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DRINKING IN CONTEXT: THE INFLUENCEOF PEER PRESSURE ON DRINKINGAMONG CHINESE COLLEGE STUDENTSLanyan DingUniversity of Nebraska-Lincoln, [email protected]

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DRINKING IN CONTEXT: THE INFLUENCE OF PEER PRESSURE ON

DRINKING AMONG CHINESE COLLEGE STUDENTS

by

Lanyan Ding

A THESIS

Presented to the Faculty of

The Graduate College at University of Nebraska

In Partial Fulfillment of Requirements

For the Degree of Master of Arts

Major: Educational Psychology

Under the Supervision of Professor Ian M. Newman and Erick S. Buhs

Lincoln, Nebraska

December 2014

DRINKING IN CONTEXT: THE INFLUENCE OF PEER PRESSURE ON

DRINKING AMONG CHINESE COLLEGE STUDENTS

Lanyan Ding. M.A.

University of Nebraska, 2014

Advisor: Ian M. Newman, Eric S. Buhs

The present study uses a cross-sectional method of subgrouping and examines the

influence of peer pressure on college students’ alcohol use in China. A total of 951

undergraduate students (freshman, sophomore, and junior) from a university in central

China volunteered to fill out questionnaires in convenient classrooms. The extent of

perceived peer pressure and corresponding drinking behavior were examined separately

in subpopulations categorized by gender and peer groups (History major and Physical

Education major). The mediational role of alcohol self-regulation self-efficacy on

pressure- drinking association was also examined.

Results have indicated gender differences and subgroup differences (HIST and

PE) for perceived peer pressure. Pressure was significantly related to alcohol drinking

frequency for both peer groups. Results from a path model indicated that perception of

peer pressure was negatively correlated with alcohol self-regulation self-efficacy. Less

alcohol drinking frequency was predicted by higher level of self-regulation self-efficacy.

The results suggest that educational strategies could be developed to teach students social

skills to resist pressure from peers.

i

ACKNOWLEDGEMENTS

Over the past two years of my life in the graduate school, I have received support

and encouragement from a great number of individuals. My foremost and deepest

appreciation goes to my advisor, Professor Dr. Ian Newman, who has been a mentor,

colleague, and friend. His persuasive attitude, patience, and kindness have imparted a

spirit of adventure in regard to my research and scholarship. Without his guidance and

constant support, this overall rewarding journey would not have been possible.

I would also like to express my sincerest gratitude to Dr. Duane Shell for his

invaluable ideas for the project. Experiences I have gained attending seminars and

discussions with him have served a source of motivation in completing this project. In

addition, I am very grateful to Dr. Eric Buhs for all his help on this project. His

suggestions, comments, and statistical expertise were indispensible components of my

success in the project and graduate life.

I would also like to take this opportunity to thank my uncle-in-law, Professor

Enlin Dong for providing connections to ensure the success of my data collection. Thanks

to Shuangshuang Cai for all her help in the data collection process. I also want to thank

Michelle and Niran for their help in editing this thesis.

Finally, my special appreciation to my husband, Liangwen Pi, for his support,

encouragement and unwavering love, which were undeniably the bedrock upon which my

past and present years of live have been built. I look forward to pursuing our dreams

together both as a couple and best friends. I thank my parents and in-laws for being

supportive of me in pursuing my dream of higher education.

ii

TABLE OF CONTEXTS

Chapter 1 Introduction ........................................................................................................ 1

Alcohol Consumption in Western College Life .............................................................. 1

Alcohol Use among Chinese College Students ............................................................... 2

Social Functions of Drinking among Chinese College Students .................................... 4

Perceived Peer Pressure in College Contexts.................................................................. 5

Alcohol Self-regulation Self-efficacy ............................................................................. 6

Purpose Statement ............................................................................................................... 7

Research Objectives ............................................................................................................ 7

Chapter 2 Literature Review ............................................................................................... 9

Definition of Peer Pressure ............................................................................................. 9

Measuring Peer Pressure ............................................................................................... 12

The Influence of Peer Pressure on College Drinking .................................................... 17

Overt drinking offers ................................................................................................. 17

Drinking modeling ..................................................................................................... 19

Drinking norms .......................................................................................................... 21

The Influence of Self-efficacy on College Drinking ..................................................... 25

Peer pressure and Self-efficacy ..................................................................................... 25

Theoretical Model ............................................................................................................. 29

Chapter 3 Methodology .................................................................................................... 30

Subjects ......................................................................................................................... 30

Procedure ....................................................................................................................... 30

Measures (see Appendix B and C) ................................................................................ 31

Data Analysis ................................................................................................................ 33

Chapter 4 Results .............................................................................................................. 34

iii

Demographics of the sample ......................................................................................... 35

Drinking Behavior ......................................................................................................... 36

Peers’ Alcohol Consumption ........................................................................................ 42

Perceived Peer Pressure ................................................................................................ 43

Self-regulation Self-efficacy ......................................................................................... 50

Major, Peer Pressure, Self-efficacy, and Drinking Frequency ...................................... 52

Chapter 5 Discussion ........................................................................................................ 56

Peer Influence on College Drinking .............................................................................. 56

The Protective Factor of Self-efficacy .......................................................................... 57

Group Difference .......................................................................................................... 59

Gender Difference ......................................................................................................... 60

Limitations .................................................................................................................... 61

References ......................................................................................................................... 63

APPENDIX A. Institutional Review Board Approval ..................................................... 77

APPENDIX B. English Version Questionnaire ................................................................ 79

APPENDIX C. Chinese Version Questionnaire ............................................................... 86

iv

LIST OF TABLES

Table 1 Instrument for Peer Pressure ............................................................................... 14

Table 2 Demographics of the Sample .............................................................................. 35

Table 3 Drinking Status in History Major ....................................................................... 37

Table 4 Drinking Status in PE major ............................................................................... 38

Table 5 Drinking Status by Gender ................................................................................. 39

Table 6 Drinking Status by Major ................................................................................... 40

Table 7 Drinking Status by Grade ................................................................................... 41

Table 8 Drinking Patterns and Peer’s Alcohol Use ......................................................... 42

Table 9 EFA for Peer Pressure Scale from the First Split Sample .................................. 44

Table 10 CFA for Peer Pressure Scale from the Second Split Sample ............................ 45

Table 11 Goodness-of-Fit Indicators of Models for Peer Pressure.................................. 46

Table 12 Unstandardized and Standardized Loadings by CFA for Peer Pressure ........... 47

Table 13 Comparing Peer Pressure by Drinking, Major, Gender, and Grade ................. 49

Table 14 CFA for Chinese Alcohol Self-regulation Self-efficacy ................................... 51

Table 15 Means and Standard Deviations for Each Variable .......................................... 53

Table 16 Path Model for Relationship among Major, Peer Pressure, Self-efficacy, and

Drinking ............................................................................................................................ 54

1

Chapter 1 Introduction

Alcohol Consumption in Western College Life

Excessive drinking and its related health and social effects in collegiate settings

has long been a concern in the United States and other western countries (e.g., Borsari &

Carey, 2001; Gilles, Turk, & Fresco, 2006; Neighbors, Larimer, Geisner, & Knee, 2004).

Compared to non college youth, college students consume more alcohol per drinking

occasion (Slutske, 2005) and are more often involved in binge drinking (Wechsler, Lee,

Kuo, & Lee, 2000).

Following abuse and dependence are cognitive impairments (Koelega, 1995;

Peterson, Rothfleisch, Zelazo, & Pihl, 1990) which may increase the risk of impaired

academic performance, including lower Grade Point Averages (GPA) (e.g., Kremer &

Levy, 2008) , missing classes (e.g., Werner, Walker, & Greene, 1996), and poor

performance in assignments and exams (e.g., Leichliter, Meilman, Presley, & Cashin,

1998). In addition, alcohol misuse has consistently been related to other risk behaviors,

such as smoking (Wechsler et al., 2000; Wechsler, 1994), risky sexual behavior (Cooper,

2002), sexual assault (Abbey, 2002), suicide attempts (Leichliter et al., 1998), physical

injury (Wechsler & Isaac, 1992; Wechsler et al., 2000; Wechsler, 1994), drug use

(O’Malley & Johnston, 2002), drunk driving (e.g. Shults et al., 2001) and antisocial

behaviors (Borsari & Carey, 2001).

Given the rate of excessive drinking among college students and the consequent

risky behaviors, college students have been identified as a high-risk population for

2

alcohol abuse (National Institute on Alcohol Abuse and Alcoholism, 2002, The National

Center on Addiction and Substance Abuse at Columbia University, 2012).

Alcohol Use among Chinese College Students

Alcohol use in China, according to written records and archeological evidences,

began approximately 7,000 years ago (Li, 1993). In the long history of Chinese alcohol

use it is evident that alcohol has played a significant role in cooking, medicine, arts,

rituals, ceremonial occasions, and sacrifice to ancestors and gods. Drinking at moderate

level is not regarded as an awful behavior in Chinese culture, but rather it is encouraged

as a medium to show respect and to facilitate interpersonal communication (Lu, Engs, &

Hanson, 1997). However, there appears to be an increase in alcohol consumption and

problems associated due to the rapid economic development and westernization in China

(Cochrane, Chen, Conigrave, & Hao, 2003). Alcohol use has increased almost 10-fold

from the 1960s to the 1990s (Hao, Derson, Shuiyuan, Lingjiang, & Yalin, 1999). In 2009,

beer sale in China was estimated to account for 22% of the global production , which

makes China the largest beer producer in the world at present (Alcohol in Moderation,

2008). According to the report published by World Health Organization (WHO) in 2014,

annual alcohol consumption per capita in China increased to 6.7 liters of pure alcohol in

2010 from 5.8 liters of pure alcohol in 2005. More important,17.3% of drinkers were

reported to had engaged in the heavy episodic drinking in the past month, whereas 22.2%

of deaths resulting from road traffic accidents involved the use of alcohol according to

the same report by WHO.

3

The drinking patterns of Chinese university students have been reported in

previous studies. Abdullah and Fielding (2002) in a study of 1197 Hong Kong

undergraduates reported 61% to be drinkers. Griffiths and her colleagues (2006) also in

Hong Kong reported 62% of 2,968 undergraduates reported ever drinking alcohol and 7%

reported binge drinking.

Similar studies have been performed in the mainland China. Rate of alcohol use

among university students in central China has been found similar to rate mentioned

above for Hongkong (Newman et al., 2011; Tang et al., 2013), higher rates in southern

China (Lu et al., 1997; Ma & Fan, 2000) and the northeastern China has the highest rate

of consuming alcohol（Han, 1994; Leng, 2009; Newman et al., 2011). Moreover, heavy

drinking behaviors and consequent problems have been reported by students in Physical

Educational disciplines (Dong et al., 2006; Tu, 2007), and students with western cultural-

orientation (Tang et al., 2013) and vocational college students (Zhang-yuan, Ping, Liang-

liang, & Xian-hong, 2012).

Similar drinking patterns have been found among Chinese university students

studying outside of China. In Singapore, Isralowitz and Hong (1988) found that 72% of

males and 52% of females consumed alcohol. Similar proportions were reported among

Chinese graduate students in the U.S.A. (Pai, 1991). Compared to noncollege students

Chinese college students males in the U.S.A. were more likely to be involved in heavy

drinking (Chi, Kitano, & Lubben, 1988).

In the light of studies suggesting the increase use of alcohol and potential risks

among Chinese students, it is critical for policy makers to examine the alcohol use and

4

drinking behaviors to develop educational programs and policies in order to reduce risky

effect of drinking behaviors among students. The foremost necessity is to understand the

drinking patterns in the university context, followed by the identification of social factors

affecting drinking behaviors among Chinese college students.

Social Functions of Drinking among Chinese College Students

Alcohol drinking among college student usually occurs on social occasions (Knee

& Neighbors, 2002). Traditional Chinese culture and philosophy encourage moderate

drinking to show hospitality and strengthen relationships (Hao, Chen, & Su, 2005). In

China, alcohol toasting plays a major role in facilitating relationships. Toasting to seniors

and supervisors is a way to demonstrate respect. Accepting toasts from others is a basic

politeness, whereas refusing others’ toasts is regarded as arrogant and an embarrassment

to those making the toast.

This situation is also true among Chinese college students, who are learning social

customs to obtain acceptance and approval from peers. Evidence suggested that most

students started drinking with friends in college (Leng, 2009). The major reasons for

drinking were socializing, making friends, and acting “cool” (e.g., Wang, Wang, Zhou,

& Liu, 2002; Wu et al., 2009). Festivals, birthday parties and repaying good deeds were

major occasions for drinking among Chinese college students (Zhang & Liu, 2008).

These studies suggested peer interaction as a major reason for drinking among college

students, rather than self-enjoyment and relieving depression. Hence, the social

influences play a critical role in alcohol drinking among Chinese college students.

5

Peer influences might be especially robust among Chinese college students

because they spend most of their time with classmates in studying, living, and

entertainment. They have a fairly stable group of classmates during the course of their

undergraduate studies. In addition to the gregarious living environment, social values in

China emphasize the collectivistic culture and place the group needs over the wishes of

each individual.

Perceived Peer Pressure in College Contexts

Perceived peer pressure has been identified as a significant factor in youth

development, and impacts college students’ attitudes and drinking behaviors (e.g., Burk,

Vorst, Kerr, & Stattin, 2011; Kremer & Levy, 2008). On the one hand, college students,

after they leave their homes, spend less time at home, and break away from their parents’

immediate control. Without parents’ supervision, they are more likely to engage in

alcohol drinking. On the other hand, these college students might look for other

relationships like peers to meet some of their other needs they think cannot be fulfilled by

parents. Hence, peers replace parent’s influence and peers’ role is increased during

college life as developing a peer network and group formation becomes a primary task

for college students. This is more significant for freshmen, who undergo a shift from

parental attachment to peer dependence (Newman & Newman, 1976; Wall, Power, &

Arbona, 1993). As a matter of fact, socialization becomes an efficient approach for

college students to associate themselves with peers and win the peer acceptance from a

peer group.

6

Alcohol Self-regulation Self-efficacy

Compared to traditional behaviorists who have stressed external stimuli, Bandura

proposed understanding behavioral change from a social cognitive perspective (Bandura

& Cervone, 1986; Britton & Tesser, 1991). Although learning and actions are influenced

by positive or negative reinforcements, human behaviors are also affected by our

cognitive or mental representations of the environment (Glanz, Rimer, & Lewis, 2008).

Intrinsic reinforcements, such as pride, satisfaction, and a sense of pleasure also change

learning behaviors (Bandura, 1977). By rejecting the behaviorists’ indifference to self-

awareness, Bandura (1977) introduced the concept of self-efficacy, which emphasized the

role of self-referent beliefs (Pajares, 2003). Self-efficacy refers to individual’s confidence

in their abilities to succeed in a particular task in a particular context (Bandura &

Cervone, 1986). Self-efficacy is particularly important in managing social pressures to

drink alcohol against one’s will (DiClemente, Carbonari, Montgomery, & Hughes, 1994).

With respect to alcohol consumption, the alcohol self-regulation self-efficacy in

this study refers to people’s confidence of their own capabilities to drink responsibly

(Annis, 1982) or to resist social pressure to drinking in a given situation (DiClemente et

al., 1994; Shell, Newman, & Fang, 2010) . Studies have consistently shown that self-

efficacy is associated with alcohol use in clinical samples (Webb & Baer, 1995), in

western populations (Ellickson & Hays, 1991), and Chinese populations (Shell et al.,

2010). Those with higher self-regulation self-efficacy were less susceptible to

7

interpersonal power, and thus were more able to manage external pressures from others

when alcohol intake was against their will.

In summary, peer pressure may significantly impact group members’ beliefs and

values, leading to differences in drinking behavior. This project explores peer pressure in

a Chinese college students populations potentially adding to our understanding of the

phenomenon in a nonwestern population.

Purpose Statement

The purpose of this study is to examine whether or not peer pressure is linked to

alcohol consumption among Chinese college students, and how peer pressure influences

college students’ cognitive process and corresponding drinking behaviors.

Research Objectives

The present study aims to assess effects of peer pressure on personal alcohol use

in a Chinese university context. In particular, there are two overall objectives for this

study: 1) to examine whether peer pressure predicts drinking, and 2) to investigate how

peer pressure influences drinking via cognitive processes on personal alcohol use. Several

hypotheses were proposed, as follows:

1) Higher peer pressure will be associated with higher drinking frequency.

2) Greater peer pressure will be associated with lower alcohol self-regulation self-

efficacy.

3) Lower alcohol self-regulation self-efficacy will predict higher drinking frequency.

8

4) There will be a difference in the level of reported peer pressure on drinking

beliefs and drinking frequency between two sets of peer groups (HIST vs. PE,

Female vs. Male) in drinking frequency.

9

Chapter 2 Literature Review

In collegiate contexts, considerable research indicated the peer influence on

personal alcohol use. The initial alcohol use was mainly predicted by peers’ drinking (Lo

& Globetti, 1993; Reifman & Watson, 2003). The increase of personal drinking was

significantly associated with the alcohol use among college peers (Baer, Kivlahan, &

Marlatt, 1995; Wood, Read, Palfai, & Stevenson, 2001). This chapter reviews previous

studies about peer pressure in college drinking field, and is divided into four parts: 1) a

review of definitions of peer pressure, and 2) peer pressure measurements, and 3) the

influence of peer pressure on college drinking, and 4) the influence of self-efficacy on

college drinking, and 5) peer pressure and self-efficacy.

Definition of Peer Pressure

For decades, researchers have tried to understand what risk factors contributed to

alcohol use in college life. The influence from peers has been shown as one significant

predictor in the initiation or maintenance of drinking behavior on university campus since

1950s (e.g., Gusfield, 1961; Maddox, 1970; Straus & Bacon, 1953). Research has

consistently demonstrated the link between peer drinking and personal alcohol use among

college students (e.g., Martin & Hoffman, 1993; Mooney & Corcoran, 1991; Orford,

Krishnan, Balaam, Everitt, & Van der Graaf, 2004; Parfrey, 1974; Sherry & Stolberg,

1987; Shore, Rivers, & Berman, 1983; Shore & Rivers, 1985; Tryon, 1992; Werner,

Walker, & Greene, 1996). Therefore, understanding peer pressure is basic to understand

alcohol use and its related problems.

10

Newman and Newman (1976) were among the first to introduce the notion of

peer pressure and posited that pressures from peers were the major contributor that

affected young people’s social interaction. They postulated that in order to form a sense

of solidarity with peers and avoid alienation, young people were more likely to adopt

behaviors that were consistent with group norms. Conformity to the reference behaviors

formed a kind of pressure for group members. This pressure is especially potent when

youth attach a high value to affiliation with specific groups.

Following this conclusion, Brown and colleagues developed and validated a

measurement for assessing peer pressure - the Peer Pressure Inventory (PPI) (Brown,

Clasen, & Eicher, 1986; Clasen & Brown, 1985). The PPI examined peer pressure in five

contexts, including peer social activities, misconduct, conformity to peer norms,

involvement in school, and involvement with family. Among these five contexts, peer

pressure was distinguished with peer norms and thus, was defined explicitly as “when

people your own age encourage you to do something or to keep from doing something

else, no matter if you personally want to or not” (Brown, Clasen, et al., 1986).

Consistent with Brown et al. (1986), Santor, Messervey and Kusumakar (2000)

defined peer pressure as a subjective feeling of being pushed, urged, or dared by others to

do something only because of expectations from others. The key point of these two

definitions is that people do things because they have detected the overt pressure from

others. These two scholars focused on the explicit aspect of peer pressure and perpetuated

the perception of peer pressure as a one-dimensional influence (Borsari & Carey, 2001).

11

Others scholars have conceptualized peer pressure as a multidimensional

construct. The scope of pressures that individuals experience is beyond the explicit aspect

and extends into the implicit aspect. For example, Gottfredson and Hirschi (1990) defined

peer pressure as being “heavily influenced by the wishes and expectations of their

friends”. Most of times, these pressures were against subjects’ own inclinations or

parents’ discipline and directed toward delinquency or even criminal behaviors (p.158).

There are two dimensions in Gottfredson and Hirschi’s definition: in the explicit

dimension, individuals are undergoing overt pressures from peers to do something; in the

implicit dimension, engaging in misconduct such as drinking and challenging authority is

regarded as a group norm (Reed & Rountree, 1997). Conformity to this group norm,

which tends to be unconventional, is accounted as the implicit dimension of peer

pressure.

Borsari and colleagues (2001) defined peer pressure in a more comprehensive

way, which includes three dimensions in college drinking context: direct pressures (active

offers to alcohol drink), modeling (temporary and concurrent imitation of peer drinking),

and perceived norms including injunctive norms (the behaviors assumed to take place in

drinking) and descriptive norms (observed typical drinking behaviors).

In addition, other terms are often used interchangeably describing college

drinking. For instance, “conformity pressures” (Ross, Bierbrauer, & Hoffman, 1976) are

defined as perceived pressures from group members to conform to group behavior

standard. It includes both direct (peer coercion) and indirect pressures (peer norm) from

group members’ judgments and behaviors.

12

Other interchangeable terms have been used in studying university students’

drinking: social norms (Perkins & Berkowitz, 1986; Perkins, Meilman, Leichliter, Cashin,

& Presley, 1997; Prentice, Miller, Perkins, & Deborah, 1993), peer norms (Lo, 1995;

Perkins, 1985), group pressure (Asch, 1956), group norms (Newman & Newman, 1976;

Reed & Rountree, 1997), and normative influences (Knee & Neighbors, 2002; Perkins,

2002a). In general, they all define peer pressure as one’s perception of others’

expectations to comply with a norm. According to these definitions, peer pressure is

distinguished from coercive pressure, which involves threats or sanctions (Keefe, 1994).

In sum, there is a general agreement about the importance of peer pressure.

However, little consensus has been achieved about the conceptualization of peer pressure,

and how many dimensions should be examined for perceptions of peer pressure, and how

it works still need to be further discussed.

Measuring Peer Pressure

Table 1 summarizes measurements used for assessing peer pressure in previous

studies. Scales including less than three items were excluded from this review. The Peer

Pressure Inventory (PPI) (Clasen & Brown, 1985) is the most widely used peer pressure

scale. However, the PPI was not specially developed for assessing peer pressure in

alcohol consumption. Only three out of 53 items in the original PPI (Clasen & Brown,

1985) and one out of 12 items in the short version of PPI (Brown, Lohr, & McClenahan,

1986) are related to alcohol use. The similar issue exists for most of peer pressure

instruments. The majority of measurements were designed for broad umbrella notions

such as delinquency (Johnston, O’Malley, & Bachman, 1987), antisocial behaviors

13

(Bámaca & Umaña-Taylor, 2006), and substance use (Dielman, Campanelli, Shope, &

Butchart, 1987; Simons-Morton, Haynie, Crump, Eitel, & Saylor, 2001). A limited

number of measurements have been developed to assess peer pressure in alcohol area, but

mainly focus on normative drinking pressures (Keefe, 1994; Knee & Neighbors, 2002).

We could not identify any ready-made measurements to estimate peer pressure among

Chinese college students.

14

Table 1

Instrument for Peer Pressure

Authors Sample Study

Design

Scale Content Limitations

Clasen &

Brown

(1985)

7-12th graders

(N=689) in the

U.S.A.

CS 53 items on a 7-point scale;

5 areas of behaviors: peer social activities, misconduct,

conformity to peer norms, involvement in school, and

involvement with family.

Only 3 items relate to

alcohol use;

Unsuitable for

screening large numbers

of youth.

Brown et

al. (1986)

7-12th graders

(N=373) in the

U.S.A.

CS Adapted from PPI (Clasen & Brown, 1985);

12 items.

Only 1 item relates to

alcohol use

Berndt

(1979)

3rd, 6th, 9th, 11th,

and 12th graders

(N=1,251) in the

U.S.A.

CS 30 items;

3 types of behaviors: prosocial, antisocial, and neutral

behaviors.

Focus on resistance

ability.

Umaña-

Taylor &

Bámaca

(2003)

9-12th graders with

Mexican-origin (N =

1,062) in the U.S.A.

CS Adapted from Berndt (1979);

20 items;

Assess resistance to peer pressure (RPP);

Includes antisocial and neutral behaviors.

Focus on resistance

ability.

Bámaca &

Umaña-

Taylor

(2006)

9-12th graders with

Mexican-origin (N=

564) in the U.S.A.

CS Adapted from Berndt (1979);

10 items;

Includes antisocial behaviors (breaking rules, negative

actions toward others, and unplanned/unintentional moral

dilemmas).

No specific items relate

to alcohol use.

Crockett,

et al.

Mid-adolescence

(N=5,518) in the

LO 5 items;

Dichotomous response;

Vague items.

15

(2006) U.S.A. Negative peer pressure.

Dielman

et al.

(1987)

5th and 6th graders

(N=2,589) in the

U.S.A.

CS 7 items;

Consists alcohol, marijuana, and cigarettes.


alcohol;

Focus on susceptibility

to peer pressure.

Farrell &

White,

(1998)

10th graders (N=630)

in the U.S.A.

LO 4 items on a 6-point scale;

Items were imbedded in the measure of drug use

frequency.

Not been specifically

designed for alcohol

use.

Johnston

et al.

(1987)

High school students

in the U.S.A.

LO 7 items;

e.g. “How do you think your close friends feel if”

subjects engage in the following 7 delinquency areas

(marijuana, smoking, amphetamine).


alcohol use.

Keefe

(1994)

7th, 9th and 11th

graders (N=386) in

the U.S.A.

CS 7 items;

e.g. “My parents [My best friends] think that I should not

drink at all.”

“My parents [My best friends] think that it’s OK for me

to have one or two drinks every other week.”

Focus on normative

pressure.

Knee &

Neighbors

(2002)

Undergraduates

(N=74) and male

fraternity members

(N=53) in the U.S.A.

CS Adapted from Keefe (1994);

10 items on a 7-point scale;

e.g. “My best friends think I should drink at a party.”

“My best friends think that I should never drink.”

“My best friends think that it’s OK for me to have five or

more drinks once or twice every weekend.”

Focus on normative

pressure.

Kiran-

esen

(2003)

8th graders (N=718)

in Turkey

CS 34 items;

5-point Likert scale.

Focus on smoking.

Santor et

al. (2000)

11th to 13rd graders

(N=148) in the

U.S.A.

CS 11 items;

Assessing risk behavior, including substance use, risk-

taking behavior, and delinquency, as well as dating

attitudes, sexual behavior, and school performance.


alcohol use.

16

Schlegel

et al,

(1977)

Catholic boy’s high

school (N=196) in

the U.S.A.

LO 9 alcohol situations, consisting 3 types of alcohol (beer,

liquor, wine) in 3 social settings;

e.g., “please answer these questions as you think you will

do or feel in the next month.”

Focus on alcohol

intentions and

normative beliefs.

Simons-

Morton et

al. (2001)

6th to 8th graders

(N=4,263) in the

U.S.A.

CS Drinking and smoking;

Direct peer pressure: whether being encouraged by a

friend to smoke/drink;

Indirect peer influence: how many of the respondent’s

five closest friends smoke/drink.


alcohol use.

Sullivan,

(2006)

Youth (N=1,389) in

the U.S.A.

LO 5 items;

Dichotomous response;

e.g., “feel pressure from your friends to skip school.”

“Feel pressure from your friends to try marijuana or other

drugs.”

For child population.

Shore et

al. (1983)

UNL undergraduates

(N=548) and NWV

undergraduates

(N=140) in the

U.S.A.

CS 6 vignettes on a 7-point scale;

Including 6 situations: bar, party, date, large formal

party, dormitory or fraternity or sorority room, and car;

Male and female versions separately.

Unsuitable for Chinese

collegiate context.

Yunus et

al ( 2012)

Adolescents from

Gujrat city, Pakistan

(N=120)

CS 15 items;

3 subscales, including belongingness, influential learning

subscale, influential consequence.

Focus on adaptive

behavior learning.

Note. CS is cross-sectional study, LO is longitudinal study. UNL is University of Nebraska-Lincoln. NWV is Nebraska Wesleyan

University.

17

The Influence of Peer Pressure on College Drinking

Support and approval from peers benefit college students’ emotional and social

wellbeing. However, peers are likely to exert pressures that direct students toward

undesirable behaviors. For example, they are more likely to encourage alcohol use than

discourage it (Johnson, 1989). They are more comfortable with (Prentice et al., 1993) and

more approving of (Berkowitz & Perkins, 1986; Perkins & Berkowitz, 1986) friends’

alcohol use than parents. The same trend happens to close friends when facing

individual’s excessive drinking (Alva, 1998; Baer, 1994; Prentice et al., 1993). Peer

influence is clearest in overt drinking offers, drinking modeling, and local drinking

norms. The next section summarized research findings concerning three forms in which

peer pressure affect alcohol drinking among college students (Borsari & Carey, 2001).

Overt drinking offers

Direct peer pressure refers to explicit offers to use alcohol (Wood, Read, Mitchell,

& Brand, 2004). Examples in this case include being offered a toast, having a drink

refilled without asking, being teased for abstinence, being urged on drinking rate, or by

buying rounds (Rosenbluth, Nathan, & Lawson, 1978). This situation is especially potent

in China, which views offering alcohol as a way of showing hospitality, whereas refusing

another’s toast is disrespectful. Even worse is accepting one person’s toast, but refusing

another’s on a banquet. In order to maintain peer acceptance and avoid inadequacy,

individuals tend to comply with others’ wishes of alcohol use.

Three qualitative studies have described the influence of overt peer pressures on

alcohol consumption among college students. Howard and his colleagues’ study (2007)

18

reported that males often encouraged each other to drink large quantities of alcohol to

show “liquid courage”. The desire to get positive evaluations from peers leads to conform

to friends’ expectations. Lashbrook (2000) has shown that students responded with

shame-related feelings, such as being afraid of being seen as inadequate, feeling isolated,

and ridiculed when facing coercion from peers. These negative emotions, according to

college students’ diaries, were shaped and reinforced by peers’ comments, teasing, and

attitudes. Refusal of offers was seen as resulting in peer isolation and exclusion from

social activities (Rabow & Duncan-Schill, 1995).

Quantitative data from Shore and her colleagues (1983) have shown that students

who got more drinking offers but had low resistance to offers were more likely to be

involved in excessive drinking. The effect of explicit drinking offers was less obvious on

junior undergraduate students and female drinkers (Klein, 1991). The influence of offered

drinks by peers was also significantly related to alcohol-related problems. Students who

received more offers to drink alcohol reported heavier drinking and suffered more from

alcohol-related problems (Wood et al., 2001). The reciprocal relationship between heavy

drinking and active pressures may intensify this effect. On the one hand, alcohol offers

lead to excessive drinking. On the other hand, heavy drinkers are more likely to attract

drinking encouragement and receive more offers than nondrinkers (Orford et al., 2004).

By contrast, other studies have suggested that peers rarely control each other’s

behavior by using explicit or coercive pressures (Savin-Williams & Berndt, 1990).

Berndt, Miller, and Park (1989) reported that a majority of adolescents denied that their

friends had changed their attitudes or behaviors. Reed and Rountree (1997) reported that

19

overt peer pressure neither significantly influenced adolescent’s alcohol use, nor

mediated the effect of different peer group associations on personal alcohol use.

In sum, the majority of research concerning the influence of overt peer pressure on

personal alcohol use has focused on adolescent population, whereas attention to college

drinking has been limited. In the few studies on university student populations, findings

of the effects of explicit peer pressure are contradictory. The possible explanation is that

adolescents may regard drinking offers as a friendly gesture and are not willing to admit

the existence of peer pressure.

Drinking modeling

Modeling refers to observing another’s drinking behavior (Maisto, Carey, &

Bradizza, 1999). Social learning theory proposes the notion of vicarious learning and

suggests that people can imitate the behaviors surrounding them. Individuals may feel

tempted to imitate drinking merely by observing the outcomes of drinking by others

modeling the behavior, or they are inspired by the excited drinking atmosphere. That is,

exposure to social models who drink heavily increases the probability of drinking among

university students. Socialization, accordingly, creates an excellent context in which peer

modeling activates and contributes to peer similarity (Berndt, 1982, 1989). More

important, unlike overt peer pressure, which produces an increase in drinking

immediately, modeling could stimulate future drinking imitation even when the modeling

behavior is absent (Bandura & Cervone, 1986; Bandura, 1977). Peer modeling, according

to findings from both laboratory and social survey studies, can explain some of the

effects of peers on university students’ drinking.

20

A number of experimental studies have explored modeling drinking effects with

college student participants (see Borsari & Carey, 2001). Overall, results from those

experiments indicated that subjects exposed to heavy-drinking modeling were inclined to

drink more than subjects exposed to light-drinking modeling or abstinence modeling.

Performance modeling increased drinking in both heavy drinking subjects and light

drinking subjects.

Longitudinal data from Lau, Quadrel, and Hartman’s (1990) study indicated that of

various social influence processes, direct modeling of peer drinking contributed the

strongest impact on drinking attitudes and behaviors among college students over the first

three years of college. Similar correlations between best friends’ drinking pattern and

respondents’ drinking as well as alcohol-related problems in college students were

identified by Werner et al. (1996). Findings from Bartholow et al.’s (2003) 11-year

longitudinal study indicated the great contribution of modeling to peer similarity in

drinking behavior among college Greek members. Greater cumulative exposure to

fraternity or sorority social networks correlated with increased heavy drinking. Therefore,

drinking behaviors of immediate models served as a significant predictor for drinking in

college (Bartholow et al., 2003).

Results from Kremer and Levy’s (2008) cross-sectional study have shown a

positive correlation between roommate drinking ratings and subjects’ own drinking-

related problem. Specifically, a male student with a drinking roommate is more likely to

be exposed to drinking, affecting students’ college grade point average.

21

Findings from studies of Chinese university students also indicated that subjects’

alcohol consumption was affected by drinking behaviors of those around them. For

example, Ma and Fan (2000) found that college students with drinking friends were more

likely to engage in alcohol drinking. Almost half of subjects (43.41%) initiated their

alcohol drinking due to persuasion from friends (Leng et al., 2009).

Drinking norms

In addition to behavioral modeling, student drinking is influenced by drinking

norms. Perceived norms (Wood et al., 2004) refer to beliefs about how much and how

often “typical” college students drink (Baer & Carney, 1993; Baer, Stacy, & Larimer,

1991; Perkins et al., 1997). Examples of drinking norms include attitudinal norms (shared

expectations in utilizing alcohol) and behaviors norms (the typical drinking behavior

within a group) (Perkins, 2002b). Those typical beliefs and actions serve as a powerful

reference and efficiently regulate behaviors of group members, which lead to a “self-

fulfilling prophecy” effect on the individual level (Merton, 1957) and a more

homogeneous situation on the group level (Cleveland & Wiebe, 2003). Behaving in

accordance with perceived social norms is a way to demonstrate an individual’s group

affiliation to others as well as themselves.

In a college context, as alcohol use becomes more common, students get

accustomed to the prevalence of excessive drinking. Some individuals will regard

drinking as an integral part of social life. The salience of drinking benefits will likely to

be overestimated, while side effects will be more downplayed within a peer group (Keefe,

1994). Thus, drinking will be regarded as a positive normative behavior for socializing,

22

rather than a negative one. These drinking norms and drinking values form a “sub-

culture” (Brown, 1982) which approves or even praises alcohol use. Drinkers who get

positive reinforcements in their drinking culture tend to drink more. Other group

members, although against their will, are more likely to participate in drinking to obtain

group acceptance (Parish & Parish, 1991; Thombs, Beck, & Mahoney, 1993), facilitate

intimacy (Nezlek, Pilkington, & Bilbro, 1994) and enjoy socialization (Carey, 1993, 1995;

Teahan, 1987).

A large number of studies have found that in college life, drinking norms are

typically strong influences on personal behavior in alcohol consumption. For example,

Perkins’ (1985) study of a cross-section of undergraduates sample at a northeastern

college found that perceived group norms of drinking was a more influential contributor

to alcohol use than other background factors including religion, gender, and parental

opinions. Perkins and Wechsler (1996) based on a nationwide data indicated that, even

after controlling for the actual norm on subjects’ campus and their personal attitude,

differing personal perceptions of the local campus norms had a significant impact on

students’ own use and drinking problems. In contrast, Hanson (1977) reported drinking

norms has little impact on college student’s alcohol consumption.

Differences in perceived group norms exist across genders and groups. Lo’s (1995)

cross-sectional study of college students sample at a southern university found that peer

norms had a stronger correlation with males’ intoxication levels than the correlation with

females’ intoxication levels. Similar gender differences in perceived drinking norms have

been demonstrated in a nationwide college survey (Wechsler, Dowdall, Davenport, &

23

Castillo, 1995). Differences in perceived drinking norms are reported among three

subgroups (fraternity group, sorority group, and non-Greek affiliations). In comparisons

with non-Greek affiliations, the binge drinking norms were more common for both

fraternities and sororities (Wechsler et al., 1995). Another nationwide study indicated that

athletes consumed alcohol more often and significantly larger amount than nonathletes

did (Leichliter et al., 1998).

The effect of group norm on college drinking is achieved through altering students’

attitude toward alcohol use. The perceived drinking norms are internalized as a cognition,

which in turn, changed drinking behavior in the future. Individuals’ cognition mediates

peer influence on college drinking (Oostveen, Knibbe, & De Vries, 1996). An

experimental study by Nye, Agostinelli, and Smith (1999) revealed how the information

for normative behavior altered university students’ judgment for heavy drinking and

consequences. Specifically, offering information about typical drinking behavior

significantly predicted changes in drinking evaluation and alcohol problem recognition.

Based on these findings, intervention programs have been developed to target drinking

norm education. Significant reductions in alcohol use have been achieved by changing

college drinking norms (Borsari & Carey, 2001).

Most scholars focused on one aspect of peer pressure, a few studies have

examined all three aspects and tried to identify the most robust factor that predicts

alcohol misuse. Wood and colleges (2001) recruited a college student sample with heavy-

drinking problems and evaluated both direct (drinking offers) and indirect (modeling and

descriptive norms) on peer influence. Results from structural equation modeling

24

demonstrated that modeling exerted the greatest impact on drinking and corresponding

consequences. Drinking offers were significantly associated with both alcohol use and

problems. Perceived drinking norms contributed to alcohol use, but not to related

problems. That is, drinking norms had relatively less influence than drinking offers and

modeling among college students. Similar results have been documented in Britt and

Campbell’s (1977) in a longitudinal study, which indicated that drinking norms from

peers imposed limited influence on alcohol use, while normative standards from parents

exerted greater influence on drinking in both high school and college life. Social norm

and normative beliefs toward drinking from peers were less likely to predict alcohol use

and related problems compared to other social factors including parental, religious, and

traditional influence (Kilty, 1978).

Based on previous findings, the present research focused on the first aspect-direct

peer pressure on drinking. Overt pressure is commonly referred as the key feature of peer

pressure construct (Santor et al., 2000) and has been shown to be more influential than

other two aspects (see Britt & Campbell, 1977; Kilty, 1978; Wood et al., 2001). Overt

immediate pressure to use alcohol is potent in socialization to get social approval, and to

avoid social discomfort and rejection so it is immediately potent (Johnson, Marcos, &

Bahr, 1987). Direct pressure is most easily detected and more likely to show in testing.

In sum, understanding peer pressure is important to understanding risky behaviors

and because there are cultural and social difference between western and Asian cultures.

It is meaningful to examine peer pressure in Chinese contexts.

25

The Influence of Self-efficacy on College Drinking

In addition to influence from peers, the individual’s personal attitudes may affect

alcohol drinking among college students. Self-efficacy for resisting pressures to drink is

important (e.g., Baldwin, Oei, & Young, 1993; Shell, 2010). Among college students,

lower levels of drink refusal self-efficacy are associated with higher levels of drinking

quantity (Hasking & Oei, 2002) and frequency (Baldwin et al., 1993) among light

drinkers and heavy drinkers (Gilles et al., 2006; Oei & Morawska, 2004; Ricciardelli,

Connor, Williams, & Young, 2001), lonely drinkers (Christiansen, Vik, & Jarchow,

2002), problem versus nonproblem drinkers (Oei, Fergusson, & Lee, 1998), regular

drinkers (Burke & Stephens, 1999; Reis & Riley, 2000; Young, Connor, Ricciardelli, &

Saunders, 2006), and Asian students (Oei & Jardim, 2007). Findings from interventions

have indicated that increases in self-efficacy to resisting pressure leads to less drinking

quantity (Schroeder & Prentice, 1998).

Similar evidences have been found in studies on Chinese adolescent population.

Results also indicated that low self-efficacy for resisting pressures to drink led to higher

drinking frequency in Mongolia (Shell, Newman, & Qu, 2009), Henan Province

(Newman, Shell, Qu, Xue, & Maas, 2006), Beijing (Shell et al., 2010), and higher

drinking quantity in Taiwan (Yeh & Chen, 2007) .

Peer pressure and Self-efficacy

Some studies have examined both self-efficacy and peer pressure on alcohol use

and related problems. For example, an Australian university study reported that both

drinking pressure and low self-efficacy in resisting alcohol use contributed significantly

26

to the alcohol use (Young, Oei, & Crook, 1991). Reis and Riley (2000) conducted a

cross-sectional study of college students and reported a general linear model indicating

that perceived gender-specific drinking norms contributed greater variance in students’

self-reported weekly alcohol consumption than did self-efficacy. Kinard and Webster

(2010) examined the simultaneous effects of advertising, parental and peer influence, and

self-efficacy on adolescent alcohol consumption and noted that peer and parental

influence were stronger predictors for alcohol consumption, while self-efficacy was a

weak predictor.

Furthermore, it has been suggested that effects of peer pressure on college

drinking might be achieved by influencing cognitive process on personal alcohol use

(Borsari & Carey, 2006). In other words, peer pressure and self-efficacy might interact to

affect alcohol use.

In college, obtaining peer acceptance and avoiding negative impressions is one of

the important motivations to join in drinking (Hawkins, Catalano, & Miller, 1992).

Students who want to avoid negative evaluation from peers may match their behaviors

with perceived expectations from others (Schroeder & Prentice, 1998). Violating these

social values can make one appear aloof, which is especially undesirable in social

situations. Consistent coercion and teasing are likely to force adolescents to comply with

group norms, and thus decreasing adolescents’ confidence for resisting peer pressure. In

this case, adolescents’ self-regulation self-efficacy tends to become lower. Greater peer

pressure decreases individual’s capacity to say “no” to drinking offers.

27

For example, Schroeder and Prentice (1998) undertook an experimental study to

examine the influence of peer pressure on drinking. Results indicated that reducing

misperceptions of alcohol prevalence among peers reduced a fear of obtaining negative

peer evaluation, which in turn, led to observed reductions in alcohol drinking. Results

from a survey of 12 high schools in Taiwan indicated that adolescents reported the lowest

self-efficacy to resist drinking when facing socializing pressure (Yeh & Chen, 2007).

However, this interaction may vary in contexts. Group difference has been

revealed regarding peer pressure in drinking and self-efficacy to resisting drinking. Asian

students reported higher drinking refusal self-efficacy and lower drinking frequency than

Caucasian students did when facing drinking pressure in college social contexts

(Christiansen et al., 2002). Drinking level might be another factor in this interaction.

Findings from a heavy drinking sample on one university campus indicated that students

who drank heavily when alone reported less self-efficacy to reduce drinking than heavy

drinkers in socialization (Christiansen et al., 2002). Opposite results were found in

regular college drinkers (Schroeder & Prentice, 1998; Yeh & Chen, 2007).

In sum, findings have shown the impact of social pressure of peers and self-

efficacy on alcohol consumption separately. However, the mechanism through which

those variables achieved in their outcomes remains to be examined. Based on previous

findings, it is reasonable to assume that some students may not feel capable of refusing

offers, especially in situations where toasting to guests and accepting a toast is regarded

as a gesture showing respect in China. In contrast, students with higher ability to refuse

28

an offered drink, albeit undergo peer pressure, would be more likely to refrain from

excessive drinking (Shore et al., 1983).

29

Theoretical Model

This cross-sectional study examines the association of peer pressure and drinking

frequency by exploring this relationship among undergraduate students in China.

Furthermore, this study explores the mediating effects of alcohol self-regulation self-

efficacy, on the relationship between peer pressure and drinking frequency. Specifically,

this study examined how the self-efficacy for resisting peer pressure might vary as a

function of peer pressure received within a peer group, and how the self-regulation self-

efficacy might influence drinking frequency.

Figure 1 presents the conceptual model postulating that 1) the perception of peer

pressure will be a significant predictor of alcohol drinking frequency and, 2) the effects

of peer pressure on drinking frequency will be primarily mediated through alcohol self-

regulation self-efficacy, and 3) majoring in a discipline will be a significant predictor of

peer pressure, self-efficacy, and drinking.

Figure 1. Conceptual model guiding estimation of the influence of peer pressure

on college drinking in China.

Peer

pressure

Major Drinking

Frequency

Self-

efficacy

30

Chapter 3 Methodology

Subjects

Provide a wide range of student drinking patterns, participants were recruited

from the major of Physical Education (PE) and History (HIST). According to literature

reviews (Dong et al., 2006; Tu, 2007), students in the major of Physical Education have a

high likelihood drinking, while those in History were assumed to have lower drinking

rate.

All participants were enrolled in a university in central China, Wuhan city. This

university has been selected because of its convenient accessibility and proximity to the

researchers. Since it is typical of above-average Chinese universities, the sample of

students was expected to present results similar to other similar universities. Specific

demographic characteristics for this sample are displayed in table 2, chapter 4.

Procedure

For each grade within the major of PE and HIST, a letter describing the study was

sent to the managers of all students enrolled. Managers and university employees were in

charge of group of students. Managers were told about the purpose of the research study

method. Classrooms were selected at random and all students invited to participate.

Approval was obtained by the Dean of each department. This research won approval by

the Institutional Review Board at the University of Nebraska-Lincoln.

The data collecting process was managed by two education professionals from

Nebraska Prevention Center for Alcohol and Drug Abuse (NPCADA).

31

Participation required 30 minutes for data collection. Data were collected via a

questionnaire. The questionnaire contained a few parts: part 1, a brief demographic

questionnaire, part 2 questions about drinking behavior, part 3, three scales measuring

peer pressure, alcohol outcome expectancies, and one for self-regulation self-efficacy.

After finishing the data collection, all of the completed questionnaires were

shipped to NPCADA and stored in a locked file. After coding and data entering, all

questionnaires were destroyed. No names or identifying information was collected. The

electronic data files are password-protected.

Measures (see Appendix B and C)

Drinking frequency. Drinking frequency measures were based on reported

frequency in the past year and the past month. Subjects were categorized as non-drinkers

(those who reported never drinking or not drinking within the past year), occasional

drinkers (those who drank in the last year but not in the last 30 days) and regular drinkers

(those who drank within the last 30 days) (Shell et al., 2009).

Perceived Peer Pressure. The perceptions of peer pressure among Chinese

university students were measured by an 8-item measurement adapted from a pre-existing

scale (Santor et al., 2000). The original measure for peer pressure consisted of 11 items

that assessed pressures toward doing risky behaviors in adolescents (breaking rules, doing

foolish things, drinking alcohol, having sex, and doing drugs). Two items that specifically

related to drinking pressure were adopted in the present study. Another three items that

assessed peer pressure toward drug use and breaking rules were adapted into peer

pressure toward to alcohol use. Since effects from general friends’ pressure and close

32

friends’ pressure might be different on personal alcohol use (Knee & Neighbors, 2002),

three items were designed to estimate pressures from general friends, while another three

items with similar content were develop to assess drinking pressures from close friends.

Participants were asked to respond to each statement on a 5-point Likert scale

ranging from (1) strongly disagree, (2) mildly disagree, (3) neither agree nor disagree, (4)

mildly agree to (5) strongly agree. Scores of eight items were summed together to get a

final score as an indication of perceived pressures from peers toward alcohol use. The

higher the scores, the higher pressures subjects perceived from peer to involve in alcohol

use. Specific test results for scale reliability and validity were presented in table 12 to

table 15 in chapter 4.

Chinese Alcohol Self-regulation Self-efficacy (CASSE). Students’ self-efficacy for

resisting pressure from peers was measured using the CASSE. This instrument was

developed by Shell, Newman and Fang (2010). This instrument has been validated and

used to assess Chinese adolescents’ confidence of resisting peer pressure (Shell et al.,

2010). The CASSE contained 28 items scored on a 0–100 scale. A score of 100

represents full confident to resist the pressure to drink. A score of 0 represent that

subjects have no confidence at all to resist the pressure toward drinking alcohol. If

subjects’ confidence level locates between these two extremes, they write the number that

best reflects their feelings.

The CASSE includes four subscales: 8 items for situational social pressures (e.g.

resist pressure to drink on a date), 4 items for mood/affect (e.g. resist the urge to drink to

when felling joyful), 8 items for personal social pressures (e.g. resist the urge to drink to

33

impress your friends), and 8 items for excessive drinking (e.g. resist pressure to get drunk

at your own birthday party). The reliability in the original scale was 0.90 for situational

social pressures, 0.80 for mood/affect, 0.91 for personal social pressures, and 0.92 for

excessive drinking (Shell et al., 2010). After applied to the present sample, the alpha

reliability in original scale was 0.90 for situational social pressures, 0.81 for mood/affect,

0.90 for personal social pressures, and 0.88 for excessive drinking respectively in the

present dataset (see table 17).

Demographic characteristics. Participants were asked to complete a demographic

questionnaire including their gender, grade (junior/sophomore/senior), and how many of

respondents’ friends are from the same discipline (see table 2 in chapter 4).

Classmates’ drinking behavior. Two questions were used to measure classmates’

drinking behaviors. Participants read six options and chose the one that represented their

perceptions. For example, “How many of your female classmates drink alcohol in the

past 12 months?” “How many of your male classmates drink alcohol in the past 12

months?”

Data Analysis

To examine how perceived peer pressure is related to self-regulation self-efficacy

and drinking frequency, SPSS 22.0 and Mplus 7.0 were used. SPSS 22.0 was used to the

item analysis for peer pressure measurement. Mplus 7.0 was used for the factor analysis

for peer pressure measurement and alcohol self-regulation self-efficacy. The path model

was used to analyze the relationship between peer pressure, self-regulation self-efficacy,

and drinking frequency by Mplus 7.0.

34

Chapter 4 Results

A total of 951 college students from History major (HIST=432) and Physical

Educational major (PE=519) volunteered to participate in this survey. One student

dropped from this participation due to religious belief. Two questionnaires were deleted

due to missing values in the demographic part. Another 57 questionnaires were excluded

from the dataset because of their illogical responses. For example, four students reported

zero drinking frequency in the last year but nonzero drinking frequency during the

previous month. Several subjects consistently chose only one option while others

regularly answered the questionnaire with a ABABAB, AAABBB, or ABCABCABC

pattern. After dropping those invalid questionnaires, a total of 891 questionnaires (94%)

were used for the analysis.

In addition, 17 subjects of the remaining dataset misunderstood instructions.

Respondents were expected to mark a separate score for each item in the self-efficacy

measurement. However, they circled only a one score on the reference scale for the entire

self-efficacy measurement. Since their responses were complete for other parts of the

questionnaire except for the self-efficacy scale, these 17 observations were excluded only

for the analysis concerning self-efficacy. Therefore, the sample size used for the

descriptive part about demographics, drinking frequency, and peer pressure was 891

questionnaires (94%). The valid sample was 874 students (92%) for the advanced

analysis of the relationship among alcohol use, peer pressure, and self-efficacy.

35

Demographics of the sample

A total of 894 questionnaires (94%) were used for describing the demographic

characteristics of subjects.

Table 2

Demographics of the Sample

PE HIST Total

N % N % N %

Major PE 487 54.7 0 0 487 54.7

HIST 0 0 404 45.3 404 45.3

Total 487 54.7 404 45.3 891 100

Gender Male 359 74.0 91 22.0 450 50.6

Female 128 26.0 313 78.0 441 49.4

Total 487 100 403 100 891 100

Grade Freshman 173 19.4 120 13.4 293 32.8

Sophomore 187 14.4 149 15.2 336 29.6

Junior 127 20.9 135 16.7 262 37.6

Total 487 100 404 100 891 100

Friends

within same

discipline

No one 4 0.8 6 1.5 10 1.1

Less than half 164 33.5 165 40.7 329 36.8

Half and more 321 65.6 234 57.7 555 62.0

Total 487 100 404 100 891 100

Note. PE is Physical Education major. HIST is History major.

As shown in Table 2, subjects from two disciplines were almost equally

distributed (PE = 489, HIST = 405). There was a large difference in the gender ratio

between the two major groups. There were more males in PE (74%) and more females in

36

HIST (78%). However, overall, both genders were almost equally distributed in this

dataset (males = 50.6%, females = 49.4%). This sample contained 32.8% freshmen,

29.6% sophomores, and 37.6% juniors. Most students reported that the majority of their

friends were from the same disciple (62%), while only a small portion of students

reported that they have no friends within their same discipline (1.1%).

Drinking Behavior

Classification of drinking status. Based on reported drinking frequency,

participants were divided into three groups. Non-drinkers had not drunk any alcohol in

the past 30 days or the last year; occasional drinkers had drunk at least once in the last

year but not in the past 30 days while regular drinkers had drunk at least once in the past

30 days.

A total of 404 undergraduates (freshman, sophomore, and junior) were included

for analyzing drinking status for HIST majors. According to results in Table 3, 121

students (30%) reported they never drank alcohol in the last year and were classified as

non-drinkers. One hundred and twenty-two subjects (30.2%) who reported only using

alcohol in the last year but not in the past month were classified as occasional drinkers,

one hundred and sixty-one subjects (39.9%) reported they drank in the past month and

were classified as regular drinkers.

37

Table 3

Drinking Status in History Major

Drinking

Frequency in

the Last Month

Drinking Frequency in the Last Year

0

day

1-2

days

3-9

days

10-19

days

20-39

days

40-99

days

100 days

or more

Total

0 day 121 82 25 4 4 5 2 243

1-2 days 0 37 61 22 7 1 2 130

3-5 days 0 0 3 3 5 1 0 12

6-9 days 0 2 2 1 0 1 1 7

10-19 days 0 0 0 0 2 1 0 3

20 or more 0 0 0 0 1 2 6 9

Total 121 121 91 30 19 11 11 404

non-drinkers

occasional drinkers

regular drinkers

38

Based on the same classification, table 4 shows the drinking frequency among the

PE major sample. Of the 487 undergraduate students (freshman, sophomore, and junior),

30 students (6.16%) were identified as non-drinkers, 78 (16%) were classified as

occasional drinkers, and 379 of them (77.8%) were defined as regular drinkers.

Table 4

Drinking Status in PE major

Drinking

frequency in

last 30 days

Drinking Frequency in the Last Year

0

day

1-2

days

3-9

days

10-19

days

20-39

days

40-99

days

100 days

or more

Total

0 day 30 41 19 8 1 3 6 108

1-2 days 0 32 96 88 40 7 2 265

3-5 days 0 0 4 20 24 7 3 58

6-9 days 0 2 1 7 6 7 5 28

10-19 days 0 0 1 1 5 4 3 14

20 or more 0 0 0 0 3 5 6 14

Total 30 75 121 124 79 33 25 487

non-drinkers

occasional drinkers

regular drinkers

39

Drinking status by gender. Table 5 described the drinking status among the

participants by gender. Two discipline groups were pooled together to investigate

subjects’ drinking status. According to this table, a majority of males reported drinking

regularly (80.9%) whereas a smaller portion of females reported drink regularly (39.9%).

Females were more likely to be non-drinkers (29.9%) than males (4.2%). These results

suggested a significant difference in drinking frequency between genders (2 (2) =

171.72, p <.0001).

Table 5

Drinking Status by Gender

Female Male Total

N % N % N %

Non-drinker 132 29.9 19 4.2 151 16.9

Occasional Drinker 133 30.2 67 14.9 200 22.4

Regular Drinker 176 39.9 364 80.9 540 60.6

Total 441 100 450 100 891 100

2 = 171.72 df = 2 p <.0001

40

Drinking status by major. Table 6 shows drinking status by two subgroups (HIST

and PE). As shown, significant difference for drinking frequency exists among students

from two majors. More regular drinkers identified as PE major (N = 379) than student

from History major (N =161). Fewer non-drinkers appeared in the PE major (N = 30)

than student from History major (N = 121). Alcohol consumption was more prevalent

among subjects from the PE discipline than subjects from the History discipline (2 (2)

=146.06, p <.0001).

Table 6

Drinking Status by Major

HIST PE Total

N % N % N %

Non-drinker 121 30.0 30 6.2 151 16.9

Occasional Drinker 122 30.2 78 16.0 200 22.4

Regular Drinker 161 39.9 379 77.8 540 60.6

Total 404 100 487 100 891 100

2 = 146.06 df = 2 p <.0001

Drinking status by grade. Table 7 illustrated drinking status by grade within the

two disciplines (HIST and PE). Overall, more subjects were identified as regular drinkers

in PE (freshman = 140, sophomore = 153, junior = 86) than students in History major

(freshman = 47, sophomore = 53, junior = 61). No significant differences for drinking

status existed among three grades within the HIST discipline (2 (4) = 4.73, p = 0.32) but

there were small difference in PE sample (2 (4) = 11.01, p = 0.03). This finding did not

41

support previous results that suggested drinking frequency increased with higher grade

level (Li, Fang, Stanton, Feigelman, & Dong, 1996; Newman et al., 2011).

Table 7

Drinking Status by Grade

Freshman Sophomore Junior Total

N % N % N % N %

Drinking Status in HIST

Non-drinker 37 30.8 52 34.9 32 23.7 121 30.0

Occasional 36 30.0 44 29.5 42 31.1 122 30.2

Regular 47 39.2 53 35.6 61 45.2 161 39.9

Total 120 100 149 100 135 100 404 100

2 = 4.73 df = 4 p = 0.32

Drinking Status in PE

Non-drinker 11 6.4 9 4.8 10 7.9 30 6.2

Occasional 22 12.7 25 13.4 31 24.4 78 16.0

Regular 140 80.9 153 81.8 86 67.7 379 77.8

Total 173 100 187 100 127 100 487 100

2 = 11.01 df = 4 p = 0.03

42

Peers’ Alcohol Consumption

Drinking Patterns and Peer’s Alcohol Use. Table 8 compares peers’ drinking and

personal alcohol use. Drinkers were more likely to regard their peers as drinkers than

non-drinkers did. Specifically, more drinkers (74%) reported that more than half of their

male peers were drinkers than non-drinkers (56%) (2 (2) =19.08 p<.0001).

Among females, drinkers (17%) were more likely to classify the majority of their

female peers as drinkers than non-drinkers (8%) (2 (2)

=10.80, p=0.013).

Table 8

Drinking Patterns and Peer’s Alcohol Use

Non-drinker Drinker TOTAL

N % N % N %

Female

classmates’

drinking

more than half 10 8.0 98 17.0 108 15.0

half 13 10.0 79 14.0 92 13.0

less than half 102 82.0 398 69.0 500 71.0

Total 125 100 575 100 700 100

2=10.80 df=2 p=.013

Male

classmates’

drinking

more than half 72 56.0 481 74.0 553 71.2

half 19 15.0 46 7.0 65 8.3

less than half 38 29.0 120 19 158 24.4

Total 129 100 647 100 776 100

2=19.08 df=2 p<.0001

43

Perceived Peer Pressure

Perceived peer pressure scale evaluation. The 8-item perceived peer pressure

scale in this study was adapted from Santor et al. (2000). Subjects were asked to rate each

item on a 5-point Likert scale ranging from (1) strongly disagree to (5) strongly agree.

For each case, an average score from all eight items was used as an indicator of perceived

peer pressure in drinking. The average score of 5 indicated strongest perceived peer

pressure toward alcohol use, while 1 indicated the lowest level of perceived peer pressure

to drinking.

The internal consistency reliability alpha (Cronbach, 1951) for the entire scale

was 0.83. The 874 subjects were randomly split into two samples and analyzed separately

for the assessment of factor analysis. One split sample (N=446) was used to test the

Exploratory Factor Analysis (EFA). Another split sample (N=428) was used for the

Confirmatory Factor Analysis (CFA). For the first split sample, table 9 displays the item

content and factor loadings for the EFA test using SPSS 22.0. According to the SPSS

output, all items loaded on one factor, which could explain 46.5% of variance in the peer

pressure scale.

44

Table 9

EFA for Peer Pressure Scale from the First Split Sample

Item Item-total

correlation

If item

deleted

EFA

factor

loading

At times I have drunk alcohol because my best

friend urged me to.

0.65 0.80 .76

4. If my friends are drinking, it would be hard for

me to resist having a drink.

0.63 0.80 .75

3. I often feel pressured to drink when I normally

would not drink.

0.60 0.80 .73

2. At times, I’ve drunk alcohol because my friends

urged me to.

0.56 0.81 .69

6. If my best friend offered toast, it would be hard

for me t to refuse drinking alcohol.

0.54 0.81 .66

1. If my friends offer toast, it would be hard for me

to say no.

0.50 0.82 .62

5. I’ve felt pressured to get drunk at parties. 0.48 0.82 .61

8. If my best friend urged me to get drunk at a party

I would have a drink.

0.48 0.82 .60

Note. The reliability α = 0.83 for the first split sample.

The second split sample was used for the CFA and model fit indexes by Mplus

7.0. Table 10 indicates the item content and factor loadings for the CFA test. Overall, six

items out of eight contributed nice factor loadings to the common factor. Item 5 (0.47)

and item 8 (0.46) presented relatively lower indices for factor loading.

45

Table 10

CFA for Peer Pressure Scale from the Second Split Sample

To assess the model fit for the perceived peer pressure, a set of fit indices such as

the chi-squares statistics, the Root Mean Square Error of Approximation (RMSEA),

Bentler’s Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Standardized

Root Mean Square Residual (SRMR) were computed using Mplus with maximum

likelihood estimation.

Since the chi-square is easily affected by a large sample size such as the situation

in this study (N = 428), it is difficult to obtain a nonsignificant chi-square for this model.

Item Factor Loading

Unstandardized

Estimate

Standardized

Estimate

7. At times I have drunk alcohol because my best

friend urged me to.

1.38 .65



.74 .74

3. I often feel pressured to drink when I normally

would not drink.

1.35 .65


urged me to.

1.17 .62



1.29 .60


to say no.

1.59 .53

5. I’ve felt pressured to get drunk at parties. .98 .47

8. If my best friend urged me to get drunk at a

party I would have a drink.

1.03 .46

46

Other indices (TLI=0.86, SRMR=0.05), however, suggested further modifications to get

a decent fitting model (see table 11 indicated below).

Perceived peer pressure scale modifications. According to the model

modifications indices, there might be covariances between error terms associated with

item 2 and item 3, error terms associated with item 3 and item 5. Several trials were made

to obtain a better fit for this model. As presented in table 11, when certain items were

dropped, we got a better model fit compared to the use of the entire 8 items for the

perceived peer pressure scale.

Table 11

Goodness-of-Fit Indicators of Models for Peer Pressure

Factor model 2 df RMSEA CFI TLI SRMR

Entire 8 items 99.45***

20 0.10 0.90 0.86 0.05

Drop item 5 66.99***

14 0.10 0.93 0.89 0.05


14 0.09 0.92 0.88 0.04


14 0.07 0.95 0.93 0.04

Drop item 2&3 24.76**

9 0.07 0.97 0.95 0.03

Drop item 3&5 36.04***

9 0.09 0.95 0.92 0.04

Note. **

p < .01. ***

p < .001.

Dropping item 2&3 got higher indices values in CFI, TLI, and SRMR, but does

not make sense in theory. Item 2 has a good correlation with the rest of the items (>0.5)

and nice factor loading to the common factor (>0.6). Its meaning also nicely targeted

overt peer pressure in the alcohol drinking context. Dropping item 3 and item 5 resulted

47

in the same level of CFI compared to dropping item 3 alone, but provided worse indices

in RMSEA, SRMR, and TLI, which did not support a good fitting model.

Overall, dropping item 3 did not obtain the most optimistic values for all fit

indices. However, using a combination of SRMR (good models < .08), the RMSEA

(good models < .06) (Hu & Bentler, 1999) with CFI=0.95, TLI=0.93, a decision can be

made that the model is most strongly supported by this dataset. One possible reason for

the bad function of item 3 is its failure in specifying from whom subjects got pressure to

drink or the drinking situation in which subjects experienced pressures. Its vague

meaning may result in its bad function for assessing peer pressure. Table 12 shows the

factor loadings for each of the remaining 7 items. The reliability alpha is 0.80.

Table 12

Unstandardized and Standardized Loadings by CFA for Peer Pressure

Item Factor Loading

Unstandardized

Estimate

Standardized

Estimate

7. At times I have drunk alcohol because my best

friend urged me to.

1.35 .65



1.53 .74


urged me to.

1.05 .57



1.34 .64


to say no.

1.0 .54

5. I’ve felt pressured to get drunk at parties. .86 .43

8. If my best friend urged me to get drunk at a

party I would have a drink.

1.07 .49

48

Perceived peer pressure by drinking status, major, gender, and grade. Table 13

shows perceived peer pressure by drinking status, majors, and gender. According to the

one-way ANOVA test, there were significant differences in perceived peer pressure

scores among non-drinkers, occasional drinkers, and regular drinkers (F (2, 801) = 43.13,

p<.0001). Specifically, subjects who had not drunk alcohol in the past year perceived the

lowest peer pressure to drink (pressure mean = 2.47) while regular drinkers reported the

highest level of perceived peer pressure (pressure mean = 3.08). The Bonferoni post hoc

tests indicated that three pairwise comparisons (non-drinkers vs. occasional drinkers,

occasional vs. regular drinkers, regular vs. non-drinkers) differed significantly (p <

.0001). Results from the one-way ANOVA test displayed no significant differences

across grade levels in perception of peer pressure to use alcohol (F (2, 801) = 0.31,

p=0.74).

Based on results of t-tests, students in History major were found to have

significantly lower perception of peer pressure in alcohol use than students from PE

major (t (802) =-8.27, p<.0001). Females reported significantly lower peer pressure

toward alcohol use than males (t (802) =-10.77, p<.0001).

49

Table 13

Comparing Peer Pressure by Drinking, Major, Gender, and Grade

Peer Pressure

Drinking

Status

Mean SD

Drinking

Status

None 2.47 0.86

Occasional 2.75 0.72

Regular 3.08 0.70

F =43.13 df =2 p<.0001

Major HIST 2.66 0.77

PE 3.10 0.73

t = -8.27 df =802 p<.0001

Gender Female 2.63 0.73

Male 3.18 0.72

t = -10.77 df =802 p<.0001

Grade

Levels

Freshman 2.92 0.72

Sophomore 2.92 0.82

Junior 2.87 0.78

F =0.31 df =2 p=0.74

50

Self-regulation Self-efficacy

The scale of Chinese Alcohol Self-regulation Self-efficacy (CASSE) was used to

assess individuals’ self-confidence in resisting peer pressure and personal cravings to use

alcohol in the Chinese cultural context. The CASSE was originally developed for high

school students in China and has been tested for its reliability and validity. However, in

the current study, this scale was with a college student population. It is highly possible

that the age gap and developmental process may impair the reliability of this scale.

Therefore, the CFA was done using Mplus with Maximum Likelihood (ML). Results,

along with key words of each item, are shown in table 14. Overall, results indicated that

the all items contributed good loadings to the common factor, having loadings of larger

than 0.5. According to the primary fit indices recommended by Hu and Bentler (1999),

the SRMR showed good fit (0.06<0.08). The recommended secondary fit indices showed

only marginal fit (RMSEA=0.10, CFI =0.82). Since the CASSE is a previously published

scale, these fit indices do not indicate a need for modifications, especially given the item

factor loadings and coefficient alpha for the individual subscales.

51

Table 14

CFA for Chinese Alcohol Self-regulation Self-efficacy

Briefed Item Unstandar

dized

Standard

ized

Factor 1. Situational Social α=0.90

1. Pressure to drink when at their homes 1.00 0.78

25. Pressure to drink at a friend's birthday party 1.18 0.83

2. Pressure to drink at a festival 1.05 0.78

24. Pressure to drink at own birthday party 1.18 0.77

7. Pressure to toast 0.98 0.72

23. Urge to drink when all friends are drinking 1.02 0.74

4. Pressure to drink on a date 0.93 0.62

3. Pressure to go to a "Western" style bar or club 0.77 0.57

Factor 2. Mood α=0.81

13. Urge to get drunk when feeling joyful 1.08 0.78

12. Urge to get drunk to improve mood 1.17 0.73

5. Urge to drink to improve mood 1.00 0.65

6. Urge to drink when feeling joyful 1.06 0.65

Factor 3. Excessive α=0.90

8. Pressure to get drunk at a party 1.00 0.85

9. Pressure to get drunk at a festival 0.99 0.83

10. Pressure to get drunk on a date 0.90 0.70

11. Drinking pressure in a "Western" style bar or club 0.80 0.73

14. Pressure to excessive toasting at a banquet 0.78 0.73

26. Pressure to get drunk at own birthday party 0.93 0.70

27. Pressure to get drunk at a friend's birthday party 0.87 0.74

52

Major, Peer Pressure, Self-efficacy, and Drinking Frequency

Variables used in the path model. A path analysis using Mplus was conducted to

estimate the relationship among major, peer pressure, self-efficacy, and drinking

frequency. The independent variable of major was dummy coded as 0 for observations

from HIST and 1 for observations from PE. The outcome variable of drinker frequency

was treated as a categorical variable including non-drinkers, occasional drinkers, and

regular drinkers. These three categories were treated as ordinal ones because it was

hypothesized that there was an inherent ordering from non-drinking to occasional

drinking and then to regular drinking situation. The peer pressure and self-efficacy were

computed as continuous variables. Table 15 indicated the means and standard deviation

of two continuous variables.

28. Pressure to get drunk at weekend camp 0.63 0.64

Factor 4. Social α=0.88

18. Urge to drink to impress your friends 1.20 0.85

19. Urge to drink to impress boyfriend /girlfriend 1.18 0.80

16. Urge to drink to feel more comfortable 1.12 0.76

17. Urge to drink to feel more comfortable on a date 1.16 0.71

20. Urge to drink with a delicious meal 0.98 0.65

21. Urge to show drinking capacity 0.93 0.66

22. Pressure to show how well you can "hold" your

alcohol

0.90 0.63

15. Pressure from host’s offer 1.00 0.54

Note. 2 (344) = 3416.10, p<.0001, RMSEA=0.10, CFI= 0.82, TLI =0.80, SRMR=0.06

53

Table 15

Means and Standard Deviations for Each Variable

Variable Total sample PE HIST

Mean SD Mean SD Mean SD

Peer pressure 2.9 0.77 3.1 0.73 2.66 0.75

Self-efficacy

Situational Social 60.0 23.37 53.82 22.05 67.63 22.72

Mood 76.67 21.86 73.45 22.82 80.66 19.92

Excessive 75.85 20.09 71.57 20.95 81.12 17.63

Social 75.75 19.69 72.60 20.41 79.63 18.06

The path model was tested in Mplus using the weighted least squares means and

variance adjusted (WLSMV) estimators. The fit indices suggest an adequate model given

the present dataset (CFI= .93, RMSEA = 0.097, WRMR=0.97). The overall explained

variances (R2) for each predicted variable in the path model were drinking= 0.39, peer

pressure= 0.08, self-efficacy= 0.23.

Predicting role of major in peer pressure, self-efficacy, and drinking. As shown in

table 16, the predicting role of major in the perception of peer pressure from the path

model show that majoring in HIST is related with lower perceived peer pressure, while

majoring in the PE major is related with higher pressures (coefficient=0.28, p<.0001).

The predicting role of major in alcohol self-regulation self-efficacy from the path model

show that majoring in HIST was associated with higher self-efficacy than being in the PE

major (coefficient =-0.41, p<.0001). The predicting role of major in the likelihood of

54

drinking from the path model show that majoring in HIST is related with lower drinking

frequency than being in the PE major (coefficient=0.33, p<.0001).

Table 16

Path Model for Relationship among Major, Peer Pressure, Self-efficacy, and Drinking

Variable Unstandardi

zed

Standardi

zed

S.E. z

Self-efficacy

Situational

social

1.00 0.814 / /

Mood 0.78***

0.67 0.04 18.53

Excessive 0.94***

0.88 0.04 24.75

Social 0.86***

0.81 0.04 22.23

Self-efficacy

Peer pressure -9.99***

-0.41 0.90 -11.15

Major -6.12***

-0.16 1.29 -4.74

Drinking

Self-efficacy -0.02***

-0.40 0.01 -10.07

Drinking

Peer pressure 0.12***

0.08 0.06 2.11

Major 0.74***

0.33 0.09 8.74

Peer pressure

Major 0.44***

0.28 0.05 8.43

Note. The 2

(11) = 101.92, RMSEA=0.097, CFI= 0.93, WRMR=0.97.

***p<.001. Major is coded 0 for HIST and 1 for PE.

Predicting role of peer pressure and self-efficacy in drinking. As shown in figure

2, all path coefficients were significant at the p< .0001 level. As the peer pressure

increased, the self-efficacy for refusing alcohol dinking tended to decrease (standardized

55

path coefficient = -0.41). As the self-efficacy decreased, the likelihood of drinking

behavior increased (standardized path coefficient = -0.40). Consistent with previous

findings, perceived peer pressures were positively associated with a higher frequency in

alcohol drinking (standardized path coefficient = 0.08).

Indirect effects. Mplus 7.0 was used to estimate mediating factors for the

relationship between major and drinking frequency. Major had an indirect effect on

drinking through peer pressure and self-efficacy (standardized coefficient =0.05, z=5.97,

p<.0001). Peer pressure had an indirect effect on drinking through self-efficacy

(standardized coefficient =0.16, z=8.20, p<.0001). Major had an indirect effect on self-

efficacy through peer pressure (standardized coefficient = -.012, z= -6.64, p<.0001).

Figure 2. Path model predicting the relationship among major, peer pressure, self-

efficacy and drinking. ***

p < .001.

Peer

pressure

Major Drinking

Frequency

Self-

efficacy

-.41

***

-.16***

.28***

.08***

-.40***

.33***

56

Chapter 5 Discussion

Peer Influence on College Drinking

Most of previous studies focused on negative consequences of alcohol

consumption and advocate either reduction or elimination of alcohol use. However,

alcohol use is an expected part of social functions (Rapaport, Minelli, Angera, & Thayer,

1999). It is also necessary to keep in consideration that alcohol use in China may not be a

choice, but a cultural obligation to display intimacy and loyalty to friends. Refusal to

drinking alcohol tends to cause adverse effect on social interaction, and people who offer

alcohol are likely to be offended by the refusal. A mere emphasis on harmful effects of

alcohol consumption and simply urging student to abstain from alcohol drinking might

have little impact on controlling excessive and irresponsible drinking among college

students. Instead of desirable result, such attempts might produce the opposite response

from students. Therefore, it is not pragmatic to teach Chinese college students to abstain

from alcohol all the time when socializing. Instead, harm reduction programs can be

effectively adopted to intervene in alcohol related behaviors including but not limited to

consumption.

The first hypothesis of this study is that higher peer pressure will be associated

with higher drinking frequency. Results of the present research have indicated that

students who perceived higher peer pressure tended to drink more often than students

who perceived lower peer pressure. One implication of this result is that educational

strategies can be developed to teach students social skills to resist pressure from peers.

57

Enhancing college students’ protective strategies (Howard et al., 2007), according to

Chinese cultural and social situation, might be beneficial in alcohol education. For

example, several strategies can be taught to help students avoid drinking when possible,

such as how to say “no” to alcohol offers. Students can practice more sophisticated

strategies to keep from heavy drinking that neither embarrass nor humiliate peers. For

example, acting like a drunken person or acting sick may be useful to reduce alcohol

offers from peers.

Another implication of the study is to recognize the importance of peer influence

on behavior of young people and to utilize the positive aspects of the influence (Swadi &

Zeitlin, 1988). Since negative effects of peer pressure have been proved in a large body

of studies, it is then reasonable to assume that peers can also be used for positive

purposes in maintaining safe drinking behaviors and discouraging risky health behavior

(Swadi & Zeitlin, 1987). For example, when a person gets drunk, his/her friends

preferably from the same gender, can help him/her by not offering any drink and by

stopping him/her from drinking more alcohol.

The Protective Factor of Self-efficacy

The second hypothesis of this study is that greater peer pressure will be associated

with lower alcohol self-regulation self-efficacy. Results from the path analysis supported

this hypothesis. One of the possible explanations is that the aspiration to be accepted and

become popular among peers leads them to conform to peer pressure of drinking and

decrease their self-efficacy in resisting pressures. There might be an issue of the lack of

interpersonal and communication skills in some students. They have limited strategies to

58

interact with peers, and are more concerned about how others will react when they are

approached. They are shy and have few strategies to interact with peers. After drinking

alcohol, they feel more relaxed and comfortable in communicating. The aspiration to be

accepted and become popular among peers leads students to conform to peer pressure to

drink. They assume not drinking or refusing the offer to drink from others in the group

might limit their chances of socialization in the group or even increase their isolation.

Refusing to be involved in drinking means that they face the risk of losing their limited

chance of joining social events.

The third hypothesis of the present research is that lower self-regulation self-

efficacy will predict higher drinking frequency. Result from the present data supported

this hypothesis. A possible explanation is that students who wish to resist drinking

pressure do not know strategies to resist drinking or are not sure whether they want to

resist it for fear of offending friends’ good intentions. Students might be regarded as

ungrateful and get negative evaluations if they decide not to drink alcohol.

Interventions can be used to improve students’ cognitive defenses in resisting peer

pressures. Hence after being trained in self-efficacy, it can be expected that students

would be more assertive to refuse alcohol offers and resist the drinking pressure from

peers. Further, the training can be useful in increasing the immunity to peer influence,

which may lead to desire to refrain from drinking for the sake of approval and

recognition among peers.

Another implication is that alcohol self-regulation self-efficacy can be taught to

reduce alcohol related risks among college students. Compared to young adolescents,

59

college students are more mature in cognition. With higher self-regulation ability, they

are able to control and keep themselves safe while consuming alcohol due to their ability

to higher self-regulation. Interventions can be used to manage their drinking behaviors by

teaching them to drink responsibly. For example, helping to understand different types of

alcohol and educating about consequences of consuming such drinks can be helpful to

students in understanding the characteristics of alcohol and develop the ability to regulate

the amount and pace of alcohol consumption accordingly. Similarly, helping students

better understand personal drinking limits can be effective in students self-regulation in

their drinking habit (Howard et al., 2007). Also, some other self-regulatory skills like

drinking at a slow pace and eating food before drinking can also be taught to college

students to reduce the intoxication when drinking alcohol.

Group Difference

The fourth hypothesis of this research is that there will be a group difference in

the level of reported peer pressure on drinking beliefs. Findings from the study have

shown differences in experienced peer pressure toward alcohol use by discipline under

study, PE major experiencing higher pressure than HIST major. This difference may have

resulted due to the difference in the prevalence of alcohol use in both groups under study.

Theoretically it is possible to reshape students’ attitude toward risky drinking behavior by

modifying school’s policies aimed at regulating drinking in colleges, improving

advertisements and discouraging drinking group norm.

In addition, educational measures and preventive techniques can be utilized to

create an alternative social norm by forming a group of students who are not willing to

60

drink alcohol. The two forces comprised of both pressure to drink and reluctance to drink

can generate a balancing effect, thus counteracting the effect of negative peer influence

and pressure (Swadi & Zeitlin, 1988).

Gender Difference

This study also hypothesized that there will be gender a gender difference in

perceived peer pressure and consequent drinking behaviors. Results have shown that both

females and males were affected by peer pressure in terms of drinking behavior. Higher

level of perceived peer pressure toward alcohol use was reported in males. This result is

similar to the finding in the study by Swadi and Zeitlin (1988), whereas the finding

contradicts to some other literature, which showed the presence of stronger peer pressure

on females than males (Brown, 1982) and the tendency of girls tend to be more likely

influenced by their peers than boys (Kandel, 1985). A general conclusion cannot be

drawn due to controversial findings mentioned above. The controversy may be due to

presence of differences in population, culture and age of the people being studied.

With respect to the perception of pressures, data obtained have indicated a

difference in alcohol drinking between males and females. Males in this sample reported

higher frequency of alcohol drinking than females. Our results have supported the

findings in previous studies that men tend to perceive more permissive alcohol norms

than females (Adams & Nagoshi, 1999; Lo, 1995; Nagoshi, Wood, Cote, & Abbit, 1994).

A possible explanation for such finding can be the interpretation of drinking alcohol as a

symbol of masculinity in the Chinese tradition (Hao et al., 1995; Zhang, Wang, Lu, Qiu,

and Fang, 2004). Males are more likely than females to compete in drinking games. They

61

tend to challenge each other to drink more, despite having the onset of drunkenness

symptoms such as alcohol flushing in order to prove their masculinity, while females

have a tendency to discourage excessive drinking after detecting drinkers’ flushing

(Newman et al., 2011).

The important implication of the result in the study is the necessity of preventive

efforts to be targeted to specific characteristics of gender to produce desirable impact.

Education related to alcohol use and its effect can be focused on males, since they are

more likely to be provoked to drinking alcohol heavily by their male friends. For

instance, if misconception among males to considered drinking alcohol as a portrayal of

masculinity can be eliminated through education and awareness, reduction in drinking

frequency, and further cut back on possible harmful effect on health can be achieved.

Limitations

First, the most important limitation of the study is that the finding of the study

cannot be generalized to the entire country because of the fact that the study site was

limited to only one city in China, a country where customs and traditions vary from one

region to the other, or even from one city to the other. For instance, people in the northern

region of China have tendency to heavy drinking as compared to their southern

counterparts due to cultural and geographical factors (Hao et al., 2005). Samples from

more areas in China could be used in further studies.

Similarly, this study is limited to one university. These factors can be studied in a

broader range of college drinking contexts (e.g. key university, general university, and

62

vocational university) and further study can include larger number and categories of peer

group.

Third, this study is dependent on cross-sectional and self-reported data.

Retrospective surveys are subjected to self-report bias. Students may have inaccurately

represented the nature of their responses to overt peer influences.

In conclusion, alcohol consumption was found to be prevalent among college

students in the study. Students under higher peer pressure are more likely to drink more

often. The influence of peer pressure was mediated by subjects’ self-efficacy to resist

pressures toward alcohol use. Results from the study conducted have underscored the

importance of peer influence and students’ cognitive defense in alcohol consumption.

These findings provide critical implications for alcohol education and intervention of

alcohol abuse among college students in China. They offer implications for the

development of educational programs targeted to improve students’ cognitive defense

capacity to resist peer pressure in drinking alcohol.

63

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77

APPENDIX A. Institutional Review Board Approval

February 23, 2014

Lanyan Ding

Department of Educational Psychology

Ian Newman

Department of Educational Psychology

232 TEAC, UNL, 68588-0345

IRB Number: 20140213516EX

Project ID: 13516

Project Title: Influence of Peer Pressure on Alcohol Use among Chinese College

Students

Dear Lanyan:

This letter is to officially notify you of the certification of exemption of your project.

Your proposal is in compliance with this institution's Federal Wide Assurance 00002258

and the DHHS Regulations for the Protection of Human Subjects (45 CFR 46). Your

project has been certified as exempt, category 2.

Dates of EX Review: 1/19/2014 & 2/14/2014

You are authorized to implement this study as of the Date of Final Approval:

02/23/2014.

We wish to remind you that the principal investigator is responsible for reporting to this

Board any of the following events within 48 hours of the event:

* Any serious event (including on-site and off-site adverse events, injuries, side effects,

deaths, or other problems) which in the opinion of the local investigator was

unanticipated, involved risk to subjects or others, and was possibly related to the research

procedures;

* Any serious accidental or unintentional change to the IRB-approved protocol that

involves risk or has the potential to recur;

* Any publication in the literature, safety monitoring report, interim result or other

finding that indicates an unexpected change to the risk/benefit ratio of the research;

78

* Any breach in confidentiality or compromise in data privacy related to the subject or

others; or

* Any complaint of a subject that indicates an unanticipated risk or that cannot be

resolved by the research staff.

If you have any questions, please contact the IRB office at 472-6965.

Sincerely,

Becky R. Freeman, CIP

for the IRB

79

APPENDIX B. English Version Questionnaire

Alcohol Drinking Questionnaire

[English translation from Mandarin]

This survey is about alcohol use and the effects of drinking alcohol on a person. The

information you provide will be used to develop better health education for young people.

Your help is greatly appreciated!

Before you begin, please read the following instructions carefully:

1) This is not an exam or a test. Please answer each question according to your

actual behaviors and thoughts. There are no right or wrong answers. How and

whether you answer all the questions will not affect your grade in this class or

your standing in the university.

2) Do not write your name on this survey. The answers you give will be kept private.

No one including your teachers will know what you have written. The questions

that ask about your background will be used only to describe the types of students

completing this survey. The information will not be used to identify you.

3) There are no hidden meanings in the questions or responses. Please answer the

questions according to your first thought.

4) You may omit any questions that you choose not to answer.

5) If you are not clear about the meaning of any question, leave the answer blank.

80

6) The survey will take less than 20 minutes to complete and includes ninety-two

items.

Thank you so much for your participation!

81

Part 1. Please choose the one answer for each question that best describes you.

1. Gender: Male Female

2. How many of your friends are in the same discipline as you

None Less than half

Hal More than half All

Part 2. In this questionnaire “alcohol” refers to beer, liquor, wine, fruit wine, rice wine,

horse milk wine, or any other beverage that contains alcohol. For this part, choose the one

answer to each question that best describes you or your class.

3. On how many days did you drink alcohol in the past 12 months from today?

I never drank alcohol

1 - 2 days

3 - 9 days

10 - 19 days

20 - 39 days

40 - 99 days

100 days or more

4. On how many days did you drink alcohol during the past 30 days from today?

0 days

1 - 3 days

4 - 5 days

6 - 9 days 10 - 19 days

20 days or more

5. Think about the students at your university who are in the same class as you. How

many do they drink alcohol in the past 12 months?

None of the male students in my university class drink alcohol.

Several of the male students in my university class drink alcohol.

Half of the male students in my university class drink alcohol.

The majority of the male students in my university class drink alcohol.

All of the male students in my university class drink alcohol.

I have no idea.

6. Think about the students at your university who are in the same class as you. How

many do they drink alcohol in the past 12 months?

None of the female students in my university class drink alcohol.

Several of the female students in my university class drink alcohol.

Half of the female students in my university class drink alcohol.

The majority of the female students in my university class drink alcohol.

All of the female students in my university class drink alcohol.

82

I have no idea.

Part 3.

Scale A. Indicate how strongly you agree or disagree with each statement that describes

what happens when a person drinks alcohol by circling a number on a 5-point scale like

this:

1 2 3 5 6

Strongest stronger neither stronger strongest

Disagree disagree disagree or agree agree agree

Please choose one number for each statement that best reflects your belief.

1. If I drink alcohol, my reaction will slow down.

2. If I drink large amounts of alcohol, I will be admired by other people.

3. If I drink alcohol, it will improve my interpersonal relationships.

4. If I drink alcohol, I will overcome my shyness.

5. It is OK to drink alcohol if I do it in moderation.

6. If I drink alcohol, I will be sexier.

7. If I drink alcohol, others will think I am mature.

8. If I drink alcohol, my physical tiredness will be relieved.

9. If I serve alcohol to my guests, they will think I am a good friend.

10. If I drink alcohol, my future will be harmed.

11. If I drink alcohol, I will be wasting my time.

12. If I drink alcohol, it will help me to make deals that otherwise cannot be done.

13. If I drink alcohol, I will enjoy the taste of it.

14. I think I will be forgivable if I drink alcohol and overdo something to a person of

the opposite sex.

15. If I drink alcohol, my health will be harmed / I will cause harm to my health.

16. If I drink alcohol, food will be tastier.

17. If I drink alcohol, my parents will blame me.

18. If I drink alcohol, my memory will be harmed.

19. If I drink alcohol, it will help me make new friends.

20. If I drink alcohol, my physical discomfort or pain will be relieved.

21. If I drink alcohol, I can say what I really think.

22. If I drink, my reputation will be ruined.

23. If I drink alcohol at festivals, it adds more pleasure to my life.

24. If I drink alcohol, it is prelude for my sexual behavior.

25. If I drink alcohol, I will behave inappropriately.

26. If I drink alcohol, I will feel happy.

27. If I refuse someone’s toasting, I am afraid of hurting his/her feeling.

28. If I drink, I will be more likely to learn bad stuff.

83

29. If I drink medicinal alcohol, it is good for my health.

30. If I drink alcohol, I will get dizzy and/or have a headache.

31. If I drink alcohol, I will be wasting my money.

32. If I drink alcohol, I show that I am enthusiastic.

33. If I drink alcohol, I will be more creative.

34. If I toast someone, I will show him/her respect.

35. If I drink alcohol, I will cause problems that will damage my neighborhood

relationship.

36. If I drink alcohol, it may encourage me to express my love to a person of the

opposite sex.

37. If I drink alcohol, my work or business will be delayed.

38. If I drink alcohol, I will be more welcomed by other people.

39. If I drink alcohol, it will help me forget about unpleasant things.

40. If I drink alcohol, I will be less depressed.

41. If I am invited to drink alcohol by others, I will be expected to invite them to

drink later.

42. If I drink a little, it is good for my health.

43. If I drink alcohol, it can stimulate my sex initiation / intention.

44. If I drink alcohol, my judgment will be impaired.

45. If I drink alcohol, other people will think I am easy going.

46. If I drink alcohol, I will feel relaxed.

47. If I drink alcohol, I will be more resistant to cold weather.

48. I will be honored whenever my classmates or friends invite me to their banquet.

49. If I drink a little, it is not a big deal.

50. If I drink alcohol, it can improve my sex performance.

51. If I drink alcohol, I will do stupid things.

52. If I drink alcohol, I can show that I am honest and sincere.

53. If I drink alcohol, I will be more inspired.

54. If I drink alcohol, I will perform poorly in my school.

55. If I drink alcohol, I will be more attractive to opposite sex classmates or friends.

56. If I drink alcohol, I will be impolite to others.

57. If I drink alcohol, my family will be angry.

58. If I entertain guests without serving them alcohol, I will be giving them a cold

shoulder.

59. If I don’t drink alcohol, others may think I am unreliable.

60. If I refuse someone’s toasting, I will show disrespect to him/her.

61. If I drink alcohol, others will think I am not graceful.

62. If I drink alcohol, my parents will be upset.

63. If I do not offer alcohol at a banquet, my guests may complain.

64. If I drink alcohol, I will be easier to get along with.

65. If I do not serve alcohol at my home parties, I will disappoint my guests.

Scale B. Listed below are a number of situations in which you might feel those pressures

to drink alcohol. Please rate how confident you are that you could successfully resist

84

these pressures or desires in the following situations. You should mark your level of

confidence on the scale provided. If you have no confidence at all that you could resist

the pressure described you should mark 0 (I cannot do it at all). If you are fully confident

that you could resist the pressure described you should mark 100 (I am certain I can do

it.). If your feeling is between these two extremes you should mark the number that best

reflects your feelings.

1. Resist pressure from your friends to drink when you are at their homes.

2. Resist pressure from your friends to drink at a festival.

3. Resist pressure from your friends to go to a "Western" style bar or club.

4. Resist pressure from your boyfriend/girlfriend to drink on a date.

5. Resist the urge to drink to improve your mood.

6. Resist the urge to drink when you are feeling joyful.

7. Resist the pressure to engage in toasting at a banquet.

8. Resist pressure from your friends to get drunk at a party.

9. Resist pressure from your friends to get drunk at a festival.

10. Resist pressure from your boyfriend/girlfriend to get drunk on a date.

11. Resist getting drunk when you are at a "Western" style bar or club.

12. Resist the urge to get drunk to improve your mood.

13. Resist the urge to get drunk when you are feeling joyful.

14. Resist the pressure to engage in excessive toasting at a banquet.

15. Refuse a host's offer of more alcohol at a social gathering when you think you already

have had enough.

16. Resist the urge to drink to make you feel more comfortable in a social setting.

17. Resist the urge to drink to make you feel more comfortable on a date.

18. Resist the urge to drink to impress your friends.

19. Resist the urge to drink to impress your boyfriend/girlfriend.

20. Resist the urge to have a drink with a delicious meal.

21. Resist the urge to show your friends how you can drink a large quantity of alcohol.

22. Resist pressure from your friends to drink a lot of drinks to show how well you can

"hold" your alcohol.

23. Resist the urge to drink when all your friends are drinking.

24. Resist pressure to drink at your own birthday party.

25. Resist pressure to drink at a friend's birthday party.

26. Resist pressure to get drunk at your own birthday party.

27. Resist pressure to get drunk at a friend's birthday party.

28. Resist pressure to get drunk at weekend camp.

85

Scale C. Please read each statement carefully and write the number that best reflects how

you feel in the space provided, from 1 (strongly disagree) to 5 (strongly agree).

strongly

disagree

mildly

disagree

neither

agree nor

disagree

mildly

agree

strongly

agree

1 2 3 4 5

1. if my friends offer toast, it would be hard for me to say no.

2. at times, I’ve drunk alcohol because my friends urged me to.

3. I often feel pressured to drink when I normally would not drink.

4. if my friends are drinking, it would be hard for me to resist having a drink.

5. I’ve felt pressured to get drunk at parties.

6. if my best friend offered toast, it would be hard for me t to refuse drinking alcohol.

7. at times I have drink alcohol because my best friend urged me to

8. if my best friend urged me to get drunk at a party I would have a drink.

(The questionnaire ends here. Thank you!)

86

APPENDIX C. Chinese Version Questionnaire

大学生问卷调查

这项调查是关于饮酒行为和酒精对人的影响。您提供的信息将会对大学生健康

教育提供帮助。此次调查中，您将被问及两个关于您个人的问题，一个关于酒的使

用的简短调查，以及三个关于对于饮酒感受的量表。在开始回答问题之前，请您仔

细阅读以下说明:

1) 这不是考试或测验, 没有所谓的正确答案。您是否回答，以及具体的答案不

会影响您的成绩和在学校的表现。

2) 请不要在问卷上填写您的名字，您的回答将会完全保密，您身边没有人会知

道您的答案，包括老师在内。有关您个人背景的问题只是用于描述参与本调

查的人群征，不会用来识别您的身份。

3) 所有的问题都没有隐藏的含义，请您根据第一反应来作答，不必花费时间去

考虑您的选择。

4) 填写问卷时，请不要跟同学交谈，也不要参考别人的答案。如果您不明白某

个题，请留下空白。

5) 请检查确认没有问题遗漏，当您完成后，请跟随问卷调查者的指示。

谢谢您的合作!

87

第一部分：请对最符合你情况的选项打√。

1．性别：男女

2．你朋友圈里，与你同属一个专业有多少人？

没有

几个

一半

大多数

全部

第二部分：本次问卷中的“酒”包括啤酒、白酒、红酒、药酒、米酒、果酒、奶酒，

以及任何含酒精的饮料。请对最符合你情况的选项打√。

3. 过去 12 个月里，你大概有多少天喝过酒?

从不喝酒

1 - 2 天

3 - 9 天

10 - 19 天

20 - 39 天

40 - 99 天

100 天或者更多

4.过去 30 天里，你大概有多少天喝过酒？

0 天

1 - 3 天

4 - 5 天

6 - 9 天

10 - 19 天

20 天或者更多

5. 过去一年里，你班上的男同学有多少人喝酒?

没有

几个

一半

大多数

全部

不知道

6. 过去一年里，你班上的女同学有多少人喝酒?

88

没有

几个

一半

大多数

全部

不知道

第三部分：

量表 A，请对最符合你看法的等级打√。即使你从不喝酒，也请根据你从他人得到

的经验来回答问题。

完不

全同

意

不

同

意

不

同

意

意

既也

不不

同反

意对

同

意

完

全

同

意

同

意 1. 如果我喝酒，我的反应能力会变慢。 1 2 3 4 5

2. 如果我能很多酒，别人会佩服我。 1 2 3 4 5

3. 喝酒会改善我的人际关系。 1 2 3 4 5

4. 酒会帮助我克服羞怯。 1 2 3 4 5

5. 如果我适量喝酒，我会觉得轻松愉快。 1 2 3 4 5

6. 如果我喝酒，我会显得更性感。 1 2 3 4 5

7. 如果我喝酒，别人会认为我长大了。 1 2 3 4 5

8. 喝酒会解除我的疲劳。 1 2 3 4 5

9. 如果我请客人喝酒，会显得我很真诚。 1 2 3 4 5

10. 喝酒会影响我的发展和前途。 1 2 3 4 5

11. 喝酒会浪费我的时间。 1 2 3 4 5

12. 喝酒会帮我谈成生意。 1 2 3 4 5

13. 如果我喝酒，我可以享受酒的醇香。 1 2 3 4 5

14. 酒后我对异性做出的过头举动是可以原

谅的。

1 2 3 4 5

15. 酒会损害我的健康。 1 2 3 4 5

16. 酒会让我觉得饭菜更加有滋味。 1 2 3 4 5

17. 如果我喝酒，我父母会责备我。 1 2 3 4 5

89

完不

全同

意

不

同

意

不

同

意

意

既也

不不

同反

意对

同

意

完

全

同

意

同

意 18. 如果我喝酒，我的记忆力会受损。 1 2 3 4 5

19. 喝酒会有助于我结交朋友。 1 2 3 4 5

20. 酒会消除我身体的不适。 1 2 3 4 5

21. 酒会使我更大胆地和别人说话。 1 2 3 4 5

22. 喝酒会影响我的名声。 1 2 3 4 5

23. 在过节时喝点酒会增加我生活的乐趣。 1 2 3 4 5

24. 我认为酒是进行性行为的前奏。 1 2 3 4 5

25. 酒会我会做出过头的事。 1 2 3 4 5

26. 酒会让我感到高兴。 1 2 3 4 5

27. 如果我拒绝别人敬酒，我可能会伤害他

（她）的感情。

1 2 3 4 5

28. 喝酒容易让我学坏。 1 2 3 4 5

28. 如果我喝点药酒，会对我的健康有利。 1 2 3 4 5

29. 如果我喝酒，我会头晕或头疼。 1 2 3 4 5

30. 喝酒会浪费我的钱。 1 2 3 4 5

31. 我请别人喝酒可以显示我的热情。 1 2 3 4 5

32. 酒会激发我的创造力。 1 2 3 4 5

33. 如果我向别人敬酒，我会让对方觉得我尊

重他（她）。

1 2 3 4 5

34. 喝酒会损害我和邻居的关系。 1 2 3 4 5

35. 酒会鼓起我向异性表示爱慕的勇气。 1 2 3 4 5

36. 酒会我会误事。 1 2 3 4 5

37. 如果聚会时我喝酒，我会更受欢迎。 1 2 3 4 5

38. 酒会让我忘掉不愉快的事情。 1 2 3 4 5

39. 酒可以消除我的烦恼。 1 2 3 4 5

40. 如果别人请我喝酒，我也会回请他们。 1 2 3 4 5

90

完不

全同

意

不

同

意

不

同

意

意

既也

不不

同反

意对

同

意

完

全

同

意

同

意 41. 如果我会少量饮酒，会有益于我的健康。 1 2 3 4 5

42. 我认为酒能激发我的性冲动。 1 2 3 4 5

43. 如果我喝酒，我的判断能力会下降。 1 2 3 4 5

44. 如果聚会时我喝酒，别人会觉得我容易交

往。

1 2 3 4 5

45. 酒会使我放松。 1 2 3 4 5

46. 酒可以帮我御寒。 1 2 3 4 5

47. 如果同学或朋友请我喝酒，我会觉得很荣

幸。

1 2 3 4 5

48. 如果我稍微喝点酒，我觉得没什么关系。 1 2 3 4 5

49. 酒能增强我的性功能。 1 2 3 4 5

50. 如果我喝了酒，我可能会干蠢事。 1 2 3 4 5

51. 喝酒会使我显得真诚和实在。 1 2 3 4 5

52. 喝酒激发我的灵感。 1 2 3 4 5

53. 喝酒我影响我的学习成绩。 1 2 3 4 5

54. 借助喝酒我可以吸引异性的注意。 1 2 3 4 5

55. 酒后我可能会对别人不礼貌。 1 2 3 4 5

56. 如果我喝酒，将来我的家庭可能会不幸

福。

1 2 3 4 5

57. 如果我招待别人时不上酒，客人会觉得我

不礼貌。

1 2 3 4 5

58. 如果与朋友聚会时不喝酒，别人会觉得我

不实在。

1 2 3 4 5

59. 如果我拒绝别人敬酒，会被认为是不给对

方面子。

1 2 3 4 5

60. 如果我喝酒，别人会认为我不雅观。 1 2 3 4 5

61. 如果我喝酒，我父母可能会不高兴。 1 2 3 4 5

91

完不

全同

意

不

同

意

不

同

意

意

既也

不不

同反

意对

同

意

完

全

同

意

同

意 62. 如果亲朋好友来访时我不招待他们喝酒，

他们就会有意见。

1 2 3 4 5

63. 如果聚会时我喝酒，就不会让别人觉得我

与周围的人格格不入。

1 2 3 4 5

64. 如果在我家聚会时我没准备酒，会使大家

觉得扫兴。

1 2 3 4 5

量表 B，请根据下面提供的刻度尺来评估自己有多大自信程度成功地拒绝饮酒压力

或者抵制饮酒诱惑。（假如：完全没有信心拒绝外来的饮酒压力，请标记 0，充分

相信自己能抵制外来饮酒压力，请标记 100，假如你的感受介于两端点之间，请

标记出能代表你自信水平的数字。）

1. 在朋友家聚会，我能够拒绝朋友的劝酒。

2. 过节时，如果朋友劝我喝酒，我能够拒绝。

3. 如果朋友邀请我去西式酒吧或者俱乐部喝酒，我能够拒绝。

4. 跟男/女朋友约会的时候，如果他/她劝我喝酒，我能够拒绝。

5. 心情不好时，我能控制自己，不会靠喝酒来改善心情。

6. 心情特别好时，我能控制住自己想干一杯的冲动。

7. 宴会上别人劝我干杯，我能够拒绝。

8. 饭局上朋友劝我喝酒，我能够控制住自己，以免喝醉。

9. 过节时朋友劝我喝酒，我能够控制住自己，以免喝醉。

10. 跟男/女朋友约会时，如果他/她劝我喝酒，我能控制住自己，以免喝醉。

11. 在西式酒吧或者俱乐部里，我能够控制住自己，以免喝醉。

12. 心情不好时，我能控制住自己，不会借酒消愁，一醉方休。

13. 特别高兴时，我能控制住自己，不会肆意狂饮而酒醉。

14. 宴会上，我能控制住自己，以免过多喝酒。

15. 社交聚会时，当我认为自己已经喝得过多时，我能够拒绝主人的劝酒。

16. 社交场合，即使喝酒会让我觉得自在一些，我也能控制住自己想喝酒的冲

动。

92

17. 约会时，即使喝酒会让我觉得自在一些，我也能够控制住自己想喝酒的冲

动。

18. 即使喝酒能够使朋友对我刮目相看，我也能控制自己想喝酒的冲动。

19. 即使喝酒能够使男/女朋友对我另眼相看，我也能控制住自己想喝酒的冲

动。

20. 即使有好菜，我也能控制住自己想喝酒的冲动。

21. 我能控制住自己向朋友炫耀酒量的冲动。

22. 当朋友劝我多喝酒以展示酒量的时候，我能够拒绝。

23. 当所有的朋友都喝酒时，我也能控制住自己想喝酒的冲动。

24. 在我自己的生日聚会上，我能控制住自己，不去喝酒。

25. 朋友的生日聚会上，我能控制住自己，不去喝酒。

26. 在我自己的生日聚会上，我能控制住自己，以免喝醉。

27. 在朋友的生日聚会上，我能控制住自己，以免喝醉。

28. 郊游时，我能控制住自己，以免喝醉。

量表 C，请对最符合你看法的等级打√（从等级 1 完全不同意，到等级 5 完全同

意）。

完不

全同

意

不

同

意

中

立

同

意

完

全

同

意

1. 如果我推辞朋友的敬酒，会驳了对方的面子。 1 2 3 4 5

2. 有时候我喝酒是迫于朋友的劝酒。 1 2 3 4 5

3. 我经常迫于无奈而喝些酒。 1 2 3 4 5

4. 假如我的朋友们都在喝酒，我迫于情面，也得

一起喝。

1 2 3 4 5

5. 饭局上我经常迫于压力而喝酒，以至于喝醉。 1 2 3 4 5

6. 如果交情深的朋友给我敬酒，我很难推辞。 1 2 3 4 5

7. 有时候我喝酒，是因为好朋友的强烈要求。 1 2 3 4 5

8. 假如交情深的朋友要与我拼酒，我就会喝醉。 1 2 3 4 5

（调查结束，谢谢！）

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