Positive and Negative Consequences of Alcohol Consumption in College Students

Abstract

While the negative consequences of alcohol use in college students are well known, less is known about the relationships of these consequences to alcohol consumption patterns. Further, almost no research has been conducted examining students' positive alcohol-related consequences. The current study examines the nature and frequency of positive and negative alcohol-related consequences, the relationship of these consequences to alcohol consumption patterns, and the impact of these consequences on subsequent drinking intentions. Findings indicate that college student drinking does indeed involve many negative consequences, some of which are quite serious, but that students also experience many positive consequences. In fact, they report their encounters with positive consequences as being more extreme and more frequent than their encounters with negative consequences. Further, consuming more alcohol is related to experiencing more positive and more negative consequences, as well as more extremely positive positive encounters, but not more extremely negative negative ones. Finally, participants reported that their positive and negative consequences would influence their future drinking decisions in a number of different ways. Future research directions and implications for interventions are discussed.

Full text

Positive and negative consequences of
alcohol consumption in college students
Crystal L. Park*
Department of Connecticut, University of Connecticut, 406 Babbidge Road Unit 1020, Storrs, CT 06296, USA
Abstract
While the negative consequences of alcohol use in college students are well known, less is known
about the relationships of these consequences to alcohol consumption patterns. Further, almost no
research has been conducted examining students’ positive alcohol-related consequences. The current
study examines the nature and frequency of positive and negative alcohol-related consequences, the
relationship of these consequences to alcohol consumption patterns, and the impact of these
consequences on subsequent drinking intentions. Findings indicate that college student drinking does
indeed involve many negative consequences, some of which are quite serious, but that students also
experience many positive consequences. In fact, they report their encounters with positive
consequences as being more extreme and more frequent than their encounters with negative
consequences. Further, consuming more alcohol is related to experiencing more positive and more
negative consequences, as well as more extremely positive positive encounters, but not more
extremely negative negative ones. Finally, participants reported that their positive and negative
consequences would influence their future drinking decisions in a number of different ways. Future
research directions and implications for interventions are discussed.
D2003 Elsevier Ltd. All rights reserved.
Keywords: Alcohol consumption; College students; Positive and negative consequences
1. Introduction
Heavy alcohol consumption, often a normative part of the college experience (Chen &
Kandel, 1995), is associated with a multitude of negative consequences, including problems
with academics, interpersonal relations, and the legal system (e.g., Syre, Pesa, & Cockley,
0306-4603/$ – see front matter D2003 Elsevier Ltd. All rights reserved.
doi:10.1016/j.addbeh.2003.08.006
* Tel.: +1-860-486-3520.
E-mail address: clpark@uconnvm.uconn.edu (C.L. Park).
Addictive Behaviors 29 (2004) 311–321

1999). These negative consequences appear to be a particularly problematic aspect of college
student drinking (Wechsler, Davenport, Dowdall, Moeykens, & Castillo, 1994). However, little
research has examined students’ own perceptions of the consequences of their drinking (cf.
Nystrom, 1992; Sadava & Pak, 1993).
The present study examines these alcohol-related consequences in greater detail, focusing on
positive consequences as well as negative ones. Specifically, this study examines the nature and
frequency of positive and negative alcohol-related consequences, the relationship of these
consequences to alcohol consumption patterns, and the impact of these consequences on
subsequent drinking intentions. Special attention is given to potential gender differences.
1.1. Nature and frequency of positive and negative consequences of alcohol consumption
The negative consequences of undergraduate drinking, including personal injuries,
unplanned sexual activity, and legal problems, have been well documented in national
samples (Wechsler, Dowdall, Davenport, & Castillo, 1995). Nevertheless, the literature
indicates that college students tend to hold very positive expectancies for their own alcohol
use (e.g., Kushner, Sher, Wood, & Wood, 1994). Moreover, these positive expectancies
persist and strengthen, with refinements, as students gain more experience with alcohol (e.g.,
Smith, Goldman, Greenbaum, & Christiansen, 1995). Because few studies have examined the
positive consequences of drinking, it is not clear whether students actually experience
positive alcohol-related consequences that reinforce their expectancies.
The present study asked students to report the levels of positive and negative alcohol-
related events that they had recently experienced. Further, students were asked to describe and
rate the intensity of their most negative and most positive recent alcohol-related experience.
Given the high levels of continued drinking by college undergraduates in spite of its
documented negative effects, it was hypothesized that positive consequences would occur
at least as frequently as negative consequences, and that students would rate their most
positive experiences as more positive than they would rate their most negative experiences as
negative.
1.2. Alcohol consumption and consequences
Research has shown that the relationship between drinking amount (quantity and
frequency) and negative consequences is consistent and substantial, but also that these
constructs are distinct (e.g., Bonin, McCreary, & Sadava, 2000; Camatta and Nagoshi,
1995). The present study hypothesized that higher levels of alcohol consumption would
be moderately related to higher levels of both negative consequences and positive
consequences.
1.3. Alcohol-related experiences and future drinking behavior
Many students continue to drink heavily in spite of encountering negative consequences,
although some students may alter their drinking habits in light of their experiences. This
C.L. Park / Addictive Behaviors 29 (2004) 311–321312

study examined relations among students’ positive and negative alcohol-related consequen-
ces and the intensity of their recent most positive and negative alcohol-related experiences
with their intentions to change their drinking in light of their experiences. Given that
alcohol consumption tends to be immediately positively reinforcing and its negative effects
are less immediate and seem to be less salient (Leigh, 1987), it was hypothesized that
positive consequences will be more influential than negative consequences in future
drinking intentions.
2. Method
Participants were 263 undergraduates (104 men, 159 women; mean age of 19.1; 3%
African American, 1% Asian, 95% Caucasian, 1% Latino) drawn from the psychology
department participant pool. All participants received research credit for their class.
2.1. Measures
2.1.1. Alcohol consumption
Participants were asked how often they consumed alcohol in the past month and how many
drinks they consumed at a typical sitting in the past month. Three aspects of heavy drinking in
the past month were assessed: frequency of binge drinking (5 or more drinks per sitting),
frequency of feeling lightheaded because of drinking, and frequency of being drunk (from
Kushner et al., 1994).
2.1.2. Most positive and most negative recent alcohol-related experience
Participants were asked a series of questions about their most negative alcohol-related
experience in the past 2 months, including a description of the encounter, ratings of the
intensity of this event and future intentions (‘‘How much does this negative consequence play
into your decisions about drinking now?’’) from 1 = not at all to 5 = extremely, and an open-
ended question asking ‘‘How?’’ A parallel set of questions was asked about their most
positive alcohol-related consequence. Participants’ descriptions of their recent most positive
and negative consequences and of how these consequences will play into their decisions about
drinking were sorted by two raters who independently categorized the responses. Their initial
agreement rate was 87%. In discordant cases, raters discussed and mutually decided on the
category for each item.
2.1.3. Negative consequences associated with drinking
Negative consequences associated with drinking were assessed by the Negative Alcohol
Consequences Scale (Wechsler et al., 1994), which asks participants the extent to which
they experienced each of the 12 negative consequences in the past 2 months as a result of
their own alcohol use (e.g., ‘‘Do something you later regretted’’) from 1 = never to 5 = very
frequently. Alpha in the present sample was .78.
C.L. Park / Addictive Behaviors 29 (2004) 311–321 313

2.1.4. Positive consequences associated with drinking
Because positive consequences of alcohol use have rarely been assessed, a measure
parallel to Wechsler’s negative consequences scale was devised to assess positive con-
sequences. This scale used the same rating format as Wechsler’s scale, but the 12 items were
taken from the expectancies measure of Kushner et al. (1994). The three highest loading items
on each of the four subscales (tension reduction, performance enhancement, activity
enhancement, and social lubrication) were converted into positive consequence items, and
participants were asked to rate the frequency with which they experienced each consequence.
Examples included ‘‘forgot my worries,’’ ‘‘felt more sexy,’’ and ‘‘had better ideas.’’ Alpha in
the present sample was .90.
3. Results
3.1. Alcohol consumption versus abstinence
Of the 270 students in the study, 28 (10%) reportedthat they had not consumed alcohol in the
past month. The analyses in this paper were conducted only with the 247 students (99 men, 142
women, and 6 who did not identify their gender) who reported that they had consumed alcohol
in the past month.
3.2. Nature and frequency of negative and positive experiences
Students reported experiencing more positive alcohol-related consequences than negative
alcohol-related consequences [M= 2.70 vs. 1.81, t(241) = 18.02, P< .001], and the frequency of
experiencing positive and negative consequences were fairly strongly correlated (r=.47,
P< .001). The most negative experiences in the last 2 months were hangovers/sickness and
kissing/sexual activity (see Table 1). The most positive experiences were having fun/socializing
and expressing oneself (see Table 2). Men reported experiencing higher mean levels of positive
[M= 2.83 vs. 2.50, t(239) = 2.29, P< .001] and negative [M= 1.97 vs. 1.69, t(239) = 3.39
P< .001] consequences than women.
Students reported that the degree to which their most positive consequence was positive
was significantly greater than the degree to which their most negative consequence was
negative [M= 4.03 vs. 3.24, t(222) = 7.65, P< .001]. Men and women did not differ on ratings
of the extremes of their most positive or negative recent alcohol-related experience (ts < 0.87,
Ps > .34).
3.3. Relations between positive and negative alcohol-related consequences and drinking
outcomes
Bivariate correlational analyses indicated that mean levels of experiencing negative and
positive consequences were related to higher levels of all of the alcohol consumption
C.L. Park / Addictive Behaviors 29 (2004) 311–321314

variables, supplementing results previously reported with this sample (Park & Levenson, in
press). A similar pattern, although with much weaker correlations, was found for the degree
to which the most positive event was positive. However, the degree to which the most
negative event was negative was unrelated to any of the alcohol consumption variables (see
Table 3). When these correlations were conduced separately by gender, almost identical
patterns resulted for men and women.
Table 1
Type and frequency of most negative experiences
Category Number of responses
(percentage of total respondents)
Examples
Men (n= 94) Women (n= 133)
Being sick/hangover 30 (27.8) 52 (32.5) ‘‘Collapsing in my room and vomiting all over
the carpet’’ ‘‘Got a migraine from a hangover’’
Sexual activity/kissing 17 (15.7) 21 (13.1) ‘‘Getting together with a girl and not
remembering the next morning’’ ‘‘Sexual
relations with a guy I’d just met’’
Fight/argument 13 (12.0) 9 (5.6) ‘‘Got in a big fight with my girlfriend’’
‘‘Beat up some guy’’
School problems 5 (4.6) 13 (8.1) ‘‘Got drunk the night before an exam and
failed it’’ ‘‘Schoolwork piled up because I
put it off to drink’’
Consequences due to
another person’s
drinking/taking
care of others
9 (8.3) 24 (15.0) ‘‘Had to take care of a severely intoxicated frosh
girl’’ ‘‘Had to sit up all night with my roommate’’
Accident 1 (0.9) 3 (1.9) ‘‘Big party with people packed on a deck which
snapped off the house’’ ‘‘Fell and sprained
my ankle’’
Aberrant behavior/
said or did
something
should not have/
out of control
12 (11.1) 22 (13.8) ‘‘Embarrassing my girlfriend at a sorority function
by belching in one of her big sister’s ears’’
‘‘Got angry and broke things in a fit of rage’’
Trouble with
authorities/legal
7 (6.5) 3 (1.9) ‘‘Arrested for minor consumption’’ ‘‘Stolen
property’’
Blackout 3 (2.8) 4 (2.5) ‘‘Blacked out and didn’t remember things I did’’
Drinking and driving 2 (1.9) 4 (2.5) ‘‘Driving home in a very expensive car’’ ‘‘Lost
control of car’’
Bout of depressed mood 2 (1.9) 0 (0.0) ‘‘Depression, wallowing in my failures’’ ‘‘Felt low
about myself because emotions were running’’
Other 6 (5.5) 4 (2.5) ‘‘Was drunk and had nothing to do. I was bored’’
None 1 (0.9) 9 (5.6)
Total 108 160
Total responses are greater than total number of participants who answered because some respondents had a
compound response (e.g., ‘‘I blacked out and said things I normally wouldn’t have, and was involved in a sexual
encounter I regretted’’).
C.L. Park / Addictive Behaviors 29 (2004) 311–321 315

Table 2
Types and frequency of most positive experiences
Category Number of responses
(percentage of total respondents)
Examples
Men (n= 93) Women (n= 130)
Met new
friends
8 (7.9) 17 (13.1) ‘‘I have met a lot of fraternity people’’ ‘‘Met a lot
of new people at a party’’
Great fun/
socializing
48 (47.5) 73 (56.2) ‘‘Had a blast dancing at a bar with friends’’ ‘‘Had a good
time at a party that wouldn’t have been as much fun sober’’
Romantic
encounter
11 (10.9) 8 (6.2) ‘‘I met my current boyfriend due to lack of social
inhibition’’ ‘‘Flirting with a girl I like when we were
both drunk’’
Sex 8 (7.9) 2 (1.5) ‘‘I went home with a ‘hotty’’’ ‘‘Got with a woman’’
Stress relief 6 (5.9) 2 (1.5) ‘‘Forgot problems of past year with my health’’
‘‘Relieved stress so I could have fun with my friends’’
Expressed
myself
14 (13.7) 23 (17.7) ‘‘Was able to express my true feelings to a girl’’
‘‘Spoke true feelings to certain people’’
Celebrated 0 (0.0) 2 (1.5) ‘‘Many toasts to my parents on their 25th wedding
anniversary’’
Controlled
drinking/
myself
4 (4.0) 2 (1.5) ‘‘Went to a party where alcohol was available, but I
didn’t drink, I restrained myself’’ ‘‘Controlled drinking’’
Nice meal 2 (2.0) 2 (1.5) ‘‘Having a glass of wine with my family at Thanksgiving
dinner’’
Other 0 (0.0) 3 (2.3)
None 5 (5.0) 12 (9.2)
Total 101 146
Total responses are greater than total number of participants who answered because some respondents had a
compound response (e.g., ‘‘Had a great time with friends and was able to express feelings I normally wouldn’t
express’’).
Table 3
Correlations between recent positive and negative alcohol-related consequences and past month drinking
outcomes
Mean level
of negative
consequences
Mean level
of positive
consequences
Degree to
which most
negative occurrence
was negative
Degree to
which most
positive occurrence
was positive
Alcohol consumption frequency .58*** .38*** .08 .17***
Alcohol consumption quantity .48*** .36*** .10 .15*
Frequency of binge drinking .61*** .41*** .09 .19**
Frequency of being drunk .61*** .38*** .07 .22**
Frequency of feeling lightheaded .57*** .40*** .10 .20**
*
p < .05.
**
p < .01.
***
p < .001.
C.L. Park / Addictive Behaviors 29 (2004) 311–321316

Table 4
Correlations among positive and negative consequences, extent of most positive and negative consequence, and
influence of most positive and negative consequence on future drinking decisions
Mean level
of positive
consequences
Degree to
which most
negative
occurrence
was negative
Extent of
influence of
most negative
occurrence
Degree to
which most
positive
occurrence
was positive
Extent of
influence of
most positive
occurrence
Mean level of
negative consequences
.54*** .18** .02 .10 .18**
Mean level of
positive consequences
– .09 .15 .31*** .37***
Degree to which most
negative occurrence
was negative
– .54*** .22*** .35***
Extent of influence of
most negative occurrence
– .09 .17**
Degree to which most positive
occurrence was positive
– .41***
Extent of influence of
most positive occurrence
–
Table 5
Types of influence most negative alcohol-related event will have
Category Number of responses
(percentage of responses)
Examples
Men (n= 86) Women (n= 122)
Drink less/try
to drink less
19 (22.1) 31 (25.4) ‘‘I try to drink less’’ ‘‘Make sure
I don’t OD’’
Am more careful
when I drink now
11 (12.8) 16 (13.1) ‘‘I know I drank too much that
night and should be careful’’ ‘‘Make
sure I handle my alcohol well’’
Think more 10 (11.7) 6 (4.9) ‘‘I try to think of consequences
ahead of time’’ ‘‘Have to be more
aware of my actions sometimes’’
Change the context in
which drinking occurs
12 (14.0) 23 (18.9) ‘‘No more parties at my house’’
‘‘Makes me realize I must always
bring condoms with me when I’m
drinking’’
Change views of
alcohol or self
5 (5.8) 1 (0.8) ‘‘Reaffirmed by belief that alcohol
is not beneficial’’ ‘‘Know I can take
care of a big, drunk dude’’
Other 3 (3.5) 3 (2.6) ‘‘Try to forget’’
Little influence 6 (7.0) 6 (5.0) ‘‘Not really; I made a mistake’’
No influence 20 (23.3) 36 (29.5) ‘‘Not at all’’ ‘‘It doesn’t; I am going
to drink anyway’’
Total number of responses 86 122
C.L. Park / Addictive Behaviors 29 (2004) 311–321 317

3.4. Positive and negative alcohol-related consequences and influence on future drinking
intentions
Regarding the influence of their most positive and negative experience on their future
drinking behavior, students reported being more strongly influenced by their most positive
experience than their most negative experience [M= 3.18 vs. 2.45, t(222) = 6.38, P< .001].
Men and women did not differ in the extent to which their most positive consequence would
influence their future drinking [M= 3.17 vs. 3.10, t(222) = 0.35, P>.72], but women reported
that their negative experience would be more influential than did men [M= 2.74 vs. 2.14,
t(222) = 3.62, P< .001].
Regarding relations between alcohol consequences and future drinking intentions, Table
4lists correlations among frequency of positive and negative consequences and character-
istics of most positive and negative alcohol-related events with influences on future
drinking. The more negative the most negative event, the more it would influence future
drinking (r=.54). The same was true, but to a lesser extent, for the positivity of the
positive event (r=.41). The positivity of the most positive event was not related to the
extent of influence of the most negative event (r=.09), but the negativity of the most
negative event was related to the extent of influence of the most positive event (r=.35).
Separate correlational analyses by gender produced almost identical patterns for men and
women.
Table 6
Types of influence most positive alcohol-related event will have
Category Number of responses
(percentage of responses)
Examples
Men (n= 81) Women (n= 110)
Reinforce positive
social aspects of drinking
12 (14.8) 23 (21.0) ‘‘It’s a good way to meet people’’
‘‘It helps me to be more likeable’’
Reinforce fun aspects
of drinking
19 (23.5) 19 (17.3) ‘‘I know I drank too much that night
and should be careful’’ ‘‘Make sure I
handle my alcohol well’’
Reinforce ideas of trust/
control regarding alcohol
4 (4.9) 12 (11.0) ‘‘I know I can trust myself not to drink
too much even when being pressured’’
‘‘I see I can have a good time drinking
but I don’t have to be falling down drunk’’
Reinforce ability
to communicate
better with alcohol
12 (14.8) 23 (21.0) ‘‘I know it helps me express myself’’ ‘‘I will
drink if I wish to communicate better’’
Desire to drink more/
repeat the experience
14 (17.3) 17 (15.5) ‘‘When you party and have a good time, you
want to do it all the time’’ ‘‘Makes me want to
drink at parties’’
Other 2 (2.5) 1 (0.9) ‘‘Feel good that I can make others happy’’
Little influence 6 (7.4) 6 (5.5) ‘‘Not much. I still go out like I did before’’
No influence 17 (21.0) 25 (23.0) ‘‘Not at all, it was just a really fun thing to do’’
Total 81 110
C.L. Park / Addictive Behaviors 29 (2004) 311–321318

Students’ reports of how their most negative and most positive occurrences will be related
to their future drinking indicate that many students report planning to drink less or more
carefully as a result of their negative experience but that they are also encouraged to drink
more as a result of their most positive alcohol-related consequence and that their positive
alcohol expectancies have been strengthened (see Tables 5 and 6).
4. Discussion
These results suggest that college student drinking does indeed involve many negative
consequences, some of which are quite serious, but that students also experience many
positive consequences. In fact, they report their encounters with positive consequences as
being more extreme and more frequent than their encounters with negative consequences.
Further, consuming more alcohol is related to more positive and more negative consequences
as well as more extremely positive positive encounters, but not more extremely negative
negative ones. Finally, students reported that their positive and negative consequences would
influence their future drinking decisions in a number of different ways.
The negative consequences of college student drinking have recently received a great
deal of attention (e.g., Wechsler, 2000). Importantly, although alcohol consumption was
related to the frequency of encountering negative experiences, the alcohol consumption
variables were unrelated to the negativity of the most negative encounter. These results
are consistent with those of Sadava and Pak (1993), who noted that negative con-
sequences are only modestly linked to heavy alcohol consumption. Most students reported
that their most negative consequence would influence their future drinking, with many
students intending to drink less or more carefully or to think more when drinking in the
future.
The positive consequences of alcohol, while clearly on the minds of many students (as
evidenced in studies of positive expectancies), have rarely been the focus of research in the
area of college student drinking. The present findings suggest that students experience a
variety of positive consequences, that these positive consequences are in many ways more
significant to them than negative ones, and that positive consequences appear to reinforce
their positive expectancies regarding alcohol. Further, as hypothesized, the most extremely
positive positive consequences were reported as being more influential in their future
decisions regarding drinking. These findings are consistent with Leigh and Stacy’s (1998)
observation that alcohol’s inherently reinforcing properties increase the likelihood that
positive affect will be encoded every time alcohol is consumed. Conversely, negative affect
is less probable and therefore less likely to be associated with alcohol. Further, they
reported evidence that positive outcome associations are more strongly related to drinking
habits than are negative outcome associations, implying that heavier alcohol use leads to
stronger associations with positive than with negative outcomes. In the present study, many
students reported quite directly their plans or desires to drink again or to engage in the
same behaviors that led to their most positive consequence, while many others reported that
the positive consequences reinforced their beliefs that alcohol use leads to more fun, better
C.L. Park / Addictive Behaviors 29 (2004) 311–321 319

times with friends, less tension, and easier socializing. Such reinforcement of positive
expectancies may lead to continued drinking in the future as well.
While this study examined gender differences, the results generally indicated that men and
women were more alike than different in their experiences of positive and negative alcohol-
related consequences. Correlation patterns among the variables did not evidence gender
differences, although men reported experiencing more positive and more negative alcohol-
related consequences, consistent with previous research (Nystrom, 1992), and women
reported being more influenced in their drinking decisions by their most negative conse-
quence than did men.
Several limitations of this study should be noted. Participants were just one group of
primarily white middle class college students. Future studies should include more socio-
economically and ethnically diverse samples. In assessing consequences and attitudinal and
behavioral changes, it would be helpful to have more sophisticated measurement tools.
Further, the cross-sectional design of the present study limits the ability to make causal
inferences; longitudinal research would be informative in examining how these variables are
related over time. In particular, repeated assessments of alcohol use, consequences, and
subsequent alcohol use would better model the relationships among these variables. A daily
diary methodology might be especially helpful in this regard (e.g., Hussong, Hicks, Levy, &
Curran, 2001).
Future research on college student drinking should attend to the consequences of drinking
as outcomes separate from (and possibly more important than) alcohol consumption
(McCreary & Sadava, 1998; Plant, 1999) and should examine positive as well as negative
outcomes. Further, it appears that some psychosocial factors may make students relatively
more or less likely to experience positive as well as negative alcohol-related consequences.
For example, Sadava and Pak (1993) found that certain variables, such as stress, coping, and
depression, were related to experiencing negative consequences, even when controlling for
the amount of alcohol consumed. Such factors should be identified. Finally, longitudinal
research should examine the sequences of alcohol consumption, consequences, and changes
in alcohol consumption to better understand the interplay of expectancies and experience.
Campus intervention efforts should also be informed by these findings. College students
not only tend to hold positive expectancies for alcohol use (Kushner et al., 1994), but they
actually have positive experiences as results of this use. Interventions involving expectancy
challenges have been shown to be somewhat effective in experimental contexts (e.g., Darkes
& Goldman, 1998), but changing expectancies in meaningful long-term ways has proven to
be difficult (e.g., Corbin, McNair, & Carter, 2001). This may be due, in part, to students’
encounters with positive experiences that reinforce their positive expectancies, which then
lead them to experience further positive consequences in a positive feedback cycle.
Intervention programs should be tempered with an awareness of the students’ likely
encounters with positive as well as negative experiences. Finally, given the semi-independ-
ence of alcohol consumption and negative consequences, intervention goals may include not
only reducing alcohol use, but also reducing the frequency and severity of negative
consequences, which may require different intervention strategies. For example, it may be
helpful to have students focus on the context of their negative consequences and to work with
C.L. Park / Addictive Behaviors 29 (2004) 311–321320

them on ways that they can change their drinking behaviors to minimize future negative
consequences.
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