The Mediating Effects of Drinking Refusal Self-Efficacy on the Associations between Alcohol Protective Behavioral Strategies and Alcohol Use Outcomes

Alcohol use continues to pose a serious public health problem at universities across the U.S., largely due to the extent of consumption and frequency of negative consequences experienced among college students. Alcohol protective behavioral strategies (PBS-A) are an empirically supported repertoire of safe drinking behaviors college students can use to monitor and control their alcohol consumption as well as limit harm while drinking. However, there remains a need to better understand how cognitive mechanisms, such as drinking refusal self-efficacy (DRSE), help explain college student safe alcohol use behaviors to enhance evidenced-based intervention and prevention efforts. Recently, studies that examined the moderating effect of DRSE on the associations among PBS and alcohol use outcomes demonstrated contradictory results. Therefore, the present study evaluated the mediating effects of DRSE broadly and its dimensions (i.e., social pressure DRSE, emotional relief DRSE, opportunistic relief DRSE) in the associations among PBS-A and its subtypes with alcohol use outcomes. Data were collected from a national sample of 380 traditional age (M = 22.50; SD = 1.82), full-time college students (51% male; 68% White, non-Hispanic) who completed an on-line survey about their safe and harmful alcohol use behaviors. Using path analysis, DRSE partially mediated all associations among PBS-A and all outcomes. Moreover, opportunistic relief DRSE mediated relationships between PBS-A and all three outcomes. Finally, all subtypes of DRSE fully mediated the relationship between serious harm reduction PBS-A and negative consequences. Altogether, these results suggest that DRSE may be an important cognitive variable to consider when evaluating PBS-A use and their relationships with alcohol outcomes among college students. Study limitations as well as clinical and research implications will be discussed