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. Author manuscript; available in PMC: 2017 Jan 1.
Published in final edited form as: J Coll Stud Dev. 2016 Jan;57(1):32–46. doi: 10.1353/csd.2016.0007

Drinking and Dating: Examining the Link between Relationship Satisfaction, Hazardous Drinking, and Readiness-to-Change in College Dating Relationships

Alexander Khaddouma 1, Ryan C Shorey 2, Hope Brasfield 3, Jeniimarie Febres 4, Heather Zapor 5, Joanna Elmquist 6, Gregory L Stuart 7
PMCID: PMC4795906  NIHMSID: NIHMS663510  PMID: 26997754

Abstract

The present study examined the influence of relationship satisfaction on readiness-to-change alcohol use and the influence of hazardous drinking on readiness-to-change relationship issues in college student dating relationships. A sample of 219 college students in a current dating relationship (aged 18–25) completed self-report measures of dating relationship satisfaction, alcohol use, readiness-to-change alcohol use, and readiness-to-change relationship issues via an online survey from August to December 2011. Participants were grouped on the basis of their scores on measures of alcohol use (hazardous drinkers vs. nonhazardous drinkers) and relationship satisfaction (high vs. low). Results indicated that alcohol use was negatively correlated with relationship satisfaction. Furthermore, hazardous drinkers with high relationship satisfaction indicated more readiness-to-change alcohol use than hazardous drinkers with low relationship satisfaction. Alcohol problems were not related to readiness-to-change relationship issues. These findings indicate that highly satisfied dating relationships during college may positively influence readiness-to-change heavy drinking habits among college students.

Effects of Romantic Relationships on Alcohol Use

Previous research has demonstrated that college students tend to drink more frequently and in greater quantities than nonstudent populations (Johnston, O’Malley, Bachman, & Schulenberg, 2012). Additionally, hazardous drinking (i.e. drinking which increases one’s risk of alcohol-related problems; Friedmann, 2013) among college students is associated with a wealth of negative outcomes, such as elevated risk for substance abuse and dependence, damage to physical health, school dropout, and high-risk sexual behavior (see White & Hingson, 2014). There are numerous reasons for the increase in alcohol use and elevated risk for negative outcomes related to drinking; however, research has revealed that the situational context of attending college explains the increased drinking behaviors of college students above and beyond the effects of pre-college background characteristics such as personality and intelligence (Jackson, Sher, & Park, 2005; Slutske et al., 2004). Thus, some researchers have posited that certain social and environmental factors may actively promote or deter engagement in hazardous drinking among college students (Presley, Meilman, & Leichliter, 2002).

One factor that has been shown to affect alcohol use and health behaviors in adults is involvement in a committed relationship. Among adults, entrance into marital relationships is associated with reduced risk for a vast range of mental and physical problems (see Robles, Slatcher, Trombello, & McGinn, 2013). Involvement in an intimate relationship seems to provide, for the majority of individuals, a protective effect, buffering against engagement in behaviors such as smoking, drinking heavily, or engaging in illegal or high risk behaviors (Beaver, Wright, DeLisi, & Vaughn, 2008; Liang & Chikritzhs, 2012; Schonbrun, Walsh, Stuart, & Strong, 2011). Furthermore, it appears that it is the presence of the relationship rather than the selection of healthier individuals into marriage that promotes favorable behavioral patterns and health outcomes among adults (Duncan, Wilkerson, & England, 2006). One possible reason for this effect of marriage is the transformation of motivation that may take place in dyads as partners begin to perceive particular behavioral changes as meaningful or important to their partner and necessary for the continuity and preservation of relationship health (Lewis et al., 2006). For example, an individual with heavy drinking patterns may begin to interpret his/her drinking as a risk to his or her own health and also as a major problem for his or her partner, which may lead to diminishing their connection and decreasing the quality of their relationship. This, in turn, may motivate an individual to contemplate changing his or her drinking (e.g., reducing the amount of alcohol consumed, drinking less frequently), whereas a non-partnered individual may lack this particular motivating factor.

Currently, few studies have addressed whether the benefits of intimate relationships in adulthood (i.e., marriage) extend to the unique developmental stage of emerging adulthood and the environmental context of collegiate life. Although previous research indicates that dating relationships rather than marriage characterize the romantic relationships of most college students (Arnett & Tanner, 2006) and that the formation of romantic relationships are an important developmental task during this lifestage (Arnett, Robins, & Rehm, 2001), it is currently unclear whether involvement in a college dating relationship would provide similar motivation to engage or abstain from hazardous alcohol use as does marriage. While recent research has shown that the presence of an intimate relationship in undergraduate college students is associated with better mental health outcomes and less problematic alcohol use (Braithwaite, Delevi, & Fincham, 2010; Simon & Barrett, 2010; Whitton, Weitbrecht, Kuryluk, & Bruner, 2013), no previous studies have examined the effects of relationship quality on college alcohol use. This is an important step in the research on this topic as partners reporting greater relationship quality may be more willing to sacrifice or make changes to fit the needs of their partner, thus furthering their motivation to alter behavioral patterns, such as problematic alcohol use (Lewis et al., 2006; Van Lange et al., 1997).

Effects of Alcohol Use on Romantic Relationships

Additionally, because of the higher likelihood for heavy alcohol use and subsequent negative consequences among college students relative to non-student populations, it is likely that heavy alcohol use impacts the relationship functioning of individuals involved in a romantic relationship during college. Previous research with adult samples has demonstrated a negative association between heavy alcohol use and relationship quality in married relationships (Cranford, Floyd, Schulenberg, & Zucker, 2011; Dethier, Counerotte, & Blairy, 2011). For example, heavy alcohol use has been associated with decreased relationship satisfaction, higher risk for marital distress, and more negative interactions between partners among adult married couples (see Leonard & Eiden, 2007; Marshal, 2003 for review).

One reason for this association may include the increased relationship stress caused when one partner engages in hazardous drinking. Because hazardous drinking is associated with increased risk for engagement in a variety of dangerous behaviors such as driving while intoxicated, intimate partner violence, and illicit drug use (Jackson et al., 2005), partners in romantic relationships may endanger themselves and their partner when drinking heavily, which may in turn negatively impact the functioning of the relationship (Rodriguez, Neighbors, & Knee, 2013). Furthermore, concern over the negative consequences of heavy alcohol consumption and the well-being of the relationship may lead dyadic partners to experience more frequent negative exchanges (e.g., arguments) and negative affect toward their romantic partner (Walitzer, Dermen, Shyhalla, & Kubiak, 2013; Rodriguez, Øverup, & Neighbors, 2013). Overall, these negative outcomes associated with hazardous alcohol use may place individuals who drink heavily at heightened risk for relationship dysfunction (Cranford, Floyd, Schulenberg, & Zucker, 2011; Marshal, 2003).

Furthermore, in addition to the higher risk for relationship dysfunction created by hazardous alcohol use, hazardous drinkers may also be less likely to actively engage in improving their relationship than non-hazardous drinkers for a variety of reasons. First, hazardous drinkers may not place as much value in the health or wellbeing of their intimate relationships as nonhazardous drinkers (Epstein, McCrady, Miller, & Steinberg, 1994). Second, individuals who drink heavily may turn to alcohol in times of stress or affective discomfort as a way of dealing with unpleasant experiences, and thus direct their attention toward medicating the negative affect through drinking rather than actively working to improve their relationship (Epstein & McCrady, 1998). This self-medication may divert attention away from the problems experienced in a dysfunctional relationship and lower the motivation to actively work toward improving it. Lastly, it may be that the presence of a dysfunctional relationship increases the desire to engage in heavier alcohol use in order to blunt or distract from unpleasant experiences (Swendsen et al., 2000). These increased alcohol use behaviors may elicit greater frequencies or intensities of negative interactions with one’s partner, as well as make one more vulnerable to engaging in relationship-damaging behaviors, such as physical violence and verbal aggression (Marshal, 2003). Thus, though heavy alcohol use may create higher risks for relationship problems, it may also prevent individuals from actively engaging in the change process to resolve these problems and interfere with the individual’s ability to work toward improving the relationship (Tambling & Johnson, 2008).

To date, no studies have examined the relationship between alcohol use and readiness-to-change relationship problems in college dating relationships. However, due to the prevalence and importance of dating relationships during college (Arnett et al., 2001), researchers need to examine factors that contribute to the health and functioning of dating relationships during this life stage. Because of the prevalence of alcohol use in college populations, this behavioral pattern may exert significant influence on the health of college dating relationships, thus warranting further examination.

The Current Study

Thus, the purpose of the present study was to examine the relationship between alcohol use, relationship satisfaction, readiness-to-change alcohol use, and readiness-to-change relationship issues in a sample of college students. Specifically, we first tested for an association between alcohol use and relationship satisfaction in college dating relationships. Next, we examined whether college students’ satisfaction with their current dating relationship influenced their level of readiness-to-change alcohol use and similarly whether students’ alcohol use influenced their level of readiness-to-change relationship issues. Based on previous literature on these topics, we hypothesized that (1) satisfaction would be negatively related to alcohol use, (2) among hazardous drinkers, relationship satisfaction would be positively associated with readiness-to-change alcohol use, and (3) among individuals with low relationship satisfaction, hazardous drinking would be negatively associated with readiness-to-change relationship issues. These hypotheses were made on the basis of previous literature indicating low baseline levels of readiness-to-change alcohol use in samples of students who do not drink heavily (Carey, Henson, Carey, & Maisto, 2007; Palfai, McNally, & Roy, 2002), and low baseline levels of readiness-to-change relationship issues in highly satisfied relationship partners (Bradford, 2012). Thus, among non-hazardous drinkers and individuals with high relationship satisfaction, we did not expect associations between alcohol use and readiness-to-change relationship issues, or between relationship satisfaction and readiness-to-change alcohol use.

Methods

Participants

A total of 219 undergraduate students from a large Southeastern public university participated in the current study. Demographic information regarding the university from which participants in the current study were drawn includes an enrollment size of approximately 27,000 students (77% undergraduate), of whom most are White (78%) and enrolled full time (89%). Previous research using a sample of participants at this institution described approximately half of their sample (mostly freshman and sophomore students) as being involved in a dating relationship (50.8%) or married (2.6%) at the time of their participation (Kivisto, Kivisto, Moore, & Rhatigan, 2011). Previous assessments of relationship satisfaction in samples of dating students at this institution (e.g. Kivisto et al., 2011; Shorey, Febres, Brasfield, & Stuart, 2012) have consistently observed average levels of relationship satisfaction comparable to those reported in other dating samples (e.g. Renshaw, McKnight, Caska, & Rebecca K. Blais, 2011; Hendrick, Dicke, & Hendrick, 1998), indicating that dating students at this institution are, on average, highly satisfied in their relationships. Regarding drinking behaviors, prevalence data indicates that students at this institution reported higher heavy drinking rates, frequency of heavy drinking, and negative consequences due to drinking than regional averages (National Social Norms Institute, 2007) and previous assessments of alcohol use in samples of students at this institution have documented average scores that meet criteria for hazardous drinking, particularly among males (Shorey, Rhatigan, Fite, & Stuart, 2011).

Eligibility criteria for the current study required students to be in a dating relationship for 1 month or longer and 18 years of age or older to participate. Participants were predominately female (60.3%; n = 132), heterosexual (96.8%; n = 212), and not currently living with their dating partner (94.1%; n = 206). The ethnic composition of participants included 87.2% (n = 191) non-Hispanic White, 7.8% (n = 17) African American, 0.9% (n = 2) Asian American, and 4.1% (n = 9) identified as “other” (e.g., Hispanic, Middle Eastern, etc.). Academically, 65.3% (n = 143) were freshmen, 22.4% (n = 49) were sophomores, 7.3% (n = 16) were juniors, and 5.1% (n = 11) were seniors. The mean age of participants was 19.29 years (SD = 1.55), and the mean length of participants’ current dating relationship was 8.59 months (SD = 8.69). Mean levels of relationship satisfaction (M = 3.48, SD = .42) and alcohol use (M = 6.26, SD = 5.78) in the current sample were comparable to those documented in previous studies of college students at the institution where the study was conducted (e.g. Kivisto et al., 2011; Shorey et al., 2011) and at other institutions (e.g. Renshaw et al., 2011; Kokotailo et al., 2004). In general, this sample reflected the previously described demographic characteristics of the university from which the sample was drawn.

Procedures

Participants completed all measures through an online survey website that uses encryption to ensure confidentiality of responses. Participants completed an informed consent prior to completing measures for the current study, which was also provided online. After obtaining consent, the measures were presented with standardized instructions. Participants were provided a list of local referrals for psychological services after completing all measures and were given credit as partial fulfillment of a social science course in return for their participation. All procedures were approved by the institutional review board at the university where the study was conducted.

Measures

Demographics questionnaire

Participants were asked to specify their age, ethnicity, academic status, sexual orientation, whether they were currently living with their dating partner, and length of their current dating relationship.

Relationship Satisfaction

The Relationship Assessment Scale (RAS; Hendrick et al., 1998) was used to examine participants’ relationship quality (i.e., satisfaction) with their current dating partner. The RAS contains 7 items that are rated on a 5-point scale (1 = poorly; 5 = very good). The mean of the seven items reflects participants’ level of satisfaction with their current relationship and higher scores on the RAS correspond to greater relationship satisfaction. The RAS is a widely used measure of relationship satisfaction that has been shown to be highly correlated with other measures of relationship functioning such as the Dyadic Adjustment Scale (Hendrick et al., 1998), and has demonstrated high internal consistency in previous college samples (Hendrick et al., 1998). The internal consistency of the RAS in the current study was .86. Following procedures from previous studies utilizing this measure (Contreras, Hendrick, & Hendrick, 1996; Gordon & Chen, 2010), participants in the current study were categorized as high or low in relationship satisfaction based on a median split (median = 3.57) of their scores on the RAS; individuals at or above the median were considered to have “high” relationship satisfaction, whereas individuals below the median were considered to have “low” relationship satisfaction. This was done because the RAS does not have a standardized cutoff score for low or high relationship satisfaction.

Alcohol use

The 10-item Alcohol Use Disorders Identification Test (AUDIT; Saunders, Aasland, Babor, & Grant, 1993) was used to assess participant’s alcohol use in the past twelve months. The AUDIT examines one’s frequency of alcohol use, intensity, symptoms that are characteristic of alcohol tolerance and dependence, and negative consequences that are related to alcohol use (e.g., injuries). Research has shown that the AUDIT is superior to other measures for problematic alcohol screening (Reinert & Allen, 2002), has demonstrated high internal consistency in previous studies (Stuart et al., 2006), and positively correlates with other measures of alcohol use in college samples (O’Hare & Sherrer, 1999). The internal consistency for the AUDIT in the current study was .84. Participants in the current study were categorized as hazardous (score above 8) or nonhazardous (score below 8) drinkers, following the recommendations of previous research utilizing this measure (Reinert and Allen, 2002).

Readiness-to-change alcohol use

The Contemplation Ladder (Biener & Abrams, 1991) is a single-item index that was used to assess motivation to change alcohol use behavior. The Contemplation Ladder has been previously used in smoking research to assess readiness to consider smoking cessation (Biener & Abrams, 1991; Herzog, Abrams, Emmons, & Linnan, 2000) and in alcohol research to assess readiness to consider change in alcohol use (Hogue, Dauber, & Morgenstern, 2010). The Contemplation Ladder has been shown to have good concurrent and predictive validity when compared to other variables previously demonstrated to be related to change in alcohol use in college samples (McGee, Williams, & Kypri, 2010). Respondents indicate their current motivation to change on a scale that ranges from 0 (no thought of changing) to 10 (taking action to change).

Readiness-to-change relationship issues

The Couples Stages of Change Questionnaire (CSCQ; Dorian & Cordova, 2001) is a 32-item self-report questionnaire that assesses participants’ level of readiness-to-change relationship issues. The CSCQ was adapted from the original 32-item Stages of Change Questionnaire (McConnaughy, Prochaska, & Velicer, 1983) to reflect issues regarding partners’ romantic relationship and has been used in previous studies to assess relationship partners’ readiness-to-change issues in their romantic relationship (Cordova et al., 2005). Four subscales of eight items each measure four of the theoretical stages of change: Precontemplation, Contemplation, Action, and Maintenance. Respondents indicate how strongly they agree or disagree with each item on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree). Previous research using this measure in married couples has shown high internal consistency for the overall measure and for individual subscales (Cordova et al., 2005). A modified 32-item index was employed in the current study to reflect dating relationships rather than marital relationships. Internal consistency for the overall measure in the current study was .92 and individual subscale alphas as follows: Precontemplative = .68, Contemplative = .89, Action = .90, and Maintenance = .86. Following procedures for obtaining single continuous readiness-to-change scores from stages-of-change measures used in previous studies (e.g., Tambling & Johnson, 2008; Kadden, Carbonari, Litt, Tonigan, & Zweben, 1998), a single continuous readiness-to-change score was calculated by subtracting Precontemplation subscale scores from the summed Contemplation, Action, and Maintenance subscale scores.

Results

Preliminary Analyses

Descriptive statistics for all study variables are reported in Table 1. Males reported greater alcohol use, as indicated by higher AUDIT scores, than females (M = 7.90, SD = 6.27 vs. M = 5.89, SD = 5.17; t(217) = 3.48, p < .01) and higher readiness-to-change alcohol than females (M = 3.65, SD = 3.63 vs. M = 2.67, SD = 2.85; t(213) = 2.22, p < .05). No gender differences emerged for relationship satisfaction or readiness-to-change relationship issues. Age was significantly positively correlated with AUDIT score (r(217) = .22, p < .01), but not with any other study variables. Academic level was significantly positively correlated with alcohol use (r(217) = .17, p < .01), and with readiness-to-change alcohol use (r(217) = .17, p < .05). No differences emerged for study variables based on ethnicity or sexual orientation, however relationship length was significantly associated with relationship satisfaction (r(217) = .21, p < .01).

Table 1.

Means, Standard Deviations, and Bivariate Correlations among Study Variables

Variable 1 2 3 4
1. CSCQ - .29** .10 -.22**
2. Contemplation Ladder - .17* -.07
3. AUDIT - -.30**
4. RAS -
Mean 66.93 3.06 6.26 3.48
Standard Deviation 17.20 3.21 5.78 .42
Range 8–104 0–10 0–25 1–5
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Note.

*

p < .05.

**

p < .01.

Ns range from 205 to 216 depending on missing data for individual variables. AUDIT = Alcohol Use Disorders Identification Test. RAS = Relationship Assessment Scale

Bivariate correlations among study variables are also reported in Table 1. As expected, relationship satisfaction was negatively associated with readiness-to-change relationship issues and AUDIT score was significantly positively related to readiness-to-change alcohol use (p < .01). Hypothesis 1 was supported such that AUDIT score was significantly negatively correlated with relationship satisfaction (p < .01). Additionally, although AUDIT score was not significantly related to readiness-to-change relationship issues, relationship satisfaction was significantly positively related to readiness-to-change alcohol use (p < .01). Lastly, readiness-to-change alcohol use and readiness-to-change relationship issues were significantly positively related to each other (p < .05).

We first divided participants into groups based on their AUDIT and RAS scores in order to examine differences in readiness-to-change alcohol use and relationship issues among hazardous drinkers and non-hazardous drinkers who reported high or low relationship satisfaction. This resulted in four participant categories: hazardous drinkers with high satisfaction (HDHS, n = 36), hazardous drinkers with low satisfaction (HDLS, n = 50), non-hazardous drinkers with high satisfaction (NDHS, n = 91), and non-hazardous drinkers with low satisfaction (NDLS, n = 42). Grouping equations, means, and standard deviations for each variable across participant categories are displayed in Table 2. Preliminary intergroup comparisons were conducted to test for significant differences in group composition based on gender, age, academic level, ethnicity, or relationship length. Preliminary intergroup comparisons revealed significant differences in the distribution of gender across grouping categories (χ2 (3, 219) = 12.91, p < .05), however no significant differences in group composition were found for age, ethnicity, academic level, or relationship length. Next, data were analyzed with analysis of covariance (ANCOVA) to test for differences in levels of readiness-to-change between groups, with gender included as a covariate. Pairwise comparisons between groups were conducted post-hoc using Tukey’s HSD.

Table 2.

Number of Participants, Means, and Standard Deviations of Key Variables in Each Participant Category

N Grouping Equation RAS
M (SD)		 AUDIT
M (SD)
Total 219
HDHS 36 >median RAS + ≥8 AUDIT 3.67 (.25) 12.00 (2.98)
HDLS 50 <median RAS + ≥8 AUDIT 3.13 (.43) 12.66 (4.38)
NDHS 91 >median RAS + <8 AUDIT 3.71 (.21) 2.02 (2.19)
NDLS 42 <median RAS + <8 AUDIT 3.23 (.44) 2.93 (2.63)
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Note. N = Number of participants in each participant category. HDHS = Hazardous drinking-High Satisfaction; HDLS = Hazardous drinking-Low Satisfaction; NDHS = Nonhazardous drinking-High Satisfaction; NDLS = Nonhazardous drinking-Low Satisfaction.

Relationship Satisfaction and Readiness-to-Change Alcohol Use

Results of ANCOVA revealed significant differences in level of readiness-to-change alcohol use among the four participant groups (F(3,214) = 12.33, p < .001). Pairwise comparisons between individual groups are summarized in Table 3. Hypothesis 2 was supported such that among hazardous drinkers, those with high relationship satisfaction (HDHS; M = 4.72, SD = 3.68) reported significantly higher readiness-to-change alcohol use than those with low relationship satisfaction (HDLS; M = 1.64, SD = 1.91). As expected, there were no differences in readiness-to-change alcohol among non-hazardous drinkers with high (NDHS; M = 3.92, SD = 2.99) and low (NDLS; M = 3.65, SD = 4.18) relationship satisfaction. Furthermore, among individuals with low relationship satisfaction, hazardous drinkers (HDLS; M = 1.64, SD = 1.91) reported significantly lower readiness-to-change alcohol use than non-hazardous drinkers (NDLS; M = 3.65, SD = 4.18). In summary, while high vs. low relationship satisfaction was not related to readiness-to-change alcohol use among non-hazardous drinkers, it was positively associated with readiness-to-change alcohol use among hazardous drinkers, thus supporting Hypothesis 2.

Table 3.

Mean Differences in Readiness-to-Change Alcohol Use and Relationship Issues between Participant Groups

Readiness-to-Change HDHS HDLS NDHS NDLS Significant Group Differences (Pairwise Contrasts)
Alcohol Use
 Contemplation Ladder 4.72 (3.68)a 1.64 (1.91)b 3.92 (2.99)a 3.65 (4.18)a HDHS>HDLS***
HDLS<NDHS***
HDLS<NDLS**
Relationship Issues
 CSCQ 61.94 (17.29)a 72.81 (14.19)b 63.78 (19.57)a 71.13 (11.54)a,b HDHS<HDLS*
HDLS>NDHS*
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Note. HDHS = Hazardous drinking-High Satisfaction; HDLS = Hazardous drinking-Low Satisfaction; NDHS = Nonhazardous drinking-High Satisfaction; NDLS = Nonhazardous drinking-Low Satisfaction. Values with different subscripts indicate significant differences between groups.

*

p < .05.

**

p < .01

***

p < .001.

Alcohol Use and Readiness-to-Change Relationship Issues

Results of ANCOVA revealed significant differences in level of readiness-to-change relationship issues among the four participant groups (F(3,207) = 4.08, p < .01.). Pairwise comparisons between individual groups are summarized in Table 3. Hypothesis 3 was not supported such that among individuals with low relationship satisfaction, non-hazardous drinkers (NDLS; M = 71.13. SD = 11.54) did not reported significantly higher readiness-to-change relationship issues than hazardous drinkers (HDLS; M = 72.81. SD = 14.19). As expected, among individuals with high relationship satisfaction, there were no differences in readiness-to-change relationship issues between hazardous (HDHS; M = 61.94, SD = 17.29) and non-hazardous drinkers (NDHS; M = 63.78, SD = 19.57). There was a significant difference among hazardous drinkers such that those with low satisfaction (HDLS; M = 72.81, SD = 14.19) had higher readiness-to-change relationship issues than those with high satisfaction (HDHS; M = 61.94, SD = 17.29). In summary, Hypothesis 3 was not supported because hazardous drinking status was not related to readiness-to-change relationship issues for individuals with high or low relationship satisfaction.

Discussion

The purpose of the present study was to examine the associations between relationship satisfaction, hazardous drinking, and level of readiness-to-change alcohol use and relationship issues in college dating relationships. To our knowledge, this is the first study to examine the link between relationship satisfaction and motivation to change alcohol use in college students, as well as the first to examine the link between hazardous drinking and motivation to change relationship issues in college dating relationships. Overall, results supported our hypotheses that relationship satisfaction would be negatively related to alcohol use and that, among hazardous drinkers, individuals with high relationship satisfaction would indicate higher readiness-to-change alcohol use than those with low relationship satisfaction. Our third hypothesis that, among individuals with lower relationship satisfaction, hazardous drinkers would indicate lower readiness-to-change relationship issues than nonhazardous drinkers, was not supported.

Results from the present study indicated that hazardous drinking individuals with higher relationship satisfaction were more ready to change their alcohol use than those with lower relationship satisfaction. This is consistent with previous research demonstrating the motivational impact of supportive, healthy romantic relationships on unhealthy behavior patterns (Lewis et al., 2006). Specifically, these results indicate that the presence of highly satisfied relationships in college may help to move one further along the continuum of change regarding unhealthy behaviors such as drinking alcohol excessively. Although further studies are necessary to explain the mechanisms underlying these associations, these findings give preliminary support to the notion that dating relationships in emerging adulthood may provide similar influences on health behaviors as older adult married relationships, and that the well-documented effects of marriage on health and health behaviors may also apply to college dating relationships.

While this study did not explore the mechanisms underlying these findings, these data may indicate an important educational target for college programming aimed at decreasing the heavy drinking patterns of college students. Because many students enter into dating relationships during college, universities might consider the provision of education about the benefits of healthy relationships to college students in order to promote healthier behaviors that result from motivation developed in the context of a healthy romantic relationship. Furthermore, future research will need to explore what specific aspects of dating relationships contribute to favorable health outcomes and bolster the motivation to engage in healthier behavior patterns.

Results from the present study also indicated that alcohol use was not significantly related to motivation to work on relationship issues. This finding is not consistent with our hypotheses, as we expected hazardous alcohol use to negatively impact readiness-to-change relationship issues. Because little research has been conducted on this topic, it is difficult to identify reasons for this result. However, several processes may help to explain why hazardous drinking was not associated with lower readiness-to-change relationship issues in this sample. One possibility is that the hazardous drinking and motivation to work on relationship problems are separate and unrelated constructs. In other words, one’s drinking habits may not exert a significant influence on one’s desire or ability to work on relationship problems because the two are not related to each other. This possibility is supported by the finding that hazardous drinking was not related to readiness-to-change relationship issues in either the high or low satisfaction groups. Additionally, because heavy drinking is often a norm in modern college environments (Baer, 2002; Ham & Hope, 2003; Kuntsche, Knibbe, Gmel, & Engels, 2005), drinking habits may not exert significant effects on motivation to work on relationship issues. In contrast, different results may be found in older adult samples because heavy drinking is less sanctioned and normative than in college populations (Ahern, Galea, Hubbard, Midanik, & Syme, 2008; Greenfield & Room, 1997; Wild, 2002). Additionally, because most college dating relationships do not possess as strong social or economic barriers to exiting the relationship as marriage (Rhoades, Stanley, & Markman, 2010), it is possible that individuals who are no longer happy in their current relationship simply choose to leave it rather than work toward its improvement (Arriaga, 2001). Thus, alcohol use may not play a significant role in readiness-to-change relationship issues for college dating relationships because individuals who are highly dissatisfied with their current relationship may choose leave it (rather than improve it) regardless of their drinking habits. Lastly, because the sample in the current study indicated fairly high levels of relationship satisfaction, it is possible that a “ceiling effect” may be present and samples with greater variability in participants’ relationship satisfaction would yield more significant links between relationship satisfaction and readiness-to-change alcohol use.

Results from the current study also revealed that, similar to previous findings in married samples (e.g. Kearns-Bodkin & Leonard, 2005; Levitt & Cooper, 2010; Roberts & Linney, 2000), alcohol use was negatively associated with relationship quality. This finding provides further support to the notion that factors affecting the health and functioning of marital relationships may also affect the quality of other kinds of romantic relationships (Kurdek, 1995). Because college-age heavy drinkers share similar risks for negative outcomes associated with excessive alcohol use as older adults (Park, 2004; Perkins, 2002), it is not surprising that heavy alcohol use could similarly impact relationship quality in college dating relationships as it does in marital relationships.

Limitations

There are a number of limitations to the current study, which should be considered when interpreting these findings. First, the cross-sectional design of the current study precludes determination of causality among the study variables. Further research with longitudinal designs will be needed to examine the potential causal relationship between relationship quality and readiness-to-change drinking behaviors, between drinking behaviors and readiness-to-change relationship issues, and between relationship quality and alcohol use. Additionally, the use of a mostly Caucasian heterosexual college dating sample limits the generalizability of these findings to more diverse populations and other types of dyads. Future research should explore these relationships in other populations, different settings, and other types of dyadic relationships. Also, while our strategy for grouping participants based on relationship satisfaction is not the first of its kind (e.g. Contreras et al., 1996; Gordon & Chen, 2010), such categorization of participants into “low” and “high” relationship satisfaction based on a median split of the distribution of satisfaction scores is not ideal. Rather, such groupings that are based on meaningful, empirically derived cutoff scores from other measures may more appropriately categorize participants into “lower” and “higher” satisfaction, as the effects of being above or below the median satisfaction score in the current sample are not known. Lastly, the current study utilized reports from only one member of the dyad. Future studies which incorporate reports from both partners in the relationships will allow for exploration of actor and partner effects on motivation to change hazardous alcohol use and relationship issues.

Conclusion

In summary, the current study contributes to a growing body of literature on relationship health, alcohol use, and readiness-to-change in college students. Findings indicate that highly satisfied intimate relationships are associated with greater readiness-to-change hazardous alcohol use, while hazardous alcohol use is not associated with readiness-to-change relationship issues. Additionally, results indicate that alcohol use is negatively associated with relationship quality in college dating relationships, mirroring previous research on marital relationships. These findings provide important new insights into the potential interplay between romantic relationships, alcohol use, and motivation to change in college students. In particular, these findings suggest that relationship health may be an important target for programs aimed at decreasing heavy alcohol use of college students and suggest that college students may benefit from relationship-oriented education and interventions. For example, the provision of relationship education programs, which has been shown to effectively reduce divorce and distress among married adults (Hawkins, Blanchard, Baldwin, & Fawcett, 2008), has also been received favorably by young adult college students (Olmstead et al., 2011). Moreover, recent efforts to provide relationship education in the form of a formal elective course (see Neilsen, Pinsof, Rampage, Solomon, & Goldestein, 2004) or as part of existing high-enrollment courses (see Fincham, Stanley, & Rhoades, 2010) have shown considerable promise in building college students’ relationship knowledge, communication skills, and reducing risky sexual behaviors. Given findings from the present study and the previously documented benefits of healthy romantic relationships to the mental and physical health of college students (Braithwaite et al., 2010; Simon & Barrett, 2010; Whitton et al., 2013), efforts to provide relationship education to college students in the form of stand-alone programs or by integrating relationship education curriculums into existent university courses may be one strategy to promote healthier drinking behaviors among college students.

Additionally, because of college students’ comfort and wide-spread use of media technology, such efforts might even be deliverable via computer-based relationship education (e.g. ePREP; see Braithwaite & Fincham, 2007; Braithwait & Fincham, 2011), which might be a particularly effective method of delivering this information at larger academic universities. Lastly, despite the utility of informational programs (e.g. relationship education) to curb potential relationship distress, many college students are already involved in a romantic relationship (Arnett & Tanner, 2006); thus, targeted brief intervention efforts for non-treatment-seeking populations (e.g. The Marriage Checkup; Cordova et al., 2006) that can be tailored to dating college students may also be effective in promoting more favorable mental, physical, and behavioral health outcomes for students involved in a romantic relationship. Overall, findings from the current study provide new insights into the interplay between alcohol use and college dating relationships, offer important implications for college student health, and suggest a promising area for future research.

Acknowledgments

Funding

This work was supported, in part, by grants F31AA020131 and K24AA019707 from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) awarded to the second and last authors, respectively. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIAAA or the National Institutes of Health.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Contributor Information

Alexander Khaddouma, University of Tennessee – Knoxville, Department of Psychology, Phone: 865-386-7394.

Ryan C. Shorey, Email: shorey@ohio.edu, Assistant Professor, Ohio University, Department of Psychology, Phone: (740) 597-3298.

Hope Brasfield, University of Tennessee – Knoxville, Department of Psychology, Phone: 865-386-7394.

Jeniimarie Febres, University of Tennessee – Knoxville, Department of Psychology, Phone: 865-386-7394.

Heather Zapor, University of Tennessee – Knoxville, Department of Psychology, Phone: 865-386-7394.

Joanna Elmquist, University of Tennessee – Knoxville, Department of Psychology, Phone: 865-386-7394.

Gregory L. Stuart, Email: gstuart@utk.edu, Professor, University of Tennessee – Knoxville, Department of Psychology, Phone: 865-974-3358.

References

  1. Ahern J, Galea S, Hubbard A, Midanik L, Syme SL. “Culture of drinking” and individual problems with alcohol use. American Journal of Epidemiology. 2008;167(9):1041–1049. doi: 10.1093/aje/kwn022. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Arnett JJ, Robins A, Rehm D. Emerging adulthood. Oxford University Press; 2001. [Google Scholar]
  3. Arnett JJ, Tanner JL. Emerging adults in America: Coming of age in the 21st century. Citeseer: 2006. [Google Scholar]
  4. Arriaga XB. The ups and downs of dating: fluctuations in satisfaction in newly formed romantic relationships. Journal of Personality and Social Psychology. 2001;80(5):754. doi: 10.1037//0022-3514.80.5.754. [DOI] [PubMed] [Google Scholar]
  5. Baer JS. Student factors: Understanding individual variation in college drinking. Journal of Studies on Alcohol and Drugs. 2002;(14):40. doi: 10.15288/jsas.2002.s14.40. [DOI] [PubMed] [Google Scholar]
  6. Beaver KM, Wright JP, DeLisi M, Vaughn MG. Desistance from delinquency: The marriage effect revisited and extended. Social Science Research. 2008;37(3):736–758. doi: 10.1016/j.ssresearch.2007.11.003. http://dx.doi.org/10.1016/j.ssresearch.2007.11.003. [DOI] [PubMed] [Google Scholar]
  7. Biener L, Abrams DB. The Contemplation Ladder: validation of a measure of readiness to consider smoking cessation. Health Psychology. 1991;10(5):360. doi: 10.1037//0278-6133.10.5.360. [DOI] [PubMed] [Google Scholar]
  8. Bradford K. Assessing readiness for couple therapy: The stages of relationship change questionnaire. Journal of Marital and Family Therapy. 2012;38(3):486–501. doi: 10.1111/j.1752-0606.2010.00211.x. [DOI] [PubMed] [Google Scholar]
  9. Braithwaite SR, Delevi R, Fincham FD. Romantic relationships and the physical and mental health of college students. Personal Relationships. 2010;17(1):1–12. [Google Scholar]
  10. Braithwaite SR, Fincham FD. ePREP: Computer based prevention of relationship dysfunction, depression and anxiety. Journal of Social and Clinical Psychology. 2007;26(5):609–622. [Google Scholar]
  11. Braithwaite SR, Fincham FD. Computer-based dissemination: A randomized clinical trial of ePREP using the actor partner interdependence model. Behaviour research and therapy. 2011;49(2):126–131. doi: 10.1016/j.brat.2010.11.002. [DOI] [PubMed] [Google Scholar]
  12. Carey KB, Henson JM, Carey MP, Maisto SA. Which heavy drinking college students benefit from a brief motivational intervention? Journal of Consulting and Clinical Psychology. 2007;75(4):663. doi: 10.1037/0022-006X.75.4.663. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Contreras R, Hendrick SS, Hendrick C. Perspectives on Marital Love and Satisfaction in Mexican American and Anglo-American Couples. Journal of Counseling & Development. 1996;74(4):408–415. [Google Scholar]
  14. Cordova JV, Scott RL, Dorian M, Mirgain S, Yaeger D, Groot A. The marriage checkup: An indicated preventive intervention for treatment-avoidant couples at risk for marital deterioration. Behavior Therapy. 2005;36(4):301–309. [Google Scholar]
  15. Cranford JA, Floyd FJ, Schulenberg JE, Zucker RA. Husbands’ and wives’ alcohol use disorders and marital interactions as longitudinal predictors of marital adjustment. Journal of abnormal psychology. 2011;120(1):210. doi: 10.1037/a0021349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Dethier M, Counerotte C, Blairy S. Marital satisfaction in couples with an alcoholic husband. Journal of Family Violence. 2011;26(2):151–162. [Google Scholar]
  17. Dorian M, Cordova J. The couples stages of change questionnaire. 2001 Unpublished questionnaire. [Google Scholar]
  18. Duncan GJ, Wilkerson B, England P. Cleaning up their act: the effects of marriage and cohabitation on licit and illicit drug use. Demography. 2006;43(4):691–710. doi: 10.1353/dem.2006.0032. [DOI] [PubMed] [Google Scholar]
  19. Epstein EE, McCrady BS. Behavioral couples treatment of alcohol and drug use disorders: Current status and innovations. Clinical Psychology Review. 1998;18:689–711. doi: 10.1016/s0272-7358(98)00025-7. [DOI] [PubMed] [Google Scholar]
  20. Epstein EE, McCrady BS, Miller KJ, Steinberg M. Attrition from conjoint alcoholism treatment: Do dropouts differ from completers? Journal of Substance Abuse. 1994;6(3):249–265. doi: 10.1016/s0899-3289(94)90447-2. [DOI] [PubMed] [Google Scholar]
  21. Fincham FD, Stanley SM, Rhoades GK. Relationship education in emerging adulthood: problems and prospects. In: Fincham FD, Cui M, editors. Romantic Relationships in Emerging Adulthood. New York, NY: Cambridge University Press; 2010. pp. 293–316. [Google Scholar]
  22. Friedmann PD. Alcohol use in adults. New England Journal of Medicine. 2013;368(4):365–373. doi: 10.1056/NEJMcp1204714. [DOI] [PubMed] [Google Scholar]
  23. Gordon AM, Chen S. When you accept me for me: The relational benefits of intrinsic affirmations from one’s relationship partner. Personality and Social Psychology Bulletin. 2010;36(11):1439–1453. doi: 10.1177/0146167210384881. [DOI] [PubMed] [Google Scholar]
  24. Greenfield TK, Room R. Situational norms for drinking and drunkenness: trends in the US adult population, 1979–1990. Addiction. 1997;92(1):33–47. [PubMed] [Google Scholar]
  25. Ham LS, Hope DA. College students and problematic drinking: A review of the literature. Clinical Psychology Review. 2003;23(5):719–759. doi: 10.1016/s0272-7358(03)00071-0. [DOI] [PubMed] [Google Scholar]
  26. Hawkins AJ, Blanchard VL, Baldwin SA, Fawcett EB. Does marriage and relationship education work? A meta-analytic study. Journal of Consulting and Clinical Psychology. 2008;76(5):723. doi: 10.1037/a0012584. [DOI] [PubMed] [Google Scholar]
  27. Hendrick SS, Dicke A, Hendrick C. The relationship assessment scale. Journal of Social and Personal Relationships. 1998;15(1):137–142. [Google Scholar]
  28. Herzog TA, Abrams DB, Emmons KM, Linnan L. Predicting increases in readiness to quit smoking: A prospective analysis using the contemplation ladder. Psychology and Health. 2000;15(3):369–381. [Google Scholar]
  29. Hogue A, Dauber S, Morgenstern J. Validation of a contemplation ladder in an adult substance use disorder sample. Psychology of Addictive Behaviors. 2010;24(1):137. doi: 10.1037/a0017895. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Jackson KM, Sher KJ, Park A. Recent developments in alcoholism. Springer; US: 2005. Drinking among college students; pp. 85–117. [DOI] [PubMed] [Google Scholar]
  31. Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE. Monitoring the Future national survey results on drug use, 1975–2011: Volume II, College students and adults ages 19–50. Ann Arbor, MI: Institute for Social Research, The University of Michigan; 2012. [Google Scholar]
  32. Kadden R, Carbonari J, Litt M, Tonigan S, Zweben A. Matching alcoholism treatments to client heterogeneity: Project MATCH three-year drinking outcomes. Alcoholism: clinical and experimental research. 1998;22(6):1300–1311. doi: 10.1111/j.1530-0277.1998.tb03912.x. [DOI] [PubMed] [Google Scholar]
  33. Kearns-Bodkin JN, Leonard KE. Alcohol involvement and marital quality in the early years of marriage: A longitudinal growth curve analysis. Alcoholism: Clinical and Experimental Research. 2005;29(12):2123–2134. doi: 10.1097/01.alc.0000191751.62025.77. [DOI] [PubMed] [Google Scholar]
  34. Kivisto AJ, Kivisto KL, Moore TM, Rhatigan DL. Antisociality and Intimate Partner Violence: The Facilitating Role of Shame. Violence and victims. 2011;26(6):758–773. doi: 10.1891/0886-6708.26.6.758. [DOI] [PubMed] [Google Scholar]
  35. Kokotailo PK, Egan J, Gangnon R, Brown D, Mundt M, Fleming M. Validity of the alcohol use disorders identification test in college students. Alcoholism: Clinical and Experimental Research. 2004;28(6):914–920. doi: 10.1097/01.alc.0000128239.87611.f5. [DOI] [PubMed] [Google Scholar]
  36. Kuntsche E, Knibbe R, Gmel G, Engels R. Why do young people drink? A review of drinking motives. Clinical Psychology Review. 2005;25(7):841–861. doi: 10.1016/j.cpr.2005.06.002. [DOI] [PubMed] [Google Scholar]
  37. Kurdek LA. Assessing multiple determinants of relationship commitment in cohabiting gay, cohabiting lesbian, dating heterosexual, and married heterosexual couples. Family Relations. 1995:261–266. [Google Scholar]
  38. Liang W, Chikritzhs T. Brief report: marital status and alcohol consumption behaviours. Journal of Substance Use. 2012;17(1):84–90. [Google Scholar]
  39. Leonard K, Eiden RD. Marital and family processes in the context of alcohol use and alcohol disorders. Annual review of clinical psychology. 2007;3:285. doi: 10.1146/annurev.clinpsy.3.022806.091424. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Levitt A, Cooper ML. Daily alcohol use and romantic relationship functioning: evidence of bidirectional, gender-, and context-specific effects. Personality and Social Psychology Bulletin. 2010;36(12):1706–1722. doi: 10.1177/0146167210388420. [DOI] [PubMed] [Google Scholar]
  41. Lewis MA, McBride CM, Pollak KI, Puleo E, Butterfield RM, Emmons KM. Understanding health behavior change among couples: An interdependence and communal coping approach. Social Science & Medicine. 2006;62(6):1369–1380. doi: 10.1016/j.socscimed.2005.08.006. [DOI] [PubMed] [Google Scholar]
  42. Marshal MP. For better or for worse? The effects of alcohol use on marital functioning. Clinical Psychology Review. 2003;23(7):959–997. doi: 10.1016/j.cpr.2003.09.002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. McConnaughy EA, Prochaska JO, Velicer WF. Stages of change in psychotherapy: Measurement and sample profiles. Psychotherapy: Theory, Research & Practice. 1983;20(3):368. [Google Scholar]
  44. McGee R, Williams S, Kypri K. College students’ readiness to reduce binge drinking: Criterion validity of a brief measure. Drug and alcohol dependence. 2010;109(1):236–238. doi: 10.1016/j.drugalcdep.2009.12.009. [DOI] [PubMed] [Google Scholar]
  45. National Social Norms Institute. The University of Tennessee. 2007 Socialnorms.org Retrieved June 3 2014 from http://www.socialnorms.org/CaseStudies/tennessee.php.
  46. Nielsen A, Pinsof W, Rampage C, Solomon AH, Goldstein S. Marriage 101: An integrated academic and experiential undergraduate marriage education course. Family Relations. 2004;53(5):485–494. [Google Scholar]
  47. O’Hare T, Sherrer MV. Validating the alcohol use disorder identification test with college first-offenders. Journal of Substance Abuse Treatment. 1999;17(1):113–119. doi: 10.1016/s0740-5472(98)00063-4. [DOI] [PubMed] [Google Scholar]
  48. Olmstead SB, Pasley K, Meyer AS, Stanford PS, Fincham FD, Delevi R. Implementing relationship education for emerging adult college students: Insights from the field. Journal of Couple & Relationship Therapy. 2011;10(3):215–228. [Google Scholar]
  49. Palfai TP, McNally AM, Roy M. Volition and alcohol-risk reduction: The role of action orientation in the reduction of alcohol-related harm among college student drinkers. Addictive Behaviors. 2002;27(2):309–317. doi: 10.1016/s0306-4603(01)00186-1. [DOI] [PubMed] [Google Scholar]
  50. Park CL. Positive and negative consequences of alcohol consumption in college students. Addictive Behaviors. 2004;29(2):311–321. doi: 10.1016/j.addbeh.2003.08.006. [DOI] [PubMed] [Google Scholar]
  51. Perkins H. Surveying the damage: A review of research on consequences of alcohol misuse in college populations. Journal of Studies on Alcohol and Drugs. 2002;(14):91. doi: 10.15288/jsas.2002.s14.91. [DOI] [PubMed] [Google Scholar]
  52. Powers MB, Vedel E, Emmelkamp PM. Behavioral couples therapy (BCT) for alcohol and drug use disorders: A meta-analysis. Clinical Psychology Review. 2008;28(6):952–962. doi: 10.1016/j.cpr.2008.02.002. [DOI] [PubMed] [Google Scholar]
  53. Presley CA, Meilman PW, Leichliter JS. College factors that influence drinking. Journal of Studies on Alcohol and Drugs. 2002;(14):82. doi: 10.15288/jsas.2002.s14.82. [DOI] [PubMed] [Google Scholar]
  54. Reinert DF, Allen JP. The alcohol use disorders identification test (AUDIT): a review of recent research. Alcoholism: Clinical and Experimental Research. 2002;26(2):272–279. [PubMed] [Google Scholar]
  55. Renshaw KD, McKnight P, Caska CM, Blais RK. The utility of the relationship assessment scale in multiple types of relationships. Journal of social and personal relationships. 2011;28(4):435–447. [Google Scholar]
  56. Rhoades GK, Stanley SM, Markman HJ. Should I stay or should I go? Predicting dating relationship stability from four aspects of commitment. Journal of Family Psychology. 2010;24(5):543. doi: 10.1037/a0021008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  57. Roberts LJ, Linney KD. Alcohol problems and couples: Drinking in an intimate relational context 2000 [Google Scholar]
  58. Robles TF, Slatcher RB, Trombello JM, McGinn MM. Marital quality and health: A meta-analytic review. Psychological Bulletin. 2013 doi: 10.1037/a0031859. [DOI] [PMC free article] [PubMed] [Google Scholar]
  59. Rodriguez LM, Neighbors C, Knee CR. Problematic alcohol use and marital distress: An interdependence theory perspective. Addiction Research & Theory. 2013:1–19. [Google Scholar]
  60. Rodriguez LM, Øverup CS, Neighbors C. Perceptions of partners’ problematic alcohol use affect relationship outcomes beyond partner self-reported drinking: Alcohol use in committed romantic relationships. Psychology of addictive behaviors. 2013;27(3):627. doi: 10.1037/a0031737. [DOI] [PMC free article] [PubMed] [Google Scholar]
  61. Saunders JB, Aasland OG, Babor TF, Grant M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction. 1993;88(6):791–804. doi: 10.1111/j.1360-0443.1993.tb02093.x. [DOI] [PubMed] [Google Scholar]
  62. Schonbrun YC, Walsh Z, Stuart GL, Strong DR. Marital status and treatment utilization for alcohol use disorders. Addictive Disorders & Their Treatment. 2011;10(3):111–122. http://dx.doi.org/10.1097/ADT.0b013e31820f7596. [Google Scholar]
  63. Shorey RC, Febres J, Brasfield H, Stuart GL. Male Dating Violence Victimization and Adjustment The Moderating Role of Coping. American journal of men’s health. 2012;6(3):218–228. doi: 10.1177/1557988311429194. [DOI] [PMC free article] [PubMed] [Google Scholar]
  64. Shorey RC, Rhatigan DL, Fite PJ, Stuart GL. Dating violence victimization and alcohol problems: An examination of the stress-buffering hypothesis for perceived support. Partner Abuse. 2011;2(1):31–45. [Google Scholar]
  65. Simon RW, Barrett AE. Nonmarital Romantic Relationships and Mental Health in Early Adulthood Does the Association Differ for Women and Men? Journal of Health and Social Behavior. 2010;51(2):168–182. doi: 10.1177/0022146510372343. [DOI] [PubMed] [Google Scholar]
  66. Slutske WS, Hunt-Carter EE, Nabors-Oberg RE, Sher KJ, Bucholz KK, Madden PA, Heath AC. Do college students drink more than their non-college-attending peers? Evidence from a population-based longitudinal female twin study. Journal of Abnormal Psychology. 2004;113(4):530. doi: 10.1037/0021-843X.113.4.530. [DOI] [PubMed] [Google Scholar]
  67. Stuart GL, Meehan JC, Moore TM, Morean M, Hellmuth J, Follansbee K. Examining a conceptual framework of intimate partner violence in men and women arrested for domestic violence. Journal of Studies on Alcohol and Drugs. 2006;67(1):102. doi: 10.15288/jsa.2006.67.102. [DOI] [PubMed] [Google Scholar]
  68. Swendsen JD, Tennen H, Carney MA, Affleck G, Willard A, Hromi A. Mood and alcohol consumption: an experience sampling test of the self-medication hypothesis. Journal of Abnormal Psychology. 2000;109(2):198. [PubMed] [Google Scholar]
  69. Tambling RB, Johnson LN. The relationship between stages of change and outcome in couple therapy. The American Journal of Family Therapy. 2008;36(3):229–241. [Google Scholar]
  70. Van Lange PAM, Rusbult CE, Drigotas SM, Arriaga XB, Witcher BS, Cox CL. Willingness to sacrifice in close relationships. Journal of Personality and Social Psychology. 1997;72(6):1373–1395. doi: 10.1037//0022-3514.72.6.1373. http://dx.doi.org/10.1037/0022-3514.72.6.1373. [DOI] [PubMed] [Google Scholar]
  71. Walitzer K, Dermen K, Shyhalla K, Kubiak A. Couple communication among problem drinking males and their spouses: a randomized controlled trial. Journal of Family Therapy. 2013;35(3):229–251. [Google Scholar]
  72. White A, Hingson R. The burden of alcohol use: Excessive alcohol consumption and related consequences among college students. Alcohol research: current reviews. 2014;35(2):201. [PMC free article] [PubMed] [Google Scholar]
  73. Whitton SW, Weitbrecht EM, Kuryluk AD, Bruner MR. Committed Dating Relationships and Mental Health Among College Students. Journal of American College Health. 2013;61(3):176–183. doi: 10.1080/07448481.2013.773903. [DOI] [PubMed] [Google Scholar]
  74. Wild TC. Personal drinking and sociocultural drinking norms: A representative population study. Journal of Studies on Alcohol and Drugs. 2002;63(4):469. doi: 10.15288/jsa.2002.63.469. [DOI] [PubMed] [Google Scholar]

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