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High risk drinking among non-affiliated college students.

ABSTRACT

This study investigated the high risk drinking practices of unaffiliated college students who are not involved in formal athletics, fraternities, or sororities. Using a qualitative research design, the investigators interviewed students at a northeast public college in fall 2010 to learn about unaffiliated students' drinking experiences and their related consequences. Five major themes emerged from the interviews: Unaffiliated students engage in high risk drinking practices consuming a range of 5 to 18 drinks per episode; they participate in "pre-gaming " or drinking before going out to party; they participate in drinking games over the course of a drinking episode; they experience negative health and social consequences including: vomiting, hangovers, confusion, memory loss, medical and law enforcement involvement, and strained interpersonal relationships; and some use psychoactive substances while drinking. The major finding is that unaffiliated college students engage in high risk drinking and experience a variety of negative consequences.

Key words: High risk drinking, unaffiliated college students, negative consequences

INTRODUCTION

Although recent findings from the Monitoring the Future study (Johnson, O'Malley, Backman & Schulenberg, 2011) indicate a modest decline in binge drinking among high school students, alcohol consumption among college students remains relatively unchanged. Moreover, high-risk drinking continues to be a serious problem on college campuses. From 1999 to 2005, the proportion of college students ages 18-24 who reported consuming five or more drinks on at least one occasion in the past month (high risk drinking) increased from 41.7% to 44.7% (Hingson, Zha, & Weitzman, 2009). High risk drinking has serious consequences for students and those around them. "Among college students ages 18-24 alcohol-related unintentional injury deaths increased 3% per 100,000 from 1,440 in 1998 to 1,825 in 2005" (Hingson et al., 2009, p. 12). The proportion of students who reported driving under the influence of alcohol between 2001 and 2005 increased from 26.5% to 28.9%. In 2001, nearly 600,000 (10.5%) full-time 4-year college students were injured because of drinking; 696,000 (12%) were hit or assaulted by another drinking college student; and 97,000 (2%) were victims of alcohol-related sexual assault or date rape.

There are other negative consequences to college students' high risk drinking. It is associated with high risk sexual behavior including decreased condom use, little or no discussion of sexual risk with partner prior to engaging in sex, and having multiple sexual partners (Bourdeau, Saltz, Bersamin, & Grube, 2007). It is also associated with non-consensual sexual experiences and sexual assault (Clark et al., 2011; Mouilso, Fischer & Calhoun, 2012). Alcohol induced memory blackouts associated with high risk drinking increases injury rates among college drinkers and are eight times greater than for other students (Mundt, Zakletskaia, Brown, & Fleming, 2012).

Further, high risk college drinking may predispose students to traumatic events (Park, Frazier, Tennan, Mills & Tomich, 2012), increased suicidality (Gonzalez, 2012; Gonzalez & Hewell, 2012), impairments of brain executive function (Bednarski et al., 2012; Parada et al, 2012), behavioral impulsivity (Shin, Hong, & Jeon, 2012), social anxiety (Buckner, Ecker & Proctor, 2011; Terlecki, Buckner, Larimer & Copeland), and depression (Geisner, Mallet, & Kilmer, 2012; Monahan, Bracken-Minor, McCausland, McDevitt-Murphy & Murphy, 2012). Lastly, there is some evidence that suggests high risk drinking may place some students at risk for alcohol dependence and associated damage to the brain (Beseler, Taylor, Kraemer & Leeman, 2012; Presley, Meilman & Leichliter, 2002).

Factors associated with high risk college drinking are complex and may include a variety of individual, environmental, and social factors. Some of these factors include age (below age 24), being male, being Caucasian, being single (Wechsler, Dowdall, Davenport & Castillo, 1995), presence of depression and school stress (Pedersen, 2013), binge drinking in high school (Patrick, 2013), and perceived social norms (Chauvin, 2012; Cullen, 2013).

Several studies have attempted to identify high risk drinking practices among members of campus organizations including fraternities (Caudill et al., 2006;; DeSimone, 2007) sororities (Cashin, Presley & Meilman, 1998; Hutchting, Lac & LaBrie, 2008;) and athletics (Brenner & Swanik, 2007: Martens, Pedersen, Smith, Stewart, & O'Brien, 2011). While students who are identified or are affiliated with such organizations have been studied, there appear to be no specific studies directly exploring the high risk alcohol use of unaffiliated students as we have defined here (no fraternity, sorority AND no athletic associations). Therefore, to understand this group, we conducted a qualitative study.

METHODS

In our review of the literature, there were no qualitative studies specifically and directly examining the use of alcohol, unaffiliated students, and negative consequences. Consequently, this study incorporated a qualitative approach for the purposes of understanding high risk drinking practices and consequences associated with unaffiliated students' alcohol use and abuse. We wanted to learn more about unaffiliated students' experiences around high risk drinking behaviors and if there were any patterns associated with their use. Our basic question was, what are the experiences of unaffiliated college students' drinking? Instead of using a quantitative type survey, which limits rich, detailed experiences, we used the grounded theory approach. This is an inductive method, which is used to gather this rich and detailed information "grounded" in participants' experiences (in this case, unaffiliated college students with high risk drinking practices). This information, or data, then, is systematically categorized and analyzed. With the use of several analytic methods--associated with qualitative analysis--the results, which are "grounded in data," provide a model of understanding high risk drinking practices among unaffiliated college students (Creswell, 1998, p. 56).

We decided that 1:1 interviews using semi-structured questions would elicit more in-depth, detailed, and rich information regarding high risk drinking practices. We designed a questionnaire that asked for basic demographic information, and information around most recent and average alcohol consumption. This questionnaire was based on one used in a previous qualitative study examining high risk drinking practices among college women (Smith & Berger, 2010). Some of the questions included "Tell us about your last drinking experience: Who did you drink with? What did you drink? How much did you drink? How long did you drink? When did you drink? Where did you drink? Details about the drinking experience?" Therefore, we asked students to tell us about their most recent high risk drinking episode and also asked them to provide as much detail as possible concerning their behavior before, during, and after this particular episode.

Procedures

First, the researchers applied for and received Institutional Review Board (IRB) approval. Students were recruited from academic majors outside of the researchers' department of Health Science to avoid a conflict of interest. To acquire participants, the researchers visited non-Health Science classrooms and explained the general purpose of the study (e.g. to examine drinking practices of students), informed them about a raffle (all students who participated in the study were entered into a $75.00 gift certificate raffle), and then asked for volunteers. To volunteer, the students wrote down their name and email address on a sign up list. The researchers contacted those students who wrote down their names, requesting their participation and reminding them of the raffle. The researchers informed the students that their professors would not be notified about their participation in the study or lack thereof. Students then emailed their interest in volunteering and were assigned a mutually agreed upon interview time and place.

There were 22 volunteers. All students who participated in the interviews agreed to meet in one of the three researchers' offices. Interviews followed a semi-structured format, were digitally tape recorded, and lasted from 1 to 1.5 hours. All digital tape recorded information was kept in a locked cabinet within a locked room. The nature of the study was reviewed with participants and written informed consent forms were signed prior to the interview session. Students were asked questions regarding their drinking experiences. A total of 14 students met the study criteria of unaffiliated and high risk drinkers. High risk drinking was categorized by students having 4 or more (female) or 5 or more (male) drinks per sitting (Wechsler, et al., 1994). Unaffiliated referred to non-membership in fraternities, sororities and formal athletics.

Participants

All of the students were undergraduates at a small, New England public college. All were Caucasian and within the age range of 18 to 22 years. There were 6 women and 8 men. The students indicated that they were from a variety of majors, ranging from education, psychology, athletic training, communication, philosophy, safety studies, sociology, biology, film studies, graphic design, and political science to undeclared. Each of the students was given an alias (e.g. Ronald, Daniel, Sally ...).

Data Analysis

To analyze the data, we used the grounded theory qualitative approach. In particular, we participated in an on-going process of deep immersion into the interview data of the participants' experiences, systemically organizing material into themes and categories to present the results in an article format (Rossman & Rallis, 2003, p. 270). In particular, in using the Grounded Theory approach, we used open, axial and selective coding as described by Creswell (1998). The transcripts were read by each of the researchers and organized into categories based on similarities among the transcripts. Using a constant comparative method, those activities, events, and people that were similar contributed to emerging categories (Creswell, 1998). Then, the categorized data was reviewed for interrelationships (Straus & Corbin, 1990).

In regards to the trustworthiness and credibility of the research, the qualitative strategies of critical friends and triangulation were employed to ensure rigor (Patton, 2002). First, in using critical friends, one of the researchers (Smith) conducted the original analysis of the data and the two other researchers (Droppa and Finneran) acted as "intellectual watchdogs" (Rossman & Rallis, 2003). The technique of triangulation was employed using multiple and different sources, methods, and results. Researchers employed content analysis of interview transcripts, behavioral analysis of interview sessions, and multiple analyst perspectives in order to deepen the understanding of the data. For example, several interview questions were repeated at different time intervals to assess the consistency of student responses around the frequency of binge drinking episodes reported and the number of drinks consumed per episode. Researchers reviewed the interviews that they had conducted to identify themes and patterns around students' high risk drinking experiences. Then, meeting as a group, the researchers compared their findings to ascertain similarities and differences in their findings. Researchers reviewed any notes made following student interviews, examined current college alcohol policies, and referred back to the scholarly literature.

RESULTS

The analysis of the unaffiliated college students' interviews generated five major themes.

The first theme is that unaffiliated students, irrespective of gender, do engage in high risk drinking practices. The lowest amount of high risk drinking was 5 drinks per sitting, with the highest amount at 18 per sitting.

On the average I'd say ... Sometimes it's less; sometimes it is more ... on the average of Like 15 [drinks] (Ronald)

... between 12 and 18, I'm saying it ranges anywhere from like I don't know four to eight hours (Daniel)

The second major theme was that many of the unaffiliated students participated in "pre-gaming" or drinking before they "went out" to "party."

Typically I usually start with my roommates. We'll have a few people over.... I'll have a few people over and we'll, you know, hard liquor drink while you're getting dressed or something like that.... (Sally)

Have like 3 or 4 before we go out. Walk to where we're going. Drink the majority of what we're going to drink like maybe like eight at the party and then come back and have like another you know, two or three depending on you know, how I'm feeling (Ronald)

Unaffiliated students also participate in drinking games, a third major theme.

Beirut or Beer Pong whatever you wanna call it. Flip Cup it's a pretty simple game ... You fill like a plastic cup you know with a little bit of beer. You have a line of people on one side of the table and another line of people on the other. It's basically you know a one on one. You match up with the person across from you and then you know the two people at the end start and then drink it and then they put it down on the table and they have to flip it so the cup like sits the other way. Once they're done you have to get the cup to sit on the other side. So I mean I see a lot of people get in trouble that way. They get too drunk on that (Ronald)

Kings is another one where you just put all the cards in the middle and you just go around in a circle and you draw a card ... and each card means you have to do something [with alcohol]. So like Ace is waterfall. So like I start drinking and then it goes all around in a circle and the person after me can't stop drinking until I do and so it goes around like ... so if you're the last person you're pretty much screwed (Tanya)

A fourth major theme related to consequences. Some of the worst consequences of a "night out drinking" were hangovers, confusion, embarrassment, vomiting, saying things one should not have, memory loss, medical personnel or police visits, being written up (by a Residence Assistant), emotional consequences and "getting out of control."

Ah, I don't know why I agreed to it. This was my sophomore year here, me and one of my friends decided to have a case race and it's pretty much whoever can finish their case of beer first wins. God knows what you win but ah, we all each of us went and bought a 30 pack and did that and I finished the 30 and that was just bad news for me. I made a complete ass of myself. I guess I tried to, to fight with one of my friends.... I've seen pictures of me. I looked like I was homeless because I was so freaking intoxicated. I'd say from what I, from what I remember, 1 pretty much woke up in my room ... we were so incredibly sick for that day that was not worth it (Daniel)

I went out with a friend. It was actually last year and I have never been so sick in my entire life ... it was both of us getting sick at the same time in their bathroom. They moved me to the tub, so I was ... Here's the toilet and I was at the tub and I literally woke up on the floor in the bathroom and I moved into bed ... I was sick. Laid down for an hour and tried again, sick again. Laid down literally could not eat or touch water like it would not by 5:00 I still hadn't moved. (Laughter). It was really bad.... It was a year ago not years it was like eight months ago but still that's a long time for me to remember exactly what happened but I remember it was an argument.... (Sally)

A fifth theme is that most of the interviewees used other psychoactive drugs, with many students stating the use of marijuana and hallucinogens.

I don't do drugs at all but in my freshman year mostly I would smoke weed with my friends ... sophomore year was pretty much the same thing. I tried ecstasy in my sophomore year and LSD my sophomore year and cocaine my sophomore year and pretty much the same with junior year and this year (Daniel)

DISCUSSION

The purpose of this study was to examine high risk drinking practices among unaffiliated students and to determine the consequences of these practices on students' lives. This study made several findings that centered on five themes.

First, unaffiliated students may drink at high risk levels. Second, unaffiliated students are participating in pre-gaming activities which appear to enhance the drinking practice or make it more acceptable by normalizing it with rituals among friends or drinking partners (Bosari, 2004; Zamboagna, Schwartz, Ham, Bosari, & Van Tyne, 2010). Third, the study found that students experienced several negative consequences as a result of their drinking from severe physical illness to assault. Although some students experienced negative consequences, there were a few that did not experience any. Finally, many of the unaffiliated study participants also used psychoactive drugs to enhance their drinking experiences.

These findings contribute to the research literature in several ways. First, it identifies a specified cohort of students who are participating in high risk drinking. That is, these students are non affiliated with athletics or sororities or fraternities. Second, it analyzes their drinking behavior resulting in information valuable to health professionals who are attempting to create interventions to reduce or prevent high risk drinking among all student populations on their campuses. Third, it clarifies the need for health professionals to target drug use in association with high risk drinking. An important benefit of this type of research is its ability to examine an issue in-depth, giving college administrators and health professionals access to population-specific information around a significant health issue. In an era of budget cuts and reduced staffing on college campuses, it seems important to gather information on particular groups of students to discover their drinking experiences so that administrators can design specific programs to meet their needs.

LIMITATIONS

This study has a number of strengths and limitations. It uses a qualitative research method that enables intensive and thoughtful analysis of a serious health-risk behavior. The information it elicits can be used by colleges and health professionals to pinpoint risky alcohol behaviors by a population of students that has not been extensively studied (e.g. unaffiliated students). The interview format likely facilitated ease of response and confidentiality resulting in a robust study sample.

Some limitations of the study are noteworthy. First, students may have under or over-estimated their recall of risky drinking behavior. This may be related to the phenomenon of euphoric recall in which the salient events of an experience may become distorted by use of alcohol and/or other psychoactive substances taken during that experience. Second, the study sample was small (14 students). Third, there is a limitation to the transferability of this study as the sample consisted predominantly of White undergraduate college students at a small New England college in the United States.

DIRECTIONS FOR FUTURE RESEARCH

Future studies could explore how colleges use information from this research to identify and create targeted interventions to suit the needs of the variety of student populations on their campuses, and whether these interventions are successful in decreasing high risk drinking. It may also be useful to perform a longitudinal study that enrolled a cohort of freshmen and followed them through to their senior year to detect whether high risk drinking behavior changes over time.

CONCLUSION

This study examined high risk drinking practices among unaffiliated college students. Students participated in high risk drinking and actively participated in pre-gaming and drinking games. Other psychoactive substances ranging from marijuana, cocaine, and energy drinks were sometimes used while these students were drinking. These students experienced negative consequences as a result of their drinking, including severe physical illness and assault.

This research may be useful to the professions of education and addictions counseling in the following ways. First, prevention programming and counseling for high risk drinking should not be confined to the traditional intervention groups, but should also target other types of students. Researchers have reported biases around the perception of drinking norms among college students; including the idea that high risk drinking occurs most prevalently among fraternities and sororities (Baer, Kivlahan, and Marlatt, 2006). The findings in this study show that college campuses should also be mindful of the high risk drinking habits of unaffiliated college students. Second, this research found that drinking practices exhibited by the traditional high risk groups are also being shared by other groups of students, thus illustrating the pervasiveness of these practices. Pre-gaming was one such practice identified by subjects interviewed for this study and has been linked in the research literature to higher blood alcohol content on the night, as well as being a predictor of intoxication (Borsari, Boyle, Hustad, et al., 2007). As such, educators and counselors may want to consider creating interventions for these types of practices among such non-traditional drinking groups as unaffiliated students.

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Margaret Smith, EdD, John Finneran, PhD, & Marj Droppa, PhD

Keene State College, Keene, NH

Corespondence concerning this article should be addressed to: Margaret A Smith, EdD, Associate Professor, Keene State College, Keene, NH, msmith@keene.edu, (802) 738 8990.
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Author:Smith, Margaret; Finneran, John; Droppa, Marj
Publication:Journal of Alcohol & Drug Education
Article Type:Report
Date:Apr 1, 2014
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