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Sampedro-Piquero P, Buades-Sitjar F, Capilla A, Zancada-Menéndez C, González-Baeza A, Moreno-Fernández RD. Risky alcohol use during youth: Impact on emotion, cognitive networks, and resting-state EEG activity. Prog Neuropsychopharmacol Biol Psychiatry 2024; 132:110994. [PMID: 38514039 DOI: 10.1016/j.pnpbp.2024.110994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/14/2024] [Accepted: 03/17/2024] [Indexed: 03/23/2024]
Abstract
The identification of the risk factors of alcohol consumption in youths is crucial for early interventions focused on reducing harmful alcohol use. In our study, 82 college students (40 healthy control (CO group) and 42 with risky alcohol use (RAU group) determined by AUDIT questionnaire) between the ages of 18 and 25 years underwent a comprehensive neuropsychological assessment covering emotional and cognitive functioning. Their resting-state activity was also recorded with an EEG for 10 min with their eyes open (EO) and 10 min with their eyes closed (EC) and analyzed using the Fitting Oscillations & One-Over-F (FOOOF) paradigm. After adjusting for sex, those in the RAU group had higher emotional dysregulation and impulsivity traits. The RAU girls presented more emotional regulation problems, such as dysregulation and negative urgency compared with the RAU boys. The RAU youths had significantly worse functioning in several cognitive domains, such as sustained attention, verbal memory, and executive functions. Cognitive network analysis revealed a different pattern of connections in each group showing that in the RAU group, the verbal memory domain had the highest connection with other cognitive functions. The EEG analyses did not reveal any significant differences between the CO and the RAU groups. However, we observed only in the EO condition that boys the from the RAU group displayed a higher theta/beta ratio than the RAU girls, whereas these differences were not observed within the CO group. Our findings highlight the need to explore more deeply the emotional, cognitive and brain changes underlying the RAU in young people.
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Affiliation(s)
- P Sampedro-Piquero
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Spain.
| | - F Buades-Sitjar
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Spain
| | - A Capilla
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Spain
| | - C Zancada-Menéndez
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja (UNIR), Logroño, Spain
| | - A González-Baeza
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Spain
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Aneni K, Fernandes CSF, Hoerner LA, Szapary C, Pendergrass Boomer TM, Fiellin LE. A Video Game Intervention to Prevent Opioid Misuse Among Older Adolescents: Development and Preimplementation Study. JMIR Serious Games 2023; 11:e46912. [PMID: 37921851 PMCID: PMC10656656 DOI: 10.2196/46912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/31/2023] [Accepted: 09/08/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Opioid misuse and mental disorders are highly comorbid conditions. The ongoing substance misuse and mental health crises among adolescents in the United States underscores the importance of widely scalable substance misuse preventive interventions that also address mental health risks. Serious video games offer an engaging, widely scalable method for delivering and implementing preventive interventions. However, there are no video game interventions that focus on preventing opioid misuse among older adolescents, and there are limited existing video game interventions that address mental health. OBJECTIVE This study aims to develop and conduct a formative evaluation of a video game intervention to prevent opioid misuse and promote mental health among adolescents aged 16-19 years (PlaySmart). We conducted formative work in preparation for a subsequent randomized controlled trial. METHODS We conducted development and formative evaluation of PlaySmart in 3 phases (development, playtesting, and preimplementation) through individual interviews and focus groups with multiple stakeholders (adolescents: n=103; school-based health care providers: n=51; and addiction treatment providers: n=6). PlaySmart content development was informed by the health belief model, the theory of planned behavior, and social cognitive theory. User-centered design principles informed the approach to development and play testing. The Exploration, Preparation, Implementation, and Sustainability framework informed preimplementation activities. Thematic analysis was used to identify themes from interviews and focus groups that informed PlaySmart game content and approaches to future implementation of PlaySmart. RESULTS We developed a novel video game PlaySmart for older adolescents that addresses the risk and protective factors for opioid misuse and mental health. Nine themes emerged from the focus groups that provided information regarding game content. Playtesting revealed areas of the game that required improvement, which were modified for the final game. Preimplementation focus groups identified potential barriers and facilitators for implementing PlaySmart in school settings. CONCLUSIONS PlaySmart offers a promising digital intervention to address the current opioid and mental health crises among adolescents in a scalable manner.
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Affiliation(s)
- Kammarauche Aneni
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, CT, United States
| | - Claudia-Santi F Fernandes
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, CT, United States
| | - Lily A Hoerner
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - Claire Szapary
- Yale School of Public Health, New Haven, CT, United States
| | | | - Lynn E Fiellin
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
- Yale School of Public Health, New Haven, CT, United States
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Armoon B, Griffiths MD, Mohammadi R, Ahounbar E. The global distribution and epidemiology of alcohol and drug use among street-involved children and youth: a meta-analysis. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:381-398. [PMID: 37310881 DOI: 10.1080/00952990.2023.2201872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/14/2023] [Accepted: 03/28/2023] [Indexed: 06/15/2023]
Abstract
Background: Street-involved children and youth (SICY) who work and live on/of the streets are more likely to inject drugs and engage in psychoactive substance use.Objectives: The present study aimed to identify the prevalence, distribution, sociodemographic determinants, and risk-taking associated with alcohol and drug use among SICY.Methods: Studies published in English related to alcohol and drug use among SICY were searched for from December 1 1985 to July 1 2022, on PubMed, Scopus, Cochrane, and Web of Science.Results: After full-text paper evaluation, 73 studies were included in the meta-analysis. Results indicated that lifetime prevalence rates were 44% (alcohol), 44% (crack), 33% (inhalants), 44% (solvents), 16% (tranquilizer/sedatives), 22% (opioids), and 62% (polysubstance use). The current prevalence rates were 40% (alcohol), 21% (crack), 20% (inhalants), 11% (tranquilizer/sedatives), and 1% (opioids). Also, life-time and current prevalence of alcohol and crack use, current prevalence of tranquilizer/sedative use, and life-time prevalence of polysubstance use were higher among older age groups. Life-time prevalence of tranquilizer/sedative use was lower among older age groups.Conclusions: The high prevalence of using alcohol, crack, and inhalants is a major issue because they are used extensively among different age groups, including minors. Such findings are beneficial for policymakers, health authorities, and professionals in developing programs aimed at minimizing inhalant use and other types of substance use harms among this group. It is important to accurately monitor this risk-exposed population to understand the mechanisms that might help protect them from high-risk substance use.
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Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Rasool Mohammadi
- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Elaheh Ahounbar
- Orygen, The National Center of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Center for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
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Kallen AM, Patrick CJ, Bartholow BD, Hajcak G. Drinking alcohol by mid-adolescence is related to reduced reward reactivity: Novel evidence of positive valence system alterations in early initiating female youth. Biol Psychol 2023; 181:108597. [PMID: 37268265 DOI: 10.1016/j.biopsycho.2023.108597] [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: 02/09/2023] [Revised: 04/24/2023] [Accepted: 05/30/2023] [Indexed: 06/04/2023]
Abstract
Initiation of alcohol use at younger ages is prognostic of later drinking problems. Reward system dysfunction is theorized to contribute to early initiation and escalation of drinking, but existing evidence supports both hyposensitivity and hypersensitivity as risk-markers; research employing effective indices of reward processing is needed for clarification. The reward positivity (RewP) is a well-established neurophysiological index of hedonic "liking," an important aspect of reward processing. Adult research has yielded conflicting findings, with different studies reporting reduced, enhanced, or null associations of RewP with engagement in or risk for harmful alcohol use. No study has examined relations between RewP and multiple indices of drinking in youth. Here, we examined how RewP measured in a gain/loss feedback task related to self-reported drinking initiation and past-month drinking, when accounting for age along with depression and externalizing symptoms, in 250 mid-adolescent females. Analyses showed that (1) compared to not-yet drinkers, adolescents endorsing drinking initiation responded less strongly to monetary gain (RewP) but not loss feedback (FN), and (2) past-month drinking was unrelated to both RewP and FN magnitude. These findings provide evidence for reduced hedonic "liking" as a concomitant of early drinking initiation in adolescent females and warrant further research with mixed-sex adolescent samples exhibiting greater drinking variability.
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Affiliation(s)
- Alexander M Kallen
- Department of Psychology, Florida State University, Tallahassee, FL, USA.
| | | | - Bruce D Bartholow
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | - Greg Hajcak
- Department of Psychology, Florida State University, Tallahassee, FL, USA; Department of Biomedical Sciences, Florida State University, USA
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Valente J, Pietrobom T, Mihic J, Caetano S, Mari J, Sanchez ZM. Externalizing and internalizing problems as predictors of alcohol-related harm and binge drinking in early adolescence: The role of gender. J Affect Disord 2023; 327:167-174. [PMID: 36623566 DOI: 10.1016/j.jad.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Externalizing problems are commonly associated with alcohol outcomes in adolescence. Nevertheless, findings regarding internalizing problems are mixed, and fewer longitudinal studies have considered the both problems concomitantly and the role of gender. We examined the role of externalizing and internalizing problems in predicting adolescent alcohol-related harm and binge drinking, taking into account the gender differences. We also evaluated if externalizing problems could moderate the association between internalizing problems and alcohol outcomes. METHOD We used longitudinal data from 2368 8th grade students across 37 public schools in three Brazilian cities. Linear and logistic regressions were performed to analyze the association between alcohol outcomes and the independent variables (externalization and internalization scores, and sociodemographic variables) according to gender. We also tested the same model with an interaction term between externalizing*internalizing. RESULTS Our results suggest that externalizing problems predict adolescents' binge drinking in both genders; it also may predict adolescents' alcohol-related harms, but only in boys. Internalizing problems seem to be a gender-specific risk factor for binge drinking among girls. All findings are independent of comorbid problems and sociodemographic variables. LIMITATION The findings should be considered taking into account the short follow-up period from risk factors to the outcomes. CONCLUSION Our results highlight the contribution of internalizing and externalizing problems to the development of alcohol-related harm and binge drinking in early adolescence and the need for interventions to prevent early behavioral problems that consider the role played by gender.
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Affiliation(s)
- Juliana Valente
- Department of Psychiatry, Universidade Federal de São Paulo, Brazil
| | - Tania Pietrobom
- Department of Preventive Medicine, Section of Epidemiology and Biostatistics, Universidade Federal de São Paulo, Brazil
| | - Josipa Mihic
- Department of Behavioural Disorders, University of Zagreb, Croatia
| | - Sheila Caetano
- Department of Psychiatry, Universidade Federal de São Paulo, Brazil
| | - Jair Mari
- Department of Psychiatry, Universidade Federal de São Paulo, Brazil
| | - Zila M Sanchez
- Department of Preventive Medicine, Section of Epidemiology and Biostatistics, Universidade Federal de São Paulo, Brazil.
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Mejía-Trujillo J, Pérez-Gómez A, de Vries H, Mercken L. Evaluating effects of IBEM-U on decreasing alcohol consumption and heavy episodic drinking among university students in Colombia: Protocol for a randomized control trial. Contemp Clin Trials Commun 2023; 32:101075. [PMID: 36949848 PMCID: PMC10025418 DOI: 10.1016/j.conctc.2023.101075] [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: 10/11/2022] [Revised: 01/05/2023] [Accepted: 01/14/2023] [Indexed: 01/24/2023] Open
Abstract
Background Alcohol misuse is a serious problem among university students in Colombia as well as in other Latin American countries. Studies show consistently that this population presents the highest rates of alcohol use. Despite such a situation, there is a lack of preventive programs for university students in this region of the world. The purpose of this paper is to present the protocol to evaluate a preventive strategy called IBEM-U, based on Motivational Interviewing and the I-Change Model. Method This protocol shows how the evaluation of the effectiveness of the IBEM-U program will be carried out. A randomized control trial with a within-subjects design with one follow-up at six months after the post-test will be implemented. The comparison group will receive an alternative program similar in length but focusing on another issue. Around 1000 participants over 18 years of age, from at least six different universities around the country, will be recruited. Results It is expected that the program will be effective in reducing past month alcohol consumption up to 15% in the experimental group as the main outcome. Secondary and tertiary outcomes include decreasing heavy episodic drinking and increasing knowledge, awareness, risk perception, attitude, self-efficacy, intention, and action planning, regarding heavy episodic drinking. Conclusion IBEM-U can be considered a highly appropriate approach for reducing alcohol misuse among university students. The main reasons for these results are the self-imposed goals based on long-term purposes, that could be seriously affected by the ingestion of high amounts of alcohol.
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Affiliation(s)
- Juliana Mejía-Trujillo
- Department of Health Promotion, Maastricht University, the Netherlands
- Corporación Nuevos Rumbos, Bogotá, Colombia
- Corresponding author. Calle 108ª No 4-15, Bogotá, Colombia.
| | | | - Hein de Vries
- Department of Health Promotion, Maastricht University, the Netherlands
| | - Liesbeth Mercken
- Department of Health Promotion, Maastricht University, the Netherlands
- Department of Health Psychology, Open University, Heerlen, the Netherlands
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Stephenson M, Aliev F, Kuo SIC, Edwards AC, Pandey G, Su J, Kamarajan C, Dick D, Salvatore JE. The role of adolescent social relationships in promoting alcohol resistance: Interrupting the intergenerational transmission of alcohol misuse. Dev Psychopathol 2022; 34:1841-1855. [PMID: 36873306 PMCID: PMC9976711 DOI: 10.1017/s0954579422000785] [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] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Genetic factors contribute to the intergenerational transmission of alcohol misuse, but not all individuals at high genetic risk develop problems. The present study examined adolescent relationships with parents, peers, and romantic partners as predictors of realized resistance, defined as high biological risk for disorder combined with a healthy outcome, to alcohol initiation, heavy episodic drinking, and alcohol use disorder (AUD). Data were from the Collaborative Study on the Genetics of Alcoholism (N = 1,858; 49.9% female; mean age at baseline = 13.91 years). Genetic risk, indexed using family history density and polygenic risk scores for alcohol problems and AUD, was used to define alcohol resistance. Adolescent predictors included parent-child relationship quality, parental monitoring, peer drinking, romantic partner drinking, and social competence. There was little support for the hypothesis that social relationship factors would promote alcohol resistance, with the exception that higher father-child relationship quality was associated with higher resistance to alcohol initiation (β ^ = - 0.19 , 95% CI = -0.35, -0.03). Unexpectedly, social competence was associated with lower resistance to heavy episodic drinking (β ^ = 0.10 , 95% CI = 0.01, 0.20). This pattern of largely null effects underscores how little is known about resistance processes among those at high genetic risk for AUD.
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Affiliation(s)
- Mallory Stephenson
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Fazil Aliev
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Sally I-Chun Kuo
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Gayathri Pandey
- Department of Psychiatry and Behavioral Sciences, Downstate Medical Center, State University of New York, Brooklyn, NY, USA
| | - Jinni Su
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Chella Kamarajan
- Department of Psychiatry and Behavioral Sciences, Downstate Medical Center, State University of New York, Brooklyn, NY, USA
| | - Danielle Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Jessica E. Salvatore
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
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Ebrahimi A, Wiil UK, Naemi A, Mansourvar M, Andersen K, Nielsen AS. Identification of clinical factors related to prediction of alcohol use disorder from electronic health records using feature selection methods. BMC Med Inform Decis Mak 2022; 22:304. [PMID: 36424597 PMCID: PMC9686074 DOI: 10.1186/s12911-022-02051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 11/16/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND High dimensionality in electronic health records (EHR) causes a significant computational problem for any systematic search for predictive, diagnostic, or prognostic patterns. Feature selection (FS) methods have been indicated to be effective in feature reduction as well as in identifying risk factors related to prediction of clinical disorders. This paper examines the prediction of patients with alcohol use disorder (AUD) using machine learning (ML) and attempts to identify risk factors related to the diagnosis of AUD. METHODS A FS framework consisting of two operational levels, base selectors and ensemble selectors. The first level consists of five FS methods: three filter methods, one wrapper method, and one embedded method. Base selector outputs are aggregated to develop four ensemble FS methods. The outputs of FS method were then fed into three ML algorithms: support vector machine (SVM), K-nearest neighbor (KNN), and random forest (RF) to compare and identify the best feature subset for the prediction of AUD from EHRs. RESULTS In terms of feature reduction, the embedded FS method could significantly reduce the number of features from 361 to 131. In terms of classification performance, RF based on 272 features selected by our proposed ensemble method (Union FS) with the highest accuracy in predicting patients with AUD, 96%, outperformed all other models in terms of AUROC, AUPRC, Precision, Recall, and F1-Score. Considering the limitations of embedded and wrapper methods, the best overall performance was achieved by our proposed Union Filter FS, which reduced the number of features to 223 and improved Precision, Recall, and F1-Score in RF from 0.77, 0.65, and 0.71 to 0.87, 0.81, and 0.84, respectively. Our findings indicate that, besides gender, age, and length of stay at the hospital, diagnosis related to digestive organs, bones, muscles and connective tissue, and the nervous systems are important clinical factors related to the prediction of patients with AUD. CONCLUSION Our proposed FS method could improve the classification performance significantly. It could identify clinical factors related to prediction of AUD from EHRs, thereby effectively helping clinical staff to identify and treat AUD patients and improving medical knowledge of the AUD condition. Moreover, the diversity of features among female and male patients as well as gender disparity were investigated using FS methods and ML techniques.
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Affiliation(s)
- Ali Ebrahimi
- grid.10825.3e0000 0001 0728 0170SDU Health Informatics and Technology, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark
| | - Uffe Kock Wiil
- grid.10825.3e0000 0001 0728 0170SDU Health Informatics and Technology, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark
| | - Amin Naemi
- grid.10825.3e0000 0001 0728 0170SDU Health Informatics and Technology, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark
| | - Marjan Mansourvar
- grid.10825.3e0000 0001 0728 0170Department of Mathematics and Computer Science, University of Southern Denmark, Odense, Denmark
| | - Kjeld Andersen
- grid.10825.3e0000 0001 0728 0170Unit for Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Anette Søgaard Nielsen
- grid.10825.3e0000 0001 0728 0170Unit for Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, Odense, Denmark
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Gender Differences in Alcohol Use: a Nationwide Study in a Multiethnic Population. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00921-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
AbstractThe increase in alcohol consumption, and the greater consequences of chronic alcohol use among females, as well as the convergence of the gender gap warrants investigation. This paper aims to uncover gender differences in individuals with alcohol use disorder (AUD) in Singapore. The SMHS 2016 was a population-based, cross-sectional, epidemiological study. Recruitment spanned from August 2016 to March 2018, where 6126 respondents were recruited. Similarly to global estimates, lifetime prevalence and 12-month prevalence for AUD were higher in males than females. However, females had a higher prevalence of obsessive–compulsive disorder (OCD) co-morbidity than males. Women also had an earlier onset and age of recovery of AUD than men. Alarmingly, male (94.14%) and female (100%) respondents reported low help-seeking for their AUD. Gender differences in individuals with AUD were identified in Singapore population. Future research should direct its effort to identify barriers to help-seeking for individuals with alcohol use disorder.
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Oliverio R, Fitzgerald J, Velazquez-Cruz R, Whitehead B, Karelina K, Weil ZM. Ovarian Steroids Mediate Sex Differences in Alcohol Reward After Brain Injury in Mice. Front Behav Neurosci 2022; 16:907552. [PMID: 35801094 PMCID: PMC9253769 DOI: 10.3389/fnbeh.2022.907552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Intoxication is a leading risk factor for injury, and TBI increases the risk for later alcohol misuse, especially when the injury is sustained in childhood. Previously, we modeled this pattern in mice, wherein females injured at postnatal day 21 drank significantly more than uninjured females, while we did not see this effect in males. However, the biological underpinnings of this sex difference have remained elusive. In this study, we utilize this preclinical model and traditional endocrine manipulations to assess the effect of perinatal sex steroids on post-injury ethanol response. We found that perinatal androgen administration and adult ovariectomy prevented the development of conditioned place preference to ethanol in females, while there was not an effect of gonadectomy either developmental time point on the severity of axonal degeneration. Finally, although TBI increased the number of microglia in males, there was no corresponding effect of gonadectomy, which suggests that males exhibit prolonged neuroinflammation after brain injury irrespective of circulating sex steroids. Taken together, our results indicate a potential role for ovarian sex steroids in the development of greater alcohol preference after a juvenile TBI in female mice.
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Affiliation(s)
- Robin Oliverio
- Department of Neuroscience and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
- *Correspondence: Robin Oliverio,
| | - Julie Fitzgerald
- Department of Neuroscience, Ohio State University, Columbus, OH, United States
| | - Ruth Velazquez-Cruz
- Department of Neuroscience and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - Bailey Whitehead
- Department of Neuroscience and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - Kate Karelina
- Department of Neuroscience and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - Zachary M. Weil
- Department of Neuroscience and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
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Gender Differences in the Factors Associated with Alcohol Binge Drinking: A Population-Based Analysis in a Latin American Country. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094931. [PMID: 35564326 PMCID: PMC9101416 DOI: 10.3390/ijerph19094931] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/18/2022]
Abstract
Alcohol consumption is a public health problem in Peru, fostered by traditional practices, where promoting social interaction in celebrations, facilitating field work as a source of energy and warmth, and achieving objectives in certain labor negotiations, play an important role. However, research on the risk factors of binge drinking according to gender is limited. The study aim was to determine the factors associated with binge drinking in the Peruvian adult population by gender. An analytical study of secondary data from the 2018 Peruvian Demographic and Family Health Survey was conducted. The dependent variable was binge drinking in the last 30 days. Adjusted prevalence ratios (aPR) were estimated for the association between sociodemographic and health-related variables with binge drinking. A total of 32,020 adults were included. Binge drinking was found in 22.4%. Men (32.6%; 95% confidence interval [CI]: 31.4–33.8) presented a higher consumption pattern compared to women (12.8%; 95% CI: 12.0–13.6). For both genders, differences were found in binge drinking according to sociodemographic characteristics (age and wealth quintile was associated in both genders while the educational level was associated only for men, and ethnic self-identification and marital status for women) and health- characteristics related (health insurance, smoking in the last 30 days, overweight and obesity were associated in both genders). Several factors are associated with binge drinking according to gender in the Peruvian population, including age and education level among men, as well as marital status and ethnic self-identification among women.
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Meier PS, Holmes J, Brennan A, Angus C. Alcohol policy and gender: a modelling study estimating gender-specific effects of alcohol pricing policies. Addiction 2021; 116:2372-2384. [PMID: 33651444 PMCID: PMC7611454 DOI: 10.1111/add.15464] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/26/2020] [Accepted: 02/17/2021] [Indexed: 11/29/2022]
Abstract
AIMS To describe gender differences in alcohol consumption, purchasing preferences and alcohol-attributable harm. To model the effects of alcohol pricing policies on male and female consumption and hospitalizations. DESIGN Epidemiological simulation using the Sheffield Alcohol Policy Model version 4. SETTING AND PARTICIPANTS Adults aged 18+ years, England. INTERVENTIONS Three alcohol pricing policies: 10% duty increase and minimum unit prices (MUP) of £0.50 and £0.70 per UK unit. MEASURES Gender-specific baseline and key outcomes data: annual beverage-specific units of alcohol consumed and beverage-specific alcohol expenditure (household surveys). Alcohol-attributable hospital admissions (administrative data). Key model parameters: literature-based own- and cross-price elasticities for 10 beverage-by-location categories (e.g. off-trade beer). Sensitivity analysis with new gender-specific elasticities. Literature-based risk functions linking consumption and harm, gender-disaggregated where evidence was available. Population subgroups: 120 subgroups defined by gender (primary focus), age, deprivation quintile and baseline weekly consumption. FINDINGS Women consumed 59.7% of their alcohol as off-trade wine while men consumed 49.7% as beer. Women drinkers consumed fewer units annually than men (494 versus 895) and a smaller proportion of women were high-risk drinkers (4.8 versus 7.2%). Moderate drinking women had lower hospital admission rates than men (44 versus 547 per 100 000), but rates were similar for high-risk drinking women and men (14 294 versus 13 167 per 100 000). All three policies led to larger estimated reductions in consumption and admission rates among men than women. For example, a £0.50 MUP led to a 5.3% reduction in consumption and a 4.1% reduction in admissions for men but a 0.7% reduction in consumption and a 1.6% reduction in hospitalizations for women. CONCLUSION Alcohol consumption, purchasing preferences and harm show strong gender patterns among adult drinkers in England. Alcohol pricing policies are estimated to be more effective at reducing consumption and harm for men than women.
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Affiliation(s)
- Petra S Meier
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - John Holmes
- Sheffield Alcohol Research Group, School of Health and Related Research (ScHARR), University of Sheffield, UK
| | - Alan Brennan
- Sheffield Alcohol Research Group, School of Health and Related Research (ScHARR), University of Sheffield, UK
| | - Colin Angus
- Sheffield Alcohol Research Group, School of Health and Related Research (ScHARR), University of Sheffield, UK
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Trends in the Use of Naltrexone for Addiction Treatment among Alcohol Use Disorder Admissions in U.S. Substance Use Treatment Facilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168884. [PMID: 34444639 PMCID: PMC8394149 DOI: 10.3390/ijerph18168884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 01/12/2023]
Abstract
Background: Naltrexone, a medication for addiction treatment (MAT), is an FDA-approved medication recommended for the treatment of alcohol use disorder (AUD). Despite the high prevalence of AUD and efficacy of naltrexone, only a small percentage of individuals with AUD receive treatment. Objectives: To identify trends for the prescription of naltrexone in AUD admissions in substance use treatment centers across the U.S. Methods: Data from the 2000–2018 U.S. Treatment Episode Data Set: Admissions (TEDS-A) were used in temporal trend analysis of naltrexone prescription in admissions that only used alcohol. Data from the 2019 National Survey of Substance Abuse Treatment Services (N-SSATS) were also used to characterize medication use among AUD clients across different treatment service settings. Results: Treatment of AUD with naltrexone was 0.49% in 2000 and tripled from 0.53% in 2015 to 1.64% in 2018 in AUD admissions (p < 0.0001 for the Cochran–Armitage trend test). Women, middle-aged adults, and admissions for clients living in the Northeast U.S. were more likely to be prescribed naltrexone than their respective counterparts, as were admissions with prior treatment episodes and referrals through alcohol/drug use care providers, who paid for treatment primarily through private insurance, used alcohol daily in the month prior to admission, and waited 1–7 days to enter treatment. Naltrexone was more commonly prescribed by AUD admissions compared to acamprosate and disulfiram and was more frequently prescribed in residential and outpatient services as opposed to hospital inpatient services. Conclusions: Naltrexone remains underutilized for AUD, and factors that influence prescription of medication are multifaceted. This study may contribute to the creation of effective interventions aimed at reducing naltrexone disparities for AUD.
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14
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Zhao Q, Sullivan EV, Műller‐Oehring EM, Honnorat N, Adeli E, Podhajsky S, Baker FC, Colrain IM, Prouty D, Tapert SF, Brown SA, Meloy MJ, Brumback T, Nagel BJ, Morales AM, Clark DB, Luna B, De Bellis MD, Voyvodic JT, Nooner KB, Pfefferbaum A, Pohl KM. Adolescent alcohol use disrupts functional neurodevelopment in sensation seeking girls. Addict Biol 2021; 26:e12914. [PMID: 32428984 DOI: 10.1111/adb.12914] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 02/20/2020] [Accepted: 04/17/2020] [Indexed: 01/11/2023]
Abstract
Exogenous causes, such as alcohol use, and endogenous factors, such as temperament and sex, can modulate developmental trajectories of adolescent neurofunctional maturation. We examined how these factors affect sexual dimorphism in brain functional networks in youth drinking below diagnostic threshold for alcohol use disorder (AUD). Based on the 3-year, annually acquired, longitudinal resting-state functional magnetic resonance imaging (MRI) data of 526 adolescents (12-21 years at baseline) from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) cohort, developmental trajectories of 23 intrinsic functional networks (IFNs) were analyzed for (1) sexual dimorphism in 259 participants who were no-to-low drinkers throughout this period; (2) sex-alcohol interactions in two age- and sex-matched NCANDA subgroups (N = 76 each), half no-to-low, and half moderate-to-heavy drinkers; and (3) moderating effects of gender-specific alcohol dose effects and a multifactorial impulsivity measure on IFN connectivity in all NCANDA participants. Results showed that sex differences in no-to-low drinkers diminished with age in the inferior-occipital network, yet girls had weaker within-network connectivity than boys in six other networks. Effects of adolescent alcohol use were more pronounced in girls than boys in three IFNs. In particular, girls showed greater within-network connectivity in two motor networks with more alcohol consumption, and these effects were mediated by sensation-seeking only in girls. Our results implied that drinking might attenuate the naturally diminishing sexual differences by disrupting the maturation of network efficiency more severely in girls. The sex-alcohol-dose effect might explain why women are at higher risk of alcohol-related health and psychosocial consequences than men.
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Affiliation(s)
- Qingyu Zhao
- Department of Psychiatry & Behavioral Sciences Stanford University School of Medicine Stanford CA USA
| | - Edith V. Sullivan
- Department of Psychiatry & Behavioral Sciences Stanford University School of Medicine Stanford CA USA
| | - Eva M. Műller‐Oehring
- Department of Psychiatry & Behavioral Sciences Stanford University School of Medicine Stanford CA USA
- Center for Health Sciences SRI International Menlo Park CA USA
| | | | - Ehsan Adeli
- Department of Psychiatry & Behavioral Sciences Stanford University School of Medicine Stanford CA USA
| | - Simon Podhajsky
- Center for Health Sciences SRI International Menlo Park CA USA
| | - Fiona C. Baker
- Center for Health Sciences SRI International Menlo Park CA USA
| | - Ian M. Colrain
- Center for Health Sciences SRI International Menlo Park CA USA
| | - Devin Prouty
- Center for Health Sciences SRI International Menlo Park CA USA
| | - Susan F. Tapert
- Department of Psychiatry University of California San Diego CA USA
| | - Sandra A. Brown
- Department of Psychiatry University of California San Diego CA USA
- Department of Psychology University of California San Diego CA USA
| | - Mary J. Meloy
- Department of Psychiatry University of California San Diego CA USA
| | - Ty Brumback
- Department of Psychological Science Northern Kentucky University Highland Heights KY USA
| | - Bonnie J. Nagel
- Departments of Psychiatry and Behavioral Neuroscience Oregon Health & Sciences University Portland OR USA
| | - Angelica M. Morales
- Departments of Psychiatry and Behavioral Neuroscience Oregon Health & Sciences University Portland OR USA
| | - Duncan B. Clark
- Department of Psychiatry University of Pittsburgh Pittsburgh PA USA
| | - Beatriz Luna
- Department of Psychiatry University of Pittsburgh Pittsburgh PA USA
| | - Michael D. De Bellis
- Department of Psychiatry & Behavioral Sciences Duke University School of Medicine Durham NC USA
| | - James T. Voyvodic
- Department of Radiology Duke University School of Medicine Durham NC USA
| | - Kate B. Nooner
- Department of Psychology University of North Carolina Wilmington Wilmington NC USA
| | - Adolf Pfefferbaum
- Department of Psychiatry & Behavioral Sciences Stanford University School of Medicine Stanford CA USA
- Center for Health Sciences SRI International Menlo Park CA USA
| | - Kilian M. Pohl
- Department of Psychiatry & Behavioral Sciences Stanford University School of Medicine Stanford CA USA
- Center for Health Sciences SRI International Menlo Park CA USA
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15
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Harper J, Malone SM, Iacono WG. Parietal P3 and midfrontal theta prospectively predict the development of adolescent alcohol use. Psychol Med 2021; 51:416-425. [PMID: 31736455 PMCID: PMC7231637 DOI: 10.1017/s0033291719003258] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Subclinical adolescent alcohol use is highly prevalent and may have deleterious effects on important psychosocial and brain outcomes. Prior research has focused on identifying endophenotypes of pathological drinking, and the predictors of normative drinking remain understudied. This study investigated the incremental predictive value of two potential psychophysiological endophenotypes, P3 amplitude (an index of decision making) and midfrontal theta power (a correlate of attentional control), for prospectively predicting the expression and initiation of alcohol use emerging in adolescence. METHODS A large (N = 594) epidemiological sample was prospectively assessed at ages 11/14/17. Alcohol/substance use was assessed at all ages via a computerized self-report inventory. EEG was recorded at age-14 during a visual oddball task to elicit P3 and theta. RESULTS Reduced target-related P3 and theta at age-14 prospectively predicted drinking at age-17 independent of one another. Among alcohol-naive individuals at age-14, attenuated P3 and theta increased the odds of new-onset alcohol behaviors 3 years later. Importantly, the endophenotypes provided significant incremental predictive power of future non-clinical alcohol use beyond relevant risk factors (prior alcohol use; tobacco/illicit drug initiation; parental alcohol use disorder). CONCLUSIONS The current report is the first of our knowledge to demonstrate that deviations in parietal P3 and midfrontal theta prospectively predict the emergence of normative/non-pathological drinking. P3 and theta provide modest yet significant explanatory variance beyond prominent self-report and familial risk measures. Findings offer strong evidence supporting the predictive utility of P3 and theta as candidate endophenotypes for adolescent drinking.
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Affiliation(s)
- Jeremy Harper
- Department of Psychology, University of Minnesota, 75 East River Road, Minneapolis, MN55455, USA
| | - Stephen M Malone
- Department of Psychology, University of Minnesota, 75 East River Road, Minneapolis, MN55455, USA
| | - William G Iacono
- Department of Psychology, University of Minnesota, 75 East River Road, Minneapolis, MN55455, USA
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16
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Staton CA, Zhao D, Ginalis EE, Hirshon JM, Sakita F, Swahn MH, Mmbaga BT, Vissoci JRN. Alcohol Availability, Cost, Age of First Drink, and Its Association with At-Risk Alcohol Use in Moshi, Tanzania. Alcohol Clin Exp Res 2020; 44:2266-2274. [PMID: 32944986 PMCID: PMC7680393 DOI: 10.1111/acer.14457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/02/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Kilimanjaro region has one of the highest levels of reported alcohol intake per capita in Tanzania. Age at first drink has been found to be associated with alcohol problems in adulthood, but there is less information on the age of first drink in the Kilimanjaro region and its associations with alcohol-related consequences later in life. Furthermore, local alcohol cost and availability may influence the prevalence of alcohol use and alcohol use disorders. METHODS Data on the age of first drink, alcohol use disorder identification tool (AUDIT), number and type of alcohol consequences (DrInC), and perceived alcohol at low cost and high availability for children and adolescents were collected from an alcohol and health behavior survey of injury patients (N = 242) in Moshi, Tanzania. Generalized linear models were used to test age at first drink, perceived alcohol cost and availability, and their association with the AUDIT and DrInC scores, and current alcohol use, respectively. RESULTS Consuming alcohol before age 18 was significantly associated with higher AUDIT and DrInC scores, with odds ratios of 1.22 (CI: 1.004, 1.47) and 1.72 (CI: 1.11, 2.63), respectively. Female gender is strongly associated with less alcohol use and alcohol consequences, represented by an odds ratio of 3.70 (CI: 1.72, 8.33) for an AUDIT score above 8 and an odds ratio of 3.84 (CI: 2.13, 6.67) with the DrInC score. Perceived high availability of alcohol for children is significantly related to higher alcohol use quantity, with the odds ratio of 1.6 (CI: 1.17, 2.20). CONCLUSIONS The first use of alcohol before the age of 18 is associated with higher alcohol use and alcohol-related adverse consequences. In Tanzania, age at first drink is an important target for interventions aiming to prevent negative alcohol-related consequences later in life.
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Affiliation(s)
| | - Duan Zhao
- Duke Kunshan Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu China
| | | | - Jon Mark Hirshon
- University of Maryland School of Medicine, College Park, Maryland USA
| | | | | | - Blandina Theophil Mmbaga
- Duke Global Health Institute, Duke University, Durham, NC USA
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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17
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Fama R, Le Berre AP, Sullivan EV. Alcohol's Unique Effects on Cognition in Women: A 2020 (Re)view to Envision Future Research and Treatment. Alcohol Res 2020; 40:03. [PMID: 32923307 PMCID: PMC7473713 DOI: 10.35946/arcr.v40.2.03] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Alcohol use and misuse is increasing among women. Although the prevalence of drinking remains higher in men than women, the gender gap is narrowing. This narrative review focuses on the cognitive sequelae of alcohol consumption in women. Studies of acute alcohol effects on cognition indicate that women typically perform worse than men on tasks requiring divided attention, memory, and decision-making. Beneficial effects of moderate alcohol consumption on cognition have been reported; however, a number of studies have cautioned that other factors may be driving that association. Although chronic heavy drinking affects working memory, visuospatial abilities, balance, emotional processing, and social cognition in women and men, sex differences mark the severity and specific profile of functional deficits. The accelerated or compressed progression of alcohol-related problems and their consequences observed in women relative to men, referred to as "telescoping," highlights sex differences in the pharmacokinetics, pharmacodynamics, cognitive, and psychological consequences of alcohol. Brain volume deficits affecting multiple systems, including frontolimbic and frontocerebellar networks, contribute to impairment. Taken together, sex-related differences highlight the complexity of this chronic disease in women and underscore the relevance of examining the roles of age, drinking patterns, duration of abstinence, medical history, and psychiatric comorbidities in defining and understanding alcohol-related cognitive impairment.
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Affiliation(s)
- Rosemary Fama
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
- Neuroscience Program, SRI International, Menlo Park, California
| | - Anne-Pascale Le Berre
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
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18
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Samek DR, Hicks BM, Iacono WG, McGue M. Personality, romantic relationships, and alcohol use disorder symptoms in adolescence and young adulthood: An evaluation of personality × social context interplay. Dev Psychopathol 2020; 32:1097-1112. [PMID: 31452479 PMCID: PMC10035555 DOI: 10.1017/s0954579419001111] [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] [Indexed: 11/07/2022]
Abstract
Prior research has shown that person-level characteristics (e.g., temperament, personality) correlate and interact with social-contextual factors (e.g., parent-child relationship quality, antisocial peer affiliation) to predict adolescent substance use, but less research has examined similar processes for adult substance use problems. We addressed this gap by testing for personality × romantic partner context interplay in relation to symptoms of alcohol use disorder (AUD) at ages 24 and 29. Participants were twins in the longitudinal Minnesota Twin Family Study (N = 2,769; 52% female). Results support the corresponsive principle of personality in that we found that key personality traits in late adolescence (low constraint, negative emotionality) predicted subsequent "selection" into key social contexts in early adulthood (poorer quality romantic relationships and greater romantic partner alcohol use), which subsequently reinforced those traits and associated outcomes (including correlated AUD symptoms) through late young adulthood. There were few meaningful gender differences in these associations. There was also no support for the personality × romantic partner context interaction as a significant predictor of AUD symptoms at ages 24 or 29. Taken together with prior studies, these results suggest that such interactions may be less relevant to the development of young adult AUD compared to adolescent substance use problems.
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Affiliation(s)
- Diana R. Samek
- Department of Human Development and Family Studies, Auburn University
| | | | | | - Matt McGue
- Department of Psychology, University of Minnesota
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19
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Robins MT, Heinricher MM, Ryabinin AE. From Pleasure to Pain, and Back Again: The Intricate Relationship Between Alcohol and Nociception. Alcohol Alcohol 2020; 54:625-638. [PMID: 31509854 DOI: 10.1093/alcalc/agz067] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 02/07/2023] Open
Abstract
AIMS A close and bidirectional relationship between alcohol consumption and pain has been previously reported and discussed in influential reviews. The goal of the present narrative review is to provide an update on the developments in this field in order to guide future research objectives. METHODS We evaluated both epidemiological and neurobiological literature interrogating the relationship between alcohol use and pain for the presence of significant effects. We outlined studies on interactions between alcohol use and pain using both self-reports and objective experimental measures and discussed potential underlying mechanisms of these interactions. RESULTS Epidemiological, preclinical and clinical literature point to three major interactions between alcohol use and pain: (a) alcohol use leading to hyperalgesia, (b) alcohol use moderating pain and hyperalgesia and (c) chronic pain as a risk factor predisposing to alcohol relapse. Neurobiological studies using animal models to assess these interactions have transitioned from mostly involuntary modes of experimenter-controlled alcohol administration to self-administration procedures, and increasingly indicate that neuronal circuits implicated in both withdrawal and anticipation stages of alcohol use disorder also have a role in chronic pain. Mechanistically, alterations in GABA, glutamate, the corticotropin-releasing factor system, endogenous opioids and protein kinase C appear to play crucial roles in this maladaptive overlap. CONCLUSIONS Many of the principles explaining the interactions between alcohol and pain remain on a strong foundation, but continuing progress in modeling these interactions and underlying systems will provide a clearer basis for understanding, and ultimately treating, the damaging aspects of this interaction.
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Affiliation(s)
- Meridith T Robins
- Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Mary M Heinricher
- Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.,Department of Neurological Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Andrey E Ryabinin
- Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
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20
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McCutcheon VV, Bucholz KK, Houston-Ludlam A, Heath AC. Elevated maternal and child mortality among women with multiple DUI convictions compared with socio-demographically matched controls. Addiction 2019; 114:1981-1991. [PMID: 31351443 PMCID: PMC6800795 DOI: 10.1111/add.14762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 12/06/2018] [Accepted: 07/23/2019] [Indexed: 11/30/2022]
Abstract
AIMS To assess whether having multiple convictions for driving while under the influence of alcohol (MDUI) in women is a risk factor for maternal, infant and child mortality. DESIGN Retrospective cohort design using record linkage, comparing women with MDUI convictions with propensity-matched women without alcohol-related driving offences ascertained through state records, on rates of maternal, infant and child mortality. SETTING Missouri, United States. PARTICIPANTS MDUI women (n = 1658) and women with no alcohol-related driving convictions (control, n = 184 252) who gave birth from 2000 to 2004. MEASUREMENTS Data were obtained from state administrative records and US Census data. The outcomes were maternal, infant and child mortality. The input variable was presence or absence of MDUI convictions. Propensity-matching variables were maternal (smoking during pregnancy, delayed prenatal care, previous child deaths, age at birth, mother Missouri-born, education, pre-pregnancy obesity, marital status), reproductive partner (un-named partner, race/ethnicity, education, DUI status) and census tract (socio-economic advantage, urbanicity) characteristics. FINDINGS Women with MDUI convictions had higher odds of maternal, infant and child mortality than propensity-matched controls [odds ratio (OR) = 2.65, 95% confidence interval (CI) = 2.07-3.40 and OR = 1.75, 95% CI = 1.17-2.61, respectively]. CONCLUSIONS Having multiple convictions for driving under the influence of alcohol in women appears to be a risk factor for increased maternal, infant and child mortality.
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Affiliation(s)
- Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110
| | - Alexandra Houston-Ludlam
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110
| | - Andrew C. Heath
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110
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21
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Cloutier RM, Blumenthal H, Trim RS, Douglas ME, Anderson KG. Real-time social stress response and subsequent alcohol use initiation among female adolescents. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 33:254-265. [PMID: 30869921 PMCID: PMC6483836 DOI: 10.1037/adb0000454] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Adolescents who are particularly sensitive to social stress may be vulnerable to earlier alcohol consumption and related problems. Although a small literature supports this contention, previous studies mostly relied on retrospective self-report. The current study used discrete-time survival analysis (DTSA) to test whether real-time social stress responding (via laboratory induction) and social anxiety symptoms predicted 12-month alcohol onset in an alcohol-naïve sample of young female adolescents. Anxiety elicited by the task was expected to predict greater and earlier rates of alcohol incidence, particularly among girls with higher levels of self-reported social anxiety symptoms. Participants were 104 community-recruited girls (ages 12-15 years) who completed a modified Trier Social Stress Test and questionnaires; follow-up calls were conducted at 3, 6, 9, and 12 months after the laboratory visit. Self-reported anxiety was assessed in response to the stressor following acclimation (baseline), instruction (anticipation), and speech (posttask). By 12 months, 30.8% of the sample had consumed a full alcoholic beverage. The DTSA revealed that girls with higher levels of social anxiety and greater elevations in anticipatory (but not posttask) anxiety compared to baseline had earlier alcohol initiation. This is the first study to examine the role of both laboratory-induced anxious responding and retrospective reports of social anxiety as prospective predictors of alcohol incidence. These preliminary findings suggest that adolescent girls who are more sensitive to social stress may be at risk for experimenting with alcohol earlier than their peers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Renee M Cloutier
- Teen Stress and Alcohol Research Laboratory, Department of Psychology, University of North Texas
| | - Heidemarie Blumenthal
- Teen Stress and Alcohol Research Laboratory, Department of Psychology, University of North Texas
| | - Ryan S Trim
- Department of Psychiatry, University of California San Diego
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22
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McCaul ME, Roach D, Hasin DS, Weisner C, Chang G, Sinha R. Alcohol and Women: A Brief Overview. Alcohol Clin Exp Res 2019; 43:774-779. [PMID: 30779446 DOI: 10.1111/acer.13985] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/11/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Mary E McCaul
- Department of Psychiatry and Behavioral Sciences , Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Deidra Roach
- National Institute on Alcohol Abuse and Alcoholism , Rockville, Maryland
| | - Deborah S Hasin
- New York State Psychiatric Institute (NYSPI) , Columbia University, New York, New York
| | | | - Grace Chang
- Department of Psychiatry , Harvard Medical School, Boston, Massachusetts
| | - Rajita Sinha
- Department of Psychiatry, Neuroscience and Child Study , Yale University School of Medicine, New Haven, Connecticut
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23
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Foster KT, Hicks BM, Durbin CE, Iacono WG, McGue M. The gender risk-severity paradox for alcohol use disorder from adolescence through young adulthood. EMERGING ADULTHOOD (PRINT) 2018; 6:375-386. [PMID: 30775160 PMCID: PMC6372236 DOI: 10.1177/2167696817740453] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
A large proportion of the public health costs of alcohol use disorder (AUD) can be accounted for by a small percentage of severe cases with a chronic course starting in adolescence and persisting into adulthood. However, chronicity may be a less effective marker of AUD severity in women than men due to a gender risk-severity paradox wherein comparable levels of risk exposure yield more co-occurring problems for women than men with AUD. To model this paradox, we compared trajectories of alcohol and drug use problems, depression symptoms, and antisocial behavior from ages 17 to 29 in men and women with a persistent, desistent, or no history of AUD. Problems followed a quadratic trajectory (i.e., increases followed by decreases), with gender and AUD chronicity moderating age-related change. Specifically, persistent and desistent courses differentiated the severity of problems more effectively in men while chronicity had less utility for differentiating AUD severity in women.
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Affiliation(s)
| | | | | | | | - Matt McGue
- Department of Psychology, University of Minnesota
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24
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Harper J, Malone SM, Iacono WG. Conflict-related medial frontal theta as an endophenotype for alcohol use disorder. Biol Psychol 2018; 139:25-38. [PMID: 30300674 DOI: 10.1016/j.biopsycho.2018.10.002] [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: 03/19/2018] [Revised: 09/19/2018] [Accepted: 10/01/2018] [Indexed: 12/28/2022]
Abstract
Diminished cognitive control in alcohol use disorder (AUD) is thought to be mediated by prefrontal cortex circuitry dysregulation. Research testing the relationship between AUD and specific cognitive control psychophysiological correlates, such as medial frontal (MF) theta-band EEG power, is scarce, and the etiology of this relationship is largely unknown. The current report tested relationship between pathological alcohol use through young adulthood and reduced conflict-related theta at age 29 in a large prospective population-based twin sample. Greater lifetime AUD symptomatology was associated with reduced MF theta power during response conflict, but not alpha-band visual attention processing. Follow-up analyses using cotwin control analysis and biometric modeling suggested that genetic influences, and not the consequences of sustained AUD symptomatology, explained the theta-AUD association. Results provide strong evidence that AUD is genetically related to diminished conflict-related MF theta, and advance MF theta as a promising electrophysiological correlate of AUD-related dysfunctional frontal circuitry.
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Affiliation(s)
- Jeremy Harper
- Department of Psychology, University of Minnesota, USA.
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Waldron JS, Malone SM, McGue M, Iacono WG. A Co-Twin Control Study of the Relationship Between Adolescent Drinking and Adult Outcomes. J Stud Alcohol Drugs 2018; 79:635-643. [PMID: 30079880 PMCID: PMC6090105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 02/24/2018] [Indexed: 03/30/2024] Open
Abstract
OBJECTIVE The effect of drinking during adolescence on adult functioning is a public health concern. A variety of mechanisms have been proposed where drinking in adolescence has an adverse impact on later outcomes; unfortunately, few studies have included methodologies that account for confounding influences that might link adolescent drinking with subsequent problems. To address this limitation, the current study used a co-twin control design, which uses members of twin pairs that differ from each other on their adolescent drinking. METHOD We used a prospective longitudinal sample drawn from the Minnesota Twin Family Study, consisting of 2,764 twins (1,434 female) assessed at regular follow-ups from age 17 to age 29. Adolescent drinking was defined by measures of early initiation of use and a measure of overall consumption at age 17. Adult outcomes included indicators of substance use, antisocial behavior, personality, socioeconomic status, and social functioning. RESULTS The co-twin control analyses suggested that many of the associations between adolescent drinking and later outcomes were largely influenced by genetic confounding. However, for the measure of adolescent alcohol consumption, results were consistent with a small causal impact of drinking on multiple domains of adult functioning. This pattern was less consistently observed for the measures of early initiation. CONCLUSIONS These results provide empirical justification for policies designed to alleviate long-term consequences associated with adolescent drinking by reducing the level of alcohol consumption in adolescence. In contrast, the evidence did not suggest that delaying drinking would have a broad impact on later-life adjustment.
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Affiliation(s)
- Jordan Sparks Waldron
- College of Applied Behavioral Sciences, University of Indianapolis, Indianapolis, Indiana
| | - Stephen M. Malone
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - William G. Iacono
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
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Waldron JS, Malone SM, McGue M, Iacono WG. A Co-Twin Control Study of the Relationship Between Adolescent Drinking and Adult Outcomes. J Stud Alcohol Drugs 2018; 79:635-643. [PMID: 30079880 PMCID: PMC6090105 DOI: 10.15288/jsad.2018.79.635] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 02/24/2018] [Indexed: 07/23/2024] Open
Abstract
OBJECTIVE The effect of drinking during adolescence on adult functioning is a public health concern. A variety of mechanisms have been proposed where drinking in adolescence has an adverse impact on later outcomes; unfortunately, few studies have included methodologies that account for confounding influences that might link adolescent drinking with subsequent problems. To address this limitation, the current study used a co-twin control design, which uses members of twin pairs that differ from each other on their adolescent drinking. METHOD We used a prospective longitudinal sample drawn from the Minnesota Twin Family Study, consisting of 2,764 twins (1,434 female) assessed at regular follow-ups from age 17 to age 29. Adolescent drinking was defined by measures of early initiation of use and a measure of overall consumption at age 17. Adult outcomes included indicators of substance use, antisocial behavior, personality, socioeconomic status, and social functioning. RESULTS The co-twin control analyses suggested that many of the associations between adolescent drinking and later outcomes were largely influenced by genetic confounding. However, for the measure of adolescent alcohol consumption, results were consistent with a small causal impact of drinking on multiple domains of adult functioning. This pattern was less consistently observed for the measures of early initiation. CONCLUSIONS These results provide empirical justification for policies designed to alleviate long-term consequences associated with adolescent drinking by reducing the level of alcohol consumption in adolescence. In contrast, the evidence did not suggest that delaying drinking would have a broad impact on later-life adjustment.
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Affiliation(s)
- Jordan Sparks Waldron
- College of Applied Behavioral Sciences, University of Indianapolis, Indianapolis, Indiana
| | - Stephen M. Malone
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - William G. Iacono
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
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Heitzeg MM, Hardee JE, Beltz AM. Sex Differences in the Developmental Neuroscience of Adolescent Substance Use Risk. Curr Opin Behav Sci 2018; 23:21-26. [PMID: 29977984 DOI: 10.1016/j.cobeha.2018.01.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Adolescence is a period associated with the initiation and escalation of substance use and is also a time during which substantial changes take place in neural development, personality and behavior. Although rates of substance use between adolescent girls and boys do not differ substantially, there is evidence for sex differences in underlying vulnerability pathways associated with the development of substance use disorder. Here we review sex differences in adolescent brain development and how these differences may contribute to different risk pathways between females and males that emerge during this developmental period. We also discuss methodological considerations in the study of sex differences in brain and behavior and their implications for interpretation. We close by highlighting promising areas for future work.
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Affiliation(s)
- Mary M Heitzeg
- Department of Psychiatry, Addiction Center, University of Michigan, 4250 Plymouth Rd, Ann Arbor MI 48109, United States
| | - Jillian E Hardee
- Department of Psychiatry, Addiction Center, University of Michigan, 4250 Plymouth Rd, Ann Arbor MI 48109, United States
| | - Adriene M Beltz
- Department of Psychology, University of Michigan, 530 Church St, Ann Arbor MI 48109, United States
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Waldron JS, Malone SM, McGue M, Iacono WG. Genetic and environmental sources of covariation between early drinking and adult functioning. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 31:589-600. [PMID: 28594187 DOI: 10.1037/adb0000283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The vast majority of individuals initiate alcohol consumption for the first time in adolescence. Given the widespread nature of its use and evidence that adolescents may be especially vulnerable to its effects, there is concern about the long-term detrimental impact of adolescent drinking on adult functioning. While some researchers have suggested that genetic processes may confound the relationship, the mechanisms linking drinking and later adjustment remain unclear. The current study utilized a genetically informed sample and biometric modeling to examine the nature of the familial influences on this association and identify the potential for genetic confounding. The sample was drawn from the Minnesota Twin Family Study (MTFS), a longitudinal study consisting of 2,764 twins assessed in 2 cohorts at regular follow-ups from age 17 to age 29 (older cohort) or age 11 to age 29 (younger cohort). A broad range of adult measures was included assessing substance use, antisocial behavior, personality, socioeconomic status, and social functioning. A bivariate Cholesky decomposition was used to examine the common genetic and environmental influences on adolescent drinking and each of the measures of adult adjustment. The results revealed that genetic factors and nonshared environmental influences were generally most important in explaining the relationship between adolescent drinking and later functioning. While the presence of nonshared environmental influences on the association are not inconsistent with a causal impact of adolescent drinking, the findings suggest that many of the adjustment issues associated with adolescent alcohol consumption are best understood as genetically influenced vulnerabilities. (PsycINFO Database Record
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Affiliation(s)
| | | | - Matt McGue
- Department of Psychology, University of Minnesota
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29
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Samek DR, Hicks BM, Durbin E, Hinnant JB, Iacono WG, McGue M. Codevelopment Between Key Personality Traits and Alcohol Use Disorder From Adolescence Through Young Adulthood. J Pers 2017; 86:261-282. [PMID: 28258610 DOI: 10.1111/jopy.12311] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Personality traits related to negative emotionality and low constraint are strong correlates of alcohol use disorder (AUD), but few studies have evaluated the prospective interplay between these traits and AUD symptoms from adolescence to young adulthood. METHOD The Minnesota Twin Family Study (N = 2,769) was used to examine the developmental interplay between AUD symptoms and three personality measures of constraint, negative emotionality, and aggressive undercontrol from ages 17 to 29. RESULTS Results from random-intercept, cross-lagged panel models showed that low constraint and aggressive undercontrol predicted subsequent rank-order increases in AUD symptoms from ages 17 to 24. AUD symptoms did not predict rank-order change in these traits from ages 17 to 24. There was support for both cross-effects from ages 24 to 29. Biometric analysis of the twin data showed genetic influences accounted for most of the phenotypic correlations over time. CONCLUSION Results are consistent with the notion that personality traits related to low constraint and aggressive undercontrol are important vulnerability/predisposition factors for the development of early adult AUD. In later young adulthood, there is more evidence for the simultaneous codevelopment of personality and AUD. Implications are addressed with attention to personality-based risk assessments and targeted AUD prevention approaches.
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Dir AL, Bell RL, Adams ZW, Hulvershorn LA. Gender Differences in Risk Factors for Adolescent Binge Drinking and Implications for Intervention and Prevention. Front Psychiatry 2017; 8:289. [PMID: 29312017 PMCID: PMC5743668 DOI: 10.3389/fpsyt.2017.00289] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/04/2017] [Indexed: 11/26/2022] Open
Abstract
Alcohol use, particularly binge drinking (BD), is a major public health concern among adolescents. Recent national data show that the gender gap in alcohol use is lessening, and BD among girls is rising. Considering the increase in BD among adolescent girls, as well as females' increased risk of experiencing more severe biopsychosocial negative effects and consequences from BD, the current review sought to examine gender differences in risk factors for BD. The review highlights gender differences in (1) developmental-related neurobiological vulnerability to BD, (2) psychiatric comorbidity and risk phenotypes for BD, and (3) social-related risk factors for BD among adolescents, as well as considerations for BD prevention and intervention. Most of the information gleaned thus far has come from preclinical research. However, it is expected that, with recent advances in clinical imaging technology, neurobiological effects observed in lower mammals will be confirmed in humans and vice versa. A synthesis of the literature highlights that males and females experience unique neurobiological paths of development, and although there is debate regarding the specific nature of these differences, literature suggests that these differences in turn influence gender differences in psychiatric comorbidity and risk for BD. For one, girls are more susceptible to stress, depression, and other internalizing behaviors and, in turn, these symptoms contribute to their risk for BD. On the other hand, males, given gender differences across the lifespan as well as gender differences in development, are driven by an externalizing phenotype for risk of BD, in part, due to unique paths of neurobiological development that occur across adolescence. With respect to social domains, although social and peer influences are important for both adolescent males and females, there are gender differences. For example, girls may be more sensitive to pressure from peers to fit in and impress others, while male gender role stereotypes regarding BD may be more of a risk factor for boys. Given these unique differences in male and female risk for BD, further research exploring risk factors, as well as tailoring intervention and prevention, is necessary. Although recent research has tailored substance use intervention to target males and females, more literature on gender considerations in treatment for prevention and intervention of BD in particular is warranted.
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Affiliation(s)
- Allyson L Dir
- Department of Pediatric Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Richard L Bell
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Zachary W Adams
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Leslie A Hulvershorn
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
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Ribadier A, Dorard G, Varescon I. Personality and Defense Styles: Clinical Specificities and Predictive Factors of Alcohol Use Disorder in Women. J Psychoactive Drugs 2016; 48:384-392. [PMID: 27705533 DOI: 10.1080/02791072.2016.1234089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study investigated personality traits and defense styles in order to determine clinical specificities and predictive factors of alcohol use disorders (AUDs) in women. A female sample, composed of AUD outpatients (n = 48) and a control group (n = 50), completed a sociodemographic self-report and questionnaires assessing personality traits (BFI), defense mechanisms and defense styles (DSQ-40). Comparative and correlational analyses, as well as univariate and multivariate logistic regressions, were performed. AUD women presented with higher neuroticism and lower extraversion and conscientiousness. They used less mature and more neurotic and immature defense styles than the control group. Concerning personality traits, high neuroticism and lower conscientiousness were predictive of AUD, as well as low mature, high neurotic, and immature defense styles. Including personality traits and defense styles in a logistic model, high neuroticism was the only AUD predictive factor. AUD women presented clinical specificities and predictive factors in personality traits and defense styles that must be taken into account in AUD studies. Implications for specific treatment for women are discussed.
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Affiliation(s)
- Aurélien Ribadier
- a Graduate Assistant, Psychopathology and Health Process Laboratory , Paris Descartes University-Sorbonne , Paris , France
| | - Géraldine Dorard
- b Associate Professor, Psychopathology and Health Process Laboratory , Paris Descartes University-Sorbonne , Paris , France
| | - Isabelle Varescon
- c Professor, Psychopathology and Health Process Laboratory , Paris Descartes University-Sorbonne , Paris , France
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Abstract
Women, alcohol, and alcohol use disorders are underresearched topics when compared with the plethora of literature exploring male alcohol consumption and its related harms. It is time to change the fact that women are underrepresented in research and programs targeting alcohol use disorders. Given the changing patterns of alcohol consumption by women, coupled with the fact that women experience a telescoping effect in alcohol-related harms, it is time that increasing attention be paid to the way gender influences the experience of alcohol-related harms, including the development of alcohol use disorders. Recovery-orientated systems are not possible without the voices of the consumers being heard. With this in mind, the purposes of this article are to explore factors that lead to alcohol-related harm in women and to highlight the gender-specific barriers to service engagement.
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Abstract
This study considers the developmental origins of alcohol use in young adulthood. Despite substantial evidence linking committed romantic relationships to less problematic alcohol use in adulthood, the uniformity of these protective benefits across different romantic relationships is unclear. Further, the extent to which the establishment and maintenance of these romantic relationships is preceded by earlier adolescence alcohol use remains unknown. To address these gaps in the literature, the current study utilized multitiple-dimensional, multiple-informant data spanning 20 years on 585 individuals in the Child Development Project. Findings from both variable- and person-centered analyses support a progression of associations predicting adolescent alcohol use (ages 15-16), drinking, and romantic relationships in early adulthood (ages 18-25), and then problematic young adult alcohol use (age 27). Although adolescent alcohol use predicted greater romantic involvement and turnover in early adulthood, romantic involvement, but not turnover, appeared to reduce the likelihood of later problematic drinking. These findings remained robust even after accounting for a wide array of selection and socialization factors. Moreover, characteristics of the individuals (e.g., gender) and of their romantic relationships (e.g., partner substance use problems and romantic relationship satisfaction) did not moderate these findings. Findings underscore the importance of using a developmental-relational perspective to consider the antecedents and consequences of alcohol use early in the life span.
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Brown JL, Talley AE, Littlefield AK, Gause NK. Young women's alcohol expectancies for sexual risk-taking mediate the link between sexual enhancement motives and condomless sex when drinking. J Behav Med 2016; 39:925-30. [PMID: 27342615 DOI: 10.1007/s10865-016-9760-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 06/17/2016] [Indexed: 11/25/2022]
Abstract
Alcohol use is prevalent among young women. Alcohol expectancies for sexual risk-taking and sexual enhancement motives have been associated with decreased condom use. This study investigated whether alcohol expectancies for sexual risk-taking mediated the association between sexual enhancement motives and condom use. Young women (N = 287, M age = 20.1) completed a survey assessing alcohol expectancies for sexual risk-taking, sexual enhancement motives, and characteristics of their most recent sexual encounter involving alcohol. Most participants (66.9 %) reported unprotected sex during their last sexual encounter involving alcohol. Higher sexual enhancement motives (OR = 1.35, p = .019) and alcohol expectancies for sexual risk-taking (OR = 1.89, p < .001) were associated with increased likelihood of condomless sex. Alcohol expectancies for sexual risk-taking mediated the association between sexual enhancement motives and condomless vaginal sex. Within the context of sexual encounters involving alcohol, expectancies that drinking may result in sexual risk-taking may account for why sexual enhancement motives relate to decreased condom use.
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Affiliation(s)
- Jennifer L Brown
- Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, 3131 Harvey Avenue, Suite 104, Cincinnati, OH, 45229, USA.
| | - Amelia E Talley
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | | | - Nicole K Gause
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
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Foster KT, Li N, McClure EA, Sonne SC, Gray KM. Gender Differences in Internalizing Symptoms and Suicide Risk Among Men and Women Seeking Treatment for Cannabis Use Disorder from Late Adolescence to Middle Adulthood. J Subst Abuse Treat 2016; 66:16-22. [PMID: 27211992 DOI: 10.1016/j.jsat.2016.01.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 01/11/2016] [Accepted: 01/18/2016] [Indexed: 02/07/2023]
Abstract
Cannabis continues to rise in popularity as the perception of its harmfulness decreases and evidence of its deleterious developmental effect increases. While internalizing distress and suicide risk have been linked with cannabis use problems [DSM-5 cannabis use disorder (CUD); DSM-IV cannabis abuse and dependence] it remains unclear how this association varies over the course of development in treatment-seeking men and women. The current study utilized the National Drug Abuse Treatment Clinical Trials Network (NIDA CTN) to conduct a cross-sectional comparison of internalizing distress and suicide risk among men (n=437) and women (n=163) spanning ages 18-50 who met DSM-5 criteria for CUD. Interactions between gender and developmental stage (i.e., late adolescence, early adulthood, and middle adulthood) were observed for suicide risk and anxiety but not depression problems. Specifically, women seeking CUD treatment in late adolescence and middle adulthood exhibited significantly higher rates of anxiety and suicide risk compared to men seeking treatment during the same developmental stages. Internalizing distress and suicide risk did not differ between treatment-seeking men and women in the early adult stage. Overall, results suggest that the structure of risk for CUD may differ in men and women across the lifespan and that women presenting for CUD treatment during late adolescence and middle adulthood may uniquely benefit from intervention designed to address these elevations in anxiety and suicide risk.
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Affiliation(s)
- Katherine T Foster
- University of Michigan, Department of Psychology; Medical University of South Carolina, Department of Psychiatry
| | - Ningfei Li
- Medical University of South Carolina, Department of Psychiatry
| | - Erin A McClure
- Medical University of South Carolina, Department of Psychiatry
| | - Susan C Sonne
- Medical University of South Carolina, Department of Psychiatry
| | - Kevin M Gray
- Medical University of South Carolina, Department of Psychiatry
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36
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Hammerslag LR, Gulley JM. Sex differences in behavior and neural development and their role in adolescent vulnerability to substance use. Behav Brain Res 2016; 298:15-26. [PMID: 25882721 PMCID: PMC4603997 DOI: 10.1016/j.bbr.2015.04.008] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 04/03/2015] [Accepted: 04/04/2015] [Indexed: 12/18/2022]
Abstract
Adolescents are especially prone to risky behavior and to the emergence of psychological disorders like substance abuse, anxiety and depression. However, there is a sex (or gender) difference in this vulnerability, with females being more prone to developing internalizing disorders and males being more likely to engage in risky behavior and drug use. While several researchers have proposed that there is a relationship between corticolimbic circuit development and adolescent vulnerability, the current proposed models do not take sex differences into account. In this review, we explore recent findings from both human and rodent studies of sex differences during adolescence. In particular, we consider epidemiological studies on the factors that contribute to the development of substance abuse and internalizing disorders, laboratory studies on reward-related and decision-making behavior, and neuroanatomical studies on the development of several structures in the corticolimbic circuit (i.e., prefrontal cortex [PFC], amygdala and striatum). We then integrate these recent findings into models of adolescent vulnerability to substance use that have previously not addressed sex differences. Lastly, we discuss methodological considerations for the interpretation and design of studies on sex (or gender) differences during adolescence while highlighting some opportunities for future investigations.
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Affiliation(s)
| | - Joshua M Gulley
- Neuroscience Program, University of Illinois, Urbana-Champaign, USA; Department of Psychology University of Illinois, Urbana-Champaign, USA.
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37
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Skogen JC, Knudsen AK, Hysing M, Wold B, Sivertsen B. Trajectories of alcohol use and association with symptoms of depression from early to late adolescence: The Norwegian Longitudinal Health Behaviour Study. Drug Alcohol Rev 2015; 35:307-16. [PMID: 26494431 DOI: 10.1111/dar.12350] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/05/2015] [Indexed: 01/20/2023]
Abstract
INTRODUCTION AND AIMS Adolescence is a period in which many have an onset of alcohol use, but there is much heterogeneity in the individual development of alcohol use. Further, there is a general increase in depressive symptoms from early to late adolescence, but less is known about how different alcohol habit trajectories are associated with symptoms of depression. The aims of the present study were: to identify trajectories of alcohol consumption and drinking to intoxication during adolescence (age 13-18 years); and examine to what extent the different trajectories of alcohol use were associated with symptoms of depression over the same age span, from early to late adolescence. METHODS Data from the Norwegian Longitudinal Health Behaviour Study were employed. Latent class growth analyses were employed to identify different trajectories of both alcohol consumption and drinking to intoxication. The resulting trajectories for each participant were used to estimate the gender-adjusted association between different development of alcohol use and symptoms of depression. RESULTS Four trajectories of both alcohol consumption and drinking to intoxication were identified. The trajectories with an early onset of alcohol consumption or drinking to intoxication were associated with higher levels of depressive symptoms compared with late onset or stable low use trajectories. CONCLUSIONS The findings from the present study suggest that early onset developmental trajectories of alcohol use are associated with depression. Therefore, broad assessment and interventions targeting both alcohol and depression may be indicated among early onset alcohol users, especially if they report increasing levels of consumption. [Skogen JC, Knudsen AK, Hysing M, Wold B, Sivertsen B. Trajectories of alcohol use and association with symptoms of depression from early to late adolescence: The Norwegian Longitudinal Health Behaviour Study. Drug Alcohol Rev 2016;35:307-316].
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Affiliation(s)
- Jens Christoffer Skogen
- Department of Public Mental Health, Division of Mental Health, Norwegian Institute of Public Health, Bergen, Norway.,Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
| | - Ann Kristin Knudsen
- Department of Health Registries, Norwegian Institute of Public Health, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
| | - Bente Wold
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Børge Sivertsen
- Department of Public Mental Health, Division of Mental Health, Norwegian Institute of Public Health, Bergen, Norway.,Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.,Department of Psychiatry, Helse Fonna HF, Haugesund, Norway
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38
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Foster KT, Hicks BM, Iacono WG, McGue M. Gender differences in the structure of risk for alcohol use disorder in adolescence and young adulthood. Psychol Med 2015; 45:3047-58. [PMID: 26118496 PMCID: PMC4631679 DOI: 10.1017/s0033291715001014] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Gender differences in the prevalence of alcohol use disorder (AUD) have motivated the separate study of its risk factors and consequences in men and women. However, leveraging gender as a third variable to help account for the association between risk factors and consequences for AUD could elucidate etiological mechanisms and clinical outcomes. METHOD Using data from a large, community sample followed longitudinally from 17 to 29 years of age, we tested for gender differences in psychosocial risk factors and consequences in adolescence and adulthood after controlling for gender differences in the base rates of AUD and psychosocial factors. Psychosocial factors included alcohol use, other drug use, externalizing and internalizing symptoms, deviant peer affiliation, family adversity, academic problems, attitudes and use of substances by a romantic partner, and adult socio-economic status. RESULTS At both ages of 17 and 29 years, mean levels of psychosocial risks and consequences were higher in men and those with AUD. However, the amount of risk exposure in adolescence was more predictive of AUD in women than men. By adulthood, AUD consequences were larger in women than men and internalizing risk had a stronger relationship with AUD in women at both ages. CONCLUSIONS Despite higher mean levels of risk exposure in men overall, AUD appears to be a more severe disorder in women characterized by higher levels of adolescent risk factors and a greater magnitude of the AUD consequences among women than men. Furthermore, internalizing symptoms appear to be a gender-specific risk factor for AUD in women.
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Affiliation(s)
| | | | | | - Matt McGue
- Department of Psychology, University of Minnesota
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