A daily-level examination of willingness to pregame, blackout, and hook up across drinking days: Associations with respective behavioral outcomes among adolescents and young adults

Research indicates general willingness to drink (i.e., "How willing are you to drink tonight?") fluctuates day-to-day and is associated with daily-level drinking. However, it is unknown whether willingness to engage in specific alcohol-related behaviors is associated with actual engagement in those behaviors above and beyond general willingness to drink at the daily level. The present study examined whether daily-level willingness to engage in specific behaviors (i.e., pre-gaming, blacking out, hooking up) predicted engaging in those respective behaviors on drinking days above and beyond one's general willingness to drink. Participants included adolescents and young adults who were part of a longitudinal ecological momentary assessment (EMA) study on cognitions and alcohol use. Participants (N = 675; 43 % male) who reported drinking on weekend days (i.e., Friday and Saturday [N = 3,727 days]), were included. The study involved a 3-week EMA burst design with bursts occurring quarterly over 12 months. Multilevel logistic regressions indicated on drinking days when participants reported being more willing than their own average to pre-game (OR = 1.77, p <.001), black out (OR = 1.46, p <.05), or drink before hooking up (OR = 1.68, p <.001), they were more likely to pregame, black out, and hook up, respectively, whereas general willingness to drink was not associated with any outcomes at the daily level.Results suggest willingness to engage in specific behaviors may be essential to target in prevention programming in comparison to general willingness to drink when aiming to reduce specific risk behaviors.

First Comes Substance Use, Then Comes Social Media Posts? Examining the Temporal Ordering and Relative Strength of Relations Across Alcohol, Tobacco and Marijuana Use and Posting Behavior

Social media posts represent a major route by which youth share their substance use cognitions and experiences with others. Extant research has primarily examined relations between alcohol-related posts and posters' own alcohol use, yet little is known about the role of social media in the use of less socially accepted substances, namely tobacco and marijuana. Our study represents the first to examine the relative strength of this relation across alcohol, tobacco, and marijuana. The current research used a one-month time lag to tease apart the temporal ordering of substance-use-posting and participants' own substance use. A sample of 282 15-20-year-olds (Mage = 18.4, SD = 1.3, 52.9% female) in the United States completed two self-report surveys, one month apart. Results of a cross-lagged panel model revealed significant effects of alcohol and marijuana consumption on subsequent alcohol- and marijuana-related posting, respectively (i.e., selection effects). However, reverse relations (i.e., self-effects) were not significant. Further, we found no differences in the strength of selection effects across substances, suggesting they are similar for both more (alcohol) and less (marijuana and tobacco) socially acceptable substances. Results point to the importance of using young people's social media posts as a way to help identify individuals at risk for heightened substance use and social media as a mechanism for targeted prevention programming.

Examining within-person associations between alcohol and cannabis use and hooking up among adolescents and young adults in the United States

OBJECTIVE

This study examined daily associations between alcohol use, cannabis use, and simultaneous alcohol and cannabis/marijuana (SAM) use with the likelihood of hooking up (uncommitted sexual encounter that may or may not include intercourse).

METHOD

We used a longitudinal measurement burst ecological momentary assessment (EMA) design with 3-week EMA bursts with daily measurements repeated quarterly across 12 months. 1,009 (57 % female, Mean age = 20.00 [SD = 3.21]) Texan adolescents and young adults ages 15-25 participated in the study. Mixed effects logistic regression models were estimated using maximum likelihood estimation to evaluate the associations between substance use and hooking up.

RESULTS

Within-person results indicated that participants were more likely to hook up on days with alcohol use and on days with cannabis use, but not on days with SAM use. Participants were also more likely to hook up on drinking days with higher-than-usual alcohol use. Between-person results indicated that participants who used alcohol more often or cannabis more often on average were more likely to hook up, and participants who tended to drink more on drinking days were more likely to hook up.

CONCLUSIONS

Given the significant daily-level associations between alcohol and cannabis use and hooking up behavior, public health initiatives should focus on developing interventions to reduce alcohol and cannabis use and promote safer hooking up behavior among adolescents and young adults.

Subjective norms as a mediator between exposure to online alcohol and marijuana content and offline use among adolescents

INTRODUCTION

While adolescent substance use (SU) may be viewed as normative, SU can quickly escalate leading to consequences. Social media use may increase SU risk. Despite using social media to connect with others, adolescents also view depictions of glamorised SU by both peers and influential figures. Exposure to online alcohol and marijuana content may impact subjective norms (i.e., injunctive and descriptive) ultimately leading to increased offline SU. Data from a multi-wave project was collected to assess whether subjective norms-mediated associations between exposure to alcohol and marijuana content by peers and influential figures on Instagram and Snapchat and offline SU.

METHODS

At Wave 1, participants were 264 adolescents (Mage  = 14.91, 51% female, 86% White, 85% Hispanic/Latino/a/x).

RESULTS

Injunctive norms significantly mediated associations between exposure to alcohol content posted by peers and influential figures on Instagram and Snapchat and offline alcohol use. Injunctive norms significantly mediated associations between exposure to marijuana content posted by peers and influential figures on Instagram, and peers on Snapchat and offline marijuana use. Descriptive norms significantly mediated associations between exposure to alcohol content posted by peers on Instagram, as well as peers and influential figures on Snapchat and offline alcohol use.

DISCUSSION AND CONCLUSION

Increased exposure to online SU content was more consistently associated with injunctive norms rather than descriptive norms. Future research should examine which social media features (e.g., the like button) contribute to increased subjective norms. Overall, findings suggest that social media may strongly convey approval of SU behaviours rather than actual use.

Daily level examination indicates that positive affect, but not negative affect, is associated with alcohol and marijuana use among adolescents and young adults

OBJECTIVE

Although there is growing evidence that alcohol use at the daily level is associated with positive but not negative affect, results are mixed when examining marijuana use and simultaneous alcohol and marijuana (SAM) use (i.e., use with overlapping effects). In addition, less is known about these daily level associations among diverse samples of adolescents and young adults. The present study will address these gaps.

METHOD

Participants (N = 1,006; 57.3% female, 43.1% White, Non-Hispanic, ages 15-25; Mage = 20.0) were part of a study on substance use that consisted of a 3-week ecological momentary assessment (EMA) burst design (eight surveys per week, up to 2×/day) that was repeated quarterly over a 12-month period.

RESULTS

Within-person results indicated that on days with elevated positive affect, participants reported consuming more drinks, whereas positive affect was not significant for hours high from marijuana. In addition, on days with elevated negative affect, participants reported fewer hours high from marijuana. No association was found between negative affect and number of drinks. Finally, within-person results indicated that on alcohol or marijuana days with elevated positive affect, individuals were more likely to report SAM use. There was no association found between negative affect and SAM use.

CONCLUSIONS

Results have implications such that in-the-moment interventions for alcohol and SAM use may be more salient when individuals have higher positive affect than average, whereas such interventions may be more relevant for marijuana use when negative affect is lower compared to average levels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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.

Frequency and Timing of Sent and Received Alcohol-Related Text Messages: Associations with Alcohol Use and Related Consequences among Adolescents and Young Adults

Background: Research supports the notion that adolescents and young adults communicate about alcohol via text messages and that this form of communication is associated with alcohol use. However, little is known about how this compares to social media content sharing or about the timing of sending and receiving alcohol-related text messages and associations with alcohol-related outcomes. The present study aimed to 1) document whether adolescents and young adults are willing to share alcohol content via text messages they are not willing to share via social media, and 2) determine associations between frequency and timing of alcohol-related text messages (both sent and received) with self-reported alcohol use and consequences. Methods: A total of 409 participants (63.30% female; age 15-25, M = 21.10, SD = 2.69) completed a baseline survey as part of a larger study. Results: While 84.50% of participants reported that they were willing to send text messages referencing alcohol that they would not share on social media, 90.00% reported that their friends would be willing to do so. Results of negative binomial regressions indicated that sending and receiving more alcohol-related text messages per week and sending and receiving text messages before and during drinking, but not after drinking, were positively associated with typical drinks per week. Neither frequency of sending and receiving text messages or timing (before, during, after) were associated with negative consequences. Conclusions: Results suggest that frequency and timing of alcohol-related text messaging may provide insights into alcohol consumption patterns among adolescents and young adults and warrants future research.

Age and Fear of Missing Out as Moderators of the Association between Peak Drinks and Alcohol-Induced Blackouts among Adolescents and Young Adults

Background: Alcohol-induced blackouts are periods of impaired memory in which an individual is unable to recount events that occurred while they were intoxicated and are associated with heavier drinking episodes. Objectives: The present study examined age and Fear of Missing Out (FoMO) as moderators of the association between peak number of drinks and experiencing alcohol-induced blackouts. Participants ages 15-25 (N = 411; Mean age = 21.4 (SD = 2.5); 61.6% female) completed baseline and daily surveys as part of a larger ecological momentary assessment study. Past month blackout experiences and peak number of drinks were reported at baseline and FoMO was reported in daily surveys one to three weeks following the baseline survey. Results: A zero-inflated negative binomial model was fit to examine the interaction between peak number of drinks with age and FoMO on alcohol-induced blacking out, controlling for relevant covariates. Findings indicated the association between peak number of drinks on the likelihood of alcohol-induced blacking out was significantly moderated by age. The association was stronger for younger compared to older individuals. Findings further indicated the associations between peak number of drinks on both the likelihood and average number of alcohol-induced blacking out was significantly moderated by FoMO. For individuals with higher levels of FoMO, the association between peak drinks and alcohol-induced blacking out was weaker for the likelihood of experiencing any blackouts and stronger for the number of blackouts. Conclusions: Findings provide support to previous literature examining age and FoMO as risk factors for alcohol-induced blackouts among adolescents and young adults.

Daily-level associations between alcohol use cognitions and normative perceptions among adolescents: An intensive longitudinal study

BACKGROUND

Adolescence is an important developmental period in which to understand the cognitive underpinnings of risky alcohol use. Normative perceptions, such as descriptive and injunctive norms, are one of the strongest and most consistent predictors in adolescent drinking research. Thus, it is essential to examine which drinking cognitions (e.g., attitudes, prototypes, perceived vulnerability) are associated with normative drinking perceptions using repeated daily-level data among adolescents. The present study assessed associations between drinking cognitions and normative perceptions using an intensive daily longitudinal design.

METHODS

Participants were ages 15-17 years (N = 306; 61.4% female; M_age (SD) = 16.0 (0.8)) who were part of a larger ecological momentary assessment study (EMA) on drinking cognitions and alcohol use. The study design consisted of a 3-week EMA burst design (8 surveys per week, up to 2x/day) that was repeated quarterly over the 12-month study. The present analyses used the afternoon assessment for all measures.

RESULTS

Our multilevel model results demonstrated that drinking attitudes, prototypes of a typical drinker, and perceived vulnerability were positively associated with both descriptive and injunctive drinking norms between individuals and within individuals across days.

CONCLUSIONS

Current findings have important clinical implications as they demonstrated how specific drinking cognitions were associated with variability in normative perceptions at the daily level. Findings support the delivery of intervention messaging to adolescents on days when drinking attitudes, prototypes of a typical drinker, and perceived vulnerability are elevated.

Cross-Tailoring Integrative Alcohol and Risky Sexual Behavior Feedback for College Students: Protocol for a Hybrid Type 1 Effectiveness-Implementation Trial

BACKGROUND

Underage drinking and related risky sexual behavior (RSB) are major public health concerns on United States college campuses. Although technology-delivered personalized feedback interventions (PFIs) are considered a best practice for individual-level campus alcohol prevention, there is room for improving the effectiveness of this approach with regard to alcohol-related RSB.

OBJECTIVE

The aims of this study are to (1) evaluate the impact of a brief PFI that integrates content on alcohol use and RSB and is adapted to include a novel cross-tailored dynamic feedback (CDF) component for at-risk first-year college students and (2) identify implementation factors critical to the CDF's success to facilitate future scale-up in campus settings.

METHODS

This study uses a hybrid type 1 effectiveness-implementation design and will be conducted in 3 phases. Phase 1 is a stakeholder-engaged PFI+CDF adaptation guided by focus groups and usability testing. In phase 2, 600 first-year college students who drink and are sexually active will be recruited from 2 sites (n=300 per site) to participate in a 4-group randomized controlled trial to examine the effectiveness of PFI+CDF in reducing alcohol-related RSB. Eligible participants will complete a baseline survey during the first week of the semester and follow-up surveys at 1, 2, 3, 6, and 13 months post baseline. Phase 3 is a qualitative evaluation with stakeholders to better understand relevant implementation factors.

RESULTS

Recruitment and enrollment for phase 1 began in January 2022. Recruitment for phases 2 and 3 is planned for the summer of 2023 and 2024, respectively. Upon collection of data, the effectiveness of PFI+CDF will be examined, and factors critical to implementation will be evaluated.

CONCLUSIONS

This hybrid type 1 trial is designed to impact the field by testing an innovative adaptation that extends evidence-based alcohol programs to reduce alcohol-related RSB and provides insights related to implementation to bridge the gap between research and practice at the university level.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05011903; https://clinicaltrials.gov/ct2/show/NCT05011903.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/43986.

Polysubstance use among young adults and differences in negative alcohol-related sexual experiences

This study aimed to compare negative alcohol-related sexual experiences among individuals who used (1) alcohol only, (2) alcohol plus marijuana, and (3) alcohol plus marijuana and stimulants. Participants in the analytic sample (N = 1,015; Mean age = 19.16 (SD = 0.79); 45.42% male) completed an online baseline survey as part of an intervention study. A hurdle negative binomial model examined the associations between polysubstance use and negative alcohol-related sexual experiences. Models examined if experiences varied by demographic factors. Compared to participants that only used alcohol, those who used alcohol plus marijuana and stimulants reported a higher likelihood and average number of negative alcohol-related sexual experiences in the past 3 months. Participants that used alcohol plus marijuana had a higher likelihood of having a negative alcohol-related sexual experience in the past 3 months compared to those who only used alcohol. These findings suggest the number and risk for negative alcohol-related sexual experiences increases with the number of substances being used.

Occasion-level investigation of playing drinking games: Associations with cognitions, situational factors, alcohol use, and negative consequences among adolescents and young adults

The present study examined occasion-level associations between cognitions (willingness to drink, descriptive norms, and injunctive norms) and situational factors (familiarity with people and locations) with playing drinking games (DGs) among adolescents and young adults. Further, this study tested the associations between playing DGs, the number of drinks consumed, and the negative consequences experienced at the occasion level. Participants were 15-25-year-olds (N = 688; 43% male, 47% White, Non-Hispanic, Mean age = 21.18) who were part of a longitudinal ecological momentary assessment (EMA) study on cognitions and alcohol use. The study design consisted of a 3-week EMA burst design (8 surveys per week) that was repeated quarterly over the 12-month study (up to 2x/day) per participant. Multilevel models showed that occasion-level risks (higher willingness, higher descriptive norms, and less familiarity with people) were associated with playing DGs. When examining the within-person associations between DGs and number of drinks, results showed that playing DGs was associated with consuming more drinks. For consequences, DGs were not uniquely predictive of experiencing more consequences and riding in a vehicle with a driver who had been drinking. This study contributes to the literature by examining associations between cognitions and situational factors with DGs and the role DGs play in experiencing negative consequences among a diverse sample of adolescents and young adults.

Lockdown, bottoms up? Changes in adolescent substance use across the COVID-19 pandemic

The COVID-19 pandemic notably altered adolescent substance use during the initial stage (Spring 2020) of the pandemic. The purpose of this longitudinal study is to examine trajectories of adolescent substance use across the pandemic and subsequent periods of stay-at-home orders and re-opening efforts. We further examined differences as a function of current high school student versus graduate status. Adolescents (n = 1068, 14–18 years, M_age = 16.95 years and 76.7% female at T1) completed 4 different self-report surveys, starting during the first stay-at-home order and ending approximately 14 months later. Negative binomial hurdle models predicted: (1) the likelihood of no substance use and (2) frequency of days of substance use. As hypothesized, results demonstrated significant increases in adolescents’ likelihood of alcohol use, binge drinking, and cannabis use once initial stay-at-home orders were lifted, yet few changes occurred as a result of a second stay-at-home order, with rates never lowering again to that of the first lockdown. Further, graduates (and particularly those who transitioned out of high school during the study) demonstrated a greater likelihood and frequency of substance use and were more stable in their trajectories across periods of stay-at-home orders than current high school students. Unexpectedly, however, there was a strong increase in current high school students’ likelihood of e-cigarette use and a significant linear increase in participants’ frequency of e-cigarette use over the study. Results suggest adolescent substance use, and in particular, e-cigarette use among current high school students, may be of increasing concern as the pandemic evolves.

A Dyadic Examination of Interpersonal Electronic Surveillance

Interpersonal electronic surveillance (IES) refers to monitoring a partner's location, conversations, and other private information such as search history. Although IES has been linked to relationship functioning, this work does not take into account the dyadic nature of relationships using data from both members of a dating pair. Thus, this study aimed to document rates and concordance of IES perpetration among a college sample of dating pairs, explore whether rates of IES perpetration differ by gender, and describe how each partner's IES perpetration is associated with trust, jealousy, negative relationship behaviors, and explore whether any associations are moderated by gender. A total of 136 couples (age 18-25 years) participated in a study wherein each member of the couple reported IES perpetration, trust, jealousy, and negative relationship behaviors. Results indicated that 44 percent of the sample presented with either one or both partners engaging in IES perpetration. Furthermore, results of actor-partner interdependence models indicated that there were significant actor effects for all outcomes such that one's own IES perpetration was related to lower trust in the partner, higher jealousy, and engagement in more negative partners toward the partner. However, no significant partner effects emerged. Results further indicated that actor effects were present for women, but not men. Overall, results of this study indicate that dyadic examinations of IES perpetration may shed light into the ways that couples use technology and that future research is warranted to determine how to prevent IES perpetration and ultimately potential relationship consequences.

A parent-based intervention for reducing high-risk social media cognitions, alcohol use, and negative consequences among adolescents: Protocol for a randomized controlled pilot study (Preprint)

Background

The prevalence of adolescent alcohol use continues to be a public health concern. Although adolescents spend an increasing amount of time with their friends, parents remain an important source of support and continue to play a key role in the lives of their adolescents. Extensive research in this area has resulted in parent-based intervention (PBI) efforts to prevent or reduce adolescent alcohol use. However, one major limitation of PBIs is that they do not currently consider the large role that social media plays in adolescents’ lives and in relation to their alcohol use. We will add to the literature by developing and refining a web-based PBI designed to reduce both high-risk social media cognitions and alcohol use among adolescents.

Objective

The central goal of the proposed study is to develop, refine, and pilot a web-based PBI to reduce both high-risk social media cognitions and alcohol use among adolescents.

Methods

A total of 100 parent-teen dyads will be randomly assigned to one of the following 2 conditions: intervention or control. Parents in the intervention group will be given access to the web-based PBI and suggestions for working through the PBI modules with their teens. The parent-teen dyads will fill out 3 questionnaires: a baseline questionnaire, 1-month questionnaire, and 6-month questionnaire.

Results

Recruitment and enrollment will begin in August 2022. Upon completion of the intervention trial, we will examine the feasibility, acceptability, and preliminary effect sizes of the newly developed web-based PBI.

Conclusions

This study has the potential to open doors for future studies examining the clinical implications of an efficacious web-based PBI to reduce alcohol use and high-risk cognitions about alcohol displays on social media.

Trial Registration

ClinicalTrials.gov NCT04333966; https://clinicaltrials.gov/ct2/show/NCT04333966

International Registered Report Identifier (IRRID)

PRR1-10.2196/38543

Are Drinking Cognitions Associated with Marijuana and Concurrent Alcohol and Marijuana Use among Adolescents and Young Adults?

Background

Concurrent use of alcohol and marijuana (i.e., CAM use) is the most common poly-drug use pattern among adolescents and young adults and is associated with negative outcomes. Research indicates that Prototype Willingness Model (PWM) drinking cognitions are associated with alcohol use. This secondary analysis was conducted to explore cross-sectional associations between PWM drinking cognitions, alcohol, marijuana, and CAM use.

Methods

Adolescents and young adults between 15-25 years (N = 124, M age = 18.7) completed a baseline assessment as part of a larger study, including questions on alcohol and marijuana use, and PWM drinking cognitions.

Results

In the social reaction pathway, descriptive norms, perceived vulnerability, and prototype favorability, but not willingness were associated with greater alcohol use, whereas in the reasoned pathway attitudes and intentions were associated with frequency of drinking whereas injunctive norms were not. Both willingness and intention to drink were related to marijuana and CAM use when controlling for alcohol use frequency. Greater willingness to drink was the only significant predictor of marijuana use, and only descriptive norms predicted CAM use. However, of the cognitions within the reasoned pathway, greater attitudes toward drinking and drinking intention were related to greater marijuana and CAM use. Results also indicated that CAM users displayed higher levels of certain risk cognitions than non-users or single substance users.

Conclusions

Findings support and extend the utility of the PWM by indicating that specific alcohol cognitions are associated with alcohol, marijuana, and CAM use in adolescents and young adults.

Likelihood of Posting Alcohol-Related Content on Social Networking Sites - Measurement Development and Initial Validation

Background: The vast majority of adolescents and young adults are active on social networking sites (SNSs). SNSs are influential, risk-conducive environments for alcohol use among adolescents and young adults. Specifically, posting or sharing alcohol-related content (ARC) is associated with higher levels of alcohol use. However, it is unknown if sharing different types of ARC associates differentially with alcohol use and consequences. Objective: The goal of the current project was to develop a measure of the likelihood of posting key types of ARC posted by adolescents and young adults and to examine their associations with SNS use patterns and actual alcohol-related behavior. Method: Participants were 15-20 years of age (n = 306; 46.7% male; 56.6% Caucasian/White; 27.0% Asian) who completed a battery of self-report measures. Results: Results from an exploratory factor analysis revealed four types of ARC: (1) self and friend consumption, (2) memes and viral photos, (3) status updates: others' drinking and consequences, and (4) pictures: others' drinking and consequences. Conclusions: Participants' likelihood of posting self and Friend Consumption was significantly associated with heightened Snapchat use, typical drinks per week, peak drinking, and negative drinking consequences. Whereas youth appear to share more readily alcohol-related viral posts and memes, it seems that the sharing of ARC that is specifically related to the participants' own use or friends' use is salient concerning alcohol use and problems. Therefore, interventions might consider sending targeted prevention messages to individuals who share certain types of ARC which are more associated with problematic alcohol behaviors.

Behavioral Willingness, Descriptive Normative Perceptions, and Prescription Stimulant Misuse among Young Adults 18-20

Objective: It is critical to gain further understanding of etiologic factors, such as descriptive normative perceptions and behavioral willingness, that are associated with prescription stimulant misuse (PSM) among young adults. Our primary hypotheses were that descriptive normative perceptions for PSM (i.e., perceptions of how much and how often others engage in PSM) and perceived peer willingness (i.e., perceptions of how open others are to PSM under certain circumstances) would be positively associated with higher willingness to engage in PSM, which in turn would account for significant shared variance with self-reported PSM. Method: Data were collected from a U.S. sample of 18-20-year-olds (N = 1,065; 54.5% females; 70.5% White) recruited for a larger study on alcohol-related risky sexual behavior. Results: Findings indicated higher descriptive normative perceptions and higher perceived peer willingness were associated with higher participants' willingness to engage in PSM. Participants' own willingness was positively associated with PSM. Finally, participants' own willingness to use, descriptive normative perceptions, and perceived peer willingness were associated with higher willingness to engage in PSM, which accounted for significant shared variance with self-reported PSM. Conclusions: Findings suggest the potential utility of personalized feedback interventions for PSM that focus on constructs such as descriptive normative perceptions and behavioral willingness.

Exploring novel strategies for social media HPV vaccine information

To respond to potential public health impacts of social media influencing vaccine confidence, Facebook proposed that prior to proceeding to any link about Human Papillomavirus (HPV) vaccination, a pop-up will prompt the user to visit a reputable website on vaccine information. This study explored the acceptability of a pop-up Facebook message for HPV vaccine information. A national sample of U.S. adults (n = 579) was surveyed online. Most participants rated the pop-up messages as acceptable, useful, and factual. Regression results indicated that being male, seeing HPV content on social media in the past month, believing that information on social media is credible, holding positive HPV vaccination attitudes, and having shared HPV content on their own social media were associated with greater likelihood of clicking on a pop-up. While the pop-up approach may be acceptable, there are many factors that may be associated with being less likely to click on the pop-up.

Testing daily-level drinking and negative consequences as predictors of next-day drinking cognitions

OBJECTIVE

Limited research has examined how alcohol use and related consequences affect drinking-related cognitions, which is important as these cognitions may contribute to future drinking. The current study examines daily associations between alcohol use and alcohol-related negative consequences with next-day Prototype Willingness Model (PWM) social reaction pathway cognitions.

METHOD

Participants ages 15-25 years (N = 124, Mean age 18.7, SD = 2.87) completed daily surveys for up to three weeks (i.e., up to 11 surveys/week) using an ecological momentary assessment design. Linear mixed models and Poisson generalized mixed models were conducted to examine whether number of alcoholic drinks or number of negative alcohol-related consequences were associated with next-day PWM social reaction cognitions, including perceived vulnerability, descriptive normative perceptions of number of drinks consumed and the percentage of friends who drink, prototype favorability, prototype similarity, and willingness (i.e., openness) to drink.

RESULTS

Within-person results indicated more alcohol use on a given day was associated with lower next-day normative perceptions of the percentage of friends who drink on that day of the week and higher prototype similarity. Furthermore, within-person results indicated that experiencing more negative alcohol-related consequences on a given day was associated with higher perceived vulnerability and lower willingness to drink the next day.

CONCLUSIONS

Findings showed that next-day social reaction PWM cognitions were associated with prior day alcohol use and negative alcohol-related consequences, suggesting that an intervention might be timed to target drinking cognitions the morning following a drinking event, particularly after experiencing negative alcohol-related consequences.

Alcohol-related cognitions: Implications for concurrent alcohol and marijuana use and concurrent alcohol and prescription stimulant misuse among young adults

INTRODUCTION

This study examined the associations between alcohol-related cognitions within the social reaction pathway of the Prototype Willingness Model and concurrent (use of two or more substances within a specified time period) use of 1) alcohol and marijuana and 2) alcohol and prescription stimulant misuse.

METHODS

A convenience sample of 1,062 emerging adults in the U.S. (18-20 years old; 54.5% female) who reported past 3-month alcohol use completed a baseline survey as part of a larger randomized controlled trial.

RESULTS

Results indicate that controlling for age, biological sex, race, ethnicity, and college enrollment, perceived descriptive norms and willingness to drink were associated with past 3-month concurrent alcohol and marijuana use and concurrent alcohol and prescription stimulant misuse. However, alcohol prototype similarity and alcohol-related perceived vulnerability were not associated with either concurrent use outcome examined.

DISCUSSION

These findings suggest that alcohol-related perceived descriptive norms and willingness to drink are associated with concurrent substance use among young adults. Thus, it is possible that existing efficacious alcohol interventions that target descriptive norms and willingness to drink may have the added benefit of also reducing concurrent substance cognitions and ultimately use.

Quality over quantity: human papillomavirus vaccine information on social media and associations with adult and child vaccination

Human Papillomavirus (HPV) vaccination is recommended for adults aged 27-45 as a shared clinical decision with their healthcare provider. With the rise of social media as a vaccine information source, this study examined the extent of exposure to HPV vaccine content by social media platform and evaluated associations between HPV vaccine content on social media and HPV vaccine intent among both 27-45 year olds and their eligible children. U.S. participants (51% women, 9% Black, 8% Hispanic/Latinx), aged 27-45, were cross-sectionally surveyed online from April to May 2020 (n = 691). Outcomes included HPV vaccination intention (intend/do not intend) for themselves and, among participants with unvaccinated children aged 9-17 (n = 223), their eligible children. Adjusted odds ratios for HPV vaccine content and both outcomes were calculated. Extent of HPV vaccination exposure on social media was not associated with intention to vaccinate for HPV. Seeing mostly negative/mixed information about the HPV vaccine on social media was associated with lower odds of vaccination intention for adults (aOR = 0.34, 95% CI 0.15, 0.79) and adolescents (aOR = 0.34, 95% CI 0.21, 0.53). Viewing HPV vaccine information from social media as not credible was associated with lower odds of vaccine intent for adults (aOR = 0.17, 95% CI 0.07, 0.41) and adolescents (aOR = 0.16, 95% CI 0.10, 0.29). Although extent of HPV vaccine exposure on social media was not associated with vaccination outcomes, findings support developing quality social media strategies that increase the dissemination of positive and credible information in favor of HPV vaccination.

COVID-19 psychological and financial stress and their links to drinking: A dyadic analysis in romantic couples

Objective: The COVID-19 pandemic has been an unprecedented event for the entire world. Stay-at-home orders, many children being taught at home, health anxieties, and the subsequent economic downturn have collectively resulted in significant stress. Recent work has established that some individuals report drinking more in response to experiencing pandemic-related stress, but data has largely been limited to individuals and to psychological stress. Methods: This research investigated how own (actor) and partner psychological and financial stress about the pandemic were associated with alcohol consumption, high-intensity drinking frequency, coping motives, and alcohol-related problems in a sample of 118 couples during the month of July 2020. We also explored whether own (actor) and partner effects were moderated by gender. Results: Results using indistinguishable Actor-partner interdependence models (APIMs) demonstrated that own psychological stress was associated with higher scores on all drinking indices, and own financial stress was associated with higher coping motives and alcohol-related problems. Partner psychological and financial stress was related to own greater endorsement of coping motives, and partner financial stress was related to own greater endorsement of alcohol-related problems. In APIMs with mixed-sex couples, men's psychological and financial stress were positively related to both his own and his partner's drinks per week, high-intensity drinking, and coping motives. Men's financial stress was also positively related to his own and his partner's alcohol-related problems. Conclusions: Results provide considerable insight into couple dynamics related to pandemic stress and have direct implications for alcohol prevention and treatment efforts as we navigate this serious crisis. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Examining Associations Between Social Networking Site Alcohol-Specific Social Norms, Posting Behavior, and Drinking to Cope During the COVID-19 Pandemic

Emerging research suggests that there may be important links between social networking site (SNS) use and alcohol consumption specific to COVID-19. In addition, substantial research indicates that descriptive normative perceptions are a strong predictor of drinking behavior more generally. However, less is known about SNS-specific norms and how they might be associated with health-related behavior. Thus, the primary goal of this study was to determine whether descriptive normative perceptions for alcohol posting related to COVID-19 on SNSs are associated with both personal SNS posting behavior and drinking to cope with COVID-19-related stress, among a sample of 587 adults (48.4 percent women; mean age = 48.7 years) across the United States. All study procedures were approved by the local IRB. Results indicate that perceiving same-age peers to be posting on SNSs about their alcohol use to cope with pandemic-related stress/boredom is associated with both an increased likelihood of making such postings oneself and increased drinking to cope with the pandemic. Results have important implications for prevention and intervention efforts aimed to curb risky drinking during the pandemic and suggest that SNS behavior and norms should be incorporated into these strategies.

Discordance Between Perinatal Alcohol Use Among Women and Provider Counseling for Alcohol Use: An Assessment of the Pregnancy Risk Assessment Monitoring System

OBJECTIVE

In the United States, guidelines indicate all pregnant women should be screened for and counseled on alcohol use to prevent adverse perinatal outcomes due to alcohol consumption. The objective of this study was to describe sociodemographic factors associated with receipt of prenatal alcohol counseling and perinatal alcohol use among US women.

METHODS

State health departments collected data for the Pregnancy Risk Assessment Monitoring System Phase 7 during 2012-2015, and we restricted the sample to a complete case analysis (N = 135 111). The 3 dichotomous outcomes were preconception alcohol use (3 months before pregnancy), prenatal alcohol use (during last 3 months of pregnancy), and prenatal alcohol counseling. Predictor variables were age, race, Hispanic ethnicity, education, marital status, health insurance status, and previous live births. We estimated survey-weighted logistic regression models for each outcome.

RESULTS

Half (56.0%) of pregnant women reported preconception alcohol use, 70.5% received prenatal alcohol counseling, and 7.7% reported prenatal alcohol use during the last 3 months of pregnancy. Black women were significantly less likely than White women (odds ratio [OR] = 0.49; 95% CI, 0.46-0.52) and Hispanic women were significantly less likely than non-Hispanic women (OR = 0.62; 95% CI, 0.58-0.66) to report preconception alcohol use. We found similar patterns for prenatal alcohol use among Black women. Black women were significantly more likely than White women (OR = 1.66; 95% CI, 1.55-1.77) and Hispanic women were significantly more likely than non-Hispanic women (OR = 1.51; 95% CI, 1.40-1.61) to receive prenatal alcohol counseling. We found similar patterns for age, education, and health insurance status.

CONCLUSION

Disparities in alcohol counseling occurred despite the national recommendation for universal screening and counseling prenatally. Continued integration of universal screening for alcohol use during pregnancy is needed.

Drinking to cope with the pandemic: The unique associations of COVID-19-related perceived threat and psychological distress to drinking behaviors in American men and women

The 2019 Coronavirus pandemic has brought about significant and unprecedented changes to the modern world, including stay-at-home orders, high rates of unemployment, and more than a hundred thousand deaths across the United States. Derived from the self-medication hypothesis, this research explored how perceived threat and psychological distress related to the COVID-19 pandemic are associated with drinking behavior among an American sample of adults. We also evaluated whether links between COVID-19-related perceived threat and psychological distress with drinking behavior are different for men and women. Participants (N = 754; 50% women) completed an online Qualtrics Panels study between April 17th and 23rd, 2020. Results suggested that psychological distress related to the COVID-19 pandemic was consistently related to alcohol use indices, and moderation results indicated this pattern was significant only among women for number of drinks consumed during the recent heaviest drinking occasion and number of drinks consumed on a typical evening. COVID-related distress' link to frequency of drinking and heavy drinking episodes was not different for men and women. Our results suggest that continued monitoring, particularly among women, should be conducted as this pandemic continues to evolve to identify the long-term public health impacts of drinking to cope with COVID-19 distress.

Cognitions and behaviors related to risk for alcohol-exposed pregnancies among young adult women

This study assessed alcohol and sex-related cognitions and behaviors, including alcohol-related sexual expectancies, descriptive norms, and protective behavioral strategies, associated with women's risk for an alcohol-exposed pregnancy. A national sample of young adults ages 18-20 years was subset to women who were capable of pregnancy and sexually active (n = 422). The outcome was risk of alcohol-exposed pregnancy as determined by contraceptive status and heavy-episodic drinking. SAS version 9.4 was used to estimate logistic regression models. Alcohol-related sexual expectancies related to enhancement were significantly associated with increased odds of alcohol-exposed pregnancy risk. In contrast, women who reported the use of more safe sex (non-condom related) protective behavioral strategies (e.g., talk to partner about birth control use) were at decreased odds of alcohol-exposed pregnancy risk. Future interventions to reduce the risk of alcohol-exposed pregnancies should consider alcohol-related sexual expectancies and safer sex protective behavioral strategies as leverage points.

What Does Adolescent Substance Use Look Like During the COVID-19 Pandemic? Examining Changes in Frequency, Social Contexts, and Pandemic-Related Predictors

PURPOSE

The overarching goal of this study was to provide key information on how adolescents' substance use has changed since the corona virus disease (COVID)-19 pandemic, in addition to key contexts and correlates of substance use during social distancing.

METHODS

Canadian adolescents (n = 1,054, Mage = 16.68, standard deviation = .78) completed an online survey, in which they reported on their frequency of alcohol use, binge drinking, cannabis use, and vaping in the 3 weeks before and directly after social distancing practices had taken effect.

RESULTS

For most substances, the percentage of users decreased; however, the frequency of both alcohol and cannabis use increased. Although the greatest percentage of adolescents was engaging in solitary substance use (49.3%), many were still using substances with peers via technology (31.6%) and, shockingly, even face to face (23.6%). Concerns for how social distancing would affect peer reputation was a significant predictor of face-to-face substance use with friends among adolescents with low self-reported popularity, and a significant predictor of solitary substance use among average and high popularity teens. Finally, adjustment predictors, including depression and fear of the infectivity of COVID-19, predicted using solitary substance use during the pandemic.

CONCLUSIONS

Our results provide preliminary evidence that adolescent substance use, including that which occurs face to face with peers, thereby putting adolescents at risk for contracting COVID-19, may be of particular concern during the pandemic. Further, solitary adolescent substance use during the pandemic, which is associated with poorer mental health and coping, may also be a notable concern worthy of further investigation.

Examining the associations between alcohol-related parental communication, alcohol use, and protective behavioral strategy use among young adults

Underage alcohol use is a public health concern as it remains prevalent and problematic. Protective behavioral strategies (PBS) may prevent or reduce alcohol-related consequences, yet daily-level findings show they instead might be associated with increased drinking and consequences. While parents are a possible source of influence to their child's decision making, it is unclear whether parental communication about alcohol affects drinking outcomes, with mixed findings noted in the literature. Furthermore, little research focuses on understanding how parental communication may impact the use of PBS. This study assessed whether alcohol specific parental communication would be associated with reduced drinking and increased use of PBS. Data from baseline and 3-month follow up were evaluated from a control group of a larger randomized controlled trial on 18- to 20-year-olds in the U.S. (N = 269). Outcomes included drinks per week, peak drinks per occasion, negative consequences and use of PBS. Using negative binomial regression modeling, controlling for age, sex, and whether participants lived with parents, findings revealed that parental communication was not associated with drinks per week, peak drinks per occasion, or negative consequences reported 3 months later. However, it was positively associated with limiting/stopping drinking PBS, manner of drinking PBS, and serious harm reduction PBS reported 3 months later. Results suggest that parental communication about alcohol may be more effective in increasing the use of protective behavioral strategies rather than reduction of drinking. Research is needed to determine why parental communication may influence the use of PBS and how we can strengthen the quality or focus of communication to ultimately increase the impact on risk behaviors.

Examining the ecological validity of the prototype willingness model for adolescent and young adult alcohol use

The present study is the first ecologically valid, daily level test of the prototype willingness model (PWM), a model previously tested with hypothetical scenarios to investigate the social reaction and reasoned pathways toward engaging in health-risk behavior. The purpose of the present study is to examine whether days with elevated alcohol-favorable PWM cognitions are also associated with greater intentions and willingness to drink and increased drinking behavior on that day. Participants included 15-25-year-olds (N = 124; 57.3% female; M_age =18.7; SD = 2.87) who were part of an ecological momentary assessment study on drinking cognitions (including willingness, intentions, perceived vulnerability, social norms, prototype favorability) and alcohol use, reported across 3 weeks. Analyses accounted for the multilevel structure of the data and the various outcome distributions. Findings supported and advanced the PWM by using real-time, real-world daily data that captured within-person variation of PWM cognitions across days and showed daily level associations between PWM cognitions and alcohol use and negative consequences among adolescents and young adults, thus supporting the social reaction and reasoned pathways at the daily level. Current results may improve interventions by precisely informing the use of technology to bring interventions to adolescents and young adults in moments when they are at highest risk (i.e., days with higher than usual PMW alcohol cognitions). (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Correlates of Nonmedical Prescription Opioid Use Among U.S. Adolescents

INTRODUCTION

The purpose of this study is to assess risk factors, including other substance use, for nonmedical prescription opioid use among U.S. adolescents.

METHODS

A secondary data analysis of the 2017 Youth Risk Behavior Survey was conducted (n=10,175) in 2018. The outcome was nonmedical prescription opioid use. Predictor variables included other substance use, mood, sleep, academic performance, and demographic characteristics. Survey-weighted procedures in SAS, version 9.4 were used, and an adjusted logistic regression model was conducted.

RESULTS

Among the sampled adolescents, 13.8% (95% confidence limit=12.4%, 15.3%) reported nonmedical prescription opioid use. Nonmedical prescription opioid use was more likely among participants aged 15 years (versus 16 years), American Indian/Alaskan Natives, and those who reported being sad or hopeless. All other substance use was significantly associated with increased odds of nonmedical prescription opioid use. Nonmedical prescription opioid use was 1.5 times more likely among electronic vapor users (AOR=1.58, 95% CI=1.34, 1.86), 2 times more likely among cigarette (AOR=2.49, 95% CI=2.16, 2.88) and marijuana users (AOR=2.45, 95% CI=2.05, 2.93), and almost 3 times as likely among alcohol users (AOR=2.98, 95% CI=2.18, 4.07).

CONCLUSIONS

Study findings suggest a need for more interventions for nonmedical prescription opioid use among adolescents in the U.S. Information on nonmedical prescription opioid use should be added to all substance use prevention programs for adolescents. Moreover, future research needs to identify longitudinal predictors of adolescent nonmedical prescription opioid use to inform prevention efforts.

Growing Up, Hooking Up, and Drinking: A Review of Uncommitted Sexual Behavior and Its Association With Alcohol Use and Related Consequences Among Adolescents and Young Adults in the United States

Hookups are uncommitted sexual encounters that range from kissing to intercourse and occur between individuals in whom there is no current dating relationship and no expressed or acknowledged expectations of a relationship following the hookup. Research over the last decade has begun to focus on hooking up among adolescents and young adults with significant research demonstrating how alcohol is often involved in hooking up. Given alcohol’s involvement with hooking up behavior, the array of health consequences associated with this relationship, as well as its increasing prevalence from adolescence to young adulthood, it is important to determine the predictors and consequences associated with alcohol-related hooking up. The current review extends prior reviews by adding more recent research, including both qualitative and experimental studies (i.e., expanding to review more diverse methods), research that focuses on the use of technology in alcohol-related hookups (i.e., emerging issues), further develops prevention and intervention potentials and directions, and also offers a broader discussion of hooking up outside of college student populations (i.e., expanding generalization). This article will review the operationalization and ambiguity of the phrase hooking up, the relationship between hooking up and alcohol use at both the global and event levels, predictors of alcohol-related hooking up, and both positive and negative consequences, including sexual victimization, associated with alcohol-related hookups. Throughout, commentary is provided on the methodological issues present in the field, as well as limitations of the existing research. Future directions for research that could significantly advance our understanding of hookups and alcohol use are provided.

Alcohol-specific social comparison as a moderator of the norms-behavior association for young adult alcohol use

Research has indicated that individuals high in social comparison orientation (SCO) are more influenced by the behavior and perceived norms of others. However, despite research indicating that behavior is more closely influenced by and modeled on more socially proximal reference groups, most social comparison research to date has utilized global measures of social comparison. As such, research has not examined whether domain-specific (i.e. alcohol-specific social comparisons) and their relation with norms are more predictive of alcohol-related outcomes than global comparisons. As such, the present study aimed to determine whether the previously found relationships between global SCO, descriptive drinking norms and their interaction are still significant when accounting for alcohol-specific SCO and its interaction with descriptive norms in the prediction of drinking willingness and behavior. Results from 355 young adults age 18-20 indicated that the association of alcohol-specific SCO and its interaction with descriptive norms for drinking predicts alcohol-related outcomes (drinking willingness and alcohol consumption), but not alcohol-related negative consequences above and beyond global SCO. Thus, alcohol-specific SCO may be of particular importance when determining for whom normative based preventive interventions may be the most efficacious.

Consideration of future consequences as a moderator of the willingness-behavior relationship for young adult marijuana use and consequences

The Prototype Willingness Model is a dual-processing (i.e., intentional and socially reactive) health-risk behavior model. The socially reactive path includes behavioral willingness, descriptive normative perceptions, and favorable images of individuals who engage in health-risk behavior (prototype favorability) as important predictors of health behaviors. Individual differences (such as consideration of future consequences) may potentiate the effects of behavioral willingness on health-risk outcomes, such as marijuana use. Given limited research investigating marijuana use and the Prototype Willingness Model, the goals of the current study were: 1) examine consideration of future consequences and Prototype Willingness Model social reaction pathway variables in relation to behavioral willingness to use marijuana longitudinally; and 2) determine if consideration of future consequences moderated the behavioral willingness-marijuana use relation prospectively. Young adults (N = 769) from a larger longitudinal study completed baseline and 3 follow-up assessments (Months 3, 4, 5). Behavioral willingness was positively related to a higher likelihood of use, more days having used marijuana, and more consequences prospectively, over and above baseline use. Consideration of future consequences moderated the association between behavioral willingness and hours high in a typical week. These findings support the willingness-behavior association of the Prototype Willingness Model and preliminarily demonstrate consideration of future consequences' differential impact on behavioral willingness-future marijuana use relation. Intervention and prevention implications are discussed.

#drunktwitter: Examining the relations between alcohol-related Twitter content and alcohol willingness and use among underage young adults

PURPOSE

Despite the importance of social networking sites on young adult alcohol use, few studies have examined Twitter as a conduit for sharing drinking behavior. However, this work generally uses random samples of tweets and thus cannot determine the extent to which Tweets correspond with self-reported drinking cognitions or behaviors. The primary aims of the present study were to (1) document basic patterns of alcohol-related Twitter activity in a subsample of young adult drinkers, and (2) examine whether willingness to drink, alcohol use, and negative consequences are associated with alcohol-related tweeting behavior.

METHODS

186 young adults age 18-20 completed an online survey and provided Twitter handle information. From these participants, a random sample of 5000 Tweets was coded by a trained team to determine whether tweets were related to alcohol use or not. Ordinary least squares regression analyses were conducted to determine whether the proportion of alcohol-related Tweets is associated with self-reported alcohol use willingness, behaviors, and negative consequences.

RESULTS

Results indicated that not only are alcohol-related tweets common among young adults, but that the proportion of one's overall tweets that are related to alcohol is significantly associated with willingness to drink, alcohol use, and negative consequences.

CONCLUSIONS

The results of this study are an important step to understanding how digital behavior (e.g., posting about alcohol on Twitter) is related to an individual's self-reported drinking cognitions, alcohol use, and negative consequences and has implications for the way Twitter data can be used for public health surveillance and interventions.

Perceived vulnerability moderates the relations between the use of protective behavioral strategies and alcohol use and consequences among high-risk young adults

Drinking protective behavioral strategies (PBS) have been associated with reductions in alcohol use and alcohol-related consequences in young adults. PBS subscales, Limiting/Stopping (LS), Manner of Drinking (MOD), and Serious Harm Reduction (SHR), have been examined in the literature; LS, MOD, and SHR have mixed support as protective factors. Understanding moderators between PBS and alcohol use and related consequences is an important development in PBS research in order to delineate when and for whom PBS use is effective in reducing harm from alcohol use. Perceptions of vulnerability to negative consequences, included in health-risk models, may be one such moderator. The current study examined whether two types of perceived vulnerability (perceived vulnerability when drinking; perceived vulnerability in uncomfortable/unfamiliar situations) moderated the relations between LS, MOD, SHR strategies and alcohol use and related negative consequences. High-risk young adults (N = 400; 53.75% female) recruited nationally completed measures of PBS, alcohol use and related consequences, and measures of perceived vulnerability. Findings demonstrated that perceived vulnerability when drinking moderated the relations between MOD strategies and alcohol use. The interactions between perceived vulnerability when drinking and PBS did not predict alcohol-related consequences. Perceived vulnerability in unfamiliar/uncomfortable social situations moderated relations between MOD strategies and both alcohol use and related negative consequences; no other significant interactions emerged. Across both perceived vulnerability types and MOD strategies, those with the highest levels of perceived vulnerability and who used MOD strategies the most had the greatest decrements in alcohol use and related negative consequences. Prevention and intervention implications are discussed.

Prototype Willingness Model Drinking Cognitions Mediate Personalized Normative Feedback Efficacy

Personalized normative feedback (PNF) interventions have been shown to be efficacious at reducing college student drinking. Because descriptive norms have been shown to mediate PNF efficacy, the current study focused on examining additional prototype willingness model social reaction cognitions, namely, prototypes and willingness, as mediators of intervention efficacy. We expected the PNF interventions to be associated with increased prototype favorability of students who do not drink, which would in turn be associated with decreased willingness to drink and subsequently, less drinking. The current study included 622 college students (53.2% women; 62% Caucasian) who reported one or more heavy drinking episodes in the past month and completed baseline and three-month follow-up assessments. As posited by the framework of the prototype willingness model, sequential mediation analyses were conducted to evaluate increases in abstainer prototype favorability on willingness on drinking, and subsequently willingness to drink on drinking behavior. Mediation results revealed significant indirect effects of PNF on three-month drinking through three-month prototypes and willingness, indicating that the social reaction pathway of the prototype willingness model was supported. Findings have important implications for PNF interventions aiming to reduce high-risk drinking among college students. Study findings suggest that we should consider looking at additional socially-based mediators of PNF efficacy in addition to perceived descriptive norms.

Examining a social reaction model in the prediction of adolescent alcohol use

The prototype willingness model (PWM; Gerrard et al., 2008) is a modified dual-processing model designed to improve the predictive value of existing health risk behavior by suggesting that there are two pathways to health risk behaviors: a reasoned path that is mediated by behavioral intention and a social reaction path that is mediated by behavioral willingness. Although there is evidence supporting the social reaction path to risk behavior among adolescents, most of this work has focused on specific components of the pathway such as prototypes or willingness rather than looking at the entire social reaction pathway as a whole. As such, the primary goal of the present study was to determine whether the social reaction pathway has acceptable fit for a sample of adolescents using a longitudinal design. Results from 835 adolescents support the social reaction pathway of the PWM model when applied to adolescent alcohol use. Specifically, prototypes, perceived vulnerability, and norms predicted willingness to drink, which in turn predicted drinking behavior (drinks per week and peak number of drinks) over a period of 12months. As such, these findings suggest that the social reaction pathway of the PWM is applicable to adolescent drinkers, meaning that adolescent drinking behavior is based on a less planned and socially based decision process.

The Chicken or the Egg: Examining Temporal Precedence Among Attitudes, Injunctive Norms, and College Student Drinking

OBJECTIVE

The present study was designed to test for projection, conformity, or reciprocal associations among attitudes, injunctive norms, and drinking. Assuming that these constructs are not independent, we proposed three possible trajectories. A conformity model would suggest that injunctive norms should temporally precede drinking or attitudes. Alternatively, a projection model would suggest that attitudes or alcohol use would precede injunctive norms. Furthermore, by examining the processes over three time points, the current study would also examine whether both conformity and projection processes were at work, indicating reciprocal relationships.

METHOD

participants included 249 college students (63.1% female), who participated as a control group in a larger intervention trial. Structural equation modeling was used to examine cross-sectional and prospective associations among injunctive norms, attitudes, and drinking across each of the three time points.

RESULTS

Findings demonstrated three significant cross-lagged associations. Injunctive norms at Time 1 was significantly associated with drinking at Time 2 (conformity), and both attitudes and drinking at Time 2 were significantly associated with injunctive norms at Time 3 (projection). The pattern of cross-lagged associations suggested one meaningful indirect pathway, from Time 1 injunctive norms to Time 2 drinking to Time 3 injunctive norms (reciprocal association).

CONCLUSIONS

The present study suggests that both the conformity and the projection processes seem to be important and evident for college student drinking when considering injunctive norms and drinking over time. Interventions that focus on both conformity and projection may be particularly effective at reducing longer-term alcohol use.

Reciprocal relationships over time between descriptive norms and alcohol use in young adult sexual minority women

Young adulthood, roughly ages 18-25, is a period of great risk for excessive consumption of alcohol, especially among sexual minority women (SMW). Despite the substantial literature examining the relationships between social norms and behavior in general, little attention has been given to the role of descriptive norms on the drinking behaviors of sexual minorities. The present study had 3 aims: to compare both typical woman descriptive norms and sexual minority-specific descriptive normative perceptions among a sample of SMW, to examine reciprocal associations between sexual minority-specific descriptive norms and alcohol consumption over time, and to examine whether these reciprocal associations were moderated by sexual orientation (i.e., whether 1 identifies as lesbian or bisexual). A national sample of 1,057 lesbian and bisexual women between the ages of 18 and 25 was enrolled in this study. Participants completed an online survey at 4 time points that assessed the constructs of interest. Results indicated that SMW consistently perceived that SMW drank more than their nonsexual minority peers; that SMW-specific descriptive drinking norms and alcohol consumption influenced 1 another over time in a reciprocal, feed-forward fashion; and that these associations were not moderated by sexual orientation. These findings highlight the importance of considering SMW-specific norms as an important factor in predicting alcohol consumption in SMW. Results further support the development and testing of normative interventions for high-risk drinking among SMW.

Examining the role of abstainer prototype favorability as a mediator of the abstainer-norms-drinking-behavior relationship

Past research has indicated that peer influence is associated with risky health behaviors, such as alcohol and other substance use (e.g., Maxwell, 2002; Santor, Messervey, & Kusumakar, 2000). Specifically, research has indicated that believing that more of one's peers use alcohol predicts more favorable prototypes (risk images) of the typical alcohol user (Litt & Stock, 2011; Teunissen et al., 2014). However, it is unclear if this same relationship would hold when considering abstainer (i.e., people who do not use alcohol) cognitions. The primary goal of the present study was to determine whether normative perceptions of peer abstinence from alcohol predict alcohol consumption and whether this relationship is mediated by abstainer prototypes. Results from 2,095 college students (42% male) indicated that the relation between abstainer norms and drinking behavior was mediated by abstainer prototypes such that believing that more peers abstained from alcohol use predicted more favorable prototypes of the typical alcohol abstainer, which in turn predicted lower alcohol use. Results from this study provide important first steps to delineating the relationship between abstainer cognitions and alcohol use. (PsycINFO Database Record

Adolescent alcohol use: Social comparison orientation moderates the impact of friend and sibling behaviour

OBJECTIVES

Research has indicated that both peers and siblings influence adolescents' alcohol use (e.g., Windle, 2000, Appl. Dev. Sci., 4, 98). The present two studies examined whether social comparison orientation (SCO) moderates the effects of perceived friend and sibling alcohol use on adolescents' alcohol use cognitions and behaviours.

DESIGN AND METHODS

Two studies examined the role of SCO as a moderator of social influence (perceived friend alcohol use in Study 1 and both perceived friend use and sibling-reported alcohol use in Study 2) on prototype perceptions and willingness to drink alcohol (Studies 1 and 2) as well as actual alcohol consumption (Study 2) among early adolescents.

RESULTS

In Study 1, cross-sectional results indicated that SCO moderated the effect of perceived friend alcohol use on favourable images of drinkers and willingness to drink. Study 2 found that SCO moderated the effects of perceived friend use and sibling use on favourable images of alcohol users, willingness to use alcohol, and change in alcohol use over 3 years such that adolescents who reported engaging in social comparison more often reported greater willingness, more favourable images, and increases in alcohol use when perceived friend use or sibling use was high.

CONCLUSIONS

These studies highlight the importance of SCO as a moderator of susceptibility to the social influences of friends and siblings and may hold important implications for adolescent alcohol use prevention programmes and models of health risk behaviour.

Randomized controlled trial of a web-delivered personalized normative feedback intervention to reduce alcohol-related risky sexual behavior among college students

OBJECTIVE

The purpose of this study was to evaluate the efficacy of personalized normative feedback (PNF) on college student alcohol-related risky sexual behavior (RSB).

METHOD

In a randomized controlled trial, 480 (57.6% female) sexually active college students were stratified by gender and level of drinking and randomly assigned to an alcohol-only intervention, an alcohol-related RSB-only intervention, a combined alcohol and alcohol-related RSB intervention, or control. All assessment and intervention procedures were Web-based.

RESULTS

Results indicated a significant reduction in drinking outcomes for the alcohol only and the combined alcohol and alcohol-related RSB interventions relative to control. Findings further demonstrated a significant reduction in alcohol-related RSB outcomes for the alcohol-related RSB only and the combined alcohol and alcohol-related RSB interventions relative to control. There were no significant intervention effects on alcohol-related negative consequences. These findings demonstrate that the combined alcohol and alcohol-related RSB intervention was the only intervention successful at reducing both drinking and alcohol-related RSB outcomes relative to control. There were no significant differences when comparing the combined alcohol and alcohol-related RSB intervention to the alcohol-only intervention or the alcohol-related RSB-only intervention. Finally, results suggested that the intervention effects on high-risk behaviors were mediated by reductions in descriptive normative perceptions.

CONCLUSIONS

These findings demonstrate that PNF specific to drinking in sexual situations was needed to reduce alcohol-related RSB. Furthermore, this study highlights the potential utility of a brief intervention that can be delivered via the Internet to reduce high-risk drinking and alcohol-related RSB among college students.

Normative misperceptions of peer seat belt use among high school students and their relationship to personal seat belt use

OBJECTIVES

This research examined gender-specific perceptions of peer seat belt use norms among high school students and their relationship with one's own seat belt use. We expected that students would underestimate the seat belt use of their peers and that these perceptions would be positively associated with their own seat belt use.

METHODS

High school students from 4 schools (N = 3348; 52% male) completed measures assessing perceived seat belt use and personal seat belt use.

RESULTS

Findings demonstrated that students perceived that others engaged in less seat belt use than they do and that perceived norms were positively associated with one's own seat belt use.

CONCLUSIONS

Peer influences are a strong predictor of behavior, especially among adolescents. Ironically, adolescents' behaviors are often influenced by inaccurate perceptions of their peers. This research establishes the presence of a misperception related to seat belt use and suggests that misperception is associated with own behaviors. This research provides a foundation for social norms-based interventions designed to increase seat belt use by correcting normative misperceptions among adolescents.

Social comparison as a moderator of the association between perceived norms and alcohol use and negative consequences among college students

OBJECTIVE

The present study aimed to extend previous research examining the relationships among perceived drinking norms, alcohol use, and related negative consequences by examining the moderating influence of social comparison orientation.

METHOD

A sample of 481 college students (44% male) completed a Web-based survey that assessed perceptions of drinking behavior, social comparison orientation, and alcohol use.

RESULTS

The results suggested that social comparison orientation moderated the norm-behavior relationship such that the association between perceived drinking norms and alcohol-related negative consequences was stronger for those higher in social comparison. Results also showed that there was no moderation effect for alcohol consumption as the dependent variable.

CONCLUSIONS

The findings of the present study are potentially important when developing efficacious alcohol prevention and intervention programs at colleges and universities and in considering more complex models of social influences on drinking.