Estrategias Conductuales de Protección ante el consumo de alcohol y sus consecuencias negativas en adultos jóvenesUn estudio prospectivo sobre sus determinantes psicosociales

Abstract

The main objective of this thesis is to study the Protective Behavioral Strategies for alcohol in young adults and their psychosocial determinants. To this end, I first examine the usefulness of these strategies to reduce alcohol consumption and its negative consequences in young adults (first specific objective). Next, a literature review is presented to identify the psychosocial factors associated with the use of alcohol and cannabis protective strategies (second specific objective). Third, the moderating role of drinking motives in the relationship between the perceived efficacy of these strategies and the use of the same strategies is examined (third specific objective). Finally, the ability of the Protection Motivation Theory to predict young adults' intention to use protective behaviors is studied, as well as the gender invariance of the resulting predictive model (fourth specific objective). To contrast the first, third and fourth specific objectives, a prospective empirical study was conducted with two evaluation moments, an initial one and a two-month follow-up. The target population consisted of 360 young adults (18-25 years) recruited from community settings. A targeted sampling procedure was used to recruit participants and, finally, the analytical sample was composed of 339 young adults (M = 21.1; SD = 2.21; women = 50.7%) who completed the initial and follow-up assessment questionnaires. To address the second specific objective, a systematic review of 76 studies analyzing psychological determinants of protective behavioral strategies was carried out. Regarding the first objective, the results showed that the strategies related to the manner of drinking were associated with less intensive alcohol consumption and fewer negative consequences. In contrast, the strategies aimed at limiting/stopping drinking showed no relationship with alcohol consumption or its consequences. On the other hand, the systematic review found that the most studied psychological determinants of protective strategies are drinking motives, anxiety, depression, and social norms. Some studies have found that protective strategies mediate the relationship between some of these determinants (motives, impulsivity, and social norms) and consumption and its consequences. The literature review has also shown that the protective effect of strategies was stronger when participants had poorer mental health, high impulsivity, or low self-regulation. Regarding the third objective, it was found that as the perceived efficacy of the strategies increased, so did their use, and that this relationship was weaker among those who scored high on positive motives (social and enhancement) and coping motives. Finally, the analyses referred to the fourth objective demonstrated the usefulness of the Protection Motivation Theory in explaining the intention to use alcohol protective strategies. Specifically, it was found that the components of coping appraisal (perceived efficacy and self-efficacy) have greater explanatory power than those of threat appraisal (perceived vulnerability to alcohol consequences and severity). The results of this model were also invariant across gender. The evidence presented can be of great utility in developing personalized interventions aimed at promoting the use of alcohol protective strategies, which can minimize the potential harms that young people are exposed to when consuming these substances.