Alcohol-related protective behavioral strategies as a mediator of the relationship between drinking motives and risky sexual behaviors

Risky sexual behaviors (RSB) frequently occur in the context of alcohol use and are associated with distinct drinking motives among college students. Use of alcohol protective behavioral strategies (PBS) is associated with reductions in alcohol use and related problems, which may extend to alcohol-related RSB. Moreover, as PBS use mediates the relationship between positive reinforcement drinking motives and alcohol-related problems, the same may be true for alcohol-related RSB, specifically. The current study examined whether PBS mediates the relationship between drinking motives and RSB among college students. Participants (N = 2039, 72.8% female, M_age = 19.79) from ten universities across ten U.S. states completed an online survey assessing past-month drinking motivation, alcohol PBS, alcohol consumption, and RSB. To test study aims, a saturated path model in which drinking motives were modeled as predictors of RSB via PBS use subscales and alcohol consumption was conducted. Several double mediation effects were found, such that stronger endorsement of motives (i.e., social, enhancement, conformity, coping for depression) were associated with lower PBS (particularly manner of drinking and serious harm reduction), which was associated with higher alcohol use, which was associated with higher RSB. Multi-group models found the mediation effects to be gender invariant, although several differences in direct associations were found across genders. For college students high in positive reinforcement motives (i.e., social or enhancement) for drinking, interventions that aim to increase PBS use, specifically related to modifying the manner in which one drinks and avoiding very dangerous consequences, may be effective in reducing alcohol-related RSB.     

Prevalence and Correlates of Depression and Drinking Behaviors Among Adolescents and Emerging Adults in a Suburban Emergency Department

Background: Both alcohol use and depression are concerning health issues among youth. The Emergency Department (ED) is a critical location to access youth with depressive symptoms and alcohol misuse. Objectives: To inform future interventions in the ED, this study examined the relationship between drinking behaviors and depressive symptoms among youth seeking ED care. Methods: Youth ages 14–20 were recruited from a level-1 trauma ED located in the Midwest as part of a larger ongoing study. Participants completed an electronic screening survey, which included assessment of alcohol use, depressive symptoms, and demographic variables. Two logistic regression models were conducted to assess the relationship between depressive symptoms with alcohol consumption and specific alcohol-related consequences. Results: Among 3,659 participants, bivariate analysis indicated that individuals screening positive for depression were more likely to be female, nonwhite, receive public assistance, and report higher scores on both alcohol consumption and alcohol-related consequences. Regression analyses indicated alcohol consumption, inability to stop drinking once starting, and feelings of guilt or remorse after drinking were significantly positively related to screening positive for depression. Conclusions/Importance: Current findings support use of the ED as a location for identifying youth who are experiencing co-morbid alcohol use and depressive symptoms. Future research should focus on the effectiveness of brief intervention in the ED that focuses on the co-occurrence of alcohol misuse and depressive symptoms among youth.     

Protective behavioral strategy use and motivations for drinking: Exploring Alternatives to Drinking strategies

Protective behavioral strategy (PBS) use is associated with less alcohol consumption and fewer alcohol-related problems. Further, greater endorsement of social or enhancement drinking motives (i.e., positive motives) is associated with less frequent PBS use. Limited research has, however, explored coping or conformity motives (i.e., negative motives) in relation to PBS. Consequently, the present study aimed to (1) identify the types of PBS most strongly associated with negative and positive motives and (2) examine different types of PBS as mediators of the relationship between each drinking motive and alcohol outcomes. Participants were college students (n = 303; 70% women) who completed measures of drinking motives, PBS, alcohol use, and alcohol-related problems. Results indicated that greater endorsement of positive drinking motives were more strongly associated with less frequent use of PBS while drinking whereas negative motives were more strongly related to less frequent Alternatives to Drinking strategy use. Further, strategies used while drinking were more relevant in a model of positive drinking motives and Alternatives to Drinking strategies were more relevant in a model of negative motives. These findings may suggest that whereas individuals with stronger positive motives have difficulty using strategies while drinking, individuals who drink to cope or conform have greater difficulty utilizing Alternatives to Drinking strategies. Based on our results demonstrating that different types of PBS are more relevant for various types of drinkers, it may be important for future interventions to discuss not only the participant's PBS use but also their motivations for consuming alcohol.     

Effects of depressive symptoms and coping motives on naturalistic trends in negative and positive alcohol-related consequences

ObjectiveDepressive symptoms and drinking to cope with negative affect increase the likelihood for drinking-related negative consequences among college students. However, less is known about their influence on the naturalistic trajectories of alcohol-related consequences. In the current study, we examined how positive and negative drinking-related consequences changed as a function of depressive symptoms and drinking motives (coping, conformity, social, enhancement).MethodParticipants (N = 652; 58% female) were college student drinkers assessed biweekly during the first two years of college. We used hierarchical linear modeling to examine means of and linear change in positive and negative consequences related to depression and motives, controlling for level of drinking.ResultsConsistent with hypotheses, negative and positive consequences decreased over the course of freshman and sophomore years. Higher levels of depression were associated with a faster decline in negative consequences during freshman year. Coping motives predicted average levels of negative and positive consequences across all years, with the effects of coping motives on consequences most pronounced at low levels of depression during sophomore year.ConclusionsThese findings indicate that screening students for depression and drinking to cope, independent of alcohol consumption, may help identify students at risk for experiencing negative alcohol consequences and that these factors should be addressed in targeted alcohol interventions.     

Can you say no? Examining the relationship between drinking refusal self-efficacy and protective behavioral strategy use on alcohol outcomes

Preliminary research has demonstrated reductions in alcohol-related harm associated with increased use of protective behavioral strategies (PBS) and higher levels of drinking refusal self-efficacy (DRSE). To extend research that has evaluated these protective factors independently of one another, the present study examined the interactive effects of PBS use and DRSE in predicting alcohol outcomes. Participants were 1084 college students (63% female) who completed online surveys. Two hierarchical linear regression models revealed that both DRSE and PBS use predicted alcohol use and consequences. Additionally, DRSE moderated the relationship between PBS use and both typical weekly drinking and negative alcohol-related consequences, such that participants who reported lower levels of PBS use and DRSE in the social pressure or emotional regulation dimensions were at greatest risk for heavy drinking and consequences respectively. Interestingly, for those who reported higher levels of social and emotional DRSE, levels of PBS use had no impact on alcohol use or alcohol consequences respectively. These findings demonstrate that DRSE and PBS use differentially reduce risk, suggesting the utility of collegiate, alcohol harm reduction interventions that aim to both increase PBS use and bolster self-efficacy for greater harm reduction.     

Drinking motives and PTSD-related alcohol expectancies among combat veterans

IntroductionCombat veterans are at increased risk for PTSD and alcohol misuse, and expectancies and motives for drinking may help explain the link between these comorbid issues. This investigation explored the relationships between PTSD symptoms, PTSD-related alcohol expectancies, motives for drinking, and alcohol consumption/misuse.Method67 veterans of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) participated in this project. We examined correlations between PTSD severity, alcohol misuse, drinking motives, PTSD alcohol expectancies, and tested models of mediation and moderation.ResultsCoping-anxiety drinking motives and positive PTSD-related alcohol expectancies were associated with alcohol misuse and alcohol-related consequences, but not with consumption. Each PTSD symptom cluster was associated with positive and negative PTSD alcohol expectancies, and coping-anxiety was specifically related to reexperiencing and avoidance. Drinking to cope mediated the relationship between PTSD symptoms and hazardous drinking. Moderation analyses showed that a positive relationship between PTSD severity and hazardous drinking existed among those with moderate and higher levels of positive PTSD-alcohol expectancies.DiscussionOur findings point to surprising, and in some cases complex, relationships between PTSD and alcohol use. Although related, PTSD alcohol expectancies and drinking motives seem to function differently in the relationship between PTSD and alcohol misuse.     

Alcohol expectancies,protective behavioral strategies,and alcohol-related outcomes: A moderated mediation study

Aims: The influence of alcohol expectancies on alcohol consumption and the negative consequences of alcohol consumption among college students has been well documented. Protective behavioral strategies are associated with decreases in alcohol use and related consequences. This study examined the extent to which the use of protective behavioral strategies mediated the influence that alcohol expectancies had for alcohol consumption and negative alcohol-related consequences.

Methods: Measures of expectancies about alcohol consumption, protective behavioral strategies used when consuming alcohol, amount of alcohol consumed and negative consequences associated with alcohol use were completed by 679 traditional age undergraduate students via a secure website. A moderated mediation data analytic strategy was employed because of the gender differences that have been observed for alcohol expectancies, consumption, and consequences.

Findings: The use of protective behavioral strategies was found to mediate the associations that positive expectancies had with both the amount of alcohol consumed and the negative consequences of alcohol consumption only for women.

Conclusions: Education and harm reduction efforts for college student drinkers, including expectancy challenge initiatives, would benefit from including information about use of protective behavioral strategies.     

College-Related Alcohol Beliefs and Problematic Alcohol Consumption: Alcohol Protective Behavioral Strategies as a Mediator

Background: College-related alcohol beliefs, or beliefs that drinking alcohol is central to the college experience, have been shown to robustly predict alcohol-related outcomes among college students. Given the strength of these associations, it is imperative to understand more proximal factors (i.e., closer in a causal chain leading to alcohol-related outcomes) that can explain these associations. Objectives: The current research examined alcohol protective behavioral strategies (PBS) as a potential mediator of the association between college-related alcohol beliefs and alcohol outcomes among college student drinkers. Method: Participants were undergraduate students from a large southeastern university (Sample 1; n = 561) and a large southwestern university (Sample 2; n = 563) in the United States that consumed alcohol at least once in the previous month. Results: Path analysis was conducted examining the concurrent associations between college-related alcohol beliefs, PBS use (both as a single facet and multidimensionally), alcohol consumption, and alcohol-related consequences (i.e., double mediation). In both samples, there was a significant double-mediated association that suggested that higher college-related alcohol beliefs is associated with lower PBS use (single facet), which is associated with higher alcohol consumption and alcohol-related consequences. Multidimensionally, only one double-mediation effect (in Sample 2 only) was significant (i.e., college-related alcohol beliefs → manner of drinking PBS → alcohol consumption → alcohol-related consequences). Conclusions/Importance: These results suggest that targeting these college-related alcohol beliefs as well as PBS use are promising targets for college alcohol interventions. Limitations and future directions are discussed.     

Drinking to Cope With Depressive Symptoms and Ruminative Thinking: A Multiple Mediation Model Among College Students

Background: Understanding the potential psychosocial mechanisms that explain (i.e., mediate) the associations between depressive symptoms and alcohol-related problems can improve interventions targeting college students. Objectives: The current research examined four distinct facets of rumination (e.g., problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) and drinking to cope motives as potential explanatory mechanisms by which depressive symptoms are associated with increased alcohol-related problems. Method: Participants were undergraduate students from a large, southeastern university in the United States that consumed at least one drink per typical week in the previous month (n = 403). The majority of participants were female (n = 291; 72.2%), identified as being either White, non-Hispanic (n = 210; 52.1%), or African American (n = 110; 27.3%), and reported a mean age of 21.92 (SD = 5.75) years. Results: Structural equation modeling was conducted examining the concurrent associations between depressive symptoms, rumination facets, drinking to cope motives, and alcohol-related problems (i.e., cross-sectional). There was one significant double-mediated association that suggested that increased depressive symptoms is associated with increased problem-focused thoughts, which is associated with higher drinking to cope motives and alcohol-related problems. Conclusions/Importance: Our results suggests that problem-focused thoughts at least partially explains the associations between depression and maladaptive coping (i.e., drinking to cope), which in turn is related to problematic drinking among college students. Limitations and future directions are discussed.     

A cross-lagged panel model examining protective behavioral strategies: Are types of strategies differentially related to alcohol use and consequences?

Protective behavioral strategies (PBS) are skills that can be used to reduce the risk of alcohol-related negative consequences. Studies have shown that, in general, PBS are related to less alcohol consumption and fewer negative consequences; however, other studies have suggested that not all types of PBS (e.g., stopping/limiting drinking [SLD], manner of drinking [MOD] and serious harm reduction [SHR]) are equally effective at reducing alcohol risk. In addition, few studies have explored the longitudinal relationships among PBS, alcohol use and consequences. Using a sample of heavy drinking college students (N = 338), the current study examined PBS use, alcohol consumption and consequences across two time points three months apart. Cross-lagged panel models revealed that MOD predicted a reduction in alcohol use and negative consequences. SHR was longitudinally related to fewer negative consequences, but unrelated to alcohol use. SLD was not associated with drinking or consequences at follow-up. These results highlight the need for future research to examine the effects of different types of PBS and have implications for alcohol intervention programs that incorporate PBS skills training.     

Poor adjustment to college life mediates the relationship between drinking motives and alcohol consequences: a look at college adjustment, drinking motives, and drinking outcomes

The current study examined whether the relationship between drinking motives and alcohol-related outcomes was mediated by college adjustment. Participants (N=253) completed an online survey that assessed drinking motives, degree of both positive and negative college adjustment, typical weekly drinking, and past month negative alcohol-related consequences. Structural equation modeling examined negative alcohol consequences as a function of college adjustment, drinking motives, and weekly drinking behavior in college students. Negative college adjustment mediated the relationship between coping drinking motives and drinking consequences. Positive college adjustment was not related to alcohol consumption or consequences. Positive reinforcement drinking motives (i.e. social and enhancement) not only directly predicted consequences, but were partially mediated by weekly drinking and degree of negative college adjustment. Gender specific models revealed that males exhibited more variability in drinking and their positive reinforcement drinking motives were more strongly associated with weekly drinking. Uniquely for females, coping motives were directly and indirectly (via negative adjustment) related to consequences. These findings suggest that interventions which seek to decrease alcohol-related risk may wish to incorporate discussions about strategies for decreasing stress and increasing other factors associated with better college adjustment.     

Relationship between General and Sport-Related Drinking Motives and Athlete Alcohol Use and Problems

Objective: Alcohol use (and adverse consequences due to alcohol use) among college student-athletes is a common occurrence and consequently garners attention as a health concern within athletic departments and the NCAA. One of the strongest predictors of alcohol use in athletes is motivation to drink. However, not much is known about the influence of alcohol use motivations on drinking in collegiate athletes. Therefore, this study examined the influence of sport-related and general drinking motives on alcohol use and alcohol-related problems. Method: Participants were female collegiate softball players (N?=?721) from 62 NCAA teams. Athletes completed the Athlete Drinking Scale (Martens et al., 2005), the Drinking Motives Questionnaire, revised (Cooper, 1994; Cooper et al., 1992), alcohol consumption measures, and the Rutgers Alcohol Problems Index (White & Labouvie, 1989). Multilevel modeling was used to analyze the data. Results: Higher scores on Positive Reinforcement motives were associated with greater alcohol consumption, heavy episodic drinking, and alcohol-related problems. Enhancement motives were positively associated with heavy episodic drinking and alcohol-related problems, while Coping motives were positively associated with alcohol-related problems. Lower scores on Conformity motives were related to higher alcohol consumption, whereas higher scores were related to more alcohol-related problems. Conclusions: These results assist in understanding salient drinking motives among athletes while accounting for nesting effects of athletes within teams. Results demonstrate alcohol use as a perceived means of reward for hard work or good athletic performance, thus attempts to control alcohol use in college athletics should emphasize alternative methods to positively reinforce efforts or celebrate victories.     

Acculturation,hazardous drinking and depressive symptomatology among Hispanics enrolled in a clinical trial

Background: Among Hispanics in USA, lower acculturation level has been found to be protective against alcohol abuse and depression. However, this relationship may not hold within at-risk samples. The prevalence and co-occurrence of hazardous drinking and depressive symptoms and their relationship to acculturation were examined among Hispanics enrolled in a study to reduce heavy drinking. At enrolment, all the participants reported past-month heavy drinking (one or more occasions of >4/5 drinks for females/males, and average weekly consumption >7/14 drinks per week). We explored whether gender moderated the effects of acculturation on hazardous drinking and depressive symptoms. Methods: Participants (N?=?100) completed measures at baseline. Results: Eighty-nine percent of participants met criteria for hazardous alcohol use as assessed by the AUDIT and of those, 55% (n?=?49) also reported elevated depressive symptoms. Of those who reported elevated depressive symptoms, nearly all (94%) met AUDIT criteria for hazardous drinking. Acculturation was not related to hazardous drinking or depressive symptoms in the full sample. Highly acculturated women reported more hazardous drinking than less acculturated women. Acculturation was not associated with hazardous drinking in men, but less acculturated men reported higher levels of depression than highly acculturated men. Discussion: Depression should be assessed in alcohol interventions for Hispanics. Alcohol interventions should be tailored for acculturation level and gender to improve relevance and efficacy. Clinical Trial Registration #NCT01996280.     

Depressive symptoms,ruminative thinking,drinking motives,and alcohol outcomes: A multiple mediation model among college students in three countries

BackgroundRecent research suggests that ruminative thinking (specifically problem-focused thoughts) may explain why individuals engage in drinking to cope (DTC) when dealing with depressive symptoms; which in turn leads to increased negative alcohol-related consequences. Cross-cultural studies addressing these phenomena are scarce.ObjectivesThe present study cross-culturally tested whether four rumination facets (problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) uniquely mediate the relationships between depressive symptoms and drinking motives/alcohol outcomes in a multicultural sample of college student drinkers (n = 1429) from Spain, Argentina, and the U.S.MethodStructural equation modeling was conducted to test the models, controlling for sex. Further, we conducted invariance testing to determine whether our models were culturally-specific or culturally-universal.ResultsWithin both proposed models, no rumination facet uniquely mediated the relationship between depressive symptoms and drinking motives. However, an exploratory model with a second-order latent factor of ruminative thinking did significantly mediate these associations (exception was conformity motives). Further, there were two significant double-mediated associations that suggested that increased depressive symptoms is associated with increased ruminative thinking, which is associated with higher DTC motives, which in turn is associated with higher alcohol consumption and negative alcohol-related consequences. All models were found to be invariant across countries and sex, suggesting that these associations may be relatively universal.ConclusionsRumination is relevant to understand the increased vulnerability of college drinkers to exhibit greater alcohol consumption and negative consequences via DTC motives when dealing with depressive symptoms.     

Drinking motives among heavy-drinking veterans with and without posttraumatic stress disorder

Objective: This study examined patterns of drinking motives endorsed by heavy drinking veterans who either did or did not meet criteria for posttraumatic stress disorder (PTSD). Method: Data were collected from 69 veterans of Operations Enduring Freedom or Iraqi Freedom (OEF/OIF) who had screened positive for hazardous drinking. The sample was 91.3% male and 65.2% Caucasian. Based on a structured interview, 58% of the sample met criteria for PTSD. Results: The PTSD group scored higher than the non-PTSD group on scales measuring drinking to cope with anxiety and depression and similarly to the non-PTSD group on scales measuring social, enhancement and conformity motives. Coping and social motives were significantly correlated with adverse alcohol consequences. Overall, the PTSD group showed stronger relations between coping scales and aspects of alcohol misuse, relative to the non-PTSD group. Conclusion: These findings suggest first, that among heavy drinking OEF/OIF veterans there is a high base rate of PTSD. Second, coping motives are frequently reported in this population, and they seem to be related to a more severe pattern of alcohol-related consequences. These findings underscore the importance of assessing the interplay between PTSD and substance abuse in trauma-exposed samples.     

Social anxiety and alcohol-related outcomes: the mediating role of drinking context and protective strategies

Purpose: Students with social anxiety are vulnerable to hazardous drinking patterns due to their social evaluative fears and tendency to perceive alcohol use as a socially-approved, normative behavior. These students do not drink as often as their peers, yet they experience more alcohol-related consequences. Thus, it is important to identify specific anxiety-provoking drinking contexts that trigger these students to engage in hazardous episodic drinking. These students are also less likely to seek treatment for mental health or substance use issues, pointing to the importance of examining their use of protective strategies, particularly in those anxiety-provoking contexts. Evidence supports the unique roles of drinking context and protective strategies as influencing the link between social anxiety and alcohol-related outcomes. Therefore, the current study tested the unique and synergistic effects of drinking context and protective strategies on the social anxiety-alcohol outcomes relationship. 

Materials and methods: Data from 678 traditional-aged college students were collected via measures assessing social anxiety symptoms, drinking contexts, and safe and risky drinking behaviors.

Results: Mediation analyses indicated that negative coping drinking contexts and serious harm reduction protective strategies independently mediated the link between interaction social anxiety and hazardous drinking, and between social anxiety and alcohol-related consequences, respectively. Further, negative coping drinking contexts and serious harm reduction strategies sequentially mediated the positive association between interaction social anxiety and alcohol-related consequences. 

Conclusions: There appears to be a complex interplay of cognitive, social, and environmental factors making students with social interaction fears more susceptible to alcohol-related harm and less focused on using safe drinking strategies. Implications and directions for future research are outlined.     

Alcohol Use and Drinking Motives Among Suddenly Bereaved College Students

Objective: Thousands of Americans grieve the sudden death of a loved one each year. These sudden deaths may be the result of violent deaths, as in the cases of homicide, suicide, or fatal accidents, or may occur as the result of natural causes such as heart attacks or strokes. Sudden loss survivors often experience negative mental health outcomes such as depression, prolonged grief disorder, and posttraumatic stress disorder. Survivors may also misuse alcohol for varied reasons after these losses, which can put them at risk for alcohol-related consequences. Thus, the purpose of this study was to explore associations between psychological distress and alcohol-related outcomes among young adults with a history of sudden loss. Methods: A sample of 659 young adults completed a series of self-report measures assessing loss history, psychosocial distress, perceived alcohol-related problems, and drinking motives. Results: Results showed that survivors of sudden, violent losses reported higher rates of past 30-day alcohol use than those who had lost a loved one to a sudden, natural loss or those who reported no loss history. Although there were no statistically significant differences in drinking motives between violent or natural loss survivors, more severe depression symptoms among bereaved individuals were associated with drinking to cope and to conform. Participants experiencing prolonged grief symptoms were also more likely to report drinking to conform. Conclusions: Bereavement-related distress may influence drinking motives among young adults with a history of sudden loss.     

Perceived vulnerability moderates the relations between the use of protective behavioral strategies and alcohol use and consequences among high-risk young adults

Drinking protective behavioral strategies (PBS) have been associated with reductions in alcohol use and alcohol-related consequences in young adults. PBS subscales, Limiting/Stopping (LS), Manner of Drinking (MOD), and Serious Harm Reduction (SHR), have been examined in the literature; LS, MOD, and SHR have mixed support as protective factors. Understanding moderators between PBS and alcohol use and related consequences is an important development in PBS research in order to delineate when and for whom PBS use is effective in reducing harm from alcohol use. Perceptions of vulnerability to negative consequences, included in health-risk models, may be one such moderator. The current study examined whether two types of perceived vulnerability (perceived vulnerability when drinking; perceived vulnerability in uncomfortable/unfamiliar situations) moderated the relations between LS, MOD, SHR strategies and alcohol use and related negative consequences. High-risk young adults (N = 400; 53.75% female) recruited nationally completed measures of PBS, alcohol use and related consequences, and measures of perceived vulnerability. Findings demonstrated that perceived vulnerability when drinking moderated the relations between MOD strategies and alcohol use. The interactions between perceived vulnerability when drinking and PBS did not predict alcohol-related consequences. Perceived vulnerability in unfamiliar/uncomfortable social situations moderated relations between MOD strategies and both alcohol use and related negative consequences; no other significant interactions emerged. Across both perceived vulnerability types and MOD strategies, those with the highest levels of perceived vulnerability and who used MOD strategies the most had the greatest decrements in alcohol use and related negative consequences. Prevention and intervention implications are discussed.     

Protective behavioral strategies mediate the effect of drinking motives on alcohol use among heavy drinking college students: gender and race differences

Objective

This study examined the extent to which protective behavioral strategies (PBS) mediated the influence of drinking motives on alcohol consumption, and if these hypothesized relationships were corroborated across subsamples of gender and race.

Method

Online surveys were completed by 1592 heavy drinking college undergraduates from two universities (49.9% male and 50.1% female; 76.9% Caucasian and 23.1% Asian). Independent samples t-tests compared males and females as well as Caucasians and Asians on measures of drinking motives, PBS use, and alcohol consumption, and structural equation models examined the mediating role of PBS.

Results

Consistent with predictions, t-tests revealed that males reported greater levels of consumption than females, but females reported greater use of PBS than males. Caucasians reported greater consumption levels, endorsed higher enhancement motives, and higher PBS related to serious harm reduction, but Asians endorsed higher coping and conformity motives, and PBS focused on stopping/limiting drinking. In multiple-sample SEM analyses, PBS were shown to largely mediate the relationship between motives and consumption in all demographic subsamples.

Conclusions

Findings indicate that PBS use leads to reductions in drinking despite pre-established drinking motives, hence pointing to the potential value of standalone PBS skills training interventions in lowering alcohol use among diverse groups of heavy drinking college students.