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Addictive Behaviors 32 (2007) 590 – 597

Alcohol self-control behaviors of adolescents


Tavis Glassman ⁎, Chudley (Chad) Werch, Edessa Jobli
Addictive and Health Behaviors Research Institute, Department of Health Education and Behavior, University of Florida,
6852 Belfort Oaks Place, Jacksonville, FL 32216, USA

Abstract

Purpose: The aims of the present study were to: (1) factor analyze a 13-item adolescent alcohol self-control
behavior scale, (2) examine associations between frequency of self-control behavior use and alcohol consumption,
and (3) to determine which self-control behaviors best predict alcohol use and consequences.
Methods: A confidential standardized survey was used to collect data on participant's 30-day frequency, quantity,
and heavy use of alcohol; alcohol-related consequences; and alcohol self-control behaviors.
Results: A principal component factor analysis produced the following three components: Healthy Alternatives
(α = .81), Self-regulation (α = .72), and Assertive Communication (α = .73). MANOVAs indicated strong
associations between frequency of use of the three types of self-control behaviors and alcohol consumption (p
values ≤ .001). Logistic regression analysis revealed that Self-regulation behaviors were the best predictor for all
alcohol use measures and consequences (p values ≤ .001).
Conclusion: Self-control behaviors differ in their ability to predict alcohol use and consequences. Self-regulation
strategies emerged as the most consistent predictor of alcohol use patterns and consequences among adolescents,
followed by Healthy Alternatives.
© 2006 Elsevier Ltd. All rights reserved.

Keywords: Self-control; Alcohol use

1. Introduction

While considered a rite of passage by some, underage drinking poses a serious threat for a variety of
reasons, including negative health outcomes, poor academic performance, and legal challenges (National
Institute on Alcohol Abuse and Alcoholism Initiative on Underage Drinking, 2003; Williams &
⁎ Corresponding author. Tel.: +1 904 281 0726; fax: +1 904 296 1153.
E-mail address: tavis@ufl.edu (T. Glassman).

0306-4603/$ - see front matter © 2006 Elsevier Ltd. All rights reserved.
doi:10.1016/j.addbeh.2006.06.003
T. Glassman et al. / Addictive Behaviors 32 (2007) 590–597 591

Ricciardelli, 1999). Recent epidemiologic trends indicate adolescent alcohol use remains a challenge for
the prevention field. According to the Youth Risk Behavior Surveillance System (YRBSS) data from
2003, nearly half of high school students (44.9%) had one or more drinks of alcohol in the last 30 days,
and almost a third (28.3%) had five or more drinks on one or more occasions in the past 30 days (Center
for Disease Control and Prevention, 2004). High school adolescents have been very resistant to
intervention efforts (Foxcroft, Ireland, Lister-Sharp, Lowe, & Breen, 2003). Nevertheless, self-control
skill instruction shows potential as one method of assisting in the prevention of alcohol and other drug
misuse (Sussman, McCuller, & Dent, 2003).
A study conducted by Carpenter, Lyons, and Miller (1985) indicated Behavioral Self Control Training
(BSCT) resulted in significant decreases in quantity and frequency of drinking, and in peak blood alcohol
levels, among Native American high school students, who identified as high risk for problem drinking.
However, according to Carey and Maisto (1985), one shortcoming of the BSCT research is it fails to
assess the use of self-control techniques that presumably account for the change in drinking behavior. In
another BSCT-related study, the treatment and control group decreased their monthly heavy drinking days
(Connors, Tarbox, & Failace, 1992). It appears both groups utilized self-control techniques; although, the
control group used the techniques to a lesser extent than the treatment group. Moreover, a cross sectional
study found that college students who used protective self-control behavioral strategies experienced fewer
negative alcohol-related consequences than their peers who did not use such techniques or did so only on
a limited basis (Martens et al., 2004). Thus, it appears that young people naturally use self-control
strategies to reduce their risk when drinking alcohol. From a prevention perspective, it is important to
know which of these self-control strategies elicit the greatest behavior impact on adolescent alcohol use.
Although previous instruments have been developed to assess alcohol-related behavioral self-control
(Collins & Lapp, 1992; Connors et al., 1992; Martens et al., 2004), we found none designed to measure
alcohol self-control strategies used by high school adolescents. The present study used a 13-item measure
of behavioral self-control strategies found in the Youth Alcohol and Health Survey (Werch, 2000). This
scale measured self-control coping behaviors such as goal-setting, self-monitoring and use of alternative
coping skills. These items were developed from two self-help program manuals (Miller & Munoz, 1982;
Vogler & Bartz, 1982), which detailed commonly suggested alcohol-related behavioral self-control
strategies (Werch, Carlson, Pappas, Edgemon, & DiClimente, 2002).
The aims of the present study were to: (1) factor analyze a 13-item adolescent alcohol self-control
behavior scale, (2) examine associations between frequency of self-control behavior use and alcohol
consumption, and (3) to determine which self-control behaviors best predict alcohol use and
consequences. Certain alcohol-related self-control strategies, and the frequency with which they are
utilized may be important in preventing or reducing alcohol misuse and problems. To that end, this study
may provide significant information for developing more efficacious adolescent prevention interventions
in the future.

2. Method

2.1. Participants

A total of 1284 students from a suburban high school in northeast Florida participated in the study.
Recruitment occurred in fall 2002 (n = 604) and fall 2003 (n = 680). Participants reported the following
592 T. Glassman et al. / Addictive Behaviors 32 (2007) 590–597

demographic data: Caucasian 49.6%, African American 21.2%, Multicultural 9.7%, Hispanic 7.9%,
Asian 7.9%, Other 3%, and Native American .7%. Females represented 58% of the sample, with a mean
age of 15.6 years (S.D. = 1.2 years). About 12% of subjects participated in the free or reduced cost lunch
program. Two out of five students (40%) reported a family member with an alcohol or drug problem. The
majority of fathers (73%) and mothers (57%) drank alcohol at least a few times a year. Over half (62%) of
subjects reported receiving some form of alcohol or drug education during the past year. Finally, just
under a third of the sample (31%) indicated they consumed alcohol within the last 30 days.

2.2. Measures

Participating adolescents completed the Youth Alcohol and Health Survey (Werch, 2000), which took
approximately 25 min to complete. The survey included a 13-item scale measuring self-control behaviors.
These items originated from Miller and Munoz's (1982) seminal work on alcohol-related behavioral self-
control strategies. Werch and Gorman (1986) used this research to develop an extensive self-control
inventory consisting of 50 plus self-control items which they administered to college students. Based on a
factor analysis and theory, 13 items were selected to create a self-control scale. This scale is currently
incorporated into the Youth Alcohol and Health Survey which includes items on alcohol use patterns,
alcohol-related consequences, and other related substance issues. A number of prevention studies have
used the survey, or some variation of it, to measure self-control and substance use behaviors (Werch et al.,
1996, 2002; Werch, Carlson, Pappas, & DiClimente, 1996; Werch, Carlson, Pappas, Edgemon, &
DiClimente, 2000).
The self-control stem-item asked: “Have you used any of the following to help you stay away from
using alcohol during the last year?” Sample-related branch items included “told others I was not going to
drink”, “stayed away from or left places where drinking takes place”, and “used non-alcohol, healthy
ways to deal with stress or nerves.” The dichotomous responses were “Yes” and “No.” This scale yielded
an α coefficient of .88.
Four measures of alcohol behaviors were also collected, including 30-day frequency, quantity, heavy
use, and alcohol-related problems. The measure for 30-day frequency of alcohol use asked: “During the
past 30 days, on how many days did you have at least one drink of alcohol?” Seven response categories
ranged from “0 days” to “all 30 days.” The measure of alcohol quantity stated: “During the past 30-days,
how much did you usually drink at one time?” Six response categories ranged from “I did not drink” to “5
or more drinks.” The item on heavy use read: “During the past 30-days, how many times have you had
five or more drinks in a row?” Five responses ranged from “none” to “10 or more times.” Another item
measured alcohol-related problems or consequences, with 13 response options. This item asked: “Have
any of these things happened to you while you were drinking or drunk?” Related sample questions
included “drove a car”, “an accident or injury”, and “trouble with police.” Responses included “yes”,
“no”, and “I don't drink.” This scale had an α coefficient of .90.

2.3. Design and procedures

The results presented are from the baseline surveys of two randomized controlled trial administered fall
2002 and 2003. A University Institutional Review Board approved the research protocols prior to
implementing the study. All subjects submitted a signed parental consent form and a student assent form
prior to participating in the study. Students received a nominal monetary incentive for their participation.
T. Glassman et al. / Addictive Behaviors 32 (2007) 590–597 593

At the participating high school, trained research staff used standardized protocols to collect data, and
ensure continuity in the research design. Participants received information concerning issues of
confidentiality including use of code numbers on surveys, and assurance that no individual student data
would be shared with anyone, including teachers, parents, or peers. To further protect confidentiality,
students personally placed their surveys in folders immediately after completion.

2.4. Data analysis

Descriptive statistics, including frequencies, percentages, means and standard deviations were
conducted to describe the sample. A principal component factor analysis, utilizing a varimax rotation, was
administered to determine the extent to which self-control items could be grouped. Individual self-control
items falling within each resulting factor component were added to create self-control behavior categories.
Each category was then stratified into three levels, representing increasingly greater frequency of self-
control utilization (i.e., none to low, moderate, and high). Multivariate analysis of variance (MANOVA)
was conducted to examine mean differences of alcohol use across levels of self-control frequency. Lastly,
a forward stepwise logistic regression analysis was generated to determine which self-control behavior
categories best predicted the four alcohol use/problem measures. SPSS version 13.0 was used to conduct
the aforementioned statistical analysis.

3. Results

Related to the first study aim, we conducted a factor analysis on the 13-item alcohol self-control
behavior scale. A principal component analysis and a varimax rotation produced a three component
solution, which included the evaluation of the eigenvalue, variance and scree plot statistical values. After
rotation, the three component solutions accounted for 55.3% of the total variance in the variables.
Variables with a loading of < .500 were removed from the analysis. Consequently, “used healthy
activities” (.468) and “thought about problems drinking can cause” (.429) were not included in the
analysis. All correlation values among the three factors fell below r < .57 indicating high uniqueness from
one another. Note: an additional factor analysis was conducted on only those students who indicated that
they drank within the last 30 days. Results were almost identical to the original factor analysis reported in
Table 1 which includes both drinkers and non-drinkers.
Table 1 shows the results of the factor analysis, including the loadings and Cronbach's α scores. The first
of the three component factors, labeled Healthy Alternatives, was comprised of four behaviors. Each of these
items represents a behavioral substitute for alcohol use. Five items loaded highly to form the second factor,
labeled Self-regulation. The two top loading items represent stimulus control strategies and the remaining
three items characterize operant conditioning strategies. Lastly factor three, labeled Assertive Communica-
tion, includes two behaviors concerning strategies to communicate a desire not to drink.
Table 2 shows the estimated marginal means of alcohol use measures by frequency of self-control
strategies. The categories were divided into the three groups based on the range of the scores from the
respective three factors. Each factor included a different number of self-control behaviors; thus, in order to
make like comparisons the categories had to be collapsed. The labels of the categories, none to low,
moderate, and high were logically labeled based on the distribution of scores. Greater use of Healthy
Alternatives and Self-regulation strategies were significantly associated with lower mean alcohol
594 T. Glassman et al. / Addictive Behaviors 32 (2007) 590–597

Table 1
Factor analysis of 13-item self-control strategies
Component Loadings
1) Healthy Alternatives: (Cronbach's α = .81)
Used non-alcohol, healthy ways to feel at ease with people .83
Used non-alcohol, healthy ways to deal with stress or nerves .82
Used non-alcohol, healthy ways to feel good or high .76
Choose non-alcoholic drink .54

2) Self-regulation: (Cronbach's α = .72)


Stayed away from people who drink .78
Avoided places where drinking takes place .74
Rewarded self for not drinking .57
Looked for more info about alcohol and health .51
Punished self for drinking alcohol .50

3) Assertive Communication: (Cronbach's α = .73)


Said NO to an offer to drink alcohol .83
Told others I was not going to drink .83

frequency, quantity, heavy use, and alcohol-related consequences (p values = .000). These associations
where generally found at each increasing level of self-control frequency. A similar pattern emerges with
the use of Assertive Communication strategies; however, these associations were limited to the three

Table 2
Estimated marginal means of alcohol use measures by frequency of self-control strategies
Self-control frequency
None/Low Moderate High
Self-control categories/alcohol use measures M S.E. M S.E. M S.E. p value
Healthy Alternatives F = 6.38; df = 8, 2496; p = .000
30-day frequency 0.74 0.05 0.60 0.04 0.30 0.05 .000 a,b,c
30-day quantity 1.17 0.07 0.81 0.06 0.47 0.08 .000 a,b,c
30-day heavy use 0.37 0.03 0.23 0.03 0.12 0.03 .000 a,b,c
Consequences 2.17 0.13 1.61 0.11 1.16 0.87 .000 a,b,c
Self-regulation F = 10.40; df = 8, 2486; p = .000
30-day frequency 0.84 0.04 0.46 0.05 0.29 0.05 .000 a,b,c
30-day quantity 1.28 0.06 0.65 0.07 0.42 0.08 .000 a,b,c
30-day heavy use 0.39 0.03 0.18 0.03 0.11 0.03 .000 a,b
Consequences 2.02 0.11 1.66 0.12 1.17 0.14 .000 a,b,c
Assertive Communication F = 3.40; df = 8, 2524; p = .001
30-day frequency 0.71 0.06 0.74 0.07 0.46 0.03 .000 b,c
30-day quantity 1.04 0.09 1.02 0.10 0.69 0.05 .001 b,c
30-day heavy use 0.34 0.04 0.36 0.04 0.17 0.02 .000 b,c
Consequences 1.72 0.15 1.74 0.17 1.62 0.09 .77
High scores = High risk.
a
Moderate is significantly different from None/Low.
b
High is significantly different from None/Low.
c
High is significantly different from Moderate.
T. Glassman et al. / Addictive Behaviors 32 (2007) 590–597 595

Table 3
Logistic regression predicting alcohol use measures using self-control strategies a
Alcohol use measures/ Odds Confidence interval Percent of cases
self-control strategies ratio Lower Upper p-value Correctly classified
Frequency of alcohol use 70
Healthy Alternatives
Self-regulation 1.98 1.68 2.34 .000
Assertive Communication
Quantity of alcohol use 70
Healthy Alternatives
Self-regulation 2.01 1.71 2.37 .000
Assertive Communication
Heavy use 86
Healthy Alternatives 1.35 1.04 1.76 .02
Self-regulation 1.87 1.43 2.43 .000
Assertive Communication
Consequences/Problems 61
Healthy Alternatives 1.40 1.16 1.69 .000
Self-regulation 1.60 1.35 1.91 .000
Assertive Communication 0.80 0.68 0.93 .004
Predictors used in the analyses:
Healthy Alternatives: Use healthy ways to 1) feel at ease with people, 2) deal with stress, 3) feel good and high, 4) non-alcoholic
drink, and 5) healthy activities.
Self-regulation: 1) stay away from people who drink, 2) avoid places where drinking takes place, 3) reward self for not drinking,
4) looked for more info about alcohol and health, 5) punished self for drinking, and 6) thought about problems drinking can
cause.
Assertive Communication: 1) Said NO to an offer to drink, and 2) told others I was not going to drink.
a
High score = High risk.

alcohol use measures (not consequences), and only occurred at the highest level of use of Assertive
Communication (p values ≤ .001).
A forward stepwise logistic regression analysis was run to determine if the three self-control factors,
Healthy Alternatives, Self-regulation and Assertive Communication could predict 30-day frequency, 30-
day quantity, 30-day heavy use, and consequences. The four dependent measures were dichotomized into
yes/no responses. Table 3, for illustrative purposes, combines the statistically significant results of the four
separate logistic regression analyses. Overall, Self-regulation strategies were found to be the best
predictor of all four measures of alcohol use and consequences. Specifically, Self-regulation predicted 30-
day frequency (OR = 1.98, p = .000), 30-day quantity (OR = 2.01, p = .000), heavy use (OR = 1.87,
p = .000), and alcohol consequences (OR = 1.60, p = .000). Healthy Alternatives strategies predicted heavy
use (OR = 1.35, p = .02) and consequences (OR = 1.40, p = .000). The analysis resulted in 70%, 70%, 86%,
and 61% cases correctly classified for frequency, quantity, heavy use, and consequences, respectively.

4. Discussion

The aims of the present study were to: (1) factor analyze a 13-item adolescent alcohol self-control
behavior scale, (2) examine associations between frequency of self-control behavior use and alcohol
596 T. Glassman et al. / Addictive Behaviors 32 (2007) 590–597

consumption, and (3) to determine which self-control behaviors best predict alcohol use and
consequences. Findings indicated that alcohol self-control behaviors used by adolescents factor into
Healthy Alternatives, Self-regulation, and Assertive Communication strategies. All three types of self-
control behaviors are associated with alcohol consumption, with Healthy Alternatives and Self-
regulation also related to alcohol problems. Lastly, self-control strategies differ in their ability to
predict alcohol use and consequences, with Self-regulation behaviors emerging as the most consistent
predictor of alcohol use patterns and negative consequences, followed by Healthy Alternative
strategies.
Based on the findings of this and prior studies, it appears that young people are naturally using self-
control strategies to restrain their drinking (Connors et al., 1992; Martens et al., 2004). Research indicates
that roughly one quarter of adolescents who drink attempt to cut down or stop drinking each year
(Wagner, Brown, Monti, Myers, & Waldron, 1999). Metrik and colleagues (2003) found that adolescents
prefer behavioral self-management strategies as methods for reducing alcohol consumption. Adolescents
may prefer to try to control their drinking using self-control behaviors than attend formal education,
counseling, or endure restrictive policy and enforcement efforts (Greenfield, Guydish, & Temple, 1989;
Metrik et al., 2003).
Results from this and other related studies suggest that practitioners and researchers may want to
incorporate specific types of behavioral self-control strategies into their prevention interventions
(Werch & Gorman, 1986). Training in the use of stimulus–control self-regulation strategies, including
staying away from people who drink and avoiding places where drinking occurs, may be particularly
useful. Operant conditioning tactics such as rewarding and punishing one's self for reaching, or failing
to reach, self-control goals also holds potential in self-regulating adolescent alcohol use. Further,
encouraging adolescents to engage in Healthy Alternatives to cope with social, stress, or pleasure
needs may reduce heavy alcohol use and related consequences among this age group. Assertive
Communication strategies, such as telling others that one is not going to drink, or refusing offers to
drink alcohol, appear to be the least useful type of self-control behaviors. Perhaps younger
adolescents, who are less advanced in their readiness to drink alcohol, and less susceptible to alcohol
use offers, may benefit more from these strategies than their older counterparts. Additional, research
needs to be conducted examining which specific self-control strategies are most useful for various
developmental levels of adolescence.
The findings presented in this study should be interpreted carefully. First, only one high school
participated in this study; consequently, generalizations concerning self-control behaviors may be
somewhat limited. Second, this study was limited to a 13-item self-control measure. Additional self-
control strategies should be studied in the future for their potential to reduce alcohol use and problems,
such as monitoring the number of drinks consumed, avoiding drinking games and high potency alcohol
beverages. Third, a cause and effect relationship cannot be established from these results because of the
cross sectional design used in this study.
Nevertheless, this study suggests the use of certain self-control behaviors is related to and predictive of
alcohol consumption patterns and problems among adolescents. Self-regulation and Healthy Alternatives
strategies figure to be a particularly promising means of reducing alcohol misuse among adolescents.
Based on the findings of this study, it appears that prevention efforts directed towards older adolescents
should include selected self-control strategies. Future research efforts need to employ controlled trials to
test the efficacy of self-control strategies alone and in combination with other prevention components for
high school as well as college age adolescents.
T. Glassman et al. / Addictive Behaviors 32 (2007) 590–597 597

Acknowledgements

This manuscript was supported in part by grants from the National Institute on Alcohol Abuse and
Alcoholism (Grant #AA9283), and the National Institute on Drug Abuse (Grant #DA018872 and
#DA019172).

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