A Multi-method Etiological Assessment of Alcohol-related Sexual Victimization and Consequences in First-year College Women

Open Access
Scaglione, Nichole Marie
Graduate Program:
Biobehavioral Health
Doctor of Philosophy
Document Type:
Date of Defense:
April 17, 2015
Committee Members:
  • Robert James Turrisi, Dissertation Advisor
  • Robert James Turrisi, Committee Chair
  • Michael John Cleveland, Committee Member
  • Laura Klein, Committee Member
  • Patricia Barthalow Koch, Committee Member
  • Margaret Ann Lorah, Committee Member
  • College student drinking
  • sexual assault
  • consequences
  • victimization prevention
Background: Alcohol-related sexual victimization and consequences (AViC) disproportionately affect first-year college women in the U.S. Heavy drinking and social factors typical of the college context have been linked to increased AViC risk, while the use of drinking-related and social protective behaviors have been shown to decrease risk. However, there is limited work simultaneously examining these behaviors, specifically at the event-level. Objective: The current study examined the effects of alcohol use, drinking protective behaviors, social protective behaviors, and contextual risk factors on AViC at the global level, using a prospective longitudinal design (Aim 1) and at the event-level using daily diary data (Aim 2). Aim 3 utilized ecological momentary assessment (EMA) to examine the processes (via intentions and willingness) that influence decisions to drink, use protective behaviors, or engage in contextual risk on a given day. Methods: A random sample of 235 first-year female drinkers completed web-based assessments at the beginning (baseline) and end (3-month follow-up) of their first semester of college (Aim 1). Two-thirds of participants were randomized to an EMA protocol, which included 3-5 short cell phone-based surveys each day for 14 days (Aims 2 & 3). Hypotheses were tested using path analysis (Aims 1 and 2) and hierarchical linear modeling (Aim 3). Results: At the global level, typical weekend drinking was positively associated with alcohol-related victimization, but not consequences. This association weakened as individuals used more protective behaviors and more frequently drank in certain contexts (e.g., at parties; with friends). At the event-level, both estimated blood alcohol concentration (eBAC) and variability in eBAC (averaged across individual drinking occasions) were associated with increased AViC. Drinking protective behavior use moderated these effects; however, social protective behavior use did not. Contextual factors also moderated the associations between event-level eBAC and AViC, such that for individuals who frequently engaged in sexual behavior during/after drinking, as their drinking and variability in drinking increased, so did their risk for AViC. Aim 3 analyses revealed individuals achieved higher eBACs, used more protective behaviors and engaged in greater contextual risk when they had greater intentions and were more willing to do so (across drinking occasions). The effects of willingness and intentions on drinking, protective behavior use, and contextual risk exposure varied within and across days. For example, women engaged in a wider variety of drinking contexts on days when their context intentions were higher than their own mean, and women used more social protective behaviors on days when their willingness to do so increased throughout the day. Implications: The current study is among the first to simultaneously examine drinking, protective behavior use, and context as predictors of AViC at multiple levels (e.g., global vs. daily). Findings suggest harm-reduction alcohol interventions remain a useful tool in reducing AViC, but that their efficacy might be enhanced by also accounting for daily variability in drinking and by promoting the use of both drinking and social protective behaviors. Momentary examination of decision-making processes revealed that intentions and willingness might influence behavior at different levels, challenging behavioral theories that assume global associations.