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Chen T, Oginni OA, Hannigan LJ, Eley TC, Maggs JL, Linden-Carmichael AN, Neiderhiser JM. Developmental trajectories of child and adolescent emotional problems: associations with early adult alcohol use behaviors. J Child Psychol Psychiatry 2024. [PMID: 38924525 DOI: 10.1111/jcpp.14034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Whether emotional problems during childhood and adolescence are longitudinally associated with adult alcohol use behaviors is unclear. This study examined associations between developmental trajectories of emotional problems and early adult alcohol use behaviors, while considering co-occurring conduct problems, developmental change/timing, sex differences, and potential confounds. METHODS Participants were from the Twins Early Development Study (analytic N = 19,908 individuals). Emotional and conduct problems were measured by parent reports at child ages 4, 7, and 9 years and via self-reports at ages 9, 11, and 16 years on the Strengths and Difficulties Questionnaire. Alcohol use behaviors (alcohol consumption and alcohol-related problems) were self-reported by the twins on the Alcohol Use Disorders Identification Test at age 22 years. Piecewise latent growth curve models described nonlinear developmental trajectories of emotional and conduct problems from ages 4 to 16. At age 22, alcohol use was regressed on emotional and conduct problems' intercepts and slopes from piecewise latent growth curve model and sex differences in regression coefficients were tested. Using twin modeling, Cholesky decompositions and direct path models were compared to test whether significant phenotypic associations were best explained by direct phenotypic influences or correlated genetic and environmental influences. RESULTS Emotional problems had different associations with alcohol-related problems versus alcohol consumption. After accounting for direct influences from conduct problems, emotional problems were not associated with alcohol-related problems, while emotional problems at age 9 were negatively associated with alcohol consumption in males. CONCLUSIONS Overall, findings did not support emotional problems as prospective risk factors for severe alcohol use above and beyond risks associated with conduct problems. Sex- and age-specific links between emotional problems and alcohol consumption in early adulthood may be worthy of further exploration, particularly as twin analyses improved our confidence that such links may be underpinned by causal mechanisms.
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Affiliation(s)
- Tong Chen
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Olakunle A Oginni
- The Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Laurie J Hannigan
- Nic Waals Institute, Lovisenberg Diakonale Hospital, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Thalia C Eley
- The Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jennifer L Maggs
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Ashley N Linden-Carmichael
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
| | - Jenae M Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
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Gardner LA, Stockings E, Champion KE, Mather M, Newton NC. Alcohol initiation before age 15 predicts earlier hazardous drinking: A survival analysis of a 7-year prospective longitudinal cohort of Australian adolescents. Addiction 2024; 119:518-529. [PMID: 37926434 DOI: 10.1111/add.16376] [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: 01/26/2023] [Accepted: 09/19/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND AND AIMS Early alcohol use may predict later alcohol problems, but the magnitude of this effect and impact of delayed onset remain uncertain. This study measured age-based differences in progression from first full alcoholic drink to hazardous drinking in one of the largest and most recent prospective cohorts of Australian adolescents. DESIGN, SETTINGS, PARTICIPANTS AND MEASUREMENT A 7-year (2012-19) prospective longitudinal cohort of 2082 Australian adolescents was established from the Climate and Preventure (cohort 1) and Climate Schools Combined (cohort 2) studies. Participants completed surveys annually from ages 13 to 20 years. Interval censored survival analyses were conducted with first episode of hazardous drinking [three or more on proxy Alcohol Use Disorders Identification Test (AUDIT-C)] as the survival end-point, controlling for age, sex and mental health symptomatology. Onset of hazardous drinking was expressed as hazard ratios (HRs), and median survival time (years) was used to model first onset of hazardous alcohol use in survival curves. FINDINGS Compared with those aged 15 or older, those who had their first full drink at 12 or younger had significantly elevated risk of hazardous drinking onset during the study period [log (HR): 9.3; 95% confidence interval (CI) = 7.0-12.0, P < 0.001]. Compared with those who had their first full drink at ages 13-14, those who delayed until 15 or older had significantly later onset of hazardous drinking; 1.63 years for males (95% CI = 1.31-1.92, P < 0.001) and 1.50 for females (95% CI = 1.15-1.81, P < 0.001), resulting in a median age of onset of hazardous drinking of > 19 for both sexes (male: 19.05 years, 95% CI = 18.74-19.38; female: 19.47 years, 95% CI = 19.19-19.75). First drink at ages 13-14 was associated with the earliest onset of hazardous drinking (males: 17.43 years; females: 17.98 years). CONCLUSIONS In Australia, alcohol initiation prior to age 15 appears to be associated with an earlier onset of hazardous drinking than initiation after age 15.
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Affiliation(s)
- Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Emily Stockings
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Marius Mather
- Sydney Informatics Hub, University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
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Lee HJ, Choi JP, Oh K, Min JY, Min KB. Impact of Physical Activity on the Association Between Unhealthy Adolescent Behaviors and Anxiety Among Korean Adolescents: A Cross-sectional Study. J Prev Med Public Health 2023; 56:552-562. [PMID: 37974058 DOI: 10.3961/jpmph.23.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES Adolescents who engage in unhealthy behaviors are particularly vulnerable to anxiety. We hypothesized that participation in physical activity could influence the relationship between anxiety and unhealthy behaviors in adolescents. These behaviors include smoking, alcohol consumption, and unsafe sexual activity. METHODS This study included 50 301 students from the first year of middle school to the third year of high school, all from Korea. The unhealthy adolescent behaviors examined included current alcohol consumption, current smoking, and unsafe sexual behavior. Anxiety levels were assessed using the Generalized Anxiety Disorder-7 questionnaire (GAD-7). RESULTS The participants had a mean age of 15.19 years and an average GAD-7 score of 4.23. No significant differences were observed in GAD-7 score among exercising participants when categorized by smoking status (p=0.835) or unsafe sexual behavior (p=0.489). In contrast, participants in the non-exercise group who engaged in these behaviors demonstrated significantly higher GAD-7 scores (p<0.001 and 0.016, respectively). The only significant interaction was found between unsafe sexual behavior and exercise (p=0.009). Based on logistic regression analysis, within the non-exercise group, significant positive associations were observed between current smoking and anxiety (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.18 to 1.57), as well as between unsafe sexual behavior and anxiety (OR, 1.33; 95% CI, 1.02 to 1.73). However, within the exercise group, no significant association was found between anxiety and either smoking or unsafe sexual behavior. Furthermore, no significant interaction was observed between unhealthy behaviors and exercise. CONCLUSIONS These findings are insufficient to conclude that physical activity influences the relationship between unhealthy behaviors and anxiety.
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Affiliation(s)
- Hyo-Jung Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Pil Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kunhee Oh
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Min
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
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Hwang JW, Eun Y, Song CH. Associations of Alcohol Consumption and Smoking Behaviors with Depressed Mood According to Gender in Korean Young Adults. Korean J Fam Med 2023; 44:274-280. [PMID: 37423254 PMCID: PMC10522473 DOI: 10.4082/kjfm.22.0146] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 04/25/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Recent studies have reported that chronic mental health problems often emerge in young adulthood. This study elucidated the independent effects of smoking and drinking on depressed mood in young adults by sex. METHODS We used Data from the Korea National Health and Nutrition Examination Surveys conducted in 2014, 2016, and 2018. A total of 3,391 participants aged 19-35 years, without serious chronic diseases, were recruited for this study. Depression was evaluated using the Patient Health Questionnaire (PHQ-9). RESULTS Smoking behavior, current smoking, and number of days smoked were significantly associated with higher PHQ-9 scores in both men and women (all P<0.05). However, past and ever smoking were positively associated with PHQ-9 scores only in women (all P<0.001). Regarding alcohol consumption, the age at which drinking first began was negatively associated with PHQ-9 scores in both men and women (all P<0.001), but the amount of alcohol consumed at 1 time was positively associated with PHQ-9 scores only in women (P=0.013). Men who drank 2-4 times a month and women who had not drunk during the past year had the lowest PHQ-9 scores. CONCLUSION Smoking and alcohol consumption were independently associated with depressed mood in young Korean adults, which was more pronounced in women, and exhibited sex-specific characteristics.
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Affiliation(s)
- Jung Won Hwang
- Department of Family Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Youngmi Eun
- Department of Family Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chan-Hee Song
- Department of Family Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Xu C, Acevedo P, Wang L, Wang N, Ozuna K, Shafique S, Karithara A, Padilla V, Mao C, Xie X, Wang K. Sleep Apnea and Substance Use Disorders Associated with Co-Occurrence of Anxiety Disorder and Depression among U.S. Adults: Findings from the NSDUH 2008-2014. Brain Sci 2023; 13:brainsci13040661. [PMID: 37190626 DOI: 10.3390/brainsci13040661] [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: 03/19/2023] [Revised: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 05/17/2023] Open
Abstract
Few studies have focused on sleep apnea and substance use disorders with co-occurrence of anxiety disorder and depression. This study included a total of 270,227 adults, 9268 with co-occurrence of anxiety disorder and depression in the past year, from the combined 2008-2014 National Survey on Drug Use and Health (NSDUH) data, which are the latest datasets with measures of anxiety disorder and sleep apnea. Weighted multinomial logistic regression analyses were used to estimate the associations between anxiety disorder and depression and their co-occurrence. Comorbidity was highly prevalent: 40.4% of those with depression also met the criteria for anxiety disorder, whereas 51.8% of those with anxiety disorder also met the criteria for depression. The prevalences of anxiety only and co-occurrence increased from 2008 to 2014. The prevalences of anxiety disorder only, depression only, and co-occurrence of anxiety disorder and depression in individuals with sleep apnea were 4.4%, 12.9%, and 12.2%, respectively, and the prevalences in substance use disorders were 6.4%, 9.4%, and 10.7%, respectively. The results showed that sleep apnea, substance use disorders, and nicotine dependence were significantly associated with increased odds of anxiety disorder, depression, and co-occurrence (all p values < 0.0001). Furthermore, several chronic diseases (asthma, bronchitis, hypertension, and heart disease) were associated with the co-occurrence of anxiety disorder and depression. These findings suggest clinicians and other healthcare providers consider screening for depression and anxiety with sleep apnea and substance use disorders for improved therapeutic outcomes.
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Affiliation(s)
- Chun Xu
- Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | - Priscila Acevedo
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Liang Wang
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA
| | - Nianyang Wang
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD 20742, USA
| | - Kaysie Ozuna
- Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | - Saima Shafique
- School of Nursing, Health Sciences Center, West Virginia University, Morgantown, WV 26506, USA
| | - Annu Karithara
- Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | - Victoria Padilla
- Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | - Chunxiang Mao
- Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | - Xin Xie
- Department of Economics and Finance, College of Business and Technology, East Tennessee State University, Johnson City, TN 37614, USA
| | - Kesheng Wang
- School of Nursing, Health Sciences Center, West Virginia University, Morgantown, WV 26506, USA
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Harmanci D, Edelman N, Richardson D, Lunt A, Llewellyn C. How are young people's mental health related to their sexual health and substance use? A systematic review of UK literature. Int J Adolesc Med Health 2023; 35:131-158. [PMID: 36636992 DOI: 10.1515/ijamh-2022-0090] [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: 10/11/2022] [Accepted: 12/15/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The transition from childhood to adulthood is complex and presents challenges to young people's mental health. Mental health impacts and is impacted by a range of contextual and personal factors. Adolescence and young adulthood also coincide with increased experimentation with sex, sexuality and substance use. Addressing the mental health, sexual health and substance-use challenges experienced by young people therefore necessitates an understanding of how these elements relate to one another. By collecting and analysing existing literature, this review aims to identify associations between young people's mental health and sexual health, their mental health and substance use and any resulting gaps-in-knowledge. CONTENT Seven electronic databases were searched between March and May 2021 and updated in May 2022 with terms collated under the categories of "young people", "mental health", "sexual health" and "substance use". English-language articles, presenting data from the UK & Ireland, on young people aged 16-24 years inclusive were screened and subjected to a selection process in accordance with PRISMA guidelines (preregistered on PROSPERO, ref. number CRD42021245096). The quality of the resulting articles were assessed using the Mixed Methods Appraisal Tool (MMAT) and findings were tabulated through a data extraction process. SUMMARY 27 articles were included in the review. Various mental health indices such as depression, anxiety, self-harm, psychotic-like experiences, hypomanic symptoms and binge-purge type eating disorders were found to be associated with higher use of substances such as alcohol, cannabis, ecstasy and generalised drug use. Additionally, mental health indices such as depression, anxiety and self-harm were found to be associated with sex before age 16 and/or unprotected sex at age 16, positive Chlamydia infection and higher levels of sexual activity at a younger age. Overall, cross-sectional associations were stronger than the longitudinal associations presented in the articles. OUTLOOK This review into the specific relations between young people's mental health, sexual health and substance use has revealed the complex and bi-directional nature of these associations, with some conditions and substances having been more extensively investigated (e.g., alcohol and depression/anxiety) as opposed to the relations between young people's sexual health and mental health which is lacking in the UK and Irish context. The findings can help inform mental health related policies and service provisions targeted at young people in the UK and Ireland. Areas for future work are suggested.
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Affiliation(s)
- Damla Harmanci
- Department of Primary Care & Public Health, Brighton and Sussex Medical School, Falmer, Brighton, UK
| | - Natalie Edelman
- Department of Primary Care & Public Health, Brighton and Sussex Medical School, Falmer, Brighton, UK.,School of Sport & Health Sciences, University of Brighton, Falmer, Brighton, UK
| | - Daniel Richardson
- Department of Primary Care & Public Health, Brighton and Sussex Medical School, Falmer, Brighton, UK.,University Hospitals Sussex NHS foundation Trust, Brighton, UK
| | - Alexandria Lunt
- Department of Primary Care & Public Health, Brighton and Sussex Medical School, Falmer, Brighton, UK
| | - Carrie Llewellyn
- Department of Primary Care & Public Health, Brighton and Sussex Medical School, Falmer, Brighton, UK
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Skipping Breakfast and Incidence of Frequent Alcohol Drinking in University Students in Japan: A Retrospective Cohort Study. Nutrients 2022; 14:nu14132657. [PMID: 35807842 PMCID: PMC9267987 DOI: 10.3390/nu14132657] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 12/10/2022] Open
Abstract
Frequency of alcohol drinking is a potential predictor of binge drinking of alcohol, a serious social problem for university students. Although previous studies have identified skipping breakfast as a predictor of various health-compromising behaviors and cardiometabolic diseases, few studies have assessed the association between skipping breakfast and the incidence of frequent alcohol drinking. This retrospective cohort study included 17,380 male and 8799 female university students aged 18–22 years admitted to Osaka universities between 2004 and 2015. The association between breakfast frequency (eating every day, skipping occasionally, and skipping often/usually) and the incidence of frequent alcohol drinking, defined as drinking ≥4 days/week, was assessed using multivariable-adjusted Cox proportional hazards models. During the median observational period of 3.0 years, 878 (5.1%) men and 190 (2.2%) women engaged in frequent alcohol drinking. Skipping breakfast was significantly associated with the incidence of frequent alcohol drinking (adjusted hazard ratios [95% confidence interval] of eating every day, skipping occasionally, and skipping often/usually: 1.00 [reference], 1.02 [0.84–1.25], and 1.48 [1.17–1.88] in men; 1.00 [reference], 1.60 [1.03–2.49], and 3.14 [1.88–5.24] in women, respectively). University students who skipped breakfast were at a higher risk of frequent alcohol drinking than those who ate breakfast every day.
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Amendola S, Hengartner MP, Ajdacic-Gross V, Angst J, Rössler W. Longitudinal reciprocal associations between depression, anxiety, and substance use disorders over three decades of life. J Affect Disord 2022; 302:315-323. [PMID: 35093414 DOI: 10.1016/j.jad.2022.01.101] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVE Studies exploring longitudinal reciprocal associations between depressive, anxiety, and substance use disorders (DD, AD and SUD, respectively) over long periods of time are mainly lacking. Therefore, the aim of the present study is to test longitudinal associations (i.e. temporal dynamics) between DD, AD and SUD from young adulthood to middle adulthood. METHODS A stratified community sample of 591 participants from the canton of Zurich, Switzerland, was interviewed with the Structured Psychopathological Interview and Rating of the Social Consequences of Psychological Disturbances for Epidemiology over seven interview waves from ages 20/21 to 49/50. Diagnostic and Statistical Manual of Mental Disorders criteria were used to evaluate the presence of DD, AD and SUD. We fitted an auto-regressive cross-lagged path analysis within a Bayesian structural equation model to test longitudinal associations. RESULTS Regarding autoregressive effects, AD (except during young adulthood) and SUD predicted themselves over the entire time period, while DD recurrently predicted itself not consistently over time. Regarding cross-lagged effects, DD predicted SUD at different time points, and vice versa. DD predicted subsequent AD in adulthood, whereas the reverse did not happen. Female gender was associated with DD and AD at all ages while male gender was associated with SUD only in young adulthood. CONCLUSIONS Reciprocal longitudinal associations were found between DD and SUD and DD usually preceded AD. Our results further confirm an increased risk of DD and AD in women and a higher risk of SUD in young men. Early treatment and broad psychosocial interventions should be provided in order to prevent chronicity and further maladjustment as well as interrupting the cycle of mutual reinforcement between DD and SUD.
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Affiliation(s)
- Simone Amendola
- Department of Dynamic and Clinical Psychology and Health Studies, Faculty of Medicine and Psychology, Sapienza - University of Rome, Rome, Italy.
| | | | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Jules Angst
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Sao Paulo, Brazil; Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
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Christ C, Schouten MJ, Blankers M, van Schaik DJ, Beekman AT, Wisman MA, Stikkelbroek YA, Dekker JJ. Internet and Computer-Based Cognitive Behavioral Therapy for Anxiety and Depression in Adolescents and Young Adults: Systematic Review and Meta-Analysis. J Med Internet Res 2020; 22:e17831. [PMID: 32673212 PMCID: PMC7547394 DOI: 10.2196/17831] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/23/2020] [Accepted: 06/21/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Anxiety and depressive disorders are prevalent in adolescents and young adults. However, most young people with mental health problems do not receive treatment. Computerized cognitive behavior therapy (cCBT) may provide an accessible alternative to face-to-face treatment, but the evidence base in young people is limited. OBJECTIVE The objective was to perform an up-to-date comprehensive systematic review and meta-analysis of the effectiveness of cCBT in treating anxiety and depression in adolescents and young adults compared with active treatment and passive controls. We aimed to examine posttreatment and follow-up effects and explore the moderators of treatment effects. METHODS We conducted systematic searches in the following six electronic databases: PubMed, EMBASE, PsycINFO, CINAHL, Web of Science, and Cochrane Central Register of Controlled Trials. We included randomized controlled trials comparing cCBT with any control group in adolescents or young adults (age 12-25 years) with anxiety or depressive symptoms. The quality of included studies was assessed using the Cochrane risk-of-bias tool for randomized trials, version 2.0. Overall quality of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Posttreatment means and SDs were compared between intervention and control groups, and pooled effect sizes (Hedges g) were calculated. Random-effects meta-analyses were conducted using Comprehensive Meta-Analysis software. Subgroup analyses and meta-regression analyses were conducted to explore whether age, guidance level, and adherence rate were associated with treatment outcome. RESULTS The search identified 7670 papers, of which 24 studies met the inclusion criteria. Most included studies (22/24) had a high risk of bias owing to self-report measures and/or inappropriate handling of missing data. Compared with passive controls, cCBT yielded small to medium posttreatment pooled effect sizes regarding depressive symptoms (g=0.51, 95% CI 0.30-0.72, number needed to treat [NNT]=3.55) and anxiety symptoms (g=0.44, 95% CI 0.23-0.65, NNT=4.10). cCBT yielded effects similar to those of active treatment controls regarding anxiety symptoms (g=0.04, 95% CI -0.23 to 0.31). For depressive symptoms, the nonsignificant pooled effect size favored active treatment controls (g=-0.70, 95% CI -1.51 to 0.11, P=.09), but heterogeneity was very high (I2=90.63%). No moderators of treatment effects were identified. At long-term follow-up, cCBT yielded a small pooled effect size regarding depressive symptoms compared with passive controls (g=0.27, 95% CI 0.09-0.45, NNT=6.58). No other follow-up effects were found; however, power was limited owing to the small number of studies. CONCLUSIONS cCBT is beneficial for reducing posttreatment anxiety and depressive symptoms in adolescents and young adults compared with passive controls. Compared with active treatment controls, cCBT yielded similar effects regarding anxiety symptoms. Regarding depressive symptoms, however, the results remain unclear. More high-quality research involving active controls and long-term follow-up assessments is needed in this population. TRIAL REGISTRATION PROSPERO CRD42019119725; https://tinyurl.com/y5acfgd9.
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Affiliation(s)
- Carolien Christ
- Department of Psychiatry, GGZ inGeest, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Research, Arkin Mental Health Care, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Maria Je Schouten
- Department of Research, Arkin Mental Health Care, Amsterdam, Netherlands
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Amsterdam, Netherlands
- Trimbos institute-The Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - Digna Jf van Schaik
- Department of Psychiatry, GGZ inGeest, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Aartjan Tf Beekman
- Department of Psychiatry, GGZ inGeest, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marike A Wisman
- Department of Youth and Family, Arkin Mental Health Care, Amsterdam, Netherlands
| | - Yvonne Aj Stikkelbroek
- Department of Child and Adolescent Studies, Universiteit Utrecht, Utrecht, Netherlands
- Depression Expert Center for Youth, Mental Health Care Oost-Brabant, Boekel, Netherlands
| | - Jack Jm Dekker
- Department of Research, Arkin Mental Health Care, Amsterdam, Netherlands
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Deficient processing of alcohol cues in the addicted brain: Evidence from event-related potential microstates. Clin Neurophysiol 2020; 131:2224-2235. [PMID: 32711347 DOI: 10.1016/j.clinph.2020.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Patients with alcohol use disorder (AUD) show altered brain responses to alcohol cues as compared to healthy controls. Event-related potential (ERP) studies mostly focus on the P3, which is usually diminished in AUD patients. The few studies that have investigated earlier components have yielded inconsistent results. The present study aimed at identifying the onset of impaired alcohol cue processing in AUD patients, as well as the association between neurophysiological processing and subjective craving. METHODS A sample of 15 inpatients with AUD and 15 healthy controls completed a cue reactivity task with alcohol-related, neutral, and scrambled pictures. Multichannel-EEG was recorded from 70 scalp electrodes, and ERP microstates were analyzed. RESULTS Patients displayed impaired neurophysiological processing, as indexed by a weaker P3 and a weaker, insensitive P1. The blunted P1 was associated with higher subjective craving. CONCLUSIONS Impaired alcohol cue processing in AUD emerges early, at the stage of sensory processing. Such deficient initial processing seems crucial to understanding cue reactivity processes in the brain and in the subjective experience of craving. SIGNIFICANCE The results highlight the importance of investigating early ERP components preceding the P3, and contribute to the debate on the onset of information-processing dysfunction in the addicted brain.
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Bonar EE, Schneeberger DM, Bourque C, Bauermeister JA, Young SD, Blow FC, Cunningham RM, Bohnert AS, Zimmerman MA, Walton MA. Social Media Interventions for Risky Drinking Among Adolescents and Emerging Adults: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e16688. [PMID: 32401225 PMCID: PMC7254293 DOI: 10.2196/16688] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/30/2020] [Accepted: 02/16/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Despite intervention efforts to date, the prevalence of risky drinking among adolescents and emerging adults remains high, increasing the risk for health consequences and the development of alcohol use disorders. Peer influences are particularly salient among this age group, including via social media. Thus, the development of efficacious early interventions for youth, delivered with a broad reach via trained peers on social media, could have an important role in addressing risky drinking and concomitant drug use. OBJECTIVE This paper describes the protocol of a randomized controlled trial (RCT) testing the efficacy of a social media intervention among adolescents and emerging adults who meet the criteria for risky drinking (using the Alcohol Use Disorders Identification Test-Consumption [AUDIT-C]), delivered with and without financial incentives for participation, compared with an attention placebo control condition (ie, entertaining social media content), on alcohol consumption and consequences. METHODS This RCT involved recruiting 955 youths (aged 16-24 years) via advertisements on Facebook and Instagram to self-administer a brief web-based screening survey. Those screening positive for past 3-month risky drinking (AUDIT-C positive: ages 16-17 years: ≥3 females and ≥4 males; and ages 18-24 years: ≥4 females and ≥5 males) were eligible for the RCT. After providing consent (a waiver of parental consent was obtained for minors), participants completed a web-based baseline survey and several verification procedures, including a selfie photo matched to Facebook profile photos. Participants were then randomized to join invitation-only secret Facebook groups, which were not searchable or viewable by parents, friends, or anyone not recruited by the study. The 3 conditions were social media intervention with incentives, social media intervention without incentives (SMI), and attention placebo control. Each condition lasted 8 weeks and consisted of bachelor's-level and master's-level therapist electronic coaches posting relevant content and responding to participants' posts in a manner consistent with Motivational Interviewing. Participants in the control condition and SMI condition did not receive payments but were blind to condition assignment between these 2 conditions. Follow-ups are ongoing and occur at 3, 6, and 12 months poststart of the groups. RESULTS We enrolled 955 participants over 10 waves of recruitment who screened positive for risky drinking into the RCT. CONCLUSIONS The findings of this study will provide the critical next step in delivering early alcohol interventions to the youth, capitalizing on social media platforms, which could have significant public health impact by altering alcohol use trajectories of adolescents and emerging adults engaged in risky drinking. TRIAL REGISTRATION ClinicalTrials.gov NCT02809586; https://clinicaltrials.gov/ct2/show/NCT02809586. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/16688.
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Affiliation(s)
- Erin E Bonar
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Addiction Center, University of Michigan, Ann Arbor, MI, United States
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
| | - Diane M Schneeberger
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Addiction Center, University of Michigan, Ann Arbor, MI, United States
| | - Carrie Bourque
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Addiction Center, University of Michigan, Ann Arbor, MI, United States
| | - Jose A Bauermeister
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Sean D Young
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California Irvine, Irvine, CA, United States
- Department of Emergency Medicine, University of California Irvine, Irvine, CA, United States
| | - Frederic C Blow
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Addiction Center, University of Michigan, Ann Arbor, MI, United States
- Center for Clinical Management Research, Veterans Health Administration, Ann Arbor, MI, United States
| | - Rebecca M Cunningham
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States
- Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Amy Sb Bohnert
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
- Center for Clinical Management Research, Veterans Health Administration, Ann Arbor, MI, United States
| | - Marc A Zimmerman
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
- Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Maureen A Walton
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Addiction Center, University of Michigan, Ann Arbor, MI, United States
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
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Ning K, Gondek D, Patalay P, Ploubidis GB. The association between early life mental health and alcohol use behaviours in adulthood: A systematic review. PLoS One 2020; 15:e0228667. [PMID: 32069303 PMCID: PMC7028290 DOI: 10.1371/journal.pone.0228667] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 01/20/2020] [Indexed: 02/07/2023] Open
Abstract
This systematic review aims to summarise current evidence on the association between early life mental health and alcohol use behaviours in adulthood. Peer-reviewed publications were located by searching EMBASE, Medline, PsycINFO, and the ISI Web of Science up to 31 October 2018. Prospective longitudinal studies reporting associations between externalising problems (EXT), internalising problems (INT), depression, anxiety before age 18, and alcohol use behaviours (alcohol consumption, heavy/problematic drinking, alcohol use disorder) after age 18 were included. After screening 17259 articles, 36 articles met the inclusion criteria. Information extracted included strength of associations, age when mental health and alcohol use behaviours were measured, sex differences in the association, and other sample characteristics. 103 tests in 23 articles were identified on the externalising domain and 135 tests in 26 articles on the internalising domain. 37 out of 103 tests reported positive associations between EXT and alcohol use behaviours. The likelihood of observing positive associations was higher for more severe alcohol use outcomes, but this trend disappeared among high-quality studies. Findings on associations between internalising domain and alcohol use varied across their subtypes. INT tended to be negatively associated with alcohol consumption but positively associated with more severe outcomes (heavy/problematic drinking, alcohol use disorder). Depression tended to be positively associated with alcohol outcomes, while no clear association between anxiety and alcohol outcomes was evident. Variation of the association across developmental timing, sex, culture, historical period was explored where appropriate. Great heterogeneity in the current literature calls for greater attention to view the relationship developmentally.
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Affiliation(s)
- Ke Ning
- Centre for Longitudinal Studies, Department of Social Science, University College of London, London, The United Kingdom
| | - Dawid Gondek
- Centre for Longitudinal Studies, Department of Social Science, University College of London, London, The United Kingdom
| | - Praveetha Patalay
- Centre for Longitudinal Studies, Department of Social Science, University College of London, London, The United Kingdom
| | - George B. Ploubidis
- Centre for Longitudinal Studies, Department of Social Science, University College of London, London, The United Kingdom
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13
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Haikerwal A, Doyle LW, Cheung MM, Wark JD, Opie G, Roberts G, Patton G, Cheong JL. High Blood Pressure in Young Adult Survivors Born Extremely Preterm or Extremely Low Birthweight in the Post Surfactant Era. Hypertension 2020; 75:211-217. [DOI: 10.1161/hypertensionaha.119.13780] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
More infants born extremely preterm (<28 weeks’ gestation) or extremely low birthweight (<1000 g) are surviving into adulthood in recent years. Preterm adolescents have higher blood pressure (BP) than normal birthweight controls, but how their BP changes with increasing age is not known. We compared BP at 25 years and trajectories of BP (change per year) from 18 to 25 years between survivors born <28 weeks/<1000 g and normal birthweight (>2499 g) controls born in the early 1990s, when survival rates began to rise. Participants were derived from 297 consecutive survivors born <28 weeks/<1000 g in 1991 to 1992 in Victoria, Australia, and 260 contemporaneous controls. At age 25 years, ambulatory BP was measured in 151 and 119 participants, respectively. Participants born <28 weeks/<1000 g had higher 24-hour systolic (mean difference 4.5 [95% CI, 1.2–7.7 mm Hg]), diastolic (3.4 [1.5–5.2 mm Hg]), and mean BPs (3.6 [1.4–5.8 mm Hg]) compared with the controls. Similar patterns were observed for both awake and asleep periods. Asleep ambulatory BP between 18 and 25 years increased more in participants born <28 weeks/<1000 g than in controls (systolic 0.56, diastolic 0.41, and mean 0.41 mm Hg increase per year; all
P
<0.05). Young adults born <28 weeks/<1000 g in the post surfactant era have higher BP and an increased trajectory of ambulatory BP compared with controls. With more survivors born <28 weeks/<1000 g now reaching adulthood, these findings are important for early detection and timely management of hypertension in this high-risk population.
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Affiliation(s)
- Anjali Haikerwal
- From the Newborn Services, The Royal Women’s Hospital, Melbourne, Australia (A.H., L.W.D., J.L.Y.C.)
- Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia (A.H., L.W.D., J.L.Y.C.)
| | - Lex W. Doyle
- From the Newborn Services, The Royal Women’s Hospital, Melbourne, Australia (A.H., L.W.D., J.L.Y.C.)
- Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia (A.H., L.W.D., J.L.Y.C.)
- Department of Obstetrics and Gynecology, The Royal Women’s Hospital (L.W.D., G.O., J.L.Y.C.), The University of Melbourne, Australia
- Department of Paediatrics (L.W.D., M.M.C., G.R., G.P.), The University of Melbourne, Australia
| | - Michael M. Cheung
- Department of Paediatrics (L.W.D., M.M.C., G.R., G.P.), The University of Melbourne, Australia
- Heart Research, Murdoch Children’s Research Institute, Melbourne, Australia (M.M.C.)
- Department of Cardiology, Royal Children’s Hospital, Melbourne, Australia (M.M.C.)
| | - John D. Wark
- Department of Medicine, The Royal Melbourne Hospital (J.D.W.), The University of Melbourne, Australia
- Bone and Mineral Medicine, The Royal Melbourne Hospital, Australia (J.D.W.)
| | - Gillian Opie
- Department of Obstetrics and Gynecology, The Royal Women’s Hospital (L.W.D., G.O., J.L.Y.C.), The University of Melbourne, Australia
- Neonatal Services, Mercy Hospital for Women, Melbourne, Australia (G.O.)
| | - Gehan Roberts
- Department of Paediatrics (L.W.D., M.M.C., G.R., G.P.), The University of Melbourne, Australia
- Centre for Community Child Health (G.R.), Royal Children’s Hospital, Melbourne, Australia
| | - George Patton
- Department of Paediatrics (L.W.D., M.M.C., G.R., G.P.), The University of Melbourne, Australia
- Centre for Adolescent Health (G.P.), Royal Children’s Hospital, Melbourne, Australia
| | - Jeanie L.Y. Cheong
- From the Newborn Services, The Royal Women’s Hospital, Melbourne, Australia (A.H., L.W.D., J.L.Y.C.)
- Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia (A.H., L.W.D., J.L.Y.C.)
- Department of Obstetrics and Gynecology, The Royal Women’s Hospital (L.W.D., G.O., J.L.Y.C.), The University of Melbourne, Australia
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Dyer ML, Easey KE, Heron J, Hickman M, Munafò MR. Associations of child and adolescent anxiety with later alcohol use and disorders: a systematic review and meta-analysis of prospective cohort studies. Addiction 2019; 114:968-982. [PMID: 30891835 PMCID: PMC6563455 DOI: 10.1111/add.14575] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/12/2018] [Accepted: 01/30/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Despite a wealth of literature, the relationship between anxiety and alcohol use remains unclear. We examined whether (a) child and adolescent anxiety is positively or negatively associated with later alcohol use and disorders and (b) study characteristics explain inconsistencies in findings. DESIGN AND SETTING We conducted a systematic review of 51 prospective cohort studies from 11 countries. Three studies contributed to a meta-analysis. We searched PubMed, Scopus, Web of Science and PsycINFO databases, and studies were included if they met the following criteria: English language publication, human participants, anxiety exposure (predictor variable) in childhood or adolescence and alcohol outcome at least 6 months later. PARTICIPANTS Study sample sizes ranged from 110 to 11 157 participants. Anxiety exposure ages ranged from 3 to 24 years, and alcohol outcome ages ranged from 11 to 42 years. MEASUREMENTS Ninety-seven associations across 51 studies were categorized by anxiety exposure (generalized anxiety disorder, internalizing disorders, miscellaneous anxiety, obsessive compulsive disorder, panic disorder, separation anxiety disorder, social anxiety disorder and specific phobias) and alcohol use outcome (drinking frequency/quantity, binge drinking and alcohol use disorders). FINDINGS The narrative synthesis revealed some evidence for a positive association between anxiety and later alcohol use disorders. Associations of anxiety with later drinking frequency/quantity and binge drinking were inconsistent. Type and developmental period of anxiety, follow-up duration, sample size and confounders considered did not appear to explain the discrepant findings. The meta-analysis also showed no clear evidence of a relationship between generalized anxiety disorder and later alcohol use disorder (odds ratio = 0.94, 95% confidence interval = 0.47-1.87). CONCLUSIONS Evidence to date is suggestive, but far from conclusive of a positive association between anxiety during childhood and adolescence and subsequent alcohol use disorder.
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Affiliation(s)
- Maddy L Dyer
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Kayleigh E Easey
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Marcus R Munafò
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
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15
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Cheong JLY, Wark JD, Cheung MM, Irving L, Burnett AC, Lee KJ, Garland SM, Smallwood D, Patton GC, Haikerwal A, Doyle LW. Impact of extreme prematurity or extreme low birth weight on young adult health and well-being: the Victorian Infant Collaborative Study (VICS) 1991-1992 Longitudinal Cohort study protocol. BMJ Open 2019; 9:e030345. [PMID: 31072865 PMCID: PMC6527969 DOI: 10.1136/bmjopen-2019-030345] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Infants born extremely preterm (EP, <28 weeks' gestation) or with extremely low birth weight (ELBW,<1000 g) in the era when surfactant has been available clinically are at high risk of health and developmental problems in childhood and adolescence. However, how their health and well-being may be affected in adulthood is not well known. This study aims to compare between EP/ELBW and normal birthweight (NBW) controls: (1) physical health, mental health and socioemotional functioning at 25 years of age and (2) trajectories of these outcomes from childhood to adulthood. In addition, this study aims to identify risk factors in pregnancy, infancy, childhood and adolescence for poor physical health and well-being in EP/ELBW young adults. METHODS AND ANALYSIS The Victorian Infant Collaborative Study (VICS) is a prospective geographical cohort of all EP/ELBW survivors to 18 years of age born in the State of Victoria, Australia, from 1 January 1991 to 31 December 1992 (n=297) and contemporaneous term-born/NBW controls (n=262). Participants were recruited at birth and followed up at 2, 5, 8 and 18 years. This 25-year follow-up includes assessments of physical health (cardiovascular, respiratory and musculoskeletal), mental health and socioemotional functioning. Outcomes will be compared between the birth groups using linear and logistic regression, fitted using generalised estimating equations (GEEs). Trajectories of health outcomes from early childhood will be compared between the birth groups using linear mixed-effects models. Risk factors for adult outcomes will be assessed using linear and logistic regression (fitted using GEEs). ETHICS AND DISSEMINATION This study was approved by the Human Research Ethics Committees of the Royal Women's Hospital, Mercy Hospital for Women, Monash Medical Centre and the Royal Children's Hospital, Melbourne. Study outcomes will be disseminated through conference presentations, peer-reviewed publications, the internet and social media.
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Affiliation(s)
- Jeanie L Y Cheong
- Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Neonatal Services, Royal Women's Hospital, Parkville, Victoria, Australia
| | - John D Wark
- Bone and Mineral Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Michael M Cheung
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Cardiology, The Royal Children's Hospital, Parkville, Victoria, Australia
- Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Louis Irving
- Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Lung Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Alice C Burnett
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Katherine J Lee
- Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Clinical Epidemiology and Biostatistics, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Suzanne M Garland
- Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
- Centre for Women's Infectious Diseases Research, Royal Women's Hospital, Parkville, Victoria, Australia
- Infection and Immunity, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - David Smallwood
- Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - George C Patton
- Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Anjali Haikerwal
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Neonatal Services, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Lex W Doyle
- Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Neonatal Services, Royal Women's Hospital, Parkville, Victoria, Australia
- Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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17
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Schroder E, Dousset C, Noel X, Kornreich C, Campanella S. Increased Neural Activity in Hazardous Drinkers During High Workload in a Visual Working Memory Task: A Preliminary Assessment Through Event-Related Potentials. Front Psychiatry 2019; 10:248. [PMID: 31057442 PMCID: PMC6482249 DOI: 10.3389/fpsyt.2019.00248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 04/01/2019] [Indexed: 11/20/2022] Open
Abstract
Despite equated behavioral performance levels, hazardous drinkers generally exhibited increased neural activity while performing simple cognitive tasks compared to light drinkers. Here, 49 participants (25 hazardous and 24 light drinkers) participated in an event-related potentials (ERPs) study while performing an n-back working memory task. In the control zero-back (N0) condition, the subjects were required to press a button when the number "2" or "6" was displayed. In the two-back and three-back (N2; N3) conditions, the subjects had to press a button when the displayed number was identical to the number shown two/three trials earlier. To assess for the impact of alcohol consumption on the updating of working memory processes under various cognitive loads, difference waveforms of "N2 minus N0" and "N3 minus N0" were computed by subtracting waveforms in the N0 condition from waveforms in the N2 and N3 conditions, for the light and the hazardous drinkers. Three main ERP components were noted for both groups: a P200/N200 complex, a P300 component, and an N400/P600 activity. The results show that, to perform the task at the same level as the light drinkers, the hazardous drinkers exhibited larger amplitude differences, mainly around the P300 and P600 components. These data may be considered, at the preventive level, as vulnerability factors for developing adult substance use disorders, and they stress the importance, at a clinical level, to consider such working memory processes in the management of alcohol dependence.
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Affiliation(s)
- Elisa Schroder
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Clémence Dousset
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Xavier Noel
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Charles Kornreich
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Salvatore Campanella
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
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Johannessen EL, Andersson HW, Bjørngaard JH, Pape K. Anxiety and depression symptoms and alcohol use among adolescents - a cross sectional study of Norwegian secondary school students. BMC Public Health 2017; 17:494. [PMID: 28535753 PMCID: PMC5442592 DOI: 10.1186/s12889-017-4389-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 05/08/2017] [Indexed: 12/12/2022] Open
Abstract
Background We investigated the associations between symptoms of anxiety and depression and alcohol drinking behavior among adolescents, by focusing on the importance of symptom load, as well as gender differences. Methods Data was derived from a cross-sectional school based survey among adolescents in upper secondary schools in Norway. Among other variables adolescents reported on symptoms of anxiety and depression, time of onset and extent of alcohol use. The sample consisted of 6238 adolescents aged 16–18 years. We estimated prevalence of alcohol drinking behaviors in relation to severity of symptoms of anxiety and depression. Results Higher levels of depression symptoms were associated with earlier onset of alcohol use, more frequent consumption and intoxications. The associations between anxiety and depression symptoms and early drinking onset were stronger for girls than for boys. Higher levels of anxiety symptoms were only associated with alcohol consumption among girls. Conclusions Boys and girls with depressive symptoms and girls with anxiety symptoms are more likely to have unhealthy patterns of alcohol drinking. Preventive strategies at all levels could possibly profit from a common approach to mental health and alcohol use, in particular for girls in mid-adolescence.
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Affiliation(s)
| | - Helle Wessel Andersson
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olav's University Hospital, Trondheim, Norway
| | - Johan Håkon Bjørngaard
- Department of Public Health and Nursing, Norwegian University of Science and Technology, 7491, Trondheim, Norway.,St. Olav's University Hospital Trondheim, Forensic Department and Research Centre Bröset, Trondheim, Norway
| | - Kristine Pape
- Department of Public Health and Nursing, Norwegian University of Science and Technology, 7491, Trondheim, Norway.
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Siennick SE, Widdowson AO, Woessner M, Feinberg ME. Internalizing Symptoms, Peer Substance Use, and Substance Use Initiation. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2016; 26:645-657. [PMID: 28070153 PMCID: PMC5215896 DOI: 10.1111/jora.12215] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study used longitudinal survey and social network data covering sixth through ninth grades to test whether internalizing symptoms make early adolescents more prone to (1) exposure to and (2) influence by substance-using peers. Random effects regressions revealed that increases in symptoms were significantly associated with increases in the proportion of friends who used cigarettes, alcohol, and marijuana; some associations weakened across grades. Event history models revealed that the effect of friends' smoking on smoking initiation decreased as internalizing symptoms increased; symptoms did not moderate the effects of friends' alcohol and marijuana use on alcohol and marijuana use initiation. These findings counter the influence hypothesis of the co-occurrence of internalizing symptoms with substance use and partly support the exposure hypothesis.
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Affiliation(s)
- Sonja E Siennick
- College of Criminology and Criminal Justice, Florida State University, 112 S. Copeland Street, Tallahassee, FL 32306
| | - Alex O Widdowson
- College of Criminology and Criminal Justice, Florida State University, 112 S. Copeland Street, Tallahassee, FL 32306
| | - Mathew Woessner
- College of Criminology and Criminal Justice, Florida State University, 112 S. Copeland Street, Tallahassee, FL 32306
| | - Mark E Feinberg
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, 310 BioBehavioral Health, University Park, PA 16802
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Prevalence and correlates of problematic smartphone use in a large random sample of Chinese undergraduates. BMC Psychiatry 2016; 16:408. [PMID: 27855666 PMCID: PMC5114822 DOI: 10.1186/s12888-016-1083-3] [Citation(s) in RCA: 190] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 10/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smartphones are becoming a daily necessity for most undergraduates in Mainland China. Because the present scenario of problematic smartphone use (PSU) is largely unexplored, in the current study we aimed to estimate the prevalence of PSU and to screen suitable predictors for PSU among Chinese undergraduates in the framework of the stress-coping theory. METHODS A sample of 1062 undergraduate smartphone users was recruited by means of the stratified cluster random sampling strategy between April and May 2015. The Problematic Cellular Phone Use Questionnaire was used to identify PSU. We evaluated five candidate risk factors for PSU by using logistic regression analysis while controlling for demographic characteristics and specific features of smartphone use. RESULTS The prevalence of PSU among Chinese undergraduates was estimated to be 21.3%. The risk factors for PSU were majoring in the humanities, high monthly income from the family (≥1500 RMB), serious emotional symptoms, high perceived stress, and perfectionism-related factors (high doubts about actions, high parental expectations). CONCLUSIONS PSU among undergraduates appears to be ubiquitous and thus constitutes a public health issue in Mainland China. Although further longitudinal studies are required to test whether PSU is a transient phenomenon or a chronic and progressive condition, our study successfully identified socio-demographic and psychological risk factors for PSU. These results, obtained from a random and thus representative sample of undergraduates, opens up new avenues in terms of prevention and regulation policies.
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Thompson KD, Leadbeater BJ, Ames ME. Reciprocal Effects of Internalizing and Oppositional Defiance Symptoms on Heavy Drinking and Alcohol-Related Harms in Young Adulthood. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2016; 9:21-31. [PMID: 26819553 PMCID: PMC4723048 DOI: 10.4137/sart.s33928] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/29/2015] [Accepted: 11/03/2015] [Indexed: 12/16/2022]
Abstract
There is a need for longitudinal research to understand how psychopathology relates to the onset and maintenance of substance use from adolescence into young adulthood. Hence, we investigate the longitudinal, reciprocal influences of internalizing (anxiety and depression) and externalizing (oppositional defiance) symptoms on heavy episodic drinking (HED; ≥5 drinks per occasion) and alcohol-related harms in a community-based sample of youth aged 12–27 years. Participants were chosen from the Victoria Healthy Youth Survey, followed six times, biennially between 2003 and 2013 (N = 662). Analyses used cross-lagged panel models to examine reciprocal relations over time. Differences across age and sex were also tested. Defiance symptoms predicted increases in HED, which reciprocally predicted increases in defiance symptoms for females. Internalizing symptoms were related to HED within time for females. Alcohol-related harms had reciprocal positive associations with internalizing and defiance symptoms for both males and females. Associations were largely invariant across age groups, suggesting that the presence and strength of associations persisted across development. While psychopathology preceded the onset of HED and harms, the overall findings suggest that these risk processes are mutually reinforcing across development and that youth may become entrenched in an interdependent cycle that significantly increases their risk of comorbid disorders in adulthood.
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Affiliation(s)
- Kara D Thompson
- Assistant Professor, Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada
| | - Bonnie J Leadbeater
- Professor, Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Megan E Ames
- Postdoctoral Fellow, Department of Psychology, University of Victoria, Victoria, BC, Canada
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Wang C, Hipp JR, Butts CT, Jose R, Lakon CM. Alcohol use among adolescent youth: the role of friendship networks and family factors in multiple school studies. PLoS One 2015; 10:e0119965. [PMID: 25756364 PMCID: PMC4355410 DOI: 10.1371/journal.pone.0119965] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 01/18/2015] [Indexed: 11/19/2022] Open
Abstract
To explore the co-evolution of friendship tie choice and alcohol use behavior among 1,284 adolescents from 12 small schools and 976 adolescents from one big school sampled in the National Longitudinal Study of Adolescent to Adult Health (AddHealth), we apply a Stochastic Actor-Based (SAB) approach implemented in the R-based Simulation Investigation for Empirical Network Analysis (RSiena) package. Our results indicate the salience of both peer selection and peer influence effects for friendship tie choice and adolescent drinking behavior. Concurrently, the main effect models indicate that parental monitoring and the parental home drinking environment affected adolescent alcohol use in the small school sample, and that parental home drinking environment affected adolescent drinking in the large school sample. In the small school sample, we detect an interaction between the parental home drinking environment and choosing friends that drink as they multiplicatively affect friendship tie choice. Our findings suggest that future research should investigate the synergistic effects of both peer and parental influences for adolescent friendship tie choices and drinking behavior. And given the tendency of adolescents to form ties with their friends' friends, and the evidence of local hierarchy in these networks, popular youth who do not drink may be uniquely positioned and uniquely salient as the highest rank of the hierarchy to cause anti-drinking peer influences to diffuse down the social hierarchy to less popular youth. As such, future interventions should harness prosocial peer influences simultaneously with strategies to increase parental support and monitoring among parents to promote affiliation with prosocial peers.
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Affiliation(s)
- Cheng Wang
- Department of Sociology, Cornell University, Ithaca, New York, United States of America
- * E-mail:
| | - John R. Hipp
- Departments of Criminology, Law and Society and Sociology, University of California Irvine, Irvine, California, United States of America
| | - Carter T. Butts
- Departments of Sociology and Statistics, University of California Irvine, Irvine, California, United States of America
| | - Rupa Jose
- Department of Psychology and Social Behavior, University of California Irvine, Irvine, California, United States of America
| | - Cynthia M. Lakon
- Program in Public Health, University of California Irvine, Irvine, California, United States of America
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Pedersen ER, Miles JNV, Hunter SB, Osilla KC, Ewing BA, D'Amico EJ. Perceived norms moderate the association between mental health symptoms and drinking outcomes among at-risk adolescents. J Stud Alcohol Drugs 2014; 74:736-45. [PMID: 23948533 DOI: 10.15288/jsad.2013.74.736] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE There has been limited research examining the association between mental health symptoms, perceived peer alcohol norms, and alcohol use and consequences among samples of adolescents. The current study used a sample of 193 at-risk youths with a first-time alcohol and/or other drug offense in the California Teen Court system to explore the moderating role of perceived peer alcohol norms on the association between mental health symptoms and drinking outcomes. METHOD Measures of drinking, consequences, mental health symptoms, and perceived peer alcohol norms were taken at baseline, with measures of drinking and consequences assessed again 6 months later. Regression analyses examined the association of perceived norms and mental health symptoms with concurrent and future drinking and consequences. RESULTS We found that higher perceived drinking peer norms were associated with heavy drinking behavior at baseline and with negative alcohol consequences both at baseline and 6 months later. Also, perceived drinking norms moderated the association between mental health symptoms and alcohol-related consequences such that better mental health was related to increased risk for alcohol-related consequences both concurrently and 6 months later among those with higher baseline perceptions of peer drinking norms. CONCLUSIONS Findings demonstrate the value of norms-based interventions, especially among adolescents with few mental health problems who are at risk for heavy drinking.
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Campanella S, Peigneux P, Petit G, Lallemand F, Saeremans M, Noël X, Metens T, Nouali M, De Tiège X, De Witte P, Ward R, Verbanck P. Increased cortical activity in binge drinkers during working memory task: a preliminary assessment through a functional magnetic resonance imaging study. PLoS One 2013; 8:e62260. [PMID: 23638017 PMCID: PMC3636085 DOI: 10.1371/journal.pone.0062260] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 03/19/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Cerebral dysfunction is a common feature of both chronic alcohol abusers and binge drinkers. Here, we aimed to study whether, at equated behavioral performance levels, binge drinkers exhibited increased neural activity while performing simple cognitive tasks. METHODS Thirty-two participants (16 binge drinkers and 16 matched controls) were scanned using functional magnetic resonance imaging (fMRI) while performing an n-back working memory task. In the control zero-back (N0) condition, subjects were required to press a button with the right hand when the number "2" was displayed. In the two-back (N2) condition, subjects had to press a button when the displayed number was identical to the number shown two trials before. RESULTS fMRI analyses revealed higher bilateral activity in the pre-supplementary motor area in binge drinkers than matched controls, even though behavioral performances were similar. Moreover, binge drinkers showed specific positive correlations between the number of alcohol doses consumed per occasion and higher activity in the dorsomedial prefrontal cortex, as well as between the number of drinking occasions per week and higher activity in cerebellum, thalamus and insula while performing the N2 memory task. CONCLUSIONS Binge alcohol consumption leads to possible compensatory cerebral changes in binge drinkers that facilitate normal behavioral performance. These changes in cerebral responses may be considered as vulnerability factors for developing adult substance use disorders.
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Affiliation(s)
- Salvatore Campanella
- Laboratoire de Psychologie Médicale et d'Addictologie, Université Libre de Bruxelles (U.L.B.) and U.L.B. Neuroscience Institute, Brussels, Belgium.
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Ranney ML, Walton M, Whiteside L, Epstein-Ngo Q, Patton R, Chermack S, Blow F, Cunningham RM. Correlates of depressive symptoms among at-risk youth presenting to the emergency department. Gen Hosp Psychiatry 2013; 35:537-44. [PMID: 23810465 PMCID: PMC3775848 DOI: 10.1016/j.genhosppsych.2013.05.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 05/20/2013] [Accepted: 05/22/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The study's objective was to identify correlates of depressive symptoms among at-risk youth in an urban emergency department (ED). METHOD A systematic sample of adolescents (ages 14-18) in the ED were recruited as part of a larger study. Participants reporting past-year alcohol use and peer aggression self-administered a survey assessing: demographics, depressive symptoms and risk/protective factors. Logistic regression identified factors associated with depressive symptoms. RESULTS Among 624 adolescents (88% response rate) meeting eligibility criteria, 22.8% (n=142) screened positive for depressive symptoms. In logistic regression, depressive symptoms were positively associated with female gender [odds ratio (OR): 2.84, 95% confidence interval (CI): 1.78-4.51], poor academic performance (OR: 1.57, 95% CI: 1.01-2.44), binge drinking (OR: 1.88, 95% CI: 1.21-2.91), community violence exposure (OR: 2.25, 95% CI: 1.59-3.18) and dating violence (OR: 2.14, 95% CI: 1.36-3.38) and were negatively associated with same-sex mentorship (OR: 0.52, 95% CI: 0.29-0.91) and older age (OR: 0.55, 95% CI 0.34-0.89). Including gender interaction terms did not significantly change findings. CONCLUSIONS Screening and intervention approaches for youth in the urban ED should address the co-occurrence of depressive symptoms with peer and dating violence, alcohol and nonmarijuana illicit drug use.
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Affiliation(s)
- Megan L. Ranney
- Injury Prevention Center, Department of Emergency Medicine, Alpert Medical School, Brown University, Ann Arbor, Michigan, USA
| | - Maureen Walton
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA,Injury Control Research Center, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Lauren Whiteside
- Department of Emergency Medicine, University of Washington, Seattle, WA, USA
| | - Quyen Epstein-Ngo
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Rikki Patton
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Stephen Chermack
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA,Department of Veterans Affairs, Health Services Research and Development, Ann Arbor, Michigan, USA
| | - Fred Blow
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA,Department of Veterans Affairs, Health Services Research and Development, Ann Arbor, Michigan, USA
| | - Rebecca M. Cunningham
- Injury Control Research Center, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA,School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Murphy A, Taylor E, Elliott R. The detrimental effects of emotional process dysregulation on decision-making in substance dependence. Front Integr Neurosci 2012; 6:101. [PMID: 23162443 PMCID: PMC3491319 DOI: 10.3389/fnint.2012.00101] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 10/19/2012] [Indexed: 01/04/2023] Open
Abstract
Substance dependence is complex and multifactorial, with many distinct pathways involved in both the development and subsequent maintenance of addictive behaviors. Various cognitive mechanisms have been implicated, including impulsivity, compulsivity, and impaired decision-making. These mechanisms are modulated by emotional processes, resulting in increased likelihood of initial drug use, sustained substance dependence, and increased relapse during periods of abstinence. Emotional traits, such as sensation-seeking, are risk factors for substance use, and chronic drug use can result in further emotional dysregulation via effects on reward, motivation, and stress systems. We will explore theories of hyper and hypo sensitivity of the brain reward systems that may underpin motivational abnormalities and anhedonia. Disturbances in these systems contribute to the biasing of emotional processing toward cues related to drug use at the expense of natural rewards, which serves to maintain addictive behavior, via enhanced drug craving. We will additionally focus on the sensitization of the brain stress systems that result in negative affect states that continue into protracted abstinence that is may lead to compulsive drug-taking. We will explore how these emotional dysregulations impact upon decision-making controlled by goal-directed and habitual action selections systems, and, in combination with a failure of prefrontal inhibitory control, mediate maladaptive decision-making observed in substance dependent individuals such that they continue drug use in spite of negative consequences. An understanding of the emotional impacts on cognition in substance dependent individuals may guide the development of more effective therapeutic interventions.
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Affiliation(s)
- Anna Murphy
- Neuroscience and Psychiatry Unit, University of ManchesterManchester, UK
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Petit G, Kornreich C, Noël X, Verbanck P, Campanella S. Alcohol-related context modulates performance of social drinkers in a visual Go/No-Go task: a preliminary assessment of event-related potentials. PLoS One 2012; 7:e37466. [PMID: 22616012 PMCID: PMC3355129 DOI: 10.1371/journal.pone.0037466] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 04/22/2012] [Indexed: 12/05/2022] Open
Abstract
Background Increased alcohol cue-reactivity and altered inhibitory processing have been reported in heavy social drinkers and alcohol-dependent patients, and are associated with relapse. In social drinkers, these two processes have been usually studied separately by recording event-related potentials (ERPs) during rapid picture presentation. The aim of our study was to confront social drinkers to a task triggering high alcohol cue-reactivity, to verify whether it specifically altered inhibitory performance, by using long-lasting background picture presentation. Methods ERP were recorded during visual Go/No-Go tasks performed by social drinkers, in which a frequent Go signal (letter “M”), and a rare No-Go signal (letter “W”) were superimposed on three different types of background pictures: neutral (black background), alcohol-related and non alcohol-related. Results Our data suggested that heavy social drinkers made more commission errors than light drinkers, but only in the alcohol-related context. Neurophysiologically, this was reflected by a delayed No-Go P3 component. Conclusions Elevated alcohol cue-reactivity may lead to poorer inhibitory performance in heavy social drinkers, and may be considered as an important vulnerability factor in developing alcohol misuse. Prevention programs should be designed to decrease the high arousal of alcohol stimuli and strengthen cognitive control in young, at-risk individuals.
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Affiliation(s)
| | | | | | | | - Salvatore Campanella
- Laboratory of Psychological Medicine, Free University of Brussels, Brussels, Belgium
- * E-mail:
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