Childhood bullying victimization, emotion regulation, rumination, distress tolerance, and depressive symptoms: A cross-national examination among young adults in seven countries.

Existing research suggests a robust association between childhood bullying victimization and depressive symptoms in adulthood, but less is known about potential mediators of this link. Furthermore, there is limited cross-national research evaluating similarities and differences in bullying victimization and its associations with mental health. The current study addressed gaps in the literature by evaluating cognitive and affective responses to stress (i.e., emotion regulation, rumination, and distress tolerance) as potential mediators of the link between recalled bullying victimization and current depressive symptoms among 5909 (70.6% female) college students from seven countries. Results revealed specific indirect associations of bullying victimization through distress tolerance and three out of four facets of rumination, as well as a persistent direct association of childhood bullying on adulthood depression. Emotion regulation strategies were not significantly associated with bullying victimization and did not mediate its association with depressive symptoms. Constrained multigroup models indicated that results were invariant across country and gender. Findings provide evidence of statistical mediation in a cross-sectional sample and await replication in prospective studies. Rumination and distress tolerance may be promising targets for resilience-promoting interventions among children experiencing peer victimization. Ongoing research is needed to clarify cross-national patterns in childhood bullying, identify additional mediators accounting for the remaining direct association, and evaluate emotion regulation as a potential moderator of associations between bullying victimization and adult mental health.

The Association Between Mindfulness Facets and Substance Use via Emotional Psychopathology and Coping Motives in Argentinian College Students.

Background: Prior studies suggest that lower levels of mindfulness contribute to the motivation of using alcohol to cope with distress. Research examining this possibility is scarce or limited to alcohol, but not marijuana, related outcomes. Objectives: We examined separate models (for alcohol and for marijuana) to determine the associations between trait mindfulness (describing, acting with awareness, non-judging, non-reactivity) and alcohol and marijuana outcomes (use indicators and negative consequences) via emotional psychopathology (i.e., a latent variable assessing symptoms of depression and anxiety) and alcohol/marijuana coping motives. Results: The final analytic sample consisted of 456 participants (Mean age = 22.96 ± 3.12 years; 66.2% women) for the alcohol model; and 232 participants (Mean age = 22.96 ± 3.01 years; 66.2% women) for the marijuana model. Two path models were conducted, such that indirect paths were examined for each trait mindfulness facet on alcohol/marijuana outcomes (e.g., describing → emotional psychopathology → alcohol coping motives → binge drinking frequency). Within the comprehensive alcohol model, describing, acting with awareness, non-judging and non-reactivity were associated with less binge drinking frequency and lower number of alcohol-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of drinking to cope motives. For the marijuana model, describing, acting with awareness, and non-judging of inner experience were associated with less marijuana quantity (grams) consumed and lower number of marijuana-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of marijuana coping motives. Conclusions: Prevention and intervention programs of alcohol and marijuana in Argentina may benefit from improving mindfulness skills and targeting emotional psychopathology and motives to use drugs, to prevent or reduce negative drug-related consequences.

Childhood Traumatic Experiences and Negative Alcohol-Related Consequences in Adulthood: A Cross-Cultural Examination of Distress Tolerance and Drinking to Cope.

Background: Prior research has established that Adverse Childhood Experiences (ACEs) predict harmful alcohol use outcomes. However, underlying mechanisms that could explain these associations are less clear. The present study examined if ACEs are indirectly related to alcohol negative consequences through their associations with distress tolerance and drinking to cope. Method: A sample of 3,763 (71.9% female) college students who drink alcohol from seven countries (U.S., Argentina, Canada, Uruguay, Spain, South Africa, and England) completed online surveys. Path analysis was performed within the whole sample testing the serial unique associations between ACEs→distress tolerance→drinking to cope→negative alcohol-related consequences. Multi-group analysis was performed to determine if the proposed pathways were invariant across gender and countries. Results: Both distress tolerance and drinking to cope uniquely accounted for the relationship between ACEs and negative alcohol-related consequences. Additionally, a significant double-mediation effect was found illustrating that a higher endorsement of ACEs was associated with lower distress tolerance, which in turn was associated with higher drinking to cope, which in turn was associated with more negative alcohol-related consequences. These effects were invariant across countries and gender groups. Conclusions: These findings provide support for the relevance of distress tolerance and coping motives as potential factors in linking ACEs to problematic alcohol use across nations. Our data are consistent with the idea that intervening on distress tolerance and drinking motives could mitigate downstream alcohol-related consequences related to ACEs in college student populations around the world.

Utility of the Brief Young Adult Alcohol Consequences Questionnaire to Identify College Students At-Risk for Alcohol Related Problems: Relative Operating Characteristics across Seven Countries.

Background: It is important to identify students who would benefit from early interventions to reduce harmful drinking patterns and associated consequences. the Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ) could be particularly useful as a screening tool in university settings. Objectives. The present study examined the utility of the B-YAACQ to distinguish among students at-risk for problematic alcohol use as measured by the AUDIT. Objectives: The present study examined the utility of the B-YAACQ to distinguish among students at-risk for problematic alcohol use as measured by the AUDIT. Methods: A sample of 6382 students (mean age=20.28, SD=3.75, 72.2% females) from seven countries (i.e., U.S., Canada, South-Africa, Spain, Argentina, Uruguay, England) completed the B-YAACQ, the AUDIT and different measures of alcohol use. Results: ROC analyses suggested that a cutoff score of 5 maximized the YAACQ's discrimination utility to differentiate between students at low versus moderate/high risk in the total sample and across countries (except in Canada, where the cutoff was 4). In addition, a cutoff of 7 differentiated between students at low/moderate versus high risk in the total sample, while cutoffs of 10, 9, 8 and 7 differentiate between students at low/moderate versus high risk in Uruguay, U.S and Spain (10), Argentina (9), England (8), and Canada and South-Africa (7), respectively. Students classified at the three risk levels (i.e., low, moderate and high) differed in age (i.e., a younger age was associated with higher risk) and drinking patters (i.e., higher drinking frequency, quantity, binge drinking and AUDIT and B-YAACQ scores in the higher risk groups). Conclusions: This study suggest that the B-YAACQ is a useful tool to identify college students at-risk for experiencing problematic patterns of alcohol use.

A cross-national examination of cannabis protective behavioral strategies' role in the relationship between Big Five personality traits and cannabis outcomes.

Background: Problematic cannabis use is common among young adults across the world. However, limited research has examined whether etiological models predicting negative consequences are universal.Objective: The present study examined whether the Five-Factor Model of personality (openness, conscientiousness, extraversion, agreeableness, and neuroticism) relates to cannabis outcomes via use of cannabis protective behavioral strategies (PBS) in a cross-national sample of college student cannabis users (i.e., used cannabis in the last 30 days).Method: Participants were 1175 university students (63.27% female) across five countries (United States, Argentina, Spain, Uruguay, and the Netherlands) recruited to complete an online survey.Results: PBS use mediated the associations between personality traits and cannabis consequences, such that higher conscientiousness (ß = .20), agreeableness (ß = .11), and lower emotional stability [i.e., higher neuroticism] (ß = -.14) were associated with more PBS use. Higher PBS use was, in turn, associated with lower frequency of cannabis use (ß = -.32); lower frequency of use was then associated with fewer cannabis consequences (ß = .34). This sequential pathway was invariant across sex, but not countries. Notably, there were a number of differences in links between PBS and cannabis outcomes when comparing countries (e.g., negative associations in the US sample, but positive associations in the Argentina sample).Conclusions: Cannabis PBS mediates the relationship between personality traits and cannabis outcomes, but there are nuanced differences across countries (i.e., relationship between PBS and cannabis outcomes). Overall, students that are low in conscientiousness, agreeableness, and neuroticism and/or report low rates of PBS use may benefit from cannabis PBS-focused interventions that promote utilization of PBS.

Measuring Impaired Control over Cannabis Use: Initial Evaluation of the Impaired Control Scale-Cannabis (ICS-C).

Background: Impaired control is a central concept in addiction. Impaired control over alcohol has been associated with heavy drinking and alcohol-related problems in young adults, but there is less research on impaired control over cannabis. Currently, there is no validated self-report instrument that comprehensively assesses impaired control over cannabis use. This study examined the factor structure, reliability, and validity of a new measure, the Impaired Control Scale-Cannabis (ICS-C), which was adapted from the widely used Impaired Control Scale (ICS) for alcohol. Method: The sample consisted of students at two Canadian universities who reported past-month cannabis use (N = 362; 63% women; 66% White, mean age = 19.91). Participants completed an online survey including the ICS-C and ICS, along with measures of cannabis use, cannabis problems, alcohol use, impulsivity, and self-regulation. Results: After trimming problematic and redundant items, the final exploratory factor analysis of the ICS-C items yielded two factors: Attempted Control (attempts to control cannabis use) and Failed Control (unsuccessful attempts to limit cannabis use). High correlations between the ICS-C subscales and the Impaired Control subscale of the Marijuana Consequences Questionnaire provided evidence for convergent validity. Support for concurrent and discriminant validity was observed in the associations of the ICS-C subscales with cannabis use, cannabis problems, impulsivity, self-regulation, alcohol use, and the alcohol ICS. Conclusions: The ICS-C is a promising tool for assessing impaired control over cannabis in young adults. Future research should further validate the ICS-C and examine its potential clinical utility for identifying individuals at risk for cannabis use disorder.

The Association between Distress Tolerance and Alcohol Outcomes via Internal Drinking Motives.

INTRODUCTION: Previous work suggests that college students who perceive themselves as less able to tolerate negative affect are more motivated to use alcohol to alleviate psychological distress. Recent findings also indicate that distress tolerance influences alcohol outcomes via a positive reinforcement pathway. However, results concerning the association between distress tolerance and alcohol outcomes remain inconsistent. Aim: The present study examined the association between distinctive features of distress tolerance and alcohol outcomes via internal drinking motives (i.e., coping and enhancement) in Argentinean college students. Method: From April to November 2019, a sample of 387 college students with last-month alcohol use (Mean age = 21.09 ± 4.98) completed an online survey assessing alcohol outcomes (past-month frequency of binge drinking and negative alcohol-related consequences), internal drinking motives, and four components of distress tolerance (i.e., tolerance, appraisal, absorption, and regulation). Results: The associations between specific facets of distress tolerance and drinking outcomes were atemporally mediated by coping and enhancement motives. Coping motives significantly mediated the effect of absorption and appraisal on alcohol-related problems (i.e., lower absorption and lower appraisal were associated with more problems via higher coping motives). Enhancement motives significantly mediated the effect of absorption (lower absorption was associated with greater enhancement motives) on binge drinking frequency and alcohol-related problems. Conclusions: Distress tolerance was associated with alcohol outcomes via coping and enhancement motives in this sample of Argentinean undergraduates. The ability to withstand negative affect could be a focal point of interventions to prevent the development of maladaptive patterns of drinking.

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.

Compounding Privilege, Resilience, and Nonmedical Prescription Stimulant Use among College Students.

Background: In this study, we examined why non-Hispanic White cisgender men are more likely than other subgroups to misuse prescription stimulants in college. The objective of the current study was to use a strength-based framework to examine intersectional demographic predictors. Methods: We examined gender and race/ethnicity as predictors of nonmedical prescription stimulant use (NPS) among college students. We also investigated resilience as a moderator. This report uses data from an online multisite study conducted at seven universities with 4,764 undergraduate students (70.1% women and 52.0% People of Color). Results: We found that college students who were cisgender men and non-Hispanic White used NPS significantly more than students who identified as another gender and as People of Color. There was also a buffering effect of resilience between race/ethnicity and NPS, such that resilience predicted lower NPS for People of Color, but not non-Hispanic White people 28% of the time. Conclusions: It may be that Students of Color are more resilient than non-Hispanic White students, and this resilience is protective of NPS use in college. Importantly, a compounding-privilege and/or intersectional approach to identity is crucial to fully understanding behavior (in this case NPS) in a diversity of college students; future studies should continue to use and develop such approaches.

ELSA 2018 Cohort: Protective Behavioral Strategies as Mediators of the Relationship between Risk Factors and Alcohol Outcomes in Argentinean College Freshmen.

AIMS: The present study examined which types of alcohol protective behavioral strategies ([PBSs], Manner of Drinking [MOD] strategies, Serious Harm Reduction [SHR] or Limiting/Stopping Drinking strategies [LSD]) mediate the effects of a comprehensive number of distal antecedents on alcohol drinking quantity and alcohol-related negative consequences. METHODS: A sample of 762 last-month college freshman drinkers from Argentina (Mean age = 19.60 ± 3.80) completed a survey that assessed alcohol outcomes (drinking quantity during a typical week and alcohol-related negative consequences), frequency of use of PBS and a set of distal antecedents (i.e. age at drinking onset, drinking motives, college alcohol beliefs and impulsivity-like traits). RESULTS: MOD significantly mediated the effects of college alcohol beliefs (higher beliefs were associated with lower MOD use) and coping motives (higher coping motives were associated with lower MOD use) on alcohol outcomes. SHR significantly mediated the effects of sex (women reported more frequent SHR use) and enhancement motives (higher motivation was associated with lower SHR use) on alcohol-related negative consequences. CONCLUSION: Our findings partially support a mediational role of PBS in the association between risk factors and alcohol outcomes, and offer valuable information for the design of interventions to reduce alcohol use in South-American college students. More studies examining PBS as mediators of distal antecedents are needed to fully understand the peculiarities of these associations in different cultures.

Anxiety Symptoms and Alcohol-Related Problems among College Students: A Moderated-Mediation Model of Rumination and Emotion Dysregulation.

OBJECTIVES: Prior research has individually linked rumination, anxiety, and emotion dysregulation to alcohol misuse, but limited research has examined a comprehensive model linking these variables together. The present study tested a moderated-mediation model to examine whether emotion dysregulation moderated the indirect association of anxiety symptoms on alcohol-related problems via ruminative thinking styles. Method: Participants were 448 college students who consumed alcohol in the previous month. A plurality of participants identified as being White, non-Hispanic (40.6%), female (68.6%), and reported a mean age of 22.75 (Median = 20.00; SD = 6.84) years. Results: Brooding and reflection subtypes of ruminative thinking mediated the association between anxiety symptoms and alcohol-related problems with higher rates of anxiety symptoms associated with higher ruminative thinking, which in turn was associated with more alcohol-related problems. Further, the indirect effect of anxiety symptoms on alcohol-related problems through ruminative thinking was stronger for individuals who reported high levels of emotion dysregulation compared to those with average and low levels of emotion dysregulation. Conclusions: In support of prior work, our results suggest that ruminative thinking, particularly brooding and reflection, are key mechanisms through which anxiety symptoms relate to problematic alcohol use, especially among individuals with high emotion dysregulation. Additional work is needed to test whether decoupling the associations between negative emotional states and ruminative thinking among college students with high emotion dysregulation is a viable intervention target to reduce problematic alcohol use.

The Relationship between Negative Affect and Alcohol and Marijuana Use Outcomes among Dual Users.

Background: Past research with college students has found that substance use motives, particularly coping motives, mediate the relationship between negative affect and alcohol- and marijuana-related outcomes. Objectives: This study aimed to investigate substance use motives of dual users of both substances (past 30-day use; not necessarily simultaneous use) and identify any mediation effects that are either common to both substances or substance-specific. Methods: The majority of dual users (n = 2,034) identified as being White, non-Hispanic (63.8%), female (69.08%), and reported a mean age of 20.24 (SD = 3.16) years. To test study aims, path models were conducted such that negative affect (stress, depressive and anxiety symptoms) were independently modeled as predictors of substance use outcomes (i.e. quantity and consequences) via substance use motives. Results: All three negative affect symptoms were indirectly related to both alcohol and marijuana consequences via coping motives, such that higher negative affect was associated with higher coping motives; which in turn were positively associated with consequences. Substance-specific effects were also found: (a) stress was indirectly related to both alcohol and marijuana use quantity via enhancement motives, (b) depressive/anxiety symptoms were indirectly related to alcohol use quantity via enhancement motives, and (c) all three negative affect symptoms were indirectly related to both marijuana use quantity and negative consequences via expansion motives. Conclusions: Findings suggests that dual users of alcohol and marijuana with negative affect symptoms engage in substance use for similar reasons as single substance users with negative affect symptoms. Intervention efforts should examine ways to replace substance-related coping and expansion methods with non-substance-related methods.

Post-traumatic stress and marijuana outcomes: The mediating role of marijuana protective behavioral strategies.

Background: The present study investigated the mediating role of protective behavioral strategies for marijuana (PBSM) on the relationship between posttraumatic stress disorder (PTSD) and marijuana outcomes (i.e. marijuana use frequency, marijuana use quantity, cannabis use disorder (CUD) symptoms, and marijuana-related problems). Methods: Participants were 1,107 traditional age college students (Mage = 20.26, SD = 3.32; 66.5% White, non-Hispanic; 68.8% female), who reported consuming marijuana at least once in the last 30 days and completed measures of PTSD symptoms, PBSM, and marijuana-related outcomes. Results: PBSM significantly mediated the positive relationships between PTSD symptoms and both CUD symptoms and marijuana-related problems. More specifically, PTSD symptoms were negatively associated with PBSM, which in turn was negatively associated with marijuana use frequency and marijuana use quantity, which were in turn positively associated with CUD symptoms and marijuana-related problems. Conclusion: Taken together, the associations between higher PTSD symptoms and greater experience of CUD symptoms and marijuana-related problems may occur because students use fewer PBSM and thus engage in larger quantity and frequency of marijuana use. These findings lend support to the utility of targeting PBSM as a harm reduction effort for students with PTSD symptoms who use marijuana.

The role of United States identity in adjustment among Veterans.

Given over 2.77 million US service members have been deployed in the past 20 years and the intense process of reintegration to civilian life, understanding factors that contribute to Veterans' mental health and substance use is critical. This study sought to understand the effects of US identity exploration, US identity commitment, US identity affirmation, and US identity centrality on substance use and symptoms of depression and anxiety. The sample consisted of 195 US military Veterans (n = 184, 53.3% women; 73.3% White; Mage = 35.12 years, SD = 9.60 years). Bivariate correlations indicated US identity affirmation was negatively associated with substance use and symptoms of depression and anxiety whereas US identity centrality was positively correlated with alcohol use. Utilizing structural equation model, US identity affirmation and US identity centrality were, respectively, negatively and positively associated with alcohol use, substance use, and symptoms of depression and anxiety. Partially consistent with our hypothesis, US identity exploration was positively associated with symptoms of anxiety. In contrast to our hypothesis, US identity commitment was not significantly associated with any outcome. Results are discussed in terms of important directions for identity research in the transition to civilian life.

The Relationship Between Social Anxiety and Alcohol and Marijuana Use Outcomes Among Concurrent Users: A Motivational Model of Substance Use.

BACKGROUND: College students with more social anxiety symptoms are particularly vulnerable to problematic alcohol and marijuana use given their susceptibility for elevated anxiety symptoms in social settings combined with the normative nature of substance use. Existing research has established substance use as coping motivated for these students when examining alcohol and marijuana use problems separately. The next step is to determine whether students with more social anxiety who use both substances do so for similar or different reasons. The current study tested a comprehensive (i.e., all variables in the same model) motivational model of alcohol/marijuana use in a sample of college students from 10 universities across the United States who endorsed both past-month alcohol and marijuana use. METHODS: College students were recruited through psychology department participant pools and completed an online survey assessing mental health symptoms, substance use motives, and substances use behaviors. Current sample comprised concurrent alcohol/marijuana users (n = 2,034), 29.6% of whom endorsed clinically indicated levels of social anxiety and nearly one-fourth exceeded the cutoff for hazardous drinking (23.2%) and hazardous marijuana use (21.9%). RESULTS: Across both substances, coping motives significantly mediated the positive relationship between social anxiety symptoms and substance use problems. Unique to alcohol, conformity motives mediated the association between social anxiety symptoms and alcohol-related problems. CONCLUSIONS: Taken together, students with more social anxiety who are focused on anxiety management may use either alcohol or marijuana; however, these students may experience more alcohol-related problems when drinking to fit in with peers.

Moral Injury, Substance Use, and Posttraumatic Stress Disorder Symptoms Among Military Personnel: An Examination of Trait Mindfulness as a Moderator.

Mindfulness-based approaches have been suggested as possible methods to treat moral injury in military personnel. However, empirical research has yet to evaluate if mindfulness acts as a protective factor for the possible negative effects of moral injury, such as alcohol use, drug use, or posttraumatic stress disorder (PTSD) symptoms. In this study, we investigated if five facets of mindfulness (i.e., observing, nonjudging, nonreactivity, awareness, and describing) moderated associations between moral injury and the outcomes of PTSD symptoms, alcohol misuse, and drug abuse symptoms in a sample of military personnel. Participants were 244 military personnel (the majority were former military members) who had been deployed at least once during the Iraq War, War in Afghanistan, other wars, or humanitarian missions. The study results indicated that nonjudging, ß = -.22, and awareness, ß = -.25, had significant attenuating effects on the association between moral injury and drug abuse symptoms. However, observing, ß = .17; nonreactivity, ß = .23; and describing, ß = .15, had significant synergistic effects (i.e., they strengthened the association between moral injury and drug abuse symptoms). There were no significant moderation effects on the associations between moral injury and PTSD symptoms or between moral injury and alcohol misuse. Our results provide initial evidence that not all facets of mindfulness may protect against the challenges of coping with moral injury. Directions for future research and implications for practice are discussed.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Daño moral, uso de sustancias y síntomas de TEPT entre el personal militar: un examen de la atención consciente de los rasgos como moderador MINDFULNESS Y DAÑO MORAL EN VETERANOS Se han sugerido enfoques basados ​​en la atención plena (o mindfulness en inglés) como posibles métodos para tratar el daño moral en el personal militar. Sin embargo, la investigación empírica aún debe evaluar si la atención plena actúa como un factor protector para los posibles efectos negativos del daño moral, como el consumo de alcohol, el uso de drogas o los síntomas del trastorno de estrés postraumático (TEPT). En este estudio, investigamos si cinco facetas de la atención plena (es decir, observar, no juzgar, no reaccionar, conciencia y describir) moderaron las asociaciones entre daño moral y los resultados de los síntomas del TEPT, el uso indebido del alcohol y los síntomas del abuso de drogas en una muestra de personal militar. Los participantes eran 244 militares (la mayoría de ellos ex militares) que habían sido desplegados al menos una vez durante la Guerra de Irak, la Guerra en Afganistán, otras guerras o misiones humanitarias. Los resultados del estudio indicaron que el no juzgar, ß = −.22, y la conciencia ß = −.25, tuvieron efectos atenuantes significativos en la asociación entre daño moral y síntomas de abuso de drogas. Sin embargo, observar, ß = .17; no reactividad, ß = .23; y describir, ß = .15, tuvo efectos sinérgicos significativos (es decir, fortalecieron la asociación entre daño moral y los síntomas de abuso de drogas). No hubo efectos significativos de moderación en las asociaciones entre el daño moral y los síntomas del TEPT o entre el daño moral y el abuso del alcohol. Nuestros resultados proporcionan evidencia inicial de que no todas las facetas de la atención plena pueden proteger contra los desafíos de enfrentar el daño moral. Se discuten lineamientos para futuras investigaciones y las implicaciones para la práctica.

Use of Alcohol Protective Behavioral Strategies as a Moderator of the Alcohol Use-Consequences Relationship: Evidence from Multiple Replications.

BACKGROUND: The use of protective behavioral strategies (PBS) has been found to attenuate the relationship between alcohol use and related consequences. OBJECTIVES: The current study examined PBS use as a moderator of the association between alcohol use and consequences in multiple samples (N = 9) of college students with different sample sizes (e.g., ns 125-736). We also examined sex as a moderator of the PBS moderation analyses. Across all samples, we predicted that the use of more PBS would attenuate the use-consequences relation. METHODS: In total, 3,524 college students completed online measures of alcohol use, consequences, and PBS use (i.e., PBSS) across two sites. Conclusions/importance: In the analyses, 3 two-way interactions were consistent with the literature (i.e., use-consequences relation weakest among those with high PBS use), 6 were opposite of what was reported in the literature (i.e., use-consequences relation strongest among those with high PBS use), and 39 were not statistically significant. These results corroborate, contradict, and extend the current body of knowledge in the extant alcohol PBS literature. In the examination of three-way interactions in the combined sample, serious harm reduction (SHR) PBS was found to moderate the use-consequences relation among female, but not among male students. Specifically, the use-consequences relation was weakest among female students who used more SHR PBS indicating that SHR PBS may be an important intervention target for female college students. Additional experimental and longitudinal studies are needed to examine the effects of PBS use on the use-consequences relation.

Work stressors, depressive symptoms and sleep quality among US Navy members: a parallel process latent growth modelling approach across deployment.

The present study examined whether work stressors contribute to sleep problems and depressive symptoms over the course of deployment (i.e. pre-deployment, post-deployment and 6-month reintegration) among US Navy members. Specifically, we examined whether depressive symptoms or sleep quality mediate the relationships between work stressors and these outcomes. Participants were 101 US Navy members who experienced an 8-month deployment after Operational Enduring Freedom/Operation Iraqi Freedom. Using piecewise latent growth models, we found that increased work stressors were linked to increased depressive symptoms and decreased sleep quality across all three deployment stages. Further, increases in work stressors from pre- to post-deployment contributed to poorer sleep quality post-deployment via increasing depressive symptoms. Moreover, sleep quality mediated the association between increases in work stressors and increases in depressive symptoms from pre- to post-deployment. These effects were maintained from post-deployment through the 6-month reintegration. Although preliminary, our results suggest that changes in work stressors may have small, but significant implications for both depressive symptoms and quality of sleep over time, and a bi-directional relationship persists between sleep quality and depression across deployment. Strategies that target both stress and sleep could address both precipitating and perpetuating factors that affect sleep and depressive symptoms.

A quantification of the alcohol use-consequences association in college student and clinical populations: A large, multi-sample study.

BACKGROUND: The present study sought to quantify the relationship between alcohol use and alcohol-related consequences in both college student and clinical samples. METHODS: We gathered 33 college student datasets comprising of 15,618 participants and nine clinical sample datasets comprising of 4,527 participants to determine the effect size of the relationship between alcohol use and alcohol-related consequences. We used random-effects meta-analytic techniques, separately in college and clinical samples, to account for a distribution of true effects and to assess for heterogeneity in effect sizes. RESULTS: Results demonstrated that the clear majority of the variability in alcohol-related consequences is not explained by alcohol use (ie, >77% in college samples; >86% in clinical samples), and that there was significant heterogeneity in all effect sizes. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Experiencing alcohol-related consequences results from factors that extend beyond frequency and quantity of alcohol consumed suggesting a need to examine other predictors of alcohol-related consequences beyond alcohol use. (Am J Addict 2018;27:116-123).

Weighing the Pros and Cons of Using Alcohol Protective Behavioral Strategies: A Qualitative Examination among College Students.

BACKGROUND: Alcohol protective behavioral strategies (PBS) are behaviors engaged in immediately prior to, during, after, or instead of drinking with the explicit goal of reducing alcohol use, intoxication, and/or alcohol-related harms. Despite the quantitative support for alcohol PBS as a protective factor among college student drinkers, we know of no qualitative research aimed at determining college student drinkers' perceptions regarding the advantages and disadvantages of using PBS. OBJECTIVES: In the style of a decisional balance exercise, we asked college student drinkers (analytic n = 113) to identify 5 reasons they would not use PBS (cons) and 5 reasons they would use PBS (pros). METHOD: Participants (majority female, 77.0%) were recruited from a psychology department participant pool at a large, southeastern university in the United States. Within our analytic sample, participants on average consumed 6.38 (SD = 8.16) drinks per typical week of drinking and reported consuming alcohol on average 7.5 days (SD = 5.83) in the last 30 days. RESULTS: Using a descriptive phenomenological approach, we identified 2 themes for pros (prevention of specific negative alcohol-related consequences and general safety) and 4 themes for cons (goal conflict, ineffectiveness, difficulty of implementation, and negative peer/social repercussions). Overall, participants reported more pros than cons and this discrepancy (i.e., number of PBS pros minus number of PBS cons) was positively related to self-reported frequency of PBS use. Conclusions/Importance: Taken together, we hope that clinicians/researchers will probe individual's reasons for choosing to use (or not use) PBS in order to tailor or improve existing PBS-based interventions.