Use of drinking protective behavioral strategies in association to sex-related alcohol negative consequences: The mediating role of alcohol consumption.

Alcohol use has been implicated as a risk factor for sexual negative consequences, such as unprotected sexual intercourse. The present research was conducted to examine the relationship between drinking protective behavioral strategies and consensual sex-related alcohol negative consequences, and whether this relationship varied by gender. Additionally, typical number of drinks during sexual behavior was evaluated as a potential mediator of this association. Heavy drinking, sexually active college students (N = 297, 50.2% women) completed self-report measures of drinking protective behavioral strategies, alcohol consumption, and sex-related alcohol negative consequences. Findings indicated that women who used drinking protective behavioral strategies more frequently were less likely to experience sex-related alcohol negative consequences whereas this relationship was not significant for men. For women, this relationship was mediated by the typical number of drinks consumed during sexual behavior. The current research demonstrates that use of drinking protective behavioral strategies is related to a reduction in women's sex-related risks when drinking. Findings are discussed in terms of alcohol myopia theory. Implications for interventions aimed to reduce higher risk sexual behavior among college students are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Decision making in altered states: Effects of alcohol on attitudes toward drinking and driving.

A laboratory experiment and 2 field studies tested the hypothesis that alcohol affects attitudes and intentions toward drinking and driving. Sober and intoxicated participants completed a questionnaire assessing their attitudes and intentions to drink and drive in a number of situations. Results indicated that when asked general or noncontingent questions, sober and intoxicated participants were equally negative about this behavior. However, when a contingency was embedded in the question (e.g., "would you drink and drive only a short distance?"), intoxicated participants were significantly less negative about drinking and driving. These results are consistent with alcohol myopia (C. M. Steele & R. A. Josephs, 1990)—the notion that alcohol intoxication decreases cognitive capacity so that people are more likely to attend to only the most salient cues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Condom use with a casual partner: What distinguishes college students' use when intoxicated?

Determining alcohol's precise role in sexual risk taking has proven to be an elusive goal. Past research has produced mixed results, depending on characteristics of individuals, their partners, and the situation, as well as how the link between alcohol consumption and sexual behavior was assessed. In this study, cross-sectional predictors of the frequency of condom use were examined for 298 heterosexual college students at a large urban university. In hierarchical multiple regression analyses that controlled for frequency of condom use when sober, alcohol expectancies regarding sexual risk taking and self-efficacy regarding condom use when intoxicated were significant predictors of frequency of condom use when intoxicated. These findings highlight the importance of targeting beliefs about alcohol's disinhibiting effects in STD- and HIV-prevention programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Protective behavioral strategies and the relationship between depressive symptoms and alcohol-related negative consequences among college students.

Approximately 40% of college students reported engaging in heavy episodic or "binge" drinking in the 2 weeks prior to being surveyed. Research indicates that college students suffering from depression are more likely to report experiencing negative consequences related to their drinking than other students are. The reasons for this relationship have not been well-studied. Hence, the purpose of this study was to determine whether use of protective behavioral strategies (PBS), defined as cognitive-behavioral strategies an individual can use when drinking alcohol that limit both consumption and alcohol-related problems, mediated the relationship between depressive symptoms and alcohol-related negative consequences among college students. Data were obtained from 686 participants from a large, public university who were referred to an alcohol intervention as a result of violating on-campus alcohol policies. Results from structural equation modeling analyses indicated that use of PBS partially mediated the relationship between depressive symptoms and alcohol-related negative consequences. Implications for clinicians treating college students who report experiencing depressive symptoms or consuming alcohol are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Analysis of item response and differential item functioning of alcohol expectancies in middle school youths.

Drinking behavior in preadolescence is a significant predictor of both short- and long-term negative consequences. This study examined the psychometric properties of 1 known risk factor for drinking in this age group, alcohol expectancies, within an item response theory framework. In a sample of middle school youths (N = 1,273), the authors tested differential item functioning (DIF) in positive and negative alcohol expectancies across grade, gender, and ethnicity. Multiple-indicator multiple-cause model analyses tested differences in alcohol use as a potential explanation for observed DIF across groups. Results showed that most expectancy items did not exhibit DIF. For items where DIF was indicated, differences in alcohol use did not explain differences in item parameters. Positive and negative expectancies also systematically differed in the location parameter. Latent variable scale scores of both positive and negative expectancies were associated with drinking behavior cross-sectionally, while only positive expectancies predicted drinking prospectively. Improving the measurement of alcohol expectancies can help researchers better assess this important risk factor for drinking in this population, particularly the identification of those with either very high positive or very low negative alcohol expectancies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining the associations among severity of injunctive drinking norms, alcohol consumption, and alcohol-related negative consequences: The moderating roles of alcohol consumption and identity.

This study examined a range of injunctive norms for alcohol use and related consequences from less severe behaviors (e.g., drinking with friends) to more severe behaviors (e.g., drinking enough alcohol to pass out), and their relationship with alcohol consumption and alcohol-related negative consequences among college students. In addition, this research aimed to determine whether these relationships between injunctive norms and consequences were moderated by alcohol consumption and level of identification with the typical same-gender college student. A random sample (N = 1,002) of undergraduates (56.9% women) completed a Web-based survey that was comprised of measures of drinking behavior, perceived approval of drinking behaviors that ranged in severity (i.e., injunctive norms), and level of identification with the typical same-gender college student. Results suggest that the association between negative consequences and injunctive drinking norms depend on one's own drinking behavior, identification with other students, and the severity of the alcohol use and related consequences for which injunctive norms are assessed. Findings are discussed in terms of false consensus and false uniqueness effects, and deviance regulation perspectives. Implications for preventive interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol myopia and condom use: Can alcohol intoxication be associated with more prudent behavior?

We tested 2 competing theories about the effects of alcohol on intentions to engage in risky behavior. Disinhibition predicts that intoxicated people will exhibit risky behavior regardless of environmental cues, whereas alcohol myopia (C. M. Steele & R. A. Josephs, 1990) predicts that intoxicated people will be more or less likely to exhibit risky behavior, depending on the cues provided. In 4 studies, we found an interaction between intoxication and cue type. When impelling cues were present, intoxicated people reported greater intentions to have unprotected sex than did sober people. When subtle inhibiting cues were present, intoxicated and sober people reported equally cautious intentions (Studies 1-3). When strong inhibiting cues were present, intoxicated people reported more prudent intentions than did sober people (Study 4). We suggest that alcohol myopia provides a more comprehensive account of the effects of alcohol than does disinhibition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Short-term neuropsychological outcome following uncomplicated mild TBI: Effects of day-of-injury intoxication and pre-injury alcohol abuse.

Research suggests that individuals who are intoxicated at the time of traumatic brain injury (TBI) have worse cognitive outcome compared with those who are sober. Worse outcome in patients with day-of-injury intoxication might (a) be related to the increased magnitude of brain injury resulting from a variety of negative responses not present following TBI in nonintoxicated individuals, or (b) reflect the effect of pre-injury alcohol abuse that is prevalent in individuals intoxicated at the time of injury. Most studies in this area have focused on patients with moderate to severe TBIs, and on medium- to long-term neuropsychological outcome. The purpose of this study was to examine the relative contributions of day-of-injury intoxication versus pre-injury alcohol abuse on short-term cognitive recovery following mild TBI. Participants were 169 patients with uncomplicated mild TBIs who were assessed on 13 cognitive measures within 7 days postinjury. The prevalence of intoxication at the time of injury was 54.4%. The prevalence of possible pre-injury alcohol abuse was 46.2%. Overall, the results suggest that pre-injury alcohol abuse, compared with day-of-injury alcohol intoxication, had the most influence on short-term neuropsychological outcome from uncomplicated mild TBI. However, the influence of pre-injury alcohol abuse was considered small at best. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intoxicated behavioral disinhibition and the heart rate response to alcohol.

This study examined the association between the heart rate (HR) response to alcohol intoxication, which is thought to reflect sensitivity to alcohol-induced reward and alcohol-induced behavioral disinhibition. High- and low-HR responders to alcohol participated in a go/no-go task, under sober and intoxicated conditions. Errors of commission on this task have previously been related to behavioral disinhibition. High-HR responders made more intoxicated commission errors as compared with low-HR responders. High-HR responders also reported increased alcohol consumption, and controlling for the latter did not alter the significant association between high-HR responders and increased intoxicated errors of commission. These results are consistent with previous findings of an increased risk for addictive and disinhibited behavioral propensities in individuals with a high-HR response to alcohol intoxication. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The link between alcohol use and aggression toward sexual minorities: An event-based analysis.

The current study used an event-based assessment approach to examine the day-to-day relationship between heterosexual men's alcohol consumption and perpetration of aggression toward sexual minorities. Participants were 199 heterosexual drinking men between the ages of 18–30 who completed (1) separate timeline followback interviews to assess alcohol use and aggression toward sexual minorities during the past year, and (2) written self-report measures of risk factors for aggression toward sexual minorities. Results indicated that aggression toward sexual minorities was twice as likely on a day when drinking was reported than on nondrinking days, with over 80% of alcohol-related aggressive acts perpetrated within the group context. Patterns of alcohol use (i.e., number of drinking days, mean drinks per drinking day, number of heavy drinking days) were not associated with perpetration after controlling for demographic variables and pertinent risk factors. Results suggest that it is the acute effects of alcohol, and not men's patterns of alcohol consumption, that facilitate aggression toward sexual minorities. More importantly, these data are the first to support an event-based link between alcohol use and aggression toward sexual minorities (or any minority group), and provide the impetus for future research to examine risk factors and mechanisms for intoxicated aggression toward sexual minorities and other stigmatized groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The social norms of alcohol-related negative consequences.

Social norms for alcohol use are important influences on individual college student drinking. The present study extends social norms research by examining alcohol-related consequences and, in particular, whether similar misperceptions exist regarding the frequency and evaluation of these consequences over time. College student drinkers (N = 624) participating in a longitudinal study completed Web-based surveys assessing alcohol use and related consequences, as well as their beliefs about frequency and evaluation of consequences for the typical college student. Findings suggest that students overestimated how often typical college students experience negative consequences and underestimated how negatively other students evaluated those consequences. Finally, results support a bidirectional model for alcohol-related consequences, possibly indicating a reciprocal, mutually influential feed-forward loop of norms and consequences that promotes maintenance of college student drinking and consequences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The subjective effects of alcohol–tobacco co-use: An ecological momentary assessment investigation.

Alcohol and tobacco use covary at multiple levels of analysis, and co-use of the 2 substances may have profound health consequences. To characterize the motivationally relevant processes contributing to co-use, the current study used ecological momentary assessment (EMA) to examine the subjective consequences of naturally occurring simultaneous use of alcohol and tobacco. Current smokers who reported frequently drinking alcohol (N = 259) used electronic diaries to monitor their daily experiences for 21 days. Participants responded to prompted assessments and also initiated recordings when they smoked a cigarette or completed the first drink in a drinking episode. Momentary reports of smoking and alcohol consumption were associated with one another, and these effects remained after adjustment for occasion- and person-level covariates. When participants consumed alcohol, they reported increased pleasure and decreased punishment from the last cigarette. Smoking was associated with small increases in pleasure from the last drink. Ratings of buzzed and dizzy were synergistically affected by co-use of alcohol and tobacco. Co-use was also followed by higher levels of craving for both alcohol and tobacco. Results point to the importance of reward and incentive processes in ongoing drug use and suggest that alcohol intensifies real-time reports of the motivational consequences of smoking more strongly than smoking affects corresponding appraisals of alcohol effects. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

21st birthday celebratory drinking: Evaluation of a personalized normative feedback card intervention.

This research was designed to evaluate a personalized normative feedback birthday card intervention aimed at reducing normative perceptions, alcohol consumption, and negative consequences associated with 21st birthday celebrations among college students (N=281; 59.15% women). Students were randomly assigned to receive or not receive a birthday card about 1 week prior to their 21st birthday. Approximately 1 week following their birthday, students were asked to complete a brief survey concerning their birthday celebration activities. Findings indicated that the birthday card intervention was not successful at reducing drinking or consequences; however, the card did reduce normative misperceptions. Additional findings indicated that many students experienced negative consequences, such as passing out or driving after consuming alcohol. Combined, these findings suggest that prevention is needed for drinking associated with turning 21. However, prevention efforts should consist of more than a birthday card. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive and negative associations with alcohol and familial risk for alcoholism.

Considerable evidence indicates that cognitions regarding favorable drinking consequences figure prominently in the development of problem drinking. Because children of alcoholics (COAs) are at particularly high risk for developing drinking problems, the authors hypothesized that they would have higher levels of such cognitions than children of nonalcoholics (CONAs). The authors administered a free-recall task consisting of alcohol, positive, negative, and neutral words to 100 college students and predicted that COAs (n?=?18) would have higher levels of positive associations (measured by contiguous recall) and lower levels of negative associations with alcohol than would CONAs (n?=?82). The results indicated that although COAs had significantly fewer negative associations than CONAs they had statistically comparable levels of positive associations. Early intervention efforts among COAs may be enhanced by placing increased emphasis on alcohol's negative consequences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acute ethanol intoxication increases the risk of infection following penetrating abdominal trauma

Acute alcohol (ETOH) intoxication as a risk factor for infection in trauma victims to our knowledge has not been previously reported. To determine if ETOH intoxication increases infection risk we examined data from 365 patients with penetrating abdominal trauma who were enrolled in a multi-center antibiotic study. Ninety-four patients sustained an injury to a hollow viscus. To separate acute from chronic ETOH effects, infections were divided into two categories: (1) trauma related; infections caused by bacterial contamination at the time of injury, while blood alcohol level (BAL) was elevated. (2) nosocomial; infections caused by bacteria acquired during hospital stay, after BAL had normalized. A BAL > or = 200 mg/dL was associated with a 2.6-fold increase in trauma-related infections. There was no association between BAL and subsequent nosocomial infection. Since infection rates for intoxicated patients were not higher after BAL had normalized, acute rather than chronic effects of ETOH appear to be responsible.     

Fitting in and feeling fine: Conformity and coping motives as mediators of the relationship between social anxiety and problematic drinking.

The present research was conducted to clarify the relationships among social anxiety, alcohol consumption, alcohol-related problems, and negative-reinforcement drinking motives among college students. Heavy drinking students (N = 316, 53.80% female) completed self-report measures of social anxiety, alcohol consumption, alcohol-related problems, and drinking motives. Findings indicated that students higher in social anxiety consumed less alcohol but experienced more negative consequences. Moreover, the relationship between social anxiety and negative consequences was mediated by coping and conformity drinking motives in addition to alcohol consumption. In the context of social anxiety, the current research demonstrates the importance of examining problematic drinking as distinct constructs: alcohol consumption and negative consequences. Findings are also discussed in terms of implications for interventions with socially anxious students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An event-based analysis of aggression women experience in bars.

The environmental and social circumstances in bars are likely to contribute to an individual's risk for becoming a victim. The present study was designed to assess differences that exist in these circumstances between times when aggression does and does not occur in bars. Participants were a subsample of 46 women who had previously participated in a larger survey of female bar drinkers. Using daily logs and biweekly interviews over 12 weeks, the author assessed the drinking patterns and aggressive experiences of these women. At times when aggression occurred women spent less time in the bar, consumed more alcohol, and reported feeling more intoxicated. Differences were found between sexual and nonsexual incidents and among the women on the basis of the type of aggression they had experienced. Women who experienced both sexual and nonsexual aggression reported using other drugs in addition to alcohol when drinking in bars. These findings and their implications for prevention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Driving after use of alcohol and marijuana in college students.

Driving after use of marijuana is almost as common as driving after use of alcohol in youth (P. M. O'Malley & L. D. Johnston, 2003). The authors compared college students' attitudes, normative beliefs and perceived negative consequences of driving after use of either alcohol or marijuana and tested these cognitive factors as risk factors for substance-related driving. Results indicated that youth perceived driving after marijuana use as more acceptable to peers and the negative consequences as less likely than driving after alcohol use, even after controlling for substance use. Results of zero-inflated Poisson regression analyses indicated that lower perceived dangerousness and greater perceived peer acceptance were associated with increased engagement in, and frequency of, driving after use of either substance. Lower perceived likelihood of negative consequences was associated with increased frequency for those who engage in substance-related driving. These results provide a basis for comparing how youth perceive driving after use of alcohol and marijuana, as well as similarities in the risk factors for driving after use of these substances. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol and social behavior: I. The psychology of drunken excess.

Conducted a meta-analysis of 34 studies of tests of alcohol's effect on a social behavior to test the hypothesis that alcohol impairment makes a social response more extreme or excessive when the response is pressured by both inhibiting and instigating cues (when it is under inhibitory response conflict). Each test was rated (validated against independent judges) as to whether it was under high or low inhibitory conflict. Results show that over low-conflict tests, intoxicated Ss behaved only a tenth of a standard deviation more extremely than their sober controls, while over high-conflict tests intoxicated Ss were a full standard deviation more extreme. The effect of conflict increased with alcohol dosage, was not mediated by drinking expectancies, and generalized (with few exceptions) across the 34 studies and 12 social behaviors included in the analysis. Studies included in the meta-analysis and rules for coding inhibitory response conflict are appended. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol, sexual arousal, and intentions to use condoms in young men: Applying alcohol myopia theory to risky sexual behavior.

Data from 7 studies were aggregated to examine how reported sexual arousal and alcohol intoxication interact to affect attitudes and intentions toward engaging in unprotected sexual intercourse in college-age men (N?=?358). When participants were in a sober or placebo condition, their self-reports of sexual arousal had no effect on their responses. When participants were intoxicated, however, those who felt sexually aroused reported more favorable attitudes, thoughts, and intentions toward having unprotected sex than did those who did not feel aroused. These findings support alcohol myopia theory (C. A Steele & R. A. Josephs, 1990), which states that alcohol intoxication restricts attentional capacity so that people are highly influenced by the most salient cues in their environment. It is suggested that sexual arousal is a powerful internal cue that interacts with alcohol intoxication to enhance attitudes and intentions toward risky sexual behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)