Understanding the Role of Cognitive Dissonance in Alcoholism

Alcohol-treatment-center-California

 

Part I: Defining the Problem

Alcohol, and often the over-consumption of alcoholic beverages, has become a highly debated issue in the United States. No matter if a person is under the legal drinking age of 21, of legal age, or even well into adulthood, the over-consumption of alcohol poses a serious threat not only to one’s personal health, but also to the health, safety, and well-being of others. According to Project Know, a website dedicated to educating readers about the dangers of alcohol and drug abuse, “50 percent of people aged 12 and over have consumed alcohol in the United States;” additionally, “approximately 10 to 15 million people in the United States can be classified as alcoholics” (Project Know, 2013). These staggering numbers truly reveal the accessibility of alcohol for nearly all ages, and also the abuse of the substance.

If one were to poll a high school or college student, their definition of over-consumption would likely differ from that of their parents. Indeed, most people generally do not have a true understanding of how over-consumption is defined. According to Project Know, “consuming two to three drinks in 60 minutes is enough to impair judgment” (P.N, 2013). In addition, if one consumes five drinks in one hour, the alcohol “can raise blood alcohol levels to 0.10 percent,” which is above the legal limit to drive. Yes, alcohol does affect each individual differently. And yes, men and women are affected differently when consuming alcohol. Ultimately, the United States defines binge drinking as five or more drinks for a man, and four or more drinks for a woman—within the span of two hours. So, coinciding with this definition, how common is this behavior? According to the Centers for Disease Control and Prevention (2012):

“One in six U.S. adults binge drinks about four times a month, consuming about eight drinks per binge. Although college students commonly binge drink, 70% of binge drinking episodes involve adults age 26 years and older. The prevalence of binge drinking among men is twice the prevalence among women. Binge drinkers are 14 times more likely to report alcohol-impaired driving than non-binge drinkers. About 90% of the alcohol consumed by youth under the age of 21 in the United States is in the form of binge drinks. More than half of the alcohol consumed by adults in the United States is in the form of binge drinks.”

As evidenced by these statistics from the CDC, the over-consumption of alcohol affects a broad range of people, young and old. Binge drinking not only affects these people at the time in which they over-consume, but also has negatively effects on their future health, mentally and physically, as well as on the health of people around them. Over-consumption of alcohol also can have detrimental effects on one’s spouse, significant other, and/or family. Abusing alcohol can lead to alcohol dependency, which can divide families, legally separate spouses, or create a physically abusive living environment for spouses and/or children. Over-consumption of alcohol can affect one’s performance at work, which can potentially lead to termination—this loss of a job can severely disrupt and affect the financial support system within a family. In addition to all of these potential negative effects resulting from binge drinking, the CDC also highlighted potential health problems resulting from over-consumption, such as “unintentional injuries (e.g., car crashes, falls, burns, drowning), intentional injuries (e.g., firearm injuries, sexual assault, domestic violence), alcohol poisoning, sexually transmitted diseases, children born with Fetal Alcohol Spectrum Disorders, high blood pressure, stroke, liver disease, and neurological damage.

Over-consumption of alcohol not only affects individuals and those close to them, but also society. According to the CDC, binge drinking cost the United States “$223.5 billion in 2006, or $1.90 a drink, from losses in productivity, health care, crime, and other expenses” (CDC, 2012). Furthermore, over-consumption of alcohol “cost federal, state, and local governments about 62 cents per drink in 2006, while federal and state income from taxes on alcohol totaled only about 12 cents per drink” (CDC, 2012). Ultimately, the over-consumption of alcohol is far too common, and has negative, drastic effects on individuals binge drinking, those close to them, and society as a whole.

Alcohol-abuse-on-the-rise-among-seniors-study-says

 

Part II: Root Causes

The Core Institute survey reports that 84.2% of college students consume alcohol. Alcohol is advertised to college students more than any other group in the United States. Alcohol consumption undoubtedly has held a consistent relationship with college students. In a campus setting, college students are constantly faced with pressures to drink. Most of this pressure comes from their peers and their desires to please them. It appears that a majority of college students fall victim to the consumption of alcohol due to the desire to “fit in.”

Our objective is to find the exact conditions under which college students are conforming and to determine the effects social influence has on self-efficacy. We will also explore whether injunctive or descriptive norms are more effective in promoting positive behavior change. Can implemented campus norms override social pressures? Researchers have found data suggesting that advertisement through the media will influence college students to consume alcohol. On the other hand, parental influence and campus guidelines can influence students to follow abstinence when it comes to drinking. Can peer influence be more effective in promoting behavior change than parental influence or advertisement? We will determine which influence is a stronger predicator on college student’s drinking behaviors. It appears that compliance-gaining techniques directly influence self-efficacy beliefs. What are the reasons behind this? Also, what misperceptions exist regarding college students’ beliefs of the amount of alcohol consumption by their peers? We will explain how students may be subject to alcohol consumption by a misconception of what they believe their fellow colleagues are doing.

  1. The correlation between social influence and college students’ alcohol consumption

To explore the role of peer pressure in consumption of alcohol by college students, Vaughan, Corbin, & Fromme (2009) developed a questionnaire to measure how descriptive norms and college students’ own personal drinking values are consistent mediators for the influence of social motives on alcohol consumption. A sample of 200 college students was assessed for the one on one questionnaire, which asked about the effectiveness of injunctive and descriptive norms as well as how likely other college students were to conform to the drinking behaviors of their friends. All the participants who completed the questionnaires were given thirty-five to fifty minutes to do so. The responses were on a scale ranging from “very effective and highly unlikely (1)” to “completely ineffective and very likely (5).”
The results consistently showed that injunctive norms are better predictors of future drinking behaviors than descriptive norms. This finding was consistent with the theory of planned behavior that indicates subjective norms are a predictor of drinking behavior. Injunctive norms result in more positive changes to behavior because they tell college students that they should not give in to the pressures to drink instead of showing students who do succumb to such pressures. Therefore, injunctive norms motivate students more to change their behavior.
College students who share strong social motives are more likely to conform to the pressures to drink so they can “fit in” with their peer group. Studies done after the questionnaire show that there is a strong indirect effect of social motives that operate through descriptive norms. The results in this investigation were consistent with other studies, such as McPherson (2001), that supported the theory that social influence is primary force behind similarity among peers.
Also, this study illustrates the idea that social categorization and peer control has a direct relationship with social influence among peers. College students are subject to adjusting their own beliefs and disciplines to that of their peer groups. When amongst others, college students are motivated to accept the attitudes and behavior of others because they are persuaded by the information received from others as well as being socially attracted to their peers. The results of this study show that discipline similarity among friends is caused by influence rather than selection.
Multiple studies over the past decades have set out to explain this correlation by examining the Clapp, Shillington, and Segars (2000) studies that suggested a majority of college students use compliance-gaining techniques to persuade their own friends to drink alcohol. High self-efficacy beliefs can serve as an important motivational function when it comes to drinking. It appears that efficacy beliefs are not concerned with the skills and abilities one has, but rather what one believes he has the potential to do in a given situation. It appears that compliance-gaining techniques directly influence self-efficacy beliefs. This leaves the question open as to whether social influence is the only driving force behind these positive correlations with student alcohol consumption.

  1. Reasons for pluralistic ignorance and misconceptions that cause college students to conform their drinking behaviors and beliefs

A large number of studies have focused on studying pluralistic ignorance with respect to college students’ drinking behaviors. Perkins and Wechsler (1996) explain that that students’ perceptions of their peers’ behavior are a stronger influence on ones alcohol consumption than are campus norms. Group and social network norms are more influential on college students’ drinking tendencies than the campus implemented drinking norms. College students’ experiences with their own drinking behaviors and those of their peers seem to have caused a disbelief in campaign messages; therefore, personal experience can override social norms. A reason for this effect is that students discount university norms campaigns, writing them off as just an attempt to control student-drinking behaviors. The college students who believed that the majority of other students who found the messages more believable than they did ultimately drank more alcohol, and discounted the effectiveness of the messages as a means of reducing alcohol consumption.
However, Brown (1986) explains that conformity is lower amongst college students who are able to explain peer group’s behavior than it is among students who cannot account for that behavior. Brown noticed that attributional thinking can be beneficial and keep students’ behaviors consistent with their own beliefs when faced with ongoing conformity pressures. Black and Weiss (1992) further explored common drinking misconceptions for college students. The authors, researchers at Leeds Metropolitan University and Loughborough University, used the social norms interventions studies and found that drinking is influenced by college students’ own misconceptions of how others drink. They explained that if those misperceptions are corrected, college students may drink less. College students are influenced by the idea that their friends drink heavily, which ultimately influences their own drinking behaviors, yet much of the peer influence is the result of inaccurate perceptions.

  1. Reasons peer pressure will influence college students’ drinking behaviors more than the influence from their own parents, campus guidelines and media advertisement.

Gebhardt (2001) studies explain that college students are subject to adopt attitudes and behaviors of their peer groups, meaning that peer influence of alcohol consumption serve as a more significant predictor than messages received from advertising and parental influence. Public service announcements and other educational programs are ineffective in being a top predicator for alcohol consumption because they work through descriptive norms. William DeJong uses data from the social norms marketing campaigns to explain campus norms can be used to reduce alcohol consumption as well as abuse on campus. This is strongly supported only in campuses where the density of the alcohol outlets is low. It appears that reducing alcohol consumption and abuse is most effective when colleges incorporate the use of norms into their own campus community. However, norms must be considered as a part of the campus’s culture in order to have a full effect. Therefore, campus norms lack the high level of significance that peer pressure has on other students’ behaviors.

Parental influence was shown to be the second most influential variable regarding alcohol consumption due to the persuasion theory of compliance. Most parents to some extent pay their children’s tuition so they have authority over them. Also, due to the fact those are their parents; college students tend to respect and follow what they tell them.

For the most part, however, peer influence is found to be the strongest predictor of college student’s alcohol consumption.

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Part III: Opportunities for Strategic Messaging

Our audience is a very interesting demographic to examine. College students are generally in their late teens and early 20’s. They tend to be ambitious, with the primary focus on improving themselves through higher education. Simultaneously however, they are also thrust into a bizarre social environment, where they’re asked to navigate numerous difficult decisions. Who will their friends be? Will they join a club? Greek life? What are they doing over Spring Break? The social politics of life on a college campus can overwhelm young people. Many people thrive socially, while others crash and burn.

Cornell students specifically are inundated with opportunities to engage in binge drinking. There are dozens of fraternities and sororities, many co-ops, and a handful of bars and clubs were students can binge drink. There are also several places to purchase alcohol within walking distance of campus and Collegetown.

We aim to influence Cornell students’ attitudes, beliefs, and behaviors in regard to binge drinking. Our goal is for Cornell students to better understand and believe the dangers of binge drinking, recognize the negative side affects of binge drinking, reflect differently upon the act of binge drinking, and actually stop binge drinking. Obviously it would be nearly impossible to convince college students, or people in general, to completely halt drinking excessive amounts of alcohol, but we can help people make decisions that lead to happier, healthier lives.

Before determining which course to take in attempting to influence Cornellians, we should first examine the effects of advertising on college students in general. In 2012 researchers from Syracuse University and Marquette University published a study about college students’ internet piracy patterns. One aspect of the study involved testing the effectiveness of advertisements on students. The study concluded the following:

Phase III of the current study concluded that motivations for digital-music piracy among college students could be reversed if certain costs that are currently perceived as minor (specifically, the threat of computer viruses, which were explored in Concept 2 and Concept 3) could be repositioned as major concerns. The current study also concluded that motivations for digital-music piracy among college students could be reversed if college students could be convinced that engaging in illegal digital downloading could have a negative impact on their job search. (Sheehan et al, 2012)

This tells us that, generally, students’ beliefs can be altered through advertisements, if done the right way. If we identify the most effective ways to engage with Cornell students, we can have a profound impact on them.

Cornellians are a large and diverse group of people, but there are surprisingly few campus publications to service local concerns, with the Cornell Daily Sun being the most popular Cornell-specific news organization. The Sun’s website tells potential advertisers the following:

The Sun is the largest paper at Cornell, reaching an estimated readership of 16,000, and is distributed for free in over fifty locations around campus, including dining halls, academic facilities and dormitories, as well as in Collegetown and the surrounding Ithaca area. More than 57% of students read The Sun at least twice a week, and more than 66% of our readers indicate that advertisements in The Sun have prompted them to make purchases. This type of exposure to Cornell’s academic and social community is not available with any other publication on campus or in the greater Ithaca region. (Advertising with Us)

Clearly, this is an enticing option for people trying to influence Cornell students. In addition to its popularity, The Sun has a huge presence online, with news updates on its website; a Twitter account with nearly 10,000 followers, and a Facebook page that’s liked by over 3,000 users. It is because of these reasons that we have decided to spread our message through The Sun. Even if a person does not directly read the Sun, they are very likely to be friends, co-workers, or classmates with people who do, and are thus very likely to indirectly receive the messages as well.

Social media will provide another outlet for our message. A study conducted by researchers at the University of New Hampshire in 2009 found that 96% of students used Facebook on a typical day, but no other social media platform was used by most students on a daily basis (Martin, 2009). Since that study, other forms of social media (such as Instagram, Twitter, Reddit, Pinterest, and LinkedIn) have grown in popularity. The rise in popularity of the smart phones has allowed social media to further play a role in the lives of millions of Americans, and especially college students, who are very connected to trends through social media.

The last opportunity to reach our target audience, is through traditional posters placed in student dorms and housing. Because many students live in these buildings, these centralized locations offer a perfect place to advertise to college students. Due to the high frequency that these locations act as social gathering locations, these dorms offer a great traffic levels for proposed messaging. Lastly, because these dorms also have bulletins where messages can be displayed for free, this option also offers a cost effective method of reaching our target market.

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Part IV: Messages

Principle #1
            Part of our campaign will focus on influencing our target population through using the principle of persuasive narration. We will focus a part of our campaign on this principle, as opposed to rhetoric elaboration, for reasons outlined below. Through the transportation-imagery model, we hope to convince our target audience through their immersion in a compelling story, since, as discussed in class, during a story there is a suspension of disbelief from the audience. Many college students, when presented with statistical facts, may try to provide counter-argumentation in favor of binge drinking. However, through telling a compelling story, this critical processing is suspended within our audience, allowing us to be more persuasive. The idea of using narrative persuasion via transportation for anti-binging campaigns is not unique, with Informa Healthcare running an experiment that showed that narrative persuasion increases anti-binging attributes, such as guilt (Banerjee).

Our message will take the form of an article printed in the Cornell Daily Sun once a semester. By utilizing this medium, the narration will have a source of legitimacy, since it will be printed from an established organization that many Cornellians interact with on a daily basis. Through this medium, the severity of the issue can be fully comprehended as a serious issue that is actively influencing and shaping the lives and experiences of all those on campus.

We plan on employing this principle by utilizing the identifiable-victim effect. Namely, rather than giving a general statistic about how many deaths per year are caused by binge drinking, we will choose a single student (Victoria Cheng) and describe who she was, and how her life was tragically cut short through binge drinking. By portraying the tragedy through a narrative, the student population will be able to identify with this student, and understand the magnitude of the situation, and thus the dangers and possible repercussions of binge drinking.
Principle # 2

Another principle of persuasion and social influence our group will be employing is peripheral processing. The elaboration-likelihood model (ELM) holds that there are two routes to evaluating a stimulus, the central route and the peripheral route. Whereas the central route processing carefully considers argument-relevant information, requiring high motivation and cognitive effort, the peripheral route instead focuses on surface level cues, requiring low motivation and cognitive effort. We have chosen to emphasize peripheral cues in our messages over argument-relevant cues because our audience of college students is notoriously busy and fixated on superficial characteristics. They are inundated with so many other targeted anti-drug and alcohol ads that it would be increasingly difficult to get through to them by only appealing to central processing. Because college students are more image-oriented and susceptible to social pressures, we feel peripheral cues will be most effective in encouraging them to drink responsibly. Also, because of the popularity amongst alcohol brands to employ celebrity endorsements for their brand, as noted by KapItAll, we intuitively feel that celebrity endorsements can also work against the industry as well (Celebrity Liquor Endorsements On The Rise).
We will use peripheral cues as part of a pervasive Internet and social media campaign. Because college students use the Internet for everything from school to work to leisure, we see the web as a major opportunity for reaching our target audience. Placing the messages on the Internet also places them on a forum where users are reading passively and casually. Unlike with a book or a newspaper, readers likely will not be evaluating our messages for argument-relevant information; so peripheral cues will be far more effective in the online arena.
We will employ peripheral cues in the form of celebrity endorsements and prestigious spokespersons. College students look up to and often can relate to these figures, maximizing the likelihood of peripheral processing. For our ad in particular, we will be using celebrity endorsements from Macklemore and Shaquille O’Neal. Both of these cultural icons are active anti-substance abuse advocates. Because of their popularity amongst college-aged individuals, we hope that our audience will be more inclined to drink responsibly. Our ad will feature both their faces combined, with one side portraying Shaq, and the other Macklemore. The copy at the top will read, “What do Shaq and Macklemore have in common?” thus prompting students to question what a middle-aged basketball legend, and an up and coming rapper, both share in common. The last line of copy will then inform the audience that both stars are against binge drinking. We chose these two icons in particular to show how binge drinking isn’t a problem isolated to one social, political, or economical demographic, but is an issue that has impacted everyone, regardless or gender, race, income, or social status.

Principle # 3

The last principle of persuasion and social influence our group will be examining will be the use of injunctive norms as a form of compliance. The focus theory of norms tells us that messages have the most influence when norms are aligned with whichever norms are made accessible. The reason we have chosen to employ a message utilizing injunctive norms is because we are attempting to change the way people will think and act through direct requests and solicitation. We believe injunctive norms will be more effective since they will be telling people not binge drink, whereas a descriptive norm will show people drinking, which may reinforce the behavior. On the other hand, alcohol brands typically feature a descriptive norm during their advertisements campaigns, thus encouraging consumers to purchase their product through the depiction of friends drinking and having fun. An experiment conducted by the NCBI, showcased how students, under a plethora of different factors, are generally more swayed by injunctive norms than descriptive (Borsari).

Since our target group is college students, the best place to integrate injunctive norms is as a flyer placed within the dorms of the university. We chose this location in particular, because it is at this location where majority of the deviant behavior occurs (during pre-gaming, etc.). By having the advertisements easily accessible in areas where students are more likely to drink, it is our hope that the advertisements will help deter the deviant behavior. Since the ads will also be in the dorms, where students frequent multiple times a day, we feel that the ad through repeated exposure, will have a stronger affect than if placed in an obscure location on campus that is visited infrequently by students.

We will use injunctive norms in the form of an image very similar to a non-smoking ad. We choose to appropriate a similar style of design, so that students can understand the inherent dangers of binge drinking, much like how we have come to understand the inherent dangers of smoking. The text for the ad refers to pluralistic ignorance, which the audience, through central processing, will be able to come to the conclusions about how pluralistic ignorance is related to drinking, which namely is, the perception that this norm is accepted by a majority, when in reality, it is not. To reinforce the idea that binge drinking is detrimental, the last line of copy is a command not to binge drink, thus implementing the injunctive norm in the advertisement.

Part V: Message Intervention Evaluation

            We would like to preface this section by acknowledging the difficulty associated with measuring alcohol consumption, particularly binge drinking and particularly within a college-age environment. There are several reasons to believe that college-age participants in alcohol-related studies may not respond with absolute truthfulness. Participants may be under the legal drinking age and/or embarrassed to reveal their actual drinking habits. We will attempt to pre-empt these potential participant fears by guaranteeing respondents that their participation in the study is fully anonymous and results are strictly confidential. While some level of response bias may still exist, we believe that communicating these guarantees to participants will allow us to gather accurate data.

That being said, we have devised an experimental design to test the efficacy of Message #2: Peripheral Processing. The experiment will feature 75 Cornell undergraduates, ranging from freshmen year through senior year status. All 75 participants will be instructed to complete a survey about their lifestyle habits on campus over the past month. The survey would include questions related to diet, exercise, sleep, academics, and, most importantly, alcohol consumption. We will be including questions on this broad range of topics in order to prevent students from realizing the true motive behind the experiment. If participants suspect our objective is to limit binge drinking, their behavior may be biased in one direction or another, thereby compromising the reliability of the experimental results. With respect to alcohol consumption, we will ask an assortment of questions, including, but not limited to:

  1. On average, how many times per week have you consumed alcohol in the past month?
  2. What is the most alcoholic drinks you have had in one day during the past month?
    3. Have you experienced feelings of a “hangover” the morning after drinking at any point    during the past month?
    Again, by placing these questions alongside questions about diet, exercise, sleep, and academics, our objective is to solicit the most accurate responses as possible.

Next, we will randomly assign each of the 75 participants into one of three groups. All participants will be instructed to complete a weekly online module. Each module will consist of 10 minutes of simple games, such as Pac-Man or Pong. During each module, participants will be interrupted by 15 seconds of either a blank screen (Control Group), an anti-binge drinking message employing central cues (Experimental Group 1), or our Message #2: Peripheral Processing, depending on what condition they were randomly assigned to. We decided to employ two experimental groups in order to isolate the peripheral processing aspect of the anti-binge drinking message. If, for example, we only had a control group and Message #2, we would not be able to determine whether drinking behaviors were influenced by a message employing peripheral cues or whether any type of anti-binge drinking message would do the trick.
Participants will complete one module per week for a duration of four weeks, at which point we will redistribute the original survey asking participants about their lifestyle habits during the past month. Although we will still include questions relating to diet, exercise, sleep, and academics on this second survey, we will only be analyzing differences in drinking behavior from survey 1 to survey 2.
The independent variable, therefore, is the type of message shown to participants during each module (Blank screen, Central cues message, Peripheral cues message). The dependent variable, meanwhile, is the level of participants’ reported alcohol consumption.
Our prediction is that Experimental Group 2 will show a statistically significant decrease in reported alcohol consumption, while the Control Group and Experimental Group 1 will show no statistically significant change in alcohol consumption. We hypothesize that the message featuring peripheral cues is more likely to be internalized than the message requiring central processing because Cornell students are more concerned with superficial characteristics and less likely to exert high cognitive effort on an online survey. While concern over a boomerang effect is legitimate, we believe that our construction and implementation of Message #2 will help prevent such an effect. Our message is not overly authoritative, nor is it repeatedly thrown in participants’ faces to the point that it would bother or threaten them.

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