Substance Use & Misuse

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Protective Behavioral Strategies Moderate the

Association between Narcissistic Traits and
Alcohol Pathology in College Student Drinkers

Matthew P. Kramer, Dexter D. Wilborn, Christopher C. Spencer, Brittany L.

Stevenson & Robert D. Dvorak

To cite this article: Matthew P. Kramer, Dexter D. Wilborn, Christopher C. Spencer, Brittany L.
Stevenson & Robert D. Dvorak (2019): Protective Behavioral Strategies Moderate the Association
between Narcissistic Traits and Alcohol Pathology in College Student Drinkers, Substance Use &
Misuse, DOI: 10.1080/10826084.2018.1547909

To link to this article: https://doi.org/10.1080/10826084.2018.1547909

Published online: 14 Jan 2019.

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SUBSTANCE USE & MISUSE
https://doi.org/10.1080/10826084.2018.1547909

NOTE

Protective Behavioral Strategies Moderate the Association between

Narcissistic Traits and Alcohol Pathology in College Student Drinkers
Matthew P. Kramer, Dexter D. Wilborn, Christopher C. Spencer, Brittany L. Stevenson , and
Robert D. Dvorak
Department of Psychology, The University of Central Florida, Orlando, Florida, USA

ABSTRACT KEYWORDS
Background: Personality traits found in Cluster B personality disorders have garnered consid- Alcohol use; alcohol
erable empirical attention and have been linked to a litany of issues, such as alcohol-related problems; protective
problems. While psychopathic traits have been linked to alcohol-use consequences, narcis- behavioral strat-
egies; narcissism
sistic traits remain understudied. Objectives: The current study examines the relationship
between narcissistic traits and alcohol use and consequences as a function of Protective
Behavioral Strategies (PBS) in a sample of college students. Method: Participants (n ¼ 387
college student drinkers; 69.25% female) completed a series of questionnaires assessing
alcohol use and consequences, PBS use, and narcissistic traits. Results: There was a signifi-
cant positive association between narcissistic traits and alcohol use and consequences. The
interaction of PBS and narcissistic traits was also statistically significant. Simple slopes
revealed that at high levels of PBS (þ1SD), the relationship between narcissistic traits and
alcohol-use consequences was attenuated and not significant, while at low levels of PBS
(–1SD), this association was potentiated. Conclusion: These findings suggest that interven-
tions targeting PBS use may be one way to reduce alcohol problems among those with
higher levels of narcissistic traits.

Introduction Weitzman, 2009; Johnston, O’Malley, Bachman,

Previous research has linked certain personality traits
(e.g., psychopathy) to problematic functioning, includ-
ing alcohol use and consequences (AUC; Stenason &
Vernon, 2016; Sylvers, Landfield, & Lilienfeld, 2011).
However, while there is an abundance of research
linking psychopathy and AUC, there is little research
regarding narcissism and AUC. Indeed, only one
study appears to have examined narcissistic traits and
alcohol use (Luhtanen & Crocker, 2005). Luhtanen
and Crocker (2005) found that narcissistic traits were
positively associated with alcohol consumption
amongst college students. They theorized that this
could be due to ego threat, which has been linked to
increased alcohol consumption in past research
(Baumeister, 1997). Given that a core tenet of
narcissism is a grandiose sense of self and fragile ego
(Raskin & Terry, 1988), it makes theoretical sense that
individuals with heightened levels of narcissistic traits
may be prone to increased AUC to cope with frequent
ego threats. Since alcohol-related problems remain
prevalent among college students (Hingson, Zha, &
Schulenberg, & Miech, 2014), and alcohol problems
may be more prevalent among students with increased
narcissistic traits (Luhtanen & Crocker, 2005), under-
standing factors that may mitigate alcohol risks
among college students is important. One such factor
is the use of protective behavioral strategies (Pearson,
D’Lima, & Kelley, 2013).
Protective behavioral strategies (PBS) are behaviors
that lead to reduced alcohol consumption and lower
alcohol-related consequences (DeMartini et al., 2013;
Martens, Pederson, LaBrie, Ferrier, & Cimini, 2007;
Martens et al., 2004; Pearson, D’Lima, & Kelley,
2013). From a simple harm reduction approach
(Marlatt, 1996), PBS use may attenuate the association
between Cluster B personality traits and AUC
(Doumas, Miller, & Esp, 2017; Kramer, Stevenson, &
Dvorak, 2017). For example, Doumas et al. (2017)
found that PBS use reduced binge-drinking episodes
and consequences among high school seniors who
endorsed high levels of impulsivity and sensation
seeking. Kramer et al. (2017) found that PBS use

CONTACT Matthew P. Kramer Matthew.kramer@knights.ucf.edu Department of Psychology, The University of Central Florida, 4111 Pictor Lane,
Psychology Building 99, Orlando, Florida 32816-1390, USA.
ß 2019 Taylor & Francis Group, LLC
2 M. P. KRAMER ET AL.

mitigated the relationship between primary psychop- harm reduction. Items are rated on a Likert-scale
athy and AUC. Despite these previous studies, it from 0 (never) to 5 (always). Previous research shows
remains to be seen if this protective effect extends to good construct validity and reliability of the PBSS
narcissistic traits. (Martens et al., 2007; Pearson et al., 2013). In the
current data, a confirmatory factor analysis of the PBS
factor structure indicated one item (“drink shots of
Study overview
liquor”) did not load with the other manner of drink-
The current study examines the association between ing subscale items (factor loading ¼ –0.28). Removing
narcissistic traits, AUC, and PBS use among college this item increased the internal consistency of the sub-
students. We hypothesized that narcissism would be scale from .72 to .80. This is consistent with previous
associated with increased AUC, and that PBS use research that has found this item to be problematic
would moderate the relationship between AUC and (Treloar, Martens, & McCarthy, 2015). The subscales
narcissism, such that this relationship would be were combined to form a global measure of PBS use
attenuated at high levels of PBS use and potentiated at (a ¼ .91, M ¼ 3.17, SD ¼ 0.66).
low levels of PBS use. Narcissistic traits were measured with the
Narcissistic Personality Inventory-13 (NPI-13), a short
Method form of the NPI-40 that taps into grandiose
narcissism (Gentile et al., 2013). The NPI-13 is a
Participants and procedure forced-choice questionnaire comprised of 13 pairs of
Participants were n ¼ 701 college students from a statements (e.g. Pair 3: “I like having authority over
Midwest university recruited from a university subject other people” OR “I don’t mind following orders”).
pool to participate in a study titled: “Experiences Items are scored based on which statement was
among College Students,” which had university IRB selected (narcissistic traits ¼ 1, non-narcissistic
approval. All participants were treated in accordance traits ¼ 0). A mean score was computed to assess
with APA ethical guidelines for research (Sales & narcissistic traits (a ¼ .65, M ¼ 0.30, SD ¼ 0.20).
Folkman, 2000). Participants followed a link to an
online platform where they completed informed Results
consent and were directed to the survey. Participants
received course credit for participating. Of this Analyses were conducted using Stata12.0 (StataCorp,
sample, n ¼ 387 (69.25% female; 92.51% Caucasian) 2012). Both PBS use and narcissistic traits were mean
reported that they consumed alcohol. Non-drinkers centered prior to analysis. Descriptive statistics and
were excluded from the analysis. The analysis sample bivariate correlations can be found in Table 1. AUC
ranged in age from 18 to 35 (M ¼ 21.14, SD ¼ 3.07). was regressed onto PBS use and narcissistic traits.
This model accounted for a significant level of
variance in AUC, p < .001. The interaction of
Measures PBS  narcissistic traits was then added to the model.
AUC was assessed via the Alcohol Use Disorder This significantly improved the model, DR2 ¼ .01,
Identification Test (AUDIT; Saunders, Aasland, Babor, p ¼ .037 (see Table 2)1.
De La Fuente, & Grant, 1993). The AUDIT consists of We then examined the relationship between narcis-
10 items comprising three subscales: alcohol consump- sistic traits and AUC at high (þ1SD) and low (–1SD)
tion, dependence symptoms, and alcohol harm. The
Table 1. Descriptive statistics and bivariate correlations.
AUDIT has shown consistent reliability and validity
Variables 1 2 3 4 5
across various settings (Allen, Litten, Fertig, & Babor,
1. Age – – – – –
1997; Saunders, Aasland, Babor, De La Fuente, & 2. Gender 0.05 – – – –
Grant, 1993). Previous research supports the use of the 3. Narcissism –0.11 0.11 – – –
4. PBS –0.11 –0.27 –0.07 – –
AUDIT among college students (DeMartini & Carey, 5. AUC –0.02 0.19 0.22 –0.32 –
2009). The total score from the AUDIT (a ¼ .81,
Mean 21.14 0.31 0.30 3.20 6.31
M ¼ 6.32, SD ¼ 4.45) was used as a measure of AUC. SD 3.07 0.46 0.20 0.71 4.45
PBS were measured with the Protective Behavioral Skew 2.50 0.69 0.49 –0.27 1.15
Strategies Scale (PBSS; Martens et al., 2005). The PBSS Range 18–35 0–1 0.00–0.85 1.00–5.00 0.00–22.00
AUC ¼ alcohol use and consequences; PBS ¼ protective behavioral strat-
is a 15-item questionnaire that assesses stopping/ egies; gender coded as 0 ¼ females, 1 ¼ males.
limiting drinking, manner of drinking, and serious p < .05.
 SUBSTANCE USE & MISUSE 3

Table 2. Regression model of AUC. To date, there has been very little research on
Model components R2 df F b p narcissistic traits and AUC (Stenason & Vernon,
Step 1 0.145 2, 384 32.47 <.001 2016), with only one study examining the relationship
PBS –0.308 <.001
Narcissism 0.202 <.001 between narcissistic traits and alcohol problems
Step 2 0.154 3, 383 23.37 <.001 (Luhtanen & Crocker, 2005). The present study
PBS –0.321 <.001
Narcissism 0.186 <.001 replicates this earlier work, furthers the literature on
PBS  narcissism –0.100 .037 possible maladaptive behaviors for those with higher
Coefficients are standardized. trait narcissism, and opens the door for future
PBS ¼ protective behavioral strategies.
research to more closely examine this relationship and
identify potential mitigating factors.
12.00
-1SD PBS Use The present results may be promising for future
10.00 Mean PBS Use interventions. Several studies have shown that PBS use
+1SD PBS Use can be increased via a targeted approach (Barnett,
AUDIT Score

8.00 Murphy, Colby, & Monti, 2007; Dvorak, Kramer,

6.00
4.00
2.00
0.00
-0.5 -0.3 -0.1 0.1
Mean Centered Narcissism
Figure 1. Narcissism on AUC at high (þ1SD) and low (–1 SD)
levels of alcohol protective behavioral strategies.
Note. PBS ¼ protective behavioral strategies.
levels of PBS (Aiken & West, 1991) (Figure 1).
Narcissism was positively associated with AUC
(b ¼ 0.19, p < .001) at mean levels of PBS use. The
association between narcissism and AUC was potenti-
ated at low levels of PBS use (b ¼ 0.29, p < .001).
However, this relationship was attenuated, and not
significant, at high levels of PBS (b ¼ 0.08, p ¼ .295).
Discussion
The current study investigated the association between
narcissistic traits, PBS, and AUC. Previous research
has found a relationship between narcissistic traits
and alcohol problems (Luhtanen & Crocker, 2005).
Hypotheses were supported. Results indicate that
those higher in narcissistic traits endorse greater
AUC, consistent with an ego threat conceptualization
(Baumeister, 1997). Additionally, PBS moderated the
relationship between trait narcissism and AUC, which
is generally consistent with the harm-reduction
approach (Marlatt, 1996) as well as previous research
regarding other Cluster B traits and PBS (Doumas
et al., 2017). Specifically, at low levels of PBS the
relationship between narcissistic traits and AUC was
potentiated; however, at high levels of PBS this
relationship was attenuated.
Stevenson, Sargent, & Kilwein, 2017; Dvorak et al.,
2016; Martens et al., 2007). Examining effects of
PBS-based interventions as a function of narcissism
may reveal populations that would benefit from
such interventions. Given that PBS may be a malleable
intervention target (Braitman, Henson, & Carey,
0.3 0.5 2015; Dvorak, Pearson, Neighbors, & Martens, 2015;
Whitley, Madson, & Zeigler-Hill, 2017), future studies
should examine PBS-based interventions among
individuals high in narcissistic traits.
Limitations
This study is not without limitations. Though previous
research suggests that the NPI-13 is a viable tool in
assessing trait narcissism, it taps into grandiose narcis-
sism (Gentile et al., 2013). Further, the original NPI-40
has been scrutinized for being a forced-choice question-
naire with a factor structure that has not been readily
agreed upon (Cain, Pincus, & Ansell, 2008). Replication
of these findings with other measures of narcissism is
warranted. Second, more comprehensive measures of
AUC are crucial to identifying the types of alcohol-
related issues most pertinent to narcissistic traits.
Furthermore, recent evidence suggests that there is
some inconsistency amongst PBS findings in the litera-
ture (Pearson, Prince, & Bravo, 2017); it is important to
replicate these findings to ensure the present findings
are not a Type I error. Finally, the data here are cross-
sectional and consisted only of college students; future
studies should look to more generalizable samples.
Conclusion
The present study examined the relationship between
narcissistic traits and AUC as a function of PBS use
among college students. Results suggest that those
higher in narcissistic traits experience greater AUC,
4 M. P. KRAMER ET AL.
but that this relationship can be attenuated via
increased PBS use. Future studies should examine
interventions that target PBS, as it appears to help
reduce alcohol-related problems for this population.
Note
1. The variables age and gender were initially included in
the primary analysis. Neither age (p ¼ .552) nor gender
(p ¼ .087) predicted AUC. However, when these
variables were included, the interaction between
narcissism and PBS no longer reached traditional levels
of significance (p ¼ .056 (vs. p ¼ .037 when excluded).
Consistent with Rosnow and Rosenthal’s (1989)
assessment, “we want to underscore that, surely, God
loves the .06 nearly as much as the .05” (p. 1277).
Disclosure statement
No potential conflict of interest was reported by the
authors. The authors alone are responsible for the content
and writing of the article.
ORCID
Brittany L. Stevenson http://orcid.org/0000-0002-
1116-4807
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