Expectativas relacionadas con el alcohol en la predicción del abuso en el consumo en jóvenes

RESUMEN

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ABSTRACT

Abstract In México, addictions among the middle- and high-school student population have been widely studied, which has shed light on certain risks associated with alcohol abuse, including a higher probability of expriencing with other drugs -particularly in the case of males-, engaging in risky sexual practices and attempting suicide, a situation that is twice as common among those who drink and drive. Nevertheless, research on alcohol abuse among the university population has been less explored, particularly as regards the identification of the variables that predict excessive alcohol consumption. A review of the international literature on factors associated with alcohol abuse in this type of population indicates that it is among university students that high or explosive consumption tends to be largest, even among young people who do not attend school, and that the period of higher consumption is between 17 and 21 years of age. Other factors that have been identified include exposure to negative life events, inappropriate coping styles, personality variables, resorting to alcohol to reduce tension, and environmental and socio-cognitive variables, foremost among which are expectations of the positive effects of alcohol. These expectations not only predict alcohol consumption but also differentiate between problem and non-problem drinking. For example, while social drinkers tend to harbor more social expectations when drinking alcohol, excessive drinkers expect alcohol to increase their aggressive and social behavior, while reducing stress or tension. This paper seeks to evaluate the impact of expectations regarding alcohol, in predicting alcohol abuse among students at public and private universities in Mexico City. Indicators of alcohol abuse include consumption of five or more drinks on each occasion, drunkenness during the past month and year as well as associated problems. The study also seeks to determine the way in which sub-scales of expectations interact with each other. An ex post facto transversal study was carried out on a sample of 678 university male and female students aged 17 to 25, with an average age of 20 (s.d. = 1.80). Participants were asked to complete a self-report which included the following areas a) Sociodemographic data, b) Questionnaire on Expectations regarding Alcohol (AEQ), in a version adapted to this population and c) Alcohol consumption habits over the past month and year. As regards drinking habits, a comparative analysis was carried out by sex and age. Consumption of 5 or more drinks per occasions tends to be more common among men, while the consumption of 5 drinks or less is more frequent in women. At the same time, a higher proportion of heavy drinkers was concentrated in the 20 to 22 age range. Consumers of over 5 glasses of alcohol began drinking at an average age of 14 (s.d. = 2.55) whereas consumers of fewer than 5 drinks began drinking at the age of 15 (t= 4.79 , p < .001). In both cases, the means obtained from the indicators of abuse were highest among consumers of five or more drinks. Males take more drinks than women when they get drunk, consuming an average of 9 glasses (s.d. = 4.7) whereas women get drunk after an average of 5 glasses (s.d. = 3.2) (t= -10.80, p < .001). Out of a total of 26% of young people who mentioned having problems associated with their drinking, most were men (17.9%) as opposed to women (8.2%). The multiple regression analysis carried out to determine the impact of the sub-scales of AEQ expectations on alcohol abuse found that expectations regarding alcohol as a "facilitator of group interaction" and the sub-scale of "reduction of psychological tension" were the main predictors of abuse. This model explained 20% of the variance (F=19.35, p < .001). A logistic regression analysis found that the sub-scale of expectations regarding "increase of power and aggression" as well as alcohol abuse predicted problems associated with drinking. A model was subsequently designed to integrate the expectations that predicted alcohol abu se and associated problems. A structural equations model was used which found that expectations regarding "reduction of psychological tension" and alcohol as a jacilitator of group interaction predicted 30% and 24% of abuse, respectively (X2sb = 33.52, p >0.00, CFI = 0.99 and RMSEA = 0.01). The rest of the sub-scales concerning expectations were regarded as mediating varia bles to see how they interacted with each other. As one can see, although the sub-scales of expectations are inter-related, group expectations were specifically associated with the sub-scales of "increase in sexuality," "physical tension" and "increase in power and aggression." At the same time, expectations regarding "reduction of psychological tension" are closely linked to the social sphere, specifically the expectations regarding "verbal expressiveness" and "lack of inhibition." Along these same lines, alcohol abuse and the expectations regarding alcohol as an agent that increases feelings of power and aggression predicted 26% and 28% of alcohol-related problems. One of the contributions of this research is that it considered the inter-relationship of sub-scales of expectations to explain alcohol abuse. Psychological tension, for example, appears to be linked to social aspects, specifically to verbal expressiveness and lack of inhibition, while group expectations refer to sexuality, the reduction of psychological tension and the increase of aggressiveness and feelings of power. Likewise, it is interesting to note that in addition to alcohol abuse, expectations regarding an increase in power and feelings of aggression are the best predictors of problems associated with alcohol use. The results have implications at the intervention level for developing programs specifically aimed at this population. The fact that expectations regarding alcohol as a "facilitator of social interaction" is one of the main predictors of abuse indicates the importance of considering environmental factors in the development of prevention programs. This involves including not only young people but also parents, schools, and other adults in order to question the cultural norms that promote beliefs regarding alcohol consumption, as a way of enjoying social interaction with positive, pleasurable states, and as a socially appropriate response for coping with negative events that arise in everyday life, such as drinking to relieve tension, handle crises and as an escape from chronic stress, by providing information on the negative consequences of use and promoting healthier lifestyles. At the intervention level, it is essential to target university students through programs specially designed for young people who engage in high-risk drinking. As regards expectations, actions must be carried out to resignify the positive beliefs surrounding alcohol, by providing information on the high health costs of heavy drinking and offering alternative resources oriented towards other means of responding to stress that do not involve excessive alcohol consumption.