Direct and Stress-Moderating Effects of Coping on Binge Drinking and Alcohol-Related Protective Behaviors Among College Students

Introduction: A small literature has examined whether different approaches to coping with stressors are associated with drinking behaviors among college students. Almost no studies have distinguished between different types of stressors or measured both alcohol-related risk and protective behaviors. The present study examines whether perceived stress and approach to coping in academic and interpersonal domains influence binge drinking and alcohol-related protective behaviors among college students (Funding: U.S. Department of Education).

Methods: Letters of invitation to participate in a prospective study of college life at a large Midwestern university were sent to 1500 randomly selected incoming freshmen aged 18-19 years in July, 2009.The sample consisted of 153 students who were surveyed via mail prior to their arrival on campus (T1) and once a semester during the first two years of college (T2-T6). Two thirds of participants were female and the majority were white (86%). The retention rate for the final survey was 91%. At baseline, students completed the Perceived Stress Scale and the Response Based Coping Inventory. At each time point, students indicated their binge drinking frequency (NIAAA Task Force on Recommended Alcohol Questions, 2003). In addition, students completed the Protective Behavioral Strategies Scale (e.g., limiting number of drinks). Growth curve analyses were conducted to examine main effects and potential interactions between perceived stress and coping variables on behaviors over time; separate analyses were conducted within academic and interpersonal domains of stress and coping. Analyses adjusted for parental education, high school grades, biological sex, and race/ethnicity.

Results: Few associations involving time emerged. Independent of time, students who coped with academic or interpersonal stressors through substance use engaged in more frequent binge drinking and lower levels of alcohol-related protective behaviors. Coping with academic or interpersonal stressors through behavioral coping, cognitive coping, or seeking support from parents was associated with more alcohol-related protective behaviors. In contrast, coping through anger, helplessness, or avoidance was associated with less alcohol-related protective behaviors. Several stress by coping interactions were observed in the domain of interpersonal stressors. For example, high levels of interpersonal stress were associated with less frequent binge drinking only among those students who engaged in low levels of coping through helplessness or avoidance.

Conclusions: In comparison to young people with less adaptive coping strategies (e.g., avoiding a problem), young people with more adaptive coping strategies (e.g., thinking differently about a stressful situation) appear better equipped to engage in protective behaviors when they consume alcohol. These individuals also appear to shape their behavior such that they engage in less frequent rather than more frequent binge drinking under conditions of high interpersonal stress. Combined with the larger literature, findings suggest that prevention programs should target the enhancement of adaptive coping strategies among children and adolescents.