual activity. The current study examined the relationship between incapacitated sexual assault (ISA) and drinking before sexual activity. Given the typical social context of both drinking before sexual activity and sexual assault in college settings, social-related drinking factors including drinking to conform motives, social drinking motives, and perceived drinking norms were examined. Six hundred and three undergraduate college women completed a survey online assessing history of ISA, social factors associated with drinking, and frequency of drinking before sexual activity. Path analysis indicated that both ISA before college and since entering college were associated with higher perceived drinking norms, more social drinking motive endorsement, and more drinking to conform. However, only higher perceived drinking norms and more social drinking motive endorsement were associated with both more severe ISA histories and more frequent drinking before sexual activity. Thus, a more severe ISA history was indeed associated with more frequent drinking before sexual activity and social factors related to drinking played a significant role in this relationship. Social factors can be easily targeted through brief interventions and these findings can inform future programming to promote more careful use of alcohol in social and sexual situations.

Concepções de profissionais de enfermagem de nível médio perante o dependente químico

RESUMO Objetivo: descrever e compreender as concepções dos profissionais de nível médio em enfermagem dos Centros de Atenção Psicossocial álcool e drogas (CAPS ad), perante o dependente químico. Método: foram entrevistados 16 auxiliares e técnicos de enfermagem de 9 CAPS ad do município de São Paulo, e os dados foram analisados utilizando-se o método de comparação constante. Resultados: o desempenho das funções no CAPS ad possibilitou a mudança de concepção dos trabalhadores, de uma visão estigmatizante e preconceituosa, para a concepção da dependência química como doença e dos dependentes químicos como pessoas doentes que possuem comorbidades e problemas familiares, que necessitam de auxílio e tratamento. Conclusão: a prática profissional em serviços especializados em álcool e outras drogas favorece a mudança nas concepções dos trabalhadores sobre o dependente químico, destacando-se a necessidade da inclusão do tema álcool e drogas no currículo escolares.

Young adult veteran perceptions of peers' drinking behavior and attitudes

Social norms-based interventions have shown promise in reducing drinking behavior and the resulting consequences in young adults. Although most research has focused on young civilians (i.e., college students), some studies have investigated social norms-based interventions with active-duty military and veteran samples. Yet, research has not yet determined how to maximize the effectiveness of social norms-based interventions in this heavy-drinking population. As an initial step toward this goal, the current study utilized a community sample of 1,023 young adult veterans to examine (a) whether veteran perceptions of the drinking behavior of their veteran peers differ from their perceptions of civilian drinking behavior, (b) whether perceptions of specific veteran groups differ from the actual drinking behavior of veterans within those groups, (c) what levels of specificity in reference groups (same-gender civilians, same-branch veterans, same-gender veterans, or same-branch-and-gender veterans) are most strongly associated with veterans' own drinking, and (d) whether perceptions about others' attitudes toward drinking also contribute independently of perceived behavioral norms to veteran drinking. Findings indicated that participants perceived that other veterans drank more than civilians and that veteran groups drank more than veterans in the sample actually drank. Veteran-specific perceived behavioral norms were similar in their associations with drinking outcomes, whereas same-gender civilian perceived behavioral norms exhibited little or no associations with drinking. Veteran-specific perceived attitudinal norms exhibited little or no association with drinking behavior after controlling for perceived behavioral norms. These findings can be used to inform the development of social norms interventions for young adult veterans.

Fitting in and standing out: increasing the use of alcohol protective behavioral strategies with a deviance regulation intervention

OBJECTIVE

Heavy alcohol use remains a consistent public health concern on college campuses. The current pilot study used deviance regulation theory (DRT) to modify protective behavioral strategies (PBS) among college student drinkers to reduce alcohol use and alcohol-related consequences.

METHOD

The sample was comprised of current college student drinkers (n = 76; 53.95% female) ranging in age from 18-24 (M = 19.29, SD = 1.42). Participants were randomly assigned to receive a positively or negatively framed message. They then reported on use of alcohol PBS (via the Protective Behavioral Strategies Scale), alcohol consumption (via the Modified Daily Drinking Questionnaire), and alcohol-related consequences (via the Young Adult Alcohol Consequences Questionnaire) each week for 6 weeks.

RESULTS AND CONCLUSIONS

Among drinkers with low PBS use norms, a positively, versus a negatively, framed message resulted in increased PBS use and consequently less alcohol consumption and fewer alcohol-related consequences. Among drinkers with high PBS use norms, a negatively, versus positively, framed message resulted in increased PBS use and consequently lower alcohol consumption and fewer alcohol-related consequences. However, these effects were only relevant among those who strongly believed the DRT frame. Findings suggest assigning drinkers to frames based on perceived PBS use norms and increasing belief in the frame may be 1 approach to increasing responsible drinking patterns among college students. Furthermore, the current data suggests important boundary conditions for norm-based interventions.