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Paul SE, Baranger DAA, Johnson EC, Jackson JJ, Gorelik AJ, Miller AP, Hatoum AS, Thompson WK, Strube M, Dick DM, Kamarajan C, Kramer JR, Plawecki MH, Chan G, Anokhin AP, Chorlian DB, Kinreich S, Meyers JL, Porjesz B, Edenberg HJ, Agrawal A, Bucholz KK, Bogdan R. Alcohol milestones and internalizing, externalizing, and executive function: longitudinal and polygenic score associations. Psychol Med 2024:1-14. [PMID: 38721768 DOI: 10.1017/s003329172400076x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
BACKGROUND Although the link between alcohol involvement and behavioral phenotypes (e.g. impulsivity, negative affect, executive function [EF]) is well-established, the directionality of these associations, specificity to stages of alcohol involvement, and extent of shared genetic liability remain unclear. We estimate longitudinal associations between transitions among alcohol milestones, behavioral phenotypes, and indices of genetic risk. METHODS Data came from the Collaborative Study on the Genetics of Alcoholism (n = 3681; ages 11-36). Alcohol transitions (first: drink, intoxication, alcohol use disorder [AUD] symptom, AUD diagnosis), internalizing, and externalizing phenotypes came from the Semi-Structured Assessment for the Genetics of Alcoholism. EF was measured with the Tower of London and Visual Span Tasks. Polygenic scores (PGS) were computed for alcohol-related and behavioral phenotypes. Cox models estimated associations among PGS, behavior, and alcohol milestones. RESULTS Externalizing phenotypes (e.g. conduct disorder symptoms) were associated with future initiation and drinking problems (hazard ratio (HR)⩾1.16). Internalizing (e.g. social anxiety) was associated with hazards for progression from first drink to severe AUD (HR⩾1.55). Initiation and AUD were associated with increased hazards for later depressive symptoms and suicidal ideation (HR⩾1.38), and initiation was associated with increased hazards for future conduct symptoms (HR = 1.60). EF was not associated with alcohol transitions. Drinks per week PGS was linked with increased hazards for alcohol transitions (HR⩾1.06). Problematic alcohol use PGS increased hazards for suicidal ideation (HR = 1.20). CONCLUSIONS Behavioral markers of addiction vulnerability precede and follow alcohol transitions, highlighting dynamic, bidirectional relationships between behavior and emerging addiction.
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Affiliation(s)
- Sarah E Paul
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - David A A Baranger
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Joshua J Jackson
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Aaron J Gorelik
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Alex P Miller
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Alexander S Hatoum
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Wesley K Thompson
- Population Neuroscience and Genetics (PNG) Center, Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Michael Strube
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Danielle M Dick
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
- Rutgers Addiction Research Center, Rutgers University, Piscataway, NJ, USA
| | - Chella Kamarajan
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - John R Kramer
- Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA
| | - Martin H Plawecki
- Department of Psychiatry, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Grace Chan
- Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA
- Department of Psychiatry, School of Medicine, University of Connecticut, Farmington, CT, USA
| | - Andrey P Anokhin
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - David B Chorlian
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Sivan Kinreich
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Jacquelyn L Meyers
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Bernice Porjesz
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Howard J Edenberg
- Department of Medical and Molecular Genetics, School of Medicine, Indiana University, Indianapolis, IN, USA
- Department of Biochemistry and Molecular Biology, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Ryan Bogdan
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
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Treiber MC, Grünberger J, Vyssoki B, Szeles JC, Kaniusas E, Kampusch S, Stöhr H, Walter H, Lesch OM, König D, Kraus C. Pupillary response to percutaneous auricular vagus nerve stimulation in alcohol withdrawal syndrome: A pilot trial. Alcohol 2024; 114:61-68. [PMID: 37661002 DOI: 10.1016/j.alcohol.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 08/19/2023] [Accepted: 08/20/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Autonomic symptoms in alcohol withdrawal syndrome (AWS) are associated with a sympathetic-driven imbalance of the autonomic nervous system. To restore autonomic balance in AWS, novel neuromodulatory approaches could be beneficial. We conducted a pilot trial with percutaneous auricular vagus nerve stimulation (pVNS) in AWS and hypothesized that pVNS will enhance the parasympathetic tone represented by a reduction of pupillary dilation in a parasympatholytic pharmacological challenge. METHODS Thirty patients suffering from alcohol use disorder, undergoing AWS, and stable on medication, were recruited in this open-label, single-arm pilot trial with repeated-measure design. Peripheral VNS (monophasic volt impulses of 1 msec, alternating polarity, frequency 1 Hz, amplitude 4 mV) was administered at the left cymba conchae for 72 h, followed by pupillometry under a tropicamide challenge. We assessed craving with a visual analog scale. We used pupillary mean as the dependent variable in a repeated-measures ANOVA (rmANOVA). RESULTS A repeated-measures ANOVA resulted in a significant difference for pupillary diameter across time and condition (F(2,116) = 27.97, p < .001, ηp2 > .14). Tukey-adjusted post hoc analysis revealed a significant reduction of pupillary diameter after pVNS. Alcohol craving was significantly reduced after pVNS (p < .05, Cohen's d = 1.27). CONCLUSION Our study suggests that pVNS activates the parasympathetic nervous system in patients with acute AWS, and that this activation is measurable by pupillometry. To this end, pVNS could be beneficial as a supportive therapy for AWS. Potential confounding effects of anti-craving treatment should be kept in mind.
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Affiliation(s)
- M C Treiber
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria.
| | - J Grünberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - B Vyssoki
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - J C Szeles
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Austria
| | - E Kaniusas
- Institute of Biomedical Electronics, Vienna University of Technology, Austria
| | | | - H Stöhr
- Faculty of Computer Science, University of Vienna, Austria
| | - H Walter
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - O M Lesch
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - D König
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - C Kraus
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
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López G, Merrill JE, Ward RM. Associations among sexual assault history, alcohol use, blackouts, and blackout intentions among college women. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-8. [PMID: 38277508 PMCID: PMC11272901 DOI: 10.1080/07448481.2023.2299415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 12/03/2023] [Indexed: 01/28/2024]
Abstract
Background: Links between alcohol-induced blackouts and sexual assault (SA) are understudied. We tested whether: (1) history of blackouts, past 30-day blackouts, and past 30-day blackout intentions would be higher among women with histories of SA relative to women without; (2) baseline history of blackouts, past 30-day blackouts, and blackout intentions would predict an increase in SA severity (i.e., a continuous variable that considers SA tactic type and assault frequency) at a one-year follow-up. Methods: 1721 undergraduate women completed a baseline survey and 313 completed the follow-up. Results: Women with SA history had 2.10 higher odds of history of blackouts, 1.47 higher odds of past 30-day blackout during "one" drinking episode, 1.78 higher odds of blackout during a "few" drinking episodes, 3.21 higher odds of blackout during "most/all" drinking episodes, and 1.54 higher odds of blackout intentions in the last 30-days. Longitudinally, history of blackouts and past 30-day blackouts at baseline were associated with an increase in SA severity at follow-up, when peak drinks were not controlled. Conclusion: Longitudinal findings provide some evidence that lifetime history of blackouts and past 30-day blackouts are significant predictors of an increase in SA severity at follow-up and therefore an essential target for interventions.
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Affiliation(s)
- Gabriela López
- Brown University Center for Alcohol and Addiction Studies, Providence, RI, 02903 USA
| | - Jennifer E. Merrill
- Brown University Center for Alcohol and Addiction Studies, Providence, RI, 02903 USA
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Fitzke RE, Atieh T, Davis JP, Canning L, Tran DD, Buch K, Hummer JF, Pedersen ER. A latent profile analysis of social anxiety, depression, and pregaming motives among heavy-drinking college students. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:142-152. [PMID: 38184800 PMCID: PMC10783532 DOI: 10.1111/acer.15221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 09/30/2023] [Accepted: 10/27/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Pregaming is a high-risk drinking behavior that is associated with heavy drinking and negative alcohol-related consequences. College students may engage in pregaming for several reasons, including to enhance social experiences or cope with negative affect. Research shows that associations between drinking, social anxiety, and depression are multifaceted. However, our understanding of the complex associations of mental health symptoms with pregaming motives and behaviors remains limited. METHODS This study examined heterogeneity in how pregaming motives, social anxiety, and depression associate with past 30-day pregaming variables (quantity, frequency, and negative consequences). We used latent profile analysis (LPA) in a sample of heavy-drinking university students (N = 479). RESULTS LPA results indicated four profiles: mild/moderate social anxiety and depression symptoms, moderate motives (n = 285), minimal social anxiety and depression symptoms, low motives (n = 61), subclinical/elevated social anxiety and depression symptoms, high motives (n = 75), and clinically elevated social anxiety and depression symptoms, moderate motives (n = 58). The subclinical/elevated symptoms, high motives profile reported the highest pregaming frequency and consequences, including blackouts. Individuals in the clinically elevated symptoms, moderate motives profile reported more consequences than those in the minimal symptoms, low motives and mild/moderate symptoms, moderate motives profiles. Individuals in the minimal symptoms, low motives profile reported the fewest consequences. CONCLUSIONS Among these students, social anxiety and pregaming motives were associated with more frequent pregaming and social anxiety and depression were associated with greater negative consequences. Interventions that target pregaming-specific motives among students with mental health symptoms may be warranted to reduce this risky behavior and associated drinking-related harm.
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Affiliation(s)
- Reagan E. Fitzke
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California
| | | | - Jordan P. Davis
- Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Liv Canning
- Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Denise D. Tran
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California
| | - Keegan Buch
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California
| | | | - Eric R. Pedersen
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California
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Miller MB, Freeman LK, Aranda A, Shoemaker S, Sisk D, Rubi S, Everson AT, Flores LY, Williams MS, Dorimé-Williams ML, McCrae CS, Borsari B. Prevalence and correlates of alcohol-induced blackout in a diverse sample of veterans. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:395-405. [PMID: 36533546 PMCID: PMC9992316 DOI: 10.1111/acer.15002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/16/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Alcohol-induced blackouts have been associated concurrently and prospectively with alcohol-related harm. Although rates of heavy drinking among military samples tend to be comparable or higher than rates among civilian samples, the prevalence and correlates of blackout in the military population are understudied. METHODS Veterans (N = 241, 29% female, 39% Black) reported on their alcohol consumption and mental health as part of a larger health-related study among veterans. In this secondary analysis, we tested theoretically and empirically informed predictors (gender, drinking quantity, and other drug use) and consequences [depression, posttraumatic stress disorder (PTSD)] of alcohol-induced blackout. Given the diversity of the sample, potential roles of racial/ethnic discrimination and drinking to cope in alcohol-induced blackout were also tested. RESULTS Past-year prevalence of alcohol-induced blackout was 53% among veterans who drank alcohol and 68% among those who screened positive for hazardous drinking. Everyday experience of racial discrimination was the strongest concurrent predictor of alcohol-induced blackout. Drinking quantity and use of other drugs were significant correlates only in bivariate models. Controlling for gender, race, drinking quantity, other drug use, and discrimination, blackout frequency was significantly associated with symptoms of depression, but not symptoms of PTSD. Both blackout and racial discrimination were associated with drinking to cope. CONCLUSIONS The prevalence and correlates of alcohol-induced blackout among veterans are largely consistent with those documented in civilian and young adult populations. Among racially diverse groups, racial discrimination may be more strongly associated with mental health symptoms than alcohol consumption or acute alcohol consequences such as blackout.
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Affiliation(s)
- Mary Beth Miller
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
- Department of Psychological Sciences, University of Missouri, College of Arts & Sciences, 210 McAlester Hall, Columbia, MO 65211, USA
| | - Lindsey K. Freeman
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
- Department of Psychological Sciences, University of Missouri, College of Arts & Sciences, 210 McAlester Hall, Columbia, MO 65211, USA
| | - Amaya Aranda
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
- Department of Psychological Sciences, University of Missouri, College of Arts & Sciences, 210 McAlester Hall, Columbia, MO 65211, USA
| | - Sydney Shoemaker
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
| | - Delaney Sisk
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
| | - Sofia Rubi
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
| | - Adam T. Everson
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
| | - Lisa Y. Flores
- Department of Psychological Sciences, University of Missouri, College of Arts & Sciences, 210 McAlester Hall, Columbia, MO 65211, USA
| | - Michael S. Williams
- Department of Educational Leadership & Policy Analysis, University of Missouri, College of Education, 202 Hill Hall, Columbia, MO 65211, USA
| | - Marjorie L. Dorimé-Williams
- Department of Educational Leadership & Policy Analysis, University of Missouri, College of Education, 202 Hill Hall, Columbia, MO 65211, USA
| | | | - Brian Borsari
- Mental Health Service, San Francisco VA Health Care System, San Francisco, CA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA
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Miller MB, Boness CL, DiBello AM, Froeliger B. Insomnia as a moderator of alcohol use and blackout: Potential role in acute physiological consequences. Addict Behav 2022; 134:107395. [PMID: 35696822 PMCID: PMC10018985 DOI: 10.1016/j.addbeh.2022.107395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/06/2022] [Accepted: 06/05/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Alcohol-induced blackout is associated concurrently and prospectively with alcohol-related harm, including emergency room visits and sexual coercion. Although sleep has not been linked empirically to blackout, symptoms of insomnia have also been linked to memory impairment, in which case insomnia symptoms may compound alcohol's negative effects on memory. This study tested insomnia symptoms as a moderator of the association between heavy drinking and alcohol-induced blackout. METHODS Heavy-drinking young adults in college (N = 461, 69% female) completed assessments online from remote locations. Hierarchical linear regression was used to test a moderation model predicting blackout frequency. Logistic regression was used to test post hoc hypotheses. RESULTS In contrast to our main hypothesis, heavy drinking was more weakly (not more strongly) associated with blackout in the context of more severe insomnia. Post hoc analyses tested insomnia symptoms as a unique moderator of the association between heavy drinking and likelihood of acute physiological consequences of alcohol use (blackout, passing out, nausea/throwing up, and hangover). Insomnia severity at least marginally moderated the association between heavy drinking and 4 out of 5 physiological consequences of alcohol use, and only moderated the association between drinking and 1 of 19 remaining consequences. CONCLUSIONS Symptoms of insomnia are associated with alcohol-related harm, but may buffer associations between drinking and acute physiological consequences of alcohol. Additional research is needed to determine if alcohol heightens sensitivity to the acute physiological effects of alcohol, in which case less alcohol may be required for young adults with insomnia to experience these effects.
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Affiliation(s)
- Mary Beth Miller
- Department of Psychiatry, University of Missouri School of Medicine, United States.
| | - Cassandra L Boness
- Department of Psychological Sciences, University of Missouri College of Arts & Sciences, United States; Center on Alcohol, Substance Use, and Addictions, University of New Mexico, United States
| | - Angelo M DiBello
- Center of Alcohol & Substance Use Studies & Graduate School of Applied and Professional Psychology, Rutgers University, United States
| | - Brett Froeliger
- Department of Psychiatry, University of Missouri School of Medicine, United States; Department of Psychological Sciences, University of Missouri College of Arts & Sciences, United States
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Núñez C, Gómez Tabares AS, Moreno Méndez JH, Agudelo Osorio MP, Caballo VE. Predictive Model of Suicide Risk in Young People: The Mediating Role of Alcohol Consumption. Arch Suicide Res 2022; 27:613-628. [PMID: 35098882 DOI: 10.1080/13811118.2022.2029783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Suicidal behavior is one of the public health problems that cause most deaths in young people and has been associated with emotional and affective problems, so predictive models are required to account for the relationship between depression, anxiety, hopelessness, and alcohol consumption to propose actions for its prevention. The Plutchik Suicide Risk Scale, the CAGE Questionnaire, the Hopelessness Scale, the Depression Inventory and the Beck Anxiety Scale were applied. A total of 1.379 young people (M = 20.45; SD = 3.23) from the cities of Manizales (n = 739; 53.6%) and Medellín (n = 640; 46.5%) in Colombia were evaluated. The variables of anxiety, hopelessness and depression explained 51% (R2 = 0.509; 95% CI = 0.467-0.552; p = 0.001) of the variation in suicidal risk. Likewise, alcohol consumption is a mediating variable between depression and anxiety in the prediction of suicidal risk, whose total, direct and indirect effects are statistically significant. The findings support the role of alcohol consumption as a mediating variable between anxiety, depression, hopelessness and suicidal risk in young people, given the difficulties it causes in information processing, regulation of emotions and therefore in having an adequate coping with the demands of the environment. This justifies the importance of directing suicide prevention actions through strategies for the reduction of alcohol consumption and the management of emotions in young people. HIGHLIGHTSAlcohol modulates the effect of depression and anxiety on suicide riskThis is a study on the risk of suicide in young people in ColombiaThe findings have implications for timely clinical interventions.
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DiBello AM, Hatch MR, Miller MB, Neighbors C, Carey KB. Opportunities for reducing college drinking: The roles of drinking attitudes and blackout experience. Alcohol Clin Exp Res 2021; 45:1494-1503. [PMID: 34086367 DOI: 10.1111/acer.14638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/16/2021] [Accepted: 05/18/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND As many as 35% of college students report having been drunk in the past month, and greater alcohol use and alcohol-related problems are associated with a positive attitude toward heavy drinking. One serious consequence of heavy drinking is alcohol-induced blackout. When they occur, alcohol-induced blackouts present a unique opportunity to increase motivation to change drinking. However, it is unclear under what conditions an alcohol-related heavy drinking attitude and experiencing a blackout represent an opportunity to change and how experiencing a blackout(s) influences an individual's motivation to reduce drinking and actual behavior. METHODS This study tested the interplay between one's positive attitude toward heavy drinking and experiencing a blackout in the past year in predicting motivation to reduce drinking (Study 1) and its impact on drinking over time (Study 2). Data were derived from complementary datasets collected at two universities (Study 1 n = 703, mean age = 20.63 years, 44% male, 52% White; Study 2 n = 568, mean age = 19.18 years, 72% male, 84% White). Drinking behavior was measured using a modified Daily Drinking Questionnaire, the Drinking Norms Rating Form, the Alcohol Use Disorders Identification Test (AUDIT), and estimated peak blood alcohol concentration (BAC). Regression analyses were conducted to determine whether a blackout would moderate the association between attitude and motivation to reduce drinking (Study 1) and drinking over time (Study 2). RESULTS Results revealed a significant interaction between attitude and blackout, such that individuals who experience a blackout (vs. those who do not) and positively evaluate heavy drinking evidenced lower motivation to reduce drinking (Study 1) and higher levels of estimated peak BAC (Study 2). CONCLUSIONS Drinkers with a negative attitude toward heavy drinking who have experienced a blackout have the strongest motivation to reduce drinking and the greatest reductions in peak drinking behavior over time. These effects are over and above that related to the level of alcohol consumed. For young adults who do not positively endorse heavy drinking, blackouts may present a "moment of opportunity" for intervention.
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Affiliation(s)
- Angelo M DiBello
- Center for Alcohol and Substance Use Studies & Department of Graduate and Applied Professional Psychology, Rutgers University, Piscataway, NJ, USA.,Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Melissa R Hatch
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Mary Beth Miller
- Department of Psychiatry, University of Missouri-Columbia, Columbia, MO, USA
| | | | - Kate B Carey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA.,Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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