Horizon Interdisciplinary Journal (HIJ). ISSN: 2992-7706

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Original Article

Cognitive Protective Factors Against Alcohol

Consumption in University Students.

Julia Elena Del Angel-García

, María Magdalena Alonso-Castillo

, Karla Selene

López-García

& Francisco Cadena-Santos

Universidad Autónoma de Nuevo León. Facultad de Enfermería. Monterrey, Nuevo León,

México.

Universidad Autónoma de Tamaulipas. Facultad de Enfermería, Nuevo Laredo, Tamaulipas.

México.

*Corresponding author: María Magdalena Alonso-Castillo, Universidad Autónoma de Nuevo

León. Facultad de Enfermería. Monterrey, Nuevo León, México. E-mail:

magdalena_al[email protected], ORCID: 0000-0002-7197-8116

Sent: 03/20/2024 Accepted: 06/03/2024 Published: 09/11/2024

Resumen: Introduction: Alcohol consumption among university students is complex and

multifactorial, with each factor potentially acting as either a risk or protective factor, influencing

decision-making regarding their behavior. The purpose of the study was to determine the relationship

and effect of resistance self-efficacy and self-control on alcohol consumption among university

students. Methods: This was a descriptive, correlational, and predictive study that included 228

university students. Participants were selected through stratified random probability sampling with

proportional allocation to stratum size. They were administered a Personal Data Form, the Situational

Confidence Questionnaire, the Abbreviated Self-Control Scale, and the Alcohol Use Disorders

Identification Test. The study adhered to the regulations of the General Health Law. Results: Of the

participants, 57.0% were women and 43.0% were men. A total of 82.0% of the students consumed

alcohol in the past year, 46.1% in the past month, and 24.1% in the past week. Sensible consumption

was observed in 42.8%, dependent consumption in 28.3%, and harmful consumption in 28.9% of the

students. Resistance self-efficacy (r

= -0.510, p<0.01) and self-control (r

= -0.187, p<0.05) were found

to have a negative and significant relationship with alcohol consumption. Additionally, resistance self-

efficacy (β= -0.381, p=0.001) showed a negative and significant effect on alcohol consumption.

Conclusions: The results of this study can significantly contribute to the understanding of the

phenomenon of alcohol consumption, providing knowledge that may serve as the basis for future

research or interventions aimed at preventing alcohol consumption among university students.

Key words: Alcohol Consumption, University Students, Resistance Self-Efficacy, Self-Control,

Protective Factors..

1. Introduction

Alcohol consumption is considered a high

risk behavior due to its health and social

environment implications

. Studies carried

out with young university students in

Mexico report that between 37.4% and

64.9% of them have consumed alcohol in

the last year

2, 3

Furthermore, an alarming practice among

young college students is the excessive

consumption of alcohol (binge drinking).

Horizon Interdisciplinary Journal (HIJ). ISSN: 2992-7706

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According to the National Institute of

Public Health, 51.8% of young people

between 20 and 29 years of age engage in

this type of consumption, which is

characterized by the ingestion of five or

more drinks per occasion within a period

of two hours in the last month for men;

and in the case of women, four or more

drinks in the same period

Due to the previously mentioned statistics

and the inherent changes of the onset of

adulthood, the population of young

university students is considered a high-

risk population

, since they undergo

psychological experiences related to

identity, the instability of the immediate

future, interpersonal relationships and

multiple characteristics of their

environment, which can lead to the onset

of risky behaviors, such as alcohol

consumption

Alcohol consumption in young college

students is a complex and multifactorial

issue; thus, each factor can behave as a risk

factor or as a protective factor. According

to the literature and the Social Cognitive

Theory

there may be cognitive factors

that can affect decision making about

one's own behavior. One of the factors that

has been associated with alcohol

consumption is alcohol resistance self-

efficacy; studies have shown that alcohol

resistance self-efficacy has a negative and

significant relationship with alcohol

consumption

. Thus, it is established that a

higher self-belief of being able to refuse or

resist alcohol consumption is associated

with lower levels of alcohol consumption

and its consequences in university

students.

Similarly, studies indicate that resistance

self-efficacy has a negative and significant

effect on alcohol consumption, and is

therefore considered a protective factor

for alcohol consumption

9-12

. Another

relevant cognitive factor in the drinking

behavior of young university students is

self-control, which can behave as a risk or

protective factor

. Studies carried out in

young university students report that self-

control has a negative and significant

relationship with alcohol consumption

14, 15

It is worth mentioning that no evidence

was identified on resistance self-efficacy

and self-control in the social and

geographic context of the present study.

Therefore, it is considered relevant to

deepen both variables, in order to

contribute knowledge to understand the

phenomenon and in the future could be

the basis for new and broader studies, as

well as to generate strategies to prevent

alcohol consumption. Based on the above,

our aim was to determine the relationship

and effect of resistance self-efficacy and

self-control on alcohol consumption in

young university students.

2. Method

2.1 Study design and participants

A descriptive, correlational and predictive

study was conducted. The population

consisted of 3,077 young university

students over 18 years of age of both sexes

from nursing and industrial engineering

courses at a university in the southern

region of Tamaulipas. Sample size was

determined using the nQuery Advisor 4.0

software under the criteria of a

Horizon Interdisciplinary Journal (HIJ). ISSN: 2992-7706

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significance level of 0.05, a confidence

level of 95%, with a power of 0.90 (90%)

and a coefficient of determination of 0.09

(median effect size) according to Cohen

A total of 228 young university students

were selected by stratified random

probability sampling with allocation

proportional to the size of the stratum.

The combinations were career (2: nursing

and industrial engineering) and grade (4:

1st, 2nd, 3rd and 4th year of studies), which

formed 8 strata. Within each stratum, one-

stage cluster sampling was used, where

the group of students formed each cluster.

2.2 Measuring instruments

To assess the sociodemographic

characteristics, a Personal Data

Questionnaire was used, which included

data such as age, sex, career, current

semester, as well as the prevalence of

alcohol consumption (ever in life, in the

last year, in the last month and in the last

week). To measure self-efficacy to resist

alcohol consumption, the Situational

Confidence Questionnaire

was used,

translated and adapted to Spanish by

Echeverría and Ayala

. This questionnaire

is made up of 39 items with a response

scale ranging from 1 to 6, where 1 denotes

“I could not resist the temptation to

consume alcohol for sure” and 6 denotes “I

could resist the temptation to consume

alcohol for sure”.)

The questionnaire includes the

intrapersonal and interpersonal subscales;

the intrapersonal subscale comprises

items 1 to 3, 7 to 13, 17 to 23, 27 to 33 and 36

to 39, which constitute the categories:

negative physical emotional states,

positive emotional state, impulses and

temptations, and personal control test.

The interpersonal subscale is made up of

items 4 to 6, 14 to 16, 24 to 26 and 34 to 35;

the minimum scale score is 39 and the

maximum is 234. This questionnaire has

shown Cronbach's Alpha consistency

between 0.94 and 0.97 and an explained

variance of 68.1% in various studies

conducted in Mexican high school

students

19,20

. In this study, an internal

consistency of 0.95 was obtained.

In order to evaluate self-control, the

Abbreviated Self-Control Scale

was used,

which was designed with the aim of

assessing self-control in university

students in the United States. This

instrument was adapted to Spanish in a

population of university students from

Argentina with an explained variance of

44% and internal consistency of the total

scale (α = .75)

. The scale consists of 13

items that are divided into two subscales:

self-discipline (items 6, 11, 5, 1, 7, 8, 2) and

impulse control (items 12, 13, 3, 9, 10, 4),

with five Likert-type response options

ranging from 1 (strongly disagree) to 5

(strongly agree) having a minimum score

of 13 and a maximum of 65. In the present

study, the Cronbach's Alpha coefficient

was 0.73.

Alcohol consumption was measured by

means of prevalence (once in a lifetime, in

the last year, in the last month and in the

last week), as well as the Alcohol Use

Disorders Identification Test (AUDIT) with

the aim of measuring drinking behavior

and problems related to alcohol

consumption in adults with problematic

alcohol consumption

. This questionnaire

Horizon Interdisciplinary Journal (HIJ). ISSN: 2992-7706

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was adapted to the Mexican population by

De la Fuente and Kershenobich (1992)

The instrument examines alcohol

consumption during the last twelve

months and its consequences, it identifies

sensible, dependent and harmful alcohol

consumption, and consists of 10 items with

Likert-type response options ranging from

0 to 4.

The AUDIT Questionnaire has a minimum

value of 0 and a maximum of 40 points. The

classification of the type of consumption is

obtained by adding the items and the cut-

off points are from 1 to 3 points is

considered sensible or low-risk

consumption, from 4 to 7 points refers to

dependent or risky consumption and from

8 to 40 may represent harmful

consumption. The interpretation was

made by calculating the index from 0 to

100, which allows us to understand how

the higher the score, the higher the

consumption and problems derived from

alcohol consumption. This questionnaire

has been used in studies conducted in

young university students in Mexico, in

which it has reported a Cronbach's Alpha

between 0.80 and 0.89

25,26

. The internal

consistency in this study was 0.77.

2.3 Procedure

This study was approved by the Research

Ethics Committee and the Research

Committee with registration number

FAEN-D-1919 of the Universidad

Autónoma de Nuevo León, Mexico.

Subsequently, authorization was obtained

from the directors of the faculties of

Nursing and Engineering belonging to a

university in the southern zone of the state

of Tamaulipas, academic departments

where the study was carried out on young

university students.

After obtaining the authorizations, the lists

of students enrolled in the August-

December 2023 school period were

requested, as well as information on the

total number of students and the

distribution of groups by career. The

above data allowed us to randomly select

the participating groups using the Excel

program.

Once the groups were selected, the

authorities of the two academic

departments arranged a day and time to

visit the young university students, at

which time an invitation was made to

participate voluntarily in the study. Data

collection was carried out in a single

session, which began with the reading and

signing of the informed consent form, and

then continued with the application of the

measuring instruments. At the end of the

collection, the participants were thanked.

It is worth mentioning that the

instruments were kept during the study

for later destruction.

2.4 Data analysis

The Statistical Package for the Social

Sciences (SPSS), version 22 for Windows,

was used to analyze the data. In order to

determine the internal consistency of the

measurement instruments, Cronbach's

Alpha Reliability Coefficient was used.

Descriptive statistics were also applied

and the Kolmogorov-Smirnov Goodness of

Fit Test with Lillieffors correction was

used. Non-parametric statistics were used

for the objectives set by applying

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Spearman's Correlation Coefficient. A

Multiple Linear Regression Model was also

used.

2.5 Ethical considerations

Our study complied with the provisions of

the Regulations of the General Health Law

on Health Research

in its latest update

published in the Official Journal of the

Federation (DOF) 02-04-2014, which

states that all health research must

consider ethical aspects that guarantee

the dignity and well-being of all individuals

who agree to participate. In order to

comply with this, the participants were

treated with respect, dignity,

confidentiality and anonymity during their

participation in the study. Likewise, each

participant was asked to sign an informed

consent form.

3. Results

3.1 Sample sociodemographic

characteristics

Of the participants, 55.7% indicated that

they were enrolled in the nursing program

while 44.3% were in industrial

engineering. The mean age of the

university students was 20.05 (SD=1.76)

years, 57.0% were female and 43.0% were

male. The average number of years of

schooling was 13.85 (SD=1.48) years. Of the

young university students, 94.3%

indicated that they were single. Regarding

occupation, 68.0% reported only studying

and 32.0% both studying and working.

3.2 Alcohol consumption in university

students

Regarding alcohol consumption, 91.7%

(95% CI [88, 95]) of the young university

students reported having consumed

alcohol at some time in their lives, 82.0%

(95% CI [77, 87]) did so in the last year,

46.1% (95% CI [40, 53]) in the last month,

and 24.1% (95% CI [19, 30]) in the last week.

Regarding binge drinking, 37.8% (95% CI

[28, 48]) of men reported binge drinking,

whereas in women it was 21.5% (95% CI

[14, 29]). Likewise, it was identified that the

average number of occasions of such

consumption in the last month in men was

1.92 (SD=1.27), while in women it was 2.18

(SD=1.58) occasions in the last month.

Relative to the type of alcohol

consumption of university students, 42.8%

(95% CI [35, 49]) had sensible alcohol

consumption, 28.3% (95% CI [21, 34]) were

dependent, and 28.9% (95% CI [22, 35])

had harmful or damaging alcohol

consumption. With respect to some

characteristics of alcohol consumption

behavior, 32.5% consumed alcohol with

friends, 14.5% with family and 26.8% with

both; likewise, it was noted that the place

of consumption was mostly in social

spaces such as friends' houses, nightclubs

or restaurants.

3.3. Study variable correlations

Table 1 shows the Correlation Coefficient

of resistance self-efficacy, self-control

and alcohol consumption, these findings

show that there is a negative and

significant relationship between

resistance self-efficacy and alcohol

consumption (rs= -0.510, p<0.01), as well as

between self-control and alcohol

consumption (rs= -0.187, p<0.05), which

could be interpreted as the lower the

resistance self-efficacy and self-control,

the higher the alcohol consumption and

vice versa.

Horizon Interdisciplinary Journal (HIJ). ISSN: 2992-7706

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Table 1. Spearman's correlation coefficient of the study variables.

Variables

1. Age

0.806**

0.040

0.103

-0.065

2. Schooling

-0.020

-0.037

-0.007

3. Resistance self-efficacy

0.310**

-0.510**

4. Self-control

-0.187*

5. Alcohol consumption

*p<0.05, **p<0.01, n= 228

3.4 Multiple Linear Regression Model

Table 2 shows the Multiple Linear

Regression Model of the study variables.

The final initial model showed to be

significant (F (137) = 16.035, p<0.001), with

an explained variance of 26.1%; which

showed that resistance self-efficacy (β= -

0.381, p=0.001) has a negative and

significant effect on alcohol consumption,

while age, schooling and self-control

reported no significant effect on alcohol

consumption (p>0.05).

After the application of the Backward

method, the final model showed to be

significant (F (137) = 31.758, p<0.001), with

an explained variance of 25.7%. In the

second model, the negative and significant

effect of resistance self-efficacy (β= -

0.378, p=0.001) on alcohol consumption

was maintained. Likewise, age, schooling

and self-control retained the absence of

significant effect on alcohol consumption

(p>0.05).

Table 2. Multiple Linear Regression Model of resistance self-efficacy, self-control and alcohol

consumption.

Regression

6560.844

1640.211

16.035

0.001

Residual

18616.696

182

102.290

Total

25177.540

186

=26.1%

Model 1

Coeficients

Constant

45.424

9.373

4.846

0.001

Age

-0.284

0.680

-0.417

0.677

Schooling

0.713

0.797

0.889

0.373

Resistance self-

efficacy

-0.381

0.054

-7.072

0.001

Self-control

-0.082

0.053

-1.567

0.119

: Coefficient of determination, SS: Sum of squares, df: degrees of freedom, MS: Mean squares, F: F

statistic value, β: Beta, p: observed significance, E: Standard error, t: t-test statistic, n = 228.

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Table 2. Multiple Linear Regression Model of Resistance Self-Efficacy, Self-Control, and Alcohol

Consumption (Backward) (continued)

Regression

6460.931

3230.466

31.758

0.001

Residual

18716.609

184

101.721

Total

25177.540

186

=25.7%

Model 2

Coeficients

Constant

49.778

4.672

10.654

0.001

Resistance self-

efficacy

-0.378

0.054

-7.069

0.001

Self-control

-0.088

0.051

-1.713

0.088

: Coefficient of determination, SS: Sum of squares, df: degrees of freedom, MS: Mean squares, F: F

statistic value, β: Beta, p: observed significance, E: Standard error, t: t-test statistic, n = 228.

4. Discussion

This study aimed to determine the

relationship and effect of cognitive

factors, such as resistance self-efficacy

and self-control, on alcohol consumption

in university students. Among the findings,

it is noteworthy that a large portion of the

participants were women, which could be

due to the inclusion of nursing as one of

the university programs in the study, a

field characterized by a higher proportion

of female students compared to male

students. The average age of the university

students was 19 years, data consistent with

other studies conducted on university

students in Mexico

28-30

Additionally, it was shown that the

prevalence of alcohol consumption in the

past year was higher than that reported in

other studies conducted on university

students

2,3,31

. Furthermore, it was

identified that binge drinking is a behavior

with high rates in both men and women,

although this differs from other studies

where this type of consumption shows

both higher and lower proportions.32-34

Regarding the type of alcohol

consumption, higher proportions of

dependent and harmful consumption were

identified in university students from

southern Tamaulipas, whereas, in sensible

consumption, a lower proportion was

observed compared to other studies

conducted on Mexican university students

from other states

32,35

The above allows us to observe that

alcohol consumption behavior is more

prevalent among university students in

southern Tamaulipas, a region where

environmental characteristics and social

customs normalize the initiation and

maintenance of this behavior among

young people. Furthermore, there is a

noticeable increase in this behavior among

women, which could be related to

Horizon Interdisciplinary Journal (HIJ). ISSN: 2992-7706

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sociocultural aspects, where there is an

effort to equalize the roles and functions

of men and women in various areas of

society.

The findings from the Correlation

Coefficient showed that both resistance

self-efficacy and self-control have a

negative and significant relationship with

alcohol consumption, which is similar to

data from other studies on resistance self-

efficacy

and self-control in university

students

14,15

. This could be interpreted as

greater resistance self-efficacy and self-

control correlating with lower alcohol

consumption, suggesting that they may

act as protective factors.

Additionally, the Multiple Linear

Regression Model showed that resistance

self-efficacy has a negative and significant

effect on alcohol consumption among

university students, results that align with

other studies conducted on university

students from countries such as the

United States, Japan, and Thailand

9-12

. This

could be explained by the fact that, despite

the studies being conducted in different

social and cultural contexts, the inherent

process of change associated with this

stage of life is similar among university

students, who are characterized by

psychological experiences that include

identity formation, interpersonal

relationships, and environmental

characteristics, which may influence

decision-making about their behaviors

either positively or negatively

6,36

Thus, a stronger belief in one’s ability to

resist the temptation of alcohol

consumption will be reflected in lower

alcohol consumption among university

students. Additionally, no significant effect

of self-control on alcohol consumption

was found, although a negative and

significant relationship between self-

control and alcohol consumption was

observed. In this regard, a study

conducted on Australian youth reported

that self-control has a negative and

significant effect on alcohol

consumption

. This discrepancy could be

explained by the characteristics of the

participants in both studies, who are

pursuing degrees with different scientific

focuses. In this study, more than half of the

students were enrolled in the nursing

program, which may provide them with

greater knowledge and awareness about

alcohol consumption and its effects,

potentially reflected in greater self-

control in alcohol consumption

situations

, in addition to possible cultural

differences related to alcohol

consumption.

Based on the above, it is emphasized that

factors such as resistance self-efficacy and

self-control play a significant role in

decision-making regarding alcohol

consumption. These findings are

consistent with what is proposed in Social

Cognitive Theory, which highlights the

possible influence of cognitive factors on

specific behaviors. The variables in this

study could be considered for further

exploration of this phenomenon using

mixed methodologies. Additionally, this

information could serve as a basis for

developing or strengthening specific

prevention strategies for this study

population, which, according to the

literature, is at high risk for alcohol

consumption and its health and societal

consequences

4,5

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5. Conclussion

Resistance self-efficacy and self-control

showed a negative and significant

relationship with alcohol consumption.

Likewise, it was demonstrated that

resistance self-efficacy regarding alcohol

consumption has a negative and

significant effect on alcohol consumption.

Thus, the results of this study can

significantly contribute to understanding

the phenomenon of alcohol consumption,

providing knowledge that could serve as a

foundation for future research or

interventions aimed at preventing alcohol

consumption in university students.

One of the limitations of the study was that

it was conducted in a single social context

of university students (educational

institution). Therefore, it is recommended

that future studies be conducted in

diverse contexts that include other types

of careers or schools (public/private),

which would allow for a deeper

understanding of this phenomenon among

university students. Although the results

were significant, it is important to

consider other young people with

different characteristics. It is thus

suggested to study these variables and

other potential factors that could generate

more evidence on alcohol consumption in

university students.

6. Statements

6.1. Authorship recognition

Conceptualization: JEDAG; Methodology:

MMAC; Validation: KSLG; Formal analysis:

JEDAG; MMAC; Research: JEDAG;

Resources: JEDAG; Data Curation: JEDAG.,

MMAC; Writing-Original draft: JEDAG.,

MMAC; Visualization: KSLG., FCS;

Supervision: JEDAG., MMAC., KSLG., FCS;

Project management: JEDAG., MMAC.

6.2 Conflict of interest

The authors declare no conflict of interest.

6.3 Acknowledgments

We thank the educational institutions that

provided support for the development of

this study.

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