Motivation and emotion/Book/2016/Underage binge drinking motivation

Overview
Underage binge drinking is a prevalent issue affecting young people across the globe (Coleman & Cater, 2005). Alcohol is the most commonly and frequently abused substance by children and teenagers and it is associated with motor vehicle accidents and suicides which are the main causes of death of this age demographic (Siqueira & Smith, 2015). Approximately 50% of children aged 12 to 14 years consume large quantities of alcohol regularly and this figure increases to 72% in the age bracket of 18 to 20 years (Coleman & Cater, 2005).

As adolescence is a time of pushing boundaries and risk taking, it is no surprise that this is the time when young people begin to experiment with alcohol (Siqueira & Smith, 2015). However, this time of exploration and experimentation poses significant risks to youth as underage drinking has consequences that can impact people well into their adult lives (Siqueira & Smith, 2015). Therefore, it is of extreme importance that researchers understand what drives underage binge drinking in order to reduce this pattern of behaviour and assist young people in living more motivationally and emotionally fulfilling lives (Siqueira & Smith, 2015).

Defining binge drinking
Binge drinking was initially defined as consuming five standard drinks within two hours (Siqueira & Smith, 2015). The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines a standard drink as containing 14g of pure alcohol (National Institute on Alcohol Abuse and Alcoholism, 2016). This is equivalent to one 350mL beer, a 150mL glass of wine or a 30mL shot of distilled spirits (National Institute on Alcohol Abuse and Alcoholism, 2016). According to the NIAAA, binge drinking is the extent that a person’s blood alcohol concentration is 0.08% or higher (National Institute on Alcohol Abuse and Alcoholism, 2016). Binge drinking can also be defined as consuming five consecutive alcoholic drinks for men and four alcoholic drinks for women over a two hour period (Siqueira & Smith, 2015).

In regards to underage binge drinking, it has been suggested that different definitions be used (Siqueira & Smith, 2015). This is because children and adolescents have a much lower body weight than adults, therefore consuming four or five drinks in a two hour period is likely to result in a blood alcohol concentration significantly higher than 0.08% (Donovan, 2009). For girls aged 9 to 17 years and boys aged 9 to 13 years, it has been suggested that binge drinking be defined as three or more standard drinks within a two hour period (Donovan, 2009). For boys aged 14 to 15 years it is suggested that four standard drinks be the threshold for binge drinking and for boys 16 to 17 years, the threshold be 5 standard drinks within two hours (Donovan, 2009).

Physiological and psychological consequences of underage binge drinking
Binge drinkers have an increased chance of experiencing alcohol related issues compared to drinkers who do not binge drink (Siqueira & Smith, 2015). Research has found that those who binge drink frequently are more likely to experience poorer quality of life and poorer mental health than those who do not binge drink or those who binge drink infrequently (Okoro et al, 2004). Research has also found that frequent binge drinkers are more likely to be diagnosed with alcohol or substance abuse disorders later in life (Chassin, Pitts & Prost, 2002).

Binge drinking has a series of detrimental short term and long term consequences (Coleman & Cater, 2005). Binge drinking significantly increases the likelihood of alcohol poisoning, facial injuries, car accidents, unsafe sex and drug use (Coleman & Cater, 2005). As underage drinkers lack complete physiological development, this can lead to lower alcohol tolerance therefore making them more susceptible to injury (Coleman & Cater, 2005). Binge drinking is also known to be associated with psychological disorders such as depression, anxiety and eating disorders (Newburn & Shiner, 2001). As well as these known consequences, it is well known that binge drinking in young people may lead to alcohol dependency and other issues later in life (Farrington, 1995).

One of the key detrimental effects of adolescent binge drinking is its impact on neuro-maturational processes such as cortical thinning and neurochemical changes (Luna, 2009). It is well understood that excessive alcohol consumption can result in neurocognitive impairments such as impaired spatial skills, learning abilities, memory and executive functioning (Grant, 1987). Neuroimaging indicates that excessive alcohol consumption leads to structural, functional and chemical abnormalities in the brain which can lead to cognitive impairment (Squeglia, Schweinsburg, Pulido & Tapent, 2011). Furthermore, functional magnetic resonance imaging (MRI) on individuals who binge drink indicates that abnormal activation patterns occur during tasks involving spatial working memory (Pffefferbaum et al, 2001).

Early adulthood is a period of continuous brain development therefore there is a high degree of neurobiological vulnerability during this stage (Silveri, 2012). Research shows that alcohol consumption, especially excessive alcohol consumption during this stage poses serious threats to brain development and there is sufficient evidence to prove that binge drinking during this stage may in fact prevent the brain from reaching full maturity (Silveri, 2012). MRI scans indicate that changes in cortical grey and white matter begin at approximately four years of age and continue up to approximately 20 years of age (Silveri, 2012). Towards the end of adolescence, brain scans reveal intellectual functions and cognitive processes improve during this stage and one of the most observed changes is in executive functioning (Silveri, 2012). The key implication of binge drinking during this stage in development is that it may have extremely detrimental effects on the last stages of brain maturation (Silveri, 2012).

What motivates underage youth to binge drink?
As underage binge drinking is highly prevalent issue, it is imperative that action is taken to reduce the occurrence of this behaviour pattern (Coleman, 2007). However, in order to reduce the prevalence of binge drinking in children and adolescents, we must firstly look at what motivates this demographic to consume excessive amounts of alcohol.

Research has found that in regards to underage binge drinking, this behaviour is motivated by both extrinsic and intrinsic factors (Coleman, 2007). A study conducted by Harnett, Herring, Thom & Kelly (2000) identified eight different styles of drinking which included childhood, adolescent, experimental, sociable, recreational, safe, therapeutic and structured drinking. Further research has identified recreational and therapeutic as the key drinking styles that motivate underage binge drinking behaviour (Coleman, 2007). Children and adolescents often engage in therapeutic drinking to reduce stress and recreational drinking for the purpose of fun and enjoyment (Coleman, 2007).

A study conducted by Coleman & Cater (2005) classified the key factors of underage binge drinking motivation into three categories including social facilitation, the benefits to the individual and societal norms and influences (Coleman & Cater, 2005). Social facilitation, such as an increase in self-confidence and comfort at social gatherings, was the most commonly reported motivator for underage binge drinking (Coleman & Cater, 2005). Young people also reported an increased sense of enjoyment in social situations as well as binge drinking allowing them to form closer friendships and relationships (Coleman & Cater, 2005). Dave, aged 15 reported,

“I’d say a definite bonding thing was like when you’re really pissed with someone, just like maybe you and another person like getting really pissed together and talking about things that aren’t very conventional to talk about, you know, like maybe things a bit more personal ... and what better sort of bonding is there than that?” (Coleman & Cater, 2005)

Individual benefits was another commonly reported motivator of underage binge drinking habits (Coleman & Cater, 2005). Escapism such as forgetting problems and a means to relieve boredom were the common individual benefits reported by young people (Coleman & Cater, 2005). The responses indicated that binge drinking was used as an antidote to relieve exam stress, escape feelings of sadness or distress as well as the desire to feel relaxed and calm (Coleman & Cater, 2005). The responses also indicated that binge drinking was used as a means to cope with friendship and relationship troubles (Coleman & Cater, 2005). Young people also reported that they drank excessively to experience the ‘buzz’ of binge drinking (Coleman & Cater, 2005). This buzz consisted of excitement and enjoyment and they reported that they did not believe this sense of enjoyment could be achieved without the consumption of alcohol (Coleman & Cater, 2005). Boredom and lack of things to do was commonly reported by those aged 14 to 17 years living in rural areas (Coleman & Cater, 2005).

In the study conducted by Coleman & Cater (2005), social norms and influences were also found to be a common motivator of underage binge drinking. This research found that perceived normality and acceptance of binge drinking was a key motivator of underage binge drinking (Coleman & Cater, 2005). There was a common belief amongst teenagers that binge drinking is a natural part of the transition to adulthood (Coleman & Cater, 2005). Another reported motivator of binge drinking was the influence of peers (Coleman & Cater, 2005). Children and early adolescents were more likely to be pressured into binge drinking than their older peers (Coleman & Cater, 2005). Younger age groups tends to be pressured to conform to this behaviour by their peers (Coleman & Cater, 2005). Older adolescents and young adults reported a higher degree of free choice in the matter and that they drink simply to keep up with their friends and to achieve the same level of intoxication (Coleman & Cater, 2005).

The theory of planned behaviour
There are a number of psychological theories which can be used to explain what motivates underage binge drinking and these theories can also be used to develop methods to reduce this behaviour. One of the key psychological models we can used is the theory of planned behaviour (Azjen, 1988).

The theory of planned behaviour suggests that if the intention exists for a person to perform a behaviour, the more likely they are to engage in this behaviour (Azjen, 1988). This model is a framework researchers use to understand behaviour and it can be successfully applied to understand the behaviour of underage binge drinking (Azjen, 1988). The theory of planned behaviour suggests that three factors contribute to an individual’s intention to perform a behaviour (Cooke, Dahah, Norman & French, 2014). These include attitudes, subjective norms and perceived behavioural control (Cook et al, 2014).



A study conducted by Leigh (1989) discovered that individual attitudes towards alcohol were a key predictor of a person’s alcohol consumption. Those who had positive attitudes towards alcohol and believed that alcohol consumption had a series of benefits were found to consume alcohol more frequently and in larger quantities than those who perceived alcohol in a negative light (Leigh, 1989). We can apply this theory to understand binge drinking in that children and youth who have more positive perceptions of alcohol and its use are more likely to be motivated to consume larger quantities of alcohol than their peers who associate excessive alcohol consumption with negative consequences (Leigh, 1989).

Subjective norms refer to the idea that a person is more likely to engage in a particular behaviour if others, whom the person interacts with, approve of the behaviour (Azjen, 1988). This concept can be applied to understand underage binge drinking in that an underage person is more likely to engage in binge drinking if they perceive their peers as accepting of the behaviour (Azjen, 1988). This coincides with the findings of Coleman & Cater (2005) in that a young person’s decision to binge drink is strongly influenced by the behaviour of their peers.

The third aspect of the theory of planned behaviour, perceived behavioural control, has found to be the strongest predictor of underage binge drinking across a range of studies (Collins & Carey, 2007). Perceived behavioural control refers to ones self-efficacy in their ability to control their own behaviour (Azjen, 1988). Those with firm belief that they can control their alcohol intake are more likely to consume alcohol responsibly than those who feel less confident in their ability to control their alcohol consumption (Collins & Carey, 2007). This theory can be applied to understand what motivates underage binge drinking as those with higher self-esteem and self-efficacy are more likely to abstain from consuming alcohol under the legal age or at the very least, refrain from consuming excessive amounts of alcohol (Collins & Carey, 2007).

Social learning theory
Social learning theory was suggested by Albert Bandura (1978) and suggests that human behaviour is a learned process by observing and interacting with others in a social setting (LaBrie et al, 2007). The theory suggests that behaviour is learned by observing, identifying with or modelling a behaviour (Capece & Lanza-Kaduce, 2013). In particular, social learning theory has been used to understand how people learn deviant and non-deviant behaviour (Capece & Lanza-Kaduce, 2013).

Social learning theory is able to be applied as a framework for understanding what drives binge drinking behaviour in underage youth (LaBrie et al, 2007). In 1969, Bandura coined the term ‘reciprocal determinism’ which describes the association between environmental and individual factors which influence individual behaviour over a period of time (LaBrie et al, 2007). In regards to underage drinking, there is a significant correlation between socio-environmental variables and binge drinking behaviour (Baer, 2002). Drinking behaviours are learned and reinforced through both active and passive experiences in a social context (Read, Wood & Capone, 2004). This suggests that young people learn and make decisions regarding alcohol use based on the behaviour of their peers (Read et al, 2004). Furthermore, research has found that peers have a much greater influence on each other’s behavioural decisions than biological or cultural influences (Borsari & Carey, 2001). This finding suggests that social learning theory can be successfully applied to understand what motivates binge drinking in underage youth (LaBrie et al, 2007).

What can we do to combat binge drinking?
As a result of the detrimental short and long term consequences of underage binge drinking, measures are being sought to reduce this behaviour pattern in children and adolescents (Coleman, 2007). By examining previous research on underage binge drinking as well as the theory of planned behaviour, we can conclude that underage binge drinking is primarily motivated by attitudes towards alcohol, how young people believe their peers perceive their behaviour and by young people’s self-efficacy in their ability to make informed choices regarding alcohol (Collins & Carey, 2007). By understanding what drives binge drinking in underage youth, we are able to implement strategies to combat this behaviour (Coleman, 2007). Alcohol education in schools is currently lacking and young people are not being provided with sufficient information to make informed choices (Coleman, 2007). Currently, peer pressure and the desire to belong to a peer group is having more influence on young people’s drinking choices than is the education being provided in schools (Coleman, 2007).

A study conducted by Kenkel (1991) discovered that the greater one’s knowledge of the detrimental consequences of excessive alcohol consumption, the lower their level of reported alcohol use. This suggests that if further education is provided in schools from childhood through to late adolescence, the more informed students will be and the more likely they will be to make responsible choices surrounding their drinking habits (Coleman, 2007).

The implications of combating underage binge drinking and directions for further research
Despite the measures being taken to combat underage binge drinking, there are a number of implications of reducing this behaviour pattern. A key implication of reducing underage binge drinking is the lack of consensus as to a definition of binge drinking (Weitzman & Nelson, 2004). There is an argument that the current threshold of four to five standard drinks is too low to constitute binge drinking and begin implementing preventative action (Weitzman & Nelson, 2004). Some argue this threshold constitutes normal drinking levels in young people therefore no action should be taken to combat this level of drinking (Weitzman & Nelson, 2004). The perception also exists that binge drinking is a normal behaviour in youth and this behaviour pattern is an acceptable part of development (Weitzman & Nelson, 2004). These attitudes pose a threat to any measures being taken to combat underage binge drinking (Weitzman & Nelson, 2004). However, it is suggested that education is likely to be the most successful measure that can be taken to reduce the prevalence of underage binge drinking (Weitzman & Nelson, 2004). It is suggested that more effort be made into education in schools not only of the consequences of excessive alcohol but also on how to make informed and individual choices surrounding drinking (Kenkel, 1991). Research indicates that further measures are required to shift attitudes among young people regarding alcohol as changing this perception among peer groups will most likely result in a reduction of individual binge drinking behaviour (Coleman & Cater, 2005).

Conclusion
Underage binge drinking is an increasingly concerning issue effecting young people in today's society (Coleman & Cater, 2005). This behavioural pattern has a series of short term and long term consequences which can impact individuals well into their adult lives (Siqueira & Smith, 2015). Research suggests that underage binge drinking is primarily influenced by the peer group and that those in younger age groups are more susceptible to peer influence than those in older age brackets (Coleman & Cater, 2005). Both the theory of planned behaviour (Azjen, 1988) and social learning theory (Bandura, 1978) can be successfully applied to understand what motivates binge drinking behaviour. However, further research is required into ways to combat this behaviour and reduce the overall prevalence of underage binge drinking (Kenkel, 1991).