Social-norms interventions for light and nondrinking students.

Social-norms approaches to alcohol prevention are based on consistent findings that most students overestimate the prevalence of drinking among their peers. Most interventions have been developed for heavy-drinking students, and the applicability of social-norms approaches among abstaining or light-drinking students has yet to be evaluated. The present research aimed to evaluate the impact of two types of online social-norms interventions developed for abstaining or light-drinking students. Identification with other students was evaluated as a moderator. Participants included 423 freshmen and sophomore college students who reported never or rarely drinking at screening. Students were randomly assigned to one of three conditions: (a) personalized-norms feedback, (b) social-norms marketing ads, or (c) attention control. Data were analyzed using generalized linear mixed models. Results provided some support for both interventions but were stronger for social-norms marketing ads, particularly among participants who identified more closely with other students.

Alcohol-involved assault and the course of PTSD in female crime victims.

Although alcohol use has been associated with increased risk of victimization, little is known about how victim substance use at the time of assault may affect posttraumatic stress disorder (PTSD) symptom development. The present study is a longitudinal examination of substance use on PTSD symptom severity and course. A community sample of female crime victims (n = 60) were assessed within 5 weeks of sexual or physical assault with 3 and 6 month post-assault follow-ups. Twenty-three participants had consumed alcohol or alcohol/drugs prior to the assault (38%) and 37 had consumed neither alcohol nor drugs. Analyses were conducted using hierarchical linear modeling. Participants who had consumed alcohol had lower initial intrusive symptoms, but their symptoms improved less over time.

The relative impact of injunctive norms on college student drinking: the role of reference group.

This research evaluated the importance of reference groups in the relationships between injunctive norms and alcohol consumption for college student drinkers. First-year students (N = 811; 58% women) completed online assessments of their drinking behavior, as well as their perceptions of the approval (injunctive norms) and prevalence (descriptive norms) of drinking by others. Injunctive norms were evaluated with respect to typical students, typical same-sex students, friends, and parents. Descriptive norms were evaluated with respect to typical students and typical same-sex students. Results suggested that for injunctive norms, only perceptions of proximal reference groups (friends and parents) are positively associated with drinking behavior. However, when considered in the context of multiple referents and norms, injunctive norms for more distal groups (typical students/same-sex students) were negatively associated with personal drinking, whereas descriptive norms for distal referents remained positively associated with drinking. Results suggest that injunctive norms are more complex than descriptive norms and these complexities warrant important consideration in the development of intervention strategies.

Injunctive norms and problem gambling among college students.

Two studies examined the relationships among injunctive norms and college student gambling. In study 1 we evaluated the accuracy of perceptions of other students' approval of gambling and the relationship between perceived approval and gambling behavior. In study 2 we evaluated gambling behavior as a function of perceptions of approval of other students, friends, and family. In study 1, which included 2524 college students, perceptions of other students' approval of gambling were found to be overestimated and were negatively associated with gambling behavior. The results of study 2, which included 565 college students, replicated the findings of study 1 and revealed positive associations between gambling behavior and perceived approval of friends and family. Results highlight the complexity of injunctive norms and the importance of considering the reference group (e.g., peers, friends, family members) in their evaluation. Results also encourage caution in considering the incorporation of injunctive norms in prevention and intervention approaches.

Incapacitated rape and alcohol use: a prospective analysis.

This study examined timing of alcohol-related sexual assaults (incapacitated rape) in relation to both alcohol consumption and alcohol-related negative consequences. The sample was drawn from a randomly selected pool of college students across three campuses (n=1238) followed over a three year time period. 91% of students never experienced an incapacitated rape, 2% reported an incapacitated rape prior to the first assessment point (n=30), and 6% reported one over the course of the study (n=76). Results indicated that incapacitated rape was associated with higher alcohol use and more negative consequences in the years prior to the assault. Incapacitated rape was also associated with higher alcohol use and more negative consequences during the year in which the rape took place and subsequent years, with highest rates measured for the year of the rape. These results suggest alcohol use can function as both risk factor and consequence of sexual victimization.

A randomized controlled trial of event-specific prevention strategies for reducing problematic drinking associated with 21st birthday celebrations.

OBJECTIVE: While research has documented heavy drinking practices and associated negative consequences of college students turning 21, few studies have examined prevention efforts aimed at reducing high-risk drinking during 21st birthday celebrations. The present study evaluated the comparative efficacy of a general prevention effort (i.e., Brief Alcohol Screening and Intervention for College Students, or BASICS) and event-specific prevention in reducing 21st birthday drinking and related negative consequences. Furthermore, this study evaluated inclusion of peers in interventions and mode of intervention delivery (i.e., in-person vs. via the Web). METHOD: Participants included 599 college students (46% male): men who intended to consume at least 5 drinks and women who intended to consume at least 4 drinks on their 21st birthday. After completing a screening/baseline assessment approximately 1 week before turning 21, participants were randomly assigned to 1 of 6 conditions: 21st birthday in-person BASICS, 21st birthday web BASICS, 21st birthday in-person BASICS plus friend intervention, 21st birthday web BASICS plus friend intervention, BASICS, or an attention control. A follow-up assessment was completed approximately 1 week after students' birthdays. RESULTS: Results indicated a significant intervention effect for BASICS in reducing blood alcohol content reached and number of negative consequences experienced. All 3 in-person interventions reduced negative consequences experienced. Results for the web-based interventions varied by drinking outcome and whether a friend was included. CONCLUSIONS: Overall, results provide support for both general intervention and ESP approaches across modalities for reducing extreme drinking and negative consequences associated with turning 21. These results suggest there are several promising options for campuses seeking to reduce both use and negative consequences associated with 21st birthday celebrations.

The influence of confidence on associations among personal attitudes, perceived injunctive norms, and alcohol consumption.

Social norms theories hold that perceptions of the degree of approval for a behavior have a strong influence on one's private attitudes and public behavior. In particular, being more approving of drinking and perceiving peers as more approving of drinking, are strongly associated with one's own drinking. However, previous research has not considered that students may vary considerably in the confidence in their estimates of peer approval and in the confidence in their estimates of their own approval of drinking. The present research was designed to evaluate confidence as a moderator of associations among perceived injunctive norms, own attitudes, and drinking. We expected perceived injunctive norms and own attitudes would be more strongly associated with drinking among students who felt more confident in their estimates of peer approval and own attitudes. We were also interested in whether this might differ by gender. Injunctive norms and self-reported alcohol consumption were measured in a sample of 708 college students. Findings from negative binomial regression analyses supported moderation hypotheses for confidence and perceived injunction norms but not for personal attitudes. Thus, perceived injunctive norms were more strongly associated with own drinking among students who felt more confident in their estimates of friends' approval of drinking. A three-way interaction further revealed that this was primarily true among women. Implications for norms and peer influence theories as well as interventions are discussed.

Coping motives as a mediator of the relationship between sexual coercion and problem drinking in college students.

Sexually coercive experiences, heavy alcohol use, and alcohol-related problems occur at relatively high base rates in college populations. As suggested by the self-medication hypothesis, alcohol consumption may be a means by which one can reduce negative affect or stress related to experiences of sexual coercion. However, few studies have directly tested the hypothesis that coping motives for drinking mediate the relation between sexual assault and problem drinking behaviors, and no published studies have tested this in men. The current study tested this hypothesis using structural equation modeling in a sample of 780 male and female undergraduates. Results revealed that coping motives partially mediated the relation between sexual coercion and drinking and alcohol-related negative consequences. In addition, direct and indirect paths between sexual coercion and drinking were found for men whereas only indirect paths were found for women. Results provide support for self-medication models of drinking and suggest the importance of exploring gender differences in mechanisms for drinking.

Event-specific drinking among college students.

College represents a period of risk for heavy drinking and experiencing unwanted consequences associated with drinking. Previous research has identified specific events, including holidays (e.g., New Years), school breaks (e.g., Spring Break) and personally relevant events (e.g., 21st birthdays), that are associated with elevated risk of heavy drinking and negative alcohol-related consequences. The systematic evaluation of relative risk offers insights into event-specific drinking and an empirical basis upon which to consider allocation of limited prevention resources. Thus, the purpose of the present study was to provide a comparative index of drinking across a wide range of holidays and compare holiday drinking to 21st birthday drinking. Participants were 1,124 students (55% female) who had turned 21 within the previous three weeks in 2008 and provided 90-day retrospective reports of their drinking using the Timeline Follow-back. Results based on a hurdle mixed model for blood alcohol content revealed several holidays that stand out for elevated drinking, including New Year's Eve and July 4th, whereas other holidays appear more similar to weekend drinking, such as Spring Break (approximately last week of March) and graduation (mid-June). Drinking on holidays or special days was substantially lower than drinking on 21st birthdays. Results are discussed in terms of practical applications for targeted intervention efforts on college campuses toward specific events where elevated drinking is known to occur.

Alcohol consumption and intimate partner violence perpetration among college students: the role of self-determination.

OBJECTIVE: The present research examined the role of self-determination theory in alcohol consumption and intimate partner violence (IPV) perpetration among college students. We were interested in evaluating the extent to which individual differences in self-determination (i.e., autonomous and controlled orientations) may influence problematic alcohol use and male-to-female IPV perpetration and the extent to which problem drinking may mediate the associations between self-determination and IPV perpetration. METHOD: A total of 313 incoming heterosexual, male freshman drinkers at a large northwestern university between the ages of 18 and 21 years completed self-report measures of autonomous and controlled orientations, alcohol use, and IPV perpetration as part of a larger social norms intervention study. Analyses evaluated the influence of autonomous and controlled orientations on alcohol consumption, associated problems, and IPV perpetration. RESULTS: The proposed model fit the data relatively well, chi(2) (11, N = 313) = 32.19, p = NS, root mean square error of approximation = .079, normed fit index = .95, nonnormed fit index = .93, comparative fit index = .96. Both autonomous and controlled orientations had significant direct and indirect effects on perpetration through alcohol consumption. Although the model fit the data well, it explained a relatively small amount of variance in both alcohol consumption (5%) and perpetration (7%). CONCLUSIONS: Findings support previous research implicating the role of alcohol in IPV perpetration. Additionally, our findings suggest that self-determination theory may be a useful heuristic in the examination of individual characteristics that promote alcohol consumption and IPV perpetration.

Efficacy of web-based personalized normative feedback: a two-year randomized controlled trial.

OBJECTIVE: Web-based brief alcohol interventions have the potential to reach a large number of individuals at low cost; however, few controlled evaluations have been conducted to date. The present study was designed to evaluate the efficacy of gender-specific versus gender-nonspecific personalized normative feedback (PNF) with single versus biannual administration in a 2-year randomized controlled trial targeting a large sample of heavy-drinking college students. METHOD: Participants included 818 freshmen (57.6% women; 42% non-Caucasian) who reported 1 or more heavy-drinking episodes in the previous month at baseline. Participants were randomly assigned in a 2 (gender-specific vs. gender-nonspecific PNF) × 2 (single vs. biannual administration of PNF) + 1 (attention control) design. Assessments occurred every 6 months for a 2-year period. RESULTS: Results from hierarchical generalized linear models provided modest effects on weekly drinking and alcohol-related problems but not on heavy episodic drinking. Relative to control, gender-specific biannual PNF was associated with reductions over time in weekly drinking (d = -0.16, 95% CI [-0.02, -0.31]), and this effect was partially mediated by changes in perceived norms. For women, but not men, gender-specific biannual PNF was associated with reductions over time in alcohol-related problems relative to control (d = -0.29, 95% CI [-0.15, -0.58]). Few other effects were evident. CONCLUSIONS: The present research provides modest support for the use of biannually administered web-based gender-specific PNF as an alternative to more costly indicated prevention strategies.

Internet-based personalized feedback to reduce 21st-birthday drinking: a randomized controlled trial of an event-specific prevention intervention.

This article presents an initial randomized controlled trial of an event-specific prevention intervention. Participants included 295 college students (41.69% male, 58.31% female) who intended to consume 2 or more drinks on their 21st birthday. Participants completed a screening/baseline assessment approximately 1 week before they turned 21 and were randomly assigned to receive Web-based personalized feedback or assessment only. Feedback included normative information, protective behaviors, and personalized blood alcohol concentration information. A follow-up assessment was completed approximately 1 week after a student's birthday. Results indicated a significant intervention effect in reducing estimated blood alcohol concentration (d = 0.33). The intervention effect was moderated by 21st-birthday drinking intentions, and the intervention was primarily effective among those who intended to reach higher levels of intoxication. Results provide some support for normative information as a mediator of intervention efficacy. Overall results provide support for Web-based personalized feedback as an intervention approach for specific events associated with extreme drinking.

Perceived approval of friends and parents as mediators of the relationship between self-determination and drinking.

OBJECTIVE: Within the context of self-determination theory, individuals vary in the extent to which they are oriented toward autonomy and control. Previous research on the relationship between motivational orientations and drinking behavior among college students has suggested that students who are more autonomously oriented consume less alcohol whereas those who are more control oriented consume more alcohol. This research evaluated the extent to which these relationships are mediated by the perceived approval of friends and parents, both of which are important sources of potential influence on the behavior of college students. METHOD: First-year students (N = 818, 58% female) who reported one or more heavy drinking episodes in the previous month completed online assessments of their drinking behavior, autonomous and controlled orientations, and perceptions of the approval of drinking (injunctive norms) by important others (friends and parents). RESULTS: The results suggested that controlled orientation was associated with greater alcohol use and that this association was mediated by perceptions of friends being more approving of problematic drinking. In contrast, autonomous orientation was associated with less alcohol use and this association was mediated by perceptions of friends being less supportive of problematic drinking. No support was found for perceptions of parents' approval as a mediator of the associations between either orientation and drinking. CONCLUSIONS: The findings highlight the importance of perceptions of friends' approval or disapproval of problematic drinking in understanding the relationship between self-determination and heavy drinking among college students.

A cross-lagged evaluation of eating disorder symptomatology and substance-use problems.

OBJECTIVE: The purpose of this study was to conduct a temporal examination of the associations among disordered eating behaviors, substance use, and use-related negative consequences in female college students-a population at high risk for developing eating and substance-use disorders. METHOD: Participants completed assessments of disordered eating behaviors, alcohol and drug use, and use-related negative consequences. RESULTS: Results support previous research suggesting that disordered eating behaviors are more strongly associated with alcohol- and substance-related problems rather than use per se. With respect to temporal precedence, results indicated that binge eating preceded alcohol-use problems, but a bidirectional relationship was found for vomiting. With regard to drug problems, laxatives use preceded drug problems, whereas drug problems preceded fasting. These associations were not better accounted for by pre-existing eating or substance-use problems or psychiatric distress (e.g., depression, anxiety). CONCLUSIONS: This study further supports the importance of assessing consequences, in addition to use patterns, when examining substance use in individuals demonstrating threshold and subthreshold eating-disordered behaviors.

Examining the relationship between typical drinking behavior and 21st birthday drinking behavior among college students: implications for event-specific prevention.

AIMS: The purpose of this research was to: (i) compare 21st birthday drinking with typical drinking; (ii) assess the prevalence of negative consequences and risk behaviors experienced during the 21st birthday week; and (iii) examine the role of typical drinking and 21st birthday drinking in explaining 21st birthday week negative consequences and risk behaviors. SETTING AND PARTICIPANTS: Participants (n = 306; 50% male) included college students turning 21 at a Midwestern public university in the United States. DESIGN AND MEASUREMENT: Approximately 1 week prior to their 21st birthday, students completed measures of typical past 3-month alcohol consumption via a web-based survey. Following their birthday, students (n = 296; 50% male) completed measures of 21st birthday week drinking as well as negative consequences and risk behaviors. FINDINGS: Findings indicated that students consumed considerably larger amounts of alcohol during the week of their 21st birthdays in comparison to typical weekly consumption. Additionally, students experienced a variety of negative consequences and risk behaviors during the week of their 21st birthday, including hangovers, vomiting and not remembering part of the previous evening. Negative binomial regression results indicated that those most likely to experience more negative consequences and risk behaviors associated with 21st birthday drinking were those who consumed heavy amounts of alcohol the week of their birthday, but who did not typically drink excessively. CONCLUSIONS: Findings underscore the need to develop event-specific prevention approaches for occasions associated with extreme drinking and provide direction for considering who may be at greatest risk for problems associated with celebratory drinking.

Intimate partner violence perpetration and problem drinking among college students: The roles of expectancies and subjective evaluations of alcohol aggression.

OBJECTIVE: The present research examined the effect of alcohol aggression expectancies and subjective evaluations of alcohol's effects on aggression in intimate partner violence (IPV) perpetration among college students. We were interested in determining the extent to which these relationships differed across gender. METHOD: A total of 780 (57.3% female) incoming heavy drinking college freshmen who were between the ages of 18 and 25 years completed self-reported measures of IPV perpetration, alcohol use and problems, and alcohol aggression expectancies and subjective evaluations of those expectancies as part of the baseline assessment for a larger social norms alcohol intervention study. Analyses evaluated the effect of alcohol aggression expectancies and subjective evaluations of those expectancies on IPV perpetration. RESULTS: Results indicated that problem drinking was positively associated with IPV perpetration for those who were lower (beta = .32, p < .001) versus those who were higher (beta = .07, p = ns) in alcohol aggression expectancies. Among men, there was a significantly stronger relationship between problem drinking and IPV perpetration among those who evaluated alcohol's effects on aggression more favorably (beta = .41, p < .001) versus less favorably (beta = .11, p = ns). Among women, there was not a significantly stronger relationship between problem drinking and IPV perpetration at less favorable (beta = .17, p < .05) versus more favorable (beta = .11, p < .06) evaluations of alcohol's effects on aggression. CONCLUSIONS: Findings suggest that, in understanding IPV perpetration, it may not be sufficient to evaluate expected alcohol effects without also including whether those effects are viewed as good or bad. Findings also suggest that the relationship between alcohol problems and IPV perpetration may be stronger and more straightforward for men than for women.

Social anxiety as a moderator of the relationship between perceived norms and drinking.

OBJECTIVE: College students overestimate the drinking of their peers, and the more they overestimate, the more they drink. The present research was designed to evaluate social anxiety as a moderator of the relationship between perceived norms and drinking among college men and women. METHOD: Participants included 1,217 first-year residence-hall students (62.8% women) who completed Web-based assessments of social anxiety, perceived norms, and self-reported drinking. RESULTS: Results replicated previous research in that students overestimated the drinking of their peers (d = 0.75, p < .001). Students who had higher social anxiety drank somewhat more but did not differ from students who had lower social anxiety on perceived norms. However, the relationship between perceived norms and drinking was stronger among students who had higher social anxiety (d = 0.92, p < .001) relative to less socially anxious students (d = 0.02, p = NS). Higher levels of social anxiety were associated with a stronger relationship between perceived norms and drinking for both men (d = 0.86, p < .001) and women (d = 0.50, p < .001) but stronger for men (d = 0.26, p < .001). CONCLUSIONS: These results corroborate previous literature, which suggests that social factors are important determinants of drinking in this population and suggest that social anxiety is associated with susceptibility to peer influences on drinking. Additional work evaluating whether reductions in social anxiety may ameliorate the impact of perceived norms on drinking would be worthwhile.

Are social norms the best predictor of outcomes among heavy-drinking college students?

OBJECTIVE: This research was designed to evaluate the relative contribution of social norms, demographics, drinking motives, and alcohol expectancies in predicting alcohol consumption and related problems among heavy-drinking college students. METHOD: Participants included 818 (57.6% women) first-year undergraduates who reported at least one heavy-drinking episode in the previous month. In addition to providing demographic information (gender and fraternity/sorority membership) participants completed Web-based assessments of social norms (perceived descriptive norms regarding typical student drinking, injunctive norms regarding friends' and parents' approval), motives (social, enhancement, coping, and conformity), and expectancies and evaluations of positive and negative alcohol effects. RESULTS: Regression results indicated that descriptive and injunctive norms were among the best predictors of college student drinking. With respect to alcohol problems, results indicated that coping motives accounted for the largest proportion of unique variance. Finally, results revealed that alcohol consumption mediated the relationships between predictors and problems for social norms, whereas coping motives, negative expectancies, and evaluation of negative effects were directly associated with alcohol problems despite having relatively weak or null unique associations with consumption. CONCLUSIONS: The results of this study substantiate social norms as being among the best predictors of alcohol consumption in this population and suggest that drinking to cope is a better predictor of problems. The findings are discussed in terms of practical prevention and treatment implications.