Decision Making Process in Alcohol Use among Youth

The persistence of alcohol use among youth when the harmful effects are well known constitutes a major puzzle for researchers. This paper reports findings from two studies exploring the rational, cost-benefit decision making processes that youth engage in when deciding to take up alcohol use. The descriptive Multi-Attribute Utility (MAU) model was used to examine whether the perceived consequences of alcohol use were associated with alcohol usage. This model allows for a detailed investigation of the impact of perceived alcohol-related consequences on the decision to use alcohol, and includes a momentary salience parameter to incorporate proximal influences. Participants' past month alcohol use and their perceived consequences of alcohol usage were assessed.

Data collected for Study 1 were from the first year of a 2-year school-based study among 1157 middle students in Southern California. Data described in Study 2 are from a cross-sectional study with 441 undergraduate students at a university in Southern California. Results from both studies are consistent, in that there are significant differences in the mean standardized MAU scores between those who reported past month alcohol use and those who had not (F(1, 1054) = 22.1 (p = .000); and F(1, 306) = 22.00 (p = .000) respectively). The adjusted odds ratio of alcohol use was 1.48 (95% CI= 1.20-1.81) for study 1 and was 1.96 (95% CI= 1.43-2.68) for study 2, indicating that one standard deviation unit increase in total MAU scores is associated with a 48% or 96% increased likelihood of past month alcohol use respectively.