Daily-level associations between protective behavioral strategies, transdermal alcohol concentration, and alcohol-induced blackouts among young adults.

OBJECTIVE: Alcohol-induced blackouts (AIBs) are more likely to occur when large quantities of alcohol are consumed quickly. Protective behavioral strategies (PBS) may mitigate the risk of experiencing an AIB by reducing the level, speed, and duration of drinking. This study examines daily associations between PBS, drinking measured using a transdermal alcohol concentration (TAC) biosensor, and AIBs among young adults. METHOD: Participants (N = 168, Mage = 20.8, 53% female, 87% White, 10% Hispanic) wore TAC biosensors and completed daily surveys about their PBS use and AIBs over six social weekends (i.e., Thursday-Sunday). TAC drinking features (peak, rise rate, and rise duration) were extracted from TAC data for each day. Two-level multilevel structural equation models were conducted to examine the associations between PBS (total and individual domains: manner of drinking, stopping/limiting drinking, and serious harm reduction) and AIBs. RESULTS: Approximately 80% of participants experienced at least one AIB (M = 3.08, SD = 2.99). On days when individuals reported using more total PBS and manner of drinking, the associated decrease in TAC features was associated with decreased odds of experiencing an AIB. Days when individuals used more serious harm reduction, the associated increase in TAC features was associated with increased AIB odds. CONCLUSIONS: Days when participants used above-average total PBS and manner of drinking were less indicative of risky TAC drinking and AIBs. Days with above-average serious harm reduction were more indicative of risky TAC drinking and AIBs. Findings demonstrate the associations between PBS, real-world intoxication dynamics measured by TAC biosensors, and subsequent AIBs among young adults who engage in risky drinking. (PsycInfo Database Record (c) 2026 APA, all rights reserved).