Help-Seeking Intentions Among High-Risk College Student Drinkers: A Theory-Driven Examination of Social and Cognitive Influences.

Alcohol use remains a prevalent issue on college campuses, with approximately 15% of students drinking at levels indicative of an Alcohol Use Disorder (AUD), yet help-seeking rates remain low. The Reasoned Action Approach (RAA) provides a framework for understanding psychosocial drivers of help-seeking intentions. This study assessed associations between college students' drinking behaviors, the RAA, and their intentions to seek professional help for alcohol use if they thought or knew they had an AUD. Cross-sectional survey data from 2,110 college students were analyzed to examine alcohol use, psychosocial risk factors, and help-seeking behaviors. Participants met inclusion criteria if they were 18 to 24 years old, enrolled full-time in a college or university, reported past-year alcohol consumption, and passed data quality checks. Measures included demographics, RAA constructs (attitudes toward, norms regarding, perceived control over, and intention to seek professional help), and alcohol use behaviors assessed via the Alcohol Use Disorder Identification Test (AUDIT). Descriptive statistics and multiple linear regression analyses were conducted to examine factors associated with help-seeking intentions. The average AUDIT score was 10.91, indicating hazardous alcohol use. Nearly one-third of participants had an AUDIT score ≥ 15, suggesting an increased likelihood of an AUD. Regression results showed that higher AUDIT scores (p < .001) were negatively associated with the intention to seek professional help for alcohol use. All RAA constructs were statistically significant predictors of intention to seek help (p < .001), with the full model explaining nearly 40% of the variance in help-seeking intentions. This study provides new insights into the complex interplay between personal beliefs and drinking behaviors in help-seeking intentions. Leveraging constructs of the RAA, specifically, positive attitudes toward professional help, greater social acceptance of help-seeking, and higher perceived autonomy over seeking help, was associated with stronger intentions to seek support. The psychosocial elements of these frameworks, combined with informing students of their risks, offer a nuanced approach to encouraging the shift from help-seeking hesitancy to help-seeking acceptance.