Academic journal article Journal of College Counseling

Anxiety and the Use of Alcohol-Related Protective Behavioral Strategies

Academic journal article Journal of College Counseling

Anxiety and the Use of Alcohol-Related Protective Behavioral Strategies

Article excerpt

Protective behavioral strategies (PBS) are useful skills for reducing the negative consequences of alcohol. The moderating effects of anxiety on the relationship between 3 different types of PBS and negative consequences were examined among students accessing college counseling services. Results revealed a significant interaction between anxiety and strategies while drinking, suggesting that these simple strategies may be particularly beneficial among students who drink heavily and experience high levels of anxiety. Implications for counseling centers are discussed.

Keywords: alcohol use, protective behavioral strategies, anxiety


Rates of heavy episodic drinking (HED) or binge drinking (i.e., four or more drinks in a row for women or five or more drinks in a row for men) in the United States have not declined in more than 15 years (Centers for Disease Control and Prevention, 2010), with 40% to 50% of college students reporting engaging in binge drinking (O'Malley & Johnston, 2002; Wechsler & Nelson, 2008). Students seeking counseling services warrant particular research attention, because a large proportion of college counseling center directors (46%) report increases in alcohol abuse problems among their student clients (Gallagher, 2010). Clearly, identifying mental health correlates of heavy drinking along with possible strategies that can be used to temper associated alcohol-related problems among this population would be of benefit to mental health professionals who are in a position to intervene with these students.

The association between alcohol use disorders and mental health challenges, such as anxiety, is well documented (Dawson, Grant, Stinson, & Chou, 2005; Goldsmith, Thompson, Black, Tran, & Smith, 2012; Ham, Zamboanga, & Bacon, 2011). According to tension-reduction theory (Conger, 1956), experiences of anxiety can increase the likelihood of alcohol consumption, with tension reduction acting as a significant motivator for alcohol use. Consistent with this theory, the relationship between anxiety and hazardous drinking is mediated by tension-reduction expectancies and coping motives (Goldsmith, Tran, Smith, & Howe, 2009; Ham, Zamboanga, Bacon, & Garcia, 2009). Consuming alcohol as a means to cope with psychological distress or alleviate anxiety appears to be especially risky because it is associated with deficient internal coping mechanisms, poor psychosocial health, and a lack of volitional control over drinking (Carpenter & Hasin, 1999; Cooper, Frone, Russell, & Mudar, 1995). Moreover, college students with an anxiety disorder are more than twice as likely as those without an anxiety disorder to meet the diagnostic criteria for alcohol dependence or abuse (Kushner & Sher, 1993). Similarly, students with generalized anxiety disorder (GAD) are more likely to engage in HED than are those without GAD (Cranford, Eisenberg, & Serras, 2009). Even after controlling for the level of alcohol use, students with anxiety are at greater risk for experiencing the negative consequences of alcohol. For example, among female students, social anxiety is associated with greater personal (e.g., doing regrettable things, putting self in danger) and role consequences (e.g., neglecting household or family responsibilities; missing class, work, or some other important event [Norberg, Olivier, Alperstein, Zvolensky, & Norton, 2011]). For students who believe that alcohol has tension-reduction properties and report low perceived self-efficacy for refusing drinks, higher levels of generalized anxiety are associated with greater alcohol-related negative consequences (e.g., feeling guilty about drinking, injury to self or others, neglected responsibilities; Goldsmith et al., 2012).

The association between alcohol use and anxiety is of particular concern considering the increasing prevalence of psychological problems among college students (Gallagher, 2010). …

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