Do Personality, Alcohol Abstinence Self-Efficacy, and Depressive Symptomatology Affect Abstinence Status in Treatment-Seeking Patients with Alcohol Use Disorder?

Given the high global incidence and disabling nature of alcohol use disorders, alongside high relapse rates, we sought to investigate potential predictors of abstinence, considered a prerequisite of full remission. With an aim to examine (i) the effect of personality, alcohol abstinence self-efficacy, and depressive symptomatology on abstinence status as our primary objective, and (ii) interactions between these three factors, as well as (iii) their changes over time as two secondary objectives, we recruited 51 inpatients at an alcohol rehabilitation center to complete the International Personality Item Pool, the Alcohol Abstinence Self-Efficacy Scale and the Beck Depression Inventory, and to provide information on abstinence attainment 2 months post-treatment. Although regression analyses revealed no evidence for the effect of the investigated factors (personality, self-efficacy, or depressive symptoms) on post-therapy abstinence, other findings emerged, demonstrating (i) a significant reduction in the severity of depressive symptoms, (ii) the effect of personality and alcohol abstinence self-efficacy on depressive symptom severity, and (iii) the role of personality in predicting the temptation to use alcohol in recovering drinkers. These preliminary indications of links between personality, self-efficacy, and subjective well-being mark a promising area for future research on powerful and relevant cues of relapse and abstinence efficacy.

Personality-Related Factors and Depressive Symptomatology Predict Behavioral Control in Patients With Alcohol Use Disorders

In the face of increasing social, economic, and health consequences of alcohol use disorders (AUDs) and limited effects of available treatment options, the search for novel prevention and management methods continues to remain a timely and valid endeavor. This, however, requires a better grasp of the theoretical framework underlying addiction mechanisms. With the goal to extend the existing body of evidence on AUDs, we set out to investigate the effect of personality-related factors and depressive symptomatology on (i) impulsivity, (ii) cognitive response inhibition, and (iii) the links between the two measures of behavioral control (different facets of impulsivity and response inhibition) in a treatment-seeking AUD sample. To this end, 53 male (n = 45) and female (n = 8) inpatients at an alcohol rehabilitation center completed three self-report questionnaires: the International Personality Item Pool (IPIP-50), the Beck Depression Inventory Second Edition (BDI-II) and the Barratt Impulsiveness Scale (BIS-11) and performed one behavioral task-an alcohol go/no go task. Regression analyses revealed conscientiousness, intellect, and depression level to be important potential predictors of self-report impulsivity and processing speed in recovering drinkers. No significant links were observed between the two measures of behavioral control, thus complementing evidence that while they both encompass behavioral under-regulation, they may indeed represent distinct psychological constructs.

A Pilot Study of Neurocognitive Function and Brain Structures in Adolescents With Alcohol Use Disorders: Does Maltreatment History Matter?

Neurocognitive and brain structural differences are associated with adolescent onset alcohol use disorders (AUDs). Maltreatment histories may contribute to current results. To examine these issues, healthy adolescents (n = 31), adolescents without maltreatment and AUD (AUD - MAL, n = 28), and adolescents with AUDs with maltreatment (AUD + MAL, n = 17) underwent comprehensive neurocognitive assessments and MRI structural scans. Controls performed significantly better than the two AUD groups in math and language. The AUD + MAL group performed significantly lower in sustained attention compared to the AUD - MAL and control groups and lower in reading compared to controls. The AUD + MAL group had larger left pars triangularis, a region of the inferior frontal gyrus, compared to the AUD-MAL and control groups, and smaller anterior corpus callosum volumes versus the AUD - MAL group. There were no group differences in other prefrontal cortex, amygdala, hippocampus, and parahippocampal volumes. The AUD + MAL group showed an inverse correlation between hippocampal volumes and age. AUD variables were associated with lower performance in fine-motor and executive function. Cannabis use variables were associated with lower performance in fine-motor, language, visual-spatial, memory, and executive function. Parahippocampal volumes positively correlated with abstinence. The preliminary results suggest adolescent AUD studies should consider examinations of maltreatment history, comorbid substance use disorders, and recovery during abstinence in their analyses.

The Risk Factors of the Alcohol Use Disorders-Through Review of Its Comorbidities

Alcohol use disorders (AUDs) represent a severe, world-wide problem, and are usually comorbid with psychiatric disorders, comorbidity increases the risks associated with AUDs, and results in more serious consequences for patients. However, currently the underlying mechanisms of comorbid psychiatric disorders in AUDs are not clear. Studies investigating comorbidity could help us understand the neural mechanisms of AUDs. In this review, we explore three comorbidities in AUDs, including schizophrenia, major depressive disorder (MDD), and personality disorders (PDs). They are all co-morbidities of AUDs with rate of 33.7, 28, and 50–70%, respectively. The rate is significantly higher than other diseases. Therefore we review and analyze relevant literature to explore whether these three diseases are the risk factors of AUDs, focusing on studies assessing cognitive function and those using neural imaging. We found that memory deficits, impairment of cognitive control, negative emotion, and impulsivity may increase an individual's vulnerability to AUDs. This comorbidity may indicate the neural basis of AUDs and reveal characteristics associated with different types of comorbidity, leading to further development of new treatment approaches for AUDs.

Clinical management of alcohol use disorders in the neurology clinic

Alcohol misuse adversely affects health outcomes, but alcohol misuse and alcohol use disorders (AUDs) are often ignored by healthcare providers in primary and specialty ambulatory care clinics. Data show that early identification and brief intervention for alcohol misuse in these settings can effectively reduce alcohol consumption and its medical sequelae. The aim of this chapter is to review the epidemiology of problematic alcohol use in ambulatory care settings, the diagnostic criteria for AUDs, the approach called SBIRT (screening, brief intervention and referral to treatment) as a model program to target alcohol misuse in everyday clinical practice, when and how to refer patients to resources beyond the clinic for their alcohol use problems, and the medical illnesses associated with AUDs.

Alcohol use disorders negatively influence antiretroviral medication adherence among men who have sex with men in Peru

As international guidelines increase access to antiretroviral therapy (ART) globally, ART adherence becomes increasingly important to achieve HIV treatment as prevention (TasP) goals. In the concentrated HIV epidemic among men who have sex with men (MSM) and transgendered women (TGW) in Lima, Peru, the independent correlates of ART nonadherence were examined to inform treatment intervention priorities. Cross sectional survey of HIV-infected MSM and TGW who are engaged in clinical care in Lima, Peru. From June to August 2012, 302 HIV-infected Peruvian MSM/TGW from three clinical care sites were recruited using convenience sampling to participate in a cross-sectional computer-assisted adherence survey. Several standardized screening measures associated with ART nonadherence were examined in order to determine the independent correlates of optimal (≥90%) and perfect (100%) adherence, which were assessed using logistic regression. Of the 302 participants recruited, 263 (87.1%) were prescribed ART. Among those prescribed ART, 229 (87.1%) reported optimal and 146 (55.5%) reported perfect adherence. The prevalence of alcohol use disorders (AUD; 43.2%), alcohol dependence (5.3%), recent drug use (6.0%), and depression (44.5%) was high, and most participants had some evidence of neurocognitive impairment. Meeting criteria for having an AUD and depression were collinear (p < 0.001). On multivariate analysis, having an AUD was inversely related and the only independent correlate of optimal (AOR = 0.427; 95% CI = 0.187-0.976) and perfect (AOR = 0.552; 95% CI = 0.327-0.930) ART adherence. AUDs are highly prevalent among Peruvian HIV-infected MSM and contribute significantly to ART nonadherence. These findings support the need for screening and treating underlying AUDs. In order to meet HIV TasP goals, evidence-based strategies targeting AUDs are likely to directly improve ART adherence and indirectly improve overall individual health, HIV treatment engagement, and reduce transmission to sexual partners among this vulnerable and disproportionally affected population.