Psychosocial Correlates of Heavy Drinking, Part 2

by National Institute of Health

(Page 4 of 4)

Alcohol Expectancies

Positive expectancies about alcohol's effects play a key role in the drinking behavior of emerging adults. With age, adolescents increasingly expect benefits from drinking and become less convinced of the risks. However, one study that followed college students over 3 years found a decline in positive expectancies, whereas alcohol use rates remained stable.

Expectancies appear to predict both drinking initiation in adolescence and maintenance of drinking throughout young adulthood. There has been less evidence that expectancies predict drinking problems across adolescence and young adulthood. As with older adults, drinking for social purposes is associated with greater consumption, and drinking for escape or relief is associated with problem drinking. In addition, among college students, heavier drinkers endorse an overall greater number and variety of reasons for drinking.

Peer Influences

People entering college or the workforce may be especially vulnerable to the influence of peers because of their need to make new friendships. They may increase their drinking to facilitate peer interactions. Borsari and Carey maintain that peer influence is exerted directly (e.g., overt drink offers or urges to drink) and indirectly (e.g., modeling perceived social norms).

Although all these influences affect drinking behavior, one of the strongest correlates of drinking among emerging adults, and the subject of the most research on this topic, is perceived norms. Many college students may drink more because of their misperceptions about the norms of drinking on their campuses. They may think campus attitudes are much more permissive toward drinking than they are and believe other students drink much more than they actually do. Borsari and Carey compared descriptive norms (i.e., perception of others' drinking behavior) and injunctive norms (i.e., perceived approval of drinking) and found students were more likely to overestimate approval of drinking among their peers than to overestimate their peers' actual drinking behavior. Recent research has shown that addressing misperceptions of these norms, especially descriptive norms, has some success in reducing drinking. It is worth noting, however, that a young person is just as likely to select a peer group based on the group members' drinking behavior as he or she is to be influenced by peers to change his or her own drinking.

Family Influences

During emerging adulthood, parental monitoring decreases, and parents therefore have less influence on drinking patterns than do peers. Nevertheless, young people's relationships with their parents continue to play a major protective role in development during this stage of the life cycle. Parental drinking patterns have been shown to affect drinking by offspring over the life course. Young people model their own behavior on their parents' patterns of consumption (including quantity and frequency), situations and contexts of use, attitudes regarding use, and use expectancies. The structure and environment of the family unit, as well as parent-child relationship attributes (e.g., parenting style, attachment and bonding, nurturance, abuse or neglect, conflict, discipline, and monitoring), have been found to correlate with adolescent alcohol use.

In addition, alcohol problems tend to aggregate in families. This family transmission can reflect genetics and/or modeling. Findings have been inconsistent about whether drinking patterns and problems during emerging adulthood differ between children of alcoholics and others. There are several possible explanations for these equivocal findings. First, studies vary greatly in their measures of family history of alcoholism. Second, this research is based primarily on college students, and children of alcoholics who are at greater risk for alcohol problems may not enroll in college. Finally, the peak in heavy drinking, which tends to occur when people reach their early twenties, may obscure differences between children of alcoholics and others. However, research using stringent criteria indicates that people with a family history of alcoholism are less likely than those with no family history to mature out of heavy drinking as they approach young adulthood. In addition to parents, siblings can influence drinking through modeling, direct social influence, and access.

Summary

In sum, during the transition from adolescence to young adulthood, many people initially increase, and then decrease, their alcohol use. Bachman and colleagues suggest that increased drinking during the early part of emerging adulthood results from changes in living arrangements (i.e., leaving parents and moving into dormitories or other housing shared with other emerging adults) as well as the freedom to purchase alcohol. Drinking during this time is culturally normative for most, although a minority of emerging adults will have drinking patterns that do not run true to this course - either they abstain completely or their drinking continues to increase after they reach adulthood. The decline in heavy drinking that occurs from the middle of emerging adulthood into young adulthood primarily results from increased responsibilities associated with marriage, parenthood, and career.

For the most part, the key factors that influence drinking in emerging adulthood are similar to those which influence adolescent drinking, although peer influence becomes increasingly more important than parental influence as the child ages, as do freedom from social control and stress related to attaining adult roles. Thus, moving out of the constraints of high school and away from parents makes emerging adulthood a stage of the life cycle in which people are at high risk for heavy drinking and alcohol-related problems. Maladaptive drinking behavior, in turn, may delay the accomplishment of developmental milestones, creating a self-defeating cycle for some. More research is needed about the intermediate and long-term effects of alcohol use during emerging adulthood, as well as the intrapersonal factors that facilitate or impede maturation out of heavy drinking.

Implications for Prevention Programs and Interventions/

Because some emerging adults will maintain or increase their problematic alcohol use over time rather than mature out of heavy drinking and related problems, it is important to intervene with emerging adults before they develop long-lasting alcohol use patterns or disorders. Given that more than half of their college sample reported drinking to get drunk or "high" during their freshman year, Jackson and colleagues suggested that it is important to implement interventions prior to or upon college entry. Such interventions should focus on reducing the harms associated with heavy drinking. Universal screening is recommended to identify high-risk students and refer them to appropriate interventions. Recent advances in Internet-based screening have made it possible to screen large numbers of students for potential risk and provide them with immediate feedback on their drinking and risks, peer norms, and techniques to reduce risk. These interventions have been found to change perceived norms and reduce alcohol consumption, although more research is needed.

Several studies indicate that the nonstudent population of emerging adults is an important target for preventive interventions, especially because people in this segment of the population may be less likely to mature out of heavy drinking patterns established during adolescence. Nonstudents' risks for alcohol-related problems in their early twenties are as high as students' risks. Unlike students, however, the risks for nonstudents appear to increase over time. This population does not have the benefits of campus health care centers or institutionally based programs that college students have. Similarly, students who do not live on campus may not have the benefits of campus substance use prevention programs (which often are designed for residents) or the protective benefits of campus organizations and peer groups. Intervening with emerging adults as they make the transition out of high school will ensure that interventions reach people who would not otherwise receive them. The period following high school graduation is an ideal time for interventions intended to prevent the problems that may result from such escalations in use, given that alcohol use increases considerably around this time. Because most of the research on drinking among emerging adults has focused on college students, more research on nonstudent populations is needed to better inform the design of appropriate prevention efforts.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.