Do hypothetical evaluations of alcohol related consequences change over time? Examining the influence of past and ongoing consequences

Each year, hundreds of thousands of college students experience drinking-related consequences such as physical and sexual assault, blackouts, and academic difficulties (Hingson et al., 2016; Grant et al., 2017, Schulenberg et al., 2018; NIAAA, 2020). Theoretically, experiencing negative consequences may deter drinking and motivate behavior change; however, students continue to drink at high rates. To dissuade underage and heavy drinking, on some campuses, students who violate alcohol policies are required to participate in harm-reduction alcohol interventions (Stone & Lucas, 1994). However, interventions for “mandated students” typically yield small effect sizes (Huh et al., 2015), highlighting the need for continued research identifying factors contributing to the maintenance of heavy drinking among mandated students.

Alcohol-related consequences do not always prompt drinking reductions, and in some cases predict increases in future drinking (Martinez et al., 2014, Read et al., 2013). Social Cognitive Theory (SCT; Bandura, 1986, Maisto et al., 1999) suggests cognitive appraisals (e.g., perceptions), not the direct alcohol-related consequence, have the most immediate influence on drinking behaviors. Accordingly, it is worthwhile to consider mandated students’ evaluations of consequences (i.e., where drinking consequences are perceived to fall on a spectrum from negative to positive; Patrick & Maggs, 2011; Foster et al., 2015). Evaluations can be measured with respect to experienced consequences (i.e., “how negative was this consequence that you experienced?”), or more hypothetically (i.e., “how negative would this consequence be, if it happened to you?”). The latter will be referred to here as hypothetical evaluations. An advantage of considering hypothetical (rather than experienced) evaluations of consequences is they reflect a range of consequences that people may have observed in others and may evaluate negatively; this broader range of potential consequences and how they are perceived may influence one’s own drinking choices whether or not those consequences have been personally experienced. Consistent with SCT, hypothetical evaluations are important to understand in that they influence future drinking (Patrick and Maggs, 2011, Schultz et al., 2021) and willingness to experience consequences (Mallett et al., 2022).

Previous research shows (non-mandated) students tend to report negative hypothetical evaluations (Aston et al., 2021), with variability across both persons and consequences. Among a set of 24 consequences, the most negative hypothetical evaluations were reported for driving after drinking too much and interpersonal problems. The least negatively evaluated consequence was unplanned drinking. While yet unknown, it is possible that hypothetical evaluations differ among mandated students, who tend to drink more heavily, experience more alcohol-related consequences (Barnett et al., 2004, Barnett et al., 2008), and tend to be at a greater risk for negative drinking-related outcomes compared to the general student population (Merrill et al., 2014).

It is also an open question whether hypothetical evaluations are stable or dynamic (i.e., changing in response to other factors). To our knowledge, only one prior study examined whether evaluations change over time among college students. This study found evaluations of experienced consequences became more negative over the weeks of freshman year among non-mandated students (Merrill, Subbaraman, et al., 2016). Evidence of similar change in how one hypothetically evaluates potential future consequences may reflect more of an attitude change, which could in turn promote behavior change.

It may also be important to consider how past and/or ongoing experiences of consequences influence hypothetical evaluations among mandated students. In one study, individuals who experienced consequences evaluated them significantly more positively than those who had not (Leavens et al., 2017). However, as findings are mixed (Merrill, Lopez-Vergara, et al., 2016), the nexus of experience and evaluations warrants further investigation. It is possible past experience of consequences moderate the extent to which hypothetical evaluations change over time. Individuals with more history of experiencing consequences may either habituate to them (i.e., perceiving consequences, even hypothetical ones, are less negative as time goes on) or be sensitized to them (i.e., perceiving consequences to be more aversive as time goes on). Understanding if either of these processes is at play may elucidate if experiencing consequences contributes to the reinforcement or change of hypothetical evaluations. In turn, this may inform future research that aims to alter evaluations, specifically among the high-risk populations such as mandated students.

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