Alcohol consumption and masculine identity among young men

Having, making and feeling home as a European immigrant in the United Kingdom post-Brexit referendum: An interpretative phenomenological study

Migrants' subjective sense of home deserves further research attention. In the particular context of the United Kingdom's (UK's) decision to leave the European Union ('Brexit'), we interviewed 10 European citizens living in the UK about their sense of home, using interpretative phenomenological analysis (IPA). In our analysis, we identified themes of (1) having more than one home, (2) making and finding a new home, (3) being permanently different from the non-migrant population and (4) a concern about feeling safe and welcome. Migration and sense of home involved building and rebuilding personal and social identity. Making a new home was effortful, and neither the old home nor the difference from the native population ever disappeared psychologically. This adds an experiential aspect to the idea of 'integration' in acculturation. Different notions of home were linked to different experiences of the impact of the Brexit referendum. We discuss the connections between acculturation, sense of home and lived experience and propose lived identity as a fruitful subject matter for social psychology.

Associations of role, area deprivation index, and race with health behaviors and body mass index among localized prostate cancer patients and their partners

PURPOSE

To examine the associations of role (localized prostate cancer (PCa) patient vs. their intimate partner), area deprivation index (ADI-higher scores indicating higher neighborhood deprivation levels), and race (Black/African American (AA) vs. White) with health behaviors and body mass index (BMI) among PCa patients and partners. The behaviors include smoking, alcohol consumption, diet quality, sedentary behaviors, and physical activity (PA).

METHODS

This study used the baseline data collected in a clinical trial. Given the nested structure of the dyadic data, multi-level models were used.

RESULTS

Significant role-race interaction effects on smoking, ADI-race effects on alcohol consumption, and role-ADI effects on BMI were found. Meanwhile, patients smoked more cigarettes, decreased alcohol consumption, had less healthful diets, spent longer time watching TV, did fewer sedentary hobbies, had more confidence in PA, and had higher BMIs than their partners. High ADI was independently associated with lower odds of drinking alcohol, using computer/Internet, and doing non-walking PA, and higher BMI compared to low ADI controlling for role and race. Black/AA dyads had less smoking amount and alcohol consumption and higher sedentary time and BMI than White dyads when adjusted for role and ADI.

CONCLUSIONS

This study identified significant interaction and main effects of role, ADI, or race on health behaviors and BMI.

IMPLICATIONS FOR CANCER SURVIVORS

Future behavioral interventions should address divergent individual needs between patients and partners, social and neighborhood barriers, and cultural indicators of racial groups to promote healthful behaviors and improve the quality of survivorship for PCa patients and partners.

Discrimination, gender dysphoria, drinking to cope, and alcohol harms in the UK trans and non-binary community

Transgender (trans) and non-binary people may be at increased risk of alcohol harms, but little is known about motives for drinking in this community. This study explored the relationship between risk of alcohol dependence, experience of alcohol harms, drinking motives, dysphoria, and discrimination within a United Kingdom sample of trans and non-binary people with a lifetime history of alcohol use. A cross-sectional survey was co-produced with community stakeholders and administered to a purposive sample of trans and non-binary people from 1 February until 31 March 2022. A total of 462 respondents were included-159 identified as non-binary and/or genderqueer (identities outside the man/woman binary), 135 solely as women, 63 solely as men, 15 as another gender identity, 90 selected multiple identities. Higher levels of reported discrimination were associated with higher risk of dependence and more reported harms from drinking. Coping motives, enhancement motives, and drinking to manage dysphoria were associated with higher Alcohol Use Disorders Identification Test scores. Social, coping, and enhancement motives alongside discrimination and drinking to have sex were associated with harms. The relationship between discrimination and risk of dependence was mediated by coping motives and drinking to manage dysphoria. Further to these associations, we suggest that reducing discrimination against trans and non-binary communities might reduce alcohol harms in this population. Interventions should target enhancement motives, coping motives and gender dysphoria. Social and enhancement functions of alcohol could be replaced by alcohol free supportive social spaces.

Very small effects of an imagery-based randomised trial to promote adherence to wearing face coverings during the COVID-19 pandemic and identification of future intervention targets

OBJECTIVE

Mental imagery interventions are a cost-effective way of promoting health behaviour change. We tested a mental imagery intervention designed to promote adherence to wearing face coverings during the COVID-19 pandemic.Design: A four-arm randomised controlled trial to explore potential mechanisms of action. Main outcome measures: Measures of behaviour (frequency of self-reported face covering adherence), theory of planned behaviour constructs (i.e. intention, attitudes, subjective norms, and perceived behavioural control), personality traits, imagery ability and barrier self-efficacy were measured at baseline (T1). Behaviour was also assessed at four-week follow-up (T2).Results: Of 297 participants, a majority always wore face coverings (N = 216, 73% overall sample). Logistic regression analyses revealed no intervention effects on changes in adherence to wearing face coverings, though T1 wearing of face coverings and being male predicted T2 behaviour. Subgroup analysis of participants self-reporting 'suboptimal T1 adherence, revealed that T2 non-adherence was predicted by being a non-student and by subjective norms and lower T1 intention to wear face coverings.Conclusion: Imagery-based interventions to increase face covering wearing adherence may exert significant public health effects but only when conducted on a very large scale. Our findings suggest that interventions should target men and disrupt habitual past behaviour.

Impulsivity, masculine norms and patron pre-drinking levels in Queensland

Pre-drinking is a common practice for young people prior to entering a night-time entertainment precinct (NEP), and is associated with numerous harms, such as increased experience of physical aggression and drink driving. The relationship between both impulsivity traits such as negative urgency, positive urgency and sensation seeking and conformity to masculine norms, and number of pre-drinks remains under-researched. The current study aims to explore whether level of negative urgency, positive urgency, sensation seeking, or conformity to masculine norms is associated with the number of pre-drinks consumed prior to entering a NEP. Participants included patrons aged under 30 years that were systematically selected for street surveys in Fortitude Valley and West End NEPs, Brisbane, Australia; and completed a follow-up survey in the week following (n = 312). Generalized structural equation modelling was used to fit five separate models with a negative binomial regression using a log link function, adjusting for age and sex. Postestimation tests were conducted to identify any indirect effects via an association between pre-drinking and enhancement motives. The standard errors were bootstrapped for the indirect effects. We found direct effects for sensation seeking. Indirect effects were present for Playboy norms, Winning norms, positive urgency and sensation seeking. While these findings provide some evidence that impulsivity traits can influence the number of pre-drinks an individual consumes, the findings suggest that some traits are more likely to be related to overall alcohol consumption and that pre-drinking is a unique type of alcohol consumption with distinct predictors that require further investigation.

'Some days I am a lunatic that thinks I can moderate': Amalgamating recovery and neo-liberal discourses within accounts of non-drinking among women active in the 'positive sobriety' community on Instagram in the UK

BACKGROUND

In recent years, reductions in drinking in the UK and the rise of online 'positive' sobriety communities have been observed, yet peer led support groups such as Alcoholics Anonymous (AA) and neo-liberal discourses of control and responsibility dominate public understandings of (problematic) alcohol use. This paper presents research exploring how women active in the 'positive sobriety' community on Instagram position and construct their non-drinking identities and relationships with alcohol within these overlapping discourses.

METHODS

Semi-structured interviews (n=15) and online content produced by women active in the positive sobriety community on Instagram were analysed using thematic analysis.

FINDINGS

Women challenged, reproduced and amalgamated AA discourses of addiction, and the broader discourses of neo-liberalism, in ways that positioned (alcohol) consumption, agency, control and individual responsibility as defining features of feminine identity making. Drawing on these discourses, binary understandings of problematic drinking, the identity of the 'alcoholic', and the need to reach 'rock bottom' in the recovery process were rejected and challenged, but at times reproduced. Whilst a broader framing of problematic drinking that situated drinking problems on a spectrum was constructed, abstinence was engaged with and promoted as the most effective way of gaining control and responsibility over drinking in gendered ways, and in establishing an authentic sense of self.

CONCLUSION

This paper contributes to emerging research on online 'positive' sobriety communities, their gendered nature, and the intertwined presence of traditional recovery and neo-liberal discourses in women's accounts. Online sober communities offered alternative spaces of support and allowed for sobriety and sober femininities to be framed more positively than within traditional AA conceptualisations. However, those involved may experience tensions around (a) the need to 'tell' their personal stories of complete abstinence whilst still appealing to those who seek to 'moderate' and (b) the pressure to create and craft an 'authentic' sober self on an online platform that demands a carefully curated self-image and personal 'brand'. Further research should aim to gain more understanding of the role social media plays in "doing" sobriety and non-drinking, how this is done by people of different genders, the intersectional experiences of those participating, and how these communities can be made more equally available and accessible to those who do not consider full abstinence as necessary, whilst still appealing to those that do.

The hammer and the nail: The triple lock of methods, realities and institutional contexts in Australian research on nightlife violence

There is considerable public and policy debate in Australia about measures to reduce violence associated with alcohol and young people in the night-time economy. Though overrepresented in violence, the role of men and masculinities is rarely explicitly addressed in policy responses to such violence, which rest on a narrow range of mainly quantitative research and recommendations favouring blanket alcohol restrictions. Drawing on John Law and colleagues' account of the 'double social life of methods' (2011), we analyse interviews conducted with Australian quantitative researchers about the role of gender in such violence. According to Law et al., methods inhabit and reproduce particular ecologies and reflect the concerns of those who advocate them. From this 'triple lock' of methods, realities, and institutional advocacies and contexts emerges particular modes of knowing. Participants described a research ecology in which the authority of quantitative research methods emerged in relation to an imperative to respond in a 'timely' and 'pragmatic' fashion to public policy debates, and prevailing governmental and policy priorities and public framings of violence. Though participants frequently acknowledged the role of men in violence, these arrangements sustain taken-for-granted assumptions about the properties and effects of alcohol while displacing men and masculinities from policy attention. The political consequences of these arrangements demand the development of innovative policy responses and new modes of knowing that make visible the gendering of violence.

Doing gender, doing alcohol: The paradox of gendered drinking practices among young Nigerians

Previous research on alcohol and gender identity constructions has primarily focused on Western countries. Studies from non-Western contexts can make crucial contributions to understandings of the impact of social constructions of masculinities and femininities on drinking behaviours and health. In traditional Nigeria, consumption norms prohibited women's and young people's alcohol use. Nowadays, young men and women use alcohol, and many enact identities with heavy drinking. This study uses gender performance theory and interviews/focus group data from 72 young Nigerian men and women to explore their masculinity performance and resistance to traditional femininity codes through drinking practices. Profiling women as vulnerable agents and the only gender that provides care and affective labour, most men reinscribed the consumption norms proscribing women's drinking while some recommended sweetened or flavour brands for women. Citing gender equality and criticizing/resisting local norms, the women argued that alcohol consumption should not be the prerogative of men. The men used competitive heavy drinking rituals and drunkenness to enact masculinity. Most of the women constructed counter-traditional/normative femininity with heavy drinking bouts, while others, who maintained the traditional femininity to avoid stigmatization, enacted secret, or solitary drinking with potential health impacts. The findings demonstrate how distinct social norms promote socio-structural constraints and power relations that suppress women's agency and encourage gender inequality with potential health impacts.

Illicit drug use and male barroom aggression among members of the Australian construction industry: Associations with personality and masculinity factors

Introduction

Illicit drug use has been found to increase the risks of male barroom aggression (MBA). Personality traits such as dispositional aggressiveness have been associated with illicit substance use and aggressive behaviour, along with social normative masculinity factors. The present study assessed the relationships between illicit drug use, key personality (trait aggression, impulsivity, narcissism) and masculinity (conformity to masculine norms, male honour) variables with physical MBA perpetration and victimisation among male Australian construction workers.

Methods

A purposive, high‐risk sample of male construction workers aged 18–69 years (n = 476, M_age = 25.90 years, SD_age = 9.44) completed interviews at their place of work or training.

Results

Participants reported high rates of both physical MBA perpetration (21%; n = 100) and victimisation (31.1%; n = 148) as well as any illicit drug use (33.61%; n = 160). Logistic regressions revealed the use of amphetamine‐type stimulants (methamphetamine, ecstasy) was associated with violence perpetration, even after accounting for high‐intensity drinking (HID) which was the strongest predictor of MBA involvement. Trait variables (Trait Physical aggressiveness, narcissism) and the masculine norm CMNI Violence were also risk factors for MBA perpetration while CMNI Playboy was protective against MBA.

Discussion and Conclusions

The use of amphetamine‐type stimulants is a risk‐factor for MBA perpetration, as are key personality traits such as aggressiveness and narcissism. Most aspects of masculinity, including male honour, were either unrelated to or protective against involvement in physical violence in bars, clubs or pubs.

Understanding autonomy and relationality in men's lives

Masculinities scholarship tends toward describing autonomy as bound up with hegemonic masculine ideals such as independence, atomization, and self-sufficiency, without fully delving into the concept of autonomy. This article offers a more in-depth conceptual treatment of autonomy, compared to its more simplified rendering in the literature on the dominant relational conceptualizations of masculinities. In doing so, we follow recent calls to avoid categorizing men according to typologies of masculinity, drawing instead on feminist theorizations of masculine autonomy and relationality to explore how both manifest in men's lives. We draw on a study of men's drinking practices, with our data coming from focus groups with 101 men in metropolitan and regional/rural Victoria, Australia; but the issues we attend to have relevance, and can be an impetus, for further scholarly thinking about autonomy in men's lives well beyond drinking practices, and in other similar industrialized nations. We explore how masculine autonomy remains an influential and harmful discourse, often impeding possibilities for men's greater intimacy, connection and care and reproducing gendered hierarchies. However, we simultaneously highlight how men are inescapably relationally situated, exposing masculine autonomy as a discursive ideal of valorized forms of masculinity rather than an achievable state in practice. We argue that acknowledging how men are relationally embedded and interdependent in practice offers potential avenues for further fostering men's care, intimacy and relationality, and might work toward ameliorating gendered inequalities that see care work and the work of sustaining relational networks disproportionately falling to women and marginalized men.

Correlates and Effects of Alcohol Use Expectancies Among Persons Living with HIV in Uganda

Unhealthy alcohol use fuels difficulties with HIV disease management and potentiates secondary transmission of HIV but less is known about how these alcohol use expectancies may shape alcohol use behaviors, particularly in the presence of depressive symptomatology. In this paper, we utilize data from a prospective study of 208 people living with HIV in Southwest Uganda, to examine the correlates of alcohol use expectancies and their association with unhealthy alcohol use. Affective depressive symptoms were positively associated with alcohol use expectancies. Gender moderation was observed such that depression was more strongly associated with alcohol use expectancies among women. In unadjusted analyses, alcohol use expectancies were marginally associated with unhealthy alcohol use and this association was not significant in adjusted analyses. Findings underscore the need to strengthen screening for depression and alcohol use within HIV care services, particularly among women.

Heavy drinking as phenomenon: gender and agency in accounts of men's heavy drinking

Alcohol consumption is a significant public health concern in Australia, with men disproportionately represented in treatment for health issues related to heavy drinking. Despite this, little is known about the experiences of these men or the gender dynamics that may shape heavy drinking. Increasingly, the treatment of alcohol and other drug-related issues, including those related to heavy drinking, is based on a biopsychosocial approach. Within this framework, heavy drinking is understood as a symptom of individual pathology in the context of various social 'factors' that influence individual capacity to exercise agency. Following the work of Karen Barad, this article employs a feminist science studies account of agency to formulate heavy drinking as a gendered 'phenomenon': enacted and sustained through the 'intra-action' of other phenomena. Drawing on interviews with men who drink heavily, our analysis explores how the phenomenon of men's heavy drinking materialises through the intra-actions of gender, isolation and healthcare. We argue that heavy drinking is not a sign of failed individual agency but an expression of entangled agencies. In concluding, we suggest it is possible to enhance the well-being of men who drink heavily by addressing specific gendered intra-actions in the making of heavy drinking.

Hospitalization due to mental and behavioral disorders caused by use of alcohol and psychoactive substances among older adults and elderly people in Brazil: a cross-sectional study

BACKGROUND

It has been estimated that 17% of individuals aged 50 years or older suffer from addiction to legal or illegal drugs. Use of alcohol and psychoactive substances has been correlated with several diseases, e.g. psychiatric conditions and cardiovascular and sexual dysfunctions.

OBJECTIVE

To discuss the Brazilian profile of mental and behavioral disorders caused by use of alcohol and psychoactive substances among older adults and elderly people, over the period from 2008 to 2019.

DESIGN AND SETTING

Cross-sectional study conducted among Brazilians aged 50 years or older.

METHODS

Hospitalization due to mental and behavioral disorders caused by use of alcohol and psychoactive substances was assessed through data obtained from the National Health System Department of Informatics (Departamento de Informática do Sistema Único de Saúde, DATASUS).

RESULTS

Decreasing and steady trends of hospitalization due to mental and behavioral disorders caused by use of alcohol among both men and women at all ages were observed. Similar trends were reported for all age ranges among men and women aged 60 years and older. In contrast, a slight increase was seen among women aged 50 to 59 years.

CONCLUSION

These data are crucial for qualifying mental healthcare for older adults and elderly people and for planning mental health services.

“Alcohol is life, it’s part of us”: Examining the Everyday Experiences of Alcohol Use in Botswana

Efforts to control and regulate alcohol has recently gained steam in Botswana. Inspired by a public health perspective, the government of Botswana has recently increased the alcohol tax levy, reduced the hours of operation for bars and increased penalties for alcohol-related offences to control alcohol-related harm. While these reforms have been central to policymaking, and caused some controversy, not much is known about the everyday experiences of alcohol consumers in Botswana. Drawing from semi-structured interviews (n = 40) collected amongst drinkers over a five-year period, this paper examines the everyday use of alcohol in Botswana. The analysis demonstrates that alcohol use constitutes an important part of leisure and night-time economy (NTE) activities in Botswana. It is a functional social activity that is used by people to take time away from the routines and pressures of daily life. More importantly, it is pleasurable to people, enhances sociability, and partaken as a form of transaction between men and women in bars. There is need for policy makers to consider the embodied experiences of alcohol use when designing alcohol interventions in Botswana.

'I just drink to feel abnormal for some time': Reconfiguring heavy drinking and intoxication as pleasurable

BACKGROUND

The sociocultural norms moderating alcohol consumption in Nigeria were more permissive for men than women in the traditional era. Alcohol use among young people was taboo, and intoxication among men who occupy drinking spaces was punished. In contemporary Nigeria, heavy drinking and the 'culture of intoxication' are reified features of some young people's leisure lives.

METHODS

Drawing on the intersections of pleasure and intoxication, this study explores the interplay between deliberate heavy drinking and the positioning of intoxication experiences as pleasurable. We conducted 53 semi-structured interviews and 3 focus groups (N = 26) with 18-24-year-old youths in Benin City, Southern Nigeria.

RESULTS

Participants deliberately pursued heavy drinking and intoxication to experience 'altered bodily effects', to know the feelings of intoxication, and to master extreme drinking levels. Other explanations given for 'determined drunkenness' included fun and excitement. Participants sought pleasurable experiences of drinking through repeated deliberate drunkenness or by taking large quantities of spirits. 'Loss of control' experiences were described as fun and exciting, and participants laughed when friends showed them videos of their 'passing out' experiences. Gendered alcohol 'providing' rituals in peer networks that facilitated intoxication and loss of consciousness were used to enact friendships. Providing drinks for friends and consuming large quantities conferred a higher status on the buyer and drinker, respectively. Friendship networks performed double-edged roles by instigating heavy drinking and providing care for inebriated members.

CONCLUSION

The emerging drinking culture in Nigeria suggests that the cultural prohibitionist approach to young people's drinking should be reconsidered. Policymakers should implement public health interventions that promote low-risk drinking practices to mitigate the risks of heavy drinking and intoxication.

Assessing motivations and gender as factors in college students' views of nonmedical prescription stimulant use

Introduction: Two prominent motivation categories of college student nonmedical prescription stimulant use (NMUPS) are for academic and recreational purposes. However, little research focuses on these motivations' association with college students' NMUPS views. Further, limited research assesses if user gender influences views. Methods: The current online scenario study implemented a 2 × 2 factorial design assessing 148 college undergraduates' (75% females; M_age = 19.18; SD_age = 1.30) NMUPS views based on user motivation and gender. Participants reported their drug use stigmatization, prescription stimulant expectancies (ie, anticipated drug use beliefs and outcomes), and personal substance use. Results and Discussion: Results showed that user gender did not influence participants' NMUPS views; however, participants viewed academic use less negatively compared to recreational use, thus highlighting the need to educate students on the negative consequences of NMUPS, even when use is for academically related tasks. Furthermore, exploratory analyses showed drug use stigmatization and prescription stimulant expectancies predicted participant NMUPS views.Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2021.1942005.

Disclosures of harming others during their most recent drinking session: Findings from a large national study of heavy-drinking adolescents

INTRODUCTION

The extant Alcohol's Harms to Others (AHTO) literature is largely comprised of reports from victims. We investigated AHTO from perpetrators' perspectives, including how harms were associated with individual characteristics, and alcohol quantities consumed during the perpetration incident.

METHODS

Participants (N = 2932) were 14-19 years old, recruited primarily through social media and screened as risky drinkers. They completed face-to-face (n = 594) or self-administered (n = 2338) surveys. They self-reported whether during their last risky drinking session (LRDS) they had perpetrated any verbal abuse, physical abuse or property damage. A multinomial logistic regression examined whether nine factors were associated with perpetrating zero, one or 2+ categories of AHTO.

RESULTS

Eleven percent (n = 323) reported perpetrating at least one form of AHTO (7.5% verbal, 1.9% physical and 4.6% property). Perpetration of AHTO at LRDS was uniquely associated with: younger age, male gender, experiences of childhood physical punishment, greater perpetration incident-specific drinking, concurrent illicit drug use, and less frequent use of safety strategies while drinking in the past 12 months. Controlling for the other variables, an increase of six Australian standard drinks (60 g of alcohol) increased the odds of perpetration by 15% [95% confidence interval (CI) adjusted odds ratio (AOR) 1.08, 1.23], and an increase of 15 Australian standard drinks increased the odds by 42% (95% CI AOR 1.20, 1.69).

DISCUSSION AND CONCLUSIONS

Individual characteristics, larger quantities of alcohol consumed, and a disinclination to practice harm reduction amplified risk of AHTO perpetration. This has implications for health promotion and risk prevention/reduction strategies.

Masculinity and misinformation: Social dynamics of liver fluke infection risk in Thailand

Liver fluke infection through the consumption of raw or undercooked freshwater fish is a major public health problem in the Mekong Region. Despite the extensive efforts of liver fluke health campaigns, Northeast Thailand still reports high human infection prevalence as consumption of raw fish dishes has diminished but not ceased. This study examines the roles of social-cultural factors, particularly the influences of masculinity and misinformation, on liver fluke infection risk. Participant observation, questionnaire surveys and semi-structured interviews were conducted in four villages in Kalasin Province, Thailand, to scrutinize reasons for raw fish consumption, gender differences in raw fish culture, processes of liver fluke information dissemination, and the extent of information mismatch. Our results show that one of the key reasons (76.9%) underlying continued raw fish consumption are deeply embedded cultural practices associated with ways of rural life. About 30% of the participants indicated that they would not avoid eating raw fish, regardless of knowing the health consequences. Gender difference is evident, with 75.6% of males consuming raw fish salad (koi pla), compared to 42.7% of females. Some male participants associate raw meat consumption with virility and strength. Such beliefs underscore the cultural linkage of koi pla consumption with masculinity. Misconceptions of liver fluke life cycle and risk of infection remain, as only 15.3% of the participants correctly selected raw fish as the food source for liver fluke infection while 84.2% misunderstood that other raw foods could lead to infection. The multi-layered and hierarchical structure of public health information dissemination from medical professionals to health officers and village health volunteers to villagers has contributed to information mismatch between different layers. Our study builds on others which call for multi-pronged scientific and social strategies, as well as culturally attuned approaches to public health messaging. The study raises masculinity and misinformation as relevant considerations in disease prevention. Incorporating grounded research and gendered perspectives are part of appreciating the cultural roots of raw fish consumption. Realizing the significant role of village health volunteers in information dissemination and in supplying coherent public health messages is vital for effective health campaigns.

Gender gap in cancer prevention and mortality. A multidimensional analysis

BACKGROUND

During 2015 in Poland, male-to-female ratio in age-adjusted cancer mortality rate amounted to 1.83, which is close to that observed in 1990 (1.94) and considerably more than in 1965 (1.38).

DATA AND METHODS

Nearest-neighbor matching and latent class model were estimated to assess gender gap in cancer prevention in 2006 and 2014. The analysis is based on nationally representative data from a two-wave survey carried out on a stratified random sample of n=7991+8079 adults.

RESULTS

Even when controlling for socio-demographic characteristics, health status, and basic knowledge of cancer, three behavioral health characteristics are dramatically lower in men: uptake of preventive health care (ATE of -0.106), perceived caring for own health (-0.070), and fruit and vegetable intake (-0.034). Between 2006 and 2014 the gender gap in uptake of preventive health care and perceived caring for own health had increased, particularly in individuals aged over 40. The adjusted difference in leisure-time physical activity between men and women is near the significance threshold in individuals aged over 40.

CONCLUSION

The gender differences are higher for the behavioral component of cancer prevention than cognitive domains. Without modifying behavioral risk factors, gender gap in cancer mortality is not expected to close.

Masculinity beliefs and willingness to seek help among young men in the United Kingdom and Pakistan

Health-related behaviors including help-seeking are related to men's felt and perceived masculinity. This study explored whether findings from studies of links between masculinity and health-related behavior in developed 'western' contexts applied in the more strongly patriarchal cultural context of Pakistan. Online questionnaires were completed by male university students aged 17-30: 307 in Pakistan and 105 in the United Kingdom. Analyses revealed that compared to British men, Pakistani respondents had less egalitarian beliefs about gender relations, gave more importance to their own masculinity, considered non-traditional behaviors to have greater negative implications for men's masculinity, and were less willing to seek help. Among Pakistani men, lower willingness to seek help for physical and mental health was predicted by having less egalitarian gender beliefs, giving greater importance to personal masculinity, and considering non-traditional behaviors to have greater negative implications for men's masculinity. Among British men, greater perceived masculinity of help seeking predicted help seeking for physical concerns, and less importance of personal masculinity predicted help seeking for mental health. The results highlight a need for sensitivity to men's gender identity concerns when providing and encouraging use of health care, and to be aware of how cultural norms shape individuals' beliefs and behavior.

A gender-sensitised weight-loss and healthy living program for men with overweight and obesity in Australian Football League settings (Aussie-FIT): A pilot randomised controlled trial

BACKGROUND

Recent evidence shows that sport settings can act as a powerful draw to engage men in weight loss. The primary objective of this pilot study was to test the feasibility of delivering and to evaluate preliminary efficacy of Aussie-FIT, a weight-loss program for men with overweight/obesity delivered in Australian Football League (AFL) settings, in preparation for a future definitive trial.

METHODS AND FINDINGS

This 6-month pilot trial took place in Perth, Australia. Participants were overweight/obese (Body Mass Index [BMI] ≥ 28 kg/m2), middle-aged (35-65 years old) men. Participants were recruited in May 2018, and the intervention took place between June and December 2018. The intervention involved 12 weekly 90-min face-to-face sessions, incorporating physical activity, nutrition, and behaviour change information and practical activities delivered by coaches at 2 clubs. Data were collected at baseline and immediately postintervention. For trial feasibility purposes, 6-month follow-ups were completed. Outcomes were differences in weight loss (primary outcome) and recruitment and retention rates, self-reported measures (for example, psychological well-being), device-measured physical activity, waist size, and blood pressure at 3 months. Within 3 days of advertising at each club, 426 men registered interest; 306 (72%) were eligible. Men were selected on a first-come first-served basis (n = 130; M age = 45.8, SD = 8; M BMI = 34.48 kg/m2, SD = 4.87) and randomised by a blinded researcher. Trial retention was 86% and 63% at 3- and 6-month follow-ups (respectively). No adverse events were reported. At 3 months, mean difference in weight between groups, adjusted for baseline weight and group, was 3.3 kg (95% CI 1.9, 4.8) in favour of the intervention group (p < 0.001). The intervention group's moderate-to-vigorous physical activity (MVPA) was higher than the control group by 8.54 min/day (95% CI 1.37, 15.71, p = 0.02). MVPA among men attracted to Aussie-FIT was high at baseline (intervention arm 35.61 min/day, control arm 38.38 min/day), which may have limited the scope for improvement.

CONCLUSIONS

Aussie-FIT was feasible to deliver; participants increased physical activity, decreased weight, and reported improvements in other outcomes. Issues with retention were a limitation of this trial. In a future, fully powered randomised controlled trial (RCT), retention could be improved by conducting assessments outside of holiday seasons.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry: ACTRN12617000515392.

Enacting alcohol realities: gendering practices in Australian studies on 'alcohol-related presentations' to emergency departments

'Alcohol-fuelled violence' and its prevention has been the subject of recent intense policy debate in Australia, with the content of this debate informed by a surprisingly narrow range of research resources. In particular, given the well-established relationship between masculinities and violence, the meagre attention paid to the role of gender in alcohol research and policy recommendations stands out as a critical issue. In this article, which draws on recent work in feminist science studies and science and technology studies, we focus on the treatment of gender, alcohol and violence in Australian research on 'alcohol-related presentations' to emergency departments (EDs), analysing this type of research because of its prominence in policy debates. We focus on four types of 'gendering practice' through which research genders 'alcohol-related presentations' to EDs: omitting gender from consideration, ignoring clearly gendered data when making gender-neutral policy recommendations, methodologically designing out gender and addressing gender in terms of risk and vulnerability. We argue that ED research practices and their policy recommendations reproduce normative understandings of alcohol's effects and of the operations of gender in social arrangements, thereby contributing to the 'evidence base' supporting unfair policy responses.

Protective behavioral strategies and alcohol-related outcomes: The moderating effects of drinking refusal self-efficacy and sex

The investigation of drinking refusal self-efficacy and alcohol protective behavioral strategies (PBSA) has revealed inconsistent results. Sex may be one factor that plays a role in these results given the demonstrable differences between the alcohol use behaviors of men and women. The current study examined the moderating effects of drinking refusal self-efficacy and sex on the relationships that PBSA subtypes have with alcohol outcomes for traditional age undergraduate students (18-25 years of age; 81% women; 60% White). Results showed negative associations between manner of drinking PBSA and alcohol consumption for individuals with high levels of drinking refusal self-efficacy but not low levels of drinking refusal self-efficacy. However, manner of drinking PBSA was positively associated with alcohol-related negative consequences for men but not for women. Results also showed negative associations between stopping and limiting drinking PBSA and alcohol related negative consequences for individuals with high levels of drinking refusal self-efficacy but not low levels of drinking refusal self-efficacy. It appears that addressing drinking refusal self-efficacy within the context of PBSA is valuable for traditional college students.

'I don't think there are great sex differences there': Processes of discursive bridging and othering in a discussion of gendered norms related to alcohol, sexual behaviour, and aggression

BACKGROUND

Existing research indicates that sexual behaviour and aggression are particularly important to the reproduction of gendered drinking norms, both in the media and in face-to-face interaction. However, research has yet to understand in more detail the discursive processes whereby actors negotiate gendered norms related to alcohol, sexual behaviour, and aggression. This article examines how actors make symbolic distinctions between themselves and others in discussing alcohol, aggression, and sexual desire, and analyses the similarities and differences within and across gender that they identify in this process.

METHODS

The study relies on individual qualitative interviews with 25 Swedish women and men. To elicit participants' normative positions, we used a newspaper article as a probe during the interviews.

RESULTS

Findings show that participants highlight similarities between women and men, and variation and individual differences among men and among women in discussing alcohol's effects on sexual desire and 'sexually active behaviour'. Differences, by contrast, are most salient when they discuss alcohol and aggression and seek to distance themselves from 'shabby bar men', rural men, and male football hooligans who drink and fight, outgroups that are marked as working-class in the participants' narratives.

CONCLUSION

Two general discursive patterns were identified: discursive bridging across gender and discursive othering across class. For the participants, drinking norms are not as much about general gender differences as they are about the 'dysfunctional' drinking of certain groups of working-class men. These findings contribute to a more specific understanding of the reconstitution of gender boundaries in relation to drinking norms.

Young men's alcohol consumption experiences and performances of masculinity

BACKGROUND

By creating a dichotomy between those who are 'out-of-control' 'binge drinkers' and those for whom alcohol contributes to friendship fun, academic and alcohol policy literature often fail to acknowledge the nuances in the diverse drinking practices of men.

METHODS

This paper engages with findings from a multiple qualitative method research project (comprising of individual and friendship group interviews; diaries; and participant observation), conducted with 16 young men, aged 15-24: eight living in the middle-class area of Chorlton, and eight living in the working-class area of Wythenshawe, Manchester, United Kingdom.

RESULTS

This paper provides fine-grained insights into the doings, complexities and contradictions of masculinity in the context of drinking. Young men are shown to tap into different co-existing versions of masculinity, one of which is based on the exclusion of femininity (i.e. they act as tough guys), while another version is more inclusive (i.e. it allows for displays of care).

CONCLUSION

This paper shows a much more complex image of young men's drinking practices than has hitherto been conceptualised in the existing literature, and brings to the fore doings of alternative masculinities. This has important implications for alcohol policy interventions targeting men, in that the complexities and contradictions of masculinity in relation to drinking must be taken seriously.

"Don't Drink Too Much!" Reactance Among Young Men Following Health-Related Social Control

This study investigated conditions under which young men responded with reactance to the suggestion to reduce their alcohol consumption. In an experimental study, 84 young men (university students, mean age: 24 years) listened to a recorded telephone call and were asked to imagine that they themselves were the recipients of this call. In this call, either a girlfriend or a male friend suggested that the recipient of the call should reduce his alcohol intake that evening. In one condition, the suggestion was highly restrictive; in the other condition, the suggestion was framed in a nonrestrictive way. Perceived threat, negative thoughts, and feelings of anger after listening to the call were assessed. Further outcome variables were intention and perceived probability of complying with the suggestion. Participants felt more anger after hearing the highly restrictive suggestion and more threatened by the suggestion made by the girlfriend. Interaction effects emerged. Participants reported more negative thoughts and lower intention and perceived probability to comply when a highly restrictive suggestion was made by the girlfriend. The male friend’s highly restrictive suggestion resulted in a perceived probability of complying (54%) that was similar to the probability of the girlfriend’s nonrestrictive suggestion (55%). Women’s efforts to reduce their male partners’ alcohol consumption can result in boomerang effects. Male peers might be more effective in motivating other men to behave in a healthier way. These results support recent findings with regard to the potential of peer positive social control.

Young men's body dissatisfaction: A qualitative analysis of anonymous online accounts

Associated with numerous adverse health outcomes, body dissatisfaction in young men requires close examination. This study explores online accounts relating to male body image, including young men's personal disclosures within one online newspaper article, and posts responding to this topic. Discursively informed thematic analysis indicated that non-disclosure was considered a problematic social expectation by the young men featured in the article. Also, reader posts variously constructed body dissatisfaction as a symptom of adolescence, a lack of self-care and an incapacity to capitalise on compensatory qualities. Our analysis suggests young men may welcome safe opportunities to critically discuss prevailing body image ideals.

Understanding drinking among midlife men in the United Kingdom: A systematic review of qualitative studies

OBJECTIVES

This study reviews qualitative research into the sociocultural meanings and subjective experiences that midlife men in the United Kingdom (UK) associate with their drinking. In the UK, average weekly alcohol consumption is highest among midlife men, and they are disproportionately affected by alcohol harm. There is increasing recognition that public health messages to support behaviour change must be based on an in-depth understanding of drinking motivations and experiences.

STUDY DESIGN AND METHODS

Systematic literature review of studies exploring motivations for and experiences of drinking among UK men aged 45-60 using qualitative methodology. Medline, PsycINFO and the Social Science Citation Index were used, along with manual searches of key journals, Google searches and a call for evidence. The Critical Appraisal Skills Programme tool was used to quality-assess papers. Thematic synthesis was used to combine and analyse the data.

RESULTS

From 5172 titles and abstracts (1995-2018), 11 publications were included, representing 6 unique studies. Five themes were identified: 'Drinking Motivations'; 'Drinking Justifications'; 'Drinking Strategies and Control'; 'Social Norms and Identity' and 'Harm'. Motivations for drinking among midlife men were associated with relaxation, socialising and maintenance of male friendships. They justified drinking as a choice and emphasised their ability to meet responsibilities, which they contrasted with 'problem drinkers'. Social norms governed drinking behaviours as an expression of masculinity.

CONCLUSION

This review highlights the significance of the meanings and social importance of alcohol consumption among midlife men. Interventions using information and guidance should consider these when aiming to effectively influence the way this group drinks.

Protocol for a gender-sensitised weight loss and healthy living programme for overweight and obese men delivered in Australian football league settings (Aussie-FIT): A feasibility and pilot randomised controlled trial

INTRODUCTION

Overweight and obesity are highly prevalent among Australian men. Professional sports settings can act as a powerful 'hook' to engage men in weight loss programmes; the Football Fans in Training programme delivered in professional UK soccer clubs was successful and cost-effective in helping men lose weight. The Australian Football League (AFL) is a potentially attractive setting to engage men in a weight loss programme. We aim to develop, pilot and evaluate the feasibility of a weight loss intervention for overweight/obese middle-aged men, delivered in AFL settings, to promote weight loss and healthier lifestyles and determine its suitability for a future randomised control trial.

METHODS AND ANALYSIS

120 overweight/obese male fans will complete baseline physical and psychological health measures and objective measures of physical activity (PA), weight, waist size and blood pressure prior to randomisation into the intervention or waitlist comparison group. The intervention group will receive 12 weekly 90 min workshops incorporating PA, nutrition education, behaviour change techniques and principles of effective motivation. Four community coaches will be trained to deliver Aussie-FIT at two AFL clubs in Western Australia. Measurements will be repeated in both groups at 3 months (post-intervention) and 6 months (follow-up). Outcomes will include programme uptake, attendance, changes in lifestyle and weight variables to inform power calculations for a future definitive trial, fidelity of programme delivery, acceptability, satisfaction with the programme and perceptions of effectiveness. We will also determine trial feasibility and potential to gather cost-effectiveness data.

ETHICS AND DISSEMINATION

Ethics approval was granted by Curtin University's Human Research Ethics Committee (HREC2017-0458). Results will be disseminated via peer-reviewed publications, conference presentations and reports. A multicomponent dissemination strategy will include targeted translation and stakeholder engagement events to establish strategies for sustainability and policy change.

TRIAL REGISTRATION NUMBER

ACTRN12617000515392; Pre-results.

What Do Parents Want From Preschool? Perspectives of Low-Income Latino/a Immigrant Families

With a qualitative approach drawing from four focus groups, this study explored what aspects of preschool are valued most by 30 low-income Latino/a immigrant parents with children enrolled in a state-funded preschool program in Texas. Beyond the push and pull factors of necessity, convenience, and supply, parents reported valuing the responsiveness of schools to families' needs and concerns, the provision of a safe and developmentally appropriate environment, the role of preschool in both care and education, the incorporation of parents within the school, and the school's capacity for developing parents' human and navigational capital. Even though parents saw great value in preschool preparing their children for school and helping themselves as parents, there was also fear and mistrust in neighborhood schools that was rooted in discrimination and long-term educational inequality.

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.

Students Who Limit Their Drinking, as Recommended by National Guidelines, Are Stigmatized, Ostracized, or the Subject of Peer Pressure: Limiting Consumption Is All But Prohibited in a Culture of Intoxication

There is an unquestionable need to address drinking patterns in subcultures where excessive drinking is normative. Regulatory bodies advocate moderating alcohol consumption but it is unclear whether individuals have agency to do so, particularly when excessive consumption is the norm. This study aimed to address this gap by examining student’s perceptions of limiting consumption, as recommended by government guidelines, in one university in New Zealand. Using a qualitative social science approach, university students surveyed and interviewed their heavy-drinking peers (n = 201) to investigate perceptions of 3 drinking behaviors (Heavy, Moderation, and Abstinence). Thematic analysis revealed that students who drink heavily are labeled positively and viewed as sociable (Dr Froth, Liver of Steel, Trooper, Champion, Hero, Good Alcoholic, popular, a friend). Students who limit drinking, on the other hand, were viewed similar to those who abstain, labeled using explicit, emotive, and derogative terminology (eg, Fag, Vagina, Grandma, Weirdo, Coward, Killjoy) and excluded, ostracized, or the subject of peer pressure. They were also expected to provide a justification for moderating their drinking (eg, being an athlete, broke). Although individuals who moderated their consumption were perceived to have strong willpower and maturity (eg, self-aware, brave, sophisticated), these positive attributes were mentioned less frequently and involved less emotive language than were labels linking moderation to a negative social identity. The method employed in this study provided a frank insight into a student culture of intoxication and the barriers facing students who try to drink in moderation. Our findings reveal that limiting consumption, even occasionally, threatens students’ social identity and inclusion in the student drinking culture. These results suggest that individualistic harm minimization strategies are unlikely to be effective. Instead, the findings underscore the need to develop alternative cultures emphasizing extracurricular activities which may facilitate students’ agency to go against the norm and moderate their drinking.

Negative Experiences of Non-Drinking College Students in Great Britain: an Interpretative Phenomenological Analysis

Research relating to alcohol use amongst university students primarily examines the effects of binge drinking. Researchers rarely focus on a range of drinking styles including light or non-drinking. This study was designed to gain an in-depth understanding of the lived experiences of female, first year UK undergraduates, who do not drink alcohol. Semi-structured interviews were conducted with eight participants. Narratives were analysed using interpretative phenomenological analysis (IPA; by Smith and Osborn (Sage 51-80, 2003). Three superordinate themes were identified: “managing the feeling that you don’t belong” highlights the importance of managing social interactions as a non-drinker; “experiencing social exclusion” recognises the impact on social bonding as a result of insufficient socialising opportunities; and “experiencing peer pressure and social stigma” highlights the scrutiny and labelling participants endured. These findings provide an understanding of some of the difficulties experienced by these undergraduates as a result of their non-drinking status. Implications of this research are discussed and areas for future research are outlined.

"I Wouldn't Be Friends with Someone If They Were Liking Too Much Rubbish": A Qualitative Study of Alcohol Brands, Youth Identity and Social Media

The consumption of alcohol by young people remains a major public health concern at both the national and international level. Levels of drinking among 15-yearolds in the United Kingdom (UK) remain significantly higher than the European average. This study explored how alcohol brands are used by young people to develop their desired identities and how these acts of consumption extend to young people's profiles on social media. It also deepens understanding of how alcohol brands are connected to young peoples' concerns about image and peer group dynamics. This involved qualitative focus groups with young people aged 14-17 in Central Scotland. Certain alcohol brands were approved and viewed as socially acceptable by young people, while others were rejected. Children as young as 14 were selecting products to portray a drinking identity that was appropriately aligned to their gender and sexuality. Participants displayed a desire to associate themselves with the mature drinking culture personified by some brands, whilst simultaneously distancing themselves from immature drinking practices associated with others. Publicly associating with alcohol brands on social media carried with it potential risks to peer group acceptance. Understanding how young people perceive alcohol brands, the importance of social media in communicating that identity to their peers and the role that alcohol brands play in adolescent identity formation is an important first step to reforming alcohol marketing regulations.

Drinking to the “edge”: gender differences in context-specific risks

Purpose

The risk associated with heavy episodic drinking in young people has caused concern among public health professionals. The purpose of this paper is to investigate the gender differences in the perception of risk in alcohol consumption behaviour for better targeting of messages.

Design/methodology/approach

This qualitative descriptive study examines the narratives of 28 young people’s experience of a “night out” framed as the Alcohol Consumption Journey to examine the ways young men and women experience context-specific risks for alcohol use.

Findings

The young people perceived participation in the Alcohol Consumption Journey involved risk to their personal safety. Both young men and young women described their alcohol consumption as controlled and perceived the risks as external inevitabilities linked to the public drinking establishments. However, they displayed noticeable gender-based differences in the perception and management of risk in diverse contexts of the Alcohol Consumption Journey. Young women drink in close friendship groups and have a collective view of risk and constructed group strategies to minimise it. Comparatively, the young men’s drinking group is more changeable and adopted a more individualistic approach to managing risk. Both groups exhibited prosocial tendencies to protect themselves and their friends when socialising together.

Originality/value

The concept of “edgework” is effective in providing an explanatory framework for understanding young people’s ritualised Alcohol Consumption Journey and to illustrate the context-specific risks associated with alcohol use.

The role of alcohol in identity construction among LGBT people: a qualitative study

Research suggests that alcohol use and misuse are higher among lesbian, gay and bisexual than heterosexual populations, yet the social context of drinking in sexual minority communities has rarely been examined. To explore lesbian, gay, bisexual and transgender (LGBT) people's relationship with alcohol, we conducted seven focus groups (N = 33) with pre-existing groups of friends and work colleagues (18 to 52 years) in Scotland, UK. We identified and analysed patterns in our data using thematic analysis. Respondents perceived heavy drinking as central to the commercial gay scene. Choice of drink and drinking vessel was an important part of identity construction. Respondents discussed the perception that gay men would drink alcopops and cocktails while lesbians would drink pints of beer. Even when stereotypes were dismissed as inaccurate, they were still thought to pressure people to drink 'appropriately'. Respondents who did not identify as male or female, and those who used drag, were particularly aware of their choice of drink as a means to express identity or to challenge people's preconceptions about gender. Researchers developing interventions to reduce alcohol-related harm in sexual minority populations need to take account of the central role of identity construction in LGBT drinking practices.

"We are the soul, pearl and beauty of Hindu Kush Mountains": exploring resilience and psychological wellbeing of Kalasha, an ethnic and religious minority group in Pakistan

The Kalasha are a marginalized ethnic and religious minority group in northern Pakistan. The Kalasha minority is known for their divergent polytheistic beliefs, and represents the outliers of the collectively monotheistic Muslim population of Pakistan. This study aimed to explore the psychological resilience beliefs and lived experiences of the Kalasha and to identify cultural protective factors and indigenous beliefs that help them maintain psychological wellbeing and resilience. Seven semi-structured interviews and two focus-group discussions were conducted. The total sample consisted of 6 women and 8 men, aged 20–58 years (M_age = 36.29, SD = 12.58). The Interpretative Phenomenological Analysis qualitative method was chosen. Study findings identified that factors contributing to the wellbeing, happiness and resilience enhancement beliefs of Kalasha included five main themes, all influenced by their unique spirituality: contentment, pride in social identity, tolerance, gender collaboration and gratitude. The study also revealed the Kalasha’s perception of their marginalization related to challenges and threats. The Kalasha emphasized bringing these resilience enhancement beliefs into practice, as a mean to buffer against challenges. In conclusion, this study revealed Kalasha’s wellbeing and resilience enhancement factors, which they believed in and practiced as an element of their indigenous culture and religion.

Mediating alcohol use in Eastern Nigeria: a qualitative study exploring the role of popular media in young people's recreational drinking

Nigeria has high levels of alcohol consumption, and little or no regulation of the alcohol industry. There is a dearth of studies exploring young adults' drinking in a Nigerian context with only a few predominantly quantitative surveys. These do not explore the social meanings attached to drinking practices nor do they shed light on potential gender differences and how these are mediated by popular media. This qualitative study addresses this gap with semi-structured interviews involving 31 undergraduate students. It identifies that media consumption shapes drinking behaviour in ways which are highly patterned and gendered. Participants with high consumption of both Hollywood films and popular American reality television series associate heavy alcohol consumption with high social status, economic independence and gender equality. By contrast, Nollywood (local) films which are intended to act as moral tales and warn of the dangers of drinking appear paradoxically to support participants' views of alcohol as positive (alleviating anxiety, depression and menstrual discomfort). Nigeria currently has no serious regulation of alcohol on television which is embedded in everyday life. Attempts to develop wider public health campaigns and policies should take this saturated media landscape into account to develop harm reduction strategies which are linked directly to media literacy programmes.

Undifferentiated Gender Role Orientation, Drinking Motives, and Increased Alcohol Use in Men and Women

BACKGROUND

Alcohol misuse has historically affected men more than women. However, the differences in drinking behaviors across sex have steadily decreased over time and accumulating research suggests that gender role orientation, or culturally scripted gender-specific characteristics, and negative reinforcement drinking motives may better explain risk for alcohol use and related problems than sex.

OBJECTIVES

The current study tested a mediational model of the undifferentiated orientation (low masculinity and low femininity), an oft neglected orientation despite evidence that it could carry much weight in drinking behaviors, versus the other three gender role orientations, coping and conformity drinking motives, and hazardous alcohol use.

METHOD

Participants were 426 current drinkers over age 21 (41% men; 77.8% Caucasian; M_age = 34.5, range = 21-73) residing across the United States who completed an online survey.

RESULTS

Structural equation modeling analyses suggested that individuals with an undifferentiated orientation (n = 99), compared to masculine (high masculinity, low femininity; n = 102), feminine (high femininity, low masculinity; n = 113), or androgynous (high masculinity, high femininity; n = 112) orientations, reported higher coping drinking motives, which were positively associated with levels of hazardous alcohol use. Although analyses suggested that undifferentiated individuals reported drinking for conformity motives more often than masculine and androgynous individuals, conformity motives were not associated with increased use. Conclusions/Importance: An undifferentiated gender role orientation may contribute a unique risk for alcohol use and related problems by increasing frequency of drinking to cope, a motive specifically associated with hazardous use trajectories.