1
|
Morris J, Tattan-Birch H, Albery IP, Heather N, Moss AC. Look away now! Defensive processing and unrealistic optimism by level of alcohol consumption. Psychol Health 2024:1-19. [PMID: 38379336 DOI: 10.1080/08870446.2024.2316681] [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: 04/04/2023] [Accepted: 02/06/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE Health risk information is insufficient as a means of reducing alcohol use, particularly when it evokes negative emotional states amongst those for whom it is most personally relevant. Appraisal biases, or 'defensive processing', may be employed to mitigate the psychological discomfort posed by such information. Few studies have evaluated the role of defensive processing in people with different levels of alcohol consumption. DESIGN Online participants (n = 597) completed measures of defensive processing of a health risk infographic, perceived susceptibility and severity of alcohol use, efficacy for resisting alcohol use, unrealistic optimism, the Alcohol Use Disorder Identification Test - Consumption (AUDIT-C) and demographics. RESULTS AUDIT-C scores were positively and linearly associated with all defensive processing measures (Pearson's correlation r from.16 to .36), threat and susceptibility (r = .16) and unrealistic optimism (r = .50). AUDIT-C scores were also negatively associated with efficacy for controlling alcohol use (r = -0.48). CONCLUSION People with alcohol use disorder (AUD) engaged in much more defensive processing of alcohol-related messages, offering an explanation for why such messages are limited at eliciting behaviour change. High levels of unrealistic optimism in people with alcohol use disorder may reflect low problem recognition in order to maintain a problem-free drinking identity.
Collapse
Affiliation(s)
- J Morris
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, United Kingdom
| | | | - I P Albery
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, United Kingdom
| | - N Heather
- University of Northumbria, Newcastle upon Tyne, United Kingdom
| | - A C Moss
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, United Kingdom
| |
Collapse
|
2
|
O’Farrell F, Jiang X, Aljifri S, Pazoki R. Molecular Alterations Caused by Alcohol Consumption in the UK Biobank: A Mendelian Randomisation Study. Nutrients 2022; 14:2943. [PMID: 35889900 PMCID: PMC9317105 DOI: 10.3390/nu14142943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/28/2022] [Accepted: 07/14/2022] [Indexed: 02/01/2023] Open
Abstract
Alcohol consumption is associated with the development of cardiovascular diseases, cancer, and liver disease. The biological mechanisms are still largely unclear. Here, we aimed to use an agnostic approach to identify phenotypes mediating the effect of alcohol on various diseases. METHODS We performed an agnostic association analysis between alcohol consumption (red and white wine, beer/cider, fortified wine, and spirits) with over 7800 phenotypes from the UK biobank comprising 223,728 participants. We performed Mendelian randomisation analysis to infer causality. We additionally performed a Phenome-wide association analysis and a mediation analysis between alcohol consumption as exposure, phenotypes in a causal relationship with alcohol consumption as mediators, and various diseases as the outcome. RESULTS Of 45 phenotypes in association with alcohol consumption, 20 were in a causal relationship with alcohol consumption. Gamma glutamyltransferase (GGT; β = 9.44; 95% CI = 5.94, 12.93; Pfdr = 9.04 × 10-7), mean sphered cell volume (β = 0.189; 95% CI = 0.11, 0.27; Pfdr = 1.00 × 10-4), mean corpuscular volume (β = 0.271; 95% CI = 0.19, 0.35; Pfdr = 7.09 × 10-10) and mean corpuscular haemoglobin (β = 0.278; 95% CI = 0.19, 0.36; Pfdr = 1.60 × 10-6) demonstrated the strongest causal relationships. We also identified GGT and physical inactivity as mediators in the pathway between alcohol consumption, liver cirrhosis and alcohol dependence. CONCLUSION Our study provides evidence of causality between alcohol consumption and 20 phenotypes and a mediation effect for physical activity on health consequences of alcohol consumption.
Collapse
Affiliation(s)
- Felix O’Farrell
- Division of Biomedical Sciences, Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK; (F.O.); (X.J.); (S.A.)
| | - Xiyun Jiang
- Division of Biomedical Sciences, Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK; (F.O.); (X.J.); (S.A.)
| | - Shahad Aljifri
- Division of Biomedical Sciences, Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK; (F.O.); (X.J.); (S.A.)
| | - Raha Pazoki
- Division of Biomedical Sciences, Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK; (F.O.); (X.J.); (S.A.)
- Department of Epidemiology and Biostatistics, School of Public Health, St Mary’s Campus, Norfolk Place, London W2 1PG, UK
| |
Collapse
|
3
|
Kock L, Shahab L, Moore G, Beard E, Bauld L, Reid G, Brose L, Horton M, Gould A, Brown J. Protocol for expansion of an existing national monthly survey of smoking behaviour and alcohol use in England to Scotland and Wales: The Smoking and Alcohol Toolkit Study. Wellcome Open Res 2021; 6:67. [PMID: 34458587 PMCID: PMC8370132 DOI: 10.12688/wellcomeopenres.16700.1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2021] [Indexed: 12/16/2022] Open
Abstract
Background The Smoking and Alcohol Toolkit Study (STS/ATS) in England has delivered timely insights to inform and evaluate strategies aimed at reducing tobacco smoking- and alcohol-related harm. From the end of 2020 until at least 2024 the STS/ATS is expanding to Scotland and Wales to include all constituent nations in Great Britain. Expanding data collection to Scotland and Wales will permit the evaluation of how smoking and alcohol related behaviours respond to divergent policy scenarios across the devolved nations. Methods The STS/ATS consists of monthly cross-sectional household interviews (computer or telephone assisted) of representative samples of adults in Great Britain aged 16+ years. Commencing in October 2020 each month a new sample of approximately 1700 adults in England, 450 adults in Scotland and 300 adults in Wales complete the survey (~n = 29,400 per year). The expansion of the survey to Scotland and Wales has been funded for the collection of at least 48 waves of data across four years. The data collected cover a broad range of smoking and alcohol-related parameters (including but not limited to smoking status, cigarette/nicotine dependence, route to quit smoking, prevalence and frequency of hazardous drinking, attempts and motivation to reduce alcohol consumption, help sought and motives for attempts to reduce alcohol intake) and socio-demographic characteristics (including but not limited to age, gender, region, socio-economic position) and will be reviewed monthly and refined in response to evolving policy needs and public interests. All data analyses will be pre-specified and available on a free online platform. A dedicated website will publish descriptive data on important trends each month. Discussion The Smoking and Alcohol Toolkit Study will provide timely monitoring of smoking and alcohol related behaviours to inform and evaluate national policies across Great Britain.
Collapse
Affiliation(s)
- Loren Kock
- Behavioural Science and Health, University College London, London, UK
| | - Lion Shahab
- Behavioural Science and Health, University College London, London, UK
| | - Graham Moore
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - Emma Beard
- Behavioural Science and Health, University College London, London, UK
| | - Linda Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | | | - Leonie Brose
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Marie Horton
- Population Health Analysis, Health Intelligence, Public Health England, London, UK
| | | | - Jamie Brown
- Behavioural Science and Health, University College London, London, UK
| |
Collapse
|
4
|
Holmes J, Beard E, Brown J, Brennan A, Kersbergen I, Meier PS, Michie S, Stevely AK, Buykx P. The impact of promoting revised UK low-risk drinking guidelines on alcohol consumption: interrupted time series analysis. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
The UK’s Chief Medical Officers revised the UK alcohol drinking guidelines in 2016 to ≤ 14 units per week (1 unit = 10 ml/8 g ethanol) for men and women. Previously, the guideline stated that men should not regularly consume more than 3–4 units per day and women should not regularly consume more than 2–3 units per day.
Objective
To evaluate the impact of promoting revised UK drinking guidelines on alcohol consumption.
Design
Interrupted time series analysis of observational data.
Setting
England, March 2014 to October 2017.
Participants
A total of 74,388 adults aged ≥ 16 years living in private households in England.
Interventions
Promotion of revised UK low-risk drinking guidelines.
Main outcome measures
Primary outcome – alcohol consumption measured by the Alcohol Use Disorders Identification Test – Consumption score. Secondary outcomes – average weekly consumption measured using graduated frequency, monthly alcohol consumption per capita adult (aged ≥ 16 years) derived from taxation data, monthly number of hospitalisations for alcohol poisoning (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision: T51.0, T51.1 and T51.9) and assault (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision: X85–Y09), and further measures of influences on behaviour change.
Data sources
The Alcohol Toolkit Study, a monthly cross-sectional survey and NHS Digital’s Hospital Episode Statistics.
Results
The revised drinking guidelines were not subject to large-scale promotion after the initial January 2016 announcement. An analysis of news reports found that mentions of the guidelines were mostly factual, and spiked during January 2016. In December 2015, the modelled average Alcohol Use Disorders Identification Test – Consumption score was 2.719 out of 12.000 and was decreasing by 0.003 each month. After the January 2016 announcement, Alcohol Use Disorders Identification Test – Consumption scores did not decrease significantly (β = 0.001, 95% confidence interval –0.079 to 0.099). However, the trend did change significantly such that scores subsequently increased by 0.005 each month (β = 0.008, 95% confidence interval 0.001 to 0.015). This change is equivalent to 0.5% of the population moving each month from drinking two or three times per week to drinking four or more times per week. Secondary analyses indicated that the change in trend began 6 months before the guideline announcement. The secondary outcome measures showed conflicting results, with no significant changes in consumption measures and no substantial changes in influences on behaviour change, but immediate reductions in hospitalisations of 7.3% for assaults and 15.4% for alcohol poisonings.
Limitations
The pre-intervention data collection period was only 2 months for influences on behaviour change and the graduated frequency measure. Our conclusions may be generalisable only to scenarios in which guidelines are announced but not promoted.
Conclusions
The announcement of revised UK low-risk drinking guidelines was not associated with clearly detectable changes in drinking behaviour. Observed reductions in alcohol-related hospitalisations are unlikely to be attributable to the revised guidelines. Promotion of the guidelines may have been prevented by opposition to the revised guidelines from the government's alcohol industry partners or because reduction in alcohol consumption was not a government priority or because practical obstacles prevented independent public health organisations from promoting the guidelines. Additional barriers to the effectiveness of guidelines may include low public understanding and a need for guidelines to engage more with how drinkers respond to and use them in practice.
Trial registration
Current Controlled Trials ISRCTN15189062.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 14. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Emma Beard
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Cancer Research UK Health Behaviour Research Centre, University College London, London, UK
| | - Jamie Brown
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Cancer Research UK Health Behaviour Research Centre, University College London, London, UK
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Inge Kersbergen
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Petra S Meier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Abigail K Stevely
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Penny Buykx
- School of Health and Related Research, University of Sheffield, Sheffield, UK
- School of Humanities and Social Science, University of Newcastle, Newcastle, NSW, Australia
| |
Collapse
|