Alcohol use in the year before marriage: alcohol expectancies and peer drinking as proximal influences on husband and wife alcohol involvement

BACKGROUND: Models of adolescent alcohol involvement that include individual difference, family, and peer risk factors indicate a significant association between the drinking of adolescents and that of their peers. Peer drinking influences, however, have not been investigated extensively in integrative models of adult drinking. The purpose of this study was to test a model of adult drinking that incorporated the potentially important risk factor of partner drinking and in which proximal risk factors (peer drinking, alcohol expectancies) were hypothesized to be strongly associated with adult alcohol use and to mediate relationships between more distal risk factors and drinking. METHODS: Couples (n = 389) were assessed at the time of their first marriage. Separate, self-administered questionnaires were completed at home by both husbands and wives. Distal risk factors included family history of alcoholism, antisocial behavior, and depressive symptomatology. Substantive relationships were tested in a model that included spousal associations with respect to distal risk factors, proximal risk factors, and drinking. RESULTS: Findings demonstrate the unique association of alcohol expectancies and peer drinking with adult alcohol use. Of particular relevance is the significance of the social network as a correlate of adult drinking. A peer network characterized by a higher level of alcohol involvement was strongly associated with heavier drinking among both men and women. This relationship was independent of sociodemographic and individual difference factors, alcohol expectancies, and partner's drinking. Results also demonstrate the similarity between husband and wife drinking, an association that cannot be attributed to assorting with respect to the other risk factors. CONCLUSIONS: The social network continues to significantly impact drinking behavior in adulthood. The relevancy of peer and partner drinking influences to adult alcohol involvement suggests that the immediate social environment may have a prominent role in the continuity/discontinuity of heavy or problem drinking during the transition to marriage.     

Prediction of alcohol-related casualties among emergency room admissions

Logistic regression models are used to determine the predictive value on injury status of drinking-in-the-event variables, quantity and frequency of alcohol consumption, alcohol-related problems, and demographic characteristics among 1,896 emergency room patients interviewed and breathalyzed at San Francisco General Hospital. Being young, White compared to Black, a positive admission breathalyzer reading, drinking prior to the event, and binge drinking were predictive of admission to the emergency room for an injury compared to a non-injury problem. A positive breathalyzer reading, more frequent usual drinking, blackouts, and a previous accident while drinking were predictive of drinking prior to the presenting injury event.     

Similarities and differences in correlates of alcohol consumption and problem behaviors among male and female adolescents

This study examined similarities and differences in correlates of alcohol consumption and problem behaviors among a random household sample of male and female adolescents between the ages of 12 and 17. Several similarities emerged between the two gender groups which were consistent with previous research, including a pattern of convergence among the variables of alcohol consumption, times drunk in the last year, and delinquent behavior; the salience of the peer context in alcohol-related behavior; and high associations between reasons, or motives, for drinking and alcohol consumption and problem behaviors. With respect to reasons for drinking, excitement-seeking, or pleasurable, reasons were highly related to outcome variables. Gender differences were reported for relationships between two indices of affective functioning, namely distress symptoms and escapist, tension-reducing reasons for drinking, and outcome variables related to delinquent behavior, school functioning, and aspects of self-concept. These differences are discussed with respect to possible differential socialization experiences among males and females.     

Drinking beliefs and behaviors among Irish adolescents

Drinking beliefs and behaviors were investigated in a survey of 2,700 Irish postprimary students. Overall, 47% of the students reported drinking within the month prior to the survey. Drinking was most frequent among older students and males. A regression analysis indicated that perceived peer drinking was the primary predictor of current alcohol use. Smoking and involvement with other problem behaviors were also important, and parental disapproval had a small effect. This pattern of results is similar to that found in other countries and provides evidence for the applicability of social learning and problem behavior theories to an understanding of adolescent drinking in another cultural context.     

Cognitive and behavioural factors as predictors of abstinence following treatment for alcohol dependence

Aim. To assess how far causal attributions about abstinence and relapse, drinking self-efficacy, drinking locus of control expectancy and coping behaviour discriminate abstainers from relapsers following treatment for alcohol dependence. Design. A multicentre 6-month follow-up study. Setting. Mental health centres and self-help groups in Vizcaya (Spain). Participants. The sample was formed by 201 alcoholics who were assessed at their centres and groups on two occasions: while they were in treatment and 6 months later. Measurements. During treatment, participants completed several questionnaires related to cognitive and behavioural variables. Drinking problem and background variables were also assessed. Six months later their drinking status and treatment attendance were examined. Findings. Multivariate tests showed that self-efficacy expectancy and long previous time in abstinence independently discriminated alcoholics who maintained abstinence from those who did not. Other cognitive-behavioural variables showed bivariate association with abstinence, but did not add predictive power to these two measures. Conclusions. The results of this study are consistent with the extensive literature that confirms the predictor power of self-efficacy. Unexpectedly, it did not find independent positive relationships between other psychological variables and abstinence. Given that self-efficacy can predict outcome in the medium term, it is suggested that treatment could target this variable.     

Drinking Patterns and Problems and Drinking in the Event: An Analysis of Injury by Cause Among Casualty Patients

The association of alcohol and injury might be expected to vary by the specific cause of injury, but few studies have examined such associations across all causes of injury coming from the same population, largely because of the lack of a sufficient number of cases. This study examines the association of drinking patterns and problems and drinking-in-the-injury-event for six mutually exclusive causes of injury (falls, penetrating trauma, motor vehicle accidents, fires, violence, and other causes) in a merged sample of 3109 patients from four emergency room/trauma center studies that used identical study methodology. The predictive value of drinking and demographic variables are examined separately for each cause of injury, and variables predictive of reporting drinking before the event, feeling drunk at the time of injury, and attributing a causal association of drinking and the injury. Injuries sustained from violence and falls had the greatest association with drinking variables, with those with positive breathalyzer readings, and those who reported drinking before injury, frequent heavy drinking, and frequent drunkenness overrepresented in these two causes. Those who reported a larger number of drinks consumed before injury and those who reported feeling drunk at the time were also overrepresented among those with injuries related to violence and falls. A larger proportion than expected of those who attributed a causal association of drinking with the event sustained injuries related to violence, whereas a smaller proportion sustained injuries from falls. Demographic characteristics were more predictive than drinking characteristics of each cause of injury, whereas drinking characteristics, particularly positive breathalyzer readings, were more predictive of drinking before specific causes of injury. These data provide information that may be useful in developing brief interventions for the prevention of alcohol-related injuries in the emergency room or trauma center setting.     

Predicting Problem Drinking: A Test of an Interactive Social Learning Model

This study tested a social learning model and explored the direct and interactive relationships between personality and environment in predicting problem alcohol use. We used longitudinal data from a nonclinical sample of males and females first tested in adolescence and followed into young adulthood. Hierarchial regression analyses were used to test main effects and interaction models. The cross-sectional data supported an interactive social learning model. Both personality and environment variables significantly predicted problem drinking. Two interactions between heavy drinking peer groups and personality variables were significant. Contrary to our hypothesis, the direction of the interaction was negative. In contrast, the longitudinal analyses did not provide strong support for our interactive model. Personality variables were significant predictors longitudinally, but in only one analysis did an environment variable significantly predict problem drinking. Furthermore, none of the interactions was significant predictors over time. Overall, the findings suggest that social learning models based on the interaction of personality and environmental influences may be more appropriate for predicting concurrent, as opposed to future problems, and that future research should include person-environment interactions. In addition, cultural tolerance of heavy drinking may be an important determinant of the role of psychological vulnerability in the development of problem drinking.     

Demographic Characteristics and the Frequency of Heavy Drinking as Predictors of Self-reported Drinking Problems

The distribution of both heavy drinking and drinking problems are well known from several previous studies. Not surprisingly, drinking problems are more prevalent among the demographic groups where heavy drinking is also more prevalent. This well-known conjunction, however, does little to determine whether some groups are more likely than others to experience drinking problems when we control for the amount of alcohol consumed. Here, this question is punned through a multiple regression analysis in which the dependent variable is a score on a drinking problem scale and the independent variables are: the frequency of heavy drinking occasions, sex, age, marital status, region, urbanicity, income, and education. The results indicate that none of these demographic variables had a strong association with the reported problem level.     

Drinking Patterns and Problems among Female Children and Adolescents: A Comparison of Abstainers,Past Users,and Current Users

The sociopsychological factors that underlie drinking behavior among 197 young girls, ages 9 through 17, are explored. Three groups-youthful abstainers, former users, and current users-were interviewed, as were their parents. These comparison groups are contrasted on 110 variables. The relative merits of four competing explanations of youthful drinking behavior-deprivation, personal deficiency, hedonistic peer culture, and family pathology-are assessed.     

Drinking patterns and problems among female children and adolescents: a comparison of abstainers, past users, and current users

The sociopsychological factors that underlie drinking behavior among 197 young girls, ages 9 through 17, are explored. Three groups-youthful abstainers, former users, and current users-were interviewed, as were their parents. These comparison groups are contrasted on 110 variables. The relative merits of four competing explanations of youthful drinking behavior-deprivation, personal deficiency, hedonistic peer culture, and family pathology-are assessed.     

Heavy Episodic Drinking and Alcohol Consumption in French Colleges: The Role of Perceived Social Norms

Background:  The effect of normative perceptions (social norms) on heavy episodic drinking (HED) behavior is well known in the U.S. college setting, but little work is available in other cultural contexts. The objective of this study is therefore to assess whether social norms of alcohol use are related to HED in France, taking account of other influential predictors.
Methods:  A cross-sectional survey was carried out among 731 second-year university students in the Paris region to explore the role of 29 potential alcohol use risk factors. The probability of heavy episodic drinking and the frequency of HED among heavy episodic drinkers were modeled independently. Monthly alcohol consumption was also assessed.
Results:  Of the students, 56% overestimate peer student prevalence of HED (37% for alcohol drinking prevalence). HED frequency rises with perceived peer student prevalence of HED. Other social norms associated with HED are perceived friends' approval of HED (increasing both HED probability and HED frequency) and perceived friend prevalence of alcohol drinking (increasing HED probability only). Cannabis and tobacco use, academic discipline, gender, and the number of friends are also identified as being associated with HED.
Conclusions:  Overestimation of peer student prevalence is not uncommon among French university students. Furthermore, perceived peer student prevalence of HED is linked to HED frequency, even after adjusting for other correlates. Interventions correcting misperceived prevalences of HED among peer students have therefore the potential to reduce the frequency of HED in this population.     

Drinking patterns, drinking contexts and alcohol-related aggression among late adolescent and young adult drinkers

AIMS: The main objectives of this study were to determine: (1) the relative roles of heavy episodic drinking (HED), drinking frequency and drinking volume in explaining alcohol-related aggression and (2) whether drinking context variables (i.e. usual drinking locations, typical drinking companions and extent of peer drinking) confound or modify the relationship between HED and alcohol-related aggression or whether they predict alcohol-related aggression independently. DESIGN: A secondary analysis of the US National Longitudinal Survey of Youth was conducted. Alcohol-related aggression (denoted fights after drinking) was measured based on self-reports of arguments or fights that occurred during or after drinking in the previous 12 months. PARTICIPANTS: A composite sample of drinkers, ages 17-21, from the 1994, 1996 and 1998 Young Adult surveys (n = 738) was used. FINDINGS: Frequency of drinking and drinking volume largely confounded the association between HED and fights after drinking. Usually drinking in public locations away from home versus private locations was found to be significantly associated with a greater likelihood of fights after drinking among females. Among males, usual drinking location modified the relationship between drinking frequency and alcohol-related aggression, with the greatest risk of aggression for males who drank frequently and usually drank in public locations away from home. CONCLUSIONS: Programs designed to reduce drinking frequency in this population and to increase the safety of drinking locations in public places away from home may prove to be beneficial in reducing alcohol-related aggression.     

The effects of alcohol expectancies on drinking behaviour in peer groups: observations in a naturalistic setting

AIMS: To study the functionality of alcohol expectancies in predicting drinking behaviour in existing peer groups of young adults in a 'naturalistic' setting. DESIGN AND SETTING: Young adults were invited to join an experiment with their peer group in a bar annex laboratory. During a 'break' of 50 minutes in this experiment, their activities, social behaviour and drinking behaviour were observed with digital video and audio equipment. PARTICIPANTS: Twenty-eight peer groups were involved in this study. A peer group consisted of seven to nine people, with relationships ranging from intimate relations and close friendships to being acquaintances. A total of 238 participants were involved. Measurements Information of the drinking behaviour from observations and questionnaire data on alcohol expectancies provide the opportunity to look at how and which expectancies are related to actual drinking patterns. Multiple regression and multi-level analyses were applied. FINDINGS: Expectancies on the positive and arousing effects of alcohol consumption were related to alcohol consumption in a naturalistic, social drinking situation, in addition to group effects of drinking. Expectancies on the negative and sedative effects of drinking, however, were not related to drinking. CONCLUSIONS: The findings indicate that among young adults observed in a peer group and naturalistic drinking setting, positive expectancies about the effects of alcohol and expectancies about the effects of alcohol on arousal are related positively to drinking level.     

Toward a stepped care approach to treating problem drinkers: the predictive utility of within-treatment variables and therapist prognostic ratings

Aims. Cost containment, a central issue in current health planning, encourages the use of brief interventions. Although brief interventions for problem drinkers have proved successful, a portion of such individuals do not change their alcohol use during treatment. Design. within-treatment and 6 months post-treatment). Setting and participants. risk for continued problem drinking, predictors of post-treatment drinking were examined for 212 problem drinkers who presented for treatment in an outpatient treatment clinic. Intervention. completed a brief cognitive behavioral motivational intervention. Measurements. assessment demographic, drinking pattern, severity of dependence and other cognitive variables (e.g. self-efficacy, goal choice) were collected. Within-treatment, drinking pattern and cognitive variables such as self-efficacy and goal choice were again measured. Findings. prognosis ratings contributed significantly to the prediction of outcome even when pre-treatment variables were controlled. However, when within-treatment variables were included in the prediction, variables such as within treatment drinking eliminated the predictive utility of therapist prognosis ratings. This pattern held for both percentage of days abstinent and drinks per drinking day at a 6-month follow-up. Conclusions. is suggested that a stepped care approach based on prediction models that include clients' within-treatment response can be applied to the treatment of problem drinkers who show little initial response to treatment. Repeated measures design (pre-treatment, To identify individuals at All participants At the pre-treatment Regression analyses showed that therapist It     

Injury and the Role of Alcohol: County-Wide Emergency Room Data

The purpose of this study is to describe variables associated with injury in an emergency room (ER) sample that is representative of an entire U.S. county. A probability sample ( n = 3717) of ER patients from the county hospital, 3 of the 0 community hospitals, and the three health maintenance organization hospitals in a single Northern California county were breathalyzed and interviewed at the time of the ER visit. Injured were most likely to consume only 1 or 2 drinks within el hr of injury occurrence. Twenty-three percent reported feeling drunk at the time of the event, and of these, 45% felt the event would not have happened if they had not been drinking. Breathalyzer reading, feeling drunk at the time of the event, and quantity-frequency (Q-F) of usual drinking were found to be predictive of admission to the ER with an injury, whereas breathalyzer reading, Q-F, and being injured in someone's home were predictive of reporting drinking prior to injury. Although feeling drunk at the time of the event and usual drinking patterns are predictive of injury occurrence, drinking prior to the event may not entail large quantities of alcohol consumed, but relatively small amounts consumed in close proximity to the injury event. These alcohol consumption variables may vary, however, depending on the type, cause, and severity of injury.     

Children's introduction to alcohol use: sips and tastes

Background:  Sipping or tasting alcohol is one of the earliest alcohol use behaviors in which young children engage, yet there is relatively little research on this behavior. The present research describes the prevalence of sipping or tasting in a community sample of children, examines the sociodemographic correlates and social contexts of this behavior, and tests whether variables reflecting psychosocial problem-behavior proneness, that predict adolescent drinking, account for this behavior.
Methods:  A sample of 452 children (238 girls) aged 8 or 10 and their families was drawn from Allegheny County PA using targeted-age directory sampling and random digit dialing procedures. Children were interviewed using computer-assisted interviews. Logistic regression analyses were used to examine the univariate and multivariate correlates of sipping/tasting.
Results:  Thirty-nine percent of the sample had only sipped or tasted alcohol (35% of 8 year olds and 48% of 10 year olds), while 6% reported having had a drink of alcohol (5% and 7%, respectively). African-American children were less likely than White children to be sippers. Neither gender nor mother's education related to sipping status. Most sipping was done in a family context. Sipping/tasting did not generally relate to variables reflecting psychosocial proneness for problem behavior. Instead, the variables most predictive of sipping/tasting were perceived parents' drinking status, perceived parents' approval for child sipping, mother's drinking frequency, and children's attitudes toward sipping/tasting alcohol.
Conclusions:  Young children's sipping/tasting of alcohol reflects parental modeling of alcohol use and increased opportunities to try alcohol in the home rather than deliberate family socialization of alcohol use, and appears not to be a precocious manifestation of a psychosocial proneness to engage in problem behavior.     

Gender differences in the impact of families on alcohol use: a lagged longitudinal study of early adolescents

Aims From the pre‐teen to the mid‐teen years, rates of alcohol use and misuse increase rapidly. Cross‐sectional research shows that positive family emotional climate (low conflict, high closeness) is protective, and there is emerging evidence that these protective mechanisms are different for girls versus boys. The aim of this study was to explore gender differences in the longitudinal impact of family emotional climate on adolescent alcohol use and exposure to peer drinking networks. Design Three‐wave two‐level (individual, within‐individual over time) ordinal logistic regression with alcohol use in the past year as the dependent measure and family variables lagged by 1 year. Setting Adolescents completed surveys during school hours. Participants A total of 855 Australian students (modal age 10–11 years at baseline) participating in the International Youth Development Study (Victoria, Australia). Measurements These included emotional closeness to mother/father, family conflict, parent disapproval of alcohol use and peer alcohol use. Findings For girls, the effect of emotional closeness to mothers on alcohol use was mediated by exposure to high‐risk peer networks. Parent disapproval of alcohol use was protective for both genders, but this effect was larger for boys versus girls, and there was no evidence that peer use mediated this effect. Peer drinking networks showed stronger direct risk effects than family variables. Conclusions Family factors unidirectionally impact on growth in adolescent alcohol use and effects vary with child gender.     

Types of alcoholics: concurrent and predictive validity of some common classification schemes

This study evaluated the discriminative power and predictive validity of five common typological schemes used to classify alcoholics for theoretical or clinical purposes. A heterogeneous sample of 321 alcoholics was classified according to primary vs secondary alcoholism, parental alcoholism, Jellinek's gamma-delta distinction, gender, and subtypes derived from MMP1 profiles. A prospective longitudinal cohort design was employed to compare the relative ability of these typologies to differentiate alcoholics according to natural history, alcohol-related consequences, response to treatment, and post-treatment adjustment. The findings indicate that while ‘one-dimensional’ typologies discriminate subgroups in terms of etiological variables, presenting symptoms, and drinking patterns, none of the classification systems emerges as a strong predictor of outcome status. In addition, these typologies do not discriminate well with respect to the alcoholic's drinking patterns and presenting symptoms, except in areas closely connected with the model (e.g. alcoholics with antisocial personality (ASP) indicate more social problems related to alcohol use than do primary alcoholics). Because there is a great deal of overlap among certain subtypes identified within different typological models (e.g. alcoholics with primary ASP tended to have, a positive family history and a gamma pattern of impaired control), we hypothesize that empirical clustering techniques that search for naturally occurring commonalities among alcoholics may be a better way to identify homogeneous subtypes.