Protective behavioral strategies, alcohol expectancies, and drinking motives in a model of college student drinking

College Student Alcohol Use: Understanding the Role of Alcohol Expectancies, Social Anxiety, Social Connectedness, and Need to Belong

ObjectiveCollege students consume more alcohol and engage in binge drinking more frequently than their non-college attending peers, and prevalence of alcohol-related consequences (e.g., drinking and driving; taking avoidable risks) has not decreased proportionally with decreases in consumption. Social anxiety and alcohol expectancies, or beliefs about the effects of alcohol, have been found to be significantly related to alcohol use and account for significant variance in alcohol use and related consequences. Few studies, however, have examined how other social variables such as need to belong and social connectedness may fit into existing models of increased and risky alcohol use. Methods: Students at a large state university (n = 1,278) completed an online survey measuring alcohol expectancies, need to belong, social anxiety, and social connectedness. Mean age of participants was 19.65 years, and 59.5% self-identified as female, 39.8% male, and 0.7% identified as transgender. Structural equation modeling supported hypothesized relationships between need to belong, social anxiety, social connectedness, alcohol expectancies, and alcohol use, a mean centered variable that included binge drinking, drinking frequency, and amount of consumption. Results: Positive alcohol expectancies related to tension reduction, sociability, and sexuality, were positively related to drinking, such that increased alcohol expectancies were associated with increased drinking. Alcohol expectancies mediated the relationship between need to belong and increased alcohol use, as well as social connectedness and increased alcohol use. Similarly, social anxiety also mediated these relationships. No direct relationships were found between need to belong or social connectedness and alcohol use, suggesting previous research exploring these relationships may have excluded control variables (e.g., biological sex, race/ethnicity) that better explain the impact of need to belong and social connectedness on alcohol use. Conclusion: Prevention and intervention efforts might be more effective in reducing alcohol use if social factors are more broadly targeted.

Daily Positive Alcohol Expectancies and Alcohol Use Outcomes among College Students

Expectancy theory supports alcohol expectancies, or the expected effects of drinking, as an important factor in alcohol use behaviors. Recent research supports that alcohol expectancies fluctuate daily, but scant research has examined specific types of expectancies and their associations with alcohol use at the daily level. Consequently, the present study examined (1) the daily association between select expectancies (i.e., sociability, tension reduction, liquid courage) and likelihood of drinking, and (2) whether daily expectancies predict alcohol use outcomes (i.e., alcohol-related problems, heavy drinking) on drinking days. Participants (N = 221; 79.2% women) were primarily White (48.4%) and Black (29.7%) university students. Participants completed daily measures of expectancies, alcohol use, and alcohol-related problems each day for 14 days. Results from multilevel models revealed daily sociability as the only expectancy subscale linked with increased odds of drinking. Daily expectancies did not predict heavy drinking or alcohol-related problems on drinking days. At the between-person level, average levels of sociability and tension reduction expectancies were associated with a greater likelihood of engaging in heavy drinking and experiencing a problem. Findings highlight that fluctuations in sociability expectancies may be proximally linked to likelihood of alcohol use, which may inform just-in-time intervention efforts targeting alcohol expectancies.

Effects of COVID-19 event intensity on college students' health lifestyles: time perspective mediating model and its gender difference

The pandemic of COVID-19 had not only led to healthy-damage behaviors, but also raised people's attention to health and generated health-promoting behaviors. However, little is known about the mechanism underlying how the perception of COVID-19 intensity affects health behaviors. The present study investigated the mediating effect of DBTP between event intensity and health behaviors and the moderating role of gender in this relation. Nine hundred and twenty-four Chinese college students (348 males and 576 females) completed a battery of self-report questionnaires, including COVID-19 Event Intensity Scale, Chinese version of Zimbardo Time Perspective Inventory (ZTPI) and Healthy Lifestyle Scale. Moderated mediation analysis was performed using conditional process analysis. The results showed that COVID-19 intensity had a positive predictive effect on college students' health behaviors. DBTP played a partial mediating role in the relationship between COVID-19 intensity and health behaviors for male and not female. In female group, COVID-19 intensity and DBTP was significantly linked with health behaviour; however, COVID-19 intensity and DBTP were not significantly linked. The findings indicated that COVID-19 intensity perceived by college students could increase their health behaviors, and intervention focus on BTP may contribute to health behaviors only in male. Practical implications were discussed in this academic research.

Harm Reduction Strategies among University Students Who Use Alcohol and Cannabis, and Related Psychological Variables: A Systematic Review

This systematic review identifies the psychological variables associated with the use of harm reduction strategies (HRS) among university students who use alcohol or cannabis. The reviewed studies are categorized according to the psychological variables studied and the different analytic approaches used (direct effects, mediation, and moderation). Among the empirical peer-reviewed studies identified (n = 76), most (94.7%) were cross-sectional studies conducted in the US (90.8%) with samples of alcohol-using university students (86.8%). Five categories were identified: mental health, motives/expectancies, personality, social cognition, and self-efficacy. The most studied constructs were motives, anxiety and depression, impulsivity, and social norms. Most studies conducted mediation or moderation analyses including psychological variables, HRS and alcohol outcomes. Social, enhancement and coping motives, impulsivity, and social norms of alcohol use were associated with lower use of HRS, which, in turn, was associated with a higher number of alcohol/cannabis outcomes. The results of moderation studies consistently suggest that HRS use was more protective for students with poor mental health, high impulsivity, and low self-regulation. The synthesis of evidence provided in this review could be useful for guiding future research and informing the design of interventions aimed at promoting the use of HRS among university students who use alcohol and/or cannabis.

Protective behavioral strategies are more helpful for avoiding alcohol-related problems for college drinkers who drink less

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.

Alcohol and Cannabis Use Milestones in Diverse Urban Adolescents: Associations with Demographics, Parental Rule Setting, Sibling and Peer Deviancy, and Outcome Expectancies

Objective: Alcohol and cannabis use progression milestones in adolescence (such as ages at first use, first intoxication and at onset of regular use) may inform the development of alcohol and cannabis use disorders. Although parent, sibling, and peer behavior and alcohol-related cognitions have been shown to be associated with alcohol milestone attainment, findings have been mixed; further, those factors' associations with cannabis use milestones are unknown. This study examined whether progression through such milestones differed as a function of perceived peer/sibling deviancy, parental rule-setting, and substance use outcome expectancies in a racially diverse adolescent sample.Methods: Data were drawn from a two-wave longitudinal health survey study of 9-11^th graders (n = 355 for the current analyses; M_age=15.94 [SD = 1.07]; 44% male; 43% Black; 22% White; 18% Asian; 17% Multiracial; 10% Hispanic/Latinx ethnicity) at an urban high school. A series of logistic and proportional hazards regressions examined associations of peer/sibling deviancy, parental rule-setting, and outcome expectancies with age and attainment of alcohol/cannabis use milestones.Results: For both alcohol and cannabis, greater peer deviancy and positive expectancies were associated with higher odds of milestone attainment, while negative expectancies were associated with slower progression through milestones. For cannabis, but not alcohol, greater perceived sibling deviancy was positively associated with milestone attainment, while negative expectancies were associated with lower odds of milestone attainment.Conclusions: Perceived deviant behavior by peers and siblings, in addition to adolescents' expectancies for either alcohol or cannabis use, is associated with attainment and progression through key adolescent substance use milestones.

The potential individual- and population-level benefits of encouraging drinkers to count their drinks

Introduction

Cross-sectional studies have established a link between overall engagement in protective behavioral strategies (PBSs) and reduced alcohol consumption. However, there are mixed results on the effectiveness of individual PBSs, with some found to result in increased consumption. A recent study examining the effects of PBS use over time found the 'Count your drinks' strategy to be most reliably associated with reduced alcohol consumption among 16 strategies. Given the apparent superior efficacy of this PBS, this exploratory study aimed to extend these results by (i) determining the extent to which increasing the frequency of PBS enactment is associated with alcohol consumption over time and (ii) predicting potential changes in population-level consumption resulting from higher levels of PBS use.

Method

1250 drinkers aged 18-70 years provided data at two time points relating to their drinking practices. Multiple regression analyses were conducted to model the relationship between changes in frequency of enactment of the 'Count your drinks' PBS and alcohol consumption. Coefficients were used to predict average reductions in alcohol consumption over one year associated with increased frequency of use of this PBS.

Results

Larger increases in the frequency of using the 'Count your drinks' PBS were associated with greater reductions in alcohol consumption. Exploratory extrapolation analyses demonstrated the potential for substantial reductions in overall alcohol consumption.

Conclusion

The results suggest health promotion efforts designed to increase the frequency with which drinkers count their drinks could produce substantial annual decreases in alcohol consumption at both individual and population levels.

The event-level impact of one's typical alcohol expectancies, drinking motivations, and use of protective behavioral strategies

INTRODUCTION

Much of the past research on the excessive consumption of alcohol by college students has focused on the interplay of individual factors and typical drinking patterns, but this is not adequate to understand behavior as it occurs. The need to understand drinking at the event-level is critical in order to develop event-level prevention. To this end, this study examined a conceptual model of college students' drinking events in order to determine the potential mediating effect of drinking motives and protective behavioral strategies (PBS) in the relationship between alcohol expectancies and event-level alcohol use and consequences.

METHODS

An existing data set containing information about 2279 college student drinking events were analyzed for this study. Students completed surveys during the administration of a commercial online alcohol course during 2010 and 2011. A theoretical model was analyzed with structural equation modeling.

RESULTS

Both typical use of PBS and drinking motives mediated the relationship between expectancies and event-level alcohol use and problems. Positive expectancies were associated with greater positive motives, greater motives were associated with less use of PBS, and less PBS use was then, in turn, associated with higher event-level intoxication. Lastly, higher intoxication was associated with more serious consequences during the event.

CONCLUSION

This is the first study to simultaneously explore the relationship between these factors and event-level drinking. There is a great need to continue to further explore the dynamic nature of drinking at the event-level to illuminate potential leverage points amendable to change.

A longitudinal examination of protective behavioral strategies and alcohol consumption among adult drinkers

Previous studies suggest that employing specific behavioral strategies when drinking can prevent excessive alcohol consumption and related harms. However, these studies have typically examined these 'protective behavioral strategies' (PBSs) in combination, limiting understanding of whether individual strategies differ in their effectiveness. Further, most existing research is cross-sectional in design, precluding the determination of causal relationships between PBS use and alcohol consumption. To address these research gaps, the present study sought to longitudinally (i) identify which individual PBSs are significantly related to reduced alcohol consumption over time and (ii) explore the effectiveness of individual PBSs among specific population groups. The sample comprised 1328 Australian adult drinkers (47% male) who completed an online survey assessing engagement in PBSs and alcohol consumption at two time points approximately four weeks apart. Reported enactment of the PBS 'Count your drinks' was associated with a significant reduction in alcohol consumption between T1 and T2. In contrast, enactment of the PBSs 'Ask a friend to let you know when you have had enough to drink', 'Put extra ice in your drink', 'Use a designated driver', and 'Leave drinking venues at a pre-determined time' was associated with an increase in alcohol consumption. The results thus suggest that many PBSs may not be effective in reducing alcohol consumption and that some may be associated with higher levels of intake. The results have implications for the development of harm-minimization campaigns designed to encourage drinkers to reduce their alcohol consumption.

Are protective behavioral strategies associated with fewer negative consequences on high-intensity drinking days? Results from a measurement-burst design

Heavy episodic drinking (HED) is prevalent among college students and associated with harms. However, many students engage in "high-intensity drinking" (HID) by drinking at thresholds beyond HED. HID relative to HED-only is associated with elevated risk for acute and severe negative consequences. When used, protective behavioral strategies (PBS) are shown to help drinkers limit their drinking and lower their odds of experiencing consequences. This study assessed whether PBS use was associated with reduced consequences on occasions college students engaged in HID relative to HED-only. Data were from a longitudinal measurement-burst design (14-day bursts across 4 semesters) from 256 college students who engaged in HID on at least 1 reported day, yielding 2,352 daily drinking reports. Participants reported the number of standard drinks consumed on each day and, on days with 1+ drinks, whether they used PBS and experienced a variety of negative drinking-related consequences. Three-level multilevel models revealed that on days when students used manner of drinking PBS there was a weaker association between HID and passing out from drinking. On days students used serious harm reduction PBS there was a weaker association of HID with having no one sober enough to drive and experiencing regretted sexual behaviors. Use of some PBS may help college students reduce harms on HID occasions relative to HED-only occasions. Interventions should promote use of planning strategies to minimize harm, especially on HID occasions. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Mediators and Moderators of a Personalized Feedback Alcohol Intervention for Nonstudent Emerging Adult Drinkers

BACKGROUND

The main objective of this study was to test proposed mediators and moderators of a personalized feedback alcohol intervention (PFI) on alcohol use. Data for the current investigation came from an earlier randomized controlled trial of a PFI targeted for nonstudent heavy drinkers between 18 and 25 years.

METHODS

Participants were 164 (65.9% men) drinkers recruited from the community. They were randomly assigned to either a single-session PFI or an assessment-only (AO) control group. Follow-up assessments at 1 and 3 months were included for analysis.

RESULTS

Perceived drinking norms mediated the intervention effect on quantity, frequency, and peak drinking; 2 dimensions of protective behavioral strategies (PBS) mediated the intervention effect on peak drinking; and drinking to cope motives did not mediate any drinking outcomes. Of the moderating factors examined (i.e., norms, PBS, drink to cope motives, age, gender), only PBS related to serious harm reduction moderated intervention impact. Specifically, for those high in serious harm reduction PBS at baseline, postintervention reductions in drinking were stronger for the PFI group compared to AO.

CONCLUSIONS

Overall, findings highlight the importance of correcting misperceived drinking norms and addressing the use of specific PBS in brief interventions. The knowledge gained from this study represents an important step toward minimizing drinking-related harms that are disproportionately experienced by those with lower educational attainment.

Crossover Effects of Protective Behavioural Strategies for Drinking on Gambling Consequences Among College Gamblers with Alcohol or Drug Abuse

Protective behavioural strategies (PBS) for drinking are behaviours that individuals engage in to reduce the amount they drink and drinking-related consequences. To date, little is known about associations that PBS might have with other risky behaviours that frequently coincide with drinking, such as gambling. The goal of this study was to examine the associations between three subscales of the Protective Behavioral Strategies Scale (PBSS) and gambling consequences in a college sample of gamblers who also met criteria for alcohol or drug abuse. We hypothesized that engaging in more drinking PBS would be associated with lower levels of gambling consequences. A sample of 316 students (55% female) completed an online survey and met criteria for problematic gambling behaviour (3 or more on the South Oaks Gambling Screen and 1 or more consequences on the Gambling Problem Index). Those endorsing a higher score on the Serious Harm Reduction subscale (but not the Stopping or Limiting Drinking or Manner of Drinking subscales) showed a lower level of lifetime gambling consequences, suggesting a crossover effect. Strategies to reduce serious harm represent a treatment target that could potentially reduce negative consequences associated with both drinking and gambling.

Testing a model of caffeinated alcohol-specific expectancies

INTRODUCTION

The present study sought to further understand the association between caffeinated alcoholic beverage (CAB) use and alcohol-related risks. In particular, we focused on the role of two identified expectancies specific to CAB use: intoxication enhancement and avoidance of negative consequences. Although outcome expectancies are consistent predictors of substance use, limited research has examined expectancies related to CAB use and their association with alcohol-related behaviors, such as protecting themselves from alcohol-related harms. Consequently, the present study examined CAB-specific expectancies and protective behavioral strategies (PBS) as mediators of CAB use and negative consequences.

METHODS

Participants were 322 (219 women) college drinkers who completed self-report measures of typical CAB and alcohol use, CAB-specific expectancies, PBS use, and alcohol-related harms.

RESULTS

Structural equation modeling revealed, after controlling for typical non-CAB heavy alcohol use, a significant indirect effect of CAB use to alcohol-related problems through avoidance of negative consequences CAB expectancies and PBS use. However, intoxication enhancement expectancies did not mediate this association.

CONCLUSIONS

Our findings indicate that heavier CAB use was associated with stronger expectations that drinking CABs can help avoid negative consequences. These beliefs were related to using fewer PBS when drinking and a greater likelihood of experiencing problems. Given that these expectancies may be underlying mechanisms of CAB use, their inclusion in existing alcohol interventions may be beneficial.