Predicting Alcohol-Related Problems from Consequence-Specific Constructs, Protective Behaviors, and Alcohol Consumption: Preliminary Results of an NIAAA-Funded Trial Examining First-Year College Students

INTRODUCTION: Alcohol consequences among college students are a significant public health concern. Although drinking is associated with negative outcomes, studies have demonstrated that alcohol-related consequences are multi-determined and routinely influenced by additional factors. The current NIAAA-funded longitudinal study takes an innovative theoretical approach by examining the relationships between both consequence-specific constructs and alcohol consumption in predicting alcohol-related problems. METHOD: Participants were 2024 first-year student drinkers at a large public university from two waves of a prospective design.  First, the study examined whether alcohol consumption, drinking- and consequence-specific protective behaviors mediated the relationship between consequence-specific predictors (willingness to experience consequences, intentions to avoid consequences) and physiological (e.g., vomiting) or non-physiological (e.g., sexual) consequences.  Second, distal intra- and inter-personal consequence-specific constructs (e.g., consequence expectancies; perceived norms about consequences; etc.) were examined as correlates of willingness to experience consequences and intentions to avoid them. RESULTS: Findings revealed differences depending on whether the outcomes were physiological or non-physiological consequences. First, consequence-specific protective behaviors and drinking significantly mediated the effects of willingness and intentions on non-physiological consequences. Second, drinking protective behaviors mediated these relationships only for physiological consequences. Finally, results of analyses evaluating distal predictors of consequences, revealed willingness and intentions were significantly associated with consequence specific expectancies, attitudes, norms and self-efficacy. CONCLUSION: These findings suggest that willingness to experience consequences and intentions to avoid them are central to predicting the protective behaviors directly related to experiencing consequences over and above drinking.  Further, distal predictors are promising targets for future intervention efforts geared toward changing the constructs of willingness to experience and intentions to avoid consequences. Together, the results provide additional support for integrating consequence-specific constructs into alcohol interventions to improve their efficacy at reducing the harmful effects of college student drinking behaviors.