The Journal of School Nursing2024, Vol. 40(4) 411–420© The Author(s) 2022Article reuse guidelines:sagepub.com/journals-permissionsDOI: 10.1177/10598405221112695journals.sagepub.com/home/jsn
Abstract
Alcohol use ranks as one of the most prevalent health-risk behaviors among Taiwanese adolescents. Possible selves—personalized future-oriented cognitions about the self—are significant motivators of one’s actions, which may potentially influence adolescent drinking behavior. This study aimed to estimate the content domain-specific possible selves and their associations with drinking behaviors among Taiwanese adolescents. A total of 225 Taiwanese seventh and eighth graders from a public junior high school were recruited. An anonymous self-reported questionnaire was used to collect data during two time-points at six-month intervals. Results showed that having a “physical appearance” related hoped-for possible self and a “friendship” related feared possible self was associated with adolescent alcohol use after six months. Whereas, having the “physical appearance” related hoped-for and feared possible selves were associated with alcohol problems, at both, baseline and six months later. Future studies could clarify the meaning behind “physical appearance” related possible selves.
Keywordsself-cognition, future-oriented cognitions, alcohol use, alcohol problems, youth, middle school
Alcohol use ranks as one of the most prevalent health-risk behaviors among adolescents globally and in Taiwan. In 2016, 37.5% of adolescents aged 15–19 years worldwide have used alcohol, 26.5% were current drinkers, and 13.6% engaged in heavy episodic drinking (World Health Organization [WHO], 2019). According to the Taiwan Youth Health Survey in 2018, by junior high school, 55.2% adolescents reported having used alcohol, 9.4% reported having been drunk, 2.7% reported problems due to alcohol use (e.g., conflict with their family or friends, skipping class or fight with others), and 14.5% reported using alcohol in the last month (Bureau of Health Promotion, 2019). It is widely known that adolescent alcohol use contributes to short- and long-term health problems such as developmental disabilities, abnormal brain structure and function (Lees et al., 2020; Spear, 2018), increased accidents, negative emotions (e.g., depression, anxiety, fear, and anger), and risk behaviors (e.g., violent or criminal behaviors, and substance abuse) (Batra et al., 2016; Huang et al., 2016; Tapia-Rojas et al., 2017). Alcohol use impacts one’s health and psychosocial functioning, and contributes to family burdens such as medical and social costs (Agabio et al., 2017). Therefore, identification of the key influencing factors regarding adolescent drinking can inform the development of intervention strategies to reduce alcohol drinking behaviors.
A recent systematic review showed that possible selves have motivational influence on health risk behavior among adolescents (Corte et al., 2020). Possible selves reflect what the self hopes to become (“hoped-for” possible selves, e.g., I hope I can go to college) and what the self fears of becoming (“feared” possible selves, e.g., I am scared to have no friends) (Markus & Nurius, 1986). Based on the schema model of self-concept (Markus, 1977), possible selves are goal-directed beliefs about the self in the future, rather than just a vague wish or dream. They are cognitive structures and function as personal goals to be achieved (for hoped-for possible selves) or avoided (for feared possible selves) (Markus & Nurius, 1986). Thus, possible selves play an essential role in motivating behavior through self-regulatory processes, which are likely to be the key constructs of valid intervention by fostering possible selves to strengthen a person’s motivation and persist in the pursuit of one’s goal (Markus & Wurf, 1987; Oyserman et al., 2004; Zhu et al., 2014). Furthermore, personal experience, social-environmental context (family, school, and media), culture, value, and achievement influence one’s formation of a constellation of content domain-specific of possible selves (Markus & Nurius, 1986; Markus & Wurf, 1987; Oyserman & Fryberg, 2006). Therefore, each person has a distinctive total collection of various content domain-specific possible selves, such as academic achievement, physical appearance, interpersonal relationships, and so on.
Researchers have found that having an alcohol drinking related possible self is associated with adolescent drinking behaviors (Corte et al., 2020; Lee et al., 2015a). Our previous work (Lee et al., 2015b) demonstrated that eighth grade adolescents whose academics related hoped-for possible self was the most important, were predicted a lower level of alcohol use than others in the following years; and adolescents whose academics related feared possible self was most important were more likely to abstain from alcohol use than others in the following years. Other researchers found that having a popular and deviant possible self among eighth grade adolescents was positively associated with risk behaviors (e.g., alcohol use, tobacco use, and sexual intercourse) in both eighth and ninth grades, but conventional possible self was negatively associated with risky behaviors (Stein et al., 1998).
Although studies have focused on the effects of possible selves on health behaviors in adolescents and some content domain-specific possible selves have been suggested to be related to adolescent drinking behaviors (Corte et al., 2020), most studies have been conducted in the West (e.g., United State and Europe) with predominantly white adolescents. Little is known about the content domains of possible selves and their associations with drinking behaviors among Asian, specifically Taiwanese adolescents. Given that the development of possible selves occurs within a specific social context, the socio-cultural context differences between Western and Eastern cultural backgrounds (e.g., individualistic culture in Western vs. collectivistic culture in Eastern countries) (Kitayama & Markus, 2014; Markus & Kitayama, 2010) may lead to differences in the construction of possible selves and their strength in regulating behaviors among adolescents (Zhang et al., 2020). The content domain of possible selves in collectivistic cultures is more likely to be interdependent (i.e., related to others in specific contexts), but is more likely to be independent (i.e., related to an individual’s internal attributes or personal growth) in individualistic cultures (English & Chen, 2007; Hernandez & Iyengar, 2001; Hong et al., 2001; Markus & Kitayama, 1991). Interdependent possible selves are more socialfocused, referring to family or occupational roles, friendships, and family or social relationships (e.g. having many friends, graduating from school, getting a good job); whereas, dependent possible selves are more self-focused, referring to family or occupational roles, friendships, and family or social relationships (e.g., being smart, being rich or successful, being attractive) (Kitayama & Markus, 2014; Rathbone et al., 2016). Persons with interdependent possible selves may be motivated to act in ways that strengthen their relationships with significant others or are group oriented. In contrast, individuals with a collection of independent possible selves may be more motivated to pursue personal achievement (Kitayama & Markus, 2014; Markus & Kitayama, 2010).
According to the Global Status Report on Alcohol and Health 2018 (WHO, 2019), alcohol consumption per capita was relatively low among people aged 15 years and above, whereas the prevalence of lifetime abstainers was relatively high among people aged 15–19 years in Asian countries compared to Western countries. Although Taiwan is not a member country of WHO, the location of Taiwan is within the Western Pacific Region. Neighboring countries of Taiwan, such as China, Japan, and the Philippines, have a lower alcohol consumption per capita (6.6 to 8.0 L) than Western countries (e.g., 9.8 in United States and 11.4 in United Kingdom). Therefore, we posit that alcohol use may be less socially acceptable in Taiwan than in the United States based on alcohol use status (WHO, 2019). While the way people view themselves regarding drinking varies according to the given socio-culture context, it is not known whether Taiwanese adolescent drinkers have alcohol-related possible selves.
Taiwan’s transformation into a more globalized and westernized culture, where cultural values and social climate have changed over time, may result in a shift in the development of the collection of possible selves in Taiwanese adolescents. Moreover, the extent to which the content domain-specific possible self motivates drinking behaviors in Taiwanese adolescents has also not been determined; therefore, it is important to do so. Yet intervention strategies based on the possible self have been developed in literature (Clark et al., 2005; Lee & Liao, 2024; Oyserman et al., 2002). Most empirical work in Western countries promotes fostering of the overall positive possible selves or content domain-specific possible selves. Understanding the similarities and differences between the content domains of possible selves and their associations with alcohol drinking behaviors between Taiwanese and Western adolescents, and determining better explanations of drinking behaviors in Taiwanese adolescents will help in selecting intervention strategies and developing a culturally appropriate intervention to prevent and reduce adolescent drinking behaviors. This study is exploratory in nature and aims to identify the content domains of possible selves as well as determine the associations of content domain-specific possible selves with drinking behavior in Taiwanese adolescents.
Our study data were part of a study of cognitive mechanisms and drinking behaviors in adolescents (see Lee et al., 2020). In the parent study, data were collected at two time-points, at baseline and six months later, from adolescents in the seventh and eighth grades of a public junior high school in southern Taiwan. All study activities and a waiver of parental permission were approved by the Human Research Ethics Committee of National Cheng Kung University. Written informed consent was obtained from participants before completion of the questionnaires. A trained research assistant distributed anonymous self-report questionnaires within a regular classroom setting during a class period of the school day. Self-study hours were used to avoid disruption of the scheduled course content and affect students’ education. The questionnaire included items related to possible selves, drinking behaviors of parents, siblings, and peers, drinking-related media exposure, and drinking behaviors of the students themselves. It took 30–40 min to complete. The research identification code was used to link data between the two time-points. At Time 1 enrollment, 234 Taiwanese adolescents were recruited. The present study included 225 Taiwanese adolescents (96.2%) who completed questionnaires at both baseline and six months later. There were nine adolescents (3.8%) who were absent from school on the date of Time 2 data collection.
Alcohol use. Alcohol use was assessed using a single question about drinking frequency in the last six months. Responses were rated from 0 (none) to 5 (almost every day). Adequate validity and reliability among adolescents has been reported (Shope et al., 1994).
Alcohol problems. Alcohol problems, negative consequences that occurred either while drinking alcohol or because of drinking in the last six months were measured using the 23-item Rutgers Alcohol Problem Index (RAPI) (White & Labouvie, 1989). Example items included: “Not able to do your homework or study for a test,” “Got into fights with other people (friends, relatives, strangers),” “Missed a day (or part of a day) of school,” and “Had withdrawal symptoms, that is, felt sick because you stopped or cut down on drinking.” Each item was scored from 0 (never) to 4 (more than 10 times). The scores were dichotomized into “yes (any alcohol problems)” and “no” for each item. Then, the sum score of all “yes” items was computed for each individual. Adequate internal consistency and convergent validity of the RAPI in adolescent and undergraduate populations have been reported (Lee et al., 2020; Martens et al., 2007; Shope et al., 1994). In this sample, the internal consistency reliability coefficient (Cronbach’s alpha) of the RAPI was 0.87.
Possible selves. Hoped-for and feared possible selves were measured using an opened-ended questionnaire developed by Oyserman and Markus (1990). Participants were asked to list as many hoped-for and feared possible selves in response to “What do you hope you will be like next year?” or “What do you want to avoid being or are afraid you might be next year?” This measure has shown good test-retest reliability among adolescents (Aloise-Young et al., 2001; Oyserman & Markus, 1990). All descriptors were content coded based on the existing coding scheme (Herzog et al., 1998). This coding schema includes both higher-level code categories and specific content code categories. The higher-level code categories used contained 35 content domains such as academics, friendships, physical appearance, occupation, health, sports/exercise activities, risky behaviors, and conscientiousness (Table S1). Each higher-level code category included several specific content code categories. For example, a higher-level code of “academics” included specific content code categories of being a good student, having an A grade, getting into a good school, etc. After the completion of content coding, each content domain-specific possible self was dichotomized for each individual, to indicate whether the participant had this content domain-specific possible self or not. Two trained research assistants independently conducted the process of content coding. Discrepancies and descriptors that did not fit within the existing coding scheme were resolved through discussion in the research team. The intercoder agreement was 0.85 across 837 descriptors of hoped-for possible selves and 771 descriptors of feared possible selves.
Covariates. Sex, parental alcohol problems, friends’ and siblings’ alcohol use, and alcohol-related media exposure were some known determinants of adolescent drinking behaviors (Chang et al., 2016; Lee et al., 2018; Yuen et al., 2020) and were treated as covariates in the present study. Parental alcohol problems were measured using the short form of the Children of Alcoholics Screening Test, including six dichotomous (yes/no) items. All “yes” responses were added to obtain the total score of each participant (range 0–6). In this sample, the Cronbach’s alpha was 0.82. The alcohol use of friends and siblings was assessed by asking participants to specify the number of their close friends and siblings who drank alcohol. Answers were dichotomized into “yes (any friend/sibling used alcohol)” and “no.” Alcohol-related media exposure was assessed by five items such as the frequency of watching alcohol advertisements, actors drinking alcohol or alcohol brands, and discussions of alcohol drinking across various media platforms (Chang et al., 2016). Each item was scored from 1 (never) to 5 (almost daily). A mean score was computed with a higher score indicating higher alcohol-related media exposure. In this sample, the Cronbach’s alpha was 0.83.
Spearman correlation (for two continuous variables), Phi correlation (for two dichotomous variables), and point-biserial correlation (for one dichotomous variable and one continuous variable) were performed to assess the relationships between possible selves and covariates (sex, parental alcohol problems, friends’ and siblings’ alcohol use, and alcohol-related media exposure). Generalized liner models (GLMs) with robust estimation were used to determine the effect of possible selves on alcohol use and alcohol problems, after controlling for covariates. GLM encompasses many other models that depended on the distribution of dependent variables, which allowed the conditions of nonnormality and heteroscedasticity. In GLMs, gamma distribution with log link was used to analyze the frequency of alcohol use (positively skewed, non-negative data). Relationships between predictors and alcohol use were expressed as the risk ratio (the exponentiation of the B coefficient; Exp(B)) of the mean frequency of alcohol use. A negative binomial distribution with a log link was used to analyze alcohol problems (over-dispersed count data). Relationships between predictors and alcohol use were expressed as incidence rate ratio (IRR).
Among the 225 adolescents, 48.9% (n = 110) were males and the mean age of the whole sample was 13.9 years (SD = 0.7). Table 1 shows the socio-demographic characteristics. About a third of the adolescents (31.6%) had parents with alcohol problems; 15.3% and 7.2% of adolescents had friends and siblings who used alcohol, respectively. Nearly a third of the adolescents reported drinking at the baseline (27.6%) and six months later (33.8%); towards one tenth of the adolescents reported having experienced alcohol problems at the baseline (8.0%) and six months later (7.1%). As the majority of adolescents who reported drinking had low frequency of alcohol use, frequency of alcohol use at the baseline (Skewness = 2.6; Kurtosis = 12.5) and six months later (Skewness = 1.9; Kurtosis = 7.2) were not normally distributed. Similarly, the number of alcohol problems at the baseline (Skewness = 6.7; Kurtosis = 55.7) and six months later (Skewness = 5.7; Kurtosis = 39.5) were also not normal distributed.
Descriptive statistics for the first ten frequent content domain-specific possible selves are presented in Table 2 (see Table S1 for all content domains). The most frequently listed content domain of hoped-for and feared possible self was related to “academics” (hopes: 72.4%; fears: 72.0%), followed by “physical appearance” (hopes: 38.7%; fears: 30.2%). Other content domains were different for the hoped-for and feared possible self. The third to fifth frequent content domain-specific hoped-for possible selves were “sports/exercise activities” (37.8%), “career/occupation” (16.0%), and “material and money” (15.1%); whereas, the third to fifth frequent content domain-specific feared possible selves were “friendship” (24.4%), “Conscientiousness” (17.8%), and “health” (15.1%).
Table 3 shows the bivariate correlations among the content domain-specific possible selves and covariates. The correlations of the content domain-specific possible selves with sex, parental alcohol problems, friends’ and siblings’ alcohol use, and alcohol-related media exposure were low (r = −0.16–0.21). The “academics” and “physical appearance” related hoped-for possible selves were moderately correlated with the “academics” (r = 0.40, p < .001) and “physical appearance” related feared possible selves (r = 0.43, p < .001), respectively. Other correlations among the content domain-specific possible selves were low (r = −0.15–0.18).
To examine the effect of possible selves on alcohol use and alcohol problems, only the first three frequently hoped-for and feared possible selves, which at least 20% of adolescents had endorsed, were included in the model. As shown in Table 4, no statistically significant associations were revealed between any content domain-specific possible self and baseline alcohol use, adjusting for the covariates. However, six months later, adolescents who endorsed a “physical appearance” related hoped-for possible self had an expected mean frequency of alcohol use that was 1.89 times higher (Exp(B) = 1.89, SE = 0.57, 95% CI = 1.05–3.42) than those who did not. Six months later, adolescents who endorsed a “friendship” related feared possible self had an expected mean frequency of alcohol use that was 66% lower (Exp(B) = 0.34, SE = 0.13, 95% CI = 0.16–0.72) than those who did not.
For alcohol problems (Table 5), adjusting for the covariates, the incidence of alcohol problems at the baseline (IRR = 4.95, SE = 2.35, 95% CI = 1.95–12.54) and six months later (IRR = 3.55, SE = 2.24, 95% CI = 1.03–12.24) was 4.95 times and 3.55 times higher in adolescents who had a “physical appearance” related hoped-for possible self, respectively than those who did not have this possible self. Whereas, the incidence of alcohol problems at the baseline (IRR = 0.13, SE = 0.09, 95% CI = 0.03–0.52) and six months later (IRR = 0.10, SE = 0.10, 95% CI = 0.02–0.67) was 87% and 90% lower in adolescents who had a “physical appearance” related feared possible self, respectively than those who did not have this possible self.
This study explored the content domain-specific possible selves and their effect on drinking behavior among Taiwanese adolescents after controlling for the known determinants of alcohol use and alcohol problems. Our findings revealed that “academics” was the most frequently listed content domain for hoped-for and feared possible selves among Taiwanese adolescents. However, having an academic possible self was not associated with alcohol use or alcohol problems in this sample. Having a hoped-for possible self related to “physical appearance” was associated with more baseline alcohol problems as well as more alcohol use frequency and alcohol problems six months later. Having a feared possible self related to “physical appearance” was associated with less alcohol problems at the baseline and six months later, but not alcohol use. Having a feared possible self related to “friendship” and was associated with less alcohol use frequency six months later.
Inconsistent with previous studies that found “academics” and “drinking” related possible selves to be associated with drinking behavior in adolescents in the US among the majority of white adolescents (Lee et al., 2015a, 2015b), academic possible selves were not associated with drinking behaviors in the present study. Similar to Western studies (Lee et al., 2015b; Stoddard et al., 2016), “academics” was also the most frequent content domain of possible selves in our sample. However, the strengths of academic-related possible self with adolescent drinking behaviors were different. This may be due to cultural, value, and educational differences in systems between Eastern and Western countries. Kao (2000) conducted focus group interviews and found that adolescents belonging to different ethnicities had different meanings associated with “academics” related possible self, which may vary through stereotypical images. For example, black adolescents may link their academic possible self to avoid failure, whereas Asian adolescents may address academic possibilities in terms of keeping up academic pursuits to fulfill parents’ high expectations. Therefore, the underlying differential meaning of academic possible self may vary one’s motivation in regulating behaviors, including drinking behaviors. Moreover, in this sample, only a few adolescents (2.7%, n = 6) endorsed the “drinking” related possible self, which was not sufficient to test the relationships between “drinking” related possible self and drinking behaviors. It is possible that those adolescents had relatively low levels of alcohol use and did not define themselves as drinkers in the near future. Future research is needed to clarify whether sociocultural differences influence the construction of diverse content domains of possible selves as well as the different values and underlying meanings of same content domainspecific possible selves. This may help clarify and explain whether the same content domain-specific possible self has differential strength of influence on behaviors across cultural backgrounds and countries.
Our findings indicated that “physical appearance” was the most significant content domain of possible selves in influencing adolescent drinking behaviors, which has not been previously shown in literature. Adolescents whose “physical appearance” was important to them as a hoped-for possible self were highly likely to engage in alcohol use and alcohol problems. Whereas adolescents whose “physical appearance” was important to them as a feared possible self were less likely to have alcohol problems. We conducted a further analysis to explore the detailed descriptors of those “physical appearance” related possible selves. A total of 87 (55.2% males, n = 48) and 68 adolescents (51.5% males, n = 35) had endorsed “physical appearance” related hoped-for and feared possible selves, respectively. Regardless of hoped-for or feared possible selves, the most frequent descriptions were related to body height (hopes: 79.3%, e.g., I want to be taller; fears: 66.2%, e.g., I am afraid I won’t grow taller), followed by body weight (hopes: 31.0%, e.g., I want to lose weight successfully; fears: 39.7%, e.g. I am afraid I will get fat). Of adolescents who endorsed “body height” related hoped for and feared possible selves, 56.5% and 53.3% were males, respectively. For those who endorsed “body weight” related hoped for and feared possible selves, 51.9% and 44.4% were males, respectively. This also suggests that males may be more likely to be concerned about height and females may be more likely be concerned about weight.
One plausible explanation is that adolescents whose “physical appearance” was important to them as a hoped-for possible self may reflect their dissatisfaction with their body image. Previous studies have shown that low satisfaction with body image was associated with a greater amount of alcohol use and problems (Bornioli et al., 2019; Jones et al., 2018). However, the existing evidence revealed that alcohol use due to body dissatisfaction is more likely to occur in late rather than early adolescence (Neumark-Sztainer et al., 2006). Moreover, adolescents who endorsed “physical appearance” related possible selves had more concern for body height than body weight. Body image dissatisfaction in adolescence tends to be caused by one’s body weight (Voelker et al., 2015). Given that our sample of adolescents consisted of seventh and eighth graders and the greatest concern of physical appearance was body height, they would be less likely to use alcohol as a coping mechanism for dissatisfaction with their physical appearance at this age. Another possible explanation is that adolescents who have the hoped-for “physical appearance” related possible selves may pay greater attention to their body image and have a desire to achieve popularity, influencing their drinking behavior (Kenny et al., 2017). Perceived attractiveness and popularity has been shown to be associated with alcohol use in adolescents (Mayeux et al., 2008; Ramseyer Winter et al., 2017). Popularity may lead adolescents to adopt behavior consistent with peer group norms and engage in health risk behaviors, including alcohol use (Fujimoto & Valente, 2015). Stein et al. (1998) have shown that adolescents with a “popular” possible self were associated with risky behaviors (e.g., alcohol use, tobacco use, and risky sexual behaviors). In contrast, adolescents with the feared “physical appearance” related possible selves may have higher satisfaction with their body image, wish to keep in shape, worry drinking alcohol may impede their growth of height or that they may gain weight. This decreases or inhibits their drinking behaviors. Future research is needed to explore the meaning behind the “physical appearance” related possible self.
This study was not without its limitations. The data were collected from a public junior high school in southern Taiwan. Student characteristics, levels of health-risk behaviors, and socioeconomic status in this sample may be different from students in private schools. Therefore, this study lacks clear generalizability. Future research with a larger sample, various types of schools and diverse socioeconomic status are needed to clarify these findings. Adolescents’ possible selves were measured by asking the adolescents to list their possible selves. We believe that it would be difficult to make these possible selves salient in the adolescents’ minds just by thinking about the possible selves once, without any continued elaboration. However, we cannot rule out the possibility that this process made those possible selves more salient and influenced the adolescents’ behaviors over time. There were only two measurements of drinking behavior, assessed only six months apart. We could not examine how the content domain-specific possible selves influence the different patterns of drinking behaviors and drinking trajectories. Subsequent studies with different measures of drinking patterns and long-term follow-up will help clarify the effects of content domain-specific possible selves on different drinking patterns and to determine their longterm effects on drinking behaviors. The present study possessed a relatively small sample size, which limited our ability to perform advanced analyzes (e.g., zero-inflated models) and include more content-domain specific possible selves. Moreover, other influence factors, such as depression and child maltreatment experiences, may also potentially contribute to drinking behaviors in adolescents, but were not be considered in the present study. Although our results should be interpreted with caution, our study provides support for the relationship between possible selves and drinking behaviors among Taiwanese adolescents. Future research with larger samples may benefit from conducting zero-inflated models with more content-domain specific possible selves and covariates.
Regardless of the above limitations, the findings of this study have implications for clinical practice. Nurses, including school nurses working with adolescents, can examine their health, and assess their thoughts about the self, in the present and in the future, and provide related intervention strategies to foster their positive possible selves. During psychological and physical assessment, nurses could evaluate adolescents’ collection of possible selves and drinking behaviors. Based on our findings, nurses should have a better understanding of the underlying concerns of adolescents’ possible selves, particularly for those who endorse the “physical appearance” and “academics” related possible selves. Clarifying adolescents’ thinking about the self in the future and the meaning of the content domain-specific possible selves may help assess the need for timely intervention to prevent or decrease the engagement of drinking behaviors. For example, if the underlying meaning for adolescents with the hoped-for “physical appearance” related possible selves is to become more popular or increase belonging in the peer group, nurses could provide them guidance to achieve their goals to protect them from engaging in drinking.
Moreover, while approaching adolescents with a high risk or those who have engaged in drinking, nurses can work with parents or caregivers to intervene based on possible selfapproach (Lee & Liao, 2024). Interventions that target fostering positive possible selves or negating negative possible selves (e.g., drinking possible self) as well as elaborating one’s best or most important possible self may prevent adolescent drinking behaviors and promote positive adolescent development (Lee & Liao, 2024; Lee et al., 2015b; Loveday et al., 2018; Oyserman et al., 2004). Guiding adolescents to acknowledge their individual strengths, image their best or most important possible selves as the realization of their life, and conceive of strategies to achieving or avoiding the possible selves through continuous discussion and narrativization may be adopted (King, 2001; Lee & Liao, 2024; Oyserman et al., 2004).
In conclusion, this study described the current content domain-specific possible selves among Taiwanese adolescents and indicated their influence on adolescent drinking behaviors. The finding indicates that “physical appearance” related hoped-for possible selves increase the likelihood of adolescents’ drinking behavior. Future studies that clarify the meaning behind “physical appearance” related possible selves are critical for the development of culturally appropriate intervention strategies to prevent or decrease drinking behaviors among Taiwanese adolescents.
The authors thank the students who participated in this study as well as the school administrators and the teachers who supported us and arranged the questionnaire survey.
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Ministry of Science and Technology, Taiwan (grant number MOST 106-2314-B-006-083) and Summer Research Project from College of Medicine at National Cheng Kung University College of Medicine (grant number NCKUMCS2019056).
Chia-Kuei Lee https://orcid.org/0000-0003-0597-0420
Supplemental material for this article is available online.
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Yi-Chen Wu, BSN, is an undergraduate student at the Department of Nursing, National Cheng Kung University, Taiwan
Chia-Kuei Lee, PhD, RN, is an associate professor at the Department of Nursing, National Cheng Kung University, Taiwan
1 Department of Nursing, College of Medicine, National Cheng Kung University, Tainan
Corresponding Author:Chia-Kuei Lee, PhD, RN, Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101.Email: chiakuei@mail.ncku.edu.tw