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. 2021 Aug:119:106924.
doi: 10.1016/j.addbeh.2021.106924. Epub 2021 Mar 26.

Relations among protective behavioral strategies, biological sex, and ADHD symptoms on alcohol use and related problems: Who benefits most, and from what type of strategy?

Alison Looby  1 , Mark A Prince  2 , John M Vasko  3 , Lauren Zimmerman  3 , Elizabeth K Lefler  4 , Kate Flory  5 , Will Canu  6 , Cynthia M Hartung  3
Affiliations

Relations among protective behavioral strategies, biological sex, and ADHD symptoms on alcohol use and related problems: Who benefits most, and from what type of strategy?

Alison Looby et al. Addict Behav. 2021 Aug.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) symptoms among college students are associated with high rates of alcohol use and alcohol-related consequences. Use of protective behavioral strategies (PBS) is generally related to lower levels of alcohol use and problems; however, it is unclear how effectively students with ADHD symptoms can implement PBS, and whether certain types of PBS use may yield better outcomes. This study examined relations between PBS type and ADHD symptoms on both alcohol use and consequences, and whether these relations varied by biological sex. Participants were 875 college student drinkers from three universities who completed measures of ADHD symptoms, PBS, past-month alcohol use, and alcohol-related consequences. There were significant moderation effects of ADHD symptoms, such that the relation between PBS use and alcohol use was more pronounced for students high in inattention, and the relation between PBS use and alcohol-related consequences was more pronounced for students high in either inattention or hyperactivity/impulsivity symptoms. These relations were found for both manner of drinking and stopping/limiting drinking PBS, and they tended to be strongest for male students. There were no significant interaction effects that included serious harm reduction PBS; for all students, increased use of this type of PBS was associated with fewer problems. These results suggest that PBS are likely effective for students with ADHD symptoms. Interventions that provide explicit instruction in employing PBS, particularly related to manner of drinking and stopping/limiting drinking strategies, are recommended for students with ADHD symptoms.

Keywords: ADHD; Alcohol; Biological sex; College students; Protective behavioral strategies.

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Conflict of interest statement

Declarations of Interest: None

Figures

Figure 1.
Figure 1.. Interaction Effects of PBS Type, ADHD Symptom Type, and Sex on Weekly Drinks
Note. The left panel depicts simple slopes of the Manner of Drinking PBS x Inattention Symptoms x Sex interaction on weekly drinks. The right panel depicts simple slopes of the Stopping/Limiting Drinking PBS x Inattention Symptoms x Sex interaction on weekly drinks. Protective Behavioral Strategies. PBS = Protective Behavioral Strategies. MOD = Manner of Drinking. SLD = Stopping/Limiting Drinking.
Figure 2.
Figure 2.. Interaction Effects of PBS Type, ADHD Symptom Type, and Sex on Alcohol-Related Problem
Note. The top left panel depicts simple slopes of the Manner of Drinking PBS x Inattention Symptoms x Sex interaction on alcohol-related problems. The bottom left panel depicts simple slopes of the Stopping/Limiting Drinking PBS x Inattention Symptoms x Sex interaction on alcohol-related problems. The top right panel depicts simple slopes of the Stopping/Limiting Drinking PBS x Hyperactivity/Impulsivity x Sex interaction on alcohol-related problems. The bottom right panel depicts simple slopes of the Manner of Drinking PBS x Hyperactivity/Impulsivity symptoms interaction on alcohol-related problems. PBS = Protective Behavioral Strategies. MOD = Manner of Drinking. SLD = Stopping/Limiting Drinking.
See this image and copyright information in PMC

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