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

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.

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).

A cross-national examination of cannabis protective behavioral strategies' role in the relationship between Big Five personality traits and cannabis outcomes

Background: Problematic cannabis use is common among young adults across the world. However, limited research has examined whether etiological models predicting negative consequences are universal.Objective: The present study examined whether the Five-Factor Model of personality (openness, conscientiousness, extraversion, agreeableness, and neuroticism) relates to cannabis outcomes via use of cannabis protective behavioral strategies (PBS) in a cross-national sample of college student cannabis users (i.e., used cannabis in the last 30 days).Method: Participants were 1175 university students (63.27% female) across five countries (United States, Argentina, Spain, Uruguay, and the Netherlands) recruited to complete an online survey.Results: PBS use mediated the associations between personality traits and cannabis consequences, such that higher conscientiousness (β = .20), agreeableness (β = .11), and lower emotional stability [i.e., higher neuroticism] (β = -.14) were associated with more PBS use. Higher PBS use was, in turn, associated with lower frequency of cannabis use (β = -.32); lower frequency of use was then associated with fewer cannabis consequences (β = .34). This sequential pathway was invariant across sex, but not countries. Notably, there were a number of differences in links between PBS and cannabis outcomes when comparing countries (e.g., negative associations in the US sample, but positive associations in the Argentina sample).Conclusions: Cannabis PBS mediates the relationship between personality traits and cannabis outcomes, but there are nuanced differences across countries (i.e., relationship between PBS and cannabis outcomes). Overall, students that are low in conscientiousness, agreeableness, and neuroticism and/or report low rates of PBS use may benefit from cannabis PBS-focused interventions that promote utilization of PBS.