1. Expectancies, peer-influences and social determinants regarding alcohol use in young people Stephan Van den Broucke UC Louvain Symposium on « Binge Drinking in Belgian Minors: an innocent problem? Palace of the Academies Brussels, 8 November 2011

2. Background College or university is the place where adolescents learn to drink alcohol

3. Studies among university students reveal –a high level of alcohol consumption –a high level of problematic use, particularly binge drinking Percentage heavy episodic drinking in the past month, ages 18-20 and 21-24, in college versus noncollege persons, 1998, 2002, and 2005 (Hingson, 2009) Source: National Household Survey on Drug Use and Health.

5. Alcohol education as a solution? Source: Bangert-Drowns, R.L. (1988). Journal of Drug Education, 18, 243-264. N= 26 N= 18 N= 14

6. To address the problem of student binge drinking it is necessary to investigate the factors that influence it

7. Factors influencing student alcohol abuse Individual -expectancies -attitudes -control perceptions -Sensation seeking and risk taking tendency -personal stress Social -family -peers -perceived norms Institutional –availability and price –rules and regulations Societal –cultural habits –economic conditions Dahlgren & Whitehead (1991)

8. Objectives of the presentation Document the individua and social factors that influence problematic alcohol use (including binge drinking) Highlight the contribution of own research Most published research on determinants of alcohol use has been carried out in the US

9. Determinants of alcohol use considered Cognitive determinants –Alcohol expectancies –Attitudes –Refusal self-efficacy Peer influences –Peer pressure –Perceived norms

10. Alcohol expectancies The cognitive, affective, and behavioral outcomes an individual expects to occur due to drinking –Expectancies vary between persons –Expectancies can be positive or negative Positive : improved social contact, sexual enhancement, relaxation, assertion Negative: loss of responsibility, decreased performance –Positive expectancies are believed to motivate to drink alcohol Drinking motives are the most proximate factor that precedes alcohol use, and are the gateway through which expectancies impact on use Findings from literature reviews –Fewer positive alcohol expectancies are associated with fewer binge drinking episodes among young adults –Negative alcohol expectancies are not related to binge drinking Courtney E, Polich J (2009), Psychological bulletin 135 (1), 142-156.

11. Alcohol expectancies in Belgian students Study among 492 students of the UCL –277 psychology students and 215 engeneering –213 male, 279 female Online questionnaire –French adaptation of the AEQ-A –4 expectancies : Relaxation and facilitating social contact Improved physical and mental abilities Enhanced sensations Loss of control Findings –males student have higher scores on positive expectancies than female students –psychology and engineering students have different expectancies Darcheville (2012)

12. Attitudes A psychological tendency that is expressed by evaluating a particular entity with some degree of favor or disfavor (Eagly & Chaiken, 1995) Based on outcome beliefs, the subjective value of the outcomes, and the perceived probability that the outcome will occur Reviews of community prevention strategies indicate that having favorable attitudes toward substance use is associated with binge drinking among adolescents Collins et al. (2007). Substance Use Misuse, 42(6), 985-1007

13. Self-efficacy and perceived control The measure of the belief in one's own ability of performing a given behavior –Applied to alcohol use and binge drinking: the ability to refuse drinks easily or to stop drinking –Is believed to influence an individuals’ drinking intentions and ultimately the behaviour Numerous studies have demonstrated an inverse association between drinking refusal self-efficacy and drinking behavior

14. Attitudes and perceived control combined Theory of Planned Behaviour

15. TPB tested among Belgian students Study among 192 students of the KU Leuven -recruited via the student medical service -53% human sciences, 24% exact sciences and 22% biomedical sciences -43% male, 57% female -Pen-and-paper questionnaire (validated) Van Campenhout (2013)

16. Attitudes and perceived control combined Behaviour Reasoning Theory

17. BRT tested among Belgian students Study among 547 students of the UCL -418 online, 129 in auditorium -218 for 2 nd completion -Different faculties (economics and political sciences, psychology, other) -242 male, 304 female -Online/pen-and-paper questionnaire De Waele & Godfrin (2013)

18. Reasons for and against drinking

19. Peer influences The influence of other students on alcohol use and binge drinking can be –Direct: offering alcohol and/or insist on drinking –Indirect: setting social norms Descriptive norms: What other people do Injunctive norms: What other people approve of Reviews indicate that binge or risky drinking among adolescents is associated with –having close friends who consumed alcohol in the past month –excessive drinking among peers Gilligan et al. Alcohol, 47(3), 349-354.

20. Peer influences tested in Belgian students Study among 282 students o f the UCL -Different faculties (psychology, bio-enginieering) -246 women (87.23%); 36 men (12.77%) -Online questionnaire measuring direct offer, perceived injunctive norms, perceived descriptive norms and alcohol consumption -Distinction between non- binge drinkers (19.1%), binge drinkers (72.3%) and frequent binge drinkers (8.5%) Kumst (2013)

21. Conclusion Alcohol expectancies, attitudes, self-efficacy, direct peer pressure and perceived norms all contribute to alcohol consumption and to binge drinking The relative importance of the determinants varies –For alcohol use and binge drinking –Between subgroups (gender) Prevention campaigns and strategies need to take the multiple determinants of alcohol use and binge drinking into account Research on the determinants of binge drinking can help to inform prevention efforts

22. “The chief reason for drinking is the desire to behave in a certain way, and to be able to blame it on alcohol” ~ Mignon McLaughlin, The Neurotic's Notebook, 1960