Solitary Alcohol Use in Teens Is Associated With Drinking in Response to Negative Affect and Predicts Alcohol Problems in Young Adulthood

Solitary Cannabis Use and Related Consequences Among College Students During the COVID-19 Pandemic

Solitary cannabis use has been associated with greater cannabis problems than social use and may be increasingly prevalent due to pandemic-related isolation. However, little is known about patterns, correlates, and consequences of solitary cannabis use. This study sought to characterize solitary cannabis use since pandemic onset, examine psychosocial risk factors, and examine interactions between solitary and social cannabis use frequency on cannabis consequences. College students (N = 168) who were lifetime cannabis users at a private, northeastern university in the US completed an online cross-sectional survey in fall of 2020. Past-year solitary cannabis use was common among life-time cannabis users (42% past year, 29% monthly or more), especially among past-year regular cannabis users (85% monthly or more). Solitary use frequency was associated with interpersonal sensitivity and pandemic-related stress. Further, solitary use attenuated associations of social use frequency with cannabis consequences, such that social use frequency was associated with greater consequences only among exclusively social users. In contrast, regardless of social use frequency, solitary users reported greater cannabis consequences than exclusively social users. Findings suggest solitary cannabis use is concurrently associated with greater cannabis consequences, and affective risk factors (interpersonal sensitivity, pandemic stress) should be considered for prevention and intervention strategies.

Language-based EMA assessments help understand problematic alcohol consumption

BACKGROUND

Unhealthy alcohol consumption is a severe public health problem. But low to moderate alcohol consumption is associated with high subjective well-being, possibly because alcohol is commonly consumed socially together with friends, who often are important for subjective well-being. Disentangling the health and social complexities of alcohol behavior has been difficult using traditional rating scales with cross-section designs. We aim to better understand these complexities by examining individuals' everyday affective subjective well-being language, in addition to rating scales, and via both between- and within-person designs across multiple weeks.

METHOD

We used daily language and ecological momentary assessment on 908 US restaurant workers (12692 days) over two-week intervals. Participants were asked up to three times a day to "describe your current feelings", rate their emotions, and report their alcohol behavior in the past 24 hours, including if they were drinking alone or with others.

RESULTS

Both between and within individuals, language-based subjective well-being predicted alcohol behavior more accurately than corresponding rating scales. Individuals self-reported being happier on days when drinking more, with language characteristic of these days predominantly describing socializing with friends. Between individuals (over several weeks), subjective well-being correlated much more negatively with drinking alone (r = -.29) than it did with total drinking (r = -.10). Aligned with this, people who drank more alone generally described their feelings as sad, stressed and anxious and drinking alone days related to nervous and annoyed language as well as a lower reported subjective well-being.

CONCLUSIONS

Individuals' daily subjective well-being, as measured via language, in part, explained the social aspects of alcohol drinking. Further, being alone explained this relationship, such that drinking alone was associated with lower subjective well-being.

Socio-economic inequalities in smoking and drinking in adolescence: Assessment of social network dynamics

AIMS

We investigated whether (1) adolescents selected friends with a similar socio-economic status (SES), (2) smoking and alcohol consumption spread in networks and (3) the exclusion of non-smokers or non-drinkers differed between SES groups.

DESIGN

This was a longitudinal study using stochastic actor-oriented models to analyze complete social network data over three waves.

SETTING

Eight Hungarian secondary schools with socio-economically diverse classes took part.

PARTICIPANTS

This study comprised 232 adolescents aged between 14 and 15 years in the first wave.

MEASUREMENTS

Self-reported smoking behavior, alcohol consumption behavior and friendship ties were measured. SES was measured based upon entitlement to an income-tested regular child protection benefit.

FINDINGS

Non-low-SES adolescents were most likely to form friendships with peers from their own SES group [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.02-1.11]. Adolescents adjusted their smoking behavior (OR = 24.05, 95% CI = 1.27-454.86) but not their alcohol consumption (OR = 1.65, 95% CI = 0.62-4.39) to follow the behavior of their friends. Smokers did not differ from non-smokers in the likelihood of receiving a friendship nomination (OR = 0.98, 95% CI = 0.87-1.10), regardless of their SES. Alcohol consumers received significantly more friendship nominations than non-consumers (OR = 1.16, 95% CI = 1.01-1.33), but this association was not significantly different according to SES.

CONCLUSIONS

Hungarian adolescents appear to prefer friendships within their own socio-economic status group, and smoking and alcohol consumption spread within those friendship networks. Socio-economic groups do not differ in the extent to which they encourage smoking or alcohol consumption.

Event-level risk for negative alcohol consequences in emerging adults: The role of affect, motivation, and context

OBJECTIVE

Decades of research has found support for the motivational model of alcohol use, such that positive/negative affect are indirectly associated with drinking behavior through drinking motives. However, research on event-level drinking motives is in its nascent stage, and studies have yet to consider how drinking context plays a role in the motivational pathway to both event- and person-level drinking behavior. Therefore, the present study seeks to test whether drinking context mediates the effect of affect and motivation on drinking outcomes at both the event- and person-level.

METHOD

Data for this Stage 1 Registered Report will come from a recently completed ecological momentary assessment (EMA) study in emerging adults. The study collected data on 131 emerging adults, of whom 107 reported event-level social and solitary drinking during the EMA period. Multilevel structural equation modeling will be used to test whether predrinking affect is associated with predrinking motives, and whether drinking context (social vs. solitary drinking) mediates the effect of drinking motives on drinking outcomes. Models will parse within-/between-person variance, allowing the present study to test whether drinking context serves as a mechanism of risk in the motivational model at the event-level, or solely at the between-person level. Findings will inform personalized interventions and motivational models of drinking behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Associations Between Social Context and Mood During Alcohol Consumption in Young Adult Smokers

OBJECTIVE

Differences in the subjective effects of alcohol in different social contexts have been well documented, but little research examines affect during drinking in real-world social contexts. This study examined differences by social context in negative affect and positive affect during alcohol consumption. We hypothesized that negative affect and positive affect with drinking would vary as a function of social context (alone or with others).

METHOD

A total of 257 young adults (M age = 21.3, 53.3% female) who were enrolled in a longitudinal, observational study assessing risk for smoking completed 7 days of ecological momentary assessment assessing alcohol use, affect, and social context at two time points of the study. Mixed-effects location scale analyses examined effects of being alone versus with others on positive affect and negative affect after drinking and compared with nondrinking times.

RESULTS

Positive affect was higher when drinking with others versus alone, and negative affect was higher when drinking alone versus with others. Both negative affect and positive affect variability were higher when participants were drinking alone compared to with others, and negative affect variability was higher at low amounts of alcohol but decreased with increased drinking.

CONCLUSIONS

These findings demonstrate that solitary drinking is less consistently reinforcing because of greater and more variable negative affect, as well as more variable positive affect. When drinking with others, increased and less variable positive affect suggests that social drinking may be particularly reinforcing in young adulthood.

Association between alcohol consumption and risk of stroke among adults: results from a prospective cohort study in Chongqing, China

BACKGROUND

The incidence of stroke in China is increasing, along with a clear trend in the prevalence of risk factors. Alcohol consumption is also a risk factor for stroke. Many cohort studies have explored the relationship between alcohol consumption and stroke risk. However, findings have been inconsistent.

METHODS

We used cluster sampling to select 13 districts and counties (at the same level) in Chongqing, China. Then, we used stratified random sampling to distribute the number of people in each district and county. 23,308 adults aged 30-79 were recruited between October 2018 and February 2019. Follow-up was conducted through a monitoring system and questionnaires until September 2022. Information on alcohol consumption and other covariates was collected using a standardized questionnaire. Participants were asked to report their weekly frequency of drinking over the past year and weekly intake of various alcoholic beverages in general. The frequency of drinking was divided into three categories: 1-2 d/week, 3-5 d/week, and 6-7 d/week. The average daily alcohol consumption is calculated based on the amount of alcohol contained in different alcoholic beverages. It is classified as nondrinker (0 g/day), light (0 to 12 g/day), moderate (13 to 36 g/day), and high (> 36 g/day). Cox proportional hazard regression models were used to estimate the association between alcohol consumption and stroke risk. Results are shown as multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs).

RESULTS

With an average follow-up of 3.80 years, there were 310 new stroke events. The incidence of total stroke was 368.69 per 100,000 person-years. Overall, after adjusting for covariates, moderate alcohol consumption (average daily alcohol consumption 13-36 g/d) was associated with a lower risk of total stroke (HR: 0.48; 95% CI: 0.25-0.92) compared with nondrinkers. The adjusted HR and 95% CI for total stroke and ischemic stroke for those who drank alcohol 6-7 days per week were 0.60(0.37, 0.96) and 0.53(0.30, 0.94), respectively. The risk of total stroke (HR: 0.39; 95% CI: 0.17-0.89) was reduced in a pattern of drinking 6-7 days per week but with a mean alcohol consumption of less than 36 g/d. There was no significant association between alcohol consumption and hemorrhagic stroke.

CONCLUSION

This study suggests moderate alcohol consumption is associated with a lower risk of total stroke. And healthy drinking patterns should be of more significant concern.

Association between food addiction with ultra-processed food consumption and eating patterns in a Brazilian sample

The study objectives were to determine whether consumption of ultra-processed foods (UPF) and eating patterns are associated with food addiction (FA) in a Brazilian sample. This is a cross-sectional study. The Brazilian Food and Nutrition Surveillance System tool assessed food consumption markers and dietary patterns. The modified Yale Food Addiction Scale 2.0 was used to determine FA. 5946 participants were included with a mean age of 24 ± 6 years, and 4371 (73.5%) were female. After statistical adjustments for confounders, individuals with FA had lower consumption of fresh fruits (PR: 0.88; 95%CI: [0.79; 0.97]), vegetables (PR: 0.87; 95%CI: [0.79; 0.97]), and beans (PR: 0.85; 95%CI: [0.77; 0.95]). They also had higher consumption of UPF: hamburgers/sausages (PR: 1.15; 95%CI: [1.04; 1.27]), instant noodles, packaged snacks, and/or salty cookies (PR: 1.27; 95%CI: [1.13; 1.42]), and sandwich cookies, sweets, and/or treats (PR: 1.26; 95%CI: [1.14; 1.40]). Positive associations between FA and having meals in front of the screen (PR: 1.48; 95%CI: [1.28; 1.71]) and having a late-night snack (PR: 1.24; 95%CI: [1.11; 1.39]) remained. The negative association between FA and skipping breakfast (PR: 0.76; 95%CI: [0.68; 0.85]) also remained. These eating patterns may contribute to FA, which could be potential targets for clinical intervention.

Drinking context, alcohol use, and subjective responses during binge drinking episodes measured by high-resolution ecological momentary assessment (HR-EMA)

OBJECTIVE

Subjective responses to alcohol play a key role in the development and maintenance of risky drinking and alcohol use disorder (AUD). The social and environmental context where drinking occurs may moderate alcohol's subjective effects, but ecologically valid studies of these associations are limited. The present study used high-resolution ecological momentary assessment (HR-EMA) targeting real-world binge drinking episodes to examine associations among drinking context, alcohol consumption, and subjective responses to alcohol.

METHOD

Young adult heavy drinkers (N = 61; 57% male) completed two smartphone-based, 3-hr HR-EMA of drinking context (social context and location), alcohol use, and subjective responses (alcohol stimulation, sedation, feeling, liking, and wanting more). Analyses examined the associations between drinking context and subjective alcohol responses, accounting for demographic characteristics and individual differences in alcohol consumption.

RESULTS

Most (85%) participants reported binge drinking during real-world drinking events. Estimated blood alcohol concentration (eBAC) and alcohol stimulation and reward (liking, wanting) were greater when participants drank with others (vs. alone) and in a bar/restaurant (vs. other location). Sedation was higher when drinking alone versus with others.

CONCLUSIONS

The present study extends prior laboratory-based research and shows that subjective responses during naturalistic binge drinking episodes may be influenced by drinking context. Drinking with others and in bars and restaurants may increase alcohol consumption, enhance alcohol's rewarding effects, and lead to more alcohol-related harm in at-risk drinkers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Solitary-specific drinking to cope motives explain unique variance in solitary drinking behavior but not alcohol problems compared to general drinking to cope motives

OBJECTIVE

Adolescent and young adult solitary drinking is prospectively associated with alcohol problems, and it is thus important to understand why individuals engage in this risky drinking behavior. There is substantial evidence that individuals drink alone to cope with negative affect, but all prior studies have assessed motives for alcohol use without specifying the context of such use. Here, we directly compared solitary-specific drinking to cope motives with general drinking to cope motives in their ability to predict solitary drinking behavior and alcohol problems. We hypothesized that solitary-specific drinking motives would provide additional predictive utility in each case.

METHODS

Current underage drinkers (N = 307; 90% female; ages 18-20) recruited from a TurkPrime panel March-May 2016 completed online surveys querying solitary alcohol use, general and solitary-specific coping motives, and alcohol problems.

RESULTS

Both solitary-specific and general coping motives were positively associated with a greater percentage of total drinking time spent alone in separate models, after controlling for solitary-specific and general enhancement motives, respectively. However, the model with solitary-specific motives accounted for greater variance than the general motives model based on adjusted R2 values (0.8 versus 0.3, respectively). Additionally, both general and solitary-specific coping motives were positively associated with alcohol problems, again controlling for enhancement motives, but the model including general motives accounted for greater variance (0.49) than the solitary-specific motives model (0.40).

CONCLUSION

These findings provide evidence that solitary-specific coping motives explain unique variance in solitary drinking behavior but not alcohol problems. The methodological and clinical implications of these findings are discussed.

Analysis of related factors for adolescents' intention to use alcohol in Korea

The harmful effects of alcohol consumption by adolescents have been increasingly emphasized. Thus, it is necessary to identify individual and environmental factors that encourage drinking. This study investigated factors associated with the sustainable use of alcohol (SUA) in adolescents who consume alcohol, and the possibility of future drinking (PFD) in non-drinking adolescents. Data from "The Adolescents Awareness Survey of Alcohol Encouraging Environment" by the Ministry of Health and Welfare and the Korea Health Promotion Institute (2017) were used. The survey was completed by 1,038 participant, selected through a proportional allocation extraction method, who were aged 13-18 years and lived in five cities with a population of over 1 million. The factors associated with SUA included gender (β = 0.634, p = 0.004), grade (8th β = 1.591, p<0.001, 9th β = 1.674, p<0.001, 10th β = 1.497, p = 0.001, 11th β = 1.041, p = 0.004, 12th β = 2.610, p<0.001), drinking alone (β = -2.147, p = 0.002), liquor commercial (β = 1.644, p<0.001), ease of alcohol purchase (β = 1.541, p = 0.025), parent's recommendation for drinking (β = 1.084, p<0.001), not knowing the mother's education level (β = -0.685, p = 0.045), positive expectancy of drinking (β = 0.141, p<0.001), number of pubs (β = 0.303, p = 0.002), internet game cafes (β = 0.456, p = 0.019), and karaokes (β = -0.098, p = 0.023) in the community. The factors associated with the PFD in non-drinkers were grade (8th β = 0.531, p = 0.024, 10th β = 0.717, p = 0.035, 12th β = 1.882, p = 0.001), liquor commercial (β = -1.355, p<0.001), parent's recommendation for drinking (β = 0.783, p = 0.020), positive expectancy of drinking (β = 0.139, p<0.001), and relationship with the father (β = 0.072, p = 0.033). Multidimensional interventions, including those by individuals, parents, peers, and local communities, are needed to prevent SUA and the PFD in adolescents.

Domestication of drinking: a survey study of changes in types of drinking occasions during periods of increasing and decreasing alcohol consumption in the 2000s in Finland

BACKGROUND AND AIMS

In Finland, per-capita alcohol consumption increased in the early 2000s and decreased after 2007. Our aim was to determine how these changes originated from changes in drinking practices.

DESIGN

Repeated cross-sectional general-population surveys.

SETTING

Finland in 2000, 2008 and 2016.

PARTICIPANTS

Finnish residents aged 15-69 years (n = 6703, response rate 59-78%).

MEASUREMENTS

Event-level data on drinking occasions (n = 21 097). Types of drinking occasions (drinking practices) were identified with latent class analysis using occasion characteristics. The aggregated volume of consumption and intoxication occasions were decomposed into contributions from drinking practice classes and years.

FINDINGS

Nine drinking occasion types were identified: three at home without company other than family (51% of occasions in 2016), three socializing occasions in different places and with different company (33%) and three party occasion types (16%). Both the frequency of drinking occasion types and the occasion type-specific amounts of alcohol consumed contributed to aggregate-level changes in alcohol use. Drinking at home without external company (with family only; for men, also alone) contributed most to the increase in alcohol use before 2008. Big parties in homes and bars became less common in the 2000s, contributing most to the decline in drinking after 2008.

CONCLUSIONS

The rise in per-capita alcohol consumption in Finland in the early 2000s appears to have been linked mainly to an increase in lighter drinking occasions at home without external company. The fall in per-capita drinking after 2007 was linked mainly to a decrease in big parties in homes and in licensed premises. Changes in drinking frequency and the amounts of alcohol consumed per occasion changed in the same direction as alcohol affordability.

I Smoke Alone: Indirect Effects of Solitary Cannabis Use on Negative Consequences Through Coping Motives

OBJECTIVE

Using cannabis in solitary contexts is associated with greater cannabis use problems than using cannabis in social contexts. However, it remains unclear why solitary use predicts greater problems. Consistent with a social learning perspective, the current study examined whether cannabis use motives mediated the association between context of cannabis use and negative consequences. We also examined whether cannabis type (concentrates vs. flower) moderated the relation between context of use and motives.

METHOD

Recreational college cannabis users (n = 387) reported their frequency of using cannabis alone or with others, motives for cannabis use, negative cannabis consequences, and type of cannabis typically used.

RESULTS

Solitary cannabis use was associated with greater global negative consequences through coping motives (β = 0.26, SE = 0.10, 95% CI [0.10, 0.43]). Cannabis type did not moderate relations between context and motives, despite concentrate users reporting more frequent cannabis use, more frequent solitary use, and greater consequences than flower users.

CONCLUSIONS

Frequent cannabis use in solitary contexts was associated with greater negative cannabis consequences, both directly and indirectly via coping motives. Efforts to reduce frequent use of cannabis in solitary contexts, particularly for the purpose of coping, may be beneficial in reducing negative consequences.

Solitary alcohol use in adolescence predicts alcohol problems in adulthood: A 17-year longitudinal study in a large national sample of US high school students

BACKGROUND

Identifying risk factors for alcohol use disorder (AUD) is important for public health. The social context of drinking-such as drinking alone-may be an independent and robust early risk marker for AUD symptoms later in life. We evaluated whether solitary alcohol use in adolescence (age 18) and young adulthood (age 23/24) was concurrently associated with binge drinking and prospectively predicted age 35 AUD symptoms, and whether associations differed by sex.

METHODS

Longitudinal data were from the Monitoring the Future study. Surveys were completed by adolescents in 12th grade at age 18 (1976-2002), young adults at age 23/24 (1981-2008), and adults at age 35 (1993-2019). Analyses included past 12-month alcohol users (n = 4464 for adolescent models; n = 4561 for young adult models). Multivariable regression analyses tested whether adolescent and young adult solitary alcohol use was associated concurrently with binge drinking frequency and prospectively with age 35 AUD symptoms.

RESULTS

Solitary alcohol use in adolescence and young adulthood was associated (a) concurrently with binge drinking and (b) prospectively with increased risk of age 35 AUD symptoms (even after controlling for earlier binge drinking, alcohol use frequency, and sociodemographic covariates). Adolescent solitary alcohol use was associated with age 35 AUD symptoms particularly among females; no interaction was observed between sex and young adult solitary alcohol use in predicting age 35 AUD symptoms.

CONCLUSIONS

Adolescent and young adult solitary alcohol use was associated with increased adult AUD symptoms above and beyond other risk factors; adolescent female solitary alcohol users were especially at risk.

Dynamic longitudinal relations among solitary drinking, coping motives, & alcohol problems during emerging adulthood

INTRODUCTION

Solitary drinking (i.e., drinking alone) and coping drinking motives are risk factors for alcohol problems. Theoretical models suggest that solitary drinking and coping motives are highly related. However, the direction of effects between solitary drinking and coping motives is unclear. It also remains unclear if relations are present solely at the between-person level, or if there are also dynamic, within-person relations. Therefore, the current study tested dynamic, reciprocal relations among solitary drinking, coping motives, and alcohol problems using Random Intercept Cross Lagged Panel Modeling (RI-CLPM).

METHODS

Data came from a large alcohol administration study with longitudinal follow-ups over 2 years (N = 448). Participants completed a baseline session and then were followed up 6, 12, 18, and 24 months later. Participants reported their solitary drinking frequency, coping motives, drinking behavior, and alcohol problems at all assessments.

RESULTS

Person-level solitary drinking was related to person-level coping motives and alcohol problems, and person-level coping motives were related to person-level alcohol problems. There were also contemporaneous within-person effects, such that a within-person increase in solitary drinking was associated with a concurrent within-person increase in coping motives, and a within-person increase in coping motives was associated with a concurrent within-person increase in alcohol problems. There were no within-person prospective relations among any variables.

CONCLUSIONS

Findings suggest strong between-person associations among solitary drinking, coping motives, and alcohol problems. Within-person associations were concurrent but not prospective. Targeting solitary and coping-motivated drinkers, as well within-person increases in both, may be effective at reducing risk for alcohol problems.

Exploring Contributing Factors of Solitary Drinking among Hong Kong Chinese Adolescents and Young Adults: A Descriptive Phenomenology

Adolescents and young adults mostly drink alcohol because of social activities. However, some drink outside of normative social contexts, exhibiting a behaviour pattern known as solitary drinking. Increasing evidence indicates that solitary drinking is strongly associated with problematic drinking in adolescents and young adults. However, it remains unclear why individuals initiate and maintain this drinking habit. To address this gap in the existing literature, the current study explored the factors contributing to solitary drinking in this population. Descriptive phenomenology was used. A convenience sample of 44 solitary drinkers aged between 10 and 24 were invited to undergo individual semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. The data were analysed by two researchers separately using Colaizzi’s method. Using qualitative descriptions, the following factors were identified as explaining the initiation and continuation of solitary drinking among adolescents and young adults: (1) enhancement and coping drinking motives, (2) social discomfort, (3) reduced self-control, (4) automatic mental process, and (5) a desperate response to stressors. Since reduced self-control plays an important role in long-term addiction, future studies should be conducted to determine potential applications of mindfulness-based interventions to improve self-control, which may prevent the progression from solitary drinking to alcohol use disorder.

Do Depression and Binge Drinking Explain the Increased Risk of Sexual Violence Among Sexual Minority Middle and High School Girls?

Sexual violence (SV) occurs at rates higher among sexual minority youth than heterosexual youth, but the mechanisms explaining this higher risk are understudied. We examined if binge drinking and depression explain the higher rates of SV victimization among sexual minority middle and high school girls. Female students (N = 1,145) in Grades 7th to 10th completed a survey that assessed for SV, binge drinking, depression, sexual orientation identification, and sex at birth. Sexual minority girls had higher rates of SV victimization compared with heterosexual girls. Binge drinking and depression fully mediated the relationship between sexual orientation status and SV victimization among girls. SV prevention programming for sexual minority girls are urgently needed. Programs that seek to reduce binge drinking and depression may be especially impactful in reducing the risk of violence among sexual minority girls.

Characteristics and reasons for use associated with solitary alcohol and marijuana use among U.S. 12th Grade Students, 2015-2021

BACKGROUND

Little is known regarding what sociodemographic characteristics and reasons for use are associated with adolescent solitary alcohol and marijuana use.

METHODS

Data from 7845 12th grade students participating in the nationally-representative Monitoring the Future study from 2015 to 2021 were used to examine cross-sectional associations between sociodemographics, heavy drinking/marijuana use, reasons for use, and past 12-month solitary alcohol or marijuana use among past 12-month users. Historical trends and possible differences related to the COVID-19 pandemic also were examined.

RESULTS

Solitary use prevalence increased from 2015 to 2021 with no evidence of significant COVID-19 deviations. In 2021, solitary alcohol use was reported by 32.1% (SE 3.01) and solitary marijuana use by 55.8% (4.72) of those reporting past 12-month use. Common and substance-specific sociodemographic risk factors were observed. Binge drinking was associated with solitary alcohol use; frequent marijuana use was associated with solitary marijuana use. Reasons for use related to coping with negative affect were associated with solitary use. Compulsive use reasons were more strongly associated with solitary alcohol than marijuana use. Drinking to have a good time with friends was negatively associated with solitary alcohol use but this association was not seen for solitary marijuana use.

CONCLUSIONS

The percentage of adolescents who use alcohol or marijuana when they were alone has increased among those who report using each substance. Associations between solitary use and (a) higher levels of consumption and (b) coping with negative affect highlight the importance of solitary use as a risk indicator.

Longitudinal Associations between Social Relationships and Alcohol Use from Adolescence into Young Adulthood: The Role of Religiousness

As adolescence is a time characterized by rapid changes in social relationships as well as an increase in risk-taking behaviors, this prospective longitudinal study examined whether social involvement and social alienation are associated with changes in alcohol use from adolescence into young adulthood moderated by organizational and personal religiousness. Participants were 167 adolescents (53% male) assessed five times between ages 14 and 18 years old. Latent change score modeling analyses indicated that social alienation was positively associated with greater increases in alcohol use among those with low organizational religiousness and those with low personal religiousness in early adolescence and during the transition into young adulthood. The findings demonstrate the detrimental effects of social relationship risk factors that promote alcohol use during adolescence into young adulthood. The results further highlight the protective roles of organizational and personal religiousness acting as additional sources of social engagement experiences to modulate the effects of social alienation predicting alcohol use progression and provide evidence for the positive impact religiousness has on healthy adolescent development.

Influence of alcohol provocation on medical professionals in Taiwan: A qualitative study

There is a paucity of research on the issue of alcohol provocation in the medical field. While studies have been performed concerning alcohol abuse among students, no studies have concentrated on alcohol provocation among medical professionals. Therefore, it is essential to look at the underlying factors that may influence alcohol use by medical professionals. A qualitative study using focus groups was conducted to construct themes depicting medical professionals' experiences of alcohol provocation. Physicians (n = 32) and residents (n = 29) were recruited from a large teaching hospital in Taiwan. The volunteers included both subjects and instigators of alcohol provocation (individuals being pressured to drink and those who exert such pressure on others). A questionnaire on their alcohol use was used to quantitatively assess the prevalence of alcohol consumption and inebriation. The participants were then interviewed separately in groups. All interview data were recorded, transcribed and analysed thematically. A notable prevalence of recent alcohol consumption was observed in both the physicians (n = 18, 56%) and residents (n = 17, 59%). Three prominent themes were identified and summarized: (1) Social drinking in the Taiwanese medical profession (2) Workplace hierarchy and changes in drinking culture, and (3) Influence on the medical profession. The behaviour of alcohol provocation among these medical professionals was revealed with its underlying factors of specific cultural norms, workplace hierarchy and social expectations. An understanding of alcohol provocation helps increase the awareness of adverse consequences associated with alcohol provocation, encourage medical professionals to avoid inappropriate drinking behaviors, and reduce the risk of compromising medical professionalism.

Personal and Social Consequences of Psychotropic Substance Use: A Population-Based Internet Survey

Background and objectives: Drug abuse has become a major worldwide health concern among all age groups. The present study analyses substance misuse and its social and personal consequences using a population-based internet survey in Spain. Materials and Methods: Screening for drug abuse (of alcohol, marijuana/hashish and psychostimulants) and its related risks and problems was performed using the Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) score. Socio-demographic factors, depressive, anxiety and stress symptoms as well as health habits were also evaluated. We used Linear regression methods to compare each variable's individual contribution so as to determine which one best explains the results. Results: In this population-based study, 1224 people completed and returned the online survey. Of all participants, 57% reported consuming at least one substance based on the CRAFFT scale. While increasing age reduces the probability of personal and social consequences of consumption, people who smoke receive up to three times more (OR = 3.370) recommendations from family and friends to reduce their consumption. As for the type of substance, the consumption of marijuana increases the risk of forgetting (OR = 2.33) and the consumption of other psychostimulant substances almost triples the risk of consuming alone (OR = 2.965). Combining substances can increase the rate of driving a vehicle after consumption by 3.4 times. Conclusions: Although age, smoking and the type of substances used increase the risk of suffering from social and personal consequences of the use or abuse of substances, future studies are needed to determine the influence of new variables as a potential tool for treating and minimizing the adverse consequences of drug abuse.

Factores que diferencian el consumo frecuente y esporádico de marihuana en estudiantes universitarios

Aunque el consumo de marihuana es altamente prevalente entre universitarios de Argentina, poco se sabe respecto a los factores que permiten distinguir a los consumidores frecuentes de marihuana de quienes consumen esporádicamente. Por esta razón, en el presente trabajo se indagó sobre las posibles variaciones en los contextos de consumo, motivos de consumo, normas percibidas y estrategias conductuales de protección entre universitarios con consumo frecuente o esporádico de marihuana, y se analizó la utilidad de este conjunto de variables para distinguir entre estos los tipos de consumidores mencionados. Para ello, se contó con una muestra de 1083 estudiantes universitarios argentinos que completó una encuesta en línea sobre el consumo de sustancias. En particular, este trabajo se realizó con la submuestra que reportó consumir marihuana en los últimos 30 días (n = 158; 51.3 % mujeres). Dicha encuesta interrogaba sobre el consumo de marihuana y las consecuencias negativas asociadas, así como por motivos de consumo, normas sociales percibidas y estrategias conductuales de protección. Como resultado, los consumidores frecuentes presentaron mayor cantidad de consecuencias negativas (M = 4.92) que los consumidores esporádicos (M = 1.82; p ≤ .05), y se halló un perfil distintivo en un conjunto de variables. A nivel multivariado, los motivos de animación (or = 1.230; p ≤ .05), las estrategias conductuales de protección (or = .941; p ≤ .05), el consumo en solitario (or = 2.024; p ≤ .05) y el consumo en fiestas universitarias (or = 2.669; p ≤ .05) discriminaron significativamente entre ambas clases de consumidores. En general, los hallazgos revelaron subpoblaciones heterogéneas de consumidores de marihuana que difieren no solo en el consumo y sus consecuencias, sino también en los contextos de consumo y en un conjunto de variables relevantes. Estas subpoblaciones distintivas requieren de intervenciones diferentes y específicas.

Correlates of solitary alcohol and cannabis use among American Indian adolescents

BACKGROUND

Solitary substance use, or using substances while alone, is common among adolescents but understudied. This is the first study to examine solitary substance use among American Indian (AI) adolescents. The objective was to examine correlates of solitary alcohol use and solitary cannabis use that occur within the individual, family, school, peer, and cultural domains of the social ecology.

METHOD

Data were from the 2009-2013 Drug Use Among Young American Indians Study, a cross-sectional cohort study. Two sets of hierarchical logistic regressions were conducted to examine solitary alcohol use (getting drunk) among lifetime alcohol users (n = 2082; Mage = 15.12 years; SD = 1.68; 54.2% female) and solitary cannabis use among lifetime cannabis users (n = 2085; Mage = 14.99 years; SD = 1.69; 50.5% female), including adjustment for level of substance involvement.

RESULTS

Prevalence of solitary alcohol use among lifetime drinkers was 24.9%. Among lifetime cannabis users, 53.6% reported solitary cannabis use. Regression analyses for solitary alcohol use showed statistically significant positive associations with coping motive, descriptive norms, violent behavior, depression, peer models for use, and (unexpectedly) peer sanctions against use and a negative association with family sanctions against use. Regression analyses for solitary cannabis use showed statistically significant positive associations with coping motive, violent behavior, and peer models for use and a negative association with family sanctions against use.

CONCLUSIONS

Solitary alcohol and cannabis use are prevalent among AI adolescents and might, in particular, reflect attempts to cope with adversity. Findings could help guide the development of screening and prevention efforts.

Risk factors for elevations in substance use and consequences during the COVID-19 pandemic among sexual and gender minorities assigned female at birth

BACKGROUND

Problematic substance use (SU) has increased substantially during the COVID-19 pandemic. While studies have identified risk factors for problematic SU during the pandemic (e.g., anxiety, depression, using substances to cope), these studies have been predominately cross-sectional, rarely examined changes in SU contexts during the pandemic as potential risk factors, and neglected sexual and gender minorities (SGM) - a health disparity population disproportionately impacted by substance use disorders and the pandemic.

METHOD

We utilized two waves of data collected one month apart from a sample of 212 SGM assigned female at birth who used alcohol and/or cannabis (18-25 years old) collected between August 2020-February 2021. We examined associations between potential risk factors (i.e., retrospectively reported changes in anxiety/depression and in using substances in different contexts since before the pandemic): and 1) retrospectively reported changes in alcohol and cannabis consumption; 2) coping motives for use and SU consequences; and 3) subsequent changes in coping motives and consequences.

RESULTS

An increase in solitary SU was a robust risk factor for concurrent and prospective increases in SU, coping motives, and consequences. Increases in SU with romantic partners were associated with concurrent increases in alcohol/cannabis consumption and consequences. Increases in anxiety and depression were associated with concurrent increases in SU and higher coping motives and consequences.

CONCLUSIONS

Results indicate that solitary SU and increases in SU with romantic partners are robust risk factors for increases in SU and consequences in the context of the pandemic. Further, findings provide support for the self-medication theory of substance use.

A systematic review and meta-analysis on the association between solitary drinking and alcohol problems in adults

BACKGROUND AND AIMS

Solitary drinking in adolescents and young adults is associated with greater risk for alcohol problems, but it is unclear whether this association exists in older demographics. The current paper is the first meta-analysis and systematic review, to our knowledge, to determine whether adult solitary drinking is associated with greater risk for alcohol problems.

METHODS

PsychINFO, PubMed and Google Scholar were searched following a pre-registered International Prospective Register of Systematic Reviews (PROSPERO) protocol (CRD42019147075) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Following the methodology used in our recent systematic review and meta-analysis on adolescent/young adult solitary drinking, we systematically reviewed solitary drinking measures/definitions, prevalence rates and associated demographic variables in adults. We then meta-analyzed (using random-effects models) associations between adult solitary drinking and alcohol use/problems, negative affect and negative/positive reinforcement-related variables (e.g. drinking to cope or for enhancement).

RESULTS

Solitary drinking was defined as drinking while physically alone in nearly all studies, but measures varied. Prevalence rates were generally in the 30-40% range, with some exceptions. In general, males were more likely than females to report drinking alone, and married individuals were less likely than unmarried individuals to report drinking alone; racial/ethnic differences were mixed. Meta-analytical results showed significant effects for the associations between solitary drinking and the following factors: alcohol consumption, r = 0.25, 95% confidence interval (CI) = 0.18, 0.33, k = 15, I²  = 97.41; drinking problems, r = 0.15, 95% CI = 0.10, 0.21, k = 14, I²  = 92.70; and negative reinforcement, r = 0.24, 95% CI = 0.14, 0.32, k = 11, I²  = 89.77; but not positive reinforcement, r = 0.02, 95% CI = 0.06, 0.09, k = 8, I²  = 76.18; or negative affect, r = 0.03, 95% CI = -0.02, 0.08, k = 8, I²  = 52.06. Study quality moderated the association between solitary drinking and negative affect (β = -0.07, P < 0.01) such that lower-quality studies were significantly associated with larger effect sizes. Study quality was generally low; the majority of studies were cross-sectional.

CONCLUSIONS

Solitary drinking appears to have a small positive association with alcohol problems.

Drinking less on cannabis use days: The moderating role of UPPS-P impulsive personality traits

Objective: Several studies suggest that alcohol and cannabis co-users are heavier drinkers and experience more alcohol-related consequences. However, day-level associations between co-use and drinking levels are mixed. One reason may be that individual characteristics moderate the daily impact of using alcohol alone or in conjunction with cannabis. The theory would suggest that highly impulsive individuals may drink more on co-use days, yet this assertion remains untested. Therefore, the current study tested whether impulsivity moderated the effect of co-use on same-day drinking quantity within veterans, a high-risk sample for substance use and impulsivity. Method: In a longitudinal observational study, co-using veterans (N = 139) completed three semi-annual assessments reporting on their daily drinking quantity and cannabis use via Timeline Followback (Observations = 19,245) and impulsivity via the UPPS-P. Mixed effect modeling was used to test hypotheses that co-use (compared to alcohol-only) days would be associated with heavier drinking for those high (but not low) in positive and negative urgency. Results: Significant interactions were found for positive urgency (PU) and lack of perseverance (LP), such that individuals at mean and low levels of PU and LP drank less on co-use (compared to alcohol-only) days. There were no significant interactions for other UPPS-P impulsivity facets. Conclusion: Findings are consistent with a substitution/compensatory effect for individuals at mean and low levels of both UPPS-P facets, and may be a byproduct of frequent cannabis use in veterans. In contrast, findings suggest that co-use and alcohol-only days may be characterized by similarly high levels of drinking for highly impulsive individuals. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Adolescent Experiences with Self-Asphyxial Behaviors and Problematic Drinking in Emerging Adulthood

Self-asphyxial behavior to achieve a euphoric high (The Choking Game; TCG), occurs most often during early adolescence. Participants in TCG often engage in other risky behaviors. This study investigated the relationship between prior experience with TCG and problematic drinking behaviors in emerging adulthood. Emerging adults, 18 to 25 years old (N = 1248), 56% female, and 78% Caucasian completed an online survey regarding knowledge of and prior engagement in TCG and current drinking behaviors. Participants who personally engaged in TCG during childhood/adolescence or were familiar with TCG reported significantly more problematic drinking behaviors during emerging adulthood. Those present when others engaged in TCG but resisted participation themselves reported significantly less current problematic drinking behaviors than those who participated, but significantly more current problematic drinking behaviors than those never present. Emerging adults with increased social familiarity with TCG during adolescence endorsed greater problematic drinking behaviors. Results suggest resistance skills may generalize across time/activities.

Social facilitation of alcohol subjective effects in adolescents: Associations with subsequent alcohol use

RATIONALE

Laboratory research in adults indicates that alcohol-related subjective effects are enhanced under some social conditions. However, it is unknown whether this "social facilitation" of alcohol effects occurs in adolescents and is associated with alcohol use in the natural ecology.

OBJECTIVES

We examined associations of social facilitation of alcohol-related subjective effects with subsequent alcohol use among a relatively high-risk group of adolescents who reported drinking alcohol both with friends and alone.

METHODS

Los Angeles high school students from a prospective study (N = 142; 51% female; 10th graders) completed a baseline survey that assessed alcohol-related "positive" and "negative" subjective effects in two contexts: social (alcohol with friends) and solitary (alcohol alone); social facilitation was calculated as the difference between social and solitary. Students then completed five semi-annual surveys spanning 30 months (2014-2017) assessing 30-day alcohol use (days used, number of drinks, binge drinking).

RESULTS

Greater social facilitation of positive effects was significantly associated with greater number of alcohol use days (RR [95% CI] = 1.48 [1.19, 1.82]; p < .001), greater number of drinks (RR [95% CI] = 1.38 [1.14, 1.66]; p = .001), and greater odds of binge drinking (OR [95% CI] = 1.75 [1.20, 2.57]; p = .004). Similar associations were found with social positive effects. There were no significant associations between solitary positive effects-or any negative effects-and alcohol use outcomes.

CONCLUSIONS

Social facilitation can be measured outside of the laboratory. Relatively high-risk drinking adolescents who are more susceptible to the social facilitation of subjective alcohol effects are more likely to use more alcohol and binge drink.

The influence of negative mood on solitary drinking preference: An experiment with young adult solitary drinkers

Solitary drinking is a risk marker for alcohol use disorder; thus, it is important to identify why individuals drink alone and for whom this association is particularly relevant. Evidence suggests the desire to ameliorate negative affect (NA) motivates solitary drinking, with some individuals particularly likely to drink alone to cope, but all past studies are cross-sectional. The present study therefore aimed to determine whether 1) experimentally induced NA increased preferences to drink alcohol alone, and 2) whether the relationship between NA and choosing to drink alcohol alone was moderated by neuroticism, drinking to cope motives, and social anxiety. Current drinkers (ages 21-29) with a solitary drinking history (N=126) were randomly assigned to either NA, positive affect [PA], or no affect change (control) conditions via differing cognitive task feedback. After the mood manipulation, participants chose between drinking alcoholic or nonalcoholic beverages in one of two contexts: alone or socially. Evidence regarding effectiveness of the mood manipulation was mixed, and few chose non-alcoholic beverages in either context. Condition did not influence outcome choice. Across conditions, increases in NA and the importance placed on receiving one's context choice were associated with solitary (versus social) alcohol preference. Neuroticism and its interaction with NA change also influenced choice; individuals high in neuroticism chose more solitary (versus social) drinking contexts while the opposite was true for those low in neuroticism, and among the latter, the preference difference was more pronounced with relatively smaller NA increases. Findings are discussed based on the existing solitary drinking literature.

Drinking Together and Drinking Alone: A Social-Contextual Framework for Examining Risk for Alcohol Use Disorder

The context in which drinking occurs is a critical but relatively understudied factor in alcohol use disorder (AUD) etiology. In this article, I offer a social-contextual framework for examining AUD risk by reviewing studies on the unique antecedents and deleterious consequences of social versus solitary alcohol use in adolescents and young adults. Specifically, I provide evidence of distinct emotion regulatory functions across settings, with social drinking linked to enhancing positive emotions and social experiences and solitary drinking linked to coping with negative emotions. I end by considering the conceptual, methodological, and clinical implications of this social-contextual account of AUD risk.

Antecedents, concurrent correlates, and potential consequences of young adult solitary alcohol use

OBJECTIVE

Research on young adults has found solitary alcohol use to be positively associated with negative emotions, coping motives for drinking, and negative alcohol-related consequences, but most research has been cross-sectional and based on samples of college students. We examined associations across multiple time points within a sample that was diverse with respect to educational status and age.

METHODS

A community sample (N = 754, ages 18-26; 56% female) completed surveys at baseline, monthly for 2 years, and at 30-month postbaseline. Multilevel and single-level regression models assessed longitudinal and concurrent associations between solitary drinking and potential correlates, adjusting for frequency of alcohol use.

RESULTS

Moderate depressive symptoms at baseline were associated with a greater likelihood of solitary drinking in drinking months in the subsequent 2 years (Adjusted Odds Ratio [AOR] = 2.22, 95% CI [1.54-3.20]). During those 2 years, both depressive symptoms and coping motives were positively concurrently associated with solitary drinking at the between- and within-person level. Although solitary drinking in a particular month had a small and nonsignificant association with negative alcohol-related consequences, the proportion of drinking months that involved solitary drinking was positively associated with negative alcohol-related consequences across months. More solitary drinking during monthly data collection was associated with greater likelihoods of hazardous drinking and moderate depressive symptoms at 30-month follow-up, but these associations were not statistically significant after adjusting for earlier measures of drinking and depressive symptoms.

CONCLUSIONS

The findings point to the importance of considering the drinking context when screening and providing treatment for alcohol misuse. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Shame's Associations with Depression and Problem Drinking: An Ecological Momentary Study

INTRODUCTION

Depression and problem drinking are comorbid in emerging adulthood, yet the processes that link them are not well understood. Research has argued that shame has a unique influence on the experience of problematic drinking, but this has rarely been assessed at the state level. Using ecological momentary assessments (EMAs), we assessed whether shame, and not guilt, mediated the association between baseline depression and alcohol use and problems.

METHODS

One hundred and eighty-four emerging adults (M_age= 19.27) completed a 12-day EMA study. Multilevel models were used to test hypotheses.

RESULTS

In a model with alcohol use as the outcome, there were no significant associations between shame or guilt and alcohol use at the within- or between-subjects level. In a model with alcohol problems as the outcome, guilt was positively associated with alcohol problems but only at the daily level. At the between-subjects level and after controlling for guilt, there was a significant association between depression, shame, and alcohol problems; average levels of shame mediated the association between depression and alcohol problems. In post-hoc reverse directionality models, average alcohol problems mediated the relationship between depression and shame and guilt at the between-person level. No mediation was present for alcohol use.

CONCLUSION

After controlling for guilt, shame is an emotion that helps explain risk for alcohol problems among depressed emerging adults, which has implications for targeted interventions. Reciprocal associations between shame, guilt, and alcohol problems emerged highlighting the need for more fulsome assessments of shame and guilt in future EMA research.

Mediational Role of Drinking to Cope in the Associations of Depression and Suicidal Ideation with Solitary Drinking in Adults Seeking Alcohol Treatment

BACKGROUND

Little research on solitary drinking has focused on clinical samples. Previous research in college students has found that depression, suicidal ideation, and drinking to cope with negative affect are associated with drinking in solitary, but not social, contexts. These associations have not been examined among individuals with alcohol use disorder, despite their high rates of depression and suicidal behavior.

METHOD

To fill this gap in knowledge, the associations of depression and suicidal ideation with solitary and social drinking were examined among 96 individuals seeking alcohol treatment, the majority of whom had alcohol use disorder (97.9%). Multiple mediation models were conducted to examine the mediating effects of two drinking to cope variables (drinking excessively to cope and coping motives) on the associations of depression and suicidal ideation with drinks per month and heavy episodic drinking in social and solitary contexts.

RESULTS

Significant indirect effects were found for depression and suicidal ideation with solitary drinking variables through greater drinking excessively to cope. No significant indirect effects were found for social drinking variables. However, a positive direct association was found between suicidal ideation and greater social drinks per month that was not mediated by drinking to cope.

CONCLUSIONS

These findings suggest that greater depression or suicidal ideation, through their effect on greater drinking to cope, are associated with greater solitary drinking in a treatment seeking sample. Drinking context should perhaps be considered in alcohol interventions, particularly when treating individuals suffering from depression or suicidal ideation.

Associations between solitary drinking and increased alcohol consumption, alcohol problems, and drinking to cope motives in adolescents and young adults: a systematic review and meta-analysis

BACKGROUND AND AIMS

Emerging evidence suggests that solitary drinking may be an important early risk marker for alcohol use disorder. The current paper is the first meta-analysis and systematic review on adolescent and young adult solitary drinking to examine associations between solitary drinking and increased alcohol consumption, alcohol problems, and drinking to cope motives.

METHODS

PsychINFO, PubMed, and Google Scholar were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology and a pre-registered International Prospective Register of Systematic Reviews (PROSPERO) protocol (no. CRD42020143449). Data from self-report questionnaires regarding negative correlates of solitary drinking (e.g. alcohol problems) and solitary drinking motives (e.g. drinking to cope) were pooled across studies using random-effects models. Studies included adolescents (aged 12-18 years) and young adults (mean age between 18 and 30 years or samples with the majority of participants aged 30 years or younger).

RESULTS

Meta-analytical results from 21 unique samples including 28,372 participants showed significant effects for the associations between solitary drinking and the following factors: increased alcohol consumption, r = 0.23, 95% confidence interval (CI) = 0.12, 0.33; drinking problems, r = 0.23, 95% CI = 0.13, 0.32; negative affect, r = 0.21, 95% CI = 0.16, 0.26; social discomfort, r = 0.17, 95% CI = 0.06, 0.27; negative reinforcement, r = 0.28, 95% CI = 0.24, 0.31; and positive reinforcement, r = 0.10, 95% CI = 0.03, 0.17. These associations were not moderated by age group (i.e. adolescent versus young adult), study quality, or differing solitary drinking definitions. Accounting for publication bias increased the effect sizes from r = 0.23 to 0.34 for alcohol consumption and from r = 0.23 to 0.30 for drinking problems, and lowered it from r = 0.10 to 0.06 and r = 0.17 to 0.11 for positive reinforcement and social discomfort, respectively.

CONCLUSIONS

Solitary drinking among adolescents and young adults appears to be associated with psychosocial/alcohol problems and drinking to cope motives.

Depression, Environmental Reward, Coping Motives and Alcohol Consumption During the COVID-19 Pandemic

Background: Increases in the incidence of psychological distress and alcohol use during the COVID-19 pandemic have been predicted. Behavioral theories of depression and alcohol self-medication theories suggest that greater social/environmental constraints and increased psychological distress during COVID-19 could result in increases in depression and drinking to cope with negative affect. The current study had two goals: (1) to examine self-reported changes in alcohol use and related outcomes after the introduction of COVID-19 social distancing requirements, and; (2) to test hypothesized mediation models to explain individual differences in self-reported changes in depression and alcohol use during the early weeks of the COVID-19 pandemic. Methods: Participants (n = 833) were U.S. residents recruited for participation in a single online survey. The cross-sectional survey included questions assessing environmental reward, depression, COVID-19-related distress, drinking motives, and alcohol use outcomes. Outcomes were assessed via retrospective self-report for two timeframes in the single survey: the 30 days prior to state-mandated social distancing ("pre-social-distancing"), and the 30 days after the start of state-mandated social distancing ("post-social-distancing"). Results: Depression severity, coping motives, and some indices of alcohol consumption (e.g., frequency of binge drinking, and frequency of solitary drinking) were significantly greater post-social-distancing relative to pre-social-distancing. Conversely, environmental reward and other drinking motives (social, enhancement, and conformity) were significantly lower post-social distancing compared to pre-social-distancing. Behavioral economic indices (alcohol demand) were variable with regard to change. Mediation analyses suggested a significant indirect effect of reduced environmental reward with drinking quantity/frequency via increased depressive symptoms and coping motives, and a significant indirect effect of COVID-related distress with alcohol quantity/frequency via coping motives for drinking. Discussion: Results provide early cross-sectional evidence regarding the relation of environmental reward, depression, and COVID-19-related psychological distress with alcohol consumption and coping motives during the early weeks of the COVID-19 pandemic. Results are largely consistent with predictions from behavioral theories of depression and alcohol self-medication frameworks. Future research is needed to study prospective associations among these outcomes.

Gender Differences in the Epidemiology of Alcohol Use and Related Harms in the United States

Over the past century, differences in alcohol use and related harms between males and females in the United States have diminished considerably. In general, males still consume more alcohol and experience and cause more alcohol-related injuries and deaths than females do, but the gaps are narrowing. Among adolescents and emerging adults, gaps in drinking have narrowed primarily because alcohol use among males has declined more than alcohol use among females. Among adults, alcohol use is increasing for women but not for men. Rates of alcohol-related emergency department visits, hospitalizations, and deaths all have increased among adults during the past two decades. Consistent with the changing patterns of alcohol use, increases in these outcomes have been larger for women. Recent studies also suggest that females are more susceptible than males to alcohol-induced liver inflammation, cardiovascular disease, memory blackouts, hangovers, and certain cancers. Prevention strategies that address the increases in alcohol consumption and unique health risks for women are needed.

What Does Adolescent Substance Use Look Like During the COVID-19 Pandemic? Examining Changes in Frequency, Social Contexts, and Pandemic-Related Predictors

PURPOSE

The overarching goal of this study was to provide key information on how adolescents' substance use has changed since the corona virus disease (COVID)-19 pandemic, in addition to key contexts and correlates of substance use during social distancing.

METHODS

Canadian adolescents (n = 1,054, Mage = 16.68, standard deviation = .78) completed an online survey, in which they reported on their frequency of alcohol use, binge drinking, cannabis use, and vaping in the 3 weeks before and directly after social distancing practices had taken effect.

RESULTS

For most substances, the percentage of users decreased; however, the frequency of both alcohol and cannabis use increased. Although the greatest percentage of adolescents was engaging in solitary substance use (49.3%), many were still using substances with peers via technology (31.6%) and, shockingly, even face to face (23.6%). Concerns for how social distancing would affect peer reputation was a significant predictor of face-to-face substance use with friends among adolescents with low self-reported popularity, and a significant predictor of solitary substance use among average and high popularity teens. Finally, adjustment predictors, including depression and fear of the infectivity of COVID-19, predicted using solitary substance use during the pandemic.

CONCLUSIONS

Our results provide preliminary evidence that adolescent substance use, including that which occurs face to face with peers, thereby putting adolescents at risk for contracting COVID-19, may be of particular concern during the pandemic. Further, solitary adolescent substance use during the pandemic, which is associated with poorer mental health and coping, may also be a notable concern worthy of further investigation.

Gender-Specific Drinking Contexts Are Associated With Social Harms Resulting From Drinking Among Australian Young Adults at 30 Years

Aims

Understanding contexts in which social harms from drinking occur can help develop context-based harm reduction efforts. However, there is little knowledge of specific drinking contexts where such harms occur and whether these are gender or age specific. We aimed to investigate associations of a range of drinking contexts and social harms from drinking among young adults at age 30.

Methods

We used data from 2187 30-year-old adults. Latent constructs of gender-specific drinking contexts were created using factor analysis. We performed multivariate logistic regression between drinking contexts and a range of social harms from drinking, separately by gender.

Results

After accounting for social roles and binge drinking, gender-specific solitary drinking contexts (‘home drinking’ for men and ‘daytime drinking’ for women) were positively associated with marital problems and problems with other family members and friends. Conversely, ‘social drinking’ was not. Work-related drinking among men was associated with marital/intimate relationship problems and friendship problems. After accounting for mental health symptoms, women’s home drinking was associated with marital problems.

Conclusion

We found that experiences of social harms from drinking at 30 years differ depending on the drinker’s gender and context. Our findings suggest that risky contexts and associated harms are still significant among 30-year-old adults, indicating that a range of gender-specific drinking contexts should be represented in harm reduction campaigns. The current findings also highlight the need to consider gender to inform context-based harm reduction measures and to widen the age target for these beyond emerging adults.

Drinking beyond the binge threshold in a clinical sample of adolescents

BACKGROUND AND AIMS

Nearly all the research conducted on high-intensity drinking has focused on college and school-based samples, with recent calls for research to understand this risky drinking pattern in non-school-based samples and across time. This study aimed to characterize predictors and consequences of non-binge drinking, age- and gender-adjusted binge drinking (level I) and drinking at levels representing two or more times (level II) and three or more times the level I binge threshold (level III) in a clinical sample of adolescents followed into young adulthood.

DESIGN

Cross-sectional associations between non-binge drinking, binge levels, and negative alcohol-related consequences were examined during adolescence; prospective analyses tested whether adolescent non-binge drinking and binge levels predicted alcohol use disorder (AUD) symptoms in young adulthood and whether changes in drinking motives over time were associated with binge levels in young adulthood.

SETTING

US clinical settings.

PARTICIPANTS

A total of 432 adolescents (aged 12-18 years) with alcohol-related problems followed into young adulthood (aged 19-25 years).

MEASUREMENTS

Life-time drinking history, Structured Clinical Interview for DSM AUDs, and Inventory of Drinking Situations.

FINDINGS

Results were generally consistent with a distinction between binge level I versus levels II-III on various negative alcohol-related consequences in adolescence (Ps < 0.05) that were maintained in young adulthood (Ps < 0.01). The maintenance of relatively high endorsement of enhancement and social motives over time was associated with binge levels II-III in young adulthood (Ps < 0.001); decreases in coping motives were associated with less risky drinking in adulthood (P = 0.003).

CONCLUSIONS

Among US adolescents with alcohol-related problems who were followed-up in young adulthood (aged 19-25 years), standard threshold binge drinking (five or more drinks per occasion; level I) was generally associated with fewer alcohol-related consequences and problem behaviors than binge drinking at two or more times (level II) or three or more times (level III) the standard binge threshold.

Putting things in context: Longitudinal relations between drinking contexts, drinking motives, and negative alcohol consequences

Recent studies suggest that solitary (but not social) drinking may confer risk for negative alcohol consequences via beliefs about alcohol's ability to reduce tension, and explicit motivations to drink to cope with negative mood states. However, because prior studies are largely cross-sectional, it is unclear if tension reduction expectancies and drinking to cope are antecedents or consequences of solitary drinking. The current study aimed to address this gap in the literature using prospective data (3 waves across 12 months) from a sample of moderate to heavy drinking young adults. Data were drawn from a larger investigation of contextual influences on subjective alcohol response. Participants (N = 448) reported on alcohol use in multiple drinking contexts and tension reduction expectancies at baseline (T1), drinking motives at a 6-month follow-up (T2), and past-month negative alcohol consequences at a 12-month follow-up (T3). We examined potential indirect effects of drinking contexts on negative consequences operating through alcohol expectancies and drinking motives. Solitary drinking was indirectly associated with later negative consequences through stronger coping motives, although tension reduction expectancies did not serve as a significant mediator. Social drinking was not directly or indirectly related to later alcohol consequences. Results suggest that solitary drinking contexts confer risk for negative consequences through coping motives, and that these effects are invariant across sex, race, and ethnicity. These findings have important clinical implications as they suggest that targeting solitary drinkers for skills-based coping interventions may reduce risk for a developmental trajectory toward negative alcohol consequences. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Using Demand Curves to Quantify the Reinforcing Value of Social and Solitary Drinking

BACKGROUND

Young adults typically drink in social settings and report high levels of episodic heavy drinking despite a range of adverse consequences. Behavioral economics posits that this may reflect a reinforcer pathology in which alcohol is overvalued relative to other reinforcers. Theoretically, the value of alcohol is related to both the direct pharmacological effects of alcohol (euphoria, sedation) and the associated social reinforcement, but to date no studies have differentiated the value of social vs. solitary drinking. The current study examines two modified hypothetical alcohol purchase tasks (APTs), one explicitly social and one explicitly solitary, in order to quantify the reward value of social vs. solitary drinking and to determine whether there are unique clinical correlates of solitary alcohol demand.

METHODS

Participants were young adults (N = 274, Mage  = 25.15, SD = 4.10) recruited from Mturk and from a university subject pool. Participants completed a solitary and social APT, in addition to measures of alcohol consumption and problems.

RESULTS

Participants reported significantly greater demand in the social APT compared to the solitary APT across all demand indices. Elevated solitary and social demand were associated with elevated levels of alcohol use and problems. Using a residualized change approach, solitary demand amplitude (maximum consumption and expenditure) and persistence (price sensitivity) contributed additional variance above and beyond their social APT composite counterparts in predicting typical drinks per week and the self-care, academic/occupational, and physical dependence subscales of the YAACQ.

CONCLUSIONS

The presence of peers increases alcohol demand compared to a solitary scenario, and greater relative solitary drinking demand may be a risk factor for greater alcohol consumption and problems.

Ashamed and Alone—Risk Factors for Alcohol Craving Among Depressed Emerging Adults

Aims

Comorbid alcohol use and depression have the highest prevalence among emerging adults and are associated with a number of consequences. Self-medication theory posits individuals with depression use alcohol to cope with their negative emotions. Preliminary work has investigated the social context of depression-related drinking and found that solitary drinking is a risky, atypical behaviour in emerging adulthood that is associated with alcohol misuse. However, it is unknown about what is unfolding in the moment that is driving depression-related drinking in solitary contexts. Accordingly, we used an experimental study to examine if shame mediated the association between depression and in-lab alcohol craving.

Methods

Emerging adults (N = 80) completed a shame induction followed by an alcohol cue exposure in either a solitary or social condition. We used moderated mediation to test hypotheses.

Results

Consistent with hypotheses, conditional indirect effects supported the mediation of depression and alcohol craving through shame among those in the solitary condition, but not in the social condition. There was no support for guilt as a mediator.

Conclusion

Our study demonstrates that shame is a specific emotional experience that contributes to solitary drinking among depressed emerging adults. It is important to use these results to inform interventions that directly target solitary contexts and shame.

Contexts of alcohol use: A latent class analysis among Argentinean college students

BACKGROUND

Alcohol use, and the association between alcohol-related variables and drinking outcomes, seem to be context dependent. We employed Latent Class Analysis, a person-centered approach, to identify distinct subpopulations based on contexts of alcohol use. We also examined if the resulting classes differ in a set of alcohol-related variables that hold promise as potential targets of interventions.

METHOD

Argentinean college students N = 1083; 64 % women; M age = 19.73 ± 3.95) completed an online survey that assessed alcohol outcomes and related variables [motives for substance use, protective behavioral strategies (PBS) and normative perceptions of alcohol use].

RESULTS

Latent Class Analysis identified a 4-classes model for drinking contexts. These classes showed differential patterns of alcohol use (both in terms of frequency and quantity) and also differed in alcohol-related variables. Alcohol use was more prevalent in contexts characterized by the presence of peers, particularly the closest friend, small same-sex or coed groups. Close to 50 % of the sample reported drinking with family members. Students with a high probability of engaging in pregaming and nightclub drinking tend to use more PBS to control how much alcohol is consumed than those who do not drink in these contexts. All the classes significantly differed in their social reasons for drinking and in the number of alcohol-related negative consequences.

CONCLUSIONS

Our findings revealed subpopulations of college students that are heterogeneous regarding contexts of alcohol use, patterns of use and in a number of relevant variables. These distinctive subpopulations require different targeted interventions.

I drink alone: Mechanisms of risk for alcohol problems in solitary drinkers

Although solitary drinking is less common than social drinking, it may be uniquely associated with heavy drinking and alcohol-related problems. There is also evidence that drinking contexts impact both expected and experienced alcohol effects. In particular, solitary drinking may be associated with an increased likelihood of drinking for negative reinforcement (e.g. to relieve stress). The current study examined how drinking context influences tension reduction expectancies and drinking motives, and the extent to which expectancies and motives mediate the link between solitary drinking and alcohol-related problems. We hypothesized that solitary drinking would be associated with greater tension reduction expectancies and coping motives which, in turn, would be associated with more alcohol related problems. Data were from 157 young adult moderate to heavy drinkers (21-30 years of age, 57% male) who completed baseline assessments in an alcohol administration study. A path model in Mplus tested the hypothesized mediated effects. Findings largely supported study hypotheses with significant indirect effects of solitary drinking (but not social drinking) on alcohol problems through stronger tension reduction expectancies and coping motives, though an indirect path through coping motives (but not expectancies) was also identified. Multi-group models by gender and race/ethnicity found that models operated similarly for men and women and for Non-Hispanic Caucasian and Racial/Ethnic Minority participants. The results provide important information about potential mechanisms through which solitary drinking may contribute to alcohol problems. These mechanisms represent potential targets of intervention (e.g. tension reduction expectancies, drinking to cope) for solitary drinkers.

[Patterns of Drinking Behaviors and Predictors of Class Membership among Adolescents in the Republic of Korea: A Latent Class Analysis]

PURPOSE

Despite the high drinking rates and the complexity of drinking behaviors in adolescents, insufficient attention has been paid to their drinking patterns. Therefore, we aimed to identify patterns of adolescent drinking behaviors and factors predicting the distinct subgroups of adolescent drinking behaviors.

METHODS

We analyzed nationally representative secondary data obtained in 2017. Our final sample included 24,417 Korean adolescents who had consumed at least one glass of alcohol in their lifetime. To investigate patterns of drinking behaviors, we conducted a latent class analysis using nine alcohol-related characteristics, including alcohol consumption levels, solitary drinking, timing of drinking initiation, and negative consequences of drinking. Furthermore, we investigated differences in demographics, mental health status, and characteristics of substance use across the latent classes identified in our study. To do so, we used the PROC LCA with COVARIATES statement in the SAS software.

RESULTS

We identified three latent classes of drinking behaviors: current non-drinkers (CND), binge drinkers (BD), and problem drinkers (PD). Compared to the CND class, both BD and PD classes were strongly associated with higher academic year, lower academic performance, higher levels of stress, suicidal ideation, lifetime conventional or electronic cigarette use, and lifetime use of other drugs.

CONCLUSION

Health professionals should develop and implement intervention strategies targeting individual subgroups of drinking behaviors to obtain better outcomes. In particular, health professionals should consider different characteristics across subgroups of adolescent drinking behaviors when developing the interventions, such as poor mental health status and other substance use among binge and problem drinkers.

A systematic review of research on adolescent solitary alcohol and marijuana use in the United States

BACKGROUND AND AIMS

Alcohol use and marijuana use tend to be social activities among adolescents. Some youth use alcohol or marijuana while alone. This article provides a framework for examining the risk factors for and consequences of solitary alcohol and marijuana use, grounded in a motivational model that emphasizes coping with negative emotions, and provides the first systematic review of research on solitary alcohol and marijuana use among middle school- and high school-aged adolescents in the United States.

METHODS

PubMed, PsycINFO and Web of Science were searched. Articles were included if they mention solitary alcohol or marijuana (or illicit drug) use among adolescents aged 12-18 years. Studies on non-human animals, college students, non-English language publications and articles exclusively about solitary tobacco or inhalant use were excluded. Overall, 22 articles were selected.

RESULTS

Prevalence of adolescent solitary alcohol and marijuana use was relatively high (e.g. 14% life-time solitary drinking in the general adolescent population), particularly in high-risk subgroups (e.g. 38.8% life-time solitary drinking in a sample of youth recruited from clinical and community settings). Risk factors for solitary alcohol and marijuana use include earlier onset and heavier use, coping motives, negative emotions and positive expectancies about use. Solitary alcohol and marijuana use are prospectively associated with later substance use disorder (SUD) symptoms, diminished academic performance and perceived health.

CONCLUSIONS

Approximately 1 in 7 adolescents in the US appear to have engaged in solitary alcohol and marijuana use at some point. It is positively associated with extent of drinking and marijuana use, cop;ing motives, negative emotions, and positive expectancies, as well as subsequent SUD symptoms and poor academic and health-related outcomes.

Social Drinking Contexts and Their Influence on Problematic Drinking at Age 30

Aims: Understanding the social contexts in which problematic drinking occurs can inform prevention strategies. In this article, we investigate gender-specific social contexts associated with problematic drinking and depression among adults aged 30 years. Because depression has been consistently linked with harmful alcohol consumption, we will also examine its association with drinking contexts. Methods: We used data from 2490 young adults who completed the 30-year follow-up phase of the Mater-University of Queensland Study of Pregnancy and its Outcomes, a prospective study commenced in 1981. Exploratory and confirmatory factor analyses were used to identify latent constructs of drinking contexts stratified by gender, with subsequent regression analysis to assess the role of these contexts in problematic drinking (measured using the Alcohol Use Disorders Identification Test). Results: Six distinct drinking contexts were identified, which differed by gender, three for men and three for women. For both men and women, "social drinking", was associated with problematic drinking. "Home drinking" was also common to men and women but associations with problematic drinking differed, being risky only among men. "Daytime drinking" (women) was associated with risk but "work-related drinking" (men) was not. Both "home drinking" (men) and "daytime drinking" (women) were linked to depression symptoms. Conclusion: Specific contexts appeared to be associated with problematic drinking for both sexes. Among both men and women, "social drinking" was associated with problematic drinking. Both "home drinking" (men) and "daytime drinking" (women) contexts, were associated with problematic drinking and depressive symptoms. Targeted alcohol-focused interventions need to address co-occurring mental health issues.

Adult substance use as a function of growth in peer use across adolescence and young adulthood in the context of ADHD: Findings from the MTA

Peer substance use strongly predicts adolescent and young adult substance use, but its role in ADHD-related risk for substance use, especially in adulthood, is unclear. In a sample with (n = 516) and without (n = 249) childhood ADHD from the Multimodal Treatment Study of ADHD, we compared associations between change over time in peer substance use and personal substance use (alcohol, cigarettes, marijuana, illicit drugs) from age 14-26 by ADHD status. Developmentally typical peer substance use trajectories across adolescence and young adulthood coincided with similar changes in personal use - but less so for those with ADHD histories. Concurrent associations between peer and personal use in adolescence and young adulthood were weaker for those with ADHD histories than without for commonly used substances (alcohol, marijuana). Prospectively, escalating peer use during adolescence forecasted adulthood declines for commonly used substances, yet persistently high substance use at age 25, regardless of ADHD history. In the reverse direction, growth in adolescent substance use predicted developmentally normative young adult declines in peer use - but for the ADHD group, adolescent heavy drinking predicted increases in young adult peer use. Findings suggest that individuals with ADHD may have difficulty emulating their peers' developmentally normative declines in substance use, highlighting the importance of social factors when treating young adults affected by ADHD and substance abuse.

Context matters: Characteristics of solitary versus social cannabis use

INTRODUCTION AND AIMS

Given the increase in cannabis availability and use in North America, identification of risk factors for cannabis use and dependence is paramount. One factor that may be associated with various cannabis-related adverse outcomes is the context in which it is used. This secondary analysis study sought to examine the extent to which the social context of cannabis use is related to patterns of use and associated harms.

DESIGN AND METHODS

One hundred and eighty-eight adult cannabis users were community-recruited in Halifax, Canada. Participants took part in a face-to-face structured interview where they provided information about the social context of their most recent cannabis-using occasion and about their patterns of, and motives for, cannabis use.

RESULTS

Compared to individuals reporting their most recent cannabis-using occasion as social, solitary users (n = 55) were significantly more likely to screen positive for psychosis, endorse more symptoms of cannabis abuse/dependence, report using cannabis to cope, and use cannabis on more days within the previous 30 days. On the other hand, social users were significantly more likely to report using alcohol in addition to cannabis during their most recent cannabis-using occasion (all P < 0.05).

DISCUSSION AND CONCLUSIONS

Results suggest that solitary cannabis use may be associated with specific motives for use and future adverse consequences. Findings from this study serve as a guide for future investigations which could ultimately inform public policy and the development of targeted harm-reduction strategies.