The Protective Behavioral Strategies Scale-20: improved content validity of the Serious Harm Reduction subscale

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.

Alcohol Protective Behavioral Strategy use and Negative Consequences Across Heavy Alcohol Users and Risky Drinkers

This study investigated differences in alcohol protective behavioral strategy (PBSA) use and negative consequences (ARNC) experienced among heavy alcohol users and non-heavy alcohol users, and risky and non-risky drinkers. Participants were from 12 universities in the United States (n = 2,163 college students, Mage = 19.47), predominantly identified as White (74%), and female (68.7%), who completed measures of typical weekly drinking, risky drinking, ARNC, and PBSA use. ANOVAs revealed that the heavy alcohol users and risky drinkers reported significantly fewer total PBSA, subtype strategy use, and greater negative consequences than their counterparts. Harm reduction interventions may benefit from identifying and targeting college students who are engaging in heavy alcohol use and risky drinking regardless of sex.

Psychometric properties and Longitudinal Measurement Invariance of the Spanish version of the Alcohol Expectancies Questionnaire Short Form among young adult binge drinkers

Background: Longitudinal Measurement Invariance (LMI) is critically important to evaluate changes in alcohol expectancies over time. However, past research has not explored the longitudinal properties of the Spanish Expectancy Questionnaire Short Form (EQ-SF).Objectives: To examine the reliability, sources of validity (structural, invariance across sex, and concurrent validity), and LMI of the Spanish EQ-SF among young adults who engage in binge drinking.Methods: Participants (n = 279; 48.4% female) completed the EQ-SF and, two months later, completed it again along with measures of alcohol use, drinking motives, and protective behavioral strategies (PBS). We performed confirmatory factor analysis for structural validity and measurement invariance analysis for longitudinal and sex stability.Results: The eight-factor intercorrelated model (i.e. social facilitation, fun, sexual disinhibition, tension reduction, antisocial effects, negative emotional states, negative physical effects, and cognitive impairments) provided the best fit (χ2(df) = 497.29(224), CFI = .962, RMSEA = .064, SRMR = .049). This model was invariant across sex and time. Reliability coefficients (Ordinal alpha) for each dimension were consistently strong at both time points (from .72 to .93 at T1 and .73 to .91 at T2). Positive alcohol expectancies at baseline were positively related to alcohol use and drinking motives and negatively related to PBS at follow-up, demonstrating predictive validity.Conclusion: Our results support the temporal invariance of the EQ-SF scores among Spanish young adults who engage in binge drinking. The evidence supports the suitability of this measure for accurately assessing changes in alcohol expectancies over time in interventions aimed at preventing binge drinking in young adults.

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.

The protection motivation theory as an explanatory model for intention to use alcohol protective behavioral strategies related to the manner of drinking among young adults

AIMS

This study aimed to prospectively examine the explanatory value of the protection motivation theory (PMT) for the intention to use manner of drinking protective behavioral strategies (MD PBS) and to explore its invariance across genders.

METHOD

A targeted sampling procedure was used to recruit 339 young adults in the community (Mage = 21.1; SD = 2.21; female = 50.7%) who completed baseline and 2-month follow-up measures of the PMT constructs and intentions to use each of the five MD PBS.

RESULTS

Regression analyses revealed that the coping appraisal components (response efficacy and self-efficacy) had greater explanatory power for the intention to use MD PBS than the threat appraisal components (perceived vulnerability and perceived severity). Perceived vulnerability to alcohol consequences was not prospectively associated with any specific behavioral intention or with the total MD PBS score. In contrast, perceived severity was prospectively associated with the intention to use three out of five PBS and the total MD score. Regression coefficients revealed gender invariance for all six models.

CONCLUSIONS

Our findings suggest that interventions aimed at encouraging young adults to use alcohol MD PBS would be most effective if they included components that enhance self-efficacy in using these strategies and emphasize their perceived usefulness in reducing alcohol-related consequences.

A Deviance Regulation Theory Intervention Affects the Association Between Narcissistic Traits and Alcohol Harm Reduction Strategies in College Students

Background: College students continue to report problematic alcohol use. To mitigate adverse outcomes, recent studies have employed harm reduction strategies known as Protective Behavioral Strategies (PBS). Deviance Regulation Theory (DRT), an impression management intervention, has been used to promote the use of PBS. DRT relies on impression management to modify behavior. This may be especially important for individuals with higher levels of trait narcissism. Method: College student drinkers (n = 132) were randomly assigned to receive a positive message about PBS users, a negative message about non-PBS users, or control. Participants reported on current PBS use norms, daily alcohol use, PBS use, and any alcohol-related problems experienced during the previous week for the next 10 weeks. Results: Data were analyzed using multilevel regression to examine PBS use across time by condition. When PBS norms were low, narcissism was strongly associated with lower rates of PBS use in the control group. If individuals received a positive or negative message, the association between narcissism and PBS use was diminished, among individuals with low PBS norms. There were no significant differences at mean or high levels of norms, indicating the messaging was only important for the highest risk group (i.e., those with low PBS norms). Discussion: The results of this study suggest that message framing may be effective at reducing the robust negative association between narcissism and PBS use for individuals with low PBS norms. Positive messages about individuals that use PBS may be one approach to mitigating problematic alcohol consumption in this at-risk group.

A Cross-Cultural Comparison of Negative Alcohol-Related Consequences in the United States and Sweden: Measurement Invariance of the Rutgers Alcohol Problem Index

Commensurate measures of alcohol-related consequences across countries and cultures are critical for addressing the global burden of hazardous alcohol use. The Rutgers Alcohol Problem Index (RAPI), developed and validated in the United States, is a popular measure of alcohol problems. This study examined measurement invariance of the RAPI across samples of U.S. and Swedish high school seniors. Latent mean differences in alcohol problems across countries and differences in associations between alcohol problems with alcohol use and protective behavioral strategies (PBS) were also examined. The RAPI was scalar invariant. Swedish students reported fewer problems than U.S. students (latent mean difference = -0.19, p = .047). In both samples, the RAPI was positively correlated with alcohol use frequency and quantity (ps < .001), and negatively correlated with PBS use (ps < .05). Overall, the RAPI demonstrated measurement invariance, and we found evidence for its validity across samples of U.S. and Swedish high school seniors.

Brief online negative affect focused functional imagery training (FIT) improves four-week drinking outcomes in hazardous student drinkers: A pilot randomised controlled trial replication in South Africa

Background

Previous study has shown that functional imagery training (FIT) to utilise positive mental imagery in response to negative affect could improve alcohol-related outcomes. The current study aimed to replicate whether this negative affect focused FIT would improve alcohol-related outcomes in hazardous student drinkers in South Africa at four-week follow-up.

Methods

50 hazardous student drinkers who reported drinking to cope with negative affect were randomised into two groups. The active group (n = 25) was trained online over two weeks to respond to personalised negative drinking triggers by retrieving a personalised adaptive strategy they might use to mitigate negative affect, whereas the control group (n = 25) received standard risk information about binge drinking. Outcome measures including alcohol consumption, drinking motives, anxiety and depression, self-efficacy and use of protective behavioural strategies were obtained at baseline and four-week follow-up.

Results

FIT effects were revealed by three significant group-by-timepoint interactions in a per-protocol analysis: there was a significant decrease in depressive symptoms, drinking to cope and drinking for social reasons from baseline to follow-up in the active group, but not the control group. No effects were observed on alcohol consumption, self-efficacy, protective behaviour strategies and anxiety.

Conclusions

Preliminary evidence supports that online negative affect focused FIT can improve depression as well as coping and social drinking motives in South African hazardous student drinkers who drank to cope, at four-week follow-up, suggesting that the principles of this FIT approach might be adapted and incorporated into a clinical intervention to test for efficacy in mitigating substance use problems.

A systematic review of the associations between protective behavioral strategies and heavy alcohol consumption and consequences among young adults

OBJECTIVE

We systematically reviewed the literature to assess the association between use of alcohol protective behavioral strategies (PBS) and young adult heavy drinking and alcohol-related consequences.

METHOD

We followed the preferred reporting items for systematic review and meta-analysis guidelines to select and review research studies that were comprised of a sample of young adults ages 18-26, included PBS derived from one of 10 validated scales as an independent variable, measured heavy alcohol use or alcohol consequences as the dependent variable, and tested the direct association between the two. Studies were gathered via PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, APA PsycInfo, and Global Health. All identified study records underwent a two-step screening process and risk of bias assessment.

RESULTS

Data were extracted from 94 studies that met inclusion criteria; 16 studies (17%) examined associations with heavy alcohol use and 91 studies (97%) tested effects of PBS on alcohol consequences. All studies that measured a total effect of PBS use (summations across all strategies) found significant negative associations with heavy alcohol use and 91% were negatively associated with alcohol consequences. Most studies that examined subscales of PBS found at least one significant, negative relation with heavy alcohol use (73%) and alcohol-related consequences (78%), though effects varied across type of subscale (e.g., manner of drinking).

CONCLUSIONS

Our results support the use of PBS to address heavy alcohol consumption and related harms among young adults. Opportunities for refinement of current PBS in preventive interventions are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

College men's use of protective behavioral strategies for sexual aggression, risky sexual behavior, and heavy episodic drinking

OBJECTIVE

Sexually aggressive behavior (SAB), risky sexual behavior (RSB), and heavy episodic drinking (HED) are serious behavioral health problems among college men. The present study substantially revises and validates protective behavioral strategies (PBS) measures in the SAB and RSB domains; evaluates the relations among PBS usage in the SAB, RSB, and HED domains; and determines whether college men with SAB, RSB, or HED histories report lower PBS usage.

METHOD

College students who identified as men (n = 1,121) completed measures of PBS, SAB, RSB, HED, rape-supportive attitudes, sociosexuality, and bar/party attendance.

RESULTS

Factor analyses resulted in three PBS scales (SAB, RSB-General, and RSB-Protection) that showed good fit and cross-validated well. Average scores for all four PBS measures converged moderately to strongly. Men reporting histories of SAB, RSB, or HED reported much lower domain-specific PBS use, and domain-specific PBS predicted concurrent SAB, RSB, or HED in the presence of other established predictors.

CONCLUSIONS

Four well-developed and validated PBS measures now provide an expanded set of potential harm-reduction strategies for college men who drink and engage in sexual activity. Given the strong concurrent associations between PBS use and problems, as well as the interrelatedness of PBS use across domains, future research should examine the impact of simultaneous personalized normative feedback on PBS use across alcohol and sexual domains. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Baseline protective behavioral strategy use predicts more moderate transdermal alcohol concentration dynamics and fewer negative consequences of drinking in young adults' natural settings

OBJECTIVE

Test whether frequent protective behavioral strategies (PBS) users report (a) fewer alcohol-related consequences and (b) less risky alcohol intoxication dynamics (measured via transdermal alcohol concentration [TAC] sensor "features") in daily life.

METHOD

Two hundred twenty-two frequently heavy-drinking young adults (Mage = 22.3 years) wore TAC sensors for 6 consecutive days. TAC features peak (maximum TAC), rise rate (speed of TAC increase), and area under the curve (AUC) were derived for each day. Negative alcohol-related consequences were measured in the morning after each self-reported drinking day. Past-year PBS use was measured at baseline.

RESULTS

Young adults reporting more frequent baseline PBS use showed (a) fewer alcohol-related consequences and (b) lower intoxication dynamics on average (less AUC, lower peaks, and slower rise rates). Limiting/stopping and manner of drinking PBS showed the same pattern of findings as the total score. Serious harm reduction PBS predicted fewer negative alcohol-related consequences, but not TAC features. Multilevel path models showed that TAC features peak and rise rate partially explained associations between PBS (total, limiting/stopping, and manner of drinking) and consequences. Independent contributions of PBS subscales were small and nonsignificant, suggesting that total PBS use was a more important predictor of risk/protection than the specific types of PBS used.

CONCLUSIONS

Young adults using more total PBS may experience fewer alcohol-related consequences during real-world drinking episodes in part through less risky intoxication dynamics (TAC features). Future research measuring PBS at the daily level is needed to formally test TAC features as day-level mechanisms of protection from acute alcohol-related consequences. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

How Do Bystanders Help in Drinking Situations: The Bystanders to Alcohol Risk Scale--Strategies

OBJECTIVE

Bystander intervention (BI) is a promising approach for promoting collective behavior change that has been applied to several domains, including sexual assault, bullying, and more recently, problematic alcohol use. Accurately measuring the strategies that bystanders use to reduce others' alcohol-related risk is an essential step toward improving bystanders' ability to reduce alcohol-related harm in their communities, but current measures of BI are not easily modifiable and applicable for alcohol-related BI. The current study aimed to develop a valid and reliable measure of the bystander construct most proximal to the reduction of risk: bystander strategies.

METHOD

Young adults (N = 1,011) who reported being around someone who showed signs of alcohol intoxication in the past 3 months were recruited via Qualtrics Panels to participate in an online survey; a subsample (n = 345) completed a 2-week follow-up. Psychometric evaluation included exploratory and confirmatory factor analyses, item response theory analyses, convergent validity, and test-retest reliability.

RESULTS

An initial set of 52 items was reduced to 17 items, representing two different factors. The first factor, Level 1, reflected strategies used during circumstances of acute risk. The second factor, Level 2, reflected strategies used to reduce risk for more longstanding problems with alcohol. Both factors demonstrated good model fit, strong internal consistency, evidence of convergent validity, and moderate test-retest reliability.

CONCLUSIONS

This novel measure can contribute to the production of knowledge about the use and efficacy of peer-focused strategies and the value of BI training for alcohol use.

Perceived helpfulness of alcohol protective behavioral strategies and consequence severity: A person-centered analysis

Objective: College students report high rates of alcohol use and negative alcohol-related consequences (ARC). Many studies document that protective behavioral strategy (PBS) use is negatively associated with ARC. Few studies examine consequence severity and PBS helpfulness, both of which may provide nuance to this relationship. Participants and method: The current study used latent profile analysis to examine variability in PBS use, PBS helpfulness, ARC count, and ARC severity patterns among college students (n = 1156). We identified latent profiles and differences in alcohol use and drinking motives across profiles. Results: Three profiles best represented the data: (1) high PBS/low consequences, (2) moderate PBS/moderate consequences, (3) low PBS/high consequences. Conclusions: College students endorsing stronger drinking motives might be less likely to use and select helpful PBS and might experience more severe ARC. Results suggest that simple modifications to common measures can add depth of understanding and nuance to the examination of alcohol-related behaviors.

Factor structure, group invariance, and concurrent validity of scores from the college eating and drinking behavior scale among U.S. college students

Food and alcohol disturbance (FAD) refers to the intersection of alcohol- and eating-related motives and behaviors, such as restricting food intake before or during alcohol use to offset caloric intake or to enhance intoxication. Valid assessment is critical for advancing research on FAD. We tested the factor structure, group invariance, and concurrent validity of the College Eating and Drinking Behavior Scale (CEDBS) in a large college student sample (n = 2610; Mage = 20.95, SD = 4.65; 71.8% female; 77% White; 86% non-Hispanic). Participants completed measures assessing antecedents of alcohol use (i.e., protective behavioral strategies and drinking motives), negative alcohol-related consequences, alcohol use severity, and risk for eating disorder. The 3-factor model of the 21-item CEDBS provided an adequate fit to the data (e.g., CFI = 0.916). These factors include Alternative Methods (4 items; "Use laxative prior to drinking alcohol"), Offset Calories (7 items; "Restrict calories prior to drinking to help maintain your figure"), and Quicker Intoxication (10 items; "Not eating before drinking alcohol because it gives you the best buzz"). The CEDBS was scalar invariant across subgroups of participants based on age, sex, race/ethnicity, socioeconomic status, sexual orientation, and political orientation. Quicker Intoxication was most strongly related to risk factors and negative consequences for alcohol (r = 0.204-0.379, all ps < 0.01), and Offset Calories was most strongly related to risk for eating disorders (r = 0.349, p < .01). These findings further support the CEDBS to assess FAD 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.

Parental Alcohol Communication and Student Drinking: Examining Potential Differences between Underage and Legal Drinking Age Students

BACKGROUND

We explored associations between parental alcohol communication (PCA) and student drinking behavior and protective behavioral strategies (PBS) use.

METHODS

College students in the United States, who had talked about alcohol with parents, (N = 251) completed an anonymous online survey in Fall 2021. Participants reported frequency of discussing 14 alcohol-related topics with parents, past 30-day drinking behaviors, and PBS use.

RESULTS

We identified two forms of PCA: general alcohol information and alcohol risk information, with alcohol risk information being more common than general alcohol information. PCA was not significantly associated with drinking behavior but was associated with two types of PBS. Specifically, general alcohol information was associated with greater use of serious harm reduction and stopping or limiting drinking strategies. Additionally, legal drinking age status moderated the associations between both forms of PCA and the use of stopping or limiting drinking strategies. In general, underage students stopping or limiting drinking strategies benefited from general alcohol information but not alcohol risk information. Legal drinking age students stopping or limiting drinking strategies benefited from alcohol risk information.

CONCLUSIONS

Among these students, PCA appears to have a greater impact on PBS use rather than drinking behavior. This may reflect a shift in students' beliefs about parental authority over alcohol and parents' acceptance of alcohol use by their children.

Likelihood of Young Adult Engagement in Protective Behavioral Strategies for Alcohol Use across Drinking Contexts: Implications for Adaptive Interventions

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.

Associations between Gender Expression, Protective Coping Strategies, Alcohol Saliency, and High-Risk Alcohol Use in Post-Secondary Students at Two Canadian Universities

BACKGROUND

This study, conducted in October 2017 at two Canadian universities, aimed to explore the relationships between gender expression, protective coping strategies, alcohol saliency, and high-risk alcohol use.

METHODS

Validated scales were employed to assess these variables using survey data. Multivariate analyses were conducted to investigate the associations between these factors and high-risk drinking.

RESULTS

This study revealed significant associations between high-risk drinking and androgynous gender roles (OR = 1.58, 95% CI: 1.19-2.10) as well as among self-reported males (OR = 2.21; 95% CI: 1.77-2.75). Additionally, protective behavioural strategies were inversely related to high-risk drinking (OR = 0.95; 95% CI: 0.94-0.96), while higher alcohol saliency exhibited a positive correlation with high-risk drinking (OR = 1.12; 95% CI: 1.11-1.14).

CONCLUSIONS

These findings underscore the importance of considering gender, alcohol saliency beliefs, and protective behavioural strategies in the development and refinement of interventions aimed at reducing high-risk alcohol use on Canadian campuses.

Characterizing Alcohol Consumption and Positive and Negative Consequences During Simultaneous Alcohol and Cannabis Use Events

OBJECTIVE

Young adults who engage in simultaneous alcohol and cannabis use report heavy use of both substances. Event-level studies examining differences between consequences experienced on simultaneous use compared with single substance use days have been mixed. Although studies often control for alcohol use levels, few have examined how quantity of alcohol may influence consequences experienced on simultaneous use days. Furthermore, little research has examined the relationship between simultaneous use and positive consequences or explored individual consequences. This study examined differences in consequences experienced on simultaneous use versus single substance use days (alcohol-only, cannabis-only) including endorsement of specific consequences and examined the relationship among simultaneous use, consequences, and alcohol consumption.

METHOD

Young adults who engage in simultaneous use (N = 86) completed 30 days of daily surveys reporting substance use and positive and negative consequences.

RESULTS

Simultaneous use days were associated with more negative and positive consequences than single substance use (alcohol-only and cannabis-only) days. We also examined endorsement of specific positive and negative consequences on alcohol-only, cannabis-only, and simultaneous use days. The effect of day type (simultaneous use vs. alcohol-only) on consequences was moderated by alcohol quantity. On lighter drinking days, more positive and negative consequences were endorsed if it was a simultaneous use versus alcohol-only day. On heavier drinking days, number of consequences did not differ between simultaneous use and alcohol-only days.

CONCLUSIONS

Findings from this study point to simultaneous use as both reinforcing and high risk and highlight the importance of intervening even on lighter drinking simultaneous use occasions to reduce harms.

The theory of planned behavior and alcohol protective behavioral strategies: a prospective study examining the role of habit and gender invariance

OBJECTIVES

Alcohol Protective Behavioral Strategies (PBS) have consistently shown to be effective in reducing alcohol use and its associated consequences. We aimed to examine the explanatory value of the Theory of Planned Behavior (TPB) for using five PBS, studying the role of habit, and its potential variation across genders.

METHODS

Targeted sampling was used to recruit 339 young adults in the community (women = 50.7%; mean age = 2.21[SD = 2.21]), who completed baseline and 2-month follow-up questionnaires.

RESULTS

The explained variance of the TPB ranged from 58-68% for intention to use PBS, and 18-50% for behavior. The inclusion of habit produced increases of 17-26% in explained variance in intention, while explained variance in behavior remained similar. Habit was the strongest predictor of intention to use PBS, followed by attitude. Except for one behavior (drinking slowly), habits did not moderate the intention-behavior relationship, and the explanatory value of the TPB did not differ across genders.

CONCLUSIONS

Our findings support the utility of the TPB as an explanatory model of alcohol PBS, along with the need to include habits within the framework of dual-process models. Interventions aimed at promoting alcohol PBS could be optimized by targeting attitudes towards PBS and habits.

Alcohol protective behavioral strategies for young adults: a content analysis across drinking contexts and gender

Background: Protective behavioral strategies (PBS) are specific harm reduction behaviors which mitigate alcohol-related consequences among young adults. Prior work indicates PBS utilization varies according to drinking context and gender, suggesting a need for further research assessing whether young adults employ unidentified PBS according to such factors.Objectives: This study examined alcohol PBS young adults suggest using across drinking contexts and gender to inform alcohol-related harm reduction interventions.Methods: An online survey with 514 young adult heavy drinkers (n = 269 female, Mage = 22.36 years) assessed PBS use generally, and across 12 physical and social contexts. We utilized qualitative content analysis methods to code and derive themes from open-ended responses from a prompt asking participants to state additional PBS used per context. The frequency of each theme's appearance was calculated across the overall sample, by gender, and within each context.Results: PBS endorsement varied across context and gender within each theme. Young adults who reported PBS use most frequently endorsed utilizing strategies related to drink content (18.30%), social support (12.36%), and engaging in other activities (10.34%). Participants infrequently endorsed strategies related to awareness of time (0.23%), standards of behavior (0.78%) and avoiding environments (0.87%).Conclusions: Young adults endorse utilizing additional PBS in varying frequency according to drinking context and gender. Given PBS are often a key component of alcohol harm reduction interventions, monitoring trends in young adult PBS use is crucial to ensure continued relevance and efficacy of such interventions to minimize harms associated with young adult heavy alcohol use.

Profiles of alcohol and cannabis protective behavioral strategies use across two large, multi-site college student samples of concurrent alcohol and cannabis users

Concurrent use of alcohol and cannabis among college students is common and confers greater harms than the use of either of these substances alone. Large and growing bodies of literature have demonstrated the independent utility of behaviors used before, during, after, or instead of alcohol and cannabis use that minimize related harms (i.e., protective behavioral strategies [PBS]). However, little is known about the relationship between alcohol and cannabis PBS and their joint influence on harms among college students who concurrently use alcohol and cannabis. In the present study, we used data from two large, multi-site samples of college students, and restricted analyses to those who reported at least one episode of alcohol and cannabis use in the past 30 days (Study 1: N = 1104[Mage = 20.3, SD = 3.8; 70.0 % female; 79.5 % white]; Study 2: N = 2034[Mage = 20.2, SD = 3.2; 69.1 % female; 76.6 % white]). A latent profile analysis supported a 4-profile solution that was largely consistent across samples: Profile 1 (low alcohol/cannabis PBS; 8.8-11.9 %), Profile 2 (average alcohol/cannabis PBS; 33.1-37.7 %), Profile 3 (average alcohol PBS/low cannabis PBS; 16.3-25.2 %), and Profile 4 (high alcohol/cannabis PBS; 29.8-37.2 %). Profile 4 reported the least alcohol/cannabis use, fewest negative alcohol-/cannabis-related consequences, and lowest alcohol/cannabis use severity. In contrast, Profile 1 was the opposite for alcohol-related outcomes, and Profile 3 was the opposite for cannabis-related outcomes. These findings are preliminary but may suggest that targeting both alcohol and cannabis PBS in intervention is generally beneficial except some groups at risk for a particular substance may benefit from increased focus on that substance in intervention.

Development and validation of the Personal Assessment of Responsible Drinking Identity (PARDI) with a college student sample

Recent research shows a link between identity and behavior change. Despite the existence of several measures that assess components of drinking identity, no measures examine the idiosyncrasies of a "Responsible Drinking Identity," though responsible drinking is an aim of many alcohol-related interventions. The present study created a measure of responsible drinking identity, the Personal Assessment of Responsible Drinking Identity (PARDI). Two cross-sectional designs and a prospective follow-up were used to develop and assess the psychometric properties of the PARDI. Study 1 used a U.S. national sample of college students who endorsed alcohol use (n = 911) to conduct an Exploratory Factor Analysis. Study 2 consisted of college students from a Southeastern University (n = 1,096) and was used to conduct a Confirmatory Factor Analysis, as well as evaluate convergent, discriminant, concurrent, and incremental validity. A subsample from Study 2 was then assessed after 1 month (n = 194). The follow-up examined test-retest reliability and predictive validity. The PARDI consists of four identity-based factors that are indicative of responsible drinking. The measure had adequate validity across all domains and good test-retest reliability. The measure appears to predict future protective behaviorial strategies (safe drinking behaviors), which mediates the relationship between the PARDI and both future alcohol use and consequences, suggesting safe or responsible drinking identity may drive a key behavioral target of substance use interventions. The PARDI may offer a tool to aid in quantifying underlying constructs of identity and behavior change in substance use interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A comprehensive examination of motivational profiles for alcohol-related behaviors among college students

Recent research demonstrates unique relations of types of motivation for drinking responsibly based on self-determination theory and drinking motives with alcohol-related outcomes among college students. In the present study, we sought to extend prior research by using a person-centered approach to simultaneously consider types of motivation within and across these motivational constructs as well as their synergistic relations with alcohol-related outcomes. We used cross-sectional survey data from 2,808 college students at 10 universities in eight states across the United States who reported past-month alcohol use (Mage = 20.59, SD = 4.18; 72.9% female; 58.2% non-Hispanic White). A series of latent profile analyses were conducted using types of motivation for drinking responsibly and drinking motives as indicators. A five-profile solution was selected as optimal. Mean comparisons indicated that profiles defined by high endorsement of higher quality motivations for drinking responsibly (i.e., more self-determined) and low endorsement of drinking motives in combination were related to the most frequent protective behavioral strategies use, least alcohol use, and fewest negative alcohol-related consequences. Additionally, these profiles were higher on dispositional autonomy and psychological need satisfaction and lower on psychological need frustration. These findings provide initial insight into simultaneously considering motivational profiles for the interrelated behaviors of drinking responsibly and drinking that can be leveraged in college drinking interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Indirect Associations between Impulsivity and Alcohol Outcomes through Motives for Drinking Responsibly among U.S. College Students: An Integration of Self-Determination Theory and the Acquired Preparedness Model

The aim of the present study was to conduct a preliminary investigation of the associations between facets of impulsivity and alcohol outcomes through motives for drinking responsibly described by self-determination theory among college students. Participants (N=2,808) were part of a multisite investigation of college student drinking across 10 universities in 8 states in the U.S. who reported past-month drinking. Results of a structural equation model testing all possible indirect associations simultaneously indicated that one-third (20 out of 60) of the indirect associations were statistically significant (p<.01). Facets with higher scores representing higher impulsivity (negative/positive urgency) were negatively associated with more internalized motives (autonomous motivation and introjected regulation) and positively associated with less internalized motives (external regulation and amotivation) for drinking responsibly. Facets with higher scores representing lower impulsivity (perseverance and premeditation) demonstrated opposite patterns of associations with motives for drinking responsibly. In turn, more internalized motives were related to higher frequency of protective behavioral strategies use, lower alcohol use severity, and fewer negative alcohol-related consequences; less internalized motives demonstrated an opposite pattern of associations with these alcohol outcomes. The present findings should be replicated using experimental and longitudinal studies for appropriately testing mediation but offer support for a novel hypothesis for motivational pathways from impulsivity to alcohol outcomes that may provide insight into intervention targets.

Correlates of college student use of protective behavioral strategies when drinking alcohol

Objective: The present study identified student characteristics associated with using protective behavioral strategies (PBS) to reduce harms when consuming alcohol. Participants: 224 college students who drink alcohol (66.5% female, 89.7% White non-Hispanic, Mage = 21.04) completed an anonymous study survey. Methods: Participants reported use of three PBSs: serious harm reduction; stopping or limiting drinking; and manner of drinking. They also reported sensation seeking, romantic involvement, parent-student alcohol communication, and attitudes toward alcohol in college life. Results: Attitudes toward alcohol in college life, Greek life participation, and sensation seeking were the variables most consistently associated with PBS use. Perceiving alcohol as an important part of college and sensation seeking were associated with less PBS use, but Greek life participation was associated with greater PBS use. Conclusions: Specific resources may be needed to encourage PBS use among high sensation seeking students and those who believe alcohol is a part of college life.

Contextual Use of Protective Behavioral Strategies for College Drinking

Background: Alcohol use on college campuses in the United States is a public health concern. Some students engage in protective behavioral strategies (PBS) before, during, or after their alcohol consumption (e.g., designated driver) to try to mitigate negative alcohol-related negative consequences. There is a gap in the literature on the use of different PBS in different situations commonly experienced by students (e.g., game day). The goal of the present study was to determine whether students would use different PBS for different situations, and to determine which PBS they would encourage their peers to use in these same situations. Objectives: A total of 182 undergraduate students were presented with three different hypothetical drinking scenarios (i.e., a friend's 21^st birthday celebration, football game day, and a house party) and asked which PBS they would use (i.e., limit drinking, change their manner of drinking, serious harm reduction strategies) and which they would recommend to their friends. They were also given the option to not drink at all. Results: Overall, students chose different strategies for different situations: they chose to limit their drinking at their friend's 21^st birthday or the game day tailgating event, to alter the manner of their drinking for the game day tailgating event, to reduce the potential of harm at the house party, and to not drink at their friend's 21^st birthday or the house party event. Students' personal choices matched their recommended choices for their friends. Conclusions: Results may have implications for prevention programs that teach harm reduction strategies such as PBS.

The Health Belief Model in the Context of Alcohol Protective Behavioral Strategies

Objective: Alcohol use continues to be prevalent and problematic among young adult samples. Protective behavioral strategies (PBS), which are harm reduction strategies utilized while drinking, have been linked to decreased alcohol use and subsequent alcohol-related problems. An individual's likelihood of adopting PBS and other health behaviors, according to The Health Belief Model (HBM), is dependent on perceived susceptibility to and severity of adverse health outcomes, as well as perceived benefits and barriers related to implementing those behaviors. The present study examined whether the perceived effectiveness of PBS in the context of the HBM leads to an increase in PBS use. Method: The analytic sample (n =694 college students, M_age =20.21, SD =4.37, 63.26% female, 72.05% Caucasian) self-reported demographics, weekly alcohol consumption (i.e., frequency, intensity, and quantity), alcohol-related problems, use of PBS, and perceived effectiveness of PBS use. A latent variable model was used to test the effect of perceived PBS effectiveness on PBS use, alcohol consumption, and alcohol-related problems. Results: Perceived PBS effectiveness was associated with a higher likelihood of using PBS subtypes (Manner of Drinking, Stopping/Limiting Drinking, and Serious Harm Reduction), which in turn was associated with reductions in alcohol consumption and problems. Conclusions: These findings suggest that increasing perceptions of PBS effectiveness may lead to more PBS use, decreased alcohol consumption, and fewer alcohol-related problems. Future research could implement longitudinal methodology to assess attempts to increase perceived effectiveness of PBS use and potentially establish a causal link between these perceptions, PBS use, and alcohol-related outcomes.

"It Breaks the Ice": A Qualitative Examination of Drinking Game Motives, Harms and Protective Behavioral Strategies among University Students in Australia

Background: Most research on drinking games (DG) behaviors and cognitions has been conducted among university students from the United States. Understanding why DGs are played, consequences and protective behavioral strategies (PBS) to reduce negative consequences is needed among Australian students. Objectives: In Australia, five focus groups (n=3-8) were held with 27 university students (63% female) aged 18-24 years who had played a DG in the past month. The study aimed to identify motives for playing DGs, consequences and adoption of PBS. Results: Four themes were identified: (1) social lubrication and conformity: playing to fit in; (2) community and camaraderie (perceived social benefits of DGs); (3) a means to an end (where getting drunk/predrinking was the goal and avoidance of PBS was prevalent); and (4) it is not a levelled playing field, which highlights that the risks are not equal for everyone. Conclusions: The interplay between DG motives, PBS and associated harms was identified. Expanding measurement of pre-existing DG motives and PBS is recommended, as well as the potential of DG motives to inform proposed interventions.

Risky Drinking in Adolescents and Emerging Adults: Differences between Individuals Using Alcohol Only versus Polysubstances

BACKGROUND

Factors related to risky drinking (e.g., motives, protective behavioral strategies [PBS]) may vary between youth who engage in polysubstance use compared to those who consume alcohol only. We examined differences in factors among youth who consume alcohol only compared to alcohol with other substances (i.e., polysubstance use), and correlates associated with risky drinking between the groups.

METHODS

Participants (N = 955; ages 16-24; 54.5% female) who reported recent risky drinking completed measures of alcohol/substance use, alcohol-related consequences, drinking motives, alcohol PBS, mental health symptoms, and emotion dysregulation. Participants were in the polysubstance group if they reported using at least one other substance (e.g., cannabis, stimulants) in addition to alcohol in the past three months. Chi-square and t-tests examined differences between the two groups and multiple regression analyses examined correlates of risky drinking.

RESULTS

Most participants (70.4%, n = 672) reported polysubstance use; these individuals engaged in riskier patterns of drinking, experienced more alcohol-related consequences, used fewer PBS, had stronger drinking motives (enhancement, social, coping), endorsed more mental health symptoms, and reported more emotion dysregulation. Regression models showed that emotion dysregulation significantly associated with risky drinking in the alcohol-only group; conformity and coping motives, alcohol PBS, and anxiety symptoms significantly associated with risky drinking in the polysubstance group.

CONCLUSIONS

Among risky drinking youth, results indicated youth engaging in polysubstance use have greater comorbidities and individual-level factors associated with risky drinking than youth who consume alcohol only. These findings may inform the tailoring of interventions for individuals who engage in risky drinking and polysubstance use.

A comprehensive examination of alcohol-related motivations among college students: Unique relations of drinking motives and motivations for drinking responsibly

Drinking motives, or reasons people choose to drink, are well-established risk factors for alcohol use and related negative consequences. Recent research has shown utility in a self-determination theory (SDT) approach for describing motivation for engaging in behaviors that reduce the harms associated with alcohol use (i.e., drinking responsibly). In the present study, we examined the relationship between drinking motives and motivations for drinking responsibly as well as their unique and incremental associations with alcohol-related outcomes (protective behavioral strategies [PBS], consumption, and negative consequences) in two samples of college student drinkers: (a) a random sample (n = 507) recruited from a Hispanic-Serving Institution on the U.S. border with Mexico (Mage = 22.84, SD = 5.84; 67.3% female; 90.9% Hispanic) and (b) a convenience sample (n = 2,808) from Psychology Department research participation pools at 10 universities in 8 U.S. states (Mage = 20.59, SD = 4.18; 72.9% female; 58.2% non-Hispanic White). Autonomous motivations (experience of volition and choice) for drinking responsibly were negatively correlated with drinking motives, but these correlations were small-to-medium in magnitude suggesting nonredundancy between the constructs. Drinking motives were risk factors for alcohol-related outcomes, especially alcohol-related problems, and autonomous motivations for drinking responsibly were protective factors for alcohol-related outcomes, especially PBS. Both motivational constructs predicted alcohol-related outcomes beyond the other, but drinking motives generally accounted for more variance. These findings suggest that integrating motivation in relation to both drinking and drinking responsibly may lead to a better understanding of alcohol-related behaviors and the associated negative consequences among college students. Implications for college drinking interventions are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Criterion Validity of Protective Behavioral Strategies for Alcohol Consumption among College Students: Comparison across Two Measures

BACKGROUND

Protective behavioral strategies (PBS), or behaviors used to reduce harm associated with alcohol use, are often associated with lower levels of alcohol consumption, lower engagement in high-risk drinking behaviors, and fewer alcohol-related consequences. Although the majority of studies have found significant associations between higher PBS use and lower consumption or consequences, some studies have found nonsignificant or even positive associations. One explanatory hypothesis is that the mixed findings are due to differential content in PBS measures.

OBJECTIVES

The current study examined the criterion validity of two widely-used PBS measures, the PBSS and the SQ. In a multi-institution online study assessing alcohol outcomes, college drinkers were randomly assigned to complete one PBS measure. Both measures had the same response options to standardize assessment and focus on content.

RESULTS

Findings suggest both measures of PBS are consistently predictive of alcohol outcomes among college drinkers, across multiple subpopulations (i.e., strength of association was not moderated by sex, race, or drinking level).

CONCLUSIONS/IMPORTANCE

Some PBS subscales were more impactful than others, suggesting researchers may want to choose which PBS scale to use based on outcomes of interest, or after determining if alternatives to drinking is an important facet of PBS for the research questions being examined. Moreover, the differential findings for subscales suggest that prevention and intervention programs incorporating PBS should focus on strategies that avoid high-risk scenarios (e.g., avoiding shots or drinking games), rather than general strategies of self-pacing.

College students' virtual and in-person drinking contexts during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has resulted in pronounced changes for college students, including shifts in living situations and engagement in virtual environments. Although college drinking decreased at the onset of the pandemic, a nuanced understanding of pandemic-related changes in drinking contexts and the risks conferred by each context on alcohol use and related consequences have yet to be assessed.

METHODS

Secondary data analyses were conducted on screening data from a large parent clinical trial assessing a college student drinking intervention (N = 1669). Participants across six cohorts (from Spring 2020 to Summer 2021) reported on the frequency of drinking in each context (i.e., outside the home, home alone, home with others in-person, and home with others virtually), typical amount of drinking, and seven alcohol-related consequence subscales.

RESULTS

Descriptive statistics and negative binomial regressions indicated that the proportion and frequency of drinking at home virtually with others decreased, while drinking outside the home increased from Spring 2020 to Summer 2021. Limited differences were observed in the proportion or frequency of individuals drinking at home alone or at home with others in-person. Negative binomial and logistic regressions indicated that the frequency of drinking outside the home was most consistently associated with more alcohol-related consequences (i.e., six of the seven subscales). However, drinking at home was not without risks; drinking home alone was associated with abuse/dependence, personal, social, hangover, and social media consequences; drinking home with others virtually was associated with abuse/dependence and social consequences; drinking home with others in-person was associated with drunk texting/dialing.

CONCLUSION

The proportion and frequency of drinking in certain contexts changed during the COVID-19 pandemic, although drinking outside the home represented the highest risk drinking context across the pandemic. Future prevention and intervention efforts may benefit from considering approaches specific to different drinking contexts.

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.

Sensation Seeking and Adolescent Drinking: Do Protective Behavioral Strategies Lower Risk?

Using a cross-sectional design, we examined protective behavioral strategies (PBS) as a moderator of the relationship between sensation seeking and hazardous drinking and alcohol-related consequences among high school seniors (N = 212). Hierarchical regression analyses indicated sensation seeking was a significant predictor of binge drinking (β = .65, p < .001), pre-partying (β = .71, p < .001), gaming (β = .75, p < .001), and alcohol-related consequences (β = .69, p < .001). Further, PBS moderated these relationships such that among high sensation seeking adolescents, PBS use was associated with better outcomes, including lower levels of binge drinking (β = -.37, p < .01), pre-partying (β = -.44, p < .01), gaming (β = -.31, p < .05), and alcohol-related consequences (β = -.53, p < .001). We discuss counseling implications, including assessment and harm reduction strategies focusing on PBS to reduce hazardous drinking among high sensation seeking adolescents.

Patterns and predictors of high-intensity drinking and implications for intervention

Efforts to intervene with subgroups at particularly high risk for alcohol use require information on factors that differentiate drinking intensity levels. This article summarizes existing research and provides new findings on sociodemographics and risk factors that differentiate high-intensity drinking (HID) to provide context for developing and delivering interventions for the highest-risk drinkers. Cross-sectional data were obtained in 2019 from participants who reported past 30-day alcohol use in 2018 as part of the nationally representative 12th grade Monitoring the Future study. Among past 2-week drinkers in 2019 (N = 601; modal age 19; 57.0% male; 67.4% non-Hispanic White), bivariate associations between drinking intensity (moderate drinking [1-4 drinks for women/1-5 drinks for men], binge-only drinking [4-7/5-9 drinks], and HID [8+/10+ drinks]) and a range of sociodemographic characteristics, risk factors, and alcohol-related consequences were examined. Results showed binge-drinking norms, social and enhancement drinking motives, nicotine vaping, and use of limiting/stopping drinking and manner of drinking protective behavioral strategies differentiated all drinking intensity levels, lending support to HID and binge-only drinking having an overlapping risk profile. However, there were also risk factors uniquely associated with HID, including sex, college attendance, employment, HID norms, use of serious harm reduction protective behavioral strategies, family history of drinking problems, any cigarette or drug use other than marijuana, and depression symptoms. Therefore, risk factors differentiate young adult drinking intensity. These results can inform efforts to adapt interventions for young adults who report HID. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Use of protective behavioral strategies and blackout experience among mandated college students

OBJECTIVE

Alcohol-induced blackouts are experienced by approximately half of college students who drink. People who use protective behavioral strategies (PBS) tend to experience fewer alcohol-related consequences of drinking, but the relationship between PBS and blackouts is unknown. This study examines the associations among the use of protective behavioral strategies and blacking out.

METHODS

Participants were 484 college students, aged 18-22 (56% male, 51% first-year), who were mandated to complete alcohol education following an alcohol violation. Before the intervention, participants completed questionnaires that included questions about past month peak consumption, alcohol-related consequences, marijuana use frequency, and frequency of PBS use. Logistic regression analyses were conducted to evaluate how use of PBS was related to the odds of experiencing a blackout, controlling for consumption and other risk factors.

RESULTS

Participants endorsing greater overall use of PBS had decreased odds of having experienced a blackout. However, this association depended on the type of PBS being used. Participants endorsing greater use of PBS regarding manner of drinking and stopping/limiting drinking had decreased odds of having experienced a blackout, but those who endorsed greater use of PBS relating to serious harm reduction did not.

CONCLUSIONS

This study adds nuance to the idea that PBS protect against adverse alcohol-related consequences. Only PBS that serve to limit or slow consumption appear to be protective against experiencing blackouts. Research on specific associations between types of PBS and consequences may lead to improved outcomes in interventions that incorporate PBS.

Thirty years of BASICS: Dissemination and implementation progress and challenges

The first clinical trial of the Brief Alcohol Screening and Intervention for College Students (BASICS) was launched at the University of Washington in 1990. Since that time, multiple trials have demonstrated the efficacy of BASICS and related approaches in a variety of young adult populations and this information has been widely disseminated. However, in practice BASICS implementation varies considerably, including formats and mediums (e.g., group, telehealth, written/electronic feedback alone) not studied in the original research. Even if delivered in an individual in-person format, implementation can stray substantially from the original design. Adaptations may be necessary to address campus resource constraints or other barriers to implementation but can have unknown impacts on intervention effectiveness. Thus, despite wide-scale efforts to disseminate and implement BASICS, challenges remain, and there are several critical research gaps that need to be addressed to support campuses in implementing BASICS successfully. The current manuscript reviews several ways in which BASICS has been adapted to address these challenges, and provides recommendations for best implementation practices as well as future research needed to improve implementation and effectiveness of BASICS going forward. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Brief Online Negative Affect Focused Functional Imagery Training Improves 2-Week Drinking Outcomes in Hazardous Student Drinkers: a Pilot Randomised Controlled Trial

BACKGROUND

Negative affect plays an important role in motivating problematic alcohol use. Consequently, training imagery-based adaptive responses to negative affect could reduce problematic alcohol use. The current study tested whether personalised online functional imagery training (FIT) to utilise positive mental imagery in response to negative affect would improve drinking outcomes in hazardous negative affect drinking students.

METHOD

Participants were 52 hazardous student drinkers who drink to cope with negative affect. Participants in the active group (n = 24) were trained online over 2 weeks to respond to personalised negative drinking triggers by retrieving a personalised adaptive strategy they might use to mitigate negative affect, whereas participants in the control group (n = 28) received standard risk information about binge drinking at university. Measures of daily drinking quantity, drinking motives, self-efficacy and use of protective behavioural strategies were obtained at baseline and 2 weeks follow-up.

RESULTS

There were three significant interactions between group and time in a per-protocol analysis: the active intervention group showed increased self-efficacy of control over negative affect drinking and control over alcohol consumption and decreased social drinking motives from baseline to 2-week follow-up, relative to the control intervention group. There were no effects on drinking frequency.

CONCLUSION

These findings provide initial evidence that online training to respond to negative affect drinking triggers by retrieving mental imagery of adaptive strategies can improve drinking-related outcomes in hazardous, student, negative affect drinkers. The findings support the utility of FIT interventions for substance use.

itMatters: Optimization of an online intervention to prevent sexually transmitted infections in college students

ObjectiveTo describe an iterative approach to developing an online intervention targeting the intersection of alcohol use and sexual behaviors among first year college students. Methods and Participants: Using the multiphase optimization strategy (MOST), we conducted two iterative optimization trials to: (1) identify candidate intervention components (i.e., descriptive norms, injunctive norms, outcome expectancies, perceived benefits of protective behavioral strategies, and self-efficacy to use strategies); (2) revise components; and (3) identify the optimized intervention. Participants were first year college students at six geographically diverse universities (optimization trial 1 N = 5,880; optimization trial 2 N = 3,551) Results: For both optimization trials, the results indicated that only descriptive and injunctive norms produced a significant effect (p<.05). Conclusions: The iterative process of MOST allowed us to develop an optimized intervention which is an essential tool to maximize intervention effectiveness and efficiency to improve uptake, sustainability, and public health impact.

Alcohol Protective Behavioral Strategies in Young Spanish Adults in the Community: A Prospective Study of Perceived Efficacy and Social Norms

BACKGROUND

Protective behavioral strategies (PBS) have been shown to be useful for reducing excessive alcohol use and alcohol-related problems. However, research on the explanatory factors of PBS is limited. This paper prospectively examines the contribution of perceived efficacy of PBS in reducing alcohol-related consequences and perceived descriptive norms of close peers´ PBS use in young adults. The mediating role of perceived efficacy of PBS between descriptive norms of PBS use and personal PBS use is also examined.

METHOD

Targeted sampling was used to recruit a community-based sample of 339 young Spanish adults aged 18-25 years, who completed baseline and two-month follow-up questionnaires. Three types of PBS (serious harm reduction-SHR, manner of drinking-MOD, and stopping/limiting drinking-SLD) were measured.

RESULTS

Both perceived efficacy and descriptive norms at baseline were positively associated with personal PBS use (SHR, MOD and SLD) at follow-up. A partial mediation effect of perceived efficacy between descriptive norms and personal PBS use was found for the three PBS subscales.

CONCLUSIONS

Our findings support the usefulness of correcting misperceptions of PBS use by peers in interventions aimed at reducing excessive drinking and alcohol-related consequences in young adults in the community. Moreover, PBS perceived efficacy should be included as a component of these interventions.

A longitudinal study among young adults into the predictive effect of perceived efficacy of behavioural strategies and the moderating role of drinking motives on use of protective behavioural strategies

INTRODUCTION

Although protective behavioural strategies (PBS) have shown to be effective in minimising alcohol-related negative consequences, research on the explanatory factors of their use is very scarce. Perceived efficacy has been demonstrated to be one of the most relevant explanatory factors in the use of health-related protective behaviours. The present study prospectively examines the relationship between the perceived efficacy of PBS in reducing alcohol-related negative consequences and the use of PBS in a community-based sample of young adults. In addition, the moderating role of drinking motives in this relationship is also examined.

METHODS

Prospective design with a baseline assessment and a 2-month follow up. Using a targeted sampling procedure, 339 young adults were recruited from the community [mean age: 21.1 (SD = 2.21); female = 50.7%] and completed questionnaires to measure perceived efficacy of PBS and drinking motives at baseline and PBS use at follow up.

RESULTS

Perceived efficacy of PBS at baseline was positively associated with PBS use at follow up, and these relationships were weaker as social, enhancement and coping motives scores increased.

DISCUSSION AND CONCLUSIONS

Our findings support the need to include the perceived efficacy of PBS to reduce alcohol-related negative consequences in future interventions aimed at promoting PBS use. Moreover, these interventions should be personalised according to the initial levels of participants' drinking motives, incorporating elements that allow for neutralising their negative effects on PBS use (e.g. training in coping skills for those with strong coping motives).

Examining Cross-Country and Sex Differences on a Comprehensive Assessment of Protective Behavioral Strategies for Alcohol

OBJECTIVE

Use of protective behavioral strategies (PBS) has been associated with reduced alcohol-related harms among college students. However, most of this research has been conducted among U.S. samples. The present study examines the use of PBS in an international context.

METHOD

Participants (n = 1512) were recruited from universities in Spain (n = 298), Argentina (n = 439), and the U.S. (n = 775) to determine if there are differences in PBS use across countries and/or across sex. Further, we examined whether the association between PBS use and negative consequences differ across country and sex.

RESULTS

We found that U.S. students reported the most frequent use of Stopping/Limiting Drinking PBS (M = 3.32, SD = 1.23) compared to Argentine (M = 2.89, SD = 0.97) and Spanish (M = 2.83, SD = 0.94) students. Argentine students reported the least frequent use of Serious Harm Reduction PBS (M = 4.57, SD = 0.99) compared to U.S. (M = 5.09, SD = 0.98) and Spanish (M = 5.03, SD = 0.78) students. Elastic net regression analyses stratified by country indicated most individual PBS predicted decreased negative alcohol-related consequences, although two items consistently predicted increased consequences and we observed some variability in the most predictive specific strategies in each country. Across each subscale and for 32 of 40 individual items, females reported more frequent use of PBS than males (ps<.05).

CONCLUSIONS

From the perspective of developing and adapting interventions, we recommend the cultural context in which PBS are used is taken into account. Although future work is needed to delineate cultural factors underlying the country-level differences we found, these findings have implications for the most promising PBS to target for college students in each country.

Social Network Drinking Feedback is Associated with Use of Protective Behavioral Strategies and Drinking-Related Outcomes in Emerging Adult Risky Drinkers

OBJECTIVE

Although emerging adult risky drinkers are generally unmotivated to change their drinking, use of protective behavioral strategies (PBS) to minimize drinking risks is associated with decreased alcohol-related harms. However, research on social influences on PBS use and associations with drinking outcomes is limited and relevant to informing interventions for this priority population. This study investigated whether emerging adults' drinking-related behaviors were associated with social network encouragement, discouragement, or mixed messages about their drinking and with PBS use.

METHOD

Risky drinkers ages 21-29 years (N = 356; 228 women; mean age = 23.6 years) were recruited from the community using digitally implemented respondent-driven sampling. A web-based survey assessed social network drinking feedback, PBS use, drinking practices and problems, and behavioral allocation of time and money to drinking.

RESULTS

Negative binomial generalized linear models indicated that friend and spouse/ partner discouragement of drinking was associated with greater PBS use, whereas mixed messages were associated with lower use (ps < .05). Greater PBS use was associated with fewer alcohol-related negative consequences and lower behavioral allocation to drinking (ps < .05); the latter association was most consistent for serious harm reduction PBS (e.g., use of a designated driver). Mixed drinking messages from all relationship types had direct negative associations with drinking outcomes, particularly time and money allocated to drinking.

CONCLUSIONS

Assessing social network features may guide interventions to increase PBS use and reduce drinking-related harms among emerging adult risky drinkers.

Further validation of the Treatment Self-Regulation Questionnaire for assessing motivations for responsible drinking: A test of self-determination theory

Alcohol protective behavioral strategies (PBS) are cognitive-behavioral strategies used before, during, and/or after drinking to reduce alcohol use and alcohol-related problems. Self-determination theory (SDT) provides a potentially useful framework to understand motivations for responsible drinking, which is operationalized in the present study as PBS use. In the present study, we examined the relation of motivations for responsible drinking, as assessed by the Treatment Self-Regulation Questionnaire (TSRQ), with other SDT constructs (psychological need satisfaction and dispositional autonomy) and PBS use. A sample of 507 college students who reported consuming alcohol at least once in the past 3 months were recruited from a random sample of students enrolled at a Hispanic serving institution to complete an online survey. Consistent with SDT and previous studies of the TSRQ, we found support for a 4-factor structure of the TSRQ. The TSRQ demonstrated measurement invariance across several sociodemographic subgroups within the sample (e.g., biological sex, age, year in school), supporting the use of the TSRQ across these subgroups. Further, consistent with SDT-based hypotheses, greater psychological need satisfaction and dispositional autonomy were related to more self-determined motivations for responsible drinking. Also consistent with SDT, more self-determined motivations for responsible drinking were related to more frequent PBS use. The present findings further support the utility of the TSRQ for assessing motivations for responsible drinking and support SDT as a framework for understanding responsible drinking. Future directions for research applying SDT to understand and promote responsible drinking among college students are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Brief Alcohol Screening and Intervention for Community College Students (BASICCS): Feasibility and preliminary efficacy of web-conferencing BASICCS and supporting automated text messages

Objective: The Brief Alcohol Screening and Intervention for College Students (BASICS; Dimeff et al., 1999) is an evidence-based approach to reduce high-risk drinking and associated harms; however, implementation may present challenges for community colleges (CCs) that have limited budgets and mostly non-residential students. We examined feasibility, acceptability, and efficacy of BASICS for CC students (BASICCS) delivered remotely via web-conferencing with supporting automated text messages. Method: Participants included 142 CC students who reported exceeding National Institute on Alcohol Abuse and Alcoholism (NIAAA's) weekly low-risk drinking recommendations and/or heavy episodic drinking (HED). Participants were randomized to BASICCS or assessment-only control (AOC) and completed 1- and 3-month follow-up assessments. Results: Most students liked the personalized information in the program and found the web-conferencing platform useful, however intervention completion rate was 56%. Significant differences were found between BASICCS and AOC. At 1-month, individuals in BASICCS had 33% fewer alcohol consequences than those in AOC. At 3-month follow-up, individuals in BASICCS had lower estimated peak blood alcohol concentration, 29% fewer drinks per week, 62% fewer episodes of HED, and 24% fewer consequences than those in AOC. Conclusions: BASICCS showed evidence of being acceptable and the technology proved feasible, although the intervention completion rate in the non-treatment-seeking volunteer sample was modest. Preliminary evidence does suggest BASICCS shows promise in reducing alcohol use and consequences. Technology-based platforms could be a viable prevention solution for CC students. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A randomized controlled trial of the effectiveness of combinations of 'why to reduce' and 'how to reduce' alcohol harm-reduction communications

INTRODUCTION

Alcohol is a major source of harm worldwide. The aim of this study was to experimentally assess the effects of exposing Australian adult drinkers to combinations of 'why to reduce' and 'how to reduce' alcohol harm-reduction messages.

METHODS

Three online surveys were administered over six weeks: Time 1 at baseline (n = 7,995), Time 2 at three weeks post-baseline (n = 4,588), and Time 3 at six weeks post-baseline (n = 2,687). Participants were randomly assigned to one of eight conditions: (1) a control condition; (2) a 'why to reduce' television advertisement; (3-5) one of three 'how to reduce' messages referring to the following protective behavioral strategies (PBSs): Keep count of your drinks, Decide how many drinks and stick to it, It's okay to say no; and (6-8) the television advertisement combined with each PBS message individually. Intention-to-treat analyses were conducted to determine effects of condition assignment on changes over time in attempts to reduce alcohol consumption and amount of alcohol consumed.

RESULTS

Participants assigned to the 'TV ad' and 'TV ad + Keep count of your drinks PBS' conditions reported significant increases in attempts to reduce alcohol consumption. Only participants assigned to the 'TV ad + Keep count of your drinks PBS' condition exhibited a significant reduction in alcohol consumed (-0.87 drinks per person per week).

CONCLUSIONS

Well-executed 'why to reduce' alcohol harm-reduction advertisements can encourage drinkers to attempt to reduce their alcohol consumption. These ads may be effectively supplemented by specific 'how to reduce' messages designed to encourage drinkers to monitor their intake.