Associations between abstainer,moderate and heavy drinker prototypes and drinking behaviour in young adults

Objective: Previous research has focused mostly on abstainer and/or general drinker prototypes. The present studies examined an abstainer, moderate drinker and heavy drinker prototype in relation to drinking behaviour.

Design: Two studies among young adults aged 18–25 (paper-and-pencil, cross-sectional, N?=?140; online, prospective, N?=?451) assessed prototype favourability and participants’ perceived similarity to the prototypes. Participants were also categorised into abstainers, moderate, and heavy drinkers.

Results: Similarity and favourability had similar sequences in both studies: the moderate drinker and abstainer prototypes were evaluated most favourable and felt similar to; the heavy drinker prototype was rated the least favourable and felt similar to. Importantly, heavy drinking participants felt most similar to the moderate drinker prototype and rated the heavy drinker least desirable. The results suggest a need for research to include other prototypes, such as the moderate drinker, besides the abstainer and heavy drinker.

Conclusion: The studies provide insights into the contribution of alternative prototypes (i.e. moderate drinker) into the relationship between prototype perceptions and drinking behaviour. The results suggest tailoring prototype-based interventions according to drinking behaviour. Importantly, realistic perceived similarity to the more favourable moderate drinker prototype may therefore need to be encouraged only after appropriate reductions in heavy drinkers’ alcohol consumption.     

The social image of drinking – mass media campaigns may inadvertently increase binge drinking

Mass media campaigns that promote responsible drinking are rarely tested for their usefulness in reducing heavy alcohol consumption. Existing campaigns that appeal to responsible drinking while simultaneously displaying young people in social drinking situations may even have paradoxical effects. To examine such possible effects, we drew on a real-world media campaign, which we systematically modified on the basis of recent prototype research. We pilot tested questionnaires (using n = 41 participants), developed two different sets of posters in the style of an existing campaign (n = 39) and investigated their effectiveness (n = 102). In the main study, young men were randomly assigned to one of three conditions: sociable or unsociable binge drinker prototype condition or a control group. Outcome variables were intention, behavioural willingness, attitude, subjective norm, self-efficacy, prototype evaluation and prototype similarity with respect to binge drinking. Binge drinking as a habit was included to control for the fact that habitual drinking in social situations is hard to overcome and poses a particular challenge to interventions. The manipulation check showed that the experimental variation (sociable vs. unsociable drinker prototype condition) was successful. Results of the main study showed that the sociable drinker prototype condition resulted in a higher willingness and – for those with less of a habit – a higher intention to binge drink the next weekend. The unsociable drinker prototype condition had no effects. The results imply that the social components of mass media campaigns might inadvertently exacerbate binge drinking in young men. We therefore advocate against campaigns including aspects of alcohol consumption that might be positively associated with drinker prototype perception. Finally, we provide suggestions for future research.     

The role of community context and psychological well-being for physical health: A dyadic study of military couples

Drawing from the social organizational theory of community action and change (SOAC) within a systemic biopsychosocial perspective, associations between community context (military community connections and satisfaction with military life), psychological well-being (depressive symptoms, anxiety, and self-efficacy), and physical health were examined for a sample of active duty service members and their civilian spouses (N = 236 couples) using an actor partner interdependence framework. Service members with higher levels of military community connections reported better psychological well-being. When civilian spouses were more satisfied with military life, both partners reported better psychological well-being. In turn, both spouses’ psychological well-being was related to their own reports of physical health. Statistically significant indirect effects were found between community contexts and spouses’ physical health. Enhancing community connections may be an important leverage point for supporting health and family readiness.     

Do research assessments make college students more reactive to alcohol events?

This study examines possible synergistic effects of alcohol-related events and postevent assessments on changes in college student readiness to change alcohol use, frequency of alcohol use, and negative consequences. Students were participants in a longitudinal study of drinking behavior. A portion of those reporting negative alcohol events/consequences (e.g., injury, vomiting, memory loss) during the parent study were randomly selected to participate in the present study (n = 492) and randomized to a postevent assessment (n = 296) or a no-assessment control (n = 196). Participants in the postevent assessment group were interviewed soon after their event, and participants in both conditions were interviewed three months after their event. Linear regression models showed higher 3-month readiness to change alcohol use in participants who received a postevent assessment than those who did not. There were reductions in drinking days, heavy drinking days, and further consequences postevent, but no differences by assessment group. However, female participants showed greater reductions in drinking days and heavy drinking days if they were assigned to assessment compared to control. There also was greater postevent reduction in drinking days among assessment group participants with high precollege alcohol severity compared to low precollege alcohol severity. Conversely, participants who reported high aversiveness of their event and were in the control group showed greater reduction in heavy drinking days than those assigned to the assessment group. Findings suggest that college student heavy drinking is reactive to alcohol events, whereas reactivity to postevent assessments may depend on gender, alcohol severity, and event aversiveness. This work highlights the importance of considering possible interactions among extratherapeutic factors in clinical outcome research.     

Do Youth Development Programs Matter? An Examination of Transitions and Well-Being Among Military Youth

The current correlational study examines the association between internal and external military family contextual factors (e.g., parental rank, having multiple military parents, school changes, living more than 30 min from a military installation, parental deployment, relationship provisions) and military youth well-being outcomes (i.e., depressive symptoms, anxiety, self-efficacy) in a sample of children of active duty military members (i.e., military youth). Data from 749 military youth, ages 11–14, were analyzed using structural equation modeling. The model explained a reasonable amount of the variation in the outcomes of interest (r-square statistics for depressive symptoms, anxiety, and self-efficacy were .151, .018, and .086, respectively). Results indicated that military youth who reported more social provisions experienced fewer depressive symptoms and more self-efficacy. Youth who reported certain military risk factors (i.e., parental rank; living farther from the military installation; multiple school changes) were associated with decreased well-being (i.e., more depressive symptoms and anxiety and less self-efficacy). However, findings suggest that participation in military programs may serve a moderating or buffering factor for these youth.     

Response burden,reliability, and validity of the CAGE,Short MAST,and AUDIT alcohol screening measures

We administered the CAGE, the Short MAST, and the AUDIT to 832 clients at drinking driver treatment programs in Southern California. Correlations among the alcohol screening measures ranged from 0.62 (CAGE and AUDIT) to 0.70 (CAGE and Short MAST). As expected, response time for the CAGE was quicker than for the Short MAST and the AUDIT, but the internal consistency reliability of the CAGE was the lowest and the standard error of measurement largest. Moreover, greater support was found for the relative validity of the Short MAST and AUDIT than the CAGE. The CAGE provides a substantial amount of information quickly, but more reliable and valid information can be obtained with the short MAST or AUDIT measures, which require an additional 1-2 min to administer.     

The biopsychosocial-spiritual health of active duty women

ABSTRACT

Women have been an active part of the military since the beginning of American history, holding various roles in the military for centuries. The purpose of this review is to explore the literature pertaining to the biopsychosocial and spiritual health of active duty women. These comparisons help to highlight factors that are most unique to women who are serving in our active duty armed forces. The current review revealed that while active duty women and men report similar levels of resiliency, and women may be no more susceptible to the negative effects of combat than men, there is evidence that active duty women experience higher levels of posttraumatic stress due to physical and sexual trauma in the military aside from combat exposure. Findings suggest that further research is needed to better understand the unique challenges of women in the military in order to create service delivery models that support the BPSS health of women in order to maintain mission readiness and retain women in the military.     

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.     

Internalizing and externalizing dimensions and alcohol use in first time DWI offenders: indirect effects through coping self-efficacy

Using cross-sectional data and structural equation modeling, we evaluated whether coping self-efficacy to abstain from drinking in various situations accounted for the relationship between internalizing (depression, anxiety) and externalizing (aggression, low socialization) dimensions with problematic alcohol use in 292 first-time DWI offenders. Results indicated that an internalizing dimension indirectly predicted problematic alcohol use through coping self-efficacy in negative situations only, whereas an externalizing dimension indirectly predicted problematic alcohol use through coping self-efficacy in positive situations only. These findings support two potential pathways to problematic drinking behavior among DWI offenders and suggest that internalizing and externalizing dimensions may differentially predict high risk drinking situations due to one's inability to abstain in specific situations.     

Military Stressors,Parent-Adolescent Relationship Quality,and Adolescent Adjustment

Elements of military life can create challenges for all family members, including military-connected adolescents, and can have detrimental consequences for their adjustment. Although research with samples of military-connected adolescents has examined the influences of military stressors for adolescent adjustment (e.g., depressive symptoms, anxiety), less research has identified possible mechanisms responsible for these effects, particularly the role of specific familial factors. Drawing from social ecological theory and attachment theory, we examined the associations between military stressors (e.g., parental rank, combat deployments, permanent change of station moves) and self-reported adolescent adjustment (e.g., depressive symptoms, self-efficacy) along with examining adolescents’ perceptions of parent-adolescent relationship quality with both the active duty and civilian parent as a linking mechanism. Using a path analysis, data from 265 Army families were examined to identify the direct and indirect associations between military stressors and adolescent adjustment through parent-adolescent relationship quality. Most military stressors were not significantly related to relationship quality of either parent or indicators of adolescent adjustment. However, parent-adolescent relationship quality with each parent (active duty and civilian parent) was uniquely related to adolescents’ adjustment. Discussion is provided regarding how military stressors and familial factors are conceptualized within the context of military families and implications for future research, family therapy, and policies are suggested.

     

Drinking patterns and drunk-driving behaviour in Catalonia,Spain: A comparative study

This study explores three alcohol-related databases so as to provide a comprehensive understanding of drinking patterns and the prevalence of alcohol-impaired driving in Catalonia (Spain). The rate of alcohol-impaired drivers is compared with the percentage of drinkers in this population, with a particular focus on heavy episodic drinkers. Two strategies adopted by law enforcement agents when conducting alcohol breath tests are examined: (i) non-random and (ii) random approaches to roadblock location and driver selection. We find that heavy drinker profiles (in terms of age and gender) closely match those of alcohol-impaired drivers detected at strategically located, non-random sobriety checkpoints (especially in the case of female drivers), and that they also correlate with the age-gender distribution of drivers involved in road accidents with victims. Different drink driving patterns are detected when sobriety checkpoints are located randomly and drivers are tested at random. Older drivers are identified as a risk group as they abandon the safer driving habits in relation to alcohol shown when they were middle-aged. A combination of non-random and random controls would increase driver perception of their chances of being detected when drink driving. As such, the whole population, regardless of their drinking profile, would be alerted to the serious personal, social and legal implications of alcohol-impaired driving.     

Changes in heavy drinking over the third decade of life as a function of collegiate fraternity and sorority involvement: a prospective, multilevel analysis.

Although affiliation with a fraternity or sorority is an important risk factor for heavy drinking, recent research indicates that this risk may be limited to the college years. Random coefficient growth modeling was used to track changes in patterns of heavy drinking over the course of 11 years as a function of gender and collegiate Greek involvement (N=318). Overall, greater cumulative exposure to the Greek system led to increased heavy drinking during the college years, particularly among men. Shortly after leaving college, heavy drinking levels dropped markedly and remained low through approximately age 30. Inclusion of peer alcohol use norms in the model reduced the influence of Greek involvement. Implications for models of heavy drinking and health risks are discussed.     

Clustering of drinker prototype characteristics: What characterizes the typical drinker?

Prototypes (social images) have been shown to influence behaviour, which is likely to depend on the type of image. Prototype evaluation is based on (un)desirable characteristics related to that image. By an elicitation procedure we examined which adjectives are attributed to specific drinker prototypes. In total 149 young Dutch adults (18–25 years of age) provided adjectives for five drinker prototypes: abstainer, moderate drinker, heavy drinker, tipsy, and drunk person. Twenty‐three unique adjectives were found. Multilevel latent class cluster analysis revealed six adjective clusters, each with unique and minor overlapping adjectives: ‘negative, excessive drinker,’ ‘moderate, responsible drinker,’ ‘funny tipsy drinker,’ ‘determined abstainer cluster,’ ‘uncontrolled excessive drinker,’ and ‘elated tipsy cluster.’ In addition, four respondent classes were identified. Respondent classes showed differences in their focus on specific adjective clusters. Classes could be labelled ‘focus‐on‐control class,’ ‘focus‐on‐hedonism class,’ ‘contrasting‐extremes‐prototypes class,’ and ‘focus‐on‐elation class.’ Respondent classes differed in gender, educational level and drinking behaviour. The results underscore the importance to differentiate between various prototypes and in prototype adjectives among young adults: subgroup differences in prototype salience and relevance are possibly due to differences in adjective labelling. The results provide insights into explaining differences in drinking behaviour and could potentially be used to target and tailor interventions aimed at lowering alcohol consumption among young adults via prototype alteration.     

Screening and brief intervention of alcohol problems in primary care in South Africa: A brief report

The aim of this randomised controlled trial was to provide screening and brief intervention for alcohol problems in a primary care setting in South Africa. Outpatients were screened for hazardous or harmful alcohol use and were randomised into an experimental (one brief counselling session) or control group (received an alcohol health education leaflet). The study population of hazardous or harmful drinkers (N=140) consisted of 105 male and 35 female women, with a mean age of 30.4 years (SD=6.6). Among the 128 (91.4%) primary care outpatients who also attended the 6-month follow-up session, the time effects on the AUDIT scores were significant but the intervention effect on the AUDIT score was statistically not significant. It would seem that alcohol screening and the provision of an alcohol health education leaflet may in itself cause reduction in drinking.     

Slowing the Tide of Alcohol Use Disorders

Alcohol use disorders (AUDs)—a spectrum including at-risk drinking, alcohol abuse, dependence, and addiction—is a highly prevalent problem worldwide with a substantial economic impact. The toll of alcohol on individual health and healthcare systems is devastating. Alcohol is estimated to be the fifth leading risk factor for global disability-adjusted life years. Tackling the problem of AUD requires a comprehensive strategy that includes solid action on price, availability, and marketing of alcohol. Restricting or banning alcohol advertising may reduce exposure to the risk posed by alcohol at the individual and general population level. Warning labels about the cancer risks associated with drinking have a high degree of public support and may be an inexpensive and acceptable way to educate the public. Religiosity may reduce risk behaviors and contribute to health decision making related to alcohol use.

     

Drinking patterns of pathological gamblers before, during, and after gambling treatment

Despite the high co-occurrence of alcohol consumption and gambling, few studies have investigated alcohol use changes during gambling treatment. Using latent growth modeling, we examined weekly alcohol use trajectories of treatment-seeking pathological gamblers across 36 weeks, allowing rates of change to differ across the 12-week pretreatment, during-treatment and posttreatment periods. For these secondary data analyses, we retained drinking gamblers (N = 163) from a combined sample of two randomized clinical trials for the treatment of pathological gambling. Results indicated a decrease in alcohol use corresponding with treatment entry and maintenance of less drinking during treatment and posttreatment. Despite these decreases in alcohol use overall, 31% (50 of 163) of participants exhibited risky drinking during the treatment or posttreatment periods. Gender, age, at-risk drinking (at any point in the 36-week interval), baseline gambling severity, treatment condition, and gambling during treatment predicted latent alcohol use growth factors. Although entry into gambling treatment was temporally associated with reductions in alcohol use in this retrospective analysis, a substantial portion of the sample exhibited at-risk drinking after treatment entry, suggesting that interventions targeting reductions in alcohol use may be useful for this population.     

Alcohol Use in Three Different Inner Cities in South Africa: AUDIT-C and CAGE

The aim of the present study was to describe the frequency of risky drinking among a general urban population survey (n=1379) in South Africa with the help of (Alcohol Use Disorders Identification Test) AUDIT-C scores, CAGE (Cut down, Annoyed, Guilty, Eye-opener) scores and compare the scores with calculated risky drinking in terms of weekly alcohol consumption or heavy episodic drinking. Results indicate 44.4% for men and 25.4% for women as hazardous or harmful drinkers and using the CAGE 44.7% (55% among men and 35.5% among women). AUDIT-C and CAGE cases were more likely to be women than men and were also more likely among Coloureds and Whites than Black Africans and Indians or Asians. This study showed a greater sensitivity of AUDIT to CAGE.     

Trajectories of alcohol and drug use and dependence from adolescence to adulthood: the effects of familial alcoholism and personality

This study describes trajectories of substance use and dependence from adolescence to adulthood. Identified consumption groups include heavy drinking/heavy drug use, moderate drinking/experimental drug use, and light drinking/rare drug use. Dependence groups include alcohol only, drug only, and comorbid groups. The heavy drinking/heavy drug use group was at risk for alcohol and drug dependence and persistent dependence and showed more familial alcoholism, negative emotionality, and low constraint. The moderate drinking/experimental drug use group was at risk for alcohol dependence but not comorbid or persistent dependence and showed less negative emotionality and higher constraint. Familial alcoholism raised risk for alcohol and drug use and dependence in part because children from alcoholic families were more impulsive and lower in agreeableness.     

The Coping Self-Efficacy Scale: Psychometric properties in an outpatient sample of active duty military personnel

ABSTRACT

Active duty military service members endure a unique constellation of stressors while deployed or at home. Yet, assessment of protective factors against these stressors among active duty service members represents an under studied area. The present study advances the assessment of protective factors through the psychometric evaluation of the Coping Self-Efficacy Scale (CSES) in a clinical sample of military service members in mental health or substance abuse treatment (n = 200). Cross-sectional data were drawn from military medical records and a supplemental self-report questionnaire. Data extracted included demographic (e.g., sex, age), military characteristics (e.g., rank, years in service), physical health and mental health (e.g., anxiety, depression), and coping self-efficacy. Findings suggest a 3-factor (i.e., problem-focused coping, thought-stopping, and getting social support) CSES structure with acceptable internal consistency. Further, there were small-to-moderate associations with physical and mental health outcomes, providing evidence of construct validity. There were few significant associations with military-related characteristics. Finally, controlling for covariates, thought-stopping beliefs explained unique variance in suicide-related behaviors. Together, findings support the use of the CSES to measure coping-related beliefs in military service members. Recommendations are offered for future research and practice with active duty service members.     

Links between sex-related expectations about alcohol, heavy episodic drinking and sexual risk among young men in a shantytown in Lima, Peru

CONTEXT: Alcohol use is frequently identified as a contributor to risky sexual behaviors; however, research results are mixed. Given the conflicting evidence, researchers have focused on other factors, such as expectations about alcohol's effects that might help explain the relationship of alcohol use and risky sexual behaviors. METHODS: Cross-sectional data from 312 sexually experienced males aged 18-30 in a shantytown in Lima, Peru, were used in logistic regression models to identify associations of heavy episodic drinking and sex-related expectations about alcohol with sexual risk behaviors. RESULTS: Heavy episodic drinking was associated with having had two or more sexual partners and having had sex with a casual partner in the past year (odds ratios, 2.8 and 2.5, respectively). After controlling for alcohol consumption, sex-related expectations about alcohol were associated with these high-risk sexual behaviors, as well as with not using a condom at last sex (1.2) and not using a condom at last sex with a casual partner (1.3). CONCLUSION: Beliefs about the effect of alcohol on sexual performance could help explain links between alcohol consumption and risky sexual behavior not completely accounted for by the pharmacological effects of alcohol.