Clinical Translation: The Role of Alcohol Use, Negative Urgency, and Sensation Seeking in Casual Sexual Behavior Among College Students
Melissa M. Ertl, Laura M. Longo, Rena L. Pazienza, Alex A. U. Agiliga, Frank R. Dillon, & Jessica L. Martin
Melissa M. Ertl
University at Albany
Members of the HABITS Research Team at University at Albany have recently collaborated to publish a study in Substance Use and Misuse titled, “Associations among Negative Urgency, Sensation Seeking, Alcohol Use, Self-Esteem, and Casual Sexual Behavior for College Students.” Casual sexual behavior includes any sexual encounter that may or may not include intercourse that occurs outside of the context of a committed or romantic relationship. This study, conducted with 413 undergraduate student men and women, investigated contextual influences of casual sexual behavior for college students to learn more about factors that could be targeted in interventions to reduce potential consequences from engaging in casual sex, especially in the context of alcohol use.
Findings from this study demonstrated that alcohol use mediated the positive association between negative urgency and casual sexual behavior as well as the positive association between sensation seeking and casual sexual behavior, as expected. However, hypotheses surrounding self-esteem as a moderator of these mediated relations were not supported. Despite lack of support for moderated mediation, these results are in line with previous research that has found positive associations between negative urgency and alcohol use, sensation seeking and alcohol use, and alcohol use and engagement in casual sexual behavior. These findings also build on previous research that found similar indirect associations between these constructs with risky sexual behavior, and yet this study represents the first examination of these constructs with casual sexual behavior, which is a distinct construct and has been understudied in comparison to risky sexual behavior. It is important to study casual sexual behavior among college students because it is increasingly common among young adults, and although it does not necessarily indicate risky sexual behavior, casual sexual behavior has nonetheless been associated with certain negative mental and physical health outcomes, such as low self-esteem, depressive symptoms, loneliness, embarrassment, disappointment, regret, condomless sex, and exposure to sexually transmitted infections.
Based on the findings of this study, psychologists should continue to conduct campus-wide health prevention and educational interventions for college students, since each semester between 30% and 55% of college students report a casual sexual experience (Manthos et al., 2014; Owen et al., 2011; Vrangalova, 2015), and as many as 80% of college students will report a casual sexual experience in their lifetime (Garcia & Reiber, 2008; Reiber & Garcia, 2010). For example, normative reeducation and expectancy challenge interventions may be efficacious in addressing heavy alcohol use. Because the present study found that alcohol use accounted for associations between facets of impulsivity (i.e., negative urgency, sensation seeking) in relation to casual sexual behavior, targeted interventions that jointly address casual sexual behavior in the context of heavy alcohol use are warranted and may be one potential pathway to reducing co-occurring health risk behaviors among college students. Especially given that consent may be impaired when casual sexual behavior occurs under the influence of alcohol, efforts to provide educational programs on consent, alcohol use, and casual sex may be beneficial.
Future prevention interventions should continue to address casual sexual behavior from a health risk prevention lens in line with harm reduction efforts. At the same time, from a sex positive perspective, interventions should also seek to support the ways in which casual sexual behavior can be healthy, to the extent that it may facilitate pleasure, meaning, and connection with others. When working with clients, psychologists should be mindful about their own biases in the context of sexual behavior and substance use, particularly surrounding values about casual sexual behavior. Moreover, psychologists should be comfortable with openly asking about and discussing clients’ casual sexual behavior in the context of alcohol use—as intoxicated sex is a risk factor for poor sexual health outcomes and other health consequences. Brief motivational interviewing interventions that incorporate personalized feedback and information on protective behavioral strategies can encourage students to monitor and reduce their alcohol consumption, and consider short- and long-term consequences for decision-making about sex.
Concerning impulsivity and personality-based interventions, individuals who are relatively high in sensation seeking may benefit from strategies to increase positive arousal, such as exercise, or to decrease potentially unrealistic positive expectancies about alcohol use, such as improved sexual experiences. Distress tolerance techniques may be useful for addressing negative urgency given that intense negative affect can disrupt efforts to maintain self-control and can lead to problematic drinking and even blackouts that precede engaging in casual sexual behavior. Addressing propensity to behave impulsively and seek out exciting, novel experiences, such as sex with a new partner or stranger, can be explored to better understand these types of behaviors and identify protective factors that promote consideration of potential long-term consequences prior to engaging in health risk behaviors.
Because casual sexual behavior has been researched less extensively than risky sexual behavior—especially in the context of alcohol use research among college students—more research is needed on the efficacy of interventions that seek to promote sexual health and well-being while reducing sexual risk, as well as on how casual sexual behavior can be a normative, healthy behavior demonstrative of exploration in college students. In light of alcohol use that may co-occur with casual sexual behavior, prevention efforts that aim to reduce the prevalence of heavy episodic drinking that can lead to intoxicated sex have the potential to reduce negative consequences associated with each of these health risk behaviors.
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