Gender stereotypes and drinking cognitions as indicators of moderate and high risk drinking among young women and men

The Association between Gender Role Attitudes and Alcohol Use among Early Adolescents in Shanghai, China

Adolescent alcohol use was a major social and public health concern given its negative impacts. Previous studies indicated gender role attitudes (GRA) were associated with alcohol use; however, few studies focused on early adolescents (10 to 14 years) and similar researches were not found in China. Objective: This study sought to explore the association between GRA and alcohol use among early adolescents. Methods: A cross-sectional study was conducted among students in grades six to eight across three public secondary schools in Shanghai, China. Data were collected by Computer-Assisted Self-Interview (CASI) questionnaire on mobile tablets. Alcohol use was measured by self-report, and six items with 5-point Likert-type options assessed the attitude toward traditional gender roles. The logistic regression model was adopted to examine the associations between GAR and alcohol use. Results: Totally 1,631 adolescents aged 10 to 14 years with 50.33% of boys included in this study. The mean score of GRA in drinkers was significantly higher than nondrinkers among boys (3.03 vs. 2.78, p < 0.001) but not girls (2.15 vs. 2.18, p = 0.499). After controlling the covariates of age, depression, peers' substance use, social cohesion, etc., we found that more traditional GRA was associated with a higher risk of alcohol use among boys (OR = 1.39, 95%CI: 1.11-1.75), whereas the association was not significant among girls (OR = 0.96, 95%CI: 0.74-1.24). Conclusions: Traditional GRA may increase the risk of alcohol use among early adolescent boys, suggesting that altering traditional GRA among this population group may help to prevent alcohol use.

Computerized Clinical Decision Support System for Prompting Brief Alcohol Interventions with Treatment Seeking Smokers: A Sex-Based Secondary Analysis of a Cluster Randomized Trial

Although brief alcohol intervention can reduce alcohol use for both men and women, health care providers (HCPs) are less likely to discuss alcohol use or deliver brief intervention to women compared to men. This secondary analysis examined whether previously reported outcomes from a cluster randomized trial of a clinical decision support system (CDSS)-prompting delivery of a brief alcohol intervention (an educational alcohol resource) for patients drinking above cancer guidelines-were moderated by patients' sex. Patients (n = 5702) enrolled in a smoking cessation program at primary care sites across Ontario, Canada, were randomized to either the intervention (CDSS) or control arm (no CDSS). Logistic generalized estimating equations models were fit for the primary and secondary outcome (HCP offer of resource and patient acceptance of resource, respectively). Previously reported results showed no difference between treatment arms in HCP offers of an educational alcohol resource to eligible patients, but there was increased acceptance of the alcohol resource among patients in the intervention arm. The results of this study showed that these CDSS intervention effects were not moderated by sex, and this can help inform the development of a scalable strategy to overcome gender disparities in alcohol intervention seen in other studies.

Developmental pathways of adolescent cannabis use: Risk factors, outcomes and sex-specific differences

BACKGROUND

Characterizing patterns of adolescent cannabis use (CU), as well as risk factors and outcomes uniquely associated with these pathways is essential for informing treatment and prevention efforts. Yet, few studies have examined these issues among youth at-risk of engaging in problematic cannabis use. Further, research accounting for use of other substances or sex differences in patterns of CU remains exceedingly sparse.

METHODS

Trajectory-based modeling was used to identify underlying CU pathways among a predominantly Hispanic (90%) sample of at-risk youth (n = 401; 46% female) across adolescence (ages∼14-18), controlling for baseline substance use and participant demographics. Adolescent psychopathology (i.e., conduct disorder, attention deficit hyperactivity disorder, anxiety, and depression) was examined as a predictor and outcome of CU.

RESULTS

Three trajectories of adolescent CU were identified, with most youth (74%) engaging in relatively "low" levels of use, followed by ∼12% exhibiting an early-initiating "chronic" course, and 14% "escalating" in use. Although boys and girls both experienced increased levels of CU across adolescence, boys were more likely to exhibit escalating and chronic patterns of use. Findings revealed unique associations between adolescent CU pathways and facets of psychopathology; most notably, the relatively robust and bidirectional association between CU trajectories and conduct problem symptoms.

CONCLUSIONS

Specific facets of psychopathology may confer unique associations with CU across development, including the initiation and exacerbation of CU during adolescence.

Alcohol research with transgender populations: A systematic review and recommendations to strengthen future studies

BACKGROUND

There is a recent and growing research literature on alcohol use and related harms among transgender and other gender minority populations; however, current definitions and measures of hazardous drinking do not consider the complexity of physiological sex characteristics and socially constructed gender, raising doubts regarding their validity, applicability, and use with these populations. To address this, we reviewed current research on alcohol-related outcomes in transgender populations and critically summarized key issues for consideration in future research.

METHODS

We conducted a systematic review of transgender alcohol research in English language, peer-reviewed journals, published 1990-2017, and extracted key details (e.g., sample composition, alcohol measures, results).

RESULTS

Forty-four studies met all inclusion criteria for the review, the majority of which were conducted in the United States. The prevalence of hazardous drinking was high; however, estimates varied widely across studies. We noted frequent methodological weaknesses, including few attempts to differentiate sex and gender, poor attention to appropriate definitions of hazardous drinking, and reliance on cross-sectional study designs and non-probability sampling methods.

CONCLUSION

Given findings that suggest high need for ongoing public health attention, we offer recommendations to improve future alcohol studies with transgender and other gender minority populations, such as being explicit as to whether and how sex and/or gender are operationalized and relevant for the research question, expanding the repertoire of alcohol measures to include those not contingent on sex or gender, testing the psychometric performance of established screening instruments with transgender populations, and shifting from descriptive to analytic study designs.

A systematic review of the salient role of feminine norms on substance use among women

AIMS

Substance use among women is a growing and significant public health concern. Given women's vulnerability to substance-use related consequences, it is essential to understand the factors that explain within-group variability in substance use and related problems. Feminine norms, or the beliefs and expectations of what it means to be a woman, appear to be a promising and theoretically-important social determinant of substance use. The present systematic review identifies the current trends and limitations of research examining feminine norms and substance use outcomes among women.

METHODS

A systematic review was conducted for peer-reviewed, full-text journal articles written in English published between 2000-2015. Articles that fit the following inclusion criteria: a) use of a feminine norms/ideology or feminine role conflict measure, b) sampling women with a mean age of 15 or higher, and c) quantitative, were included.

RESULTS

Twenty-three eligible studies were identified. Many women engaged in heavy episodic drinking or were classified as high-risk drinkers. Seventy-four percent of the studies detected a significant relationship between feminine norms and substance use, of which 52% of the studies reviewed reported the harmful role of feminine norms as conferring risk for alcohol use. In addition to substance use risk, women who more strongly endorsed traditional feminine norms were more likely to report concomitant chronic diseases and eating disorder behavior.

CONCLUSION

The systematic review highlights that femininity appears to play a distinct and significant role in explaining within-group differences and patterns of substance use among women.

Gender and Alcohol Use Disorders Diagnostic Criteria in Emergency Department Patients of Argentina

BACKGROUND

Alcohol consumption and its related consequences are not equal for women and men, although related studies do not frequently include gender analysis.

OBJECTIVE

Our aim was to characterize differences in endorsement of ICD-10 and DSM 5 alcohol use disorder (AUD) criteria by gender in an Argentinean emergency department population.

METHODS

A probability sample of patients (N = 923) from the largest emergency department in the city of Mar del Plata, Argentina (44% were females, aged 16 to 86, M (SD) = 37.31(15.20) was collected. Using a structured questionnaire, diagnostic criteria for alcohol use disorders, alcohol consumption, and socio-demographic variables were obtained. Bivariate and multivariate analyses were used to assess differences in the endorsement of each diagnostic criterion by gender.

RESULTS

Women were less likely to endorse each of the criteria for each of the diagnostic schemes. Even after controlling alcohol consumption, socio-demographic variables, severity of alcohol use disorders and adjusting for multiple comparisons females had a lower probability than males of endorsing withdrawal and impaired control.

CONCLUSIONS

gender differences in the endorsement of diagnostic criteria for both the DSM 5 and ICD-10 were found. Some differences in endorsement but not all, might be partially explained by alcohol consumption patterns and socio-demographic factors, and same remained after controlling severity of the AUD. Results also suggest a differential functioning of DSM 5 and ICD-10 AUD criteria for women and men.

It’s Her Fault

The present study examined factors that are associated with an individual’s adherence to rape myths at two colleges located in the same town. Particularly, we examined sex, race, and participants’ drinking behavior in relation to rape myth acceptance. We found that males and heavy drinkers are more likely than females and non/low drinkers to adhere to rape myths. An interaction between males and drinking was also found indicating a moderated effect of gender on rape myth acceptance. In addition, the college with sexual assault programming did not experience a lowered acceptance of rape myths compared with the college with no programming.

Gender-specific gene-environment interaction in alcohol dependence: the impact of daily life events and GABRA2

Gender-moderated gene-environment interactions are rarely explored, raising concerns about inaccurate specification of etiological models and inferential errors. The current study examined the influence of gender, negative and positive daily life events, and GABRA2 genotype (SNP rs279871) on alcohol dependence, testing two- and three-way interactions between these variables using multi-level regression models fit to data from 2,281 White participants in the Collaborative Study on the Genetics of Alcoholism. Significant direct effects of variables of interest were identified, as well as gender-specific moderation of genetic risk on this SNP by social experiences. Higher levels of positive life events were protective for men with the high-risk genotype, but not among men with the low-risk genotype or women, regardless of genotype. Our findings support the disinhibition theory of alcohol dependence, suggesting that gender differences in social norms, constraints and opportunities, and behavioral undercontrol may explain men and women's distinct patterns of association.

Development and validation of the cannabis refusal self-efficacy questionnaire (CRSEQ) in adult cannabis users in treatment

BACKGROUND

There are few valid clinical assessment instruments for cannabis. Self-efficacy, or the ability of users to resist temptation, is a central feature of social cognitive theory. This study outlines the development and validation of the cannabis refusal self-efficacy questionnaire (CRSEQ), which measures the situational confidence to refuse cannabis.

METHOD

One thousand two hundred and forty-six patients referred for cannabis assessment completed the CRSEQ including measures of cannabis consumption and dependence severity (severity of dependence scale-cannabis, SDS-C). The CRSEQ was subject to independent exploratory (n=621, mean age 26.88, 78.6% male) and confirmatory (n=625, mean age 27.51, 76.8% male) factor analysis.

RESULTS

Three factors: Emotional Relief, Opportunistic and Social Facilitation were identified. They provided a good statistical and conceptual fit for the data. Emotional relief cannabis refusal self-efficacy was identified as most predictive of cannabis dependence, after controlling for cannabis consumption.

CONCLUSIONS

The CRSEQ is recommended as a psychometrically sound and clinically useful measure for cannabis misuse treatment planning and assessment.

Gender differences in factors influencing alcohol use and drinking progression among adolescents

While prevalence rates for alcohol use and related disorders differ widely between adult men and women, male and female adolescents do not exhibit the same disparity in alcohol consumption. Previous research and reviews do not address the emergence of differences in drinking patterns that occur during late adolescence. Therefore, a developmental perspective is presented for understanding how various risk and protective factors associated with problematic drinking affect diverging alcohol trajectories as youth move into young adulthood. This review examines factors associated with risk for developing an alcohol use disorder in adolescent girls and boys separately. Findings indicate that certain biological (i.e., genetic risk, neurological abnormalities associated with P300 amplitudes) and psychosocial (i.e., impact of positive drinking expectancies, personality characteristics, and deviance proneness) factors appear to impact boys and girls similarly. In contrast, physiological and social changes particular to adolescence appear to differentially affect boys and girls as they transition into adulthood. Specifically, boys begin to manifest a constellation of factors that place them at greater risk for disruptive drinking: low response to alcohol, later maturation in brain structures and executive function, greater estimates of perceived peer alcohol use, and socialization into traditional gender roles. On an individual level, interventions which challenge media-driven stereotypes of gender roles while simultaneously reinforcing personal values are suggested as a way to strengthen adolescent autonomy in terms of healthy drinking decisions. Moreover, parents and schools must improve consistency in rules and consequences regarding teen drinking across gender to avoid mixed messages about acceptable alcohol use for boys and girls.

Women's gender role orientation predicts their drinking patterns: a follow-up study of Czech women

AIMS

Evaluation of the hypothesis that women's non-traditional gender role orientation contributes to drinking patterns typical for men.

DESIGN

A two-wave prospective study with data collected in 1992 and 1997.

SETTING

The data reflect Czech women's changing gender role orientation and their drinking patterns during a historical period of post-totalitarian societal transformation.

PARTICIPANTS

A representative cohort of 497 Prague women aged 30-59 years in 1997.

MEASUREMENTS

Face-to-face interview data on drinking patterns and individually collected original questionnaire on gender role orientation.

FINDINGS

An analysis of the principal components of the gender role orientation questionnaire has led to four components, designated as egalitarianism, liberalism, feminism and hedonism. Constructed role orientation scales had Cronbachs's alpha reliabilities ranging from 0.57 to 0.74. With possible confounders controlled (thanks mainly to the prospective design), non-traditional gender role orientation components assessed in 1992 predicted the usual quantities of alcohol women have consumed per occasion in 1997, as well as three hazardous drinking patterns (occasional use of > or = 96 g alcohol, usual use of > or = 48 g and daily intake of > or = 40 g). Specifically, women's usual quantity per occasion and occasional use of > or = 96 g were predicted by egalitarianism and hedonism, and hedonism predicted usual use of > or = 48 g as well as average daily intake of > or = 40 g ethanol.

CONCLUSIONS

Women's gender role orientation can be associated with their drinking patterns with non-traditional gender role identification being associated with greater likelihood of hazardous drinking.

Possible contributors to the gender differences in alcohol use and problems

Research on alcohol use and problems has demonstrated a much higher rate of alcohol use disorders (AUDs) among men compared with women. The authors review the most frequently researched biological and psychosocial factors that may play a role in the gender differences in alcohol use and problems. Among the biological factors, women might carry a lower genetic risk for AUDs and tend to suffer more negative biological consequences from drinking as compared with men. Regarding psychosocial factors, men appear to be more likely than women to manifest certain risk factors for alcohol use and problems (e.g., fewer perceived social sanctions for drinking, positive expectancies for alcohol use, personality traits such as impulsivity) and have fewer protective factors. Although these findings have helped to explain some of the gender differences in alcohol use and problems, there are inconsistencies in the literature. Additionally, many studie may not have enough statistical power to detect gender differences. The authors suggest that the biological and social consequences of alcohol abuse for women may be especially potent protective factors against AUDs and discuss the possibility of public health campaigns developed on the basis of this idea.

How the quality of peer relationships influences college alcohol use

Peer relationships are consistently linked to alcohol use in college students. However, this disparate literature often reveals contradictory findings regarding the precise mechanisms of peer influence. In this review, we use an organisational framework based on social learning theory (SLT) to demonstrate how the quality of peer relationships may influence personal alcohol use. We propose that the quality of peer relationships enhance the influence of social reinforcement, modelling and cognitive processes on personal alcohol use. Research indicates that the quality of peer relationships influences drinking via three pathways: the lack or breakdown of quality peer relationships, alcohol use being an integral part of peer interactions, and if peers disapprove of alcohol use or do not drink. This conceptualisation of peer influence informs the consistent finding of gender differences in college student drinking. Limitations of the reviewed research include reliance on cross-sectional surveys, self-report and homogeneous populations. Future directions for research on quality peer relationships involve detailed longitudinal assessment and the application of advanced statistical methods.

Drogues du viol et agression sexuelle : perception de jeunes en milieu collégial1

La littérature scientifique indique que l’usage de substances (alcool et drogues), particulièrement chez les jeunes, peut générer un état de vulnérabilité propice à l’agression sexuelle, notamment à cause de périodes deblackout,et que l’alcool serait surtout en cause. Cependant, l’oubli pouvant découler d’une consommation abusive a été médiatisé et présenté comme résultant de la consommation de « drogues du viol », notamment le GHB. La littérature rapporte également des relations entre l’adhésion à de fausses croyances entourant le viol (mythes) et l’agression sexuelle elle-même. L’étude vise à vérifier les liens possibles entre la présence de mythes entourant le viol et la fréquence d’épisodes de consommation menant à l’oubli chez des étudiants de niveau collégial de la région de Montréal. La perception des substances pouvant être liées à l’agression sexuelle chez les jeunes est également explorée. Les résultats indiquent que, pour les étudiants, le GHB constitue la drogue la plus souvent associée au viol, même si l’alcool est également identifié. On observe aussi que ceux qui rapportent le plus fréquemment avoir eu une période d’oubli à cause d’une consommation d’alcool ou de drogue adhèrent davantage à de fausses croyances reliées au viol que les autres. Il serait souhaitable d’explorer davantage les liens entre la consommation de substances et l’agression sexuelle en vue d’établir un lien de causalité entre les deux. De même, compte tenu des statistiques disponibles, il serait important d’intégrer de l’information concernant la consommation de substances dans les programmes de prévention des agressions sexuelles.

Gender differences in risk factors and consequences for alcohol use and problems

Women drink less alcohol and have fewer alcohol-related problems than men. Women appear to be less likely than men to manifest certain risk factors for alcohol use and problems and are more likely to have certain protective factors against these problems: women perceive greater social sanctions for drinking; women are less likely to have characteristics associated with excessive drinking including aggressiveness, drinking to reduce distress, behavioral undercontrol, sensation-seeking and antisociality; and women are more likely to have desirable feminine traits (e.g., nurturance) protective against excessive drinking. In addition, consequences of heavy alcohol use, or alcohol use disorders, appear to be more negative for women than men, at least in some domains: women suffer alcohol-related physical illnesses at lower levels of exposure to alcohol than men, and some studies suggest women suffer more cognitive and motor impairment due to alcohol than men; women may be more likely than men to suffer physical harm and sexual assault when they are using alcohol; heavy alcohol use in women is associated with a range of reproductive problems. Implications of these findings for future research and public health education campaigns are discussed.

The effects of alprazolam and buspirone in light and moderate female social drinkers

Individuals who are moderate/heavy drinkers are at increased risk to abuse benzodiazepines and this risk is increased in women compared to men. However, no studies have determined whether female moderate drinkers (MD) show a differential response to the subjective and performance effects of benzodiazepines compared to female light drinkers (LD). Fourteen female MD who consumed an average of 36 drinks/month were compared to 14 female LD who consumed an average of 4.2 drinks/month. None of the participants had either a first- or second-degree family history of alcoholism. The acute effects of placebo, alprazolam (0.25, 0.50, 0.75 mg) and buspirone (5, 10, 15 mg) were evaluated using a double-blind, placebo-controlled outpatient design. Drug effects were assessed using a full range of performance measures and subjective-effects questionnaires. Alprazolam impaired performance in a dose-related manner on all performance tasks for both groups of females, whereas buspirone had minimal effects on performance. There were few differences between LD and MD with respect to subjective response or performance impairment following either alprazolam or buspirone. Although MD reported greater ratings of Good Drug Effect and Drug Liking than LD, this was neither dose-related, nor specific to alprazolam. The results of the present study suggest that female MD without a family history of alcoholism experience the same level of performance impairment as female LD, although they tend to report greater positive subjective effects from alprazolam.

D(2) dopamine receptor (DRD2) polymorphism is associated with severity of alcohol dependence

The A(1) allele of the D(2) dopamine receptor (DRD2) gene has been associated with alcohol dependence. However, the expression of this allele risk on the severity of drinking behavior in patients with alcohol dependence has not been systematically explored. The present study examines the association between DRD2 A(1)(+) (A(1)/A(1) and A(1)/A(2) genotypes) and A(1)- (A(2)/A(2) genotype) allele status and key drinking parameters in alcohol-dependent patients. A sample of Caucasian adults was recruited from an alcohol detoxification unit. A clinical interview and the Alcohol Dependence Scale (ADS) questionnaire provided data on consumption, dependence, chronology of drinking and prior detoxification. A(1)(+) allele compared to A(1)- allele patients consumed higher quantities of alcohol, commenced problem drinking at an earlier age, experienced a shorter latency between first introduction to alcohol to the onset of problem drinking and had higher ADS scores. Moreover, A(1)(+) allele patients had more detoxification attempts than their A(1)- allele counterparts. In sum, alcohol-dependent patients with the DRD2 A(1) allele compared to patients without this allele are characterized by greater severity of their disorder across a range of problem drinking indices. The implications of these findings are discussed.