Internalizing Symptoms, Alcohol Use, and Protective Behavioral Strategies: Associations with Regretted Sexual Experiences of College Students

Feeling in control in sexual situations: Day-level associations with alcohol use and alcohol protective behavioral strategies

BACKGROUND

Feeling in control in a sexual situation may vary as a function of contextual factors, such as whether alcohol is used prior to a sexual experience. Alcohol protective behavioral strategies (PBS) reduce adverse alcohol-related outcomes and may promote greater sense of control in sexual situations. It was hypothesized that, at the day level, (1) greater alcohol use would be associated with lower likelihood of feeling in control in sexual situations, (2) more PBS would be associated with a greater likelihood of feeling in control, and (3) more PBS would weaken the negative association between alcohol use and sexual control.

METHODS

For 28 days, daily data on feeling in control during sex, number of drinks, and PBS were collected from young adults who engage in high-intensity drinking (8+/10+ drinks in a sitting for women/men). A sample of 112 young adults (age 18-29, 61% female; 78.6% White; 9.8% Hispanic/Latino) reported sex after alcohol use at least once (n = 322 days total). Alcohol use, PBS (total as well as subtype: stopping/limiting drinking [SLD], manner of drinking [MD], and serious harm reduction [SHR]), and alcohol use by PBS interactions were tested as day-level correlates of sexual control via hierarchical generalized linear modeling.

RESULTS

A significant interaction between alcohol and total PBS on control was observed. At low levels of PBS, more drinks were related to lower likelihood of feeling in control during sex. At high levels of PBS, number of drinks was unrelated to control. A similar pattern of results was observed when examining the PBS subscale of SLD. No main effects of daily PBS or alcohol use on control were observed.

CONCLUSIONS

Findings provide insight into feeling in control when drinking alcohol and engaging in sex, at varying levels of PBS. Interventions focused on harm reduction strategies have the potential to reduce risk of alcohol-related adverse sexual experiences.

Revised Alcohol Protective Behavioral Strategies Scale-20 (PBSS-20) Sub-Types: An Analysis of Direct/Controlled Consumption and Indirect/Harm Reduction PBS

Alcohol protective behavioral strategies (PBS) are commonly conceptualized with a three-factor model, as used in the Protective Behavioral Strategies Scale-20 (PBSS-20). However, inconsistencies exist between factors and drinking outcomes. The current study used factor analysis to test a two-factor structure directly via controlled consumption (Direct/CC) and indirectly via harm reduction (Indirect/HR) using the PBSS-20 among a combined sample of n = 4,883 drinkers. Both the two- and three-factor structures evince similar model fit. A two-factor model yielded more concise PBS measurement. Negative associations were observed with consumption (Direct/CC PBS) and problems (Indirect/HR). A condensed, eight-item, two-factor model accounted for less variance in alcohol consumption, however more variance in alcohol-related problems. A more consistent framework for understanding the impact of PBS on alcohol-related outcomes is provided.

Development and Validation of the Sexual and Negative Dating Inventory (SANDI): A Measure of Dating and Sexual Protective Behaviors

Adverse sexual experiences are highly prevalent among college students and associated with increased mental health symptoms and decreased use of protective behavioral strategies (PBS). The current study developed and validated a measure of dating and sexual PBS: the Sexual and Negative Dating Inventory (SANDI). Participants (64.28% female, 19.59 [2.90 SD] years old, 68.90% non-Hispanic, 71.42% white, and 76.06% heterosexual) responded to baseline (n = 1,298) and one-month (n = 336) surveys. Exploratory Structural Equation Modeling identified a 24-item measure with five-factors: Location Sharing, Assertiveness, Self-Protection, Risk Reduction, and Privacy. The model revealed good fit: χ2(242) = 2115.52, p < .001, CFI = .977, RMSEA = .077 (90% CI = .074, .080), SRMR = .043. Test-retest reliability revealed acceptable reliability of 0.74 at follow-up. Overall, SANDI showed acceptable reliability and adequate convergent and discriminant validity among college students.

Protective behavioral strategies as a protective factor against suicidal ideation among college student drinkers

Objective: Research shows that alcohol use is linked to suicidal ideation (SI), while depression is strongly associated with SI. Protective behavioral strategies (PBS) are safe drinking strategies. PBS are broadly protective across alcohol-related problems; however, it is unclear if these effects extend to those at risk for SI. We hypothesized that alcohol use and depressive symptoms would be risk factors for SI, and that these factors would moderate the effects of PBS. PBS was hypothesized to be protective for individuals with elevated depressive symptoms and alcohol use. Participants: College student drinkers (n = 990; M age = 19.97, SD = 3.75) from a Southeastern University. Methods: Participants completed an online survey inquiring about demographics, depressive symptoms, SI, alcohol use, and PBS use. Results: Depressive symptoms were associated with an increased likelihood of SI; however, alcohol use was not. PBS were most protective for individuals with high levels of alcohol use and/or depressive symptoms. Conclusions: PBS may be protective for heavier drinkers who are at heightened risk for SI.