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.

Alcohol and marijuana protective behavioral strategies mediate the relationship between substance use identity and use-related outcomes: A multi-sample examination.

Substance use identity has been consistently associated with problematic substance use. Limited attention has considered mechanisms of this association. This research examined whether greater identification as a drinker or marijuana user would be associated with the use of fewer alcohol/marijuana protective behavioral strategies (PBS; e.g., avoiding drinking games/avoiding using marijuana in public places). Further, PBS have been associated with lower levels of negative alcohol/marijuana-related outcomes (i.e., frequency, quantity, consequences). In the current multi-sample study, PBS were examined as a mediator of the relationship between drinking/marijuana identity and alcohol/marijuana-related outcomes across three studies. Study 1 was an intervention study with heavy drinking college students (N = 605), Study 2 was a multisite study of marijuana outcomes among college students (N = 2,077), and Study 3 was a study of substance use in a community sample (n = 369alcohol; n = 146marijuana). Cross-sectional and/or longitudinal data were collected across studies. Substance use identity, PBS, and use-related outcomes were measured across the three studies. Indirect effects were evaluated by Monte Carlo confidence intervals. Manner of Drinking PBS were found to be the only statistically significant mediator of the relationship between drinking identity and alcohol-related outcomes (i.e., quantity and consequences) cross-sectionally. These significant cross-sectional mediation effects for alcohol were replicated in one of three longitudinal models. Marijuana PBS were also found to mediate the relationship between marijuana identity and all marijuana-related outcomes examined in the current study. Study findings may help to inform the development of identity-based and PBS-based interventions that aim to reduce negative alcohol/marijuana-related outcomes.

Cognitive factors and addiction.

The present paper provides a brief review of cognitive factors related to addiction. Five representative cognitive constructs were selected from the current literature. These include the distinction between implicit and explicit cognitions; metacognitions; expectancies; motives; and social norms. For each of these a general overview is provided along with specific findings from selected recent studies. The intention is to provide the reader with a succinct but reasonable view of how each construct is currently studied in relation to the use of alcohol and other substances and to become aware of some of the strengths and limitations corresponding to the study of these constructs.

The Relationship Between Risk Factors and Alcohol and Marijuana Use Outcomes Among Concurrent Users: A Comprehensive Examination of Protective Behavioral Strategies.

OBJECTIVE: Among college samples, both alcohol and marijuana protective behavioral strategies (PBS) have been shown to mediate the effects of known risk factors (i.e., sex, age at substance use onset, college substance use beliefs, substance use motives, and impulsivity-like traits) on alcohol and marijuana outcomes. However, it is unknown whether PBS use would operate similarly for both substances among concurrent users. The present study examined which risk factors relate to alcohol/marijuana outcomes via alcohol/marijuana PBS use among a large group of concurrent alcohol/marijuana users. METHOD: Participants were college students who consumed both alcohol and marijuana at least 1 day in the previous month (n = 2,034; 69.08% female). RESULTS: Across both substances, PBS use significantly mediated the effects of sex (women reported higher PBS use), age at first use (having an older age at first use was associated with more PBS use), and college substance use beliefs (higher beliefs was associated with lower PBS use). Unique to alcohol outcomes, alcohol PBS use significantly mediated the effects of negative urgency, social motives, and enhancement motives (all associated with lower PBS use). Unique to marijuana outcomes, marijuana PBS use mediated the effects of coping, expansion (both associated with lower PBS use), and conformity motives (associated with more PBS use). CONCLUSIONS: Our results suggest that PBS for both alcohol and marijuana can help explain why some risk factors are associated with alcohol/marijuana outcomes. Taken together, PBS use seems to be an important intervention target for alcohol/marijuana concurrent users.