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.

[1]  Joseph W. LaBrie,et al.  Measuring alcohol-related protective behavioral strategies among college students: further examination of the Protective Behavioral Strategies Scale. , 2007, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[2]  Elissa R Weitzman,et al.  Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18-24, 1998-2005. , 2009, Journal of studies on alcohol and drugs. Supplement.

[3]  P. Monti,et al.  Efficacy of counselor vs. computer-delivered intervention with mandated college students. , 2007, Addictive behaviors.

[4]  T. Adams,et al.  Protective Behavioral Strategies and Negative Alcohol-Related Consequences in College Students , 2008, Journal of drug education.

[5]  S. Walters,et al.  Correlates of protective behavior utilization among heavy-drinking college students. , 2007, Addictive behaviors.

[6]  M. Griffin,et al.  Staying Safe While Consuming Alcohol: A Qualitative Study of the Protective Strategies and Informational Needs of College Freshmen , 2007, Journal of American college health : J of ACH.

[7]  S. L. Benton,et al.  College student protective strategies and drinking consequences. , 2004, Journal of studies on alcohol.

[8]  Scott T Walters,et al.  Dismantling motivational interviewing and feedback for college drinkers: a randomized clinical trial. , 2009, Journal of consulting and clinical psychology.

[9]  D. Kivlahan,et al.  Secondary prevention with college drinkers: evaluation of an alcohol skills training program. , 1990, Journal of consulting and clinical psychology.

[10]  Andrew Lac,et al.  Protective behavioral strategies mediate the effect of drinking motives on alcohol use among heavy drinking college students: gender and race differences. , 2011, Addictive behaviors.

[11]  W. Miller,et al.  Controlling Your Drinking: Tools to Make Moderation Work for You , 2004 .

[12]  Dawn E. Sugarman,et al.  The relationship between drinking control strategies and college student alcohol use. , 2007, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[13]  B. Boekeloo,et al.  Dimensionality and Psychometric Analysis of an Alcohol Protective Behavioral Strategies Scale , 2011, Journal of drug education.

[14]  K. Witkiewitz,et al.  Overview of harm reduction treatments for alcohol problems , 2006 .

[15]  Matthew K Nock,et al.  Conceptual and design essentials for evaluating mechanisms of change. , 2007, Alcoholism, clinical and experimental research.

[16]  D. J. Hanson,et al.  Surveying the damage: a review of research on consequences of alcohol misuse in college populations. , 2002, Journal of studies on alcohol. Supplement.

[17]  B. Rounsaville,et al.  Coercive Sexual Experiences, Protective Behavioral Strategies, Alcohol Expectancies and Consumption Among Male and Female College Students , 2010, Journal of interpersonal violence.

[18]  Scott T Walters,et al.  Reactivity to alcohol assessment measures: an experimental test. , 2009, Addiction.

[19]  Sam Porter,et al.  On the problems of mixing RCTs with qualitative research: the case of the MRC framework for the evaluation of complex healthcare interventions , 2010 .

[20]  Kelly S. DeMartini,et al.  Individual-level interventions to reduce college student drinking: a meta-analytic review. , 2007, Addictive behaviors.

[21]  H. Wechsler,et al.  What we have learned from the Harvard School Of Public Health College Alcohol Study: focusing attention on college student alcohol consumption and the environmental conditions that promote it. , 2008, Journal of studies on alcohol and drugs.

[22]  R. Vuchinich,et al.  Using behavioral theories of choice to predict drinking outcomes following a brief intervention. , 2005, Experimental and clinical psychopharmacology.

[23]  R. L. Collins,et al.  Binge drinking among underage college students: a test of a restraint-based conceptualization of risk for alcohol abuse. , 2001, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[24]  Clayton Neighbors,et al.  Personalized mailed feedback for college drinking prevention: a randomized clinical trial. , 2007, Journal of consulting and clinical psychology.

[25]  M. Martens,et al.  Development of the Protective Behavioral Strategies Survey. , 2005, Journal of studies on alcohol.

[26]  R. Room,et al.  Problem Drinking Among American Men , 1974 .

[27]  C. Werch.  Behavioral self-control strategies for deliberately limiting drinking among college students. , 1990, Addictive behaviors.

[28]  A. Luebbe,et al.  Reciprocal Relations of Protective Behavioral Strategies and Risk-Amplifying Behaviors with Alcohol-Related Consequences: Targets for Intervention with Female College Students. , 2009 .

[29]  Internet-based personalized feedback to reduce 21st-birthday drinking: a randomized controlled trial of an event-specific prevention intervention. , 2009, Journal of consulting and clinical psychology.

[30]  W. Miller,et al.  The Check-up: A model for early intervention in addictive behaviors. , 1989 .

[31]  Kennon M. Sheldon,et al.  There's nothing more practical than a good theory: integrating motivational interviewing and self-determination theory. , 2006, The British journal of clinical psychology.

[32]  D. Kaysen,et al.  Use of drinking protective behavioral strategies in association to sex-related alcohol negative consequences: the mediating role of alcohol consumption. , 2010, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[33]  K. Carey,et al.  A review of the use of self-control techniques in the treatment of alcohol abuse , 1985, Cognitive Therapy and Research.

[34]  H. Kraemer,et al.  Mediators and moderators of treatment effects in randomized clinical trials. , 2002, Archives of general psychiatry.

[35]  K. Carey,et al.  Computer-delivered interventions to reduce college student drinking: a meta-analysis. , 2009, Addiction.

[36]  J. MacKillop,et al.  Relative reinforcing efficacy of alcohol among college student drinkers. , 2006, Experimental and clinical psychopharmacology.

[37]  J. Arnett.  The Developmental Context of Substance use in Emerging Adulthood , 2005 .

[38]  L. Sobell,et al.  Controlled drinking after 25 years: how important was the great debate? , 1995, Addiction.

[39]  C. Werch,et al.  Relationship between self-control and alcohol consumption patterns and problems of college students. , 1988, Journal of studies on alcohol.

[40]  D. Gorman,et al.  Factor Analysis of Internal and External Self-Control Practices for Alcohol Consumption , 1986, Psychological reports.

[41]  Melissa A Lewis,et al.  Gender-specific normative perceptions of alcohol-related protective behavioral strategies. , 2009, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[42]  Kelly S. DeMartini,et al.  Injunctive norms for alcohol-related consequences and protective behavioral strategies: effects of gender and year in school. , 2011, Addictive behaviors.

[43]  Kari K. Taylor,et al.  Protective behavioral strategies when drinking alcohol and their relationship to negative alcohol-related consequences in college students. , 2004, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[44]  M. Martens,et al.  The role of college students' use of protective behavioral strategies in the relation between binge drinking and alcohol-related problems. , 2011, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[45]  R. Munoz,et al.  How to Control Your Drinking , 1982 .

[46]  Dawn E. Sugarman,et al.  Drink less or drink slower: the effects of instruction on alcohol consumption and drinking control strategy use. , 2009, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[47]  S. Sadava.  Problem behavior theory and consumption and consequences of alcohol use. , 1985, Journal of studies on alcohol.

[48]  Shawn A. Lawrence,et al.  Protective Strategies and Alcohol Use Among College Students: Ethnic and Gender Differences , 2010, Journal of ethnicity in substance abuse.

[49]  J. Delva,et al.  A Study of the Relationship Between Protective Behaviors and Drinking Consequences Among Undergraduate College Students , 2004, Journal of American college health : J of ACH.

[50]  Andrew Lac,et al.  The Use of Protective Behavioral Strategies is Related to Reduced Risk in Heavy Drinking College Students with Poorer Mental and Physical Health , 2010, Journal of drug education.

[51]  Anne E. Ray,et al.  Social-cognitive correlates of protective drinking behaviors and alcohol-related consequences in college students. , 2009, Addictive behaviors.