Negative evaluation of role transitions is associated with perceived stress and alcohol consequences: Examination of the Transitions Overload Model in young adulthood using two years of monthly data.

BACKGROUND: Young adulthood is characterized by transitions into and out of social roles in multiple domains. Consistent with self-medication models of alcohol use, the Transitions Overload Model (J Stud Alcohol Suppl, 14, 2002, 54) hypothesizes that one cause of increased alcohol use during young adulthood may be the stress of navigating simultaneous role transitions. This study examined the simultaneous occurrence of major developmental role transitions in the domains of education, employment, romantic relationships, and residential status and their associations with perceived stress, heavy episodic drinking (HED), and negative alcohol-related consequences. Further, we extended the Transitions Overload Model to explore whether the number of transitions rated as having a negative impact on one's life was related to perceived stress, HED, and alcohol-related consequences. METHODS: A community sample of young adult drinkers (N = 767, 57% women, ages 18 to 25 years) in the Pacific Northwest provided monthly data across 2 years. Multilevel models were used to assess the average (between-person) and month-to-month (within-person) associations of role transitions with perceived stress, HED, and negative alcohol-related consequences. RESULTS: Although having more role transitions was positively associated with HED frequency and alcohol-related consequences at both the between- and within-person (monthly) levels, it was not associated with increased stress. The number of transitions rated as having a negative impact on one's life, however, was positively associated with stress. Thus, rather than the total number of transitions, it is the number of negatively perceived major developmental role transitions that is associated with perceived stress and increased risk for negative alcohol-related consequences. CONCLUSIONS: Contrary to Transitions Overload Model assumptions, more transitions were not a significant predictor of more perceived stress; rather, the evaluation of the transition as negative was associated with stress and negative alcohol-related outcomes. This distinction may help elucidate the etiology of stress and subsequent alcohol consequences and identify individuals at-risk of these effects.

A Daily Study Comparing Alcohol-Related Positive and Negative Consequences for Days With Only Alcohol Use Versus Days With Simultaneous Alcohol and Marijuana Use in a Community Sample of Young Adults.

BACKGROUND: Alcohol and marijuana are psychoactive substances commonly used by young adults and are independently associated with numerous acute and long-term consequences. Many young adults engage in simultaneous alcohol and marijuana (SAM) use to cross-fade (i.e., to enhance the effects of intoxication), although the extent to which alcohol use and alcohol-related consequences increase on SAM occasions compared to alcohol-only occasions is unclear. This study examines daily data among a sample of SAM users comparing SAM days to other days when young adults only used alcohol. METHODS: A sample of 409 young adults (age 18 to 25; Mage  = 21.6, SD = 2.2; 50.9% women) who reported SAM use in the past month completed 2 bursts of 14 days of daily surveys (28 days in total) assessing alcohol use, alcohol-related consequences, and SAM use. RESULTS: Multilevel models based on alcohol-only and SAM days (n = 3,016 days; 391 individuals) indicated young adults drank more alcohol on SAM days compared to alcohol-only days (with no marijuana use). Similarly, days with SAM use were associated with more alcohol-related positive and negative consequences. The daily association between SAM use and positive consequences was statistically significant, after accounting for the amount of alcohol consumed; in contrast, the association between SAM use and negative consequences was diminished and nonsignificant. CONCLUSIONS: Among young adult SAM users, days with SAM use were associated with more alcohol use and positive consequences compared to days they only drank alcohol. Further examination of the motivational context for engaging in SAM use, as well as potential physiological interactions between alcohol and marijuana use on alcohol's effects, is warranted. Alcohol interventions might benefit from addressing increased alcohol use and alcohol-related consequences as risks associated with SAM use.

Alcohol and marijuana use, consequences, and perceived descriptive norms: Differences between two- and four-year college students.

Objective: Among two-year college students, alcohol and marijuana use, related consequences, and risk factors for use are not well understood. We examined differences between two- and four-year students in alcohol and marijuana use, consequences, and perceived descriptive norms, and explored whether two-year status moderated associations between norms and use. Participants: Data were drawn from a cross-sectional subsample of two- and four-year students aged 18-23 (n = 517) participating in a longitudinal study on alcohol use. Results: Four-year students reported greater alcohol use and consequences than two-year students; two-year students reported greater marijuana use than four-year students. Perceived alcohol and marijuana norms were positively related with use; two-year status did not moderate these associations. Conclusions: Perceived alcohol and marijuana norms function similarly for two- and four-year students in terms of associations to actual use. Adapting normative interventions for two-year students may be an effective strategy for reducing high-risk use among this underserved population.

Social norms and vaccine uptake: College students' COVID vaccination intentions, attitudes, and estimated peer norms and comparisons with influenza vaccine.

BACKGROUND: Vaccination may be critical to curtailing the spread of the SARS-CoV-2 virus responsible for the COVID-19 pandemic, but herd immunity can only be realized with high vaccination coverage. There is a need to identify empirically supported strategies to increase uptake, especially among young adults as this subpopulation has shown relatively poor adherence to physical distancing guidelines. Social norms - estimates of peers' behavior and attitudes - are robust predictors of health behaviors and norms-based intervention strategies may increase COVID vaccine uptake, once available. This study examined the extent that vaccination intentions and attitudes were associated with estimated social norms as an initial proof-of-concept test. METHOD: In November of 2020, 647 undergraduate students (46.21% response rate) completed online surveys in which they reported intentions to get COVID and influenza vaccines, perceived importance of these vaccines for young adults, and estimated social norms regarding peers' vaccination behaviors and attitudes. RESULTS: Students reported significantly greater intentions to get a COVID vaccine (91.64%) than an influenza vaccine (76.04%), and perceived COVID vaccination as significantly more important than influenza vaccination. The sample generally held strong intentions to receive a COVID vaccine and thought that doing so was of high importance, but participants, on average, perceived that other young adults would be less likely to be vaccinated and would not think vaccination was as important. Multiple regression models indicated that estimated social norms were positively associated with participants' own intentions and perceived importance of getting a COVID vaccine. CONCLUSIONS: These significant associations highlight the potential value in developing and testing norms-based intervention strategies, such as personalized normative feedback, to improve uptake of forthcoming COVID vaccines among young adults.

Calendar Month Variation in Alcohol and Marijuana Use in a Community Sample of Young Adults.

OBJECTIVE: Alcohol use among adults varies by season, and drinking among 4-year college students has been linked to holidays and the academic calendar. Little research has assessed calendar-related variation in marijuana use. We examined calendar month variation in alcohol and marijuana use among a sample of young adults that was diverse with respect to college status and educational attainment. METHOD: Data were drawn from a community sample of 761 individuals (57% female; ages 18-23 at enrollment). Participants were surveyed monthly for 24 consecutive months. Multilevel models accounted for nesting of monthly data within individuals. RESULTS: All measures of substance use showed evidence of variation by calendar month, with the exception of hours high in months when marijuana was used. Drinks per week and peak number of drinks were relatively elevated in summer months and in October and December; the prevalence of heavy episodic drinking was also elevated in October and December. Attending a 4-year college was associated with more drinking than not being enrolled in a 4-year college, regardless of whether a 4-year degree had been obtained. Students in a 4-year college reported more drinks per week than those not in a 4-year college in September and October, whereas the peak number of drinks converged across educational status in the summer months and in December. Across educational statuses, marijuana use was highest in April and December. CONCLUSIONS: Findings may guide the targeting and timing of substance use prevention programs by focusing efforts before and during higher risk months.

An Event-Level Investigation of Factors Associated With Young Women's Experiences of Coerced Consensual Sex.

Little is known about instances of coerced consensual sex in which women report both that they consented to have sex and that their partner used coercive tactics (e.g., made threats) to get them to have sex when they did not want to. Yet, these experiences are frequently reported by young sexually active women. We examined the relationship between sexual victimization history and the woman's level of alcohol intoxication in the likelihood of experiencing coerced consensual sex using event-level data collected over a 1-year period from 548 young adult nonproblem drinking women who engaged in sexual activity with men. Twenty percent (n = 112) reported at least one incident of coerced consensual sex. A generalized estimating equation model revealed main effects of daily estimated blood alcohol content (eBAC) and sexual victimization severity. The more women increased their alcohol consumption above their own average and the more severe their sexual victimization history, the more likely they were to experience coerced consensual sex. Our findings highlight the fact that coercion and consent are not mutually exclusive in some situations and shed light on this important yet understudied coercive sexual experience.

Influences of sexual sensation seeking, alcohol consumption, and sexual arousal on women's behavioral intentions related to having unprotected sex.

This experimental study examined effects of alcohol consumption and sexual sensation seeking on unprotected sex intentions, taking into account sexual arousal, indirectly discouraging sex, and condom insistence. Women (N = 173; mean age = 25.02) were randomly assigned to a control, placebo, low-dose beverage (target blood alcohol level = .04), or high- dose beverage (target blood alcohol level = .08) condition. Participants projected themselves into a hypothetical sexual interaction with a man in which no condom was available. Structural equation modeling demonstrated that both sexual sensation seeking and alcohol dose directly increased sexual arousal early in the interaction, but later sexual arousal indirectly increased unprotected sex intentions by decreasing endorsement of indirect discouragement and, in turn, condom insistence. These findings help to clarify the role of alcohol consumption and sensation seeking in women's sexual decision making and point to the importance of examining it as a multistage process. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Effects of relationship motivation, partner familiarity, and alcohol on women's risky sexual decision making.

This experiment examined the effects of women's relationship motivation, partner familiarity, and alcohol consumption on sexual decision making. Women completed an individual difference measure of relationship motivation and then were randomly assigned to partner familiarity condition (low, high) and to alcohol consumption condition (high dose, low dose, no alcohol, placebo). Then women read and projected themselves into a scenario of a sexual encounter. Relationship motivation and partner familiarity interacted with intoxication to influence primary appraisals of relationship potential. Participants' primary and secondary relationship appraisals mediated the effects of women's relationship motivation, partner familiarity, and intoxication on condom negotiation, sexual decision abdication, and unprotected sex intentions. These findings support a cognitive mediation model of women's sexual decision making and identify how individual and situational factors interact to shape alcohol's influences on cognitive appraisals that lead to risky sexual decisions. This knowledge can inform empirically based risky sex interventions.

Daily Motives for Alcohol and Marijuana Use as Predictors of Simultaneous Use Among Young Adults.

OBJECTIVE: Research on substance use motives typically examines each substance separately. However, simultaneous alcohol and marijuana (SAM) use-that is, using alcohol and marijuana at the same time so that their effects overlap-is common among young adults. This study examines day-to-day fluctuations in motives for using alcohol and/ or marijuana among young adult substance users as predictors of alcohol, marijuana, and SAM use across days. METHOD: Data were from a community sample of young adults who reported SAM use in the past month (analytic sample: N = 399, mean [SD] age = 21.63 [2.17]; 50.9% women). Participants reported alcohol, marijuana, and SAM use, and also motives "for alcohol and/or marijuana use" for 14 consecutive days. RESULTS: Multilevel models showed that elevated enhancement motives were associated with heavy episodic drinking, drinking more, and more hours high from marijuana. Elevated social motives were associated with heavy episodic drinking and drinking more, and also with fewer hours high. Elevated conformity motives were associated with drinking more. SAM use was more likely: on alcohol days and on marijuana days with elevated enhancement and conformity motives, on alcohol days with elevated coping motives, and on marijuana days with elevated social motives. CONCLUSIONS: SAM use on a given day was primarily associated with enhancement and conformity motives. Social motives were more strongly linked to alcohol use, and to some extent coping motives were linked to marijuana use in this young adult sample. Further examination of situation-specific motives and contexts of use is needed to inform development of real-time interventions for SAM use and consequences.

Alcohol motivations and behaviors during months young adults experience social role transitions: Microtransitions in early adulthood.

The study examines how young adult transitions into and out of social roles (i.e., starting or ending a job, a romantic relationship, school) are associated with drinking motives (coping, enhancement, social, and conformity) and alcohol use in a given month. A community sample of young adult drinkers (N = 767; 56.3% female; 59.3% White; Ages 18-23) completed 24 consecutive months of online surveys (N = 15,333 months of data) about the previous month's experiences, social role transitions, and alcohol use. During the 2-year data collection window, participants reported starting/ending a job (10.0%/8.2%), a relationship (2.7%/4.3%), and school (9.2%/17.4%). Between persons, those who more often started jobs were more likely to drink and those who more often ended jobs had higher enhancement motives; those who more often ended relationships were more likely to drink, have a greater number of drinks when drinking, and have higher coping and enhancement motives; and those who more often started relationships had higher conformity motives. Within persons, during months when a relationship ended, participants reported stronger coping motives, and during months when a relationship started, they reported stronger social motives for drinking. During months when a relationship started or ended, participants also reported consuming a greater number of drinks when drinking. There were no differences based on starting or ending school. Young adult social role transitions are associated with concurrent changes in both alcohol use and motives for drinking. Understanding these contextual changes and their concomitant risks is key to providing salient interventions to reduce alcohol-related harm. (PsycINFO Database Record (c) 2018 APA, all rights reserved).