Consequences, Motives, and Expectancies of Consumption as Predictors of Binge Drinking in University Women

The increasing presence of women, especially university women, in risky alcohol consumption such as Binge Drinking (BD), which is associated with gender-specific biopsychosocial problems, makes it necessary to analyze the variables underlying BD in order to adjust possible interventions more in line with their reality. The motives and expectancies of this pattern of consumption, as well as the consequences derived from it, are some of the variables that are shown to have the greatest weight in the prediction of BD. In the present study we analyze, on the one hand, the performance of these variables among college women with alcohol use, and on the other hand, which of these variables allow us to classify BD. A total of 501 female university consumers of alcohol (mean age 19.02 years) were assessed. Specifically, they completed a self-report of alcohol consumption (77.1% engage in BD), the Expectancy Questionnaire (EQ), the Drinking Motives Questionnaire (DMQ-R) and the Alcohol Consumption Consequences Evaluation (ACCE). BD female students scored significantly higher on these instruments, except for compliance motives. The logistic regression analysis carried out to estimate the probability of performing BD using the social and conformity motives, the ACCE and positive expectancies correctly estimated (χ2 8 = 9.149, p < 0.33) 88.6% of the cases and explained 26.2% of the BD. Thus, young women with a level of consequences classified as high risk (>25 in ACCE) have a 3.55-fold increase in the probability of having BD, compared to women classified as low risk by the ACCE. On the other hand, women classified as moderate risk by the ACCE have a 4.77-fold increase in the probability of having BD. In the case of social motives and positive expectancies, their increase multiplies by 1.165 and 1.024, respectively, the probability of having BD. The results of this study highlight the importance of adapting preventive measures to the consequences experienced by BD university students, especially in relation to the social motives and positive expectancies that modulate decision-making when engaging in this pattern of consumption.

Expectancies and Motives as Predictors of Risky Alcohol Consumption in College Women

Despite the consequences of alcohol use, it continues showing a high incidence among college students. Besides, the increasing presence of women in risk alcohol patterns calls for a gender-sensitive approach to design specific actions. Some variables have been analyzed as underlying alcohol consumption (expectations and motives). This paper assesses the type and influence of both variables on female university alcohol consumers at different levels of risk. Five hundred four college women were assessed using the Spanish adaptations of the Expectancy Questionnaire, the Drinking Motives Questionnaire-Revised, and the AUDIT. We determine the unique contributions of expectancies, motives, and the presence of binge drinking (BD) to the pattern of risky drinking. The percentage of variance explained by risky drinking is 37.7%. Negative expectancies (20.4%) are the most explanatory variables, followed by enhancement motives (10.4%). Interventions with university women should focus on their negative expectancies, in addition to addressing for improvement, coping with depression, and conformity motives.

Binge Drinking: The Top 100 Cited Papers

We conducted a review to analyze the 100 most-cited studies on binge drinking (BD) in the Web of Science (WoS) database to determine their current status and the aspects that require further attention. We carried out a retrospective bibliometric analysis in January 2021. The year of publication, authors, design, subject, journal, institution and lead author’s country, as well as the definition of BD, were extracted from the articles. The data on the country, year, thematic category of the journals and their rank were obtained from the Institute for Scientific Information (ISI) Journal Citation Reports 2020. The number of citations was collected from the WoS, and the h index was collected from the Scopus database. The citation density and Bradford’s law were calculated. The majority of the articles were empirical quantitative studies with a cross-sectional design published between 1992 and 2013 in 49 journals. There were 306 authors, mostly English-speaking and from the USA. The definitions used to describe BD are not homogeneous. The most-cited topics were the analysis of consequences, determinants and epidemiology. There is a need to unify the definitions of BD and base them on scientific evidence. The multidisciplinary nature of BD is not well reflected in each of the thematic areas discussed in this work.

Evaluation of AUDIT Consumption Items New Adaptation to Improve the Screening of College Students Binge Drinking

The strong presence of Binge Drinking (BD) amongst university students, as well as the consequences associated with the same and the changes taking place over recent years regarding its conceptualization make it necessary to examine the usefulness of screening instruments used to detect this drinking pattern. This study examines the usefulness of a briefer adaptation of the AUDIT proposed by Cortés, Giménez, Motos, and Sancerni (2017a).College students self-administered the AUDIT, the revised items 2 and 3 (A2r and A3r), and completed a weekly self-report of their alcohol intake. BD was classified according to the amount consumed and the frequency of that consumption over the past six months. The AUDIT, AUDIT-C and items A2r+A3r (AR2I) were examined. The results obtained from a sample of 605 college students (18-21 years old/55.2% female) indicate that 449 meet the BD criteria. Items A2r and A3r, adapted to the most consensual definition of BD, were found to identify 98% of BD college students when using a cut-off point of ≥ 3 in females and ≥ 4 in males with optimum levels of sensitivity and specificity. The new adaptation, which includes fewer items, identifies BD college students more accurately. This confirms the need to adjust both consumption items from the model according to the pattern of consumption in college students to detect BD more precisely and as soon as possible.

Psychometric Properties of the "Alcohol Consumption Consequences Evaluation" (ACCE) Scale for Young Spanish University Students

Instruments that evaluate alcohol use consequences among young people do not consider the intensive alcohol consumption pattern that is so characteristic during these ages. Some of these instruments are even ineffective in the Spanish population. Hence the interest in developing an instrument more adapted to the reality of our young people. A total of 601 university students (35.9% male and 64.1% female) from 18 to 20 years old were recruited. All of them answered a total of 77 items obtained from the review of both the scientific literature and the different scales used to measure consequences derived from alcohol consumption. In addition, they completed the AUDIT and the Timeline Followback for self-reported consumption. The data were analyzed using factor analysis and a two-parameter logistic model. ROC curve analysis was used to establish cut-off points for different risk levels of alcohol consumption distinguishing between genders. The final 43-item scale Alcohol Consumption Consequences Evaluation (ACCE) (Evaluación de Consecuencias derivadas del Consumo de Alcohol [ECCA]) shows adequate psychometric properties: α = 0.94; unidimensionality through exploratory factor analysis (EFA) (26.25% of explained variance) and confirmatory factor analysis (CFA) (RMSEA = 0.39; TLI and CFI > 0.90). In addition, ROC analyses, both at a global scale and distinguishing between genders, were able to characterize consumers with different levels of risk, obtaining areas under the curve between 0.82 and 0.88. A scale has been obtained that enables the establishment of cut-off points to distinguish between the consequences of low, moderate and high risk alcohol consumption. The clinical utility of the ACCE is highlighted by using one single instrument to perform the screening of a possible alcohol risk consumption as well as identifying the consequences that need to be worked on in the evaluated person’s or group’s intervention.

Revision of AUDIT Consumption Items to Improve the Screening of Youth Binge Drinking

This study analyzes the appropriateness of an improved version of one of the most frequently used instruments for the screening of high-risk alcohol consumption. This adaptation was created in accordance with certain limitations recognized by other researchers and in an attempt to adjust the content and scales of some items to a more consensual definition of binge drinking. After revising items 2 and 3, the areas under the ROC curves of the AUDIT and of different abbreviated versions were calculated. A total of 906 minors (468 females) between the ages of 15 and 17 were evaluated. Stratified sampling was conducted on a population of high school students in the city of Valencia (Spain). One school was randomly chosen from each of the city’s 16 school districts. Information was collected on sociodemographic aspects, consumption patterns and the AUDIT containing the improved items. The percentage of underage BD reached 36%, regardless of gender or age. BD groups have been differentiated by different intensity levels, both in males and females. Upon comparing the effectiveness of the distinct versions of the AUDIT, it is recommended that researchers and clinics use the combination of the revised items 2 and 3 to ensure a more precise identification of underage BD. A cut-off point of 5 for this test would permit identification of 94% of the underage BD and would notably reduce false positives.

Different versions of the Alcohol Use Disorders Identification Test (AUDIT) as screening instruments for underage binge drinking

BACKGROUND

The changes experienced in recent years in the conceptualization of binge drinking (BD) make it necessary to revise the usefulness of the existing instruments for its detection among minors. The AUDIT and its abbreviated versions have shown their utility in different populations and consumption ranges, but there has been little research into their use in the detection of BD among adolescents. This study tests the capacity of the AUDIT, AUDIT-C and AUDIT-3 to identify BD adolescents, indicating the optimal cut-off points for each sex.

METHODS

High school students self-administered the AUDIT and completed a weekly self-report of their alcohol intake. BD is classified into different groups according to parameters like the quantity consumed and its frequency in the past six months, adjusting the cut-off points for each case.

RESULTS

The results obtained with a sample of 634 adolescents (15-17 years old/52.2% female) indicate that cut-off points of 4 on the AUDIT and 3 on the AUDIT-C show the best fit. Dividing the sample by sexes, the AUDIT and the AUDIT-C would detect BD males with scores of 5 and 4, respectively (with the AUDIT-C being more sensitive), and BD females with a score of 3 on both (the more sensitive being the AUDIT).

CONCLUSIONS

All three versions are adequate to classify BD adolescents but none of them made it possible to safely differentiate binge drinkers with different consumption intensities.