Not just fun and games: a review of college drinking games research from 2004 to 2013.

Drinking games are a high-risk social drinking activity consisting of rules and guidelines that determine when and how much to drink (Polizzotto et al., 2007). Borsari's (2004) seminal review paper on drinking games in the college environment succinctly captured the published literature as of February 2004. However, research on college drinking games has grown exponentially during the last decade, necessitating an updated review of the literature. This review provides an in-depth summary and synthesis of current drinking games research (e.g., characteristics of drinking games, and behavioral, demographic, social, and psychological influences on participation) and suggests several promising areas for future drinking games research. This review is intended to foster a better understanding of drinking game behaviors among college students and improve efforts to reduce the negative impact of this practice on college campuses.

Characterizing high school students who play drinking games using latent class analysis.

Heavy alcohol use and its associated negative consequences continue to be an important health issue among adolescents. Of particular concern are risky drinking practices such as playing drinking games. Although retrospective accounts indicate that drinking game participation is common among high school students, it has yet to be assessed in current high school students. Utilizing data from high school students who reported current drinking game participation (n=178), we used latent class analysis to investigate the negative consequences resulting from gaming and examined underlying demographic and alcohol-related behavioral characteristics of students as a function of the resultant classes. Three classes of "gamers" emerged: (1) a "lower-risk" group who had a lower probability of endorsing negative consequences compared to the other groups, (2) a "higher-risk" group who reported that they experienced hangovers and difficulties limiting their drinking, got physically sick, and became rude, obnoxious, or insulting, and (3) a "sexual regret" group who reported that they experienced poor recall and unplanned sexual activity that they later regretted. Although the frequency of participating in drinking games did not differ between these three groups, results indicated that the "lower-risk" group consumed fewer drinks in a typical gaming session compared to the other two groups. The present findings suggest that drinking games are common among high school students, but that mere participation and frequency of play are not necessarily the best indicators of risk. Instead, examination of other constructs such as game-related alcohol consumption, consequences, or psychosocial variables such as impulsivity may be more useful.

Knowing where they're going: destination-specific pregaming behaviors in a multiethnic sample of college students.

OBJECTIVES: To examine how legal age status, gender, and self-reported reasons for pregaming are linked to pregaming for two common drinking contexts: a bar and a Greek party. METHOD: Participants who reported pregaming at least once a month (n = 2888 students aged 18-25 years) were recruited from 30 colleges/universities across the United States. RESULTS: Many students pregame for social reasons regardless of pregaming destination. Multivariate analyses indicated that legal age students were more likely than underage students to pregame before going to a bar, whereas the opposite was true with respect to pregaming for a Greek party. Women were more likely than men to pregame before going to a bar or a Greek party, whereas men reported higher levels of consumption while pregaming for these destinations compared with women. CONCLUSIONS: The present findings suggest areas for targeted intervention efforts and promising avenues for research on context-specific pregaming behaviors among college students.

Alcohol expectancies and risky drinking behaviors among high school athletes: "I'd rather keep my head in the game".

Research suggests that high school students who participate in sports may be at elevated risk for alcohol use compared to their non-athlete peers; however, reasons for this association are unclear. Alcohol expectancy theory posits that individuals who expect favorable outcomes to occur because of alcohol use are more likely to drink than those who do not endorse such beliefs. As such, the present study was designed to examine the associations of alcohol expectancy outcomes and valuations (i.e., beliefs about whether an outcome is good or bad), as well as alcohol expectancies related to sports functioning (e.g., alcohol's effects on one's ability to learn new plays and recover physically from sporting activities), with risky drinking among high school athletes. Participants were 219 in-season high school athletes (mean age = 15.6, range = 13-18) who completed anonymous self-report surveys. A structural equation model indicated that endorsement of positive alcohol expectancy outcomes and favorable evaluations of negative expectancy outcomes were associated with higher levels of risky drinking. Conversely, greater endorsement of negative athletic-functioning drinking expectancies was associated with lower levels of risky drinking. Future research considerations and implications for intervention efforts targeting high school athletes are discussed.

Alcohol expectancies among adolescent nondrinkers: they may not be drinking now, but they're "thinkin bout it".

PURPOSE: To examine the associations of alcohol expectancy outcomes and valuations with intention to use. METHOD: A total of 157 adolescent nonusers completed anonymous self-report surveys. RESULTS: Adolescents who perceived more access to alcohol, expected less negative and more positive drinking outcomes, and evaluated positive outcomes favorably reported greater intentions to drink in adulthood. CONCLUSION: Findings may be useful for efforts to further delay the initiation of alcohol use.

Pregaming in high school students: relevance to risky drinking practices, alcohol cognitions, and the social drinking context.

Pregaming is the practice of consuming alcohol prior to going out to a social event. Although pregaming has begun to receive research attention in the college setting, very little is known about this risky drinking behavior in high school students. As pregaming has health implications for both students who are college bound and those who are not, we examined the prevalence of this behavior in a sample of high school students who reported current alcohol use and completed pregaming measures (n = 233). The present study examined the associations of gender, age, alcohol expectancies, motivations for drinking (e.g., social, enhancement, and coping), and engagement in other risky drinking practices (i.e., general hazardous use and drinking game participation) with pregaming. Results indicate that pregaming was significantly associated with being older, being a male, having high levels of hazardous alcohol use, and participating in drinking games frequently. Pregaming also occurred most often before parties and sporting events and it was associated positively with frequency of attendance at parties where alcohol is available, the tendency to use alcohol at these parties, and the amount of alcohol consumed at these parties. We discuss the findings in the context of pregaming research that has been conducted with college students, and make suggestions regarding prevention and intervention efforts focused on this risky drinking practice.

The utility of a gender-specific definition of binge drinking on the AUDIT.

OBJECTIVE: Although binge drinking is commonly defined as the consumption of at least 5 drinks in 1 sitting for men and 4 for women, the Alcohol Use Disorders Identification Test (AUDIT) defines binge drinking as the consumption of 6 or more drinks in 1 sitting for both men and women. This study examined the effect of using gender-specific binge drinking definitions on overall AUDIT scores. PARTICIPANTS: Participants were 331 college men and 1224 college women. METHODS: Participants completed a self-report questionnaire, which included the AUDIT. RESULTS: Findings showed that defining binge drinking as 4 or more drinks for women, rather than 6 or more, does impact their AUDIT scores and could affect the percentage of women classified as hazardous users. Among men, AUDIT scores were unaffected by the use of a gender-specific definition of binge drinking. CONCLUSIONS: Results suggest that the AUDIT might be underidentifying hazardous users among college women.

Drinking game behaviors among college students: how often and how much?

BACKGROUND: Participation in drinking games (DG) has been identified as a common health-risk behavior among college students. However, research suggests that the frequency of DG participation alone may not pose a significant health risk; rather, gaming may be most hazardous when large amounts of alcohol are consumed. OBJECTIVES: The present study was designed to examine whether specific gaming behaviors (frequency of play and amount of consumption) place gamers at elevated risk for negative drinking outcomes. METHOD: Students from 30 U.S. colleges completed self-report questionnaires via the Internet about their drinking attitudes and behaviors. Four groups of student gamers (N = 2,230) were examined: low frequency/low consumption (n = 1,047), low frequency/high consumption (n = 453), high frequency/low consumption (n = 326), and high frequency/high consumption (n = 404). RESULTS: Multilevel regression analyses indicated that the frequency x consumption interaction emerged as a significant predictor of negative drinking consequences. Follow-up analyses indicated that quantity of alcohol consumed during DG predicted negative drinking consequences for high-frequency gamers only. CONCLUSIONS/SCIENTIFIC CONTRIBUTION: The present results challenge the assumption that all drinking-gaming practices pose equivalent health risks for gamers. Considering only participation in or level of consumption during DG may not tell the complete story with respect to the health hazards involved with gaming behaviors among college students.

WITHDRAWN: Alcohol Expectancies Among Adolescent Non-Drinkers: They May Not Be Drinking Now, But They Are "Thinkin Bout It"

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Acculturation and substance use among Hispanic early adolescents: investigating the mediating roles of acculturative stress and self-esteem.

We examined the extent to which Hispanic orientation and American orientation are associated with substance use (cigarette, alcohol, and marijuana) both directly and indirectly through acculturative stress and self-esteem. Participants were 347 Hispanic early adolescents (50.7% male; mean age = 12.57, SD = 0.92, range 11-15) from two middle schools in western Michigan. Findings showed that self-esteem emerged as the most consistent predictor of likelihood and extent of substance use. Ethnic identity was positively related to risk for substance use, and acculturative stress and self-esteem mediated the relationships of Hispanic cultural orientation to alcohol use. Self-esteem was the most important protective factor against substance use, and as such, we conclude that prevention programs designed to address precocious substance use that incorporate a self-esteem building component could prove useful among Hispanic early adolescents residing in monocultural contexts within the United States.