A systematic review of the Alcohol norms literature: A focus on context

Abstract

Objective: To proffer a theoretically driven assessment of the validity of research which examines alcohol-related normative beliefs.

Methods: A systematic review of 68 articles matching the inclusion criteria, published between 1970 and 2013.

Results: Potential causes of deviations in research findings are identified and compelling gaps in our knowledge with regards to the influence of participant gender, age and contextual factors are highlighted and discussed in relation to the broader literature.

Conclusions: It is proposed that a standardization of research approaches and alcohol intake measures are required in order to increase the validity of present research and enable useful comparisons between studies. Further attention to key, potentially mediatory variables is also highlighted as important for increasing research validity with a view to facilitating the improvement of interventions.

Full text

Drugs: education, prevention and policy, Early Online: 1–20
ß2014 Informa UK Ltd.
ISSN: 0968-7637 print/1465-3370 online
DOI: 10.3109/09687637.2014.899990
A systematic review of the Alcohol norms literature: A focus on
context
Rebecca Louise Monk & Derek Heim
Department of Psychology, Edge Hill University, Lancs, Ormskirk, UK
Objective: To proffer a theoretically driven assess-
ment of the validity of research which examines
alcohol-related normative beliefs.
Methods: A systematic review of 68 articles match-
ing the inclusion criteria, published between 1970
and 2013.
Results: Potential causes of deviations in research
findings are identified and compelling gaps in our
knowledge with regards to the influence of partici-
pant gender, age and contextual factors are high-
lighted and discussed in relation to the broader
literature.
Conclusions: It is proposed that a standardization of
research approaches and alcohol intake measures
are required in order to increase the validity of
present research and enable useful comparisons
between studies. Further attention to key, poten-
tially mediatory variables is also highlighted as
important for increasing research validity with a
view to facilitating the improvement of
interventions.
INTRODUCTION
Pepper (1942) suggests that the specific context of an
event is highly important to an understanding of the
world. This focus on context is termed functional
contextualism – a philosophy that extols the critical
importance of considering the environments in which
behaviour occurs. The importance of considering
where an event occurs and the environmental factors
that may be involved is therefore paramount within this
approach (Hayes, 2004). Furthermore, functional con-
textualism has been referred to as studying the
‘ongoing act in context’ (Biglan, 2001; Hayes, 2004)
and it is this definition that also identifies the perceived
impotence of social context (i.e. who you are with as
well as where you are). Biglan and Hayes (1996) argue
that the failure to use this approach has lead to an
expanse of research, which is not useful in terms of
practical application. The fields of Teaching and
Education, Sociology and Art have all adopted a
contextualist approach for many years (Jonassen,
2006), and research across disciplines has demon-
strated that social and environmental contextual factors
can impact any area of investigation – from helping
behaviour (e.g. Mathews & Canon, 1975) to littering
(e.g. Kallgren, Reno, & Cialdini, 2000). However, in
the field of alcohol research, there has been little
uptake of this contextualist approach within quantita-
tive research. Indeed, qualitative research instinctively
acknowledges and oftentimes examines the role of
contextual factors, particularly in its drive for greater
reflexivity (Shaw, 2010). However, whilst it has been
hypothesized that context is likely to moderate alcohol-
related cognitions (c.f. for example McAlaney,
Bewick, & Bauerle, 2010), the effect of context has
remained under-examined in quantitative psycho-social
research, despite early indications that this may be
important (e.g. Monk & Heim, 2013a, 2013b). The
implications of applying a contextualist perspective to
the field of alcohol research are therefore highly
pertinent. The validity and generalizability of existing
research may be questioned and, instead, research and
interventions which measure, assess and are formulated
around the contextually changing interests of alcohol
consumers may be more beneficial.
This article reports a systematic review of articles
published between 1970 and 2013, focusing specific-
ally on quantitative examinations of alcohol-related
normative beliefs – that is, people’s beliefs about
their own and others’ drinking. The purpose of this
review is to assess the validity of the research into
Correspondence: Rebecca Louise Monk, Msc, Department of Psychology, Edge Hill University, Saint Helens Rd, Lancs, Ormskirk L39
4QP, UK. E-mail: monkre@edgehill.ac.uk
1
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alcohol-related normative beliefs, highlighting con-
flicting findings and sampling and methodological
variations and limitations. Guided by contextualist
theory, a particular focus of this review is to system-
atically examine whether contextual factors have been
previously assessed within research, and if so, whether
they have been shown to be important to alcohol-
related cognitions. Context has been defined as the
immediate environment of the individual (Nyaronga,
Greenfield, & McDaniel, 2009) and the physical/
environmental setting in which drinking occurs,
combined with the relationships and interactions
between individuals present in the social setting
(Holyfield, Ducharme, & Martin, 1995). The notion
of a mediating role of context in behaviour is not a new
one. Lott (1996) states that behaviour always occurs
within one form of context or another and is therefore
always influenced by a particular situation. Similarly,
Bourdieu (1977) refers to the role of ‘social space’
in human behaviour and De Haes (‘epidemiological
triangle’, 1987) and Harre, Clake, and De Carlo
(1985) note that context is one of the key driving
forces of behaviour. As such, Rosnow and Rosenthal
(1989) noted that ‘there is a growing awareness in
psychology that just about everything under the sun is
context dependent in some way or another’ (p. 1290).
The first research question was therefore, ‘have
contextual factors been considered within the norms
literature and, if so, what effect does context exert
on alcohol-related normative beliefs?’. Preliminary
analyses of the literature in this area also revealed
that there is considerable variability in the populations
studied within this research area and resultantly
there has been substantial discussion regarding the
generalizability of the norm literature. It was there-
fore decided that this review should also question
‘how does the target population impact normative
beliefs?’
METHODS
The literature search was primarily conducted by the
lead author, with the second author conducting a
comparative title search using the same criteria to
avoid missing research. The inclusion of research
papers and the synthesis of the studies into appropriate
categories (context, target population, proximal dis-
tance and alcohol measure) were conducted through
detailed discussions between both authors. In line with
recommendations (Wright, Brand, Dunn, & Spindler,
2007), the minimum threshold for inclusion were that
the full text of articles were available in English and
that publications were peer reviewed and published
within the set time constraints (1970–2013).
Preliminary search results produced very few relevant
results prior to 1970. For this reason, 1970 was taken as
the earliest admissible publication date, in order to
restrict the search but enable a broad analysis of the
research conducted over time. The quality criteria
selected were that studies consider internal and external
validity, have methodological rigor and broad meas-
urement items (Khan, Riet, Popay, Nixon, & Kleijne,
2009). However, in line with recommendations, we did
not use these criteria as exclusion factors. Instead, these
criteria formed the basis of guiding our analyses and
interpretation (Khan et al., 2009; Wells & Littell,
2009). This action was taken as studies of varying
methodological quality may help explain variations in
results (Wilson & Lipsey, 2001). Limiting inclusion to
those studies that utilize diverse measures and demo-
graphics may also exclude information that is pertinent
to the proposed research questions. This methodology
is in accordance with a similar systematic review of
the expectances literature (Monk & Heim, 2013a), and
an overview of this review process can be seen
in Figure 1.
Published empirical (68) works on alcohol norms
were therefore identified. Articles published between
1970 and 2013 and written in English were located
searching JSTOR, PsycARTICLES, PsychINFO,
ScienceDirect and Web of Knowledge. These search
engines were selected in order to produce a wide search
network of psycho-social research papers, whilst
limiting results with a primary biomedical focus,
which were deemed less relevant. Search terms utilized
were ‘alcohol norms/normative beliefs’; ‘drinking
environments’; and ‘drinking contexts’. Particular
effort was made to identify any papers with titles that
simultaneously referenced norms and contexts/envir-
onment. Articles that focused specifically on imple-
menting norm-based therapeutic interventions were
excluded unless they contributed to the examination of
context effects. Search terms relating to participant
demographics (e.g. age) and consumption measures
(e.g. frequency and quantity) were also added follow-
ing the initial searches to broaden the scope of the
review and answer the additional research questions.
Additional articles and academic texts were located by
reading the references of retrieved articles. Nine
reviews (Berkowitz, 2004; Borsari & Carey, 2001;
Foxcroft, Lister-Sharp, & Lowe, 1997; McAlaney,
Hughes, & Bewick, 2011; McAlaney & McMahon,
2007a; Moreira, Smith, & Foxcroft, 2009; Pape, 2012;
Perkins, 2002; Ward, 2011; Wechsler & Nelson, 2008)
and two meta analyses (Borsari & Carey, 2003;
Quigley & Collins, 1999) that fit these search criteria
were also identified. The majority (n¼42) of work
uncovered was published in North America. However,
articles were also identified from the UK (n¼6),
France (n¼2), Czechoslovakia (n¼1), Finland
(n¼1), Australia (n¼1), Switzerland (n¼1),
Sweden (n¼1) and Latin America (n¼1). There was
also one cross continental piece of research. Table I
summarizes the articles considered. Key findings from
each article were ascertained and were considered with
regards to variant methodologies and the context in
which studies were conducted.
2R. L. MONK & D. HEIM
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NORMATIVE BELIEFS: A SHORT
OVERVIEW
Normative beliefs are described as beliefs about what
is the normal or prevailing behaviour or attitude
within a group (McAlaney et al., 2011; McAlaney &
McMahon, 2007b). Festinger’s (1954) theory of social
comparison processes asserts that the innate human
drive for personal evaluation results in self comparison
with alike others in order to judge what is appropriate.
However, according to social norms theory, people
incorrectly perceive their own attitudes/behaviours to
be different to those of others, known as pluralistic
ignorance (Berkowitz, 2004). In the alcohol literature,
a sense of cognitive dissonance is proposed to result
from believing one’s own consumption to be different
from normative or typical consumption. This causes
behaviours to be adjusted in an attempt to redress this
imbalance (Berkowitz, 2004) and resultantly, social
norms are commonly found to be predictive of alcohol
consumption (c.f. for example, Arterberry, Smith,
Martens, Cardigan, & Murphy, 2013). Believing
one’s alcohol intake to be lower than the norm
(positive self other differences) is asserted to create
an increase in consumption, whilst the converse
perception of ‘negative self other differences’ is
proposed to reduce such (Borsari & Carey, 2012;
Carey, Borsari, Carey, & Maisto, 2006). Perkins (2007)
refers to this as a ‘reign of error’, and such normative
beliefs regarding alcohol consumptions are reliably
found to predict consumption (e.g. Clapp &
McDonnell, 2000). Accordingly, Perkins and
Berkowitz (1986) and Perkins, Meilman, Leichliter,
Cashin and Presley (1999) found that college students
misperceived the level of peer alcohol consumption,
and subsequent similar studies have consistently found
that students overestimate the drinking of peers relative
to their own (e.g. Borsari & Carey, 2001; Carey et al.,
2006; Miley & Frank, 2006; Perkins, 2002, 2007;
Perkins, Haines, & Rice, 2005; Wechsler & Kuo,
2000). Over 45 studies document a norm misperception
(Berkowitz, 2004), and overestimation of drinks per
week, frequency of consumption and consumption in a
typical session are prevalent findings (Lewis &
Neighbors, 2004; Thombs, Wolcott, & Farkash,
1997). As many as 91% of students have been found
to believe that their peers drink more than they do
(Broadwater, Curtin, Martz, & Zrull, 2006), and a meta
analysis by Borsari and Carey (2003) supports the high
rate of student misperceptions. A misperception of
injunctive norms regarding perceived acceptability of
alcohol consumption has also been observed in student
(over) estimations of peer alcohol consumption
(Perkins & Wechsler, 1996).
How does target population impact normative
beliefs?
Age of the participants
Participant age is a further factor that may impact
research findings; however, there is a marked discrep-
ancy between studies utilizing student samples and
studies, which survey wider age ranges. Indeed, the
majority of the research examining the contexts
associated with alcohol consumption (e.g. Treno,
Alaniz, & Gruenewald, 2000) and alcohol norms
(Foxcroft et al., 1997; McAlaney & McMahon,
2007b) is based solely on university and college
student samples. The prevalence of heavy drinking in
-Norms +/
normative beliefs
norms and drinking
behavio(u)r,
-Drinking
environments
-Drinking contexts
-Freq/Quant/Age
No
Focus Areas
for
Review:
Target Proximity?
Alcohol Measures
used? Examine Context?
No
Impact of study
validity Examine
context in
vivo or by
other method?
Methodology
variations and
diverging findings?
Discard Study
Full Text
Available in
English?
Peer
Reviewed?
Published
1970-2013?
Yes Yes
No
No
Quality
Criteria?
Yes
Yes
Search
Terms
Population studied?
Figure 1. Flow diagram depicting the systematic review process.
A CRITICAL SYSTEMATIC REVIEW OF THE ALCOHOL NORMS LITERATURE 3
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Table I. Summary of the norms literature reviewed with key methodologies and findings.
Authors (Year) Focus
Sample
location
Sample age (years)
M¼Mean
Sample gender (%
female) Target population Method
Alcohol consumption
measure Context Key Findings
Andersson et al.
(2012)
Context Sweden Age 20 and 25 years 100 Adults (non clinical) Interview and ques-
tionnaire (phone
and postal)
RSR (frequency and
quantity across
contexts)
NAR (own home) Contextual alterations in
alcohol consumption
Barry & Goodson
(2012)
Context America Qualitative Study 1
(non specified)
Quantitative study 2
(M ¼22)
Qualitative study
1–85
Quantitative study
2–55
University students
(non clinical)
Interview and
questionnaire
N/A NAR (university
building)
Social and environmental
contextual factors
found to be associated
with drinking
Beck et al. (1993) Context America High school (age not
specified)
50 Students (non
clinical)
Questionnaire RSR (frequency and
quantity across
contexts)
NAR (classrooms) Alcohol consumption
associated with
context
Beck & Treinman
(1996)
Context America High school (age not
specified)
54 Students (non
clinical)
Questionnaire RSR (frequency and
quantity across
contexts)
NAR (classrooms) Alcohol consumption
associated with
context
Berkowitz (2004) N – – – – Review – – Over 45 studies document
a norm misperception
Bond et al. (2010) Context 22 countries; in
Europe (8); the
Americas (7);
Asia (3);
Australasia (2)
and Africa (2)
Majority
18–75
Nos. Male and
female (n
varied cross
country vari-
ation
c.f. Bond, pg.
2141)
Adults (non clinical) Survey (face-to-face,
telephone and/or
post)
RSR (frequency and
quantity of public
and private)
NAR (Lab or
home)
Gender and context (pri-
vate versus public)
variations in the fre-
quency and quantity of
alcohol consumed
Borsari & Carey
(2001)
N – – – Students (non
clinical)
Review – – Perceived social norms
make excessive alco-
hol use appear
common/acceptable
Borsari & Carey
(2003)
N – – – Students (non
clinical)
Meta analysis – – High rate of student
alcohol norm
misperception
Broadwater et al.
(2006)
N America M ¼18.66 59.1 Students (non
clinical)
Questionnaire RSR (personal and
close friends’
average drinking
and desired
drinking)
NAR (on campus) High rate of student
alcohol norm
misperception
Bustamante et al.
(2009)
N Latin America 18–24 75.7 Students (non
clinical)
Questionnaire RSR (frequency of
personal and
peers’ alcohol
consumption)
NAR
(unspecified)
Students correctly
assessed or under esti-
mated alcohol use in
peers.
Carey et al. (2006) N America Freshmen or sopho-
mores
(unspecified)
64 Students (non
clinical)
Questionnaire RSR (what type of
alcohol, number of
standard drinks
consumed:
NAR
(Unspecified)
‘Reference group specifi-
city’ (Target proxim-
ity) and interaction
with gender)
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Personal, close
friends’, typical
same gender stu-
dent at their col-
lege, typical same
gender college
student)
Clapp et al. (2000) Context America M ¼24.0 44.5 Students (non
clinical)
Phone survey RSR (quantity of
drinks across pro-
vided contexts)
NAR (partici-
pant’s home)
Social context impacts
alcohol consumption
Clapp et al. (2006) Context America 18–20 (M ¼24.58) 54.8 Students (non
clinical)
Phone survey RSR (quantity of
drinks across pro-
vided contexts)
NAR (partici-
pant’s home)
‘Wet’ environment such
as pub associated with
higher alcohol
consumption
Clapp &
Shillington
(2001a)
Context America M ¼23.8 56.2 Students (non
clinical)
Telephone survey RSR (quantity in dif-
fering contexts)
NAR
(Participant’s
home)
Context variation in
consumption
Clapp &
Shillington
(2001b)
Context America 14–21 (M ¼16.3) 51.5 Teenagers (non
clinical)
Longitudinal youth
survey data
RSR (quantity in dif-
fering contexts)
NAR
(Participant’s
home)
Context variation in
consumption
Clapp et al. (2000) Context America Study 1: 18–61
(M ¼24.4)
Study 2: (M ¼25.4)
Study 1 ¼55
Study 2 ¼not
specified
Students (non
clinical)
Telephone survey RSR (quantity in dif-
fering contexts)
NAR
(Participant’s
home)
Context variation in
consumption
Clapp &
McDonnell
(2000)
N America M ¼24 55.8 Students (non
clinical)
Telephone interview RSR (number of days
in last 30 that
alcohol was
consumed)
NAR (partici-
pant’s home)
Normative beliefs pre-
dicted consumption
Clark (1988) Context America 18–22 years
18–40þ
48.6 Adult sample Questionnaire RSR (frequency,
quantity and types)
NAR (place ques-
tionnaire
received)
Context variation in
consumption
Cox & Bates
(2011)
N America 18–25þ63.4 Students (non
clinical)
Online questionnaire RSR (average number
of personal drinks
and friends and
student cohort)
NAR (place of e-
mail response)
Effect of target proximity
on consumption
Cooke & French
(2011)
N and Context UK University students
(exact age
unspecified)
37.6 Students (non
clinical)
Questionnaire RSR (no. of differ-
ently specified
drinks)
Pub or Library
Context
Effect of context and
norms on consumption
Cullum et al.
(2012)
N America College students
(M ¼20.70)
56 Students (non
clinical)
Questionnaire
(online)
RSR (quantity of own
consumption and
no. of drinking
partners)
NAR (place of
computer)
Larger groups were asso-
ciated with greater
quantities of self-
reported drinking
when context-specific
norms were high
Demers et al.
(2002)
Context Canada Undergraduate
(unspecified)
57.2 Students (non
clinical)
Multilevel analysis of
questionnaire
(postal)
RSR (No. of drinks
per occasion)
NAR (personal
residence
unspecified)
Alcohol consumption
higher in the contexts
of: social groups, bars,
pubs, parties, meal.
(continued )
A CRITICAL SYSTEMATIC REVIEW OF THE ALCOHOL NORMS LITERATURE 5
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Table I. Continued.
Authors (Year) Focus
Sample
location
Sample age (years)
M¼Mean
Sample gender (%
female) Target population Method
Alcohol consumption
measure Context Key Findings
Foxcroft et al.
(1997)
N – – – – Review – – 91% of normative belief
studies reviewed took
place within a school
context
Franca et al.
(2010)
N France 18–65 Male and females
(no.
unspecified)
College students (non
clinical)
Questionnaire RSR (Personal and
friends’ quantity of
alcohol consumed
and drunkenness)
NAR (lecture) Participants overestimate
peer alcohol approval/
consumption, posi-
tively associated
heavy episodic
drinking
Harford (1979) Context America þ18 years Male and female
(no.
unspecified)
Adult Questionnaire RSR (frequency,
quantity and
volume)
NAR (at place
questionnaire
and interview
administered)
Gender and context spe-
cific variation in
alcohol consumption
Holyfield et al.
(1995)
Context America Adult (national survey
data 18–65þ)
Male and female
(no.
unspecified)
Adult (problem and
non-problem)
Interview (question-
naire based)
RSR (frequency and
alcohol-related
impairment
measures)
NAR (place of
interview)
Context effects on alco-
hol-related beliefs
Hughes et al.
(2008)
N Australia 6–16 (M ¼11.66) Females ‘slightly
under 50%’
High school students
(non clinical)
Questionnaire RSR (personal and
friends’)
NAR
(Unspecified)
Overestimation in peer
alcohol approval and
consumption
Kuendig &
Kuntsche
(2012)
Context Switzerland 18–25 Not specified University students
(non clinical)
Simulated wine-tast-
ing event
RSR (frequency and
quantity of past
consumption) and
direct observation
of grams con-
sumed during
testing
Staged wine-
tasting event
Consumption influences
by social context
(hypotheses made
regarding links to nor-
mative beliefs)
Labrie et al.
(2010)
N America M ¼19.88 61 College students (non
clinical)
Questionnaire
(Online)
RSR (no. of drinks
consumed per
week)
College campuses
(online)
Reference group specifi-
city in injunctive
norms
Larimer et al.
(2011)
N America 18–25 (M ¼19.8) 47.8 University students
(non clinical)
Questionnaire
(Online)
RSR (no. of drinks
consumed in a
month)
NAR (personal
residence
unspecified)
Reference group specifi-
city of norm
misperception
Larimer et al.
(2009)
N America 17–24 (M ¼18.49) 58 University students
(non clinical)
Questionnaire
(Online)
RSR (no. of drinks
consumed in three
months)
NAR (personal
residence
unspecified)
Reference groups specifi-
city of norm
misperception
Lau-Barraco &
Dunn (2009)
Context America M ¼24.04 All male University students
(non clinical)
Questionnaire and
lab/simulated con-
text bar
assessments
RSR (frequency and
total and alcohol
consumed in lab
measured)
In Lab, in pres-
ence of alcohol
Primed with a simulated
bar showed signifi-
cantly greater alcohol-
related memory asso-
ciations and consumed
significantly more
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Lewis et al.
(2011)
N
Context
America 18-2 yrs (M ¼19.90) 56.4 University students
(non clinical)
Questionnaire
(online)
RSR (number of
drinks across
contexts)
NAR (personal
residence
unspecified)
Reference groups specifi-
city of norm
misperception
Lewis &
Neighbors
(2004)
N America M ¼19.85 51 University students
(non clinical)
Questionnaire RSR (personal and
‘typical student
quantity and
frequency)
NAR (individu-
ally or in
groups on
campus)
Gender specific norm
misperception
Lintonen & Konu
(2004)
N Finland 14 year olds only 53.7 (total across
three years of
sampling)
Adolescents (non
clinical)
Questionnaire (postal
– adolescent health
and lifestyle
survey)
RSR (personal and
same sex peer
drinking and
drunkenness
frequencies)
NAR (personal
residence
unspecified)
Overestimation in peer
alcohol consumption
positively associated
increase consumption
Lo Monaco et al.
(2011)
N France M ¼20.16 41.25 University students
(non clinical)
Questionnaire and
vignette
N/A NAR
(unspecified)
Alcohol consumption is
more favourably per-
ceived when occurring
in social groups than
when alone
Martinus et al.
(2012)
N UK 12–18 46 High school students
(non clinical)
Questionnaire RSE (personal and
Peer frequency of
drinking and
drunkenness)
NAR (classroom) Alcohol consumption
perceived as more fre-
quent and occurring in
greater quantity with
one’s peers
McAlaney et al.
(2011)
N – – – – Review – – Norm misperception
findings are also
replicated outside of
the US
McAlaney &
McMahon
(2007a)
N – – – – Review – – Overview of norm mis-
perception research
McAlaney &
McMahon
(2007b)
NUKM¼28 65 Students (non
clinical)
Questionnaire
(internet)
RSR (frequency of
drinking and
drunkenness and
quantity of alco-
hol: personal,
friends, student
cohort, demo-
graphic cohort)
NAR (online) Significant correlations
between the respond-
ents’ behaviour and
the perception of that
behaviour in others
-Reference group specifi-
city
-Older participants exhi-
bit smaller normative
misperception of alco-
hol consumption
Melson et al.
(2011)
N UK 12–18 47.5 High school students
(non clinical)
Questionnaire RSR (personal and
‘typical pupil’
Frequency of con-
sumption and
drunkenness)
NAR (classroom) Multiple-target surveys
may increase peer
‘over-overestimate’ of
drinking
Miley & Frank
(2006)
N America M ¼20 58 College students (non
clinical)
Questionnaire RSR (frequency of
personal and
NAR
(unspecified)
(continued )
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Table I. Continued.
Authors (Year) Focus
Sample
location
Sample age (years)
M¼Mean
Sample gender (%
female) Target population Method
Alcohol consumption
measure Context Key Findings
students in general,
college males, col-
lege females, on
and off campus
students, fraternity
and sorority mem-
bers and intercol-
legiate athletes)
Students overestimate
peer alcohol
consumption
Monk & Heim
(2013b)
N
Context
UK M ¼20.52 62 University students
(non clinical)
RSR (frequency and
quantity)
RSR (frequency and
quantity)
University labora-
tory (during
exposure to
immersive,
video footage –
alcohol related
or neutral)
Normative frequency rat-
ings were higher
during exposure to pub
(vs. lecture) footage
and during group (vs.
solitary testing).
Monk & Heim
(2013c)
N
context
UK M ¼20 67 University students
(non clinical)
Questionnaire
(in vivo)
RSR (frequency and
quantity)
Student union bar
and lecture
theatre
Variations in alcohol-
related cognitions
between alcohol
related and neutral
contexts. However,
after controlling for
variations in alcohol
consumption, context-
ual differences in nor-
mative beliefs were
not found.
Moreira et al.
(2009)
N – – – – Review – – Variation in the effect-
iveness of norm based
interventions
-Preponderant use of stu-
dents and American
samples
Neighbors et al.
(2006)
Norms and
context
America Sample 1 ¼21 years
Sample 2 ¼some
Sample 1 ¼56
Sample 2 ¼48
University students
(non clinical)
Questionnaire (post
and online)
RSR (frequency and
quantity)
NAR (place in
which
Context specific norm
misperception
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under 21 years,
69% over 21 years
questionnaire
received)
Nyaronga et al.
(2009)
Context America Age 18þNot specified Population (non
clinical)
National survey
data
RSR (frequency,
quantity, volume
across contexts)
NAR (place ques-
tions
answered)
People categorized by
preferred drinking
context
O’Hare (1990) Context America Undergraduates (age
unspecified)
56.1 University students
(non clinical)
Questionnaire
(postal)
RSR (quantity and
frequency)
NAR (partici-
pant’s own
home or place
questionnaire
received)
Context, sex and gender
differences in
consumption
Page et al. (2008) N Czechosl-ovakia 13–23 (M ¼16.5) 55.9 Adolescents (non
clinical)
Questionnaire RSR (frequency of
personal, friends’
and schoolmates’
consumption)
NAR (school, not
clearly
specified)
Peer alcohol consumption
related to norm
misperception
Pape (2012) N – – – – Review – – Norm misperception
findings exaggerated
Park et al. (2003) Context America M ¼17.9 58 College students (non
clinical)
Questionnaire RSR (frequency and
quantity of per-
sonal
consumption)
NAR (college
campus)
Social context associated
with consumption
Paschall & Saltz
(2007)
Context America 18–26
(M ¼20.25)
58 University students
(non clinical)
Questionnaire
(mail or online)
RSR (total 28 day
quantity
NAR (place in
which ques-
tionnaire
received par-
ticipants asked
to give a report
for different
contexts)
Context related variation
on alcohol
consumption
Pedersen et al.
(2008)
Norms and social
context
America 64.1 M ¼1.13 University students
(non clinical)
Questionnaire
(mail and paper)
RSR (frequency and
quantity of per-
sonal and college
cohort
consumption)
NAR (university
hall)
Social Context impacts
injunctive and
descriptive norms
Perkins (2002) N – – – – Review – – Students overestimate the
drinking of peers rela-
tive to their own which
impacts alcohol
consumption
Perkins (2007) N Canada 19–25þ63 College students
(non clinical)
Questionnaire
(postal)
RSR (frequency and
quantity of per-
sonal and college
cohort
consumption)
NAR (personal
residence
unspecified)
Students overestimate the
drinking of peers rela-
tive to their own
Perkins &
Berkowitz
(1986)
N America 18þ50 High school students
(non clinical)
Questionnaire RSR (frequency of
personal and
school cohort
consumption)
NAR
(unspecified)
Perceived Consistency/
discrepancy between
personal consumption
and perceived norm
(continued )
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Table I. Continued.
Authors (Year) Focus
Sample
location
Sample age (years)
M¼Mean
Sample gender (%
female) Target population Method
Alcohol consumption
measure Context Key Findings
significantly asso-
ciated with drinking
Perkins & Craig
(2003)
N America 9–21 (M ¼15.0) 51 School/high school
students (non
clinical)
Questionnaire
(online)
RSR (frequency of
personal and
school cohort
consumption)
NAR
(unspecified)
Perception of peer con-
sumption is signifi-
cantly correlated with
alcohol consumption
Perkins et al.
(2005)
N America 18þ57.1 High school students
(non clinical)
Questionnaire
(national survey)
RSR (personal quan-
tity and peers’ on
that campus)
NAR
(unspecified)
Students’ perception of
their campus drinking
norm was the strongest
predictor of alcohol
consumed
Perkins et al.
(1999)
N America Unspecified Unspecified University students
(multiple
institutions)
Questionnaire RSR (personal and
peer consumption)
NAR
(unspecified)
Norm misperception in
consumption
Perkins &
Wechsler
(1996)
N America 45% ¼21
38% ¼21–23
17% ¼24þ
58 College and univer-
sity students (non
clinical)
Questionnaire Personal attitudes to
alcohol consump-
tion (multiple situ-
ations) and
perceptions of col-
lege cohort views
NAR
(unspecified)
Misperception of alcohol-
related injunctive
norms
Prince & Carey
(2010)
N America 18þ(M ¼19) 57 University students-
undergrad (non
clinical)
Questionnaire
(online)
RSR (personal quan-
tity and frequency
and of close
friends and typical
students)
NAR (campus
computer labs)
Traditional masculine
identification asso-
ciated with elevated
permissive injunctive
norms and alcohol
consumption
Thombs et al.
(1997)
N and social
context
America 11–20 (M ¼14.5
(girls)
18–23 (M ¼20
women)
50.8 (girls)
53.8 (women)
Middle/high school
students (non
clinical)
Questionnaire RSR (frequency and
quantity of
drinking)
NAR (classroom) Norm misperception
-Norm misperception and
social context asso-
ciated with alcohol
consumption
Treno et al.
(2000)
Context America 14 years þ(55.93%
below 41 years)
Approx 50 Community sample
(non clinical)-
Telephone survey RSR (frequencies of
use, average drinks
per occasion and a
measure of the
variance of drink-
ing levels across
different contexts)
NAR (home) Context variation on
alcohol consumption
Quigley & Collins
(1999)
– – – – Meta analysis – – Consumption of alcohol
is situation specific
10 R. L. MONK & D. HEIM
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Alcohol consump-
tion and
context
Ward (2011) norms and context – – – – Review/model
development
– – Proposed a socio-envir-
onmental context
model
Wechsler & Kuo
(2000)
N America Unspecified Unspecified College students (non
clinical)
Questionnaire RSR (quantity and
frequency of
binging)
NAR
(unspecified)
Students overestimate
(47%) the drinking of
peers relative to their
own (29% overesti-
mated it, and 13%
were accurate)
Wechsler &
Nelson (2008)
Context America – – – Review – Context important in
consumption
Weitzman et al.
(2003)
Context America Unspecified (previous
research cohort)
Unspecified (pre-
vious research
cohort)
First year college
students
Questionnaire (postal) RSR (number of
drinks)
NAR (personal
residence
unspecified)
Context important in
consumption
N – norms: RSR ¼retrospective self-report; NAR ¼non alcohol related.
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younger people relative to older people (e.g. Jarvinen
& Room, 2007; Wechsler, Dowdall, Davenport, &
Castillo, 1995) and the comparative ease of student
recruitment may account for this lack of more varied
samples. However, the prevalence of alcohol consump-
tion in younger samples may reflect variations between
adults’ and adolescents’ alcohol-related cognitions.
Indeed, research that has examined age as a variable
within norms research points to age-related deviations
in perceptions, albeit with a student sample (McAlaney
& McMahon, 2007b). For instance, older participants
were found to exhibit smaller normative mispercep-
tions of alcohol consumption (McAlaney & McMahon,
2007b). As alcohol norm misperceptions appear to
increase when there is reduced proximity from the
alcohol use in question (Carey et al., 2006), there is
reason to believe that exposure to alcohol use may alter
normative beliefs. Indeed, if alcohol norms are based,
at least in part, on actual experiences of alcohol,
variance in norms across age categories may be the
expected result of age-related increases in exposure to
and experience of alcohol consumption (McAlaney
& McMahon, 2007b). There may therefore be a limit
to the generalizability of this research owing to
its preponderant use of students samples (Moreira
et al., 2009). Resultantly, future research may be
improved by the expansion of sample ages, thus also
considering the effects of psychosocial context on
alcohol norms.
Gender of the participant
There have also been internationally observed vari-
ations between males and females in both the fre-
quency and quantity of alcohol consumed privately and
in public (Bond et al., 2010). Indeed, gender and
preferred drinking contexts (as well as ethnicity) have
been found to be interactively associated with different
levels of consumption (Nyaronga et al., 2009).
Accordingly, gender of participants is a further
participant variable, which impacts on alcohol norms.
Indeed, ‘Gender specific norm misperception’ (Lewis
& Neighbors, 2004) has been observed in research.
Lewis et al. (2011) observed that the drinking of the
typical same sex student was consistently overesti-
mated by participants. Furthermore, whilst both male
and female students have been found to misperceive
the frequency and quantity of male drinking, other
research found male misperceptions to be higher than
those of females (Lewis & Neighbors, 2004; Page,
Ihasz, Hantiu, Simoneck, & Khan, 2008). In addition,
traditional masculine identification has also been found
to be associated with elevated permissive injunctive
norms and alcohol consumption (Prince & Carey,
2010), although such findings have not been found in
UK student samples (McAlaney & McMahon, 2007a).
Gender of the participant is, thus, a variable, which
should be considered in all research within this area,
and studies which do not stratify by gender may be
ignoring a potentially important variable. Previously
highlighted studies, where a high proportion of the
students utilized were female (e.g. Broadwater et al.,
2006; Bustamante et al., 2009; Perkins, 2007), must
therefore be considered cautiously (Carey et al., 2006).
Female students have also been found to perceive
smaller self-other differences when the comparison
target was a close friend, but larger self-other differ-
ences when the target was a ‘typical female student’.
Males, however, indicated larger self-other differences
when assessing friends, but smaller differences when
assessing a ‘typical male student’ (ibid). Not only do
such findings suggest that normative feedback may be
more effective for female students but they also again
highlight gender differences, which are hitherto largely
unexamined in this area but which may be illuminated
by future research.
Variations across culture
The norms literature is also largely based on studies
conducted using North American samples (McAlaney
& McMahon, 2007a, 2007b; McAlaney et al., 2010,
2011; Moreira et al., 2009). Misperceptions are noted
to increase when there is reduced proximity from the
alcohol use in question (Carey et al., 2006). American
samples may therefore exhibit greater misperceptions
than their international counterparts (McAlaney &
McMahon, 2007a), owing to the restricted access,
which results from the extended legal drinking age in
America (Degenhardt et al., 2008). A British study
utilizing a student sample found that respondents
estimated others’ alcohol consumption to be signifi-
cantly more frequent and greater in quantity than their
personal consumption (McAlaney & McMahon,
2007b). Similarly, Scottish students have been found
to overestimate how much and how often their peers
consume alcohol (Martinus, Melson, Davies, &
Mclaughlin, 2012) and French students showed a
56% overestimation in peer alcohol approval and
consumption, such also being positively associated
with heavy episodic drinking (Franca, Dautzenberg, &
Reynaud, 2010). Studies in Czechoslovakia (Page
et al., 2008), Finland (Lintonen & Konu, 2004) and
Australia (Hughes, Julian, Richman, Mason, & Lang,
2008) also showed similar findings.
Such research therefore suggests that there is a
degree of cross-cultural replication in findings, which
indicate that students display a general tendency to
overestimate peer alcohol consumption (Carey et al.,
2006). On the other hand, students across Latin
America, including Brazil and Peru (Bustamante
et al., 2009), whilst overestimating cocaine, marijuana
and tobacco use in peers, were largely found to either
correctly assess or under-estimate alcohol use in their
peers. Differences in the alcohol exposure of these
students may be the source of these findings
(McAlaney & McMahon, 2007b), suggesting that
geographic location of studies may be a potentially
important mediating variable. However, the finding of
this study may also be attributable to methodological
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variations. Unlike other studies in this area, students
were asked to estimate the percentage of their peers
they believed to consume alcohol. This task may be
more difficult for participants, when compared to the
task of recording perceived quantities (e.g. Perkins
et al., 2005) or frequency (e.g. McAlaney & McMahon,
2007b), which is more typical of research in this area.
Research therefore suggests there are good foundations
on which to assert a general tendency of students to
overestimate the amount of alcohol consumed by
others, and that these norms are associated with alcohol
consumption (Carey et al., 2006).
Legislation variations
The legal restrictions often placed on drinking mean it
is possible that geographic locality/social-cultural
environmental and age may have an interactive role
in determining the context of alcohol consumption.
This is suggested by findings from Clapp et al. (2006),
which showed that, whilst American students of legal
drinking age reported being equally likely to consume
alcohol in a bar or a private party, those under the legal
drinking age were significantly more likely to drink at
a private party or prior to going out. Similarly, US
American students of legal drinking age appear less
likely to drink before going to an alcohol-associated
context (Paschall & Saltz, 2007), whilst those under the
legal drinking age appear more likely to drink before
going out (ibid). Treno et al. (2000) also found, in
calculating relative use ratios, that those under 21 years
were more likely to drink alcohol at others’ homes than
any other age group, whilst those over 50 years were
more likely than any other age group to drink alcohol at
their own home. Furthermore, those 21–30 years of age
were more likely to drink at bar than any other age
category, whilst those under 21 years were the least
likely group to do so (ibid). These findings may, again,
be attributed to American legal drinking restrictions
(ibid). Such findings support research by O’Hare
(1990), suggesting that the legal drinking age has
little effect on alcohol consumption levels, although it
does appear to impact drinking contexts. Age and
cross-cultural variations in alcohol-related legislation
therefore remain factors, which warrant further assess-
ment within the research in this area.
The proximity of the target
The ‘reference group specificity’ is a noted mediator of
norm perceptions (Borsari & Carey, 2003; LaBrie,
Hummer, Neighbors, & Larimer, 2010). This refers to
the observation that the participants’ social proximity
to the targeted reference group may influence misper-
ceptions (Larimer et al., 2011). Indeed, it has been
found that greater misperceptions are found when the
target group is more distal to the participant (Larimer
et al., 2009; Lewis & Neighbors, 2004). Such findings
are believed to result from the fact that distal reference
groups require generalizations from relatively few
direct observations. Increasing group proximity has
therefore been shown to impact normative reports. In
this study, heavy drinking sub-groups (e.g. American
sororities/fraternities groups) were consistently found
to report higher estimates of alcohol consumption when
they were asked to rate the drinking of their fellow
sorority members (Larimer et al., 2011). The associ-
ation between perceived consumption and personal
consumption may also be stronger when close friends,
as opposed to general peers, are the reference group in
question (Carey et al., 2006; Labrie et al., 2010;
McAlaney & McMahon, 2007b). This has also been
found to be the case in university students whose
alcohol use is low, relative to other student populations
(Cox & Bates, 2011). It, therefore, appears evident that
people place more importance on the perceived norms
of close others (Perkins & Craig, 2003) and are thus
more likely to attempt to match their drinking.
Therefore, whilst norm misperceptions, and their
effect on consumption, have been demonstrated at all
levels of group specificity (Larimer et al., 2009, 2011),
reference group specificity is a factor that should
seemingly be considered in all norms research.
Have contextual factors been considered within the
norms literature and, if so, what effect does context
exert on alcohol-related normative beliefs?
The theoretical basis for expecting contextual change
Accordingly, a motivational model of alcohol con-
sumption hypothesizes that immediate situational con-
texts could determine alcohol-related beliefs. These in
turn may then act as cognitive mediators in the decision
to drink (Cox & Klinger, 1990). This is supported by
research by Kairouz, Gliksman, Demers, & Adlaf
(2002), which showed contextually varying drinking
motivations. This process may work via a series of
spreading activations, whereby memories and asso-
ciated constructs, out of conscious awareness, are
triggered by a given context (Reder, Park, & Kieffaber,
2009). Environmental contexts may thus activate
normative beliefs in much the same way that contexts
have been found to impact drug withdrawal, tolerance
and overdose (e.g. Kenny, Chen, Kitamura, Markou, &
Koob, 2006; Siegel, 2001). In support of this, Marlatt
(1990) asserted that alcoholics may experience changes
in cognition in high risk environments, which may lead
to consumption, and such changes in alcohol-related
cognitions have been found in both clinical and non-
clinical populations (Cooney, Gillespie, Baker, &
Kaplan, 1987). Accordingly, alcohol cravings have
been found to significantly increase in a virtual reality
party context, in contrast to the cravings reported
within a virtual office environment (Traylor, Parrish,
Copp, & Bordnick, 2011). Furthermore, changes in
physiological responses to visual cues of alcohol-
related contexts and paraphernalia have also been
demonstrated (Nees, Diener, Smolka, & Flor, 2011).
Indeed, pictures manipulating social and physical
alcohol consumption contexts, including pictures of
full glasses (relative to half full or empty), and social
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drinking scenes (relative to neutral scenes) have been
found to be associated with increases in skin conduct-
ance and reduced startle responses (Nees et al., 2011).
Such findings appear to further suggest the potential
for context to cue cognitions, which may drive
intake (ibid).
Environmental and social contexts of consumption
It is widely acknowledged that the consumption of
alcohol is situation-specific rather than the sole product
of transitional individual factors (Harford, 1979;
Quigley & Collins, 1999). There has been long
standing attention to the contexts of drinking. Early
work examined where students drink most frequently
(Straus & Bacon, 1953) and, more recently, people
have been classified on the basis of their preferred
dinking locations (Andersson et al., 2012; Nyaronga
et al., 2009). As such, certain environments are more
commonly associated with consumption than others
(c.f. Wechsler & Nelson, 2008) and context has been
found to be a significant predictor of both the
frequency and quantity of alcohol consumption (e.g.
Clapp, Shillington, & Segars, 2000; Clapp et al., 2006;
Holyfield et al., 1995; Weitzman et al., 2003).
It has also been stated that this context-dependent
variation in consumption may be attributable to
deviation in drinking norms across contexts
(Greenfield & Room, 1997).
Context has been asserted to include not only
environmental factors but also the social or interper-
sonal characteristics of a particular setting or occasion
(c.f. Barry & Goodson, 2012; Thombs et al., 1997).
As such, numerous social contexts have also been
found to be associated with alcohol consumption
(Beck, Thombs, & Summons, 1993; Holyfield et al.,
1995) and abstinence (Polcin, Henderson, Trocki,
Evans, & Wittman, 2012). Indeed, social context has
been asserted to work as well, if not better, than social
norms in predicting problematic adolescent alcohol
consumption (Beck & Treiman, 1996). Being at a party
with friends (Thombs et al., 1997), drinking as a group
(Demers et al., 2002), peer pressure (McKay & Cole,
2012), drinking with close friends and the number of
intoxicated people at an event have thus also been
demonstrated to be factors predictive of alcohol
consumption (Clapp & Shillington, 2001a, 2001b;
Clapp et al., 2003). Social group membership (soror-
ity/fraternity) (Park, Sher, & Krull, 2003) has also been
found to be associated with the quantity and frequency
of alcohol consumption in college students. Similarly,
heavier drinking has been reported in participants who
prefer to drink in larger social contexts of mixed gender
groups (Senchak, Leonard, & Greene, 1998). Alcohol
consumption is also more preferred (O’Hare, 1990) and
more favourably perceived when occurring in social
groups than when alone (Lo Monaco, Piermatte
´o,
Guimelli, & Ernst-Vintila, 2011).
Such research corresponds with social impact theory
(Latane, 1981), which postulates that other people
impact behaviour in social situations. Specifically, the
strength, immediacy and number of people are believed
to determine the influence observed. Findings of this
nature appear to correspond with the focus theory of
normative conduct (Kallgren et al., 2000), which states
that a behavioural norm may appear more salient in a
particular environment and that this in turn may
influence behaviour. For instance, a small group of
friends surrounded by other drinkers in a pub may be
influenced to drink, owing to the salience of the social
drinking norm in the pub environment. However, this
research is based upon self-reports regarding alcohol
consumption. Yet, whilst it has been suggested that this
is a largely accurate method (Glovannucci et al., 1991),
there is evidence that heavy alcohol consumption may
be significantly under reported via self-report
(Northcote & Livingston, 2011), and it is common
for published work to acknowledge the potential
limitations of their self-report data (e.g. McKay,
Percy, & Cole, 2013). Furthermore, the processes
driving this context specific alcohol consumption have
been under researched.
Normative beliefs and contextual variation research
McAlaney et al. (2011) propose that environments,
such as bars and pubs, are ‘environments of perceptual
distortion’ (p. 2) as, here, risky behaviour, such as
excessive drinking, may be perceived as more preva-
lent (normative). This resultant (mis)perception is in
turn asserted to cause a concomitant increase in alcohol
consumption (ibid). Ward’s (2011) socio-environmen-
tal context model also advocates the importance
of considering the ‘physical-geographical dimension’
in regard to alcohol-related norms, specifically that
environments may change alcohol norms and thus also
consumption as they are the ‘stage on which social
norms are created and reinforced’ (p. 504).
Furthermore, Lo Monaco et al. (2011) propose that
drinking contexts may act as ‘normative frameworks’
(p. 2). In this study, it is suggested that one’s
environment may determine what is perceived as
‘normative’ alcohol consumption and this in turn may
impact alcohol intake. These contextually driven
normative perceptions also appear to impact how
others’ drinking is perceived. For example, a student
drinking alone has been shown to be viewed negatively
as opposed to a student drinking in a group of friends
(Lo Monaco et al., 2011). Such findings lend support to
the ‘Black Sheep Effect’ (Marques & Paez, 1994),
whereby actions which fit normative prescriptions are
viewed favourably, whilst behaviours that are seen as
anti-normative are considered negatively, owing to the
environment in which they occur. However, there is
little research that examines such a suggestion within
alcohol-related cognitions. In an early review, it was
noted that 91% of normative belief studies reviewed
took place within a school context (Foxcroft et al.,
1997) and the present review suggests that this area
remains under researched.
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Neighbors, Oster-Aaland, Bergstrom, and Lewis
(2006) concluded that norm misperceptions were
context specific upon finding that students over-
estimated norm alcohol consumption at 21st birthday
parties and other specifically outlined contexts.
However, without a control context, it is hard to
establish whether such findings suggest the commonly
observed norm misperception found in students, or
whether misperceptions are indeed heightened by
context. Thombs et al. (1997) also indicated that both
normative misperceptions and context were associated
with, and account for, a large proportion of variance in
alcohol consumption. Furthermore, Lewis et al. (2011)
recruited university students who were asked to report
on the level of alcohol they consumed in five settings,
including home, bars and college parties. In this study,
it was found that participants consistently overesti-
mated the alcohol consumption of typical students in
all contexts, with overestimations being highest for
sorority/fraternity parties. Such results further demon-
strate the potentially important and mediatory role of
environmental setting on norm misperception (ibid)
and offer support for the assertion that certain envir-
onments may increase the perceived prevalence of
risky behaviour (McAlaney et al., 2011). Similarly,
social context and normative beliefs have been sug-
gested to interact. In this study, larger groups were
found to be associated with greater quantities of self-
reported drinking when context-specific norms were
high (Cullum, O’Grady, Armeli, & Tennen, 2012).
The problems of retrospective self report measures
However, whilst such research offers an initial insight
into a largely unexamined area, the design of the
research may be questioned. Indeed, research such as
that by Neighbors et al. (2006), Lewis et al. (2011) and
Thombs et al. (1997) required students to consider/
estimate the number of drinks that they themselves and
others consume in a number of different contexts.
Similarly, Cullum et al. (2012) required participants to
recall the number of people they were with and the
quantity of drinks they consumed in the previous night.
However, this would seem problematic for a number
of reasons.
First, tasks such as this may encourage fabrication in
an effort to satisfy the demands of the researchers.
Indeed, it may be asserted that by asking these
questions, the researchers may have, in fact, signalled
to the participants that variance in estimations would
be expected across these contexts (c.f. Melson, Davies,
& Martinus, 2011). Such a possibility would be in line
with signalling effects (Davies & Best, 1996). Second,
such a task appears highly cognitively demanding. It
requires participants to make retrospective judgments
about the typical drinking of peers in a variety of
contexts. This task is axiomatically dependent on the
participant’s own memory. However, given the falli-
bility of memory and the limitations of autobiographic
or episodic memory (e.g. Loftus & Hoffman, 1989),
such results may have questionable validity. This
problem may also be further exacerbated if alcohol
consumption occurred during the target period, as
alcohol may further impair memory (c.f. Walker &
Hunter, 1978). Finally, the difficulty of the task
requiring the retrospective recall of multiple occasions
may also be heightened, as conducting these assess-
ments in a non alcohol-related environment necessi-
tates recall in absence of any associated environmental
stimuli, which may aid recall (c.f. Godden & Baddeley,
1975). Indeed, the environments in which such con-
sumption assessments take place are often far removed
from the setting in which the drinking occurs, by nature
of their post hoc design (Verster, Tiplady, &
McKinney, 2012). Therefore, as well as being meth-
odologically problematic, the highlighted research may
not be fulfilling its aims to examine the impact of
context on normative beliefs. Arguably, these studies
do not represent in vivo (contextually aware/sensitive)
assessments and, as a result, they may lack ecological
validity. Instead, the reported contextual variations in
alcohol-related cognitions appear, at best, retrospective
accounts of alcohol consumption, as opposed to a real-
life measure of participants’ contextually varying
cognitions. It would therefore appear likely that context
may have a dynamic relationship with normative
beliefs, in light of aforementioned research suggesting
an effect of context on wider cognitions. Accordingly,
recent field research has also demonstrated that vari-
ations in alcohol-related cognition would be expected
across contexts (Monk & Heim, 2013c).
Measures of in vivo alcohol-related cognitions
A recent study by Kuendig and Kuntsche (2012)
suggests that ‘in situ’ alcohol consumption may indeed
be the product of ‘context-specific behavioural norms’.
In this study, participants’ alcohol consumption in a
wine-tasting event was found to be greater during
group tasting than in their first wine tasting, which was
conducted alone. It therefore appeared that an inhibi-
tive perceptual norm of behaviour governed consump-
tion in this novel environment – i.e. solitary wine-
tasting was driven by the belief that it would not be
appropriate, or normative, to drink large quantities in
this setting. Resultantly, consumption was lower in the
solitary condition than in the subsequent group tasting
condition, once a more permissive norm had been
established amongst the group. However, it was also
found that the opposite was true when the order of the
conditions was reversed, i.e. when participants’ first
tasting experience was as part of a group and their
second tasting session was solitary. In this condition,
participants’ consumption was higher when they were
alone than when they consumed alcohol as part of a
group. For these participants, their first experience of
this environment involved interacting and drinking as
part of a group and it appeared that this was where
normative beliefs were formulated/learnt. This meant
that in subsequent, solitary testing, a more permissive
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behavioural norm had developed and ‘overwrote’ the
previously more restrictive injunctive norm. This led
consumption to be higher in the later, solitary drinking
session (ibid). Social context (i.e. who one is with) can,
therefore, be seen to interact with experienced-based
normative beliefs – an interaction that appears to
differentially impact consumption. In support of this
assertion, normative frequency ratings have been
shown to increase during exposure to immersive,
alcohol-related videos (footage of a populated pub)
(Monk & Heim, 2013b). Similarly, field research that
assessed contextual variations in alcohol-related cog-
nitions (including outcome expectancies and normative
beliefs) indicated that cognitions, which were assessed
whilst respondents were situated in a university bar
differed from those who responded whilst in a univer-
sity lecture theatre (Monk & Heim, 2013c). Contextual
variations in normative beliefs were not found after
controlling for individual differences in self-reported
alcohol consumption. However, the authors note that
this may be due to contextual confounds of the
covariate (self-reported consumption) used within the
statistical analysis (c.f. Monk & Heim, 2013c for
further information).
Research has also assessed the effects of social
context on normative beliefs in vivo, participants being
assessed either individually or as part of a group. In this
srudy, assessment within a group of like peers was
associated with higher normative estimates than indi-
vidual assessments (Monk & Heim, 2013b; Pedersen,
Labrie, & Lac, 2008). The impact of environmental
context was not assessed, by Pedersen et al. (2008),
however. All participants completed their questionnaire
in a college lecture theatre meaning that environmental
influences have not been considered or assessed.
Certainly, research has demonstrated that context and
normative beliefs have an interactive effect on con-
sumption. Cooke and French (2011) found that sub-
jective norms of participants in a bar were more
predictive of their intentions to binge drink, whereas
the subjective norms of participants in a library were
less predictive of intentions to binge drink. There are
therefore indications, particularly from in vivo
research, that one’s present context can impact norma-
tive beliefs. However, the research examining this
remains scarce. The effect of context on normative
beliefs is thus an area that seemingly requires more
detailed research.
CONCLUSION
The diverse measures of alcohol intake appear to
impact study comparability and point to a need for
more standardized quantity-frequency measures in this
area of research. Furthermore, diminutive evidence of
age and gender effects on norms, interactions between
participant demographics and evidence of cross-cul-
tural variations in research findings, also suggests that
further research is required in order to increase research
validity. Finally, the findings of this review show that
context is a variable which is substantively under-
researched within the norms literature, despite early
indications that this may be an important variable.
Indeed, researchers predominantly administer ques-
tionnaires in non-alcohol related contexts such as
laboratories or classrooms. This calls into question the
validity and real world applicability of existing norms
research. It is therefore proposed that present literature
be expanded by examining in vivo normative beliefs, in
accordance with a functional contextualist approach to
research. By standardizing the methodology and out-
come measures used, and examining the ‘ongoing act
in context’ (Biglan, 2001), a more valid and dynamic
model of alcohol consumption may be developed. This
may prove a valuable step toward better informing
interventions by enabling the targeting of appropriate
contexts and demographic groups.
Declaration of interest: The authors declare no conflict of
interests.
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