Examining the role of abstainer prototype favorability as a mediator of the abstainer-norms-drinking-behavior relationship.

Peer influence is associated with risky health behaviors, such as alcohol and other substance use (e.g., Maxwell, 2002; Santor, Messevey, & Kusumakar, 2000). For example, adolescents’ perceptions about peers’ risk behavior, or descriptive norms, have been shown to predict adolescent alcohol use (e.g., Borsari & Carey, 2001; Elek, Miller-Day, & Hecht, 2006) such that if adolescents or young adults believe that most of their peers drink alcohol, they are more likely to drink alcohol as well. Additional research has indicated reciprocal influences between drinking and norms (Lee, Geisner, Patrick, & Neighbors, 2010; Wardell & Read, 2013) as well as selection effects whereby individuals choose and keep friends whose behavior and beliefs are similar to their own (e.g., Burk, van der Vorst, Kerr, & Stattin, 2011; Mundt, Mercken, & Zakletskaia, 2012; McCabe, Schulenberg, Johnston et al., 2005). Findings suggest more favorable perceptions of the social image of a typical drinker, or prototypes, influence individuals decisions to drink (Gerrard, Gibbons, Houlihan, Pomery, & Stock, 2008). The importance of norm perceptions and prototypes indicate that individual's cognitions about their peers play a important role in determining risk behavior. This assumption is in line with research indicating that believing that more of one's peers use alcohol predicts more favorable prototypes of the alcohol user (Litt & Stock, 2011; Teunnisen et al., 2014). However, it is unclear if this same relationship would hold when considering abstainer (i.e. people who don't use alcohol) cognitions. The present study aims to determine whether perceptions of peer abstention from alcohol predict alcohol consumption, and whether this relationship is mediated by the favorability of risk images of the type of person who abstains from alcohol. Alcohol use during adolescence typically occurs in the context of peers (e.g., Barnes, Hoffman, Welte, Farrell, & Dintcheff, 2006; Ingram, Patchin, Huebner, McCluskey, & Bynum, 2007). In fact, several major reviews of alcohol use norms have indicated that adolescents’ beliefs about their peers’ alcohol use is significantly related to their own use (Borsari & Carey, 2001; Lewis & Neighbors, 2006), and as such, are important to include in models of health risk behavior (e.g., Rivis & Sheeran, 2003; Gerrard et al., 2008). An additional conceptualization of social influence that has been identified as being of particular relevance to adolescent health behavior are prototypes, or risk images. Both sources of social influence, namely descriptive norms (perceptions of other's behavior) and prototypes are included in the prototype/willingness model (PWM) of adolescent health-risk behavior (Gibbons, Gerrard, & Lane, 2003). The PWM combines elements of the Theory of Reasoned Action (Fishbein & Azjen, 1975), with a more heuristic approach to decision making (Gibbons et al., 2003). The PWM is based on three primary assumptions. First, for young people, health risk behaviors are volitional, but not necessarily rational or intentional. This discrepancy between intentions and behavior is not necessarily due to a lack of awareness of their intentions, but instead it is a reflection of the nature of risk behavior as being a reaction to risk-conducive and socially-based environments (Gibbons, Gerrard, Blanton, Russell, 1998). Second, health-risk behaviors, such as alcohol use, are social events for adolescents, as they rarely engage in such behaviors alone (Gibbons et al., 1998). Finally, these risk behaviors have clear social images associated with them that likely derive from the behavior of their peers and others in their social environments (Gibbons et al., 2003). Although originally developed for adolescent populations (Gibbons & Gerrard, 1998; Gibbons et al., 2003), several recent studies have indicated that the PWM is also applicable for young adults, including college students (Litt, Lewis, Patrick, et al., 2014; van Lettow, Vermunt, de Vries et al., 2013; Zimmerman & Sieverding, 2010). A unique construct within the PWM is the risk prototype, defined as the image of the type of person who engages in a risk behavior. To date, support for prototype influence on behavior has been obtained primarily in relation to risk behavior, such as heavy drinking and has indicated that favorable drinker prototypes predicted increased alcohol consumption among adolescents (Andrews, Hampson, Barckley, Gerrard, & Gibbons, 2008; Blanton et al., 1997; Gerrard et al., 2002; Spijkerman, Van Den Eijenden, Overbeek, & Engels, 2007). Distinct from prototypes, injunctive norms (i.e., perceived approval of a behavior by others) and descriptive norms (perceived quantity or frequency of a behavior by others)(Borsari & Carey, 2001) are also central to the PWM (Gerrard et al., 2008; Litt & Stock, 2011). A wealth of literature has demonstrated that having a drinking conducive peer group predicts greater alcohol use by adolescents (Borsari & Carey, 2001; Lewis & Neighbors, 2006). In contrast to the work looking at risk cognitions, few studies have investigated the impact of abstainer cognitions, namely abstainer norms (e.g. how many of one's peers are perceived to abstain from alcohol use) or abstainer prototypes (e.g. the type of person who abstains from alcohol use). When assessing descriptive normative perceptions for alcohol use, participants are generally asked to estimate the percent of students who drink or the perceived typical students’ quantity or frequency of alcohol use. Research has shown that abstaining or light drinking students overestimate peer drinking behavior (Lewis, Lee, Rees, & Oster-Aaland, 2008) and that interventions aimed to reduce normative perceptions among abstaining and light drinkers to be efficacious (Neighbors et al., 2011). Little research has examined descriptive normative perceptions for the typical student who does not drink. Studies have shown that adolescents hold mental representations of the type of person abstains from engaging in health risk behaviors (Gerrard et al., 2002; Wills, Gibbons, Gerrard, Murry, & Brody, 2003). In fact, abstainer prototypes have been shown to predict behavioral willingness to use alcohol as strongly as user prototypes in adolescence (Rivis et al., 2006). In a series of studies that examined the relationship between adolescents’ images of typical drinkers and non-drinkers and their subsequent alcohol consumption, Gerrard and colleagues (2002) concluded that abstainer images primarily exert an inhibiting effect on risk behavior: wanting to acquire characteristics of the positive image of non-drinkers inhibits willingness to drink among young people. Research has indicated that holding more favorable prototypes of abstainers is directly and positively related to greater willingness to refuse substances (Wills, Gibbons, Gerrard, Murry, & Brody, 2003). Other cross-sectional and longitudinal studies suggest that positive abstainer prototypes are related to lower willingness and intentions to drink, and lower self-reported alcohol consumption (Gerrard et al., 2002; Zimmermann & Sieverding, 2010; 2011) among adolescents and young adults respectively. Together, there is growing evidence that abstainer prototypes may have a significant impact on decisions to engage in alcohol use. According to the PWM, there is an important link between peers' behaviors (i.e., peer norms) and prototypes (Gibbons et al., 2003). This link suggests that peer norms may play a key role in the formation of prototypes. This assumption is in line with longitudinal research showing that affiliation with drinking peers and higher perceived drinking norms of friends are related to the development of more favorable drinker prototypes (Blanton et al., 1997; Gerrard et al., 1999; Ouellette et al., 1999) and experimental research that indicates that believing that more of one's peers use alcohol predicts more favorable prototypes of the alcohol user (Litt & Stock, 2011; Teunnisen, Spijkermen et al., 2014). However, it is unclear if this same relationship would hold when looking at abstainer cognitions, specifically abstainer prototype favorability and perceived abstainer norms. To our knowledge, no study to date has examined whether the relationship between alcohol abstainer norms and behavior is mediated by abstainer prototypes. The present study aims to elucidate the relationship between abstainer descriptive norms, abstainer prototypes, and alcohol use. Specifically, it is hypothesized that the relationship between abstainer norms and alcohol consumption will be mediated by abstainer prototypes such that favorable prototypes for alcohol abstainers will be positively associated with perceived abstainer norms, which in turn will be negatively associated with alcohol consumption.