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Salud mental

versión impresa ISSN 0185-3325

Salud Ment vol.28 no.2 México mar./abr. 2005

 

Artículos originales

Expectativas relacionadas con el alcohol en la predicción del abuso en el consumo en jóvenes*

Jazmín Mora-Ríos1 

Guillermina Natera2 

Francisco Juárez1 

1Investigadores del Departamento de Investigaciones Psicosociales. Dirección de Investigaciones Epidemiológicas y Psicosociales. Instituto Nacional de Psiquiatría Ramón de la Fuente, México.

2Jefa del Departamento de Investigaciones Psicosociales. Dirección de Investigaciones Epidemiológicas y Psicosociales. Instituto Nacional de Psiquiatría Ramón de la Fuente, México.

Resumen:

En México, los estudios realizados sobre las adicciones en poblaciones escolares de enseñanza media y media superior constituyen ya una tradición, lo que ha permitido conocer algunos riesgos que se asocian con el abuso de alcohol. Entre éstos destacan la probabilidad mayor de experimentar con otras drogas, principalmente en el caso de los hombres y el incurrir en prácticas sexuales de riesgo y en intentos de suicidio, circunstancias dos veces más frecuentes entre quienes beben y conducen después de haber bebido. No obstante, la investigación sobre el abuso de alcohol en población universitaria ha sido un campo menos explorado, particularmente en lo referente a la identificación de las variables que predicen el consumo excesivo de alcohol. Una revisión de la bibliografía internacional sobre los factores asociados con el abuso de alcohol en esta población, indica que es entre los universitarios donde el consumo alto o explosivo tiende a ser mayor, inclusive entre los jóvenes que no asisten a la universidad, y que el periodo de mayor consumo se da entre los 18 y 21 años de edad.

Otros factores identificados son la exposición a los sucesos negativos de la vida, las formas inadecuadas de enfrentamiento, las variables de personalidad, el recurrir al alcohol para reducir la tensión y las variables de contexto medioambiental y sociocognitivas, entre las cuales destacan las expectativas respecto a los efectos positivos del alcohol. Las expectativas no sólo predicen el consumo de alcohol, sino que también permiten diferenciar el consumo problemático del no problemático. Por ejemplo, mientras los bebedores sociales tienden a tener expectativas más de tipo social al consumir alcohol, los bebedores excesivos esperan que el alcohol incremente su potencial de conducta agresiva y sexual, y que a la vez, reduzca el estrés o la tensión. El objetivo de este trabajo consiste en evaluar el impacto de las expectativas respecto al alcohol para la predicción del abuso de alcohol en estudiantes de universidades públicas y privadas de la Ciudad de México. Entre los indicadores del abuso de alcohol se consideraron el consumo de cinco copas o más por ocasión, la embriaguez en el último mes y año, y los problemas asociados. Adicionalmente, se pretende conocer de qué manera interactúan las subescalas de expectativas entre sí. Se llevó a cabo un estudio transversal ex posfacto en una muestra de 678 estudiantes universitarios de uno y otro sexo entre los 17 y 25 años edad; la edad promedio fue de 20 años (d.e. = 1.80). Se aplicó un cuestionario de autorreporte que incluye las siguientes áreas: a) datos sociodemográficos, b) Cuestionario de Expectativas respecto al Alcohol (AEQ), versión adaptada en esta población y c) hábitos de consumo de alcohol en el último mes y año. A través de un modelo estructural de ecuaciones, se encontraron evidencias de que las expectativas respecto al alcohol como facilitador de la interacción grupal y las de reducción de la tensión psicológica predicen el abuso del mismo (X2 SB=33.52, p < .00, CFI = 0.99, RMSEA = 0.010). Los resultados tienen implicaciones a nivel de intervención en el sentido de que permiten desarrollar programas dirigidos especialmente a esta población. El hecho de que las expectativas respecto al alcohol como "facilitador de la interacción social" sean uno de los principales predictores del abuso, habla de la importancia que tiene el tomar en cuenta los factores medioambientales para desarrollar programas de prevención, lo que implica incluir no sólo a los jóvenes sino también a los padres, a otros adultos y a la escuela, con el fin de cuestionar las normas culturales que promueven las creencias relacionadas con el consumo como medio para disfrutar de la interacción social y de estados placenteros positivos y también como una respuesta socialmente adecuada para hacer frente a los sucesos negativos que surgen en la vida diaria: por ejemplo, el consumo de alcohol para reducir la tensión, enfrentar las crisis y como una forma de escape al estrés crónico. Deberá brindarse información sobre las consecuencias negativas del consumo y también promover estilos de vida más saludables.

Palabras clave: Expectativas hacia el alcohol; consumo de alto riesgo; estudiantes universitarios; Ciudad de México

Abstract:

In México, addictions among the middle- and high-school student population have been widely studied, which has shed light on certain risks associated with alcohol abuse, including a higher probability of expriencing with other drugs -particularly in the case of males-, engaging in risky sexual practices and attempting suicide, a situation that is twice as common among those who drink and drive. Nevertheless, research on alcohol abuse among the university population has been less explored, particularly as regards the identification of the variables that predict excessive alcohol consumption. A review of the international literature on factors associated with alcohol abuse in this type of population indicates that it is among university students that high or explosive consumption tends to be largest, even among young people who do not attend school, and that the period of higher consumption is between 17 and 21 years of age. Other factors that have been identified include exposure to negative life events, inappropriate coping styles, personality variables, resorting to alcohol to reduce tension, and environmental and socio-cognitive variables, foremost among which are expectations of the positive effects of alcohol. These expectations not only predict alcohol consumption but also differentiate between problem and non-problem drinking. For example, while social drinkers tend to harbor more social expectations when drinking alcohol, excessive drinkers expect alcohol to increase their aggressive and social behavior, while reducing stress or tension. This paper seeks to evaluate the impact of expectations regarding alcohol, in predicting alcohol abuse among students at public and private universities in Mexico City. Indicators of alcohol abuse include consumption of five or more drinks on each occasion, drunkenness during the past month and year as well as associated problems. The study also seeks to determine the way in which sub-scales of expectations interact with each other. An ex post facto transversal study was carried out on a sample of 678 university male and female students aged 17 to 25, with an average age of 20 (s.d. = 1.80). Participants were asked to complete a self-report which included the following areas: a) Sociodemographic data, b) Questionnaire on

Expectations regarding Alcohol (AEQ), in a version adapted to this population and c) Alcohol consumption habits over the past month and year. As regards drinking habits, a comparative analysis was carried out by sex and age. Consumption of 5 or more drinks per occasions tends to be more common among men, while the consumption of 5 drinks or less is more frequent in women. At the same time, a higher proportion of heavy drinkers was concentrated in the 20 to 22 age range. Consumers of over 5 glasses of alcohol began drinking at an average age of 14 (s.d. = 2.55) whereas consumers of fewer than 5 drinks began drinking at the age of 15 (t= 4.79 , p < .001). In both cases, the means obtained from the indicators of abuse were highest among consumers of five or more drinks. Males take more drinks than women when they get drunk, consuming an average of 9 glasses (s.d. = 4.7) whereas women get drunk after an average of 5 glasses (s.d. = 3.2) (t= -10.80, p < .001). Out of a total of 26% of young people who mentioned having problems associated with their drinking, most were men (17.9%) as opposed to women (8.2%). The multiple regression analysis carried out to determine the impact of the sub-scales of AEQ expectations on alcohol abuse found that expectations regarding alcohol as a "facilitator of group interaction" and the sub-scale of "reduction of psychological tension" were the main predictors of abuse. This model explained 20% of the variance (F=19.35, p < .001). A logistic regression analysis found that the sub-scale of expectations regarding "increase of power and aggression" as well as alcohol abuse predicted problems associated with drinking. A model was subsequently designed to integrate the expectations that predicted alcohol abu se and associated problems. A structural equations model was used which found that expectations regarding "reduction of psychological tension" and alcohol as a jacilitator of group interaction predicted 30% and 24% of abuse, respectively (X2sb = 33.52, p >0.00, CFI = 0.99 and RMSEA = 0.01). The rest of the sub-scales concerning expectations were regarded as mediating varia bles to see how they interacted with each other. As one can see, although the sub-scales of expectations are inter-related, group expectations were specifically associated with the sub-scales of "increase in sexuality," "physical tension" and "increase in power and aggression." At the same time, expectations regarding "reduction of psychological tension" are closely linked to the social sphere, specifically the expectations regarding "verbal expressiveness" and "lack of inhibition." Along these same lines, alcohol abuse and the expectations regarding alcohol as an agent that increases feelings of power and aggression predicted 26% and 28% of alcohol-related problems. One of the contributions of this research is that it considered the inter-relationship of sub-scales of expectations to explain alcohol abuse. Psychological tension, for example, appears to be linked to social aspects, specifically to verbal expressiveness and lack of inhibition, while group expectations refer to sexuality, the reduction of psychological tension and the increase of aggressiveness and feelings of power. Likewise, it is interesting to note that in addition to alcohol abuse, expectations regarding an increase in power and feelings of aggression are the best predictors of problems associated with alcohol use. The results have implications at the intervention level for developing programs specifically aimed at this population. The fact that expectations regarding alcohol as a "facilitator of social interaction" is one of the main predictors of abuse indicates the importance of considering environmental factors in the development of prevention programs. This involves including not only young people but also parents, schools, and other adults in order to question the cultural norms that promote beliefs regarding alcohol consumption, as a way of enjoying social interaction with positive, pleasurable states, and as a socially appropriate response for coping with negative events that arise in everyday life, such as drinking to relieve tension, handle crises and as an escape from chronic stress, by providing information on the negative consequences of use and promoting healthier lifestyles. At the intervention level, it is essential to target university students through programs specially designed for young people who engage in high-risk drinking. As regards expectations, actions must be carried out to resignify the positive beliefs surrounding alcohol, by providing information on the high health costs of heavy drinking and offering alternative resources oriented towards other means of responding to stress that do not involve excessive alcohol consumption.

Key words: Alcohol expectancies; high risk consumption; college students; Mexico City

Texto completo disponible solo en PDF

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Recibido: 13 de Julio de 2004; Aprobado: 17 de Noviembre de 2004

Correspondencia. Mtra. Guillermina Natera. Departamento de Investigaciones Psicosociales. Dirección de Investigaciones Epidemiológicas y Psicosociales. Calz. México-Xochimilco 101, San Lorenzo Huipulco. 14370, México DF. Fax. 513 3446, e-mail: naterar@imp.edu.mx.

*

Una versión preliminar de este trabajo se presentó en el "World Congress of Behavioural and Cognitive Therapies". Association for Advancement of Behaviour Therapy (AABT), julio 17-21, 2001. Vancouver, Canadá.

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