Examination of a dual-process model predicting riding with drinking drivers

Alcohol's Role in Sexual Decision Making in First-Year College Women: An Event-Level Assessment

Sexual decision making is often grounded in social scripts that can be detrimental to women's healthy relationship and sexual development during the transition to college. Little is known about the malleable decision-making processes and drinking behaviors that influence sexual behaviors from day-to-day. We examined whether women were more likely to engage in sexual behaviors on days they had higher intentions and willingness to engage in sex or drink alcohol. We also explored interactions between sex- and alcohol-related decision constructs. Eighty-two first-year college women completed 14-days of ecological momentary assessment, reporting on alcohol- and sex-related intentions and willingness (3x daily) and daily drinking and sexual behaviors. We found partial support for our hypotheses: intentions and willingness to have sex were positively associated with sex behaviors, but willingness to drink was negatively associated with sex behaviors. Heavy drinking was associated with sexual behavior, even when women indicated no prior willingness to engage in sexual behavior on those days. Findings highlight the need to address event-level variability in sexual decision making, with a particular focus on how alcohol impacts these processes. Further, the robust association between sexual intentions and behavior suggests intention setting may be a particularly useful sexual empowerment education tool.

Injunctive Norms and Driving Under the Influence and Riding With an Impaired Driver Among Young Adults in Washington State

PURPOSE

Alcohol- and cannabis-impaired driving behaviors remain a public health concern especially among young adults (i.e., ages 18-25). Limited updates to prevention efforts for these behaviors may be due, in part, to limited understanding of malleable psychosocial predictors. The current study assessed associations between perceived injunctive norms (i.e., acceptability) of driving under the influence of alcohol (DUI-A) and cannabis (DUI-C), and riding with a driver under the influence of alcohol (RWI-A) and cannabis (RWI-C) in Washington State young adults.

METHODS

Participants included 1,941 young adults from the 2019 cohort of the Washington Young Adult Health Survey. Weighted logistic regressions assessed the associations between peer injunctive norms and impaired driving-related behaviors.

RESULTS

A weighted total of 11.5% reported DUI-A, 12.4% DUI-C, 10.9% RWI-A, and 20.9% RWI-C at least once in the past 30 days. Overlap between the outcomes was observed, indicating some young adults had engaged in multiple impaired driving-related behaviors. After controlling for substance use frequency, weighted logistic regressions indicated more positive perceived injunctive norms were associated with nearly 2 ½ times higher odds of DUI-A, 8 times higher odds of DUI-C, 4 times higher odds of RWI-A and six and a half times higher odds of RWI-C.

DISCUSSION

Results increase the understanding of how injunctive norms-a potentially malleable psychosocial factor-are associated with four impaired driving-related outcomes. Prevention programs that focus on assessing and addressing the norms of these outcomes individually and collectively, such as normative feedback interventions and media campaigns, may be helpful in reducing these behaviors.

Intoxicated driving and riding with impaired drivers: Comparing days with alcohol, marijuana, and simultaneous use

BACKGROUND

Young adults who engage in simultaneous alcohol and marijuana (SAM) use may be more likely to engage in unsafe behaviors including riding with impaired drivers and driving after alcohol and/or marijuana use.

METHODS

Young adult SAM users (N = 408) self-reported their behavior for five 14-day bursts, yielding daily-level responses on a total of 14,675 substance use days. Adjusted odds ratios (AOR) estimated the likelihood of riding with an impaired driver and of driving after use on SAM use days compared to alcohol- or marijuana-only use days.

RESULTS

More frequent SAM users were more likely to ride with an impaired driver and to drive after use than less frequent SAM users (between-persons). On SAM use days, there were greater odds of riding with an impaired driver, compared to alcohol-only days (AOR = 1.28) and marijuana-only days (AOR = 2.22), and of driving after use, compared to marijuana-only days (AOR = 1.25). Driving after use was more likely on days with non-simultaneous alcohol and marijuana use compared to SAM use (AOR = 1.59).

CONCLUSIONS

Riding with an impaired driver is common among young adult substance users, and more likely following simultaneous use of alcohol and marijuana compared to other types of alcohol and marijuana use. Driving after use is more likely after SAM use than marijuana-only use days, but most likely on days when both alcohol and marijuana were used but not simultaneously. Future research on situation-level predictors of riding and driving-related risks among young adults is warranted.

An Ecological Momentary Assessment of Affect, Mental Health Symptoms, and Decisions to Drink Among First-Year College Women: A Pilot Study

College women experience more consequences (e.g., blacking out, unprotected/unwanted sex) on days when they engage in their heaviest drinking. To inform prevention efforts, research is needed to understand decision-making processes that influence women's drinking behaviors at the event level. The present study used ecological momentary assessment (EMA) methods to examine: (1) associations between positive affect (PA) and negative affect (NA) and decision-making processes on days leading up to, during, and following heavy drinking events; and (2) mental health symptoms as moderators of these associations. Female undergraduate drinkers (N = 57) completed a 14-day EMA protocol on their smartphones, which included three daily assessments of PA, NA, and willingness and intentions to drink. Trait anxiety and depressive symptoms were measured before the EMA protocol and assessed as moderators. Time-varying effect models were used to examine covariation among PA, NA, and willingness and intentions to drink on the days leading up to participants' heaviest drinking events, the day of the event itself, and the days following the event. Results revealed PA was positively associated with willingness to drink the 2 days before, the day of, and the day after the heaviest drinking event. Similar effects were observed for PA and intentions to drink. Trait anxiety moderated the association between PA and intentions to drink. Findings underscore that positive affect may influence drinking-related decision-making processes surrounding heavy drinking events, particularly in those college women low in anxiety. Results identify potential entry points for real-time intervention efforts targeting college women during times of elevated PA.

Decision making processes and alcohol use among college students

Objective: The neurobiological model of risk-taking and the dual-process model of decision making each provide possible explanations of risky behavior among youth, but their interconnections have rarely been explored, especially among college students, a time of increased alcohol use. Participants: n = 382; Mage = 19.25, SD = 1.33. Method: Participants completed a survey about their deliberative and intuitive decision making style (based on the dual-process model), their socioemotional and cognitive control processes (based on the neurobiological model), and alcohol use. Results: Structural equation modeling showed that dual-process variables and neurobiological variables were positively related. Deliberative decision making and cognitive control were negatively related to alcohol use whereas intuitive decision making was not. Comment: Discussion focuses on the integration of theoretical models with real-world health behaviors and considers implications of the current findings in terms of prevention and intervention to reduce drinking among college students.

Willingness as a mediator of the effects of personality on alcohol-related consequences between the first and second years of college: A longitudinal prospective study

The present study used a prospective longitudinal design to examine whether willingness to experience negative alcohol-related consequences mediated the effects of personality on consequences (e.g., blacking out, getting into a fight, and regretted sex). Students (N = 2024) were assessed at three time points: fall semester of the students' first year in college (baseline), 6-months post-baseline, and one-year post-baseline. Personality constructs were assessed at baseline (i.e., impulsivity, sensation seeking, self-regulation), willingness to experience negative alcohol-related consequences was assessed at baseline and 6-months, and negative alcohol-related consequences were examined at baseline and one-year post-baseline. A structural path model was used to examine if willingness mediated the effects of personality on consequences. Baseline drinking was included as a covariate in the model. Results demonstrated willingness to experience consequences significantly mediated the effects of impulsivity, sensation seeking, and self-regulation on consequences. Findings from this study support the idea that consequence-specific cognitions, such as willingness, can explain changes in consequences associated with personality. This suggests that intervention efforts aimed at reducing negative alcohol-related consequences could benefit from the inclusion of consequence-specific cognitions, personality (e.g., impulsivity, sensation seeking, and self-regulation), and drinking.

A Longitudinal Examination of Decisions to Ride and Decline Rides with Drinking Drivers

BACKGROUND

Riding with a drinking driver (RWDD) is a serious concern that leads to numerous preventable deaths every year. There is a significant gap in research on empirically tested predictors of RWDD that could be implemented in prevention efforts. College students are in need of such prevention efforts, as they have some of the highest rates of alcohol-related crash fatalities and may engage in RWDD more than their noncollege peers. This study utilized behavioral decision-making approach to examine predictors of RWDD and declining a ride from a drinking driver (Decline) in older college students.

METHODS

Students (n = 791) in their third year of college were enrolled from 3 large and diverse universities. Psychosocial (e.g., expectancies, norms) and decision-making variables (willingness to RWDD and intentions to use alternatives) were assessed in the fall of their third year. One year later, RWDD and Decline behaviors were assessed. Zero-inflated Poisson analyses were used to assess how decision-making variables predicted RWDD and Decline behavior. Associations between psychosocial and decision-making variables were also assessed.

RESULTS

Thirteen percent of students reported RWDD and ~28% reported Decline behavior. Willingness to RWDD and typical weekly drinking were both associated with increases in RWDD (odds ratio [OR] = 1.58 and 1.40, respectively), whereas intentions to use alternatives, sex, and ethnicity were not associated with RWDD. Only weekly drinking was associated with Decline, with an increase in drinking associated with increased Decline (OR = 1.48). All psychosocial variables were significantly associated with the decision-making variables except positive expectancies.

CONCLUSIONS

Results provide evidence that willingness to RWDD is a predictor of future RWDD, even if students intend to use safe alternatives. Future research is needed to better understand decision-making factors that influence Decline. Results also suggest prevention and interventions efforts, such as brief motivational intervention, Parent-Based Interventions, and normative feedback interventions could be adapted to reduce RWDD.