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.     

Being controlled by normative influences: self-determination as a moderator of a normative feedback alcohol intervention.

The objectives of this research were to evaluate the efficacy of computer-delivered personalized normative feedback among heavy drinking college students and to evaluate controlled orientation as a moderator of intervention efficacy. Participants (N = 217) included primarily freshman and sophomore, heavy drinking students who were randomly assigned to receive or not to receive personalized normative feedback immediately following baseline assessment. Perceived norms, number of drinks per week, and alcohol-related problems were the main outcome measures. Controlled orientation was specified as a moderator. At 2-month follow-up, students who received normative feedback reported drinking fewer drinks per week than did students who did not receive feedback, and this reduction was mediated by changes in perceived norms. The intervention also reduced alcohol-related negative consequences among students who were higher in controlled orientation. These results provide further support for computer-delivered personalized normative feedback as an empirically supported brief intervention for heavy drinking college students, and they enhance the understanding of why and for whom normative feedback is effective.     

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.     

Protective behavioral strategies and the relationship between depressive symptoms and alcohol-related negative consequences among college students

Approximately 40% of college students reported engaging in heavy episodic or "binge" drinking in the 2 weeks prior to being surveyed. Research indicates that college students suffering from depression are more likely to report experiencing negative consequences related to their drinking than other students are. The reasons for this relationship have not been well-studied. Hence, the purpose of this study was to determine whether use of protective behavioral strategies (PBS), defined as cognitive-behavioral strategies an individual can use when drinking alcohol that limit both consumption and alcohol-related problems, mediated the relationship between depressive symptoms and alcohol-related negative consequences among college students. Data were obtained from 686 participants from a large, public university who were referred to an alcohol intervention as a result of violating on-campus alcohol policies. Results from structural equation modeling analyses indicated that use of PBS partially mediated the relationship between depressive symptoms and alcohol-related negative consequences. Implications for clinicians treating college students who report experiencing depressive symptoms or consuming alcohol are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).     

Concurrent drinking and smoking among college students: An event-level analysis

Cigarette smoking and drinking commonly co-occur among college students, a population that is at high risk for developing alcohol and nicotine use disorders. Several studies have been conducted that have examined predictors of drinking or smoking to gain a better understanding of the antecedents of engaging in these behaviors. Yet, few studies have examined specific factors that influence concurrent smoking and drinking in this population. The current study used data from a 21-day electronic diary-based study of college students (n=86) who engaged in concurrent drinking and smoking to examine event-level associations between alcohol use and cigarette smoking in the student's natural environment. We specifically focused on within-person analyses of contexts in which students reported smoking and drinking simultaneously in comparison to contexts in which students reporting drinking without smoking. Situational contexts included environmental setting, whether s/he was alone or with others, and changes in stress and urges to smoke before initiating drinking. Results indicated that students drank more while smoking and smoked three times as many cigarettes, on average, during drinking episodes. Being with others at a party or a bar was associated with increased odds of smoking while drinking. Likewise, increased stress since the prior assessment predicted a greater likelihood of smoking while drinking. Based on the findings from the present study, it is important for future prevention and intervention efforts to consider social settings and heightened stress among students as potential risk factors for engaging in concurrent drinking and smoking.     

Gender congruence in confirmatory and compensatory drinking.

The relationship between gender-stereotypical traits and drinking behaviors was examined in 422 university students via both positive and negative measures of masculinity and femininity. Two canonical variates summarized the underlying relationships. The 1st canonical variate indicated that both high negative masculinity and low positive femininity predicted alcohol consumption and alcohol-related problems. This behavior was labeled confirmatory drinking because it depicts a style of drinking that reinforces gender-stereotypical images about alcohol use; masculine characteristics are typically associated with high levels of alcohol consumption. The 2nd canonical variate indicated that both low positive masculinity and low positive femininity predicted problem drinking. This behavior was labeled compensatory drinking because drinkers often use alcohol to express their masculinity and femininity. The distinction between confirmatory and compensatory drinking has important implications for the development of more effective education and preventative strategies.     

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.     

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.     

Reducing Alcohol‐Related Consequences Among High School Seniors: Efficacy of a Brief,Web‐Based Intervention

The authors examined the efficacy of a brief, web‐based personalized feedback intervention on reducing alcohol‐related consequences among high school seniors (N = 105) using a group‐randomized controlled design. Results of repeated measures mixed‐models analyses indicated significant intervention effects over time for alcohol‐related consequences at 30‐day and 6‐month follow‐up assessments. Drinking risk status moderated intervention effects such that results were only significant for high‐risk drinkers (i.e., students reporting initiation of heavy episodic drinking at baseline).     

Reducing Youth Access to Alcohol: Findings from a Community-Based Randomized Trial

Underage drinking continues to be an important public health problem and a challenge to the substance abuse prevention field. Community-based interventions designed to more rigorously control underage access to alcohol through retailer education and greater enforcement of underage drinking laws have been advocated as potentially effective strategies to help address this problem, but studies designed to evaluate such interventions are sparse. To address this issue we conducted a randomized trial involving 36 communities to test the combined effectiveness of five interrelated intervention components designed to reduce underage access to alcohol. The intervention was found to be effective in reducing the likelihood that retail clerks would sell alcohol to underage-looking buyers, but did not reduce underage drinking or the perceived availability of alcohol among high school students. Post hoc analyses, however, revealed significant associations between the level of underage drinking law enforcement in the intervention communities and reductions in both 30-day use of alcohol and binge drinking. The findings highlight the difficulty in reducing youth drinking even when efforts to curtail retail access are successful. Study findings also suggest that high intensity implementation of underage drinking law enforcement can reduce underage drinking. Any such effects of enhanced enforcement on underage drinking appear to be more directly attributable to an increase in perceived likelihood of enforcement and the resultant perceived inconveniences and/or sanctions to potential drinkers, than to a reduction in access to alcohol per se.     

Social anxiety, reasons for drinking, and college students

Recent research suggests that social anxiety may be associated with higher rates of alcohol problems in women, yet may be associated with lower levels of drinking in men. The current study investigated putative mechanisms that may underlie potential gender differences in the social anxiety-alcohol relationship. One hundred and eighteen college students (61.0% women) completed an interview assessing drinking behaviors and questionnaires measuring social anxiety, drinking motives, and drinking situations. Although college men and women both reported similar frequencies of drinking in positive situations and to enhance positive emotions, women reported drinking more often in negative situations and to cope with aversive emotions than men. Mediated moderation analyses suggested that women with social anxiety may be at greater risk of encountering adverse consequences because of their likelihood to drink to conform or to cope with the aversive affect they experience in negative situations. Conversely, when men experience high rates of adverse consequences, it may be due to drinking greater quantities of alcohol in positive situations. Highly socially anxious college men may drink less alcohol and experience fewer adverse consequences than their nonanxious or mildly anxious counterparts because they may find themselves in positive situations and drinking to enhance positive feelings less often, potentially due to avoidant behavior. These findings may help to explain why social anxiety serves as a potential risk factor for alcohol-related problems for college women, but a protective factor for college men.     

Temperament and Problematic Alcohol Use in Adolescence: an Examination of Drinking Motives as Mediators

The present study investigated the associations between temperamental reactivity, drinking motives, alcohol consumption and alcohol-related consequences. Furthermore, it investigated whether drinking motives mediate the relations between temperamental reactivity and the alcohol use variables. The sample consisted of 188 adolescents (64.9% boys) between the ages of 13–20 years (M _age  = 16.9, SD = 1.32). Results revealed that the temperament factors of high BAS fun seeking and high negative affectivity were related to alcohol consumption and alcohol-related consequences respectively. Furthermore, high social and enhancement motives and low conformity motives were associated with alcohol consumption, whereas high coping-depression motives were associated with alcohol-related consequences. Finally, the relation between BAS fun seeking and alcohol consumption was mediated by enhancement and social motives and the association between negative affectivity and alcohol-related consequences was mediated by coping-depression motives. These results highlight the importance of focusing on temperament profiles and their associated drinking motives in the prevention and intervention of alcohol use problems among adolescents.     

A cross-cultural investigation of college student alcohol consumption: a classification tree analysis

In this cross-cultural study, the authors attempted to identify high-risk subgroups for alcohol consumption among college students. American and Greek students (N = 132) answered questions about alcohol consumption, religious beliefs, attitudes toward drinking, advertisement influences, parental monitoring, and drinking consequences. Heavy drinkers in the American group were younger and less religious than were infrequent drinkers. In the Greek group, heavy drinkers tended to deny the negative results of drinking alcohol and use a permissive attitude to justify it, whereas infrequent drinkers were more likely to be monitored by their parents. These results suggest that parental monitoring and an emphasis on informing students about the negative effects of alcohol on their health and social and academic lives may be effective methods of reducing alcohol consumption. Classification tree analysis revealed that student attitudes toward drinking were important in the classification of American and Greek drinkers, indicating that this is a powerful predictor of alcohol consumption regardless of ethnic background.     

Live interactive group-specific normative feedback reduces misperceptions and drinking in college students: a randomized cluster trial.

This research evaluated the efficacy of a live and interactive group-specific normative feedback intervention designed to correct misperceptions of alcohol-related group norms and subsequently reduce drinking behavior. Campus organizations (N = 20) containing 1,162 college students were randomly assigned to intervention or assessment-only control conditions. Participants in the intervention condition attended an intervention during their organization's regular standing meeting. Data were gathered in vivo using computerized handheld keypads into which participants entered personal responses to a series of alcohol-related questions assessing perceptions of normative group behavior as well as actual individual behavior. These data were then immediately presented in graphical form to illustrate discrepancies between perceived and actual behavioral group norms. Results indicated that compared with the control group, the intervention group reduced drinking behavior and misperceptions of group norms at 1-month and 2-month follow-ups. Changes in perceived norms mediated the reductions in drinking. Results demonstrate the effectiveness of a novel, technologically advanced, group-based, brief alcohol intervention that can be implemented with entire groups at relatively low cost.     

The Role of Psychological Reactance in Drinking Following Alcohol Prevention Messages1

Two experiments tested whether a dogmatic alcohol prevention message may, by arousing psychological reactance (the motivation to reassert a threatened freedom) result in more subsequent alcohol consumption, compared to a neutral message. In Study 1, 535 college students received either a high-threat (dogmatic) or low-threat (neutral) message recommending either abstinence or controlled drinking. Results indicated that high-threat messages were rated more negatively and resulted in more drinking intentions compared to low threat. The negative effect of high threat on message ratings was most pronounced for habitually heavy drinkers and an abstinence-espousing message. In Study 2, under the guise of a “memory study,” 74 college students received either a high- or low-threat message recommending abstinence from alcohol. Then, under the guise of a “perception study,” all subjects participated in a taste-rating task in which their beer consumption was unobtrusively measured. Results indicated that the effect of high threat was most negative for male heavy drinkers, who drank significantly more beer compared to low-threat controls. These results suggest that the persuasive ability of alcohol prevention efforts depend to a considerable extent on the reactance-arousing properties of the materials and that dogmatic alcohol prevention materials may have counterproductive effects for some college 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.     

Randomized controlled trial of brief interventions to reduce college students' drinking and risky sex

The present study tested the proposition that an intervention to reduce alcohol use among college students will also reduce their risky sexual behavior. In a randomized controlled trial, 154 heavy-drinking, predominantly White, heterosexual college students at behavioral risk for infection with HIV and other sexually transmitted diseases were assigned to receive no intervention or a two-session, in-person, motivational interviewing-based intervention focused on (a) reducing alcohol risk behavior, (b) reducing HIV risk behavior, or (c) reducing both alcohol and HIV risk behavior. Three-month retrospective assessments of alcohol use and sexual behavior were conducted at intake and at 3-, 6-, 9-, 12-, and 15-month follow-up appointments. During follow-up, participants who received the single-focus alcohol risk-reduction intervention drank less frequently and consumed fewer drinks per drinking day as compared with no-intervention control participants, but did not differ from control participants in their frequency of intercourse without a condom or number of sexual partners. Participants who received the single-focus HIV risk-reduction intervention evidenced fewer unprotected sex events during follow-up, as compared with control participants. The number of sexual partners reported during follow-up did not differ by condition. Effects of the interventions did not vary significantly over time and were not moderated by participant gender. Results suggest that intervening to reduce alcohol use may not reduce risky sexual behavior among nonminority college students, but that a brief motivational intervention targeting HIV risk behavior may have utility for reducing the frequency of unprotected sex in this population.     

College Students With Military Experience Report Greater Alcohol-Related Consequences

This study examined associations among military experience, alcohol use, and alcohol-related consequences among a large national sample of 27,249 students pursuing postsecondary education. Because of the uniqueness of the developmental period of emerging adulthood, we stratified all analyses by age groups of 18–24 and 25 and older. There were no differences between students with and without military service history in terms of 3 indicators of alcohol use: alcohol consumption in the last 30 days, binge drinking in the last 2 weeks, and drinking and driving in the last 30 days. There were, however, several differences in self-reported consequences of drinking. Among individuals ages 18–24, students with military service history had nearly twofold increased odds of police encounters as a consequence of drinking (adjusted odds ratio [aOR] = 1.91, 95% confidence interval [CI] [1.02, 3.57]) and increased odds greater than twofold of experiencing nonconsensual sex (aOR = 2.68, 95% CI [1.17, 6.19]). Among both age groups, students with military service history reported greater odds of having unprotected sex as a consequence of drinking when compared to students without military service history. Research is needed to identify the reasons why alcohol use results in these particular negative consequences for students with military service history, which can inform prevention and intervention efforts.     

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.     

Social anxiety and vulnerability for problematic drinking in college students: the moderating role of post-event processing

Socially anxious college students are at increased risk for engaging in problematic drinking (i.e. heavy or risky drinking) behaviors that are associated with the development of an alcohol use disorder. The present study examined whether post-event processing (PEP), repeatedly thinking about and evaluating one’s performance in a past social situation, strengthens the association between social anxiety and vulnerability to problematic drinking among college students. Eighty-three college drinkers with high or low social anxiety participated in a social interaction task and were exposed to a manipulation that either promoted or inhibited PEP about the social interaction. Among participants randomized to the PEP promotion condition, those with high social anxiety exhibited a greater urge to use alcohol after the social interaction and greater motivation to drink to cope with depressive symptoms over the week following the manipulation than did those with low social anxiety. These findings suggest that targeting PEP in college drinking intervention programs may improve the efficacy of such programs for socially anxious students.