Protective behavioral strategies and mental health: Reducing alcohol-related risk

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DESCRIPTION (provided by applicant): Escalating rates of psychological distress among college students create a new and, as yet, understudied area of concern for college personnel interested in reducing alcohol-related problems. Not only do students with poorer mental health (anxiety, depression, greater levels of psychological distress in comparison to peers) drink at levels equivalent to other students, but when controlling for drinking, they experience significantly more alcohol-related negative consequences. However, few alcohol interventions have targeted this population despite that fact that efforts to uncover effective strategies to reduce risk among students with co-morbid mental health issues and high-risk drinking hold wide implications. Further, our preliminary cross-sectional work has found that among students spontaneously employing cognitive behavioral protective behavioral strategies (PBS; e.g., spacing out drinks, avoiding risky activities while drinking such as playing drinking games or driving) aimed at reducing drinking (compared to students not employing PBS), students with poorer mental health experienced significantly greater reductions in consequences than those with better mental health, even after control for drinking. While PBS skills training has been part of several multi-component brief interventions, there is no published data about its efficacy as a stand-alone intervention. Thus, the proposed study will evaluate the efficacy of a stand-alone PBS cognitive-behavioral skills training with personalized feedback (PBS-STPF) intervention at increasing PBS use and reducing risky drinking and negative consequences among students seeking services from a college counseling center. Participants will be 350 student-clients from a college counseling center (60% female) who have had at least one heavy episodic drinking event in the past month. They will be randomized to either the PBS-STPF intervention or health information control condition. Both conditions involve completing a baseline survey on a computer followed by a one-one-one 20- 25 minute discussion. The PBS-STF intervention utilizes a personal PBS feedback sheet to reinforce existing PBS use while suggesting other protective strategies that the participant may use in the future. Participants will also explore ways to implement these strategies in frequently encountered and high-risk situations and explore ways to overcome barriers to implementation. Following either the PBS intervention or control discussion, the participants will be assessed via online surveys twice (1-month and 6-months post-intervention). We will also evaluate whether PBS use mediates intervention efficacy and whether level of severity of psychological distress and coping motives for drinking moderate intervention efficacy. This project will provide valuable information on both the efficacy of a cognitive behavioral based PBS stand-alone intervention among students with poorer mental health and preliminary data on relationships between various levels of general and specific mental health, alcohol use, and negative alcohol-related consequences. PUBLIC HEALTH RELEVANCE: This study evaluates the efficacy of a protective behavioral strategies (PBS) cognitive-behavioral skills training with personalized feedback (PBS-STPF) intervention aimed at increasing PBS use and reducing risky drinking and negative consequences among students seeking services from a college counseling center.