Impulsivity and Problem Drinking in College: Examining the Mediating Role of Sex-Related Alcohol Expectancies and Alcohol Use at Sex

Background: Dispositional impulsivity has been consistently implicated as a risk factor for problem drinking among college students and research suggests that this relationship may be explained in part by alcohol expectancies. A subset of alcohol expectancies, sex-related alcohol expectancies, is particularly linked to problem drinking among college students. The acquired preparedness model of risk postulates that people with dispositional impulsivity develop stronger sex-related alcohol expectancies, are subsequently more likely to drink at problematic levels in sexual situations, and thus, engage in more problem drinking. Objectives: Using this model, the current study examined whether sex-related alcohol expectancies and alcohol use at sex mediated the relationship between impulsivity and problem drinking among college students. Methods: College students (N = 101) completed self-report measures of alcohol use, sex-related alcohol expectancies, and five dimensions of impulsivity: negative urgency, positive urgency, sensation seeking, lack of premeditation, and lack of perseverance. Results: Two facets of impulsivity—sensation seeking and lack of premeditation—provided unique contributions to problem drinking. Sex-related alcohol expectancies significantly mediated the effects of lack of premeditation and sensation seeking on problem drinking. In support of the acquired preparedness model, the relationship between the impulsivity traits and problem drinking was serially mediated by sex-related alcohol expectancies and alcohol use at sex. Conclusions: Results suggest that sensation seeking and lack of premeditation continue to be areas of intervention for problem drinking among college students, and implicate sex-related alcohol expectancies as an area of intervention for alcohol use at sex and problem drinking.     

Impaired control over alcohol use: An under-addressed risk factor for problem drinking in young adults?

Impaired control over alcohol use may be defined as "a breakdown of an intention to limit consumption in a particular situation" (Heather, Tebbutt, Mattick, & Zamir, 1993, p. 701) and has long been considered an important feature of alcohol dependence. Evidence suggests impaired control is highly relevant to young adult problem drinking. In the natural history of problem drinking, impaired control tends to develop early and may predict alcohol-related problems prospectively in undergraduates. Impaired control over alcohol use may be a facet of generalized behavioral undercontrol specifically related to drinking. In particular, impaired control is theoretically and empirically related to impulsivity. The question of whether impaired control represents a facet of impulsivity or a related but separate construct requires further study. However, theoretical arguments and empirical evidence suggest that there are unique qualities to the constructs. Specifically, existing data suggest that self-report measures of impaired control and impulsivity over alcohol use relate distinctly to problem drinking indices in young adults. Several lines of future research concerning impaired control are suggested, using the impulsivity literature as a guide. We conclude that impaired control is a valuable construct to the study of young adult problem drinking and that measures of impaired control should be included in more young adult alcohol studies. The extent to which impaired control over the use of other substances and impaired control over engagement in other addictive behaviors are clinically relevant constructs requires additional study.     

Positive drinking consequences among hazardous drinking college students

Negative drinking consequences in college students have been well studied, but emerging evidence points to a role for positive drinking consequences in predicting alcohol related problems. Positive drinking consequences appear to be distinct from other drinking constructs such as drinking expectancies and drinking motives. However, no work has evaluated the role of positive drinking consequences in hazardous drinking college students, a population at high risk for alcohol related problems. The goal of the current study was to examine the effect of positive drinking consequences on problem drinking and alcohol problem recognition in a hazardous drinking college sample. Participants (N=222) were hazardous drinking undergraduate students completing a battery of self-report measures about alcohol use. Findings indicated that positive drinking consequences predicted problem drinking above and beyond other related constructs including positive drinking motives (i.e. enhancement and social). However, positive drinking consequences did not appear to play a significant role in alcohol problem recognition. Future research directions and implications for interventions with hazardous drinking college students are discussed.     

Spiritual Struggles and Problem Drinking: Are Younger Adults at Greater Risk than Older Adults?

Background: Although a good deal of research has assessed the positive effects that involvement in religion has on alcohol use, there is relatively little research on the negative aspects of religious life and alcohol problems. Objectives: This study has two objectives. The first is to see if spiritual struggles are associated with problem drinking. The second is to see if the relationship between spiritual struggles and problem drinking is stronger for younger than for older adults. Methods: The data come from a recent nationwide survey of adults of all ages who reside in the United States (N = 2142).The study was conducted in 2014. Problem drinking is assessed with the CAGE questionnaire. Results: The findings indicate that people who encounter more spiritual struggles are more likely to experience problem drinking. The relationship between spiritual struggles and problem drinking was stronger than the relationship between three other frequently used measures of religion and problem drinking (i.e., attendance at worship services, private prayer, and affiliation with Evangelical denominations). The results further reveal that spiritual struggles are associated with a greater risk of drinking problems among younger than among older individuals. Conclusions/Importance: Although many studies show that various facets of religion are associated with a lower risk of experiencing problems with alcohol the findings from the current study show that there are negative aspects of religious life that may be associated with a greater risk of having problems with alcohol.     

Research issues concerning alcohol consumption among aging populations

Research concerning alcohol consumption by the elderly has primarily focused on the extent of problem drinking among seniors. Although an important research agenda, an exclusive concern with problem drinking rates can work to obscure interesting health policy and theoretical questions which might be addressed through the study of drinking practices of older age strata. Primary among these is the study of how alcohol use patterns change across the life course, with the goal of showing how such lifelong drinking patterns influence consumption in old age. The literature concerning alcohol use and aging is reviewed to highlight reasons for change and stability in alcohol consumption during latter half of life. From this literature seven hypotheses, amenable to empirical testing, are identified for ongoing research.     

Abstinence and alcohol use among urban Aborigines in Western Australia

Aboriginal males and females aged 15 years and over were recruited from patients attending community-controlled health services in Perth and Carnarvon, Western Australia. Questions were asked about present and past use of alcohol. Rates of abstinence and drinking cessation were greater than in the general population. Both samples contained sizeable numbers of people whose weekly consumption of alcohol was within recommended limits. These are encouraging findings for Aboriginal health workers and others concerned to help those who continue to drink at hazardous and harmful levels.     

Perceptions of partner drinking problems,regulation strategies and relationship outcomes

The current research evaluates how perceptions of one's partner's drinking problem relate to attempts to regulate partner behavior and relationship functioning, and whether this varies by perceptions of one's own drinking. New measures are offered for Thinking about your Partner's Drinking (TPD) and Partner Management Strategies (PMS). Participants included 702 undergraduates who had been in a romantic relationship for at least three months. Participants completed an online survey assessing perceptions of problematic drinking for one's self and partner, ways in which attempts were made to regulate or restrain their partner's drinking, relationship outcomes (i.e., satisfaction, commitment, trust, and need fulfillment), and alcohol use and consequences for self and partner. Factor analyses supported a single factor for Thinking about your Partner's Drinking (TPD) and two factors for the Partner Management Strategies (PMS) scale (i.e., punishment and reward). Results using structural equation modeling indicated that perceiving one's partner to have a drinking problem was associated with lower relationship functioning. Further, this association was mediated by strategies using punishment aimed at changing one's partner's drinking, but was not mediated by strategies using rewards. Finally, moderation results suggested that this relationship was not as detrimental for participants who perceived they also had an alcohol problem. In sum, perceiving one's partner to have a drinking problem was associated with relationship problems through punishing regulation strategies, and was weaker among individuals who also perceived themselves to have a drinking problem.     

One of these things is not like the others: Testing trajectories in drinking frequency,drinking quantity,and alcohol-related problems in undergraduate women

Alcohol misuse is an increasingly common problem in undergraduate women. Building upon research suggesting that maturing out of risky patterns of alcohol use can occur, our study tested how three facets of alcohol use change differentially over time in undergraduate women. A sample of 218 undergraduate women (M age = 20.6 years) participated in a four-wave, 18-month longitudinal study measuring frequency of alcohol consuming occasions, quantity of alcohol consumed per occasion, and alcohol-related problems. Growth curve analyses showed that alcohol frequency remained stable over 18 months, whereas alcohol quantity and problems decreased over time. Results indicate undergraduate women are drinking with similar frequency over time, but they are drinking a smaller quantity of alcohol per drinking occasion and they are experiencing fewer alcohol-related problems. Findings help clarify the maturity principle by showing a different pattern of drinking as undergraduate women age that involves lower quantities of alcohol per drinking occasion and less problematic alcohol use, but not necessarily less frequent drinking.     

Does a Retrospective Seven-day Alcohol Diary Reflect Usual Alcohol Intake for a Predominantly Disadvantaged Australian Aboriginal Population?

Background: Alcohol disproportionately affects socially disadvantaged groups including Aboriginal and Torres Strait Islander Australians. Methods to assess alcohol intake for disadvantaged communities need to be able to capture variable or episodic drinking. The ability of a seven-day diary to capture typical consumption for a predominantly Aboriginal sample has not been assessed. Objective: One aim of this paper was to examine agreement between a seven-day retrospective diary and ‘usual’ drinking assessed by a modified version of the Alcohol Use Disorders Identification Test question 3 (AUDIT-3m; two questions). Other aims were to describe drinking patterns as reported in the seven-day diary. Method: In 2012, consecutive adults attending an Aboriginal Community Controlled Health Service completed a cross-sectional health risk survey on a touch screen laptop (n = 188). Alcohol consumption questions included the retrospective diary and AUDIT-3m. Agreement was assessed using weighted kappa analysis. Results: There was good agreement between the two measures of consumption; however, the AUDIT-3m questions identified more current drinkers. Respondents who were drinkers (54%) tended to consume large amounts per drinking occasion: almost half (46%) of diary completers reported nine or more standard drinks on at least one occasion in the last week. Conclusions: The seven-day diary did not adequately capture variability in alcohol consumption common among this sample. Although the AUDIT-3m appeared acceptable, alternative approaches to assess usual or risky alcohol consumption, such as asking about specific drinking occasions, or allowing participants to respond in non-standard drink sizes, also need to be considered for indigenous and other disadvantaged communities.     

Solitary drinking is associated with specific alcohol problems in emerging adults

Hazardous drinking in emerging adulthood is associated with multiple domains of alcohol problems, which range in type and severity. Alcohol problems at the severe end of the spectrum (e.g., impaired control) may be early warning signs of alcohol use disorders (AUDs) among emerging adults. However, given the emphasis in the literature on predictors of overall problem risk, we still know very little about predictors of these specific (and severe) domains of alcohol problems in emerging adults. Many emerging adults drink at social events (e.g., parties), but an estimated 15% engage in solitary drinking. Solitary drinking – a developmentally atypical behavior in emerging adulthood – may be especially risky. Data suggests that frequent solitary drinking may reflect a loss of control over drinking, leading to hazardous use and subsequent problems. Accordingly, we expected that frequent solitary drinking among emerging adults would predict severe alcohol problems that map onto diagnostic criteria for AUDs and these effects would be mediated by hazardous alcohol use. Undergraduates (N = 118) completed self-report measures as a part of a larger study on motivation and alcohol use. As predicted, path analysis showed that solitary drinking positively predicted hazardous alcohol use, and this in turn predicted severe alcohol problems associated with diagnostic criteria for AUDs, particularly risky behaviors and blackout drinking. Solitary drinking also positively predicted less severe problems of diminished self-perception and poor self-care through hazardous use. Though comparatively smaller, some indirect effects were observed from social drinking (at parties, but not at bars) to alcohol problems, via hazardous alcohol use. Overall, our results suggest that solitary drinking is particularly harmful in emerging adulthood.     

Comparison of the predictors of alcohol use and misuse among Han and aboriginal students in Taiwan

The objective of this study was to compare the predictors of alcohol usage between the Han and aboriginal students in Taiwan. Results showed a significant gender difference for alcohol use and problematic drinking in both Han and aboriginal adolescents, with males having a higher prevalence of these problems than females in both groups. Aboriginal adolescents did not show gender differences in alcohol-related negative consequences. Male, paternal drinking, single-parent household, peer drinking, and peer relationships are the significant predictors for the Hans adolescents' problematic drinking. Gender, paternal drinking, and peer drinking are the significant predictors for aboriginal adolescents' problematic drinking. If the father drinks frequently, odds ratio is 6.48 likely for aboriginal adolescents to have problematic drinking. If peers drink frequently, odds ratio is 6.26 likely for aboriginal adolescents to have alcohol-related negative consequences. Frequent peer drinking was associated with a 6.26 odds ratio of have alcohol-related negative consequences.     

Negative urgency, problem drinking and negative alcohol expectancies among members from one First Nation: a moderated-mediation model

Problematic alcohol use is a major health concern for many Native communities in both Canada and the United States (Spillane & Smith, 2007, 2010; Spillane, Smith, & Kahler, in press). Because health disparities related to alcohol use are pronounced in this population (Beauvais, 1996; Whitesell et al., 2007), it is important to study factors that may contribute to risk for this set of problems. Alcohol expectancies represent a well known risk factor for alcohol use in non-Natives. This study sought to examine the relationship between negative urgency and negative alcohol expectancies, and to determine if this relationship is influenced by problem drinking behaviors. We hypothesized that negative urgency's effects on the development of negative alcohol expectancies would be mediated by negative urgency's influence to increase drinking behaviors in a First Nation sample (see Spillane & Smith, 2010). We also hypothesized that this relationship would be moderated by sex. We administered measures of alcohol use, negative urgency, and negative alcohol use expectancies to a total of 209 First Nation people (96 men; 113 women). Following the steps of moderated mediation outlined by Preacher, Rucker, and Hayes (2007), we found that the relationship between negative urgency and negative alcohol expectancies was significantly mediated by problem drinking for males (β=0.42, p<0.001), but not for females (β=0.13, p=0.32). The current study suggests that for males in this First Nation sample, negative urgency's effects on development of negative alcohol expectancies is mediated by problem drinking behavior.     

Drinking patterns of Australian tertiary youth

Abstract: In this review Australian research on the drinking patterns, beliefs and attitudes toward alcohol of young adults undertaking tertiary education is examined. Most studies reveal that a majority of students are light to moderate drinkers. Alcohol is readily available to these young adults, and is an important component in many of their social activities. Students generally do not perceive alcohol use to be a possible health problem for themselves. For the majority this is probably true. However, many studies identify groups drinking at “at risk” levels (> 40 grams per day for males and > 20 grams per day for females). To develop strategies for minimising alcohol-related problems it is important that health authorities gain a better understanding of the social context in which young adults' drinking occurs. The main social influences identified by current research are presented in this review.     

Problem drinking and marital adjustment

To examine the interdependency between alcohol misuse and marital adjustment, emphasis was placed on investigating how different patterns of alcohol use vary with different levels of marital satisfaction, and how such relationships might be mediated by the sociobehavioral consequences of problem drinking within the family. It was found that the likelihood of marital disruption was greater in heavy drinking households than in nonheavy drinking households. However, differences between heavy drinking and nonheavy drinking settings with respect to the marital relationship became largely nonsignificant when the number of sociobehavioral consequences of alcohol use for the marriage was controlled. The relationship between patterns of alcohol misuse and marital adjustment seems to be complex and variable and is in need of further investigation. Findings in the present study are compared with other research on the alcoholic marriage. Recommendations are offered for future studies on this topic.     

The Need for Understanding the Role of Spirituality in Twelve-Step Programs

Abstract

The Boston Lesbian Health Project II, a national survey of 1139 self-identified lesbian women, found higher rates of drinking alcohol, heavy alcohol intake and self reported alcoholism than in national studies of women in general. Several known risk factors for alcoholism were higher in lesbians who self defined as alcoholic in this sample: family history of alcoholism and drug abuse, rape and childhood sexual abuse and report of having made a suicide attempt. These findings are consistent with other studies that found a high rate of drinking alcohol, alcohol abuse and problem drinking among lesbians. The reasons for these findings are not clear and further research is needed to continue to explore the reasons.     

The Relationship Among Alcohol Consumption,Tailgating, and Negative Consequences

Tailgating has been associated with both problem drinking and high-risk behaviors. The purpose of this study was to determine if student participation in game day on-campus tailgating activities is associated with increased alcohol consumption. Employing a convenience sample of 567 university students, the authors compared the alcohol use patterns of students who participated in tailgating activities with students who did not. Survey results indicate that tailgating is positively associated (p < .05) with increased drinking and greater high-risk behaviors for college students. Implications for practice and future research are highlighted.     

Racial Discrimination and Alcohol Use: The Moderating Role of Religious Orientation

Background: An outgrowth of research has established a relationship between racial discrimination and alcohol use, as well as factors that moderate this association. Objectives: The main objective of this study was to determine if religious orientation moderates the relationship between perceived racial discrimination and alcohol use. Methods: This study utilized a cross-sectional data collection strategy to examine the relationship among discrimination, religious orientation, and alcohol use among undergraduate students (N = 349) at a midsize southeastern university. Data was collected in 2014. Participants completed a demographic questionnaire, the General Ethnic Discrimination Scale, the Extrinsic/Intrinsic Religious Orientation Scale-Revised and the Drinking and Drug Habits Questionnaire. Results: Analyses using hierarchical linear regression indicate a significant interaction effect (lifetime discrimination × extrinsic religious orientation) on problem drinking. Additional moderation analyses reveal a significant interaction effect between lifetime discrimination and the extrinsic-personal religious orientation on problem drinking. Conclusions: Results suggest that an extrinsic religious orientation, and particularly, an extrinsic-personal religious orientation, moderates the relationship between lifetime discrimination and problem drinking, suggesting that turning to religion for comfort and protection, rather than for the superficial purpose of seeing/making friends at church, may buffer against the deleterious effects of discrimination—specifically, engaging in problem drinking to cope with the stress of discrimination. Limitations, directions for future research, and clinical implications are discussed.     

Using media exposure to predict the initiation and persistence of youth alcohol use in Taiwan

BackgroundYouth consumption of alcohol is a major public health problem in Taiwan, yet little research has been conducted to examine the potential influence of exposure to alcohol advertising. The present study examined the prospective influence that exposure to alcohol advertising has on the initiation and persistence of youthful drinking in Taiwan.MethodsA total of 2315 students from 26 high schools in Taipei, Taiwan were assessed in the 10th grade with follow-up conducted in the 11th grade. Self-administered questionnaires were collected in 2010 and 2011 to assess the patterns of change in youth alcohol drinking behaviors, media exposure to alcohol, and risk and protective factors.ResultsOf the 1712 non-drinking students in the 10th grade, 285 (16.6%) had initiated drinking by the 11th grade. Of the 590 drinkers in the 10th grade, 396 (67.1%) were persistently drinking by the 11th grade. Multivariate analysis results indicated that when other potential confounders were accounted for, greater media exposure to alcohol advertising in the 10th grade was found to be significantly associated with the initiation of alcohol use and when combined with an increase in media exposure from grades 10 to 11, this was significantly associated with the persistence of alcohol use.ConclusionExposure to alcohol advertising in the media was associated with both the initiation and the persistence of alcohol use by youth.     

Investment in drinking identity is associated with alcohol consumption and risk of alcohol use disorder

Problematic alcohol consumption is elevated among those who identify (i.e., associate themselves) with drinking. We extended prior research on drinking identity by considering two dimensions of investment in identity – i.e., mental resources allocated to that identity that may motivate the pursuit of identity-related goals. We considered drinking identity importance (i.e., how important one considers it to be) and drinking identity thought frequency (i.e., how frequently one thinks about it). We investigated these dimensions from two perspectives: an absolute perspective (i.e., investment in drinking identity irrespective of other identities) and a relative perspective (i.e., investment in drinking identity compared to identities associated with other life domains [education, well-being, and personal relationships]). We aimed to evaluate whether these investment dimensions were positively associated with alcohol consumption and risk of alcohol use disorder either in interaction with or in addition to endorsement of drinking identity. College students (N = 521) who were screened for exhibiting hazardous drinking completed self-report measures of alcohol consumption, risk of alcohol use disorder, and drinking identity endorsement and investment. Controlling for gender and drinking identity endorsement, absolute and relative drinking identity thought frequency were uniquely and positively associated with alcohol consumption and risk of alcohol use disorder. Neither absolute nor relative importance of identification with drinking uniquely predicted outcomes. Drinking identity investment, as signaled by absolute and relative frequency of thought related to identification with drinking, may be an additional risk factor and/or clinical target for alcohol consumption and risk of alcohol use disorder.     

Longitudinal Effects of Age at Onset and First Drinking Situations on Problem Drinking

The purpose of this study was to describe aspects of the first alcohol-use experience, and examine the predictive relations among age of first use, context of alcohol use initiation, and problem drinking with and without controls for psychosocial risk factors. Data were from the Rutgers Health and Human Development Project, a five-wave, prospective study of substance-use behaviors in a community sample. Respondents, who were first interviewed at age 12 (1979–81) and most recently at age 30 or 31 (1999–2000) (N = 371), reported on their first drinking experience, and on a range of known risk factors for alcohol abuse. Most alcohol initiation occurred during a family gathering. Regardless of initiation context, youth who drank at an early age were more likely than youth who initiated later to become problem drinkers, although the risk was relatively greater for the youth who first drank outside a family gathering. Based on multivariate logistic regressions, feeling drunk at initiation was the only onset-related variable significantly associated with problem drinking; other significant risks factors included male gender, delinquency, and family history of alcoholism. Because most initiation occurs at a family gathering, alcoholism prevention research may benefit from examining the role that drinking in family contexts could play with regard to socializing young drinkers to less risky drinking behaviors in adulthood. In particular, further research focusing on the subjective effects experienced by youth when they first drink may be merited.