1
|
Salazar AL, Centanni SW. Sex Differences in Mouse Models of Voluntary Alcohol Drinking and Abstinence-Induced Negative Emotion. Alcohol 2024; 121:45-57. [PMID: 39053705 DOI: 10.1016/j.alcohol.2024.07.004] [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: 04/15/2024] [Revised: 07/03/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024]
Abstract
Alcohol Use Disorder (AUD) is a growing problem worldwide, causing an incredible burden on health and the economy. Though AUD impacts people of all backgrounds and demographics, increasing evidence has suggested robust sex differences in alcohol drinking patterns and AUD-induced negative emotionality or hyperkatifeia. Rates of problematic drinking have significantly risen among women, and women face more severe negative emotional consequences in abstinence such as increased risk of comorbidity with an anxiety or mood disorder and more severe symptoms of depression. As such, a bevy of preclinical literature using contingent methods of alcohol (ethanol) consumption has amassed in recent years to better understand sex as a biological variable in alcohol drinking and abstinence-induced negative emotionality. Mice are widely used to model alcohol drinking, as they are conducive to genetic manipulation strategies, and many strains will voluntarily consume alcohol. Sex-specific results from these mouse studies, however, have been inconsistent. Therefore, this review aims to summarize the current knowledge on sex differences in AUD-related contingent ethanol drinking and abstinence-induced negative emotionality in mice. Various contingent mouse drinking models and negative emotional-based behavioral paradigms are introduced and subsequently discussed in the context of sex differences to show increasing indications of sex specificity in mouse preclinical studies of AUD. With this review, we hope to inform future research on potential sex differences in preclinical mouse models of AUD and provide mounting evidence supporting the need for more widespread inclusion of preclinical female subjects in future studies.
Collapse
Affiliation(s)
- Amanda L Salazar
- Department of Translational Neuroscience, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA
| | - Samuel W Centanni
- Department of Translational Neuroscience, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA.
| |
Collapse
|
2
|
Fodstad EC, Erga AH, Pallesen S, Ushakova A, Erevik EK. Personality traits as predictors of recovery among patients with substance use disorder. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 162:209360. [PMID: 38631658 DOI: 10.1016/j.josat.2024.209360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 02/22/2024] [Accepted: 04/07/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION Substance use disorder (SUD) is often considered a chronic illness in which prolonged recovery, in terms of abstinence, is uncommon. Personality has been found to predict recovery, but not much is known about its long-term predictive ability as the majority of previous studies have had short follow-up periods (≥ one year). The current longitudinal cohort study therefore investigated whether personality traits predict short- (STR) as well as long-term recovery (LTR) in SUD patients. METHODS Treatment-seeking patients with SUD (n = 123) completed the NEO Personality Inventory - Revised. STR and LTR categories were defined as scoring <8 on the Alcohol Use Disorders Identification Test - C and <2 on the Drug Use Disorder Identification Test - C at the one-year and 6-8-year follow-up, respectively. Whether personality traits predicted outcome was investigated by two-tailed independent samples t-tests, α < 0.05. Additional analysis was conducted with latent growth curve model. RESULTS Neuroticism (inversely, p = .004, d = 0.55) and Extraversion (p = .04, d = 0.38) predicted STR (n = 114). Although not significant the effect size for Conscientiousness was above the cut-off for a practical significant effect (d = 0.31). No traits predicted LTR category. Still, the effect sizes for LTR regarding Neuroticism (d = 0.36), Extraversion (d = 0.21) and Conscientiousness (d = 0.27) indicated that these traits have relevance for LTR. The latent growth curve model indicated that these traits predicted the short-term use of drugs and long-term use of alcohol in this cohort dominated by patients suffering from severe poly-SUD. CONCLUSION Personality traits predict recovery. The effect sizes indicate that more studies with larger samples on personality traits and LTR are required to understand their possible influences on the recovery process.
Collapse
Affiliation(s)
- Elise Constance Fodstad
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway; Centre for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway.
| | - Aleksander Hagen Erga
- Centre for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway; Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Anastasia Ushakova
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway
| | - Eilin Kristine Erevik
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| |
Collapse
|
3
|
Lewis C, Fischer IC, Tsai J, Harpaz-Rotem I, Pietrzak RH. Barriers to Mental Health Care in US Military Veterans. Psychiatr Q 2024:10.1007/s11126-024-10078-7. [PMID: 38940875 DOI: 10.1007/s11126-024-10078-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/02/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Military veterans often encounter multiple obstacles to mental health care, such as stigma, practical barriers (e.g., high cost), and negative beliefs about mental health care. To date, however, nationally representative data on the prevalence and key correlates of these barriers to care are lacking. Such data are critical to informing population-based efforts to reduce barriers and promote engagement in mental health treatment in this population. METHODS Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed 4,069 US veterans, 531 (weighted 15.0%) of whom screened positive for a mental disorder but never received mental health treatment. Multivariable logistic regression and relative importance analyses were conducted to identify key predisposing, enabling, and need-based factors associated with endorsement of stigma, instrumental barriers, and negative beliefs about mental health care. RESULTS A total 47.1% of veterans endorsed any barrier to care, with 38.7% endorsing instrumental barriers to care, 28.8% perceived stigma, and 22.0% negative beliefs about mental health care. Lower purpose in life, grit, and received social support were most consistently associated with these barriers to care. CONCLUSIONS Nearly half of US veterans with psychiatric need and no history of mental health treatment report barriers to care. Modifiable characteristics such as a low purpose in life, grit, and received support were associated with endorsement of these barriers. Results may help inform resource allocation, as well as prevention, psychoeducation, and treatment efforts to help reduce barriers and promote engagement with mental health services in this population.
Collapse
Affiliation(s)
- Connor Lewis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
| | - Ian C Fischer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Jack Tsai
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs, National Center on Homelessness Among Veterans, Washington, DC, USA
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| |
Collapse
|
4
|
Stefanovics EA, Potenza MN, Tsai J. Prevalence and Clinical Characteristics of Recreational and At-Risk/Problematic Gambling Among Low-Income U.S. Veterans: Results from the National Veteran Homeless and Other Poverty Experiences (NV-HOPE) Study. J Gambl Stud 2024; 40:915-935. [PMID: 37751035 DOI: 10.1007/s10899-023-10257-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
This study examined associations between recreational gambling (RG) and at-risk/problem gambling (ARPG), and clinical measures of mental illness and substance use, functionality, homelessness, in a nationally representative sample of U.S. military veterans. Data were analyzed from 781 veterans who participated National Veteran Homeless and Other Poverty Experiences (NV-HOPE) study conducted in 2021. Chi-square tests, analyses of variance (ANOVAs) and logistic regressions analyses were conducted to examine unadjusted and adjusted associations between gambling group status and sociodemographic, psychiatric, substance use, functioning, and homelessness measures. A significant minority of low-income U.S. veterans reported gambling, with 24.9% (95% confidence interval [CI] 95% CI 21.12-28.76%) exhibiting RG and 6.7% (95% CI 3.88-9.42%) screening positive for ARPG. The prevalence of ARPG was higher among younger, non-White veterans. ARPG was associated with greater symptoms of substance use and anxiety; poorer physical functioning; history of any mental illness; lifetime history of homelessness; and having any student or car loans relative to NG. Veterans who had RG were more likely to screen positive for drug use disorders relative to NG. Results of the current study provide an up-to-date estimate of the current prevalence of RG and ARPG among low-income U.S. veterans and underscore the importance of routine screening, monitoring, and development of interventions for problematic gambling severity, as well as interventions for ARPG in this population. These findings may inform targeted intervention strategies for this vulnerable subpopulation.
Collapse
Affiliation(s)
- Elina A Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center (MIRECC), VA Connecticut Healthcare System (116A-4), 950 Campbell Avenue, Building 36, West Haven, CT, 06516, USA.
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, FL, USA.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Yale Child Study Center, Yale University, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Jack Tsai
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, FL, USA
- Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| |
Collapse
|
5
|
Rivera-Irizarry JK, Zallar LJ, Levine OB, Skelly MJ, Boyce JE, Barney T, Kopyto R, Pleil KE. Sex differences in binge alcohol drinking and the behavioral consequences of protracted abstinence in C57BL/6J mice. Biol Sex Differ 2023; 14:83. [PMID: 37957762 PMCID: PMC10644501 DOI: 10.1186/s13293-023-00565-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/18/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Binge alcohol drinking is a risk factor linked to numerous disease states including alcohol use disorder (AUD). While men binge drink more alcohol than women, this demographic gap is quickly shrinking, and preclinical studies demonstrate that females consistently consume more alcohol than males. Further, women are at increased risk for the co-expression of AUD with neuropsychiatric diseases such as anxiety and mood disorders. However, little is understood about chronic voluntary alcohol drinking and its long-term effects on behavior. Here, we sought to characterize sex differences in chronic binge drinking and the effects of protracted alcohol abstinence on anxiety- and affective-related behaviors in males and females. METHODS We assessed binge alcohol drinking patterns in male and female C57BL/6J mice using a modified Drinking in the Dark (DID) paradigm in which mice received home cage access to one bottle of 10% or 20% alcohol (EtOH) or water for 2 h per day on Days 1-3 and to two bottles (EtOH/H2O + H2O) for 24 h on Day 4 for 8 weekly cycles. Mice were then tested for the effects of protracted abstinence on avoidance, affective, and compulsive behaviors. RESULTS Female mice consumed more alcohol than males consistently across cycles of DID and at 2, 4, and 24-h timepoints within the day, with a more robust sex difference for 20% than 10% EtOH. Females also consumed more water than males, an effect that emerged at the later time points; this water consumption bias diminished when alcohol was available. Further, while increased alcohol consumption was correlated with decreased water consumption in males, there was no relationship between these two measures in females. Alcohol preference was higher in 10% vs. 20% EtOH for both sexes. During protracted abstinence following chronic binge drinking, mice displayed decreased avoidance behavior (elevated plus maze, open field, novelty suppressed feeding) and increased compulsive behavior (marble burying) that was especially robust in females. There was no effect of alcohol history on stress coping and negative affective behaviors (sucrose preference, forced swim test, tail suspension) in either sex. CONCLUSION Female mice engaged in higher volume binge drinking than their male counterparts. Although females also consumed more water than males, their higher alcohol consumption was not driven by increased total fluid intake. Further, the effects of protracted abstinence following chronic binge drinking was driven by behavioral disinhibition that was more pronounced in females. Given the reciprocal relationship between risk-taking and alcohol use in neuropsychiatric disease states, these results have implications for sex-dependent alcohol drinking patterns and their long-term negative neuropsychiatric/physiological health outcomes in humans.
Collapse
Affiliation(s)
- Jean K Rivera-Irizarry
- Neuroscience Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Lia J Zallar
- Pharmacology Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Olivia B Levine
- Neuroscience Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Mary Jane Skelly
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Psychology Department, Iona University, New Rochelle, NY, USA
| | - Jared E Boyce
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Medical Scientist Training Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Thaddeus Barney
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Ruth Kopyto
- Pharmacology Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Kristen E Pleil
- Neuroscience Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA.
- Pharmacology Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA.
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA.
| |
Collapse
|
6
|
Rivera-Irizarry JK, Zallar LJ, Levine OB, Skelly MJ, Boyce JE, Barney T, Kopyto R, Pleil KE. Sex differences in binge alcohol drinking and the behavioral consequences of protracted abstinence in C57BL/6J mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.12.540565. [PMID: 37808817 PMCID: PMC10557617 DOI: 10.1101/2023.05.12.540565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Background Binge alcohol drinking is a risk factor linked to numerous disease states including alcohol use disorder (AUD). While men binge drink more alcohol than women, this demographic gap is quickly shrinking, and preclinical studies demonstrate that females consistently consume more alcohol than males. Further, women are at increased risk for the co-expression of AUD with neuropsychiatric diseases such as anxiety and mood disorders. However, little is understood about chronic voluntary alcohol drinking and its long-term effects on behavior. Here, we sought to characterize sex differences in chronic binge drinking and the effects of protracted alcohol abstinence on anxiety- and affective-related behaviors in males and females. Methods We assessed binge alcohol drinking patterns in male and female C57BL/6J mice using a modified Drinking in the Dark (DID) paradigm in which mice received home cage access to one bottle of 10% or 20% alcohol (EtOH) or water for 2 hrs per day on Days 1-3 and to two bottles (EtOH/H2O + H2O) for 24 hrs on Day 4 for eight weekly cycles. Mice were then tested for the effects of protracted abstinence on avoidance, affective, and compulsive behaviors. Results Female mice consumed more alcohol than males consistently across cycles of DID and at 2, 4, and 24-hr timepoints within the day, with a more robust sex difference for 20% than 10% EtOH. Females also consumed more water than males, an effect that emerged at the later time points; this water consumption bias diminished when alcohol was available. Further, while increased alcohol consumption was correlated with decreased water consumption in males, there was no relationship between these two measures in females. Alcohol preference was higher in 10% vs. 20% EtOH for both sexes. During protracted abstinence following chronic binge drinking, mice displayed decreased avoidance behavior (elevated plus maze, open field, novelty suppressed feeding) and increased compulsive behavior (marble burying) that was especially robust in females. There was no effect of alcohol history on stress coping and negative affective behaviors (sucrose preference, forced swim test, tail suspension) in either sex. Conclusion Female mice engaged in higher volume binge drinking than their male counterparts. Although females also consumed more water than males, their higher alcohol consumption was not driven by increased total fluid intake. Further, the effects of protracted abstinence following chronic binge drinking was driven by behavioral disinhibition that was more pronounced in females. Given the reciprocal relationship between risk-taking and alcohol use in neuropsychiatric disease states, these results have implications for sex-dependent alcohol drinking patterns and their long-term negative neuropsychiatric/physiological health outcomes in humans.
Collapse
Affiliation(s)
- Jean K Rivera-Irizarry
- Neuroscience Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Lia J Zallar
- Pharmacology Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Olivia B Levine
- Neuroscience Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Mary Jane Skelly
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Jared E Boyce
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Thaddeus Barney
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Ruth Kopyto
- Pharmacology Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Kristen E Pleil
- Neuroscience Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Pharmacology Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| |
Collapse
|
7
|
Hochheimer M, Glick JL, Garrison-Desany H, Huhn AS. Transgender individuals are at higher risk for suicidal ideation and preparation than cisgender individuals in substance use treatment. Front Psychiatry 2023; 14:1225673. [PMID: 37779622 PMCID: PMC10535091 DOI: 10.3389/fpsyt.2023.1225673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/14/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction This study describes the differences and similarities in mental health, substance use, and substance use treatment outcomes between people presenting for SUD treatment who identified as transgender and those who identified as cisgender men or women. Methods We compared 64 individuals who self-identified as transgender and presented for SUD treatment to samples of cisgender men and women (separately) matched based on propensity scores which were created based on sociodemographic factors known to influence both the nature of substance use and patterns of treatment engagement including age, education, race, stable housing, and employment status. Comparisons were made using χ2 tests and t-tests in over 150 variables collected at treatment intake regarding physical and mental health, substance use patterns, events that led to treatment, reasons for seeking treatment, and treatment outcomes. Results The transgender sample endorsed six of the seven suicide-related items more often than at least one of the cisgender-matched samples. Furthermore, the transgender sample remained in treatment significantly longer (M = 32.3, SD = 22.2) than the cisgender male sample (M = 19.5, SD = 26.1, t = 2.17, p = 0.03). Discussion This study is a first step into understanding gender minority population experiences during SUD treatment. While there was no significant difference between the cisgender and transgender samples on most variables, there was an elevated prevalence of suicidal ideation and behaviors in the transgender sample, which warrants further investigation.
Collapse
Affiliation(s)
- Martin Hochheimer
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Jennifer L. Glick
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Henri Garrison-Desany
- Department of Social and Behavioral Science, Harvard University T.H. Chan School of Public Health, Boston, MA, United States
| | - Andrew S. Huhn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| |
Collapse
|
8
|
Muñoz-Galán R, Lana-Lander I, Coronado M, Segura L, Colom J. Association between Cannabis Use Disorder and Mental Health Disorders in the Adolescent Population: A Cohort Study. Eur Addict Res 2023; 29:344-352. [PMID: 37586355 PMCID: PMC10614238 DOI: 10.1159/000530331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 03/16/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION According to the literature, early initiation to cannabis use and a dependent pattern of use are important risk factors for the development of mental health disorders. However, there are few cohort studies which look at the development of mental health disorders associated with cannabis use among young people with cannabis use disorder (CUD). The aim of the study was to determine the cumulative incidence of mental health disorders and the risk of developing mental health disorders among minors who commenced treatment for CUD in Catalonia during 2015-2019. METHODS This was a retrospective fixed cohort study, matched for confounding variables, based on data from the Catalan Health Surveillance System. The exposed cohort comprised young people who entered treatment for CUD during 2015-2019 (n = 948) and who were minors on the date of commencing treatment. Matching was done with a paired cohort (n = 4,737), according to confounding variables. Individuals with a diagnosis of a mental health disorder prior to the study period were excluded. The cumulative incidence was calculated for mental health disorders for the exposed and the paired cohorts and stratified by type of mental disorder. Incidence rate ratios were estimated using the conditional Poisson model with robust variance, stratified by sex. RESULTS The cumulative incidence for development of a mental health disorder was 19.6% in the exposed cohort and 3.1% in the paired cohort; with higher incidence among females (females 32.7%; males 15.8%). The exposed cohort had an 8.7 times increased risk of developing a mental health disorder than the paired cohort. The most frequent diagnoses were reaction to severe stress, adjustment disorder, and personality disorders. CONCLUSION This study confirmed that the exposed cohort was at increased risk of developing mental health disorders compared to the paired cohort. To date, few studies have analyzed the association between cannabis use and the development of mental health disorders, considering cannabis dependence. Further studies should be undertaken considering CUD. In addition, more studies are needed to understand the factors that determine the development of CUD. Further research in these areas would contribute to the design of prevention strategies aimed at those young individuals with a higher risk of developing cannabis dependence and suffering its consequences.
Collapse
Affiliation(s)
- Regina Muñoz-Galán
- Public Health Agency of Catalonia, Department of Health, Government of Catalonia, Programme on Addictions, HIV, STI and Viral Hepatitis, Barcelona, Spain
| | - Irene Lana-Lander
- Public Health Agency of Catalonia, Department of Health, Government of Catalonia, Programme on Addictions, HIV, STI and Viral Hepatitis, Barcelona, Spain
| | - Marta Coronado
- Public Health Agency of Catalonia, Department of Health, Government of Catalonia, Programme on Addictions, HIV, STI and Viral Hepatitis, Barcelona, Spain
| | - Lidia Segura
- Public Health Agency of Catalonia, Department of Health, Government of Catalonia, Programme on Addictions, HIV, STI and Viral Hepatitis, Barcelona, Spain
| | - Joan Colom
- Public Health Agency of Catalonia, Department of Health, Government of Catalonia, Programme on Addictions, HIV, STI and Viral Hepatitis, Barcelona, Spain
| |
Collapse
|
9
|
Hanson JD, Harris A, Gilbertson RJ, Charboneau M, O'Leary M. Feasibility and Acceptability of Using Ecological Momentary Assessment to Evaluate Alcohol Use with American Indian Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6071. [PMID: 37372658 DOI: 10.3390/ijerph20126071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/24/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Ecological momentary assessments (EMA) are one way to collect timely and accurate alcohol use data, as they involve signaling participants via cell phones to report on daily behaviors in real-time and in a participant's natural environment. EMA has never been used with American Indian populations to evaluate alcohol consumption. The purpose of this project was to determine the feasibility and acceptability of EMA for American Indian women. METHODS Eligible participants were American Indian women between the ages of 18 and 44 who were not pregnant and had consumed more than one drink within the past month. All participants received a TracFone and weekly automated messages. Self-reported measures of daily quantity and frequency of alcohol consumption, alcohol type, and context were assessed once per week for four weeks. Baseline measurements also included the Drinking Motives Questionnaire-Revised (DMQ-R) and the Interpersonal Support Evaluation List (ISEL). RESULTS Fifteen participants were enrolled in the study. All but one participant completed all data collection time points, and drinking patterns were consistent across the study period. A total of 420 records were completed across 86 drinking days and 334 non-drinking days. Participants reported drinking an average of 5.7 days over the 30-day period and typically consumed 3.99 drinks per drinking occasion. Sixty-six percent of participants met gender-specific cut-points for heavy episodic drinking, with an average of 2.46 binge drinking occasions across the four week study period. CONCLUSIONS This proof-of-concept project showed that EMA was both feasible and acceptable for collecting alcohol data from American Indian women. Additional studies are necessary to fully implement EMA with American Indian women to better understand the drinking motives, contexts, patterns, and risk factors in this population.
Collapse
Affiliation(s)
- Jessica D Hanson
- Department of Applied Human Sciences, University of Minnesota Duluth, 1216 Ordean Court, Duluth, MN 55812, USA
| | - Amy Harris
- Department of Applied Human Sciences, University of Minnesota Duluth, 1216 Ordean Court, Duluth, MN 55812, USA
| | - Rebecca J Gilbertson
- Department of Psychology, University of Minnesota Duluth, 1216 Ordean Court, Duluth, MN 55812, USA
| | - Megan Charboneau
- Missouri Breaks Industries Research Inc, 118 Willow Street, Eagle Butte, SD 57625, USA
| | - Marcia O'Leary
- Missouri Breaks Industries Research Inc, 118 Willow Street, Eagle Butte, SD 57625, USA
| |
Collapse
|
10
|
Weidberg S, González-Roz A, Castaño Y, Secades-Villa R. Emotion dysregulation in relation to cannabis use and mental health among young adults. Addict Behav 2023; 144:107757. [PMID: 37224581 DOI: 10.1016/j.addbeh.2023.107757] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Emotion dysregulation (ED) is a transdiagnostic variable that accounts for the onset and maintenance of mental health disorders. The interplay between ED, cannabis use and mental health has not been appraised in the young adult population and whether there are sex-dependent effects has yet to be examined. This study looked at whether ED mediates the association between past-month cannabis use and mental health, while considering sex as a moderator. METHODS 2,762 (64.2% women) undergraduate Spanish students completed an online battery. Among others, they fulfilled the Depression Anxiety Stress Scale-21 (DASS-21) and the Difficulties in Emotion Regulation Scale (DERS-28). A two-way ANOVA assessed the effects of sex and past-month cannabis use on participants' DASS-21 scores. A set of moderated mediations tested whether the indirect effect of past-month cannabis use on DASS-21 through DERS differed by sex. RESULTS Past-month cannabis female users showed higher levels of depression, anxiety and stress (M = 51.10, SD = 26.72) than did men [(M = 33.76, SD = 20.31); F(1, 2758) = 5.119, p =.024, η2p =.002]. In female young adults only, the effect of past-month cannabis use on mental health was mediated by ED (total score), non-acceptance of emotional responses, lack of emotional control, difficulties in engaging in goal-directed behavior, and lack of emotional clarity (all p's < 0.005) CONCLUSIONS: Findings indicate the importance of considering ED in assessment and intervention practices. Interventions targeting ED may be particularly effective for female young adult cannabis users.
Collapse
Affiliation(s)
- Sara Weidberg
- Department of Psychology. Addictive Behaviors Research Group (GCA), University of Oviedo. Plaza Feijoo s/n, 33003, Oviedo, Spain
| | - Alba González-Roz
- Department of Psychology. Addictive Behaviors Research Group (GCA), University of Oviedo. Plaza Feijoo s/n, 33003, Oviedo, Spain.
| | - Yasmina Castaño
- Department of Psychology. University of the Balearic Islands. Ctra. Valldemossa, km 7.5, 07122, Palma, Spain
| | - Roberto Secades-Villa
- Department of Psychology. Addictive Behaviors Research Group (GCA), University of Oviedo. Plaza Feijoo s/n, 33003, Oviedo, Spain
| |
Collapse
|
11
|
Levy BR, Pietrzak RH, Slade MD. Societal impact on older persons' chronic pain: Roles of age stereotypes, age attribution, and age discrimination. Soc Sci Med 2023; 323:115772. [PMID: 36965204 PMCID: PMC10763575 DOI: 10.1016/j.socscimed.2023.115772] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 02/01/2023] [Accepted: 02/10/2023] [Indexed: 03/12/2023]
Abstract
RATIONALE In view of the severity and prevalence of chronic pain, combined with the limited success of long-term treatments, there is the need for a more expansive understanding of its etiology. We therefore investigated over time three societal-based potential determinants of chronic pain that were previously unexamined in this connection: negative age stereotypes, age attribution, and age discrimination. METHODS The cohort consisted of 1373 Americans aged 55 and older, who participated in four waves of the National Health and Resilience in Veterans Study, spanning seven years. RESULTS Consistent with the hypotheses, negative age stereotypes as well as age discrimination predicted chronic pain, and age attribution acted as a mediator between the negative age stereotypes and chronic pain. In a subset of participants who were free of chronic pain at baseline, those who had assimilated negative age stereotypes were 32% more likely to develop chronic pain in the next seven years than those who had assimilated positive age stereotypes. CONCLUSION Our finding that the three societal-based and modifiable predictors contributed to chronic pain refutes the widely held belief that chronic pain experienced in later life is entirely and inevitably a consequence of aging.
Collapse
Affiliation(s)
- Becca R Levy
- Social and Behavioral Science Department, Yale School of Public Health, USA; Psychology Department, Yale University, USA.
| | - Robert H Pietrzak
- Social and Behavioral Science Department, Yale School of Public Health, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, USA; Department of Psychiatry, Yale School of Medicine, USA
| | - Martin D Slade
- Department of Internal Medicine, Yale School of Medicine, USA
| |
Collapse
|
12
|
Cusack SE, Wright AW, Amstadter AB. Resilience and alcohol use in adulthood in the United States: A scoping review. Prev Med 2023; 168:107442. [PMID: 36736834 PMCID: PMC9974891 DOI: 10.1016/j.ypmed.2023.107442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
High levels of alcohol use and the development of alcohol use disorder (AUD) are associated with various adverse consequences. Resilience has been proposed as a protective factor against increased alcohol use, though the existing research is limited by inconsistencies in the conceptualization and measurement of resilience. As such, the current scoping review examined 14 studies on individual, trait-level resilience as a protective factor against alcohol use and related consequences in adults over the age of 21 in the United States. Findings from the included studies generally suggest resilience as a protective factor against various outcomes, though methodological limitations should be considered. Although future research in this area should improve upon methodological limitations, the present review suggests clinical implications of resilience as beneficial in prevention and intervention programming for alcohol use outcomes.
Collapse
Affiliation(s)
- Shannon E Cusack
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, United States of America.
| | - Anna W Wright
- Department of Psychiatry, Virginia Commonwealth University, United States of America
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, United States of America; Department of Psychiatry, Virginia Commonwealth University, United States of America; Department of Psychology, Virginia Commonwealth University, United States of America; Department of Human and Molecular Genetics, Virginia Commonwealth University, United States of America
| |
Collapse
|
13
|
Fodstad EC, Ushakova A, Pallesen S, Hagen E, Erga AH, Erevik EK. Personality and substance use disorder: Characteristics as measured by NEO-personality inventory–revised. Front Psychol 2022; 13:982763. [PMID: 36420387 PMCID: PMC9676467 DOI: 10.3389/fpsyg.2022.982763] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
The present study investigates the personality characteristics of a cohort of patients with Substance Use Disorders. The included participants (n = 123) were recruited from specialized treatment for addictions in Norway. The personality scores in the current sample were compared to the Norwegian norm sample with t-tests. Age and gender differences in personality scores were assessed by bivariate correlation analyses and t-tests, respectively. The sample had higher scores on Neuroticism and lower scores on Conscientiousness, Agreeableness, Extraversion, and Openness compared to the norm sample (p < 0.01). The effect sizes of the differences between the current sample and the Norwegian norm sample were large for Neuroticism and Conscientiousness. Older participants scored higher on Agreeableness and its facets A1: Trust and A2: Straightforwardness and lower on the facet E5: Excitement-Seeking (p < 0.01). No significant (p < 0.01) gender differences in NEO-PI-R scores were found. In conclusion, the current results support previous findings regarding personality traits associated with SUD. The clinical relevance of the findings is discussed.
Collapse
Affiliation(s)
- Elise Constance Fodstad
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
- Centre for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway
- *Correspondence: Elise Constance Fodstad,
| | - Anastasia Ushakova
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Egon Hagen
- Centre for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway
| | - Aleksander Hagen Erga
- Centre for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Eilin Kristine Erevik
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| |
Collapse
|
14
|
Obesity in Latinx and White U.S. military veterans: prevalence, physical health, and functioning. J Psychiatr Res 2022; 155:163-170. [PMID: 36030571 DOI: 10.1016/j.jpsychires.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/03/2022] [Accepted: 08/16/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE While Latinx Americans in the general population are more likely to have obesity than non-Hispanic Whites, limited research has examined ethnic differences in obesity and its correlates among military veterans. To address this gap, we examined the prevalence, physical health and functional correlates of obesity in a population-based sample of Latinx and White U.S. military veterans. METHODS Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of veterans. Bivariate and multivariate analyses were conducted to evaluate the relation between obesity, and health and functioning measures in Latinx and White veterans. RESULTS The prevalence of obesity was significantly higher among Latinx veterans (weighted 43.6% vs. 35.5%; odds ratio (OR) = 1.4, 95% confidence interval (CI) = 1.10-1.81). While obesity was associated with a greater number of medical conditions, reduced functioning, higher somatic symptoms, and insomnia severity in both Latinx and White veterans, these differences were more pronounced in Latinx relative to White veterans, with higher rates of arthritis, liver disease, diabetes, high blood pressure and cholesterol, heart attack, stroke, migraine, and physical disability, and greater physical, mental, and psychosocial dysfunction. CONCLUSION Obesity is more prevalent in Latinx than in White U.S. veterans, and the associated elevated health and functional impairments are more pronounced in Latinx veterans. Characterization of co-occurring physical and functioning problems among Latinx and White veterans with obesity may help inform ethnically-sensitive obesity prevention and treatment efforts in this population.
Collapse
|
15
|
Sánchez-Peña JF, Jáñez-Álvarez M, Álvarez-Cotoli PG, García-Laredo E. Dual diagnosis in immigrant patients with alcohol use disorder: 2-years of follow-up treatment. ACTAS ESPANOLAS DE PSIQUIATRIA 2022; 50:276-286. [PMID: 36622715 PMCID: PMC10803857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 01/10/2023]
Abstract
There is a high prevalence of comorbid psychiatric disorders in alcohol abuse disorder. The presence of dual diagnosis in patients decreases the maintenance of abstinence and increases the likelihood of relapse, which makes treatment more complicated.
Collapse
|
16
|
Lespine LF, Bramness JG, Pignon B, Vaiva G, Thomas P, Roelandt JL, Benradia I, Amad A, Geoffroy PA, Rolland B. Gender-related associations between psychiatric disorders and alcohol use disorder: Findings from the french "Mental health in the general population" survey. Arch Womens Ment Health 2022; 25:895-902. [PMID: 36083520 DOI: 10.1007/s00737-022-01253-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/03/2022] [Indexed: 11/26/2022]
Abstract
Women with alcohol use disorder (AUD) might be particularly vulnerable to psychiatric comorbidities. However, population surveys have yielded disparate findings. We used data from the French Mental Health in the General Population survey to investigate gender-related risks of psychiatric comorbidities associated with AUD. A cross-sectional survey based on face-to-face interviews, including the Mini International Neuropsychiatric Interview, was conducted among 38,717 subjects. Logistic regression models were used to assess risks of psychiatric comorbidities associated with AUD. After adjustment for socio-demographics and other psychiatric disorders, both women and men with AUD were at higher risk of comorbid depressive disorder (odds ratio [OR] = 2.6, 95% confidence interval [CI]: 2.0-3.4 in women, and OR = 2.0, 95% CI: 1.7-2.4 in men), bipolar I disorder (2.5; 1.4-4.4 in women vs. 2.6; 1.9-3.4 in men), and psychotic disorder (1.6; 1.01-2.5 in women vs. 1.8; 1.4-2.3 in men). Women with AUD exhibited an increased risk of comorbid panic disorder (OR = 1.6, 95% CI: 1.1-2.2) while the increased risk of post-traumatic stress disorder (PTSD) was significant in men only (OR = 2.6, 95% CI: 1.6-4.2). The increased risk of comorbid substance use disorder (SUD) was more elevated in women, compared to men (12.9; 8.1-18.1 vs. 4.8; 4.0-5.8 in men). Most of psychiatric conditions were over-represented in both women and men with AUD, relative to controls. Gender-specific findings were that women with AUD had an increased risk of comorbid SUD or panic disorder, while men had a significantly higher risk of comorbid PTSD.
Collapse
Affiliation(s)
- Louis-Ferdinand Lespine
- Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, Centre Hospitalier Le Vinatier, 95 Bd Pinel, 69500, Bron, France.
- UCBL1, INSERM, U1028, CNRS, UMR5292, CRNL, PSYR2, Lyon, France.
| | - Jørgen G Bramness
- Institute of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
- Norwegian National Advisory Unit On Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Baptiste Pignon
- DMU IMPACT, Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires « H. Mondor», Fondation FondaMental, Créteil, France
| | - Guillaume Vaiva
- Lille Neuroscience & Cognition (LilNCog), Université Lille, Inserm, CHU Lille, U1172, 59000, Lille, France
| | - Pierre Thomas
- Centre National de Ressources & Résilience Pour Les Psychotraumatismes (Cn2r Lille Paris), 59000, Lille, France
| | - Jean-Luc Roelandt
- Centre Collaborateur de L'Organisation Mondiale de La Santé Pour La Recherche Et La Formation en Santé Mentale, EPSM Lille Métropole, 211 rue Roger Salengro, 59 260, Hellemmes, France
- ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Imane Benradia
- Centre Collaborateur de L'Organisation Mondiale de La Santé Pour La Recherche Et La Formation en Santé Mentale, EPSM Lille Métropole, 211 rue Roger Salengro, 59 260, Hellemmes, France
- ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Ali Amad
- Centre National de Ressources & Résilience Pour Les Psychotraumatismes (Cn2r Lille Paris), 59000, Lille, France
| | - Pierre-Alexis Geoffroy
- Service de Psychiatrie Et dAddictologie, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Bichat, Paris, France
- Université de Paris, Inserm, 75019, NeuroDiderot, Paris, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, Centre Hospitalier Le Vinatier, 95 Bd Pinel, 69500, Bron, France
- UCBL1, INSERM, U1028, CNRS, UMR5292, CRNL, PSYR2, Lyon, France
| |
Collapse
|
17
|
Crum RM, Green KM, Amin-Esmaeili M, Susukida R, Mojtabai R, Storr CL, Riehm KE, Young AS, Reboussin BA. The role of mood disorders in the progression of and recovery from alcohol and drug use problems: A latent transition analysis. Drug Alcohol Depend 2022; 238:109566. [PMID: 35917762 PMCID: PMC10187057 DOI: 10.1016/j.drugalcdep.2022.109566] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 06/29/2022] [Accepted: 07/03/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Longitudinal research assessing whether mood disorders predict substance use behaviors is limited. We extend our prior work evaluating transition patterns with alcohol use to assess patterns with alcohol and drug use problems. METHOD Using National Epidemiologic Survey on Alcohol and Related Conditions prospective data, waves 1 and 2, we completed latent class analyses to empirically define classes of alcohol and drug problems from DSM disorder criteria. Latent transition analyses were used to assess associations of lifetime mood disorders at baseline with transitions across classes of alcohol and drug problems during follow-up. RESULTS A three-class model of alcohol and drug problems was identified (No problems, Alcohol Problems Only, and Alcohol and Drug Problems) for males and females. Females with mood disorders were over two times more likely to transition from No Problems, and Alcohol Problems Only at baseline to having both Alcohol and Drug Problems at follow-up relative to those without mood disorders (aOR=2.30, 95 % CI=1.31-4.05, p = 0.004, and aOR=2.64, CI=1.24-5.62, p = 0.011, respectively). Furthermore, females with mood disorders were significantly less likely to recover from baseline Alcohol and Drug Problems to Alcohol Problems Only at follow-up (aOR=0.35, CI=0.12-0.98, p = 0.047) relative to those without mood disorders. There were no significant findings for males. DISCUSSION Our study provides evidence that mood disorders impact transitions through classes of alcohol and drug problems among females. The findings emphasize the need for ongoing evaluation of substance use among those with mood conditions, and recognition and treatment of mood disorders among those recovering from substance use problems.
Collapse
Affiliation(s)
- Rosa M Crum
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Kerry M Green
- Department of Behavioral and Community Health, University of Maryland College Park School of Public Health, College Park, MD, USA
| | - Masoumeh Amin-Esmaeili
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ryoko Susukida
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ramin Mojtabai
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Carla L Storr
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Kira E Riehm
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Andrea S Young
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
18
|
Paiva-Santos MA, Leão AHFF, Kurita JPF, Becegato MS, Lima AC, Bioni VS, Meurer YSR, Cunha DMG, Medeiros AM, Silva RH. Sex differences in the acute ethanol effects on object recognition memory: influence of estrous cycle. Behav Pharmacol 2022; 33:322-332. [PMID: 35502955 DOI: 10.1097/fbp.0000000000000680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Effects of acute ethanol (EtOH) on memory depend on several factors, including type of behavioral task. Sex differences in EtOH effects have been reported in humans and animals, and recognition memory can be influenced by circulating sex hormones. The aim of this study was to investigate the influence of sex and estrous cycle in the acute effects of EtOH on novel object recognition memory in rats. Male and female Wistar rats were part of one of the groups: control, 0.6-g/kg EtOH and 1.8-g/kg EtOH (administered intraperitoneally before the training session). The estrous cycle was evaluated by vaginal smear. The task was conducted in an open field arena. During training, animals were exposed to two identical objects, and test sessions were performed 1 h (short-term) and 24 h (long-term) later. One of the objects was changed in each test. Increased novel object exploration was shown by male and female controls in the short- and long-term tests, respectively. In the short-term test, females did not show preference for the novel object, and EtOH 1.8 g/kg impaired performance in males. In the long-term test, both sexes showed object discrimination, and 1.8-g/kg EtOH reduced preference for the new object in male rats. The phase of the cycle, the performance on proestrus was worse compared with other phases, and EtOH failed to impair performance mainly on estrous. In conclusion, while male rats displayed ethanol-induced recognition memory deficit, female rats were unaffected by EtOH impairing effects. In addition, the performance of female rats was influenced by the estrous cycle phases.
Collapse
Affiliation(s)
| | | | - João P F Kurita
- Department of Pharmacology, Universidade Federal de São Paulo, São Paulo
| | - Marcela S Becegato
- Department of Pharmacology, Universidade Federal de São Paulo, São Paulo
| | - Alvaro C Lima
- Department of Pharmacology, Universidade Federal de São Paulo, São Paulo
| | - Vinicius S Bioni
- Department of Pharmacology, Universidade Federal de São Paulo, São Paulo
| | - Ywlliane S R Meurer
- Memory and Cognition Laboratory, Department of Psychology, Universidade Federal da Paraíba, João Pessoa
| | - Débora M G Cunha
- Department of Pharmacology, Universidade Federal de São Paulo, São Paulo
| | - André M Medeiros
- Department of Health Sciences, Center of Health and Biological Sciences, Universidade Federal Rural do Semi-Árido, Mossoró, Brazil
| | - Regina H Silva
- Department of Pharmacology, Universidade Federal de São Paulo, São Paulo
| |
Collapse
|
19
|
Plasma Amino Acid Concentrations in Patients with Alcohol and/or Cocaine Use Disorders and Their Association with Psychiatric Comorbidity and Sex. Biomedicines 2022; 10:biomedicines10051137. [PMID: 35625874 PMCID: PMC9138967 DOI: 10.3390/biomedicines10051137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/08/2022] [Accepted: 05/13/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: Co-occurrence of mental and substance use disorders (SUD) is prevalent, but complicates their clinical courses, and specific biomarkers are required. Amino acids are altered in primary mental disorders; however, little is known about SUD and psychiatric comorbidity. Because most psychiatric disorders and biomarkers show sex differences, we investigated amino acids in men and women with alcohol and/or cocaine use disorders (AUD and/or CUD) and psychiatric comorbidity. (2) Methods: A cross-sectional study was conducted in 295 participants, who were divided into four groups (AUD, n = 60; CUD, n = 41; AUD + CUD, n = 64; and control, n = 130). Participants were clinically assessed, and plasma amino acid concentrations were analyzed in relation to sex, diagnosis of SUD and psychiatric comorbidity (3) Results: In the total sample, there were sex differences, and women showed lower Iso, Leu, Gln and Glu than men. While patients with CUD and AUD + CUD had higher Glu, Gly, Orn and Ser than controls, patients with AUD showed no differences. In SUD, patients with psychiatric comorbidity had lower Orn and higher Ala than non-comorbid patients in the AUD group. (4) Conclusions: There was a dysregulation of plasma amino acids in abstinent patients with SUD. However, our results suggest the importance of considering the clinical characteristics and sex in the validity of amino acids as potential biomarkers for SUD.
Collapse
|
20
|
Caetano R, Vaeth PAC, Gruenewald PJ, Ponicki WR, Kaplan Z, Annechino R. Population-Based Correlates of Spatially Aggregated Drug-Related Arrests On and Off the U.S.-Mexico Border in California. J Stud Alcohol Drugs 2022; 83:323-331. [PMID: 35590172 PMCID: PMC9134994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 09/03/2021] [Indexed: 05/03/2023] Open
Abstract
OBJECTIVE The purpose of this study was to examine drug-related arrest rates in California from 2005 to 2017 with a focus on the measurement of presumptive excess arrests across areas proximate to the U.S.-Mexico border. METHOD Arrest data come from the Monthly Arrest and Citation Register (MACR) by the California Department of Justice. U.S. Census demographic population information, and alcohol outlet data from the California Department of Alcoholic Beverage Control, were aggregated at the level of 499 Law Enforcement Reporting Areas (LERA) that contributed to the MACR report. Multivariable analyses were conducted using hierarchical Bayesian Poisson spacetime models. RESULTS Multivariable results showed that felony and misdemeanor arrests increased with distance from the U.S.-Mexico border (felony relative rate [RR] = 1.007, 95% CI [1.003, 1.010]; misdemeanor RR = 1.013, 95% CI [1.010, 1.016]) and were greater in areas with greater outlet concentrations (felony RR = 1.008, 95% CI [1.008, 1.008]; misdemeanor RR = 1.007, 95% CI [1.007, 1.007]) and a greater percentage of bars and pubs (felony RR = 1.031, 95% CI [1.030, 1.032]; misdemeanor RR = 1.052, 95% CI [1.051, 1.053]). Areas with greater Black populations had greater felony and fewer misdemeanor arrests (felony RR = 1.078, 95% CI [1.076, 1.079]; misdemeanor RR = 0.865, 95% CI [0.864, 0.867]). Areas with greater Hispanic populations had greater misdemeanor arrests (RR = 1.008, 95% CI [1.006, 1.009]). The percentage of off-premise outlets was inversely associated with misdemeanor arrest rates (RR = 0.995, 95% CI [0.994, 0.995]). CONCLUSIONS Although arrest rates were substantively related to the racial composition of areas across California, there was no evidence of excess drug-related arrests along border areas.
Collapse
Affiliation(s)
- Raul Caetano
- Prevention Research Center, Berkeley, California
| | | | | | | | - Zoe Kaplan
- Prevention Research Center, Berkeley, California
| | | |
Collapse
|
21
|
Bloch S, Holleran KM, Kash TL, Vazey EM, Rinker JA, Lebonville CL, O'Hara K, Lopez MF, Jones SR, Grant KA, Becker HC, Mulholland PJ. Assessing negative affect in mice during abstinence from alcohol drinking: Limitations and future challenges. Alcohol 2022; 100:41-56. [PMID: 35181404 PMCID: PMC8983487 DOI: 10.1016/j.alcohol.2022.02.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 01/09/2023]
Abstract
Alcohol use disorder (AUD) is frequently comorbid with mood disorders, and these co-occurring neuropsychiatric disorders contribute to the development and maintenance of alcohol dependence and relapse. In preclinical models, mice chronically exposed to alcohol display anxiety-like and depressive-like behaviors during acute withdrawal and protracted abstinence. However, in total, results from studies using voluntary alcohol-drinking paradigms show variable behavioral outcomes in assays measuring negative affective behaviors. Thus, the main objective of this review is to summarize the literature on the variability of negative affective behaviors in mice after chronic alcohol exposure. We compare the behavioral phenotypes that emerge during abstinence across different exposure models, including models of alcohol and stress interactions. The complicated outcomes from these studies highlight the difficulties of assessing negative affective behaviors in mouse models designed for the study of AUD. We discuss new behavioral assays, comprehensive platforms, and unbiased machine-learning algorithms as promising approaches to better understand the interaction between alcohol and negative affect in mice. New data-driven approaches in the understanding of mouse behavior hold promise for improving the identification of mechanisms, cell subtypes, and neurocircuits that mediate negative affect. In turn, improving our understanding of the neurobehavioral basis of alcohol-associated negative affect will provide a platform to test hypotheses in mouse models that aim to improve the development of more effective strategies for treating individuals with AUD and co-occurring mood disorders.
Collapse
Affiliation(s)
- Solal Bloch
- Department of Neuroscience, Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Katherine M Holleran
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27101, United States
| | - Thomas L Kash
- Bowles Center for Alcohol Studies, Department of Pharmacology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Elena M Vazey
- Department of Biology, University of Massachusetts Amherst, Amherst, MA 01003, United States
| | - Jennifer A Rinker
- Department of Neuroscience, Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Christina L Lebonville
- Department of Neuroscience, Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Krysten O'Hara
- Department of Neuroscience, Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Marcelo F Lopez
- Department of Psychiatry & Behavioral Sciences, Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Sara R Jones
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27101, United States
| | - Kathleen A Grant
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR 97006, United States
| | - Howard C Becker
- Department of Psychiatry & Behavioral Sciences, Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Patrick J Mulholland
- Department of Neuroscience, Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, SC 29425, United States.
| |
Collapse
|
22
|
Gender Differences in Dual Diagnoses Associated with Cannabis Use: A Review. Brain Sci 2022; 12:brainsci12030388. [PMID: 35326345 PMCID: PMC8946108 DOI: 10.3390/brainsci12030388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/21/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022] Open
Abstract
Gender differences in psychiatric disorders and drug use are well known. Cannabis is the most widely used illegal drug among young people. In recent years, its use has been related to the development of psychiatric pathologies; however, few studies have incorporated the gender perspective as of yet. The present work analyses the literature to determine the existence of gender differences in the development of psychotic, depressive and anxious symptoms associated with cannabis use. First, we describe cannabis misuse and its consequences, paying special attention to adolescent subjects. Second, the main gender differences in psychiatric disorders, such as psychosis, depression, anxiety and cannabis use disorders, are enumerated. Subsequently, we discuss the studies that have evaluated gender differences in the association between cannabis use and the appearance of psychotic, depressive and anxious symptoms; moreover, we consider the possible explanations for the identified gender differences. In conclusion, the studies referred to in this review reveal the existence of gender differences in psychiatric symptoms associated with cannabis use, although the direction of such differences is not always clear. Future research is necessary to discern the causal relationship between cannabis use and the development of psychiatric symptoms, as well as the gender differences found.
Collapse
|
23
|
Westman J, Jayaram-Lindström N, Kane K, Franck J, Gissler M. Mortality in adult children of parents with alcohol use disorder: a nationwide register study. Eur J Epidemiol 2022; 37:815-826. [PMID: 35737206 PMCID: PMC9463262 DOI: 10.1007/s10654-022-00883-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/20/2022] [Indexed: 12/15/2022]
Abstract
Research suggests that adult children of parents with harmful alcohol use are at increased risk for premature death. This national cohort study investigated mortality in adult children of parents with alcohol use disorder (AUD), adjusting for sociodemographic variables. The study used 1973 to 2018 data from Swedish national registers to compare mortality risk in children who had ≥ 1 parent with AUD (ICD-10 code F10 and its ICD-8 and ICD-9 equivalents) (n = 122,947) and those who did not (n = 2,298,532). A Cox regression model adjusted for year of birth, sex, parental education, and childhood loss of a parent was used. Before the age of 18 years, about 5% of children born in Sweden lived with ≥ 1 parent who had a clinical diagnosis of AUD. Overall mortality was higher in adult children of parents with AUD: hazard ratio (HR) 1.76, 95% confidence interval (CI) 1.71-1.82. Mortality remained elevated after adjustments for sociodemographic factors (HR 1.45, 95% CI 1.40-1.50). Children of parents with AUD had increased mortality from all investigated causes. The highest excess risk was for death from drug-related causes (excluding accidental poisonings) (HR 3.08, 95% CI 2.74-3.46). For most causes, mortality was higher if the mother had AUD than if the father had AUD. Patterns of mortality were similar in both sexes. This study provides evidence that parental AUD raises the risk of offspring mortality from preventable causes such as drug use, suicide (HR 2.16, 95% CI 1.98-2.36), accident (HR 2.00, 95% CI 1.87-2.13), and assault (HR 1.76, 95% CI 1.38-2.24).
Collapse
Affiliation(s)
- Jeanette Westman
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden ,Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden ,Academic Primary Health Care Centre, Region Stockholm, Sweden
| | - Nitya Jayaram-Lindström
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Kimberly Kane
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden ,Academic Primary Health Care Centre, Region Stockholm, Sweden
| | - Johan Franck
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Mika Gissler
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden ,Academic Primary Health Care Centre, Region Stockholm, Sweden ,Department of Child Psychiatry, Turku University Hospital, Turku University, Turku, Finland ,Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland
| |
Collapse
|
24
|
Hartwell EE, Merikangas AK, Verma SS, Ritchie MD, Kranzler HR, Kember RL. Genetic liability for substance use associated with medical comorbidities in electronic health records of African- and European-ancestry individuals. Addict Biol 2022; 27:e13099. [PMID: 34611967 PMCID: PMC9254745 DOI: 10.1111/adb.13099] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/17/2021] [Accepted: 09/01/2021] [Indexed: 01/03/2023]
Abstract
Polygenic risk scores (PRS) represent an individual's summed genetic risk for a trait and can serve as biomarkers for disease. Less is known about the utility of PRS as a means to quantify genetic risk for substance use disorders (SUDs) than for many other traits. Nonetheless, the growth of large, electronic health record-based biobanks makes it possible to evaluate the association of SUD PRS with other traits. We calculated PRS for smoking initiation, alcohol use disorder (AUD), and opioid use disorder (OUD) using summary statistics from the Million Veteran Program sample. We then tested the association of each PRS with its primary phenotype in the Penn Medicine BioBank (PMBB) using all available genotyped participants of African or European ancestry (AFR and EUR, respectively) (N = 18,612). Finally, we conducted phenome-wide association analyses (PheWAS) separately by ancestry and sex to test for associations across disease categories. Tobacco use disorder was the most common SUD in the PMBB, followed by AUD and OUD, consistent with the population prevalence of these disorders. All PRS were associated with their primary phenotype in both ancestry groups. PheWAS results yielded cross-trait associations across multiple domains, including psychiatric disorders and medical conditions. SUD PRS were associated with their primary phenotypes; however, they are not yet predictive enough to be useful diagnostically. The cross-trait associations of the SUD PRS are indicative of a broader genetic liability. Future work should extend findings to additional population groups and for other substances of abuse.
Collapse
Affiliation(s)
- Emily E. Hartwell
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA,Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Alison K. Merikangas
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Shefali S. Verma
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Marylyn D. Ritchie
- Department of Genetics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA,Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, PA
| | | | - Henry R. Kranzler
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA,Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Rachel L. Kember
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA,Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| |
Collapse
|
25
|
Venegas A, Donato S, Meredith LR, Ray LA. Understanding low treatment seeking rates for alcohol use disorder: A narrative review of the literature and opportunities for improvement. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:664-679. [PMID: 34464542 PMCID: PMC9059657 DOI: 10.1080/00952990.2021.1969658] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/12/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
Despite a well-documented global burden of disease attributable to alcohol use disorder (AUD), treatment seeking rates remain low. In this qualitative literature review, we address treatment seeking for AUD from a host of perspectives and summarize the literature on key factors. First, we summarize the rates of alcohol treatment seeking across various epidemiological surveys, spanning decades. Second, we discuss the definition of treatment seeking and 'what' is typically considered formal treatment. Third, we consider timing and discuss 'when' individuals are most likely to seek treatment. Fourth, we review the literature on 'who' is most likely to seek treatment, including demographic and clinical correlates. Fifth, we address the critical question of 'why' so few people receive clinical services for AUD, relative to the number of individuals affected by the disorder, and review barriers to treatment seeking at the treatment- and person-levels of analysis. Finally, we identify opportunities to improve treatment seeking rates by focusing on tangible points of intervention. Specifically, we recommend a host of adaptations to models of care including efforts to make treatment more appealing across stages of AUD severity, accept a range of health-enhancing drinking goals as opposed to an abstinence-only model, educate providers and consumers about evidence-based behavioral and pharmacological treatments, and incentivize the delivery of evidence-based services.
Collapse
Affiliation(s)
- Alexandra Venegas
- Department of Psychology, University of California, Los Angeles, California, USA
| | - Suzanna Donato
- Department of Psychology, University of California, Los Angeles, California, USA
| | - Lindsay R. Meredith
- Department of Psychology, University of California, Los Angeles, California, USA
| | - Lara A. Ray
- Department of Psychology, University of California, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
| |
Collapse
|
26
|
Holzhauer CG, Epstein EE, Smelson DA, Mattocks K. Targeting women veteran's stress-induced drinking with cognitive reappraisal: Mechanisms and moderators of change. J Subst Abuse Treat 2021; 130:108408. [PMID: 34118700 PMCID: PMC8478824 DOI: 10.1016/j.jsat.2021.108408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/26/2022]
Abstract
Emotion dysregulation mediates the effects of stress on drinking among individuals with co-occurring emotional and alcohol use disorders (AUD). The current study examined the effects of cognitive reappraisal (CR), an adaptive emotion regulation strategy, on mechanisms that contribute to drinking (alcohol craving, inhibitory control) among 50 women veterans. In session one, participants were randomized to one of two 50-min "microinterventions", either to learn a CR coping strategy or receive non-therapeutic psychoeducation control. In session two, all participants underwent a personalized stress induction, after which women in the experimental condition were instructed to use CR to reduce stress, while those in the control group were instructed to sit quietly. Craving and inhibitory control were measured at post-stress induction and after using CR/sitting quietly. Moderating effects of AUD, depression, and PTSD severity were assessed. Craving and inhibitory control improved among women in both conditions (CR or sitting quietly), with no main effect of condition. Condition by AUD severity had a significant interaction effect (b = 0.018, p = .013), whereby women with more severe AUD had greater decreases in craving after sitting quietly, and women with less severe AUD had greater decreases in craving after CR. The opposite pattern was observed for inhibitory control (b = 6.45, p = .004), with women with less severe AUD having greater decreases in inhibitory control after sitting quietly, and women with more severe AUD having greater decreases in inhibitory control after CR. Results highlight CR's immediate effects on alcohol-related outcomes and the important role of symptom severity.
Collapse
Affiliation(s)
- Cathryn Glanton Holzhauer
- VA Central Western Massachusetts, Division of Research and Education, 421 North Main Street, Leeds, MA 01053, United States of America; University of Massachusetts Medical School, Department of Psychiatry, 365 Plantation Street Biotech One, Worcester, MA 01605, United States of America.
| | - Elizabeth E Epstein
- University of Massachusetts Medical School, Department of Psychiatry, 365 Plantation Street Biotech One, Worcester, MA 01605, United States of America
| | - David A Smelson
- University of Massachusetts Medical School, Department of Psychiatry, 365 Plantation Street Biotech One, Worcester, MA 01605, United States of America
| | - Kristin Mattocks
- VA Central Western Massachusetts, Division of Research and Education, 421 North Main Street, Leeds, MA 01053, United States of America; University of Massachusetts Medical School, Department of Psychiatry, 365 Plantation Street Biotech One, Worcester, MA 01605, United States of America
| |
Collapse
|
27
|
Gender Differences among Sardinians with Alcohol Use Disorder. J Clin Med 2021; 10:jcm10204688. [PMID: 34682808 PMCID: PMC8537954 DOI: 10.3390/jcm10204688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/27/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
Sardinia is an Italian island in the Mediterranean characterized by secular isolation and the singular genetic characteristics of its inhabitants. Findings obtained in populations with diverse genetic make-up and cultural background indicate gender differences and/or similarities in drinking characteristics of patients with alcohol use disorder (AUD). Knowledge of these characteristics in AUD patients is useful to improve access to treatments. This paper investigated the drinking characteristics of 66 female and 282 male outpatients with AUD, born from 1937 to 1991, living in Sardinia, and compared their characteristics with those of AUD patients living in other countries. Most Sardinian patients were men, approximately 3 years younger than women; women consumed lower amounts of alcohol than men but did not differ from men in the severity of AUD. Men were more often single than women, while a higher proportion of women reported that their mother or spouse was affected by AUD. Anxiety and depression were more prevalent among women while a higher proportion of men were affected by substance use disorders. Women were older than men at the age of first drink, regular drinking, and onset of AUD, and progressed faster than men from regular use to AUD onset. Women did not differ from men in age at first request for care, and in the lapse from AUD onset to first request for care. Women and men waited for more than 8 and 9 years, respectively, before receiving medical treatment. Gender differences progressively decreased among younger patients. Although the scarce number of women in some cohorts limits the strength of these findings, drinking characteristics of Sardinian patients did not vary significantly from those of AUD patients living in other countries. These results suggest that the number of Sardinian women with AUD is increasing and services for treatment of AUD should (a) consider women’s specific needs, and (b) realize effective policies to reduce latency prior to accessing medical treatment for both men and women with AUD.
Collapse
|
28
|
Therapeutic potential of ketamine for alcohol use disorder. Neurosci Biobehav Rev 2021; 126:573-589. [PMID: 33989669 DOI: 10.1016/j.neubiorev.2021.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/02/2021] [Accepted: 05/09/2021] [Indexed: 12/12/2022]
Abstract
Excessive alcohol consumption is involved in 1/10 of deaths of U.S. working-age adults and costs the country around $250,000,000 yearly. While Alcohol Use Disorder (AUD) pathology is complex and involves multiple neurotransmitter systems, changes in synaptic plasticity, hippocampal neurogenesis, and neural connectivity have been implicated in the behavioral characteristics of AUD. Depressed mood and stress are major determinants of relapse in AUD, and there is significant comorbidity between AUD, depression, and stress disorders, suggesting potential for overlap in their treatments. Disulfiram, naltrexone, and acamprosate are current pharmacotherapies for AUD, but these treatments have limitations, highlighting the need for novel therapeutics. Ketamine is a N-methyl-D-Aspartate receptor antagonist, historically used in anesthesia, but also affects other neurotransmitters systems, synaptic plasticity, neurogenesis, and neural connectivity. Currently under investigation for treating AUDs and other Substance Use Disorders (SUDs), ketamine has strong support for efficacy in treating clinical depression, recently receiving FDA approval. Ketamine's effect in treating depression and stress disorders, such as PTSD, and preliminary evidence for treating SUDs further suggests a role for treating AUDs. This review explores the behavioral and neural evidence for treating AUDs with ketamine and clinical data on ketamine therapy for AUDs and SUDs.
Collapse
|
29
|
Livingston NA, Simpson T, Lehavot K, Ameral V, Brief DJ, Enggasser J, Litwack S, Helmuth E, Roy M, Rosenbloom D, Keane TM. Differential alcohol treatment response by gender following use of VetChange. Drug Alcohol Depend 2021; 221:108552. [PMID: 33556659 DOI: 10.1016/j.drugalcdep.2021.108552] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/30/2020] [Accepted: 01/05/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Proportionally more women use online alcohol interventions but also report less robust treatment outcomes compared to men. Less is known about outcome disparities among veteran women, who are a growing demographic nationally. The current study examined gender differences among returning veteran men and women who used VetChange, a web-based intervention for hazardous drinking and posttraumatic stress symptoms (PTSS). METHOD Using data from a nationwide implementation study of returning combat veterans (n = 222), we performed hierarchical linear modeling to examine gender differences in alcohol and PTSS outcomes over six months following VetChange registration. Additional analyses examined gender differences in proportional changes in hazardous drinking and at each assessment point. RESULTS Returning veterans reported significant decreases in alcohol use and PTSS over time, yet men evidenced significantly greater reduction in average weekly drinks and drinks per drinking day compared to women. Follow up analyses indicated that women were significantly less likely than men to achieve low-risk drinking by one month post-registration. Proportional change in alcohol use yielded marginal and non-significant trends that were, nonetheless, consistent with the overall pattern of gender differences. CONCLUSION These results contribute to emerging literature suggesting that women use online alcohol use interventions at proportionately higher rates than do men, but do not reduce their drinking as much as men. There are a number of potential content changes that could improve outcomes for returning veteran women using online interventions, and data-driven adaptations based on stakeholder input are recommended.
Collapse
Affiliation(s)
- Nicholas A Livingston
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA; U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, USA.
| | - Tracy Simpson
- Center of Excellence in Substance Addiction, Treatment, and Education (CESATE), VA Puget Sound Healthcare System, Seattle, WA, USA; Department of Psychiatry & Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Keren Lehavot
- Department of Psychiatry & Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA; Seattle-Denver HSR&D Center of Innovation (COIN), Seattle, WA, USA; Department of Health Services, University of Washington, Seattle, WA, USA
| | - Victoria Ameral
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
| | - Deborah J Brief
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, USA
| | - Justin Enggasser
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, USA
| | - Scott Litwack
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, USA
| | | | - Monica Roy
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, USA
| | | | - Terence M Keane
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA; U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, USA
| |
Collapse
|
30
|
Christoffersen LAN, Mortensen EL, Osler M, Sørensen HJ, Becker U, Flensborg-Madsen T. Lifetime psychiatric hospital diagnoses among 8,412 Danish men registered in an outpatient alcohol clinic. Brain Behav 2021; 11:e02004. [PMID: 33421359 PMCID: PMC7994687 DOI: 10.1002/brb3.2004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/26/2020] [Accepted: 11/28/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To describe the prevalence of lifetime psychiatric hospital diagnoses among men registered in an outpatient alcohol clinic and compare the prevalence with matched controls. To assess temporality of alcohol use disorder (AUD) diagnoses and another psychiatric hospital diagnosis and examine the prevalence of lifetime psychiatric hospital diagnoses according to this temporal order. METHODS The study included 8,412 Danish men registered in an outpatient alcohol clinic, and 8,412 unregistered controls from the Danish Conscription Database matched on birth date, lifespan, intelligence and draft board district. Information on first outpatient AUD treatment was retrieved from the Copenhagen Alcohol Cohort. Information on lifetime psychiatric hospital diagnoses was retrieved from national Danish psychiatric registers and based on the International Classification of Diseases the 8th and 10th Revisions. Prevalence estimates of lifetime psychiatric hospital diagnoses were compared with odds ratios (OR) between men registered in an outpatient alcohol clinic and the control population. RESULTS Among men registered in an outpatient alcohol clinic, 66.6% had a lifetime psychiatric hospital diagnosis. In total, 8.6% had neuroses and anxiety disorders, while 25.3% had personality disorders. The OR of a lifetime psychiatric hospital diagnosis was 9.77 (95%CI: 8.87-10.75) when comparing men registered in an outpatient alcohol clinic with the control population. Among men with a lifetime psychiatric hospital diagnosis, 42.8% was registered with another psychiatric hospital diagnosis before registration with an AUD diagnosis. CONCLUSION Among men with a lifetime psychiatric hospital diagnosis, AUD is rarely diagnosed without psychiatric comorbidity at first-time admissions to psychiatric hospital departments.
Collapse
Affiliation(s)
- Lea A N Christoffersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark.,National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Erik L Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Merete Osler
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Holger J Sørensen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Mental Health Centre Copenhagen, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - Ulrik Becker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Trine Flensborg-Madsen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
31
|
Huỳnh C, Kisely S, Rochette L, Pelletier É, Jutras-Aswad D, Larocque A, Fleury MJ, Lesage A. Using administrative health data to estimate prevalence and mortality rates of alcohol and other substance-related disorders for surveillance purposes. Drug Alcohol Rev 2021; 40:662-672. [PMID: 33432695 DOI: 10.1111/dar.13235] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/16/2020] [Accepted: 11/22/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Administrative health databases (AHD) are critical to guide health service management and can inform the whole spectrum of substance-related disorders (SRD). This study estimates prevalence and mortality rates of SRD in administrative health databases. METHODS The Quebec Integrated Chronic Disease Surveillance System consists of linked AHD. Analyses were performed on data of all Quebec residents aged 12 and over and eligible for health-care coverage using the International Classification of Diseases (ninth or tenth revision) for case identification. Mortality rate ratios stratified by causes of death were obtained to calculate an excess of mortality. RESULTS Since 2001-2002, the annual age-adjusted prevalence rate of diagnosed overall SRD remained stable (8.6 per 1000 in 2017-2018). In any given year, the annual prevalence rate was significantly higher in males; adolescents had the lowest rate, while adults 65 years and older the highest. The annual 2017-2018 rate was 2.1 per 1000 for alcohol-induced disorder, 1.9 for other drug-induced disorder, 0.7 for alcohol intoxication and 0.6 for other drug intoxications. Cumulative rate of any diagnosis related to alcohol was 32 per 1000 females and 53 per 1000 males (2001-2018), and 33 per 1000 females and 49 per 1000 males for any diagnosis related to other drugs. There was an excess of all-cause mortality among individuals with SRD compared to the general population. DISCUSSION AND CONCLUSIONS AHD can complement epidemiological surveys in monitoring SRD jurisdiction-wide. Surveillance of services utilisation and interventions, coupled with health outcomes like mortality, could be useful in guiding health services planning.
Collapse
Affiliation(s)
- Christophe Huỳnh
- University Institute on Addictions, CIUSSS du Centre-Sud-de-l'Île-de-Montréal (Integrated University Centre of Health and Social Services of the Centre-South-of-the-Island-of-Montréal), Montreal, Canada.,Department of Psychiatry and Addiction, University of Montréal, Montreal, Canada.,School of Psychoeducation, University of Montreal, Montreal, Canada.,Bureau d'information et d'études en santé des populations (Bureau of Information and Studies on the Health of Populations), Institut National de Santé Publique du Québec (National Institute of Public Health of Quebec), Quebec City, Canada
| | - Steve Kisely
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada.,School of Medicine, University of Queensland, Brisbane, Australia
| | - Louis Rochette
- Bureau d'information et d'études en santé des populations (Bureau of Information and Studies on the Health of Populations), Institut National de Santé Publique du Québec (National Institute of Public Health of Quebec), Quebec City, Canada
| | - Éric Pelletier
- Bureau d'information et d'études en santé des populations (Bureau of Information and Studies on the Health of Populations), Institut National de Santé Publique du Québec (National Institute of Public Health of Quebec), Quebec City, Canada
| | - Didier Jutras-Aswad
- University Institute on Addictions, CIUSSS du Centre-Sud-de-l'Île-de-Montréal (Integrated University Centre of Health and Social Services of the Centre-South-of-the-Island-of-Montréal), Montreal, Canada.,Department of Psychiatry and Addiction, University of Montréal, Montreal, Canada.,Research Centre, Centre Hospitalier de l'Université de Montréal (University of Montreal Health Centre), Montreal, Canada
| | - Alexandre Larocque
- Department of Emergency Medicine, Centre Hospitalier de l'Université de Montréal (University of Montreal Health Centre), Montreal, Canada.,Quebec Poison Control Center, Québec City, Canada
| | | | - Alain Lesage
- Department of Psychiatry and Addiction, University of Montréal, Montreal, Canada.,Bureau d'information et d'études en santé des populations (Bureau of Information and Studies on the Health of Populations), Institut National de Santé Publique du Québec (National Institute of Public Health of Quebec), Quebec City, Canada.,Research Centre of the Montreal Mental Health University Institute, Montreal, Canada
| |
Collapse
|
32
|
Gorvine MM, Haynes TF, Marshall SA, Clark CJ, Lovelady NN, Zaller ND. An Exploratory Study of the Acceptability and Feasibility of Yoga Among Women in Substance Use Disorder Recovery. J Altern Complement Med 2020; 27:273-281. [PMID: 33373528 DOI: 10.1089/acm.2020.0351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives: This qualitative study explored the acceptability and feasibility of yoga among women in substance use disorder (SUD) recovery. Design: Seventeen women in SUD recovery for 2 weeks or longer were recruited from nine sites in the mid-South, including a Medication-Assisted Treatment clinic in a hospital setting, prison re-entry housing, community-based peer support organizations (e.g., Alcoholics Anonymous [AA], Narcotics Anonymous [NA]), a residential SUD treatment facility, a yoga teachers' online group, and through referrals. The median age of participants was 41.5, with ages ranging from 25 to 65. We used an interpretive description approach to explore both the perceptions of women without yoga experience and the experiences of women with yoga experience to collect formative data for intervention development and implementation. The interviews were recorded and transcribed verbatim. A hybrid analysis (i.e., inductive and deductive coding) was applied to the data. Results: Women's narratives included a high prevalence of trauma exposure. Overall, women in this sample were interested in either beginning or continuing yoga. Barriers to participation included perceived lack of self-efficacy of yoga, weight, and physical injuries. Additional environmental barriers included balancing care of self with caring for others, including partners, children, and NA/AA sponsees; as well as prioritizing finances, housing, employment, and transportation. Conclusion: High prevalence of trauma exposure among women in SUD recovery necessitates careful consideration of co-occurring psychiatric disorders such as post-traumatic stress disorder, anxiety and depression and the necessary professional psychological support, as well as serious physical injuries that require modification in yoga āsana classes. As transportation and balancing care needs were salient in these data, rural SUD populations could be served with telehealth interventions that provide SUD recovery support with integrative health practices such as adjunctive yoga interventions.
Collapse
Affiliation(s)
- Margaret M Gorvine
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Tiffany F Haynes
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S Alexandra Marshall
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Cari J Clark
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nakita N Lovelady
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Nickolas D Zaller
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| |
Collapse
|
33
|
Abstract
The current article provides a brief summary of biopsychosocial gender differences in alcohol use disorder (AUD), then reviews existing literature on gender differences in treatment access, retention, outcomes, and longer-term recovery. Among psychotherapies for AUD, there is support for the efficacy of providing female-specific treatment, and for female-only treatment settings but only when female-specific treatment is included. However, despite mandates from the National Institutes of Health to do so, there is little work thus far that directly compares genders on outcomes of specific psychotherapies or pharmacotherapies for AUD. Although existing research has mixed findings on sex and gender differences in overall outcomes, there are more consistent findings suggesting different mechanisms of behavior change among men and women in AUD treatment and long-term recovery. Thus, more work is needed that attends to gender and sex differences, including planning studies that are structured to examine not only gender-differentiated outcomes in treatment response, but equally important, differences in treatment access and attendance as well as differences in mechanisms of change in drinking behavior.
Collapse
Affiliation(s)
- Cathryn Glanton Holzhauer
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts.,Division of Research and Education, VA Central Western Massachusetts, Leeds, Massachusetts
| | - Michael Cucciare
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,VA South Central Mental Illness Research, Education, and Clinical Center and Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas
| | - Elizabeth E Epstein
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts
| |
Collapse
|
34
|
Bloch S, Rinker JA, Marcus MM, Mulholland PJ. Absence of effects of intermittent access to alcohol on negative affective and anxiety-like behaviors in male and female C57BL/6J mice. Alcohol 2020; 88:91-99. [PMID: 32777473 DOI: 10.1016/j.alcohol.2020.07.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/03/2020] [Accepted: 07/27/2020] [Indexed: 12/15/2022]
Abstract
Alcohol use disorder is highly comorbid with other neuropsychiatric disorders such as depression and anxiety. Importantly, women and men are affected differentially by heavy drinking, with women experiencing longer negative affective states after intoxication and increased likelihood to present with comorbid mood or anxiety disorders. In rodents, several studies using different alcohol administration models have shown the development of depressive-like or anxiety-like phenotypes that emerge during abstinence. In this study, we compared the emergence of negative affective behaviors during abstinence from 7 weeks of two-bottle choice intermittent access to 20% alcohol in male and female C57BL/6J mice, a drinking paradigm little studied in this context. Half of the mice were tested 24 hours into abstinence on the elevated zero maze and 19-20 days into abstinence in a novel object in the home cage encounter test. The other half of the mice were tested 27-28 days into abstinence with the novelty-suppressed feeding test. As expected, females drank more than males across the 7 weeks of access to alcohol. Drinking history did not affect performance on these tasks, with the exception of increasing the number of open arm entries on the elevated zero maze. Interestingly, in alcohol-naïve mice, females showed fewer anxiety-like behaviors than males in the elevated zero maze and the novelty-suppressed feeding test. Our results suggest that the intermittent access model does not reliably induce negative affective behaviors on these tasks, and that behavior in female and male mice differs across these tests. Rather, intermittent alcohol drinking may induce a mild form of behavioral disinhibition. Thus, the model of alcohol access is a critical factor in determining the appearance of behavioral disturbances that emerge during abstinence.
Collapse
|
35
|
Alcohol misuse and separation from military service: A dyadic perspective. Addict Behav 2020; 110:106512. [PMID: 32623237 DOI: 10.1016/j.addbeh.2020.106512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/14/2020] [Accepted: 06/08/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Alcohol misuse is a prevalent problem among military service members and their spouses. Service member alcohol misuse may contribute to poor job performance, legal infractions, and failure to meet physical standards. Spousal alcohol misuse may indicate problems with military life. However, limited information is available about how alcohol misuse in military families affects occupational outcomes, specifically military attrition. METHOD The current study examined 7,965 opposite sex married couples from the Millennium Cohort Family Study with one military and one civilian/veteran partner. Both partners reported on three measures of alcohol misuse (binge drinking, alcohol problems, and heavy weekly drinking). The associations between each partner's measures of alcohol misuse and subsequent military separation were evaluated using logistic regression. Sex, concordance of alcohol misuse, mental health, and service branch were explored as moderators. RESULTS In fully adjusted models, service member alcohol problems were directly related to military separation. Additionally, service member heavy weekly drinking was strongly associated with military separation among female service members but not male service members. Service member and spouse binge drinking interacted such that when only one partner reported binge drinking military separation was less likely, but both partners' binge drinking conveyed a marginally increased risk of military separation. CONCLUSIONS Prevalence of alcohol misuse was high among military families. Service member alcohol misuse was more strongly related to military separation than spouse alcohol misuse. Additionally, heavy weekly drinking among female service members may be an indicator of a significant issue that merits interventions aimed at retaining these service members.
Collapse
|
36
|
Masferrer L, Mancini AD, Caparrós B. Understanding the Relationship Between Complicated Grief Symptoms and Patterns of Personality Disorders in a Substance Users' Sample: A Network Analysis Approach. Front Psychol 2020; 11:566785. [PMID: 33250810 PMCID: PMC7673378 DOI: 10.3389/fpsyg.2020.566785] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 09/11/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The presence of personality disorders is greatly prevalent among substance users. Personality disorders could increase vulnerability to complicated grief symptoms. Bereavement is commonly overlooked among substance users. We used network analysis to estimate the structure of relations between patterns of personality disorders and complicated grief symptoms among a bereaved substance-using population. METHODS Complicated grief and personality disorders were assessed in a sample of 196 bereaved substance users. We use the graphical least absolute shrinkage selection operator (LASSO) to compute a regularized partial correlation network revealing associations among different patterns of personality disorders and complicated grief symptoms. RESULTS In a network involving nodes for personality disorders and symptomatology of complicated grief, patterns of depressive and paranoid personality disorder showed small relationships to complicated grief symptoms. All other personality disorders showed negligible to no relationship to complicated grief symptoms. Further, in the overall network, complicated grief showed the lowest level of centrality, suggesting that it is independent of personality disorders, whereas depressive and paranoid personality disorder symptoms showed the highest centrality. CONCLUSION Network analysis can be used to understand the relationships among higher-level constructs such as disorders. We found that complicated grief is largely independent of patterns of personality disorders with the exception of depressive and paranoid. Findings have implications for assessment and appropriate treatment of complicated grief symptoms and substance use disorder.
Collapse
Affiliation(s)
- Laura Masferrer
- CAS Girona, Mental Health and Addiction Research Group, Institutd’Assistència Sanitària (IAS), Institut d’Investigació Biomèdica de Girona (IDIBGI), Girona, Spain
- Department of Psychology, University of Girona, Girona, Spain
| | | | | |
Collapse
|
37
|
Mitchell RHB, Hower H, Birmaher B, Strober M, Merranko J, Rooks B, Goldstein TR, Hunt JI, Dickstein DP, Diler RS, Ryan ND, Gill MK, Axelson D, Keller MB, Yen S, Goldstein BI. Sex Differences in the Longitudinal Course and Outcome of Bipolar Disorder in Youth. J Clin Psychiatry 2020; 81:19m13159. [PMID: 33113597 PMCID: PMC8597235 DOI: 10.4088/jcp.19m13159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 05/15/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Despite substantial literature on sex differences in adults with bipolar disorder (BD), little is known about this topic in youth; this study examines sex differences in mood symptomatology and psychiatric comorbidity in prospectively followed youth with BD. METHODS A subsample of the Course and Outcome of Bipolar Youth study (N = 370; female n = 199, male n = 171) enrolled October 2000-July 2006 (age at intake = 7-17.11 years) who met DSM-IV criteria for bipolar I disorder (BD-I; n = 221), bipolar II disorder (BD-II; n = 26), or operationalized BD not otherwise specified (BD-NOS; n = 123) with ≥ 4 years follow-up was included. Analyses examined sex differences at intake and, prospectively, in mood symptomatology and psychiatric comorbidity for a mean ± SD follow-up of 10.5 ± 1.72 years. RESULTS Females were older than males at intake (mean ± SD age = 13.33 ± 3.32 vs 12.04 ± 3.16 years; P = .0002) and at age at mood onset (9.33 ± 4.22 vs 7.53 ± 3.74 years; P < .0001). After adjustment for confounders, males spent more time with syndromal ADHD (Padjusted = .001) and females spent more time with syndromal anxiety (Padjusted = .02). There were trends toward males spending more time with substance use disorder and females having more non-suicidal self-injurious behavior (Padjusted = .07 and .09, respectively). There were no sex differences on outcome variables, including rate of or time to recovery and recurrence. CONCLUSIONS Contrasting with adult literature, this study identified minimal sex differences in the course of youth with BD. Longer-term studies are needed to clarify if youth-onset BD remains a "sex neutral" subtype of BD or diverges according to sex in adulthood.
Collapse
Affiliation(s)
- Rachel H B Mitchell
- Department of Psychiatry, Sunnybrook Health Sciences Centre, EG-47, 2075 Bayview Ave, Toronto, ON M4N 3M5.
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Heather Hower
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
- Department of Psychiatry, School of Medicine, University of California at San Diego, San Diego, California, USA
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - John Merranko
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Brian Rooks
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Tina R Goldstein
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jeffrey I Hunt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Bradley Hospital, East Providence, Rhode Island, USA
| | - Daniel P Dickstein
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Bradley Hospital, East Providence, Rhode Island, USA
| | - Rasim S Diler
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Neal D Ryan
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Mary Kay Gill
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - David Axelson
- Department of Psychiatry, Nationwide Children's Hospital and The Ohio State College of Medicine, Columbus, Ohio, USA
| | - Martin B Keller
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Butler Hospital, Providence, Rhode Island, USA
| | - Shirley Yen
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Massachusetts Mental Health Center and the Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Benjamin I Goldstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| |
Collapse
|
38
|
Meshesha LZ, Aston ER, Teeters JB, Blevins CE, Battle CL, Marsh E, Feltus S, Stein MD, Abrantes AM. Evaluating alcohol demand, craving, and depressive symptoms among women in alcohol treatment. Addict Behav 2020; 109:106475. [PMID: 32480282 DOI: 10.1016/j.addbeh.2020.106475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Depression and alcohol craving predict drinking and relapse rates among alcohol treatment seekers. Alcohol demand, or one's valuation of alcohol may be another determinant of drinking. There is little known about alcohol demand and its association with depression, craving, and drinking among treatment-seeking adults. METHOD Participants were 71 women with elevated depressive symptoms seeking outpatient treatment for alcohol use disorder (AUD). At baseline, participants self-reported daily drinking amount, alcohol craving, depressive symptoms, and alcohol demand assessed with the alcohol purchase task (APT; a task requesting participants to make hypothetical purchases of drinks at escalating prices). Baseline associations among alcohol demand, depressive symptoms, alcohol craving, and drinking severity were assessed. RESULTS Participants averaged 40.68 (SD = 11.78) years of age, consumed 8.84 (SD = 5.14) drinks per drinking day and reported 15.45 (SD = 7.51) heavy drinking days in the past 30 days, and had an average PHQ-9 depression score of 13.00 (SD = 4.28). Results suggest that the alcohol demand metrics of intensity (consumption level when drinks are free) and Omax (maximum expenditure on alcohol) were associated with drinks per drinking day, whereas craving and depressive symptoms were not significantly associated with drinking. The number of heavy drinking days were not significantly associated with demand, craving, or depressive symptoms. CONCLUSIONS These results suggest that demand may reflect unique risk for drinking relative to craving or depressive symptoms. These findings provide support for the utility of the APT within a clinical setting to assess individualized valuation of alcohol.
Collapse
|
39
|
Hawn SE, Cusack SE, Amstadter AB. A Systematic Review of the Self-Medication Hypothesis in the Context of Posttraumatic Stress Disorder and Comorbid Problematic Alcohol Use. J Trauma Stress 2020; 33:699-708. [PMID: 32516487 PMCID: PMC7572615 DOI: 10.1002/jts.22521] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/10/2019] [Accepted: 12/10/2019] [Indexed: 11/12/2022]
Abstract
Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) commonly co-occur and are associated with many negative public health outcomes. There are several etiological models that explain the overlap between PTSD and AUD, including shared genetic risk and phenotypic causality, but the predominant model of etiologic association is the drinking-to-cope self-medication model. Although the self-medication model is conceptually appealing and has been widely accepted within the literature examining alcohol use and anxiety (e.g., PTSD) phenotypes, the findings are inconsistent and there is a lack of rigorous empirical evidence in support of this model. This review, which was, to our knowledge, the first systematic review of the self-medication model in relation to PTSD to date, aimed to synthesize the current literature on the association between PTSD and problematic alcohol use within the context of the self-medication model. In total, 24 studies met the inclusion criteria for the review and assessed the self-medication hypothesis using a variety of measurement instruments and data analytic approaches, such as mediation, moderation, and regression. Overall, the included studies provide evidence for the self-medication hypothesis but are limited in rigor due to methodological limitations. These limitations, which include issues with the operationalization (or lack thereof) of trauma-related drinking to cope, are discussed, and directions for future research are presented.
Collapse
Affiliation(s)
- Sage E Hawn
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Shannon E Cusack
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
40
|
Fernández-Artamendi S, Águila-Otero A, F Del Valle J, Bravo A. Victimization and substance use among adolescents in residential child care. CHILD ABUSE & NEGLECT 2020; 104:104484. [PMID: 32305798 DOI: 10.1016/j.chiabu.2020.104484] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 03/04/2020] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Adolescents in Residential Child Care (RCC) report high levels of victimization. This has been linked to mental health problems and a higher risk of substance use and substance use problems. The present study aimed to evaluate the specific impact of different forms of victimization on alcohol and cannabis use problems among adolescents in RCC, attending to sex differences. METHODS 321 adolescents from 38 residential therapeutic care facilities in Spain participated in the study. Thirty-six different forms of victimization were evaluated, as well as alcohol and cannabis use problems. Impact of polyvictimization and specific forms of victimization on alcohol and cannabis use problems and disorders were calculated using Analysis of Variance (ANOVA) and logistic regression models. RESULTS Girls in RCC reported significantly more experiences of victimization. Polyvictimization was associated with alcohol use problems but not cannabis use problems. Property, domestic and community victimization showed the highest predictive role regarding alcohol and cannabis use disorders, with significant interactions with sex and migrant family background. CONCLUSIONS Adolescents in RCC reported considerably high levels of victimization and alcohol and cannabis use problems. In this population, property victimization, as well as indirect domestic and community victimization were predictors of further substance use problems, with girls being particularly sensitive to victimization. Migrant family backgrounds can also have an influence on the impact of some victimization forms on substance use. Victimization associated to high-risk environments and families could contribute to explain the high levels of substance use problems in this population.
Collapse
Affiliation(s)
- Sergio Fernández-Artamendi
- Universidad Loyola Andalucia. Department of Psychology, Av. de las Universidades s/n, Dos Hermanas, Sevilla, 41704, Spain.
| | - Alba Águila-Otero
- Family and Childhood Research Group (GIFI). Department of Psychology. University of Oviedo. Pza Feijoo s/n, Oviedo, Asturias, 33001, Spain
| | - Jorge F Del Valle
- Family and Childhood Research Group (GIFI). Department of Psychology. University of Oviedo. Pza Feijoo s/n, Oviedo, Asturias, 33001, Spain
| | - Amaia Bravo
- Family and Childhood Research Group (GIFI). Department of Psychology. University of Oviedo. Pza Feijoo s/n, Oviedo, Asturias, 33001, Spain
| |
Collapse
|
41
|
Personality and psychiatric disorders in chronic pain male affected by erectile dysfunction: prospective and observational study. Int J Impot Res 2020; 33:339-347. [PMID: 32382105 DOI: 10.1038/s41443-020-0294-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 03/24/2020] [Accepted: 04/16/2020] [Indexed: 11/08/2022]
Abstract
The prevalence of personality disorders (PDs) and sexual dysfunction in chronic pain patients is higher than in general population. Our main objective was to analyse the influence of PD in patients with erectile dysfunction and chronic non-cancer pain and their response to andrological treatment. One-hundred one patients were included along 30 months. Pain intensity, quality of life, sexual life quality, anxiety and depression were analysed together with opioid dose. Erectile functioning was measured with the International Index of Erectile Function (IIEF) and PDs with Millon Clinical Multiaxial Inventory (MCMI-III). The mean age was 57 ± 12 years old, with moderate to severe pain, 70% were sexually active and presented moderate to severe ED. PDs were very frequent (31%, cut-off 85 and 84% cut-off 75 scores) mostly anxiety, compulsive, though disorder, somatoform and narcissistic. Self-defeating feature presence was significantly correlated (r = -0.4, 95% CI = -0.605 to -0.145, p = 0.002) with a more severe baseline ED and narcissistic, and a better response to andrological treatment (p = 0.010, d = 1.082). Patients with dysthymia features required significantly higher opioid doses vs. control (238 vs. 102 mg/day, respectively). These findings underline the importance of diagnosing PDs to rigorously treat patients with chronic pain and ED.
Collapse
|
42
|
Hawn SE, Bountress KE, Sheerin CM, Dick DM, Amstadter AB. Trauma-related drinking to cope: A novel approach to the self-medication model. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 34:465-476. [PMID: 32027148 PMCID: PMC7148178 DOI: 10.1037/adb0000552] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Multiple etiological models have been proposed to explain posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) comorbidity, but the predominant model to date is the "drinking to cope" self-medication model. Despite its popularity, the self-medication model lacks rigorous empirical support related to inconsistencies and methodological limitations, particularly the failure to operationalize drinking to cope with trauma symptoms specifically. The present study sought to measure trauma-related drinking to cope (TRD) in order to provide a more specific test of the self-medication model among a representative sample of 1,896 undergraduates with a history of trauma exposure and alcohol use. Using a model-building approach in Mplus, a correlated multiple mediator model tested the association between PTSD symptoms and alcohol use problems (AUPs) through TRD and more generalized drinking to cope motives (as assessed by the coping subscale of the Drinking Motives Questionnaire; DMQ-Cope) as moderated by sex. Results indicated that, while accounting for the effects of generalized drinking to cope motives, TRD partially mediated the relation between PTSD symptoms and AUPs and that this relationship was stronger for males than for females. With the exception of moderation by sex, results were substantiated using longitudinal data. Findings were consistent with the self-medication model, suggesting that TRD motives may serve as a mechanism through which PTSD symptoms influence AUPs. TRD may serve as a more specific screening tool for AUP risk among individuals endorsing PTSD symptoms compared with the commonly used DMQ-Cope. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Sage E Hawn
- Virginia Institute for Psychiatric and Behavioral Genetics
| | | | | | - Danielle M Dick
- Department of Psychology and Department of Human and Molecular Genetics
| | | |
Collapse
|
43
|
Hayaki J, Holzhauer CG, Epstein EE, Cook S, Gaba A, Lorenzo AC, McCrady BS. Menstrual cycle phase, alcohol consumption, alcohol cravings, and mood among women in outpatient treatment for alcohol use disorder. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 34:680-689. [PMID: 32250129 DOI: 10.1037/adb0000576] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Research shows fluctuations in drinking across the menstrual cycle among women with alcohol use disorder (AUD), but little work has investigated moderators of these fluctuations. This study examined drinking and craving intensity across the menstrual cycle, and the moderating effect of baseline depression and emotional distress during the midlate luteal phase and/or menses, among women receiving AUD treatment. Fifty-nine regularly cycling women reported menstrual history and baseline depression. Over 3 months of treatment, they kept daily logs of drinks, alcohol cravings, and menstruation (yes/no). Emotional distress during the midlate luteal phase and/or menses of their most recent menstrual cycle was also assessed during treatment. Menstrual cycle phase was estimated for each within-treatment day. Mixed model analyses tested main and interactive effects of menstrual cycle phase, baseline depression, and emotional distress during the midlate luteal phase and/or menses on daily drinks and craving intensity. Women drank most during the midlate luteal phase and menses compared with other phases. Among women with lower baseline depression, those with lower distress during the midlate luteal phase and/or menses reported more intense cravings during the midlate luteal phase (ΔM = .77, p = .000) and menses (ΔM = .51, p = .012); those with higher distress reported more intense cravings during menses, compared with all other phases (p < .01). Among women with higher baseline depression, craving intensity remained consistently high. Results document more drinking during the midlate luteal phase and menses and suggest that cycle-related distress and depression moderate the alcohol-menstrual association among women in AUD treatment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Jumi Hayaki
- Department of Psychology, College of the Holy Cross
| | | | | | - Sharon Cook
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey
| | - Ayorkor Gaba
- Department of Psychiatry, University of Massachusetts Medical School
| | - Ava C Lorenzo
- Graduate School for Applied and Professional Psychology, Rutgers, The State University of New Jersey
| | - Barbara S McCrady
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico
| |
Collapse
|
44
|
Kamarajan C, Ardekani BA, Pandey AK, Chorlian DB, Kinreich S, Pandey G, Meyers JL, Zhang J, Kuang W, Stimus AT, Porjesz B. Random Forest Classification of Alcohol Use Disorder Using EEG Source Functional Connectivity, Neuropsychological Functioning, and Impulsivity Measures. Behav Sci (Basel) 2020; 10:bs10030062. [PMID: 32121585 PMCID: PMC7139327 DOI: 10.3390/bs10030062] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 12/16/2022] Open
Abstract
: Individuals with alcohol use disorder (AUD) manifest a variety of impairments that can be attributed to alterations in specific brain networks. The current study aims to identify features of EEG-based functional connectivity, neuropsychological performance, and impulsivity that can classify individuals with AUD (N = 30) from unaffected controls (CTL, N = 30) using random forest classification. The features included were: (i) EEG source functional connectivity (FC) of the default mode network (DMN) derived using eLORETA algorithm, (ii) neuropsychological scores from the Tower of London test (TOLT) and the visual span test (VST), and (iii) impulsivity factors from the Barratt impulsiveness scale (BIS). The random forest model achieved a classification accuracy of 80% and identified 29 FC connections (among 66 connections per frequency band), 3 neuropsychological variables from VST (total number of correctly performed trials in forward and backward sequences and average time for correct trials in forward sequence) and all four impulsivity scores (motor, non-planning, attentional, and total) as significantly contributing to classifying individuals as either AUD or CTL. Although there was a significant age difference between the groups, most of the top variables that contributed to the classification were not significantly correlated with age. The AUD group showed a predominant pattern of hyperconnectivity among 25 of 29 significant connections, indicating aberrant network functioning during resting state suggestive of neural hyperexcitability and impulsivity. Further, parahippocampal hyperconnectivity with other DMN regions was identified as a major hub region dysregulated in AUD (13 connections overall), possibly due to neural damage from chronic drinking, which may give rise to cognitive impairments, including memory deficits and blackouts. Furthermore, hypoconnectivity observed in four connections (prefrontal nodes connecting posterior right-hemispheric regions) may indicate a weaker or fractured prefrontal connectivity with other regions, which may be related to impaired higher cognitive functions. The AUD group also showed poorer memory performance on the VST task and increased impulsivity in all factors compared to controls. Features from all three domains had significant associations with one another. These results indicate that dysregulated neural connectivity across the DMN regions, especially relating to hyperconnected parahippocampal hub as well as hypoconnected prefrontal hub, may potentially represent neurophysiological biomarkers of AUD, while poor visual memory performance and heightened impulsivity may serve as cognitive-behavioral indices of AUD.
Collapse
Affiliation(s)
- Chella Kamarajan
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
- Correspondence: ; Tel.: +1-718-270-2913
| | - Babak A. Ardekani
- Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA;
- Department of Psychiatry, NYU School of Medicine, New York, NY 10016, USA
| | - Ashwini K. Pandey
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - David B. Chorlian
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Sivan Kinreich
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Gayathri Pandey
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Jacquelyn L. Meyers
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Jian Zhang
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Weipeng Kuang
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Arthur T. Stimus
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| |
Collapse
|
45
|
Barger BT, Obedin-Maliver J, Capriotti MR, Lunn MR, Flentje A. Characterization of substance use among underrepresented sexual and gender minority participants in The Population Research in Identity and Disparities for Equality (PRIDE) Study. Subst Abus 2020; 42:104-115. [PMID: 32032500 DOI: 10.1080/08897077.2019.1702610] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Profiles of substance use among less commonly described subgroups of sexual and gender minority (SGM) people (e.g., queer, genderqueer) remain largely unknown. Objective(s): To identify substance use differences among less commonly described SGM identity-based subgroups. Methods: The PRIDE Study is a national, online, longitudinal cohort study of self-identified SGM adults living in the U.S. Between 2015-2017, an iPhone application was used to administer three cross-sectional health questionnaires to participants, one of which included questions about binge alcohol, marijuana, and other drug use (substance use). This study was a secondary data analysis of participant responses to substance use survey items. Logistic regression and generalized linear modeling assessed relationships between sexual orientation or gender and use of or reported problems with substances within the past year. Results: Among the 1790 participants included in this study, 51.0% reported binge alcohol use, 39.8% reported marijuana use, and 19.7% reported other drug use (65.9% endorsed use of one or more of these) within the past year. Over 30% indicated substance use had been a problem in their life. Asexual individuals had lower odds of reporting past year binge alcohol and marijuana use (aOR: 0.27, 95% CI: 0.12-0.61; aOR: 0.38, 95% CI: 0.15-0.96, respectively), and queer participants had higher odds of reporting past year marijuana use (aOR: 2.52, 95% CI: 1.58-4.03) compared to lesbian participants. Gender nonbinary participants had lower odds of reporting past year binge alcohol use (aOR: 0.48, 95% CI: 0.32-0.71) and transmasculine participants had higher odds of reporting past year marijuana use (aOR: 2.18, 95% CI: 1.10-4.31) compared to cisgender women. Conclusions: Substance use heterogeneity exists between SGM groups. Comprehensive assessment of sexual orientation and gender may improve understanding of substance use and increase equity within support and treatment services for SGM populations. Highlights We examined substance use among less represented sexual and gender minority groups. Alcohol and other drug use were examined by both sexual orientation and gender identity. Analyses included identities such as queer, pansexual, genderqueer and nonbinary. Alcohol use differed across asexual, genderqueer and gender nonbinary groups. Marijuana use differed across queer, asexual and transmasculine groups.
Collapse
Affiliation(s)
- Branden T Barger
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California, USA.,The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA
| | - Juno Obedin-Maliver
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA.,Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
| | - Matthew R Capriotti
- Department of Psychology, San Jose State University, San Jose, California, USA.,Division of Nephrology, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California, USA
| | - Mitchell R Lunn
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA.,Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Annesa Flentje
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA.,Department of Community Health Systems, University of California, San Francisco, School of Nursing, San Francisco, California, USA.,Alliance Health Project, Department of Psychiatry, University of California, San Francisco, School of Medicine, San Francisco, California, USA
| |
Collapse
|
46
|
Agterberg S, Schubert N, Overington L, Corace K. Treatment barriers among individuals with co-occurring substance use and mental health problems: Examining gender differences. J Subst Abuse Treat 2020; 112:29-35. [PMID: 32199543 DOI: 10.1016/j.jsat.2020.01.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Despite the narrowing gender gap in the prevalence of substance use disorders, women continue to be vastly underrepresented in substance use services. Relational factors, family responsibilities, mental health, and stigma may present unique barriers encountered by women. AIMS The aims of this study were to examine: (1) gender differences in substance use treatment barriers, (2) gender differences in perceptions of stigmatization for seeking substance use treatment, and symptoms of depression, anxiety, and trauma-related stress, and (3) whether perceived stigmatization and mental health symptoms are associated with greater barriers among women. METHODS One hundred adults (50% self-identified women) from a substance use and concurrent disorders program in Ontario, Canada, completed a questionnaire package containing measures of sociodemographic information, substance use, mental health, perceived stigma, and substance use treatment barriers. RESULTS Women reported more barriers related to family responsibilities, relational factors, and mental health (p < .01), and higher levels of perceived stigma (p < .01) compared to men. CONCLUSIONS Findings from this study contribute to our understanding of treatment barriers and perceived stigmatization among women. This knowledge may be used to aid in the development and delivery of accessible, gender-responsive services that address these barriers and challenge the stigma attached to substance use among women.
Collapse
Affiliation(s)
- Silvana Agterberg
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave, Bronx, NY 10461, United States of America.
| | - Nicholas Schubert
- The Royal Ottawa Mental Health Centre, Substance Use and Concurrent Disorders Program, 1145 Carling Ave., Ottawa, ON K1Z 7K4, Canada.
| | - Louise Overington
- The Royal Ottawa Mental Health Centre, Substance Use and Concurrent Disorders Program, 1145 Carling Ave., Ottawa, ON K1Z 7K4, Canada; The Royal's Institute of Mental Health Research, 1145 Carling Ave., Ottawa, ON K1Z 7K4, Canada.
| | - Kimberly Corace
- The Royal Ottawa Mental Health Centre, Substance Use and Concurrent Disorders Program, 1145 Carling Ave., Ottawa, ON K1Z 7K4, Canada; The Royal's Institute of Mental Health Research, 1145 Carling Ave., Ottawa, ON K1Z 7K4, Canada; Faculty of Medicine, Department of Psychiatry, University of Ottawa, 5457-1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada.
| |
Collapse
|
47
|
Abstract
There are vast literatures on the neural effects of alcohol and the neural effects of exercise. Simply put, exercise is associated with brain health, alcohol is not, and the mechanisms by which exercise benefits the brain directly counteract the mechanisms by which alcohol damages it. Although a degree of brain recovery naturally occurs upon cessation of alcohol consumption, effective treatments for alcohol-induced brain damage are badly needed, and exercise is an excellent candidate from a mechanistic standpoint. In this chapter, we cover the small but growing literature on the interactive neural effects of alcohol and exercise, and the capacity of exercise to repair alcohol-induced brain damage. Increasingly, exercise is being used as a component of treatment for alcohol use disorders (AUD), not because it reverses alcohol-induced brain damage, but because it represents a rewarding, alcohol-free activity that could reduce alcohol cravings and improve comorbid conditions such as anxiety and depression. It is important to bear in mind, however, that multiple studies attest to a counterintuitive positive relationship between alcohol intake and exercise. We therefore conclude with cautionary notes regarding the use of exercise to repair the brain after alcohol damage.
Collapse
|
48
|
Wang N, Ouedraogo Y, Chu J, Liu Y, Wang K, Xie X. Variable reduction for past year alcohol and drug use in unmet need for mental health services among US adults. J Affect Disord 2019; 256:110-116. [PMID: 31174026 DOI: 10.1016/j.jad.2019.05.069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/24/2019] [Accepted: 05/28/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND No previous study has focused on the inter-relationship among alcohol and drug use variables in the past year. This study aimed to classify the past year alcohol and drug use variables and investigate the selected variables in past year alcohol and drug use with the unmet need for mental health services among US adults. METHODS Data came from the 2015 National Survey on Drug Use and Health (NSDUH). Oblique principal component cluster analysis (OPCCA) was used to classify 37 variables on alcohol and drug use in the past year into disjoint clusters. Weighted multiple logistic regression analysis was used to examine the associations of selected variables with the unmet need. RESULTS 37 alcohol and drug use variables were divided into 7 clusters. The variable with the lowest 1-R2 ratio (R2 is the squared correlation) from each cluster was selected as follows: tobacco use, pain reliever use, tranquilizer use, stimulant use, zolpidem products use, illicit drug and alcohol use, and benzodiazepine tranquilizers misuse. Multiple logistic regression analysis showed that pain reliever use (OR = 1.33, 95% CI = 1.17-1.50), tranquilizer use (OR = 2.49, 95% CI = 2.16-2.86), stimulant use (OR = 1.22, 95% CI = 1.01-1.47), and illicit drug and alcohol use (OR = 1.54, 95% CI = 1.34-1.77) revealed positive associations with the unmet need for mental health services. CONCLUSION This is the first study using OPCCA to reduce the dominations of alcohol and drug use; several alcohol and drug use variables in the past year were associated with unmet need of mental health services.
Collapse
Affiliation(s)
- Nianyang Wang
- Department of Health Services Administration, School of Public Health, University of Maryland, College Park, MD 20742, USA
| | - Youssoufou Ouedraogo
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Jun Chu
- Department of Health Services Administration, School of Public Health, University of Maryland, College Park, MD 20742, USA
| | - Ying Liu
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Kesheng Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Xin Xie
- Department of Economics and Finance, College of Business and Technology, East Tennessee State University, PO Box 70686, 227 Sam Wilson Hall, Johnson City, TN 37614, USA.
| |
Collapse
|
49
|
Quisenberry AJ, Pittman J, Goodwin RD, Bickel WK, D'Urso G, Sheffer CE. Smoking relapse risk is increased among individuals in recovery. Drug Alcohol Depend 2019; 202:93-103. [PMID: 31325822 PMCID: PMC6685745 DOI: 10.1016/j.drugalcdep.2019.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The prevalence of cigarette smoking among individuals with a history of substance use disorders (SUDs) remains up to four times higher than those without a history of SUDs. More than half of individuals who attain sustained remission from SUDs will die of tobacco-related diseases. The aim of this secondary data analysis was to compare the risk for smoking relapse among smokers with no history of SUDs and smokers in recovery from SUDs after multi-component, cognitive-behavioral treatment for tobacco dependence. METHODS Participants were randomized to receive 6 sessions of multicomponent cognitive-behavioral therapy (adapted for lower socioeconomic groups or standard), 8 weeks of nicotine patches, and were followed for 6 months in the parent randomized clinical trial. Participants passed a urine drug test prior to enrollment. Recovery was assessed at baseline by self-report to the question, "Do consider yourself in recovery from drugs or alcohol?" Relapse was defined as any smoking for 7 consecutive days. RESULTS Participants were primarily lower SES and identified as racial and/or ethnic minorities. Cox proportional hazards models revealed that the risk of smoking relapse following tobacco dependence treatment was greater among smokers in long-term (HR: 1.44; 95% CI: 1.01, 2.05) and short-term (HR: 1.98; 95% CI: 1.30, 3.03) recovery than for smokers with no history of SUDs. CONCLUSIONS Our findings indicate that smokers in recovery from SUDs have 1.5-2 times the risk of relapse than smokers with no history of SUDs. More effective relapse prevention interventions are needed for this vulnerable, high-risk group of smokers.
Collapse
Affiliation(s)
- Amanda J Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14203, United States.
| | - Jami Pittman
- College of Liberal Arts & Sciences, Wayne State University, 4841 Cass Avenue, Detroit, MI, 48201, United States
| | - Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, United States; Institute of Implementation in Population Health, The City University of New York, 55 West 125th Street, New York, New York, 10027, United States
| | - Warren K Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA, 24016, United States
| | - Giordano D'Urso
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14203, United States
| |
Collapse
|
50
|
Caetano R, Vaeth PAC, Canino G. Comorbidity of Lifetime Alcohol Use Disorder and Major Depressive Disorder in San Juan, Puerto Rico. J Stud Alcohol Drugs 2019; 80:546-551. [PMID: 31603756 PMCID: PMC6811725 DOI: 10.15288/jsad.2019.80.546] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 06/17/2019] [Indexed: 01/29/2024] Open
Abstract
OBJECTIVE The purpose of this study was to update estimates of comorbidity between lifetime alcohol use disorder (AUD) severity and lifetime major depressive disorder (MDD) in San Juan, Puerto Rico. METHOD Data are from a household random sample of 1,510 individuals (816 female) 18-64 years of age in San Juan, Puerto Rico. AUD and MDD identification follow criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and Fourth Edition, respectively, both implemented with the Composite International Diagnostic Interview (CIDI). It is possible to implement DSM-5 AUD identification with the CIDI, but only DSM-IV criteria can be applied to identify MDD. RESULTS The prevalence of lifetime MDD was 11% among men, 17% among women, and 14% for both genders; the prevalence of lifetime AUD was 38% among men, 16% among women, and 26% for both genders. Among those with AUD, the rate of MDD was 17% among men and 35% among women. Among those without AUD the rate of MDD was 7% among men and 15% among women. Results of multiple logistic regression analysis controlling for gender, illegal drug use, age, level of family cohesion, religion, employment status, marital status, education, and family annual income showed that AUD severity was positively associated with the likelihood of MDD, as follows: mild AUD, adjusted odds ratio [AOR] = 1.78 (95% CI [1.09, 2.91], p < .05); moderate AUD, AOR = 2.58 (95% CI [1.33, 5.01], p < .01); and severe AUD, AOR = 3.34 (95% CI [1.70, 6.56], p < .01). CONCLUSIONS MDD frequently occurs as a comorbid condition with AUD in San Juan, Puerto Rico. The frequency of occurrence increases as AUD severity increases. AUD treatment providers should therefore be equally prepared to treat these two comorbid conditions.
Collapse
Affiliation(s)
- Raul Caetano
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Patrice A. C. Vaeth
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Glorisa Canino
- Behavioral Sciences Research Institute, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| |
Collapse
|