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Wycoff AM, Rogers K, Parlette B, Miranda R, Padovano HT. Cannabis craving in response to alcohol cues in the laboratory and in daily life among adolescents ages 15-17 years. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:2366-2374. [PMID: 38151781 PMCID: PMC10756637 DOI: 10.1111/acer.15215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Most adolescents who drink alcohol also use cannabis, and adolescents who use both substances experience worse long-term outcomes than adolescents who use only one or the other. Recent clinical trials with adolescents and emerging adults show that alcohol cues are associated with elevated cannabis craving in the natural environment but not in the laboratory, highlighting cross-cue reactivity as a potential intervention target. This study extends this work to a younger sample of adolescents at an earlier stage of substance use to examine the generalizability of prior findings and inform etiological mechanisms. METHODS Participants were 81 adolescents aged 15-17 years who endorsed past-month alcohol and lifetime cannabis use. They completed a laboratory cue reactivity protocol where they rated their cannabis craving during alcohol cue and control conditions. They also completed 24 days of ecological momentary assessment where they reported multiple times per day on their cannabis craving and whether alcohol cues were visible. RESULTS Mixed models demonstrated lower cannabis craving following alcohol cue presentation in the laboratory compared to control cues, but higher cannabis craving during moments when alcohol was visible in daily life compared to moments when alcohol was not visible. Frequency of cannabis use at baseline was associated with greater cannabis craving in the laboratory and in daily life regardless of cue type or alcohol visibility, and cannabis craving following alcohol cue presentation in the laboratory was positively related to daily life cannabis craving across contexts. CONCLUSIONS This study adds to prior work suggesting that daily life cannabis craving is elevated when alcohol cues are visible. This cross-cue reactivity may be one factor that drives and maintains alcohol and cannabis use in adolescence.
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Affiliation(s)
- Andrea M. Wycoff
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02912
| | - Kristin Rogers
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02912
| | - Brianna Parlette
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02912
| | - Robert Miranda
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02912
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI 02906
| | - Hayley Treloar Padovano
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02912
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI 02906
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Meisel SN, Padovano HT, Pielech M, Goodyear K, Miranda R. Peer-elicited alcohol craving in adolescents and emerging adults: Bridging the laboratory and natural environment. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:975-985. [PMID: 37526595 PMCID: PMC10394274 DOI: 10.1111/acer.15057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/01/2023] [Accepted: 03/09/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Although peers figure prominently in developmental models of alcohol use, our understanding of the influence of peer social context in cue reactivity paradigms with adolescents and emerging adults in the human laboratory and the natural environment is limited. This study tested associations between alcohol craving among youth in the human laboratory using alcohol-related images, with and without peers, and in the natural environment using ecological momentary assessment (EMA). METHODS Data for this preregistered secondary analysis were collected prior to randomization in two medication trials (N = 115). Participants completed an image cue exposure paradigm at the baseline laboratory session followed by approximately 7 days of EMA. RESULTS In the laboratory, model-based mean comparisons from multilevel models (MLMs) showed that all drinking images elicited greater craving than neutral images. No differences were observed across the three image categories containing alcohol. Image category by age interactions demonstrated that, compared to older youth, younger youth displayed lower craving in response to neutral versus social drinking context with peers images and older, compared to younger, youth displayed higher craving in response to nonsocial drinking images versus social drinking contexts with peers images. In the natural environment, craving was greatest when youth were in the presence of alcohol-using peers and alcohol-related cues, regardless of age. Laboratory craving to alcohol images was positively associated with craving in the natural environment. CONCLUSIONS For youth, peers are a salient social context associated with increased craving, particularly in the natural environment. Laboratory cue reactivity to alcohol images predicted real-world craving, further supporting the ecological validity of this paradigm in youth.
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Affiliation(s)
- Samuel N. Meisel
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode island 02912, USA
- E. P. Bradley Hospital, Riverside, Rhode island 02915, USA
| | - Hayley Treloar Padovano
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode island 02912, USA
| | - Melissa Pielech
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode island 02912, USA
| | - Kimberly Goodyear
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode island 02912, USA
| | - Robert Miranda
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode island 02912, USA
- E. P. Bradley Hospital, Riverside, Rhode island 02915, USA
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Zech HG, Reichert M, Ebner-Priemer UW, Tost H, Rapp MA, Heinz A, Dolan RJ, Smolka MN, Deserno L. Mobile Data Collection of Cognitive-Behavioral Tasks in Substance Use Disorders: Where Are We Now? Neuropsychobiology 2022; 81:438-450. [PMID: 35350031 DOI: 10.1159/000523697] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/11/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Over the last decades, our understanding of the cognitive, motivational, and neural processes involved in addictive behavior has increased enormously. A plethora of laboratory-based and cross-sectional studies has linked cognitive-behavioral measures to between-subject differences in drinking behavior. However, such laboratory-based studies inevitably suffer from small sample sizes and the inability to link temporal fluctuations in task measures to fluctuations in real-life substance use. To overcome these problems, several existing behavioral tasks have been transferred to smartphones to allow studying cognition in the field. METHOD In this narrative review, we first summarize studies that used existing behavioral tasks in the laboratory and self-reports of substance use with ecological momentary assessment (EMA) in the field. Next, we review studies on psychometric properties of smartphone-based behavioral tasks. Finally, we review studies that used both smartphone-based tasks and self-reports with EMA in the field. RESULTS Overall, studies were scarce and heterogenous both in tasks and in study outcomes. Nevertheless, existing findings are promising and point toward several methodological recommendations: concerning psychometrics, studies show that - although more systematic studies are necessary - task validity and reliability can be improved, for example, by analyzing several measurement sessions at once rather than analyzing sessions separately. Studies that use tasks in the field, moreover, show that power can be improved by choosing sampling schemes that combine time-based with event-based sampling, rather than relying on time-based sampling alone. Increasing sampling frequency can further increase power. However, as this also increases the burden to participants, more research is necessary to determine the ideal sampling frequency for each task. CONCLUSION Although more research is necessary to systematically study both the psychometrics of smartphone-based tasks and the frequency at which task measures fluctuate, existing studies are promising and reveal important methodological recommendations useful for researchers interested in implementing behavioral tasks in EMA studies.
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Affiliation(s)
- Hilmar G Zech
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - Markus Reichert
- Department of eHealth and Sports Analytics, Faculty of Sport Science, Ruhr-Universität Bochum (RUB), Bochum, Germany.,Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Mental mHealth Lab, Karlsruhe, Germany.,Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ulrich W Ebner-Priemer
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Mental mHealth Lab, Karlsruhe, Germany.,Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Heike Tost
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Michael A Rapp
- Department for Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Raymond J Dolan
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK.,Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Michael N Smolka
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - Lorenz Deserno
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany.,Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Würzburg, Würzburg, Germany.,Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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Mereish EH, Miranda R. A Preliminary Experimental Study of Minority Stress, Startle Reactivity, and Alcohol Use among Heavy Drinking Sexual Minority Young Adults. Subst Use Misuse 2021; 56:162-168. [PMID: 33222602 DOI: 10.1080/10826084.2020.1846197] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Sexual minorities (e.g. lesbian, gay, bisexual) are at increased risk for alcohol use disorder (AUD) compared to heterosexuals. The minority stress model postulates that disparities in AUD stem, in part, from stress specific to sexual minorities (e.g. heterosexism). However, little research has examined psychophysiological markers of minority stress reactivity and how psychophysiological stress reactivity is associated with lifetime minority stress and alcohol use among sexual minorities. Emotion modulation of the startle response is a well-established paradigm for capturing psychophysiological stress reactivity under controlled laboratory conditions. Purpose: This preliminary study is the first to use the startle experimental paradigm to examine psychophysiological reactivity to stigma among sexual minorities. Procedures: Sexual minority participants (N = 20; 55% female), aged 18 to 27 years (M = 21.80, SD = 2.65), were recruited from the community. We compared startle reactivity in response to three types of stimuli (stigma, negative, and neutral) among heavy drinking sexual minority young adults. Although statistically underpowered, we also explored the associations between startle reactivity and self-reported drinking behaviors and lifetime minority stress. Results: Both stigma and general unpleasant stimuli produced more psychophysiological stress reactivity than neutral stimuli among sexual minorities. Psychophysiological stress reactivity was correlated with greater quantity of drinks reported on drinking days in the past month, but not greater frequency. Additionally, lifetime exposure to minority stress was associated with a blunted reactivity to stigma stimuli. Conclusions: These findings provide methodological advances and important implications for minority stress theory and alcohol use among sexual minorities.
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Affiliation(s)
- Ethan H Mereish
- Department of Health Studies, American University, Washington, DC, USA.,Center for Alcohol and Addiction Studies (CAAS), Brown University, Providence, Rhode Island, USA
| | - Robert Miranda
- Center for Alcohol and Addiction Studies (CAAS), Brown University, Providence, Rhode Island, USA
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