Keeping your balance: freedom and regulation in female university students' drinking practices.

Binge drinking is a focus for concerns about young women’s alcohol consumption at university. Twenty females, all regular binge drinkers, were interviewed individually and in focus groups to explore alcohol beliefs and exposure to harm. Four themes were identified in a thematic analysis. Alcohol use was associated with freedom but regulated by group norms. Drinking to excess was stigmatized as an abuse of freedom, yet the threshold for excess was very high. The drug effects of alcohol were enjoyed, with drinking harms managed through trivialization. As part of a problem of imbalance, peer groups must be part of the solution.

A young person's game: immersion and distancing in bar work.

Previous research indicates that bar workers report high levels of alcohol consumption, but the bar work experience itself has been little studied as a means to understand health threats associated with this job role. The subjective experience and meaning of bar work was explored in this study by interviewing current and ex-bar workers from a district in an Irish city that had a high density of bars and busy tourism industry. A total of 12 participants took part in focus groups (FGs) and seven in individual interviews. Four themes were identified in a thematic analysis. The central depiction of bar work was of an initial immersion in an intensive lifestyle characterised by heavy drinking, with subsequent distancing from the extremes of the lifestyle. The participants affiliated strongly with the bar work occupational identity, which included alcohol use in group scenarios for drinking during work, after work and on time off. The bar work lifestyle was most intense in the ‘superpub’ environment, characterised by permissive staff drinking norms and reported stress. Although an important identity, bar work was ultimately a transient role. The findings are considered in relation to research on occupation-specific stress and alcohol use, social identity and developmental needs in young adulthood

Young people, alcohol and sex: what’s consent got to do with it? Exploring how attitudes to alcohol impact on judgements about consent to sexual activity: a qualitative study of university students.

This qualitative study explores the intersection of university students’ attitudes to alcohol use and consent to engage in sexual activity. The study was carried out by researchers at the School of Psychology, National University of Ireland, Galway, commissioned by Rape Crisis Network Ireland (RCNI), between March and December, 2013. This report describes: • The background to the study • The two qualitative methodologies used to collect and analyse data • The findings that arose from student reactions to hypothetical scenarios of non-consenting sexual activity, and • Discusses the findings in respect of the scope to support change in attitudes to alcohol use and consent. One of the key findings in the extensive RCNI Rape and Justice in Ireland report (Hanley et al., 2009) was the high rate of co-occurrence of heavy drinking with rape, by perpetrators and / or victims. This finding led RCNI to develop a year-long campaign in 2012, titled Calling Time on Sexual Violence and Alcohol. The current study builds on this work to address the links that exist between sexual violence and alcohol use. Internationally, it is recognised that extreme intoxication is a component of how the public understand sexual coercion and rape. For instance, this link underpins a ‘double standard’ attitude, whereby victims are attributed more responsibility if they had been drinking while perpetrators are often perceived as less responsible (Abbey, 2008). Studies of university student attitudes to alcohol use and non-consenting sexual encounters are not available in the Irish context, so relevant work from other countries will be cited in introducing this study. One reference point in the existing research literature is that of stereotypical rape myths (Ryan, 2011). These myths rely on attitudes and social scripts that support a network of fixed, false beliefs about sexual violence. Such rape myths are linked to the stigmatisation of victims by others. They are also associated with self-stigma, as many women who have been forced to have sex do not label the experience of rape, due to their own internalised expectations for what rape entails (Littleton et al., 2006). Thus, a victim who has been drinking may be less likely to label sexual violence as rape, in the mistaken belief that he or she shares responsibility for the assault. It is not just through rape-specific expectations that preconceptions and stereotypes inform attitudes to non-consenting sex. Berntson et al. (2013) take a broader view on how college students use scripts and pre-existing expectations to make sense of their relationship experiences. For them, relationships and sexual activity are interpreted through interpersonal sexual scripts that are shared among peers. Berntson et al. suggest that women are more likely to view their sexual activity within a communicative, relationship-based script. They contrast this with the traditional male preference for a recreational script for ‘no strings’ sex. This picture reflects long-standing cultural norms, in which men and women may be pursuing different, potentially conflicting objectives through sexual activity. It should be noted that gender role differences in expectations for sexual activity may now be changing. According to U.S. research, recreational sexual scripts have gained traction among young adults as an acceptable option for both sexes. This has been seen in the emergence of the ‘hook up’ culture. Hooking up refers to engaging in sexual behaviours without a pre-existing romantic relationship (Downing-Matibag & Geisinger, 2009). This might include sexual intercourse, but a hook up can also include or be restricted to oral sex, sexual touching, or masturbation. It is at this point that it becomes essential to consider the intersection between attitudes to sex and the impact that alcohol use has for sexual expression among young adults. Alcohol use has been identified as a critical issue for the well-being of young adults who take part in hook ups. In one recent survey of U.S. students, Thomson Ross et al. (2011) found that non-consenting sex was strongly associated with binge drinking and reports of harms arising from alcohol consumption. The link between drinking and non-consenting sex is especially relevant in an Irish context, as, quite apart from the emergence of a hook up culture, alcohol use is a dominant feature of socialising among young adults. For instance, a comparative study of 21 countries established that Irish university students exhibited one of the highest rate of drinking internationally (94%) (Dantzer et al., 2006). Dantzer et al. found no gender difference in the rate of non-drinking among Irish students, whereas in most countries rates of non-drinking are substantially higher among females than males. Ireland is one of several European countries with particularly high rates of alcohol consumption, along with Denmark, England, Scotland, Wales, and the Netherlands (Dantzer et al., 2006). All of these countries have high rates of binge drinking as well, a style of drinking that involves the consumption of large amounts of alcohol within a short period. There is by now little doubt that binge drinking is associated with considerably elevated risks of exposure to alcohol-related harms. These span the physical domain (e.g., injury, blackouts), psychological harms (e.g., lower quality of life, alcohol dependence), and social harms (e.g., higher rates of public disorder convictions, lower academic performance) (Kypri et al., 2009). Following repeated exposure to harms among peer networks, negative events such as a memory blackout or interpersonal conflict may become normalised. It may be the case that these adverse outcomes become accepted as the cost of accommodating heavy drinking as an integral part of the university experience. The degree to which alcohol-related harms such as non-consenting sex, rape, and sexual assault have been normalised is as yet unstudied in the Irish context

How do individuals develop alcohol use disorder after bariatric surgery? A grounded theory exploration.

BACKGROUND: Bariatric surgery is the most effective treatment for severe obesity. However, following Roux-en-Y gastric bypass (RYGB) surgery, a small minority of patients develop new-onset alcohol use disorder (AUD), the aetiology of which is poorly understood. AIM: The aim is to construct a theory to explain the development of AUD among a sample of individuals who reported problematic drinking following RYGB. METHOD: Semi-structured interviews were conducted with eight RYGB patients diagnosed with AUD attending a multi-disciplinary outpatient weight management service at a public hospital in the Republic of Ireland. A constructivist grounded theory methodology was used to analyse interview transcripts. RESULTS: Participants' main concern was identified as 'unresolved psychological issues' which were managed by 'external coping mechanisms', namely, 'eating to cope'. After RYGB, comfort eating was no longer possible to the same extent. Following a 'honeymoon period', participants' need for an external coping mechanism resurfaced. 'Filling the void' provides a framework to explain how participants managed the symptoms of their unresolved psychological issues through 'behavioural substitution', that is, drinking alcohol instead of eating. CONCLUSION: The theoretical framework of 'filling the void' adds to contemporary research that conceptualises AUD behavioural substitution as 'addiction transfer' by describing the process by which the phenomenon occurs as well as the characteristics of participants. The clinical implication of this research is to advocate for a reshaping of treatment of RYGB patients, with increased psychological input following surgery

A review of harm reduction approaches in Ireland and evidence from the international literature.

This report examines international literature on harm reduction and also presents primary research in health services in Ireland on approaches to harm reduction. The aim of harm reduction efforts is to minimise the risks stemming from shared use of drug-use paraphernalia, such as needle exchange programmes. One of the criticisms of Irish drug services is that the restricted opening hours and limited number of exchange services may contribute to continued sharing of needles among drug users. The report points out that other non-injecting paraphernalia such as spoons are also associated with the risk of contracting diseases, yet services do not as yet focus on them. The report notes that specific risk factors that contribute to risky drug practices include youth, a shorter injecting history, confinement to prison, homelessness and being involved in a sexual relationship with another intravenous drug user. The report suggests that harm reduction practices can be introduced into a prison population without a subsequent increase in drug consumption rates. The provision of consumption rooms and the prescription of heroin are also discussed, with the report noting that legislation would have to altered to implement these new strategies

Using vignette methodology to study comfort with consensual and nonconsensual depictions of pornography content

Spanking, whipping, and choking are examples of aggressive behaviours that can be performed in consensual sexual encounters. However, within the pornography research literature, such behaviours are often perceived as being nonconsensual, categorized as “violent,” and argued to predict sexual aggression. Viewing nonconsensual pornography may be associated with negative attitudes toward consent; however, viewing consensual pornography that features typically violent behavior may not. In this study, we sought to more clearly distinguish between consensual and nonconsensual pornography depictions by using vignettes to examine individuals’ consent attitudes in relation to these pornographic vignettes. We also sought to assess the hypothesis that more frequent pornography engagement will be associated with greater comfort with the nonconsensual vignettes. A series of pornography vignettes were developed by the researchers and categorized by a group of sexual consent experts as “consensual” or “nonconsensual” vignettes during a three-round Delphi study. The finalized vignettes were administered to a convenience sample of Irish university students (n = 1,121), who also answered questions regarding their attitudes toward consent and frequency of pornography engagement. More frequent pornography engagement was not associated with greater comfort with the nonconsensual vignettes. Greater comfort with the nonconsensual pornography vignettes was negatively associated with attitudes toward establishing consent and the endorsement of sexual consent norms.peer-reviewed2021-05-1