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Compared to college women, college men face elevated risks for problematic drinking and negative alcohol-related consequences. These risks highlight the critical need to investigate gender issues and risk factors contributing to intoxication and related problems among men. Theoretical models suggest that conforming to masculine norms or the beliefs and expectations of what it means to be a man, may help explain patterns of problematic drinking among men. The current study advances the literature by investigating the association between masculine norms, drinking to intoxication, and alcohol-related consequences among 776 undergraduate males after taking into account the importance of fraternity status and perceived peer norms. Results indicate that fraternity status and higher perceived peer norms regarding drinking increased the risks of getting drunk and experiencing alcohol-related consequences. Specifically, the masculine norms of being a “playboy”, risk-taking, and winning were risk factors of drinking to intoxication; while, being a “playboy”, risk-taking, and self-reliance increased the risks of alcohol-related problems. Primacy of work and heterosexual presentation were two masculine norms that were protective of drinking to intoxication. Our findings contribute to important future considerations for prevention, clinical interventions, and public-health implications in college settings.
Problematic drinking in United States colleges is an ongoing public health problem with many adverse consequences (Hingson, Heeren, Winter & Weschler, 2005). Approximately 80% of all college students consume some alcohol (80%), and of these, about half drink to become intoxicated (O'Malley & Johnston, 2002). A survey of 10 universities revealed that about 54% of undergraduate drinkers reported getting drunk at least once weekly (DuRant, et al., 2008). In particular, binge drinking (5 drinks in a 2-h session for men, 4 drinks in a 2-h session for women) has important public-health implications, as it increases the risk of engaging in risky sexual behavior as well as alcohol-related unintentional injuries and deaths (Hingson, Heeren, & Zakocs, 2002).
Important gender differences in alcohol use and abuse among college populations have been noted, with a higher prevalence among men of binge drinking and problems related to heavy drinking. Specifically, male college students report more heavy-drinking days (Seo & Li, 2009) and more alcohol-related problems than do women (Slutske, 2005), including risky sexual behavior (Wells et al., 2010). Furthermore, prevalence rates of alcohol-use disorders are twice as high for young adult men as compared to women (Grant et al., 2004). Compared to college women, college men face elevated risks for problematic drinking and negative alcohol-related consequences. These risks highlight the critical need to investigate gender issues and risk factors contributing to intoxication and related problems among men.
According to gender theorists, masculine norms play a significant role in contributing to problematic drinking in men (Courtenay, 2000; Lemle & Mishkind, 1989; Mahalik et al., 2003). Masculine norms are socially constructed beliefs, values, and expectations of what it means to be a man (Mahalik et al., 2003) and often dictate rules that men are expected to follow in order to demonstrate manliness. Salient masculine norms in contemporary U.S. have been identified as: striving to win at all costs (winning), sexual prowess (being a playboy), controlling one’s emotions (emotional control), engaging in risk-taking behaviors (risk-taking), inclination towards physical aggression (violence), asserting influence over situations (dominance), proclivity towards independence (self-reliance), regarding work as the main priority in life (primacy of work), controlling women (power over women), aversion to being perceived by others as being gay (heterosexual presentation), and the desire to be important in society (pursuit of status) (Mahalik et al., 2003). Men may adopt masculine scripts such as risk-taking, emotional restraint, power over women, and violence as a way to establish their masculinity (Iwamoto, 2010; Mahalik et al., 2003). Lemle and Mishkind’s (1989) review of research concerning masculinity and its interplay with alcohol research documented that in the United States, social drinking is viewed as a “cultural symbol of manliness” (p. 213). The ready accessibility of alcohol at collegiate sporting events and alcohol advertisements in the U.S. and other countries, demonstrates the cultural association between masculinity and alcohol consumption.
Theoretical models suggest that conforming to masculine norms can either increase the risk or protect against negative consequences related to alcohol consumption (Courtenay, 2000; Levant & Richmond, 2007). Masculine norms such as self-reliance or emotional control may protect against problematic drinking patterns because they are consistent with self-control and potentially regulate alcohol intake. Primacy of work may also hypothetically reduce drinking, as those who endorse this norm may not engage in problematic drinking for fear that it may affect their work performance (Iwamoto, 2010). On the other hand, the masculine norms of willingness to take risks and the values placed on power and stamina may increase the risk of drinking to intoxication because they reflect one’s perceived ability to consume and tolerate increasing amounts of alcohol (Young et al., 2005). In a recent study, 68% of male college students equated the ability to physically consume and tolerate large amounts of alcohol without adverse reactions as being characteristic of “masculine” behavior (Peralta, 2007). Conversely, the inability to consume and hold down large amounts of alcohol was perceived as a sign of weakness, feminine behavior, or homosexuality(Gough & Edwards, 1998). For example, drinking games often focus on how fast one can consume alcohol (speed), the amount of consumption at one setting (quantity), and how much one can “hold” (tolerance) (Lemle & Mishkind, 1989). According to masculine norms theory (Courtenay, 2000; Levant & Richmond, 2007), men who are able to display all these attributes are deemed manly, and those who are unable to drink “up” to this standard are considered impotent or less of a man (Lemle & Mishkind, 1989). In fact one study (Liu & Iwamoto, 2007) found that specific masculine norms such as less emotional control and risk-taking were associated with greater alcohol consumption among Asian American college students. However, it is unclear how these norms operate in relation to drinking to intoxication and alcohol-related problems when other risk factors such as fraternity status and perceived peer norms of alcohol consumption are accounted for.
Two well-established risk factors of drinking to intoxication and alcohol-related consequences among men are fraternity status and perceived peer norms (or the individual’s perception of how many drinks their peer-group members consume on a daily basis) (Capone,Wood, Borsari, & Laird, 2007). Fraternity members tend to drink more alcoholic beverages on a typical drinking day, engage in higher rates of problematic drinking and report more alcohol-related problems when compared to non-fraternity members (Scott-Sheldon, Carey, & Carey, 2008). In addition, college students often overestimate their peer’s drinking and believe their drinking is about equal to or greater than their peers. These normative beliefs are especially salient among men who engage in problematic drinking (Borsari & Carey, 2001; 2003; Jackson 2008).
The current study advances the literature by investigating the association between masculine norms, drinking to intoxication and alcohol-related consequences among college men by taking into account the importance of fraternity status and perceived peer norms of alcohol consumption. In particular, we are interested in examining the unique effects of masculine norms on drinking outcomes while controlling for well-established risk factors, including fraternity status (Capone, et al., 2007; Park, Sher, & Krull, 2008) and perceived peer norms of alcohol consumption (Borsari, Murphy, & Carey, 2007; Colby, Colby, & Raymond, 2009). Based on theory (Lemle & Mishkind, 1989; Courtney, 2001) and research (Liu & Iwamoto, 2007), we hypothesize that masculine norms will have a distinct influence on drinking to intoxication and to alcohol-related problems beyond the effects of fraternity status and perceived peer norms. Furthermore, the associations will be complex, such that some masculine norms are protective, while others heighten the risk of drinking to intoxication and alcohol-related problems.
Participants were 776 undergraduate men from a large public university located in Southern California. The average age of the men was 20.24 (SD = 2.16), 30% were seniors (4th year in college), 27% juniors (3rd year in college), 21% sophomores (second year in college), and 30% freshmen (1st year in college). Greek affiliated individuals or individuals who “planned to join a fraternity” included 20% of the sample. The largest percentage of participants identified as Asian American (63%), followed by Caucasians (19%), Latino (9%), Other 4%), Bi-racial (4%), and African American (1%).
The demographic information included age, race/ethnicity (i.e., participants were asked “what is your race/ethnicity group?”), and class standing (i.e., freshman, sophomore, junior, senior).
In order to measure the frequency of drinking to intoxication, participants were asked, “During the last 3 months how many times did you get drunk (not just a little high) on alcohol?” (Collins, Parks, & Marlatt, 1985). Participants wrote in their own responses to provide more accurate frequency counts.
The Rutgers Alcohol Problems Index examines the frequency an individual experiences alcohol-related problems or negative consequences while or because of drinking. The instrument measures the occurrence of 23 negative consequences and response options on a five-point Likert scale: 0 (never) to 4 (10 or more times). The total score was calculated by the sum of the individual items. The higher the score, the higher the number of consequences a participant reported while drinking alcohol. Sample items include “Got into fights with other people” or “Felt that you had a problem with alcohol.” The reliability estimate for the RAPI in the current study was α =.94.
One demographic item assessed for Greek/Fraternity involvement. Participants responded to the question, “Do you belong to a fraternity?” If “Yes” or “plan to” the response was coded (1); a “no” response was coded 0.
The perceived peer norms instrument is based on the Daily Drinking Questionnaire (DDQ; Collins et al., 1985), which evaluates the individual’s perception of how many drinks he believed his peers consumed on a daily basis in a typical week. The composite score of perceived peer norms is calculated by averaging the perceived weekly consumption for women and men in the individual’s peer group.
The CMNI-46 (Parent & Moradi, 2009) is the brief version based on the original CMNI (Mahalik et al., 2003). The CMNI assesses an individual’s conformity to traditional and non-traditional masculine norms. It measures masculine norms that are common in masculinity literature and in American cultural beliefs and attitudes (Mahalik et al., 2003). The original CMNI consisted of 94 items and measured 11 masculine norms, including winning, emotional control, risk-taking, violence, power over women, playboy, self-reliance, primacy of work, dominance, pursuit of status, and heterosexual self-presentation. Sample items on the CMNI include “I would feel uncomfortable if someone thought I was gay” (heterosexual-presentation scale), “In general, I will do anything to win” (winning scale), and “If I could, I would frequently change sexual partners” (playboy scale). Items on this measure were scored on a four-point Likert-type scale, from 0 (strongly disagree) to 3 (strongly agree). Because of the length of the original CMNI, CMNI-46 was developed through a confirmatory factor-analytic study that reduced the length of the CMNI measure to about half, while still maintaining the original factor structure (Parent & Moradi, 2009). The internal consistency estimates of the CMNI-46 subscales were also good and ranged from α = .77 to .91. The results indicated that the CMNI-46 was theoretically consistent with the original CMNI measure. In the present study the internal consistency estimate for the CMNI-46 subscales ranged from α = .70 to .86.
Prior to collecting the data, the study was approved by the institution’s Institutional Review Board. Participants were recruited through a secure web-based survey from a large public university (N = 25,000) in Southern California. Only men were included in the current study. Two convenience sampling methods were used to obtain the sample. The first method, Experimetrix (n = 500), is an online forum in which students from all majors (in this particular university) can participate in experiments for extra credit. The other method included recruiting participants through various classrooms, in every major, using a link to the online survey. The classroom recruitment (n =276) procedure was used to obtain students from non-social-science-related fields, who are often heavily represented in Experimetrix. Incentives were different for participants recruited through Experimetrix versus classrooms. The Experimetrix participants received extra credit, while those who were recruited through classrooms had the option to enter a raffle to win one of five $50 gift cards. No differences were noted between participants recruited using either of the two methods in regards to response rate, drinking pattern, and masculine norms. Through these procedures, we collected 866 potential participants. We deemed participants ineligible if their survey packet had incomplete data on 75% of the measures (n = 66) or if they identified themselves as a graduate student (n = 24). The sample size was thus reduced to 776. Sample characteristics collected using both methods reflect the university’s population demographics.
Prior to conducting the analyses, distributions of the variables were inspected for collinearity and assumptions of normality. We examined the variance inflation factor (VIF) and Tolerance statistics, and used the criteria of VIF scores of greater than 10 and Tolerance score of less than .20 as indication of multicollinearity (Cohen, Cohen, West, & Aiken, 2003). The analysis revealed that the largest VIF score was 1.48, with a Tolerance value of .67, suggesting that there were no problems with multicollinearity. Next, we inspected the distribution of the outcome variables, drinking to intoxication and alcohol-related problems. The results revealed that drinking to intoxication (Skewness = 6.49) and alcohol-related problems (Skewness = 2.63) were skewed and there was overdispersion in the data, meaning that the variance was significantly greater than the mean (e.g., drinking to intoxication the variance = 25.37, mean = 2.21). This type of distribution is common for alcohol outcomes such as alcohol-related problems (Neal & Simons, 2007), especially in cases of count outcomes.
Negative binomial (NB) regression is an appropriate analytical procedure used for count or alcohol outcomes that are highly skewed and overdispersed (Lewis, Logan, & Neighbors, 2009; Neal & Simons, 2007). NB includes a random component that accounts for dispersion, thus resulting in more accurate standard errors for the regression coefficient (Elhai, Calhoun, & Ford, 2008), and allowing us to investigate the effects over the full distribution (Neal & Simons, 2007). Specifically, we selected NB over logistic-regression procedures because we were interested in investigating “how many times,” as opposed to “whether or not,” (logistic regression; Lewis et al., 2009) students have reported drinking to intoxication or experienced alcohol-related problems.
Little’s (1988) test of MCAR was used to determine if the data were missing completely at random. The findings suggested that the assumption of MCAR was met (p =. 46). Accordingly, we used full information maximum likelihood (FIML) procedures to handle missing data. Rather than inputting data for missing cases, FIML procedures use all of the available data to estimate the parameters in the model (Enders, 2001).
Correlations, means, standard deviations and range of scores are presented in Table 1. Participants reported getting intoxicated 2.21 times (SD = 5.04) during the previous three months, and 45% of the sample reported getting drunk at least once during that period. Participants also reported an average of 5.62 (SD = 9.27) alcohol-related problems during that same period. The correlation analysis suggested that masculine norms of winning (r = .14, p <.01), risk-taking (r = .20, p <.01), playboy (r = .25, p <.01), fraternity status (r = .25, p <.01), and perceived peer norms (r = .12, p <.01) were all positively related to drinking to intoxication, while emotional control (r = −.08, p <.05) and heterosexual presentation (r = −.07, p <.05) were negatively related. Fraternity status (r = .20, p <.01), perceived peer norms (r = .10, p <.01), and the masculine norms of risk-taking (r = 19, p <.01), power over women (r = .20, p <.01), playboy (r = .28, p <.01), self-reliance (r = .10, p < .01), and primacy of work (r = .09, p <.05) were associated with increased alcohol-related problems.
Results of the negative binomial regression of the drinking-to-intoxication model confirmed the first two hypotheses (Table 2). Men involved in a fraternity (IRR = 4.64, p <.001) and higher perceived peer norms (IRR = 1.01, p <.001) were positively associated to drinking to intoxication. The three masculine norms that were positively associated with drinking to intoxication were playboy (IRR = 1.21, p <.01), risk taking (IRR = 1.14, p <.001) and winning norms (IRR = 1.09, p <.001). Whereas primacy of work (IRR =.92, p <.001) and heterosexual presentation (IRR = .95, p <.01) appeared to be protective as evidenced by the inverse relationship with the criterion. In other words, men who endorsed masculine norms, such as ”being a playboy,” enjoy risky activities and strive to win at all cost, are more likely to drink to intoxication. In contrast, men who highly prioritized work and reported a strong aversion to being perceived by others as gay were found to be less likely to drink to intoxication.
The second negative binomial regression examined factors associated with alcohol-related problems (Table 2). Similar to the drinking-to-intoxication model, fraternity status (IRR = 3.06, p <.001) was significantly associated with alcohol-related problems. However, unlike the prior model, perceived peer norms was not significantly associated with alcohol-related problems The three masculine norms that increased risk of alcohol-related problems were being a “playboy” (IRR = 5.01, p <.001), risk-taking (IRR = 2.66, p <.001), and self-reliance (IRR= 3.12, p <.001). These results suggest that men who more highly endorse being a playboy and who more highly value risk-taking and self-reliance are at heightened risk of alcohol-related problems, whereas individuals who score higher in heterosexual presentation are at decreased risk.
While college-aged men consume more alcohol, report more heavy-drinking days, and report more problems consequent to their alcohol consumption than college-aged women (Sher & Rutledge, 2007; Geisner, Larimer, & Neighbors, 2004), little is known about the gender-specific factors that may contribute to higher alcohol consumption and related problems among the male population. This study highlights how distinct masculine norms are strongly associated to drinking to intoxication and alcohol-related problems, even after controlling for well-established risk factors, such as fraternity membership and perceived drinking norms.
As expected, fraternity involvement increased both the likelihood of drinking to intoxication and reporting more problems associated with alcohol consumption. Specifically, fraternity status was the most robust predictor in our drinking-to-intoxication and related-problems models. Our findings are consistent with prior studies documenting that fraternity status increases risk of drinking to intoxication, as alcohol is often used as “social lubrication” at many fraternity events (Borsari, Murphy & Barnett, 2007; Cashin et al., 1998). In addition, the Greek environment often fosters problematic drinking behaviors by contributing to a shared belief that heavy drinking is normative (Borsari & Carey, 1999).
Consistent with prior research, men who reported higher perceived peer norms were more likely to report drinking to intoxication but did not report more alcohol-related consequences (Wood, Nagoshi, & Dennis, 1992; Wood, Read, Palfai, & Stevenson, 2001). Similarly, studies have found the link between perceived norms and increased alcohol consumption but not with alcohol-related problems (Capone et al., 2007; Borsari & Carey, 2001). The convergence of such past research with our current findings supports the possibility of a different pathway whereby perceived peer norms indirectly increase the risk of alcohol-related problems. Specifically, perceived peer norms could predispose individuals to drink more, which in turn increase their vulnerability to problems (Borsari & Carey, 2001). These findings suggest that perceived norms need to be acknowledged when designing harm-reduction interventions to reduce alcohol consumption and to minimize harm that is related to alcohol consumption in college settings.
The unique and significant contribution of this study is the elucidation of the distinct relationship between masculine norms, problematic drinking, and related consequences. Consistent with masculine norms theory, distinct masculine norms such as being a “playboy”, risk-taking and winning were risk factors for drinking to intoxication, while risk-taking, being a “playboy,” and self-reliance also increased risk for alcohol-related problems. Consequently, it appears that men who have the desire to have multiple sexual partners (i.e., playboy), like to take risks, and are driven to win have a higher likelihood of engaging in problematic drinking. According to masculine norms theory (Levant, 1996), men may be striving to conform to traditionally perceived masculine norms in order to establish or demonstrate their manhood. In other words, in addition to being a “playboy” and taking risks, our study suggests that heavy drinking may also be perceived as a typically “masculine” behavior. Therefore, men who adhere to masculine norms are more likely to drink to intoxication and to experience alcohol-related problems.
The association between self-reliance and increased risk for alcohol-related problems is a surprising and interesting finding. While self-reliance or the proclivity towards independence may be a positive attribute in many cases, it may be that those who value self-reliance in the context of alcohol-related consequences, may be less likely to seek early intervention for their heavy drinking because it is believed that he/she can take care of the problem on their own. Therefore, self-reliance may be associated with greater alcohol-related consequences because help is not sought as problems accrue or as the severity of drinking worsens. Further research is needed to examine the associations between self-reliance, heavy-drinking behaviors, and alcohol-related consequences.
While some masculine norms may increase the risk of problematic drinking, others, such as primacy of work and heterosexual presentation (HP), appear to decrease the risk of drinking to intoxication. Primacy of work as a protective buffer makes theoretical sense given this factor is reflective of an individual’s high priority towards work (Mahalik et al., 2003). Men oriented towards high primacy of work may be less likely to engage in heavy drinking because drinking to get drunk might jeopardize their work or academic performance. In contrast, the relationship between heterosexual presentation and alcohol outcomes is not as clear. We found that those who endorsed HP were less likely to report drinking to intoxication and alcohol-related problems. Men with higher HP orientation may be concerned with managing how others perceive them: viz, their social appearance. In other words, higher HP norms may be protective, as the desire to present oneself as responsible or stable may discourage drinking-to-intoxication behavior. Future studies are warranted to clarify this finding.
Our research findings have important prevention, clinical and public-health implications. They suggest that including a masculine norms measure in screening and treatment planning would help to identify young men who are likely to engage in problem drinking (Iwamoto, 2010). Doing so would facilitate the identification of men who may be at greater risk for drinking to intoxication and for developing alcohol-related problems. Many college counseling centers include alcohol screening in their outreach programs followed by counseling treatment (Larimer & Cronce, 2002). Possible interventions could include increasing awareness around masculine norms and how they can predispose heavier drinking and related negative consequences.
The results of the present study should be considered in light of several important limitations. First, the current study utilized a cross-sectional design that limits the examination of possible casual relationships between masculinity norms and intoxication. Future studies utilizing longitudinal designs should investigate the role of masculine norms on drinking trajectories. It should also be noted that the data set was collected at one university and is thus not representative of all undergraduate males in the United States. Future investigations could also examine (1) the relation between masculine "risktaking" and garden-variety "impulsivity"; (2) higher base rates of drinking in homosexuals (see Talley, Sher & Littlefield, 2010: "Sexual orientation and substance use trajectories in emerging adulthood"); (3) the clear danger of being a "playboy," and its association to fraternity membership; (4) whether and how these "masculine norms" correspond to/interact with injunctive norms for being a college student; (5) cultural factors, and generalizability of this largely Asian-American sample to other racial/ethnic groups, and (6) what exactly "primacy of work" looks like or means in college males as opposed to others in the job force.
Despite these limitations, this study has considerable strengths and contributes to the literature. It is the first study to our knowledge to examine the relationship between multidimensional measures of masculine norms and drinking to intoxication and alcohol-related problems using a large sample of ethnically diverse men. Study findings demonstrated the complex nature of masculine norms on problem drinking and problems associated with excessive drinking. The findings have important implications for understanding individual differences among men and underscore the salience of masculine norms on problematic drinking.
This study was supported by the National Institute on Drug Abuse [5T32 DA-019426-06 & R01-DA018730]. The authors thank the reviewers for their insightful comments and helpful suggestions.
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