Interpersonal communication and perceived norms as social influence mechanisms of e-cigarette use among adults: a systematic review.

Background: Given the increasing popularity of e-cigarette use among adults and the ongoing debate about the benefits and the potential adverse health risks associated with e-cigarette use, it is critical to identify the correlates of e-cigarette use. Prior research has found associations between interpersonal communication, perceived norms, and adults' e-cigarette use, but the evidence has yet to be summarized and synthesized.Objectives: This paper reviewed empirical studies examining the relationship between interpersonal communication, perceived norms, and e-cigarette use among adults.Methods: Following PRISMA guidelines, articles were searched on DOAJ, EMBASE, Europe PubMed Central, Google Scholar, PsychINFO, PubMed, Web of Science, and the reference list of the retrieved studies for studies that examined social influence on e-cigarette use. Three reviewers independently screened 1,713 non-duplicate papers and further screened the full text of 195 articles for inclusion.Results: Thirty studies (30), consisting of quantitative (n = 25) and qualitative (n = 5) data, were included in this review. The twenty-five (25) quantitative studies consisted of both cross-sectional (n = 20) and longitudinal (n = 5) studies. Interpersonal communication portraying e-cigarettes as beneficial or harmful was found to increase e-cigarette use and quit attempts, respectively. Across study designs, greater perceptions of others' e-cigarette use or approval were related to more frequent e-cigarette use.Conclusions: The findings highlight that e-cigarette-related interpersonal communication and perceived norms are associated with e-cigarette use. These factors may be useful targets in brief interventions. However, most of the included studies were cross-sectional, limiting the ability to establish clear cause-and-effect relationships; therefore, more longitudinal studies are needed.

A Bluetooth-Based Smartphone App for Detecting Peer Proximity: Protocol for Evaluating Functionality and Validity.

BACKGROUND: While ecological momentary assessment (EMA) is commonly used to study social contexts and social influence in the real world, EMA almost exclusively relies on participant self-report of present circumstances, including the proximity to influential peers. There is the potential for developing a proximity sensing approach that uses small Bluetooth beacons and smartphone-based detection and data collection to collect information about interactions between individuals passively in real time. OBJECTIVE: This paper aims to describe the methods for evaluating the functionality and validity of a Bluetooth-based beacon and a smartphone app to identify when ≥2 individuals are physically proximal. METHODS: We will recruit 20 participants aged 18 to 29 years with Android smartphones to complete a 3-week study during which beacon detection and self-report data will be collected using a smartphone app (MEI Research). Using an interviewer-administered social network interview, participants will identify up to 3 peers of the same age who are influential on health behavior (alcohol use in this study). These peers will be asked to carry a Bluetooth beacon (Kontakt asset tag) for the duration of the study; each beacon has a unique ID that, when detected, will be recorded by the app on the participant's phone. Participants will be prompted to respond to EMA surveys (signal-contingent reports) when a peer beacon encounter meets our criteria and randomly 3 times daily (random reports) and every morning (morning reports) to collect information about the presence of peers. In all reports, the individualized list of peers will be presented to participants, followed by questions about peer and participant behavior, including alcohol use. Data from multiple app data sets, including beacon encounter specifications, notification, and app logs, participant EMA self-reports and postparticipation interviews, and peer surveys, will be used to evaluate project goals. We will examine the functionality of the technology, including the stability of the app (eg, app crashes and issues opening the app), beacon-to-app detection (ie, does the app detect proximal beacons?), and beacon encounter notification when encounter criteria are met. The validity of the technology will be defined as the concordance between passive detection of peers via beacon-to-app communication and the participant's EMA report of peer presence. Disagreement between the beacon and self-report data (ie, false negatives and false positives) will be investigated in multiple ways (ie, to determine if the reason was technology-related or participant compliance-related) using encounter data and information collected from participants and peers. RESULTS: Participant recruitment began in February 2023, and enrollment was completed in December 2023. Results will be reported in 2025. CONCLUSIONS: This Bluetooth-based technology has important applications and clinical implications for various health behaviors, including the potential for just-in-time adaptive interventions that target high-risk behavior in real time. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/50241.

Associations between frequency of exposure to peer-generated alcohol-related posts and alcohol use within a social network of college students.

Peer alcohol use, commonly assessed via perceptions of how many drinks peers consume, is a robust predictor of college drinking. These perceptions are formed by in-person exposure to peer drinking but also may be affected by seeing alcohol-related content (ARC) shared on peer social media accounts. Most research assesses exposure by asking about the frequency of ARC sharing by a whole friend group, potentially missing influences from specific friends. Social network methods collect information about specific friends and their behavior but few studies have used these methods to examine the effects of ARC on drinking, nor have they examined potential moderators of this relationship. The purpose of this study was to examine whether perceived frequency of exposure to ARC shared by social network members on social media is associated with participant alcohol use after controlling for network members' self-reported alcohol use, and if participant gender and relationship qualities with network members moderate this association. Participants were 994 college students (Mage = 21.17, SD = 0.47; 61.8 % female; 55.4 % White; 12.3 % Hispanic) who completed a web-based survey. Due to the social network design, network autocorrelation analyses were conducted, which revealed that greater perceived frequency of exposure to network member ARC was significantly associated with higher alcohol quantity above and beyond network members' alcohol use. Peer ARC had a unique association with drinking behavior independent of in-person peer alcohol use, although the cross-sectional design precludes making causal inferences. Clinicians delivering alcohol interventions to college students may wish to discuss exposure to ARC as another important source of peer influence and how media literacy may help reduce the effects.

Dynamic social network analysis of a brief alcohol intervention trial in heavy-drinking college students shows spillover effects.

BACKGROUND: Heavy-drinking college students tend to have close social networks, and there is theoretical and empirical support for the idea that behavior change can spread through those networks via close ties. The objective of this research was to determine whether intervention-induced behavior change in a subset of heavy drinkers in a sociometric (whole) college class-year social network is transmitted to other heavy drinkers in the network, resulting in reduced behavioral risk and change in network ties. METHODS: We conducted a controlled trial in which most of a first-year college class (N = 1236; 56.9% female) was enrolled, with alcohol use and social network ties measured early in each of three semesters. Following a baseline assessment, the network was divided into two groups, brief motivational intervention (BMI) and natural history control (NHC) according to dormitory residence location. A subset of heavy drinkers in each group was selected, and those in the BMI group received an in-person intervention. RESULTS: Using stochastic actor-oriented modeling, we found a significant tendency for participants in the BMI group to shed ties with individuals with similar drinking behaviors between the first and second semesters, relative to the NHC group. Furthermore, heavy drinkers with reciprocal ties to intervention recipients in the BMI group showed a significant reduction in drinks per week. CONCLUSIONS: Individual alcohol interventions appear to have effects both on behavior and network connections among individuals who did not receive the intervention. Continued research is needed to identify the optimal conditions for the diffusion of behavior change.

How Do Bystanders Help in Drinking Situations: The Bystanders to Alcohol Risk Scale--Strategies.

OBJECTIVE: Bystander intervention (BI) is a promising approach for promoting collective behavior change that has been applied to several domains, including sexual assault, bullying, and more recently, problematic alcohol use. Accurately measuring the strategies that bystanders use to reduce others' alcohol-related risk is an essential step toward improving bystanders' ability to reduce alcohol-related harm in their communities, but current measures of BI are not easily modifiable and applicable for alcohol-related BI. The current study aimed to develop a valid and reliable measure of the bystander construct most proximal to the reduction of risk: bystander strategies. METHOD: Young adults (N = 1,011) who reported being around someone who showed signs of alcohol intoxication in the past 3 months were recruited via Qualtrics Panels to participate in an online survey; a subsample (n = 345) completed a 2-week follow-up. Psychometric evaluation included exploratory and confirmatory factor analyses, item response theory analyses, convergent validity, and test-retest reliability. RESULTS: An initial set of 52 items was reduced to 17 items, representing two different factors. The first factor, Level 1, reflected strategies used during circumstances of acute risk. The second factor, Level 2, reflected strategies used to reduce risk for more longstanding problems with alcohol. Both factors demonstrated good model fit, strong internal consistency, evidence of convergent validity, and moderate test-retest reliability. CONCLUSIONS: This novel measure can contribute to the production of knowledge about the use and efficacy of peer-focused strategies and the value of BI training for alcohol use.

Measuring Exposure to the Hazardous Drinking of Others and Perceived Opportunity to Intervene as a Bystander.

OBJECTIVE: Excessive alcohol use is very prevalent among young adults, and consequences of drinking are often observed by witnesses. Understanding the circumstances under which witnesses of risky alcohol use help others and whether they perceive these circumstances as an opportunity to engage in bystander intervention are important, but valid measures of these constructs are needed. The current study is a psychometric evaluation of the Exposure to Hazardous Drinking in Others (EHDO) scale and a single-item indicator of Perceived Alcohol-Related Bystander Opportunity (PARBO). METHOD: Young adults (N = 1,011; 46.0% women) who reported being around someone who showed signs of alcohol intoxication in the past 3 months were recruited via Qualtrics Panels. The initial item set for the EHDO was developed through qualitative methods and reflected observed or reported risks or consequences. Factor analyses and Item Response Theory analyses were used to reduce and categorize EHDO items, and construct validity was assessed for the EHDO and the PARBO item. RESULTS: An initial set of 33 EHDO items was reduced to 21, representing two factors: Situational Risk Signs and Problematic Pattern. Both factors demonstrated good model fit, internal consistency, and evidence of convergent validity. The PARBO item showed good construct validity but was distinct from the EHDO. CONCLUSIONS: These instruments are useful for measuring secondhand alcohol risks in a community and are particularly applicable for evaluating bystander intervention for alcohol risk.

Social Network Composition, Relationship Type, and Alcohol Use Among Young Adults Not in Four-Year College.

Background: The drinking of social network members has been consistently associated with personal drinking. However, less attention has been paid to emerging adult populations outside of four-year college students and to potential moderators of this relationship. In a sample of emerging adults who never attended four-year college, this research examined: 1) the compositional characteristics of the social networks, 2) the association between the drinking of network members and personal drinking, and 3) how the association between network and personal drinking was moderated by relationship type (e.g., friend, parents, significant other). Methods: Data was provided by a sample of 525 emerging adults who participated in Qualtrics Panels. Results: In this noncollege sample, the composition of the social network was diverse, with roughly one-third of network members being friends and a little less than half being family members. Parents tended to consume alcohol more frequently than friends and significant others, but participants consumed alcohol more frequently with friends and significant others. Furthermore, drinking among friends and significant others tended to have stronger associations with personal alcohol use than drinking among parents. However, relationship type did not moderate the association between drinking with network members and personal alcohol use. Conclusions: Because of this, interventions need to be delivered to drinking groups.

Changes in College Student Anxiety and Depression From Pre- to During-COVID-19: Perceived Stress, Academic Challenges, Loneliness, and Positive Perceptions.

The COVID-19 pandemic is a major stressor that has negatively impacted global mental health. Many U.S. college students faced an abrupt transition to remote learning in March 2020 that significantly disrupted their routines, likely causing changes in mental health. The current study examined changes in anxiety and depressive symptoms among 990 college students, from before COVID-19 had reached U.S. community spread to 5 months into the pandemic. Results indicate overall increases in anxiety and depressive symptoms; this effect was amplified as more COVID-related challenges with academic impact and loneliness were reported. Increases in anxiety and depression were buffered as a function of greater perceived positive changes attributed to COVID-19; the differences in anxiety and depressive symptoms over time were also lessened when greater perceived stress prior to COVID-19 was reported. Findings reveal an unexpected effect involving pre-pandemic stress, and highlight potential targets to promote resilience, which should be examined long-term.

Education-based stigma and discrimination among young adults not in 4-year college.

BACKGROUND: Lower levels of education are strongly associated with negative health outcomes. The current study examined the degree to which those without a history of 4-year college attendance experience social stigmatization of their educational status and if these experiences are associated with mental health symptoms. METHODS: Data was obtained from 488 emerging adults who never attended 4-year college using Qualtrics Panels. RESULTS: 79.4% of participants agreed to one of the six statements that not attending 4-year college is stigmatized, and 71.8% endorsed experiencing at least one form of discrimination. Higher levels of education-related stigma and more frequent experiences of education-related discrimination was associated with greater past-month anxiety and depression symptoms. CONCLUSIONS: These findings could serve to increase awareness regarding the unique and significant discrimination faced by young adults who do not attend 4-year college and identify specific areas of intervention that can help these young adults cope with the effects of stigma and discrimination.

Peer selection and influence for marijuana use in a complete network of first-year college students.

BACKGROUND: Marijuana is the most frequently used illicit drug among college students, and there is a need to understand the social processes that contribute to young adults' marijuana use. Substance use behaviors tend to be more similar (homophilous) among individuals with social ties to one another. However, little is known about whether marijuana use homophily within young adult relationships is due to social selection (seeking out ties with similar marijuana use to one's own) or social influence (adopting similar marijuana use behaviors as one's ties), or both. METHODS: Students (N = 1,489; 54.6% female; Mage = 18.6 years) at one University completed online surveys in their first three semesters of college. Surveys assessed participant characteristics, marijuana use, and ties to up to 10 other students in the whole (sociocentric) network of first-year college students. Stochastic-actor oriented models (SAOMs) were used to analyze the co-evolution of marijuana use and social ties over time. RESULTS: Participants were more likely to select peers with similar past 30-day marijuana use as themselves. Concurrently, students' past 30-day marijuana use became more similar to their peers' use over time. DISCUSSION: Evidence for selection and influence effects were highly significant after controlling for network structure and other covariates indicating these processes may work in tandem to increase marijuana use homophily over the first year of college. This highlights the importance of relationships made early in the first-year of college, as these initial peer ties are likely to reinforce marijuana use behaviors that occur within these relationships.

Associations between social network characteristics and alcohol use alone or in combination with cannabis use in first-year college students.

OBJECTIVE: Simultaneous use of alcohol and cannabis is common among young adults, but little research has examined social ties and their relation to simultaneous use. This study investigated the social network characteristics of college students at two time points in the first year of college. Participants were categorized into those who used alcohol and cannabis, such that their effects overlap (simultaneous users), those who used both substances without overlapping effects (concurrent users), and those who used alcohol only. METHOD: First-year college students (N = 1,294) completed online questionnaires during the fall and spring semester. At both assessments, participants nominated up to 10 important peers in their class, reported on peers' alcohol and cannabis use, and reported their own use of alcohol or cannabis with each peer. RESULTS: Concurrent and simultaneous users reported a greater proportion of drinking buddies than those who used alcohol only. A greater proportion of friends who used alcohol or cannabis, but not the proportion who were "drinking buddies" or "cannabis buddies," was associated with increased odds of simultaneous use relative to concurrent use. Participants nominated network ties that paralleled their own substance use (e.g., the majority of simultaneous users' networks ties were also simultaneous users). CONCLUSION: Having a larger percentage of friends who use cannabis and alcohol is associated with increased odds of using both substances at the same time, perhaps because it gives access to both substances at the same time. Interventions should account for amount of exposure to alcohol and cannabis use from network members. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The influence of peer and parental norms on first-generation college students' binge drinking trajectories.

INTRODUCTION: First-generation college students are those whose parents have not completed a four-year college degree. The current study addressed the lack of research on first-generation college students' alcohol use by comparing the binge drinking trajectories of first-generation and continuing-generation students over their first three semesters. The dynamic influence of peer and parental social norms on students' binge drinking frequencies were also examined. METHODS: 1342 college students (n = 225 first-generation) at one private University completed online surveys. Group differences were examined at Time 1, and latent growth-curve models tested the association between first-generation status and social norms (peer descriptive, peer injunctive, parental injunctive) on binge drinking trajectories. RESULTS: Overall, binge drinking frequency tended to decline over the first three semesters of college. After controlling for demographics, substance-free dormitory residence, parental alcohol problems and norms, first-generation status was associated with steeper declines in binge drinking frequency. During the first semester, the association between parental injunctive norms and binge drinking frequency was stronger for first-generation students than for continuing-generation students; this influence declined over time for first-generation students. The influence of peer descriptive norms on binge drinking increased for continuing-generation students; while this influence remained stable over time for first-generation students. CONCLUSIONS: First-generation student status appears to be protective against binge drinking. Substance-free dormitory residence, and perceived parental and peer norms likely play a role in first-generation students' tendency to engage in binge drinking less often over the first year of college.

Promotion by Others through Social Networks.

Although self-promotion may be the most direct way people self-present, it carries social costs. We propose a novel phenomenon-promotion by others-wherein social networks may afford similar advantages with fewer costs. We utilized egocentric network analysis to examine relationships between social connections and perceived promoter potential (i.e., likelihood a friend will tell others about successes; PPP) and relationship dynamics. Participants enumerated friends and reported perceptions these friends would promote them, were valuable, and the extent to which they wanted these friends to know about successes. PPP was positively related to (a) network connectedness, (b) relational value, and (c) desire to know about success. We discuss benefits of promotion by others and individual differences related to engagement in this process.

Do misperceptions of peer drinking influence personal drinking behavior? Results from a complete social network of first-year college students.

This study considered the influence of misperceptions of typical versus self-identified important peers' heavy drinking on personal heavy drinking intentions and frequency utilizing data from a complete social network of college students. The study sample included data from 1,313 students (44% male, 57% White, 15% Hispanic/Latinx) collected during the fall and spring semesters of their freshman year. Students provided perceived heavy drinking frequency for a typical student peer and up to 10 identified important peers. Personal past-month heavy drinking frequency was assessed for all participants at both time points. By comparing actual with perceived heavy drinking frequencies, measures of misperceptions of heavy drinking (accurately estimate, overestimate, underestimate) were constructed for both general and important peers. These misperceptions were then used as predictors of concurrent and prospective personal heavy drinking frequency and intentions using network autocorrelation analyses. The majority of students (84.8%) overestimated, 11.3% accurately estimated, and 3.9% underestimated heavy drinking among their general peers, whereas 42.0% accurately estimated, 36.9% overestimated, and 21.1% underestimated important peers' heavy drinking. For both referents, overestimation of peer heavy drinking was associated with more frequent heavy drinking and higher drinking intentions at both time points. Importantly, the effects of underestimating and overestimating close peers' drinking on personal alcohol use were significant after controlling for the influence of misperceptions of general peers' heavy drinking. Close peers are a critical referent group in assessments related to social norms for young adult alcohol use. Implications for prevention and intervention are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Enrollment and assessment of a first-year college class social network for a controlled trial of the indirect effect of a brief motivational intervention.

Heavy drinking and its consequences among college students represent a serious public health problem, and peer social networks are a robust predictor of drinking-related risk behaviors. In a recent trial, we administered a Brief Motivational Intervention (BMI) to a small number of first-year college students to assess the indirect effects of the intervention on peers not receiving the intervention. OBJECTIVES: To present the research design, describe the methods used to successfully enroll a high proportion of a first-year college class network, and document participant characteristics. METHODS: Prior to study enrollment, we consulted with a student advisory group and campus stakeholders to aid in the development of study-related procedures. Enrollment and baseline procedures were completed in the first six weeks of the academic semester. Surveys assessed demographics, alcohol use, and social network ties. Individuals were assigned to a BMI or control group according to their dormitory location. RESULTS: The majority of incoming first-year students (1342/1660; 81%) were enrolled (55% female, 52% nonwhite, mean age 18.6 [SD = 0.51]). Differences between the intervention and control group were noted in alcohol use, but were in large part a function of there being more substance-free dormitory floors in the control group. CONCLUSIONS: The current study was successful in enrolling a large proportion of a first-year college class and can serve as a template for social network investigations.

U.S. College Students' Social Network Characteristics and Perceived Social Exclusion: A Comparison Between Drinkers and Nondrinkers Based on Past-Month Alcohol Use.

OBJECTIVE: There is a general perception on college campuses that alcohol use is normative. However, nondrinking students account for 40% of the U.S. college population. With much of the literature focusing on intervening among drinkers, there has been less of a focus on understanding the nondrinker college experience. The current study has two aims: to describe the social network differences between nondrinkers and drinkers in a college setting, and to assess perceived social exclusion among nondrinkers. METHOD: First-year U.S. college students (n = 1,342; 55.3% female; 47.7% non-Hispanic White) were participants in a larger study examining a social network of one college class and network associations with alcohol use. Alcohol use, sociocentric and egocentric network ties were assessed, as were experiences of social exclusion related to nondrinking. RESULTS: Drinking homophily based on past-month use was found; students tended to associate with others with a similar drinking status. Compared with drinkers, nondrinkers received fewer network nominations within the first-year network and made more nominations outside the first-year network. Nondrinkers' perceived social exclusion was positively related to the number of drinkers in their social networks, such that those with more drinkers in their network reported more social exclusion. CONCLUSIONS: College students' past-month drinking status in the first semester of college is related to their network position and perception of social exclusion. Nondrinking students who are part of a nondrinking community are less likely to feel socially excluded. Improving our understanding of the nondrinker college experience should improve support services for these students.

Relationships between social network characteristics, alcohol use, and alcohol-related consequences in a large network of first-year college students: How do peer drinking norms fit in?

A burgeoning area of research is using social network analysis to investigate college students' substance use behaviors. However, little research has incorporated students' perceived peer drinking norms into these analyses. The present study investigated the association between social network characteristics, alcohol use, and alcohol-related consequences among first-year college students (N = 1,342; 81% of the first-year class) at one university. The moderating role of descriptive norms was also examined. Network characteristics and descriptive norms were derived from participants' nominations of up to 10 other students who were important to them; individual network characteristics included popularity (indegree), network expansiveness (outdegree), relationship reciprocity, and network density. Descriptive norms were defined as participants' average perceived binge drinking frequency among their nominated peers. Network autocorrelation models revealed that indegree and descriptive norms were positively associated with participants' average number of drinks per week, binge drinking frequency, and alcohol-related consequences. Indegree and outdegree interacted with descriptive norms, such that when participants perceived less frequent binge drinking among their peers, outdegree was associated with less alcohol consumption but not consequences. When participants perceived more frequent binge drinking among their peers, indegree and outdegree were associated with more alcohol consumption but not consequences. The present results suggest that being popular and believing that heavy episodic drinking is normative among one's peers are associated with greater alcohol risk. Further, alcohol risks associated with nominating more peers may be enhanced or lessened depending on students' peer drinking norms. Implications for future research and interventions are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Initiation of vaporizing cannabis: Individual and social network predictors in a longitudinal study of young adults.

BACKGROUND: A trend has recently emerged of individuals using electronic nicotine delivery systems (ENDS) or similar devices to vaporize cannabis, either in the form of high-potency THC concentrates or cannabis plant material. Peer use is central to the adoption of substance use behaviors in young adulthood, but little is known about peer influence for initiating cannabis vaping. METHODS: A longitudinal investigation of first-year college students (N = 1313) using social network methods was conducted to determine the prevalence of vaping cannabis, differences in networks between individuals who initiate vaping cannabis, and predictors of initiation of vaping cannabis across two time points. The surveys were available for two weeks beginning in the sixth week of each semester. RESULTS: We found that 9.4% vaped in their lifetime but not since the first survey, 7.5% vaped in their lifetime and since the first survey, and 5.9% reported vaping cannabis at the second survey. Lifetime cannabis use, lifetime ENDS use, and number of peers who initiated vaping cannabis from Time 1 to Time 2 were significantly associated with increased odds of the initiation of vaping cannabis; the number of any-cannabis-using or any-ENDS-using peers was not associated with increased odds of initiating vaping cannabis. CONCLUSIONS: Individuals with the greatest risk of initiation of vaping cannabis during the first year of college are those with a prior history of other cannabis use and ENDS use and who have peers in their network who initiate cannabis vaping.

Poor mental health, peer drinking norms, and alcohol risk in a social network of first-year college students.

OBJECTIVE: College students with anxiety and depressive symptomatology face escalated risk for alcohol-related negative consequences. While it is well-established that normative perceptions of proximal peers' drinking behaviors influence students' own drinking behaviors, it is not clear how mental health status impacts this association. In the current study, we examined cross-sectional relationships between anxiety and depressed mood, perceived drinking behaviors and attitudes of important peers, and past month alcohol consumption and related problems in a first-semester college student social network. METHOD: Participants (N = 1254, 55% female, 47% non-Hispanic White) were first-year students residing on campus at a single university who completed a web-based survey assessing alcohol use, mental health, and social connections among first-year student peers. Network autocorrelation models were used to examine the independent and interactive associations between mental health and perceptions of close peers' drinking on drinking outcomes, controlling for important variables. RESULTS: Mental health interacted with perceptions to predict past-month drinking outcomes, such that higher anxiety and higher perceptions that peers drink heavily was associated with more drinks consumed and consequences, and higher depression and perceptions was associated with more drinks consumed, heavy drinking frequency, and consequences. Attitudes that peers approve of heavy drinking were associated with more drinks consumed and heavy drinking frequency among students with lower (vs. higher) depressed mood. CONCLUSIONS: This study provides strong evidence that perceiving that close peers drink heavily is particularly risk-enhancing for anxious and depressed college students, and offers implications about alcohol intervention targeted at these subgroups.

Resistance to peer influence moderates the relationship between perceived (but not actual) peer norms and binge drinking in a college student social network.

INTRODUCTION: Adolescent and young adult binge drinking is strongly associated with perceived social norms and the drinking behavior that occurs within peer networks. The extent to which an individual is influenced by the behavior of others may depend upon that individual's resistance to peer influence (RPI). METHODS: Students in their first semester of college (N=1323; 54.7% female, 57% White, 15.1% Hispanic) reported on their own binge drinking, and the perceived binge drinking of up to 10 important peers in the first-year class. Using network autocorrelation models, we investigated cross-sectional relationships between participant's binge drinking frequency and the perceived and actual binge drinking frequency of important peers. We then tested the moderating role of RPI, expecting that greater RPI would weaken the relationship between perceived and actual peer binge drinking on participant binge drinking. RESULTS: Perceived and actual peer binge drinking were statistically significant predictors of participant binge drinking frequency in the past month, after controlling for covariates. RPI significantly moderated the association between perceptions of peer binge drinking and participant's own binge drinking; this association was weaker among participants with higher RPI compared to those with lower RPI. RPI did not interact with the actual binge drinking behavior of network peers. CONCLUSIONS: RPI may function to protect individuals from the effect of their perceptions about the binge drinking of peers, but not from the effect of the actual binge drinking of peers.