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Cibich M, Hines S, Carey TA. Effectiveness of strategies to reduce risky alcohol consumption among youth living in rural or remote areas: a systematic review. JBI Evid Synth 2023; 21:1971-2021. [PMID: 37338285 DOI: 10.11124/jbies-22-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
OBJECTIVE This review aimed to evaluate the effectiveness of strategies to reduce risky alcohol consumption among youth living in rural and remote areas. INTRODUCTION Youth living in rural and remote areas are more likely to drink alcohol and experience alcohol-related harm than youth living in urban locations. This review assessed the effectiveness of strategies to reduce young people's risky alcohol consumption in rural and remote areas. INCLUSION CRITERIA We considered papers that included youth (aged 12 to 24 years; also referred to in this review as young people ) who were identified as living in rural or remote locations. Any intervention or strategy designed to reduce or prevent alcohol consumption among this population was included. The primary outcome was frequency of short-term risky alcohol consumption as measured by self-reported incidents of drinking 5 or more standard drinks in 1 session. METHODS We conducted this systematic review in accordance with the JBI methodology for systematic reviews of effectiveness. We searched for published and unpublished English-language studies and gray literature from 1999 to December 2021. Two authors screened titles and abstracts before full-text screening and data extraction. Two authors reviewed the extracted data to identify studies that reported duplicate data (eg, due to progressive publication of longitudinal data sets) and, where multiple studies reported the same data set, the study with the measure most proximal to the primary outcome measure and/or with the longest follow-up was selected. Two authors then critically appraised the studies. There were no interventions that were assessed for impact on the primary outcome in more than 1 study; in turn, the feasibility and utility of statistical pooling and the Summary of Findings were limited. Instead, results and certainty of evidence is provided in narrative format. RESULTS Twenty-eight articles reporting on 16 studies were included in the review: 10 randomized controlled trials, 4 quasi-experimental studies, and 2 cohort studies. All studies except 1 were conducted in the United States. Only 3 studies measured the primary outcome of short-term risky alcohol consumption and included a comparison group. A meta-analysis of 2 of these studies showed that interventions that included motivational interviewing had a small and non-significant effect on short-term risky alcohol consumption among Indigenous youth in the United States. Meta-analyses of the effect of a variety of interventions on secondary outcomes demonstrated that intervention was not more effective than control for reducing past month drunkenness; however, intervention was more effective for reducing past month alcohol use (odds radio 0.3; 95% CI 0.13 to 0.67; P =0.003). The heterogeneity of effects was evident within these meta-analyses as well as in the studies unable to be meta-analyzed. CONCLUSION Based on this review, no interventions can be broadly recommended for reducing short-term risky alcohol consumption among youth in rural and remote areas. Further research to increase the robustness of available evidence in relation to the effectiveness of strategies to reduce short-term risky alcohol consumption among youth in rural and remote areas is urgently required. REVIEW REGISTRATION PROSPERO CRD42020167834.
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Affiliation(s)
- Mikaela Cibich
- Flinders Rural and Remote Health NT, College of Medicine and Public Health, Flinders University, NT, Australia
| | - Sonia Hines
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
| | - Timothy A Carey
- Country Health Research and Innovation, Curtin University, Perth, WA, Australia
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Farmer RF, Seeley JR, Kosty DB, Gau JM. Deconstructing the heterogeneity of alcohol use disorder: lifetime comorbid non-alcohol substance use disorder as a distinct behavioral phenotype? Psychol Med 2023; 53:4962-4976. [PMID: 35781344 DOI: 10.1017/s0033291722001921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Alcohol use disorder (AUD) is an etiologically and clinically heterogeneous condition. Accumulating evidence suggests that persons with lifetime histories of comorbid AUD and non-alcohol substance use disorder (DRUG) constitute an important subgroup of AUD. This study evaluated the distinctiveness of the comorbid AUD/DRUG behavioral phenotype in a community sample with respect to risk factors, AUD course features, and outcome variables assessed at age 30. Contrast groups included persons with histories of AUD only, DRUG only, and neither AUD nor DRUG. METHODS This research utilized a prospective study design with an age-based cohort (n = 732). Participants completed four comprehensive diagnostic evaluations during the high-risk periods of adolescence, emerging adulthood, and young adulthood. RESULTS The comorbid AUD/DRUG group was distinguished from the AUD only group by risk factors, AUD course features, and outcomes. Group differences in outcomes were also explained by overall substance use disorder (SUD) severity. Persons with AUD/DRUG comorbidity were indistinguishable from those with DRUG only histories with respect to risk factors and outcomes but demonstrated greater overall SUD severity. Persons with AUD only were indistinguishable from those with neither AUD nor DRUG histories in risk factor endorsements and were mostly similar in outcomes. CONCLUSIONS Findings collectively suggest that young adults with histories of AUD only and those with comorbid AUD/DRUG are drawn from dissimilar populations. Similarities between the AUD only group with those absent AUD or DRUG histories are likely related to the former group's developmentally limited AUD course accompanied by relatively few or short-lived alcohol-related problems.
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Affiliation(s)
- Richard F Farmer
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
| | - John R Seeley
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
- College of Education, University of Oregon, 901 East 18th Ave., Eugene, OR 97403, USA
| | - Derek B Kosty
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
- College of Education, University of Oregon, 901 East 18th Ave., Eugene, OR 97403, USA
| | - Jeff M Gau
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
- College of Education, University of Oregon, 901 East 18th Ave., Eugene, OR 97403, USA
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Mackiewicz Seghete KL, Filbey FM, Hudson KA, Hyun B, Feldstein Ewing SW. Time for a paradigm shift: The adolescent brain in addiction treatment. Neuroimage Clin 2022; 34:102960. [PMID: 35172248 PMCID: PMC8850747 DOI: 10.1016/j.nicl.2022.102960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 12/29/2021] [Accepted: 02/06/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE One route to improve adolescent addiction treatment outcomes is to use translational approaches to help identify developmental neuroscience mechanisms that undergird active treatment ingredients and advance adolescent behavior change. METHODS This sample included 163 adolescents (ages 15-19) randomized to motivational interviewing (MI) vs. brief adolescent mindfulness (BAM). Youth completed an fMRI paradigm assessing adolescent brain response to therapist language (complex reflection vs. mindful; complex reflection vs. confront; mindful vs. confront) at pre- (prior to the completion of the full intervention) and post-treatment (at 3-month follow-up) and behavioral measures at 3, 6 and 12 months. RESULTS Youth in both treatment groups showed significant problem drinking reductions at 3 and 6 months, but MI youth demonstrated significantly better treatment outcomes than BAM youth at 12 months. We observed several significant treatment group differences (MI > BAM) in neural response to therapist language, including at pre-treatment when examining complex reflection vs. mindful, and complex reflection vs. confront (e.g., superior temporal gyrus, lingual gyrus); and at post-treatment when examining mindful vs. confront (e.g., supplementary motor area; middle frontal gyrus). When collapsed across treatment groups (MI + BAM), we observed significant differences by time, with youth showing a pattern of brain change in response to complex reflection vs. mindful, and complex reflection vs. confront (e.g., precuneus; postcentral gyrus). There was no evidence of a significant group × time interaction. However, brain change in response to therapist language (complex reflection vs. confront) in regions such as middle frontal gyrus, was associated with reductions in problem drinking at 12 months. Yet, few treatment group differences were observed. CONCLUSIONS These data underscore the need to better understand therapist language and it's impact on the developing brain, in order to inform and aggregate the most impactful elements of addiction treatment for future treatment development for adolescents.
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Affiliation(s)
- Kristen L Mackiewicz Seghete
- Oregon Health & Science University, Department of Psychiatry, 3181 SW Sam Jackson Park Rd, M/C UHN80R1, Portland, OR 97239, USA.
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, 2200 West Mockingbird Lane, Dallas, TX 75235, USA.
| | - Karen A Hudson
- Departments of Psychology and Interdisciplinary Neuroscience, University of Rhode Island, 130 Flagg Rd, Kingston, RI 02881 USA.
| | - Benedict Hyun
- Departments of Psychology and Interdisciplinary Neuroscience, University of Rhode Island, 130 Flagg Rd, Kingston, RI 02881 USA.
| | - Sarah W Feldstein Ewing
- Departments of Psychology and Interdisciplinary Neuroscience, University of Rhode Island, 130 Flagg Rd, Kingston, RI 02881 USA.
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McArdle P, Coulton S, Kaner E, Gilvarry E, Drummond C. Alcohol Misuse among English Youth, Are Harms Attributable to Alcohol or to Underlying Disinhibitory Characteristics? Alcohol Alcohol 2022; 57:372-377. [PMID: 34875694 DOI: 10.1093/alcalc/agab077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Alcohol use by young people is associated with a range of psychological and physical harms. However, similar harms are also reported with disinhibitory conditions such as conduct problems that are said to precede and predispose to alcohol misuse. We explored whether alcohol use or indicators of underlying disinhibition predict psychological and physical harms in a cohort of young people. METHODS We used data from a randomised controlled intervention trial that identified young people who consumed alcohol (n = 756), mean age = 15.6 years, attending emergency departments (EDs) in England. Disinhibition was measured by the self-report Strengths and Difficulties Questionnaire hyperactivity and conduct problem items, and alcohol-related harms by questions from the ESPAD, a major European school survey. We conducted a mediation analysis with a primary outcome of frequency of engaging in alcohol-related harms 12 months after screening in ED, exploring for the mediating influence of alcohol consumed at six months. We included age, gender, allocated group and baseline consumption as covariates and adjusted for the multi-level nature of the study, where young people were nested within EDs. RESULTS Conduct problems and to a lesser extent hyperactivity predicted harms at twelve months. This effect was not mediated by alcohol consumed at 6 months. CONCLUSIONS Among young drinkers underlying behavioural attributes predict harm independently of alcohol use. This suggests that the harms associated with alcohol use are attributable more to underlying disinhibitory characteristics than the quantity of alcohol consumed.
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Affiliation(s)
- Paul McArdle
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Jubilee Road, NE3 3XT, Newcastle upon Tyne, UK
| | - Simon Coulton
- Centre for Health Services Studies, University of Kent, Canterbury, Kent CT2 7NF, UK
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Baddiley-Clark Building, NE2 4AX, Newcastle-upon-Tyne, UK
| | - Eilish Gilvarry
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Jubilee Road, NE3 3XT, Newcastle upon Tyne, UK
| | - Colin Drummond
- Addictions Department, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 de Crespigny Park, London SE5 8AF, UK
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Grahn R, Padyab M, Lundgren L. Associations between a risky psychosocial childhood and recurrent addiction compulsory care as adult. NORDIC STUDIES ON ALCOHOL AND DRUGS 2020; 37:54-68. [PMID: 32934593 PMCID: PMC7434189 DOI: 10.1177/1455072519882785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/23/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Treatment for substance use disorder (SUD), results, in general, in
improvements in terms of both drug use and social functioning. However,
there are clients who are in need of repeated treatment. The aim of this
retrospective study was to identify, for adults in compulsory care for
severe SUD, the association between reporting having experienced a risky
psychosocial childhood and repeated entries into the Swedish compulsory care
system for SUD. Method: Hierarchical logistic regression and mediation analysis methods were used to
analyse data from the Swedish National Board of Institutional Care (SiS)
database. The sample included 2719 adults assessed at their compulsory care
intake. The study examined the association between history of institutional
care, family with SUD or psychiatric problem and repeated compulsory care
entries as an adult controlling for main drug, age and gender. Results: In the regression model the factor with the strongest association with
repeated compulsory care intakes for SUD, was as a child having been in
mandated institutional care (OR = 2.0 (1.60–2.51)). The
proportion of the total effect that is mediated through LVU (law (1990:52)
the care of young persons (special provisions) act) was 33% for SUD problems
in family during childhood, 44% for psychiatric problems in family during
childhood, and 38% for having been in foster care. Conclusion: Having been in mandated institutional care as a youth was strongly associated
with repeated compulsory care for SUD as an adult. This is concerning since
receipt of services as a child is supposed to mediate against the
consequences of risky childhood conditions. These adults, as a group, are in
need of a well-coordinated and integrated system of extensive aftercare
services to reduce the likelihood of re-entry into compulsory care for an
SUD.
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Affiliation(s)
| | | | - Lena Lundgren
- University of Denver Graduate School of Social Work, USA
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Jeon YJ, Han YJ, Choi MH, Lee JS, Lee JH, Jo SH, Kim SH. Mental health states and influencing factors of risky and problem drinking in South Korean female adolescents. Public Health 2020; 185:61-69. [PMID: 32570147 DOI: 10.1016/j.puhe.2020.04.030] [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: 12/17/2019] [Revised: 04/12/2020] [Accepted: 04/21/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Alcohol is one of the most used and abused psychoactive substances by adolescents. We investigated influencing factors of risky and problem drinking in Korean female adolescents. STUDY DESIGN The study design used is a cross-sectional modeling. METHODS We used data from the 13th Korean Youth Risk Behavior Web-based Survey (KYRBS) conducted in 2017. KYRBS data were obtained from a stratified, multistage, clustered sample. Risky drinking was binge drinking and problem drinking was drinking with several conflicts association with alcohol consumption. RESULTS Among 62,276 participants, the rates of current, risky, and problem drinking among all participants were 16.1%, 8.3%, and 6.1%, respectively. Although all of these rates were higher in males, risky and problem drinking rates among current female drinkers were higher than those of males (55.4 vs 48.5%, 38.9 vs 37.2%, respectively). Problem drinking was most strongly associated with risky drinking (adjusted odds ratio: 17.53 [95% confidence interval: 14.63-21.00]), similarly, risky drinking was most strongly associated with problem drinking in female current drinkers (17.76 [14.84-21.27]). Current smoking was the second strongest risk factor for risky and problem drinking in females (5.22 [3.92-6.95] and 2.93 [2.21-3.89], respectively). CONCLUSION Many female adolescents in Korea drink alcohol in an unhealthy manner. The female risky and problem drinking rates among current drinkers were higher than those of males. Risky drinking and problem drinking was most significant influencing factor among females, reciprocally. Public education on abstinence in female adolescents is warranted.
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Affiliation(s)
- Y J Jeon
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Y J Han
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - M H Choi
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - J S Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - J H Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - S H Jo
- Department of Biostatstics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - S H Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
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Birrell L, Slade T, Teesson M, Prior K, Chapman C, Hides L, McBride N, Mewton L, Allsop S, Andrews G, Newton NC. Bidirectional relationships in the development of internalising symptoms and alcohol use in adolescence. Drug Alcohol Rev 2020; 39:950-959. [PMID: 32314463 DOI: 10.1111/dar.13070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 02/20/2020] [Accepted: 03/07/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS Previous literature has demonstrated an inconsistent relationship between alcohol use and internalising symptoms (anxiety, depression) in youth. This study aimed to clarify this link examining the bidirectional relationships between internalising symptoms and alcohol use in a community sample of adolescents, taking into account the effect of gender and externalising symptoms. DESIGN AND METHODS Parallel latent growth models were run to prospectively explore the bidirectional relationships between internalising symptoms and alcohol use when assessed five times over 2 years, among 1557 (67% female) adolescents from age 13.5 years. RESULTS Results showed that higher initial levels of internalising symptoms predicted increasing alcohol use frequency; however, this association was no longer significant once externalising symptoms and gender were accounted for. No bidirectional associations between internalising symptoms and alcohol use were found. DISCUSSION AND CONCLUSIONS This study adds to the literature examining the bidirectional relationships between internalising symptoms and alcohol use in adolescence. Findings highlight the importance of both gender and externalising symptoms in the development of this type of comorbidity and may help explain discrepant findings in the existing literature. Future prevention efforts for internalising problems and alcohol use should consider gender and externalising symptoms.
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Affiliation(s)
- Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Catherine Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Louise Mewton
- Centre for Healthy Brain Ageing, UNSW Sydney, Sydney, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Gavin Andrews
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, UNSW Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Grahn R, Padyab M, Hall T, Lundgren L. The Associations between Risky Psychosocial Environment, Substance Addiction Severity and Imprisonment: A Swedish Registry Study. Subst Use Misuse 2020; 55:697-706. [PMID: 31813334 DOI: 10.1080/10826084.2019.1696823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Both childhood and adult psychosocial stressors have been identified as links to both increased risk for substance use disorder (SUD) and increased risk of imprisonment. The aim of this retrospective study is to identify, for a sample of 14,914 adults who all were assessed for risky substance use or a SUD, the importance of having a history of psychosocial stressors compared to current addiction severity. The analyses control for age, gender and education on the likelihood of future imprisonment. Method: Baseline Addiction Severity Index data (ASI) were merged with national registry data on prison sentences from 2003 to 2016. In the analysis, a Cox regression was used to study the association between independent variables and the likelihood of future imprisonment. Results: In the regression, five variables showed significant association to increased risk of imprisonment: ASI drugs other than alcohol Composite Score (positive relationship), ASI alcohol Composite Score (negative relationship), age (younger), education (lower) and parental problems with drugs other than alcohol. The factor with strongest association with imprisonment was the ASI drugs other than alcohol Composite Score, which showed the highest HR = 10.63 (3.50-32.31) for women and HR = 5.52 (3.77-8.08) for men to predict the likelihood of imprisonment. Discussion: Research is needed on why individuals with history of psychosocial stressors have a higher likelihood of imprisonment compared to their counterparts. Findings indicate that a high ASI Composite Score for drugs other than alcohol are strong predictors of future criminality and criminal justice system involvement.
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Affiliation(s)
| | - Mojgan Padyab
- Department of Social Work, Umeå University, Umeå, Sweden
| | - Taylor Hall
- Bridgewater State University, Bridgewater, Massachusetts, USA
| | - Lena Lundgren
- University of Denver Graduate School of Social Work, Denver, Colorado, USA
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Castillo-Carniglia A, Keyes KM, Hasin DS, Cerdá M. Psychiatric comorbidities in alcohol use disorder. Lancet Psychiatry 2019; 6:1068-1080. [PMID: 31630984 PMCID: PMC7006178 DOI: 10.1016/s2215-0366(19)30222-6] [Citation(s) in RCA: 165] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/13/2019] [Accepted: 05/30/2019] [Indexed: 01/10/2023]
Abstract
Alcohol use disorder is a major contributor to the morbidity and mortality burden worldwide. It often coexists with other psychiatric disorders; however, the nature of this comorbidity is still a matter of debate. In this Series paper, we examine the main psychiatric disorders associated with alcohol use disorder, including the prevalence of co-occurring disorders, the temporal nature of the relationship, and mechanisms that might explain comorbidity across the lifespan. Overall, this disorder co-occurs with a wide range of other psychiatric disorders, especially those disorders involving substance use and violent or aggressive behaviour. The causal pathways between alcohol use disorder and other psychiatric disorders are heterogeneous. Hypotheses explaining these relationships include reciprocal direct causal associations, shared genetic and environmental causes, and shared psychopathological characteristics of broader diagnostic entities (eg, externalising disorders). Efforts to untangle the associations between alcohol use disorder and other disorders across the lifespan remain a crucial avenue of research.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile; Department of Population Health, New York University School of Medicine, New York, NY, USA.
| | - Katherine M Keyes
- Department of Epidemiology, College of Physicians and Surgeons, Mailman School of Public Health, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Deborah S Hasin
- Department of Psychiatry, College of Physicians and Surgeons, Mailman School of Public Health, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University School of Medicine, New York, NY, USA
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De Bellis MD, Morey RA, Nooner KB, Woolley DP, Haswell CC, Hooper SR. A Pilot Study of Neurocognitive Function and Brain Structures in Adolescents With Alcohol Use Disorders: Does Maltreatment History Matter? CHILD MALTREATMENT 2019; 24:374-388. [PMID: 30935216 DOI: 10.1177/1077559518810525] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Neurocognitive and brain structural differences are associated with adolescent onset alcohol use disorders (AUDs). Maltreatment histories may contribute to current results. To examine these issues, healthy adolescents (n = 31), adolescents without maltreatment and AUD (AUD - MAL, n = 28), and adolescents with AUDs with maltreatment (AUD + MAL, n = 17) underwent comprehensive neurocognitive assessments and MRI structural scans. Controls performed significantly better than the two AUD groups in math and language. The AUD + MAL group performed significantly lower in sustained attention compared to the AUD - MAL and control groups and lower in reading compared to controls. The AUD + MAL group had larger left pars triangularis, a region of the inferior frontal gyrus, compared to the AUD-MAL and control groups, and smaller anterior corpus callosum volumes versus the AUD - MAL group. There were no group differences in other prefrontal cortex, amygdala, hippocampus, and parahippocampal volumes. The AUD + MAL group showed an inverse correlation between hippocampal volumes and age. AUD variables were associated with lower performance in fine-motor and executive function. Cannabis use variables were associated with lower performance in fine-motor, language, visual-spatial, memory, and executive function. Parahippocampal volumes positively correlated with abstinence. The preliminary results suggest adolescent AUD studies should consider examinations of maltreatment history, comorbid substance use disorders, and recovery during abstinence in their analyses.
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Affiliation(s)
- Michael D De Bellis
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
| | - Rajendra A Morey
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Mental Illness Research Education and Clinical Center for Post Deployment Mental Health, Durham VA Medical Center, Durham, NC, USA
| | - Kate B Nooner
- Department of Psychology, University of North Carolina at Wilmington, Wilmington, NC, USA
| | - Donald P Woolley
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Courtney C Haswell
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Stephen R Hooper
- Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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Brunborg GS, Scheffels J, Tokle R, Buvik K, Kvaavik E, Burdzovic Andreas J. Monitoring young lifestyles (MyLife) - a prospective longitudinal quantitative and qualitative study of youth development and substance use in Norway. BMJ Open 2019; 9:e031084. [PMID: 31662382 PMCID: PMC6830719 DOI: 10.1136/bmjopen-2019-031084] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/29/2019] [Accepted: 10/01/2019] [Indexed: 12/11/2022] Open
Abstract
PURPOSE The Monitoring Young Lifestyles (MyLife) project was initiated as an integrated quantitative and qualitative prospective investigation of correlates, causes, and consequences of adolescent substance use and other addictive behaviours in Norway. PARTICIPANTS The MyLife cohort was recruited from middle schools in Norway, which were selected from low, medium and high standard of living areas in both rural and urban regions of the country. A total of 3512 eighth, ninth and tenth graders (55% girls) from 33 schools were enrolled in the quantitative project arm (QT), while a total of 120 eighth graders (52% girls) from six schools were enrolled in the qualitative project arm (QL). FINDINGS TO DATE QT baseline was conducted in the fall of 2017, when 2975 adolescents completed an online questionnaire at school during a regular class time. A total of 2857 adolescents participated in the first QT follow-up 1 year later. QL baseline was conducted across the fall semesters of 2014 (one class) and 2015 (five classes), when a total of 118 eighth graders completed face-to-face interviews. QL follow-ups were conducted in the spring of 2015 and fall of 2017 (n=98) for group interviews, and in the spring of 2017 and 2018 (n=95) for individual interviews. In terms of additional data sources, a total of 3035 parents consented to own participation, of which 1899 completed a brief online questionnaire at QT baseline in late 2017. School principals completed brief surveys at the same time. FUTURE PLANS Both QT and QL arms have planned follow-ups through 2021. Consents were obtained for individual-level linkages of adolescent and parental quantitative surveys to each other, as well as to the information available in multiple national registries and databases. These supplemental data sources will provide key information on additional putative exposures as well as on the long-term health, educational, and social outcomes of the MyLife participants.
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Affiliation(s)
- Geir Scott Brunborg
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Janne Scheffels
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Rikke Tokle
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Kristin Buvik
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Elisabeth Kvaavik
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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12
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Ryan SA, Kokotailo P, Camenga DR, Patrick SW, Plumb J, Quigley J, Walker-Harding L. Alcohol Use by Youth. Pediatrics 2019; 144:peds.2019-1357. [PMID: 31235608 DOI: 10.1542/peds.2019-1357] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Alcohol use continues to be a major concern from preadolescence through young adulthood in the United States. Results of recent neuroscience research have helped to elucidate neurobiological models of addiction, substantiated the deleterious effects of alcohol on adolescent brain development, and added additional evidence to support the call to prevent and reduce underage drinking. This technical report reviews the relevant literature and supports the accompanying policy statement in this issue of Pediatrics.
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Affiliation(s)
- Sheryl A. Ryan
- Division of Adolescent Medicine, Department of Pediatrics, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania; and
| | - Patricia Kokotailo
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, Wisconsin
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13
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Marks KR, Leukefeld CG, Dennis ML, Scott CK, Funk R. Geographic differences in substance use screening for justice-involved youth. J Subst Abuse Treat 2019; 102:40-46. [PMID: 31202287 DOI: 10.1016/j.jsat.2019.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 11/17/2022]
Abstract
Justice-involved youth report high rates of substance use. Community Supervision (CS) agencies are uniquely positioned to impact public health through substance use identification and early intervention. Geographic location (i.e., living in an urban versus rural area) is an understudied factor that can be associated with differences in service and resource availability. A secondary analysis of a nationally representative sample of CS agencies assessed agency and youth characteristics, as well as substance use screening in urban and rural CS agencies. Respondents representing rural agencies reported higher rates of substance use, yet were less likely to report using screeners focused on substance use. Respondents representing urban CS agencies reported a wider variety of screening instruments and were more likely to test for drug use during screening. Differences in the screening process can reflect adaptive and culturally responsive approaches to addressing substance use as well as unique barriers to service provision. System-wide improvement is contingent upon implementation strategies that identify and acknowledge geographic differences to more adequately address the common and unique needs of the justice-involved youth they serve.
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Affiliation(s)
- Katherine R Marks
- University of Kentucky, Department of Behavioral Science, 108 Medical Behavioral Science Building, Lexington, KY 40536, USA.
| | - Carl G Leukefeld
- University of Kentucky, Department of Behavioral Science, 108 Medical Behavioral Science Building, Lexington, KY 40536, USA
| | | | - Christy K Scott
- Chestnut Health Systems, 448 Wylie Drive, Normal, IL 61761, USA
| | - Rod Funk
- Chestnut Health Systems, 448 Wylie Drive, Normal, IL 61761, USA
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14
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Silvers JA, Squeglia LM, Rømer Thomsen K, Hudson KA, Feldstein Ewing SW. Hunting for What Works: Adolescents in Addiction Treatment. Alcohol Clin Exp Res 2019; 43:578-592. [PMID: 30779445 PMCID: PMC6443447 DOI: 10.1111/acer.13984] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 02/08/2019] [Indexed: 12/11/2022]
Abstract
Although adolescents are developmentally distinct from adults, they often receive addiction treatment based on adult models. This is problematic because adolescents face significantly different conditions in addiction treatment, including distinct basic biological and neurodevelopmental stages, unique sociodevelopmental concerns, distinctive addiction trajectories, and, in turn, disparate treatment goals and outcomes. In sum, it can be difficult for even savvy clinicians to know how to approach addiction treatment with this important age group. In an effort to help clinicians and researchers consider substance use via a neurodevelopmental lens, we approached this review with 4 goals: (i) characterize the prevalence, and related health and safety implications of substance use within this age group; (ii) identify the nature of the adolescent brain, including characteristic features of this phase of neurodevelopment relevant to adolescent substance use treatment; (iii) provide an overview of current adolescent addiction interventions and avenues to improve clinical treatment and clinical research efforts for adolescents; and (iv) examine the intersection between the nature of the developing brain and adolescent substance use, and utilize that information to inform alternative routes and directions for substance use treatment in this critical age group. This review concludes by offering a novel neurodevelopmental model and framework to examine substance use interventions, along with a series of recommendations to optimize adolescent substance use treatment and clinical research.
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Affiliation(s)
- Jennifer A. Silvers
- University of California, Los Angeles, Department of Psychology, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA;
| | - Lindsay M. Squeglia
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 67 President St., MSC 861, Charleston, SC 29425, USA;
| | - Kristine Rømer Thomsen
- Aarhus University, Department of Psychology and Behavioral Sciences, Center for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark;
| | - Karen A. Hudson
- Oregon Health & Science University, Department of Child & Adolescent Psychiatry, 3181 SW Sam Jackson Park Rd, M/C UHN80R1, Portland, OR 97239, USA,
| | - Sarah W. Feldstein Ewing
- Oregon Health & Science University, Department of Child & Adolescent Psychiatry, 3181 SW Sam Jackson Park Rd, M/C UHN80R1, Portland, OR 97239, USA,
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15
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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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16
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Binge Drinking among adolescents is related to the development of Alcohol Use Disorders: results from a Cross-Sectional Study. Sci Rep 2018; 8:12624. [PMID: 30135518 PMCID: PMC6105639 DOI: 10.1038/s41598-018-29311-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 07/09/2018] [Indexed: 12/12/2022] Open
Abstract
Binge drinking (BD) is a common pattern of alcohol consumption among adolescents. At present few data are available on the possible relationship between BD and alcohol use disorders (AUD) in adolescents. The aim of this study was to assess the prevalence of BD and relationship between BD behavior and AUD among adolescents. A total of 2704 students attending 10 purposively selected high schools from three Italian provinces were surveyed. Questionnaires regarding socio-demographic data, pattern and amount of alcohol intake, smoking habits, use of illicit drugs, and physical activity were administered. AUD and affective disorders were also evaluated. Alcohol intake was reported by 2126 participants; 1278 reported at least one episode BD in the last year and 715 in the last month. A diagnosis of AUD was made in 165 adolescents. The prevalence of AUD was higher in adolescents that reported BD behavior than in those that did not report BD (11.6% vs 0.9%, respectively; p < 0.0001). Logistic regression showed a positive relationship between a diagnosis of AUD and BD behavior (OR 9.6; 95% CI 4.7–22·9; p < 0.0001). In conclusion alcohol consumption with the pattern of BD among adolescents is highly related to development of AUD.
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17
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Saitz R, Heeren TC, Zha W, Hingson R. Transitions To and From At-Risk Alcohol Use in Adults in the United States. JOURNAL OF SUBSTANCE USE 2018; 24:41-46. [PMID: 30559602 DOI: 10.1080/14659891.2018.1497101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Introduction The objective of this research was to study transitions to and from at-risk alcohol use. Methods Logistic regression analyses (done 2015-2016) assessed transitions to and from past-year at-risk drinking in a representative sample of U.S. adults surveyed twice (in 2001-2 and 2004-5). Results Among 34,653 adults, 28% reported at-risk use at time 1. Of those, 73% had at-risk use at time 2. Of those without at-risk use at time 1, 15% reported at-risk use at time 2. Positive high-risk drinking transition predictors were, at time 1, being young, male, white, childless, in good to excellent health, ever smoking, using drugs, military membership (time 1 but not 2), and becoming divorced or separated by time 2. Positive low-risk drinking transition predictors were being elderly (age ≥65), female, non-white, never smoking or using drugs, no alcohol use disorder, alcohol treatment, and, after time 1, having children. Conclusions Many adults transition to and from at-risk alcohol use; youth is the strongest positive predictor of transition to at-risk and not transitioning to low-risk drinking. Persons transitioning to legal drinking age are most likely to transition to high-risk and least likely to low-risk drinking.
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Affiliation(s)
- Richard Saitz
- Department of Community Health Sciences, Boston University School of Public Health; Clinical Addiction Research and Education Unit, Boston University School of Medicine and Boston Medical Center, Boston, MA
| | - Timothy C Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Wenxing Zha
- Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD
| | - Ralph Hingson
- Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD
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18
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Nadkarni A, Weiss HA, Bhat B, Patel V. Trajectories of Alcohol Use Disorders and Their Differential Impact: A Population-Based Cohort Study in Goa, India. Alcohol Alcohol 2017. [PMID: 28637313 PMCID: PMC5860081 DOI: 10.1093/alcalc/agx038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Aims The aim of this study was to examine trajectories of Alcohol Use Disorders (AUD) over a 6 year period and compare the bio-psycho-social correlates between these trajectories. Methods Community-based cohort of 1899 adult men were interviewed in 2006–2008 and 2012–2014. AUD were assessed using the Alcohol Use Disorder Identification Test, and potential correlates including psycho-social problems, morbidity and physiological parameters were measured at follow-up. Logistic regression was conducted to estimate odds ratios (ORs) for the association of persistent and incident AUD, respectively, with the potential correlates. Analyses were weighted to account for sampling design, number of adults aged 18–49 years in the household and non-response. Results Compared with men who had recovered from AUD, there was strong evidence (P < 0.001) that men with persistent AUD were more likely to have marital problems, tobacco use, and raised Gamma Glutamyl Transferase (GGT) and strong evidence (0.001 < P < 0.01) that they were more likely to have workplace problems, social problems, increased healthcare contact and raised Mean Corpuscular Volume (MCV). Compared with men who did not have AUD at baseline and follow-up, there was strong evidence (P < 0.001) that men with incident AUD were more likely to have workplace problems, social problems, marital problems, tobacco use, and raised GGT and strong evidence (0.001 < P < 0.01) that they were more likely to have hypertension, accident and injuries and Common Mental Disorders (CMD). Conclusion This community-based longitudinal study of AUD, the first from a low and middle income country, clearly demonstrates significant health and social consequences of AUD in men and highlights the need for interventions for their treatment and prevention. Short Summary Compared to persistent AUD, recovery from AUD has several benefits in health and social domains. Compared to developing new AUD, not having AUD has several benefits in health and social domains. Sustaining the state of not having AUD or recovery can lead to accumulation of health and social capital over time.
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Affiliation(s)
- Abhijit Nadkarni
- Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez 403501, Goa, India.,London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Helen A Weiss
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Bhargav Bhat
- Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez 403501, Goa, India
| | - Vikram Patel
- Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez 403501, Goa, India.,London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA 02115, USA
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19
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Freyer CH, Morley KC, Haber PS. Alcohol use disorders in Australia. Intern Med J 2017; 46:1259-1268. [PMID: 27813358 DOI: 10.1111/imj.13237] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 06/26/2016] [Accepted: 07/28/2016] [Indexed: 12/19/2022]
Abstract
Alcohol use disorders are common in Australia and are often unrecognised. Alcohol places a significant burden on our healthcare system by increasing the risk of injuries as well as many chronic medical conditions. Diagnosis requires a high index of suspicion and can be aided by the use of specific questionnaires, such as the Alcohol Use Disorder Identification Test-C. The current available laboratory tests are of limited sensitivity and specificity, but can nevertheless aid in the diagnosis in some circumstances. Newer tests, such as ethyl-glucuronide and phosphatidylethanol, are more sensitive and specific but are costly and not widely available. The effective management of alcohol use disorder entails psychosocial or pharmacological treatments or a combination of both. In those who cannot reduce alcohol consumption, harm reduction strategies can be applied to reduce the burden of harm to the drinkers as well as the community at large.
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Affiliation(s)
- C H Freyer
- Drug Health Services, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
| | - K C Morley
- NHMRC Centre for Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - P S Haber
- Drug Health Services, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,NHMRC Centre for Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine, The University of Sydney, Sydney, New South Wales, Australia
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20
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Belenko S, Knight D, Wasserman GA, Dennis ML, Wiley T, Taxman FS, Oser C, Dembo R, Robertson AA, Sales J. The Juvenile Justice Behavioral Health Services Cascade: A new framework for measuring unmet substance use treatment services needs among adolescent offenders. J Subst Abuse Treat 2016; 74:80-91. [PMID: 28132705 DOI: 10.1016/j.jsat.2016.12.012] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 12/15/2016] [Accepted: 12/28/2016] [Indexed: 11/26/2022]
Abstract
OVERVIEW Substance use and substance use disorders are highly prevalent among youth under juvenile justice (JJ) supervision, and related to delinquency, psychopathology, social problems, risky sex and sexually transmitted infections, and health problems. However, numerous gaps exist in the identification of behavioral health (BH) problems and in the subsequent referral, initiation and retention in treatment for youth in community justice settings. This reflects both organizational and systems factors, including coordination between justice and BH agencies. METHODS AND RESULTS This paper presents a new framework, the Juvenile Justice Behavioral Health Services Cascade ("Cascade"), for measuring unmet substance use treatment needs to illustrate how the cascade approach can be useful in understanding service delivery issues and identifying strategies to improve treatment engagement and outcomes for youth under community JJ supervision. We discuss the organizational and systems barriers for linking delinquent youth to BH services, and explain how the Cascade can help understand and address these barriers. We provide a detailed description of the sequential steps and measures of the Cascade, and then offer an example of its application from the Juvenile Justice - Translational Research on Interventions for Adolescents in the Legal System project (JJ-TRIALS), a multi-site research cooperative funded by the National Institute on Drug Abuse. CONCLUSION As illustrated with substance abuse treatment, the Cascade has potential for informing and guiding efforts to improve behavioral health service linkages for adolescent offenders, developing and testing interventions and policies to improve interagency and cross-systems coordination, and informing the development of measures and interventions for improving the implementation of treatment in complex multisystem service settings. Clinical Trials Registration number - NCT02672150.
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Affiliation(s)
- Steven Belenko
- Temple University, 1115 Polett Walk, Philadelphia, PA 19122, United States.
| | - Danica Knight
- Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX 76129, United States.
| | - Gail A Wasserman
- Columbia University, 1051 Riverside Drive, Unit 78, New York City, NY 10032, United States.
| | - Michael L Dennis
- Chestnut Health Systems, 448 Wylie Drive, Normal, IL 61701, United States.
| | - Tisha Wiley
- National Institute on Drug Abuse, 6001 Executive Boulevard, Room 5191, Bethesda, MD 20892, United States.
| | - Faye S Taxman
- George Mason University, 4087 University Drive, 4100, MSN 6D3, Fairfax, VA 22030, United States.
| | - Carrie Oser
- University of Kentucky, 1531 Patterson Office Tower, Lexington, KY 40506, United States.
| | - Richard Dembo
- University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, United States.
| | - Angela A Robertson
- Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759, United States.
| | - Jessica Sales
- Emory University, Rollins School of Public Health, 1518 Clifton Road, Room 570, Atlanta, GA 30322, United States.
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21
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Gabrielli J, Jackson Y, Brown S. Associations Between Maltreatment History and Severity of Substance Use Behavior in Youth in Foster Care. CHILD MALTREATMENT 2016; 21:298-307. [PMID: 27663751 DOI: 10.1177/1077559516669443] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Substance use (SU) in youth remains a significant public health concern and a risk factor for morbidity and mortality in adolescents. The present study offers examination of the association between severity and chronicity of maltreatment history and SU in youth in foster care. Two hundred and ten (48% female) foster youth with a mean age of 12.71 years ( SD = 2.95 years) completed surveys using an audio-computer-assisted self-interview program. Results revealed 31% of participants reported past-year SU, and substance users had a mean CRAFFT score of 3.43 ( SD = 1.90). Reported age of SU onset was 11.08 years ( SD = 2.21 years). The SU measurement model demonstrated excellent fit in this sample. Accounting for both youth age and youth placement type, the structural model with maltreatment predicting SU severity demonstrated strong model fit with a significant path between maltreatment and SU. Youth in residential facilities and older youth had higher rates of use than those residing in traditional foster home environments and younger youth. Findings provide additional support for the link between maltreatment experiences and SU severity in foster youth and suggest the need for screening and intervention services appropriate for this high-risk population.
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Affiliation(s)
- Joy Gabrielli
- 1 Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- 2 Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Yo Jackson
- 2 Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Shaquanna Brown
- 2 Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
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22
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Stapinski LA, Montgomery AA, Araya R. Anxiety, depression and risk of cannabis use: Examining the internalising pathway to use among Chilean adolescents. Drug Alcohol Depend 2016; 166:109-15. [PMID: 27427415 DOI: 10.1016/j.drugalcdep.2016.06.032] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Adolescents who experience internalising symptoms may be susceptible to the use of alcohol and other substances in an attempt to alleviate or cope with these symptoms. We examined the hypothesised internalising pathway from symptoms of depression, generalised anxiety, social anxiety and panic, to incidence and frequency of cannabis use 18 months later. METHOD Longitudinal cohort study of participants (n=2508; 45% female; mean age 14.5 years) recruited from the 9th grade at 22 low-income secondary schools in Santiago, Chile. Baseline internalising symptoms were assessed using the Beck Depression Inventory and the Revised Child Anxiety and Depression Scale. Frequency of cannabis was assessed at baseline, 6 month and 18 month follow-up. RESULTS High rates of use were observed in this sample, with 40.3% reporting cannabis use at least once over the study period. Adjusted for baseline cannabis use, symptoms of depression, panic and generalised anxiety were associated with greater cannabis use frequency 18 months later. When all predictors were considered simultaneously, only generalised anxiety symptoms showed an independent association with subsequent cannabis use frequency (OR: 1.23, 95% CI: 1.08-1.41). Generalised anxiety symptoms were also associated with a 25% increased risk of transitioning from non-user to use of cannabis during the study (OR: 1.25, 95% CI: 1.09-1.44). CONCLUSIONS Internalising symptoms, and in particular symptoms of generalised anxiety, increase risk of cannabis use during adolescence. Targeted interventions that promote adaptive anxiety management among high-risk adolescents may represent a promising strategy to prevent uptake of cannabis use during adolescence.
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Affiliation(s)
- Lexine A Stapinski
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney 2052, Australia; School of Social and Community Medicine, University of Bristol, United Kingdom.
| | - Alan A Montgomery
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, United Kingdom
| | - Ricardo Araya
- School of Social and Community Medicine, University of Bristol, United Kingdom; Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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23
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Farmer RF, Gau JM, Seeley JR, Kosty DB, Sher KJ, Lewinsohn PM. Internalizing and externalizing disorders as predictors of alcohol use disorder onset during three developmental periods. Drug Alcohol Depend 2016; 164:38-46. [PMID: 27141839 PMCID: PMC4893997 DOI: 10.1016/j.drugalcdep.2016.04.021] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 03/26/2016] [Accepted: 04/15/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND The developmental pathways associated with an enhanced risk for future alcohol use disorders (AUDs) continue to be a topic of both interest and debate. In this research, internalizing and externalizing disorders were evaluated as prospective predictors of the index AUD episode onset, separately within three developmental periods: early-to-middle adolescence (age 13.0-17.9), late adolescence (18.0-20.9), and early adulthood (21.0-30.0). METHODS Participants (N=816) were initially randomly selected from nine high schools in western Oregon and subsequently interviewed on four separate occasions between ages 16 and 30, during which current and past AUDs were assessed as well as a full range of psychiatric disorders associated with internalizing and externalizing psychopathology domains. RESULTS In adjusted analyses for each of the three developmental periods investigated, externalizing domain psychopathology from the most proximal adjoining developmental period predicted AUD onset. Distal externalizing psychopathology also predicted AUD onset among early adult onset cases. Proximal or distal internalizing psychopathology, in comparison, was not found to be a significant predictor of AUD onset in adjusted analyses for any of the developmental periods examined. CONCLUSIONS Findings overall suggest that externalizing developmental histories are robust predictors of AUD onset within the age range during which index episodes are most likely to occur, and that gender does not moderate this association.
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Affiliation(s)
- Richard F. Farmer
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR,
97403, United States,Corresponding author at: Oregon Research
Institute, 1776 Millrace Drive, Eugene, OR, 97403
| | - Jeff M. Gau
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR,
97403, United States
| | - John R. Seeley
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR,
97403, United States,University of Oregon, College of Education, Department of
Special Education and Clinical Sciences, Eugene, OR, 97403, United States
| | - Derek B. Kosty
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR,
97403, United States
| | - Kenneth J. Sher
- University of Missouri – Columbia, Department of
Psychological Sciences, 200 South Seventh Street, Columbia, MO, 65211, United
States
| | - Peter M. Lewinsohn
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR,
97403, United States
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24
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Boelema SR, Harakeh Z, van Zandvoort MJE, Reijneveld SA, Verhulst FC, Ormel J, Vollebergh WAM. Executive functioning before and after onset of alcohol use disorder in adolescence. A TRAILS study. J Psychiatr Res 2016; 78:78-85. [PMID: 27086184 DOI: 10.1016/j.jpsychires.2016.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 03/25/2016] [Accepted: 03/30/2016] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The aim of the present study was to investigate whether executive functioning (EF) in early adolescence predicted alcohol use disorder (AUD) in late adolescence and whether adolescents with AUD differed in maturation of EF from controls without a diagnosis. METHODS We used the data from the Tracking Adolescents' Individual Lives Survey (TRAILS), a cohort of 2230 Dutch adolescents. Working memory, inhibition, and attention were measured at ages 11 and 19. At age 19, lifetime DSM-IV diagnoses were determined, resulting in a control group (n = 1111) and two AUD groups, i.e., alcohol abusers (n = 381) and alcohol dependents (n = 51). Regression analyses assessed whether EF at age 11 predicted the transition to AUD in late adolescence and whether AUD affected maturation of EF from age 11 to 19. RESULTS EF in early adolescence did not predict AUD in late adolescence. A significant interaction effect emerged between gender and alcohol dependence for shift attention (β = 0.12, SE=0.36), with girls showing smaller maturational rates. This effect remained significant after controlling for alcohol intake (ages 16 and 19) and comorbid psychiatric disorders. DISCUSSION Our results do not replicate the finding that EF in early adolescence is a significant predictor of AUD in late adolescence. Furthermore, for the majority of tasks, adolescents with AUD do not differ in EF maturation over the course of adolescence. Alcohol dependent girls however, show less maturation of shift attention. This is independent of the quantity of alcohol intake, which could suggest that non-normative maturation of EF is associated with the behavioural components of AUD.
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Affiliation(s)
- Sarai R Boelema
- Faculty of Social and Behavioural Sciences, Utrecht University, P.O. Box 80.140, 3508 TC, Utrecht, The Netherlands.
| | - Zeena Harakeh
- Faculty of Social and Behavioural Sciences, Utrecht University, P.O. Box 80.140, 3508 TC, Utrecht, The Netherlands
| | - Martine J E van Zandvoort
- Experimental Psychology, Helmholtz Institute Utrecht University, P.O. Box 80.125, 3508 TC, Utrecht, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, PO Box 96, 9700 AD, Groningen, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
| | - Johan Ormel
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE); P.O. Box 30.001, Hospital Mail Address CC72, 9700, RB, Groningen, The Netherlands
| | - Wilma A M Vollebergh
- Faculty of Social and Behavioural Sciences, Utrecht University, P.O. Box 80.140, 3508 TC, Utrecht, The Netherlands
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A Preliminary Prospective Study of an Escalation in 'Maximum Daily Drinks', Fronto-Parietal Circuitry and Impulsivity-Related Domains in Young Adult Drinkers. Neuropsychopharmacology 2016; 41:1637-47. [PMID: 26514582 PMCID: PMC4832027 DOI: 10.1038/npp.2015.332] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 09/14/2015] [Accepted: 09/14/2015] [Indexed: 12/23/2022]
Abstract
Excessive alcohol use in young adults is associated with greater impulsivity and neurobiological alterations in executive control systems. The maximum number of drinks consumed during drinking occasions ('MaxDrinks') represents a phenotype linked to vulnerability of alcohol use disorders, and an increase, or 'escalation', in MaxDrinks may be indicative of greater risk for problematic drinking. Thirty-six young adult drinkers performed a Go/No-Go task during fMRI, completed impulsivity-related assessments, and provided monthly reports of alcohol use during a 12-month follow-up period. Participants were characterized by MaxDrinks at baseline and after follow-up, identifying 18 escalating drinkers and 18 constant drinkers. Independent component analysis was used to investigate functional brain networks associated with response inhibition, and relationships with principal component analysis derived impulsivity-related domains were examined. Greater baseline MaxDrinks was associated with an average reduction in the engagement of a right-lateralized fronto-parietal functional network, while an escalation in MaxDrinks was associated with a greater difference in fronto-parietal engagement between successful inhibitions and error trials. Escalating drinkers displayed greater impulsivity/compulsivity-related domain scores that were positively associated with fronto-parietal network engagement and change in MaxDrinks during follow-up. In young adults, an escalating MaxDrinks trajectory was prospectively associated with altered fronto-parietal control mechanisms and greater impulsivity/compulsivity scores. Continued longitudinal studies of MaxDrinks trajectories, functional network activity, and impulsivity/compulsivity-related features may lend further insight into an intermediate phenotype vulnerable for alcohol use and addictive disorders.
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Knight DK, Belenko S, Wiley T, Robertson AA, Arrigona N, Dennis M, Bartkowski JP, McReynolds LS, Becan JE, Knudsen HK, Wasserman GA, Rose E, DiClemente R, Leukefeld C. Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS): a cluster randomized trial targeting system-wide improvement in substance use services. Implement Sci 2016; 11:57. [PMID: 27130175 PMCID: PMC4850663 DOI: 10.1186/s13012-016-0423-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/20/2016] [Indexed: 01/11/2024] Open
Abstract
Background The purpose of this paper is to describe the Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, a cooperative implementation science initiative involving the National Institute on Drug Abuse, six research centers, a coordinating center, and Juvenile Justice Partners representing seven US states. While the pooling of resources across centers enables a robust implementation study design involving 36 juvenile justice agencies and their behavioral health partner agencies, co-producing a study protocol that has potential to advance implementation science, meets the needs of all constituencies (funding agency, researchers, partners, study sites), and can be implemented with fidelity across the cooperative can be challenging. This paper describes (a) the study background and rationale, including the juvenile justice context and best practices for substance use disorders, (b) the selection and use of an implementation science framework to guide study design and inform selection of implementation components, and (c) the specific study design elements, including research questions, implementation interventions, measurement, and analytic plan. Methods/design The JJ-TRIALS primary study uses a head-to-head cluster randomized trial with a phased rollout to evaluate the differential effectiveness of two conditions (Core and Enhanced) in 36 sites located in seven states. A Core strategy for promoting change is compared to an Enhanced strategy that incorporates all core strategies plus active facilitation. Target outcomes include improvements in evidence-based screening, assessment, and linkage to substance use treatment. Discussion Contributions to implementation science are discussed as well as challenges associated with designing and deploying a complex, collaborative project. Trial registration NCT02672150.
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Affiliation(s)
- Danica K Knight
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA.
| | - Steven Belenko
- Department of Criminal Justice, Temple University, Philadelphia, PA, USA
| | - Tisha Wiley
- National Institute on Drug Abuse, Bethseda, MD, USA
| | - Angela A Robertson
- Social Science Research Center, Mississippi State University, Starkville, MS, USA
| | - Nancy Arrigona
- Council of State Governments Justice Center, Austin, TX, USA
| | | | - John P Bartkowski
- Department of Sociology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Larkin S McReynolds
- Center for the Promotion of Mental Health in Juvenile Justice, Columbia University/NYSPI, New York, NY, USA
| | - Jennifer E Becan
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA
| | | | - Gail A Wasserman
- Center for the Promotion of Mental Health in Juvenile Justice, Columbia University/NYSPI, New York, NY, USA
| | - Eve Rose
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ralph DiClemente
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Carl Leukefeld
- Behavioral Science, University of Kentucky, Lexington, KY, USA
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Jackson KM, Barnett NP, Colby SM, Rogers ML. The prospective association between sipping alcohol by the sixth grade and later substance use. J Stud Alcohol Drugs 2016; 76:212-21. [PMID: 25785796 DOI: 10.15288/jsad.2015.76.212] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Although there is a clear association between early use of alcohol and short- and long-term adverse outcomes, it is unclear whether consumption of minor amounts of alcohol (less than a full drink) at a young age is prognostic of risk behaviors in later adolescence. METHOD Data were taken from 561 students enrolled in an ongoing prospective web-based study on alcohol initiation and progression (55% female; 25% White non-Hispanic). Based on a combination of monthly and semiannual surveys, we coded whether participants sipped alcohol before sixth grade and examined associations between early sipping and alcohol consumption by fall of ninth grade, as well as other indices of problem behavior. Participants also reported on the context of the first sipping event. RESULTS The prevalence of sipping alcohol by fall of sixth grade was 29.5%. Most participants indicated that their first sip took place at their own home, and the primary source of alcohol was an adult, usually a parent. Youth who sipped alcohol by sixth grade had significantly greater odds of consuming a full drink, getting drunk, and drinking heavily by ninth grade than nonsippers. These associations held even when we controlled for temperamental, behavioral, and environmental factors that contribute to proneness for problem behavior, which suggests that sipping is not simply a marker of underlying risk. CONCLUSIONS Our findings that early sipping is associated with elevated odds of risky behaviors at high school entry dispute the idea of sipping as a protective factor. Offering even just a sip of alcohol may undermine messages about the unacceptability of alcohol consumption for youth.
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Affiliation(s)
- Kristina M Jackson
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Nancy P Barnett
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Michelle L Rogers
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
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Plevová I, Hlávková M. Alcohol consumption in adolescents. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2016. [DOI: 10.15452/cejnm.2016.07.0003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Cornelius MD, De Genna NM, Goldschmidt L, Larkby C, Day NL. Prenatal alcohol and other early childhood adverse exposures: Direct and indirect pathways to adolescent drinking. Neurotoxicol Teratol 2016; 55:8-15. [PMID: 26994529 DOI: 10.1016/j.ntt.2016.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 02/02/2016] [Accepted: 03/11/2016] [Indexed: 10/22/2022]
Abstract
We examined direct and indirect pathways between adverse environmental exposures during gestation and childhood and drinking in mid-adolescence. Mothers and their offspring (n=917 mother/child dyads) were followed prospectively from second trimester to a 16-year follow-up assessment. Interim assessments occurred at delivery, 6, 10, and 14years. Adverse environmental factors included gestational exposures to alcohol, tobacco, and marijuana, exposures to childhood maltreatment and violence, maternal psychological symptoms, parenting practices, economic and home environments, and demographic characteristics of the mother and child. Indirect effects of early child behavioral characteristics including externalizing, internalizing activity, attention, and impulsivity were also examined. Polytomous logistic regression analyses were used to evaluate direct effects of adverse environmental exposures with level of adolescent drinking. Structural equation modeling (SEM) was applied to simultaneously estimate the relation between early adversity variables, childhood characteristics, and drinking level at age 16 while controlling for significant covariates. Level of drinking among the adolescent offspring was directly predicted by prenatal exposure to alcohol, less parental strictness, and exposures to maltreatment and violence during childhood. Whites and offspring with older mothers were more likely to drink at higher levels. There was a significant indirect effect between childhood exposure to violence and adolescent drinking via childhood externalizing behavior problems. All other hypothesized indirect pathways were not significant. Thus most of the early adversity measures directly predicted adolescent drinking and did not operate via childhood behavioral dysregulation characteristics. These results highlight the importance of adverse environmental exposures on pathways to adolescent drinking.
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Affiliation(s)
- Marie D Cornelius
- University of Pittsburgh, School of Medicine, Department of Psychiatry, United States.
| | - Natacha M De Genna
- University of Pittsburgh, School of Medicine, Department of Psychiatry, United States
| | | | - Cynthia Larkby
- University of Pittsburgh, School of Medicine, Department of Psychiatry, United States
| | - Nancy L Day
- University of Pittsburgh, School of Medicine, Department of Psychiatry, United States
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Lövenhag S, Larm P, Åslund C, Nilsson KW. Antisocial behavior reduces the association between subdimensions of ADHD symptoms and alcohol use in a large population-based sample of adolescents. Scand J Psychol 2015; 56:489-97. [PMID: 26094652 DOI: 10.1111/sjop.12234] [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] [Received: 08/22/2014] [Accepted: 04/10/2015] [Indexed: 01/11/2023]
Abstract
The aim of this study was to investigate possible effects of antisocial behavior on reducing the association between subdimensions of ADHD symptoms (inattention, hyperactivity and impulsivity) and alcohol use. Boys and girls were analyzed separately using a population-based Swedish adolescent sample. A randomly selected cross-sectional survey was performed in secondary and upper secondary schools in Västmanland County during 2010. Participants were a population of 2,439 15-16 year-olds and 1,425 17-18 year-olds (1,947 girls and 1,917 boys). Psychosocial adversity, antisocial behaviors, symptoms of ADHD and alcohol use were assessed by questionnaires. Except for girls' inattention, subdimensions of ADHD symptoms were not associated with alcohol use when variance due to antisocial behavior was accounted for. Among boys, instead of an indirect effect of antisocial behavior on the association between impulsivity and alcohol use, a moderating effect was found. Among girls, the inattention component of ADHD was independently associated with alcohol use even when adjusted for antisocial behavior. The reduced associations between symptoms of hyperactivity, impulsivity, and alcohol use for boys and girls after adjusting for antisocial behavior suggest a considerable overlap between hyperactivity, impulsivity, and antisocial behavior. The direct pathway between inattention and alcohol use among girls suggests that girls with inattention symptoms are at risk of alcohol use regardless of antisocial behavior. Special attention should be given to these girls. Accounting for antisocial behavior reduced the relation between subdimensions of ADHD symptoms and alcohol use, and antisocial behaviors should therefore be screened for when symptoms of ADHD are present.
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Affiliation(s)
- Sara Lövenhag
- Centre for Clinical Research, Västerås Hospital, Västerås, Sweden
| | - Peter Larm
- Centre for Clinical Research, Västerås Hospital, Västerås, Sweden
| | - Cecilia Åslund
- Centre for Clinical Research, Västerås Hospital, Västerås, Sweden
| | - Kent W Nilsson
- Centre for Clinical Research, Västerås Hospital, Västerås, Sweden
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Blumenthal H, Leen-Feldner EW, Knapp AA, Badour CL, Boals A. Traumatic Event Exposure and Alcohol Use Expectancies among Adolescents. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2015. [DOI: 10.1080/1067828x.2013.839407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Life Course Trajectories of Labour Market Participation among Young Adults Who Experienced Severe Alcohol-Related Health Outcomes: A Retrospective Cohort Study. PLoS One 2015; 10:e0126215. [PMID: 25938764 PMCID: PMC4418731 DOI: 10.1371/journal.pone.0126215] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 03/30/2015] [Indexed: 11/19/2022] Open
Abstract
Background Long-term employment trajectories of young problem drinkers are poorly understood. Methods We constructed retrospective labour market participation histories at ages 18–34 of 64 342 persons born in 1969–1982. Beginning from the year of each subject’s 18th birthday, we extracted information from the records of Statistics Finland on educational attainment, main type of economic activity, months in employment, and months in unemployment for a minimum of seven years (range 7–16 years). We used information on the timing of alcohol-related hospitalizations and deaths in the same period to define problem drinkers with early onset limited course, early onset persistent course, and late onset problem drinking. Results Early onset limited course problem drinkers improved their employment considerably by age, whereas early onset persistent problem drinkers experienced a constant decline in their employment by age. From the age of 18 to 34, early onset persistent problem drinkers were in employment merely 12% of the time, in comparison with 39% among the early onset limited course problem drinkers, and 58% among the general population. Conclusions These results indicate that young adults who were retrospectively defined as having early onset persistent course problem drinking were extensively marginalized from the labour market early on during their life course, and that their employment trajectory was significantly worse compared to other problem drinkers.
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Bailly D, Rouchaud A, Garcia C, Roehrig C, Ferley JP. Consommation d’alcool chez les jeunes adolescents : enquête en milieu scolaire. Arch Pediatr 2015; 22:510-7. [DOI: 10.1016/j.arcped.2015.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 12/17/2014] [Accepted: 02/24/2015] [Indexed: 11/29/2022]
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Cook WK, Karriker-Jaffe KJ, Bond J, Lui C. Asian American problem drinking trajectories during the transition to adulthood: ethnic drinking cultures and neighborhood contexts. Am J Public Health 2015; 105:1020-7. [PMID: 25393183 PMCID: PMC4386507 DOI: 10.2105/ajph.2014.302196] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We aimed to identify problem drinking trajectories and their predictors among Asian Americans transitioning from adolescence to adulthood. We considered cultural and socioeconomic contextual factors, specifically ethnic drinking cultures, neighborhood socioeconomic status, and neighborhood coethnic density, to identify subgroups at high risk for developing problematic drinking trajectories. METHODS We used a sample of 1333 Asian Americans from 4 waves of the National Longitudinal Study of Adolescent to Adult Health (1994-2008) in growth mixture models to identify trajectory classes of frequent heavy episodic drinking and drunkenness. We fitted multinomial logistic regression models to identify predictors of trajectory class membership. RESULTS Two dimensions of ethnic drinking culture-drinking prevalence and detrimental drinking pattern in the country of origin-were predictive of problematic heavy episodic drinking and drunkenness trajectories. Higher neighborhood socioeconomic status in adolescence was predictive of the trajectory class indicating increasing frequency of drunkenness. Neighborhood coethnic density was not predictive of trajectory class membership. CONCLUSIONS Drinking cultures in the country of origin may have enduring effects on drinking among Asian Americans. Further research on ethnic drinking cultures in the United States is warranted for prevention and intervention.
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Affiliation(s)
- Won Kim Cook
- All authors are with the Alcohol Research Group, Public Health Institute, Emeryville, CA. Camillia Lui is also with the School of Public Health, University of California, Berkeley
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Prospective Effects of Family Cohesion on Alcohol-Related Problems in Adolescence: Similarities and Differences by Race/Ethnicity. J Youth Adolesc 2015; 44:1941-53. [DOI: 10.1007/s10964-014-0250-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 12/30/2014] [Indexed: 10/24/2022]
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Farmer RF, Kosty DB, Seeley JR, Duncan SC, Lynskey MT, Rohde P, Klein DN, Lewinsohn PM. Natural course of cannabis use disorders. Psychol Med 2015; 45:63-72. [PMID: 25066537 PMCID: PMC4229487 DOI: 10.1017/s003329171400107x] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Despite its importance as a public health concern, relatively little is known about the natural course of cannabis use disorders (CUDs). The primary objective of this research was to provide descriptive data on the onset, recovery and recurrence functions of CUDs during the high-risk periods of adolescence, emerging adulthood and young adulthood based on data from a large prospective community sample. METHOD Probands (n = 816) from the Oregon Adolescent Depression Project (OADP) participated in four diagnostic assessments (T1-T4) between the ages of 16 and 30 years, during which current and past CUDs were assessed. RESULTS The weighted lifetime prevalence of CUDs was 19.1% with an average onset age of 18.6 years. Although gender was not significantly related to the age of initial CUD onset, men were more likely to be diagnosed with a lifetime CUD. Of those diagnosed with a CUD episode, 81.8% eventually achieved recovery during the study period. Women achieved recovery significantly more quickly than men. The recurrence rate (27.7%) was relatively modest, and most likely to occur within the first 36 months following the offset of the first CUD episode. CUD recurrence was uncommon after 72 months of remission and recovery. CONCLUSIONS CUDs are relatively common, affecting about one out of five persons in the OADP sample prior to the age of 30 years. Eventual recovery from index CUD episodes is the norm, although about 30% of those with a CUD exhibit a generally persistent pattern of problematic use extending 7 years or longer.
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Affiliation(s)
- Richard F. Farmer
- Oregon Research Institute, 1776 Millrace Drive, Eugene, Oregon, 97403, USA
| | - Derek B. Kosty
- Oregon Research Institute, 1776 Millrace Drive, Eugene, Oregon, 97403, USA
| | - John R. Seeley
- Oregon Research Institute, 1776 Millrace Drive, Eugene, Oregon, 97403, USA
| | - Susan C. Duncan
- Oregon Research Institute, 1776 Millrace Drive, Eugene, Oregon, 97403, USA
| | - Michael T. Lynskey
- Addictions Department, Institute of Psychiatry, King’s College, London, SE5 8BB, UK
| | - Paul Rohde
- Oregon Research Institute, 1776 Millrace Drive, Eugene, Oregon, 97403, USA
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, New York, 11794, USA
| | - Peter M. Lewinsohn
- Oregon Research Institute, 1776 Millrace Drive, Eugene, Oregon, 97403, USA
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Adrian M, McCarty C, King K, McCauley E, Stoep AV. The internalizing pathway to adolescent substance use disorders: mediation by ruminative reflection and ruminative brooding. J Adolesc 2014; 37:983-91. [PMID: 25113394 PMCID: PMC4171395 DOI: 10.1016/j.adolescence.2014.07.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 02/21/2014] [Accepted: 07/21/2014] [Indexed: 10/24/2022]
Abstract
Two subtypes of rumination were examined in relationship to substance use and substance use disorders in adolescents. In the 8th and 9th grade, 521 adolescents completed measures assessing depressive symptoms, conduct problems, and reflective and brooding subtypes of rumination. In 12th grade, adolescents reported substance use and were administered the substance use disorders modules from the DISC. Path analyses conducted with data from 428 participants indicated that neither depression nor rumination variables significantly affected the presence of substance use. However, indirect effects of depression through reflection and brooding were differentially related to risk of developing substance use disorders, with brooding positively associated with Marijuana Use Disorders, and reflection negatively related to both Marijuana and Alcohol Use Disorders. Pathways did not differ by sex. These findings suggest that promoting self-reflection may be an effective strategy to prevent and intervene with the development of problematic substance use.
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Affiliation(s)
- Molly Adrian
- University of Washington, Department of Psychiatry and Behavioral Sciences, 6200 NE 74th St., Ste. 110, Seattle, WA 98115, USA.
| | - Carolyn McCarty
- Department of Pediatrics, University of Washington, Box 359300, CW8-6 Seattle WA 98145, USA
| | - Kevin King
- Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195, USA
| | - Elizabeth McCauley
- University of Washington, Department of Psychiatry and Behavioral Sciences, 6200 NE 74th St., Ste. 110, Seattle, WA 98115, USA
| | - Ann Vander Stoep
- University of Washington, Department of Psychiatry and Behavioral Sciences, 6200 NE 74th St., Ste. 110, Seattle, WA 98115, USA
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Ewing SWF, Sakhardande A, Blakemore SJ. The effect of alcohol consumption on the adolescent brain: A systematic review of MRI and fMRI studies of alcohol-using youth. NEUROIMAGE-CLINICAL 2014; 5:420-37. [PMID: 26958467 PMCID: PMC4749850 DOI: 10.1016/j.nicl.2014.06.011] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background A large proportion of adolescents drink alcohol, with many engaging in high-risk patterns of consumption, including binge drinking. Here, we systematically review and synthesize the existing empirical literature on how consuming alcohol affects the developing human brain in alcohol-using (AU) youth. Methods For this systematic review, we began by conducting a literature search using the PubMED database to identify all available peer-reviewed magnetic resonance imaging (MRI) and functional magnetic resonance imaging (fMRI) studies of AU adolescents (aged 19 and under). All studies were screened against a strict set of criteria designed to constrain the impact of confounding factors, such as co-occurring psychiatric conditions. Results Twenty-one studies (10 MRI and 11 fMRI) met the criteria for inclusion. A synthesis of the MRI studies suggested that overall, AU youth showed regional differences in brain structure as compared with non-AU youth, with smaller grey matter volumes and lower white matter integrity in relevant brain areas. In terms of fMRI outcomes, despite equivalent task performance between AU and non-AU youth, AU youth showed a broad pattern of lower task-relevant activation, and greater task-irrelevant activation. In addition, a pattern of gender differences was observed for brain structure and function, with particularly striking effects among AU females. Conclusions Alcohol consumption during adolescence was associated with significant differences in structure and function in the developing human brain. However, this is a nascent field, with several limiting factors (including small sample sizes, cross-sectional designs, presence of confounding factors) within many of the reviewed studies, meaning that results should be interpreted in light of the preliminary state of the field. Future longitudinal and large-scale studies are critical to replicate the existing findings, and to provide a more comprehensive and conclusive picture of the effect of alcohol consumption on the developing brain. A large proportion of adolescents drink alcohol. Studies show how alcohol affects human adolescent brain development. This includes a systematic review of MRI and fMRI studies in alcohol-using youth. Changes in structure and function are observed in the brain in alcohol-using youth.
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Affiliation(s)
| | - Ashok Sakhardande
- UCL Institute of Cognitive Neuroscience, 17 Queen Square, London WC1N 3AR, UK
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Foster KT, Hicks BM. Alcohol use disorder in women: Risks and consequences of an adolescent onset and persistent course. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2014; 28:322-35. [PMID: 24955662 PMCID: PMC4067596 DOI: 10.1037/a0035488] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Women are more vulnerable to the deleterious effects of both acute and protracted alcohol use than men, but women's lower levels of alcohol consumption and alcohol use disorder (AUD) have resulted in a paucity of investigations on the development of alcohol problems in women. In particular, it is not clear to what extent the cascading effects of key etiological factors that contribute to an especially severe course of AUD in men also underlie the development of AUD in women. To fill this gap, we examined the adolescent risk factors and adult consequences associated with an adolescent onset and persistent course of AUD in a community sample of women (n = 636) from ages 17 to 29. Women with AUD exhibited greater psychopathology and psychosocial impairment than those without, with an adolescent onset and persistent course indicative of the greatest severity. Notably, high levels of impairment across all women with AUD reduced the utility of onset and course to differentiate profiles of risk and impairment. In contrast to previous work in men, even women whose AUD symptoms desisted continued to exhibit impairment, suggesting that an adolescent onset of AUD is associated with enduring consequences for women's health and functioning, even after ostensible "recovery."
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Affiliation(s)
- Katherine T. Foster
- Department of Psychiatry, University of Michigan
- Department of Psychology, University of Michigan
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Intellectual, neurocognitive, and academic achievement in abstinent adolescents with cannabis use disorder. Psychopharmacology (Berl) 2014; 231:1467-77. [PMID: 24619597 PMCID: PMC3969383 DOI: 10.1007/s00213-014-3463-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 01/21/2014] [Indexed: 11/27/2022]
Abstract
RATIONALE The active component of cannabis, delta-9 tetrahydrocannabinol (THC), has a long half-life and widespread neurocognitive effects. There are inconsistent reports of neurocognitive deficits in adults and adolescents with cannabis use disorders (CUD), particularly after a period of abstinence. OBJECTIVES This study aims to examine neurocognitive measures (IQ, academic achievement, attention, memory, executive functions) in abstinent adolescents with CUD, while controlling for demographic, psychopathology, and poly-substance confounders. METHODS We investigated neurocognitive performance in three groups: adolescents with CUD after successful first treatment and in full remission (n = 33); controls with psychiatric disorders without substance use disorder history (n = 37); and healthy adolescents (n = 43). RESULTS Adolescents with psychiatric disorders, regardless of CUD status, performed significantly worse than the healthy adolescents in academic achievement. No group differences were seen in IQ, attention, memory, or executive functions. Lower academic achievement was positively associated with younger age of CUD onset, regular cannabis use, and maximum daily use. In the CUD group, lifetime nicotine use episodes were negatively associated with IQ. Lower overall neurocognitive function was associated with younger age of onset of regular cannabis use and relapse within the 1 year follow-up. CONCLUSIONS Verifiably, abstinent adolescents with CUD history did not differ from the two comparison groups, suggesting that previously reported neurocognitive deficits may be related to other factors, including residual drug effects, preexisting cognitive deficits, concurrent use of other substances (e.g., nicotine), or psychopathology. Adolescents with CUD may not be vulnerable to THC neuropsychological deficits once they achieve remission from all drugs for at least 30 days.
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Nishimura ST, Hishinuma ES, Goebert D. Underage drinking among Asian American and Pacific Islander adolescents. J Ethn Subst Abuse 2014; 12:259-77. [PMID: 23967886 DOI: 10.1080/15332640.2013.805176] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study assessed the prevalence of alcohol abuse and dependence rates among four major ethnic groups of Hawai'i and examined the relationship among risk factors, protective factors, and demographic variables related to underage drinking. A total of 196 students were administered the Diagnostic Interview Schedule for Children, the American Drug and Alcohol Survey, and the Prevention Planning Survey. Drinking rates for Native Hawaiian students were significantly higher than those for Japanese and Caucasian students. Multiple logistic regression models accounted for 49% of the variance for any alcohol use. Ethnic group differences were found when data were disaggregated for Asian and Pacific Islander students.
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De Bellis MD, Wang L, Bergman SR, Yaxley RH, Hooper SR, Huettel SA. Neural mechanisms of risky decision-making and reward response in adolescent onset cannabis use disorder. Drug Alcohol Depend 2013; 133:134-45. [PMID: 23773952 PMCID: PMC3786021 DOI: 10.1016/j.drugalcdep.2013.05.020] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 05/14/2013] [Accepted: 05/17/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Neural mechanisms of decision-making and reward response in adolescent cannabis use disorder (CUD) are underexplored. METHODS Three groups of male adolescents were studied: CUD in full remission (n=15); controls with psychopathology without substance use disorder history (n=23); and healthy controls (n=18). We investigated neural processing of decision-making and reward under conditions of varying risk and uncertainty with the Decision-Reward Uncertainty Task while participants were scanned using functional magnetic resonance imaging. RESULTS Abstinent adolescents with CUD compared to controls with psychopathology showed hyperactivation in one cluster that spanned left superior parietal lobule/left lateral occipital cortex/precuneus while making risky decisions that involved uncertainty, and hypoactivation in left orbitofrontal cortex to rewarded outcomes compared to no-reward after making risky decisions. Post hoc region of interest analyses revealed that both control groups significantly differed from the CUD group (but not from each other) during both the decision-making and reward outcome phase of the Decision-Reward Uncertainty Task. In the CUD group, orbitofrontal activations to reward significantly and negatively correlated with total number of individual drug classes the CUD patients experimented with prior to treatment. CUD duration significantly and negatively correlated with orbitofrontal activations to no-reward. CONCLUSIONS The adolescent CUD group demonstrated distinctly different activation patterns during risky decision-making and reward processing (after risky decision-making) compared to both the controls with psychopathology and healthy control groups. These findings suggest that neural differences in risky decision-making and reward processes are present in adolescent addiction, persist after remission from first CUD treatment, and may contribute to vulnerability for adolescent addiction.
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Affiliation(s)
- Michael D. De Bellis
- Healthy Childhood Brain Development Developmental Traumatology Research Program, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27710, USA,Department of Psychology and Neuroscience, Duke University, Durham, NC, 27710, USA,Correspondence: should be addressed to Michael D. De Bellis MD, MPH, Professor of Psychiatry and Behavioral Sciences, Director Healthy Childhood Brain Development and Developmental Traumatology, Research Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 104360, Durham NC, 27710, USA, 919-683-1190 ext 351; fax 919-682-7805,
| | - Lihong Wang
- Brain Imaging Analysis Center and Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710, USA,Center for Biomedical Imaging Research, Tsinghua University, Beijing, China
| | - Sara R. Bergman
- Brain Imaging Analysis Center and Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710, USA
| | - Richard H. Yaxley
- Healthy Childhood Brain Development Developmental Traumatology Research Program, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27710, USA
| | - Stephen R. Hooper
- Healthy Childhood Brain Development Developmental Traumatology Research Program, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27710, USA,Department of Psychiatry and Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27516, USA
| | - Scott A. Huettel
- Department of Psychology and Neuroscience, Duke University, Durham, NC, 27710, USA
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Petit G, Kornreich C, Verbanck P, Campanella S. Gender differences in reactivity to alcohol cues in binge drinkers: a preliminary assessment of event-related potentials. Psychiatry Res 2013; 209:494-503. [PMID: 23684055 DOI: 10.1016/j.psychres.2013.04.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 02/15/2013] [Accepted: 04/08/2013] [Indexed: 02/02/2023]
Abstract
Binge drinking is associated with functional brain abnormalities similar to those observed in alcoholics and can be viewed as a first step towards alcohol dependence. Adult men are twice as likely as women to develop alcoholism. This study investigates (1) the presence of alcohol cue reactivity in bingers, a feature that has been proposed to underlie the emergence of alcohol dependence; and (2) a possible higher alcohol cue reactivity in men binge drinkers which could explain their higher risk for alcohol use disorders in adulthood.The P3 component of the event-related potentials (ERPs) was recorded during a visual oddball task in which controls (n=27: 10 men and 17 women) and binge drinkers (n=29: 15 men and 14 women) had to detect infrequent deviant stimuli (related to alcohol or not) among frequent neutral stimuli. Results showed that binge drinkers, compared to light drinkers, displayed increased P3 reactivity to alcohol related cues with a greater effect among men. Our results suggest the phenomenon of alcohol cue reactivity to be a possible avenue by which a higher risk population, binge drinkers, and men in particular, are prone to develop problematic alcohol use.
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Affiliation(s)
- Géraldine Petit
- Laboratoire de Psychologie Médicale et Addictions, Université Libre de Bruxelles, Brussels, Belgium.
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Abstract
Alcohol use disorder (AUD) occurs in few young adolescents, but is as common as in adults by the late teens. To address problems with the current American Psychiatric Association DSM-IV criteria, the anticipated DSM-V will eliminate the distinction between substance abuse and dependence in favour of a single category. For adolescents, pharmacotherapy for AUD may target alcohol withdrawal symptoms, alcohol consumption reinforcement properties, craving or co-morbid mental disorders. While uncommon among adolescents, severe alcohol withdrawal may require the closely monitored application of benzodiazepines. Disulfiram alters alcohol metabolism and has been shown to increase abstinence in adolescents with AUD, but sufficient motivation to maintain abstinence is needed for this approach to be appropriate. Medications to reduce alcohol craving, including naltrexone and acamprosate, may also assist some adolescents in maintaining abstinence. Adolescents with AUD typically also have co-morbid mental disorders and problems with other substances. Co-morbid mental disorders, such as major depressive disorder and attention-deficit hyperactivity disorder, may be addressed by pharmacotherapy. The potential for interactions between prescribed medications and alcohol or illicit substances necessitates patient education and monitoring. While there is a paucity of empirical information on the applicability of these pharmacotherapy approaches in adolescents, cautious application of these medications in selected cases in the context of systematic psychosocial interventions is warranted to promote abstinence and address associated problems.
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Affiliation(s)
- Duncan B Clark
- Department of Psychiatry, University of Pittsburgh Medical Center, PA, USA.
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45
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Cavariani MB, Oliveira JBD, Kerr-Corrêa F, Lima MCP. [Positive expectations towards alcohol use and binge drinking: gender differences in a study from the GENACIS project, São Paulo, Brazil]. CAD SAUDE PUBLICA 2012; 28:1394-404. [PMID: 22729269 DOI: 10.1590/s0102-311x2012000700017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Accepted: 04/03/2012] [Indexed: 11/22/2022] Open
Abstract
The objective was to investigate expectations towards alcohol use among men and women and the association between these expectations and binge drinking (or heavy episodic drinking). An epidemiological cross-sectional population-based household survey with a stratified probabilistic sample was conducted in Greater Metropolitan São Paulo, Brazil. Males and females were interviewed (n = 2,083) with the GENACIS questionnaire (Gender, Alcohol, and Culture: an International Study). The dependent variable was binge drinking, and logistic regression models were constructed for each gender, adjusting for age, schooling, and income. All expectations, with the exception of increased ease in talking with one's partner, were associated with binge drinking. The study shows that binge drinking can be associated with expectations towards alcohol use. Understanding such expectations can contribute to the design of effective polices to prevent binge drinking.
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McCarty CA, Wymbs BT, King KM, Mason WA, Vander Stoep A, McCauley E, Baer J. Developmental consistency in associations between depressive symptoms and alcohol use in early adolescence. J Stud Alcohol Drugs 2012; 73:444-53. [PMID: 22456249 PMCID: PMC3316716 DOI: 10.15288/jsad.2012.73.444] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 11/01/2011] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Despite frequent theorizing, prior literature on the association between depressive symptoms and alcohol use in adolescence has been inconsistent. Yet studies have varied widely with respect to age at assessments, time frame of prediction, and controls for comorbid conditions and demographic factors. The current study examined whether the associations between depressive symptoms and alcohol use were similar in valence and magnitude over a 4-year period in early adolescence. METHOD A sample of 521 young adolescents and their parents were interviewed every year from sixth (Mage = 12.0 years) through ninth grades. At each interview, symptom counts on depressive and conduct disorders were generated from the Diagnostic Interview Schedule for Children. Adolescents also reported on their alcohol use, which was converted to a binary variable. Autoregressive, cross-lagged panel models specifying depressive and conduct disorder symptoms as predictors of alcohol use 1 year later with equality constraints were tested and compared with models allowing path coefficients to vary over time. RESULTS For youth self-report, depressive symptoms were positively associated with alcohol use 1 year later over and above conduct problems and earlier alcohol use throughout early adolescence. By parental report, only very early adolescent depressive symptoms (sixth to seventh grades) were associated with alcohol use. Gender did not moderate findings for analyses with self- or parental-report data. CONCLUSIONS These results indicate that, even in the context of conduct disorder symptoms, depressive symptoms are important indicators of risk for use of alcohol across early adolescence.
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Affiliation(s)
- Carolyn A McCarty
- University of Washington and Seattle Children's Hospital, Center for Child Health, Behavior, and Development, Seattle, WA 98121, USA.
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Swendsen J, Burstein M, Case B, Conway KP, Dierker L, He J, Merikangas KR. Use and abuse of alcohol and illicit drugs in US adolescents: results of the National Comorbidity Survey-Adolescent Supplement. ARCHIVES OF GENERAL PSYCHIATRY 2012; 69:390-8. [PMID: 22474107 PMCID: PMC3746542 DOI: 10.1001/archgenpsychiatry.2011.1503] [Citation(s) in RCA: 238] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
CONTEXT Comprehensive descriptions of substance use and abuse trajectories have been lacking in nationally representative samples of adolescents. OBJECTIVE To examine the prevalence, age at onset, and sociodemographic correlates of alcohol and illicit drug use and abuse among US adolescents. DESIGN Cross-sectional survey of adolescents using a modified version of the Composite International Diagnostic Interview. SETTING Combined household and school adolescent samples. PARTICIPANTS Nationally representative sample of 10,123 adolescents aged 13 to 18 years. MAIN OUTCOME MEASURES Lifetime estimates of alcohol and illicit substance use and DSM-IV diagnoses of abuse, with or without dependence. RESULTS By late adolescence, 78.2% of US adolescents had consumed alcohol, 47.1% had reached regular drinking levels defined by at least 12 drinks within a given year, and 15.1% met criteria for lifetime abuse. The opportunity to use illicit drugs was reported by 81.4% of the oldest adolescents, drug use by 42.5%, and drug abuse by 16.4%. The median age at onset was 14 years for alcohol abuse with or without dependence, 14 years for drug abuse with dependence, and 15 years for drug abuse without dependence. The associations observed by age, sex, and race/ethnicity often varied significantly by previous stage of use. CONCLUSIONS Alcohol and drug use is common in US adolescents, and the findings of this study indicate that most cases of abuse have their initial onset in this important period of development. Prevention and treatment efforts would benefit from careful attention to the correlates and risk factors that are specific to the stage of substance use in adolescents.
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Affiliation(s)
- Joel Swendsen
- University of Bordeaux, National Center for Scientific Research, Bordeaux, France
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Srisurapanont M, Kittiratanapaiboon P, Likhitsathian S, Kongsuk T, Suttajit S, Junsirimongkol B. Patterns of alcohol dependence in Thai drinkers: a differential item functioning analysis of gender and age bias. Addict Behav 2012; 37:173-8. [PMID: 22001084 DOI: 10.1016/j.addbeh.2011.09.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 09/12/2011] [Accepted: 09/20/2011] [Indexed: 10/17/2022]
Abstract
In Caucasians, the patterns of alcohol use disorders in women and adolescents are likely to be different from those in men and adults, respectively. The authors examined these differences in a Southeast Asian sample of Thai people living in communities. A two-parameter logistic model of the IRT log-likelihood-ratio (IRTLR) test for differential item functioning (DIF) procedure was used. Participants were a subsample of 3718 current drinkers participating in the 2008 Thai National Mental Health Survey (n=17,140). The 1-year prevalence rates of alcohol dependence were 1.4% in women and 13.7% in men. Based on the Mini International Neuropsychiatric Interview (MINI), alcohol dependence and abuse module, all current drinkers were interviewed for a yes/no response to each of seven alcohol dependence criteria. Confirmatory factor analysis suggested a single-factor model of alcohol dependence criteria (χ2=211.51, RMSEA=0.06, SRMR=0.03 and CFI=0.96). Compared with 3174 men, 544 women had a significantly higher threshold estimate for quit/control problems and a lower threshold value for drinking despite physical/mental problems (b parameter difference of 0.25 and -0.30, respectively). Thai adolescents (n=272) and Thai adults (n=3446) had no statistically significant DIF on any criterion. The criterion of time spent drinking had significantly high discrimination estimates in women, men, adolescent and adults (a parameters of 2.50, 2.08, 2.33 and 2.16, respectively). Gender bias on alcohol dependence criteria can be found in Thai drinkers. Time spent drinking may be the most useful criterion for discriminating the severity of alcohol dependence across age and gender groups of Thai drinkers.
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Clark DB, Chung T, Thatcher DL, Pajtek S, Long EC. Psychological dysregulation, white matter disorganization and substance use disorders in adolescence. Addiction 2012; 107:206-14. [PMID: 21752141 PMCID: PMC3237873 DOI: 10.1111/j.1360-0443.2011.03566.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIMS Adolescents with substance use disorders (SUD) have difficulties with cognitive, behavioral and affective regulation. White matter (WM) disorganization has been observed in adolescents with SUD and may be related to psychological dysregulation. This study compared adolescents with SUD and control adolescents to investigate relationships among psychological dysregulation, WM disorganization and SUD symptoms. DESIGN Cross-sectional observation. SETTING Adolescents with SUD were recruited from SUD treatment programs. Controls were recruited from the community. PARTICIPANTS The 55 participants were aged 14-19; 35 with SUD and 20 controls without SUD. MEASUREMENTS Psychological dysregulation was characterized by the Behavior Rating Inventory of Executive Function. WM disorganization was measured by diffusion tensor imaging, and fractional anisotropy, radial diffusivity and axial diffusivity were examined within cortical regions of interest. FINDINGS Compared to controls, SUD adolescents showed significantly greater psychological dysregulation and prefrontal and parietal WM disorganization. WM disorganization was correlated positively with psychological dysregulation and cannabis-related symptoms. In multivariate mediation models, the results were consistent with both the neurodevelopmental immaturity model, in which WM disorganization leads to psychological dysregulation and cannabis-related symptoms, and with the substance effects model, in which cannabis-related symptoms lead to WM disorganization and psychological dysregulation. CONCLUSIONS In adolescents, substance use disorder and psychological dysregulation appear to be associated with reduced frontoparietal network white matter maturation.
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Affiliation(s)
- Duncan B Clark
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA. clarkdb@upmc. edu
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van Lier PAC, Huizink A, Vuijk P. The role of friends' disruptive behavior in the development of children's tobacco experimentation: results from a preventive intervention study. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2011; 39:45-57. [PMID: 20694577 PMCID: PMC3035805 DOI: 10.1007/s10802-010-9446-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Having friends who engage in disruptive behavior in childhood may be a risk factor for childhood tobacco experimentation. This study tested the role of friends' disruptive behavior as a mediator of the effects of a classroom based intervention on children's tobacco experimentation. 433 Children (52% males) were randomly assigned to the Good Behavior Game (GBG) intervention, a universal preventive intervention targeting disruptive behavior, and facilitating positive prosocial peer interactions. Friends' disruptive behavior was assessed from age 7-10 years. Participants' experimentation with tobacco was assessed annually from age 10-13. Reduced rates in tobacco experimentation and friends' disruptive behavior were found among GBG children, as compared to controls. Support for friends' disruptive behavior as a mediator in the link between intervention status and tobacco experimentation was found. These results remained after controlling for friends' and parental smoking status, and child ADHD symptoms. The results support the role of friends' disruptive behavior in preadolescents' tobacco experimentation.
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Affiliation(s)
- Pol A C van Lier
- Department of Developmental Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands.
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