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The International Journal of the Addictions, 27(10), 121 1-1221, 1992
Young Heavy Drinkers and Their Drinking Experiences: Predictors of Later Alcohol Use Rock L. Clapper, Ph.D.,' and Lewis P. Lipsitt, Ph.D.*
' Box G, Center tor Alcohol and Addiction Studies, Brown University, Providence, Rho& Island 02912 *Psychology and Medical Science Department, and Child Study Center, Brown University, Providence, Rhode Island 02912. American Psychological Association, 1200 Seventeenth Street, N. W., Washington, D.C. 20036
ABSTRACT This study illustrated the impact of late adolescent and young adult alcohol experiences on current level of alcohol use. Additional factors investigated include reported age of problem onset, initial age of alcohol use, marital status, and life-span risk-taking behavior. A stepwise discriminant analysis was used to determine the importance of various subtypes of drinking experiences and combinations of these subtypes. Correct classification of current light and heavy alcohol drinkers by use of these experiences was 83.7% for late adolescent experiences and 77.5% for young adulthood experiences. The results suggest that early drinking experiences are useful predictors of future drinking patterns.
Key words. Alcohol experience; Remission; Cessation
INTRODUCTION The decision-making processes which lead individuals to seek change either through treatment or self-change is an important topic concerning 121 I
Copyright 01992 by Marcel Dekker, Inc
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1212
CLAPPER AND LIPSITT
researchers in alcohol and substance use treatment. Studying individuals who have made this effort should enable researchers to identify the psychological and social environmental factors which influenced the decision to change. Given the importance of past alcohol-related problems in the decision to change current drinking status (Stall and Biernacki, 1986), an examination of specific types of alcohol-related experiences preceding a change in alcohol intake appears warranted. Donovan et al. (1983), as part of their ongoing longitudinal research program, found that most of their adolescent and young adult subjects eventually “matured out” of problem drinking, but they do not offer explicit information to illustrate which psychological or social factors contribute to this process. However, they do note that marriage appears to be a correlate of reduced drinking, a finding reported by others who emphasize social support as a key to motivating the change process (Ludwig, 1985; Saunders and Kershaw, 1979; Tuchfeld, 1981). A recent report from the Institute of Medicine (1989) pointed out the need for further research into the influential factors leading to adolescent “remittance” from problem drinking, indicating that 50 to 60% of male adolescent problem drinkers and 75 % of female adolescent problem drinkers remit (Institute of Medicine, 1989, p. 53). A recent investigation concerning factors leading to alcohol cessation or reduction has determined that subjects who reported having problems at one point in time were more likely to report abstinence when reinterviewed approximately 9 years later (Hermos et al., 1988). Subjects who reported having drinking problems that adversely affected their physical health or psychosocial functioning at Time 1 were more likely to be abstinent at Time 2 . This finding was confirmed in another study where it was discovered that more problems were reported by heavy drinking young males than in heavy drinking older males (Fillmore and Midanik, 1984). These authors also report that cessation or a reduction of drinking was higher among the young heavy drinkers. Tuchfeld (1981) also found a relationship between alcohol-related problems and abstinence from alcohol problem drinking, a finding also reported by Clark and Cahalan (1976). The empirical evidence suggests that the number and severity of alcohol-related problems is linked to a reduction of alcohol consumption in heavy alcohol users. In the present exploratory investigation, within the context of a large survey, we examined the importance of different types of drinking experiences that heavy drinking individuals undergo and determined which subtypes of these experiences, or combination of experience subtypes, contributed to their becoming abstinent or infrequent drinkers. Additionally, we examined a number of demographic and behavioral differences between those who have become abstinent or infrequent drinkers and those who have remained heavy drinkers over a span of 25 years.
DRINKING EXPERIENCES OF YOUNG HEAVY DRINKERS
1213
METHOD
Subst Use Misuse Downloaded from informahealthcare.com by ThULB Jena on 11/12/14 For personal use only.
Subjects In 1988, male university alumni ( n = I,OOO) who were freshmen, sophomores, juniors, or seniors 25 years ago were asked to complete a comprehensive questionnaire package containing questions regarding past alcohol use and related thoughts and behaviors, including current functioning. Of the 1,000 individuals who received this mailed packet, 332 respondents returned questionnaires.
Procedure and Questionnaire items Questionnaire packets were mailed to university alumni along with the request that they complete the questionnaire and return it promptly. Respondents were told that the study was an examination of past and current drinking-related activities and informed that information contained in the questionnaire would be confidential. Treatment of the data included coding questionnaires for matching purposes and entering information into a computer file without entering data which could lead to the identification of subjects. Items of interest used in the current study were drawn from the larger questionnaire. Items include: quantity and frequency of alcohol use during the freshman, senior, and current years (Engs, 1977); a life-span risk-taking scale (developed by the second author); the age of the subject’s first drink; multiple experiences with alcohol use during the freshman and senior years (see Porter, 1990); and a question regarding the age of onset of drinking problems. The multiple experiences with alcohol were added together to provide total amounts of alcohol experiences within the subtypes listed below. They can be classified into six substantive types of experiences: negative consequences (e.g., get arrested for DWI, have physical problems, etc.), feeling adjustment (e.g., drink as an aid in forgetting disappointments or worries, drink to cut loose or go wild, etc.), implicative signs (e.g., skip meals when drinking, find it difficult to stop or could not stop drinking before becoming intoxicated, etc.), drinking fears (e.g., seek advice of others regarding your drinking, fear you might become dependent or addicted to alcohol, etc.), aggressive behaviors (e.g., become argumentive or overcritical with others, get into a fight after drinking, etc.), and aggressive attitudes (e.g., feel a party was a flop because there was no alcohol, try to stay 1 or 2 drinks ahead of the others, etc.). Respondents were asked to indicate the frequency of a problem occurring during the year specified. The responses were “has not happened to me during this period,” “has happened only once to me during this period,” and “has happened more than once to me during this period.”
Subst Use Misuse Downloaded from informahealthcare.com by ThULB Jena on 11/12/14 For personal use only.
1214
CLAPPER AND LIPSITT
The five item risk-taking scale had an internal consistency of .66 (see Clapper and Lipsitt, 1991). Interitem correlations ranged from r = .41 to r = .15. A risk-taking scale score was computed for each individual by recoding items where necessary, adding the five items together, and dividing the total by 5. Alcohol use represents a combination of frequency and quantity during each respective year. The categories used were “abstainer,” “infrequent drinker,” “light drinker,” “moderate drinker,” “moderate-heavy drinker,” and “heavy drinker” (Engs, 1977). The frequency item asked subjects “How often, on the average, did you usually have a drink?” Response options ranged from never to daily or almost daily. The quantity item asked subjects “When you drank, how many drinks, on the average, did you USUALLY drink at any one time?” The response options for this item ranged from less than 1 drink to over 6 drinks. The criteria for placement in one of the categories is a function of quantity and frequency of alcohol use. As can be seen in Table 1, a subject would be coded as a “moderate drinker” for a given year if he had any of the frequency and quantity combination of alcohol use items listed.
RESULTS Subjects were selected for these analyses if they were classified as a moderate-heavy drinker or a heavy drinker on the frequency-quantity dimension during their freshman and their senior year of college ( n = 49). Subjects were divided based on current drinking classification. That is, one group was either abstaining or were infrequent drinkers (light drinkers), while the other group was drinking at the same level as they were in college (heavy drinkers).
Table 1. Example of Frequency and Quantity Combination of a “Moderate Drinker” Frequency Frequency Frequency Frequency Frequency Frequency Frequency Frequency
= 3,
= 3, = 4, = = = =
5,
6, 4, 5, = 6,
Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity
=3 = 1 = 1 = I
= I =2
=2 =2
1215
DRINKING EXPERIENCES OF YOUNG HEAVY DRINKERS
Subst Use Misuse Downloaded from informahealthcare.com by ThULB Jena on 11/12/14 For personal use only.
Risk Taking, First Drink, Marital Status, and Drinking Problem Onset ?-Tests for the risk-taking construct found a significant difference between current light (mean = 3.02) and heavy drinkers (mean = 2.59) ( t = 2.19, df = 47, p < .05). The t-test for the age of onset of drinking problems was not significant (means: current light = 22, current heavy = 28). Additionally, the age for the first drink was not significant (means: current light = 13.3, current heavy = 14.7). 78% of the heavy drinkers and 77% of the light drinkers are married, with 10% of the heavy drinkers and 23% of the light drinkers either currently divorced or separated.
Drinking Experiences Means, standard deviations, and univariate F tests of past drinking experience categories for the current light and current heavy drinkers can be seen in Table 2 (freshman year) and Table 3 (senior year). As can be seen, feeling adjustment, implicative signs, aggressive behaviors, and aggressive attitudes are significantly different for the two freshman drinker groups. For the senior drinker groups, the aggressive behaviors variable did not reach significance, but drinking fears did reach significance. Two stepwise discriminant analyses were used so that an interpretation of the impact of drinking experiences for both the freshman and senior years could be made. The stepwise procedure used in the analysis chooses the variable which has the greatest possibility of minimizing the overall Wilks' lambda
Table 2. Tofa/ Freshman Drinking Experiences Means and Standard Deviations for Current Light and Heavy Drinkers ~
~
Light
Heavy
Drinking experience
M
SD
M
SD
F
Negative consequences Feeling adjustment Implicative signs Drinking fears Aggressive behaviors Aggressive attitudes
7.4 7.4 3.2 2.4 1.8 1.5
5.8 2.1 2.4 0.4 I .6 I .7
5.8 4.8 1.6 0. I 0.8 0.6
3.8 2.4 1.6 0.2 1.1 0.9
1.34 I3.32** 7.98** 3.16 5.45* 5.97"
* p < .05. * * p < .01.
CLAPPER AND LIPSITT
1216
Table 3. Total Senior Drinking Experiences Means and Standard Deviations for Current Light and Heavy Drinkers
Subst Use Misuse Downloaded from informahealthcare.com by ThULB Jena on 11/12/14 For personal use only.
Light
Heavy
Drinking experience
M
SD
M
SD
Negative consequences Feeling adjustment Implicative signs Drinking fears Aggressive behaviors Aggressive attitudes
8.8 7.4 3.8 0.6 1.8 I .9
6.4 2.9 3 .O I .2 1.6 I .7
7. I 5. I 2 .o 0. I 1.1
3.5 2 .I I .8 0.4 I .I
0.6
1 .o
*p < **p
F I .46 7.99** 6.69** 5.19*
3.60 I1.52**
.os.
The International Journal of the Addictions, 27(10), 121 1-1221, 1992
Young Heavy Drinkers and Their Drinking Experiences: Predictors of Later Alcohol Use Rock L. Clapper, Ph.D.,' and Lewis P. Lipsitt, Ph.D.*
' Box G, Center tor Alcohol and Addiction Studies, Brown University, Providence, Rho& Island 02912 *Psychology and Medical Science Department, and Child Study Center, Brown University, Providence, Rhode Island 02912. American Psychological Association, 1200 Seventeenth Street, N. W., Washington, D.C. 20036
ABSTRACT This study illustrated the impact of late adolescent and young adult alcohol experiences on current level of alcohol use. Additional factors investigated include reported age of problem onset, initial age of alcohol use, marital status, and life-span risk-taking behavior. A stepwise discriminant analysis was used to determine the importance of various subtypes of drinking experiences and combinations of these subtypes. Correct classification of current light and heavy alcohol drinkers by use of these experiences was 83.7% for late adolescent experiences and 77.5% for young adulthood experiences. The results suggest that early drinking experiences are useful predictors of future drinking patterns.
Key words. Alcohol experience; Remission; Cessation
INTRODUCTION The decision-making processes which lead individuals to seek change either through treatment or self-change is an important topic concerning 121 I
Copyright 01992 by Marcel Dekker, Inc
Subst Use Misuse Downloaded from informahealthcare.com by ThULB Jena on 11/12/14 For personal use only.
1212
CLAPPER AND LIPSITT
researchers in alcohol and substance use treatment. Studying individuals who have made this effort should enable researchers to identify the psychological and social environmental factors which influenced the decision to change. Given the importance of past alcohol-related problems in the decision to change current drinking status (Stall and Biernacki, 1986), an examination of specific types of alcohol-related experiences preceding a change in alcohol intake appears warranted. Donovan et al. (1983), as part of their ongoing longitudinal research program, found that most of their adolescent and young adult subjects eventually “matured out” of problem drinking, but they do not offer explicit information to illustrate which psychological or social factors contribute to this process. However, they do note that marriage appears to be a correlate of reduced drinking, a finding reported by others who emphasize social support as a key to motivating the change process (Ludwig, 1985; Saunders and Kershaw, 1979; Tuchfeld, 1981). A recent report from the Institute of Medicine (1989) pointed out the need for further research into the influential factors leading to adolescent “remittance” from problem drinking, indicating that 50 to 60% of male adolescent problem drinkers and 75 % of female adolescent problem drinkers remit (Institute of Medicine, 1989, p. 53). A recent investigation concerning factors leading to alcohol cessation or reduction has determined that subjects who reported having problems at one point in time were more likely to report abstinence when reinterviewed approximately 9 years later (Hermos et al., 1988). Subjects who reported having drinking problems that adversely affected their physical health or psychosocial functioning at Time 1 were more likely to be abstinent at Time 2 . This finding was confirmed in another study where it was discovered that more problems were reported by heavy drinking young males than in heavy drinking older males (Fillmore and Midanik, 1984). These authors also report that cessation or a reduction of drinking was higher among the young heavy drinkers. Tuchfeld (1981) also found a relationship between alcohol-related problems and abstinence from alcohol problem drinking, a finding also reported by Clark and Cahalan (1976). The empirical evidence suggests that the number and severity of alcohol-related problems is linked to a reduction of alcohol consumption in heavy alcohol users. In the present exploratory investigation, within the context of a large survey, we examined the importance of different types of drinking experiences that heavy drinking individuals undergo and determined which subtypes of these experiences, or combination of experience subtypes, contributed to their becoming abstinent or infrequent drinkers. Additionally, we examined a number of demographic and behavioral differences between those who have become abstinent or infrequent drinkers and those who have remained heavy drinkers over a span of 25 years.
DRINKING EXPERIENCES OF YOUNG HEAVY DRINKERS
1213
METHOD
Subst Use Misuse Downloaded from informahealthcare.com by ThULB Jena on 11/12/14 For personal use only.
Subjects In 1988, male university alumni ( n = I,OOO) who were freshmen, sophomores, juniors, or seniors 25 years ago were asked to complete a comprehensive questionnaire package containing questions regarding past alcohol use and related thoughts and behaviors, including current functioning. Of the 1,000 individuals who received this mailed packet, 332 respondents returned questionnaires.
Procedure and Questionnaire items Questionnaire packets were mailed to university alumni along with the request that they complete the questionnaire and return it promptly. Respondents were told that the study was an examination of past and current drinking-related activities and informed that information contained in the questionnaire would be confidential. Treatment of the data included coding questionnaires for matching purposes and entering information into a computer file without entering data which could lead to the identification of subjects. Items of interest used in the current study were drawn from the larger questionnaire. Items include: quantity and frequency of alcohol use during the freshman, senior, and current years (Engs, 1977); a life-span risk-taking scale (developed by the second author); the age of the subject’s first drink; multiple experiences with alcohol use during the freshman and senior years (see Porter, 1990); and a question regarding the age of onset of drinking problems. The multiple experiences with alcohol were added together to provide total amounts of alcohol experiences within the subtypes listed below. They can be classified into six substantive types of experiences: negative consequences (e.g., get arrested for DWI, have physical problems, etc.), feeling adjustment (e.g., drink as an aid in forgetting disappointments or worries, drink to cut loose or go wild, etc.), implicative signs (e.g., skip meals when drinking, find it difficult to stop or could not stop drinking before becoming intoxicated, etc.), drinking fears (e.g., seek advice of others regarding your drinking, fear you might become dependent or addicted to alcohol, etc.), aggressive behaviors (e.g., become argumentive or overcritical with others, get into a fight after drinking, etc.), and aggressive attitudes (e.g., feel a party was a flop because there was no alcohol, try to stay 1 or 2 drinks ahead of the others, etc.). Respondents were asked to indicate the frequency of a problem occurring during the year specified. The responses were “has not happened to me during this period,” “has happened only once to me during this period,” and “has happened more than once to me during this period.”
Subst Use Misuse Downloaded from informahealthcare.com by ThULB Jena on 11/12/14 For personal use only.
1214
CLAPPER AND LIPSITT
The five item risk-taking scale had an internal consistency of .66 (see Clapper and Lipsitt, 1991). Interitem correlations ranged from r = .41 to r = .15. A risk-taking scale score was computed for each individual by recoding items where necessary, adding the five items together, and dividing the total by 5. Alcohol use represents a combination of frequency and quantity during each respective year. The categories used were “abstainer,” “infrequent drinker,” “light drinker,” “moderate drinker,” “moderate-heavy drinker,” and “heavy drinker” (Engs, 1977). The frequency item asked subjects “How often, on the average, did you usually have a drink?” Response options ranged from never to daily or almost daily. The quantity item asked subjects “When you drank, how many drinks, on the average, did you USUALLY drink at any one time?” The response options for this item ranged from less than 1 drink to over 6 drinks. The criteria for placement in one of the categories is a function of quantity and frequency of alcohol use. As can be seen in Table 1, a subject would be coded as a “moderate drinker” for a given year if he had any of the frequency and quantity combination of alcohol use items listed.
RESULTS Subjects were selected for these analyses if they were classified as a moderate-heavy drinker or a heavy drinker on the frequency-quantity dimension during their freshman and their senior year of college ( n = 49). Subjects were divided based on current drinking classification. That is, one group was either abstaining or were infrequent drinkers (light drinkers), while the other group was drinking at the same level as they were in college (heavy drinkers).
Table 1. Example of Frequency and Quantity Combination of a “Moderate Drinker” Frequency Frequency Frequency Frequency Frequency Frequency Frequency Frequency
= 3,
= 3, = 4, = = = =
5,
6, 4, 5, = 6,
Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity
=3 = 1 = 1 = I
= I =2
=2 =2
1215
DRINKING EXPERIENCES OF YOUNG HEAVY DRINKERS
Subst Use Misuse Downloaded from informahealthcare.com by ThULB Jena on 11/12/14 For personal use only.
Risk Taking, First Drink, Marital Status, and Drinking Problem Onset ?-Tests for the risk-taking construct found a significant difference between current light (mean = 3.02) and heavy drinkers (mean = 2.59) ( t = 2.19, df = 47, p < .05). The t-test for the age of onset of drinking problems was not significant (means: current light = 22, current heavy = 28). Additionally, the age for the first drink was not significant (means: current light = 13.3, current heavy = 14.7). 78% of the heavy drinkers and 77% of the light drinkers are married, with 10% of the heavy drinkers and 23% of the light drinkers either currently divorced or separated.
Drinking Experiences Means, standard deviations, and univariate F tests of past drinking experience categories for the current light and current heavy drinkers can be seen in Table 2 (freshman year) and Table 3 (senior year). As can be seen, feeling adjustment, implicative signs, aggressive behaviors, and aggressive attitudes are significantly different for the two freshman drinker groups. For the senior drinker groups, the aggressive behaviors variable did not reach significance, but drinking fears did reach significance. Two stepwise discriminant analyses were used so that an interpretation of the impact of drinking experiences for both the freshman and senior years could be made. The stepwise procedure used in the analysis chooses the variable which has the greatest possibility of minimizing the overall Wilks' lambda
Table 2. Tofa/ Freshman Drinking Experiences Means and Standard Deviations for Current Light and Heavy Drinkers ~
~
Light
Heavy
Drinking experience
M
SD
M
SD
F
Negative consequences Feeling adjustment Implicative signs Drinking fears Aggressive behaviors Aggressive attitudes
7.4 7.4 3.2 2.4 1.8 1.5
5.8 2.1 2.4 0.4 I .6 I .7
5.8 4.8 1.6 0. I 0.8 0.6
3.8 2.4 1.6 0.2 1.1 0.9
1.34 I3.32** 7.98** 3.16 5.45* 5.97"
* p < .05. * * p < .01.
CLAPPER AND LIPSITT
1216
Table 3. Total Senior Drinking Experiences Means and Standard Deviations for Current Light and Heavy Drinkers
Subst Use Misuse Downloaded from informahealthcare.com by ThULB Jena on 11/12/14 For personal use only.
Light
Heavy
Drinking experience
M
SD
M
SD
Negative consequences Feeling adjustment Implicative signs Drinking fears Aggressive behaviors Aggressive attitudes
8.8 7.4 3.8 0.6 1.8 I .9
6.4 2.9 3 .O I .2 1.6 I .7
7. I 5. I 2 .o 0. I 1.1
3.5 2 .I I .8 0.4 I .I
0.6
1 .o
*p < **p
F I .46 7.99** 6.69** 5.19*
3.60 I1.52**
.os.
