Multilevel analysis of situational drinking among Canadian undergraduates

Sources of Environmental Reinforcement and Engagement in Health Risk Behaviors Among a General Population Sample of US Adults

Research supports the premise that greater substance use is associated with fewer sources of environmental reinforcement. However, it remains unclear whether types of environmental reinforcement (e.g., social or work) may differentially influence use. This study tested the association between types of environmental reinforcement and engagement in multiple health risk behaviors (alcohol use, binge eating, and nicotine use). Cross-sectional data were collected from a general population sample of US adults (N = 596). The Pleasant Events Schedule (PES) was used to measure sources of reinforcement. Exploratory structural equation modeling (ESEM) characterized different areas of environmental reinforcement and correlations with alcohol consumption, binge eating, and nicotine use. A four-factor structure of the PES demonstrated a conceptually cohesive model with acceptable fit and partial strict invariance. Social-related reinforcement was positively associated with alcohol consumption (β = 0.30, p < 0.001) and binge eating (β = 0.26, p < 0.001). Work/school-related reinforcement was negatively associated with binge eating (β = -0.14, p = 0.006). No areas of reinforcement were significantly associated with nicotine use (p values = 0.069 to 0.755). Social-related activities may be associated with engagement in multiple health risk behaviors (more binge eating and alcohol use), whereas work/school-related activities may be preventative against binge eating. Understanding these relationships can inform prevention efforts targeting health risk behaviors.

Alcohol use contexts (social settings, drinking games/specials, and locations) as predictors of high-intensity drinking on a given day among U.S. young adults

BACKGROUND

This study examined whether variability in young adult drinking social settings, drinking games/drink price specials, and locations differentiated daily high-intensity drinking (HID) likelihood; whether contexts varied by legal drinking age and college status (attending a 4-year college full-time); and whether legal drinking age and college status moderated drinking context/intensity associations.

METHODS

Participants (n = 818 people, 46.3% female) were part of the Young Adult Daily Life Study in 2019 to 2022. They were originally selected because they were past 30-day drinkers from the 2018 U.S. national probability Monitoring the Future 12th grade sample and because they reported one or more days of alcohol use during 14-day data collection bursts across the following 4 years (n = 5080 drinking days). Weighted multilevel modeling was used to estimate drinking context/intensity associations. Drinking intensity was defined as moderate (females 1 to 3, males 1 to 4 drinks), binge (4 to 7, 5 to 9 drinks), or HID (8+, 10+ drinks). Models controlled for other within-person (weekend, historical time period) and between-person (sex and race/ethnicity) covariates.

RESULTS

Contexts differentiating HID and binge drinking days included drinking with large groups, strangers, pregaming, drinking games, and more drinking locations. Legal drinking age was associated with lower odds of free drinks but greater odds of drinking at bars/restaurants. College status was associated with lower odds of drinking alone or free drinks, but greater odds of drinking with friends, large groups, pregaming, drinking games, discounted price drinks, and at bars/restaurants, parties, and more drinking locations. Legal drinking age and college status moderated some context-intensity associations.

CONCLUSIONS

Social settings, pregaming, drinking games, and drinking at more locations were associated with increased risk of HID on a given day. Legal drinking age and college status were associated with specific drinking contexts and moderated some context/intensity associations. Incorporating the contexts associated with HID into interventions may help to reduce HID and related consequences in young adults.

A social contextual review of the effects of alcohol on emotion

Drinking and drinking problems are complex phenomena. Understanding the etiology of alcohol use disorder requires consideration of biological, psychological, and social processes. It is our view that the last of these dimensions is just beginning to receive adequate scrutiny. In this selective review, we discuss the concept of a biopsychosocial analysis of the effects of alcohol. After briefly addressing biological and psychological research on alcohol's emotional effects, we bid to make a case for the vital role that social processes play in understanding why people drink. The bulk of the paper describes research illustrating the contributions that a social psychological perspective can make to advance understanding of the rewarding effects of alcohol. Overall, studies incorporating social contexts have revealed reliable evidence that alcohol enhances emotional experience in many social environments and have identified socio-contextual variables that moderate responses to alcohol. Further, these studies have broadened the scope of constructs thought to be socially rewarding, including social bonding, relationship functioning, and humor enjoyment. Our analysis concludes by identifying research areas we believe would profit from additional research.

Drinking location moderates the association between social group size and alcohol consumption among young adults: An event-level study

INTRODUCTION

Previous studies have demonstrated relationships between social and environmental characteristics of the drinking context and alcohol use. However, the use of event-level data to investigate individual and joint relationships between such characteristics and alcohol use remains a gap in the literature. This study aimed to examine associations between drinking context (location and social group size) and alcohol consumption, and estimate the relationship between the interaction of context and alcohol consumption.

METHODS

Using an Internet-based cellphone-optimised assessment technique, 183 Swiss young adults (mean: 23 years; range: 17-37 years) completed hourly assessments from 8 pm to midnight Thursday through Saturday for five consecutive weeks. Participants contributed 3454 hourly questionnaires. The number of drinks, the number of friends present and location (off-premise-home, outdoors; on-premise-bars, restaurants) were assessed based on the previous hour. Multilevel mixed-effects models were used to assess the relationships of interest.

RESULTS

Being off-premise compared to on-premise was associated with fewer hourly drinks consumed (b = -0.44, P < 0.001). Greater numbers of friends present were associated with more drinks consumed (b = 0.02, P < 0.001). The association between number of friends and number of drinks consumed was significantly stronger for off-premise compared to on-premise locations (b = 0.03, P < 0.001).

DISCUSSION AND CONCLUSIONS

Compared to off-premise locations, on-premise locations are associated with more hourly drinks consumed. However, the positive relationship between social group size and drinks consumed is significantly stronger for off-premise locations compared to on-premise locations. Findings have implications for tailored interventions focused on reducing alcohol consumption by young adults.

Real-world simultaneous alcohol and cannabis use: An ecological study of situational motives and social and physical contexts

OBJECTIVE

Given the adverse outcomes associated with simultaneous alcohol and marijuana (SAM) use, understanding factors that give rise to occasions of simultaneous use is critical. This study examines the relationships between situational motives and contexts and three situational outcomes: simultaneous alcohol and marijuana use (SAM) use versus cannabis-only use, number of cannabis uses, and subjective effects.

METHOD

Past-month SAM users (n = 341; 52% female; 75% White; 10% Latinx/Hispanic; age 18-24) from three U.S. college campuses completed 8 weeks of surveys up to five times a day. Three-level generalized linear mixed-effects models tested the effects of situational motives and social and physical contexts on occasion type (SAM vs. cannabis-only), cannabis use, and subjective effects.

RESULTS

Situational social and enhancement motives were related to greater odds of SAM relative to cannabis-only use; expansion motives were reported more often on cannabis-only occasions. Using with others and at friends' places, being with others consuming cannabis, and being with others who are intoxicated were more likely when combining alcohol with cannabis. Increased number of cannabis uses and subjective effects in a social context were evident only on cannabis-only occasions. Using alone and using at home were greater on cannabis-only occasions and were associated with lower cannabis use and subjective effects.

CONCLUSIONS

The combination of alcohol and cannabis use occurs during social situations and when motivated by positive reinforcement but number of cannabis uses is not increased when consuming cannabis with alcohol in social situations. Characterizing the complex interplay of situational factors that contribute to risky use will inform interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The association between intended drinking contexts and alcohol expectancies in college students: A daily diary study

BACKGROUND

Because of the role alcohol outcome expectancies play in subsequent drinking, it is important to understand factors that can shape alcohol expectancies to guide intervention efforts. This study examined among college students whether intended social contexts for drinking were associated with positive and negative alcohol expectancies at the daily-level.

METHODS

Participants included in analyses were 323 students, ages 18 to 24 years, enrolled at a 4-year university in the Pacific Northwest. At four 2-week measurement bursts across one year, participants were asked each afternoon to report whether they planned to drink alcohol later that day. If so, they were further asked how much they intended to drink, whether they plan to drink alone or with others, whether they plan to drink at home or bar/party, and their positive and negative expectancies of alcohol use that evening.

RESULTS

A total of 2953 person-day observations from planned drinking days were used. Results from linear mixed models, adjusted for covariates including intended number of drinks, showed that students reported greater positive alcohol expectancies on days when they intended to drink with others vs. alone and intended to drink at a bar or party vs. at home. For negative expectancies, only intended drinking with others showed a statistically significant association.

CONCLUSION

This study suggests that contextual factors may shape college students' expectancies about effects of alcohol at the daily-level. Intended drinking contexts may be important to address in event-level interventions to reduce high-risk drinking in young adults.

Frequency of Binge Drinking and Perception of Peer Alcohol Use: A Survey of University Students in a Western Canadian Province

OBJECTIVES

College and university student binge drinking is a critical health issue, and studies demonstrate students perceive high rates of drinking among their peers. High alcohol consumption and binge drinking are normalized throughout college and university, and there are gross misperceptions of perceived alcohol use among peers. The purpose of our study was to examine differences in perceptions of peer alcohol use after grouping students based on their frequency of binge drinking over a 2-week period.

METHODS

A one-way analysis of variance test was used to compare the differences in the perception of peer alcohol use after grouping students by their frequency of binge drinking.

RESULTS

Students who binge drink have significantly higher perceptions of peer alcohol use than their non-binge-drinking and abstaining peers.

CONCLUSIONS

These findings provide direction toward the feasibility of using perceptions of peer alcohol use to identify at-risk students to curtail dangerous drinking behavior.

Ten seconds of my nights: Exploring methods to measure brightness, loudness and attendance and their associations with alcohol use from video clips

Introduction

Most evidence on associations between alcohol use behaviors and the characteristics of its social and physical context is based on self-reports from study participants and, thus, only account for their subjective impressions of the situation. This study explores the feasibility of obtaining alternative measures of loudness, brightness, and attendance (number of people) using 10-second video clips of real-life drinking occasions rated by human annotators and computer algorithms, and explores the associations of these measures with participants’ choice to drink alcohol or not.

Methods

Using a custom-built smartphone application, 215 16-25-year-olds documented characteristics of 2,380 weekend night drinking events using questionnaires and videos. Ratings of loudness, brightness, and attendance were obtained from three sources, namely in-situ participants’ ratings, video-based annotator ratings, and video-based computer algorithm ratings. Bivariate statistics explored differences in ratings across sources. Multilevel logistic regressions assessed the associations of contextual characteristics with alcohol use. Finally, model fit indices and cross-validation were used to assess the ability of each set of contextual measures to predict participants’ alcohol use.

Results

Raw ratings of brightness, loudness and attendance differed slightly across sources, but were all correlated (r = .21 to .82, all p < .001). Participants rated bars/pubs as being louder (Cohen’s d = 0.50 [95%-CI: 0.07–0.92]), and annotators rated private places as darker (d = 1.21 [95%-CI: 0.99–1.43]) when alcohol was consumed than when alcohol was not consumed. Multilevel logistic regressions showed that drinking in private places was more likely in louder (OR_participants = 1.74 [CI: 1.31–2.32]; OR_annotators = 3.22 [CI: 2.06–5.03]; OR_algorithm = 2.62 [CI: 1.83–3.76]), more attended (OR_participants = 1.10 [CI: 1.03–1.18]; OR_algorithm = 1.19 [CI: 1.07–1.32]) and darker (OR = 0.64 [CI: 0.44–0.94]) situations. In commercial venues, drinking was more likely in darker (OR_participants = 0.67 [CI: 0.47–0.94]; OR_annotators = 0.53 [CI: 0.33–0.85]; OR_algorithm = 0.58 [CI: 0.37–0.88]) and louder (OR_participants = 1.40 [CI: 1.02–1.92]; OR_algorithm = 2.45 [CI: 1.25–4.80]) places. Higher inference accuracies were found for the models based on the annotators’ ratings (80% to 84%) and the algorithms’ ratings (76% to 86%) than on the participants’ ratings (69% to 71%).

Conclusions

Several contextual characteristics are associated with increased odds of drinking in private and commercial settings, and might serve as a basis for the development of prevention measures. Regarding assessment of contextual characteristics, annotators and algorithms might serve as appropriate substitutes of participants’ in-situ impressions for correlational and regression analyses despite differences in raw ratings. Collecting contextual data by means of sensors or media files is recommended for future research.

Multilevel Contextual Analysis of Poker Cash Game Gambling

This article examines the effect of gambling location on the frequency, expenditure, and time spent on cash game poker in relation to individual characteristics of gamblers. Data were drawn from a 2012 Québec epidemiological gambling survey. The quantitative analysis used multilevel methods to model the dual-level hierarchical design of gambling location (level 1) and individual characteristics nested within poker cash game players (level 2). The sample was comprised of 270 individuals aged 18 years and above and living in private homes, who reported gambling on poker cash games in the past 12 months. Participants reported their gambling habits in up to three locations: private homes, the casino, and the Internet. Demographic data included age, gender, education level, and income. Significant variation was reported between the three locations and the gameplay patterns variables, i.e. betting frequency, time, and spending. The most frequently reported gambling locations were private dwellings (87.4%), followed by casinos (15.9%), and the Internet (13.7%). Some interactions between location and the demographic variables were observed. Moreover, the multilevel analysis revealed an important relationship between the location and poker cash gambling behavior. This study reveals the significance of contextual factors as a fundamental element in gambling behaviors and highlights the need for prevention strategies that target specific high-risk contexts rather than individually based interventions.

The socio-environmental context of simultaneous alcohol and marijuana use among young adults: Examining day-level associations

INTRODUCTION AND AIMS

Simultaneous alcohol and marijuana (SAM) use is reported by roughly 30% of young adult drinkers. Among SAM users, SAM use days have more negative substance-related consequences than single-substance days. Little information is available about contextual factors contributing to the likelihood of SAM use on a particular day. This study compared days on which individuals reported SAM use relative to days on which they reported alcohol but not marijuana use in terms of physical location, engagement in risky activities and social context of use.

DESIGN AND METHODS

Participants were 148 young adults (57% female) reporting past-month SAM use and past two-week binge drinking. Participants completed up to 14 daily surveys assessing substance use behaviour and socio-environmental characteristics of use.

RESULTS

For those <21 years, only using at home was associated with greater odds of SAM use. For those 21+, using at a friend's house and outdoors were associated with increased odds of use; using at a bar/club was associated with lower odds. Using alone was associated with lower odds of use for those 21+. Engagement in risky activities (pre-gaming and drinking games) was not associated with SAM use.

DISCUSSION AND CONCLUSIONS

SAM days are linked with use in private settings and social situations. Despite experiencing more harms on SAM days, SAM use is not more likely than alcohol use alone to occur in certain environments and situations traditionally found to be linked with increased risk. Findings may provide key insight for developing context-informed interventions focused on SAM use.

Beverage-specific situational norms: Evidence from the Dutch electronic appropriate beverage task

INTRODUCTION AND AIMS

By the time young adolescents initiate alcohol consumption they have firmly established attitudes, expectations and beliefs about alcohol and its effects. To further unravel the origins of this knowledge in childhood, we aim to address Dutch children's knowledge of the types of alcoholic beverages adults typically consume in certain situational contexts (i.e. their knowledge of beverage-specific situational norms).

DESIGN AND METHODS

A total of 329 children (4-8 years old) completed the Dutch electronic Appropriate Beverage Task at three-time points (2015, 2016, 2017). Three-level regression models were estimated examining whether children's beverage-specific situational norms depend on the gender of the person displayed in the task, sex of the participant and whether there were any beverage-specific changes over time.

RESULTS

Beverage-specific findings seem to be robust across the appropriateness of the situation. Beer was the most frequently attributed alcoholic beverage overall and across the common drinking situations. White wine was attributed significantly more to females in the task. Beer, red wine and champagne were attributed significantly more to males. Attributions of individual alcoholic beverages did not change significantly over time. There were no significant differences between the participating boys and girls.

DISCUSSION AND CONCLUSIONS

Results suggest that 4-8-year olds are yet to form knowledge of beverage-specific situational norms. Independent of the situation, time and participants' sex, the gender of the person displayed in the task seemed to be more salient to children than situational or environmental indicators in determining consumption.

Personalized feedback tempers weekend increases in alcohol use among nonstudent emerging adult drinkers

A common pattern of problematic alcohol consumption among emerging adults consists of little to no drinking during the week, with heavy drinking episodes on the weekend. However, little is known about whether brief alcohol interventions exert impact on decreasing weekend drinking escalations or simply overall consumption throughout the week. A recent randomized controlled trial of heavy drinking emerging adult nonstudents (N = 164) demonstrated the efficacy of a personalized feedback intervention (PFI). Specifically, the PFI was associated with reduced overall alcohol consumption relative to assessment-only controls. However, it is not clear if patterns of weekend drinking escalation may have been disrupted by the intervention. The current study was a follow-up analysis of the parent trial. Using retrospective daily drinking data provided at each timepoint (up to 9-months), data were coded to reflect condition, time (coded to capture initial changes post-intervention as well as long-term maintenance), and day of the week (coded to capture weekend versus weekday). A multilevel negative binomial hurdle analysis was conducted, yielding two sets of results: 1) predicting the probability of a non-drinking day, and 2) predicting number of drinks consumed. Although the three-way interaction was not significant, 2 two-way interactions indicated that weekend increases in drinking were less steep over time for both groups, and less steep for PFI participants. In addition, the higher weekend likelihood of drinking was decreased over time for both groups. Steep weekend increases in drinking were disrupted over time, particularly among PFI recipients. Personalized feedback may be effective at helping nonstudent emerging adults avoid high risk drinking situations.

Social Drinking Contexts and Their Influence on Problematic Drinking at Age 30

Aims: Understanding the social contexts in which problematic drinking occurs can inform prevention strategies. In this article, we investigate gender-specific social contexts associated with problematic drinking and depression among adults aged 30 years. Because depression has been consistently linked with harmful alcohol consumption, we will also examine its association with drinking contexts. Methods: We used data from 2490 young adults who completed the 30-year follow-up phase of the Mater-University of Queensland Study of Pregnancy and its Outcomes, a prospective study commenced in 1981. Exploratory and confirmatory factor analyses were used to identify latent constructs of drinking contexts stratified by gender, with subsequent regression analysis to assess the role of these contexts in problematic drinking (measured using the Alcohol Use Disorders Identification Test). Results: Six distinct drinking contexts were identified, which differed by gender, three for men and three for women. For both men and women, "social drinking", was associated with problematic drinking. "Home drinking" was also common to men and women but associations with problematic drinking differed, being risky only among men. "Daytime drinking" (women) was associated with risk but "work-related drinking" (men) was not. Both "home drinking" (men) and "daytime drinking" (women) were linked to depression symptoms. Conclusion: Specific contexts appeared to be associated with problematic drinking for both sexes. Among both men and women, "social drinking" was associated with problematic drinking. Both "home drinking" (men) and "daytime drinking" (women) contexts, were associated with problematic drinking and depressive symptoms. Targeted alcohol-focused interventions need to address co-occurring mental health issues.

Do Associations Between Drinking Event Characteristics and Underage Drinking Differ by Drinking Location?

OBJECTIVE

We investigated how associations between social and situational characteristics (number of people, adult supervision, group gender composition, group age composition, ease of alcohol access, and weekend) and underage drinking are moderated by the specific locations in which drinking occurs.

METHOD

Using a case-crossover design and retrospective surveys, a sample of 385 adolescents (mean age = 16.5 years; 47.3% female) from 24 mid-size California cities reported the last time they drank alcohol in a specific location (restaurant, outdoors, home) and the last time they were at the same type of location without drinking, as well as characteristics of each drinking and nondrinking event (N = 1,096 events).

RESULTS

Results of multilevel regression models indicated that perceived ease of alcohol access was associated with drinking across all locations (adjusted odds ratios [aORs] = 2.11-2.75, all p < .01). Weekend (vs. weekday) increased the odds of drinking outdoors (aOR = 3.75, p < .001) and in the home (aOR = 4.37, p < .001), as did a lack of adult supervision (aOR = 1.70, p < .05 for outdoors; aOR = 1.64, p < .01 for home). Larger groups (aOR = 1.06, p < .001) and being with older people (aOR = 2.28, p < .001) increased the odds of drinking in the home only. Significant cross-level interaction effects between location and group size (aOR = 0.96; p < .001), group gender composition (aOR = 0.78, p < .05), group age composition (aOR = 0.70, p < .01), ease of alcohol access (aOR = 0.88, p < .05), and weekend (aOR = 0.66, p < .05) suggested that these predictors were less significant in outdoor locations compared with the home.

CONCLUSIONS

Locations moderate the social and situational characteristics of events and are important for underage drinking. Results can inform targeted prevention efforts.

Toward the prevention of alcohol use disorders: Overdrinking (unintentional binge drinking) in a community sample

Approximately 64,000,000 people in the United States report binge drinking at least once in the past month. Unlike overeating and oversleeping, "overdrinking"-defined as drinking more than a person intends to drink-does not exist in the literature. Terms such as binge and problem drinking do not consider the intent of the drinker. The results of this pilot study suggest that most people drink more than they intend to drink. Moreover, they also report often being surprised that they overdrank. Smartphones may help overdrinkers be less often surprised by overdrinking and may prevent drinkers from developing an alcohol use disorder.

Perceptions of Heavy Drinking and Alcohol Problems among Young Adults

Data from focus groups are presented. Interviews were conducted in various regions of Sweden with young men and women from different social groups. The groups were composed of naturally existing networks of friends. Participants provided definitions of three types of problem drinkers: an alcoholic, a heavy drinker, and a drunkard. The role of background factors in influencing the way the definitions were formed is examined. Two background factors of importance stood out in the analysis: personal drinking habits and gender. One finding was that the young people's own drinking habits influenced the way they perceived the three types of drinkers, and in particular how they perceived the difference between a heavy drinker and an alcoholic. Another finding was that the young women tended to describe the alcoholic in terms of drinking alone and in disguise, while the young men rather attributed problems at work to the alcoholic.

Characteristics of drinking events associated with heavy episodic drinking among adolescents in the United States

PURPOSE

To examine associations between characteristics of drinking events and the quantity of alcohol consumed by adolescents in the United States.

METHODS

Analyses relied on 2011-2015 data from the National Survey on Drug Use and Health (NSDUH). The study sample included 8110 adolescents, ages 12-17years old, who drank alcohol in the past 30days. A logistic regression model, weighted for national estimation, was constructed to examine factors associated with heavy episodic drinking (HED; 5+ drinks for males, 4+ drinks for females) during the underage drinker's most recent drinking event. These models were adjusted for study year and individual characteristics, including past year drinking frequency, age of drinking onset, and demographic variables.

RESULTS

Buying alcohol off-premise or from another person and being given alcohol from non-parent social sources were associated with greater odds of HED compared to being given alcohol by one of their parents. Drinking alcohol at someone else's house or multiple locations were associated with heavier alcohol consumption compared to drinking at one's own home. Being older and an earlier age of alcohol onset were associated with greater odds of HED.

CONCLUSIONS

This study identifies contextual factors associated with HED by adolescents. Compared to global association studies, the findings from these event-specific analyses provide strong evidence of the environmental conditions that contribute to HED in American adolescents. Although no level of alcohol consumption is safe for adolescents, knowledge of event-level risk factors can inform targeted interventions.

The Spirit Is Willing, But the Flesh is Weak: Why Young People Drink More Than Intended on Weekend Nights-An Event-Level Study

BACKGROUND

Heavy alcohol use is common among young adults on weekend nights and is assumed to be intentional. However, little is known about the extent to which heavy consumption is planned prior to the onset of drinking and what factors contribute to drinking more than intended. This study investigates drinking intentions at the beginning of an evening and individual and situational factors associated with a subsequent consumption over the course of multiple nights.

METHODS

Using a smartphone application, 176 young people aged 16 to 25 (mean age = 19.1; 49% women) completed questionnaires on drinking intentions, consumption, and drinking environments before, during, and after multiple Friday and Saturday nights (n = 757). Multilevel regressions were used to investigate individual-level and night-level factors associated with previous drinking intentions and subsequent deviations from intentions.

RESULTS

Participants intended to consume 2.5 drinks (SD = 2.8) per night yet consumed 3.8 drinks (SD = 3.9) on average. Drinking intentions were higher among those who frequently went out at night and engaged in more frequent predrinking. Participants drank more than intended on 361 nights (47.7%). For both genders, the number of drinks consumed before 8 pm, attending multiple locations, and being with larger groups of friends contributed to higher consumption than intended at the individual and the night levels. Heavier consumption than intended also occurred when drinking away from home for men and when going to nightclubs for women.

CONCLUSIONS

Making young adults aware of the tendency to drink more than intended, particularly when drinking begins early in the evening, moves from location to location, and includes large groups of friends, may be a fruitful prevention target. Structural measures, including responsible beverage service, may also help in preventing excessive drinking at multiple locations.

Do alcohol use reasons and contexts differentiate adolescent high-intensity drinking? Data from U.S. high school seniors, 2005-2016

The purpose of this study was to examine associations between (a) self-reported reasons for and contexts of alcohol use and (b) high-intensity drinking (i.e., having 10+ drinks in a row in the past 2 weeks) among national samples of U.S. 12th grade students. Data were obtained from 16,902 students who reported any past 12-month alcohol use from nationally representative annual 12th grade student samples from 2005-2016. When asked about drinking behavior during the past 2 weeks, 72% reported consuming less than 5 drinks at most during 1 drinking occasion; 14% reported 5-9 drinks, 7% reported 10-14 drinks, and 7% reported 15+ drinks. Adolescent drinkers in all categories (<5, 5-9, 10-14, and 15+ drinks) endorsed "to have a good time" as the most prevalent reason for alcohol use, and "at a party" as the most prevalent context of alcohol use. However, high-intensity drinking was particularly likely among adolescents drinking for coping, compulsive use, and drug effect reasons, as well as those who enjoyed the taste. Having 15+ drinks (vs. 10-14 drinks) was particularly associated with compulsive use and enjoying the taste. The relative risk of any high-intensity drinking, and of higher levels of high-intensity drinking involvement, increased with the total number of reasons and contexts endorsed. Alcohol appears to serve a larger number of functions for high-intensity drinking adolescents than non-high-intensity drinking youth. (PsycINFO Database Record

A descriptive analysis of where and with whom lesbian versus bisexual women drink

Purpose

Sexual minority women (SMW) are at increased risk for alcohol use disorders and related problems. Social context (e.g., where and with whom one drinks) has been identified as an important factor associated with drinking behavior, but little is known about social context among SMW. An improved understanding of social context among SMW has the potential to inform efforts to reduce problematic drinking and its consequences in this high-risk population.

Methods

We examined where and with whom SMW drink in a national sample recruited via social media (N = 1,057).

Results

SMW reported more frequent drinking in private locations (compared to public locations), with friends and romantic partners (compared to family members and strangers), and in locations with both heterosexuals and sexual minorities (compared to mostly or exclusively sexual minorities). Additionally, lesbians reported more frequent drinking in bars and in locations with more sexual minorities compared to bisexual women.

Conclusion

Interventions to reduce problematic drinking among SMW may benefit from addressing social context.

Protective behavioral strategies as a context-specific mediator: A multilevel examination of within- and between-person associations of daily drinking

Research indicates that a drinker's environmental and social context can be differentially associated with drinking outcomes. Further, although many researchers have identified that more frequent use of protective behavioral strategies (PBS) is associated with lower alcohol consumption and negative consequences, scant research has examined how one's drinking context may promote or hinder PBS use. The present study examined how the context of drinking each day (i.e., where and with whom) is associated with level of consumption and reported alcohol-related problems among n = 284 college drinkers (69.0% female) directly, as well as indirectly through the use of PBS. Two different dimensions of PBS are examined (i.e., "Limits" or limiting consumption, and "Avoidance" or avoiding alcohol in general or specific alcohol situations), as well as their relationship with daily drinking. Moreover, we explored these relationships intraindividually (within-person across time), as well as interindividually (between people). Daily drinking was assessed using a weekly diary design. Using multilevel structural equation modeling, we found that environmental context (i.e., drinking at a bar or party) is associated with heavier alcohol use directly and indirectly through PBS that involve limiting one's drinking; these effects occurred only at the daily (within-person) level. Additionally, social context (i.e., drinking with friends) predicts elevated drinking but is unrelated to PBS use. Similar findings were present for alcohol-related problems, controlling for consumption level. College student drinking interventions may benefit from a focus on increasing the use of PBS within potentially risky drinking environments to help reduce problematic alcohol use. (PsycINFO Database Record

Mind the Gender Gap!

This article investigates the gender gap in alcohol use and partying among Danish adolescents by means of a survey of 15–16-year-olds. The aim is, first, to reveal the present gender differences in alcohol use when using measurements such as ‘age of onset of drinking’, ‘frequency of intoxication’, ‘binge drinking’ etc. Second, by drawing on other types of questions, the issue of the gender gap is readdressed from a perspective which contextualises adolescents' use of alcohol. The context is the last party the adolescent went to, and the questions centre on whether boys and girls party differently and how alcohol might effect how they party. By using graphical models for high-dimensional contingencies developed by Kreiner (1987; 1996; 2003), it is first analysed if consumption of alcohol makes boys rate the party more successful than girls. Second, by mapping out what boys and girls do when they party it is analysed whether alcohol consumption results in boys and girls doing the same or different activities at the party. Finally, it is analysed what activities are associated with rating the party as successful. At the very end it is then discussed how a gender gap in alcohol consumption could also be explained by how alcohol is embedded in a social setting, where the adolescents perform traditional gender roles.

Drinking with mixed-gender groups is associated with heavy weekend drinking among young adults

AIMS

To investigate how gender composition of the drinking group affects young adults' alcohol consumption on weekend evenings over and above the effect of drinking-group size.

DESIGN

Using the internet-based cellphone-optimized assessment technique (ICAT), participants completed online questionnaires on their cell phones every hour from 8 p.m. to midnight on Thursday, Friday and Saturday evenings during five consecutive weekends.

SETTING

French-speaking Switzerland.

PARTICIPANTS

Convenience sample of 183 young adults (53.0% female, mean age = 23.1) who completed a total of 4141 hourly assessments.

MEASUREMENTS

Alcohol consumption and number of male and female friends present assessed at 8 p.m., 9 p.m., 10 p.m., 11 p.m. and midnight.

FINDINGS

Results of three-level negative binomial regression analyses showed that women consumed significantly more drinks per hour when drinking in mixed-gender groups (Z-values ranging from 2.9 to 5.3, all P < 0.01) and significantly fewer drinks when drinking with men only (Z = -2.7, P < 0.01), compared with drinking with women only. Men reported consuming more drinks per hour in mixed-gender groups of equal gender composition (Z = 2.4, P < 0.05) or mixed-gender groups with men in the majority (Z = 2.2, P < 0.05) and fewer hourly drinks when drinking with women only (Z = -4.9, P < 0.001), compared with drinking with men only. Drinking-group size predicted the hourly number of drinks for women (Z = 6.0, P < 0.001) and men (Z = 5.5, P < 0.001).

CONCLUSIONS

Drinking-group gender composition is associated with number of drinks consumed per hour, over and above the impact of the drinking-group size. Young adults report consuming more drinks per hour when drinking with mixed-gender groups than with same-gender groups.

Implementation of a multicomponent Responsible Beverage Service programme in Sweden-a qualitative study of promoting and hindering factors

Aims

The objective of this study was to identify factors that either promote or hinder implementation of a multicomponent Responsible Beverage Service programme in Swedish municipalities.

Design

Forty semi-structured interviews were conducted in six municipalities and directed content analysis, guided by the Consolidated Framework for Implementation Research (CFIR), was performed.

Results

The CFIR framework was useful as an underlying theoretical model in this study. Importance of the following factors, described in the five domains of CFIR, was empirically supported in this study: local needs, evidence strength and advantages of the intervention, costs and available resources, clear goals, evaluation and feedback, access to knowledge and information, clear role definitions and cooperation, and enthusiastic key persons with high confidence in the effectiveness of the intervention. Hindering factors listed by the informants were lack of enthusiasm and opportunities to specialise, low degree of self-efficacy, unengaged decision-makers, complexities of the programme, and a top-down approach.

Conclusions

This study indicates that previously identified factors shown to promote and hinder implementation processes are also valid in the context of multicomponent community action programmes like RBS. Suggestions on how to elude some of the hindering factors are proposed, e.g. to develop long-time financial plans, to provide better information about the RBS program in full, and to stress the importance of collaboration between representatives from the municipalities, police authorities and owners of on-licenced premises.

Acute alcohol intoxication among adolescents-the role of the context of drinking

This study aims (1) to describe the context of drinking among adolescents with acute alcohol intoxication (AAI) by gender, (2) to explore temporal changes in the context of drinking and (3) to analyse the association between the context of drinking and blood alcohol concentration (BAC). A retrospective chart review of 12- to 17-year-old inpatients with AAI (n = 1441) of the years 2000 to 2006 has been conducted in five participating hospitals in Germany. Gender differences in the context of drinking were tested with t test and chi² test. Differences over time were analysed using logistic regressions. Multivariate linear regression was used to predict BAC. Girls and boys differed in admission time, drinking situation, drinking occasion and admission context. No temporal changes in drinking situation and in admission to hospital from public locations or places were found. Higher BAC coincided with male gender and age. Moreover, BAC was higher among patients admitted to hospital from public places and lower among patients who drank for coping.

CONCLUSION

The results suggest gender differences in the context of drinking. The context of drinking needs to be considered in the development and implementation of target group-specific prevention and intervention measures. What is known: • The context of drinking, e.g. when, where, why and with whom is associated with episodic heavy drinking among adolescents. What is new: • Male and female inpatients with acute alcohol intoxication differ with regards to the context of drinking, i.e. in admission time, drinking situation, drinking occasion and admission context. • Being admitted to hospital from public places is associated with higher blood alcohol concentration.

Extraversion and the Rewarding Effects of Alcohol in a Social Context

The personality trait of extraversion has been linked to problematic drinking patterns. Researchers have long hypothesized that such associations are attributable to increased alcohol-reward sensitivity among extraverted individuals, and surveys suggest that individuals high in extraversion gain greater mood enhancement from alcohol than those low in extraversion. Surprisingly, however, alcohol administration studies have not found individuals high in extraversion to experience enhanced mood following alcohol consumption. Of note, prior studies have examined extraverted participants-individuals who self-identify as being highly social-consuming alcohol in isolation. In the present research, we used a group drinking paradigm to examine whether individuals high in extraversion gained greater reward from alcohol than did those low in extraversion and, further, whether a particular social mechanism (partners’ Duchenne smiling) might underlie alcohol reward sensitivity among extraverted individuals. Social drinkers (n 720) consumed a moderate dose of alcohol, placebo, or control beverage in groups of 3 over the course of 36 min. This social interaction was video-recorded, and Duchenne smiling was coded using the Facial Action Coding System. Results indicated that participants high in extraversion reported significantly more mood enhancement from alcohol than did those low in extraversion. Further, mediated moderation analyses focusing on Duchenne smiling of group members indicated that social processes fully and uniquely accounted for alcohol reward-sensitivity among individuals high in extraversion. Results provide initial experimental evidence that individuals high in extraversion experience increased mood-enhancement from alcohol and further highlight the importance of considering social processes in the etiology of alcohol use disorder.

Identifying Strategies to Limit Youth Drinking in the Home

OBJECTIVE

The present study aims to better understand the situational, contextual, and social event-level characteristics that contribute to youth drinking behavior in the home.

METHOD

We used survey data from 1,217 adolescents (15-18 years, 47.7% female) living in 24 midsized, noncontiguous California cities. The study focused on those who reported at least one drink during their last drinking occasion at home or a friend's home (n = 336). We obtained data about total drinks at last event as well as contextual and situational characteristics at last event, including adult presence, number of people present, participant's home or friend's home, ease of alcohol access, and gender ratio. We also gathered information on individual-level characteristics such as past-year drinking behavior, perceived drinking norms, age, ethnicity, and gender. Multilevel Poisson regression models were used to analyze the data.

RESULTS

Among the full sample, the number of people at the event and the perceived ease of access were positively associated with an increase in number of drinks consumed. Among females, having a responsible adult present was associated with consuming fewer drinks. Among males, having more boys at the event was related to consuming fewer drinks, whereas increased perceived access to alcohol was positively associated with consuming more drinks.

CONCLUSIONS

Parents may be able to manage or manipulate the home drinking environment to reduce heavy drinking and alcohol-related problems. Future research is needed to explore additional contextual factors that may enable or inhibit heavy drinking.

Relapse prediction: A meteorology-inspired mobile model

Predicting relapses to binge drinking in non-dependent drinkers may now be possible with smartphones. Smartphones have been shown to help individuals reduce their drinking and may help binge drinkers accelerate that process. Predicting the weather has improved greatly over the past 50 years, but predicting a binge drinking episode may be less difficult. It is hypothesized that the number of factors with high predictive value for any particular individual may not be large. Collecting data over time, a smartphone should be able to learn which combination of factors has a high probability of leading to an episode of binge drinking.

Consumption of Wine with Meals and Subjective Well-being: A Finnish Population-Based Study

AIMS

To examine in the general population the association of regular consumption of wine with meals, subjective well-being and risky drinking.

METHODS

A random sample of Finnish people aged 18-69 ('Finnish Drinking Habits Survey 2008', n = 2591, response rate 74%) were interviewed regarding psychological distress, self-efficacy, self-perceived health, uncontrolled drinking, negative events during drinking, hazardous drinking and consumption of alcohol. The analysis focused on comparison of those who drank wine at least once a week versus more seldom. Regression models adjusted for social determinants, smoking and chronic illness.

RESULTS

Twelve percent of Finnish adults drank wine with meals at least once a week. Drinking wine with meals was an urban phenomenon and associated with higher socioeconomic status. Regular wine with meal drinkers reported better health, higher self-efficacy and less psychological distress than others even when various confounders were adjusted for. They also reported more risky drinking and higher yearly consumption than other alcohol consumers. Especially those who drank both wine and beer during meals had higher rates of risky drinking. Those restricting themselves to only wine with meals reported less hazardous drinking than the general population.

CONCLUSION

Consumption of wine with meals was associated with high socioeconomic status and high subjective well-being. Risky drinking was prevalent among wine with meal drinkers, but only among those who drank both wine and beer with meals. Potential unknown confounders may exist, but the results underline a link between subjective well-being and drinking wine with meals.

Changes in living arrangement, daily smoking, and risky drinking initiation among young Swiss men: a longitudinal cohort study

OBJECTIVES

The aim of this study was to assess the association between changes in living arrangement and the initiation of daily smoking and monthly risky single-occasion drinking (RSOD) in a cohort of young Swiss men.

STUDY DESIGN

Longitudinal cohort study.

METHODS

The sample consisted of 4662 young men drawn from the Cohort Study on Substance Use Risk Factors who lived with their family at baseline. Follow-up assessments occurred 15 months later. Multiple regression models were adjusted for individual and family factors (family model), as well as for individual and peer-related factors (peer model).

RESULTS

Relative to those still living with their parents at follow-up (n = 3845), those who had moved out (n = 817) were considerably more likely to have taken up smoking or RSOD after adjusting for several individual, family, and peer-related variables: OR (daily smoking) = 1.67 (95% CI 1.15-2.41) (P = 0.007) and OR (monthly RSOD) = 1.42 (95% CI 1.08-1.88) (P = 0.012). The strongest family-related predictors of smoking initiation were family structure and the lack of parental regulation and the strongest peer-related factors alcohol/drug problems in peers. Meanwhile, the strongest peer-related predictors of RSOD initiation were peer pressure (misconduct), perceived social support from friends, and perceived social support from a significant other, whereas family factors were not associated with RSOD initiation. Further subanalyses were conducted to examine the impact of different living arrangement changes on substance use initiation and revealed that living with peers at follow-up was associated with the greatest risk.

CONCLUSIONS

We identified a strong association between moving out of one's parents' home and daily smoking and monthly RSOD initiation in young Swiss men. Moving out to live with peers was an especially strong predictor of substance use initiation. Campaigns that aim to prevent heavy smoking and drinking should be intensified at the end of obligatory school.

A Multilevel Study of Students in Vietnam: Drinking Motives and Drinking Context as Predictors of Alcohol Consumption

BACKGROUND

This study used multi-level analysis to estimate which type of factor explains most of the variance in alcohol consumption of Vietnamese students.

METHODS

Data were collected among 6011 students attending 12 universities/faculties in four provinces in Vietnam. The three most recent drinking occasions were investigated per student, resulting in 12,795 drinking occasions among 4265 drinkers. Students reported on 10 aspects of the drinking context per drinking occasion. A multi-level mixed-effects linear regression model was constructed in which aspects of drinking context composed the first level; the age of students and four drinking motives comprised the second level. The dependent variable was the number of drinks.

RESULTS

Of the aspects of context, drinking duration had the strongest association with alcohol consumption while, at the individual level, coping motive had the strongest association. The drinking context characteristics explained more variance than the individual characteristics in alcohol intake per occasion.

CONCLUSIONS

These findings suggest that, among students in Vietnam, the drinking context explains a larger proportion of the variance in alcohol consumption than the drinking motives. Therefore, measures that reduce the availability of alcohol in specific drinking situations are an essential part of an effective prevention policy.

Drinking Location and Pregaming as Predictors of Alcohol Intoxication Among Mandated College Students

BACKGROUND

Both drinking location and pregaming have been associated with heavy alcohol use among college students, yet the manner by which they uniquely contribute to alcohol intoxication remains unclear.

OBJECTIVE

The current study examined the unique utility of drinking location and pregaming in predicting alcohol intoxication among college students who violated campus alcohol policy.

METHOD

Between 2011 and 2012, mandated college students who reported drinking prior to their referral events (N = 212, 41% female, 80% White, Mage = 19.4 y) completed a computerized assessment of drinking location and related behaviors as part of larger research trial. Chi-squared statistics, t-tests, one-way analyses of covariance, and regression were used to examine study aims.

RESULTS

Participants were most likely (44%) to report drinking in off-campus housing prior to the referral event, and approximately half (47%) reported pregaming. Alcohol intoxication on the night of the referral event differed significantly as a function of both drinking location and pregaming, but pregaming did not moderate the association between drinking location and alcohol intoxication among mandated students. Female birth sex, pregaming, and drinking at either fraternities or off-campus housing predicted greater levels of alcohol intoxication on the night of the referral incident, while drinking in a residence hall/dorm predicted lower intoxication.

CONCLUSIONS/IMPORTANCE

Drinking location and pregaming are distinct predictors of alcohol intoxication among mandated college students. Future interventions may benefit from targeting both where and how college students consume alcohol.

Trajectories of Alcohol Use and Binge Drinking Among Pregnant Inuit Women

BACKGROUND

This study investigated trajectories of alcohol use and binge drinking among Inuit women starting from a year before pregnancy until a year after delivery, examined transition rates between time periods, and established whether specific factors could be identified as predictors of changes in alcohol behaviors.

METHODS

Drinking trajectories and movement among alcohol users and binge drinkers (i.e. non-binging and binging) were explored by Markov modeling across time periods. Two hundred and forty-eight Inuit women from Arctic Quebec were interviewed at mid-pregnancy, and at 1 and 11 months postpartum to obtain descriptive data on alcohol use during the year before pregnancy, the conception period, the pregnancy and the year after delivery.

RESULTS

The proportions of drinkers and bingers were 73 and 54% during the year prior to pregnancy and 62 and 33% after delivery. Both alcohol use and binge drinking trajectories demonstrated a significant drop in prevalence between the year before conception to the conception period. We also noted high probabilities of becoming an abstainer or not binging at this time. However, up to 60% of women continued to drink alcohol during pregnancy. Women in couples and not consuming marijuana were more likely to decrease their binge drinking at conception.

CONCLUSIONS

This study emphasizes the importance of including the period around conception in the definition of drinking patterns during pregnancy. The importance of considering alcohol consumption in a multidimensional way (personal, familial and social determinants) is also addressed while trying to minimize problems both for the fetus and the mother.

Context-Specific Drinking Risks Among Young People

BACKGROUND

Limited research suggests the context in which drinking occurs may contribute to specific alcohol-related consequences. Therefore the aims are to (i) determine whether the use of drinking contexts affects risks for several drinking consequences among young people in the general population and (ii) assess the degree to which additional risks are associated with greater levels of drinking in those contexts.

METHODS

A New Zealand survey of 16- to 29-year-olds asked about context-specific drinking and incidence of alcohol-related consequences grouped as follows: total, alcohol-related disorderly behavior, symptoms of dependence, effects of heavier drinking, and felt effects the next day. A context-specific dose-response model separated the effects of frequency (i.e., how often someone consumes 1 drink in each context) and context-specific quantity (i.e., the count of each successive drink consumed above the first), and these were estimated as predictors of consequences. Demographic covariates were included.

RESULTS

Exposure (number of visits): Increased exposure to drinking at bars/nightclubs, even at a very low level of consumption, that is, 1 drink, was independently related to the experience of greater consequences, including alcohol-related disorderly behavior. Risks for alcohol-related consequences were more strongly related to exposure to bars/nightclubs than they were to heavier drinking in that context. Greater use of private motor vehicles and outdoor public places was also associated with greater consequences (independently of the heavier drinking in these contexts). Quantity: Risk of consequences associated with others' home, restaurants, and own home depended primarily on quantity consumed.

CONCLUSIONS

Bars/nightclubs are inherently risky contexts for drinking by young people and improved controls are required. Drinking at others' home, private motor vehicles, and outdoor public places were also associated with consequences; prevention efforts increasing the price and reducing the availability of takeaway alcohol should work to reduce consequences at these contexts. Innovative context-specific interventions may be useful.

Bars and nightclubs associated with higher HIV prevalence

BACKGROUND

Alcohol outlet density is positively associated with alcohol consumption and a number of related risk behaviors. However, very little is known about the effects of different types of alcohol outlets on HIV prevalence. The current cross-sectional study examines associations between the number of each type of alcohol outlet and HIV prevalence within 350 cities located in 26 U.S. metropolitan statistical areas.

METHODS

State and local health department and U.S. Census Bureau surveillance data were analyzed from 1056 ZIP codes, where an estimated 39 million people reside. Multilevel negative binomial regression models were used to examine the association between the number of each type of alcohol outlet in ZIP codes and HIV prevalence.

RESULTS

Number of on-premise alcohol outlets within a ZIP code was associated with greater HIV prevalence. In this sample, the presence of one additional on-premise outlet in a ZIP code was associated with a 1.5% increase in the HIV prevalence rate in that location.

CONCLUSION

This study extends previous research by examining the relationship between alcohol outlets and HIV prevalence in a large sample of U.S. ZIP codes. Research is needed to more closely examine the mechanisms by which on-premise alcohol outlets may affect HIV transmission. Effective policies to reduce HIV transmission may include limiting the density of on-premise alcohol establishments.

Speech volume indexes sex differences in the social-emotional effects of alcohol

Men and women differ dramatically in their rates of alcohol use disorder (AUD), and researchers have long been interested in identifying mechanisms underlying male vulnerability to problem drinking. Surveys suggest that social processes underlie sex differences in drinking patterns, with men reporting greater social enhancement from alcohol than women, and all-male social drinking contexts being associated with particularly high rates of hazardous drinking. But experimental evidence for sex differences in social-emotional response to alcohol has heretofore been lacking. Research using larger sample sizes, a social context, and more sensitive measures of alcohol's rewarding effects may be necessary to better understand sex differences in the etiology of AUD. This study explored the acute effects of alcohol during social exchange on speech volume--an objective measure of social-emotional experience that was reliably captured at the group level. Social drinkers (360 male; 360 female) consumed alcohol (.82 g/kg males; .74 g/kg females), placebo, or a no-alcohol control beverage in groups of 3 over 36-min. Within each of the 3 beverage conditions, equal numbers of groups consisted of all males, all females, 2 females and 1 male, and 1 female and 2 males. Speech volume was monitored continuously throughout the drink period, and group volume emerged as a robust correlate of self-report and facial indexes of social reward. Notably, alcohol-related increases in group volume were observed selectively in all-male groups but not in groups containing any females. Results point to social enhancement as a promising direction for research exploring factors underlying sex differences in problem drinking.

Connection between drinking context choices and self-reported alcohol-related social harm: Results from the Finnish Drinking Habit Survey 2008

INTRODUCTION AND AIMS

Few general population studies have examined connections between harms and the social contexts where people drink. We examine how the dominant characteristics of respondents' latest drinking occasions are associated with self-reported alcohol-related harm and to what extent the associations function over and above the effects of drinking patterns.

DESIGN AND METHODS

We used a general population sample of Finns aged 15-69 years in 2008 (n = 2725, response rate 73.6%). Data from 2362 respondents detailed the characteristics of drinking occasions, such as circumstance, location, company and timing for 8713 recent drinking occasions. Harms analysed were aggressive behaviour (fights and arguments while drinking) and being asked to cut down on drinking by family members (informal control of drinking).

RESULTS

With drinking patterns held constant, fights and arguments were more common among men whose drinking occasions started early or were described as 'visits', and among women where occasions ended late or occurred in mixed-gender groups. Requests to cut down were less frequent among men drinking mostly in connection with sauna bathing and meals or in single-gender company and among women who mostly drank in licensed premises or at weekends. Requests to cut down were more common among women drinking mostly in the company of friends.

DISCUSSION AND CONCLUSIONS

Fights and arguments were associated with the timing of drinking occasions and some characteristics related to social interaction, while requests from family members to cut down were common when drinking extended beyond special occasions.

Experiences of forced sex among female patrons of alcohol-serving venues in a South African township

South Africa has among the highest rates of forced sex worldwide, and alcohol use has consistently been associated with risk of forced sex in South Africa. However, methodological challenges affect the accuracy of forced sex measurements. This study explored the assessment of forced sex among South African women attending alcohol-serving venues and identified factors associated with reporting recent forced sex. Women (n = 785) were recruited from 12 alcohol-serving venues in a peri-urban township in Cape Town. Brief self-administered surveys included questions about lifetime and recent experiences of forced sex. Surveys included a single question about forced sex and detailed questions about sex by physical force, threats, verbal persuasion, trickery, and spiked drinks. We first compared the single question about forced sex to a composite variable of forced sex as unwanted sex by physical force, threats, or spiked drinks. We then examined potential predictors of recent forced sex (demographics, drinking behavior, relationship to the venue, abuse experiences). The single question about forced sex had low sensitivity (0.38); more than half of the respondents who reported on the detailed questions that they had experienced forced sex by physical force, threats, or spiked drinks reported on the single question item that they had not experienced forced sex. Using our composite variable, 18.6% of women reported lifetime and 10.8% reported recent experiences of forced sex. In our adjusted logistic regression model, recent forced sex using the composite variable was significantly associated with hazardous drinking (OR = 1.92), living farther from the venue (OR = 1.81), recent intimate partner violence (OR = 2.53), and a history of childhood sexual abuse (OR = 4.35). The findings support the need for additional work to refine the assessment of forced sex. Efforts to prevent forced sex should target alcohol-serving venues, where norms and behaviors may present particular risks for women who frequent these settings.

Tridimensionality of alcohol use in Canada: Patterns of drinking, contexts and motivations to drink in the definition of Canadian drinking profiles according to gender

OBJECTIVES

The aim of this paper is to examine whether there is an underlying multidimensional typology of drinking according to gender among a population presenting heterogeneous drinking profiles in Canada.

METHODS

Latent class analysis was chosen to analyze the degree of statistical relationship among three indicators of drinking practices: patterns of drinking - i.e., frequency and quantity; contexts; and motivations to drink. Multivariate multilogistic regressions were conducted to explore the composition of each typology by age and education. Participants were selected from the Canadian GENACIS survey (Gender, Alcohol, and Culture: An International Study) and comprised 871 men and 843 women (N = 1,714) aged between 18 and 77 years and being regular alcohol drinkers (consumption at least once a month). Respondents to the GENACIS questionnaire completed questions on use, contexts and reasons to drink as well as socio-economic questions (age and education), adjusted by Canadian province of residence.

RESULTS

Six profiles were distinguished among men and five among women. Men and women share four drinking patterns but present distinctive characteristics of drinking. We also observed variability in the relationship according to socio-economic status and gender.

CONCLUSION

Our results confirmed the complexity and variability of drinking practices according to gender in Canada and the necessity to focus on gender and social dimensions in order to enhance our understanding of alcohol use. This study also reinforces the idea of adapting promotion strategies and interventions in public health by gender and social status in order to make them more efficient.

Alcohol and Emotional Contagion: An Examination of the Spreading of Smiles in Male and Female Drinking Groups

Researchers have hypothesized that men gain greater reward from alcohol than women. However, alcohol-administration studies testing participants drinking alone have offered weak support for this hypothesis. Research suggests that social processes may be implicated in gender differences in drinking patterns. We examined the impact of gender and alcohol on "emotional contagion"-a social mechanism central to bonding and cohesion. Social drinkers (360 male, 360 female) consumed alcohol, placebo, or control beverages in groups of three. Social interactions were video recorded, and both Duchenne and non-Duchenne smiling were continuously coded using the Facial Action Coding System. Results revealed that Duchenne smiling (but not non-Duchenne smiling) contagion correlated with self-reported reward and typical drinking patterns. Importantly, Duchenne smiles were significantly less "infectious" among sober male versus female groups, and alcohol eliminated these gender differences in smiling contagion. Findings identify new directions for research exploring social-reward processes in the etiology of alcohol problems.

A social-attributional analysis of alcohol response

Conventional wisdom and survey data indicate that alcohol is a social lubricant and is consumed for its social effects. In contrast, the experimental literature examining alcohol's effects within a social context reveals that alcohol does not consistently enhance social-emotional experience. We identify a methodological factor that might explain inconsistent alcohol-administration findings, distinguishing between studies featuring unscripted interactions among naïve participants (k = 18) and those featuring scripted social interactions with individuals identified as study confederates (k = 18). While 89% of naïve-participant studies find positive effects of alcohol on mood (d = 0.5), only 11% of confederate studies find evidence of significant alcohol-related mood enhancement (d = -0.01). The naïve-participant versus confederate distinction remains robust after controlling for various moderators including stress manipulations, gender, group size, anxiety outcome measure, and within-group consistency of beverage assignment. Based on the findings of our review, we propose a multidimensional, social-attributional framework for understanding alcohol-related reward. Borrowing organizing principles from attribution theory, the social-attributional approach predicts that alcohol will enhance mood when negative outcomes are perceived to be unstable and/or self-relevant. Our framework proposes that alcohol's effects within a social context are largely explained by its tendency to free individuals from preoccupation with social rejection, allowing them to access social rewards. The social-attributional approach represents a novel framework for integrating distinct, well-validated concepts derived from several theories of alcohol's effects. It further presents promising lines of inquiry for future research examining the role of social factors in alcohol reward and addiction susceptibility.

Does Drinking Location Matter? Profiles of Risky Single-Occasion Drinking by Location and Alcohol-Related Harm among Young Men

In adolescents and young adults, acute consequences like injuries account for a substantial proportion of alcohol-related harm, especially in risky single-occasion (RSO) drinkers. The primary aim of the study was to characterize different drinking profiles in RSO drinkers according to drinking locations and their relationship to negative, alcohol-related consequences. The sample consisted of 2746 young men from the Cohort Study on Substance Use Risk Factors who had reported drinking six or more drinks on a single-occasion at least monthly over the preceding 12 months. Principal component analysis on the frequency and amount of drinking at 11 different locations was conducted, and 2 distinguishable components emerged: a non-party-dimension (loading high on theater/cinema, sport clubs, other clubs/societies, restaurants, and sport events) and a party-dimension (loading high on someone else’s home, pubs/bars, discos/nightclubs, outdoor public places, special events, and home). Differential impacts of drinking location profiles were observed on severe negative alcohol-related consequences (SAC). Relative to those classified as low or intermediate in both dimensions, no significant difference experiencing SAC was found among those who were classified as high in the non-party-dimension only. However, those who were classified as high in the party-dimension alone or in both dimensions were more likely to experience SAC. These differential effects remained after adjusting for alcohol consumption (volume and risky single-occasion drinking), personality traits, and peer-influence [adjusted OR = 0.83 (0.68–1.02), 1.57 (1.27–1.96), and 1.72 (1.23–2.41), respectively], indicating independent effects of drinking location on SAC. The inclusion of sociodemographic factors did not alter this association. The fact that this cluster of party-dimension locations seems to predispose young men to experiencing SAC has important implications for alcohol control policies.

Drinking in social groups. Does 'groupdrink' provide safety in numbers when deciding about risk?

AIMS

To investigate the impact of alcohol consumption on risk decisions taken both individually and while part of a four- to six-person ad-hoc group.

DESIGN

A 2 (alcohol: consuming versus not consuming alcohol) × 2 (decision: individual, group) mixed-model design; decision was a repeated measure. The dependent variable was risk preference, measured using choice dilemmas.

SETTING

Opportunity sampling in campus bars and a music event at a campus-based university in the United Kingdom.

PARTICIPANTS

A total of 101 individuals were recruited from groups of four to six people who either were or were not consuming alcohol.

MEASUREMENTS

Participants privately opted for a level of risk in response to a choice dilemma and then, as a group, responded to a second choice dilemma. The choice dilemmas asked participants the level of accident risk at which they would recommend someone could drive while intoxicated.

FINDINGS

Five three-level multi-level models were specified in the software program HLM 7. Decisions made in groups were less risky than those made individually (B = -0.73, P < 0.001). Individual alcohol consumers opted for higher risk than non-consumers (B = 1.27, P = 0.025). A significant alcohol × decision interaction (B = -2.79, P = 0.001) showed that individual consumers privately opted for higher risk than non-consumers, whereas risk judgements made in groups of either consumers or non-consumers were lower. Decisions made by groups of consumers were less risky than those made by groups of non-consumers (B = 1.23, P < 0.001).

CONCLUSIONS

Moderate alcohol consumption appears to produce a propensity among individuals towards increased risk-taking in deciding to drive while intoxicated, which can be mitigated by group monitoring processes within small (four- to six-person) groups.