Background Participation in drinking games is associated with excessive drinking and alcohol risks. levels of social anxiety lower levels of DRSE and playing drinking games predicted greater alcohol-related consequences. Moreover two-way interactions (Social Anxiety × Drinking Games DRSE × Drinking Games) exhibited that social stress and DRSE each moderated the relationship between drinking game participation and alcohol-related consequences. Participation in drinking games resulted in more alcohol problems for students with high social anxiety but not low social anxiety. Students with low DRSE experienced high levels of consequences regardless of whether they participated in drinking games; however drinking game participation was associated with more consequences for students confident in their ability to resist drinking. Conclusion Findings highlight the important role that social stress and DRSE play in drinking game-related risk and hence provide valuable implications for screening at-risk students and designing targeted harm reduction interventions that address social anxiety and drink refusal in the context of drinking games. =1 493 55.5%) were asked to complete an additional baseline survey. Of these 1493 students 1 367 (91.6%) completed the baseline survey and received a nominal cash incentive for their time. As part of the baseline survey participants reported whether they had prepartied (i.e. consumed “alcohol prior to attending an event or activity [e.g. party bar concert] at which more alcohol may or may not be consumed”) at least once in the past month. Participants who had prepartied (=988) were asked a series of event-level questions about drinking game participation and alcohol-related consequences on both the last drinking event when they had prepartied and when they had not prepartied. As prepartying and drinking game participation can potentially have an additive influence on consequences (38) the current study focuses on the event in which CNX-774 students had not prepartied. Thus our analyses looked solely at the context of drinking games and its influence on consequences moderated by social stress and DRSE in heavy drinking college students. Only students who responded to the question CORO2A assessing drinking game participation during a drinking event in which they had not prepartied were included in the current analyses (=976). Overall 45.3% (=442) reported that they had played drinking games during the last occasion that they drank and did not preparty. The final sample was 63.6% female and ranged in age from 18-24 years (=20.11 SD =1.35). The racial composition of the sample was 67.7% White 12.6% Asian 11.8% Multiracial 3.2% Other 2.4% African American 1.9% Native Hawaiian/Pacific CNX-774 Islander and 0.4% American Indian/Alaskan Native. With regard to CNX-774 ethnicity 12.2% of participants identified as Hispanic/Latino (a). The sample demographics were similar to the larger sample from which it was drawn (62% female 68 White mean age =20.1 years). Data used in the current analyses were collected prior to participants receiving any alcohol intervention. Measures Prior to answering questions regarding alcohol use participants were presented with the definition of a standard drink (i.e. 12 oz. beer 10 oz. wine cooler 4 oz. wine 1 oz. 100 proof [1 ? oz. 80 proof] liquor). Drinking game participation Participants were asked whether or not they had played drinking games (=1 =0) during the last occasion when they drank but did not preparty. Social anxiety Social anxiety was assessed using the Social Interaction Anxiety Scale (SIAS 40 Due to a computer programming error a single item from the 20-item measure was not assessed and a composite was created from the remaining 19 items (=0.93). The SIAS assesses stress related to social interactions (i.e. “distress when initiating and maintaining conversations with friends strangers or potential mates”) (41). Example items include “I have difficulty talking with other people” and “When mixing socially I am unpleasant”. Reactions were measured on the 5-stage Likert scale which range from CNX-774 0 (=0.94) including “When somebody offers me a glass or two” and “AFTER I am angry.” Reactions were given on the 6-stage Likert scale.