4 - (SYM 2) Protective Behavioral Strategy Use in College Students with and Without ADHD in a Daily Diary Study

Background: College students with ADHD are at higher risk for experiencing alcohol-related negative consequences relative to their peers without ADHD. The factors that contribute to alcohol problems among students with ADHD are poorly understood. Protective behavioral strategies (PBS) include behaviors that are designed to mitigate the negative consequences of drinking. Students with ADHD may underuse PBS, perhaps due to characteristic deficits in self-regulation and executive function. Still, preliminary work on PBS use among students with ADHD is mixed and relies on cross-sectional analyses of past PBS use. In the current study, we examined the association among ADHD and PBS using daily dairy methodology. We also evaluated whether PBS use was associated with alcohol use, negative consequences, and heavy episodic drinking.

Methods: Participants were college students who participated in a larger daily diary study of college student drinkers aged 18-22 (49% female), with (n = 51) and without (n = 50) ADHD. Participants reported on their drinking, PBS use, and alcohol-related negative consequences across 14 days of daily diaries (98.2% completion rate). A series of multilevel path models with random intercepts and fixed slopes were conducted. Sex (Level 2) and weekend (Level 1) were covaried in all models.

Results: Participants reported using an average of 1.5 PBS per drinking episode (SD = 1.22, range 0-5; M_ADHD = 1.47, M_Control = 1.55). ADHD did not predict PBS use on drinking days (b = -0.07, p = .67). Regardless of ADHD status, when a person used more PBS than they typically did, they also reported less alcohol use (b = -0.69, p < .001), fewer negative consequences (b = -0.24, p < .001), and less heavy episodic drinking (b = -.35, p < .001). Between-person, those who used more PBS when drinking also reported less alcohol use (b= -0.97, p < .001) and less heavy episodic drinking (b = -.39, p </em>< .001). There were no associations of PBS use on negative consequences between-person (b = -0.16, p = .08). Analyses exploring the specific PBS used among drinkers with vs without ADHD will be presented.

Conclusion: Findings suggest that PBS use is common among college student drinkers with and without ADHD and is associated with less drinking and harm at the event level. These results suggest that brief alcohol intervention approaches that encourage PBS use may be effective for students with ADHD. Intensive longitudinal data analyses have potential to inform just-in-time interventions for college drinkers and promote improved well-being through reduction of consequences.