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Cox MJ, Johnson L, Roudebush M, Godbole A, Egan KL. Likelihood of Young Adult Engagement in Protective Behavioral Strategies for Alcohol Use across Drinking Contexts: Implications for Adaptive Interventions. Subst Use Misuse 2024; 59:902-909. [PMID: 38308201 PMCID: PMC11057384 DOI: 10.1080/10826084.2024.2310484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
OBJECTIVE This study examined how young adults' likelihood to engage in protective behavioral strategies (PBS) to reduce alcohol harms varies across physical and social contexts for drinking. METHOD We conducted an online survey with 514 heavy drinking young adults (Mage = 22.4 years, 52% women, 30% Hispanic/Latin(x), 40% non-White). Participants were asked to rate their likelihood to engage in 26 PBS generally, and specifically in six physical contexts (e.g., bar/club), and six social contexts (e.g., in a large group). We conducted regression analyses to examine the overall effect of context on the likelihood to engage in each PBS and post-hoc Tukey tests to assess pairwise comparisons of the differences in likelihood to engage in each PBS across response options for physical and social context. Analyses were conducted using the full sample, and for men and women separately. RESULTS There were significant differences in six strategies across physical contexts; likelihood to engage in PBS varied across public and private spaces for different strategies. We also found significant differences in five strategies across social contexts; participants were more likely to engage in PBS among larger numbers of people and those who are intoxicated. There were numerous differences in pairwise comparisons of PBS engagement across physical and social contexts for women, while men demonstrated only two differences in PBS across physical context. CONCLUSIONS Results suggest that alcohol interventions for young adults that include PBS should consider tailoring strategies to the individual and the specific context of the drinking event.
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Affiliation(s)
- Melissa J. Cox
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; 306 Rosenau Hall CB#7440, Chapel Hill, NC, 27599
| | - Lois Johnson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599
| | - McKenna Roudebush
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; 302 Rosenau Hall CB#7440, Chapel Hill, NC, 27599
| | - Avanti Godbole
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; 302 Rosenau Hall CB#7440, Chapel Hill, NC, 27599
| | - Kathleen L. Egan
- Department of Health Education and Behavior, East Carolina University; 3107 Carol Belk Building, Greenville, NC, 27858
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Li X, Clarke N, Kim SY, Ray AE, Walters ST, Mun EY. Protective behavioral strategies are more helpful for avoiding alcohol-related problems for college drinkers who drink less. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1493-1499. [PMID: 32870746 PMCID: PMC7917150 DOI: 10.1080/07448481.2020.1807555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/27/2020] [Accepted: 08/02/2020] [Indexed: 06/11/2023]
Abstract
Objective: To examine race, gender, and alcohol use level as moderators of the association between protective behavioral strategies (PBS) and alcohol-related problems. Participants: A sample of 12,011 participants who reported recent drinking (87.7% White, 61% Women) from Project INTEGRATE, a study that combined individual participant data (IPD) from 24 brief motivational intervention trials for college students. Methods: Hierarchical regressions were conducted to determine whether there was a moderated effect of PBS on alcohol problems across alcohol use levels, and whether the moderated protective effect of PBS by alcohol use differed by gender and race. Results: The protective association between PBS and alcohol-related problems was greater for those who drank less. This moderated effect did not differ across men and women or across racial groups. Conclusions: College drinking prevention programs should ensure that students are aware of the limits of PBS as a mitigator of alcohol problems.
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Affiliation(s)
- Xiaoyin Li
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, USA
| | - Nickeisha Clarke
- Clarke Counseling & Psychological Services LLC, Brandon, Florida, USA
| | - Su-Young Kim
- Department of Psychology, Ewha Womans University, Seoul, South Korea
| | - Anne E. Ray
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, USA
| | - Scott T. Walters
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, USA
| | - Eun-Young Mun
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, USA
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3
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Li M, Sun W, Wang Y, Qi C. Prevalence and Differences of Depression, Anxiety, and Substance Use Between Chinese College-Age Students Studying in China and America During the Coronavirus Disease 2019 Pandemic. Front Psychiatry 2022; 13:805120. [PMID: 35370855 PMCID: PMC8965811 DOI: 10.3389/fpsyt.2022.805120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/31/2022] [Indexed: 01/03/2023] Open
Abstract
Introduction The coronavirus disease (COVID-19) swept the globe and harmfully influenced the mental health and behaviors of the college student population. This study aims to examine the prevalence and difference of mental health and the substance use problems of the Chinese college-age students studying in China and America (CSA) during the COVID-19 pandemic. Methods One thousand five hundred four students participated in this study. A total of 42.12% of students are enrolled in Chinese colleges, and 57.78% of students are enrolled in American colleges, aged 17-23 years (x ¯ ± s = 19.90 ± 1.50). Binary logistic regression and independent t-test were used in this study to find the predictor variables and association among mental health, substance use problems, and student population. Results The two student groups had a statistical difference in General Anxiety Disorder-7 scale, alcohol, medicines, drinks, drugs and cigarettes (p < 0.01). The students suffering depression problems from the two groups have statistical significance with drinks (odds ratio = 0.89, 95% confidence interval = 0.81-0.97, p < 0.05; odds ratio = 1.11, 95% confidence interval = 1.04-1.19, p < 0.01). CSA experiencing anxiety problem had a significant association with alcohol, drinks, cigarette, and desserts (p < 0.05). Conclusion This is the first cross-sectional study focusing on the comparison of the Chinese college-age students' mental health and substance use problems who are studying in China and America during the pandemic. Our study revealed severe mental health and substance use problems in both student groups, particularly in the CSA during the COVID-19 pandemic. The findings of our study also highlight the evidence to find more interventions and preventions to solve the different mental health and substance use problems for college students.
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Affiliation(s)
- Mingsheng Li
- Department of Geriatric VIP No. 3 (Department of Clinical Psychology), Rehabilitation Medicine Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
- Psychology Department, Denison University, Granville, OH, United States
| | - Wangdi Sun
- Department of Geriatric VIP No. 3 (Department of Clinical Psychology), Rehabilitation Medicine Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Ye Wang
- Department of Geriatric VIP No. 3 (Department of Clinical Psychology), Rehabilitation Medicine Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
- Psychology Department, Air Force Health Care Center for Special Services Hangzhou, Hangzhou, China
| | - Chang Qi
- Department of Geriatric VIP No. 3 (Department of Clinical Psychology), Rehabilitation Medicine Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
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Blanchard BE, Stevens AK, Littlefield AK. Differences in alcohol-related protective behavioral strategies among female and male college students. Addict Behav 2021; 120:106969. [PMID: 34000650 DOI: 10.1016/j.addbeh.2021.106969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 01/14/2023]
Abstract
Alcohol use is prevalent among college students, and some are at risk for developing alcohol use disorders. However, many students report using alcohol without experiencing negative consequences, which may be due, in part, to use of protective behavioral strategies (PBS). Although evidence of PBS effectiveness on reducing alcohol use and negative consequences is mixed, gender/sex differences in PBS use remain a consistent finding. To further explore these associations, we used item response theory models and assessed item-level PBS correlations with alcohol outcomes separately for female and males. Results indicated specific items exhibited significant sex differences in the amount of information and location of information across the latent trait. Some items provided little information across females and males, suggesting these items can be removed. All PBS items significantly associated with alcohol outcomes were negative in direction, but effects ranged from small to large in magnitude. These findings suggest strategies that are effective against alcohol-related harms vary across females and males, and PBS measurement may be improved by establishing sex-specific norms and analyzing females and males separately when studying PBS. Future research priorities include examining PBS among intersex, trans, and nonbinary people.
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Affiliation(s)
- Brittany E Blanchard
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA.
| | - Angela K Stevens
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02912, USA.
| | - Andrew K Littlefield
- Department of Psychological Sciences, Texas Tech University, Psychology Building, Box 42051, Lubbock, TX 79409, USA.
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5
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Greń J, Ostaszewski K, Pisarska A, Bobrowski K. Drinking and alcohol-related problems among at-risk adolescents: The role of protective behavioral strategies. Addict Behav 2021; 114:106746. [PMID: 33316591 DOI: 10.1016/j.addbeh.2020.106746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Protective Behavioral Strategies (PBS) are an alcohol-specific cognitive-behavioral strategies that may be employed before, during and/or after drinking, in order to reduce alcohol consumption and related consequences, particularly in the at-risk populations. Previous research on PBS was limited to North American college students. The purpose of this study was to examine the role of PBS use in a sample of Polish adolescents attending Special Educational Centers (SEC). METHOD Data were collected from a nationwide sample of 12-19 year-old (Mean = 15.8; SD = 1.22) students attending SEC in Poland (N = 1585; about 33% female). The self-administered anonymous questionnaires were completed on-site in the SEC. PBS were measured by the authors adaptation of the PBSS-20. Alcohol-related problems were assessed by the Polish adaptation of the measures used in the MINI-KID tool. Alcohol use was measured by a single question on drinking frequency. These two latter variables were measured in the past year timeframe. Hierarchical regression models were used to test the main and interaction effects of employing PBS (total and subscales scores) on alcohol-related problems, after adjusting for demographics (gender, family composition and type of SEC) and alcohol use. RESULTS The majority (about 94%) of study participants reported employment of some PBS. Regression analyses indicated that PBS use was associated with reduced risk of alcohol use and alcohol-related problems. We found that PBS significantly moderated the relationship between alcohol use and alcohol-related problems, for PBS total scale (F-change (1,1555) = 15.96, p < .001) and one of the PBS subscale: Limiting/Stopping Drinking (F-change (1,1555) = 4.80, p < .029). Findings were discussed within the results of PBS literature and resilience theory framework. CONCLUSION The use of PBS helps to reduce alcohol-related problems among adolescents attending SEC. Implementation of tailored interventions that teach PBS among vulnerable adolescents may be an effective way to strengthen adolescent self-protection, reduce risky alcohol use and related negative consequences.
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Affiliation(s)
- Jakub Greń
- Public Health Department, Institute of Psychiatry and Neurology, Warsaw, Poland.
| | | | - Agnieszka Pisarska
- Public Health Department, Institute of Psychiatry and Neurology, Warsaw, Poland.
| | - Krzysztof Bobrowski
- Public Health Department, Institute of Psychiatry and Neurology, Warsaw, Poland.
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Grazioli VS, Studer J, Larimer ME, Lewis MA, Bertholet N, Marmet S, Daeppen JB, Gmel G. Protective behavioral strategies and alcohol outcomes: Impact of mood and personality disorders. Addict Behav 2021; 112:106615. [PMID: 32889443 DOI: 10.1016/j.addbeh.2020.106615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 08/12/2020] [Accepted: 08/15/2020] [Indexed: 10/23/2022]
Abstract
Although young men or young adults with mental health disorders are at higher risk to engage in problematic drinking, they typically evince stronger associations between protective behavioral strategies (PBS) and fewer alcohol outcomes. This study aimed to contribute to this line of research by examining the moderating effect of depression, bipolar spectrum disorder, borderline personality disorder and social anxiety disorder on the association between PBS and alcohol outcomes. Participants (N = 4,960; mean age = 25.43) were young men participating in the Cohort Study on Substance Use Risk Factors. Measures of PBS use, typical drinks per week, alcohol-related consequences, depression, bipolar spectrum disorder, borderline personality disorder and social anxiety disorder were used from the second follow-up assessment. Main results indicated that the negative association between PBS and alcohol use was stronger in participants with borderline personality disorder than among those without this disorder. Unexpectedly, in participants with depression, PBS were not significantly associated with alcohol use, whereas they were related to fewer drinks among those without the disorder. Similarly, in participants with bipolar spectrum disorder, the association between PBS and alcohol-related consequences was not significant, whereas PBS were associated with fewer consequences in those without the disorder. Finally, findings indicated that social anxiety disorder did not significantly moderate the associations between PBS and alcohol outcomes. If replicated by future research, these findings imply that PBS-intervention may not equally impact young adults with diverse mental health disorders.
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7
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Dekker MR, Jongenelis MI, Hasking P, Kypri K, Chikritzhs T, Pettigrew S. Factors Associated with Engagement in Protective Behavioral Strategies among Adult Drinkers. Subst Use Misuse 2020; 55:878-885. [PMID: 31913057 DOI: 10.1080/10826084.2019.1708944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Protective behavioral strategies (PBSs) have been proposed as useful individual-level approaches to reducing alcohol consumption and alcohol-related harm. However, recent research suggests that few of the recommended PBSs may be effective in reducing longer-term alcohol consumption, with some appearing to result in increased intake over time. Objectives: To identify factors associated with enactment of specific PBSs to inform alcohol control efforts that aim to encourage the use of effective strategies and attenuate the effects of strategies found to be associated with increased consumption. Methods: Australian adult drinkers (n = 2,003; 50% male) completed an online survey assessing their alcohol consumption, frequency of attending drinking venues, enactment of specific PBSs, and demographic characteristics. Results: Greater enactment of the PBS that has previously been found to be associated with reduced alcohol use ('Count your drinks') was found among older respondents and those with lower levels of alcohol consumption. Older respondents were also more likely to enact two of the three PBSs that have been found to be associated with increased alcohol consumption ('Use a designated driver' and 'Leave drinking venues at a pre-determined time'). Conclusions/Importance: Results suggest that enactment of specific PBSs may differ according to the individual-level variables of gender, age, and preferred beverage type, and the environmental-level variable of attendance at licensed premises. Randomized trials investigating the effectiveness of PBS interventions among drinker subgroups are needed to determine the extent to which enactment reduces alcohol consumption and alcohol-related harm and whether effects are moderated by the variables assessed in this study.
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Affiliation(s)
- Maria R Dekker
- School of Psychology, Curtin University, Bentley, Australia
| | - Michelle I Jongenelis
- School of Psychology, Curtin University, Bentley, Australia.,Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
| | | | - Kypros Kypri
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Tanya Chikritzhs
- National Drug Research Institute, Health Sciences, Curtin University, Bentley, Australia
| | - Simone Pettigrew
- School of Psychology, Curtin University, Bentley, Australia.,The George Institute for Global Health, Newtown, Australia
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8
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Miller CM, Whitley RB, Scully KA, Madson MB, Zeigler-Hill V. Protective behavioral strategies and alcohol-related outcomes: The moderating effects of drinking refusal self-efficacy and sex. Addict Behav 2019; 99:106110. [PMID: 31480010 DOI: 10.1016/j.addbeh.2019.106110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 08/21/2019] [Accepted: 08/23/2019] [Indexed: 10/26/2022]
Abstract
The investigation of drinking refusal self-efficacy and alcohol protective behavioral strategies (PBSA) has revealed inconsistent results. Sex may be one factor that plays a role in these results given the demonstrable differences between the alcohol use behaviors of men and women. The current study examined the moderating effects of drinking refusal self-efficacy and sex on the relationships that PBSA subtypes have with alcohol outcomes for traditional age undergraduate students (18-25 years of age; 81% women; 60% White). Results showed negative associations between manner of drinking PBSA and alcohol consumption for individuals with high levels of drinking refusal self-efficacy but not low levels of drinking refusal self-efficacy. However, manner of drinking PBSA was positively associated with alcohol-related negative consequences for men but not for women. Results also showed negative associations between stopping and limiting drinking PBSA and alcohol related negative consequences for individuals with high levels of drinking refusal self-efficacy but not low levels of drinking refusal self-efficacy. It appears that addressing drinking refusal self-efficacy within the context of PBSA is valuable for traditional college students.
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9
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Grazioli VS, Studer J, Larimer ME, Lewis MA, Marmet S, Lemoine M, Daeppen JB, Gmel G. Protective Behavioral Strategies Scale-20: Psychometric properties of a French and German version among young males in Switzerland. Int J Methods Psychiatr Res 2019; 28:e1777. [PMID: 30848002 PMCID: PMC6877153 DOI: 10.1002/mpr.1777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 01/30/2019] [Accepted: 02/02/2019] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE The Protective Behavioral Strategies Scale (PBSS-20) is one of the most commonly used measures of engagement in protective behavioral strategies (PBS). This research aimed to examine the psychometric properties of a French and German version of the PBSS-20 in a large sample of young males in Switzerland. METHOD The sample included 5,017 young males (mean age = 25.44) participating in the Cohort Study on Substance Use Risk Factors in Switzerland. Measures of PBS use, total drinks per week, and alcohol-related consequences were used from a second follow-up assessment. RESULTS Confirmatory factor analysis testing different models previously documented in the literature provided initial support for a four-factor model. Fit statistics indicated that this model adequately reflects the structure of data. Further findings also provided support for adequate internal consistency and for convergent validity of this four-factor model, whereas metric-but not scalar-measurement invariance across linguistic regions was demonstrated. CONCLUSION Although further research testing measurement invariance across linguistic regions and gender is warranted, results of the current study suggest that the French and German PBSS-20 is reliable and that it may represent a promising research and clinical tool that can be used in both French- and German-speaking countries.
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Affiliation(s)
- Véronique S Grazioli
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - Joseph Studer
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Melissa A Lewis
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Simon Marmet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - Mélissa Lemoine
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - Jean-Bernard Daeppen
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - Gerhard Gmel
- Addiction Switzerland, Lausanne, Switzerland.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,University of the West of England, Bristol, UK
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10
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Martin JL, Zamboanga BL, Haase RF, Buckner LC. Measurement Invariance of the Protective Behavioral Strategies Scale Across Racial Groups. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2019. [DOI: 10.1080/07481756.2019.1640615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | - Richard F. Haase
- University at Albany, State University of New York, Albany, NY, USA
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11
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Longo LM, Martin JL, Zamboanga BL, Milroy JJ, Wyrick DL. Ethnic, gender, and seasonal difference in heavy drinking and protective behavioral strategies among student-athletes. J Ethn Subst Abuse 2018; 19:253-270. [DOI: 10.1080/15332640.2018.1520172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Laura M. Longo
- University at Albany, State University of New York, Albany, New York
| | - Jessica L. Martin
- University at Albany, State University of New York, Albany, New York
| | | | | | - David L. Wyrick
- University of North Carolina Greensboro, Greensboro, North Carolina
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12
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Grazioli VS, Lewis MA, Fossos-Wong N, Larimer ME. Attitudes toward protective behavioral strategies: Do they predict use of strategies and alcohol outcomes over time? Addict Behav 2018; 87:190-195. [PMID: 30053704 DOI: 10.1016/j.addbeh.2018.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 07/18/2018] [Accepted: 07/18/2018] [Indexed: 10/28/2022]
Abstract
Whereas past research among young adults has established that the use of protective behavioral strategies (PBS) is negatively related to alcohol outcomes, fewer studies have examined constructs related to PBS use. This study aimed to examine longitudinally the associations of attitudes toward PBS with PBS use and alcohol outcomes, as well as between PBS use and attitudes toward PBS. It also aimed to examine biological sex as a moderator of these associations. Participants (N = 248) were young adults participating in a longitudinal study in the US. Measures of attitudes toward PBS, PBS use, alcohol use and related consequences at 18, 24 and 30-months were included in the analyses. Results indicated that attitudes toward PBS were positively related to subsequent PBS use when prior PBS use was not controlled for; similarly, PBS use was positively related to attitudes toward PBS when prior attitudes were not taken into account. Both associations did not remain significant after controlling for prior PBS use and attitudes. These associations were not significantly moderated by biological sex. There was, however, a significant interaction between attitudes toward PBS and biological sex in predicting alcohol use, such that positive attitudes toward PBS were significantly related to fewer drinks over time among males but not among females, even after controlling for prior PBS use and alcohol use. Finally, after controlling for prior PBS use and consequences, attitudes toward PBS were not significantly related to consequences over time. Implications of these findings for prevention among young adults are discussed.
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13
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Jordan HR, Madson MB, Nicholson BC, Bravo AJ, Pearson MR. Posttraumatic stress disorder symptoms and problematic alcohol use in college students: The moderating role of alcohol protective behavioral strategies and gender. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2018; 11:247-255. [PMID: 30346206 DOI: 10.1037/tra0000417] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The present study evaluated the moderating role of alcohol protective behavioral strategy subtypes (alcohol PBS; serious harm reduction, manner of drinking, limiting/stopping drinking) and gender on the relationship between posttraumatic stress disorder (PTSD) symptoms and alcohol-related negative consequences. METHOD Participants were 2,138 traditional college students (i.e., age between 18 and 25 years old) recruited from 10 universities in the United States who reported drinking in the past month. All participants reported their gender and completed measures of PTSD symptoms, alcohol PBS use, alcohol consumption, and alcohol-related negative consequences through an online survey. RESULTS Experiencing greater PTSD symptoms was associated with increased alcohol-related negative consequences and all alcohol PBS subtypes were independently associated with fewer alcohol-related negative consequences. Gender had a moderating effect such that the relationship between manner of drinking and alcohol-related negative consequences was weaker among men. Further, we found significant three-way interactions such that the associations between PTSD symptoms and alcohol-related negative consequences were weaker at higher levels of serious harm reduction and limiting/stopping drinking, but only among women. CONCLUSIONS Although alcohol PBS appear beneficial for all college student drinkers, these findings highlight the additional protective value of certain alcohol PBS for college women experiencing PTSD symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Hallie R Jordan
- School of Psychology, The University of Southern Mississippi
| | | | | | - Adrian J Bravo
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico
| | - Matthew R Pearson
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico
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14
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Mugavin J, Room R, MacLean S, Callinan S. Strategies associated with low-risk drinking: a population-based study. Aust N Z J Public Health 2018; 42:315-320. [PMID: 29644759 DOI: 10.1111/1753-6405.12780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 11/01/2017] [Accepted: 01/01/2018] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To examine the relative frequency of use of seven strategies to moderate drinking (SMD) among low-risk and risky drinkers. METHODS Cross-sectional data from the 2013 National Drug Strategy Household Survey was used. The analytical sample included 11,462 Australians aged 18-64 who had consumed alcohol in the previous year. Logistic regression was used. RESULTS Analyses indicated a curvilinear relationship between use of SMD and alcohol consumption. Across the seven SMD, constant use of a strategy, compared with never using a strategy, was associated with low-risk drinking. Never using a strategy, compared with using one rarely, was also associated with low-risk drinking. When used occasionally, strategies that implied less alcohol consumed per hour (e.g. refuse unwanted drinks) increased the likelihood of low-risk drinking, whereas less direct strategies (e.g. counting drinks) increased the likelihood of risky drinking. CONCLUSIONS Adult Australians who drink at low levels use a range of strategies to moderate their alcohol consumption. Overall, consistent use of one or more SMD was associated with low-risk drinking patterns. IMPLICATIONS Public health responses to risky drinking may be enhanced by promoting the consistent use of SMD as a way to reduce overall alcohol consumption.
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Affiliation(s)
- Janette Mugavin
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Victoria
| | - Robin Room
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Victoria.,Centre for Social Research on Alcohol and Drugs, Stockholm University, Sweden
| | - Sarah MacLean
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Victoria.,School of Allied Health, La Trobe University, Victoria
| | - Sarah Callinan
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Victoria
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15
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Moylett S, Hughes BM. The associations among personality, alcohol-related Protective Behavioural Strategies (PBS), alcohol consumption and sexual intercourse in Irish, female college students. Addict Behav Rep 2017; 6:56-64. [PMID: 29450237 PMCID: PMC5800550 DOI: 10.1016/j.abrep.2017.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 08/10/2017] [Accepted: 08/10/2017] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION The study presented one of the first examinations of the associations among personality, alcohol-related protective behavioural strategies (PBS), alcohol consumption, sexual intercourse and sex-related alcohol negative consequences in Irish, female college students (n = 522). METHODS A cross-sectional observational design was employed and participants completed the study online. Participants completed measures of personality, alcohol-related PBS, alcohol consumption and sexual intercourse. Hierarchical multiple regression was utilised to access the associations between such measures. RESULTS From the analyses, it was found that age, frequency of sexual intercourse, frequency of alcohol consumption, level of alcohol consumption and openness were all significantly related to the use of alcohol-related protective behavioural strategies, and in turn, sex-related negative consequences. However, inconsistent findings with other personality dimensions to those of previous research were noted. CONCLUSIONS The findings of this study posited that the use of PBS has a key role to play in the levels of sexual intercourse and alcohol consumption, age and openness, and the associated negative sexual consequences in Irish, female college students.
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Affiliation(s)
- Sinéad Moylett
- School of Psychology, National University of Ireland Galway, University Road, Galway, Ireland
- Division of Population Medicine, School of Medicine, Cardiff University, 3rd Floor, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK
| | - Brian M. Hughes
- School of Psychology, National University of Ireland Galway, University Road, Galway, Ireland
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Savage MW, Menegatos L, Roberto AJ. When Do Friends Prevent Friends from Hooking Up Intoxicated? An Examination of Sex Differences and Hypothetical Intoxication in Peer Interventions. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:1819-1829. [PMID: 28474308 DOI: 10.1007/s10508-017-0969-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 01/01/2017] [Accepted: 02/21/2017] [Indexed: 06/07/2023]
Abstract
Despite the risks involved when mixing alcohol with casual sexual activity, the majority of college students engage in hookups, and the majority of those hookups involve alcohol. This study focused on the protective role college students' peers can play and the situational factors that might influence their willingness to intervene when a close friend is about to hook up intoxicated. Drawing on the theory of planned behavior (TPB), this study investigated differences in students' (N = 1270) attitudes, norms, perceived behavioral control, and intentions to persuade a close friend not to engage in a hypothetical drunken hookup using a 2 (friend sex) × 2 (participant sex) × 2 (sober/intoxicated) factorial design. Results indicated significant differences in the TPB variables. Participants intended to intervene with female friends, but not male friends, and women were more likely to intervene than men. Participants in the sober condition had stronger intentions to intervene than those in the intoxicated condition, but this effect was driven by increases in men's intentions when sober. Implications for theory and prevention programming are discussed.
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Affiliation(s)
- Matthew W Savage
- School of Communication, San Diego State University, San Diego, CA, 92182-4560, USA.
| | - Lisa Menegatos
- Honors College and Communication Studies, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Anthony J Roberto
- Hugh Downs School of Human Communication, Arizona State University, Tempe, AZ, USA
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Braitman AL, Linden-Carmichael AN, Henson JM. Protective behavioral strategies as a context-specific mediator: A multilevel examination of within- and between-person associations of daily drinking. Exp Clin Psychopharmacol 2017; 25:141-155. [PMID: 28240925 PMCID: PMC5426965 DOI: 10.1037/pha0000111] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Research indicates that a drinker's environmental and social context can be differentially associated with drinking outcomes. Further, although many researchers have identified that more frequent use of protective behavioral strategies (PBS) is associated with lower alcohol consumption and negative consequences, scant research has examined how one's drinking context may promote or hinder PBS use. The present study examined how the context of drinking each day (i.e., where and with whom) is associated with level of consumption and reported alcohol-related problems among n = 284 college drinkers (69.0% female) directly, as well as indirectly through the use of PBS. Two different dimensions of PBS are examined (i.e., "Limits" or limiting consumption, and "Avoidance" or avoiding alcohol in general or specific alcohol situations), as well as their relationship with daily drinking. Moreover, we explored these relationships intraindividually (within-person across time), as well as interindividually (between people). Daily drinking was assessed using a weekly diary design. Using multilevel structural equation modeling, we found that environmental context (i.e., drinking at a bar or party) is associated with heavier alcohol use directly and indirectly through PBS that involve limiting one's drinking; these effects occurred only at the daily (within-person) level. Additionally, social context (i.e., drinking with friends) predicts elevated drinking but is unrelated to PBS use. Similar findings were present for alcohol-related problems, controlling for consumption level. College student drinking interventions may benefit from a focus on increasing the use of PBS within potentially risky drinking environments to help reduce problematic alcohol use. (PsycINFO Database Record
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Affiliation(s)
| | - Ashley N. Linden-Carmichael
- Department of Psychology, Old Dominion University,The Methodology Center and The Department of Biobehavioral Health, The Pennsylvania State University
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Zhou J, Droste N, Curtis A, Zinkiewicz L, Miller P. Playing it safe: Patron safety strategies and experience of violence in night-time entertainment districts. Drug Alcohol Rev 2017; 37:340-347. [PMID: 28557132 DOI: 10.1111/dar.12570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 03/30/2017] [Accepted: 04/09/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND AIMS Incidences of violence are elevated in night-time entertainment districts. Research suggests that safety-related behavioural strategies adopted while drinking can reduce negative alcohol-related outcomes. The current study investigates the use of safety strategies and its association with experiences of violence among patrons from the general population. DESIGN AND METHODS Patron interviews (N = 3949) were conducted in and around licenced venues in Newcastle (New South Wales) and Geelong (Victoria) during peak trading hours (Friday and Saturday, 21:00-01:00 h). Participants (mean age = 24.3, SD = 5.8; male 54.4%) were asked to report what measures, if any, they used to keep safe when drinking and whether they had been involved in a violent incident in the last 12 months. RESULTS After controlling for patron demographics and location, the use of multiple (more than one) safety strategies was significantly associated with reduced odds of involvement in a violent incident (odds ratio = 0.64, 95% confidence interval 0.49-0.85, P = 0.002). Significant gender differences were observed in the number and type of safety strategies reported. DISCUSSION AND CONCLUSIONS Increasing the number of safety-related behaviours during drinking occasions is associated with a small but significant reduction in experiencing alcohol-related harms, such as violence. [Zhou J, Droste N, Curtis A, Zinkiewicz L, Miller P. Playing it safe: Patron safety strategies and experience of violence in night-time entertainment districts.
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Affiliation(s)
- Jin Zhou
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | - Nicolas Droste
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | - Ashlee Curtis
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | - Lucy Zinkiewicz
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | - Peter Miller
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
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Suffoletto B, Merrill JE, Chung T, Kristan J, Vanek M, Clark DB. A text message program as a booster to in-person brief interventions for mandated college students to prevent weekend binge drinking. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2016; 64:481-489. [PMID: 27149662 PMCID: PMC4992551 DOI: 10.1080/07448481.2016.1185107] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate a text message (SMS) program as a booster to an in-person alcohol intervention with mandated college students. PARTICIPANTS Undergraduates (N = 224; 46% female) who violated an on-campus alcohol policy over a 2-semester period in 2014. METHODS The SMS program sent drinking-related queries each Thursday and Sunday and provided tailored feedback for 6 weeks. Response rates to SMS drinking-related queries and the associations between weekend drinking plans, drinking-limit goal commitment, and alcohol consumption were examined. Gender differences were explored. RESULTS Ninety percent of SMS queries were completed. Weekend binge drinking decreased over 6 weeks, and drinking-limit goal commitment was associated with less alcohol consumption. Compared with women, men had greater reductions in alcohol consumption when they committed to a drinking-limit goal. CONCLUSIONS Preliminary evidence suggests that an SMS program could be useful as a booster for helping mandated students reduce weekend binge drinking.
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Affiliation(s)
- Brian Suffoletto
- a Department of Emergency Medicine , University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA
| | - Jennifer E Merrill
- b Center for Alcohol and Addiction Studies, Brown University School of Public Health , Pittsburgh , Pennsylvania , USA
| | - Tammy Chung
- c Department of Psychiatry , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Jeffrey Kristan
- a Department of Emergency Medicine , University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA
| | - Marian Vanek
- d Student Health Services, University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Duncan B Clark
- c Department of Psychiatry , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
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Borsari B, Merrill JE, Yurasek A, Miller MB, Carey KB. Does a Brief Motivational Intervention Reduce Frequency of Pregaming in Mandated Students? Subst Use Misuse 2016; 51:1056-66. [PMID: 27070727 PMCID: PMC4884148 DOI: 10.3109/10826084.2016.1152494] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Pregaming, also known as frontloading or predrinking, is a common but risky drinking behavior among college students. However, little is known about the way in which a brief motivational intervention (BMI) addressing general alcohol use and consequences may impact pregaming frequency. OBJECTIVES This study examined whether mandated students reduced frequency of pregaming following a BMI when pregaming was spontaneously discussed and whether gender moderated these effects. METHODS Participants (n = 269, 32% female) were mandated college students who had received a campus-based alcohol citation and continued to exhibit risky alcohol use six weeks after receiving a brief advice session. Participants were randomized to a brief motivational intervention (BMI, n = 145) or assessment only (AO, n = 124) and completed follow-up assessments at 3, 6, and 9 months postintervention. Hierarchical Linear Modeling (HLM) was used to examine both between-person (Level 2) effects (i.e., condition) and within-person (Level 1) effects (i.e., time) on pregaming frequency. Analyses examining discussions of pregaming within the BMI were conducted using a subsample of the BMI sessions which had been transcribed (n = 121). RESULTS Participants in the BMI group did not significantly reduce the frequency of pregaming compared to those in the AO group, even when pregaming was explicitly discussed during the BMI. Moreover, the BMI was equally ineffective at reducing pregaming frequency for both males and females. Conclusion/Importance: Pregaming frequency appears to be resistant to conventional intervention efforts, but recent research suggests several innovative strategies for addressing pregaming in the college student population.
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Affiliation(s)
- Brian Borsari
- a Mental Health and Behavioral Sciences Service , Department of Veterans Affairs Medical Center , Providence , Rhode Island , USA.,b Department of Behavioral and Social Sciences , Brown University, Providence , Rhode Island , USA
| | - Jennifer E Merrill
- b Department of Behavioral and Social Sciences , Brown University, Providence , Rhode Island , USA
| | - Ali Yurasek
- b Department of Behavioral and Social Sciences , Brown University, Providence , Rhode Island , USA
| | - Mary Beth Miller
- b Department of Behavioral and Social Sciences , Brown University, Providence , Rhode Island , USA
| | - Kate B Carey
- b Department of Behavioral and Social Sciences , Brown University, Providence , Rhode Island , USA
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Bravo AJ, Prince MA, Pearson MR. Does the How Mediate the Why? A Multiple Replication Examination of Drinking Motives, Alcohol Protective Behavioral Strategies, and Alcohol Outcomes. J Stud Alcohol Drugs 2016; 76:872-83. [PMID: 26562595 DOI: 10.15288/jsad.2015.76.872] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The present study attempted to assess the evidence of use of protective behavioral strategies (PBS) as a mediator in the relationship between drinking motives and alcohol outcomes. Specifically, to understand various statistical approaches in modeling this proposed mediation model (e.g., drinking motives to PBS use to alcohol outcomes), we tried to replicate models based on earlier research. METHOD To maximize the robustness of our replication attempts, we conducted each replication attempt across two distinct data sets whenever possible. Participants were recruited from psychology department research pools at a large southeastern U.S. university (Sample 1; n = 774) and a large southwestern U.S. university (Sample 2; n = 594). We matched the original articles' analytic procedures as closely as possible including overall analysis approach, measurement of variables, and inclusion/exclusion criteria. RESULTS Consistent with previous studies, we found that PBS use may be a mechanism through which both positively reinforcing (i.e., social and enhancement) motives and coping motives relate to alcohol outcomes (e.g., alcohol-related consequences). Specifically, students who tend to drink for these specific motives appear to use fewer PBS, which may place them at risk for heavier, more problematic drinking. CONCLUSIONS Our results suggest that when drinking motives are examined separately, they demonstrate differential relationships with PBS use and alcohol outcomes. Overall, it is clear that PBS use plays a role in the drinking motives-alcohol outcomes relationship, but this role varies by type of motive.
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Affiliation(s)
- Adrian J Bravo
- Department of Psychology, Old Dominion University, Norfolk, Virginia
| | - Mark A Prince
- Research Institute on Addictions, University at Buffalo, The State University of New York, Buffalo, New York
| | - Matthew R Pearson
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, New Mexico
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Grazioli VS, Lewis MA, Garberson LA, Fossos-Wong N, Lee CM, Larimer ME. Alcohol expectancies and alcohol outcomes: effects of the use of protective behavioral strategies. J Stud Alcohol Drugs 2016; 76:452-8. [PMID: 25978832 DOI: 10.15288/jsad.2015.76.452] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Alcohol expectancies (AEs) are positively associated with drinking behaviors, whereas the use of protective behavioural strategies (PBS) is negatively related to alcohol outcomes among young adults. PBS have been shown to weaken relationships between some alcohol risk factors and alcohol outcomes. This study aimed to examine longitudinally the moderating effect of PBS on the relationships between AEs and alcohol outcomes among young adults. METHOD Participants (N = 188; 61.7% female) were U.S. young adults participating in a larger longitudinal study. Measures of PBS, AEs, alcohol use, and related consequences were used from the baseline and 12-month follow-up assessments. RESULTS Negative binomial hurdle models found that PBS (total score) significantly moderated the relationship between positive AEs and consequences, such that among high school seniors endorsing higher positive AEs, those using more PBS in high school reported fewer negative consequences 1 year later. PBS (Manner of Drinking) also moderated the relationship between negative AEs and alcohol use, revealing the use of PBS in high school as having a protective function against later drinking among participants with high positive AEs. Last, PBS (Serious Harm Reduction) significantly moderated the associations between positive AEs and alcohol use and between negative AEs and consequences, such that participants with higher AEs and higher PBS use in high school were at greatest risk for drinking and experiencing negative consequences later. CONCLUSIONS Overall, these findings suggest that PBS use may be protective by weakening relationships between positive AEs and alcohol outcomes. Limitations and future directions are discussed.
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Affiliation(s)
- Véronique S Grazioli
- Department of Community Medicine and Health, Lausanne University Hospital, Lausanne, Switzerland.,Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Melissa A Lewis
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Lisa A Garberson
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Nicole Fossos-Wong
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Christine M Lee
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Mary E Larimer
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
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Kim J, Park S. Association between protective behavioral strategies and problem drinking among college students in the Republic of Korea. Addict Behav 2015; 51:171-6. [PMID: 26275844 DOI: 10.1016/j.addbeh.2015.07.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/20/2015] [Accepted: 07/22/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The literature indicates that protective behavioral strategies (PBS) have been effective in addressing problem drinking among college students. However, the effects of PBS on problem drinking have not been thoroughly investigated among Korean college students. Thus, the two study aims were to (a) examine drinking behavior among Korean college students and (b) investigate the effects of PBS on problem drinking. METHODS A pilot study was first conducted to obtain information needed to determine a sample size and to examine the understandability and reliability of seven instruments. The instruments were then used to collect data from full-time college students (N=479). The data were analyzed using (a) descriptive statistics such as frequencies and means for the first aim and (b) multivariate logistic regression for the second aim. RESULTS Approximately 93% of the respondents had drunk alcohol during the month before the survey, and 72.7% were problem drinkers. The use of PBS significantly decreased the odds of problem drinking (odds ratio [OR]=0.90 [95% CI, 0.87-0.93]). In addition, male gender and positive alcohol expectancy were associated with increased odds of problem drinking (ORs=3.32 [95% CI, 1.59-6.94] and 1.04 [95% CI, 1.01-1.08]), whereas greater age of drinking onset was associated with decreased odds of problem drinking (OR=0.81 [95% CI, 0.70-0.94]). CONCLUSIONS Given the prevalence of the drinking problem among Korean college students, it is important to develop and implement interventions that will encourage students to use PBS in order to avoid problem drinking and its negative consequences.
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Cadigan JM, Weaver CC, McAfee NW, Herring TE, Martens MP. A confirmatory factor analysis of the Protective Behavioral Strategies Scale among OEF/OIF veterans. Addict Behav 2015; 51:127-30. [PMID: 26255637 DOI: 10.1016/j.addbeh.2015.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/06/2015] [Accepted: 07/14/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Military veterans of the wars in Afghanistan and Iraq (OEF/OIF/OND) are at-risk for increased alcohol consumption and alcohol-related consequences. The Protective Behavioral Strategies Scale (PBSS) has been shown to be a reliable and valid measure of assessing strategies to facilitate more responsible drinking and to reduce alcohol-related harm among college student populations. The purpose of this study was to examine the psychometric properties of the PBSS among the OEF/OIF veteran population. METHOD Participants were 251 veterans (94% male; 83% White; M age=31.77years) who were participating in a larger alcohol intervention trial and reported consuming alcohol within the past 30days. RESULTS Confirmatory Factor Analyses indicated the model fit of the PBSS was similar to college student samples. Although a confirmatory three-factor model best fits the data, model fit indices were slightly below commonly accepted guidelines. All PBSS subscales were negatively correlated with alcohol outcomes. Greater use of Manner of Drinking (MOD) and Stopping/Limiting Drinking (SLD) strategies were associated with less alcohol consumption and lower peak BAC. Greater use of MOD strategies was associated with less alcohol-related problems. CONCLUSIONS Findings provide initial support for use of the PBSS among OEF/OIF veterans. Strategies aimed at Stopping/Limiting Drinking and the Manner of Drinking may be more effective with a veteran sample. Additional studies examining the external validity of this measure are encouraged.
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Clarke N, Kim SY, Ray AE, White HR, Jiao Y, Mun EY. The association between protective behavioral strategies and alcohol-related problems: An examination of race and gender differences among college drinkers. J Ethn Subst Abuse 2015; 15:25-45. [PMID: 26114577 DOI: 10.1080/15332640.2014.1002877] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examined race and gender differences in use of specific types of protective behavioral strategies (PBS) and the moderating effects of race and gender on the relationship between PBS use and alcohol problems, controlling for alcohol use, among a large sample of Asian, Black, and White college drinkers. There were significant racial and gender differences in the types of PBS used. Moderation analyses indicated that PBS were more protective for women than men against experiencing alcohol-related problems. There were no significant race effects or race-by-gender interaction effects on alcohol problems. Implementing PBS may be beneficial for all college students.
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Affiliation(s)
- Nickeisha Clarke
- a Rutgers, The State University of New Jersey , Piscataway , New Jersey
| | - Su-Young Kim
- b Department of Psychology , Ewha Womans University , Seoul , South Korea
| | - Anne E Ray
- a Rutgers, The State University of New Jersey , Piscataway , New Jersey
| | - Helene R White
- a Rutgers, The State University of New Jersey , Piscataway , New Jersey
| | - Yang Jiao
- a Rutgers, The State University of New Jersey , Piscataway , New Jersey
| | - Eun-Young Mun
- a Rutgers, The State University of New Jersey , Piscataway , New Jersey
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Napper LE, Kenney SR, Montes KS, Lewis LJ, LaBrie JW. Gender as a moderator of the relationship between preparty motives and event-level consequences. Addict Behav 2015; 45:263-8. [PMID: 25746359 DOI: 10.1016/j.addbeh.2015.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 01/21/2015] [Accepted: 02/16/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Prepartying is often associated with increased alcohol consumption and negative alcohol-related consequences among college students. General drinking motives are often only weakly related to preparty alcohol use, and few studies have examined the associations between preparty-specific drinking motives and alcohol-related consequences that occur during or after a preparty event. The current study utilizes event-level data to address this gap in the literature by examining the relationship between four types of preparty motives (prepartying to relax or loosen up, to increase control over alcohol use, to meet a dating partner, and to address concerns that alcohol may not be available later) and alcohol consequences as a function of gender. METHODS Participants (N=952) reported on their most recent preparty event in the past month. RESULTS After controlling for general drinking motives, all four preparty motives predicted greater event-level consequences for both males and females. Further, prepartying to increase control over alcohol consumed was associated with greater consequences for males as compared to females. CONCLUSIONS The findings are consistent with research suggesting that preparty specific motives may further our understanding of prepartying outcomes over and above the use of general drinking motive measures.
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Kristan J, Suffoletto B. Using online crowdsourcing to understand young adult attitudes toward expert-authored messages aimed at reducing hazardous alcohol consumption and to collect peer-authored messages. Transl Behav Med 2015; 5:45-52. [PMID: 25729452 DOI: 10.1007/s13142-014-0298-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Text message delivered prevention interventions have the potential to improve health behaviors on a large scale, including reducing hazardous alcohol consumption in young adults. Online crowdsourcing can be used to efficiently develop relevant messages, but remains largely understudied. This study aims to use online crowdsourcing to evaluate young adult attitudes toward expert-authored messages and to collect peer-authored messages. We designed an online survey with four drinking scenarios and a demographic questionnaire. We made it available to people who reported age 18-25 years, residence in the US, and any lifetime alcohol consumption via the Amazon Mechanical Turk crowdsourcing platform. Participants rated 71 sample text messages on instrumental (helpful) and affective (interesting) attitude scales and generated their own messages. All messages were coded as informational, motivational, or strategy facilitating. We examined differences in attitudes by message type and by drinking status and sex. We surveyed 272 participants in 48 h, and 222 were included in analysis for a total participant payment cost of $178. Sample mean age was 23 years old, with 50 % being female, 65 % being of white race, and 78 % scored as hazardous drinkers. Informational messages were rated the most helpful, whereas motivational messages were rated the most interesting. Hazardous drinkers rated informational messages less helpful than non-hazardous drinkers. Men reported messages less helpful and interesting than women for most categories. Young adults authored 161 messages, with the highest proportion being motivational. Young adults had variable instrumental and affective attitudes toward expert-authored messages. They generated a substantial number of peer-authored messages that could enhance relevance of future alcohol prevention interventions.
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Affiliation(s)
- Jeffrey Kristan
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Iroquois Building, Suite 400A, 3600 Forbes Ave, Pittsburgh, PA 15261 USA
| | - Brian Suffoletto
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Iroquois Building, Suite 400A, 3600 Forbes Ave, Pittsburgh, PA 15261 USA
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Treloar H, Martens MP, McCarthy DM. The Protective Behavioral Strategies Scale-20: improved content validity of the Serious Harm Reduction subscale. Psychol Assess 2015; 27:340-6. [PMID: 25558969 PMCID: PMC4355382 DOI: 10.1037/pas0000071] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Excessive drinking in college leads to serious harms, but students who use protective behavioral strategies (PBS) avoid negative consequences by drinking in a safer manner. This study aimed to increase the content validity of the Serious Harm Reduction (SHR) subscale of the most widely used measure of PBS, the Protective Behavioral Strategies Scale (PBSS: Martens et al., 2005). An initial item pool was developed from literature on college student drinking, existing lists of drinking control strategies, and an online pilot survey of college students (N = 1,832). Items were also evaluated by focus groups of experts and members of the target population. Next, 1,376 students (57.9% women; Mage = 18.5 years; 86.3% White) completed questionnaires online. A subset (n = 170; 12.4%) completed a second survey 4-6 weeks later to examine test-retest reliability and criterion-related validity. The remaining students (n = 1,206) were divided into equal development and validation samples. Analyses included exploratory and confirmatory factor analysis of the development sample, factor structure replication, and gender invariance testing in the validity sample. Results of this process produced the PBSS-20, with an expanded SHR scale of eight items. The revised SHR scale demonstrated improved internal consistency and was associated with a broader range of alcohol-related negative consequences at follow-up. Given its focus on reducing serious harms, the SHR scale is arguably the most clinically relevant PBSS factor, and those who use this measure will benefit from the expanded breadth of SHR content and improved psychometric properties of the PBSS-20.
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Affiliation(s)
- Hayley Treloar
- Center for Alcohol and Addiction Studies, Brown University
| | - Matthew P Martens
- Department of Educational, School, and Counseling Psychology, University of Missouri
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Mun EY, de la Torre J, Atkins DC, White HR, Ray AE, Kim SY, Jiao Y, Clarke N, Huo Y, Larimer ME, Huh D. Project INTEGRATE: An integrative study of brief alcohol interventions for college students. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2014; 29:34-48. [PMID: 25546144 DOI: 10.1037/adb0000047] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This article provides an overview of a study that synthesizes multiple, independently collected alcohol intervention studies for college students into a single, multisite longitudinal data set. This research embraced innovative analytic strategies (i.e., integrative data analysis or meta-analysis using individual participant-level data), with the overall goal of answering research questions that are difficult to address in individual studies such as moderation analysis, while providing a built-in replication for the reported efficacy of brief motivational interventions for college students. Data were pooled across 24 intervention studies, of which 21 included a comparison or control condition and all included one or more treatment conditions. This yielded a sample of 12,630 participants (42% men; 58% first-year or incoming students). The majority of the sample identified as White (74%), with 12% Asian, 7% Hispanic, 2% Black, and 5% other/mixed ethnic groups. Participants were assessed 2 or more times from baseline up to 12 months, with varying assessment schedules across studies. This article describes how we combined individual participant-level data from multiple studies, and discusses the steps taken to develop commensurate measures across studies via harmonization and newly developed Markov chain Monte Carlo (MCMC) algorithms for 2-parameter logistic item response theory models and a generalized partial credit model. This innovative approach has intriguing promises, but significant barriers exist. To lower the barriers, there is a need to increase overlap in measures and timing of follow-up assessments across studies, better define treatment and control groups, and improve transparency and documentation in future single intervention studies.
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Affiliation(s)
| | | | - David C Atkins
- Department of Psychiatry and Behavioral Sciences, The University of Washington
| | | | | | - Su-Young Kim
- Department of Psychology, Ewha Womans University
| | | | | | | | - Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, The University of Washington
| | - David Huh
- Department of Psychiatry and Behavioral Sciences, The University of Washington
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Kenney SR, Napper LE, LaBrie JW, Martens MP. Examining the efficacy of a brief group protective behavioral strategies skills training alcohol intervention with college women. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2014; 28:1041-51. [PMID: 25347024 PMCID: PMC4329783 DOI: 10.1037/a0038173] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
College students' use of protective behavioral strategies (PBS; e.g., determining not to exceed a set number of drinks, avoiding drinking games) is related to lower levels of alcohol consumption and problems. The present study evaluated the efficacy of a novel brief, single-session group PBS skills training intervention aimed at increasing college students' use of PBS and reducing risky drinking and consequences. Participants (N = 226) were heavy-drinking incoming first-year college women randomized to either a PBS skills training intervention or study skills control condition. Participants attended a 45-min group session and completed online surveys pre- and postintervention (1 month and 6 months). We conducted a series of 2 × 2 × 3 repeated-measures ANCOVAs with condition and baseline mental health (anxiety/depression) as the between-subjects factors and time as the within-subjects factor. Intervention participants, relative to controls, reported significantly greater increases in PBS use and reductions in both heavy episodic drinking and alcohol consequences. The intervention was particularly effective in increasing PBS use at 1 month among participants with high anxiety. Further, tests of moderated mediation showed a significant conditional indirect effect of condition on 1-month consequences through PBS use among participants with high levels of anxiety. Findings provide preliminary support for a brief PBS-specific group intervention to reduce alcohol risk among college women, particularly anxious women. Future research is needed to strengthen the long-term effectiveness of the present approach and further explore the moderating effects of mental health.
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Affiliation(s)
| | - Lucy E Napper
- Department of Psychology, Loyola Marymount University
| | | | - Matthew P Martens
- Department of Educational, School, and Counseling Psychology, University of Missouri
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Logan DE, Koo KH, Kilmer JR, Blayney JA, Lewis MA. Use of drinking protective behavioral strategies and sexual perceptions and behaviors in U.S. college students. JOURNAL OF SEX RESEARCH 2014; 52:558-569. [PMID: 25350078 PMCID: PMC4412788 DOI: 10.1080/00224499.2014.964167] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Alcohol use among college students is linked to an increased likelihood of engaging in risky sexual behaviors, including casual sex and unprotected sex. These behaviors increase college students' risks for negative social and health-related consequences. This study examined the relationship between drinking behaviors and protective behavioral strategies (PBS), expectancies and perceptions of sexual risk, and actual alcohol-related sexual behaviors and consequences. Sexually active college students completed Web-based self-report measures of drinking behaviors and use of PBS, alcohol expectancies and perceptions of risk, and sexual behaviors and related consequences (n = 524; 57.1% women). Findings indicated that PBS were related to lower expectancies of sexual risk and sexual disinhibition, and among lighter drinkers, lower expectancies of sexual enhancement from alcohol. PBS were also related to decreased perceptions of sexual-related risks, some alcohol-related sexual behaviors, including number of drinks before/during sex, and number of sexual consequences, but were not related to abstaining during sex, frequency of alcohol-related sexual behaviors, or general condom use. These findings demonstrate a disconnect between perceived and actual risks among college students, such that decreased perceptions of risk may not be associated with protective behaviors. Prevention and intervention implications are discussed.
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Affiliation(s)
- Diane E. Logan
- Department of Behavioral and Social Sciences; Brown University
| | - Kelly H. Koo
- Department of Mental Health; San Francisco VA Medical Center
- Department of Psychiatry; University of California, San Francisco
| | - Jason R. Kilmer
- Department of Psychiatry and Behavioral Sciences; University of Washington
- Health & Wellness, Division of Student Life; University of Washington
| | | | - Melissa A. Lewis
- Department of Psychiatry and Behavioral Sciences; University of Washington
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Braitman AL, Henson JM, Carey KB. Clarifying observed relationships between protective behavioral strategies and alcohol outcomes: The importance of response options. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2014; 29:455-66. [PMID: 25180560 DOI: 10.1037/adb0000024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Protective behavioral strategies (PBS), or harm-reduction behaviors that can potentially reduce alcohol consumption or associated problems, have been assessed in varied ways throughout the literature. Existing scales vary in focus (i.e., broad vs. narrow), and importantly, in response options (i.e., absolute frequency vs. contingent frequency). Absolute frequency conflates PBS use with number of drinking occasions, resulting in inconsistencies in the relationship between PBS use and alcohol outcomes, whereas contingent frequency is less precise, which could reduce power. The current study proposes the use of absolute frequencies to maximize precision, with an adjustment for number of drinking days to extricate PBS use from drinking occasions, resulting in a contingent score. Study 1 examined the associations between PBS subscales using the Strategy Questionnaire (Sugarman & Carey, 2007) and alcohol outcomes, finding that in raw score form the association between PBS and typical alcohol outcomes varied greatly from significantly positive to significantly negative, but adjusted score relationships were all consistent with harm reduction perspectives. In addition, curvilinear relationships with typical alcohol use were eliminated using the score adjustment, resulting in linear associations. Study 2 confirmed the findings from Study 1 with a more precise timeframe, additional alcohol assessments, and heavier college drinkers. The relationships between alcohol outcomes and PBS in raw score form were again varied, but became consistently negative using the score adjustment. Researchers examining PBS and related constructs should consider modifying current scales to include a precise frequency response scale that is adjusted to account for number of drinking occasions. (PsycINFO Database Record
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Affiliation(s)
| | | | - Kate B Carey
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University
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Merrill JE, Reid AE, Carey MP, Carey KB. Gender and depression moderate response to brief motivational intervention for alcohol misuse among college students. J Consult Clin Psychol 2014; 82:984-92. [PMID: 24865872 DOI: 10.1037/a0037039] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Brief motivational interventions (BMIs) effectively reduce problematic drinking in college students. However, not all students benefit, and little is known about the subgroups of students for whom BMIs are most effective. In the present study, we examined 2 factors that may influence BMI efficacy: gender and depression. METHOD We reanalyzed data from a clinical trial in which heavy drinking students (N = 330; 65% female) were randomized to a BMI (n = 165) or an assessment only control (n = 165). Depression was assessed at baseline; past-month typical drinks per week, heavy drinking frequency, and consequences were assessed at baseline and 1 month. Three- and 2-way interactions among intervention condition (BMI vs. control), gender (male vs. female), and depression (low vs. high) were tested. RESULTS We observed 3-way interaction effects on 2 outcomes: (a) typical drinks per week and (b) frequency of heavy drinking at 1 month. Relative to controls and adjusting for baseline drinking, low-depression women reduced their drinking more after a BMI whereas high-depression women did not show differential improvement. In contrast, high-depression men showed significant reductions in weekly drinks following the BMI whereas low-depression men did not show differential improvement. In addition, higher levels of depression were associated with higher levels of consequences at follow-up across conditions. CONCLUSIONS BMIs are indicated for heavy drinking, depressed men, consistent with recommendations for implementing screening and brief intervention in mental health settings. However, BMIs may need to be refined to enhance their efficacy for depressed women.
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Affiliation(s)
| | - Allecia E Reid
- Center for Alcohol and Addiction Studies, Brown University
| | - Michael P Carey
- Department of Behavioral and Social Sciences, Brown University
| | - Kate B Carey
- Center for Alcohol and Addiction Studies, Brown University
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The nature and correlates of young women's peer-directed protective behavioral strategies. Addict Behav 2014; 39:1000-5. [PMID: 24556153 DOI: 10.1016/j.addbeh.2014.01.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 01/14/2014] [Accepted: 01/29/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Recently, a number of studies have identified self-employed Protective Behavioral Strategies (PBS) as effective in decreasing the level of alcohol-related harm among young people. However, much of the published research has ignored important gender differences, such as women's increased tendency to rely on PBS that are social in nature. To further the understanding of women's PBS, the current study sought to investigate the nature and correlates of the strategies young women employ to keep their friends safe when drinking (i.e., peer-directed PBS). METHOD A scale measuring peer-directed PBS was developed and administered in conjunction with existing measures of alcohol consumption, personal PBS, and peer attachment. Participants consisted of 422 women aged 18-30 years, recruited among psychology students and the general public. RESULTS Exploratory factor analysis revealed two clusters of peer-directed PBS; those that were aimed at reducing intoxication among one's friends and those that were designed to minimize alcohol-related harms. Further analysis found a positive relationship between women's tendency to implement personal and peer-directed PBS and that risky drinkers were less likely to engage in personal or peer-directed PBS (either type). CONCLUSION Findings indicate that personal and peer-directed PBS are related behaviors that are less frequently adopted by risky drinkers.
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Lostutter TW, Lewis MA, Cronce JM, Neighbors C, Larimer ME. The use of protective behaviors in relation to gambling among college students. J Gambl Stud 2014; 30:27-46. [PMID: 23224712 DOI: 10.1007/s10899-012-9343-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of the current study was to evaluate a measure of gambling protective behaviors and examine the relationship between indices of gambling behavior, including frequency, quantity and problem severity, and the use of gambling protective behaviors. Undergraduates from a large public university (N = 4,014) completed a web-based screening survey comprising measures of gambling and health behaviors, from which those who gambled within the past 6-months (n = 1,922, 48 % of the entire sample) were invited to complete the baseline assessment, including the Gambling Protective Behavior Scale (GPBS). The GPBS was determined to have two subscales, primarily consisting of harm reduction strategies that reduce the money or time spent on gambling, or avoidance strategies that help to minimize engagement in gambling activities. Hierarchical multiple regressions found participants' sex moderated the relationship between use of protective behavioral strategies and gambling outcomes. However, effects were in the opposite direction to those hypothesized. Specifically, because women gambled less, had lower gambling problem severity, and reported more frequent use of gambling avoidance protective behaviors, the relationship between use of gambling protective behaviors and gambling outcomes was stronger for men than women. Men who used more avoidance strategies gambled less frequently compared to men who used fewer avoidance strategies. Similarly, men who used more harm reduction strategies spent fewer dollars on gambling and had lower scores on gambling problem severity compared to men using fewer harm reduction strategies for women these relationships were less pronounced. Implications of incorporating specific gambling protective behavioral strategies into prevention and treatment programs are discussed.
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Affiliation(s)
- Ty W Lostutter
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, 1100 NE 45th St., Suite 300, Box 354944, Seattle, WA, 98195, USA,
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Crawford-Williams FM, Roberts RM, Watts D. Alcohol consumption and protective behavioural strategy use among Australian young adults. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2013. [DOI: 10.1080/02673843.2013.831363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Nguyen N, Walters ST, Wyatt TM, DeJong W. Do college drinkers learn from their mistakes? Effects of recent alcohol-related consequences on planned protective drinking strategies among college freshmen. Subst Use Misuse 2013; 48:1463-8. [PMID: 23750616 DOI: 10.3109/10826084.2013.778278] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study examined whether recent alcohol-related consequences affect intentions to use protective drinking strategies. Responses were collected from incoming college freshmen (N = 84,367) at 279 U.S. colleges and universities. Plans to limit future drinking were significantly lower among students who were male, younger, White, or were in or intending to join a fraternity or sorority. For heavy drinkers, having recently experienced a higher level of external harms predicted increased plans to limit drinking. For all drinkers, a lower level of recent impaired driving predicted increased plans to limit drinking. Limitations and implications are discussed.
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Affiliation(s)
- Norma Nguyen
- 1Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine , El Paso, Texas , USA
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Kenney SR, LaBrie JW. Use of protective behavioral strategies and reduced alcohol risk: examining the moderating effects of mental health, gender, and race. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2013; 27:997-1009. [PMID: 24079648 PMCID: PMC3983969 DOI: 10.1037/a0033262] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent research indicates that protective behavioral strategies (PBS)-previously established as effective self-regulating tools for reducing alcohol risk among college students-may be especially useful for students with poor mental health, who are shown to be at heightened risk for alcohol-related harm. The current study examined the moderating influence of mental health (depression and anxiety severity), gender, and race (White, Asian) in the relationship between PBS use and alcohol-related negative consequences. Participants were 1,782 undergraduate students from two West Coast universities who reported past-month incidence of heavy episodic drinking (HED). Students reported on their drinking, experience of alcohol-related consequences, use of PBS, and depression and anxiety symptomatology. Overall, results demonstrated that among participants experiencing depression or anxiety, greater PBS utilization was associated with significantly lower levels of alcohol-related consequences, even after controlling for drinking and other predictors. However, findings also revealed important distinctions in the potential effectiveness of PBS by depression/anxiety severity and racial-gender subgroup, such that Asian men with poor mental health appeared to garner unique and substantial benefit (i.e., lesser consequences) from increased PBS use. Further, PBS were found to offer substantial protective benefit for White females, irrespective of mental health. This study points to the potential for targeted PBS-specific skills training and interventions to minimize alcohol-related risks faced by the growing subpopulation of college students experiencing psychological distress, and further highlights important race and gender differentials.
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Pearson MR. Use of alcohol protective behavioral strategies among college students: a critical review. Clin Psychol Rev 2013; 33:1025-40. [PMID: 24036089 DOI: 10.1016/j.cpr.2013.08.006] [Citation(s) in RCA: 202] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 08/12/2013] [Accepted: 08/16/2013] [Indexed: 10/26/2022]
Abstract
Protective behavioral strategies (PBS) are specific behaviors one can utilize to minimize the harmful consequences of alcohol consumption. Recently, there has been an increasing amount of interest in use of PBS among college students, especially as an intervention target. The purpose of the present comprehensive review of the PBS literature was to examine the measurement of PBS and summarize the quantitative relationships between PBS use and other variables. The review found inconsistency across studies in terms of how the use of PBS is operationalized and found only two PBS measures with good psychometric properties that have been replicated. Although several antecedents to PBS use were identified, most were only examined in single studies. Moderators of the predictive effects of PBS use on outcomes have similarly suffered from lack of replication in the literature. Of all 62 published reports reviewed, 80% reported only cross-sectional data, which is unfortunate given that PBS use may change over time and in different contexts. In addition, only two attempted to minimize potential recall biases associated with retrospective assessment of PBS use, and only two used an approach that allowed the examination of both within-subject and between-subject effects. In terms of the gaps in the literature, there is a dearth of longitudinal studies of PBS use, especially intensive longitudinal studies, which are integral to identifying more specifically how, when, and for whom use of PBS can be protective.
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Affiliation(s)
- Matthew R Pearson
- Center on Alcoholism, Substance Abuse, & Addictions, University of New Mexico, Albuquerque, NM, United States.
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40
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Madson MB, Zeigler-Hill V. Protective Behavioral Strategies, Alcohol Consumption, and Negative Alcohol-Related Consequences: Do Race and Gender Moderate these Associations? J Ethn Subst Abuse 2013; 12:242-58. [PMID: 23967885 DOI: 10.1080/15332640.2013.798848] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Prince MA, Carey KB, Maisto SA. Protective behavioral strategies for reducing alcohol involvement: a review of the methodological issues. Addict Behav 2013; 38:2343-51. [PMID: 23584196 DOI: 10.1016/j.addbeh.2013.03.010] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 01/18/2013] [Accepted: 03/11/2013] [Indexed: 10/27/2022]
Abstract
Alcohol use among college students remains a major public health concern with many students experiencing negative alcohol-related consequences as a result of their drinking. Protective behavioral strategies (PBS) have been conceptualized as skills used by drinkers to moderate their drinking and/or resulting consequences. The correlational evidence for the relationships among PBS, alcohol use, and related problems has been mixed. Experimental research reveals inconsistent relationships among intervention condition, PBS use, and alcohol outcomes. There is currently insufficient evidence to support the claim that PBS function as a mechanism of behavior change for college drinkers. We propose that the inconsistencies found in the correlational and experimental research are explained in part by psychometric and methodological issues. This review summarizes measurement and methodological issues in studies that have directly assessed the relationship between PBS and alcohol use and/or alcohol-related consequences in college drinking samples. Additionally, we provide some suggestions and future directions to overcome methodological and conceptual limitations and to advance understanding of the role of protective behavioral strategy use in reducing alcohol involvement among college drinkers.
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Buettner CK, Khurana A. “She’s getting married; I’m getting drunk”: women’s risk and protective strategies at bachelorette parties. JOURNAL OF SUBSTANCE USE 2013. [DOI: 10.3109/14659891.2013.777479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hoffmann E, Davis AK, Ashrafioun L, Kraus SW, Rosenberg H, Bannon EE, Kryszak E, Carhart V, Baik K, Jesse S. Evaluation of the criterion and predictive validity of the Alcohol Reduction Strategies-Current Confidence (ARS-CC) in a natural drinking environment. Addict Behav 2013; 38:1940-3. [PMID: 23380498 DOI: 10.1016/j.addbeh.2012.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 10/30/2012] [Accepted: 12/27/2012] [Indexed: 10/27/2022]
Abstract
To evaluate several psychometric properties of a questionnaire designed to assess young people's self-efficacy to employ 31 alcohol reduction strategies, we assessed breath alcohol concentration, self-reported drinking, current strategy self-efficacy, and recent past use of these strategies in 100 young adults as they walked to and from the local bar district of a Midwestern college town. In support of criterion and predictive validity of the questionnaire, we found that lower self-efficacy at the initial assessment was significantly correlated with higher scores on a screening measure of consumption, with having engaged in more heavy drinking episodes in the past 30 days, and with higher levels of intoxication and use of fewer reduction strategies later that evening. Frequency counts indicate that 10 of the alcohol reduction strategies had been used by at least half of the sample to reduce their drinking earlier that evening.
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Madson MB, Moorer KD, Zeigler-Hill V, Bonnell MA, Villarosa M. Alcohol expectancies, protective behavioral strategies, and alcohol-related outcomes: A moderated mediation study. DRUGS-EDUCATION PREVENTION AND POLICY 2013. [DOI: 10.3109/09687637.2013.766788] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ji CY, Hu PJ, Song Y. The epidemiology of alcohol consumption and misuse among Chinese college students. Alcohol Alcohol 2012; 47:464-72. [PMID: 22493047 DOI: 10.1093/alcalc/ags037] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS To understand alcohol-related risk behaviours among Chinese college students. METHODS As part of the first China National Youth Risk Behaviour Survey, undertaken in 2009, 52,150 students at 119 colleges were randomly sampled. Information was obtained from self-administered questionnaires. RESULTS Prevalences were: lifetime drinkers 80.8%, current drinkers 49.3% (drank alcohol in past 30 days) and binge drinkers 23.5% ('binge drinkers' reporting at least five alcoholic drinks on a single occasion at least six times during the past 30 days). Multinomial logistic analysis revealed the contribution of sociodemographic factors to three high-risk drinking behaviours: odds ratio (95% confidence interval) = 3.64 (2.69-4.60) with frequent drinking; 3.27 (1.82-4.72) with binge drinking; and 5.48 (3.20-7.77) with heavy binge drinking. These three rates were greater among males than females, in the Western more than the Eastern region, among students living off-campus and among those whose mothers had higher education. Heavy drinking was linked to lower academic self-rating. CONCLUSION There is a trend towards risky drinking among Chinese college students. Measures such as a minimum drinking age, advertisement restrictions, taxation, drunk-driving penalties and campaigns to heighten public awareness of alcohol-related health risks should be instituted in order to improve the situation on college campuses where alcohol abuse is particularly prevalent.
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Affiliation(s)
- Cheng-Ye Ji
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Road, Beijing, Haidian District 100191, People’s Republic of China.
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Ray AE, Stapleton JL, Turrisi R, Philion E. Patterns of drinking-related protective and risk behaviors in college student drinkers. Addict Behav 2012; 37:449-55. [PMID: 22281283 DOI: 10.1016/j.addbeh.2011.12.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 11/13/2011] [Accepted: 12/13/2011] [Indexed: 11/29/2022]
Abstract
Drinking-related protective (e.g., pacing consumption) and risk (e.g., participating in drinking games) behaviors influence both the amount of alcohol consumed and the consequences experienced by college students. Previous studies of these behaviors have typically examined use and predictors of these constructs separately. In the current study, latent profile analysis (LPA) was used to identify latent subgroups of drinkers with distinct patterns of use of both drinking-related protective and risk behaviors in a sample of college students. A random sample of first year student drinkers (N=229, 59.4% female) at a large, public university in the Northeastern United States completed a web-based assessment of drinking-related protective and risk behaviors, alcohol use, and related consequences. Three patterns of use were identified, including: 1) students who used protective behaviors frequently and seldom engaged in risk behaviors (10%), 2) students who used risk behaviors more frequently and used protective behaviors less often (30%), and 3) students who used both risk and protective behaviors at similar frequencies (60%). Significant differences in the distribution of profiles were observed when considering gender, age of onset of alcohol use, and recent drinking outcomes including weekend alcohol use, heavy-episodic drinking, and alcohol-related problems. Prevention and intervention programs may benefit from a focus on not only increasing protective actions, but on also reducing risk behaviors beyond that of quantity and frequency of alcohol use alone.
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Affiliation(s)
- Anne E Ray
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, 607 Allison Road, Piscataway, NJ 08854, United States.
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Bonar EE, Hoffmann E, Rosenberg H, Kryszak E, Young KM, Ashrafioun L, Kraus SW, Bannon EE. Development of a questionnaire to assess university students' intentions to use behavioral alcohol-reduction strategies. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2012; 60:395-402. [PMID: 22686362 PMCID: PMC4123810 DOI: 10.1080/07448481.2012.663842] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To evaluate the psychometric properties of a new self-report questionnaire designed to assess college students' intentions to employ 31 specific alcohol-reduction strategies. METHOD Students attending a large public university were recruited to complete alcohol-reduction, drinking history, and personality questionnaires online. RESULTS Based on item-total correlations and principal components analysis, the authors eliminated 3 items and calculated average intention ratings across the remaining 28 items. The resulting scale had appropriate unidimensionality and excellent internal consistency. Correlations of intention questionnaire scores with measures of drinking history, alcohol outcome expectancies, sensation seeking, and impression management provided some support for criterion and discriminant validity of the questionnaire. CONCLUSION This questionnaire could be employed as an outcome measure to evaluate prevention programs and as a clinical tool to identify clients who have little intention to employ drinking reduction strategies in heavy drinking situations.
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Affiliation(s)
- Erin E Bonar
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA.
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Dermody SS, Cheong J, Walther CA. A study of alcohol use by designated drivers among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2012; 60:310-315. [PMID: 22559090 DOI: 10.1080/07448481.2011.599351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE College students tend to drink while serving as a designated driver (DD). The predictors of alcohol use by DDs among college students were examined. PARTICIPANTS Participants were 119 undergraduate students in introductory psychology courses who had experience with DD use. METHODS Survey data were analyzed to examine the predictors of planning components of DD use, such as choosing a DD before drinking and choosing an abstinent DD, and the relations of these components to alcohol use by DDs. RESULTS History of DD use, friends' willingness to be the DD, frequency of riding with a driver who drank and drove, and age of drinking onset were associated with planning components of DD use. Among the planning components of DD use, choosing a DD before drinking was significantly related to less alcohol use by DDs. CONCLUSIONS Increasing awareness of the planning components of DD use could deter alcohol use by DDs among college students.
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Affiliation(s)
- Sarah S Dermody
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Martens MP, Martin JL, Littlefield AK, Murphy JG, Cimini MD. Changes in protective behavioral strategies and alcohol use among college students. Drug Alcohol Depend 2011; 118:504-7. [PMID: 21612879 PMCID: PMC3176975 DOI: 10.1016/j.drugalcdep.2011.04.020] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2011] [Revised: 04/25/2011] [Accepted: 04/26/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Protective behavioral strategies (PBS) are specific cognitive-behavioral strategies designed to reduce alcohol consumption and resulting negative consequences. A host of studies have examined the cross-sectional relationship between such strategies and alcohol use in the high-risk population of United States college students, but prospective studies on the construct are lacking. The primary purposes of this study were to determine if PBS use prospectively predicted subsequent alcohol use/alcohol-related problems and if changes in PBS use were associated with less alcohol use and fewer problems. METHODS Data were examined from 521 heavy drinking college students (60% male, 84% White, mean age=18.9 years). Participants completed questionnaires assessing alcohol use, alcohol-related problems, and PBS use at baseline, 6-month, and 12-month follow-ups. RESULTS Analysis of residualized change scores indicated that increases in some PBS across time were associated with less alcohol use and fewer alcohol-related problems at follow-up. Findings regarding the prospective relationship between PBS use and subsequent alcohol use/problems were equivocal. DISCUSSION Results from the study suggest that PBS may have value in alcohol-related interventions among college students. Clinicians who help clients increase their use of PBS may help those clients increase the probability of drinking less and experiencing fewer alcohol-related problems in the future.
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Affiliation(s)
- Matthew P. Martens
- Department of Educational, School, and Counseling Psychology, 16 Hill Hall, University of Missouri, Columbia, MO 65211
| | - Jessica L. Martin
- Department of Educational and Counseling Psychology, ED 220, University at Albany-SUNY, Albany, NY 12222
| | - Andrew K. Littlefield
- Department of Psychological Sciences, Psychology Building 105, University of Missouri-Columbia, Columbia, MO 65211
| | - James G. Murphy
- Department of Psychology, Psychology Building 348, University of Memphis, Memphis, TN 38152
| | - M. Dolores Cimini
- University Counseling Center, University at Albany-SUNY, 400 Patroon Creek Blvd, Albany, NY 12206
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Use and correlates of protective drinking behaviors during the transition to college: analysis of a national sample. Addict Behav 2011; 36:1008-14. [PMID: 21719203 DOI: 10.1016/j.addbeh.2011.06.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Revised: 04/08/2011] [Accepted: 06/06/2011] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study examined patterns and correlates of protective drinking behaviors among incoming first-year college students. METHOD Incoming first-year students (n=76,882) from 258 colleges across the U.S. provided baseline data on demographics, drinking practices, and protective behaviors as part of a web-based alcohol education program. Across the several colleges, responses to protective behavior questions were collected from seven weeks before the start of the school year to five weeks after. RESULTS Factor analysis identified three protective behavior sub-factors: Limit Drinking, Avoid Drinking and Driving, and Intent to Get Drunk. Both Limit Drinking and Avoid Drinking and Driving generally declined over the course of the data collection period while Intent to Get Drunk and peak blood alcohol concentration increased immediately after the start of school. In multiple regression analyses, the number of heavy drinking episodes in the past two weeks had a strong negative association with a Total Protective Behavior Score and the Limit Drinking Score, and a positive association with the Intent to Get Drunk Score. With the exception of the Intent to Get Drunk Score, women were more likely to use protective behaviors than men. Underage drinkers used protective behaviors less often than their of-age peers, though the effect was small. Race/ethnicity, time to matriculation, and intent to join/membership in a fraternity/sorority had negligible effects on protective behavior scores. CONCLUSIONS College students increase risky drinking after the start of school while progressively using fewer behaviors that might mitigate the consequences of drinking.
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