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Conlin WE, Hoffman M, Steinley D, Vergés A, Sher KJ. Predictors of symptom course in alcohol use disorder. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:2288-2300. [PMID: 38151783 PMCID: PMC10935605 DOI: 10.1111/acer.15201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 09/14/2023] [Accepted: 09/21/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Symptoms often play an important role in the scientific inquiry of psychological disorders and have been theorized to play a functional role in the disorders themselves. However, little is known about the course of specific symptoms and individual differences in course. Understanding the course of specific symptoms and factors influencing symptom course can inform psychological theory and future research on course and treatment. METHODS The current study examined alcohol use disorder (AUD) criteria to explore how etiologically relevant covariates differentially affected the course of individual criteria. The study examined 34,653 participants from Wave 1 (2001-2002) and Wave 2 (2003-2004) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), to analyze the extent to which AUD symptom course is predicted by alcohol consumption patterns, family history of alcoholism, the presence of internalizing and externalizing disorders, and race. RESULTS The course of all AUD criteria was significantly influenced by these predictors, with the magnitude of the influence varying across different criteria and different aspects of the course (i.e., onset, persistence, recurrence). The strength of the relationship is partially related to the theoretical proximity of a given covariate to AUD symptomatology, with heavy drinking being the strongest and family history of AUD being the weakest. The course of all criteria was strongly associated with the prevalence of the criterion in the overall sample. CONCLUSIONS The course of AUD criteria is heterogeneous, appearing to be influenced by conceptually proximal predictors, the prevalence of the criterion, and perhaps an underlying common factor. Diagnostic accuracy may be improved by including a criterion related to alcohol consumption. Future work should include exploring the interchangeability of criteria and alternative operationalization of them.
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Affiliation(s)
- William E. Conlin
- Department of Psychological Sciences, University of Missouri, Missouri, Columbia, USA
| | - Michaela Hoffman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, South Carolina, Charleston, USA
| | - Douglas Steinley
- Department of Psychological Sciences, University of Missouri, Missouri, Columbia, USA
| | - Alvaro Vergés
- Universidad de los Andes, Escuela de Psicología, Las Condes, Chile
- Núcleo Milenio para Mejorar la Salud Mental de Adolescentes y Jóvenes, Michigan, Imhay, USA
| | - Kenneth J. Sher
- Department of Psychological Sciences, University of Missouri, Missouri, Columbia, USA
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2
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Hisler GC, Pedersen SL, Hasler BP. The 24-hour rhythm in alcohol craving and individual differences in sleep characteristics and alcohol use frequency. Alcohol Res 2022; 46:1084-1093. [PMID: 35383960 DOI: 10.1111/acer.14826] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/15/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Evidence implicates sleep/circadian factors in alcohol use, suggesting the existence of a 24-h rhythm in alcohol craving, which may vary by individual differences in sleep factors and alcohol use frequency. This study sought to (1) replicate prior findings of a 24-h rhythm in alcohol craving, and (2) examine whether individual differences in sleep timing, sleep duration, or alcohol use frequency are related to differences in the timing of the peak of the craving rhythm (i.e., the acrophase) or magnitude of fluctuation of the rhythm (i.e., amplitude). Finally, whether such associations varied by sex or racial identity was explored. METHODS Two-hundred fifteen adult drinkers (21 to 35 years of age, 72% male, 66% self-identified as White) completed a baseline assessment of alcohol use frequency and then smartphone reports of alcohol craving intensity six times a day across 10 days. Sleep timing was also recorded each morning of the 10-day period. Multilevel cosinor analysis was used to test the presence of a 24-h rhythm and to estimate acrophase and amplitude. RESULTS Multilevel cosinor analysis revealed a 24-h rhythm in alcohol craving. Individual differences in sleep timing or sleep duration did not predict rhythm acrophase or amplitude. However, alcohol use frequency moderated this rhythm wherein individuals who used alcohol more frequently in the 30 days prior to beginning the study had higher mean levels of craving and greater rhythm amplitudes (i.e., greater rhythmic fluctuations). Associations did not vary by sex or racial identity. CONCLUSIONS Results show that alcohol craving exhibits a systematic rhythm over the course of the 24 h and that the frequency of alcohol use may be relevant to the shape of this rhythm. Consideration of daily rhythms in alcohol craving may further our understanding of the mechanisms that drive alcohol use.
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Affiliation(s)
- Garrett C Hisler
- University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Sarah L Pedersen
- University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Brant P Hasler
- University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA
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3
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Pedersen SL, Kennedy TM, Holmes J, Molina BS. Momentary associations between stress and alcohol craving in the naturalistic environment: differential associations for Black and White young adults. Addiction 2022; 117:1284-1294. [PMID: 34859912 PMCID: PMC8983429 DOI: 10.1111/add.15740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 10/20/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Black drinkers compared with White drinkers experience more alcohol-related problems. Examination of social determinants of inequities in alcohol problems is needed. The current study measured (1) associations between acute stress and alcohol craving in the naturalistic environment for self-identified Black and White individuals who drink alcohol and (2) whether a history of attention deficit hyperactivity disorder (ADHD) moderated these associations. DESIGN AND SETTING Observational study using ecological momentary assessment (EMA) to collect data from participants at six semi-random time-points throughout the day during a 10-day period. A series of three-level multi-level models examined between- and within-person associations for stress and alcohol and tested if these associations differed for Black and White adults. PARTICIPANTS Participants were 229 adult drinkers (aged 21-35 years) who completed a larger study examining alcohol response for Black and White adults with and without a history of childhood ADHD. MEASUREMENTS Momentary stress and alcohol craving, ADHD history and socio-demographic characteristics (i.e. racial identity, sex, age, current education level, household income) were assessed. Participants were required to self-identify as either 'African American or Black' or 'European American or White'. FINDINGS Significant racial identity × stress interactions indicated that associations between stress and craving were stronger for Black compared with White adults across the 10-day period (between-person: B = 0.14, P = 0.007), concurrently within a given EMA time-point (within-person: B = 0.04, P = 0.001) and prospectively from time-point to time-point (within-person: B = 0.05, P = 0.001). Results remained while accounting for income × stress interactions. CONCLUSIONS Acute stress appears to be more strongly related to alcohol craving in self-identified Black compared with self-identified White individuals. This provides support for policy changes to eliminate structural inequities that increase stress exposure and the development of just-in-time culturally responsive interventions focused on coping with acute stress for Black individuals.
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Affiliation(s)
- Sarah L. Pedersen
- Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St. Pittsburgh, PA, 15213, USA
| | - Traci M. Kennedy
- Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St. Pittsburgh, PA, 15213, USA
| | - Jordan Holmes
- Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St. Pittsburgh, PA, 15213, USA
| | - Brooke S.G. Molina
- Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St. Pittsburgh, PA, 15213, USA
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4
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Slade T, Mewton L, O'Dean S, Tibbetts J, Clay P, Isik A, Johnson P, McCraw S, Upton E, Kypri K, Butterworth P, McBride N, Swift W. DSM-5 and ICD-11 alcohol use disorder criteria in young adult regular drinkers: Lifetime prevalence and age of onset. Drug Alcohol Depend 2021; 229:109184. [PMID: 34813987 DOI: 10.1016/j.drugalcdep.2021.109184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 10/28/2021] [Accepted: 10/31/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Alcohol Use Disorder (AUD) is a significant contributor to global disease burden. AUD has a relatively early onset during young adulthood (Teesson et al., 2010). However, compared to AUD in adults, we have relatively little understanding of AUD in adolescents and emerging adults. METHODS The RADAR study is a prospective cohort study designed to investigate the emergence of AUD in community-dwelling adolescents and emerging adults across Australia (age range = 18-21 at baseline). At 6 monthly intervals over 2.5 years, participants were interviewed regarding alcohol consumption and alcohol use disorder criteria by clinical psychologists using the SCID-IV-RV. This paper reports the baseline findings of the RADAR cohort. RESULTS Proportions of lifetime criteria endorsement among regular drinkers varied considerably. Tolerance was the most endorsed criterion (50.3%), followed by Social Problems (10.4%) and Larger/Longer (9.0%). The median age of onset for most individual AUD criteria was 18 years of age. 18.4% of our cohort met DSM-5 AUD diagnosis in their lifetime to date, and 16.8% met ICD-11 dependence. When removing Tolerance from the AUD criteria, DSM-5 AUD lifetime prevalence reduced to 11.0%, and ICD-11 AUD lifetime prevalence fell to 7.1% in our cohort. CONCLUSIONS Variable rates of criteria endorsement likely reflect both true differences in the experience of AUD criteria and methodological challenges in the assessment of AUD in an emerging adult age group. High rates of tolerance to the effects of alcohol, and relatively low rates of drinking larger/longer than intended are discussed considering methodological challenges in assessing these criteria in young adults.
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Affiliation(s)
- Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia.
| | - Louise Mewton
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Siobhan O'Dean
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Joel Tibbetts
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Peter Clay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Ashling Isik
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Phoebe Johnson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Stacey McCraw
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Emily Upton
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, NSW, Australia
| | - Peter Butterworth
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Wendy Swift
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
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Maurage P, Lannoy S, Mange J, Grynberg D, Beaunieux H, Banovic I, Gierski F, Naassila M. What We Talk About When We Talk About Binge Drinking: Towards an Integrated Conceptualization and Evaluation. Alcohol Alcohol 2021; 55:468-479. [PMID: 32556202 DOI: 10.1093/alcalc/agaa041] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/17/2020] [Accepted: 04/24/2020] [Indexed: 12/11/2022] Open
Abstract
RATIONALE Binge drinking (BD), characterized by recurring alternations between intense intoxication episodes and abstinence periods, is the most frequent alcohol consumption pattern in youth and is growing in prevalence among older adults. Many studies have underlined the specific harmful impact of this habit by showing impaired abilities in a wide range of cognitive functions among binge drinkers, as well as modifications of brain structure and function. AIMS Several controversies and inconsistencies currently hamper the harmonious development of the field and the recognition of BD as a specific alcohol consumption pattern. The main concern is the absence of consensual BD conceptualization, leading to variability in experimental group selection and alcohol consumption evaluation. The present paper aims at overcoming this key issue through a two-step approach. METHODS AND CONCLUSIONS First, a literature review allows proposing an integrated BD conceptualization, distinguishing it from other subclinical alcohol consumption patterns. Six specific characteristics of BD are identified, namely, (1) the presence of physiological symptoms related to BD episodes, (2) the presence of psychological symptoms related to BD episodes, (3) the ratio of BD episodes compared to all alcohol drinking occasions, (4) the frequency of BD episodes, (5) the consumption speed and (6) the alternation between BD episodes and soberness periods. Second, capitalizing on this conceptual clarification, we propose an evaluation protocol jointly measuring these six BD characteristics. Finally, several research perspectives are presented to refine the proposed conceptualization.
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Affiliation(s)
- Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve 1348, Belgium
| | - Séverine Lannoy
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford 94305, CA, USA
| | - Jessica Mange
- Laboratoire de Psychologie Caen Normandie (LPCN; EA 7452), University of Caen Normandy, Caen 14032, France
| | - Delphine Grynberg
- SCALab UMR 9193, Sciences Cognitives et Sciences Affectives, University of Lille, CNRS, CHU Lille, Lille 59000, France.,Institut Universitaire de France, Paris 75231, France
| | - Hélène Beaunieux
- Laboratoire de Psychologie Caen Normandie (LPCN; EA 7452), University of Caen Normandy, Caen 14032, France
| | - Ingrid Banovic
- CRFDP EA 7475, University of Rouen Normandie, Rouen 76000, France
| | - Fabien Gierski
- Cognition, Health, Society Laboratory (C2S-EA 6291), University of Reims Champagne Ardenne (URCA), Reims 51571, France.,INSERM UMR 1247, Research Group on Alcohol and Pharmacodependences, GRAP, University of Picardie Jules Verne, Amiens 80025, France
| | - Mickaël Naassila
- INSERM UMR 1247, Research Group on Alcohol and Pharmacodependences, GRAP, University of Picardie Jules Verne, Amiens 80025, France
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6
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Yoon G, Thompson K, Hakes JK, Westermeyer J, Petrakis IL, Kim SW. Alcohol Craving and Psychiatric Disorders Among Current Drinkers. Am J Addict 2020; 30:34-42. [PMID: 32667738 DOI: 10.1111/ajad.13083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 06/07/2020] [Accepted: 06/16/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Previous research has shown that alcohol craving is associated with psychiatric comorbidities. However, no population studies have examined the odds of psychiatric disorders in cravers and noncravers. The purpose of this study was to investigate current prevalence rates and odds ratios of psychiatric disorders among alcohol drinkers with and without alcohol craving in a population-based sample. We also compared four craving groups (cravers with and without alcohol use disorder [AUD], noncravers with and without AUD) for psychiatric comorbidities. METHODS The study data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). A subset of the NESARC sample (N = 22 000) who reported alcohol use during the past 12 months was included. Prevalence rates of psychiatric disorders were compared among current drinkers with alcohol craving (N = 900) and without alcohol craving (N = 21 500). RESULTS Cravers had higher prevalence rates of current psychiatric disorders than noncravers. Even after adjustment for other psychiatric disorders including AUD, cravers had significantly higher odds of any substance use disorder (adjusted odds ratio [AOR], 9.01), any mood disorder (AOR, 1.78), any anxiety disorder (AOR, 1.86), and any personality disorder (AOR, 1.92) than noncravers. Interestingly, cravers without AUD had even higher rates of any anxiety disorder and any personality disorder than noncravers with AUD. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Alcohol craving is associated with a higher prevalence of various psychiatric disorders. These findings suggest that alcohol craving may be related to transdiagnostic features that are present across various psychiatric disorders. (Am J Addict 2021;30:34-42).
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Affiliation(s)
- Gihyun Yoon
- VA Connecticut Healthcare System, West Haven, Connecticut.,Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut
| | - Katie Thompson
- Minneapolis VA Health Care System, Minneapolis, Minnesota
| | | | - Joseph Westermeyer
- Minneapolis VA Health Care System, Minneapolis, Minnesota.,Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Ismene L Petrakis
- VA Connecticut Healthcare System, West Haven, Connecticut.,Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut
| | - Suck Won Kim
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
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7
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Kuerbis AN, Shao S, Treloar Padovano H, Jadanova A, Selva Kumar D, Vitale R, Nitzburg G, Vadhan NP, Morgenstern J. Context and craving among individuals with alcohol use disorder attempting to moderate their drinking. Exp Clin Psychopharmacol 2020; 28:677-687. [PMID: 31971419 PMCID: PMC7375899 DOI: 10.1037/pha0000349] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Many individuals with alcohol use disorder (AUD) prefer a goal of moderation, because they do not see their drinking as causing severe enough consequences to merit abstinence. Given that individuals attempting to moderate will continue to put themselves in contexts where drinking occurs, understanding how distinct external alcohol cues prompt craving is important for implementing the optimal treatments for individuals with AUD. Using data from a randomized controlled trial of stepped care brief interventions for AUD, this study explored the relationship between drinking contexts and craving in individuals attempting to moderate their drinking using ecological momentary assessment (EMA). At baseline, participants were asked to prospectively identify drinking contexts that were particularly likely to elicit intense craving and heavy drinking, called highly valued drinking contexts (HVCs). During EMA, participants were asked to report three times a day (morning, afternoon, evening) on their non-mutually exclusive contexts and their level of craving. Using multilevel modeling, all drinking contexts were tested as concurrent predictors of craving across the 84 days of the study. Next, AUD severity was tested as a moderator of HVC on craving. Results demonstrated that being in an HVC corresponded to greater reports of any craving and intensity of craving, over and above the influences of several other contextual factors (e.g., negative affect and already drinking). AUD severity significantly moderated HVC's impact on any craving, such that greater AUD severity potentiated HVC's already high odds of any craving. Implications for treatments for individuals with AUD are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | - Sijing Shao
- Center for Addiction Services and Psychotherapy Research
| | | | - Anna Jadanova
- Center for Addiction Services and Psychotherapy Research
| | | | - Rachel Vitale
- Center for Addiction Services and Psychotherapy Research
| | | | - Nehal P Vadhan
- Center for Addiction Services and Psychotherapy Research
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8
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Stohs ME, Schneekloth TD, Geske JR, Biernacka JM, Karpyak VM. Alcohol Craving Predicts Relapse After Residential Addiction Treatment. Alcohol Alcohol 2019; 54:167-172. [DOI: 10.1093/alcalc/agy093] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 12/04/2018] [Accepted: 12/26/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Matthew E Stohs
- Department of Psychiatry and Behavioral Health, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Jennifer R Geske
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Victor M Karpyak
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
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9
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Wagner V, Acier D, Dietlin JE. Outpatient Addiction Treatment for Problematic Alcohol Use: What Makes Patients Who Dropped Out Different from Those Who Did Not? Subst Use Misuse 2018; 53:1893-1906. [PMID: 29469633 DOI: 10.1080/10826084.2018.1441310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND A minority of individuals with problematic alcohol use effectively seek help. Moreover, dropouts from care are not uncommon. It remains a major concern for health professionals, as adherence to treatment is significantly associated with better physical and psychological outcomes. OBJECTIVES The main aim of this research was to assess what factors could distinguish patients with problematic alcohol use who dropped out from those who did not. METHODS The sample included 150 patients followed-up in an outpatient treatment center in France for a problematic alcohol use. Two measurement times were planned: at the first appointment and after six month of treatment. A large set of individual, environmental and institutional variables were considered to compare both subgroups. RESULTS Patients who dropped out mostly differ from patients who did not with a higher level of alcohol-related problems, ambivalence, inclinations to use the substance, number of missed appointments. Significant results were also observed regarding a lower time gap between the first contact with the center and the first appointment, as well as the season of the last appointment. CONCLUSIONS Tailored motivational interventions could be offered to ambivalent patients, especially during the beginning of the treatment and some significant periods of the year. A particular focus should be brought on patients presenting such profiles in terms of level of alcohol problems, inclinations to drink and motivation to change. Overall, the study provides elements to better understand what may bring one patient to drop out of the treatment, and to improve the continuity of care.
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Affiliation(s)
- Vincent Wagner
- a Department of Clinical Psychology , Laboratoire de Psychologie des Pays de la Loire, University of Nantes , Nantes , France.,b Beauséjour Addiction Care, Support and Prevention Center, Les Apsyades , Nantes , France
| | - Didier Acier
- a Department of Clinical Psychology , Laboratoire de Psychologie des Pays de la Loire, University of Nantes , Nantes , France
| | - Jean-Eric Dietlin
- b Beauséjour Addiction Care, Support and Prevention Center, Les Apsyades , Nantes , France
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10
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Cheng HG, Anthony JC. Female-male differences in alcohol dependence levels: Evidence on newly incident adolescent and young-adult drinkers in the United States, 2002-2014. Int J Methods Psychiatr Res 2018; 27:e1717. [PMID: 29745044 PMCID: PMC6744833 DOI: 10.1002/mpr.1717] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 02/08/2018] [Accepted: 03/06/2018] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE In this study of newly incident drinkers (NIDs), we (a) investigate and calibrate measurement equivalence of 7 clinical features of an alcohol dependence syndrome (ADS) across sex and age-of-onset subgroups and (b) estimate female-male differences in ADS levels soon after taking the first full drink, with focus on those with first full drink before the 24th birthday. METHODS The study population is 12- to 23-year-old NIDs living in the United States (n = 33,561). Calibrated for measurement equivalence, male-female differences in levels of newly incident ADS are estimated for 6 age-of-onset subgroups. RESULTS Measurement equivalence is achieved by dropping the "difficulty cutting down" item. Then, among early-adolescent-onset NID, females have higher ADS levels (for 12- to 13-year-old NID: β = .25; 95% CI [0.05, 0.45]). In contrast, when drinking onset is delayed to adulthood, males have higher ADS levels (e.g., for 18- to 19-year-old NID: β = -.27; 95% CI [-0.52, -0.02]; for 20- to 21-year-old NID: β = -.38; 95% CI [-0.65, -0.12]). CONCLUSIONS In the United States, there is female excess in ADS levels measured soon after drinking onset in early adolescence. The traditional male excess is seen when drinking onset occurs after mid-adolescence. Evidence from other countries will be useful.
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Affiliation(s)
- Hui G Cheng
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - James C Anthony
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
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11
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Predicting Young Adults Binge Drinking in Nightlife Scenes: An Evaluation of the D-ARIANNA Risk Estimation Model. J Addict Med 2018; 12:401-409. [PMID: 29847462 DOI: 10.1097/adm.0000000000000419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Binge drinking (BD) among young people has significant public health implications. Thus, there is the need to target users most at risk. We estimated the discriminative accuracy of an innovative model nested in a recently developed e-Health app (Digital-Alcohol RIsk Alertness Notifying Network for Adolescents and young adults [D-ARIANNA]) for BD in young people, examining its performance to predict short-term BD episodes. METHODS We consecutively recruited young adults in pubs, discos, or live music events. Participants self-administered the app D-ARIANNA, which incorporates an evidence-based risk estimation model for the dependent variable BD. They were re-evaluated after 2 weeks using a single-item BD behavior as reference. We estimated D-ARIANNA discriminative ability through measures of sensitivity and specificity, and also likelihood ratios. ROC curve analyses were carried out, exploring variability of discriminative ability across subgroups. RESULTS The analyses included 507 subjects, of whom 18% reported at least 1 BD episode at follow-up. The majority of these had been identified as at high/moderate or high risk (65%) at induction. Higher scores from the D-ARIANNA risk estimation model reflected an increase in the likelihood of BD. Additional risk factors such as high pocket money availability and alcohol expectancies influence the predictive ability of the model. CONCLUSIONS The D-ARIANNA model showed an appreciable, though modest, predictive ability for subsequent BD episodes. Post-hoc model showed slightly better predictive properties. Using up-to-date technology, D-ARIANNA appears an innovative and promising screening tool for BD among young people. Long-term impact remains to be established, and also the role of additional social and environmental factors.
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12
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Wagner V, Acier D, Dietlin JE. Mediation of time perspectives on inclinations to use alcohol and motivation to change relationship. J Clin Psychol 2018; 74:1854-1866. [PMID: 29756291 DOI: 10.1002/jclp.22637] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 02/07/2018] [Accepted: 04/13/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Trajectories of change accompanying alcohol-specialized care can be affected by numerous variables. Massive urges to drink can substantially hamper personal motivation to change. However, time perspective could also play an indirect role in this association. This research explores whether time perspectives mediates the relationship between inclinations to use or not to use alcohol and patients' motivation to change. DESIGN The sample included 150 outpatients in care for their problematic alcohol use. Models of mediation were planned. RESULTS At the entry in care, three specific time perspectives, Past Negative, Present Fatalistic, and Future, acted as discrete mediators. CONCLUSIONS These findings highlight underlying mechanisms connecting inclinations to use or to avoid the substance and the patient's motivation to change. Time perspective could also be an interesting intervention target in existing alcohol-specialized treatment programs.
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Affiliation(s)
- Vincent Wagner
- University of Nantes.,Beausejour Addiction Care, Support, and Prevention Center
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