J. DRUG EDUCATION, Vol. 42(2) 211-227, 2012
DOES SELF-ESTEEM MODERATE THE ASSOCIATIONS
BETWEEN PROTECTIVE BEHAVIORAL STRATEGIES
AND NEGATIVE OUTCOMES ASSOCIATED WITH
ALCOHOL CONSUMPTION?
VIRGIL ZEIGLER-HILL
Oakland University, Rochester, Michigan
MICHAEL B. MADSON
AMY RICEDORF
University of Southern Mississippi
ABSTRACT
Previous research has shown that protective behavioral strategies tend to be
associated with lower levels of alcohol consumption and fewer negative
alcohol-related consequences. The purpose of the present study was to
examine whether self-esteem would moderate the association between protective behavioral strategies and alcohol-related outcomes. Participants were
undergraduates (94 men and 363 women) between the ages of 18-25 who
reported that they had consumed alcohol within the past 30 days. Results
showed that greater use of protective behavioral strategies was associated
with lower rates of alcohol consumption, less harmful drinking patterns,
and fewer negative consequences for everyone except men with low selfesteem. The implications of these findings for understanding the link between
protective behavioral strategies and alcohol-related outcomes are discussed.
Alcohol use among college students is a widely studied topic within the field
of higher education. This interest is due, at least in part, to the high rates of alcohol
211
Ó 2012, Baywood Publishing Co., Inc.
doi: http://dx.doi.org/10.2190/DE.42.2.f
http://baywood.com
212 / ZEIGLER-HILL, MADSON AND RICEDORF
consumption and accompanying negative consequences that are often found
among college students (Hingson, Zha, & Weitzman, 2009). Researchers estimate
that approximately 65% of college students have consumed alcohol in the past
month, with about 44% engaging in heavy episodic drinking (Johnston, O’Malley,
Bachman, & Schulenberg, 2011). Perhaps of even greater concern is the fact that
13% of college students report drinking 10 or more drinks in a row during the
past 2 weeks and 5% report that they have consumed 15 or more drinks (Johnston
et al., 2011). A myriad of negative consequences have been shown to accompany
heavy episodic drinking such as feeling sick, having unwanted sexual experiences,
and experiencing injury or death (Borden, Martens, McBride, Sheline, Bloch,
& Dude, 2011). Trends in alcohol consumption and negative consequences have
remained relatively consistent in recent years and continue to be the focus of
considerable empirical investigation.
Many colleges and universities have made attempts to reduce alcohol-related
consequences by introducing educational programs that promote harm reduction
strategies (i.e., ways to minimize the negative consequences of alcohol use) rather
than advocating total abstinence (i.e., not drinking alcohol at all; Larimer, &
Cronce, 2007). This has been an important change because students are often
aware of the dangers and consequences of consuming too much alcohol but still
choose to drink heavily (Larimer & Cronce, 2007). Programs that focus on harm
reduction strategies educate college students about the choices they can make
to increase their level of safety when consuming alcohol. Protective behavioral
strategies (PBS) are tactics that individuals can employ while drinking that are
intended to minimize the negative consequences that may result from alcohol
consumption (Martens, Ferrier, Sheehy, Corbett, Anderson, & Simmons, 2005;
Martens, Taylor, Damann, Page, Mowry, & Cimini, 2004). Examples of PBS
include drinking slowly rather than chugging, alternating between alcoholic and
non-alcohol drinks, using a designated driver, and avoiding drinking games.
The use of PBS has been found to be associated with lower levels of alcohol
consumption and fewer negative alcohol-related consequences (Benton, Schmidt,
Newton, Shin, Benton, & Newton, 2004; Martens, Pederson, LaBrie, Ferrier, &
Cimini, 2007(b); Martens et al., 2004). The use of PBS has also been found to
partially mediate the relationship between negative consequences and depressive
symptoms (Martens, Martin, Hatchett, Fowler, Fleming, Karakashian, et al.,
2008) as well as the associations that positively reinforcing drinking motives
have with both alcohol consumption and alcohol-related consequences (Martens,
Ferrier, & Cimini, 2007a).
Researchers have identified a variety of demographic and psychosocial variables that influence the amount of alcohol that college students drink as well as
the negative consequences that they experience. Borsari, Murphy, and Barnett
(2007) emphasized the moderating role that gender plays in college student
drinking because men have consistently been found to consume more alcohol
than women and to experience more negative consequences. Psychosocial
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variables such as membership in fraternities/sororities (Grekin & Sher,
2006), alcohol expectancies (Greenbaum, Del Boca, Wang, & Goldman, 2005),
descriptive and injunctive norms (Perkins & Craig, 2006), and drinking motives
(Kuntsche, Knibbe, Gmel, & Engels, 2005) have also been shown to influence
alcohol consumption. Not surprisingly, alcohol consumption and negative consequences have been found to be associated with indicators of psychological
adjustment (Weitzman, 2004).
There has been considerable speculation that individuals with low levels of
self-esteem may consume relatively large amounts of alcohol in order to feel
better about themselves, but the association between self-esteem level and selfreported alcohol consumption has failed to consistently emerge (e.g., Luhtanen
& Crocker, 2005; McGee & Williams, 2000; Trzesniewski, Donnellan, Moffitt,
Robins, Poulton, & Caspi, 2006). Although low self-esteem is not associated
with greater alcohol consumption, individuals with low levels of self-esteem
have been found to report more negative consequences resulting from their
alcohol use than are reported by those with high levels of self-esteem (e.g.,
Hammer & Pape, 1997). That is, individuals with low levels of self-esteem do
not necessarily report drinking more than those with high self-esteem but they do
appear to suffer more negative consequences associated with their consumption
or at least to perceive that they suffer more of these consequences. However,
little is known about the role that self-esteem may play in the connection
between PBS and alcohol-related outcomes.
The purpose of the present study was to examine whether self-esteem level
moderated the association between PBS and negative alcohol-related consequences among college students. We expected that PBS would be effective for
those with high levels of self-esteem such that those who reported higher levels
of PBS would experience fewer alcohol-related problems. In contrast, we
predicted that PBS would not be as effective for those with low self-esteem.
That is, we thought that individuals with low self-esteem would continue to
report high levels of negative alcohol-related consequences even if they reported
using high levels of protective behavioral strategies. The rationale for our
prediction was that low levels of self-esteem would serve as a risk factor for
alcohol-related problems due to the fact that individuals with low self-esteem
often lack the coping resources that are available to those with higher levels
of self-esteem (see Zeigler-Hill, 2011, for a review). In addition, individuals
with low levels of self-esteem may be motivated to drink in an effort to escape
negative emotional states, whereas those with high self-esteem may be more
likely to drink in order to experience pleasure (e.g., Gerrard, Gibbons, ReisBergan, & Russell, 2000; Neumann, Leffingwell, Wagner, Mignona, & Mignona,
2009). In essence, low self-esteem may make it more likely that individuals
will experience negative alcohol-related consequences even when they employ
PBS that are intended to protect them from the negative outcomes associated
with their alcohol use.
214 / ZEIGLER-HILL, MADSON AND RICEDORF
METHOD
Participants and Procedure
Participants were 930 undergraduates at a university in the southern region
of the United States who were enrolled in psychology courses and participated
in return for partial fulfillment of a research participation requirement. This
research was approved by the Institutional Review Board of the institution where
the data were collected. Participants completed measures of PBS, self-esteem,
alcohol use, harmful drinking patterns, and negative consequences of drinking—
along with other measures that are not relevant to the present study—via a
secure website. We excluded 410 participants from the study who did not report
consuming alcohol during the past 30 days because we were interested in the
negative alcohol-related outcomes experienced by college students. We excluded
these participants because we were concerned that the inclusion of so many
participants who had not consumed alcohol would distort our results. That is,
44% of the original sample did not report drinking during the past month which
would have led to considerable skew in our data concerning alcohol consumption
and the negative consequences experienced by those who had consumed alcohol.
We also excluded another 113 participants because their ages were outside of
the traditional college age range of 18 to 25. The average age of the remaining
457 participants (94 men, 363 women) was 19.93 years (SD = 1.83) and their
racial/ethnic composition was 64% White, 31% Black, and 5% Other.
Measures
Protective Behavioral Strategies
The Protective Behavioral Strategies Scale (Martens et al., 2005) is a 15-item
instrument that was developed to identify the extent to which individuals protect
themselves when they are consuming alcohol through strategies such as using
a designated driver or avoiding drinking games. Participants responded to the
items using scales ranging from 1 (never) to 6 (always). Previous research has
shown the Protective Behavioral Strategies Scale to be associated with less
alcohol use and fewer alcohol-related problems among college students (Benton
et al., 2004; Martens et al., 2005; Martens et al., 2007a). The internal consistency
estimate for the present study was .88.
Self-Esteem Level
The Rosenberg Self-Esteem Scale (Rosenberg, 1965) is a 10-item measure of
global self-esteem (e.g., “On the whole, I am satisfied with myself”). Participants
were instructed to complete the instrument according to how they typically or
generally feel about themselves. Responses were made on scales ranging from
1 (strongly disagree) to 5 (strongly agree). This instrument is generally regarded
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as a well-validated and reliable measure of global self-regard (e.g., Blaskovich
& Tomaka, 1991). The internal consistency estimate for the present study was
high (a = .89).
Amount of Alcohol Consumed
The amount of alcohol consumed by participants was assessed using the Daily
Drinking Questionnaire (Collins, Parks, & Marlatt, 1985). The Daily Drinking
Questionnaire identifies the amount of alcohol consumed by respondents by
asking them to report their drinking behavior for the past week. The total number
of alcoholic drinks consumed during the past week was calculated by summing
the number of drinks reported for each day. A standard drink was defined as
a shot of hard liquor, 5 oz. of wine, 10 oz. of wine cooler, or 12 oz. of beer. Scores
for the Daily Drinking Questionnaire have been found to be associated with
other instruments designed to measure the amount of alcohol consumed such
as the Drinking Practices Questionnaire (Collins et al., 1985).
Harmful Drinking Patterns
The Alcohol Use Disorders and Identification Test (AUDIT; Saunders,
Aasland, Babor, De La Fuente, & Grant, 1993) is a 10-item instrument that
assesses harmful drinking patterns (e.g., “How often do you have six or more
drinks on one occasion?”). The AUDIT is the leading instrument for the detection of early-phase risky drinking patterns across different cultures and age
groups (e.g., Bradley, Bush, McDonell, Malone, & Fihn, 1998; Fiellin, Reid,
& O’Connor, 2000; Reinert & Allen, 2002). The internal consistency estimate
for the AUDIT was .81 for the present study.
Negative Consequences of Drinking
The Brief Young Adult Alcohol Consequences Questionnaire (Kahler,
Strong, & Read, 2005) consists of 24 yes/no items that assess the negative
alcohol-related consequences that individuals perceive themselves as having
experienced during the past year (e.g., “I’ve not been able to remember large
stretches of time while drinking heavily”). This instrument has been found to be
a reliable and valid indicator of negative alcohol-related consequences among
college students (Kahler et al., 2005). The internal consistency estimate for this
instrument was .91 for the present study.
RESULTS
Table 1 presents the means, standard deviations, and intercorrelations for
the present measures. Greater use of PBS was associated with higher levels of
self-esteem (r = .13, p < .01), less alcohol consumption (r = –.29, p < .001), lower
216 / ZEIGLER-HILL, MADSON AND RICEDORF
levels of harmful drinking patterns (r = –.41, p < .001), and fewer negative
consequences (r = –.44, p < .001). Self-esteem level was not associated with
the amount of alcohol consumed (r = .01, ns) but it was negatively associated
with harmful drinking patterns (r = –.12, p < .01) and negative consequences
(r = –.20, p < .001).
Self-Esteem and Protective Behavioral Strategies
as Predictors of Alcohol Use, Harmful Drinking
Patterns, and Negative Consequences of Drinking
A series of hierarchical multiple regression analyses were used to examine
the possibility that self-esteem would moderate the associations between PBS and
alcohol-related outcomes (i.e., amount of alcohol consumed, harmful drinking
patterns, and negative consequences of drinking). The main effect terms for
PBS, self-esteem, and gender (0 = female, 1 = male) were entered on Step 1 with
higher-order interactions entered on subsequent steps. Gender was included in
these analyses because men have been found to consume more alcohol, use fewer
protective strategies, and experience more negative alcohol-related consequences
than women (Borden et al., 2011). Continuous predictor variables were centered
for the purpose of testing interactions and these analyses were followed by
the simple slopes tests recommended by Aiken and West (1991) to describe the
interaction of continuous variables. The results of these analyses are presented
in Table 2.
Amount of Alcohol Consumed
Main effects emerged for PBS (b = –.27, t = –5.97, p < .001, d = –.56) and
gender (b = .18, t = 4.09, p < .001, d = .39), such that higher levels of alcohol
Table 1. Descriptive Statistics and Intercorrelations
1
1. Protective behavioral strategies
2. Self-esteem level
2
3
4
5
—
.13**
—
3. Amount of alcohol consumed
–.29***
.01
4. Harmful drinking patterns
–.41*** –.12**
—
.51***
—
5. Negative consequences of drinking –.44*** –.20*** .33*** .69***
—
M
3.99
3.98
0.84
0.60
6.81
SD
0.98
0.81
1.15
0.43
5.65
**p < .01; ***p < .001.
–.23***
.17***
Step 3
PBS × SEL × Gender
*p < .05; **p < .01; ***p < .001.
–.13**
.04
.00
.14***
Step 2
PBS × SEL
PBS × Gender
SEL × Gender
.03***
.02*
.27***
.04
.18***
.12***
.12***
Step 1
Protective Behavioral Strategies (PBS)
Self-Esteem Level (SEL)
Gender
.21***
.19***
.18***
R2
.02**
.01
.18***
b
–.15**
–.03
.06
.00
–.39***
–.07
.08
DR2
b
DR2
R2
Harmful drinking
patterns
Amount of alcohol
consumed
.24***
.22***
.21***
R2
.02*
.01
.21***
DR2
b
–.10*
.04
.07
.07
–.42***
–.14***
–.03
Negative alcohol
consequences
Table 2. Analyses Regressing Alcohol-Related Outcomes onto Protective Behavioral Strategies,
Self-Esteem Level, and Gender
ALCOHOL / 217
218 / ZEIGLER-HILL, MADSON AND RICEDORF
consumption were observed for men and those who reported using relatively
few PBS. These main effects were qualified by the three-way interaction of
PBS, self-esteem level, and gender which emerged from this analysis (b = –.23,
t = –4.42, p < .001, d = –.42). The predicted values for this interaction are
presented in Figure 1. As suggested by Cohen, Cohen, West, and Aiken (2003),
this interaction was probed by first examining whether the two-way interaction
of self-esteem level and PBS was significant for men and women separately.
These analyses found that the interaction of PBS and self-esteem level emerged
for men (b = –.37, t = –3.46, p < .001, d = –.33) but not for women (b = –.05,
t = –1.05, ns). Simple slopes tests were then conducted which found that the
slope of the line representing the association between PBS and the amount of
alcohol consumed was negative for women with low self-esteem (b = –.25,
t = –2.73, p < .01, d = –.26) as well as women with high self-esteem (b = –.37,
t = –4.32, p < .001, d = –.41). The association between PBS and the amount
of alcohol consumed was negative for men with high self-esteem (b = –.56,
t = –6.38, p < .001, d = –.60) but it did not reach conventional levels of significance for men with low self-esteem (b = –.16, t = –1.58, ns). Taken together,
these results show that men with low self-esteem consumed relatively large
amounts of alcohol regardless of their use of PBS, whereas men with high
self-esteem only reported such high levels of consumption when they reported
using relatively few PBS.
Harmful Drinking Patterns
The only main effect that emerged was for PBS (b = –.39, t = –8.97, p < .001,
d = –.85), such that individuals who reported using more PBS reported less
harmful drinking patterns. The main effect of PBS was qualified by the three-way
interaction of PBS, self-esteem level, and gender which emerged (b = –.15,
t = –2.99, p < .01, d = –.28). The predicted values for the interaction are presented
in Figure 2. Probing of this three-way interaction revealed that the two-way
interaction of PBS and self-esteem level was significant for men (b = –.27,
t = –2.48, p < .05, d = –.23) but not for women (b = .03, t < 1, ns). Simple slopes
tests were then conducted which found that the slope of the line representing
the association between PBS and harmful drinking patterns was negative for
women with low self-esteem (b = –.54, t = –6.40, p < .001, d = –.60) as well as
women with high self-esteem (b = –.35, t = –3.99, p < .001, d = –.38). For men,
however, the association between PBS and harmful drinking patterns was negative for men with high self-esteem (b = –.49, t = –5.75, p < .001, d = –.54) but it
was not significant for men with low self-esteem (b = –.13, t = –1.30, ns). These
results show that men with low self-esteem reported relatively high levels of
harmful drinking patterns regardless of their use of PBS, whereas those with
high self-esteem only reported high levels of harmful drinking patterns when
they reported using relatively few PBS.
Figure 1. Predicted values for amount of alcohol consumed illustrating the three-way interaction of protective behavioral
strategies, self-esteem level, and gender at values that are one standard deviation above and below their respective means.
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Figure 2. Predicted values for harmful drinking patterns illustrating the three-way interaction of protective behavioral strategies,
self-esteem level, and gender at values that are one standard deviation above and below their respective means.
220 / ZEIGLER-HILL, MADSON AND RICEDORF
ALCOHOL
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Negative Consequences of Drinking
Main effects emerged for PBS (b = –.42, t = –9.94, p < .001, d = –.94) and
self-esteem level (b = –.14, t = –3.41, p < .001, d = –.32) such that more negative
consequences were reported by individuals who reported using fewer PBS and
those with lower levels of self-esteem. These main effects were qualified by
the three-way interaction of PBS, self-esteem level, and gender which emerged
(b = –.10, t = –2.07, p < .05, d = –.20). The predicted values for the interaction
are presented in Figure 3. Probing of this three-way interaction revealed that
the two-way interaction of self-esteem level and PBS was significant for men
(b = –.26, t = –2.51, p < .05, d = –.24) but not for women (b = .08, t = 1.79, ns).
Simple slopes tests were then conducted which found that the slope of the line
representing the association between PBS and negative consequences was negative for women with low self-esteem (b = –.61, t = –7.34, p < .001, d = –.69) as well
as women with high self-esteem (b = –.35, t = –4.07, p < .001, d = –.38). The
association between PBS and negative consequences was negative for men with
high self-esteem (b = –.40, t = –4.75, p < .001, d = –.45), but it was not significant for men with low self-esteem (b = –.18, t = –1.67, ns). Taken together,
these results show that men with low self-esteem reported relatively high levels
of negative consequences regardless of their use of PBS, whereas those with
high self-esteem only reported high levels of negative consequences when they
reported using relatively few PBS.
DISCUSSION
In partial support of our predictions, we found that self-esteem level moderated
the association between PBS and alcohol-related outcomes. The pattern that
emerged was that PBS served their intended protective functions for everyone
except men with low self-esteem. That is, men with high self-esteem and women
with both high and low levels of self-esteem reported lower levels of alcohol
consumption, less harmful drinking patterns, and fewer negative consequences
when they used higher levels of PBS. In contrast, the utilization of PBS did
not appear to be effective for men with low self-esteem, as evidenced by the
fact that these individuals continued to report relatively high levels of alcohol
consumption, more harmful drinking patterns, and more negative consequences
even when they reported using high levels of PBS.
It is important to note the role that gender played in these analyses. The expected
pattern of low self-esteem individuals failing to benefit from the utilization of
PBS only emerged for men. For example, men with low self-esteem continued
to consume relatively high levels of alcohol even when they reported using
high levels of PBS. This finding is consistent with previous studies showing
gender differences in the links between self-esteem and alcohol-related outcomes
(Neumann et al., 2009). The moderating role of gender in these studies may be
Figure 3. Predicted values for negative consequences of alcohol use illustrating the three-way interaction of protective behavioral
strategies, self-esteem level, and gender at values that are one standard deviation above and below their respective means.
222 / ZEIGLER-HILL, MADSON AND RICEDORF
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due, at least in part, to gender norms concerning alcohol consumption (Neighbors,
O’Connor, Lewis, Chawla, Lee, & Fossos, 2008). For example, women often
consume less alcohol than men for various reasons, including concerns about the
risks involved with intoxication (e.g., unwanted sexual experiences; Wilsnack,
Wilsnack, Kristjanson, Vogeltanz-Holm, & Gmel, 2010). These gender differences may provide enough motivation for women to modify their drinking
behavior even when their level of self-esteem is relatively low, whereas men
with low self-esteem may lack this additional source of motivation.
The connections between low self-esteem and alcohol-related problems for
men may be explained by the vulnerability model of self-esteem, which suggests
that low self-esteem serves as a risk factor for negative behaviors and poor
psychological adjustment (e.g., Zeigler-Hill, 2011). Low self-esteem may contribute to alcohol-related problems through both intrapsychic processes and
interpersonal strategies. For example, individuals with low self-esteem have
been found to be more likely than those with high self-esteem to drink in order
to escape negative emotional states that they are currently experiencing (Gerrard
et al., 2000; Neumann et al., 2009). PBS are generally intended to be used in
social situations but individuals with low self-esteem who are drinking to escape
negative emotional states may drink less often in social situations, which may
reduce the degree of protection offered by these strategies (LaBrie, Kenney,
Lac, Garcia, & Ferraiolo, 2009; Martens et al., 2008). An important aspect
of the vulnerability model is the idea that low self-esteem may increase the
probability of poor outcomes in the wake of stressful or negative experiences.
This pattern is believed to emerge because individuals with low self-esteem
possess fewer coping resources than those with high self-esteem. To put it
another way, this stress-buffering hypothesis proposes that self-esteem and
stress will interact to predict behavior such that high levels of self-esteem will
buffer individuals from the deleterious consequences of stress, whereas low
levels of self-esteem may increase their vulnerability to the effects of stress. It
may be helpful for future researchers to examine whether individuals with low
self-esteem differ from those with high self-esteem in terms of their use of PBS
and the extent to which they experience alcohol-related problems following
negative experiences such as social rejection or achievement failure.
These results highlight the benefits associated with the use of PBS for
alcohol consumption, harmful drinking patterns, and negative consequences.
However, these results demonstrate that the benefits of PBS are not experienced
by everyone because men with low self-esteem continue to report high levels
of alcohol consumption, harmful drinking patterns, and negative consequences
even when they utilize high levels of PBS. These results suggest that it is important
to account for self-esteem and gender when considering the connections between
PBS and alcohol-related outcomes. Similarly, interventions aimed at reducing
alcohol-related harm among college students may benefit from helping students
understand the links between their level of self-esteem, motives for drinking,
224 / ZEIGLER-HILL, MADSON AND RICEDORF
alcohol use, and negative alcohol-related consequences, as well as encouraging
those with lower self-esteem to utilize more PBS (Borsari et al., 2007).
The present study had a number of strengths (e.g., use of a large sample,
inclusion of multiple measures of alcohol-related outcomes), but it is also
important to acknowledge some of its limitations. First, we were unable to
determine whether low levels of self-esteem actually cause negative alcoholrelated outcomes due to the correlational nature of our data. We assumed that
low self-esteem would lead individuals to experience more alcohol-related
problems regardless of their use of PBS, but this causal relationship cannot
be established using the present data. For example, it is unclear whether low
self-esteem causes negative alcohol-related outcomes as suggested by the vulnerability model or if the direction of causation was reversed such that negative
alcohol-related outcomes lead to the development of low self-esteem which is
consistent with the scar model (see Zeigler-Hill, 2011, for a review). Second,
the present study relied exclusively on self-report measures so it is possible that
our results may have been influenced by socially desirable response distortions.
This is particularly important because self-report measures capture perceptions
of alcohol use and its consequences which may be somewhat different from
the actual experiences of these individuals. For example, individuals may not
always be aware of the extent to which their alcohol consumption is having a
detrimental impact on their lives. It is important that researchers include indicators
of alcohol-related outcomes and PBS that are less susceptible to these distortions
in future studies as well as employing additional sources of information about
alcohol-related consequences experienced by the individual in order to clarify
the link between self-esteem and alcohol use (e.g., evaluations by a clinician,
peer-reports of alcohol-related behavior). Third, the generalizability of the present
findings may be limited to college students in the southern region of the United
States. It is unclear, for example, whether similar patterns would emerge for other
samples because college students in the southern United States have some of the
lowest alcohol consumption rates in the country (Johnston, O’Malley, Bachman,
& Schulenberg, 2009). Researchers should extend the present results to college
samples in other regions of the country as well as non-college student samples
(e.g., community samples, clinical samples).
CONCLUSION
The present results show that self-esteem moderates the association between
PBS and alcohol-related outcomes. We found that higher levels of PBS were
associated with lower levels of alcohol consumption, less harmful drinking
patterns, and fewer negative consequences for everyone except men with low
levels of self-esteem. Unlike the other individuals, men with low self-esteem
continued to report relatively high levels of alcohol consumption, more harmful
drinking patterns, and more negative consequences even when they used higher
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levels of PBS. These results extend our understanding of the link between PBS
and alcohol-related outcomes as well as showing that feelings of self-worth
may play an important role in understanding the connection between PBS and
alcohol-related problems.
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Direct reprint requests to:
Virgil Zeigler-Hill
Department of Psychology
Oakland University
212A Pryale Hall
Rochester, MI 48309
e-mail: [email protected]