Effects of alcohol problem discrepancy on relationship adjustment: The moderating role of conflict negotiation among couples with alcohol use disorder and intimate partner violence.

Alcohol use disorder (AUD) has well-known negative effects on romantic relationship functioning, including the occurrence of intimate partner violence (IPV). A separate literature focused on community couples indicates that relationship functioning is more likely to suffer when partners report greater discrepancies in alcohol consumption. It is important to expand this literature to couples with AUD and to examine the role of impactful AUD domains in dyadic functioning. Furthermore, few studies have examined adaptive, treatment-malleable factors that could potentially offset the negative impact of alcohol discrepancies on relationship functioning. This study examined the association between couples' alcohol problem discrepancies and relationship adjustment, as well as the moderating effect of self-reported adaptive conflict negotiation behaviors. Participants were 100 couples (N = 200 individual participants) with intimate partner violence wherein at least one partner met diagnostic criteria for AUD. Actor-Partner Interdependence Models indicated that greater alcohol problem discrepancy was associated with lower dyadic adjustment. Moderation analyses revealed that the highest level of relationship adjustment was observed among couples with lower alcohol problem discrepancy and greater negotiation behaviors, while relationship adjustment was similar for couples with larger alcohol problem discrepancy, regardless of negotiation behaviors. Although further study is needed to clarify under what specific conditions adaptive negotiation behaviors are most helpful, they appear to be beneficial for some couples in this sample. We found no evidence that negotiation behaviors may be harmful among these high-risk couples.

A laboratory study of the effects of men's acute alcohol intoxication, perceptions of women's intoxication, and masculine gender role stress on the perpetration of sexual aggression.

BACKGROUND: Although research has established an association between alcohol use and sexual assault, few studies have examined how characteristics of the perpetrator may influence sexual aggression depending upon whether alcohol is consumed by the perpetrator and/or the victim. This laboratory-based investigation was designed to disentangle the effects of individual differences in masculine gender role stress (MGRS) and the perpetration of sexual aggression as a function of (1) men's acute alcohol intoxication and (2) whether a woman was consuming alcohol or not. METHOD: A community sample of 156 men participated in two laboratory sessions, during which they completed a self-report measure of MGRS (Session 1) and a modified version of the sexual imposition paradigm after consuming an alcoholic or non-alcoholic beverage (Session 2). In this paradigm, participants and a male friend were told that an ostensible female participant had consumed or not consumed alcohol. They were also told that she did not wish to view sexual content. Participants were then provided the opportunity to make the female confederate view a sexually or non-sexually explicit film. Sexual aggression was operationalized by selection of the sexually explicit film. RESULTS: A hierarchical logistic regression showed that men higher in MGRS who were intoxicated were (1) more likely than sober men to select the sexually explicit film when the woman was intoxicated and (2) less likely than sober men to select the sexually explicit film when the woman was sober. CONCLUSIONS: These findings suggest that the perpetration of sexual aggression is most likely among men with higher MGRS when there is concordance in drinking (i.e., when either the man and woman are both drinking or are both not drinking).

Alcohol use and alcohol-related consequences based on gender and sexual orientation among college students.

BACKGROUND AND OBJECTIVES: Research has not yet investigated how the association between alcohol and alcohol-related consequences differs across cisgender heterosexual women (CHW), cisgender heterosexual men (CHM), and sexual and gender minority (SGM) college students. METHODS: Participants were N = 754 college students (34.5% CHW [n = 260]; 34.5% CHM [n = 260]; 31.0% SGM [n = 234]) between the ages 18 and 25 who completed a survey on sexual orientation, gender identity, alcohol use (i.e., average drinks per week), and alcohol-related consequences. RESULTS: Among individuals who reported alcohol use, CHM reported significantly more drinks per week compared to CHW and SGM. The logistic model of a zero-inflated negative binomial regression indicated that excess zeros in the alcohol-related consequences were more likely among (1) nondrinkers and (2) SGM compared to CHM. The count portion of the model indicated that, among drinkers, there was a positive association between drinks per week and alcohol-related consequences. Estimated alcohol-related consequences per drink were 1.90% higher among CHW than CHM and 2.76% higher among SGM than CHM. Exploratory analyses did not find significant differences in outcomes between cisgender female and male sexual minority students. DISCUSSION AND CONCLUSION: Findings suggest that although CHW and SGM students consume less alcohol than CHM, these students experience more alcohol-related consequences per drink. SCIENTIFIC SIGNIFICANCE: This study advances the field's knowledge of alcohol use patterns and consequences among SGM college students. There is a need for alcohol education programming that is tailored to the unique experiences, identities, and minority stressors of SGM college students.

Sexual Violence Perpetration Within Intimate Relationships: An I3 Model Analysis of the Effects of Sexual Violence Victimization and Psychological Flexibility.

The I3 Model posits that intimate partner violence (IPV) is determined by the relative strength of instigatory, impellance, and inhibitory factors. Although much research has examined nonsexual IPV, few studies have used the I3 Model to examine sexual IPV. This study investigated the effects of sexual IPV victimization (an impellor) and psychological flexibility (an inhibitor) on sexual IPV perpetration within a dyadic framework. Participants nested within 617 intimate couples completed measures of psychological flexibility and sexual IPV perpetration and victimization. Results showed that Actor IPV victimization was positively and Actor psychological flexibility was negatively associated with Actor IPV perpetration. Among those who experienced low levels of IPV victimization, psychological flexibility inhibited IPV perpetration. This inhibiting effect did not extend to Actors who experienced high levels of IPV victimization. Findings highlight the complex interactions between I3 factors and support continued dyadic examination of IPV perpetration etiology.

Association of Cannabis Use With Intimate Partner Violence Among Couples With Substance Misuse.

BACKGROUND AND OBJECTIVES: There is a well-established causal link between substance use and intimate partner violence (IPV) perpetration and victimization. However, little is known about the complex emerging relationship between cannabis use and IPV. Because cannabis is the most commonly used drug in the United States and is associated with numerous IPV risk factors such as alcohol use, it is important to examine this relationship in greater detail. METHOD: The current exploratory study examined the association between (a) self-reported cannabis use during the past 90 days and (b) Δ9-tetrahydrocannabinol (THC) urine drug screens and IPV perpetration and victimization in a sample of 30 alcohol or drug-misusing community couples (N = 60 individual participants). RESULTS: The majority of participants (n = 50 individuals, 83.3%) had concordant cannabis self-reported and urine drug screen results. After accounting for demographic variables and quantity and frequency of alcohol and stimulant use, greater quantity and frequency of cannabis use as well as positive THC urine drug screen results were associated with greater physical IPV victimization, and greater quantity and frequency of cannabis were associated with greater IPV psychological victimization and perpetration, and physical IPV victimization. CONCLUSION AND SCIENTIFIC SIGNIFICANCE: Findings emphasize the unique and important role that cannabis plays in the occurrence of IPV among intact couples. Findings also underscore the feasibility and utility of integrating confirmatory biological samples into future studies on this topic in order to advance the science in this area. (Am J Addict 2020;00:00-00).

The "White Knight" effect: Benevolent sexism accounts for bystander intervention in party situations among high status men.

Prior research indicates that adherence to the male role norm suggesting men should seek to attain social status (i.e., status) is positively related to prosocial bystander attitudes and behavior; however, moderators of this effect have yet to be examined. One construct that may influence this effect is benevolent sexism. The present study sought to fill this gap in the literature. Participants were 148 men 21-30 years of age from the metro Atlanta area who reported that they had engaged in heavy drinking at least three times in the past year. A moderation model was used to examine the independent and interactive effects of adherence to the status norm and benevolent sexism on bystander behavior within party settings for friends and strangers. The model predicting bystander behavior towards friends showed a significant interaction between status and benevolent sexism (b = .59, p = .021). The association between adherence to the status norm and bystander behavior was significant and positive among men who reported high benevolent sexism (ß = .96, p = .003), but not low benevolent sexism (ß=.15, p=.619). No such effects were detected for bystander behavior for strangers. Findings suggest that males who hold traditional male ideologies around chivalry may be more likely to engage in prosocial bystander behavior towards women in party situations, perhaps as a way of demonstrating their high status. These findings have implications for future programming for men.

Acute Alcohol Intoxication Inhibits Bystander Intervention Behavior for Sexual Aggression Among Men with High Intent to Help.

BACKGROUND: Bystander training programs aim to encourage third-party witnesses to intervene in high-risk sexual situations; however, these programs rarely focus on training bystanders to effectively intervene when intoxicated. This is not surprising due to the limited evidence on the proximal effects of alcohol on bystander intervention for sexual aggression. To this end, the aim of the present study was to test the effects of men's self-reported intent to help strangers and acute alcohol intoxication on the likelihood and speed of sexual aggression intervention. METHODS: Participants were 74 men who completed a measure of intent to help (Session 1) and were randomly assigned to consume alcohol or a no-alcohol control beverage (Session 2). Next, they engaged in a novel laboratory paradigm in which they and 4 other confederates (2 men, 2 women) watched a female confederate, who reported a strong dislike of sexual content in the media, view a sexually explicit film which they could stop at any time. Bystander intervention was operationalized as whether and how quickly participants stopped the film. RESULTS: Findings indicated that (i) intent to help strangers predicted faster sexual aggression intervention and (ii) intent to help strangers predicted a higher likelihood and faster rate of sexual aggression intervention among sober, but not intoxicated, men. This latter finding suggests that among men who endorsed a high willingness to intervene in sexual aggression, alcohol intoxication decreased intervention behavior. CONCLUSIONS: Results demonstrate that alcohol functions as a barrier to intervention for men who would otherwise intervene. Findings are interpreted using an integrative framework for intoxicated sexual aggression intervention and highlight the need for bystander training programs to incorporate alcohol interventions to reduce heavy drinking and psychoeducation to train bystanders how to intervene when intoxicated.

Misogynistic peers, masculinity, and bystander intervention for sexual aggression: Is it really just "locker-room talk?"

The present study utilized a laboratory paradigm to examine the extent to which bystander behavior for sexual aggression is independently and jointly influenced by situational misogynistic peer norms and men's adherence to hegemonic male norms. Participants were a racially diverse college sample of self-identified heterosexual men (N = 104) between the ages of 18-35. Men completed a measure of hegemonic masculinity and engaged in a laboratory paradigm in which they and three male confederates watched a female confederate, who reported a strong dislike of sexual content in the media, view a sexually explicit film which they could stop at any time. Prior to the woman viewing the film, participants were randomly assigned to a peer norm manipulation wherein the male confederates set a misogynistic or ambiguous norm. Results indicated the presence of a misogynistic peer norm decreased the likelihood and speed of intervention. Among men exposed to misogynistic, compared to ambiguous, peer norms, men who strongly endorsed the status male role norm were less likely to display prosocial bystander behavior. Findings indicate that exposure to peers who sexually objectify and disrespect women decreases prosocial bystander intervention. Further, these findings provide evidence that misogynistic peer norms heighten men's adherence to a hegemonic masculinity that men should attain social status, thereby deterring bystander behavior for sexual aggression.

Dormant Masculinity: Moderating Effects of Acute Alcohol Intoxication on the Relation Between Male Role Norms and Antigay Aggression.

Acute alcohol intoxication was examined as a moderator of the association between men's adherence to traditional gender norms and aggression towards a gay male. Participants were 164 heterosexual drinking men between the ages of 21-30. Participants completed a battery of questionnaires that included a measure of adherence to male role norms (i.e., status, toughness, antifemininity), were randomly assigned to consume an alcohol or no-alcohol control beverage, and completed the Taylor Aggression Paradigm in which electric shocks were administered to, and received from, a fictitious gay or heterosexual male opponent. Results indicated a greater adherence to both the toughness (ß = .50, p = .002) and antifeminine (ß = .37, p = .023) norms predicted high levels of aggression towards a gay man only among participants who were intoxicated. This interaction effect was not detected for the status norm. Consistent with previous research, findings suggest that adherence to the toughness norm does not increase sober men's risk of aggression toward gay men. However, this is the first study to demonstrate that alcohol intoxication may activate concepts of toughness, and thus influence men to act in line with this facet of the masculine concept. Importantly, these data support the view that men's adherence to various dimensions of masculinity may be dormant in some contexts, only to be activated, and subsequently demonstrated, in other contexts.

A Within-Person Examination of Alcohol Involved and Non-Alcohol Involved Internal and External Sexual Consent Communication.

OBJECTIVE: External consent communication and internal consent feelings may be influenced by alcohol consumption. However, whether the way someone communicates sexual consent differs when alcohol is or is not involved is not well understood. The goal of this study was to assess the within and between person effects of alcohol use, gender, and sexual identity on internal and external consent. METHOD: Young adults (n = 375) completed a 10-minute web administered survey about their internal and external consent in a recent alcohol and non-alcohol involved sexual encounter. External consent included five different behaviors to communicate consent. We conducted a repeated measures ANOVA to assess the within and between person effects of alcohol use, gender, and sexual identity on internal and external consent. RESULTS: Internal consent did not differ across sexual experiences or identities. In alcohol involved encounters, there was a decreased use of implicit communication. Heterosexual women used more verbal communication during alcohol encounters than sober encounters. Compared with men, women used more nonverbal and implicit communication across encounters. DISCUSSION: Alcohol use did not influence internal consent and was associated with a reduced use of implicit communication. The disinhibiting effects of alcohol may lead people to feeling more confident and open about expressing their sexual desires. Affirmative consent initiatives can use findings to encourage more clear communication and continue to educate on gender differences in sexual consent.

Large Language Models in an App: Conducting a Qualitative Synthetic Data Analysis of How Snapchat's "My AI" Responds to Questions About Sexual Consent, Sexual Refusals, Sexual Assault, and Sexting.

Comprehensive sexual health education for young people often remains largely inaccessible, leaving gaps in knowledge about sexual consent, refusals, sexual assault, and sexting. Snapchat's My AI, tailored to its users, offers accessible and potentially stigma-free responses to sexual health queries, showing promise in addressing these gaps. This study aimed to evaluate My AI's effectiveness in handling questions related to sexual communication, assault, and sexting, and its response consistency across users. Collaborating with young adults and leveraging prior literature, our team formulated questions on sexual consent, refusals, sexual assault, and sexting submitted to My AI by 15 researchers. Each team member opened a chat with My AI in Snapchat and asked it a set of questions in the same order. We then conducted a qualitative content analysis to assess for consistency across users. My AI responses emphasized the importance of clear, honest consent and refusal communication through physical contact or direct conversation. With potential experiences of sexual assault or sexting, it advised consultation with a trusted caregiver. While My AI provided similar responses across researchers, variations were noted. My AI's responses mirrored common sexual health education messages and the responses used language reflective of sympathy toward potential assault victims or those who were asked for sexual images. My AI's potential to enhance accessibility to sexual health information could empower young people in making informed sexual health decisions. However, variability in responses may limit impact and comprehension, underscoring the importance of educators complementing these tools.

Alcohol intoxication, condom use rationale, and men's coercive condom use resistance: The role of past unintended partner pregnancy.

OBJECTIVE: Cisgender men's condom use resistance (CUR), deliberate attempts to avoid using a condom with a partner who wishes to use one, may include coercive strategies, such as deception and force, and places their partners at risk for unintended pregnancy and sexually transitted infections (STIs). This investigation used an alcohol administration design to examine one distal (history of unintended partner pregnancy) and two proximal (acute alcohol intoxication, condom use rationale) contributors to men's intentions to engage in coercive CUR. METHOD: Nonproblem drinking, cisgender men (N = 313) completed questionnaires, then were randomized to a beverage condition (control, placebo, low dose [.04%gm], and high dose [.08%gm]). Participants completed a sexual risk analog and reported their coercive CUR intentions after a hypothetical, female partner provided a condom use rationale (STI avoidance or pregnancy avoidance). RESULTS: Men who received the pregnancy condom use rationale reported higher intentions to engage in coercive CUR when they received a high alcohol dose relative to sober men. For men who had a history of unintended partner pregnancy, receiving a pregnancy condom use rationale was associated with greater intentions to have forced, condomless sex if they received a high alcohol dose relative to sober men. CONCLUSIONS: Intoxicated men may be more likely to engage in coercive CUR; this may indicate that when intoxicated, pregnancy risks are less salient relative to STI-related outcomes. As reproductive rights are being decimated, effective interventions targeting CUR, particularly when intoxicated, are needed in tandem with policies that affirm one's ability to prevent and terminate pregnancy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Acceptability of RealConsent: A Sexual Violence Web-Based Risk Reduction Program for College Women.

Acceptability of a sexual violence (SV) risk reduction program called RealConsent designed for first-year female college students was conducted as part of a larger, randomized controlled trial. RealConsent uses web-based and mobile technology to deliver four 45-minute theoretically and empirically derived modules designed to increase knowledge, affect attitudes and normative beliefs, increase bystander and other protective behaviors, and reduce alcohol misuse. Educational entertainment is used throughout the program to achieve these aims. A total of 444 first-year female college students recruited from three Southeastern universities who were eligible and provided informed consent were randomized to RealConsent. Acceptability was ascertained both quantitatively and qualitatively through a survey administered following the completion of each of four modules. Results suggest that overall, RealConsent was viewed as relatable, realistic, and relevant. Most participants rated modules as good/excellent in quality, in organization, and in the conveying of a high degree of knowledge regarding alcohol misuse, consent for sex, sexual communication, defense strategies, protective strategies, and intervening to prevent SV. Suggestions to improve RealConsent centered on having more content inclusive of sexual and gender-minoritized students. Results suggest that RealConsent is an acceptable SV risk reduction program among first-year female college students and may have advantages for dissemination over in-person programs due to its web-based and mobile technology.

Emotion Regulation Difficulties Moderate the Association Between Typical Drinking and Sexual Assault Victimization Among Sexual and Gender Minority University Students.

Sexual and gender minority (SGM) students report higher alcohol consumption, emotion regulation difficulties, and sexual assault victimization severity than cisgender, heterosexual individuals. A sample of 754 undergraduate students completed an online survey assessing alcohol use, emotion regulation, and sexual victimization. Regression analyses indicated that, among SGM students with higher emotion regulation difficulties, typical weekly drinking was positively associated with sexual assault victimization severity, but among cisgender, heterosexual students and SGM students with lower emotion regulation difficulties, there was no association between drinking and victimization severity. Thus, SGM students benefit from interventions targeting alcohol use and emotion regulation difficulties.

Identifying brief intervention factors to improve cannabis related outcomes in adolescents and young adults: A systematic review of sample characteristics and intervention components.

INTRODUCTION: Prior systematic and meta-analytic reviews observed mixed evidence for the efficacy of cannabis brief interventions (BIs). Inconsistent support for cannabis BIs may be the result of intersecting methodological factors, including intervention structure and content, participant eligibility criteria, and outcome assessment measures. The current systematic review of cannabis BI studies narratively synthesizes these data to guide intervention development decision-making in future cannabis BI studies (PROSPERO CRD42022285990). METHODS: We searched PubMed/MEDLINE, PsycINFO, and CINAHL databases in January 2022 and again in June 2023 to capture newly published studies. Studies were included if they were a randomized trial, enrolled adolescents (13-17) and/or young adults (18-30), specified cannabis use and/or problems inclusion criteria, and evaluated a cannabis BI (defined as ≤4 sessions). We extracted and synthesized data on intervention characteristics (e.g., components, length/duration, modality), cannabis inclusion criteria and recruitment setting, baseline cannabis use descriptives and treatment-seeking status, and outcome assessment measures to discern if/how they may intersect to determine intervention efficacy. The Cochrane Risk of Bias Tool 2 assessed study quality. RESULTS: Our search resulted in a final sample of 25 study records including 4094 participants. Recruitment setting seemed to provide an influential backdrop for how well inclusion criteria determined baseline cannabis use level, as well as for the type/length of the BI evaluated. Motivational interviewing (MI) and personalized feedback (PF) were the most frequently used BI components overall; however, some differences were observed in the proportion of BIs with reported intervention effects using MI vs. PF. Frequency of use days was the most commonly used outcome measure, although this may not be the most sensitive measure for assessing cannabis BI efficacy. CONCLUSIONS: Our systematic review indicates that cannabis BI studies require greater precision in their design, giving special attention to matching the content and structure of the BI to the needs of the target population and selecting outcomes commensurate to the goals of the BI and the target population to more accurately reflect the efficacy of the BI. However, consistent with prior reviews, all included studies demonstrated at least some concerns for risk of bias, and most were at high risk.

An Integrative Model of Alcohol-Facilitated Intimate Partner Aggression Perpetration in Sexual and Gender Diverse Couples.

OBJECTIVE: Sexual and gender diverse (SGD) individuals are at heightened risk for intimate partner aggression (IPA) perpetration relative to their heterosexual and cisgender peers. Alcohol is a well-established cause of IPA perpetration in cisgender, heterosexual couples; however, minimal research has investigated the alcohol-IPA perpetration link in SGD couples. The relative lack of work in this area is a major barrier to addressing this health disparity. SGD individuals experience unique stressors related to their and/or their partner's intersecting minoritized identities that are critical to understanding alcohol-IPA etiology and informing culturally affirming intervention programming. METHOD: We advance prior work by members of the authorship team (see Parrott et al., 2023a; Shorey et al., 2019) to propose an integrative theoretical model that invokes (1) the I3 Model to organize risk and resilience factors at the individual and dyadic level, and (2) Alcohol Myopia Theory to explain the mechanism by which proximal alcohol use facilitates IPA as a function of individual differences in those factors. RESULTS: This integrative model provides a framework to understand how the confluence of stigma, minority stressors, proximal alcohol use, and other factors contribute to IPA perpetration in SGD couples. DISCUSSION: Application of this integrative model has potential to facilitate more rigorous research (e.g., intensive longitudinal designs, dyadic analysis) focused on putative risk and resilience factors across the social ecology. Further, the model provides guidance for intervention development by identifying how individual (e.g., minority stress), relationship (e.g., relationship functioning), and structural factors (e.g., SGD stigma) interactively contribute to alcohol-facilitated IPA perpetration.

Examining the role of alcohol and cannabis use patterns in bystander opportunity and behavior for sexual and relationship aggression.

OBJECTIVE: This study aimed to investigate the association between alcohol and cannabis use patterns and bystander intervention for sexual and relationship violence risk among college students who have used cannabis in the past year. The study tested two hypotheses: (1) reports of bystander opportunities will differ based on participants' alcohol and cannabis use patterns, and (2) among those who report bystander opportunities, reports of bystander behaviors will differ based on their alcohol and cannabis use patterns. METHOD: Participants were 870 students recruited from two large, minority-serving universities in the United States who reported past year cannabis use. Participants reported about their typical alcohol and cannabis use patterns and bystander opportunities and behaviors. Students were grouped for analysis based on their reported average substance use into four groups: alcohol and cannabis use on the same day, alcohol use only, cannabis use only, or no use. RESULTS: Students who reported alcohol and cannabis use on the same day, compared with those who reported alcohol use only, reported more bystander opportunities and behaviors in situations at risk for sexual and relationship violence. Compared with alcohol use only, students who reported only using cannabis or no use reported fewer bystander opportunities and behavior related to keeping others safe in party settings. CONCLUSIONS: Alcohol and cannabis use patterns are associated with bystander intervention, emphasizing the need to include knowledge about cannabis and co-use in bystander programming that aims to reduce sexual and relationship violence.

The association between alcohol use and sexual assault victimization among college students differs by gender identity and race.

PURPOSE: Alcohol use and sexual assault (SA) are common on college campuses. The purpose of this study is to examine if the association between alcohol use and SA differs by gender identity, sexual orientation, race, or ethnicity. METHODS: A total of 3,243 college students aged 18-25 at two large, minority-serving, public universities in the southwest and southeast United States completed an online survey about alcohol and sexual behaviors. Two negative binomial regressions were conducted to examine main effects and interaction effects. RESULTS: Almost half of the sample reported a SA victimization history. The main effects negative binomial regression indicated that more drinks per week, older age, identifying as a cisgender woman (vs. cisgender man), identifying as a gender minority (vs. cisgender man), and identifying as a sexual minority (vs. heterosexual) were associated with more severe SA victimization. Participants who identified as Latine (vs. non-Latine White) reported less severe SA. The negative binomial regression assessing interactions indicated that the association between alcohol use and SA severity was stronger among cisgender women and gender minority identities than cisgender men, and Black identities than non-Latine White identities. CONCLUSION: Findings suggests that alcohol use is an important factor for SA severity among all students, but that the association is stronger among some with marginalized identities. Given that perpetrators target people who hold some marginalized identities, prevention programming could address cisnormative, heteronormative, and White normative ideas about alcohol and sex to attain social justice and health equity.

Mixed method examination of alcohol and suicidality among actively suicidal adults who engage in heavy episodic drinking.

Suicide is a serious public health problem in the United States. Alcohol use has been substantially documented as a risk factors for suicide, yet it is unclear how alcohol is associated with suicidal ideation (SI) and behavior (SIB) at the event level. We examined the association between alcohol use and SI using a mixed methods approach that included daily assessments from 13 adults who engage in heavy episodic drinking with current SI and qualitative interviews among 12 of those adults. Participants were recruited on social media. Separate mixed effects logistic regression models indicated that individuals' alcohol use on a given day was associated with SI (OR = 1.37), and suicidal urges (OR = 1.41). Adjusting for repeated measures, the expected marginal mean for intensity of SI (EMM = 3.33) and urges (EMM = 2.94) were higher on days with reported drinking behavior than days without reported drinking (EMM = 2.68 and EMM = 2.62 respectively). Qualitative data indicated that the association between alcohol use and SIB is more complex than a single directionality. Instead, the association can be unidirectional, bidirectional, and/or dependent on factors including mental health and amount of alcohol consumed. Overall, these findings emphasize a need for integrated alcohol and SIB interventions while providing insight on possible daily, just-in-time adaptations.

Alcohol's Effects on the Bystander Decision-Making Model: A Systematic Literature Review.

To decrease rates of sexual assault victimization, young people are encouraged to become involved when they see questionable sexual situations (i.e., be a prosocial bystander). Several factors can facilitate or inhibit intervention, including alcohol use. To inform bystander prevention programs that aim to address alcohol's impact on bystanders, the current study reviewed research focused on alcohol use and bystander decision making. In December 2022, the authors searched published studies from six major electronic databases. Empirical articles were deemed eligible if they examined alcohol and the bystander decision-making model within the context of sexual assault, were based in the United States or Canada, and not an intervention study; 32 studies were included in the final review. Across 32 studies published between 2015-2022, 12 assessed the proximal effects of alcohol on bystander constructs and the additional studies examined the distal effects of alcohol on bystander constructs. Alcohol use appeared to impede earlier steps of the bystander decision-making model; however, alcohol use was associated with impeding and facilitating bystander decision making at the latter half of the model. Overall, alcohol use appears to be negatively rather than positively associated with bystander constructs. Bystander intervention programs may want to move beyond the narrative of alcohol as a risk factor for sexual assault and discuss how alcohol impairs a bystanders' ability to recognize risk. More work is needed to ensure researchers assess alcohol consistently and with similar methods (number of drinks, subjective intoxication) to increase generalizability of findings to prevention programs.