Efficacy of expectancy challenge interventions to reduce college student drinking: A meta-analytic review

Interventions challenging alcohol expectancies may lead to reductions in alcohol consumption. We conducted a meta-analysis to examine the efficacy of alcohol expectancy challenge (EC) interventions for college alcohol abuse prevention. Included were 14 studies (19 EC interventions) that measured alcohol expectancies and consumption, provided sufficient information to calculate effect sizes, and were available as of June 2010 (N = 1,415; M age = 20 years; 40% women; 88% White). Independent raters coded participant characteristics, design and methodological features, and intervention content, and calculated weighted mean effect sizes at first follow-up, using both fixed and random effects models. Compared with controls, EC participants reported lower positive alcohol expectancies, reduced their alcohol use, and reduced their frequency of heavy drinking (d+s ranged from 0.23 to 0.28). Within-group improvements in alcohol expectancies and consumption emerged for the EC group only; relative to their own baseline, EC participants reported lower positive alcohol expectancies, reduced their alcohol use, and reduced their frequency of heavy drinking (d+s ranged from 0.13 to 0.36). Supplemental analyses found improvements in specific alcohol expectancies (social, sexual, tension, and arousal) both between groups and within group. The short-term effects of EC interventions on college student drinking are not maintained at follow-ups greater than 4 weeks. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

21st birthday drinking and associated physical consequences and behavioral risks

Twenty-first birthday celebrations often involve dangerously high levels of alcohol consumption, yet little is known about risk factors for excessive drinking on this occasion. Participants (N = 150) from a larger prospective study who consumed at least one drink during their celebration completed questionnaires and semistructured interviews about their 21st birthday within four days after the event. Assessments were designed to characterize 21st birthday alcohol use, adjusted for alcohol content, as well as situational/contextual factors (e.g., celebration location, peer influence) that contribute to event-level drinking. Participants reported an average of 10.85 drinks (9.76 adjusted drinks), with experienced drinkers consuming significantly more than relatively na?ve drinkers who had no previous binge or drunken episodes. Men consumed more drinks, whereas age of first drunken episode and heavier drinking during the 3-months preceding the 21st birthday predicted higher estimated blood alcohol concentrations (eBACs) on the 21st birthday. Celebrating in bars and engaging in birthday-specific drinking traditions (free drinks at bars) explained additional variance in 21st birthday eBACs. Both physical consequences (e.g., blacking out or having a hangover) and behavioral risks (e.g., sexually provocative behaviors) were prevalent and were predicted by higher eBACs. Together these findings indicate that 21st birthday celebrations are associated with heavy drinking and a variety of physical consequences and behavioral risks.     

Evaluations and expectancies of alcohol and marijuana problems among college students.

Two studies examined the associations between evaluations (good-bad) and expected likelihood (likely-unlikely) of alcohol- and marijuana-related problems and hazardous consumption and problems among college students. Participants provided data on alcohol use, alcohol-related problems, and expectancies and evaluations of alcohol problems; marijuana use indices, marijuana-related problems, marijuana effect expectancies, and likelihood and evaluations of marijuana problems. Evaluations of alcohol problems were positively related to the number of binge drinking occasions and alcohol-related problems. The interaction between evaluations and expectancies was significant in predicting the number of binge drinking occasions. Expectancies demonstrated a curvilinear relationship with binge drinking and alcohol-related problems. Marijuana users evaluated marijuana-related problems as less negative and less likely to occur than did nonusers. Expectancies, but not evaluations, of negative consequences were significantly associated with marijuana use intensity. Expectancies of problems demonstrated a curvilinear relationship with marijuana-use intensity and marijuana problems. Men evaluated alcohol and marijuana problems less negatively than did women. In summary, the expected likelihood of alcohol-marijuana problems and the evaluation of such problems represent a vulnerability factor associated with increased liability for hazardous alcohol and marijuana use.     

Understanding the Relationship Between Religiousness, Spirituality, and Underage Drinking: The Role of Positive Alcohol Expectancies

Research has consistently found that religiousness and spirituality are negatively associated with underage drinking. However, there is a paucity of research exploring the mechanisms by which these variables influence this important outcome. With 344 underage young adults (ages 18–20; 61 % women), we investigated positive alcohol expectancies as a mediator between religiousness and spirituality (measured separately) and underage alcohol use. Participants completed the Religious Commitment Inventory-10, Daily Spiritual Experiences Scale, Alcohol Expectancies Questionnaire, and Drinking Styles Questionnaire. Results indicate less positive alcohol expectancies partially mediate the relationship between both religiousness and spirituality and underage alcohol use. This suggests religiousness and spirituality’s protective influence on underage drinking is partly due to their influence on expectations about alcohol’s positive effects. Since underage drinking predicts problem drinking later in life and places one at risk for serious physical and mental health problems, it is important to identify specific points of intervention, including expectations about alcohol that rise from religious and spiritual factors.     

Evaluation of a single-session expectancy challenge intervention to reduce alcohol use among college students

In this study, the authors developed and evaluated a single-session experiential expectancy challenge (EC) intervention, seeking to reduce alcohol use by changing key positive expectancies among moderate to heavy drinking male and female college students. Participants (N=217) were randomly assigned to attend a 90- to 120-min EC session, CD-ROM alcohol education, or assessment only. Participants were assessed at pretest, posttest, and 1-month follow-up. Exposure to the EC intervention led to significant decreases in alcohol expectancies and subsequent alcohol consumption in both genders at follow-up. No significant changes were evident in either control condition. This study is the first to effectively decrease expectancies and drinking in college students with a single-session EC intervention. Further, although several studies have demonstrated the utility of the intervention with men, it is the first to do so with women. This study represents a critical step in the process of translating an innovative, theory-based intervention into a more practical format that makes it more accessible to those who seek effective drinking-reduction strategies for college campuses.     

Alcohol expectancies and context-specific drinking behaviors among female college athletes

Alcohol expectancies have been associated with drinking behaviors among college students. Few studies, however, have focused on researcher-labeled "positive" and "negative" expectancies as well as the valuations (i.e., desirability) of these expectancies. Moreover, research on the correlates of heavy drinking among female college athletes remain relatively sparse, despite the prevalence of elevated alcohol use in this population. We examined the associations of expectancies and valuations with frequency of heavy drinking and context-specific drinking behaviors. The sample consisted of 145 female college athletes (mean age=19.6; range=17 to 22) who completed self-report surveys and indicated alcohol use in the past 30 days. Regression analyses indicated that favorable valuations of negative expectancies were related to heavy drinking, and that valuations accounted for significant proportions of variance in the model. Elevated endorsement of negative expectancies was also associated with the perceived likelihood of heavy use in convivial and personal-social drinking contexts, and favorable valuations of these expectancies accounted for significant variance in these models. These findings highlight the relevance of negative expectancies and valuations with respect to heavy drinking and context-specific drinking behaviors among female college athletes. The perception of "negative" effects of alcohol as "positive" could help explain the high rates of problematic drinking among female athletes. Future research considerations and potential implications for assessment and prevention efforts are discussed.     

Mass Media as Alcohol Educator for Everyone? Effects of Portrayed Alcohol Consequences and the Influence of Viewers’ Characteristics

ABSTRACT

Many correlative and experimental studies indicate that the portrayal of alcohol in the mass media impacts viewers’ alcohol expectancies, attitudes, and behaviors. Based on social cognitive theory, the portrayed consequences and the valence of the character experiencing these consequences are important to consider when investigating the portrayal of alcohol in the mass media. However, experimental studies manipulating character valence and consequences are scarce. This study presents an experimental examination of an adult sample, manipulating the occurrence of consequences (no consequences, positive consequences, and negative consequences), as well as character valence (a positive or negative character). We investigated the effects of media portrayals on positive and negative alcohol expectancies, as well as on attitudes toward alcohol. Furthermore, the moderating role of participants’ level of alcohol consumption was considered. We found main effects only on the negative alcohol expectancies, supporting the differentiation of alcohol expectancies and attitudes. However, the valence of the depicted character did not moderate the impact of the portrayed consequences. Interaction effects of participants’ individual levels of alcohol consumption and portrayals of consequences of alcohol consumption in the mass media were uncovered. This finding has important implications for further research and prevention efforts directed at risk groups.     

Risk for Substance Abuse: Memory as a Common Etiological Pathway

Memory processes may be part of the causal chain by which known antecedents of alcohol and drug abuse influence drinking. Recent findings on alcohol expectancies are consistent with a memory model and help articulate how consumption may be influenced by memory representations of biological and environmental characteristics. This line of research suggests novel prevention and intervention strategies.     

Using a modified Stroop task to implicitly discern the cognitive organization of alcohol expectancies

Alcohol expectancies have been statistically modeled as memory networks that influence future consumption. To test the organization of expectancies suggested by these models, a modified Stroop color-naming task incorporated expectancy words associated in past research with heavy and light drinking. Light and heavy drinkers ink-named expectancy targets after being cued with an alcohol beverage word or a nonalcohol beverage word. Consistent with predictions derived from statistical models, heavy drinkers displayed significant interference when arousing expectancy words had been primed by an alcohol beverage word, whereas light drinkers displayed significant interference when sedating expectancy targets had been so primed. These results reinforce the idea that mediation o falcohol use by expectancies may be implicit as well as explicit.     

High school drinking and its consequences

The present study surveyed 930 high school students regarding self-reported alcohol use, their perceptions of parents and peers, and the negative consequences of drinking. Two-fifths of males and one-fifth of females reported frequent problem (binge) drinking. Problem drinkers reported more negative consequences associated with drinking. In addition, problem drinkers reported greater susceptibility to peer pressure, perceived their peers as drinking more, and reported less parental monitoring and more use of alcohol by parents. The results demonstrate the importance of both parent and peer variables in adolescent substance use and highlight the negative consequences of drinking reported by high school students.     

Effects of message framing and temporal context on college student drinking behavior

This study evaluated the interactive effects of message framing and temporal context on college student alcohol use. Participants (n = 228) were randomly assigned to read an alcohol prevention message that varied by message frame (gains vs. losses) and temporal context (short- vs. long-term consequences). Participants returned to the lab one month later to report their drinking behavior over the past month. As predicted, students exposed to the gain-framed message reported lower alcohol use (drank less frequently, drank fewer alcoholic beverages per drinking occasion, and engaged in less binge drinking) as compared to students exposed to the loss-framed message, but only if they read about short-term consequences of alcohol use. Message frame had no effect when participants were exposed to long-term consequences. This investigation extends previous research by demonstrating the effectiveness of message framing for reducing health-damaging behaviors and by identifying temporal context as a moderator of framing effects.     

Psychological predictors of young adults' drinking behaviors

Path analyses using data from 72 men and 78 women between 22 and 32 years of age compared two models linking personality (conflict resolution styles, intimacy maturity, and occupational identity status) and social roles (family and work status) to young adults' alcohol use. Poor conflict resolution skills and less adult work statuses best accounted for men's excessive drinking, and problems with intimacy best accounted for women's use of alcohol to alleviate emotional distress. In addition, poor conflict resolution skills partly mediated the effects of parent's drinking on son's alcohol consumption. Occupational identity status and intimacy maturity correlated with men's use of drugs rather than men's alcohol use.     

The Question of Higher Education for the Blind

Building on the theory of reasoned action (I. Ajzen & M. Fishbein, 1973, 1980; M. Fishbein & I. Ajzen, 1975) and expectancy theory, the authors examined the mediating role of alcohol expectancies in adolescent drinking behaviors by testing whether alcohol expectancy outcomes and valuations (the extent to which these outcomes are perceived as good or bad) mediate the association between peer influences and lifetime alcohol use. Early adolescents (N = 904) from 2 public middle schools in western Michigan completed a battery of questionnaires. Overall, results showed that alcohol expectancies and valuations partially mediated the relations between peer influences (peer use and peer approval) and lifetime alcohol use. The findings suggest that associating with peers who are perceived as using alcohol and approving of drinking may influence adolescents’ alcohol expectancies. The authors briefly discuss future research directions and implications for prevention.     

High risk drinking and college students' self-perceptions

The present study examined the relationship between high risk drinking and college students' self-perceptions. High risk drinking was defined as the consumption of four or more drinks in a row for women and five or more drinks in a row for men during a single sitting (within the last year). Historical trends regarding college-age drinking indicate that 44% of college students fit the criteria for high risk drinking at least once over the past year. A survey was administered to 210 college students (52 men and 158 women) between 18 and 22 years of age (M = 20.9, SD = 1.3) to assess their use of alcohol and their self-perceptions. Students' self-perceptions were measured with four subscales from the Neemann-Harter Self-perception Profile for College Students. Students either volunteered to participate in this study outside of class or were solicited during class. It was predicted that students' self-perceptions would differ significantly depending upon their alcohol consumption, i.e., 17.1% were Abstainers, 25.2% were Nonproblem Drinkers, and 57.6% were High Risk Drinkers. Analysis gave significant difference on Global Self-worth between students who abstained and those who were High Risk Drinkers. However, students' perceptions of Scholastic Competence, Intellectual Ability, and Social Acceptance did not differ significantly for the alcohol consumption groups. In addition to high risk drinking, a number of other variables were associated with self-perceptions, such as high school alcohol use, low high school GPA, and students' reported academic involvement. These relations are discussed.     

Influence of subject and interviewer characteristics on the reliability of young adults' self-reports of drinking

The influence of subject and interviewer characteristics on the reliability of self-reports of alcohol consumption among young adults was investigated. Data were gathered from black and white college students of both sexes (N's=24) using a time-line procedure. The results snowed that these young adults provided highly reliable self-reports regarding their use of alcohol. Test-retest correlations for a criterion interval of 90 days were .96, .93, and .97 for the numbers of abstinent, moderate-drinking, and heavy-drinking days, respectively. Analyses also showed that white female subjects generally provided more reliable reports of abstinent and heavy-drinking days and that white female interviewers gathered more reliable reports across the three drinking disposition categories. These findings suggest that nonalcoholic young adults' retrospective reports of their drinking behavior can be reliably assessed using the time-line methodology. Future research is required to determine the validity of these self-reports and to understand the differential influence of subject and interviewer characteristics on the levels of reliability found.     

Predictors of heavy drinking and drinking problems over the first 4 years of marriage.

This study investigated the factors predictive of heavy drinking and drinking problems over the early years of marriage, focusing on premarital drinking and the relatively stable individual risk and protective factors that were present prior to marriage and on social-interpersonal factors that may change or emerge over marriage. Newlywed couples were assessed at the time of marriage and at the 1st, 2nd, and 4th anniversaries with respect to frequency of heavy drinking and the extent of drinking problems and a variety of factors that have been found to be predictive of adult alcohol problems. The results indicated that antisocial characteristics, family history of alcoholism, negative affect, and alcohol expectancies were related to heavy drinking and alcohol problems at the time of marriage. Changes after marriage were predicted by the drinking of one's partner and of one's peers and by alcohol expectancies for social/physical pleasure for both men and women. In addition, the quality of the marriage was longitudinally protective from the experience of alcohol problems for both men and women, although it was not related to changes in heavy drinking.     

A randomized motivational enhancement prevention group reduces drinking and alcohol consequences in first-year college women.

Alcohol consumption among college students has become an increasing problem that requires attention from college administrators, staff, and researchers. Despite the physiological differences between men and women, college women are drinking at increasingly risky rates, placing them at increased risk for negative consequences. The current study tested a group motivational enhancement approach to the prevention of heavy drinking among 1st-year college women. Using a randomized design, the authors assigned participants either to a group that received a single-session motivational enhancement intervention to reduce risky drinking that focused partly on women's specific reasons for drinking (n = 126) or to an assessment-only control group (n = 94). Results indicated that, relative to the control group participants, intervention participants drank fewer drinks per week, drank fewer drinks at peak consumption events, and had fewer alcohol-related consequences over a 10-week follow-up. Further, the intervention, which targeted women's reasons for drinking, was more effective in reducing consumption for participants with high social and enhancement motivations for drinking.     

Fitting in and feeling fine: conformity and coping motives as mediators of the relationship between social anxiety and problematic drinking.

The present research was conducted to clarify the relationships among social anxiety, alcohol consumption, alcohol-related problems, and negative-reinforcement drinking motives among college students. Heavy drinking students (N = 316, 53.80% female) completed self-report measures of social anxiety, alcohol consumption, alcohol-related problems, and drinking motives. Findings indicated that students higher in social anxiety consumed less alcohol but experienced more negative consequences. Moreover, the relationship between social anxiety and negative consequences was mediated by coping and conformity drinking motives in addition to alcohol consumption. In the context of social anxiety, the current research demonstrates the importance of examining problematic drinking as distinct constructs: alcohol consumption and negative consequences. Findings are also discussed in terms of implications for interventions with socially anxious students.     

Perceived Norms,Outcome Expectancies,and Collegiate Drinking: Examining the Mediating Role of Drinking Motives

The authors examined the mediational role of drinking motives in explaining the associations among psychosocial antecedents and collegiate drinking. Results indicated that drinking motives partially mediated the relationships between outcome expectancies, perceived norms, alcohol use intensity, and alcohol‐related negative consequences.     

Restrained drinking and cognitive control among adolescents

The present study investigated restrained drinking and self-control in relation to alcohol consumption and problem drinking in a sample of adolescents. One hundred ninety-eight high school students (97 males and 101 females; mean age = 16.45 years) completed questionnaires that assessed levels of alcohol consumption, problem drinking, restrained drinking, and cognitive self-control. The findings were similar for males and females: higher levels of restrained drinking, as measured by cognitive emotional preoccupation (CEP), predicted higher levels of alcohol consumption and problem drinking. Moreover, it was high CEP in combination with a low score on a general measure of cognitive self-control that differentiated problem drinking from high levels of drinking. The results are consistent with previous research on young adults. The findings are discussed in relation to Baumeister and Heatherton's (1996) model of self-regulation failure.