Academic journal article The Psychological Record

Behavioral Economic Predictors of Alcohol and Sexual Risk Behavior in College Drinkers

Academic journal article The Psychological Record

Behavioral Economic Predictors of Alcohol and Sexual Risk Behavior in College Drinkers

Article excerpt

Nearly 60% of college students report drinking alcohol in the past month, with more than 35% reporting binge drinking (i.e., 4+/5+ drinks for women/men; Center for Behavioral Health Statistics and Quality, 2015). Heavy drinking among college students is a major public health concern, and higher rates of alcohol use are related to a variety of negative consequences, including poor grades, injury, and assault (White & Hingson, 2014). Further, alcohol is associated with higher rates of risky sexual behaviors and related consequences among college students (Cooper, 2002). Specifically, higher rates of drinking are associated with regretted sexual encounters (Osberg & Boyer, 2016), unprotected sex (Kiene, Barta, Tennen, & Armeli, 2009), and sexual assault (Abbey, Zawacki, Buck, Clinton, & McAuslan, 2004).

The relation between alcohol and sexual risk among college students is well documented, but the underpinnings of this relation are less clear (Cooper, 2006; Scott-Sheldon, Carey, Cunningham, Johnson, & Carey, 2016). Research has examined the acute effects of alcohol on sexual decision making (Scott-Sheldon et al., 2016), suggesting that alcohol increases the salience of sexual cues (Steele & Josephs, 1990). Others, however, have suggested that the environments in which precursors to sexual behavior occur (e.g., seeking a sexual partner at a bar or party) lead to increased alcohol consumption (Corbin, Scott, & Treat, 2016; Vander Ven & Beck, 2009). Although alcohol consumption and sexual risk behavior relate at both global (i.e., prevalence patterns across an extended time period; O'Hara & Cooper, 2015) and event (i.e., occasion-specific co-occurrence; Brown & Vanable, 2007) levels, less is known about how decision-making processes regarding alcohol and sex interact to produce problematic alcohol and sexual risk-related outcomes.

Behavioral economic paradigms have provided insight into the decision-making processes underlying a range of issues related to problematic health choices, such as drug abuse (Aston, Metrik, Amlung, Kahler, & MacKillop, 2016) and obesity (Epstein et al., 2014). One such process, discounting, characterizes how quickly a reward loses its value due to increased delay or reduced probability of receipt (Rachlin, Raineri, & Cross, 1991). Delay discounting, a behavioral process whereby an individual devalues delayed rewards (Bickel & Marsch, 2001), is typically assessed through a series of choices between smaller-but-immediate and larger-but-delayed amounts of money. Delay discounting rates are related to a number of behavioral problems, including drug abuse (Kirby, Petry, & Bickel, 1999; MacKillop et al., 2011), obesity (Epstein et al., 2014; Jarmolowicz, Cherry, et al., 2014; Rasmussen, Lawyer, & Reilly, 2010), problem gambling (Dixon. Marley, & Jacobs, 2003), and alcohol use (Bickel, Jarmolowicz, Mueller, Franck, et al., 2012; Petry, 2001; Vuchinich & Simpson, 1998). Such broad applicability to clinical problems has led to the suggestion that discounting is a trans-disease process underlying a range of clinical problems related to choice (Bickel, Jarmolowicz, Mueller, Koffarnus, & Gatchalian, 2012).

With alcohol-related problems, a propensity to prefer immediate money, associated with relatively higher rates of delay discounting, is associated with more alcohol-related risk behavior (Rossow, 2008); earlier onset of alcohol use (Kollins, 2003); and greater alcohol consumption (Christiansen, Cole, Goudie, & Field, 2012; Yankelevitz, Mitchell, & Zhang, 2012). Moreover, rates of money discounting are higher in problem drinkers relative to light drinking controls (Bickel, Jarmolowicz, Mueller, et al., 2012; Petry, 2001; Vuchinich & Simpson, 1998). Although money is the most commonly studied reward, patterns of excessive valuation of delayed rewards tend to extend across commodities, such as food (Estle, Green, Myerson, & Holt, 2007; Odum & Rainaud, 2003) and drugs of abuse (Bickel, Landes, et al. …

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