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)     

Personality and cognitive factors influencing substance use and sexual risk for HIV infection among gay and bisexual men.

Substance use reliably predicts sexual risk behavior, and sensation-seeking personality characteristics have been found to covary with these associations. In a study of 289 gay and bisexual men attending a large gay pride event, the authors examined the role of substance use sexual outcome expectancies in explaining associations between sensation seeking, substance use, and risky sex. Consistent with previous research, alcohol and other drugs were associated with sexual behavior. However, path analyses showed that sensation seeking accounted for variance in sexual behavior over and above substance use before sex and that sensation seeking predicted substance use expectancies that in turn predicted substance use before sex. It was concluded that altering substance use outcome expectancies may be an important strategy for HIV risk reduction for individuals high in sensation seeking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reducing sexual risk behaviors and alcohol use among HIV-positive men who have sex with men: A randomized clinical trial.

This randomized clinical trial (N = 253) evaluated the efficacy of a theory-based intervention designed to reduce both alcohol use and incidence of unprotected sexual behaviors among HIV-positive men who have sex with men with alcohol use disorders. An integrated, manualized intervention, using both individual counseling and peer group education/support, was compared with a control condition in which participants received resource referrals. The intervention was based on the transtheoretical model’s stages and processes of change, and motivational interviewing was used to enhance client readiness for change. Major findings include treatment effects for reduction in number of drinks per 30-day period, number of heavy drinking days per 30-day period, and number of days on which both heavy drinking and unprotected sex occurred. Practitioners employing this intervention may achieve enhanced client outcomes in reduction of both alcohol use and risky sexual behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

College student drinking and meaning in the pursuit of life goals.

The current study was designed to examine the association between risky alcohol use and life goals among college students. Introductory psychology students completed a questionnaire that included measures of typical life goals and alcohol use behavior. Students listed their 5 most typical life goals and rated them each on a series of dimensions from which 2 factors were derived (i.e., Goal Meaning, Goal Efficacy). Hierarchical regression analyses showed that the lower levels of goal meaning were associated with more heavy episodic use of alcohol and alcohol-related negative consequences. Results are consistent with motivational models of drinking that depict alcohol use as a function of satisfaction from other life goals. Findings support the importance of understanding college student drinking within the broader context of life goal appraisal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol use, expectancies, and sexual sensation seeking as correlates of HIV risk behavior in heterosexual young adults.

Most theoretical models of HIV risk behavior have not considered the role of personality factors, and few studies have examined mechanisms accounting for dispositional influences on sexual risk taking. This study elaborated on a conceptual model emphasizing sexual sensation seeking, alcohol expectancies, and drinking before sex as key predictors of HIV risk (S. C. Kalichman, L. Tannenbaum, & D. Nachimson, 1998). Multiple groups structural equation modeling was used to determine whether gender moderated relationships among these variables in a sample of 611 heterosexual, young adult drinkers (49% women, 76% Caucasian, mean age = 25 years). The model provided an excellent fit to the data, and gender differences were not substantiated. Sexual sensation seeking predicted HIV risk directly as well as indirectly via sex-related alcohol expectancies and drinking in sexual contexts. Findings suggest that expectancies and drinking before sex represent proximal mechanisms through which dispositional factors influence sexual risk outcomes. Moreover, these relationships appear to be similar in men and women. Interventions could benefit from targeting alcohol expectancies and drinking before sex in individuals with a dispositional tendency toward sexual risk taking. (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)     

A Prospective Study of Sensation Seeking and Alcohol Use as Predictors of Sexual Risk Behaviors Among Men and Women Receiving Sexually Transmitted Infection Clinic Services.

Sensation seeking, the propensity to seek optimal stimulation and engage in risk behaviors, correlates with alcohol expectancies, which are related to alcohol use in sexual situations, potentially increasing risks for sexually transmitted infections (STIs). In the current prospective study of 313 male and 140 female STI clinic patients, path analyses showed that sensation seeking predicted unprotected intercourse 6 months later. Sensation seeking also predicted alcohol outcome expectancies, which predicted alcohol use in sexual contexts 6 months later, which in turn predicted unprotected sex. Tests for mediation showed that alcohol expectancies accounted for the association between sensation seeking and alcohol use in sexual contexts. These findings replicate previous research, with the prospective design confirming directional hypotheses and supporting causal conclusions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Collegiate heavy drinking prospectively predicts change in sensation seeking and impulsivity.

Recent models of alcohol use in youth and young adulthood have incorporated personality change and maturation as causal factors underlying variability in developmental changes in heavy drinking. Whereas these models assume that personality affects alcohol use, the current prospective study tested the converse relation. That is, we tested whether, after accounting for the effect of traits on drinking, collegiate heavy drinking in turn predicted individual differences in change in alcohol-related aspects of personality. We also examined whether affiliation with heavy-drinking peers better accounted for this relation. Following a cohort of recent high school graduates (N = 1,434) through the college years, we found evidence for transactional relations between heavy drinking and changes in impulsivity and sensation seeking. Both traits predicted increases in heavy drinking, but more important, heavy drinking predicted increases in sensation seeking and impulsivity. In final models, social influences did not underlie the effect of heavy drinking on increases in sensation seeking and impulsivity. The results of this investigation suggest that collegiate heavy drinking may negatively and pervasively impact a wide range of behaviors because of its effect on personality change. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Role of impulsivity in the relationship between depression and alcohol problems among emerging adult college drinkers.

Depression is common among college students and higher levels of depression are associated with greater alcohol-related problems. However, depression is frequently not found to be directly associated with more alcohol use. This study examined whether various aspects of impulsivity (negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and delay discounting) and drinking to cope with negative affect help to account for the relationship between depression and alcohol problems among emerging adult college drinkers who reported at least a minimal level of depressive symptoms. In this cross-sectional study, 143 emerging adult (between 18 and 25 years old) female (69.9%, n = 100) and male (30.1%, n = 43) college drinkers with at least minimal depressive symptoms completed measures of depression, alcohol use and problems, drinking to cope, and impulsivity. A multiple mediation analysis revealed that only negative urgency and drinking to cope partially mediated the depression-alcohol problems relationship. Moderated mediation analyses revealed that impulsivity-related constructs did not significantly interact with drinking to cope to increase alcohol problems. It appears that alcohol use is particularly problematic for students with elevated depression, and this is partly attributable to depression's association with negative urgency, in addition to its association with drinking to cope. Our findings suggest that students who suffer from depression may engage in problematic drinking behavior in part because negative affect is detrimental to their short-term impulse control and decision making, independent of maladaptive attempts to regulate affect through drinking to cope. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Alcohol and sexual risk behaviors as mediators of the sexual victimization–revictimization relationship.

Objective: Women who experience sexual victimization, whether in childhood, adolescence, or adulthood, are at elevated risk of sexual revictimization. The mechanism responsible for this robust association is unclear, however. The present study proposed and tested a prospective, mediated model that posited that the association between adolescent and college victimization is mediated via 2 types of risk exposure in the first semester of college: alcohol-related and sexual risk behaviors. Method: Female adolescents (N = 469) were recruited from the community at the time of high school graduation. They completed baseline assessments as well as follow-ups at the end of the first and second semesters of college. Results: Consistent with hypotheses, adolescent sexual victimization was associated indirectly, via high school risk behaviors, with increased first-semester college risk behaviors (i.e., sexual partners, hookups, heavy episodic drinking, and heavy drinking contexts), which were, in turn, strongly predictive of sexual victimization experiences in the first year of college. College risk behaviors partially mediated the significant association between adolescent and first-year college victimization; however, even women without prior victimization faced elevated risk of college victimization with higher levels of college risk behaviors. Conclusions: Women who have experienced adolescent sexual victimization engage in higher levels of risk taking in college, thereby increasing vulnerability to college victimization. Intervention to reduce these primarily alcohol-related risk-taking behaviors may reduce vulnerability to college sexual victimization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influences of sexual sensation seeking, alcohol consumption, and sexual arousal on women's behavioral intentions related to having unprotected sex.

This experimental study examined effects of alcohol consumption and sexual sensation seeking on unprotected sex intentions, taking into account sexual arousal, indirectly discouraging sex, and condom insistence. Women (N = 173; mean age = 25.02) were randomly assigned to a control, placebo, low-dose beverage (target blood alcohol level = .04), or high- dose beverage (target blood alcohol level = .08) condition. Participants projected themselves into a hypothetical sexual interaction with a man in which no condom was available. Structural equation modeling demonstrated that both sexual sensation seeking and alcohol dose directly increased sexual arousal early in the interaction, but later sexual arousal indirectly increased unprotected sex intentions by decreasing endorsement of indirect discouragement and, in turn, condom insistence. These findings help to clarify the role of alcohol consumption and sensation seeking in women's sexual decision making and point to the importance of examining it as a multistage process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospective associations among alcohol use-related sexual enhancement expectancies, sex after alcohol use, and casual sex.

Higher levels of alcohol use have consistently been related to higher rates of sexual risk taking; however, it is not clear whether this relationship is causal. This study examined the concurrent and predictive associations among alcohol use-related sexual enhancement expectancies, drinking alcohol before engaging in sex, and casual sex during the transition into emerging adulthood and whether these associations differed for men and women. Data came from 590 men and women who were interviewed 3 times at 6-month intervals after high school. Growth curve analyses indicated that alcohol-related sexual enhancement expectancies were related to casual sex indirectly through drinking before sex but did not predict change in either of these behaviors. However, increases in drinking before sex predicted increases in casual sex over time. The findings provide some support for prevention programs that focus on alcohol-related sexual expectancies to reduce sexually transmitted illnesses among emerging adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical relevance of heavy drinking during the college years: Cross-sectional and prospective perspectives.

This study investigated the clinical relevance of heavy drinking during the college years and beyond on concurrent and prospective alcohol-related problems in a high-risk sample (N?=?377). Measures of heavy drinking and alcohol-related problems were significantly correlated cross-sectionally over the study frame, regardless of how these constructs were operationalized. However, the magnitude of the association between heavy drinking and alcohol-related problems declined substantially over time, with the most pronounced decrease following the college years. Despite this cross-sectional decrease in the association between heavy drinking and alcohol-related problems over time, heavy drinking during the college years significantly and substantially predicted alcohol-use disorders up to 10 years later. Implications for assessment of heavy drinking as well as prevention of problematic alcohol use in college students are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of drink price and next-day responsibilities on college student drinking: A behavioral economic analysis.

More than [3/4] of U.S. college students report a heavy drinking episode (HDE; 5 (for men) and 4 (for women) drinks during an occasion) in the previous 90 days. This pattern of drinking is associated with various risks and social problems for both the heavy drinkers and the larger college community. According to behavioral economics, college student drinking is a contextually bound phenomenon that is impacted by contingencies such as price and competing alternative reinforcers, including next-day responsibilities such as college classes. This study systematically examines the role of these variables by using hypothetical alcohol purchase tasks to analyze alcohol consumption and expenditures among college students who reported recent heavy drinking (N = 207, 53.1% women). The impact of gender and the personality risk factor sensation seeking (SS) were also assessed. Students were asked how many drinks they would purchase and consume across 17 drink prices and 3 next-day responsibility scenarios. Mean levels of hypothetical consumption were highly sensitive to both drink price and next-day responsibility, with the lowest drinking levels associated with high drink prices and a next-day test. Men and participants with greater levels of SS reported more demand overall (greater consumption and expenditures) than women and students with low SS personality. Contrary to our hypotheses women appeared to be less sensitive to increases in price than men. The results suggest that increasing drink prices and morning academic requirements may be useful in preventing heavy drinking among college students. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Standardized measures of alcohol-related problems: A review of their use among college students.

College students' alcohol consumption has received considerable attention in the scientific literature and the media for its impact on students and the college community. Misuse of alcohol can lead to a wide range of consequences, the most severe being alcohol abuse, dependence, and death. Researchers have struggled to develop effective methods to assess problems related to alcohol, and the literature on college drinking lacks a strong theoretical framework for such assessment. The authors contend that measures of alcohol-related problems for college students should assess specific dimensions pertaining to 3 main domains: alcohol abuse, alcohol dependence, and what the authors define as risky drinking. The authors examined how existing measures fit into this model. In a comprehensive review of the college literature, the authors identified 9 measures (and their revised versions) assessing alcohol-related problems. Their analysis revealed that most measures do not assess comprehensively the domains outlined, and instead provide only partial assessments of the potential consequences of drinking for college students. The authors include directions for future research so that measurement of drinking consequences for college students can be refined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential utility of three indexes of risky drinking for predicting alcohol problems in college students.

This study evaluated the relationship between alcohol-related problems and 3 indexes of risky drinking in college student drinkers: number of drinks consumed per week, frequency of binge drinking, and estimated blood alcohol levels (BALs). Use of 2 independent samples (N??=?204, N??=?181) allowed a cross-validation of obtained associations. Results indicated that neither binge drinking frequency nor BAL were more highly related to alcohol-related problems than was weekly drinking. Furthermore, BAL did not provide unique explanatory power in accounting for alcohol-related problems; mixed results were obtained regarding the relationship of binge drinking estimates with problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sensation seeking, alcohol use, and sexual behaviors among sexually transmitted infection clinic patients in Cape Town, South Africa.

Alcohol use is associated with risks for HIV/AIDS. The association between alcohol and sexual risk may be accounted for by sensation seeking personality. However, sensation seeking in relation to substance use and HIV risk has not been examined in Africa. In this study, 292 men and 219 women receiving sexually transmitted infection (STI) diagnostic and treatment services in Cape Town, South Africa, completed anonymous behavioral surveys. Structural modeling was used to test a model of alcohol use and sensation seeking in relation to sexual risk behaviors. Results showed that sensation seeking and alcohol use in sexual contexts were related to HIV risks, controlling for gender and marital status. The association between sensation seeking and HIV risk was partly accounted for by alcohol use in proximity to sex. In contrast to studies conducted in the United States, sensation seeking was not related to alcohol-sex outcome expectancies. These findings suggest that alcohol use is an important HIV transmission risk factor for many STI clinic patients and that interventions for individuals who are characterized as sensation seekers are urgently needed in South Africa. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Up Close and Personal: Temporal Variability in the Drinking of Individual College Students During Their First Year.

Surveys have documented excessive drinking among college students and tracked annual changes in consumption over time. This study extended previous work by examining drinking changes during the freshman year, using latent growth curve (LGC) analysis to model individual change, and relating risk factors for heavy drinking to growth factors in the model. Retrospective monthly assessments of daily drinking were used to generate weekly estimates. Drinking varied considerably by week, apparently as a function of academic requirements and holidays. A 4-factor LGC model adequately fit the data. In univariate analyses, gender, race/ethnicity, alcohol expectancies, sensation seeking, residence, and data completeness predicted growth factors (ps     

The role of sexual arousal and sexual partner characteristics in HIV+ MSM's intentions to engage in unprotected sexual intercourse.

Objective: This study investigated the effects of sexual arousal and sexual partner characteristics as determinants of HIV+ men who have sex with men's (MSM) intentions to engage in unprotected sex. Design: In a computer-based controlled experiment, 67 HIV+ MSM underwent a sexual arousal manipulation and indicated their intentions to engage in unprotected sex with hypothetical partners who differed in terms of HIV serostatus, physical attractiveness, relationship type, and preference for condom use. Main Outcome Measures: Computer-delivered questions assessed HIV+ MSM's intentions to engage in various sexual acts with each hypothetical partner. Results: As predicted, sexually aroused HIV+ MSM indicated stronger intentions to engage in unprotected sex than nonaroused HIV+ MSM; and having a partner who was attractive, HIV+, long term, or who preferred not to use condoms, also led to riskier intentions. Several significant interactions among these factors were found, which were generally consistent with predictions and with theory and research on cognitive processing and decision making. Conclusions: These findings have implications for understanding risky sexual behavior among HIV+ individuals and for the development of interventions to reduce this risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Thinking about drinking: Need for cognition and readiness to change moderate the effects of brief alcohol interventions.

Research has demonstrated the efficacy of brief motivational interventions (BMI) and alcohol expectancy challenge (AEC) in reducing alcohol use and/or problems among college students. However, little is known about variables that may qualify the effectiveness of these approaches. The present analyses tested the hypothesis that need for cognition (NFC), impulsivity/sensation seeking (IMPSS) and readiness to change (RTC) would moderate the effects of BMI and AEC. Participants (N = 335) were heavy drinking college students enrolled in a randomized 2 × 2 factorial study of BMI and AEC. Latent growth curve analyses indicated significant interactions for BMI × NFC and AEC × RTC on alcohol use but not problems. Simple slopes analyses were used to probe these relationships and revealed that higher levels of NFC at baseline were associated with a stronger BMI effect on drinking outcomes over time. Similarly, higher levels of baseline RTC were associated with stronger AEC effects on alcohol use. Future preventive interventions with this population may profit by considering individual differences and targeting approaches accordingly. (PsycINFO Database Record (c) 2010 APA, all rights reserved)