Cognitive Changes

Cognitive changes during adolescence include gradual improvements in social perspective, to about age 16 (Steinberg and Cauffman, 1996). These newfound perspective-taking skills allow an adolescent to recognize how the thoughts and actions of one person influence those of another and to imagine how others might perceive them. Although generally an indicator of greater maturity, a downside of this new ability is that adolescents are highly concerned with peer conformity, which may make them particularly susceptible to peer influence. The majority of studies indicate a positive relationship between susceptibility to peer pressure and risk-taking behavior (such as drinking). For reasons not yet known, there is variation in the extent to which adolescents succumb to social influence, including pressure to engage in behaviors that are undesirable (see Steinberg and Cauffman, 1996, for a review).

In general, thinking becomes more abstract and more future-oriented during adolescence, allowing adolescents to consider multiple aspects of any decision at one time, assess potential consequences of a decision, consider possible outcomes associated with various choices, and plan for the future. These cognitive changes enhance the adolescent's capacity for competent decision making (see, for example, Halpern-Felsher and Cauffman, 2001; Steinberg and Cauffman, 1996). However, these newly formed competencies are not always practiced when adolescents are confronted with real-world social situations. Many studies suggest that adolescents, as well as adults, may make less than optimal decisions when personal goals, beliefs, prior experience, values, social expectations, and emotions are added to the decision making equation (Jacobs and Klaczynski, 2002). This outcome is especially true for social decisions (like choosing whether to drink or how much to drink). This is so for a variety of reasons.

First, outcomes of decisions in social situations are probabilistic, meaning that negative consequences of bad decisions may not occur and may not even be highly likely, although they are devastating if they do occur. For example, while the probability of having a car crash after drinking is much higher than after not drinking, drinking and driving does not always end in a crash or a ticket. Because outcomes are probabilistic, adolescents may interpret the fact that they previously drank too much and drove home without a crash as evidence that they can drink and drive safely (Jacobs and Ganzel, 1994). In one study, older adolescents who had a lot of experience drinking and driving, but had not experienced a negative outcome, such as a traffic citation or crash, believed that they were in little danger of having an accident after drinking (Finken et al., 1998), this result suggests that engaging in risky behaviors without consequence may have caused them to lower their perceptions of the risks of drinking and driving. Other correlational studies have shown that greater involvement in risk-taking behaviors was related to lower perceptions of personal risk (e.g., Halpern-Felsher and Cauffman, 2001; Goldberg et al., 2002). Second, the norms for social decisions are not typically known. Instead, individuals are often forced to make judgments on the basis of their own estimates of the norms of social behaviors or attitudes. This general dilemma, faced by people of all ages, is even more difficult for adolescents because they must make decisions based on a limited amount of experience and little feedback from earlier decisions (Jacobs et al., 1995). Several studies indicate that most adolescents overestimate the number of others who drink alcohol (e.g., Basch et al., 1989; Jaccard and Turrisi, 1987). Not surprisingly, the overestimation is greatest for those individuals who drink. This same pattern has been found for other risk-taking and deviant behaviors (e.g., Benthin et al., 1993; Nucci et al., 1991), and it may be related to the fact that those who drink have friends who drink and so they begin to believe that everyone is drinking. In one longitudinal study, adolescents who spent time with peers who encouraged drinking later reported more positive views of drinkers (Blanton et al., 1997).

In addition, studies indicate that adolescents make more biased estimates when they are reasoning about populations with greater variability and when they are reasoning about unfamiliar others (Jacobs, 2004) Underage drinking and other forms of risk taking are likely to occur in social situations and when adolescents find themselves with large groups of unfamiliar peers. In these situations, they are left to estimate how others typically behave and what they think. The outcome may be overestimates of others' drinking and acceptance of such behavior, leading them to believe that the norm is to drink and that they should do it, too. However, providing adolescents with more realistic information about the extent to which people drink alcohol may not by itself reduce alcohol consumption. Instead, a focus on injunctive norms—views concerning what others think about one's drinking—might be more effective (Cialdini et al., 1990; Kallgren et al., 2000; Prentice and Miller, 1993).

Social Situations

The social situations in which adolescents find themselves also change during this period. Indeed, movement toward autonomy is accompanied by real and perceived changes in the social world as adolescents mature. Most move from environments in which they are protected, scheduled, and dominated by adults into environments that are primarily populated with other adolescents and in which they actually have much more autonomy. On average, middle-class adolescents spend about 20 percent of their time with parents and other relatives, 25 percent of their time alone, and the rest with friends and classmates (Csikszentmihalyi and Larson, 1984). Younger adolescents report that television and home- and family-centered activities fill much of their leisure time, but this shifts dramatically as they get older and report that peer-focused and solitary activities fill most of their time (Larson and Kleiber, 1990). Thus, as adolescents get older, they spend greater periods of their leisure time away from adult supervision, increasing the opportunities for becoming involved in such risk-taking behaviors as drinking alcohol.

In addition to the actual changes in supervision, teens are much more focused on real or imagined peer norms. They are most likely to attend to the standards set by their friends than by another same-age group. The often reported, “peer pressure” is, in reality, “friend pressure.” As adolescents get older, they are more likely to choose friends who share their tastes and interests than when they were younger. Thus, they are likely to join crowds of teens who have similar values and life-styles. Crowd membership has been associated with alcohol consumption: some crowds or groups include drinking as part of how they spend their time, and an adolescent's choice to be involved in that crowd will include the knowledge that drinking is a typical activity for that group (Prinstein et al., 1996). For example, participation in competitive sports in high school has been related to higher rates of alcohol use (Eccles and Barber, 1999).

Unfortunately, information about a particular group's norms may not be available until after an adolescent has had one or more experiences with the group and has been faced with situations in which saying “no” to alcohol will be viewed unfavorably by peers. Younger adolescents report having more trouble moving between crowds than older adolescents, so it may be more difficult for them to go against the norms of a crowd if they feel uncomfortable (Brown et al., 1994).

Personality Differences

Is there a personality profile that is related to adolescent risk for alcohol abuse? Cloninger (1991) found that three traits, present as early as age 10, were associated with alcoholism at age 28: (1) being easily bored and needing constant stimulation; (2) being driven to avoid negative consequence for actions; and (3) craving immediate external rewards for efforts. In addition, antisocial personality disorder has been linked to alcohol misuse among adolescents (Clark et al., 1998). Similarly, a recent study of children aged 8 to 15 found that conduct disorder often predates and predicts later alcohol use (Clark et al., 1998).

In nonclinical populations, a major personality characteristic that has been related to adolescent risk taking is sensation seeking, defined by seeking novel, complex, or risky situations (Zuckerman, 1979). The appeal of drinking alcohol and other “forbidden” behaviors for adolescents may be the novel and intense sensations provided by the experiences (Arnett and Balle-Jensen, 1993); students who have higher needs for sensation seeking are more likely to report higher levels of drinking, as well as other delinquent behaviors. Others have also reported associations between sensation seeking or novelty seeking and alcohol use (e.g., Martin et al., 2002). Donohew and colleagues (1999) argued that sensation seeking influences alcohol use indirectly, through peer affiliations: teens who are sensation seekers tend to choose friends with similar sensation seeking desires, and such peer group affiliations increase alcohol use.

Beliefs About Risk

Although many adults believe that adolescents underestimate the risks of engaging in particular behaviors, most research indicates that adults and adolescents actually give similar estimates of various types of risk taking, including drinking alcohol (e.g., Beyth-Marom et al., 1993; Quadrel et al., 1993). Although sweeping age differences in risk estimates have not typically been found (Millstein and Halpern-Felsher, 2002), individuals' perceptions of risk vary, and their perceptions have been linked to their behaviors. In general, drinkers of all ages view consuming alcohol as less risky than nondrinkers (Goldberg et al., 2002), although the absolute accuracy of various risk perceptions has been the topic of debate (e.g., Slovic, 2000). Although adolescents generally overestimate their mortality risks for a variety of activities including alcohol (e.g., Fischhoff et al., 2000), recent studies suggest that adolescents who perceive a higher likelihood of negative consequences following alcohol consumption do not drink at all or drink more moderately than others (e.g., Goldberg et al., 2002; Halpern-Felsher and Cauffman, 2001; Small et al., 1993.)

Both adults and adolescents tend to overestimate how many other people are involved in activities in which they, themselves, are engaged (e.g., Kruglanski, 1989). Indeed, adolescents as well as adults who participate in high-risk activities generally believe that the rate of participation by others is higher than do nonparticipants (Benthin et al., 1993); thus, beliefs about normative practices may be related to older adolescents' decisions to engage in risky behaviors (Basch et al., 1989; Beck and Treiman, 1996; Olds and Thombs, 2001). In one recent study, adolescents who reported higher levels of alcohol consumption and other risk-taking behavior than their peers overestimated how much other adolescents in their school were participating in the same high-risk behaviors (Jacobs, 2000). Extreme overestimaters engaged in significantly more mild and severe deviant behaviors than either the moderate overestimaters or those whose estimates were correct, and they reported poorer self-esteem, lower grade point averages, and less rational decision-making skills. One of the most intriguing implications of the research focusing on individual differences is that some adolescents are more likely than others to perceive drinking as low risk, to overestimate the likelihood of others' drinking, and to look for sensation-seeking opportunities. This is the group that one would expect to drink the most and take the most risks when drinking.

Prior Experience

Although correlated with age, drinking experiences have a significant and independent effect on alcohol expectancies, which in turn play a role in alcohol use (Christiansen et al., 1989; Christiansen et al., 1982; Chen et al., 1994; Grube et al., 1995; Jones et al., 2001; Smith et al., 1995; Wood et al., 1992; Goldberg et al., 2002). More specific expectancies, such as enhanced sexual feelings, power, and reduced tension have been reported by those with greater drinking experiences, while youth with little or no alcohol experiences have more global expectancies of increased pleasure (Christiansen et al., 1982). As one gains more experience with alcohol, positive outcomes are reinforced and predict future drinking behaviors (Goldberg et al., 2002; Jones et al., 2001). Furthermore, positive drinking-related expectancies increase and negative expectations for risks decrease among adolescents with more drinking experiences (Halpern-Felsher et al., 2000; Goldberg et al., 2002).

Self-Efficacy

Drinking refusal self-efficacy, borrowed from Bandura's (1986, 1997) concept of general self-efficacy, refers to one's belief in her or his ability to resist urges or social pressures to drink, to drink in particular situations, or to consume large amounts of alcohol at one time. Adolescents with more positive self-efficacy are less likely to drink or drink excessively (Oei et al., 1998; Webb and Baer, 1995), and those with fewer refusal skills are more likely to drink (Hays and Ellickson, 1996). Refusal skills may be a better predictor of problem drinking than alcohol expectancies, especially for heavy or frequent alcohol use (Connor et al., 2000; Oei et al., 1998). Given that adolescents are more susceptible to peer pressure, it stands to reason that they will have lower drinking refusal skills. However, there is evidence that adolescents can be taught drinking refusal self-efficacy skills and that such skills can then result in less substance use (Bell et al., 1993; Ellickson et al., 1993).

Community

U.S. culture is replete with messages touting the attractions of alcohol use, and—notwithstanding the legal norm—suggesting that drinking is acceptable for people under 21. Recent content analyses indicate that alcohol use was depicted, typically in a positive light, in more than 70 percent of a sample of episodes in prime-time television programming in 1999 (Christensen et al., 2000), and in more than 90 percent of the two hundred most popular movie rentals for 1996-1997 (Roberts et al., 1999b). Roberts et al. (1999b) also found that 17 percent of the 1,000 of the most popular songs in 1996-1997 across five genres of music popular with youth contained alcohol references, including almost one-half of the rap music recordings. The alcohol industry spent $1.6 billion on advertising in 2001, and probably twice that much in other promotional activity. Young people are exposed to a steady stream of images and lyrics presenting alcohol use in an attractive light.

Within any country, the specific community environment may contribute to drinking to a greater or lesser extent. The drinking environment can be characterized as varying on a “wet-dry” continuum. A “wet” community environment is one in which drinking is prevalent and common, public opinion is generally tolerant or positive, and alcohol is readily available both commercially and at private social occasions and is advertised as available. A “dry” community would be one in which drinking at social occasions is not the norm and is generally frowned on, and alcohol outlets are relatively scarce. One commonly used statistical indicator for the “wetness” of the environment is the per capita consumption of alcohol (the average number of drinks per person) for the population age 14 and over per year. In the United States, for example, per capita consumption ranged from 1.3 gallons of ethanol per capita in Utah to 2.8 gallons in Wisconsin, in 1997; see Table 4-1.

TABLE 4-1

Alcohol Consumption, 1999.

To what extent do environmental factors influence individual drinking choices by youth? It is interesting in this regard to analyze trends in youth drinking over time. Based on their analysis of Monitoring the Future data for high school seniors, Cook and Moore (2001) report that the 30-day prevalence of drinking and also of heavy drinking¹ peaked in 1979, and then declined by approximately one-third (30.6 and 37.5 percent, respectively), reaching a low point in 1993 and increasing only slightly since then. This downward trend is unrelated to demographic changes in the composition of the population of high-school seniors and cannot be fully explained by trends in prices, minimum drinking age, or availability (Cook and Moore, 2001). However, this trend in drinking prevalence closely tracks the societal trend in drinking, as measured by national per capita consumption. Thus, whatever the reason for the decline in youth drinking during the 1980s, it seems to be related to, and perhaps in some sense is the result of, the overall decline in drinking in the society.

More persuasive evidence of the link between “wetness” and youth consumption comes from a study of individual drinking behavior. Cook and Moore (2001) analyzed data from the National Longitudinal Survey of Youth (NLSY) that included annual items on individual drinking for 1982-1985 and 1988-1989. The initial cohort of 12,000 respondents ranged in age from 17 to 24 at the beginning of this period in 1982, so that the NLSY data provide information on drinking trajectories for older teens and those in their twenties. They found that, even after controlling for family, religion, schooling, aspirations, employment, and cognitive ability, various aspects of the environment contributed significantly to patterns of drinking. Specifically, youth with similar backgrounds and individual characteristics were more likely to drink if they lived in a state with relatively high per capita consumption.

The minimum drinking age and the excise tax on beer are also related to youth drinking. Thus, an 18-year-old living in a state in which his drinking was legal in 1982 would have been more likely to drink (and to drink heavily) than an identical twin living in a state with a higher minimum drinking age. Increases in the beer tax (which has a direct effect on average price) generally tend to lower drinking, although it is harder to pin down with the NLSY data; however, other studies are quite consistent at documenting that taxes and prices influence youth drinking (Chaloupka and Wechsler, 1996). This research suggests that a “wetter” environment may provide adolescents with more social occasions to drink, more positive attitudes about drinking, more advertising and outlets, and more lenient regulations concerning the sale and consumption of alcohol. In short, such environments have an enabling effect on underage drinking.

In addition to specific community norms for drinking, several other societal factors may affect the prevalence of heavy drinking in adolescence. First, U.S. society is largely segregated by age. As adolescents get older, they spend more and more time alone or with other peers in unsupervised settings, and both age-segregation and lack of adult supervision have been related to higher levels of substance abuse and deviance, including greater alcohol consumption. “Hanging out” with friends in unstructured, unsupervised contexts is generally related to negative outcomes, while spending time with others in adult-sanctioned, structured contexts is generally related to positive outcomes (e.g., Osgood, 1998; Osgood et al., 1996).

A particularly vulnerable time for youth is the after-school period, 3:00 to 6:00 p.m. This time is especially likely to be unsupervised as adolescents get older and parents believe that it is “safe” to leave them at home unattended. Youth who participate in after-school programs, such as sports, clubs, library-based activities, and youth-serving organizations are less likely to use alcohol than nonparticipants (Eccles and Barber, 1999). The same point about age segregation and lack of supervision applies to adolescents' attendance at unchaperoned parties and other activities. It is not uncommon for caring parents to decide to host an all-night party with alcohol for their teenage children, taking the car keys from the guests as they arrive, on the theory that it is safer to allow drinking at home rather than to forbid it and have teens drink and drive. Individuals or organizations that host and support such events are providing opportunities that enable adolescents to drink to excess. Not surprisingly, having parents who sanction alcohol use (even in “controlled” settings) is related to heavier drinking among adolescents (Barnes et al., 1995; Peterson et al., 1994).

By and large, adolescents are even segregated by age in the workplace. Adolescents who work for pay are often employed in fast-food and similar jobs in which most of their coworkers are other adolescents (Mortimer et al., 1992). It is not uncommon for a 17-year-old to be managing a fast-food establishment and supervising 15- and 16-year-olds. Given this situation, it may not be surprising that part-time work during adolescence is positively related to involvement in drugs, alcohol, and other deviant behaviors (e.g., Bachman and Schulenberg, 1993; Greenberger and Steinberg, 1986; Steinberg et al., 1993).

The place in which adolescents are most segregated is likely to be at residential colleges. Although less than one-quarter of college students are in such settings, student-segregated apartments or college residence halls provide the conditions under which binge drinking is likely to occur: cultural norms that support drinking, little supervision by any adults, and peers who are likely to be heavily involved in drinking. In a recent study, Cook and Moore (2001) found support that college students are more likely to engage in drinking, especially heavy drinking, if they live in a dormitory than if they live off campus, even after controlling for other factors (such as age) that might explain this difference.

Social Setting

While adolescents are experiencing community-level influences related to the place of alcohol in our society, each adolescent is also making decisions about drinking within a particular social setting. Of particular importance with regard to social influences are adolescents' peers and friendship networks and their changing relationships with their parents. The effect of parents' and peers' alcohol consumption on adolescents' drinking patterns is both direct, through observation and modeling (Bandura, 1986) and indirect, through its influence on alcohol-related expectancies and attitudes (see Kuther, 2002, for a review).