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Background We examined differences in response to self-reported alcohol use items by survey mode, whether self-report differences were the result of modality effects or self-selection, and whether these differences varied across the treatment and control arms of a preventative intervention trial. Methods Data from an existing alcohol prevention trial were used to estimate the effect of survey modality on adolescent's self-reported alcohol use at ages 17 to 18. Estimates were derived from regression models controlling for self-reported alcohol use during 8th grade, measured using a single survey modality, as well as time invariant selection factors. Results No statistically significant survey modality effects were found. No differential effects of survey modality were observed by assigned intervention group. Conclusions We provide initial evidence that adolescent alcohol prevention trials may use multiple survey modalities when necessary to increase response rates without harming interpretation of intervention effects. [ABSTRACT FROM AUTHOR]

Background Low levels of alcohol responses (low LRs) are genetically influenced phenotypes that are identified before alcohol dependence and predict future heavy drinking and alcohol problems. A recent paper described 13 LR-related blood oxygen level-dependent ( BOLD) response contrast patterns observed during an emotional face recognition task that might reflect cognitive processes contributing to LR and that might themselves predict adverse alcohol outcomes ( Paulus et al., Biol Psychiatry 2012; 72: 848). This paper evaluates the predictive implications of those functional magnetic resonance imaging (f MRI) patterns. Methods Of 120 subjects from Paulus and colleagues (2012), 114 (57 low and high LRs; ~50% females) were interviewed 5 years later at age 25. Correlations between baseline f MRI patterns and alcohol-related outcomes were evaluated, and regression analyses were used to determine if BOLD response contrasts incremented over LR in predicting outcomes. Results Baseline f MRI patterns in 5 of 13 baseline regions of interest correlated with adverse outcomes. Such patterns in insular regions, particularly the left anterior insula, and the right frontal gyrus, added to LR in predicting alcohol problems. The relationships remained robust when exact binomial procedures were used, but, reflecting the small sample size, it was not possible to adequately consider Bonferroni corrections. Conclusions The data suggest that f MRI BOLD response contrasts predicted heavier drinking and alcohol problems 5 years later, even after considering baseline low LRs. Future work will focus on whether f MRI results can predict outcomes in larger samples and among young nondrinkers, as well as how the imaging results increase understanding of the processes through which LR operates. [ABSTRACT FROM AUTHOR]

Background: Low level of responses (low LRs) to alcohol established using the Self‐Report of the Effects of Alcohol (SRE) questionnaire are genetically influenced phenotypes related to heavy drinking and alcohol problems. To date, most studies using SREs focused on scores for the number of drinks needed for effects across the first 5 times of drinking (SRE‐5), and few evaluated scores that also included the prior 3 months and heaviest drinking periods (SRE‐T). This paper evaluates characteristics of SRE‐5 and SRE‐T within and across generations. Methods: Data were extracted from 407 participants across 2 generations of 107 families in the San Diego Prospective Study (SDPS). Pearson's product–moment correlations for SRE‐5 and SRE‐T were determined across first‐degree relatives both within and across generations and sexes, as well as correlations of each measure to maximum drinking quantities and alcohol problems. Results: Responding to 4 hypotheses, first the analyses demonstrated significant within‐generation positive correlations for both SRE measures across brother–brother and sister–sister pairs as well as cross‐generation correlations for fathers and sons, although correlations for mothers and daughters were not robust. Second, both SRE‐5 and SRE‐T correlated with maximum drinks and alcohol problems for both sexes and both generations. Third, within parental and offspring generations SRE‐T correlated more robustly than SRE‐5 to maximum drinks and alcohol problems. Fourth, across generations SRE values for sons were more closely related to drinking quantities and problems than for their fathers, but the mother–daughter SRE relationships to adverse alcohol characteristics were not different. Conclusions: Both the SRE‐5 and SRE‐T offered useful information about propensities toward heavier drinking and alcohol problems in SDPS families. Correlations with adverse alcohol outcomes were greater for the more broad‐based SRE‐T, but both scores appeared to be genetically influenced and continue to operate in a robust manner in both generations of these families. [ABSTRACT FROM AUTHOR]

Background Alcohol-related blackouts are periods of amnesia that reflect the failure of the brain to record memories of what transpires while drinking. This paper examined the incidence, predictors, and behavioral correlates of blackouts among emerging adults and examined whether questions about blackouts could serve as better markers of risk for other alcohol related harms than questions about levels of consumption. Methods In 2012 to 2013, 1,463 (68%) of 2,140 respondents 1-year past high school reported having consumed alcohol. They were asked whether, in the past 6 months because of drinking, they forgot where they were or what they did. The survey also explored demographics, substance use behaviors, and other alcohol-related problems in the past 6 months. Chi-square and logistic regression analyses explored bivariate and multivariate predictors of blackouts and other alcohol-related problems. Results Twenty percent of respondents who ever drank alcohol reported a blackout in the past 6 months. Blackouts were more prevalent among females and those who, in the past 30 days, used multiple drugs, more frequently binged, were drunk, smoked, had lower body weight, and lived in college dorms. After controlling for drinking levels, having a blackout was the strongest independent predictor of most other alcohol problems examined, including in the past 6 months because of drinking, missing class or work, getting behind in work or school, doing something respondents later regretted, arguing with friends, experiencing an overdose, and total number of alcohol problems reported. It was also an independent predictor of hangovers, damaging property, getting hurt, and trouble with police. Conclusions Because blackouts indicate drinking at levels that result in significant cognitive and behavioral impairment, questions about blackouts could serve as important, simple screeners for the risk of experiencing other alcohol related harms. Additional work on this subject is warranted. [ABSTRACT FROM AUTHOR]

Background Despite harmful drinking causing a significant burden on global health, there is a large treatment gap, especially in low- and middle-income countries. A major barrier to care is the lack of adequately skilled human resources to deliver contextually appropriate treatments. This paper describes the systematic process used to develop Counselling for Alcohol Problems ( CAP), a brief psychological treatment (PT) for delivery by lay counselors in routine primary care settings to men with harmful drinking in India. Methods CAP was developed using a methodology involving 3 sequential steps: (i) identifying potential treatment strategies; (ii) developing a theoretical framework for the treatment; and (iii) evaluating the acceptability and feasibility of the treatment. Results CAP is a 3-phase treatment delivered over 1 to 4 sessions based on a motivational interviewing ( MI) stance and involves the following strategies: assessment and personalized feedback, family engagement, drink refusal skills, skills to address drinking urges, problem-solving skills and handling difficult emotions, and relapse prevention and management. Data from a case series were used to inform several adaptations to enhance the acceptability of CAP to the recipients and feasibility of delivery by lay counselors of the treatment, for example expansion of the target group to include alcohol-dependent patients and the extension of the delivery settings to include home-based delivery. There was preliminary evidence of the effectiveness of CAP. Conclusions CAP is an acceptable brief PT for harmful drinking delivered by lay counselors in primary care whose effectiveness is currently being tested in a randomized controlled trial based in primary care in Goa, India. [ABSTRACT FROM AUTHOR]

Background Although most people are aware of government guidelines for alcohol consumption, few have accurate knowledge of these and fewer still use these guidelines to monitor their drinking. Most people also lack accurate knowledge of the alcohol content of the drinks they consume. The aim of the study reported here was to examine whether or not personalized feedback on alcohol consumption based on performance in a drink-pouring task and self-reported alcohol intake would improve university students' knowledge of alcohol consumption guidelines and reduce their alcohol intake. Methods A quasi-randomized control trial with a 2-month follow-up was conducted with 200 students aged 18 to 37 in the south of England. Participants were allocated to a 'pour + feedback' group that completed a drink-pouring task and received personalized feedback, a 'pour only' group that completed the drink-pouring task but did not receive feedback, and a control group. Results At follow-up, participants in the 'pour + feedback' group had significantly better knowledge of government guidelines, and significantly lower weekly alcohol intake when compared to the 'control' and 'pour only' groups. Conclusions Further refinement of the drink-pouring intervention and feedback is reported in this paper, and assessment of their impact in various populations may lead to better understanding of which elements of personalized feedback have the greatest influence on young people's alcohol use. [ABSTRACT FROM AUTHOR]

Background Alcohol-related blackouts ( ARBs) are reported by ~50% of drinkers. While much is known about the prevalence of ARBs in young adults and their cross-sectional correlates, there are few prospective studies regarding their trajectories over time during mid-adolescence. This paper reports latent trajectory classes of ARBs between age 15 and 19, along with predictors of those patterns. Methods Latent class growth analysis ( LCGA) was used to evaluate the pattern of occurrence of ARBs across 4 time points for 1,402 drinking adolescents from the Avon Longitudinal Study of Parents and Children ( ALSPAC). Multinomial regression analyses evaluated age-15 demography, substance-related items, externalizing characteristics, and estimated peer substance use as predictors of latent class membership. Results ARBs were reported at age 15 in 30% and at age 19 in 74% of these subjects. Four latent trajectory classes were identified: Class 1 (5.1%) reported no blackouts; for Class 2 (29.5%), ARBs rapidly increased with age; for Class 3 (44.9%), blackouts slowly increased; and for Class 4 (20.5%), ARBs were consistently reported. Using Class 2 (rapid increasers) as the reference, predictors of class membership included female sex, higher drinking quantities, smoking, externalizing characteristics, and estimated peer substance involvement (pseudo R2 = 0.22). Conclusions ARBs were common and repetitive in these young subjects, and predictors of their trajectories over time involved multiple domains representing diverse characteristics. [ABSTRACT FROM AUTHOR]

Background It has been argued that the excessive consumption of energy drinks ( EDs) may have serious health consequences, and that may serve as an indicator for substance use and other risky behaviors. The present paper offers a perspective on this topic that remains underexplored on the population of adolescents. Methods Data were collected via self-administered anonymous questionnaires from 870 adolescents aged 15 to 19 years who were recruited from a random sample of public secondary schools in the geographic area of the Calabria Region, in the South of Italy. Results A total of 616 participants completed the survey for a response rate of 70.8%. Nearly 68% of respondents had drunk at least a whole can of ED during their life, and about 55% reported consuming EDs during the 30 days before the survey. Only 13% of interviewed adolescents were aware that drinking EDs is the same as drinking coffee, whereas a sizable percentage believed that drinking EDs is the same as drinking carbonated beverages or rehydrating sport drinks. Forty-six percent of adolescents had drunk alcohol-mixed energy drinks ( AmEDs) during their life, and 63% of lifetime users admitted drinking AmEDs during the 30 days before the survey. Overall, 210 (63.3%) had drunk alcohol alone not mixed with EDs during their life, and more than half (56.3%) reported having consumed it at least once during the 30 days before the survey. Multivariate analysis showed that the factors independently associated with the consumption of AmEDs were the increasing number of sexual partners, being a current smoker, being male, riding with a driver who had been drinking alcohol, and having used marijuana. Conclusions Comprehensive educational programs among youths focusing on potential health effects of EDs, alcohol, and the combination of the two, designed to empower the ability to manage these drinking habits, are strongly advisable. [ABSTRACT FROM AUTHOR]

Background: This paper describes a new multicountry collaborative project to assess the impact of alcohol control policy. Longitudinal surveys of drinkers in a number of participating countries and analysis of the policy context allow for the assessment of change over time within countries and comparison between countries. The design of the study is modeled on the International Tobacco Control study and aims to assess the impact of alcohol policies in different cultural contexts on policy-related behaviors and alcohol consumption. A survey instrument and protocol for policy analysis have been developed by the initial participating countries: England, Scotland, Thailand, South Korea, and New Zealand. The first round of data collection is scheduled for 2011-2012. Measurements: The survey instrument (International Alcohol Control [ IAC] survey) measures key policy relevant behaviors: place and time of purchase, amounts purchased and price paid; ease of access to alcohol purchase; alcohol marketing measures; social supply; perceptions of alcohol affordability and availability and salience of price; perceptions of enforcement; people's experiences with specific alcohol restrictions; support for policy and consumption (typical quantity, frequency using beverage and location-specific measures). The Policy Analysis Protocol ( PoLAP) assesses relevant aspects of the policy environment including regulation and implementation. Results: It has proved feasible to design instruments to collect detailed data on behaviors relevant to alcohol policy change and to assess the policy environment in different cultural settings. Conclusions: In a policy arena in which the interest groups and stakeholders have different perceptions of appropriate policy responses to alcohol-related harm, a robust methodology to assess the impact of policy will contribute to the debate. [ABSTRACT FROM AUTHOR]

Background: This paper examines differences in drinking and binge drinking between Mexican Americans living along the U.S.-Mexico border and those living in 2 metropolitan areas away from the border (Houston, Texas and Los Angeles, California). Methods: Respondents in the non-border area (Houston and Los Angeles) constitute a multistage probability sample ( N = 1,288), who were interviewed as part of the 2006 Hispanic Americans Baseline Alcohol Survey (HABLAS). Respondents in the border area ( N = 1,307) constitute a household probability sample of Mexican Americans living on the U.S.-Mexico border. In both surveys, data were collected during computer-assisted interviews conducted in respondents' homes. The HABLAS and the border sample response rates were 76 and 67%, respectively. Results: There were no differences between border and non-border Mexican American men in the proportion of drinkers, the proportion who binge drink at least once a year, and volume of alcohol consumption. However, within each location, there were significant differences in drinking by age, indicating that younger men drank more than men who were older. Border women showed significant differences across age-groups in the proportion of drinkers, in binge drinking, and volume of alcohol consumption, which were not seen among non-border women. Conclusions: Women's drinking seems to be more affected than men's by their residence on or off the U.S.-Mexico border. This is seen most clearly among young women 18 to 29 years old, and it is associated with an increased proportion of drinkers, a higher volume of drinking, and an increased proportion of women who report binge drinking. Increased drinking in this group of younger women seems to be associated with drinking in Mexico. [ABSTRACT FROM AUTHOR]

Background: There have been limited trend studies examining variations on the patterns of alcohol consumption among Whites, Blacks, and Hispanics in the United States. The current paper reports national trends in drinking patterns, volume of drinking (number of drinks per month), binge drinking, and drinking to intoxication among Blacks, Whites, and Hispanics over a period of 10 years and identifies sociodemographic predictors of these behaviors across the 3 ethnic groups. Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results: Trends varied across different dimensions of drinking and ethnic groups. There were no statistically significant differences in the mean number of drinks consumed per month among men and women in any of the 3 ethnic groups between 1992 and 2002, but there was a significant rise in the proportion of current drinkers in both genders and in all 3 ethnic groups. Multivariate analysis indicated that, compared to Whites in 1992, Blacks and Hispanics did not increase their volume of drinking, but Whites did. Drinking 5 or more drinks in day at all did not increase between 1992 and 2002, but drinking 5 or more drinks at least once a month was more likely for all groups in 2002 compared to Whites in 1992. Drinking to intoxication at all was more likely among Whites in 2002 than 1992, but drinking to intoxication at least once a month was more likely among Whites and Blacks in 2002 than 1992. Conclusion: The only common trend between 1992 and 2002 across both genders and 3 ethnic groups was a rise in the proportion of drinkers. There was also a rise in drinking 5 or more drinks in a day (Whites, Blacks, and Hispanics) and drinking to intoxication (Whites and Blacks), but this was limited to those reporting such drinking at least once a month. The reasons for these changes are many and may involve complex sociodemographic changes in the population. It is important for the field to closely monitor these cross-ethnic trends in alcohol consumption. [ABSTRACT FROM AUTHOR]

Background Alcohol is a common target of counterfeiting in Russia. Counterfeit alcohol is defined here as the manufacture, distribution, unauthorized placement (forgery) of protected commodity trademarks, and infringement of the exclusive rights of the registered trademark holders of alcoholic beverages. It is often argued that the expansion of the counterfeit product market is due to the steady demand of economically disadvantaged people for low-priced goods. The situation becomes more complicated once deceptive and nondeceptive forms of counterfeiting are taken into account. This study aimed to identify markers of risky behavior associated with the purchase of counterfeit alcohol in Russia. Methods The analysis relied on consumer self-reports of alcohol use and purchase collected nationwide by the Russia Longitudinal Monitoring Survey (RLMS-HSE) in 2012 to 2014. I used a generalized linear mixed-model logistic regression to identify predictors of risky behavior by consumers who purchased counterfeit alcohol, either knowingly or unknowingly, during the 30 days preceding the survey. Results Purchases of counterfeit alcohol declined slightly from 2012 to 2014, mainly due to a decrease in consumers mistakenly purchasing counterfeit products. Predictors of counterfeit alcohol purchases differed between consumers who knowingly and unknowingly purchased counterfeit products. Nondeceptive purchase of counterfeit alcohol was related primarily to an indifference to alcohol brands. Consumers with social networks that include drinkers of nonbeverage alcohol and producers of homemade alcohol were highly likely to consume counterfeit alcohol deliberately. Problem drinking was significantly associated with a higher risk of both deceptive and nondeceptive purchases of counterfeit alcohol. Poverty largely contributed to nondeceptive counterfeiting. Conclusions The literature has overestimated the impact of low prices on counterfeit alcohol consumption. Problem drinking and membership in social networks of consumers of surrogate alcohol (i.e., nonbeverage) are more influential in explaining why people purchase counterfeit alcohol. Further research on these 2 factors is needed to more fully understand the purchase and consumption of counterfeit alcoholic beverages. [ABSTRACT FROM AUTHOR]

Background and aims: For most treatment‐seeking patients with severe Alcohol Use Disorder (AUD), abstinence is the clinically indicated goal. Existing AUD motivation scales are non‐specific about treatment consumption goals, which limit their effectiveness. Desires and mental imagery are relevant in the motivation for AUD treatment engagement. The Motivational Thought Frequency Scale for an abstinence goal (MTF‐A) was adapted from the MTF for controlled drinking (MTF‐CD). This study psychometrically evaluated the MTF‐A in an alcohol‐dependent sample engaged in treatment with a goal of abstinence. To enhance the clinical utility of the scale, a secondary aim was to evaluate a psychometrically equivalent short version of the MTF‐A. Method: A sample N of 329 treatment‐seeking patients with AUD (mean age of 44.44 years, SD = 11.89 years, 72% male) who were undertaking a cognitive behavioral treatment (CBT) program for abstinence completed the Motivational Thought Frequency Scale for Abstinence (MTF‐A) and the Severity of Alcohol Dependence Questionnaire (SADQ). The MTF‐A measured motivation for abstinence through four factors: intensity, self‐efficacy imagery, incentives imagery, and availability. Confirmatory factor analyses (CFAs) were conducted to examine factor structure and model fit. Cronbach's alpha assessed internal consistency. Predictive validity was determined by logistic regression predicting first‐session treatment non‐attendance and alcohol consumption between baseline assessment and commencement of treatment, controlling for potential confounds. Results: A four‐factor structure provided the best fit for the MTF‐A, compared with one‐ and three‐factor models. A shortened 9‐item MTF‐A scale (S‐MTF‐A) provided better fit than the 13‐item MTF‐A scale. Both MTF‐A and S‐MTF‐A displayed good internal consistency. Although both MTF‐A and S‐MTF‐A successfully predicted first‐session treatment non‐attendance, neither predicted alcohol consumption between the baseline assessment and commencement of treatment. Conclusions: The model fit of the four‐factor, 9‐item S‐MTF‐A was superior to the original 13‐item MTF‐A. Both scales were predictive of participation of AUD treatment. Desires and mental imagery play an important role in AUD treatment motivation. [ABSTRACT FROM AUTHOR]

Background: Research examining emotion dysregulation and alcohol use has increased exponentially over the past decade. However, these studies have been limited by their use of cross‐sectional designs and narrow definitions of emotion dysregulation. To address these significant gaps in the extant literature, this study utilized state‐of‐the‐art methodology (i.e., experience sampling) and statistics (i.e., dynamic structural equation modeling) to examine potential reciprocal associations between negative and positive emotion dysregulation and alcohol use at the momentary level. Methods: Participants were 145 community women (mean age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances. Surveys assessing negative and positive emotion dysregulation and alcohol use (i.e., number of standard drinks) were administered three times a day for 30 days using phone‐based interactive voice recording. Results: Significant contemporaneous effects indicated that negative and positive emotion dysregulation both co‐occurred with alcohol use. However, levels of negative and positive emotion dysregulation did not predict later alcohol use, nor did alcohol use predict later levels of negative or positive emotion dysregulation. There was significant variability among participants in cross‐lagged effects. Conclusions: Findings showed that negative and positive emotion dysregulation co‐occurred with alcohol use and that there was significant interindividual variability in the cross‐lagged associations between negative and positive emotion dysregulation and alcohol use. Research using idiographic approaches may identify women experiencing IPV for whom negative and positive emotion dysregulation drive alcohol use and alcohol use drives negative and positive emotion dysregulation. [ABSTRACT FROM AUTHOR]

Background: Assessing risk for excessive alcohol use is important for applications ranging from recruitment into research studies to targeted public health messaging. Social media language provides an ecologically embedded source of information for assessing individuals who may be at risk for harmful drinking. Methods: Using data collected on 3664 respondents from the general population, we examine how accurately language used on social media classifies individuals as at‐risk for alcohol problems based on Alcohol Use Disorder Identification Test‐Consumption score benchmarks. Results: We find that social media language is moderately accurate (area under the curve = 0.75) at identifying individuals at risk for alcohol problems (i.e., hazardous drinking/alcohol use disorders) when used with models based on contextual word embeddings. High‐risk alcohol use was predicted by individuals' usage of words related to alcohol, partying, informal expressions, swearing, and anger. Low‐risk alcohol use was predicted by individuals' usage of social, affiliative, and faith‐based words. Conclusions: The use of social media data to study drinking behavior in the general public is promising and could eventually support primary and secondary prevention efforts among Americans whose at‐risk drinking may have otherwise gone "under the radar." [ABSTRACT FROM AUTHOR]

Background: While drinking alcohol, one must choose between the immediate rewarding effects and the delayed reward of a healthier lifestyle. Individuals differ in their devaluation of a delayed reward based on the time required to receive it, i.e., delay discounting (DD). Previous studies have shown that adolescents discount more steeply than adults and that steeper DD is associated with heavier alcohol use in both groups. Methods: In a large‐scale longitudinal study, we investigated whether higher rates of DD are an antecedent or a consequence of alcohol use during adolescent development. As part of the IMAGEN project, 2220 adolescents completed the Monetary Choice Questionnaire as a DD measure, the Alcohol Use Disorders Identification Test, and the Timeline Follow Back interview at ages 14, 16, 18, and 22. Bivariate latent growth curve models were applied to investigate the relationship between DD and drinking. To explore the consequences of drinking, we computed the cumulative alcohol consumption and correlated it with the development of discounting. A subsample of 221 participants completed an intertemporal choice task (iTeCh) during functional magnetic resonance imaging at ages 14, 16, and 18. Repeated‐measures ANOVA was used to differentiate between high‐risk and low‐risk drinkers on the development of neural processing during intertemporal choices. Results: Overall, high rates of DD at age 14 predicted a greater increase in drinking over 8 years. In contrast, on average, moderate alcohol use did not affect DD from ages 14 to 22. Of note, we found indicators for less brain activity in top‐down control areas during intertemporal choices in the participants who drank more. Conclusions: Steep DD was shown to be a predictor rather than a consequence of alcohol use in low‐level drinking adolescents. Important considerations for future longitudinal studies are the sampling strategies to be used and the reliability of the assessments. [ABSTRACT FROM AUTHOR]

Background: Despite its potential to produce serious adverse outcomes, DSM‐5 alcohol withdrawal syndrome (AWS) has not been widely studied in the general population. Methods: We used cross‐sectional data from 36,309 U.S. adults from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions‐III to examine the past‐year prevalence of AWS and its correlates. We focused on an important clinical population–past‐year drinkers with unhealthy alcohol use–i.e., those with a positive score on the Alcohol Use Disorders Identification Test–Consumption (AUDIT‐C) questionnaire. We also examined the association of AWS with sociodemographic measures, psychiatric disorders, alcohol‐related measures, and healthcare utilization. Results: Approximately one‐third (n = 12,634) of respondents reported unhealthy alcohol use (AUDIT‐C+). Of these, 14.3% met criteria for a DSM‐5 AWS diagnosis. The mean (SE) number of withdrawal symptoms among individuals with AWS was 2.83 (1.88), with the most common being nausea/vomiting and insomnia (19.8% and 11.6%, respectively). Among AUDIT‐C+ respondents, the odds of AWS were significantly higher among males (adjusted odds ratio [aOR] = 1.17 [95% CI, 1.02–1.33]), unmarried participants (aOR = 1.55 [95% CI, 1.25–1.92]), and those at the lowest (vs. highest) income levels (aOR = 1.62 [95% CI, 1.37–1.92]). Among AUDIT‐C+ respondents, AWS was also associated with psychiatric disorders (with aORs that ranged from 2.08 [95% CI, 1.79–2.41]) for major depressive disorder to 3.14 (95% CI, 1.79–2.41) for borderline personality disorder. AUDIT‐C+ respondents with AWS also had higher odds of past‐year alcohol use disorder (aOR = 11.2 [95% CI, 9.66–13.07]), other alcohol‐related features (e.g., binge drinking), and healthcare utilization. Conclusions: Among individuals with unhealthy alcohol use, AWS is prevalent, highly comorbid, and disabling. Given the risk of AWS among unhealthy drinkers, a comparatively large segment of the general population, clinicians should seek to identify individuals with AWS and intervene with them to prevent serious adverse outcomes. [ABSTRACT FROM AUTHOR]

Background: Although the effects of prenatal alcohol exposure (PAE) have been studied extensively, there is relatively little information available on adult mental health functioning among exposed individuals. The current study compares the self‐reported midlife mental health status of individuals who were prenatally exposed to alcohol and diagnosed in childhood with the effects of this exposure with that of unexposed individuals. Methods: Participants (N = 292) were recruited from two longitudinal cohorts in Atlanta and Seattle and asked to complete an Adult Health Questionnaire that surveyed their current health and mental health status. The questionnaire was completed either in‐person or remotely and included questions about current symptoms of depression and anxiety and mental health disorder diagnoses. The analysis compared a Nonexposed Contrast group to those in two exposure groups: (1) Alcohol Exposed with Fetal Alcohol Effect but not meeting criteria for Fetal Alcohol Syndrome (FAS) and (2) Alcohol Affected and meeting criteria for FAS. Results: Both alcohol‐exposed groups reported higher levels of current depressive symptoms and a higher prevalence of diagnoses of depression, anxiety, bipolar disorder, and/or attention deficit/hyperactivity disorder. No differences were noted for psychotic disorders. PAE was also associated with greater environmental stressors, including higher levels of adverse childhood events and lower current socioeconomic status. Path analyses suggested that PAE was indirectly related to mood disorders with its effects being mediated by other environmental factors. Conclusions: PAE is associated with greater rates of mental health disorders in middle adulthood. These outcomes appear to result from multiple stressors that affect individuals made vulnerable by their early alcohol exposure. Clinical outcomes could be improved by prevention efforts directed at preventing prenatal alcohol use and reducing environmental stressors later in life, and by the early identification of PAE and its effects. [ABSTRACT FROM AUTHOR]

Background: Data from 2 generations of participants in the San Diego Prospective Study (SDPS) were used to compare cross‐sectional and prospective relationships of 5 measures of the low level of response (low LR) to alcohol to 2 key alcohol‐related outcomes. Methods: The analyses used data from 373 SDPS male probands and 158 male and female offspring of these individuals to evaluate relationships of 5 LR measures to the prior 5‐year maximum drinks per occasion and the number of 11 DSM‐IV alcohol use disorder (AUD) criteria experienced. Probands' LR measures included responses to alcohol challenges administered 15 years previously, and ratings for both generations included measures of the number of standard drinks during four periods: the first five times of drinking (SRE‐5), the prior three drinking months (SRE‐3), the period of heaviest drinking (SRE‐H), and a total average across all time frames (SRE‐T). Analyses included zero‐order correlations, correlations using covariates, and hierarchical multiple regression analyses. Results: All 5 LR measures were correlated with aspects of maximum drinks and the number of AUD criteria, but the most robust results were seen for SRE‐3 and maximum drinks. Correlations were less consistent for SRE‐5, a measure more closely related to outcomes in the offspring. Hierarchical regression analyses supported most of these conclusions and showed that alcohol challenge–based LRs added significant information regarding maximum drinks even when evaluated with SRE values. The close correlation between SRE‐H and SRE‐T argues against the need for studies to include both measures. The patterns of results were similar irrespective of whether covariates were included. Conclusions: There were significant correlations of maximum drinks and the number of AUD criteria with findings from prior alcohol challenges and all SRE scores. Challenges and SRE reports are related but not identical LR measures. All SRE scores, including SRE‐5, offered useful information regarding subsequent drinking behavior. The low level of response (low LR) to alcohol predicts future heavier drinking and alcohol problems and can be measured using alcohol challenges or by four scores from the SRE questionnaire regarding the number of drinks required for up to four alcohol effects. These analyses compare how the five LR measures predict future maximum drinks and alcohol problems across generations of participants in a 40‐year study. All measures correlated significantly with each other, but each added unique information about future adverse alcohol outcomes. [ABSTRACT FROM AUTHOR]

Background: Despite the social nature of most drinking experiences, prior work has largely failed to incorporate social context into the study of alcohol's effects on emotion. The present study provides an initial test of the effect of alcohol on mood among platonic friends drinking together in a non‐stress setting. We hypothesized that subjects would report more positive postdrink mood after consuming alcohol than after consuming a nonalcoholic control beverage. Methods: Dyads of platonic male friends (n = 36; 55.55% White, 38.88% Asian, 5.55% Black) attended two laboratory‐based experimental sessions, wherein their drink conditions (alcohol vs. no alcohol control) were randomized by dyad and counter‐balanced across sessions. They reported their mood before and after consuming their beverages together, using the Positive and Negative Affect Schedule and an 8‐item mood measure. Results: As hypothesized, alcohol enhanced positive mood (β = 0.26, p < 0.01). Although in the expected direction, the effect of alcohol on negative mood was not significant (β = −0.12, p = 0.17). Post hoc analyses revealed that alcohol yielded greater increases in both stimulation (β=0.26, p = 0.00) and sedation (β=0.40, p = 0.00) as compared to the control condition. Conclusion: This study highlights the positive mood‐enhancing and broader subjective effects of alcohol when drinking with a platonic friend and encourages further consideration of friendship contexts in the examination of alcohol's effects when developing models of the etiology of alcohol use disorder. [ABSTRACT FROM AUTHOR]

Background: As many as 35% of college students report having been drunk in the past month, and greater alcohol use and alcohol‐related problems are associated with a positive attitude toward heavy drinking. One serious consequence of heavy drinking is alcohol‐induced blackout. When they occur, alcohol‐induced blackouts present a unique opportunity to increase motivation to change drinking. However, it is unclear under what conditions an alcohol‐related heavy drinking attitude and experiencing a blackout represent an opportunity to change and how experiencing a blackout(s) influences an individual's motivation to reduce drinking and actual behavior. Methods: This study tested the interplay between one's positive attitude toward heavy drinking and experiencing a blackout in the past year in predicting motivation to reduce drinking (Study 1) and its impact on drinking over time (Study 2). Data were derived from complementary datasets collected at two universities (Study 1 n = 703, mean age = 20.63 years, 44% male, 52% White; Study 2 n = 568, mean age = 19.18 years, 72% male, 84% White). Drinking behavior was measured using a modified Daily Drinking Questionnaire, the Drinking Norms Rating Form, the Alcohol Use Disorders Identification Test (AUDIT), and estimated peak blood alcohol concentration (BAC). Regression analyses were conducted to determine whether a blackout would moderate the association between attitude and motivation to reduce drinking (Study 1) and drinking over time (Study 2). Results: Results revealed a significant interaction between attitude and blackout, such that individuals who experience a blackout (vs. those who do not) and positively evaluate heavy drinking evidenced lower motivation to reduce drinking (Study 1) and higher levels of estimated peak BAC (Study 2). Conclusions: Drinkers with a negative attitude toward heavy drinking who have experienced a blackout have the strongest motivation to reduce drinking and the greatest reductions in peak drinking behavior over time. These effects are over and above that related to the level of alcohol consumed. For young adults who do not positively endorse heavy drinking, blackouts may present a "moment of opportunity" for intervention. [ABSTRACT FROM AUTHOR]

Background: The current study examined the extent to which within‐person variation in drinking motives differentiates moderate, binge, and high‐intensity drinking; and independent associations of motives and drinking intensity with alcohol use consequences in a sample of young adult drinkers from across the United States. Methods: Participants were past 30‐day drinkers in the U.S. nationally representative Monitoring the Future 12th grade sample in 2018, who also reported alcohol use during a 14‐day data collection burst 1 year later (N = 484 people, mean age 19.3 [SD 0.40], 43% female; N = 1042 drinking days) as part of the Young Adult Daily Life Study in 2019. Weighted multilevel modeling estimated within‐ and between‐person associations of drinking motives, drinking intensity (i.e., moderate [women 1–3, men 1–4 drinks], binge [women 4–7, men 5–9 drinks], and high‐intensity drinking [women 8+, men 10+ drinks]), and number of positive and negative alcohol consequences. Results: On days participants reported greater enhancement and social motives, they were more likely to engage in high‐intensity (vs. binge) drinking and binge (vs. moderate) drinking and experience more positive alcohol consequences. On days participants reported greater enhancement and coping motives, they experienced more negative alcohol consequences. Binge (vs. moderate) drinking on a given day was associated with more positive and negative alcohol consequences; high‐intensity (vs. binge) drinking on a given day was associated with more negative alcohol consequences that day. Moderation analyses indicated that social motives were associated with high‐intensity (vs. binge) drinking only among college students. Conclusions: Stronger drinking motives on a given day were associated with drinking intensity (enhancement and social motives) and negative consequences (enhancement and coping). High‐intensity (vs. binge or moderate) drinking was associated with more negative consequences but not more positive consequences. These results underscore that high‐intensity drinking and consequences vary across days and time‐varying, occasion‐specific risks such as current motivational context are appropriate targets for intervention. [ABSTRACT FROM AUTHOR]

Background: Accurate characterization of prenatal alcohol exposure (PAE) is challenging due to inconsistent use of screening questionnaires in routine prenatal care and substantial underreporting due to stigma associated with alcohol use in pregnancy. The aim of this study was to identify self‐report tools that are efficient in accurately characterizing PAE. Methods: Participants meeting eligibility criteria for mild‐to‐moderate PAE were recruited into the University of New Mexico Ethanol, Neurodevelopment, Infant and Child Health cohort (N = 121) and followed prospectively. Timeline follow‐back (TLFB) interviews were administered at baseline to capture alcohol use in the periconceptional period and 30 days before enrollment; reported quantity was converted to oz absolute alcohol (AA), multiplied by frequency of use and averaged across 2 TLBF calendars. The interview also included questions about timing and number of drinks at the most recent drinking episode, maximum number of drinks in a 24‐hour period since the last menstrual period, and number of drinks on "special occasions" (irrespective of whether these occurred within the TLFB reported period). Continuous measures of alcohol use were analyzed to yield the number of binge episodes by participants who consumed ≥4 drinks/occasion. The proportion of women with ≥1 binge episode was also tabulated for each type of assessment. Results: Average alcohol consumption was 0.6 ± 1.3 oz of AA/day (≈ 8.4 drinks/wk). Only 3.3% of participants reported ≥1 binge episode on the TLFB, 19.8% had ≥1 binge episode when asked about "special occasions," and 52.1% when asked about the number of drinks the last time they drank alcohol. An even higher prevalence (89.3%) of bingeing was obtained based on the maximum number of drinks consumed in a 24‐hour period. Conclusions: Self‐reported quantity of alcohol use varies greatly based on type of questions asked. Brief targeted questions about maximum number of drinks in 24 hours and total number of drinks during the most recent drinking episode provide much higher estimates of alcohol use and thus might be less affected by self‐reporting bias. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol is among the most commonly used psychoactive drugs, yet it can produce markedly different subjective effects in different people. Certain effects, including both heightened stimulatory effects and lesser sedative effects, are thought to predict repeated or excessive use. However, we do not fully understand the nature of these individual differences or their relationships to alcohol consumption. This controlled laboratory study examined subjective and physiologic responses to a moderate dose of alcohol in social drinkers in relation to the subjects' decision to consume alcohol. Methods: Healthy adult volunteers (N = 95) participated in a 5‐session double‐blind alcohol choice study. On the first 4 sessions, they received alcohol (0.8 g/kg) and placebo in alternating order, and on the fifth session, they chose and consumed whichever of the 2 they preferred. During each session, participants completed the Profile of Mood States (POMS) and Biphasic Alcohol Effects Scale (BAES) questionnaires and had their vitals recorded every 30 minutes. We compared subjective and physiologic response to alcohol during the sampling sessions in participants who chose alcohol or placebo on session 5. Results: Of the 95 participants, 55 chose alcohol (choosers) and 40 chose placebo (nonchoosers). In the full sample, alcohol produced its expected effects (e.g., increased friendliness, elation, and vigor (POMS), and stimulation and sedation (BAES)). The chooser and nonchooser groups did not differ in demographic characteristics, blood alcohol levels, or cardiovascular measures. However, the choosers experienced greater alcohol‐induced increases in positive mood (POMS) and liked the drug more, whereas the nonchoosers experienced greater anger, anxiety (POMS), and sedation (BAES) after alcohol. Conclusion: Both greater positive mood effects and lesser sedative effects after alcohol predicted preference under controlled conditions, suggesting that both factors can predict future consumption of alcohol. [ABSTRACT FROM AUTHOR]

Background: Alcohol contributes to numerous annual deaths and various societal problems not just in adult, but also in adolescent, populations. Therefore, it is vital to find methods for reliably detecting alcohol use for early preventative measures. Research has shown phosphatidylethanol (PEth) to be superior to self‐report instruments and indirect biomarkers for alcohol consumption in adult populations. However, the transferability onto an adolescent population has not yet been investigated. Methods: N = 106 adolescents and young adults aged between 13 and 21 years were included. PEth analysis using high‐pressure liquid chromatography–tandem mass spectrometry was performed on dried blood spot samples. Self‐report questionnaires for alcohol consumption (Alcohol Use Disorders Identification Test—Consumption, AUDIT‐C, and Timeline Followback, TLFB) and drug and alcohol consumption (Detection of Alcohol and Drug Problems in Adolescents, DEP‐ADO) were completed by each participant. Results: AUDIT‐C scores showed large correlations with PEth 16:0/18:1 (rs = 0.732) and PEth 16:0/18:2 (rs = 0.661) concentrations. AUDIT‐C with a cutoff value ≥3 was largely correlated with PEth 16:0/18:1 (η = 0.411) and showed a medium‐sized correlation with PEth 16:0/18:2 (η = 0.397) concentrations. Using an AUDIT‐C cutoff value ≥5 showed large correlations with both PEth 16:0/18:1 (η = 0.510) and PEth 16:0/18:2 (η = 0.497) concentrations, respectively. ROC curves indicated higher PEth concentrations are a good model for detecting positive AUDIT‐C cutoff values (AUROC range: 0.800 to 0.849). PEth concentrations showed medium to large correlations with DEP‐ADO and TLFB subscales (range rs = 0.469 to 0.746). Conclusion: The results suggest that PEth is a reliable and objective marker for quantifying alcohol consumption in adolescents and young adults. This could be of importance for early preventative measures against hazardous alcohol consumption, which is increasingly common at younger ages. [ABSTRACT FROM AUTHOR]

Background: Approach bias modification (ApBM) and interpretation bias modification (IBM) are two promising adjunct treatments for alcohol use and social anxiety, respectively. However, the acceptability of combining ApBM and IBM into one program for people who experience both of these disorders is unknown. The present study describes the codevelopment of a new, hybrid ApBM + IBM program and provides insight into the perceptions of acceptability from service providers and emerging adults. Methods: Service providers (n = 14) and emerging adults aged 18 to 25 years with lived experience of hazardous alcohol use and heightened social anxiety (n = 15) were recruited via online advertisements and through existing networks. All participants were shown a beta version of the program and asked to complete qualitative and quantitative questions to ascertain feedback on the program's acceptability and suggestions for improvement. Results: Themes emerged relating to the ApBM + IBM program's quality and usefulness, appropriateness, motivation and engagement, and potential clinical value. The program was well received and deemed acceptable for the target age group. It was rated particularly highly with regard to the overall quality and ease of use. Emerging adults had fewer suggestions for how the intervention might be revised; however, there were suggestions from both groups regarding the need for a compelling rationale at the outset of treatment and a suggestion to include a motivational interviewing and psychoeducational‐based module prior to the first training session, to increase user buy‐in and engagement. Conclusions: The current findings reflect positively on the acceptability of a hybrid ApBM + IBM for emerging adults with co‐occurring hazardous alcohol use and social anxiety. Service providers and emerging adults identified a number of ways to improve the design and implementation of the program, which will likely improve adherence to, and outcomes of, the intervention when added as an adjunct to treatment as usual. [ABSTRACT FROM AUTHOR]

Background: Prenatal alcohol exposure (PAE) is associated with a variety of structural abnormalities in the brain, including several within the para‐limbic system. Children with PAE have higher rates of internalizing disorders, including depression and anxiety, which may be related to underlying limbic system anomalies. Methods: Children aged 8 to 16 with PAE (n = 41) or without PAE (n = 36) underwent an magnetic resonance imaging of the brain and parents completed behavioral questionnaires about their children. Semi‐automated procedures (FreeSurfer) were used to derive para‐limbic volumes from T1‐weighted anatomical images. Results: There were significant group differences (PAE vs. nonexposed controls) in the caudate, hippocampus, and the putamen; children with PAE had smaller volumes in these regions even after controlling for total intracranial volume. A trend‐level association was seen between caudate volume and internalizing symptoms in children with PAE; smaller caudate volumes (presumably reflecting less optimal neurodevelopment) were associated with higher levels of anxiety and depression symptoms in these children. Conclusions: Caudate structure may be disproportionately affected by PAE and may be associated with the later development of internalizing symptoms in those affected by PAE. [ABSTRACT FROM AUTHOR]

Background: Valid measurement of alcohol use can be difficult in surveys, which are subject to biases like underreporting and differential nonresponse. Still, monitoring trends, policy impacts, disparities, and related issues all require valid individual‐ and state‐level drinking data collected over time. Here, we propose a double‐adjustment approach for improving the validity of the Behavioral Risk Factor Surveillance System (BRFSS) alcohol measures. Methods: Validity analyses of the 1999 to 2016 BRFSS, a general population survey of U.S. adults. Measures are aggregated to state level for N = 918 observations, single‐adjusted for BRFSS methodologic changes, and double‐adjusted by per capita consumption. Fixed‐effects models: (i) assess predictive validity using adjusted BRFSS drink volume to predict mortality outcomes and (ii) assess outcome validity using state‐level alcohol taxes to predict adjusted BRFSS volume. Results: Neither the raw nor the single‐adjusted BRFSS drinking measures were related to mortality in the expected direction, while double‐adjusted BRFSS volume and 5+ days were significantly positively related to mortality, as expected. Spirits and beer taxes were not related to single‐adjusted BRFSS drinking in the expected direction. However, spirits and beer taxes were both significantly related to double‐adjusted BRFSS volume in the expected directions. Conclusions: Future studies should consider using the double‐adjusted BRFSS measures to ensure the validity of drinking survey data in analyses where variation over time is considered. [ABSTRACT FROM AUTHOR]

Introduction: Behavioral economic theory views addiction as a reinforcer pathology characterized by excessive demand for drugs relative to alternatives. Complementary to this theory, Lamb and Ginsburg (Pharmacology Biochemistry and Behavior, 164, 2018, 62) describe addiction as a behavioral allocation disorder and predict that decisions to drink under increasingly stringent constraints are a central indicator of addiction. This study used a modified demand‐curve paradigm to examine alcohol demand in the context of a next‐day contingency (high opportunity cost demand) as a specific indicator of a severe pattern of alcohol problems. Methods: Participants were 370 undergraduates (61.1% female, 86.5% white, Mage = 18.8) reporting multiple past‐month heavy drinking episodes (5/4 drinks per occasion for men/women) who completed 2 versions of an alcohol purchase task (APT), along with measures of past‐month alcohol use and problems. In 1 APT (low opportunity cost), students imagined they had no next‐day responsibilities, and in the other APT (high opportunity cost), they imagined having a 10:00 am test the next day. Item‐response theory analyses were used to determine mild and severe alcohol problems from the Young Adult Alcohol Consequences Questionnaire (Journal of Studies on Alcohol, 67, 2006, 169), and the most and least severe binge drinking days throughout the week. Results: Low opportunity cost demand (β = 0.15, p = 0.02) significantly predicted beyond high opportunity cost demand for the least severe problems, and high opportunity cost demand (β = 0.17, p = 0.009) significantly predicted beyond low opportunity cost demand for the most severe problems. Similarly, low opportunity cost demand (β = 0.26, p < 0.001) was more highly associated with weekend drinking, whereas high opportunity cost demand (β = 0.21, p = 0.001) was more highly associated with weekday drinking. Conclusions: The current results suggest high opportunity cost alcohol demand is a distinct marker of severe alcohol problems among college student heavy drinkers. [ABSTRACT FROM AUTHOR]

Background: Hazardous alcohol use is a predictor of intimate partner violence (IPV), and both are increasingly prevalent in sub‐Saharan Africa. The accurate measurement of alcohol consumption is therefore critical in IPV intervention studies that target hazardous drinking. Collecting a collateral report in addition to self‐report is one convergent validity approach to improve alcohol measurement. We investigated concordance between self‐ and partner‐reported alcohol use among women who reported recent IPV and their male partners in Zambia. Methods: Data were from the baseline of a randomized IPV intervention trial of 247 heterosexual couples in which a woman has reported recent IPV and her male partner has recent hazardous alcohol use. Both partners completed the Alcohol Use Disorders Identification Test (AUDIT) in reference to their own drinking and in reference to their partner's drinking. We calculated percent agreement across a range of outcomes: any use, quantity, frequency, and hazardous use. We also compared self‐ and partner‐reported AUDIT scores using t‐tests. Results: Concordance was poor across most outcomes. Percent agreement with respect to the women's drinking ranged from 60% to 65% across outcomes and with respect to the men's drinking from 51% to 89%. Women's average partner‐reported AUDIT score (20.7) was statistically significantly (p < 0.0001) higher than men's average self‐reported score (15.8). Conclusions: In contrast to collateral report studies conducted in the United States, concordance between self‐ and partner‐reported alcohol consumption was poor among families experiencing IPV in Zambia. Given the possible biases associated with self‐reported alcohol use, findings suggest that a convergent validity approach is useful in this research context. [ABSTRACT FROM AUTHOR]

Background: Alcohol can lead to fatal and nonfatal overdose (OD) through its neurobiological inhibitory effects when used alone or with other drugs. Little research has examined alcohol OD characteristics in the context of concomitant drug use. Methods: This study utilized alcohol OD data (defined as alcohol poisoning, passing out, or blacking out) collected in a large residential addiction treatment facility (N = 660). Latent class analysis identified classes of alcohol OD events based on concomitant drug use at the time of OD. We evaluated correlates of alcohol OD classes, including depression, emergency medical services, and hospitalization, using latent class regression. Results: Only 20% of alcohol ODs involved alcohol alone. Marijuana was the most commonly used drug during the most recent alcohol OD (43.2%), followed by sedatives (27.9%), cocaine or crack (25.9%), prescription opioids (26.1%), and heroin (20%). The final latent class model included 3 classes: no/low drug involvement (61%), moderate drug involvement (33%), and high drug involvement (6%). Relative to the no/low drug involvement class, participants admitted to the hospital were 6.4‐fold more likely to be in the high drug involvement class (95% CI: 2.4 to 16.6) and 2.9‐fold more likely to be in the moderate drug involvement class (95% CI: 1.2 to 7.2). Participants receiving emergency medical services were more likely to be in the high drug involvement class (aOR: 2.2, 95% CI: 2.2, 1.1 to 4.5) and less likely to be in the moderate drug involvement class (aOR 0.39, 95% CI: 0.2 to 0.96). Conclusions: Combining drug classes with alcohol prior to OD was common and associated with a higher likelihood of hospitalization. Overdose prevention efforts should address acute risks of alcohol ingestion with other drugs. [ABSTRACT FROM AUTHOR]

Background: The 35‐year‐long San Diego Prospective Study documented 2‐fold increases in alcohol problems and alcohol use disorders (AUDs) in young‐adult drinking offspring compared to rates in their fathers, the original probands. The current analyses use the same interviews and questionnaires at about the same age in members of the 2 generations to explore multiple potential contributors to the generational differences in adverse alcohol outcomes. Methods: Using data from recent offspring interviews, multiple cross‐generation differences in characteristics potentially related to alcohol problems were evaluated in 3 steps: first through direct comparisons across probands and offspring at about age 30; second by backward linear regression analyses of predictors of alcohol problems within each generation; and finally third through R‐based bootstrapped linear regressions of differences in alcohol problems in randomly matched probands and offspring. Results: The analyses across the analytical approaches revealed 3 consistent predictors of higher alcohol problems in the second generation. These included the following: (i) a more robust relationship to alcohol problems for offspring with a low level of response to alcohol; (ii) higher offspring values for alcohol expectancies; and (iii) higher offspring impulsivity. Conclusions: The availability of data across generations offered a unique perspective for studying characteristics that may have contributed to a general finding in the literature of substantial increases in alcohol problems and AUDs in recent generations. If replicated, these results could suggest approaches to be used by parents, healthcare workers, insurance companies, and industry in their efforts to mitigate the increasing rates of alcohol problems in younger generations. [ABSTRACT FROM AUTHOR]

Background: Alcohol expectancies (AE), that is, the anticipated effects of alcohol, start developing early in childhood and are important predictors of alcohol use years later. Whereas previous research has demonstrated that parental drinking relates to children's AE, this study aims to test whether exposure to parental alcohol use mediates the link between parental alcohol use and positive and negative AE among children (6 to 8 years) and early adolescents (12 to 15 years). Methods: Longitudinal multi‐informant family studies were conducted in the Netherlands among children (Study 1 (2015 to 2017): N = 329; 48.9% boys; Mage = 4.6) and adolescents (Study 2 [2015 to 2018]: N = 755; 45.6% boys; Mage = 11.3). Fathers' and mothers' alcohol use in terms of quantity and exposure (i.e., the frequency of alcohol use in 9 family‐specific situations), and offspring's AE were collected using online questionnaires. Results: Structural equation modeling conducted in the full sample and separately by gender revealed the following: For children, no associations were found in the full sample. However, gender‐specific results indicated that fathers' exposure was associated with (and mediated) favorable AE. Among adolescents, fathers' exposure was associated with (and mediated) social and coping AE (both boys and girls) and enhancement AE (only boys). Contrastingly, neither mothers' alcohol use nor its exposure was associated with any AE. Although different associations were found by offspring's gender, strong evidence for gender differences was lacking. Conclusions: This study indicates that, for specific expectancies, exposure to fathers' alcohol use shapes offspring's cognitions about the effects of alcohol, rather than fathers' alcohol use in general. Prevention efforts could focus on lowering the degree to which fathers expose their drinking, which might be more easily changeable than drinking in general. [ABSTRACT FROM AUTHOR]

Background: Although the risks of using central nervous system depressant (CNS‐D) medications with alcohol are well documented, little is known about trends in prescribed use of these medications among individuals who regularly consume alcohol (i.e., trends in "concurrent use"). We examined changes in the prevalence of prescribed CNS‐D medications among individuals who drank alcohol on 52 or more occasions in the past year ("regular drinking"). CNS‐D medications included sedative‐hypnotics (subclassified as anxiolytics or sleep medications) and opioids. Methods: We used 8 cross‐sectional cycles of the National Health and Nutrition Examination Survey (1999–2000 to 2013–2014) from participants aged 20 and older (n = 37,709). We used log‐binomial regression to examine (i) prevalence trends of prescribed CNS‐D medication use, (ii) trend differences by drinking status, and (iii) correlates of CNS‐D medication use. Results: Among those who drink regularly, the relative annual increase in prevalence of sedative‐hypnotic use was 5.3% (95% CI: 2.7 to 7.9): Anxiolytic and sleep medication use increased annually by 3.7% (95% CI: 0.8 to 6.7) and 11.2% (95% CI: 6.5 to 16.0), respectively. Opioid use trends among those who drink regularly were not statistically significant but were nonlinear. Differences in CNS‐D medication trends between those who drink regularly and those who drink infrequently/abstain were not statistically significant. Those who drink regularly were less likely than those who drink infrequently/abstain to use opioids (adjusted relative risk [ARR]: 0.69, 95% CI: 0.60 to 0.78) and anxiolytics (ARR: 0.71, 95% CI: 0.61 to 0.81), but not sleep medications (ARR: 1.04, 95% CI: 0.80 to 1.35). Those aged 40 and older were 2 to 5 times as likely as those aged 20 to 29 to use sedative‐hypnotics. Conclusions: Among those who drink regularly, the prevalence of prescribed sedative‐hypnotic use increased and prescribed opioid use remained common. These trends indicate that a substantial portion of the population is at risk of alcohol‐related adverse drug reactions—particularly those aged 40 and older. [ABSTRACT FROM AUTHOR]

Background: Behavioral economic approaches have revealed several characteristics of alcohol demand (e.g., intensity, elasticity, and essential value) in university students; however, these approaches have not yet examined alcohol demand among students outside of the United States. The current study examined alcohol demand among student samples in the United States and France using a hypothetical alcohol purchase task (APT) and a novel APT Choice task, in which nonalcoholic beverages were concurrently available at a fixed low price. Methods: Participants at each site (United States, n = 132; France, n = 132) were asked to complete an Internet‐based survey including the APT, APT Choice, Alcohol Use Disorders Identification Test, Daily Drinking Questionnaire, and Drinking Motives Questionnaire‐Revised Short Form. Group demand functions were produced for each of the 2 samples in both country‐specific and standardized drink units, and the exponential demand equation was fitted to each of the APT and APT Choice demand curves. Slope analyses were performed on the Non‐Alcoholic Cross‐Price demand to assess substitutability. Results: APT data revealed that in both samples, alcohol price and consumption were inversely related and demand measures were significantly associated with other alcohol measures. In addition, the availability of a nonalcoholic alternative reduced alcohol demand in both samples, with evidence of substitutability revealed by increases in cross‐price consumption. Conclusions: Low‐cost alcohol is associated with increased alcohol consumption in both French and U.S. university students, and concurrent availability of a nonalcoholic beverage within the APT both reduces alcohol demand and demonstrates behavioral economic substitutability. These findings will inform future studies investigating behavioral and environmental factors underlying transcultural differences and specific prevention efforts. Samples of students in the U.S. and France completed a hypothetical alcohol purchase task (APT) and a novel APT Choice task, in which non‐alcoholic beverages were also available at a fixed low price. Low‐cost alcohol was associated with greater reported alcohol consumption in both samples, and the availability of a non‐alcoholic beverage reduced alcohol demand and demonstrated behavioral economic substitutability, particularly among the French students. These findings indicate cultural similarities—and differences—in alcohol demand amonguniversity students. [ABSTRACT FROM AUTHOR]

Background: Preventing alcohol‐exposed pregnancies (AEPs) could reduce the incidence of fetal alcohol spectrum disorders. Previous face‐to‐face interventions significantly reduced risk for AEP, but a scalable intervention is needed to reach more women at risk. Methods: This study compared a 6 Core automated, interactive, and tailored Internet intervention, the Contraception and Alcohol Risk Reduction Internet Intervention (CARRII), to a static patient education (PE) website for its effect on AEP risk. Participants were recruited online to a pilot randomized clinical trial (RCT) with baseline, 9 weeks posttreatment, and 6‐month (6‐M) follow‐up assessments. Seventy‐one women completed online questionnaires and telephone interviews and were randomized to CARRII (n = 36) or PE (n = 35). Primary outcomes were rates of risky drinking, unprotected sex episodes, and AEP risk, collected from online prospective diaries. Results: CARRII participants showed significant reductions in rate of unprotected sex from pretreatment (88.9%) to posttreatment (70.6%) (p < 0.04) and to 6‐M follow‐up (51.5%) (p = 0.001); rate of risky drinking from pretreatment (75.0%) to posttreatment (50.0%) (p < 0.02), but insignificant change from pretreatment to 6‐M follow‐up (57.6%) (p < 0.09); and rate of AEP risk from pretreatment (66.7%) to posttreatment (32.4%) (p = 0.001) and to 6‐M follow‐up (30.3%) (p = 0.005). PE participants demonstrated no significant changes on all 3 variables across all time points. Intent‐to‐treat group‐by‐time tests were not significant, but power was limited by missing diaries. Over 72% of CARRII participants completed all 6 Cores. Exploratory analyses suggest that higher program utilization is related to change. Conclusions: These data show that CARRII was acceptable, feasible, promising to reduce AEP risk, and merits further testing in a fully powered RCT. [ABSTRACT FROM AUTHOR]

Background Attentional bias modification ( ABM) techniques for reducing problematic alcohol consumption hold promise as highly accessible and cost-effective treatment approaches. A growing body of literature has examined ABM as a potentially efficacious intervention for reducing drinking and drinking-related cognitions in alcohol-dependent individuals as well as those at-risk of developing problem drinking habits. Methods This study tested the effectiveness of a single session of visual probe-based ABM training in a cohort of 60 non-treatment-seeking young adult drinkers, with a focus on examining mechanisms underlying training efficacy. Participants were randomly assigned to a single session of active ABM training or a sham training condition in a laboratory setting. Measures of implicit drinking-related cognitions (alcohol Stroop and an Implicit Association Task) and attentional bias (AB; alcohol visual probe) were administered, and subjective alcohol craving was reported in response to in vivo alcohol cues. Results Results showed that active ABM training, relative to sham, resulted in significant differences in measures of implicit alcohol-related cognition, alcohol-related AB, and self-reports of alcohol craving. Mediation analysis showed that reductions in craving were fully mediated by ABM-related reductions in alcohol-Stroop interference scores, suggesting a previously undocumented relationship between the 2 measures. Conclusions Results document the efficacy of brief ABM to reduce both implicit and explicit processes related to drinking, and highlight the potential intervention-relevance of alcohol-related implicit cognitions in social drinkers. [ABSTRACT FROM AUTHOR]

Background Reducing meat consumption is often advised; however, inadvertent nutritional deficiencies during pregnancy may result in residual neurodevelopmental harms to offspring. This study assessed possible effects of maternal diets in pregnancy on adverse substance use among adolescent offspring. Methods Pregnant women and their 13-year-old offspring taking part in a prospective birth cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC), provided Food Frequency Questionnaire data from which dietary patterns were derived using principal components analysis. Multivariable logistic regression models including potential confounders evaluated adverse alcohol, cannabis, and tobacco use of the children at 15 years of age. Results Lower maternal meat consumption was associated with greater problematic substance use among 15-year-old offspring in dose-response patterns. Comparing never to daily meat consumption after adjustment, risks were greater for all categories of problem substance use: alcohol, odds ratio OR = 1.75, 95% CI = (1.23, 2.56), p < 0.001; tobacco use OR = 1.85, 95% CI = (1.28, 2.63), p < 0.001; and cannabis OR = 2.70, 95% CI = (1.89, 4.00), p < 0.001. Given the likelihood of residual confounding, potential causality was evaluated using stratification for maternal allelic variants that impact biological activity of cobalamin (vitamin B12) and iron. Lower meat consumption disproportionally increased the risks of offspring substance misuse among mothers with optimally functional (homozygous) variants (rs1801198) of the gene transcobalamin 2 gene ( TCN2) which encodes the vitamin B12 transport protein transcobalamin 2 implicating a causal role for cobalamin deficits. Functional maternal variants in iron metabolism were unrelated to the adverse substance use. Risks potentially attributable to cobalamin deficits during pregnancy include adverse adolescent alcohol, cannabis, and tobacco use (14, 37, and 23, respectively). Conclusions Lower prenatal meat consumption was associated with increased risks of adolescent substance misuse. Interactions between TCN2 variant status and meat intake implicate cobalamin deficiencies. [ABSTRACT FROM AUTHOR]

Background Although studies have shown that alcohol expectancies are prominent predictors of alcohol initiation and subsequent drinking levels, the questionnaires used to assess these expectancies among young adolescents have been criticized as being time-intensive, biased, and inappropriate. Methods In response, we developed the Alcohol Expectancy Task ( AET), in which 8 scenarios featuring adults in everyday situations and in different emotional states, accompanied by photographs of a range of beverages (4 alcoholic, 8 nonalcoholic), are displayed on a tablet screen, and participants are then asked to tap on the beverage they think the given person had been drinking. Results In a first study among 184 adults (75.1% women; mean age = 37.8, SD = 12.2), results from a repeated-measures analysis of variance revealed a strong correspondence between the emotions depicted in the scenarios and how the participants interpreted them. In a second study, this time among 283 third and fourth graders (50.2% girls; mean age = 10.6, SD = 0.69), a confirmatory factor analysis confirmed the 4-factor structure of the AET. The results from a logistic regression analysis showed that the more often young adolescents assigned alcohol to the adults in an arousal-positive mood than to those in a sedation-negative mood, the more likely they were to have already consumed alcohol more than twice. Questionnaire-assessed expectancies were unrelated to adolescents' drinking and did not affect the associations of the AET. Conclusions The AET has the advantage of being time-efficient and convenient and could overcome certain limitations associated with questionnaire-based assessments of alcohol expectancy. [ABSTRACT FROM AUTHOR]

Background Blood brain-derived neurotrophic factor ( BDNF) levels are influenced by both addiction and mood disorders, as well as somatic conditions, gender, and genetic polymorphisms, leading to widely varying results. Depressive symptoms and episodes are frequently observed in patients with alcohol use disorder, and vary widely over time, making it a challenge to determine which aspects are specifically involved in variations of serum BDNF levels in this population. Methods We assessed 227 patients with alcohol dependence involved in a detoxification program, at baseline and after a follow-up of 6 months, for the Alcohol Use Disorders Identification Test score, the length of alcohol dependence, and the number of past detoxification programs. The Beck Depression Inventory and information on current tobacco and alcohol use, suicidal ideation, body mass index, age, gender, and psychotropic treatments were also collected. Serum BDNF ( ELISA) and 2 genetic polymorphisms of the BDNF gene (Val33Met and rs962369) were analyzed. Results The presence of the Met allele, 2 markers of the history of alcohol dependence (gamma glutamyl transferase and the number of past treatments in detoxification programs), and the presence of a depressive episode (but not depressive score) were significantly associated with the 2 blood levels of BDNF at baseline and after 6 months. After controlling for baseline BDNF levels, the presence of the Met allele and an ongoing depressive episode were the only variables associated with changes in BNDF levels after 6 months. Conclusions Low serum BDNF levels are associated with characteristics related to alcohol consumption and mood disorders, and variants of the BDNF gene in alcohol use disorder patients. The factors that most strongly influenced changes in serum BDNF levels following treatment in an alcohol detoxification program were variants of the BDNF gene and ongoing depression. [ABSTRACT FROM AUTHOR]

Background Laboratory alcohol challenges are the 'gold standard' for obtaining accurate measurements of subjective alcohol stimulation, sedation, and reward. However, these approaches are time and resource intensive. This study examined the extent to which self-reported anticipated alcohol stimulation, sedation, and reward corresponded with those same responses measured with the Biphasic Alcohol Effects Scale ( BAES), Brief- BAES (B- BAES), and Drug Effects Questionnaire ( DEQ) during a controlled laboratory alcohol challenge. Methods Participants were 106 light-to-heavy social drinkers (58.5% male; mean ± SD age = 35.8 ± 3.2 years) who completed the Anticipated BAES and DEQ, as well as laboratory-derived versions of these scales 30 and 60 minutes after consuming placebo and 0.8 g/kg alcohol on separate days as part of laboratory sessions in the Chicago Social Drinking Project. Results Anticipated BAES/B- BAES and Anticipated DEQ alcohol effects were strong predictors of their corresponding laboratory-derived responses during both the rising limb and at peak breath alcohol concentrations. Effects were significant even when accounting for age, sex, past-month heavy drinking frequency, and laboratory session order (placebo or alcohol first). Conclusions This study provides strong preliminary support for measuring anticipated alcohol effects with the Anticipated BAES/B- BAES and Anticipated DEQ as a proxy of subjective responses experienced during a controlled laboratory alcohol challenge. The findings lend support for these measures as viable alternatives to other anticipatory scales when laboratory-derived alcohol response measurement is not feasible. [ABSTRACT FROM AUTHOR]

Background Large general population surveys show that heavy regular and episodic alcohol consumption are associated with lower intakes of fruits and vegetables, and higher intakes of processed and fried meat. This is of particular concern regarding pregnant women, as both alcohol intake and inadequate maternal nutrition are independently associated with adverse fetal outcomes. The current study aimed to determine associations between maternal dietary patterns and alcohol consumption during pregnancy. Methods Women were participating in the Avon Longitudinal Study of Parents and Children, and provided details of alcohol consumption at 18 weeks' gestation and diet at 32 weeks' gestation ( n = 9,839). Dietary patterns were derived from the food frequency questionnaire data using principal components analysis. Associations between alcohol consumption and dietary patterns were determined using multiple linear regression, adjusted for various sociodemographic and lifestyle factors. Results After adjustment, drinking ≥1 unit/d during the first trimester ( β = 0.23 [95% CI: 0.08, 0.38]; p = 0.002) and binge drinking (≥4 units in 1 day) during the first half of pregnancy ( β = 0.14 [95% CI: 0.07, 0.21]; p < 0.0001) were associated with greater adherence to the 'Processed' dietary pattern (high intakes of processed meat and low intakes of fruit and vegetables). Light-to-moderate alcohol consumption (≤1 drink/d) during the first trimester was associated with greater adherence to the 'Health conscious' dietary pattern (high intakes of fruit, vegetables, whole grains, and fish) ( β = 0.09 [95% CI: 0.04, 0.14]; p < 0.0001). Conclusions Two important components of health behavior during pregnancy appear to be related: greater consumption of processed foods associated with heavier alcohol consumption, and healthier dietary choices associated with light-to-moderate alcohol intake. Potential synergistic effects of these behaviors may have implications for maternal and fetal health and warrant further investigation. A more holistic approach to addressing health behaviors in women of reproductive age is required. [ABSTRACT FROM AUTHOR]

Background Although alcohol risk is heritable, few genetic risk variants have been identified. Longitudinal electronic health record (EHR) data offer a largely untapped source of phenotypic information for genetic studies, but EHR-derived phenotypes for harmful alcohol exposure have yet to be validated. Using a variant of known effect, we used EHR data to develop and validate a phenotype for harmful alcohol exposure that can be used to identify unknown genetic variants in large samples. Herein, we consider the validity of 3 approaches using the 3-item Alcohol Use Disorders Identification Test consumption measure ( AUDIT-C) as a phenotype for harmful alcohol exposure. Methods First, using longitudinal AUDIT-C data from the Veterans Aging Cohort Biomarker Study Cohort ( VACS- BC), we compared 3 metrics of AUDIT-C using correlation coefficients: (i) AUDIT-C closest to blood sampling (closest AUDIT-C), (ii) the highest value (highest AUDIT-C), (iii) and longitudinal trajectories generated using joint trajectory modeling ( AUDIT-C trajectory). Second, we compared the associations of the 3 AUDIT-C metrics with phosphatidylethanol ( PEth), a direct, quantitative biomarker for alcohol in the overall sample using chi-square tests for trend. Last, in the subsample of African Americans ( AAs; n = 1,503), we compared the associations of the 3 AUDIT-C metrics with rs2066702 a common missense (Arg369Cys) polymorphism of the ADH1B gene, which encodes an alcohol dehydrogenase isozyme. Results The sample ( n = 1,851, 94.5% male, 65% HIV+, mean age 52 years) had a median of 7 AUDIT-C scores over a median of 6.1 years. Highest AUDIT-C and AUDIT-C trajectory were correlated r = 0.86. The closest AUDIT-C was obtained a median of 2.26 years after the VACS- BC blood draw. Overall and among AAs, all 3 AUDIT-C metrics were associated with PEth (all p < 0.05), but the gradient was steepest with AUDIT-C trajectory. Among AAs (36% with the protective ADH1B allele), the association of rs2066702 with AUDIT-C trajectory and highest AUDIT-C was statistically significant ( p < 0.05), and the gradient was steeper for the AUDIT-C trajectory than for the highest AUDIT-C. The closest AUDIT-C was not statistically significantly associated with rs2066702. Conclusions EHR data can be used to identify complex phenotypes such as harmful alcohol use. The validity of the phenotype may be enhanced through the use of longitudinal trajectories. [ABSTRACT FROM AUTHOR]

Background Several psychometrically sound measures of alcohol use have been developed to assess drinking. The Alcohol Use Disorders Identification Test (AUDIT) and its shorter counterpart the AUDIT-C, which contains the first 3 AUDIT questions, were developed by the World Health Organization and have become the preferred brief measures for screening and evaluating problem severity. This study compared the first 3 questions on the AUDIT with another psychometrically sound brief measure of alcohol use, the Quick Drinking Screen (QDS). Methods Data were obtained from a randomized controlled trial of a mail-based intervention promoting self-change with 472 alcohol abusers ( n = 280, no prior alcohol treatment; n = 192, prior alcohol treatment). Participants' retrospective self-reports of alcohol consumption were collected using the QDS and the 3 AUDIT-C questions and compared. Although both measures contain similar questions (2 quantity-frequency and 1 binge drinking), they differ in 2 important ways: (i) temporal interval over which data are collected, and (ii) formatting of response options (i.e., a continuous number vs. categorical). Results Intraclass correlations for drinking variables were moderate to moderately high. A repeated-measures MANOVA using treatment condition and gender as variables revealed significant differences in absolute values between the 2 drinking measures with the QDS showing greater consumption on almost all variables. Participants' numerical answers on the QDS were compared to their categorical answers to the similar alcohol use questions on the AUDIT-C. The comparison revealed that participants' answers on the AUDIT-C were associated with extreme variability compared to their QDS answers. This variability suggests the AUDIT-C would be unreliable as a quantitative measure of alcohol consumption. Conclusions The differences between the 3 alcohol use questions on the AUDIT-C and the same questions on the QDS may reflect the imprecision of the AUDIT-C's drinking response categories. Results suggest that the QDS can be used to identify risky drinking and to provide a more informative characterization of a drinker's alcohol consumption than that provided by the AUDIT-C. [ABSTRACT FROM AUTHOR]

Background Prior studies have found that social rejection is associated with increases in negative affect, distress, and hostility. Fewer studies, however, have examined the impact of social rejection on alcohol use, and no known studies have tested whether the impact of social rejection by close others differs from social rejection by acquaintances in its association with subsequent drinking. Methods Participants completed event-contingent reports of their social interactions and alcohol use for 14 consecutive days on smartphones. Multilevel negative binomial regression models tested whether experiencing more social rejection than usual was associated with increased drinking, and whether this association was stronger when participants were rejected by close others (e.g., friends, spouses, family members) versus strangers or acquaintances. Results Results showed a significant interaction between social rejection and relationship closeness. On days characterized by rejection by close others, the likelihood of drinking significantly increased. On days characterized by rejection by acquaintances, by contrast, there was no increase in the likelihood of drinking. There was no main effect of rejection on likelihood of drinking. Conclusions These results suggest that relationship type is a key factor in whether social rejection translates to potentially harmful behaviors, such as increased alcohol use. This finding is in contrast to many laboratory paradigms of rejection, which emphasize rejection and ostracism by strangers rather than known others. In the more naturalistic setting of measuring social interactions on smartphone in daily life, our findings suggest that only social rejection delivered by close others, and not strangers, led to subsequent drinking. [ABSTRACT FROM AUTHOR]

Background Alcohol-dependent liver transplantation ( LT) patients who resume alcohol consumption are at risk for a number of alcohol-related problems including liver injury and liver failure. Post- LT patients are strongly advised to remain abstinent. However, we do not know how well this population complies due to a lack of valid methods (self-report and/or biomarkers) to identify alcohol use. Studies suggest as many as 50% resume alcohol use within 5 years. Phosphatidylethanol ( PEth) is a new cell-membrane phospholipid biomarker to identify alcohol use in the past 28 days. This prospective study followed 213 LT recipients at 2 U.S. liver transplant centers. Methods Sample included 213 LT subjects; 70.9% ( n = 151/213) had a history of alcohol dependence prior to transplantation and 29.1% ( n = 62/213) served as non-alcohol-dependent controls. Subjects participated in face-to-face interviews to assess alcohol use using a 30-day calendar. The protocol called for collecting blood samples at baseline, 6-, and 12-month follow-up. Results Seventy percent (149/213) who reported no alcohol use had consistently negative PEth levels (<8 ng/ml). A total of 26.4% (57/213), 44 alcohol-dependent patients and 13 controls, had a positive PEth test of >8 ng/ml either at baseline and/or during the follow-up period. Alcohol-dependent subjects (23.8%; n = 36/151) and 16.1% ( n = 10/62) controls reported no alcohol use but had at least 1 positive PEth test. Of the 11.2% (24/213) post- LT subjects who reported recent alcohol use, over half (11/24) had a positive PEth. The 13 self-reported alcohol users with a negative PEth level reported insufficient drinking to trigger PEth formation. Conclusions Adoption of PEth as part of routine posttransplant care of LT recipients will enable early identification of patients at risk of alcohol use and facilitate abstinence in patients with a history of alcohol dependence and alcohol-related liver damage. [ABSTRACT FROM AUTHOR]

Background Alcohol consumption patterns on the U.S.-Mexico border and their relationships with DSM-5 alcohol use disorders ( AUD) have been understudied. Yet, the effects of drinking by Mexican-origin individuals may differ between cities on versus off the border both in the United States and in Mexico. We characterize prior 12-month drinking patterns and examine their relationships with AUD, in border and off-border cities of Texas and adjacent Mexican states. Methods Data come from the U.S.-Mexico Study of Alcohol and Related Conditions involving 2,336 Mexican Americans in Texas and 2,460 Mexicans in bordering states of Nuevo Leon and Tamaulipas in Mexico. Drinking pattern was defined as an interaction between volume and maximum amount, or intensity (never vs. ever 5+/4+ [men/women], 8+, and 12+ drinks in a day). DSM-5 AUD was assessed using an adaptation of the Alcohol Section of the World Health Organization Composite International Diagnostic Interview core. Separately by gender, 5 logistic regressions models controlling for age were estimated predicting symptoms in 2 or more AUD criteria domains from volume, heavy pattern and, successively, effects of country, and (by country) residing on vs. off the border, or in each of 3 cities/country. Results A segmentation analysis for Texas males based on rate of experiencing AUD generated several distinct volume groups, each partitioned by an empirically selected maximum, and helped identify a drinking-pattern typology. In gender-stratified models of AUD rates using this typology, adjusting for age, significant volume and intensity effects were seen, more strongly in the United States. Border versus interior differences implied more AUD for given patterns at the border in the United States and the reverse in Mexico, with some city differences also evident. Conclusions Drinking-pattern analyses confirm that border proximity may affect drinking problems but in opposite directions in the United States and Mexico, possibly related to economic and psychological stresses specific to respective communities. [ABSTRACT FROM AUTHOR]

Background Alcohol marketing is known to be a significant risk factor for underage drinking. However, little is known about youth and adult exposure to alcohol advertising in digital and social media. This study piloted a comparative assessment of youth and adult recall of exposure to online marketing of alcohol. Methods From September to October 2013, a pilot survey of past 30-day exposure to alcohol advertising and promotional content in traditional and digital media was administered to a national sample of 1,192 youth (ages 13 to 20) and 1,124 adults (ages ≥21) using a prerecruited Internet panel maintained by GfK Custom Research. The weighted proportions of youth and adults who reported this exposure were compared by media type and by advertising and promotional content. Results Youth were more likely than adults to recall exposure to alcohol advertising on television (69.2% vs. 61.9%), radio (24.8% vs. 16.7%), billboards (54.8% vs. 35.4%), and the Internet (29.7% vs. 16.8%), but less likely to recall seeing advertising in magazines (35.7% vs. 36.4%). Youth were also more likely to recall seeing advertisements and pictures on the Internet of celebrities using alcohol (36.1% vs. 20.8%) or wearing clothing promoting alcohol (27.7% vs. 15.9%), and actively respond (i.e., like, share, or post) to alcohol-related content online. Conclusions Youth report greater exposure to alcohol advertising and promotional content than adults in most media, including on the Internet. These findings emphasize the need to assure compliance with voluntary industry standards on the placement of alcohol advertising and the importance of developing better tools for monitoring youth exposure to alcohol marketing, particularly on the Internet. [ABSTRACT FROM AUTHOR]

Background Treatment for alcohol use disorders (AUDs) has traditionally been abstinence oriented, but new research and regulatory guidelines suggest that low-risk drinking may also be an acceptable treatment outcome. However, little is known about long-term outcomes for patients who become low-risk drinkers posttreatment. This study explores a posttreatment low-risk drinking outcome as a predictor of future drinking and psychosocial outcomes over 9 years. Methods Study participants were adults with AUDs at treatment entry who received follow-up interviews 6 months posttreatment intake ( N = 1,061) in 2 large randomized studies conducted at Kaiser Permanente Northern California, a large private, nonprofit, integrated health system. Six-month drinking status was defined as abstinent, low-risk (nonabstinent, no 5+ drinking days), or heavy drinking (1 or more days of 5+ drinks). Using logistic regression models, we explored the relationship between past 30-day drinking status at 6 months and odds of being abstinent or a low-risk drinker (compared to heavy drinking), and positive Addiction Severity Index psychosocial outcomes over 9 years (9-year follow-up rate of 73%). Results Abstainers and low-risk drinkers at 6 months had higher odds of recent abstinence/low-risk drinking over 9 years than heavy drinkers; abstainers had better drinking outcomes than low-risk drinkers. Additionally, among those with interview data, 95% of abstainers and 94% of low-risk drinkers at 6 months were abstinent/low-risk drinkers at 9 years; surprisingly, 89% of heavy drinkers at 6 months were also abstinent/low-risk drinkers although still significantly fewer than the other groups. Abstainers and low-risk drinkers at 6 months had better psychiatric outcomes, and abstainers had better family/social outcomes than heavy drinkers; medical outcomes did not differ. Low-risk drinkers and abstainers showed no reliable differences across psychosocial measures. Conclusions The findings suggest that a low-risk drinking outcome may be reasonable over the long-term for some alcohol-dependent individuals receiving addiction treatment. [ABSTRACT FROM AUTHOR]

Background All stages of development of alcohol use disorder ( AUD) have not been equally studied. While initiation of drinking has been given considerable attention, other stages have not been as thoroughly investigated. It is not clear whether the same factors are associated consistently across early and late transitions in AUD involvement. High-risk family samples that are enriched for AUD vulnerability and transitions in AUD development offer an opportunity to examine influences across multiple stages of AUD development. Methods Data from adolescents and young adults from high-risk families were used to study 4 transitions in AUD development-time to first drink, first drink to first problem, first drink to first diagnosis, and first problem to first diagnosis. Cox modeling was used to compare associations of parental AUD, parental separation, peer substance use, offspring ever-use of cannabis, trauma exposures, and internalizing and externalizing psychopathology across transitions. Results Hazards of most transitions were elevated for those who had ever used cannabis, those who attributed substance use to their peers, those with externalizing disorders, and those with parents with AUD. Many risk factors were linked to early initiation of alcohol, particularly cannabis use. Internalizing disorders were associated with later stages. Nonassaultive trauma was associated only with early initiation; assaultive trauma was not associated with any transition. Conclusions In this large, ethnically diverse sample of high-risk youth, significant influences across transitions were fairly consistent, with externalizing disorders and cannabis ever-use elevating the likelihood of each stage, and peer and parental (and especially maternal AUD) influences linked to initiation and some later stages. Finally, in light of the increasingly permissive legal and social stances toward cannabis in the United States, the marked elevations of all alcohol outcomes observed for cannabis use underscore the importance of studying the underpinnings of this relationship. [ABSTRACT FROM AUTHOR]