Harmful drinking in young adults contributes to a wide variety of consequences spanning all aspects of health.  High school students, despite not being old enough to purchase alcoholic beverages, may frequently participate in risky forms of alcohol consumption.  The ubiquity of alcohol use in college-aged populations is well documented, presenting many public health issues related to the demographic.  When treating problematic alcohol use in students, many intervention designs have been utilized.  This study presents a meta-analysis of alcohol use interventions which target the alcohol expectancies of students.

The meta-analysis used a total of 23 alcohol expectancy challenge studies which met the following criteria: ample data for calculating alcohol consumption expectancy effect sizes, randomized control trial design, and published prior to August of 2020.  These studies were collected via electronic database literature searches in PubMed, ERIC, PsycInfo, and Medline.  Variables within the analysis were coded as either study characteristics, intervention characteristics, or sociodemographic characteristics.  The overall quality of each individual study was evaluated according to the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.  The following common outcome variables were used for the meta-analysis, chosen according to prevalence and availability: alcohol consumption, global alcohol expectancies, sexual enhancement expectancies, sociability expectancies, tension reduction expectancies, liquid courage expectancies, cognitive consequences expectancies, risk aggression expectancies, and negative self-perception expectancies.  Data analysis was performed using a battery tests found within the Comprehensive Meta-Analysis software package.

Results of the analysis included descriptive statistics of the entire data pool, reporting the total number of participants to be 4122, an average of 19, and a gender-breakdown of 57% male.  Effect size analysis of the data revealed positive associations between expectancy challenge interventions and decreased alcohol consumption and global alcohol expectancies, particularly in high school and college students.  This effect was noted to be small, however. Analysis of the remaining outcome variables found expectancy challenges to have a significant effect on social expectancies, tension reduction expectancies, liquid courage expectancies, and risk aggression expectancies. The authors noted their findings mirrored that of a previous meta-analysis published in 2012. 

Takeaway: expectancy challenge interventions for the treatment of problematic alcohol use continue to decrease alcohol use and global expectancies with a small effect size.  The research team discussed this finding as being due to the often brief manner in which the interventions are administered.  Expectancy challenge interventions may be usefully implemented in alcohol treatment programs alongside other evidence-based techniques.

Gesualdo C, Pinquart M. Expectancy challenge interventions to reduce alcohol consumption among high school and college students: A meta-analysis. Psychology of Addictive Behaviors. Published online 2021; doi:10.1037/adb0000732