Rob Turrisi

Background: Alcohol use is necessary—but not sufficient—for understanding why individuals experience an alcohol‐induced blackout (AIB). Drinking motives are one of the most proximal risk factors for alcohol use. This study conducts a comprehensive within‐person examination of AIBs predicted by prospective daily reports of drinking motives and alcohol use measured using a transdermal alcohol concentration (TAC) biosensor. Methods: Participants were young adults who engaged in risky drinking and experienced at least 1 AIB in the past 3‐months ( N = 169, M _age = 20.8, 53% female, 87% White, 10% Hispanic). They wore TAC biosensors and completed twice daily surveys about drinking motives and AIBs over six social weekends (i.e., Thursday–Sunday). TAC drinking features (peak, rise rate, and rise duration) were extracted from TAC data for each day. Two‐level multilevel structural equation models were conducted to examine the associations between drinking motives, latent intoxication estimated from TAC features, and AIBs. Aim 1 examined separate models for each motive (enhancement, social, coping, conformity). Aim 2 examined a single model with each motive adjusting for the others. Results: In Aim 1, on days when participants reported higher enhancement, social, coping, and conformity motives, the associated increase in TAC intoxication was associated with increased odds of experiencing an AIB. In Aim 2, when all motives were entered into a single model, only social motives resulted in increased TAC, which subsequently increased the odds of an AIB occurring. Conclusions: Findings demonstrate that days when an individual reports above average drinking motives relative to their own average, they are at increased risk of engaging in riskier drinking, which may result in subsequent AIBs. These findings suggest that daily changes in drinking motives may be an important intervention pathway for preventing risky drinking and subsequent AIBs.

Adolescent alcohol use is a significant public health concern in the United States. Protective behavioral strategies (PBS) can minimize risk associated with alcohol use. To date, however, no studies have examined sex differences in PBS use and alcohol-related consequences among high school students. The aims of this study are to examine sex differences in PBS use and to examine sex as a moderator of the relationship between PBS and alcohol-related consequences among high school seniors. Participants (N = 129) completed questionnaires on PBS, alcohol-related consequences, and alcohol use. Females used PBS significantly more frequently than males. Further, the frequency of using Manner of Drinking (MD) strategies was inversely associated with alcohol-related consequences for females and males. Sex moderated the relationship between use of Serious Harm Reduction (SHR) strategies and alcohol-related consequences. Specifically, among females, SHR was inversely associated with alcohol-related consequences. In contrast, SHR was positively associated with alcohol-related consequences for males. Use of Stopping/Limiting Drinking (SLD) strategies was not significantly associated with alcohol-related consequences. Female students may benefit more from the use of PBS, particularly SHR strategies, than male students. Findings provide sex-specific information to guide harm-reduction prevention efforts related to PBS.

Using a cross-sectional design, we examined protective behavioral strategies (PBS) as a moderator of the relationship between sensation seeking and hazardous drinking and alcohol-related consequences among high school seniors (N = 212). Hierarchical regression analyses indicated sensation seeking was a significant predictor of binge drinking (beta = 0.65, p < 0.001), prepartying (beta = 0.71, p < 0.001), gaming (beta = 0.75, p < 0.001), and alcohol-related consequences (beta = 0.69, p < 0.001). Further, PBS moderated these relationships such that among high sensation seeking adolescents, PBS use was associated with better outcomes, including lower levels of binge drinking (beta = -0.37, p < 0.01), prepartying (beta = -0.44, p < 0.01), gaming (beta = -0.31, p < 0.05), and alcohol-related consequences (beta = -0.53, p < 0.001). We discuss counseling implications, including assessment and harm reduction strategies focusing on PBS to reduce hazardous drinking among high sensation seeking adolescents.

Despite the escalation of alcohol use through high school, the majority of research on school‐based alcohol interventions has been conducted with junior high students or first and second‐year high school students. Preliminary research indicates a brief, web‐based personalized feedback intervention developed for college students (eCHECKUP TO GO) may be a promising program for high school seniors. Although these studies demonstrate positive intervention effects, there is some evidence for greater program efficacy for females in this age group. The current study investigates sex differences in program acceptability of the eCHECKUP TO GO and its relationship to short‐term alcohol outcomes among high school seniors (N = 135). Overall, the majority of students reported they found the program to be acceptable (i.e., user‐friendly and useful). However, contrary to our hypothesis, results indicated that male students reported significantly higher perceptions of program acceptability than females. Although we did not find sex differences in alcohol outcomes, program user‐friendliness was related to reductions in alcohol use for males. The results of this study add to the literature supporting the eCHECKUP TO GO for high school seniors and highlight the importance of program user‐friendliness for males. Implications for implementing the program as a school‐based intervention are discussed.