Longitudinal associations between descriptive and injunctive norms on college drinking.

Perceived norms of drinking prevalence (descriptive norms) and approval (injunctive norms) are among the most robust predictors of college student drinking, but the dynamic fluctuations of these relationships over time are less understood. We examined longitudinal associations of descriptive and injunctive norms on alcohol consumption, disaggregating within-person fluctuations from between-person associations. Participants were 593 heavy drinking college students who completed measures of perceived descriptive and injunctive norms and drinking at baseline, one month, three months, six months, and 12 months. Longitudinal multilevel model analyses revealed that, at the between-person level, only descriptive norms predicted drinking. In contrast, both descriptive and injunctive norms at the within-person level predicted weekly drinking. The findings are the first to examine between- and within-person effects of descriptive and injunctive norms simultaneously on drinking and suggest that future college drinking interventions using normative influence would benefit from recognizing and incorporating within-person fluctuations in perceived norms.

Longitudinal relations between physical activity and alcohol consumption among young adults.

OBJECTIVE: Recent research has revealed positive associations between alcohol use and physical activity. However, findings from these studies have been inconsistent, and longitudinal designs have been underutilized. Therefore, the present study examined longitudinal associations between physical activity and alcohol use in a sample of young adults. METHOD: This study is a secondary analysis of 383 college students (57% female) who reported their drinking behaviors at 3-month assessments over an approximately 2-year period. Self-reported physical activity was examined for the first 9 months, and drinking was assessed over 21 months. RESULTS: Analyses revealed that increases in the intensity of physical activity over the first 9 months predicted increases in drinking over the same time period; however, predictions over the subsequent year were nonsignificant. Conversely, increases in alcohol use over the first 9 months were associated with concurrent increases in duration of physical activity. CONCLUSIONS: Results extend previous cross-sectional research findings by indicating that positive associations between physical activity and alcohol use also are found longitudinally. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Ecological Momentary Assessment of Associations Between Social Interactions and Physical Activity Outcomes Among Women in Midlife With CVD Risk Conditions.

BACKGROUND: Risk for cardiovascular disease is particularly high among women in midlife (ages 40-60). Moderate-to-vigorous-intensity physical activity (PA) can protect against risk during this time, and research is needed to understand contributors to PA motivation and behavior in daily life. PURPOSE: This study used ecological momentary assessment to examine: (a) within-person associations between social interactions (both quantity and quality) and PA outcomes (motivation and behavior) among women in midlife, and (b) variability in within-person associations across days. METHODS: Women ages 40-60 with one or more cardiovascular disease risk conditions (e.g., hypertension; n = 75; MAge = 51.6 years, MBMI = 34.0 kg/m2) wore waistband accelerometers and completed five surveys per day for 10 days. RESULTS: Controlling for social interactions overall, at times when women reported a higher number of positive interactions, they reported higher PA motivation; this association was negative for both the number and valence of negative interactions. At times when women experienced a higher number of interactions overall, they engaged in fewer subsequent minutes of moderate-to-vigorous-intensity PA, though reports of positive and negative interactions were not associated with moderate-to-vigorous-intensity PA behavior. Importantly, the direction of these within-person associations differed between days of observation (positive associations on ~50% of days and negative associations on ~50% of days). CONCLUSIONS: Findings show that social interactions influence PA motivation and behavior among women in midlife but that these influences are inconsistent, suggesting the need for careful consideration of how to engage social interactions to promote PA in this group.

Design, efficacy, and methodology considerations for brief interventions: Intervention delivery and incentives.

This research evaluated the effects of two methodological factors (i.e., delivery modality and incentives) on attrition, data quality, depth of processing, and perceived value of a personalized normative feedback (PNF) intervention targeting drinking reduction in college students. We expected in lab (vs. remote) participation would be associated with lower attrition, better data quality, and greater depth of processing and intervention value. We further expected that being offered an incentive (vs. not) would be associated with less attrition and better data quality, but lower depth of processing and intervention value. Finally, we expected depth of processing and intervention value to be related to reductions in drinking among PNF participants. Heavy drinking college students (N = 498) participated in a 2 (in-person vs. remote delivery) × 2 (incentive [$30 gift card] vs. no incentive) × 2 (PNF vs. attention control) design. Follow-ups occurred remotely 3 and 6 months later; all participants were compensated with a $15 giftcard per completed follow-up. In-lab participants and those offered an incentive were less likely to drop out of the study. In-lab participants gave higher quality data at baseline and reported greater depth of processing and higher intervention value. PNF was related to reductions in drinking, but depth of processing and intervention value were not, nor was the interaction with PNF. Results suggest several benefits for motivating students to come into the lab and a few for offering an incentive but suggest that this is not a necessary requirement for PNF brief interventions to work. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Self in the Service: Self-Identification Moderates the Association between Perceived Drinking Norms and Own Drinking among Veterans.

PURPOSE: Drinking is common among young adult veterans. Previous research has established that veterans' drinking is more strongly associated with veteran versus civilian drinking norms. The present research extends these findings by examining the influence of self-identification both with other veterans and with civilians as moderators of the association between perceived norms and drinking. METHODS: Veterans aged 18-34 (N = 1015; 88.7% male; M = 28.23, SD = 3.44) were recruited via Facebook to participate. Measures included same-gender veterans/same-gender civilians self-identification, same-gender veterans/same gender-civilians perceived drinking norms, and own drinking. RESULTS: Pairwise comparisons revealed both male and female veterans identified more with other veterans than civilians and perceived drinking to be more prevalent among other veterans than civilians. However, males overestimated male veteran drinking norms to a greater degree than male civilian norms whereas the opposite was true for females. Negative binomial analysis examining a three-way interaction between veteran identification, civilian identification, and civilian norms revealed civilian drinking norms were positively associated with drinking, particularly for veterans who strongly identified with both veterans and civilians. Conversely, civilian drinking norms were also found to be negatively associated with drinking, particularly for those who did not identify strongly with civilians but identified strongly with veterans. IMPLICATIONS: This study represented a preliminary step for understanding how identity plays a role in terms of veterans' drinking. Given that veterans drank at differing levels of identification, it may be important to consider identities that are most salient when designing interventions targeting individual veterans.

Shyness and susceptibility to social influence: Stronger concordance between norms and drinking among shy individuals.

Despite a large body of work exploring associations between perceived norms and drinking and norms-based interventions for drinking, less work has examined moderators of associations between norms and drinking outcomes to determine potential sub-groups that might benefit most from brief norms-based interventions. The present study investigates shyness as a moderator of associations between drinking norms and alcohol use. We hypothesized that shyness would moderate associations between drinking norms and alcohol use such that individuals who are higher in shyness might be more sensitive to social influence and thus show stronger associations between drinking norms and alcohol use. Participants included 250 college students (70% female; 44.5% White/Caucasian) aged 18-26 (M = 21.02, SD = 2.16) who met heavy drinking criteria (4/5 drinks on one or more occasions in the past month for women/men). Participants completed measures of demographics, shyness, alcohol use, alcohol-related problems, and drinking norms remotely at baseline and one-month follow-up (N = 169). Drinking norms were negatively associated with shyness and positively associated with baseline and follow-up drinking. Shyness was negatively associated with baseline drinking but not associated with follow-up drinking. Interaction models tested longitudinal associations between shyness, descriptive drinking norms, and follow-up drinking, controlling for baseline drinking and gender. Results showed that associations between drinking norms and drinks per week were strongest among people who were higher in shyness. Individuals who are shy may be more susceptible to social influence and thus may benefit more from a norms-based drinking intervention. Future work may explore shyness as a moderator of norms-based intervention efficacy.

Guilt and expressive writing for reducing alcohol use in college students: Study protocol for a randomized control trial.

The current proposed study aims to evaluate expressive writing as a novel intervention for reducing problematic drinking among college students. College students are at increased risk for alcohol misuse compared to other adults, and the development of efficacious intervention approaches is an urgent priority. The vast majority of individually focused brief interventions targeting college drinking have focused on personalized feedback approaches and recent innovations have largely been limited to refinements of this paradigm, which require large-scale assessment and intricate programming for implementation. The present research proposes expressive writing as a novel alternative, which has been used extensively in other domains but not as an alcohol intervention strategy. We propose a theoretically-based approach that incorporates expression of the self-conscious emotion of guilt and the written analogue of change talk as proposed mechanisms of intervention efficacy. We will also examine individual differences in guilt-proneness as a moderator of intervention efficacy. Heavy drinking college students (N = 600) will be randomly assigned to one of six expressive writing conditions based on a 2 (alcohol vs. distress) × 2 (guilt vs. no guilt) + 1 (control writing) + 1 (personalized feedback) design. Participation in the study involves completion of a screening assessment, a baseline assessment, three in-lab intervention sessions, post-intervention assessments, and follow-up assessments one-month, three-months, six months, and twelve-months later. If effective, this novel intervention approach would not require any pre-assessment or programming of personalized feedback, and would serve as a more easily disseminable alternative to existing approaches.

Incorporating Writing into a Personalized Normative Feedback Intervention to Reduce Problem Drinking Among College Students.

BACKGROUND: Personalized normative feedback (PNF) interventions have repeatedly been found to reduce drinking among undergraduates. However, effects tend to be small, potentially due to inattention to and inadequate processing of the information. Adding a writing component to PNF interventions may allow for greater cognitive processing of the feedback, thereby boosting intervention efficacy. Additionally, expressive writing (EW) has been shown to reduce drinking intentions; however, studies have not examined whether it can reduce drinking behavior. The present experiment evaluated whether including a writing task would improve the efficacy of PNF and whether EW alone can be used to reduce drinking and alcohol-related problems. METHODS: Heavy drinking undergraduates (N = 250) were randomized to receive either: (i) PNF about their alcohol use; (ii) EW about a negative, heavy drinking occasion; (iii) PNFplus writing about the norms feedback; or (iv) attention control feedback about their technology use in an online brief intervention. Participants (N = 169) then completed a 1-month follow-up survey about their past month alcohol use and alcohol-related problems online. RESULTS: PNFplus writing reduced alcohol-related problems compared to all other conditions. No significant reductions were found for EW. Both PNF and PNFplus writing reduced perceived norms and perceived norms mediated intervention effects for both feedback conditions. CONCLUSIONS: The current findings suggest that adding a writing component to traditional norms-based feedback approaches might be an efficacious strategy, particularly for reducing alcohol-related consequences.

Online personalized normative feedback intervention to reduce event-specific drinking during Mardi Gras.

High-risk drinking events (e.g., Mardi Gras) are associated with heavy and problematic drinking behaviors in college students. Online personalized normative feedback (PNF) interventions have been found to reduce college drinking, yet few studies have investigated the effect of event-specific PNF on drinking. The present study investigated the impact of a Mardi Gras-specific PNF intervention on Mardi Gras drinking and normative beliefs. Undergraduate students who reported intending to drink during Mardi Gras were randomly assigned to receive PNF (n = 74) or nondrinking control feedback (n = 73), both delivered online. Compared to those in the control condition, those in the PNF condition reported lower normative beliefs at follow-up. Follow-up beliefs mediated the relation between condition and peak estimated blood alcohol content (eBAC) during Mardi Gras such that the PNF condition was related to lower follow-up maximum estimated eBAC via lower follow-up normative beliefs. Baseline drinking moderated treatment effects such that the PNF was related to lower follow-up eBAC among heavier but not lighter baseline drinkers. This is the first known study to find that an event-specific stand-alone PNF intervention administered online in anticipation of a university-wide holiday associated with drinking can result in decreased event-specific drinking via changes in event-specific normative beliefs. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Personalized normative feedback for heavy drinking: An application of deviance regulation theory.

Deviance Regulation Theory (DRT) proposes that individuals regulate their behavior to be in line with the behaviors of others. Specifically, individuals desire to stand out in positive way and not stand out in a negative way. DRT has been successfully applied to encourage other health behaviors and offers a unique method to utilize both injunctive norms in combination with descriptive norms in brief alcohol interventions. This randomized controlled trial evaluated a computer-delivered, norms-based personalized feedback intervention which systematically varied the focus on whether specific drinking behaviors were described as common or uncommon (a descriptive norm), whether the drinking behaviors were healthy versus unhealthy, and whether the drinking behaviors were positively or negatively framed (an injunctive norm). Nine-hundred and fifty-nine college drinkers completed baseline, three-month, and six-month follow-up assessments. Results indicated messages focusing on unhealthy drinking behaviors, particularly when described as uncommon, were most effective in reducing drinking and alcohol-related problems over time. This research utilizes deviance regulation theory as a way of improving personalized normative feedback by elucidating how to construct messages for brief interventions based on descriptive characteristics associated with specific target drinking behaviors in combination with perceptions of prevalence and acceptability of such drinking behaviors (an injunctive norm).

The Epidemiology of Binge Drinking Among College-Age Individuals in the United States.

Rates of alcohol consumption continue to be a concern, particularly for individuals who are college age. Drinking patterns have changed over time, with the frequency of binge drinking (consuming four/five or more drinks for women/men) remaining high (30% to 40%). Young adults in the college age range are developmentally and socially at higher risk for drinking at binge levels. Changes in autonomy, parental control, norms, and attitudes affect binge drinking behaviors. This article reviews those changes, as well as the individual and environmental factors that increase or decrease the risk of participating in binge drinking behaviors. Risk factors include risky drinking events (e.g., 21st birthdays), other substance use, and drinking to cope, while protective factors include religious beliefs, low normative perceptions of drinking, and use of protective behavioral strategies. Additionally, this article discusses the physical, social, emotional, and cognitive consequences of consuming alcohol at binge levels. Alcohol policies and prevention and intervention techniques need to incorporate these factors to reduce experiences of alcohol-related problems. Targeting policy changes and prevention and intervention efforts toward young adults may increase effectiveness and prevent both short- and long-term consequences of binge drinking.

Drinking to cope moderates the efficacy of changing veteran drinking norms as a strategy for reducing drinking and alcohol-related problems among U.S. veterans.

Heavy and problematic drinking is a concern among young adult military veterans. Personalized normative feedback (PNF) interventions that target normative misperceptions regarding drinking have been efficacious among young adults and have recently begun to be implemented among veteran populations in an effort to reduce heavy drinking. However, moderators of PNF intervention efficacy among veterans are largely unexplored. This study is a secondary data analysis that evaluated whether a PNF intervention would work better at reducing perceived norms, drinking, and alcohol-related problems specifically for young adult veterans who drink to cope with negative affect. Veterans of the United States (U.S.) military (86% male; Mean age = 28.9 years, SD = 3.4) were randomly assigned to receive either: 1) PNF comparing their drinking and perceived norms to actual drinking rates for same sex veterans; or 2) feedback about same sex veteran video game play (control condition). Seven hundred eighty-four individuals completed baseline and 622 completed 1-month follow-up assessments (79% follow-up), including measures of alcohol use, alcohol-related problems, and drinking motives. Moderated mediation analyses indicated that changes in normative misperceptions as a result of the intervention were more strongly associated with reductions in drinking and problems among veterans scoring higher on drinking to cope. These findings suggest that PNF may be an especially efficacious brief intervention for veterans who drink for coping reasons. (PsycINFO Database Record

Explicit drinking identity and alcohol problems: The mediating role of drinking to cope.

Drinking identity, or the tendency to view one's self as a drinker, is a unique predictor of alcohol use and related consequences among young adults; yet the mechanism by which it leads to alcohol problems is poorly understood. Based on self-presentation and self-verification perspectives, we examined drinking to cope as a mediator of the association between explicit drinking identity and alcohol-related problems among two samples of young adults. Study data come from two large, longitudinal studies. Participants from Sample 1 and Sample 2 included undergraduates (55% and 59% female, respectively) who reported drinking in the previous three months. Tests of the indirect effects indicated that 3-month drinking to cope significantly mediated the positive association between baseline drinking identity and 6-month alcohol-related problems in both samples. In contrast, 3-month drinking identity did not mediate the association between baseline drinking to cope and 6-month alcohol-related problems. Findings indicate that individuals with a stronger drinking identity are more likely to use alcohol to cope and, subsequently, experience more problems. Thus, drinking identity may be an important intervention target for college students as it appears to temporally proceed drinking to cope in the prediction of alcohol-related problems.

Evaluations and Perceptions of Others' Evaluations of Negative Alcohol-Related Consequences Predict Negative Alcohol-Related Consequences Among College Drinkers.

OBJECTIVE: A key assumption when assessing alcohol-related problems is that these problems are considered negative. A growing literature suggests that college drinkers do not perceive all measured consequences to be negative. Research has established the impact of others' beliefs on personal beliefs and behaviors. The purpose of this study was to assess the effect of perceptions of others' evaluations (POE) of consequences on one's own evaluations and subsequent experiences of consequences. METHOD: A sample of 885 heavy drinking college students participated in a longitudinal study. Participants reported the number of alcoholic drinks consumed per week, experiences of alcohol-related problems, evaluations of those consequences, and perceptions of how typical university students evaluate those consequences. A moderated mediation of POE on negative alcohol-related consequences via evaluations of consequences at differing levels of alcohol consumption was conducted, with gender, baseline consequences, and intervention effects being controlled for. RESULTS: Results indicated that POE had no direct effect on subsequent consequences. However, an indirect effect was found through evaluations of consequences, such that there was a positive association between both POE and evaluations of consequences, and evaluations of consequences and subsequent consequences. Average weekly drinking moderated the association between POE and evaluations of consequences, such that the association between POE and evaluations of consequences was stronger for those who drank more heavily. CONCLUSIONS: Results are consistent with social cognition processes, such as pluralistic ignorance, and suggest that POE and evaluations of consequences should be considered in the construction of interventions targeting heavy-drinking college students.

Compounding risk: An examination of associations between spirituality/religiosity, drinking motives, and alcohol-related ambivalence among heavy drinking young adults.

OBJECTIVES: The present study assessed combinations of spirituality/religiosity (S/R), a known protective factor against heavy drinking, with drinking motives, and alcohol-related ambivalence to better understand how these factors interrelate and are associated with drinking and alcohol-related problems. METHODS: Participants were 241 heavy drinking undergraduate students (81.74% female; Mage=23.48years; SD=5.50) who completed study questionnaires online. RESULTS: Coping, enhancement, and conformity drinking motives were associated with greater alcohol use and problems, however there were no main effects of either ambivalence or S/R on alcohol outcomes. S/R interacted with ambivalence with respect to drinking and problems. S/R also interacted with conformity drinking motives with respect to drinking and problems. Further, ambivalence interacted with conformity drinking motives regarding problems. Three-way interactions emerged between ambivalence, S/R, and drinking motives (social, coping, and enhancement motives) regarding drinking and problems. Results show that individuals at highest risk for problematic drinking are those who more strongly endorse drinking motives, are low in S/R, and high in ambivalence. CONCLUSIONS: Findings supported hypotheses and provide support for clusters of individual difference factors that put heavy drinking college students at higher risk for problematic drinking. These examinations have practical utility and may inform development and implementation of interventions and programs targeting alcohol misuse among heavy drinking undergraduate students.

Coping Motives Moderate Efficacy of Personalized Normative Feedback Among Heavy Drinking U.S. College Students.

OBJECTIVE: Personalized normative feedback (PNF) interventions have received empirical support, are presumed to work by reducing normative misperceptions, and have been found to be particularly efficacious for those who drink for social reasons. However, PNF interventions also offer direct comparisons between one's own drinking and normative drinking, which may be especially important for coping drinkers. The present research evaluated whether reduced perceived norms and drinking at follow-ups varied as a function of coping motives. METHOD: Aims were examined as a secondary analysis of a PNF intervention study among 252 U.S. college students. Following baseline assessment, participants were randomly assigned to receive PNF or assessment only. Follow-up assessments occurred 3 and 6 months after baseline. RESULTS: Findings indicated that the PNF intervention was more effective at both follow-ups in reducing drinking, but not alcohol use problems, for participants scoring higher in coping motives. Furthermore, coping motives were the only drinking motive that uniquely moderated PNF efficacy. Analyses indicated that intervention effects on drinking varied as a function of coping drinking motives; however, intervention effects on norms did not vary by coping motives. Finally, coping motives were found to moderate associations between perceived norms and drinking. CONCLUSIONS: These results suggest that coping motives may be useful for identifying young adults-and presumably others-who can most benefit from PNF approaches. Furthermore, PNF may influence future drinking behavior through mechanisms other than changes in perceived norms. Future investigations could examine other pathways through which PNF may reduce drinking.

God, Can I Tell You Something? The Effect of Religious Coping on the Relationship between Anxiety Over Emotional Expression, Anxiety, and Depressive Symptoms.

The current study investigated whether religious coping would moderate the association between ambivalence over emotional expression (AEE) and depressive symptoms and anxiety symptoms such that the positive relationship between AEE and depressive symptoms and anxiety symptoms would be weaker among those higher in religious coping. Three-hundred and fifty-two undergraduates (M age=23.51 years, SD=6.80; 84.4% female) completed study materials. Contrary to expectations, results revealed a significant interaction between religious coping and AEE such that religious coping exacerbated the relationship between higher AEE and distress symptoms. The implications of this study suggest that religious coping may not be an ideal coping mechanism for individuals with high levels of AEE. These results indicate the need to further examine the role of AEE in religious coping, and have potential implications for clinicians, healthcare professionals, and religious mentors who may promote the use of religious coping in treatment.

A multisite randomized trial of normative feedback for heavy drinking: Social comparison versus social comparison plus correction of normative misperceptions.

OBJECTIVE: Given widespread alcohol misuse among college students, numerous intervention programs have been developed, including personalized normative feedback (PNF). Most research evaluating PNF assumes that presenting one's own perceived norms is necessary to correct normative misperceptions and thereby reduce drinking. Alternatively, simply providing social comparison information showing that one drinks more than others may be sufficient. The present study evaluated the efficacy of full PNF (one's own drinking, campus drinking rates, and perceived norms) and a partial personalized social comparison feedback (PSCF; one's own drinking and campus drinking rates) in a randomized trial among heavy-drinking college students. METHOD: Participants included 623 heavy-drinking students from 3 universities. Assessments occurred at baseline and 3- and 6-months postbaseline. RESULTS: Primary analyses examined differences across 4 drinking outcomes (drinks per week, total drinks past month, frequency of past month drinking, and negative alcohol-related consequences) at 3- and 6-month follow-ups controlling for the baseline variable. Results revealed significant reductions across all alcohol consumption outcomes at 3 months in both intervention conditions compared to attention-control. Mediation analyses demonstrated significant indirect effects of the intervention on 6-month drinking through changes in perceived norms at 3 months. Moreover, evidence emerged for changes in drinking at 3 months as a mediator of the association between PSCF and 6-month perceived norms. CONCLUSIONS: The present research suggests PNF may not require explicit consideration of one's perceived norms to be effective and that direct social comparison provides an alternative theoretical mechanism for PNF efficacy.

Cultural differences and shame in an expressive writing alcohol intervention.

The present study evaluates the relationships between shame, culture, and drinking behavior in predicting drinking intentions in the context of an expressive writing intervention. Theory and empirical findings have generally found that shame is maladaptive and can lead to anxiety, depression, and problematic alcohol use. However, research on cultural differences suggests that shame may be differentially damaging to individuals of collectivist, Asian cultures. Previous research evaluating expressive writing as a brief alcohol intervention has shown promising results such as reduced drinking intentions and increased readiness to change drinking behavior. The present study tested the hypothesis that feelings of shame after writing about a negative heavy drinking event would be associated with greater alcohol use generally and that this effect would differ for Caucasian compared to Asian individuals. We also explored whether this differed for light and heavy drinkers. Two hundred sixty-four undergraduates (74% female) who drank at least one alcoholic beverage in the past month completed measures of demographics, baseline drinking, event-related shame and guilt, pre- and postwriting affect, and drinking intentions. Results revealed that, independent of affect, social desirability, and event-related guilt, shame was generally negatively associated with drinking intentions for Caucasians and light drinking Asians. However, for heavy drinking Asians, shame was associated with increased drinking intentions. Results suggest that interventions that elicit shame are differentially effective and should be targeted accordingly.

Blood is thicker than booze: Examining the role of familism and gender in alcohol use and related consequences among Hispanic college students.

The present study evaluated cultural, ethnic, and gender differences in drinking and alcohol-related problems among Hispanic students. Familism protects against negative outcomes in Hispanic populations, thus we expected familism to buffer against alcohol problems. Participants (N = 623; 53% female) completed a battery of measures. Results suggested that familism was protective against drinking. Furthermore, alcohol use mediated the association between familism and alcohol-related problems. In sum, understanding that culture plays an important role in people's behaviors and identifying protective factors is critical to inform culturally sensitive prevention and intervention efforts.