Dimensionality and psychometric analysis of an alcohol protective behavioral strategies scale

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).

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.

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.

Insights into the context of simultaneous alcohol and cannabis use among young adults

Simultaneous alcohol and cannabis use (simultaneous use) is common among young adults and is associated with a greater number of substance use-related consequences compared to single substance use. Understanding what drives simultaneous use among young adults is crucial. This study aimed to gather qualitative data on physical, social, and situational characteristics of simultaneous use among young adults. Participants were 36 heavy drinking young adults (Mage = 21.79) who engaged in simultaneous use at least twice during the past 30 days. Individual semistructured interviews were conducted via Zoom videoconferencing. Thematic analyses were used to analyze interview data. Findings indicated that young adults are selective of where and with whom they engage in simultaneous use with. Physical characteristics associated with simultaneous use included being in familiar and safe locations. Young adults were less likely to engage in simultaneous use in public spaces. Social characteristics associated with simultaneous use included being at parties, being around close peers, and if others are approving of and/or also using alcohol and cannabis so their effects overlap. Being around family or being alone decreased the likelihood of simultaneous use. Situational characteristics associated with simultaneous use included having access to alcohol and/or cannabis, being a weekend and/or evening, pregaming, and using cannabis at the end of a drinking occasion. Young adults based their decision to engage in simultaneous use on a range of physical, social, and situational contextual factors. Future research should examine multiple characteristics of the context in order to identify specific context with an increased risk of simultaneous use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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.

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.

"It'll Never Be Safe, But You Can Limit the Harms". Exploring Adolescents' Strategies to Reduce Harms Associated with Psychoactive Substance Use

Introduction: Harm reduction strategies are behaviors that may be applied in order to reduce adverse consequences associated with psychoactive substance use. Adolescents who use substances make up a large population that may benefit from applying such strategies. However, previous research in this area has focused on adults. Therefore, the purpose of this qualitative study was to describe and examine harm reduction strategies among adolescents who use psychoactive substances. Methods: Semi-structured individual interviews were conducted with 72 adolescents of equal sex distribution (aged 17-18 years) who had used various substances at least three times in the past 12 months and had no history of substance use disorders (SUD) treatment. Data were transcribed and then analyzed thematically based on the Consensual Qualitative Research approach. Findings: Adolescents who use substances described the harm reduction strategies they use. According to the meaning youth attributed to these strategies, five themes were developed, that included approaches to risk, substance use safety conditions, preparation for use, manner of use, and controlled use. Most of the identified strategies correspond to those found in studies on adults. The main source of adolescents' knowledge about these strategies was the Internet. Peers appeared to play an important role in reducing substance-related risks. Conclusions: Despite risk-taking, adolescents in our study showed active engagement in reducing their substance-related risks and harms. Practical implications are provided, including supporting harm reduction strategies, enhancing the active role of peers and the Internet as communication channels in preventing SUDs as well as other substance-related problems among adolescents.

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).

Optimal assessment of protective behavioral strategies among college drinkers: An item response theory analysis

College student alcohol use and related consequences continue to warrant significant concern. Extant research demonstrates protective behavioral strategies (PBS; self-regulatory strategies that can be employed before, during, or after drinking to prevent intoxication or negative consequences) have promise for preventative interventions. Variations in conceptualization and measurement of the construct limit generalization of PBS research. To advance generalization of PBS research, there is a need for a brief, comprehensive, content valid, PBS measure that demonstrates equivalence in measurement across demographically diverse college students. The present study aimed to develop a psychometrically robust measure of PBS using item response theory (IRT) to address measurement and methodological issues including identifying optimal response anchors and items that represent the full range of the PBS construct for use with college men and women from different racial backgrounds. Participants were 503 college students enrolled in a midsized university in the Southern United States. IRT and differential item functioning (DIF) analyses of 68 PBS items extracted from 6 existing PBS measures resulted in a 20-item instrument, the Protective Drinking Practices Scale, with items that functioned equivalently for White and Black/African American college men and women. The measure also demonstrated good internal and external validity. Widespread use of this measure will help enhance the comparability of findings in PBS research, allowing for more targeted and impactful research on PBS as a mechanism of change. Suggestions for future research are provided. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Drinking, Social Abstaining, and Refusing Invitations: Demographic Differences Persist Across College

BACKGROUND

Alcohol use and misuse are prevalent on many college campuses. The current study examined participation in college environments where alcohol is present and being consumed. We documented students' alcohol consumption, social abstaining (i.e., attending an alcohol-present event, but not drinking), and refusing invitations to drinking events. We tested for differences by parental education, immigrant status, race-ethnicity, and gender. We charted longitudinal change across college.

METHODS

First-year students attending a large public US university (n = 681, 18% first-generation college student, 16% first-generation immigrant, 73% racial-ethnic minority group member, 51% women) were recruited and followed longitudinally for 7 semesters. Each semester, students completed up to 14 daily surveys; responses were aggregated to the semester level (n = 4,267).

RESULTS

Multilevel logistic regression models demonstrated that first-generation college students were less likely to drink and refuse invitations to drinking events than students with a college-educated parent (Adjusted Odds Ratios [AORs]: 0.66, 0.72, respectively). Similarly, first-generation immigrants were less likely to drink, socially abstain, and refuse invitations (AORs: 0.58 to 0.73). Compared with White students, Black and Asian American students were less likely to drink (AORs: 0.55, 0.53) and refuse invitations to drinking events (AORs: 0.68, 0.66). The proportion of days spent drinking increased across college, and refusing invitations was the most common at the start and end of college.

CONCLUSIONS

First-generation college students, first-generation immigrant students, and Black and Asian students participated less in prodrinking environments during college. These findings indicate that on drinking and nondrinking days, students' participation in alcohol-present situations differed by background. Furthermore, our results indicate that the students who are most likely to refuse invitations to drinking events are the same students who drink most frequently.

Weighing the Pros and Cons of Using Alcohol Protective Behavioral Strategies: A Qualitative Examination among College Students

BACKGROUND

Alcohol protective behavioral strategies (PBS) are behaviors engaged in immediately prior to, during, after, or instead of drinking with the explicit goal of reducing alcohol use, intoxication, and/or alcohol-related harms. Despite the quantitative support for alcohol PBS as a protective factor among college student drinkers, we know of no qualitative research aimed at determining college student drinkers' perceptions regarding the advantages and disadvantages of using PBS.

OBJECTIVES

In the style of a decisional balance exercise, we asked college student drinkers (analytic n = 113) to identify 5 reasons they would not use PBS (cons) and 5 reasons they would use PBS (pros).

METHOD

Participants (majority female, 77.0%) were recruited from a psychology department participant pool at a large, southeastern university in the United States. Within our analytic sample, participants on average consumed 6.38 (SD = 8.16) drinks per typical week of drinking and reported consuming alcohol on average 7.5 days (SD = 5.83) in the last 30 days.

RESULTS

Using a descriptive phenomenological approach, we identified 2 themes for pros (prevention of specific negative alcohol-related consequences and general safety) and 4 themes for cons (goal conflict, ineffectiveness, difficulty of implementation, and negative peer/social repercussions). Overall, participants reported more pros than cons and this discrepancy (i.e., number of PBS pros minus number of PBS cons) was positively related to self-reported frequency of PBS use. Conclusions/Importance: Taken together, we hope that clinicians/researchers will probe individual's reasons for choosing to use (or not use) PBS in order to tailor or improve existing PBS-based interventions.

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).

A psychometric evaluation of the Protective Behavioral Strategies Scale-20 among internet samples of adult drinkers

Protective behavioral strategies (PBS) are most commonly defined as behaviors that are used while drinking to reduce alcohol use and/or limit alcohol-related problems. Few studies have examined and quantified PBS use among non-college student populations. The purpose of the present two studies was to evaluate the psychometric properties of the Protective Behavioral Strategies Scale-20 (PBSS-20; Treloar, Martens, & McCarthy, 2015) among internet samples of adult drinkers. In the first study, we conducted an exploratory factor analysis of the PBSS-20 with a sample (n = 360) of adult drinkers who were recruited from Mechanical Turk. We then conducted a second study that recruited adult drinkers from Mechanical Turk and randomly split the data in half. With the first split-half sample (n = 339), we conducted a confirmatory factor analysis of the PBSS-20 and assessed the internal consistency and concurrent validity of the subscales. With the second split-half sample (n = 338), we tested measurement invariance across gender. The results support a three-factor structure of the PBSS-20 that is similar to what has been found among college students. However, six items were dropped and two Serious Harm Reduction items loaded best onto the Manner of Drinking factor. Furthermore, two subscales demonstrated adequate internal consistency and all three subscale were negatively associated with alcohol-related outcomes. Similar to college students, there was lack of measurement invariance across gender. We discuss the implications of the present findings in extending research on PBS to the more general population of U.S. adult drinkers.

Developing Text Messages to Reduce Community College Student Alcohol Use

Objectives The aim of this study is to evaluate how community college students with hazardous drinking perceived the usefulness of alcohol protective behavioral strategy text messages (TM-PBS). Methods Community college students with past hazardous single occasion or weekly drinking (N = 48; 60% female) were randomized to receive 2 TM-PBS on 3 typical drinking days per week for 2 weeks selected by: (1) research investigators (ie, based on clinical and theoretical application); (2) participants (ie, messages highly rated at baseline by the participants); or (3) a random process. Prior to 2 typical drinking days per week, immediately after receiving TMs, we asked: "How useful do you think this strategy will be for you when you drink? Text a number from 1 (not useful) to 5 (very useful)." Results Response rates for the 12 messages ranged from 72.9% to 87.5%, with no differences in response rates across selection categories (ie, investigator, participant, random). Investigator-selected messages were rated as less useful than messages that were self-selected by participants or messages that were selected at random. Conclusions TM-PBS chosen a priori by students were perceived as more useful than TM-PBS chosen by investigators, supporting this form of tailoring in alcohol interventions to optimize usefulness.

Strategies associated with low-risk drinking: a population-based study

OBJECTIVE

To examine the relative frequency of use of seven strategies to moderate drinking (SMD) among low-risk and risky drinkers.

METHODS

Cross-sectional data from the 2013 National Drug Strategy Household Survey was used. The analytical sample included 11,462 Australians aged 18-64 who had consumed alcohol in the previous year. Logistic regression was used.

RESULTS

Analyses indicated a curvilinear relationship between use of SMD and alcohol consumption. Across the seven SMD, constant use of a strategy, compared with never using a strategy, was associated with low-risk drinking. Never using a strategy, compared with using one rarely, was also associated with low-risk drinking. When used occasionally, strategies that implied less alcohol consumed per hour (e.g. refuse unwanted drinks) increased the likelihood of low-risk drinking, whereas less direct strategies (e.g. counting drinks) increased the likelihood of risky drinking.

CONCLUSIONS

Adult Australians who drink at low levels use a range of strategies to moderate their alcohol consumption. Overall, consistent use of one or more SMD was associated with low-risk drinking patterns.

IMPLICATIONS

Public health responses to risky drinking may be enhanced by promoting the consistent use of SMD as a way to reduce overall alcohol consumption.

Moderators of the Effects of Alcohol Protective Behavioral Strategies: Three Attempts of Replication and Extension

BACKGROUND

Protective behavioral strategies (PBS) can be used to reduce alcohol-related harm when drinking. Despite much research demonstrating that use of protective behavioral strategies (PBS) is associated with decreased alcohol use/problems, few studies have examined moderators of these associations. Moderation tests are important as they define the boundary conditions of the protective effects of PBS use (i.e., identify for whom and in what context PBS use reduces harm).

OBJECTIVES

We aimed to replicate and extend the findings from three published studies that have examined putative moderators of PBS-alcohol associations: self-regulation, negative urgency, and drinking refusal self-efficacy.

METHOD

Participants were recruited from a psychology department participant pool at a large, southwestern university in the United States (N = 628).

RESULTS

Although we replicated most main effects and bivariate correlations, we failed to replicate any of the moderation effects (i.e., interaction effects). Conclusions/Importance: We urge PBS researchers to attempt to replicate moderation effects in independent samples to determine these effects' reproducibility. Limitations and future directions are discussed.

Protective behavioral strategies as a context-specific mediator: A multilevel examination of within- and between-person associations of daily drinking

Research indicates that a drinker's environmental and social context can be differentially associated with drinking outcomes. Further, although many researchers have identified that more frequent use of protective behavioral strategies (PBS) is associated with lower alcohol consumption and negative consequences, scant research has examined how one's drinking context may promote or hinder PBS use. The present study examined how the context of drinking each day (i.e., where and with whom) is associated with level of consumption and reported alcohol-related problems among n = 284 college drinkers (69.0% female) directly, as well as indirectly through the use of PBS. Two different dimensions of PBS are examined (i.e., "Limits" or limiting consumption, and "Avoidance" or avoiding alcohol in general or specific alcohol situations), as well as their relationship with daily drinking. Moreover, we explored these relationships intraindividually (within-person across time), as well as interindividually (between people). Daily drinking was assessed using a weekly diary design. Using multilevel structural equation modeling, we found that environmental context (i.e., drinking at a bar or party) is associated with heavier alcohol use directly and indirectly through PBS that involve limiting one's drinking; these effects occurred only at the daily (within-person) level. Additionally, social context (i.e., drinking with friends) predicts elevated drinking but is unrelated to PBS use. Similar findings were present for alcohol-related problems, controlling for consumption level. College student drinking interventions may benefit from a focus on increasing the use of PBS within potentially risky drinking environments to help reduce problematic alcohol use. (PsycINFO Database Record

Playing it safe: Patron safety strategies and experience of violence in night-time entertainment districts

INTRODUCTION AND AIMS

Incidences of violence are elevated in night-time entertainment districts. Research suggests that safety-related behavioural strategies adopted while drinking can reduce negative alcohol-related outcomes. The current study investigates the use of safety strategies and its association with experiences of violence among patrons from the general population.

DESIGN AND METHODS

Patron interviews (N = 3949) were conducted in and around licenced venues in Newcastle (New South Wales) and Geelong (Victoria) during peak trading hours (Friday and Saturday, 21:00-01:00 h). Participants (mean age = 24.3, SD = 5.8; male 54.4%) were asked to report what measures, if any, they used to keep safe when drinking and whether they had been involved in a violent incident in the last 12 months.

RESULTS

After controlling for patron demographics and location, the use of multiple (more than one) safety strategies was significantly associated with reduced odds of involvement in a violent incident (odds ratio = 0.64, 95% confidence interval 0.49-0.85, P = 0.002). Significant gender differences were observed in the number and type of safety strategies reported.

DISCUSSION AND CONCLUSIONS

Increasing the number of safety-related behaviours during drinking occasions is associated with a small but significant reduction in experiencing alcohol-related harms, such as violence. [Zhou J, Droste N, Curtis A, Zinkiewicz L, Miller P. Playing it safe: Patron safety strategies and experience of violence in night-time entertainment districts.

Protective behavioral strategies as a mediator between depressive symptom fluctuations and alcohol consumption: a longitudinal examination among college students

OBJECTIVE

Use of protective behavioral strategies (PBS) has been shown to be associated with alcohol outcomes among college students in general. Only a few studies, however, have examined how mental health is related to PBS and alcohol use. Furthermore, research has not yet investigated these associations in a longitudinal framework. Consequently, the present study aimed to examine PBS as a mediator of depressive symptom fluctuations and alcohol consumption in a longitudinal weekly diary design.

METHOD

Participants were 260 (70.8% women) undergraduate college student drinkers who completed four weekly self-report assessments of their depressive symptoms, PBS use, and alcohol outcomes experienced in the past week.

RESULTS

RESULTS indicated significant indirect effects such that increases in depressive symptoms were associated with higher alcohol consumption (i.e., quantity, frequency, peak drinking) through reduced PBS use. PBS did not mediate the association between depressive symptoms and alcohol-related problems.

CONCLUSIONS

These findings suggest that experiencing an increase in depressive symptoms was associated with a failure to use PBS and, in turn, engagement in heavier alcohol consumption. College students with greater depressive symptoms may benefit from harm-reduction alcohol intervention programs that emphasize the use of PBS in drinking contexts.

Clarifying observed relationships between protective behavioral strategies and alcohol outcomes: The importance of response options

Protective behavioral strategies (PBS), or harm-reduction behaviors that can potentially reduce alcohol consumption or associated problems, have been assessed in varied ways throughout the literature. Existing scales vary in focus (i.e., broad vs. narrow), and importantly, in response options (i.e., absolute frequency vs. contingent frequency). Absolute frequency conflates PBS use with number of drinking occasions, resulting in inconsistencies in the relationship between PBS use and alcohol outcomes, whereas contingent frequency is less precise, which could reduce power. The current study proposes the use of absolute frequencies to maximize precision, with an adjustment for number of drinking days to extricate PBS use from drinking occasions, resulting in a contingent score. Study 1 examined the associations between PBS subscales using the Strategy Questionnaire (Sugarman & Carey, 2007) and alcohol outcomes, finding that in raw score form the association between PBS and typical alcohol outcomes varied greatly from significantly positive to significantly negative, but adjusted score relationships were all consistent with harm reduction perspectives. In addition, curvilinear relationships with typical alcohol use were eliminated using the score adjustment, resulting in linear associations. Study 2 confirmed the findings from Study 1 with a more precise timeframe, additional alcohol assessments, and heavier college drinkers. The relationships between alcohol outcomes and PBS in raw score form were again varied, but became consistently negative using the score adjustment. Researchers examining PBS and related constructs should consider modifying current scales to include a precise frequency response scale that is adjusted to account for number of drinking occasions. (PsycINFO Database Record

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

An extensive body of research asserts alcohol expectancies, or beliefs regarding the effects of alcohol, as an important influence on drinking. However, the extent to which expectancies are related to drinking motives and protective behavioral strategies (PBS) has yet to be examined. Existing alcohol mediational models suggest associations between expectancies and drinking motives as well as positive drinking motives and PBS use. Thus, it is possible that drinking motives and PBS use act as intervening factors in the relationship between expectancies and alcohol outcomes. Consequently, the cross-sectional study presented here aimed to test the indirect effect of expectancies (i.e., social facilitation) on alcohol outcomes through drinking motives and PBS use. Participants were 520 (358 female) college student drinkers with a mean age of 20.80 (SD = 4.61) years. Students completed measures of expectancies, drinking motives, PBS use, alcohol use, and alcohol-related problems. Results from structural equation modeling indicated that drinking motives and PBS mediated the relationship between social expectancies and alcohol use. In particular, expectancies were associated with greater positive drinking motives, drinking motives were associated with less PBS use, and PBS was associated with less alcohol use and fewer alcohol-related problems. Given the key role of PBS in explaining drinking outcomes in our model, active efforts to incorporate PBS in alcohol interventions may be particularly beneficial for college students. Further, our findings support the consideration of PBS use as a part of the motivational model of alcohol use in future work.

The nature and correlates of young women's peer-directed protective behavioral strategies

OBJECTIVE

Recently, a number of studies have identified self-employed Protective Behavioral Strategies (PBS) as effective in decreasing the level of alcohol-related harm among young people. However, much of the published research has ignored important gender differences, such as women's increased tendency to rely on PBS that are social in nature. To further the understanding of women's PBS, the current study sought to investigate the nature and correlates of the strategies young women employ to keep their friends safe when drinking (i.e., peer-directed PBS).

METHOD

A scale measuring peer-directed PBS was developed and administered in conjunction with existing measures of alcohol consumption, personal PBS, and peer attachment. Participants consisted of 422 women aged 18-30 years, recruited among psychology students and the general public.

RESULTS

Exploratory factor analysis revealed two clusters of peer-directed PBS; those that were aimed at reducing intoxication among one's friends and those that were designed to minimize alcohol-related harms. Further analysis found a positive relationship between women's tendency to implement personal and peer-directed PBS and that risky drinkers were less likely to engage in personal or peer-directed PBS (either type).

CONCLUSION

Findings indicate that personal and peer-directed PBS are related behaviors that are less frequently adopted by risky drinkers.

Use of alcohol protective behavioral strategies among college students: a critical review

Protective behavioral strategies (PBS) are specific behaviors one can utilize to minimize the harmful consequences of alcohol consumption. Recently, there has been an increasing amount of interest in use of PBS among college students, especially as an intervention target. The purpose of the present comprehensive review of the PBS literature was to examine the measurement of PBS and summarize the quantitative relationships between PBS use and other variables. The review found inconsistency across studies in terms of how the use of PBS is operationalized and found only two PBS measures with good psychometric properties that have been replicated. Although several antecedents to PBS use were identified, most were only examined in single studies. Moderators of the predictive effects of PBS use on outcomes have similarly suffered from lack of replication in the literature. Of all 62 published reports reviewed, 80% reported only cross-sectional data, which is unfortunate given that PBS use may change over time and in different contexts. In addition, only two attempted to minimize potential recall biases associated with retrospective assessment of PBS use, and only two used an approach that allowed the examination of both within-subject and between-subject effects. In terms of the gaps in the literature, there is a dearth of longitudinal studies of PBS use, especially intensive longitudinal studies, which are integral to identifying more specifically how, when, and for whom use of PBS can be protective.

Protective behavioral strategies for reducing alcohol involvement: a review of the methodological issues

Alcohol use among college students remains a major public health concern with many students experiencing negative alcohol-related consequences as a result of their drinking. Protective behavioral strategies (PBS) have been conceptualized as skills used by drinkers to moderate their drinking and/or resulting consequences. The correlational evidence for the relationships among PBS, alcohol use, and related problems has been mixed. Experimental research reveals inconsistent relationships among intervention condition, PBS use, and alcohol outcomes. There is currently insufficient evidence to support the claim that PBS function as a mechanism of behavior change for college drinkers. We propose that the inconsistencies found in the correlational and experimental research are explained in part by psychometric and methodological issues. This review summarizes measurement and methodological issues in studies that have directly assessed the relationship between PBS and alcohol use and/or alcohol-related consequences in college drinking samples. Additionally, we provide some suggestions and future directions to overcome methodological and conceptual limitations and to advance understanding of the role of protective behavioral strategy use in reducing alcohol involvement among college drinkers.

Daily use of protective behavioral strategies and alcohol-related outcomes among college students

The purpose of the present study was to examine associations between use of protective behavioral strategies (PBS) and alcohol-related outcomes (alcohol consumption, negative alcohol consequences, and positive alcohol consequences) using a daily diary approach. This approach is less affected by retrospective memory biases than typical self-reports of alcohol-related variables and allows the examination of both between-subjects and within-person effects. Using hierarchical linear modeling of data from 40 subjects who completed daily dairies for up to 15 days, we found significant within-person variation in PBS use over time, and each type of PBS had unique relationships with alcohol-related outcomes. For example, within-person variation in Serious Harm Reduction, one form of PBS, predicted increased daily alcohol use, negative consequences, and positive consequences. Our findings suggest the importance of intensive longitudinal methods to examine both between-subjects and within-subjects effects of PBS use and alcohol-related outcomes.

The assessment of protective behavioral strategies: comparing the absolute frequency and contingent frequency response scales

The purpose of the present studies was to examine the effects of response scale on the observed relationships between protective behavioral strategies (PBS) measures and alcohol-related outcomes. We reasoned that an "absolute frequency" scale (stem: "how many times …"; response scale: 0 times to 11+ times) conflates the frequency of using PBS with the frequency of consuming alcohol; thus, we hypothesized that the use of an absolute frequency response scale would result in positive relationships between types of PBS and alcohol-related outcomes. Alternatively, a "contingent frequency" scale (stem: "When drinking … how often …"; response scale: never to always) does not conflate frequency of alcohol use with use of PBS; therefore, we hypothesized that use of a contingent frequency scale would result in negative relationships between use of PBS and alcohol-related outcomes. Two published measures of PBS were used across studies: the Protective Behavioral Strategies Survey (PBSS) and the Strategy Questionnaire (SQ). Across three studies, we demonstrate that when measured using a contingent frequency response scale, PBS measures relate negatively to alcohol-related outcomes in a theoretically consistent manner; however, when PBS measures were measured on an absolute frequency response scale, they were nonsignificantly or positively related to alcohol-related outcomes. We discuss the implications of these findings for the assessment of PBS.