Addictive Behaviors 39 (2014) 1159–1162
Contents lists available at ScienceDirect
Addictive Behaviors
Short Communication
The role of personality variables in drinking game participation Andrea R. Diulio, Mark M. Silvestri, Christopher J. Correia ⁎ Auburn University, Department of Psychology, 226 Thach Hall, Auburn, AL 36849, United States
H I G H L I G H T S • • • •
Impulsivity and sensation seeking associated with frequency of drinking game play. Impulsivity and sensation seeking associated with negative consequences. Impulsivity and sensation seeking had direct and indirect effects on consequences. Results highlight relationship between personality and risky drinking.
a r t i c l e
i n f o
Available online 3 March 2014 Keywords: Alcohol Personality Drinking games College students
a b s t r a c t Drinking games are prevalent among college student and associated with increased risk of experiencing negative alcohol-related consequences. Personality variables, and specifically impulsivity and sensation seeking, have been linked to increased alcohol consumption and related negative consequences, but research on the relationship between personality and drinking game participation is limited. The current study used path analysis to assess the impact of sensation seeking and impulsivity on frequency of drinking game participation and related consequences in a sample of undergraduate college students. Findings suggest that sensation seeking and impulsivity are positively associated with frequency of drinking game participation. Both impulsivity and sensation seeking had a direct effect on negative consequences associated with drinking games, and both had an indirect relationship when controlling for the frequency of drinking game participation. The results are largely consistent with previous studies in suggesting that impulsivity and sensation seeking play a role in predicting risky alcohol use and related negative consequences. Understanding the relationship between personality variables and negative drinking game consequences may better inform the treatment of hazardous drinking among college students. © 2014 Elsevier Ltd. All rights reserved.
1. Introduction Alcohol consumption is common on college campuses, with 71.8% of students reporting drinking in the past 30 days (Core Institute, 2006) and about half report binge drinking (≥ 5 drinks for males, ≥ 4 for females) (e.g. Johnston, O'Malley, Bachman, & Schulenberg, 2012). College binge drinking is associated with increased reports of alcohol related consequences such as unplanned sexual relations, legal problem, and nausea (e.g. Hingson & White, 2013). However, previous findings (e.g., White & Labouvie, 1989) indicate that quantity and frequency of drinking do not fully account for negative consequences, suggesting a need to consider unique drinking practices and intrapersonal factors that also contribute to risk. One variable that consistently predicts binge drinking and related problems is drinking game (DG) participation (Borsari, 2004; Pedersen & LaBrie, 2006). DGs refer to “social activities in which standardized ⁎ Corresponding author. Tel.: +1 334 844 6480; fax: +1 334 844 4447. E-mail address: [email protected] (C.J. Correia).
http://dx.doi.org/10.1016/j.addbeh.2014.02.005 0306-4603/© 2014 Elsevier Ltd. All rights reserved.
rules determine the amount of and the manner in which alcohol is consumed” (Polizzotto, Saw, Tjhung, Chua, & Stockwell, 2007, p. 469). Participation in DGs is relatively common among college students (Borsari, 2004; Neighbors, Foster, Fossos, & Lewis, 2013), and playing DGs has been associated with higher BrAC levels (Breath Alcohol Concentration; Borsari, Bergen-Cico, & Carey, 2003; Clapp, Johnson, Shillington, Lange, & Voas, 2008), and negative alcohol-related consequences (e.g. Cameron et al., 2010). Given the prevalence and unique risks associated with of DGs, it is imperative to examine intrapersonal factors that may contribute to DG participation as well as the associated negative consequences. Literature on college drinking points to personality traits, specifically sensation seeking and impulsivity, as personal factors accounting for some variability in alcohol use (Baer, 2002; Ham & Hope, 2003). Impulsivity is defined as carelessness and quick decision-making (Evenden, 1999). Previous studies have suggested that impulsivity is associated with alcohol use and related problems among college students (e.g., MacKillop, Mattson, Anderson, Castelda, & Donovick, 2007; Simons, Gaher, Oliver, Bush, & Palmer, 2005). Sensation seeking is the tendency to seek out
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novel experiences and risk taking (Zuckerman, 1994). An association between sensation seeking and alcohol consumption has been demonstrated in several studies (e.g., Simons, Gaher, Oliver, et al., 2005), with those high in sensation seeking reporting higher levels of alcohol consumption (Quinn, Stappenbeck, & Fromme, 2011). Recently these personality traits have been investigated in the context of high risk drinking events. For example, the amount that college students consume while celebrating 21st birthdays and their beliefs about the role of alcohol during these celebrations, have been found to be related positively to these personality traits (Day-Cameron, Muse, Hauenstein, Simmons, & Correia, 2009). Two previous studies have looked at the relationship between sensation seeking and DG participation in samples of college students. One study linked DG participation and associated negative consequences to higher levels of sensation seeking (Johnson & Cropsey, 2000). The second study found that individuals high in sensation seeking may continue to play these games for fun and excitement, despite the increased risk of negative consequences; the study also found that students low in sensation seeking tend to have negative attitudes towards DGs (Johnson & Cohen, 2004). To our knowledge there are no published studies linking impulsivity to DG participation among college students. However, one study of high school students identified an association between impulsivity and experiencing a report regrettable sexual situations following DG participation (Borsari et al., 2013). While it has been suggested that sensation seeking and impulsivity represent aspects of a single unitary construct (see Baer, 2002), recent empirical work suggests that they can be viewed as overlapping but distinct aspects of behavior (e.g., Magid, MacLean, & Colder, 2007; Smith et al., 2007). Magid et al. (2007) suggest that failing to include measures of both traits can mask or confound unique relationships between sensation seeking, impulsivity, and alcohol use among college students. Studies that have simultaneously investigated sensation seeking and impulsivity have reported that both play a role in the prediction of alcohol use, although through different mediational pathways (Lammers, Kuntsche, Engels, Wiers, & Kleinjan, 2013; Magid et al., 2007; Simons, 2003; Simons, Gaher, Correia, Hansen, & Christopher, 2005). For example, Magid et al. (2007) noted that the effect of sensation seeking on alcohol consequences was mediated by frequency of drinking and drinking motives, whereas the effect of impulsivity on alcohol-related problems was mediated through coping motives but not frequency of drinking. Similarly, Simons (2003) and Simons, Gaher, Correia, et al. (2005) have reported that impulsivity is directly related to alcoholrelated problems and sensation seeking is indirectly related to motives and frequency of use. However, Lammers et al. (2013) reported that the relationships between drinking behavior (frequency of use, binge drinking, and alcohol-related problems) and both impulsivity and sensations seeking were mediated – but through different motivational variables – in a sample of adolescents. As a set these studies present inconsistent findings, suggesting that additional work is needed to further understand the mechanisms through which both impulsivity and sensation seeking are related to negative drinking outcomes. Magid et al. (2007) made a strong case for developing theoretical accounts to understand these mechanisms. In short, individual with elevated sensation seeking are likely to consume alcohol to increase arousal, which may indirectly lead to increased consequences. Elevated impulsivity is often characterized by failure to inhibit behavior and poor attempts at coping with distress; these features are thought to be more directly related to experiencing negative alcohol-related consequences. Understanding the mechanisms through which various personality traits lead to alcohol use and related problems has implications for prevention and intervention efforts. 1.1. Current study Recent studies report that a significant proportion of college students engage in DGs, and that such participation can result in a variety
of negative outcomes. The findings from these studies suggest that both sensation seeking and impulsivity are linked to increased alcohol consumption, negative alcohol-related consequences, and DG participation. However, no published studies have simultaneously investigated the association between DG and both sensation and impulsivity in a sample of college students, and previous studies on the mechanisms through which these personality variables relate to alcohol-related problems have produced inconsistent results The current study attempted to bridge this gap by examining the impact of sensation seeking and impulsivity on frequency of DG participation and related consequences using a path analytic model. Based on previously published studies on the link between personality and alcohol-related problems, we expected that the relationship between sensation seeking and negative DG consequences would be mediated by frequency of DG participation. The literature on the potential for the frequency of DG participation to mediate the relationship between impulsivity and DG consequences was less clear; in the current study both direct and indirect relationships were assessed. 2. Method 2.1. Participants Participants were 831 undergraduates (71% female, mean age: 20.38, 81% White) enrolled at large public Southeastern University, who completed an online survey in exchange for course credit. Nearly 70% of participants reported drinking in the past 30 days, with an average of 10 drinks a week. Lifetime participation in a DG was endorsed by 81% of the sample; 53% reported playing in the past month, with 79% of those who played in the past month reporting at least one negative DG consequence in the past month. 2.2. Measures The Eysenck Impulsiveness Scale (EPI; Eysenck, Pearson, Easting, & Allsopp, 1985) was used to assess Impulsivity. Sensation seeking was assessed with a 16-item scale adapted from the work of Zuckerman's Sensation Seeking Scales (Donohew et al., 2000; Zuckerman, 1979). The Hazardous Drinking Games Measure (HDGM) was used to measure frequency and negative consequences of DG (Borsari et al., 2003, 2013). Participants indicated how often in the past 30 days they played DGs, from 1 (Never) to 5 (Four or More Times a Week) and if they experienced a series of negative DG consequences. 2.3. Data editing Univariate outliers, as defined as +/− two interquartile values from the median, were identified for sensation seeking, and were changed to two interquartiles from the median. Univariate outliers were also identified for consequences of DGs; however, after further assessing the data the consequences of DGs outliers were determined to be indicative of the intended population and were not deleted or modified. Seven
Table 1 Descriptive statistics and bivariate correlations (N = 831). Variables
M
(SD)
Range
1.
2.
3.
1. Impulsivity 2. Sensation Seeking 3. Frequency of Game Play 4. Drinking Game Consequences
7.09 52.37 2.03 0.92
4.32 9.84 1.12 1.41
0–18 24–75 1–5 0–8
– 0.40⁎ 0.29⁎ 0.36⁎
– 0.41⁎ 0.36⁎
– 0.63⁎
Note: Impulsivity: Eysenck Impulsivity Scale total score. Sensation seeking: total sensation seeking score. Frequency of Game Play: Number of times participant played drinking games in the past month (1 = 0 times, 2 = once, 3 = 2–4 times a month, 4 = 2–3 times a week, 5 = 4 or more times a week). Drinking game consequences: sum of number of drinking game consequences endorsed. ⁎ p b 0.001.
A.R. Diulio et al. / Addictive Behaviors 39 (2014) 1159–1162
cases of multivariate outliers were identified using Mahalanobis distance; however, they were determined to be reflective of the intended population and therefore not deleted. 3. Results 3.1. Descriptive statistics and bivariate correlations Descriptive statistics and bivariate correlations are presented in Table 1. Sensation seeking and impulsivity were positively associated with each other. Both personality variables exhibited modest positive associations with consequences of game play. Frequency of DG play exhibited a substantial positive association with consequences of DG play. Finally, impulsivity exhibited a low positive association with frequency of DG play; whereas sensation seeking demonstrated a moderate association with frequency of DG play. 3.2. Path analysis The path model was tested using Mplus (Muthén & Muthén, 2011). In the current model, direct pathways from sensation seeking and impulsivity to frequency and negative consequences of DG were identified. We also correlated sensation seeking with impulsivity. Given that the model is just-identified (therefore perfectly fitting the data), fit indices have little utility and are not reported (Kline, 2010). Results indicated direct effects of impulsivity on both DG frequency and consequences of DG, direct effects from sensation seeking on both DG frequency and consequences of DG, and a direct effect from DG frequency on negative consequences (Fig. 1). Indirect effects were calculated using bias corrected bootstrapped confidence intervals (5000 samples were drawn). Results indicated a significant indirect effect from sensation seeking to DG consequences via frequency of DG (β = 0.19, p b 0.001), and an indirect effect from impulsivity to consequences via frequency (β = 0.08, p b 0.001). 4. Discussion Findings suggest that sensation seeking and impulsivity are positively associated with frequency of DGs, with sensation seeking displaying a slightly stronger relationship. The fact that both sensation seeking and impulsivity were related to alcohol use variables underscores the complex nature of DG participation. Decisions to play DGs are likely related to tendencies towards a desire to optimize positive affect (sensation seeking) and a propensity to take risks and act rashly (impulsivity). Studies investigating the relationships between personality, motives for drinking, and more general drinking patterns have been informative (Magid et al., 2007; Simons, Gaher, Correia, et al., 2005). Similar studies focusing on how personality variables influence motives to participate in DGs and actual frequency of DG participation are warranted. Greater sensation seeking and impulsivity were also found to be associated with greater endorsement of negative consequences, even when accounting for frequency of play. These results are consistent with previous research demonstrating a relationship between Impulsivity 0.17* 0.15*
Frequency of Playing Games
0.40*
0.55*
Consequences of Games Play
0.35* 0.07*
Sensation Seeking
Fig. 1. Path analysis model (N = 831). All values are standardized coefficients. *p b 0.01.
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impulsivity and sensation seeking with risky alcohol use (e.g. Ham & Hope, 2003; Simons, Gaher, Oliver, et al., 2005) and lend support to the notion that DG participation can function as a high-risk drinking event. The indirect relationship between sensation seeking and DG consequences, with frequency of DG participation serving as a mediator, is consistent with previous research (Magid et al., 2007). However, in contrast to previously reviewed studies our results found that both sensation seeking and impulsivity displayed both direct and indirect (though frequency of play) associations with DG consequences. It is unclear if our divergent results are due to a focus on a specific form of risky drinking and not more general patterns of alcohol use. Additional research on the direct and indirect (mediational) pathways between personality, frequency of DG participation, and negative outcomes of DG participation would be useful in determining the theoretical role that different aspects of personality play in DG-related behavior. In addition, this line of research should be extended to other forms of risky drinking (e.g., spring break, tailgating, pre-gaming, 21st birthday celebrations). Perhaps more practically speaking, such research would also help determine individual difference variables that account for the negative outcomes that some but not all students who participate in DGs and other forms of high-risk drinking experience (e.g., Borsari et al., 2013). 4.1. Limitations The cross sectional design of the study allows for the measurement of statistical associations among variables. However, due to personality variables and frequency and negative consequences of DG being simultaneously measured, course of endorsement for each variable cannot be determined. Relatedly, path analysis was designed to model causal relationships between variables; however, the paths of the current model are limited in regards to causality due to the use of cross-sectional data. A follow-up study that collects longitudinal data will need to be performed to confirm the sequence in which the variables may impact each other, as well as to confirm the findings in a second unique sample of students. Relatedly, the study's participant demographics (i.e., primarily Caucasian females who were under 21 years old) limit the study's generalizability. A follow up study with greater male participation and ethnic diversity should be conducted to determine if the same model can be applied to the general student population. Regarding the path analysis, there are alternative and near-alternative models that could produce similar fit. In regards to equivalent models, any variation of the current model will continue to result in a perfect fit given that the model is just-identified. Finally, the EPI assesses personality as a unitary construct. Impulsivity measures that assess distinct components of impulsivity would allow for the evaluation of more specific correlates of drinking game behavior (see Sharma, Markon, & Clark, 2013, for a review of measures). 4.2. Clinical implications Despite these limitations, the study contributes to the existing literature regarding drinking games among college students. To our knowledge, no previous study has examined the relationships between impulsivity, sensation seeking, frequency of playing drinking games, and negative consequences associated with game play. The study points to the direct relationships between impulsivity and sensation seeking with negative consequences related to DG participation. Ultimately, understanding the relationship between personality variables and negative drinking game consequences may better inform the treatment of hazardous drinking among college students. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has suggested that multifaceted, event-specific prevention efforts for college students be implemented by universities and communities in an effort to reduce problematic alcohol consumption (NIAAA, 2002). Neighbors et al. (2007) have taken this recommendation and applied it to a variety of high-risk behaviors; the recommended intervention and prevention
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strategies incorporate individual-focused interventions, environmental changes, and policy changes. To date, these recommendations have not been applied to interventions designed to address DG participation. Relatedly, interventions informed by the relationships between personality and alcohol use have been developed (e.g. Conrod, Castellanos, & Mackie, 2008), but this work has not been tailored to address the link between personality and DGs. Thus further research is needed to determine how a range of prevention and intervention strategies can be utilized to reduce the risks associated with DG participation. Role of funding sources This study was not externally funded. Auburn University had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. Contributors Correia designed the study, wrote the IRB protocol and oversaw the collection of data. Diulio and Silvestri conducted data analysis. Diulio wrote an initial draft of the manuscript, and Silvestri and Correia contributed to subsequent draft. All authors contributed to and have approved the final manuscript. Conflict of interest All authors declare that they have no conflicts of interest.
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Ham, L. S., & Hope, D. A. (2003). College students and problematic drinking: A review of the literature. Clinical Psychology Review, 23, 719–759. Hingson, R. W., & White, A.M. (2013). Prevalence and consequences of college student alcohol use. In C. J. Correia, J. G. Murphy, & N.P. Barnett's (Eds.), College student alcohol abuse: A guide to assessment, intervention, and prevention (pp. 3–24). Hoboken, NJ: Wiley. Johnson, T., & Cohen, E. (2004). College students' reasons for not drinking and not playing drinking games. Substance Use & Misuse, 39(7), 1137–1160. Johnson, T. J., & Cropsey, K. L. (2000). Sensation seeking and drinking game participation in heavy-drinking college students. Addictive Behaviors, 25, 109–116. Johnston, L. D., O'Malley, P.M., Bachman, J. G., & Schulenberg, J. E. (2012). Monitoring the Future national survey results on drug use, 1975–2011: Volume II, College students and adults ages 19–50. Ann Arbor: Institute for Social Research, The University of Michigan. Kline, R. B. (2010). Principles and practice of structural equation modeling (3rd ed.). New York: The Guilford Press. Lammers, J., Kuntsche, E., Engels, R., Wiers, R. W., & Kleinjan, M. (2013). Mediational relations of substance use risk profiles, alcohol-related outcomes, and drinking motives among young adolescents in the Netherlands. Drug and Alcohol Dependence, 133, 571–579. MacKillop, J., Mattson, R. E., Anderson, E. J., Castelda, B.A., & Donovick, P. J. (2007). Multidimensional assessment of impulsivity in undergraduate hazardous drinkers and controls. Journal of Studies on Alcohol and Drugs, 68, 785–788. Magid, V., MacLean, M. G., & Colder, C. R. (2007). Differentiation between sensation seeking and impulsivity through their mediated relations with alcohol use and problems. Addictive Behaviors, 32, 2046–2061. Muthén, L. K., & Muthén, B. O. (1998–2011). Mplus user's guide (6th ed.). Los Angeles, CA: Muthén & Muthén. National Institute on Alcohol Abuse and Alcoholism (2002). A call to action: Changing the culture of drinking at U.S. colleges. Washington, DC: Author. Neighbors, C., Foster, D. W., Fossos, N., & Lewis, M.A. (2013). Window of risk: Events and contexts associated with extreme drinking. In C. J. Correia, J. G. Murphy, & N.P. Barnett's (Eds.), College student alcohol abuse: A guide to assessment, intervention, and prevention (pp. 53–80). Hoboken, NJ: Wiley. Neighbors, C., Walters, S. T., Lee, C. M., Vader, A.M., Vehige, T., Szigethy, T., et al. (2007). Event-specific prevention: Addressing college student drinking during known windows of risk. Addictive Behaviors, 32, 2667–2680. Pedersen, E., & LaBrie, J. (2006). Drinking game participation among college students: Gender and ethnic implications. Addictive Behaviors, 31(11), 2105–2115. Polizzotto, M., Saw, M., Tjhung, I., Chua, E., & Stockwell, T. (2007). Fluid skills: Drinking games and alcohol consumption among Australian university students. Drug and Alcohol Review, 26(5), 469–475. Quinn, P. D., Stappenbeck, C. A., & Fromme, K. (2011). Collegiate heavy drinking prospectively predicts change in sensation seeking and impulsivity. Journal of Abnormal Psychology, 3, 543–556. Sharma, L., Markon, K. E., & Clark, L. A. (2013). Toward a theory of distinct types of “impulsive” behaviors: A meta-analysis of self-report and behavioral measures. Psychological Bulletin. http://dx.doi.org/10.1037/a0034418 (Advance online publication). Simons, J. S. (2003). Differential prediction of alcohol use and problems: The role of biopsychological and social– environmental variables. American Journal of Drug and Alcohol Abuse, 29, 861–879. Simons, J. S., Gaher, R. M., Correia, C. J., Hansen, C. L., & Christopher, M. S. (2005). An affective-motivational model of marijuana and alcohol problems. Psychology of Addictive Behaviors, 19, 326–334. Simons, J. S., Gaher, R. M., Oliver, M. N. I., Bush, J. A., & Palmer, M.A. (2005). An experience sampling study of associations between affect and alcohol use and problems among college students. Journal of Studies on Alcohol, 66, 459–469. Smith, G. T., Fischer, S., Cyders, M.A., Annus, A.M., Spillane, N. S., & McCarthy, D.M. (2007). On the validity and utility of discriminating among impulsivity-like traits. Assessment, 14(2), 155–170. White, H. R., & Labouvie, E. W. (1989). Towards the assessment of adolescent problem drinking. Journal of Studies on Alcohol, 50, 30–37. Zuckerman, M. (1979). Sensation seeking: Beyond the optimal level of arousal. Hillsdale, NJ: Lawrence Erlbaum. Zuckerman, M. (1994). Behavioral expression and biosocial bases of sensation seeking. New York: Cambridge University Press.
Contents lists available at ScienceDirect
Addictive Behaviors
Short Communication
The role of personality variables in drinking game participation Andrea R. Diulio, Mark M. Silvestri, Christopher J. Correia ⁎ Auburn University, Department of Psychology, 226 Thach Hall, Auburn, AL 36849, United States
H I G H L I G H T S • • • •
Impulsivity and sensation seeking associated with frequency of drinking game play. Impulsivity and sensation seeking associated with negative consequences. Impulsivity and sensation seeking had direct and indirect effects on consequences. Results highlight relationship between personality and risky drinking.
a r t i c l e
i n f o
Available online 3 March 2014 Keywords: Alcohol Personality Drinking games College students
a b s t r a c t Drinking games are prevalent among college student and associated with increased risk of experiencing negative alcohol-related consequences. Personality variables, and specifically impulsivity and sensation seeking, have been linked to increased alcohol consumption and related negative consequences, but research on the relationship between personality and drinking game participation is limited. The current study used path analysis to assess the impact of sensation seeking and impulsivity on frequency of drinking game participation and related consequences in a sample of undergraduate college students. Findings suggest that sensation seeking and impulsivity are positively associated with frequency of drinking game participation. Both impulsivity and sensation seeking had a direct effect on negative consequences associated with drinking games, and both had an indirect relationship when controlling for the frequency of drinking game participation. The results are largely consistent with previous studies in suggesting that impulsivity and sensation seeking play a role in predicting risky alcohol use and related negative consequences. Understanding the relationship between personality variables and negative drinking game consequences may better inform the treatment of hazardous drinking among college students. © 2014 Elsevier Ltd. All rights reserved.
1. Introduction Alcohol consumption is common on college campuses, with 71.8% of students reporting drinking in the past 30 days (Core Institute, 2006) and about half report binge drinking (≥ 5 drinks for males, ≥ 4 for females) (e.g. Johnston, O'Malley, Bachman, & Schulenberg, 2012). College binge drinking is associated with increased reports of alcohol related consequences such as unplanned sexual relations, legal problem, and nausea (e.g. Hingson & White, 2013). However, previous findings (e.g., White & Labouvie, 1989) indicate that quantity and frequency of drinking do not fully account for negative consequences, suggesting a need to consider unique drinking practices and intrapersonal factors that also contribute to risk. One variable that consistently predicts binge drinking and related problems is drinking game (DG) participation (Borsari, 2004; Pedersen & LaBrie, 2006). DGs refer to “social activities in which standardized ⁎ Corresponding author. Tel.: +1 334 844 6480; fax: +1 334 844 4447. E-mail address: [email protected] (C.J. Correia).
http://dx.doi.org/10.1016/j.addbeh.2014.02.005 0306-4603/© 2014 Elsevier Ltd. All rights reserved.
rules determine the amount of and the manner in which alcohol is consumed” (Polizzotto, Saw, Tjhung, Chua, & Stockwell, 2007, p. 469). Participation in DGs is relatively common among college students (Borsari, 2004; Neighbors, Foster, Fossos, & Lewis, 2013), and playing DGs has been associated with higher BrAC levels (Breath Alcohol Concentration; Borsari, Bergen-Cico, & Carey, 2003; Clapp, Johnson, Shillington, Lange, & Voas, 2008), and negative alcohol-related consequences (e.g. Cameron et al., 2010). Given the prevalence and unique risks associated with of DGs, it is imperative to examine intrapersonal factors that may contribute to DG participation as well as the associated negative consequences. Literature on college drinking points to personality traits, specifically sensation seeking and impulsivity, as personal factors accounting for some variability in alcohol use (Baer, 2002; Ham & Hope, 2003). Impulsivity is defined as carelessness and quick decision-making (Evenden, 1999). Previous studies have suggested that impulsivity is associated with alcohol use and related problems among college students (e.g., MacKillop, Mattson, Anderson, Castelda, & Donovick, 2007; Simons, Gaher, Oliver, Bush, & Palmer, 2005). Sensation seeking is the tendency to seek out
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novel experiences and risk taking (Zuckerman, 1994). An association between sensation seeking and alcohol consumption has been demonstrated in several studies (e.g., Simons, Gaher, Oliver, et al., 2005), with those high in sensation seeking reporting higher levels of alcohol consumption (Quinn, Stappenbeck, & Fromme, 2011). Recently these personality traits have been investigated in the context of high risk drinking events. For example, the amount that college students consume while celebrating 21st birthdays and their beliefs about the role of alcohol during these celebrations, have been found to be related positively to these personality traits (Day-Cameron, Muse, Hauenstein, Simmons, & Correia, 2009). Two previous studies have looked at the relationship between sensation seeking and DG participation in samples of college students. One study linked DG participation and associated negative consequences to higher levels of sensation seeking (Johnson & Cropsey, 2000). The second study found that individuals high in sensation seeking may continue to play these games for fun and excitement, despite the increased risk of negative consequences; the study also found that students low in sensation seeking tend to have negative attitudes towards DGs (Johnson & Cohen, 2004). To our knowledge there are no published studies linking impulsivity to DG participation among college students. However, one study of high school students identified an association between impulsivity and experiencing a report regrettable sexual situations following DG participation (Borsari et al., 2013). While it has been suggested that sensation seeking and impulsivity represent aspects of a single unitary construct (see Baer, 2002), recent empirical work suggests that they can be viewed as overlapping but distinct aspects of behavior (e.g., Magid, MacLean, & Colder, 2007; Smith et al., 2007). Magid et al. (2007) suggest that failing to include measures of both traits can mask or confound unique relationships between sensation seeking, impulsivity, and alcohol use among college students. Studies that have simultaneously investigated sensation seeking and impulsivity have reported that both play a role in the prediction of alcohol use, although through different mediational pathways (Lammers, Kuntsche, Engels, Wiers, & Kleinjan, 2013; Magid et al., 2007; Simons, 2003; Simons, Gaher, Correia, Hansen, & Christopher, 2005). For example, Magid et al. (2007) noted that the effect of sensation seeking on alcohol consequences was mediated by frequency of drinking and drinking motives, whereas the effect of impulsivity on alcohol-related problems was mediated through coping motives but not frequency of drinking. Similarly, Simons (2003) and Simons, Gaher, Correia, et al. (2005) have reported that impulsivity is directly related to alcoholrelated problems and sensation seeking is indirectly related to motives and frequency of use. However, Lammers et al. (2013) reported that the relationships between drinking behavior (frequency of use, binge drinking, and alcohol-related problems) and both impulsivity and sensations seeking were mediated – but through different motivational variables – in a sample of adolescents. As a set these studies present inconsistent findings, suggesting that additional work is needed to further understand the mechanisms through which both impulsivity and sensation seeking are related to negative drinking outcomes. Magid et al. (2007) made a strong case for developing theoretical accounts to understand these mechanisms. In short, individual with elevated sensation seeking are likely to consume alcohol to increase arousal, which may indirectly lead to increased consequences. Elevated impulsivity is often characterized by failure to inhibit behavior and poor attempts at coping with distress; these features are thought to be more directly related to experiencing negative alcohol-related consequences. Understanding the mechanisms through which various personality traits lead to alcohol use and related problems has implications for prevention and intervention efforts. 1.1. Current study Recent studies report that a significant proportion of college students engage in DGs, and that such participation can result in a variety
of negative outcomes. The findings from these studies suggest that both sensation seeking and impulsivity are linked to increased alcohol consumption, negative alcohol-related consequences, and DG participation. However, no published studies have simultaneously investigated the association between DG and both sensation and impulsivity in a sample of college students, and previous studies on the mechanisms through which these personality variables relate to alcohol-related problems have produced inconsistent results The current study attempted to bridge this gap by examining the impact of sensation seeking and impulsivity on frequency of DG participation and related consequences using a path analytic model. Based on previously published studies on the link between personality and alcohol-related problems, we expected that the relationship between sensation seeking and negative DG consequences would be mediated by frequency of DG participation. The literature on the potential for the frequency of DG participation to mediate the relationship between impulsivity and DG consequences was less clear; in the current study both direct and indirect relationships were assessed. 2. Method 2.1. Participants Participants were 831 undergraduates (71% female, mean age: 20.38, 81% White) enrolled at large public Southeastern University, who completed an online survey in exchange for course credit. Nearly 70% of participants reported drinking in the past 30 days, with an average of 10 drinks a week. Lifetime participation in a DG was endorsed by 81% of the sample; 53% reported playing in the past month, with 79% of those who played in the past month reporting at least one negative DG consequence in the past month. 2.2. Measures The Eysenck Impulsiveness Scale (EPI; Eysenck, Pearson, Easting, & Allsopp, 1985) was used to assess Impulsivity. Sensation seeking was assessed with a 16-item scale adapted from the work of Zuckerman's Sensation Seeking Scales (Donohew et al., 2000; Zuckerman, 1979). The Hazardous Drinking Games Measure (HDGM) was used to measure frequency and negative consequences of DG (Borsari et al., 2003, 2013). Participants indicated how often in the past 30 days they played DGs, from 1 (Never) to 5 (Four or More Times a Week) and if they experienced a series of negative DG consequences. 2.3. Data editing Univariate outliers, as defined as +/− two interquartile values from the median, were identified for sensation seeking, and were changed to two interquartiles from the median. Univariate outliers were also identified for consequences of DGs; however, after further assessing the data the consequences of DGs outliers were determined to be indicative of the intended population and were not deleted or modified. Seven
Table 1 Descriptive statistics and bivariate correlations (N = 831). Variables
M
(SD)
Range
1.
2.
3.
1. Impulsivity 2. Sensation Seeking 3. Frequency of Game Play 4. Drinking Game Consequences
7.09 52.37 2.03 0.92
4.32 9.84 1.12 1.41
0–18 24–75 1–5 0–8
– 0.40⁎ 0.29⁎ 0.36⁎
– 0.41⁎ 0.36⁎
– 0.63⁎
Note: Impulsivity: Eysenck Impulsivity Scale total score. Sensation seeking: total sensation seeking score. Frequency of Game Play: Number of times participant played drinking games in the past month (1 = 0 times, 2 = once, 3 = 2–4 times a month, 4 = 2–3 times a week, 5 = 4 or more times a week). Drinking game consequences: sum of number of drinking game consequences endorsed. ⁎ p b 0.001.
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cases of multivariate outliers were identified using Mahalanobis distance; however, they were determined to be reflective of the intended population and therefore not deleted. 3. Results 3.1. Descriptive statistics and bivariate correlations Descriptive statistics and bivariate correlations are presented in Table 1. Sensation seeking and impulsivity were positively associated with each other. Both personality variables exhibited modest positive associations with consequences of game play. Frequency of DG play exhibited a substantial positive association with consequences of DG play. Finally, impulsivity exhibited a low positive association with frequency of DG play; whereas sensation seeking demonstrated a moderate association with frequency of DG play. 3.2. Path analysis The path model was tested using Mplus (Muthén & Muthén, 2011). In the current model, direct pathways from sensation seeking and impulsivity to frequency and negative consequences of DG were identified. We also correlated sensation seeking with impulsivity. Given that the model is just-identified (therefore perfectly fitting the data), fit indices have little utility and are not reported (Kline, 2010). Results indicated direct effects of impulsivity on both DG frequency and consequences of DG, direct effects from sensation seeking on both DG frequency and consequences of DG, and a direct effect from DG frequency on negative consequences (Fig. 1). Indirect effects were calculated using bias corrected bootstrapped confidence intervals (5000 samples were drawn). Results indicated a significant indirect effect from sensation seeking to DG consequences via frequency of DG (β = 0.19, p b 0.001), and an indirect effect from impulsivity to consequences via frequency (β = 0.08, p b 0.001). 4. Discussion Findings suggest that sensation seeking and impulsivity are positively associated with frequency of DGs, with sensation seeking displaying a slightly stronger relationship. The fact that both sensation seeking and impulsivity were related to alcohol use variables underscores the complex nature of DG participation. Decisions to play DGs are likely related to tendencies towards a desire to optimize positive affect (sensation seeking) and a propensity to take risks and act rashly (impulsivity). Studies investigating the relationships between personality, motives for drinking, and more general drinking patterns have been informative (Magid et al., 2007; Simons, Gaher, Correia, et al., 2005). Similar studies focusing on how personality variables influence motives to participate in DGs and actual frequency of DG participation are warranted. Greater sensation seeking and impulsivity were also found to be associated with greater endorsement of negative consequences, even when accounting for frequency of play. These results are consistent with previous research demonstrating a relationship between Impulsivity 0.17* 0.15*
Frequency of Playing Games
0.40*
0.55*
Consequences of Games Play
0.35* 0.07*
Sensation Seeking
Fig. 1. Path analysis model (N = 831). All values are standardized coefficients. *p b 0.01.
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impulsivity and sensation seeking with risky alcohol use (e.g. Ham & Hope, 2003; Simons, Gaher, Oliver, et al., 2005) and lend support to the notion that DG participation can function as a high-risk drinking event. The indirect relationship between sensation seeking and DG consequences, with frequency of DG participation serving as a mediator, is consistent with previous research (Magid et al., 2007). However, in contrast to previously reviewed studies our results found that both sensation seeking and impulsivity displayed both direct and indirect (though frequency of play) associations with DG consequences. It is unclear if our divergent results are due to a focus on a specific form of risky drinking and not more general patterns of alcohol use. Additional research on the direct and indirect (mediational) pathways between personality, frequency of DG participation, and negative outcomes of DG participation would be useful in determining the theoretical role that different aspects of personality play in DG-related behavior. In addition, this line of research should be extended to other forms of risky drinking (e.g., spring break, tailgating, pre-gaming, 21st birthday celebrations). Perhaps more practically speaking, such research would also help determine individual difference variables that account for the negative outcomes that some but not all students who participate in DGs and other forms of high-risk drinking experience (e.g., Borsari et al., 2013). 4.1. Limitations The cross sectional design of the study allows for the measurement of statistical associations among variables. However, due to personality variables and frequency and negative consequences of DG being simultaneously measured, course of endorsement for each variable cannot be determined. Relatedly, path analysis was designed to model causal relationships between variables; however, the paths of the current model are limited in regards to causality due to the use of cross-sectional data. A follow-up study that collects longitudinal data will need to be performed to confirm the sequence in which the variables may impact each other, as well as to confirm the findings in a second unique sample of students. Relatedly, the study's participant demographics (i.e., primarily Caucasian females who were under 21 years old) limit the study's generalizability. A follow up study with greater male participation and ethnic diversity should be conducted to determine if the same model can be applied to the general student population. Regarding the path analysis, there are alternative and near-alternative models that could produce similar fit. In regards to equivalent models, any variation of the current model will continue to result in a perfect fit given that the model is just-identified. Finally, the EPI assesses personality as a unitary construct. Impulsivity measures that assess distinct components of impulsivity would allow for the evaluation of more specific correlates of drinking game behavior (see Sharma, Markon, & Clark, 2013, for a review of measures). 4.2. Clinical implications Despite these limitations, the study contributes to the existing literature regarding drinking games among college students. To our knowledge, no previous study has examined the relationships between impulsivity, sensation seeking, frequency of playing drinking games, and negative consequences associated with game play. The study points to the direct relationships between impulsivity and sensation seeking with negative consequences related to DG participation. Ultimately, understanding the relationship between personality variables and negative drinking game consequences may better inform the treatment of hazardous drinking among college students. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has suggested that multifaceted, event-specific prevention efforts for college students be implemented by universities and communities in an effort to reduce problematic alcohol consumption (NIAAA, 2002). Neighbors et al. (2007) have taken this recommendation and applied it to a variety of high-risk behaviors; the recommended intervention and prevention
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strategies incorporate individual-focused interventions, environmental changes, and policy changes. To date, these recommendations have not been applied to interventions designed to address DG participation. Relatedly, interventions informed by the relationships between personality and alcohol use have been developed (e.g. Conrod, Castellanos, & Mackie, 2008), but this work has not been tailored to address the link between personality and DGs. Thus further research is needed to determine how a range of prevention and intervention strategies can be utilized to reduce the risks associated with DG participation. Role of funding sources This study was not externally funded. Auburn University had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. Contributors Correia designed the study, wrote the IRB protocol and oversaw the collection of data. Diulio and Silvestri conducted data analysis. Diulio wrote an initial draft of the manuscript, and Silvestri and Correia contributed to subsequent draft. All authors contributed to and have approved the final manuscript. Conflict of interest All authors declare that they have no conflicts of interest.
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