Articles of Public Interest

Abstract

How much alcohol a person drinks is strongly linked to how much their peers drink—and not just among teens and young adults. A new study of mature adults, published in Alcohol: Clinical and Experimental Research, has found that adults’ social connections influence a person's drinking, both contemporaneously and over time. And, an individual's social network is more influential in changing their drinking behavior over time than other factors, such as their occupation or smoking. The study highlights the importance of understanding social connections in order to design interventions for mature adults who drink heavily. Prior studies have found that peer pressure, family dynamics, and social environment play a critical role in whether adolescents begin and continue to engage in substance use. However, there have been fewer studies of factors contributing to drinking among mature adults, who have more alcohol-related health risks and different social environments, stressors, and coping behaviors than teens and young adults. The current study sought to fill this gap in the research by examining how the drinking behaviors of adults with an average age of 55 years old related to factors such as smoking and their perceived job prestige, as well as the drinking behaviors of their peers. All of the study's analyses of social networks found that, for mature adults, the social environment plays a crucial role in influencing individual drinking behavior. Individual drinking was highly correlated with the contemporaneous drinking behavior of their peers, and, over time, their drinking behavior both influences and is influenced by their social network. People who drank more were more likely to show an increase over time in the proportion of connections with those who drink heavily, while those who drank less showed an increase over time in the proportion of connections who abstain from alcohol. Those who had an increase in the number of heavy drinking connections increased their drinking over time, while those who had an increase in the number of friends or family who abstained from alcohol drank less over time. The study found that higher perceived job prestige tended to be associated with more regular drinking, fewer connections who abstain from alcohol, and less smoking. However, there were no clear associations over time between smoking habits, job prestige, and drinking, suggesting that the social environment is a more influential factor in modifying drinking behavior than smoking or socioeconomic status. Data for this study came from the Framingham Heart Study, an ongoing longitudinal study that began in 1948. Researchers analyzed self-reported information about drinking and smoking behaviors. Social connections consisted of friendships, familial ties, and individuals living at the same address, as obtained through self-report and municipal data. The 30 years of data used for this study were collected between 1971 and 2003, so they may not apply to contemporary populations. The study authors recommend additional research with more detailed data to better understand the nuances of social connections among mature adults, including different age groups or sexes.

Societal spirits in the silver streak: Unraveling complexity in drinking habits of the mature adult population. van den Ende, M., Freischel, R., van der Maas, H., Wiers, R. & Epskamp. S. (https://doi.org/10.1111/acer.15486)

Self-consciousness plays a role in a young adult's tendency to binge drink, but that role evolves over time. A new study published in Alcohol: Clinical and Experimental Research found that people who are self-conscious may be more likely to binge drink as young adults but less likely to binge drink as they mature. The findings may help facilitate early identification and interventions for certain young adults who may be at risk for problem drinking. The study is the first to examine the relationship between social-attentional focus and problem drinking using an objective measure in a real-world context. Participants aged 21 to 30 were invited to a laboratory where they engaged in unscripted conversations with another participant. While in separate rooms, participants engaged in video calls where their own and conversation partners’ images were displayed side by side on the monitor. Each participant had two conversations, either with a friend or with a stranger. Researchers tracked participants’ eye movements during the conversation and compared how much time they spent looking at themselves and how much time they spent looking at their conversation partner as a measure of social attention and self-consciousness. At the outset of the study and one and two years after the beginning of the study, participants completed questionnaires about their drinking behavior and occurrences of negative experiences related to alcohol in the prior thirty days. The researchers found that the more self-focused a participant was during the video calls, the more binge drinking days they tended to have reported at the outset of the study. Specifically, for each percentage point increase in time participants spent looking at themselves on the screen, there was a 1.3 percent increase in binge drinking days at the outset of the study. And for every one percent increase in time spent looking at the other person on the screen, there was a 1.1 percent decrease in binge drinking days at baseline. However, over time, those who were more self-focused in their video calls showed greater declines in binge drinking days. The young adults who looked at themselves more often during their conversations with their friend showed a considerable decrease in binge drinking days—more than a 50 percent reduction each year. The average reduction for all participants was less than 40 percent each year, a typically observed trajectory for this age group. The researchers speculate that people who are self-conscious may be more sensitive to social norms and expectations and, therefore, drink more in their late teens and early twenties when heavy drinking may be more typical and drink less as they get older and norms around drinking change. They note that it is unclear whether self-consciousness may drive binge drinking, for example, as a coping strategy, or whether it may be a consequence of binge drinking, as heavy drinking can lead to depression and anxiety, which is associated with self-consciousness. The study's findings may not be applicable to those with alcohol use disorder, who were excluded from the study. Researchers recommend future studies on different age groups and lengthening the duration of the longitudinal follow-up to better understand the role of social attention in drinking behavior.

Examining social attention as a predictor of problem drinking behavior: A longitudinal study using eye-tracking. Han, J. Fairbairn, C. Venerable, W. Brown-Schmidt, S. Ariss. T. (https://doi.org/10.1111/acer.15490)

Young men's commonly held beliefs and attitudes about drinking, gender role stereotypes, and peer pressure may be key drivers impacting women's sexual victimization in bars and clubs. That's according to a recent study testing a new measurement tool designed to assess beliefs and attitudes related to men's perpetration of sexual violence in drinking venues. Sexual violence, encompassing sexual harassment, unwanted touching, and persistence, as well as assault, is a pervasive problem with major emotional, health, and economic impacts. Most perpetrators are men, and most targets are women. While previous research has found that certain beliefs and attitudes are linked to sexual violence, existing research tools do not fully assess or account for beliefs and attitudes related to sexual violence occurring in drinking venues. In fact, many forms of sexual violence are so common in drinking venues that they are normalized and seen as socially acceptable among young men. Understanding men's beliefs and attitudes specific to alcohol-related sexual violence in bars and clubs is essential for effective prevention initiatives. For the study in Alcohol: Clinical & Experimental Research, investigators developed and tested a new measurement tool for assessing how men's beliefs and attitudes about sexual violence in drinking venues related to their own perpetration.

The researchers drew from established behavioral models and theories relating to gender-based violence, situational crime prevention, peer influence, and alcohol to construct a measure of beliefs and attitudes about men's alcohol-related sexual harassment and aggression—BAMASHA—toward women in drinking venues. Using findings drawn from focus groups with young men, the researchers began with a questionnaire consisting of 82 items reflecting several dimensions, including personal approval, peer approval, perceived normality, gender roles, anticipated consequences, and the role of alcohol. They recruited 330 Canadian men aged 19-25 (average age 23, 48% white) to complete the questionnaire online by rating the extent that they agreed or disagreed with each of the 82 beliefs/attitude statements. The participants also completed existing validated measures assessing their bar-going behavior, frequency of heavy episodic (binge) drinking, sexual behaviors, and general attitudes to sexual violence, women, and drinking. Almost 3 in 4 (72%) participants reported perpetrating at least one sexual violence behavior in a club/bar (e.g., grabbing a girl's breast or butt to make friends laugh). The researchers used statistical techniques to refine the tool, selecting the most valid and concise items. This resulted in 24 items in the final measure, retaining attitudes and beliefs from each initial dimension. The BAMASHA was highly predictive of perpetration of sexual violence in drinking venues. The researchers also developed and validated a short-form version of the BAMASHA (12 items), which has potential value for evaluation of sexual violence intervention programs. The correlations between the BAMASHA and existing measures of men's general attitudes toward sexual violence toward women (e.g., rape myth acceptance, hostility toward women) supported the validity of the new tool. Although the BAMASHA findings aligned closely with a validated measure of rape myth acceptance, the BAMASHA provided additional insights into sexual violence in drinking venues. The findings suggest that efforts to change commonly held beliefs and attitudes toward sexual violence in drinking venues may be key to preventing men's sexual violence in these contexts. Further research is needed to confirm the validity of the new instrument with different samples of men and to apply this knowledge of men's beliefs and attitudes to prevention programming and evaluation.

Beliefs and attitudes about men's alcohol-related sexual harassment and aggression (BAMASHA): Development and initial validation of a new scale. Huellemann, K.L. Graham, K., Bernards, S., Tremblay, P., Abbey, A., Senn, C., Banyard, V., McMahon, S., Dumas, T. & Wells, S. (https://doi.org/10.1111/acer.15477)

People with prenatal alcohol exposure (PAE) are at raised risk of postnatal adversity (PA), according to an evaluation of current research. The review in Alcohol: Clinical & Experimental Research highlights substantial vulnerabilities for affected people and major gaps in mental health interventions and other supports. PAE is related to fetal alcohol spectrum disorders (FASD), neurodevelopmental disabilities affecting at least 1–5% of school-age children in the USA. People with PAE are more likely than others to experience PA, such as neglect or abuse in childhood. This additional risk, along with genetic and environmental factors, contributes to wide variation in developmental trajectories and life experiences. The new assessment of the scientific literature on the intersection of PAE and PA identifies possible routes to improving outcomes. Investigators affiliated with the University of Rochester, New York, were guided by a Developmental Psychopathology framework, new to this field, that acknowledges complex interactions between multiple factors. They used established review criteria to identify 29 published studies exploring PAE, PA, biological, cognitive, and emotional functioning, the role of external systems such as mental health care, and family and cultural contexts. Their systematic review highlights the complex interaction of PAE, PA, systems, and cultural factors, as well as the varied effects on multiple areas of development and functioning in affected people. Essentially, PAE raises the risk of PA, with PA, in turn exacerbating the effects of PAE. People with PAE experience an average of 4.4 adverse childhood experiences (ACEs); those with FASD experience 3.7 more ACEs than those without FASD. Adversity is associated with atypical neurological and hormonal development. It compounds the risks for physical and mental health issues, including psychological trauma and cognitive, academic, and behavioral challenges. The co-occurrence of PAE and PA has substantive impacts on families and systems. Outcomes experienced by people with both conditions are highly variable. The research acknowledges the strengths of people with PAE, including social motivation and determination and the protective value of caregiver stability. The review commends researchers for exploring the complexities of the issue. In addition, it highlights substantial gaps in resources—most notably, no mental health interventions that meet the needs of people with PAE and trauma have been developed for or tested in this population. The reviewers recommend building on the strengths of people with PAE to cultivate resilience. They also advise certain system changes. For example, while the data point to the need for routine PAE and PA screening in some clinical care settings, the overlap in symptom presentation calls for incorporating the possibility of PA into the FASD diagnostic procedure and PAE into the diagnosis of trauma-related conditions. The mix of methods and tools and limited sample sizes in studies to date prevented fuller synthesis of the findings. The reviewers call for further research with large, diverse samples, community-based participatory approaches, and tracking people over time to illuminate the dual developmental impact of PAE and PA. This could help identify, for example, how the timing of adversity affects outcomes and additional factors that have a role in resilience. Research should account for socioeconomic status, cultural context (such as intergenerational colonial trauma affecting Indigenous communities), and life experiences outside the school-age and teen years, informing interventions accordingly.

Understanding the intersection of prenatal alcohol exposure and postnatal adversity: A systematic review from a developmental psychopathology lens. Rockhold, M., Handley, E. & Petrenko, C. (https://doi.org/10.1111/acer.15483)