Risk For Heavy Alcohol Use Research Articles

Conformity to masculine norms and its association with drinking behaviors and alcohol-related consequences among adult men: A meta-analysis

ObjectivesStudies typically show that men are at higher risk for heavy alcohol use than women. Research linking conformity to masculine norms and drinking behaviors among adult males has grown steadily during the past 10 years. We conducted the first meta-analysis that examines (a) the strength of the associations between conformity to masculine norms and alcohol use outcomes, and (b) the extent to which the strength of these associations would be affected by the specific type of drinking behavior or methodological factors. MethodsWe included 35 studies (N=32,412) in this meta-analysis that examined the association between scores on the Conformity to Masculine Norms Inventory (CMNI) and alcohol use outcomes. ResultsAcross all studies, the average correlation between conformity to masculine norms and alcohol variables was small (r = 0.17). The associations between conformity to masculine norms and specific alcohol variables were also modest: alcohol use composite score of frequency and quantity (r = 0.20), binge drinking frequency (r = 0.14), and alcohol-related consequences (r = 0.16). The mean correlation between each CMNI subscale and alcohol variables was also small (alcohol use composite, rs range from 0.07 to 0.22; alcohol-related consequences, rs range from 0.04 to 0.29; frequency of binge drinking, rs range from −0.06 to 0.22). There was a significant difference in effect size by specific type of drinking behavior (i.e., effect sizes for binge drinking were smaller than effect sizes for other alcohol variables). Methodological factors (i.e., CMNI version; sample type: university vs. adult vs. mixed samples; country where the study was conducted) did not affect the associations between masculine norms and the alcohol-outcome variables. ConclusionsConformity to masculine norms is modestly associated with drinking behaviors and alcohol-related consequences. The effect sizes reported in this meta-analysis can assist in power analyses in future studies on conformity to masculine norms and specific drinking behaviors among adult males.

Does the Relationship between Affect and Social Interactions among Adults Experiencing Homelessness Differ during Moments when at a Shelter versus Not?

The prevalence of alcohol use disorders is higher amongst adults experiencing homelessness (AEH) compared with domiciled adults. Greater exposure to heavy drinkers increases personal risk for heavy alcohol use. AEH spend substantial periods of time at shelters and report greater pressure to use alcohol when near shelter locations, as well as greater negative affect when near a shelter. It is unclear if the relationship between affect and 1) interacting with people and 2) being near someone AEH drank alcohol with before differs when AEH are at a shelter versus not. AEH reporting alcohol misuse (n = 72, Mage= 47, 85% Male, 68% Non-White) completed five daily smartphone-based ecological momentary assessments (EMAs) over 28 days. Generalized multilevel modeling revealed that when AEH were interacting with someone they drank with before, they had significantly lower positive affect when at a shelter (b = -0.17, p = 0.05), versus when not (b = 0.00, p = 0.99). AEH are likely to interact with previous drinking partners while at shelters. It may be important to deliver real-time treatment messages targeting affect in these moments, as well as deliver alcohol reduction/abstinence messages.

Anxiety, Depression, Coping, Alcohol Use and Consequences in Young Adult College Students

Background Young adult college students experience a high risk for heavy alcohol use and resulting consequences. Symptoms of anxiety and depression increase this risk. Coping style has been associated with alcohol use and consequences, with approach coping being inversely related to use and consequences, and avoidance coping being directing related to use and consequences. The purpose of this study is to examine whether coping style moderates or mediates the relationship between anxiety/depression and alcohol use and consequences. Methods 250 young adult college students ages 18 to 25 years (Women = 85, 34%) anonymously self-reported anxiety, depression, coping style, alcohol use and consequences. Results Path analysis showed that avoidance coping was positively related to alcohol use (β = 0.33, p < 0.05), social consequences (β = 0.39, p < 0.05), and personal consequences (β = 0.26, p < 0.05), while approach coping was inversely related to use (β = −0.20, p = 0.005). Coping did not moderate the relationship between anxiety and depression and alcohol use or consequences. Avoidance coping mediated the relationship between depression and alcohol use (β = 0.14, p < 0.05), social consequences (β = 0.16, p < 0.05), and personal consequences (β = 0.11, p < 0.05). Conclusion Findings build on alcohol use and consequences research, and support further research into implementing coping-based alcohol use interventions. Interventions aimed at reducing avoidance coping and increasing approach coping may be beneficial for young adult college students.

Masculine Drinking Norms and Alcohol Use in a National Sample of NCAA Male Student-Athletes.

Participation in sports can increase young adults' risk for heavy alcohol use and related consequences. Among student-athletes, more men report heavy drinking than women. These gender differences may reflect men's expression of masculinity which can encompass excessive consumption. While a growing body of research indicates that general masculine norms are positively associated with alcohol use and consequences among men, the extent to which alcohol-specific masculine norms can increase student-athletes' risk for elevated drinking and related outcomes is not yet known. Thus, we examined how masculine drinking norms are associated with alcohol use and related consequences while accounting for demographics and multiple dimensions of general masculine norms. 1,825 NCAA student-athletes (White=79%, Mage=20.1/SDage=1.3; 50 colleges/universities) completed a confidential online survey which included questions regarding masculine drinking norms of excess and control and conformity to general masculine norms. We created latent constructs and tested a path model in SEM. Results indicated that, after accounting for demographics and multiple dimensions of general masculine norms, the masculine drinking norm of excess was positively associated with alcohol use and consequences. Conversely, control was negatively related to alcohol use but unrelated to consequences. Compared to control and other dimensions of general masculine norms, excess was most strongly related to alcohol use and consequences. A move from assessing general masculine norms toward alcohol-specific masculine norms can further researchers' and practitioners' knowledge of masculine norms and their link to drinking behaviors, and enhance the application of masculine norms in alcohol intervention and prevention programs.

Marital Quality and Alcohol Use among Couples in Mid- and Later-Life.

Spouses influence one another's drinking behavior, but little research has explored how relationship quality may impact older couples' alcohol use. Using data from the 2014-2018 waves of the Health and Retirement Study (HRS) and actor-partner interdependence models, we examined how marital quality is related to total alcohol consumption and risk of heavy drinking for married couples over age 50. Neither husbands' nor wives' perceptions of negative marital quality were related to changes in heavy drinking or number of drinks consumed over the observation period. However, wives' positive marital quality was associated with increased risk of heavy alcohol use for both wives and husbands, and with an increase in the number of drinks wives consume over time. Couples over age 50 do not appear to use alcohol as a way of coping with negative marital relationships, but rather may increase their drinking in the context of positive relationships.

Racial, ethnic, and sex differences in heavy drinking and negative alcohol-related consequences in a national sample of NCAA student-athlete drinkers

Objective: Athletic involvement is linked to increased risk for heavy alcohol use among college students. We examined whether student-athletes from diverse racial/ethnic backgrounds differ with respect to heavy drinking and related consequences. Method: Participants were 15,135 student-athlete drinkers (50.7% female) from 170 NCAA member institutions who participated in an online study. Results: Findings from our hierarchical linear models indicated that being a male student-athlete was associated with an increased likelihood of high intensity drinking (10/8 + drinks/per sitting for males/females) for White, Asian American/Pacific Islander, and Black student-athletes, but not for Hispanic student-athletes. Additionally, being a female student-athlete was associated with higher levels of negative alcohol-related consequences across all racial/ethnic groups. Finally, at similar drink quantities, compared to being a White student-athlete, being an Asian American/Pacific Islander student-athlete was associated with higher levels of alcohol-related consequences. Conclusions: Student-athlete drinkers are not homogeneous with respect to heavy drinking and related consequences.

Reducing Alcohol Use among High School Athletes: A Randomized Controlled Trial of a Brief, Web-Based Personalized Normative Feedback Intervention.

High school athletes are at risk for heavy alcohol use, which is associated with consequences that may negatively impact performance and eligibility to participate in sports. This study evaluated the efficacy of a web-based personalized normative feedback (PNF) intervention on reducing alcohol use among high school athletes in their senior year. Class periods were randomized to the intervention or an assessment-only control group. Athletes completed surveys at baseline and a 6-week follow-up. Athletes were classified as high-risk or low-risk drinkers based on baseline reports of binge drinking. Results indicated for athletes classified as high-risk drinkers, those in the intervention group reported significantly greater reductions in quantity of weekly drinking and peak drinking quantity compared to those in the assessment-only control group. There were no significant intervention effects for frequency of alcohol use. Findings provide support the efficacy of web-based PNF intervention for reducing alcohol use among high school senior athletes.

Excitement-Seeking Gambling in Adolescents: Health Correlates and Gambling-Related Attitudes and Behaviors.

Motivational characteristics such as excitement-seeking are key components of models of addiction, including problem gambling. Previous studies have established associations between excitement-seeking and problem gambling in youth. However, these studies have employed dimensional psychological assessments which are unlikely to be routinely administered. Other approaches to conceptualize excitement-seeking could be of value. In the present study, we employed a single question (What are the reasons that you gamble?) to identify adolescents who reported excitement-seeking motivation for gambling. Cross-sectional data from 2030 adolescent gamblers who participated in a Connecticut high-school survey were examined. Gambling perceptions and correlates of problem-gambling severity were examined relative to excitement-seeking and non-excitement-seeking gambling. Gambling perceptions were more permissive and at-risk/problem gambling was more frequent among adolescents with excitement-seeking gambling versus non-excitement-seeking gambling. A weaker relationship between problem-gambling severity and moderate and heavy alcohol use was observed for excitement-seeking versus non-excitement-seeking gambling. Excitement-seeking gambling is associated with more permissive gambling-related attitudes and riskier gambling behaviors and may account for some variance in adolescent risk of heavy alcohol use. A single question may provide important information for identifying adolescents who are at elevated risk of problem gambling and associated negative outcomes, although the utility of the question in specific settings warrants direct examination, especially given the observed high prevalence of excitement-seeking motivations for gambling.

Tailgating Protective Behavioral Strategies Mediate the Effects of Positive Alcohol Outcome Expectancies on Game Day Drinking.

Although a growing body of evidence suggests protective behavioral strategies are associated with lower alcohol use among college students, we know little about what contributes to students' decisions to use these strategies. Alcohol outcome expectancies have been associated with alcohol use among college students, and may contribute to their decisions to use protective behavioral strategies while drinking in contexts associated with an elevated risk for heavy alcohol use. University football game tailgating is one high-risk context that has received limited empirical attention with respect to identifying risk and protective factors for use. We sought to determine whether expectancy effects on tailgating drinking may be attributable to the approach or avoidance of protective strategies in this context. We expected college students who perceive greater positive expectancies to report engaging in more protective strategies on game day, whereas we hypothesized greater negative expectancies would be associated with less use of protective strategies. College students (N = 231) reported outcome expectancies online within 7days of tailgating and quantity of alcoholic drinks consumed while tailgating, as well as whether they used limiting consumption (i.e., counting drinks, alternating drinking water and alcohol) and harm reduction (HR; i.e., sober transportation) strategies 48h after tailgating. Results indicated higher positive expectancies were associated with greater use of HR strategies. Positive expectancies were indirectly positively related to greater game day tailgating drinking and negatively to odds of abstaining through the use of protective strategies, and unique indirect effects were observed for HR strategies. These findings highlight important individual differences that contribute to the use of protective behaviors, and suggest that expectancy-challenge interventions may be tailored to address unsafe drinking practices and promote college student health.

SU138SHARING OF GENETIC RISK FACTORS BETWEEN DIFFERENT PROXY MEASURES OF ALCOHOL USE DISORDERS AND RISK OF MENTAL HEALTH DISORDERS

Two ecological cross-sectional studies which relied on national survey data (U.S. and Australia) have shown that starting drinking at a younger age increases the frequency of heavy drinking in the general population, including those with good mental and physical health status. This study further investigates the hypothesis that age at first use of alcohol increases the risk of heavy alcohol use by applying data from a longitudinal study.This study used public-use data collected from Wave I, Wave III and Wave IV of the National Longitudinal Study of Adolescent Health in the United States. The association between age at first use of alcohol and heavy alcohol use (5+ drinks per occasion) was examined with two different multivariate analysis approaches with data from 2316 participants: ordered logistic regression models and Poisson regression models with longitudinal data settings. In addition, the newly developed proxy outcome approach was further used to estimate and adjust for unmeasured/unobserved confounding factors.Age at first use of alcohol before 18 years was associated significantly higher risk of heavy alcohol use at follow-up.After adjusting for known and residual confounders, younger age at first use of alcohol was associated with significantly higher risk of heavy alcohol use, moreover, we posit that the association observed from this longitudinal study is probably causal. Abstinence from alcohol until the age of 18 years will likely reduce individual risk of alcohol-related problems in adulthood. In the longer term, delayed onset of exposure with widespread abstinence among this age group is also likely to reduce the overall prevalence of alcohol-related problems in the general population.

Testing Assumptions of the Categorization Approach to Studying Sports Participation and Alcohol Use.

The present study tested whether playing football or lacrosse in high school is associated with more problematic alcohol use during college compared with playing other sports in high school. A sample of undergraduate males ( n = 2,940) in their freshmen year who had played sports in high school completed a web-based questionnaire. Results showed that males who played lacrosse or both football and lacrosse in high school engaged in heavier alcohol use in college than males who played football or other sports in high school. In addition, males who played football in high school engaged in heavier alcohol use in college than males who played other high school sports. Thus, not all high school sports place males at equal risk for heavy alcohol use in college.

Heavy alcohol use, job satisfaction, and job escapism drinking among foodservice employees: a comparative analysis

ABSTRACT This study explored the relationship between employment in the foodservice industry and higher risk of alcohol consumption, with consideration to job satisfaction and job escapism. A mixed method approach was used to examine whether a correlation exists between employment in the foodservice industry and a higher risk for heavy alcohol use. Job dissatisfaction was cited as a motivation for drinking as compared to those working individuals employed in industries other than foodservice. The interviews and survey confirmed the hypothesis that workers in the foodservice industry would report higher alcohol consumption than their colleagues in other sectors, concluded foodservice workers experience low levels of job satisfaction relative to non-foodservice employees, and revealed job dissatisfaction and job escapism are related to heavy alcohol consumption among foodservice workers.

The Effects of Perceived Racial/Ethnic Discrimination on Substance Use Among Youths Living in the Cherokee Nation

ABSTRACTWe examined frequency and intensity of racial/ethnic discrimination and the longitudinal relationship to substance use. The sample included (N = 1,421) American Indian, American Indian and White, and White adolescents. A high frequency of perceived racial discrimination was associated with an increased risk for heavy alcohol use, prescription drug misuse, and other illicit drug use. Experiences of perceived racial discrimination high in intensity were associated with further increased risk of prescription drug misuse and other illicit drug use. Race/ethnicity did not moderate the relationship between perceived racial discrimination and substance use. Interventions targeting the deleterious effects of racial discrimination may need to be designed to account for both the environment and the individual.

Future orientation climate in the school class: Relations to adolescent delinquency, heavy alcohol use, and internalizing problems

It is well known, based on previous research, that adolescents' thoughts and feelings about their future are related to the risk of delinquency, alcohol use as well as health. However, other well-known facts are that adolescents' actions are substantially shaped in interaction with peers and that, during adolescence, individuals spend a considerable amount of the day at school, in interaction with classmates. Despite this, there is an almost complete lack of studies exploring to what extent the school climate, as measured by thoughts and feelings about the future, can influence individual adolescents. The aim of the current study is to investigate whether the future orientation (FO) climate, measured at the school class level, is related to delinquency, alcohol use and internalizing problems at the individual level, among a sample of Swedish students 14–15years of age. The data used come from the Swedish part of the Youth in Europe (YES!) study, which is part of the larger project Children of Immigrants - Longitudinal Survey in Four European Countries (CILS4EU). In the present paper, we use data from the first wave, collected among 8th grade students in 2010/11 (n=4119–4364). The method used was multilevel modeling (linear probability models (LPM) and linear regression analysis). The results showed that, in school classes where a high proportion of students had a positive future orientation, the risk of heavy alcohol use at the individual level was lower, also after adjusting for individual FO and for individual- and class-level socioeconomic conditions. A similar, but not statistically significant, tendency was found for delinquency. In addition, having a high proportion of students with a positive FO in a school class was associated with fewer internalizing problems, also after controlling for individual FO and socioeconomic conditions at the individual and school class level. We conclude that the surrounding school class, in terms of its general future orientation climate, may play a role for individual outcomes in the form of problem behaviors and mental health.

The Effects of a Web-Based Alcohol Prevention Program on Social Norms, Expectancies, and Intentions to Prevent Harm among College Student-Athletes

College athletes are at risk for heavy alcohol use, which jeopardizes their general health, academic standing, and athletic performance. Effective prevention programming reduces these risks by targeting theory-based intermediate factors that predict alcohol use while tailoring content to student-athletes. The purpose of this study was to examine the impact of the myPlaybook online prevention program on student-athletes’ social norms, negative alcohol expectancies, and intentions to use alcohol-related harm prevention strategies. NCAA Division II student-athletes were recruited from 60 institutions across the United States to complete myPlaybook and pretest/posttest surveys measuring demographics and targeted outcome variables. Participants were randomly assigned to the treatment group (pretest-program-posttest; final n = 647) or the delayed treatment “control” group (pretest-posttest-program; final n = 709). Results revealed significant program effects on social norms (p &lt; .01) and intentions to use harm prevention strategies (p &lt; .01), while the effect on negative alcohol expectancies was nonsignificant (p = .14). Implications for future research and practice are discussed.

Utility of the Athlete Drinking Scale for assessing drinking motives among high school athletes

Research suggests that high school athletes are at greater risk for heavy alcohol use and alcohol-related problems than their non-athlete peers. Drinking motives unique to the athletic experience may contribute to elevated use. The Athlete Drinking Scale (ADS) was designed to assess sport-related motives for alcohol use, but has not yet been validated among high school athletes. The purpose of this study was to examine the psychometric properties of the ADS among a sample of high school athletes. Participants were 216 high school student-athlete drinkers who completed anonymous self-report surveys. A confirmatory factor analysis resulted in a revised three-factor solution with a satisfactory overall model fit. Path analyses indicated that the Positive Reinforcement motives subscale was the only ADS subscale that was significantly associated with alcohol use and alcohol-related problems when controlling for the effects of the other factors (i.e., age and gender) in this population. The ADS may be a valuable assessment tool for researchers and clinicians involved in alcohol prevention efforts for high school athletes.

Risk of alcohol abuse in urban versus rural DUI offenders

Background: Research concerning driving under the influence (DUI) offenses in rural populations is scarce and has often been carried out in the context of substance abuse and illicit drug use. Although previous studies have suggested that rural individuals are more likely to abstain from alcohol use, recent trends suggest that alcohol and substance abuse problems in rural areas are occurring at rates similar to urban areas. It is possible that urban and rural DUI offenders may differ on psychological and behavioral characteristics associated with heavy alcohol consumption. Objective: The aim of this study was to examine alcohol use differences between urban and rural DUI offenders. Methods: Data from 11 066 DUI offenders in a Midwestern state were used for this study. The Alcohol subscale of the Driver Risk Inventory II was used to assess the risk of problem alcohol use. Results: Higher levels of alcohol risk were associated with rural DUI offenders after adjusting for several demographic variables and blood-alcohol content level at time of arrest [Medium Risk OR = 1.43, 95% CI: (1.20, 1.71); Problem Risk OR = 1.43, 95% CI: (1.19, 1.72); Severe Risk OR = 1.38, 95% CI: (1.14, 1.67)]. Conclusions: The results of this study indicate that rural DUI offenders have a significantly greater risk of heavy alcohol use when compared to urban DUI offenders. Practical implications of these results suggest that evaluators and assessors should be aware of an increased likelihood of alcohol problems in rural DUI individuals relative to those in urban areas.

Age at first use of alcohol predicts the risk of heavy alcohol use in early adulthood: A longitudinal study in the United States

BackgroundTwo ecological cross-sectional studies which relied on national survey data (U.S. and Australia) have shown that starting drinking at a younger age increases the frequency of heavy drinking in the general population, including those with good mental and physical health status. This study further investigates the hypothesis that age at first use of alcohol increases the risk of heavy alcohol use by applying data from a longitudinal study. MethodThis study used public-use data collected from Wave I, Wave III and Wave IV of the National Longitudinal Study of Adolescent Health in the United States. The association between age at first use of alcohol and heavy alcohol use (5+ drinks per occasion) was examined with two different multivariate analysis approaches with data from 2316 participants: ordered logistic regression models and Poisson regression models with longitudinal data settings. In addition, the newly developed proxy outcome approach was further used to estimate and adjust for unmeasured/unobserved confounding factors. ResultsAge at first use of alcohol before 18 years was associated significantly higher risk of heavy alcohol use at follow-up. ConclusionAfter adjusting for known and residual confounders, younger age at first use of alcohol was associated with significantly higher risk of heavy alcohol use, moreover, we posit that the association observed from this longitudinal study is probably causal. Abstinence from alcohol until the age of 18 years will likely reduce individual risk of alcohol-related problems in adulthood. In the longer term, delayed onset of exposure with widespread abstinence among this age group is also likely to reduce the overall prevalence of alcohol-related problems in the general population.

Accounting for the Association of Family Conflict and Heavy Alcohol Use Among Adolescent Girls: The Role of Depressed Mood

Heavy alcohol use increases dramatically at age 14, and there is emerging cross-sectional evidence that when girls experience family conflict at younger ages (11-13 years) the risk of alcohol use and misuse is high. This study evaluated the role of family conflict and subsequent depressed mood in predicting heavy alcohol use among adolescent girls. This was a three-wave longitudinal study with annual assessments (modal ages 12, 13, and 14 years). The participants (N = 886, 57% female) were from 12 metropolitan schools in Victoria, Australia, and participants completed questionnaires during school class time. The key measures were based on the Communities That Care Youth Survey and included family conflict (Wave 1), depressed mood (Wave 2), and heavy alcohol use (Wave 3). Control variables included school commitment, number of peers who consumed alcohol, whether parents were living together, and ethnic background. With all controls in the model, depressed mood at Wave 2 was predicted by family conflict at Wave 1. The interaction of family conflict with gender was significant, with girls showing a stronger association of family conflict and depressed mood. Depressed mood at Wave 2 predicted heavy alcohol use at Wave 3. Girls may be especially vulnerable to family conflict, and subsequent depressed mood increases the risk of heavy alcohol use. The results support the need for gender-sensitive family-oriented prevention programs delivered in late childhood and early adolescence.

Age at First Use of Alcohol and Risk of Heavy Alcohol Use: A Population-Based Study

Aim. To examine the association between age at first alcohol use and risk of heavy alcohol use among the adult US general drinking population. Methods. This population-based study used the 2010 National Survey on Drug Use and Health (NSDUH) from United States. Multivariate Poisson regression was employed to predict the frequency of heavy alcohol use (five or more drinks per occasion) in the last 30 days with age at first use of alcohol controlling for potential confounding factors. Results. Younger age at first use of alcohol was associated with increased likelihood of heavy alcohol use in the last 30 days in this population-based sample. This association remained significant when analysis was reperformed for the subgroup of participants who were with desired good health status and Kessler score lower than 12. Conclusion. Younger age at first use of alcohol was associated with increased likelihood of heavy alcohol use.