Skip to main content

Advertisement

SpringerLink
Log in

The Efficacy of a Standalone Protective Behavioral Strategies Intervention for Students Accessing Mental Health Services

  • Published:
Prevention Science Aims and scope Submit manuscript

Abstract

Students with poor mental health are at increased risk for problematic alcohol use. These students also tend to underutilize alcohol-related protective behavioral strategies (PBS). Cross-sectional studies indicate that PBS use may be particularly useful for students with mental health challenges; however, it is unclear whether training these students to use PBS is an effective approach for reducing alcohol use and consequences. The current study evaluated the efficacy of a standalone PBS skills training and personalized feedback (PBS-STPF) intervention among students accessing mental health services. Participants (N = 251) were randomly assigned to either an individual facilitator-led PBS-STPF intervention or a health-related control condition. Participants completed online follow-up surveys 1 and 6 months post-intervention which included measures of alcohol use, negative consequences, and a composite measure of PBS use. Relative to control participants, students in the PBS-STPF condition reported significantly greater PBS use but no differences in alcohol use or consequences. Participants in both conditions reported decreases in drinking outcomes over time. Tests of mediation indicated that the intervention indirectly led to reduction in drinking outcomes at 6 months through increased PBS use. Although the intervention resulted in changes in PBS use that were maintained for up to 6 months post-intervention, the effects of the intervention on drinking and consequences were limited. A brief standalone PBS training may need augmentation in order to promote effective use of PBS for substantial decreases in alcohol consequences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • American College Health Association (2011). American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2011. Hanover, MD: Author.

  • American College Health Association. (2007). American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2011 (abridged). Journal of American College Health, 55, 195–206. doi:10.3200/JACH. 55.4.195-206.

  • Araas, T., & Adams, T. (2008). Protective behavioral strategies and negative alcohol-related consequences in college students. Journal of Drug Education, 38, 211–224. doi:10.2190/DE.38.3.b.

    Article  PubMed  Google Scholar 

  • Baer, J. S. (1993). Etiology and secondary prevention of alcohol problems with young adults. In J. S. Baer, G. A. Marlatt, & R. J. McMahon (Eds.), Addictive behaviors across the lifespan (pp. 111–137). Newbury Park: Sage.

    Google Scholar 

  • Barnett, N. P., Murphy, J. G., Colby, S. M., & Monti, P. M. (2007). Efficacy of counselor vs. computer-delivered intervention with mandated college students. Addictive Behaviors, 32, 2529–2548. doi:10.1016/j.addbeh.2007.06.017.

    Article  PubMed Central  PubMed  Google Scholar 

  • Barry, A. E. (2007). Using theory-based constructs to explore the impact of Greek membership on alcohol-related beliefs and behaviors: A systematic literature review. Journal of American College Health, 56, 307–315. doi:10.3200/Jach. 56.3.307-316.

  • Britton, P. (2004). The relation of coping strategies to alcohol consumption and alcohol-related consequences in a college sample. Addiction Research and Theory, 12, 103–114. doi:10.1080/16066350310001613062.

    Article  Google Scholar 

  • Camatta, C. D., & Nagoshi, C. T. (1995). Stress, depression, irrational beliefs, and alcohol use and problems in a college student sample. Alcoholism: Clinical and Experimental Research, 19, 142–146. doi:10.1111/j.1530-0277.1995.tb01482.x.

    Article  CAS  Google Scholar 

  • Center for the Study of Collegiate Mental Health (2009). 2009 Pilot Study: Executive Summary. Retrieved from http://www.sa.psu.edu/caps/pdf/2009-CSCMH-Pilot-Report.pdf.

  • Collins, R. L., Parks, G. A., & Marlatt, G. A. (1985). Social determinants of alcohol consumption: The effects of social interaction and model status on the self-administration of alcohol. Journal of Consulting and Clinical Psychology, 53, 189–200. doi:10.1037/0022-006X.53.2.189.

    Article  CAS  PubMed  Google Scholar 

  • Cooper, M. L., Agocha, V. B., & Sheldon, M. S. (2000). A motivational perspective on risky behaviors: The role of personality and affect regulatory processes. Journal of Personality, 68, 1059–1088.

    Article  CAS  PubMed  Google Scholar 

  • Crawford, J. R., & Henry, J. D. (2003). The Depression Anxiety Stress Scales (DASS): Normative data and latent structure in a large non-clinical sample. British Journal of Clinical Psychology, 42, 111–131.

    Article  PubMed  Google Scholar 

  • Dawson, D. A., Grant, B. F., Stinson, F. S., & Chou, P. S. (2005). Psychopathology associated with drinking and alcohol use disorders in the college and general adult populations. Drug and Alcohol Dependence, 77, 139–150. doi:10.1016/j.drugalcdep.2004.07.012.

    Article  PubMed  Google Scholar 

  • Erdur-Baker, O., Aberson, C. L., Barrow, J. C., & Draper, M. R. (2006). Nature and severity of college students’ psychological concerns: A comparison of clinical and nonclinical national samples. Professional Psychology: Research and Practice, 37, 317–323. doi:10.1037/0735-7028.37.3.317.

    Article  Google Scholar 

  • Frank, C., Thake, J., & Davis, C. G. (2012). Assessing the protective value of protective behavioral strategies. Journal of Studies on Alcohol and Drugs, 73, 839–843.

    Article  PubMed  Google Scholar 

  • Gallager, R. (2006). national survey of counseling center directors. Washington D.C: International Association of Counseling Services.

  • Gallagher, R. P. (2006). National survey of counseling center directors. International Association of Counseling Services. Arlington, VA. Retrieved from http://www.collegecounseling.org/pdf/2006_survey.pdf.

  • Ham, L. S., & Hope, D. A. (2003). College students and problematic drinking: A review of the literature. Clinical Psychology, 23, 719–759. doi:10.1016/S0272-7358(03)00071-0.

    Google Scholar 

  • Hayes, A. F. (2009). Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. Communication Monographs, 76, 408–420. doi:10.1080/03637750903310360.

    Article  Google Scholar 

  • Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44, 227–239. doi:10.1348/014466505X29657.

    Article  PubMed  Google Scholar 

  • Kahler, C. W., Strong, D. R., & Read, J. P. (2005). Toward efficient and comprehensive measurement of the alcohol problems continuum in college students: The Brief Young Adult Alcohol Consequences Questionnaire. Alcoholism, Clinical and Experimental Research, 29, 1180–1189. doi:10.1097/01.ALC.0000171940.95813.A5.

  • Kahler, C. W., Hustad, J., Barnett, N. P., Strong, D. R., & Borsari, B. (2008). Validation of the 30-day version of the Brief Young Adult Alcohol Consequences Questionnaire for use in longitudinal studies. Journal of Studies on Alcohol and Drugs, 69, 611–615.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kenney, S. R., Napper, L. E., Martens, M. P., & LaBrie, J. W. (2014). Examining the efficacy of a brief group protective behavioral strategies skills training intervention with college women. Psychology of Addictive Behaviors, 28, 1041–1051. doi:10.1037/a0038173.

  • Kuntsche, E., Knibbe, R., Gmel, G., & Engels, R. (2005). Why do young people drink? A review of drinking motives. Clinical Psychology, 25, 841–861. doi:10.1016/j.cpr.2005.06.002.

    Google Scholar 

  • LaBrie, J. W. (2009). [Alcohol use among first time clients at a college counselling center]. Unpublished raw data.

  • LaBrie, J. W., Kenney, S. R., Lac, A., Garcia, J. A., & Ferraiolo, P. (2009). Mental and social health impacts the use of protective behavioral strategies in reducing risky drinking and alcohol consequences. Journal of College Student Development, 50, 35–49. doi:10.1353/csd.0.0050.

    Article  PubMed Central  PubMed  Google Scholar 

  • LaBrie, J. W., Kenney, S. R., & Lac, A. (2010). The use of protective behavioral strategies is related to reduced risk in heavy drinking college students with poorer mental and physical health. Journal of Drug Education, 40, 361–378. doi:10.2190/DE.40.4.c.

    Article  PubMed Central  PubMed  Google Scholar 

  • Larimer, M. E., & Cronce, J. M. (2007). Identification, prevention, and treatment revisited: Individual-focused college drinking prevention strategies 1999–2006. Addictive Behaviors, 32, 2439–2468. doi:10.1016/j.addbeh.2007.05.006.

    Article  PubMed  Google Scholar 

  • Larimer, M. E., Lee, C. M., Kilmer, J. R., Fabiano, P. M., Stark, C. B., Geisner, I. M., & Neighbors, C. (2007). Personalized mailed feedback for college drinking prevention: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 75, 285–293. doi:10.1037/0022-006X.75.2.285.

  • Litt, D. M., Lewis, M. A., Blayney, J., & Kaysen, D. (2013). Anxiety as a mediator of the protective behavioral strategy and alcohol use relationship. Journal of Studies on Alcohol and Drugs, 74, 168–174.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lovibond, P. F., & Lovibond, S. H. (1995a). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, 335–343. doi:10.1016/0005-7967(94)00075-U.

    Article  CAS  PubMed  Google Scholar 

  • Lovibond, S. H., & Lovibond, P. F. (1995b). Manual for the depression, anxiety and stress scales (2nd ed.). Sydney: Psychology Foundation.

    Google Scholar 

  • Geisner, I. M., Larimer, M. E., & Neighbors, C. (2004). The relationship among alcohol use, related problems, and symptoms of psychological distress: Gender as a moderator in a college sample. Addictive Behavior, 29, 843–848. doi:10.1016/j.addbeh.2004.02.024.

  • Marlatt, G. A., Baer, J. S., & Larimer, M. E. (1995). Preventing alcohol abuse in college students: A harm-reduction approach. In G. M. Boyd, J. Howard, & R. A. Zucker (Eds.), Alcohol problems among adolescents: Current directions in prevention research (pp. 147–172). Hillsdale: Lawrence Erlbaum Associates, Inc.

  • Martens, M. P., Ferrier, A. G., Sheehy, M. J., Korbett, K., Anderson, D. A., & Simmons, A. (2005). Development of the protective behavioral strategies survey. Journal of Studies on Alcohol, 66, 698–705.

    Article  PubMed  Google Scholar 

  • Martens, M. P., Martin, J. L., Hatchett, E. S., Fowler, R. M., Fleming, K. M., Karakashian, M. A., & Cimini, M. D. (2008). Protective behavioral strategies and the relationship between depressive symptoms and alcohol-related negative consequences among college students. Journal of Counseling Psychology, 55, 535–541. doi:10.1037/a0013588.

    Article  PubMed Central  PubMed  Google Scholar 

  • Martens, M. P., Smith, A. E., & Murphy, J. G. (2013). The efficacy of single-component brief motivational interventions among at-risk college drinkers. Journal of Consulting & Clinical Psychology. doi:10.1037/a0032235.

    Google Scholar 

  • Martin, R. J., Cremeens, J. L., Umstattd, M. R., Usdan, S. L., Talbott-Forbes, L., & Garner, M. M. (2012). Drinking behaviour, protective behavioural strategies and school performance of college students. Drugs: Education, Prevention & Policy, 19, 64–71. doi:10.3109/09687637.2011.560910.

    Google Scholar 

  • Monti, P. M., Rohsenow, D. J., & Hutchison, K. E. (2000). Toward bridging the gap between biological, psychobiological and psychosocial models of alcohol craving. Addiction, 95, 229–236.

    Article  Google Scholar 

  • Murphy, J. G., Skidmore, J. R., Dennhardt, A. A., Martens, M. P., Borsari, B., Barnett, N. P., & Colby, S. M. (2012). A behavioral economic supplement to brief motivational interventions for college drinking. Addiction Research & Theory, 20, 456–465. doi:10.3109/16066359.2012.665965.

    Article  Google Scholar 

  • Napper, L. E., Kenney, S. R., Lac, A., Lewis, L. J., & LaBrie, J. W. (2014). A cross-lagged panel model examining protective behavioral strategies: Are types of strategies differentially related to alcohol use and consequences? Psychology of Addictive Behaviors, 39, 480–486. doi:10.1016/j.addbeh.2013.10.020.

    Article  Google Scholar 

  • Neighbors, C., Dillard, A. J., Lewis, M. A., Bergstrom, R. L., & Neil, T. A. (2006). Normative misperceptions and temporal precedence of perceived norms and drinking. Journal of Studies on Alcohol, 67, 290–299.

    Article  PubMed Central  PubMed  Google Scholar 

  • Nelson, T. F., Xuan, Z., Lee, H., Weitzman, E. R., & Wechsler, H. (2009). Persistence of heavy drinking and ensuing consequences at heavy drinking colleges. Journal of Studies on Alcohol and Drugs, 70, 726–734.

    Article  PubMed  Google Scholar 

  • O’Malley, P. M., & Johnston, L. D. (2002). Epidemiology of alcohol and other drug use among American college students. Journal of Studies on Alcohol, 23–39.

  • Park, C. L., & Grant, C. (2005). Determinants of positive and negative consequences of alcohol consumption in college students: Alcohol use, gender, and psychological characteristics. Addictive Behaviors, 30, 755–765. doi:10.1016/j.addbeh.2004.08.021.

    Article  PubMed  Google Scholar 

  • Park, C. L., Armeli, S., & Tennen, H. (2004). The daily stress and coping process and alcohol use among college students. Journal of Studies on Alcohol, 65, 126–135.

    Article  PubMed  Google Scholar 

  • Patrick, M. E., Lee, C. M., & Larimer, M. E. (2011). Drinking motives, protective behavioral strategies, and experienced consequences: Identifying students at risk. Addictive Behaviors, 36, 270–273. doi:10.1016/j.addbeh.2010.11.007.

    Article  PubMed Central  PubMed  Google Scholar 

  • Pearson, M. R., Kite, B. A., & Henson, J. M. (2012a). The assessment of protective behavioral strategies: Comparing prediction and factor structures across measures. Psychology of Addictive Behaviors, 26, 573–584. doi:10.1037/A0028187.

    Article  PubMed  Google Scholar 

  • Pearson, M. R., Kite, B. A., & Henson, J. M. (2012b). Predictive effects of good self-control and poor regulation on alcohol-related outcomes: Do protective behavioral strategies mediate? Psychology of Addictive Behaviors. doi:10.1037/a0028818.

    Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36, 717–731.

    Article  Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891. doi:10.3758/BRM.40.3.879.

    Article  PubMed  Google Scholar 

  • Ray, A. E., Turrisi, R., Abar, B., & Peters, K. E. (2009). Social-cognitive correlates of protective drinking behaviors and alcohol-related consequences in college students. Addictive Behaviors, 34, 911–917. doi:10.1016/j.addbeh.2009.05.016.

    Article  PubMed Central  PubMed  Google Scholar 

  • Scott-Sheldon, L. A., Carey, K. B., & Carey, M. P. (2008). Health behavior and college students: Does Greek affiliation matter? Journal of Behavioral Medicine, 31, 61–70. doi:10.1007/s10865-007-9136-1.

    Article  PubMed Central  PubMed  Google Scholar 

  • Simons, J. S., Gaher, R. M., Correia, C. J., Hansen, C. L., & Christopher, M. S. (2005). An affective-motivational model of marijuana and alcohol problems among college students. Psychology of Addictive Behaviors, 19, 326. doi:10.1037/0893-164X.19.3.326.

    Article  PubMed  Google Scholar 

  • Sugarman, D. E., & Carey, K. B. (2007). The relationship between drinking control strategies and college student alcohol use. Psychology of Addictive Behaviors, 21, 338–345. doi:10.1037/0893-164X.21.3.338.

    Article  PubMed Central  PubMed  Google Scholar 

  • Sugarman, D. E., & Carey, K. B. (2009). Drink less or drink slower: The effects of instruction on alcohol consumption and drinking control strategy use. Psychology of Addictive Behaviors, 23, 577–585. doi:10.1037/a0016580.

    Article  PubMed Central  PubMed  Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston: Allyn & Bacon.

    Google Scholar 

  • Wechsler, H., & Nelson, T. F. (2006). Relationship between level of consumption and harms in assessing drink cut-points for alcohol research: Commentary on “Many college freshmen drink at levels far beyond the binge threshold” by White et al. Alcoholism: Clinical & Experimental Research, 30, 922–927. doi:10.1111/j.1530-0277.2006.00124.x.

    Article  Google Scholar 

  • Wechsler, H., & Nelson, T. F. (2008). 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. Journal of Studies on Alcohol and Drugs, 69, 481–490.

    Article  PubMed  Google Scholar 

  • Weitzman, E. R. (2004). Poor mental health, depression, and associations with alcohol consumption, harm, and abuse in a national sample of young adults in college. Journal of Nervous and Mental Disease, 192, 269–277. doi:10.1097/01.nmd.0000120885.17362.94.

    Article  PubMed  Google Scholar 

  • Zhao, X. S., Lynch, J. G., & Chen, Q. M. (2010). Reconsidering Baron and Kenny: Myths and truths about mediation analysis. Journal of Consumer Research, 37, 197–206. doi:10.1086/651257.

    Article  Google Scholar 

Download references

Acknowledgments

This research was supported by Grant R21AA020104 from the National Institute of Alcohol Abuse and Alcoholism (NIAAA). Support for Drs. Napper and Kenney was provided by ABMRF/The Foundation for Alcohol Research. Dr. Kenney is also supported by Grant T32AA007459 (NIAAA). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIAAA or the National Institutes of Health.

Conflict of Interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Psychology, Loyola Marymount University, 1 LMU Drive, Suite 4700, Los Angeles, CA, 90045, USA

    Joseph W. LaBrie

  2. Department of Psychology, Lehigh University, 17 Memorial Drive East, Chandler-Ullmann Hall, Bethlehem, PA, 18015, USA

    Lucy E. Napper

  3. Department of Psychology, Pennsylvania State University, 140 Moore Building, University Park, PA, 16802, USA

    Elizabeth M. Grimaldi

  4. Center for Alcohol and Addiction Studies, Brown University, Box G-S121-4, Providence, RI, 02912, USA

    Shannon R. Kenney

  5. Division of Behavioral and Organizational Sciences, Claremont Graduate University, 123 E. 8th Street, Claremont, CA, 91711, USA

    Andrew Lac

Authors
  1. Joseph W. LaBrie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lucy E. Napper
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elizabeth M. Grimaldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shannon R. Kenney
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andrew Lac
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joseph W. LaBrie.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

LaBrie, J.W., Napper, L.E., Grimaldi, E.M. et al. The Efficacy of a Standalone Protective Behavioral Strategies Intervention for Students Accessing Mental Health Services. Prev Sci 16, 663–673 (2015). https://doi.org/10.1007/s11121-015-0549-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11121-015-0549-8

Keywords

Search

Navigation