Curbing College Binge Drinking: What Role Do ‘Alcohol Expectancies’ Play?

Researchers at The Miriam Hospital say interventions targeting what college students often see as the pleasurable effects of alcohol – including loosened inhibitions and feeling more bold and outgoing – may be one way to stem the tide of dangerous and widespread binge drinking on college campuses.

According to a new report, “alcohol expectancy challenges,” or social experiments aimed at challenging students’ beliefs about the rewards of drinking, can successfully reduce both the quantity of alcohol consumed and the frequency of heavy or binge drinking among college students.

The findings are published online by the Psychology of Addictive Behaviors.

“We know drinking habits can be influenced by what people expect will happen when they consume alcohol, so if you believe alcohol gives you ‘liquid courage’ or that drinking helps you ‘fit in’ or be more social, you’re likely to drink more,” said the study’s lead author, Lori A.J. Scott-Sheldon. Ph.D., of The Miriam Hospital’s Centers for Behavioral and Preventive Medicine

“If we can prove to students that many of the perceived positive side effects of alcohol are actually due to their expectations, rather than the alcohol itself, then we could potentially reduce frequent binge drinking and its negative consequences,” she added.

Drinking is pervasive on most college campuses in the United States. Data from several national surveys indicate that about four in five college students drink and that about half of college student drinkers engage in heavy episodic consumption. Excessive alcohol use is associated with a number of short- and long-term consequences, including academic problems, sexual assault, unsafe sex, injuries and violence, arrests, college attrition, alcohol abuse and dependence, and accidental death. As a result, reducing alcohol consumption by college students has been declared a public health priority by the Surgeon General.

Alcohol expectancy challenges have been designated by the National Institute on Alcohol Abuse and Alcoholism as one of only three effective alcohol-prevention treatments for college students. During a typical expectancy challenge intervention, alcohol is provided to a group in a bar-like setting; some drinks contain alcohol while others are non-alcoholic, but the participants do not know which type of beverage they have. Students then engage in activities that promote social interaction, such as party games, and after some time, they are asked to evaluate whether other participants were drinking alcohol versus a placebo. In the majority of cases, groups had difficulty determining who actually received alcohol and who did not.

The challenge also offers an opportunity to educate college drinkers about alcohol expectancies, myths about the effects of alcohol, the pharmacology of alcohol and drinking responsibly.

Scott-Sheldon and colleagues conducted a meta-analysis of 19 separate alcohol expectancy challenges among more than 1,400 college students across the country. Overall, participants reported lower positive alcohol expectancies and reduced both their alcohol use and their frequency of heavy drinking for as long as one month post-intervention.

In most cases, expectancy challenge interventions were delivered in three or fewer group sessions. Because it may not require as many resources as the more individualized strategies that are commonly used for college drinkers, Scott-Sheldon says colleges may find this approach a more attractive alternative.

“This relatively brief, group-based intervention is something that could be easily implemented within the context of campus group activities, such as the residence life program, student orientation or student organization events,” she said.

Because the effects of alcohol expectancy challenges are brief, researchers say providers might consider implementing these interventions before periods when students are more likely to engage in at-risk drinking behavior, such as spring break or “rush week” for fraternities or sororities.

The National Institutes of Health funded the study. Co-authors include Michael P. Carey, Ph.D., director of The Miriam Hospital’s Centers for Behavioral and Preventive Medicine; Danielle L. Terry of Syracuse University; and Kate B. Carey, Ph.D., of the Center for Alcohol and Addiction at Brown University, and Lorra Garey of Brown University.

The principal affiliation of Lori A.J. Scott-Sheldon, Ph.D., is The Miriam Hospital (a member hospital of the Lifespan health system in Rhode Island). Scott-Sheldon is also an assistant professor of psychiatry and human behavior (research) at The Warren Alpert Medical School of Brown University.

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