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Kuypers K, Verkes RJ, van den Brink W, van Amsterdam J, Ramaekers JG. Intoxicated aggression: Do alcohol and stimulants cause dose-related aggression? A review. Eur Neuropsychopharmacol 2020; 30:114-147. [PMID: 29941239 DOI: 10.1016/j.euroneuro.2018.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 05/23/2018] [Accepted: 06/02/2018] [Indexed: 12/30/2022]
Abstract
RATIONALE Violence and drug use are significant public health challenges that are strongly linked. It is known that alcohol plays a major role in the causation of unnatural deaths and that stimulants like cocaine and amphetamine are often implicated in aggressive acts or violence. However, a clear causal relationship between these substances and aggression, and more specifically a blood concentration threshold at which intoxicated aggression emerges is lacking. In case of a crime and subsequent law enforcement, knowledge about dose-response relationships could be of pivotal importance when evaluating the role of alcohol and drugs in aggressive offences. AIMS The present review aimed to determine whether there is a causal relation between intoxication with these psychoactive substances and aggression, and to define blood concentration thresholds above which these substances elicit aggression. METHODS Empirical articles published between 2013 and 2017 and review papers containing the predefined search strings were identified through searches in the PubMed and Embase databases and additional reference list searches. The complete search query yielded 1578 publications. Initially all articles were manually screened by title and abstract. Articles with irrelevant titles, given the selected search terms and review aims were discarded. Remaining articles were carefully studied and those that did not comply with the main objectives of this review were discarded. At the end of this process, 167 titles were found eligible for review. FINDINGS AND CONCLUSION While placebo-controlled experimental studies clearly showed a causal link between alcohol and aggression, it is evident that such a link has not yet been established for cocaine and amphetamines. In case of alcohol, it is clear that there are various individual and contextual factors that may contribute to the occurrence of an aggressive act during intoxication. A clear threshold blood alcohol concentration has not been defined yet for alcohol, but a statistically significant increase of aggression has been demonstrated at a dose of 0.75 g/kg and higher. Future studies into intoxicated aggression should include multiple doses of alcohol and stimulants and take into account individual and contextual factors.
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Affiliation(s)
- Kpc Kuypers
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
| | - R J Verkes
- Radboud UMC, Psychiatry, Radboud University, Nijmegen, The Netherlands
| | - W van den Brink
- AMC Psychiatry, University of Amsterdam, Amsterdam, The Netherlands
| | | | - J G Ramaekers
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
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Norberg MM, Newins AR, Crone C, Ham LS, Henry A, Mills L, Dennis PA. Why are caffeinated alcoholic beverages especially risky? Addict Behav 2019; 98:106062. [PMID: 31377447 DOI: 10.1016/j.addbeh.2019.106062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 06/28/2019] [Accepted: 07/25/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Evidence suggests that people drink more alcohol and experience more adverse alcohol-related consequences (ARCs) on occasions when they also consume caffeine. The current study examined whether this increase in risk is a result of caffeine attenuating the subjective effects of alcohol intoxication (i.e., the masking hypothesis). METHODS Undergraduate students (n = 148) reported their drinking patterns using a modified Timeline Followback approach. For each recalled drinking occasion, alcohol consumption, caffeine consumption, perceived blood alcohol concentration, and ARCs were assessed. Generalized linear mixed models were used to examine the influence that alcohol and caffeine consumption had on perceived intoxication and the experience of ARCs. RESULTS At the occasion level, greater caffeine consumption was associated with increased consumption of alcohol and increased ARCs. There was also a significant curvilinear relationship between the amount of alcohol consumed and perceived intoxication, such that the more alcohol was consumed on each occasion the less each additional drink increased perceived intoxication. Increased caffeine consumption weakened the association between alcohol consumption and perceived intoxication and it also weakened the association between alcohol consumption and ARCs. Specifically, the weakest relationship between ARCs and alcohol consumption existed at the highest level of caffeine consumption (240+ mg). Caffeine increased subjective intoxication. CONCLUSIONS These findings do not support the masking hypothesis. Caffeine was strongly associated with ARCs when consumed at high doses and this effect does not appear to be the result of drinking more alcohol or underestimating one's blood alcohol content. Efforts to reduce caffeinated alcohol beverage use are greatly needed.
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Affiliation(s)
- Melissa M Norberg
- Centre for Emotional Health, Department of Psychology, Room 714, C3A Building, Macquarie University, Sydney, NSW 2109, Australia.
| | - Amie R Newins
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Cassandra Crone
- Centre for Emotional Health, Department of Psychology, Room 714, C3A Building, Macquarie University, Sydney, NSW 2109, Australia
| | - Lindsay S Ham
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Alastair Henry
- Centre for Emotional Health, Department of Psychology, Room 714, C3A Building, Macquarie University, Sydney, NSW 2109, Australia
| | - Llew Mills
- Division of Addiction Medicine, University of Sydney, NSW, Australia
| | - Paul A Dennis
- Durham VA Medical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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Varlinskaya EI, Hosová D, Towner T, Werner DF, Spear LP. Effects of chronic intermittent ethanol exposure during early and late adolescence on anxiety-like behaviors and behavioral flexibility in adulthood. Behav Brain Res 2019; 378:112292. [PMID: 31626849 DOI: 10.1016/j.bbr.2019.112292] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/19/2019] [Accepted: 10/07/2019] [Indexed: 12/31/2022]
Abstract
Although both humans and laboratory rodents demonstrate cognitive and affective alterations associated with adolescent alcohol exposure, it is still unknown whether the consequences of early initiation of alcohol use differ from those of later binge drinking within the adolescent developmental period. The present study was designed to assess the effects of early and late AIE on (1) anxiety-like behavior under social (modified social interaction test) and non-social test circumstances (modified light/dark box test, elevated plus maze), and (2) behavioral flexibility, indexed via set shifting in males and females. Early-mid adolescent intermittent exposure (early AIE) occurred between postnatal days (P) 25 and 45, whereas late adolescent intermittent exposure (late AIE) was conducted between P45 and P65, with behavioral testing initiated not earlier than 25 days after repeated exposure to ethanol (4.0 g/kg intragastrically, every other day for a total of 11 exposures). Anxiety-like behavior on the EPM was evident in males and females following early AIE, whereas only males demonstrated non-social anxiety on the EPM following late AIE. Social anxiety-like alterations and deficits in behavioral flexibility were evident only in males following early AIE. Taken together, the results of the present study demonstrate a particular vulnerability of young adolescent males to long-lasting detrimental effects of repeated ethanol and an insensitivity of older adolescent females to the intermittent ethanol exposure paradigm.
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Affiliation(s)
- Elena I Varlinskaya
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), Center for Development and Behavioral Neuroscience, Department of Psychology, Binghamton University, Binghamton, NY 13902-6000, United States
| | - Dominika Hosová
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), Center for Development and Behavioral Neuroscience, Department of Psychology, Binghamton University, Binghamton, NY 13902-6000, United States
| | - Trevor Towner
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), Center for Development and Behavioral Neuroscience, Department of Psychology, Binghamton University, Binghamton, NY 13902-6000, United States
| | - David F Werner
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), Center for Development and Behavioral Neuroscience, Department of Psychology, Binghamton University, Binghamton, NY 13902-6000, United States.
| | - Linda P Spear
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), Center for Development and Behavioral Neuroscience, Department of Psychology, Binghamton University, Binghamton, NY 13902-6000, United States
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Rabbi M, Philyaw Kotov M, Cunningham R, Bonar EE, Nahum-Shani I, Klasnja P, Walton M, Murphy S. Toward Increasing Engagement in Substance Use Data Collection: Development of the Substance Abuse Research Assistant App and Protocol for a Microrandomized Trial Using Adolescents and Emerging Adults. JMIR Res Protoc 2018; 7:e166. [PMID: 30021714 PMCID: PMC6070723 DOI: 10.2196/resprot.9850] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/18/2018] [Accepted: 05/08/2018] [Indexed: 11/23/2022] Open
Abstract
Background Substance use is an alarming public health issue associated with significant morbidity and mortality. Adolescents and emerging adults are at particularly high risk because substance use typically initiates and peaks during this developmental period. Mobile health apps are a promising data collection and intervention delivery tool for substance-using youth as most teens and young adults own a mobile phone. However, engagement with data collection for most mobile health applications is low, and often, large fractions of users stop providing data after a week of use. Objective Substance Abuse Research Assistant (SARA) is a mobile application to increase or sustain engagement of substance data collection overtime. SARA provides a variety of engagement strategies to incentivize data collection: a virtual aquarium in the app grows with fish and aquatic resources; occasionally, funny or inspirational contents (eg, memes or text messages) are provided to generate positive emotions. We plan to assess the efficacy of SARA’s engagement strategies over time by conducting a micro-randomized trial, where the engagement strategies will be sequentially manipulated. Methods We aim to recruit participants (aged 14-24 years), who report any binge drinking or marijuana use in the past month. Participants are instructed to use SARA for 1 month. During this period, participants are asked to complete one survey and two active tasks every day between 6 pm and midnight. Through the survey, we assess participants’ daily mood, stress levels, loneliness, and hopefulness, while through the active tasks, we measure reaction time and spatial memory. To incentivize and support the data collection, a variety of engagement strategies are used. First, predata collection strategies include the following: (1) at 4 pm, a push notification may be issued with an inspirational message from a contemporary celebrity; or (2) at 6 pm, a push notification may be issued reminding about data collection and incentives. Second, postdata collection strategies include various rewards such as points which can be used to grow a virtual aquarium with fishes and other treasures and modest monetary rewards (up to US $12; US $1 for each 3-day streak); also, participants may receive funny or inspirational content as memes or gifs or visualizations of prior data. During the study, the participants will be randomized every day to receive different engagement strategies. In the primary analysis, we will assess whether issuing 4 pm push-notifications or memes or gifs, respectively, increases self-reporting on the current or the following day. Results The microrandomized trial started on August 21, 2017 and the trial ended on February 28, 2018. Seventy-three participants were recruited. Data analysis is currently underway. Conclusions To the best of our knowledge, SARA is the first mobile phone app that systematically manipulates engagement strategies in order to identify the best sequence of strategies that keep participants engaged in data collection. Once the optimal strategies to collect data are identified, future versions of SARA will use this data to provide just-in-time adaptive interventions to reduce substance use among youth. Trial Registration ClinicalTrials.gov NCT03255317; https://clinicaltrials.gov/show/NCT03255317 (Archived by WebCite at http://www.webcitation.org/70raGWV0e) Registered Report Identifier RR1-10.2196/9850
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Affiliation(s)
- Mashfiqui Rabbi
- Department of Statistics, Harvard University, Cambridge, MA, United States
| | - Meredith Philyaw Kotov
- Department of Psychiatry and Addiction Center, University of Michigan, Ann Arbor, MI, United States
| | - Rebecca Cunningham
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, United States.,Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States.,School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Erin E Bonar
- Department of Psychiatry and Addiction Center, University of Michigan, Ann Arbor, MI, United States.,Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
| | - Inbal Nahum-Shani
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | - Predrag Klasnja
- School of Information, University of Michigan, Ann Arbor, MI, United States
| | - Maureen Walton
- Department of Psychiatry and Addiction Center, University of Michigan, Ann Arbor, MI, United States.,Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
| | - Susan Murphy
- Department of Statistics, Harvard University, Cambridge, MA, United States
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Marczinski CA, Fillmore MT, Stamates AL, Maloney SF. Alcohol-Induced Impairment of Balance is Antagonized by Energy Drinks. Alcohol Clin Exp Res 2017; 42:144-152. [PMID: 29112285 DOI: 10.1111/acer.13521] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 10/03/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND The acute administration of alcohol reliably impairs balance and motor coordination. While it is common for consumers to ingest alcohol with other stimulant drugs (e.g., caffeine, nicotine), little is known whether prototypical alcohol-induced balance impairments are altered by stimulant drugs. The purpose of this study was to examine whether the coadministration of a high-caffeine energy drink with alcohol can antagonize expected alcohol-induced increases in body sway. METHODS Sixteen social drinkers (of equal gender) participated in 4 separate double-blind dose administration sessions that involved consumption of alcohol and energy drinks, alone and in combination. Following dose administration, participants completed automated assessments of balance stability (both eyes open and eyes closed) measured using the Biosway Portable Balance System. Participants completed several subjective measures including self-reported ratings of sedation, stimulation, fatigue, and impairment. Blood pressure and pulse rate were recorded repeatedly. RESULTS The acute administration of alcohol increased body sway, and the coadministration of energy drinks antagonized this impairment. When participants closed their eyes, alcohol-induced body sway was similar whether or not energy drinks were ingested. While alcohol administration increased ratings of sedation and fatigue, energy drink administration increased ratings of stimulation and reduced ratings of fatigue. Modest increases in systolic and diastolic blood pressure following energy drink administration were also observed. CONCLUSIONS Visual assessment of balance impairment is frequently used to indicate that an individual has consumed too much alcohol (e.g., as part of police-standardized field sobriety testing or by a bartender assessing when someone should no longer be served more alcohol). The current findings suggest that energy drinks can antagonize alcohol-induced increases in body sway, indicating that future work is needed to determine whether this observation regarding neuromotor functioning applies to alcohol in combination with all types of stimulant drugs.
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Affiliation(s)
- Cecile A Marczinski
- Department of Psychological Science, Northern Kentucky University, Highland Heights, Kentucky
| | - Mark T Fillmore
- Department of Psychology, University of Kentucky, Lexington, Kentucky
| | - Amy L Stamates
- Department of Psychological Science, Northern Kentucky University, Highland Heights, Kentucky
| | - Sarah F Maloney
- Department of Psychological Science, Northern Kentucky University, Highland Heights, Kentucky
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Effects of acute alcohol intoxication on executive functions controlling self-regulated behavior. Alcohol 2017; 61:1-8. [PMID: 28599712 DOI: 10.1016/j.alcohol.2017.02.177] [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] [Received: 06/25/2016] [Revised: 12/31/2016] [Accepted: 02/10/2017] [Indexed: 11/23/2022]
Abstract
Alcohol consumption may lead to deficits in the executive functions that govern self-regulation. These deficits could lead to risk-taking behaviors; therefore, it is important to determine the magnitude of these deficits on executive functioning. The purpose of this experiment was to investigate the acute effects of alcohol on three of the executive functions that are hypothesized to affect self-regulation, which are inhibition, set shifting, and working memory, using a mixed-methods study design. The participants were 75 moderate or heavy drinkers between the ages of 21 and 35 who were randomized into one of three beverage conditions (control, placebo, or 0.65-g alcohol dose/kg body weight). Performance on working memory, set shifting, and inhibition were measured pre- and post-beverage consumption. The results showed only a significant interaction in the working memory data, as there was an increase in performance post-beverage relative to pre-beverage for the control participants as compared to the alcohol and placebo participants. It was concluded that the dose of alcohol (BAC = 0.063%) given to moderate to heavy drinkers was not sufficient to cause significant impairment in the executive functions tested. The results were further discussed and methodological concerns were considered, such as the low BAC achieved, practice effects, and insensitivity of tasks.
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Subjective alcohol responses in a cross-sectional, field-based study of adolescents and young adults: Effects of age, drinking level, and dependence/consequences. Drug Alcohol Depend 2017; 170:156-163. [PMID: 27918951 PMCID: PMC5218599 DOI: 10.1016/j.drugalcdep.2016.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 10/24/2016] [Accepted: 11/09/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Adolescents are physically, cognitively, socially, and emotionally different than adults in ways that may partially explain why alcohol misuse typically develops during this period. Ample animal-science evidence and nascent ecological evidence points toward developmentally limited differences in sensitivity to alcohol's stimulatory and sedative effects. Field-based research methods were used to test for such age-related differences in a sample of adolescents through young adults. Potential moderating influences of estimated blood alcohol content (eBAC), as well as typical consumption and level of dependence/consequences were explored. METHODS Subjective alcohol responses were collected from 1,364 participants, aged 17 to 32 years, recruited outside of venues where drinking takes place in a small metropolitan bar district. RESULTS Self-reports of stimulatory response to alcohol were age-related, such that younger participants reported increased subjective stimulation at the time of data collection relative to older participants. Age-related differences in stimulatory responses were more pronounced at lower eBACs and among younger participants who typically drank more heavily. Stimulatory responses generally diminished among older than younger participants, although individuals with greater dependence/consequences consistently reported greater stimulation from drinking. Contrastingly, age, typical consumption, and dependence/consequences were not related to sedation in this sample. CONCLUSIONS This research provides cross-sectional evidence to support age-, consumption-, and dependence/consequences-related differences in stimulatory alcohol responses among adolescents and young adults assessed within a bar-area context. While cross-sectional, the results of this field-based study provide support for the theory that addiction liability is developmentally linked and associated, in part, with age-related differences in subjective alcohol responses.
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Usala JM, Celio MA, Lisman SA, Day AM, Spear LP. A field investigation of the effects of drinking consequences on young adults' readiness to change. Addict Behav 2015; 41:162-8. [PMID: 25452061 PMCID: PMC4314315 DOI: 10.1016/j.addbeh.2014.10.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 08/19/2014] [Accepted: 10/19/2014] [Indexed: 11/25/2022]
Abstract
In the research on readiness to change (RTC) one's drinking, there has been little assessment of the influence of positive drinking consequences or other potential moderating variables. To address these limitations, we examined how young adults' RTC their alcohol consumption shortly following a drinking episode was associated with self-reported drinking consequences, as well as any potential moderating effects of gender and Breath Alcohol Concentration (BrAC). In street interviews outside bars, 238 young adults were administered questionnaires about their drinking, including a measure examining participants' current readiness to reduce their alcohol consumption. Within 72h of their drinking episode, 67 participants (36 males; entire sample Mage=20.90years, Range=18-26years) completed an online survey, once again measuring RTC as well as positive and negative drinking consequences. Consistent with our hypothesis, positive drinking consequences were negatively associated with participants' changes in RTC. Additionally, a three-way interaction of gender×BrAC×positive drinking consequences on RTC showed that females with low BrACs reported higher RTC scores when they had endorsed fewer positive drinking consequences. Interestingly, negative drinking consequences alone did not impact individuals' RTC. Because positive drinking consequences were a significantly better predictor of RTC than were negative drinking consequences, researchers are advised to examine both types of consequences in future studies. Finally, effective alcohol education programs for those who have never consumed alcohol as well as social drinkers should include consideration of the experience of positive outcomes.
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Affiliation(s)
- Julie M Usala
- Department of Psychology, Binghamton University (SUNY), P.O. Box 6000, Binghamton, NY 13902-6000, United States.
| | - Mark A Celio
- Brown University School of Public Health, Center for Alcohol and Addiction Studies, Box G-S121-4, Providence, RI 02912, United States
| | - Stephen A Lisman
- Department of Psychology, Binghamton University (SUNY), P.O. Box 6000, Binghamton, NY 13902-6000, United States
| | - Anne M Day
- Brown University School of Public Health, Center for Alcohol and Addiction Studies, Box G-S121-4, Providence, RI 02912, United States
| | - Linda P Spear
- Department of Psychology, Binghamton University (SUNY), P.O. Box 6000, Binghamton, NY 13902-6000, United States; Developmental Exposure Alcohol Research Center (DEARC), Binghamton University (SUNY), P.O. Box 6000, Binghamton NY 13902-6000, United States
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Day AM, Celio MA, Lisman SA, Johansen GE, Spear LP. Acute and chronic effects of alcohol on trail making test performance among underage drinkers in a field setting. J Stud Alcohol Drugs 2014; 74:635-41. [PMID: 23739029 DOI: 10.15288/jsad.2013.74.635] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Alcohol's effects on executive functioning are well documented. Research in this area has provided much information on both the acute and chronic effects of alcohol on processes such as working memory and mental flexibility. However, most research on the acute effects of alcohol is conducted with individuals older than 21 years of age. Using field recruitment methods can provide unique empirical data on the acute effects of alcohol on an underage population. METHOD The current study examined the independent effects of acute alcohol intoxication (measured by breath alcohol content) and chronic alcohol use (measured by years drinking) on a test of visuomotor performance and mental flexibility (Trail Making Test) among 91 drinkers ages 18-20 years recruited from a field setting. RESULTS Results show that breath alcohol predicts performance on Trails B, but not on Trails A, and that years drinking, above and beyond acute intoxication, predicts poorer performance on both Trails A and B. CONCLUSIONS These data suggest that, independent of the acute effects of alcohol, chronic alcohol consumption has deleterious effects on executive functioning processes among underage drinkers. Our discussion focuses on the importance of these data in describing the effect of alcohol on adolescents and the potential for engaging in risky behavior while intoxicated.
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Affiliation(s)
- Anne M Day
- Center for Alcohol and Addiction Studies, Behavioral and Social Sciences, Brown University, Providence, Rhode Island 02912, USA.
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