Peak Drinking Research Articles

Mindfulness training for clinically elevated social anxiety: The impact on peak drinking

Social anxiety is related to more drinking in high-risk drinking situations and to more drinking-related problems. Given the rise in mindfulness-based interventions for social anxiety, it is important to test whether drinking impacts outcomes among individuals with clinically elevated social anxiety. Undergraduates with clinically elevated social anxiety were randomly assigned to mindfulness training (n = 29) or thinking-as-usual control (n = 29). They were encouraged to practice mindfulness or thinking-as-usual in response to social events daily for two-weeks following baseline. Follow-up measures were completed one month post-baseline. The interaction of baseline peak estimated blood alcohol content (eBAC) X condition predicted one-month follow-up peak eBAC such that among those with greater (but not lower) baseline eBAC, mindfulness was related to lower follow-up eBAC compared to control. Similarly, mindfulness training resulted in less post-training anxiety among those with greater (but not lower) baseline eBAC. However, this effect was not evident during a two-week practice period nor at one-month follow-up. Rather, at one-month follow-up, the interaction of baseline eBAC X condition predicted follow-up mindfulness (non-reactivity); among those with higher (but not lower) baseline eBAC, mindfulness training was associated with less follow-up mindfulness than the control condition. Results indicate that among those with greater baseline peak eBAC, mindfulness practice resulted in lower follow-up eBAC compared to control among those with clinically elevated social anxiety. However, although mindfulness training may result in less anxiety in the short-term among heavy drinkers with social anxiety, this effect did not last longer-term. Rather, heavier drinkers evinced poorer longer-term mindfulness-related outcomes.

Changes in Sexual Identity and Associations With Alcohol Use and Depression Among Young Adult Sexual Minority Women

Sexual minority women report more problematic alcohol use and depression than heterosexual women. Despite evidence that sexual identity can change over time, most studies treat it as a static construct. As a result, little is known about the extent to which changes in sexual identity influence alcohol use and depression. The current study examined (a) changes in sexual identity over 36 months, (b) the associations between the number of changes in sexual identity and measures of alcohol use (typical weekly alcohol consumption, peak drinking, and alcohol-related consequences) and depression at the final assessment, and (c) baseline sexual identity as a moderator of the associations. The analyses used four waves of data from a national U.S. sample of sexual minority women ages 18-25 (n = 1,057). One third (34%) of participants reported at least one change in sexual identity over the course of the study. The number of changes in sexual identity was positively associated with typical weekly alcohol consumption and depression but was not significantly associated with peak drinking or alcohol-related consequences. None of the associations were moderated by baseline sexual identity. These findings provide additional evidence that sexual identity continues to change over time for a sizeable proportion of young adult sexual minority women and these changes are relevant to their health and well-being.

The role of underutilization of protective behavioral strategies in the relation of social anxiety with risky drinking

Social anxiety is prominent among undergraduates and increases the risk of experiencing alcohol problems. In fact, social anxiety more than quadruples the risk of developing an alcohol use disorder, yet it is inconsistently related to heavier drinking. Inconsistent findings may be due to lack of attention on protective behavioral strategies (PBS) among socially anxious drinkers. PBS are cognitive-behavioral strategies to reduce drinking and alcohol-related harm. Due to the nature of social anxiety, affected individuals may be especially vulnerable to PBS underutilization, leading to heavier and more problematic drinking. The current study examined the mediating role of PBS in the relationships of social anxiety with past-month drinking and alcohol problems using cross-sectional data among current (past-month) heavy undergraduate drinkers (N = 431). Social anxiety was significantly positively related to past-month alcohol problems and peak drinking. Social anxiety was significantly negatively related to typical drinking, drinking frequency, and PBSS Manner of Drinking. Social anxiety was indirectly (via PBSS Manner of Drinking) related to greater past-month peak drinks and more drinking problems. Findings suggest that socially anxious persons may be vulnerable to heavier and more problematic drinking due to PBS underutilization. Treatment implications are discussed.

Leveraging copresence to increase the effectiveness of gamified personalized normative feedback

Virtual copresence, or the sense of being with others in an online space, is a feeling induced on many apps and websites through user avatars and browsable profile pages. Despite the small/modest effect sizes observed in popular web-based personalized normative feedback (PNF) alcohol interventions for college students, previous research has yet to consider how copresence might boost efficacy. This study builds on previous PNF gamification work to investigate whether specific copresence features (visual and text-based information about peers) increase PNF's ability to reduce alcohol use relative to a standard PNF condition and a gamified PNF condition. Copresence and perceptions of drinking norms (average drinks, peak drinks, and binge episodes) were assessed during a 3-week period following random assignment of college students (N = 235) to 1 of the 4 web-based PNF conditions (Standard PNF, Gamified PNF Only, Gamified PNF + Visual Copresence, and Gamified PNF + Maximum Copresence). These conditions asked the same questions about drinking and delivered identical PNF on alcohol use, but differed in the level of visual and text-based information about peers. Overall, only the gamified condition that featured maximum copresence significantly reduced drinking outcomes relative to standard PNF. However, conditional effects were moderated by pre-intervention drinking. Among heavier pre-intervention drinkers, both gamified conditions that featured copresence significantly improved upon Standard PNF in reducing alcohol use at follow-up. Findings suggest that including social media-like copresence features to visually represent and provide basic information about the peers contributing to the norms can enhance the efficacy of gamified PNF interventions, especially among high-risk heavy drinkers.

Drinking goals and attainment in a naltrexone trial of young adult heavy drinkers.

Drinking goals set at treatment onset predict treatment outcome in patients with alcohol use disorders. Yet the cognitive constructs of goal setting and goal attainment are understudied in young adult drinkers. This study sought to examine how the interplay of goal setting and goal attainment during treatment impacts treatment outcome in a sample of young adult heavy drinkers. Participants were 128 young adult heavy drinkers (Mage = 21.5 years) who participated in a double-blind, placebo-controlled, 8-week efficacy trial of naltrexone plus brief counseling. Participants were not required to be interested in changing their drinking for inclusion. Drinking goals were assessed at baseline, midtreatment, and end of treatment. Outcomes were peak drinking, typical drinking, and drinking frequency. Results from PROCESS serial, multiple mediator models showed that midtreatment goal setting and goal attainment collectively predicted peak drinking (b = 0.87, 95% CI [0.40, 1.37]) and drinking frequency (b = 0.66, 95% CI [0.37, 1.06]). Only midtreatment goal setting mediated the relationship between baseline goal setting and typical drinking (b = 0.35, 95% CI [0.10, 0.85]). Participants who set more ambitious drinking goals at baseline were more likely to set subsequent, ambitious goals; more ambitious goals at midtreatment were associated with better treatment outcomes. Setting initial, ambitious goals led to further ambitious goals, which ultimately contributed to lower levels of drinking. Thus, cognitive processes during treatment may be an important target of intervention efforts. For example, the inclusion of goal-setting exercises during treatment could serve to improve intervention effects. (PsycINFO Database Record

Mediators and Moderators of a Personalized Feedback Alcohol Intervention for Nonstudent Emerging Adult Drinkers.

The main objective of this study was to test proposed mediators and moderators of a personalized feedback alcohol intervention (PFI) on alcohol use. Data for the current investigation came from an earlier randomized controlled trial of a PFI targeted for nonstudent heavy drinkers between 18 and 25years. Participants were 164 (65.9% men) drinkers recruited from the community. They were randomly assigned to either a single-session PFI or an assessment-only (AO) control group. Follow-up assessments at 1 and 3months were included for analysis. Perceived drinking norms mediated the intervention effect on quantity, frequency, and peak drinking; 2 dimensions of protective behavioral strategies (PBS) mediated the intervention effect on peak drinking; and drinking to cope motives did not mediate any drinking outcomes. Of the moderating factors examined (i.e., norms, PBS, drink to cope motives, age, gender), only PBS related to serious harm reduction moderated intervention impact. Specifically, for those high in serious harm reduction PBS at baseline, postintervention reductions in drinking were stronger for the PFI group compared to AO. Overall, findings highlight the importance of correcting misperceived drinking norms and addressing the use of specific PBS in brief interventions. The knowledge gained from this study represents an important step toward minimizing drinking-related harms that are disproportionately experienced by those with lower educational attainment.

An examination of heavy drinking, depressed mood, drinking related constructs, and consequences among high-risk college students using a person-centered approach

IntroductionResearch has identified college students who experience depressed mood and consume alcohol are at an increased risk for experiencing alcohol problems. The present study identified profiles of differential alcohol use, depression, key psychosocial indicators of drinking (e.g., normative perceptions) and examined the relationship between these profiles and alcohol-related consequences. MethodStudents with a history of risky drinking and elevated depressed mood (n=311; 62.4% female) completed a web-based survey assessing typical and peak drinking, depressive symptoms, descriptive norms, drinking to cope motives, protective behavioral strategies, and alcohol-related consequences. RESULTS: Latent profile analysis was used to classify participants into distinct profiles focusing on alcohol use patterns and level of depressed mood and drinking related constructs. Profiles were then compared based on their association with reported rates of alcohol-related consequences. Four profiles emerged: 1) Mild Depression, Heavy Drinkers; 2) Mild Depression, Severe Drinkers; 3) Moderate Depression, Heavy Drinkers; and 4) Moderate Depression, Severe Drinkers. Findings revealed significant differences between the four profiles on both risky drinking and alcohol-related consequences. ConclusionThese findings suggest the importance of assessing and addressing depressive symptoms among college students in order to reduce rates of risky drinking and alcohol-related consequences.

Delivering normative feedback to heavy drinking college students via text messaging: A pilot feasibility study

Correcting misperceptions in drinking norms is an established method of reducing college student drinking; however, delivery of accurate norms has typically been limited to a single dose within the confines of an alcohol intervention. The present study tests the feasibility, acceptability, and preliminary efficacy of using text messages to promote pro-moderation descriptive and injunctive norms. Following a baseline survey, 68 heavy drinking college students were randomly assigned to receive 28 daily messages with either accurate norms information (experimental group, n=34) or fun facts (control group, n=34). Participants rated each message on a 5-point scale of interest, and at the end of the 28days completed a follow-up assessment of normative perceptions and drinking behavior. The study protocol was feasible: 87% of invited students completed the screener, 64% of eligible students completed the consent form, and 93% agreed to participate. All messages were delivered and 98% were rated. Regarding acceptability, the mean interest rating for the alcohol-related text messages was 2.84 (SD=1.30), and no participants withdrew from the study. Although between-group differences were not observed at follow-up, participants in the experimental group showed significant reductions between baseline and follow-up on peak drinks, frequency of heavy episodic drinking (HED), negative consequences, and injunctive norms (ps<0.01). Results lay the groundwork for development of a text-based prevention strategy for use in college settings.

Change in college students' perceived parental permissibility of alcohol use and its relation to college drinking

College students who perceive their parents to hold permissive views about their alcohol use engage in heavier drinking. However, few studies have assessed perceived parental permissibility of alcohol use (PPP) longitudinally across the later college years, and few have assessed variation in changes in PPP and whether or not these changes differentially predict drinking. This study assessed whether PPP changed across college and used two approaches to determine whether PPP predicted binge drinking frequency and peak drinking. Data on college students' daily lives and risk behaviors were collected from 687 students (51% female) in a large university in the Northeast United States over four years. Perceived parental permissibility of alcohol use increased from the last year of high school through the third year of college with males reporting significantly higher PPP by the third year of college. From 12th grade through the third year of college, between-person differences in mean PPP were positively associated with binge drinking frequency and peak drinking, and patterns of PPP change differentially predicted both drinking outcomes through fourth year. These findings suggest that PPP is a dynamic construct that may evidence important developmental changes across college and the transition to adulthood. More broadly, the results indicate that aspects of the parent-child relationship continue to change after high school and may be important as they are linked with college student risk behaviors.

Individual, interpersonal, and contextual factors associated with discrepancies between intended and actual spring break drinking

The purpose of the present paper was to examine the extent to which college students underestimate the quantity of alcohol they will consume during Spring Break (SB), and whether individual, interpersonal, and contextual factors may be related to underestimation of SB drinking and drinking consequences. College students participated in web-based surveys prior to and after SB (N=603; 57% women). Overall, results indicated that individual factors (being male, being a member of a fraternity or sorority, previously experiencing more alcohol-related consequences, and intending to drink less during SB), interpersonal factors (reporting friends encourage getting drunk), and contextual factors (going on a SB trip with friends and receiving drinks from others) predicted underestimating peak drinks consumed during SB. Underestimating the peak number of drinks to be consumed on SB was associated with experiencing a greater number of alcohol-related consequences. Targeted interventions designed specifically to focus on underestimation of college student drinking and the impact of SB contextual and interpersonal factors may be an important area of study to reduce negative consequences of alcohol use during SB.

The role of perceived injunctive alcohol norms in adolescent drinking behavior

Peers have a major influence on youth during adolescence, and perceptions about peer alcohol use (perceived norms) are often associated with personal drinking behavior among youth. Most of the research on perceived norms among adolescents focuses on perceived descriptive norms only, or perceptions about peers' behavior, and correcting these perceptions are a major focus of many prevention programs with adolescents. In contrast, perceived injunctive norms, which are personal perceptions about peers' attitudes regarding the acceptability of behaviors, have been minimally examined in the adolescent drinking literature. Yet correcting perceptions about these perceived peer attitudes may be an important component to include in prevention programs with youth. Using a sample of 2493 high school-aged youth (mean age=17.3), we assessed drinking behavior (past year use; past month frequency, quantity, and peak drinks), drinking consequences, and perceived descriptive and injunctive norms to examine the relationships of perceived injunctive and descriptive norms on adolescent drinking behavior. Findings indicated that although perceived descriptive norms were associated with some drinking outcomes (past year use; past month frequency; past month quantity; peak drinks), perceived injunctive norms were associated with all drinking outcomes, including outcomes of consequences, even after controlling for perceived descriptive norms. Findings suggest that consideration of perceived injunctive norms may be important in models of adolescent drinking. Prevention programs that do not include injunctive norms feedback may miss an important opportunity to enhance effectiveness of such prevention programs targeting adolescent alcohol use.

Assessment reactivity: A randomized controlled trial of alcohol-specific measures on alcohol-related behaviors

IntroductionCompletion of alcohol assessments influences treatment outcomes, yet little is known about the aspects of assessment that may contribute to this response. The present study is a randomized controlled trial examining how the themes of alcohol assessments (e.g., assessment of alcohol-related consequences as opposed to drinking patterns) may affect drinking behaviors. MethodsUndergraduate students (N=290, Mage=19.97, SDage=1.81, 61.7% female), reporting at least one binge drinking episode during the past month, completed one of five baseline assessment batteries that varied thematically: (a) Control (e.g., minimal drinking quantity and frequency questions), (b) Consequences (e.g., College Alcohol Problems Scale; CAPS-r), (c) Norms (e.g., Drinking Norms Rating Form), (d) Diagnostic (e.g., Alcohol Use Disorders Identification Test), and (e) Combined (all themes). Participants completed a one-month follow-up of drinking quantity/frequency and the CAPS-r. ResultsAll groups decreased their self-reported peak drinks consumed (p<0.001, ηp2=0.05) and past month frequency of drinking (p=0.002, ηp2=0.03; except for the consequences group) from baseline to follow-up. There were no between-group differences. No changes emerged in drinks per week (p=0.09, ηp2=0.01) or alcohol-related consequences (p=0.06, ηp2=0.03) from baseline to follow-up. ConclusionMinimal assessment of drinking quantity and frequency may result in assessment reactivity. Reductions in markers of risky drinking behaviors did not differ as a function of the type of assessments completed (e.g., Consequences vs Diagnostic). Continued research is needed to determine what other important variables (e.g., treatment seeking) may affect assessment reactivity.

Randomized controlled trial of a very brief, multicomponent web-based alcohol intervention for undergraduates with a focus on protective behavioral strategies.

Tertiary Health Research Intervention via Email (THRIVE), a very brief, freely available, multicomponent Web-based alcohol intervention originally developed and tested among students in Australia and New Zealand, was tested in the United States. We also evaluated effects of systematically varying the protective behavioral strategies (PBS) component of the intervention to include shorter, focused lists of direct (e.g., alternating alcoholic with nonalcoholic drinks) or indirect (e.g., looking out for friends) strategies. Undergraduates with past-month heavy drinking (N = 208) were randomized to education/assessment control or one of three U.S.-THRIVE variants, including direct PBS only, indirect PBS only, or full (direct and indirect PBS). After 1 month, compared to the control condition, full condition participants reported fewer drinks per week (rate ratio [RR] = .62) and lower peak drinking (RR = .74). The indirect-only condition reported reduced peak drinking (RR = .74) and a trend toward fewer drinks per week (RR = .78). Changes in drinking relative to control were significant through 6 months for the full and indirect-only conditions. There were no significant differences between the direct-only and control conditions. U.S.-THRIVE was not associated with decreased heavy drinking or alcohol-related problems relative to control. To our knowledge, this was the first study to systematically vary the types of PBS provided in an intervention. Initial results suggest U.S.-THRIVE is efficacious. Compared to control, presenting indirect PBS only as part of U.S.-THRIVE was associated with lower drinks per week and peak past 30-day drinking. Targeting indirect PBS may be more appropriate for non-treatment-seeking young adults receiving a brief intervention. (PsycINFO Database Record

Does one day of drinking matter? 21st birthday drinking predicts subsequent drinking and consequences

ObjectiveThere has been ample research on college student risks and consequences related to 21st Birthday Drinking. To date, no studies we are aware of have examined how 21st birthday drinking impacts subsequent drinking and related consequences. This study evaluates the effect of a single night of drinking on peak drinking, heavy drinking, and negative consequences over 12months following the event. Furthermore, we examine if typical drinking behavior prior to 21st birthday moderates the relationship between the event drinking and subsequent use. MethodParticipants included 599 college students (46% male) who intended to consume at least five/four drinks (men/women respectively) on their 21st birthday. Screening and baseline assessments were completed approximately four weeks before turning 21. A follow-up assessment was completed approximately one week after students' birthdays and every 3months for one year thereafter. ResultsThose who drank more on their 21st birthday, also reported higher peak consumption, increased likelihood of consequences, and increased number of consequences throughout the year. Additionally, baseline peak drinking moderated the relationship such that those who drank less at peak occasion prior to turning 21 showed the strongest effects of 21st BD drinking on subsequent consumption. Conclusions21st BD drinking could impact subsequent choices and problems related to alcohol. Interventions are warranted and implications discussed.

Personalized boosters for a computerized intervention targeting college drinking: The influence of protective behavioral strategies

ABSTRACTObjective: Computerized interventions are cost-effective and can quickly deliver individual feedback to many students. However, in-person interventions are more efficacious. The current study sought to improve the efficacy of a popular online intervention via e-mailed boosters with personalized feedback. Participants: Participants were 213 student drinkers at a southeastern public university, ages 18–24. Methods: Students were randomized into (1) intervention only, or (2) intervention plus booster. Alcohol consumption and related problems were assessed at baseline, 2 weeks post, and 4 weeks post. Results: Boosters yielded reductions in drinking, but not alcohol-related problems. Boosters were associated with significant reductions for drinking frequency, heavy drinking days, peak drinks, and associated blood alcohol concentration (BAC). Protective behavioral strategies (PBS) moderated this effect, with significant reductions for students low in PBS, but not students already highly engaged in PBS use. Conclusions: Easy dissemination and low cost make e-mailed boosters a very efficient way to promote student health.

Validation of the Drinking Motives Questionnaire-Revised across US and Portuguese college students

The present study aimed to evaluate the invariance of the factor structure of the Drinking Motives Questionnaire Revised (DMQ-R) between Portuguese and US university students. Following tests of factor model invariance we further evaluated cross-cultural differences in (1) mean levels of the four motives, and (2) the association of the four motives with weekly drinking, peak drinking, and binge drinking among college students from the United States and Portugal. Participants were 983 undergraduate students (67% female) from the US (N=515) and Portugal (N=468). Participants completed a confidential online (US) or paper and pencil (Portugal) survey. Results of a CFA demonstrated that the four-factor model of the DMQ-R was invariant with respect to factor loadings, factor variances, and factor covariances across the two countries. Mean differences in ratings of drinking motives were found, with US students ranking all motives higher than Portuguese students. However, rank order of motives (social>enhancement>coping>conformity) were equivalent across countries. Support for convergent validity was demonstrated by significant associations between drinking motives and alcohol consumption for men and women of both samples. Results support the factorial invariance and convergent validity of the DMQ-R across US and Portuguese college students, making it a trustworthy means of assessing college students' drinking motives, and a useful instrument for clinical and research purposes, both within and across cultures.

I'm a Social (Network) Drinker: Alcohol-Related Facebook Posts, Drinking Identity, and Alcohol Use

Drinking identity is a component of identity that is associated with heavier drinking and more negative alcohol-related consequences. Social identity is displayed through social networking sites, which are being used on a daily basis by millions of young adults. The current research provides insight into understanding for whom social network sites are more strongly associated with alcohol use by examining the potentially interactive effects of Facebook use and drinking identity. We explored whether the association between alcohol-related posts on Facebook and drinking differs based on the extent to which students identify with drinking. Undergraduates (N = 109) provided researchers access to their Facebook profile before completing an online survey assessing their drinking identity and alcohol use (i.e., drinks per week, frequency, typical drinking, peak drinks). Their previous 100 Facebook posts (e.g., status updates, photos) were coded for alcohol-related content. Results using negative binomial regress...

Brief motivational interventions for college student drinking may not be as powerful as we think: an individual participant-level data meta-analysis.

For over 2 decades, brief motivational interventions (BMIs) have been implemented on college campuses to reduce heavy drinking and related negative consequences. Such interventions include in-person motivational interviews (MIs), often incorporating personalized feedback (PF), and stand-alone PF interventions delivered via mail, computer, or the Web. Both narrative and meta-analytic reviews using aggregate data from published studies suggest at least short-term efficacy of BMIs, although overall effect sizes have been small. This study was an individual participant-level data (IPD) meta-analysis of 17 randomized clinical trials evaluating BMIs. Unlike typical meta-analysis based on summary data, IPD meta-analysis allows for an analysis that correctly accommodates the sampling, sample characteristics, and distributions of the pooled data. In particular, highly skewed distributions with many zeroes are typical for drinking outcomes, but have not been adequately accounted for in existing studies. Data are from Project INTEGRATE, one of the largest IPD meta-analysis projects to date in alcohol intervention research, representing 6,713 individuals each with 2 to 5 repeated measures up to 12months postbaseline. We used Bayesian multilevel over dispersed Poisson hurdle models to estimate intervention effects on drinks per week and peak drinking, and Gaussian models for alcohol problems. Estimates of overall intervention effects were very small and not statistically significant for any of the outcomes. We further conducted post hoc comparisons of 3 intervention types (individual MI with PF, PF only, and group MI) versus control. There was a small, statistically significant reduction in alcohol problems among participants who received an individual MI with PF. Short-term and long-term results were similar. This study questions the efficacy and magnitude of effects of BMIs for college drinking prevention and intervention and suggests a need for the development of more effective intervention strategies.

Randomized controlled trial of brief alcohol screening and intervention for college students for heavy-drinking mandated and volunteer undergraduates: 12-month outcomes.

This is the first randomized trial testing whether heavy-drinking undergraduates mandated to the Brief Alcohol Screening and Intervention for College Students (BASICS) program following a campus alcohol violation would benefit as much as heavy-drinking volunteers up to 1 year postintervention using control groups with high-risk drinkers to model disciplinary-related and naturalistic changes in drinking. Participants (61% male; 51% mandated; 84% Caucasian; M age = 20.14 years) were screened for heavy drinking and randomized to BASICS (n = 115) or assessment-only control (n = 110). Outcome measures (drinking, alcohol problems) were collected at baseline, 4 weeks, 3, 6, and 12 months postintervention. At 4 weeks postintervention, intent-to-treat multilevel longitudinal models showed that regardless of referral group (mandated or volunteer), BASICS significantly decreased weekly drinking, typical drinks, and peak drinks relative to controls (ds = .41-.92). BASICS had a large effect on decreases in alcohol problems (d = .87). At 12 months postintervention, BASICS participants (regardless of referral group) reported significantly fewer alcohol problems (d = .56) compared with controls. Significant long-term intervention gains for peak and typical drinks were sustained in both referral groups relative to controls (ds = .42; .11). Referral group had no significant main effect and did not interact with intervention condition to predict outcomes. Given that BASICS was associated with less drinking and fewer alcohol problems (even among heavier drinking mandated students up to 1 year postintervention), provision of BASICS-style programs within disciplinary settings may help reduce heavy and problematic drinking among at-risk students. (PsycINFO Database Record

Protective Behavioral Strategies as a Mediator Between Depressive Symptom Fluctuations and Alcohol Consumption: A Longitudinal Examination Among College Students

Use of protective behavioral strategies (PBS) has been shown to be associated with alcohol outcomes among college students in general. Only a few studies, however, have examined how mental health is related to PBS and alcohol use. Furthermore, research has not yet investigated these associations in a longitudinal framework. Consequently, the present study aimed to examine PBS as a mediator of depressive symptom fluctuations and alcohol consumption in a longitudinal weekly diary design. Participants were 260 (70.8% women) undergraduate college student drinkers who completed four weekly self-report assessments of their depressive symptoms, PBS use, and alcohol outcomes experienced in the past week. RESULTS indicated significant indirect effects such that increases in depressive symptoms were associated with higher alcohol consumption (i.e., quantity, frequency, peak drinking) through reduced PBS use. PBS did not mediate the association between depressive symptoms and alcohol-related problems. These findings suggest that experiencing an increase in depressive symptoms was associated with a failure to use PBS and, in turn, engagement in heavier alcohol consumption. College students with greater depressive symptoms may benefit from harm-reduction alcohol intervention programs that emphasize the use of PBS in drinking contexts.