image: Meagan Brem.
Credit: Photo by Hunter Q. Gresham for Virginia Tech.
Beer pong. Quarters. Flip cup. The drinking games college students play can seem like an alcohol-laced version of intramural sports.
When college-aged drinkers imbibe too heavily, the risk for physically harming a romantic partner rises considerably.
What if there was a way for heavy drinkers to monitor their alcoholic intake and blood-alcohol levels in real time, before an intimate situation cascades into physical violence?
Or, as Virginia Tech researcher and assistant professor of psychology Meagan Brem put it: “If we can identify a cut-off where students’ risk for perpetration [of violence] would be highest, we might be able to perform just-in-time delivery of interventions to prevent perpetration.”
Brem, director of the university’s Research for Alcohol and Couples Health Lab and an Institute for Society, Culture, and Environment Scholar, leads a team of Virginia Tech researchers in the development of a study where self-identified heavy drinkers use pocket-sized electronic devices to monitor their drinking habits, alcohol levels, mood, and behavior. The study, initially supported by seed funding from the institute, has recently secured a $434,491 grant from the National Institute on Alcohol Abuse and Alcoholism, commonly called an R21 grant, as part of a National Institutes of Health program to support research projects in the nascent stages of development.
Early this year, Brem and her professional and student colleagues will assemble a group of 100 heavy-drinking men and women students who have self-reported histories of intimate partner violence who will then be expected to report their drinking habits and other information for 30 consecutive days. The study relies on simple methods that require only a hand-held breathalyzer, a smartphone app, and quick daily reports.
Each day during the 30-day study period, participants will receive prompts through their phone at five specific times that will ask them to submit results from the provided breathalyzer and to answer a brief survey about how they feel, when they had their last drink, and other pertinent questions.
Even though participants’ survey answers might be hard to quantify, the breathalyzer information is not. Working closely with co-researcher Warren Bickel, behavioral research professor with Fralin Biomedical Research Institute at VTC whose research has involved the use of breathalyzers, Brem expects to get objective data about student drinking and the likelihood that someone could perpetrate violence against an intimate partner. Studies have shown that adults will often under-report the number of alcoholic beverages they have consumed.
And college students?
“They're especially bad at it,” Brem said.
That’s why breathalyzer data is necessary, she said. The participant blows into the breathalyzer, which connects to a smartphone via Bluetooth to record the numbers.
“We wondered,” Brem said, “can we identify exact blood-alcohol concentration level when there might be the greatest likelihood that they would perpetrate sexual assault or intimate partner violence, sort of in the same way that we do with driving while intoxicated?”
The range of blood alcohol levels among heavy drinkers can be vast. In fact, during a pilot study conducted for this project, Brem’s team found that participants’ blood alcohol concentrations ranged from zero to a staggering 0.25 percent — more than three times the legal limit for driving while intoxicated and dangerously close to alcohol-poisoning levels.
“It's amazing that people are still alive and functioning at that point,” Brem said.
Another reason why breathalyzer data beats self-reported information is because many students simply don’t know how much alcohol constitutes a standard “drink.”
Heavy-drinking college students might be guzzling unknowable amounts of alcohol from bottles, cups, plastic jugs, aluminum pails, even rubber hoses.
“They're drinking directly out of bottles of liquor sometimes or they're drinking a concoction of various high-powered spirits made in large quantities, or mixed drinks,” Brem said. “Even when we give them a definition of a standard drink … they're really poor reporters when it comes to how much they've consumed.”
But the breathalyzer doesn’t lie.
As important as the objective alcohol data is for this study, there is some need for subjective self-reporting, especially when it comes to a heavy drinker’s mood, feelings or behavior toward other people. That’s why the survey’s daily questions are tailored in ways that don’t sound accusatory to the participants.
“For instance,” Brem said, “we will ask, ‘Since the last survey have you yelled at your partner or have you called them names? Have you pushed or shoved your partner?’’”
That method generated eye-popping answers during the pilot study. Fifty-four percent of the participants reported at least one intimate partner violence event during that study’s 28-day period.
Brem’s team takes a broad view when it comes to intimate partner violence, considering not only physical altercations, but online and technology-based violence, such as cyberstalking, bullying or making threats on social media.
This broader perspective also shifts the common narratives around intimate violence. Sexual perpetrators are often men, as research has shown for years, but men suffer the same rates of physical and psychological harm as women, Brem said. However, even in those cases where abuse rates are similar, women sustain more negative consequences.
“We do see that women are more likely to experience a greater severity of negative repercussions after the IPV,” Brem said, “meaning they need more resources such as shelter or financial support. They're more likely to miss work, they're more likely to experience mental health symptoms.”
Which means that Brem’s project has potential real-world societal and economic implications when it comes to reducing alcohol-related domestic violence and the societal costs required to handle the consequences — whether they be in healthcare, the judicial system, rehabilitation, workplaces, or other social safety-net programs.
The more information the public has, the better prepared it will be to prevent domestic violence and mitigate the fallout, according to TJ Shaw, a Ph.D. candidate and research assistant helping guide the data collection.
“We want to find out if this study is a way to get more information from college students who are at risk for this,” Shaw said. “We need to know if we can design an intervention system to reduce the likelihood of violence before it happens.”