April/May 2002 Article 1 Article 2

Binge Drinking Among Underage College Students: A Test of a Restraint-based Conceptualization of Risk for Alcohol Abuse R. Lorraine Collins, Ph.D., James R. Koutsky, M.A., and Elizabeth T. Morsheimer, Ed.M. Research Institute on Addictions, University at Buffalo, The State University of New York Michael G. MacLean, Ph.D. Department of Psychology, Buffalo State College, The State University of New York Abstracted from the Psychology of Addictive Behaviors, 15, 333-340, 2001. Researchers tested a model of binge drinking based on previous studies examining drinking restraint. The model suggests that underage drinkers have competing and alternating urges to be attracted to alcohol and to regulate excessive alcohol use. Underage (18- to 20-year-olds, 204 men and 225 women) college student drinkers completed measures that assessed the attraction to alcohol (e.g., temptation to drink, alcohol expectancies), concern about regulating alcohol intake (e.g. restriction of alcohol intake, reasons for limiting drinking), and alcohol-related outcomes (binge drinking, alcohol problems). The lead investigator on the project was R. Lorraine Collins, a senior scientist at RIA who has been examining drinking restraint (i.e., the preoccupation with controlling alcohol intake) as a risk factor for misuse of alcohol and development of alcohol problems. Drinking Restraint as a Model of Binge Drinking Binge drinking, or the consumption of five or more drinks on one occasion, gained national attention as a problem on college campuses in the 1990s. Most research on college drinking focuses on the factors that make drinking appealing or attractive. The drinking-restraint model acknowledges the impact of an individual’s attraction to alcohol, but in conjunction with their need to control or regulate how much alcohol they drink. The model further states that when an individual’s attempts to regulate alcohol consumption fail (i.e., the person drinks heavily when they tried not to), negative emotions are experienced (e.g., depression). This model also suggests that the individual subsequently drinks more alcohol to repair their negative mood. Over time this cycle of attraction, failed regulation and continued drinking contributes to the risk of alcohol abuse. This study tested whether underage drinkers’ alcohol consumption could be explained by the competing tendencies of being attracted to alcohol while also being concerned about regulating drinking. Among underage drinkers, attraction to alcohol may result from positive beliefs about the effects of drinking (e.g., alcohol facilitates social interaction), positive motives for drinking (e.g., alcohol improves mood), or being unable to stop thinking about drinking. Attempts at regulation of drinking behaviors may result from a variety of reasons — legal sanctions against its use, alcohol-related violence or victimization, poor grades, even arrest for DWI — particularly for those who have previously experience these negative consequences. The Survey The investigators were interested in learning to what extent binge drinking and the experience of negative consequences of alcohol use could be explained by (a) attraction to alcohol, and (b) interest in regulating alcohol use. To this end, participants were asked about their daily alcohol use for the previous four weeks, as well as their experience of negative drinking-related consequences over the past three years. Participants answered questions regarding their attraction to alcohol and their concern about regulating alcohol use. Included among the attraction to alcohol items were reasons for drinking, beliefs about the effects of alcohol, and preoccupation with alcohol. Included among the regulating alcohol use items were reasons for limiting drinking, self-control strategies used for regulating alcohol use (e.g., avoid playing drinking games), negative physical or mood changes related to drinking, and efforts to restrict and control alcohol use. Results Underage college student drinkers were found to be grappling with the competing tendencies of being attracted to alcohol while engaging in efforts to regulate the amount they drink. Both attraction to alcohol and efforts to regulate drinking predicted the number of binge drinking days and the occurrence of alcohol problems. Consistent with previous research, these data suggest that binge drinking by underage college students occurs because they are preoccupied with alcohol, have the expectation that alcohol produces positive effects, and see drinking as enhancing positive experiences. However, attempts to regulate drinking also predicted the number of days binge drinking occurred. Consistent with the restraint model, the failure to use self-control strategies was associated with a higher number of binge drinking days, whereas the use of self-control strategies was associated with alcohol problems. It is possible that these efforts to regulate their drinking were not effectively implemented. Although these drinkers reported having reasons for limiting drinking and engaging in some self-control behaviors, they still reported experiencing problems. Thus, problems increased as a function of being highly attracted to alcohol, even when reasons for regulating alcohol intake were acknowledged and some attempts to lessen drinking were made. Of interest, awareness of physical and mood changes were positively related to alcohol problems. This may be due, in part, to the positive impact physical sensations of impairment have for young adult drinkers who consume alcohol to “get drunk.” Finally, although gender and depression played negligible roles in the number of binge drinking days, they were significantly related to alcohol problems. Specifically, males, and more depressed participants regardless of gender, reported experiencing an increased number of alcohol problems. Implications for Binge Drinking Prevention Underage college-student drinkers often have to cope with negative feelings, want to feel good, and are encouraged by peers to use large quantities of alcohol. Clearly, there are many forces in a young person’s life that make alcohol use attractive, and binge drinking (and its associated problems) a possibility. However, these findings suggest that there also are other forces at play in students’ lives that may help them to control the amount of alcohol consumed. Programs geared to prevent or intervene with binge drinking in this population should consider both aspects of the restraint cycle (being attracted to alcohol and being concerned about regulating drinking). Traditionally, such programs only have focused on reducing college students’ attraction (e.g., education about negative consequences) or access (e.g., inception of “dry” campuses) to alcohol. These findings suggest the need to go further in order to help those underage drinkers who are interested in regulating their drinking. Programs that combine reducing underage drinkers’ attraction to alcohol with training in the skills needed to regulate alcohol use might lessen the levels of binge drinking and alcohol problems on college campuses. Future Research In an ongoing study, underage drinkers are using handheld computers to provide multiple daily reports of their cognitive and affective state and social activities, as well as specific information about each episode of drinking. These data will provide a more fine-grained analysis of the factors that place underage binge drinkers at risk for alcohol abuse. The National Institute on Alcohol Abuse and Alcoholism/National Institutes of Health Grant R01-AA07595, awarded to R. Lorraine Collins, funded this research. Article 2

William R. Greiner, President

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