Reductions in alcohol use have often led to smaller reductions in harms than expected, and this may result from inadequate measurement of alcohol-related consequences. Harms questionnaires typically include consequences that can occur in the absence of alcohol use leading to an over attribution of certain harms to drinking (e.g., an individual might endorse engaging in risky behavior while drinking and while sober). The purpose of this study was to examine limitations of harms assessment by collecting data on frequency of harms while drinking and while sober, and to identify potential determinants of harms unrelated to alcohol use. College student participants (N = 768) completed measures of alcohol-related harms, sober harms, and potential predictor variables. Mixed effects negative binomial regression and structural equation modeling were used to compare frequency of sober and alcohol-related harms and to examine possible determinants of these consequences. Results revealed seven out of eight harms occurred more often while sober. Many sober harms occurred at comparable rates for drinkers and non-drinkers. The structural model of alcohol-related harms revealed significant relationships with impulsivity (B = 0.17, p < .001), expectancies (B = 0.09, p = .007), and academic engagement (B = 0.04, p = 0.019). The structural model of sober harms revealed significant relationships with depression (B = 0.95, p < .001) and social anxiety (B = 0.15, p = .001) in relation to sober harms. Results indicate most of the harms measured in this study occur more frequently in the absence of alcohol use, and these harms may have unique determining factors. These findings may explain the persistence of high rates of consequences reported in relation to alcohol use despite significant decreases in drinking following intervention. Future research should integrate risk and protective factors that predict all harms to better inform prevention/intervention strategies.
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Doctor of Philosophy (Ph.D.)
College of Sciences
Length of Campus-only Access
Doctoral Dissertation (Open Access)
Flori, Jessica, "Defining Sober Harms and Factors that Influence Them: Blame it on the Alcohol?" (2023). Electronic Theses and Dissertations, 2020-. 1560.