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Objective: Population drinking trends show clear developmental periodicity, with steep increases in harmful alcohol use from ages 18 to 22 followed by a gradual decline across the 20s, albeit with persistent problematic use in a subgroup of individuals. Cross-sectional studies implicate behavioral economic indicators of alcohol overvaluation (high alcohol demand) and lack of alternative substance-free reinforcers (high proportionate alcohol-related reinforcement) as potential predictors of change during this developmental window, but longitudinal evidence is sparse. Method: Using a sample of emerging adults (N = 497, Mage = 22.61 years, 62% female, 48.69% White, 40.44% Black), this study examined prospective, bidirectional relations between both past-week heavy drinking days (HDD) and alcohol problems and proportionate alcohol-related reinforcement (reinforcement ratio), alcohol demand intensity (consumption at zero price), alcohol demand Omax (maximum expenditure), and change in demand elasticity (rate of change in consumption across escalating price) over five assessments (every 4 months) using random intercept cross-lagged panel models. Results: Alcohol problems and HDD decreased across assessments. Significant between-person effects indicated that each behavioral economic variable was associated with increased drinking risk. Change in reinforcement ratio was positively associated with decreases in alcohol problems. Multigroup invariance modeling revealed distinct risk pathways in that change in demand intensity and Omax predicted change in alcohol problems for male participants and change in intensity predicted change in alcohol problems for non-White participants. Conclusion: The study provides consistent support for proportionate alcohol-related reinforcement and mixed support for demand as within-person predictors of reductions in drinking. Public Health Significance Statement: This study demonstrates that reductions in the value of alcohol relative to alternative alcohol-free activities precede reductions in alcohol-related problems, which provide support for intervention and treatment approaches that increase reinforcement from alternative activities. [ABSTRACT FROM AUTHOR]

INTRODUCTION Substance use disorder (SUD) is among the most prevalent mental health disorders in the United States and in general clinical practice, with 7% of the U.S. population age 12 [...]

INTRODUCTION Alcohol use is associated with tremendous social and economic costs and contributes to 5% of the global disease burden. (1) Most of the costs are due to excessive drinking [...]

AbstractBackgroundMethodsResultsConclusionsAbstinence has long been considered the defining feature of recovery from substance use disorder, with a focus on individual level factors associated with abstinence rather than identifying individual and socioecological factors that support recovery. This paper proposes greater consideration of dynamic behavioral ecological influences on recovery and offers an expanded contextualized approach to understanding and promoting recovery and predicting dynamic recovery pathways.Conceptual and empirical bases are summarized that support moving beyond research, treatment, and policy agendas that focus narrowly on the individual as the fundamental change agent in recovery and that emphasize changes in substance use as the primary outcome metric. A model is presented that expands the scope of recovery-relevant variables to include dynamically-varying ecological contexts that variously support or hinder recovery along with an expanded scope of functional and contextual outcome variables.Examining behavior patterns through time in changing environmental contexts that include community and neighborhood-level variables and social determinants of health is critical for understanding recovery and developing multi-level interventions to promote change. Molar behavioral and ecological perspectives are needed to understand how recovery is influenced by broader contextual features in addition to individual determinants. This paper provides concrete recommendations for the pursuit of this broadened research agenda.Individual pathology-based approaches to understanding and promoting substance use disorder recovery are too narrowly focused. This review calls for greater consideration of the dynamic behavioral ecological and temporally extended contexts that contribute to harmful substance use and systemic changes necessary to promote and sustain recovery. [ABSTRACT FROM AUTHOR]

Natural health information sources used by African-American emerging adults were investigated to identify sources associated with high and low substance-related risk. Participants (110 males, 234 females; M age = 18.9 years) were recruited using respondent-driven sampling, and structured interviews assessed substance use, sources of health information, and preferences for help. Friends and social network sites were associated with higher risk, whereas teachers/schools were associated with lower risk (ps < 0.025). Despite risks associated with friends, more participants preferred receiving help from friends than the other sources. The findings inform targeted prevention messages that are sensitive to contextual and audience characteristics.

Compared to campus-based alcohol interventions for college students, services for emerging adult (EA) risky drinkers who reside off-campus in disadvantaged communities are not well established. This web survey assessed drinking practices, problems, and preferences for professional and lay helping resources spanning digital and in-person formats among community-dwelling EAs to guide services for them and determine whether drinking risk levels varied by preferences for help. Digital respondent-driven sampling recruited EA risky drinkers from disadvantaged communities (N  = 356; M age = 23.6 years, 64.0% women, 77.4% employed, 64.9% residing in impoverished areas above the US average, 53.5% income < $20k/year). A web survey assessed participants' drinking practices and problems, including alcohol use disorder symptoms, and help-seeking preferences for smartphone apps; online help; in-person help from doctors, clinics, teachers, and school programs; mutual help groups; and help from friends and family. Preferences were related to participant drinking risks using generalized linear modeling. Modeling results showed that risk levels were related to help-seeking preferences. EAs reporting more negative consequences preferred smartphone apps and help from friends, whereas EAs reporting fewer negative consequences and drinking days preferred professional in-person help (P s < 0.05). Although >90% fulfilled alcohol use disorder diagnostic criteria, <4% had received an alcohol-related intervention. EAs who are riskier drinkers appear less likely to use professional resources in favor of informal and online resources that allow greater anonymity. Findings can guide services for this underserved population that are responsive to drinker risk levels. [ABSTRACT FROM AUTHOR]

Data were pooled from 3 studies of recently resolved community-dwelling problem drinkers to determine whether a behavioral economic index of the value of rewards available over different time horizons distinguished among moderation (n = 30), abstinent (n = 95), and unresolved (n = 77) outcomes. Moderation over 1- to 2-year prospective follow-up intervals was hypothesized to involve longer term behavior regulation processes than abstinence or relapse and to be predicted by more balanced preresolution monetary allocations between short-term and longer term objectives (i.e., drinking and saving for the future). Standardized odds ratios (ORs) based on changes in standard deviation units from a multinomial logistic regression indicated that increases on this "Alcohol-Savings Discretionary Expenditure" index predicted higher rates of abstinence (OR = 1.93, p = 0.004) and relapse (OR = 2.89, p less than 0.0001) compared with moderation outcomes. The index had incremental utility in predicting moderation in complex models that included other established predictors. The study adds to evidence supporting a behavioral economic analysis of drinking resolutions and shows that a systematic analysis of preresolution spending patterns aids in predicting moderation. (Contains 4 tables and 1 figure.)

This study investigated whether a behavioral economic index of the value of rewards available over different time horizons improved prediction of drinking outcomes beyond established biopsychosocial predictors. Preferences for immediate drinking versus more delayed rewards made possible by saving money were determined from expenditures prior to resolution attempts by problem drinkers with different help-seeking experiences (N = 144). As hypothesized, stable resolutions over a 2-year follow-up were associated with proportionally more pre-resolution discretionary expenditures on savings and less on alcohol compared with unstable resolutions. The relationship held regardless of help-seeking history, and pre-resolution drinking practices, problems, and income were similar across outcomes. The findings extend experimental work on behavioral economics and indicate that measuring monetary allocation improves prediction of outcomes.

Objectives: Behavioral economic (BE) theory posits that harmful alcohol use is a joint product of elevated alcohol demand and preference for immediate over delayed rewards. Despite cross-sectional research support, whether expected bidirectional relations exist between BE indicators and drinking during recovery attempts is unknown. Therefore, this prospective research investigated quarter-by-quarter cross-lagged associations between BE simulation tasks and drinking following a natural recovery attempt. Higher demand and discounting in a given quarter should predict subsequent drinking. Conversely, drinking in a given quarter should predict subsequent higher demand and discounting. Method: Community-dwelling problem drinkers were enrolled shortly after stopping heavy drinking without treatment (N = 191). Drinking practices, problems, delay discounting, and alcohol demand (intensity, Omax, Pmax, elasticity) were assessed at baseline and 3-, 6-, 9-, and 12-month follow-ups. Longitudinal cross-lagged models related each BE indicator in the previous quarter to drinking status in the next quarter, and vice versa. Results: Higher demand intensity (consumption when drinks are free) at Quarter 1 distinguished participants who drank heavily in Quarter 2 from those who abstained. In turn, heavy drinking participants in Quarter 2 had higher intensity at Quarter 3 than abstainers and moderate drinkers in Quarter 2, and higher intensity at Quarter 3 distinguished heavy drinkers in Quarter 4 from moderate drinkers (ps < .05). Hypothesized associations for other BE indices were inconsistent or partially supported. Conclusions: Alcohol purchase task metrics showed some hypothesized prospective associations with drinking during a natural recovery attempt, which supports their ecological validity as relapse risk indicators. [ABSTRACT FROM AUTHOR]

Objective: Consistent with behavioral economic models that emphasize the context-dependance of behavioral choice, choice architecture strategies change the environmental context to promote or nudge healthier choices including the healthfulness of food purchases that may help reduce disease and premature death. This review summarizes research that investigated nudging interventions to promote healthful food purchase choices among adults.Method: A comprehensive systematized search strategy identified research published since 2009 that investigated the role of nudges and choice architecture interventions on adult food purchasing decisions with behavioral outcomes. Study data were extracted and summarized regarding nudge characteristics, design features, study quality, and food purchasing outcomes.Results: The search identified 1,129 articles, 33 of which met inclusion criteria. Twelve studies were rated as high quality, 21 as neutral, and none as low quality. Some evidence of effectiveness was found for priming nudges that manipulated physical, verbal, or sensational cues to promote healthy choices (8 of 11 studies); salience and affect nudges that used novel or personally relevant cues to direct attention to healthy choices (3/3); messenger nudges that presented information on socially normative food choices (2/2), and default nudges that made healthy options the preset choice (1/2). In studies that combined nudge types, combining priming and salience and affect nudges was at least partially effective in 5 of 5 studies.Conclusions: Nudge applications in food purchasing settings, particularly priming, offers a promising public health strategy to encourage healthier food choices among adults. More research is needed to determine optimal nudge combinations and contexts. (PsycInfo Database Record (c) 2022 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

Objective: Translational research on addictive behaviors viewed as molar behavioral allocation is critically reviewed. This work relates rates of behavior to rates of reinforcement over time and has been fruitfully applied to addictive behaviors, which involve excessive allocation to short-term rewards with longer term costs. Method: Narrative critical review. Results: This approach distinguishes between final and efficient causes of discrete behaviors. The former refers to temporally extended behavior patterns into which the act fits. The latter refers to environmental stimuli or internal psychological mechanisms immediately preceding the act. Final causes are most clear when addictive behaviors are studied over time as a function of changing environmental circumstances. Discrete acts of addictive behavior are part of an extended/molar behavior pattern when immediate constraints on engagement are low and few rewarding alternatives are available. Research framed by efficient causes often use behavioral economic simulation tasks as individual difference variables that precede discrete acts. Such measures show higher demand for addictive commodities and steeper discounting in various risk groups, but whether they predict molar addictive behavior patterning is understudied. Conclusions: Although efficient cause analysis has dominated translational research, research supports viewing addictive behavior as molar behavioral allocation. Increasing concern with rate variables underpinning final cause analysis and considering how study methods and temporal units of analysis inform an efficient or final cause analysis may advance understanding of addictive behaviors that occur over time in dynamic environmental contexts. This approach provides linkages between behavioral science and disciplines that study social determinants of health. [ABSTRACT FROM AUTHOR]

Howard Rachlin and his contemporaries pioneered basic behavioral science innovations that have been usefully applied to advance understanding of human substance use disorder and related health behaviors. We briefly summarize the innovations of molar behaviorism (the matching law), behavioral economics, and teleological behaviorism. Behavioral economics and teleological behaviorism's focus on final causes are especially illuminating for these applied fields. Translational and applied research are summarized for laboratory studies of temporal discounting and economic demand, cohort studies of alcohol and other drug use in the natural environment, and experimental behavioral economic modeling of health behavior‐related public health policies. We argue that the teleological behavioral perspective on health behavior is conducive to and merges seamlessly with the contemporary socioecological model of health behavior, which broadens the contextual influences (e.g., community, economic, infrastructure, health care access and policy) of individuals' substance use and other health risk behaviors. Basic‐to‐applied translations to date have been successful and bode well for continued applications of basic science areas pioneered by Howard Rachlin and his contemporaries. [ABSTRACT FROM AUTHOR]

The article revisits the question of the impact of the COVID-19 pandemic on addictive disorders. Topics covered include consumption of opioid, alcohol and cannabis, levels of gambling problem, and mortality rate. It also discusses the need for studies on harms among people who use stimulant drugs and have underlying respiratory or cardiovascular disease, particularly during the pandemic.

In the past 40 years, the alcohol research field has made great strides in developing evidence-based treatments for alcohol problems (National Institute on Alcohol Abuse and Alcoholism [NIAAA] 2005). Nevertheless, [...]

Data were pooled from 3 studies of recently resolved community-dwelling problem drinkers to determine whether a behavioral economic index of the value of rewards available over different time horizons distinguished among moderation (n = 30), abstinent (n = 95), and unresolved (n = 77) outcomes. Moderation over 1- to 2-year prospective follow-up intervals was hypothesized to involve longer term behavior regulation processes than abstinence or relapse and to be predicted by more balanced preresolution monetary allocations between short-term and longer terna objectives (i.e., drinking and saving for the future). Standardized odds ratios (ORs) based on changes in standard deviation units from a multinomial logistic regression indicated that increases on this 'Alcohol-Savings Discretionary Expenditure' index predicted higher rates of abstinence (OR = 1.93, p = .004) and relapse (OR = 2.89, p < .0001) compared with moderation outcomes. The index had incremental utility in predicting moderation in complex models that included other established predictors. The study adds to evidence supporting a behavioral economic analysis of drinking resolutions and shows that a systematic analysis of preresolution spending patterns aids in predicting moderation. Keywords: problem drinking, natural resolution, moderation, behavioral economics

Abstract: Aims: Emerging adulthood, spanning adolescence into early adulthood, is marked by heightened substance use and sexual risk-taking, and emerging adults living in disadvantaged urban areas experience disproportionately more negative outcomes. Research on the social psychology of time perspective and the behavioral economics of substance use suggests that such impoverished environments contribute to development of a decision-making style characterized by devaluation of delayed rewards and outcomes that support adaptive functioning in favor of persistent preference for short-term rewards associated with longer term costs. This cross-sectional observational study investigated the hypothesis that substance use and sexual risk-taking among young African American women living in such communities were related to present-dominated time perspectives and higher delay discounting, which reflect relative preference for sooner typically smaller than later larger rewards. Methodology: Young African American women ages 15 – 25 (N = 223, M age = 20.4 years) from disadvantaged urban neighborhoods in the Southern United States were recruited using Respondent Driven Sampling, a peer-driven sampling method suitable for recruiting community-dwelling participants that compensates for biases of snowball sampling. In-person structured field interviews assessed substance use, sexual practices, and risk/protective factors, including time perspectives (Zimbardo Time Perspective Inventory [ZTPI]) and behavioral impulsivity (delay discounting task). Multiple regression analyses were conducted to examine whether substance use and sexual risk-taking were associated with delay discounting and ZTPI present hedonistic and future time perspective subscales, controlling for several demographic characteristics. Results: As hypothesized, regression models showed that higher ZTPI present hedonism scores were significantly associated with both greater substance involvement and sexual risk-taking, whereas greater discounting was associated only with greater sexual risk-taking (ps <.05). Future time perspectives were not associated with either risk behavior. Conclusions: Risk behaviors among young women living in disadvantaged urban areas appear to be associated with hedonistic rewards available in the present without considering future outcomes. Future research should investigate experimentally whether lengthening time perspectives and promoting enriched views of possible futures may prevent and reduce substance involvement and sexual risk-taking among disadvantaged young adults. Those living in disadvantaged communities likely have great need for such interventions because they tend to have limited rewarding economic and social opportunities that can compete with present choices to use substances and engage in risky sex. [ABSTRACT FROM AUTHOR]

Objective: Interactive voice response (IVR) systems allow respondents to report information privately using the telephone keypad and appear to enhance reports of sensitive behaviors like problem drinking. They hold promise for telehealth applications with problem drinkers who will not seek clinical care, but IVR feasibility and data quality using such community samples have not been well studied across lengthy reporting periods in relation to established retrospective measures that are less costly and burdensome. These issues were evaluated using recently resolved, untreated problem drinkers who are targets for telehealth interventions. Method: Problem drinkers recruited from the community (24 men, 20 women) engaged in IVR self-monitoring (SM) for up to 128 days after initial resolution when the risk of relapse was high. Participants reported daily drinking, money spent on alcohol, and life-event occurrences. An expanded Timeline Followback (TLFB) interview and life-events assessment were completed after the IVR SM interval and covered the same time period. Results: IVR and TLFB reports showed excellent agreement for summary measures of drinking and money spent on alcohol, but IVR reports were higher on several measures. Most, but not all, individuals showed good agreement for reports of day-to-day drinking practices. Reports of life events were less convergent across reporting methods. Conclusions: The findings further established the use of IVR SM with problem drinkers, including assessment of behavioral economic variables, and extended its use to community settings, which offer opportunities to reach the majority who do not seek clinical services., AUTOMATED DATA COLLECTION SYSTEMS that allow respondents to enter information privately appear to enhance reporting of complex and sensitive information about substance use and other risk behaviors. Studies that compared [...]

This study investigated whether a behavioral economic index of the value of rewards available over different time horizons improved prediction of drinking outcomes beyond established biopsychosocial predictors. Preferences for immediate drinking versus more delayed rewards made possible by saving money were determined from expenditures prior to resolution attempts by problem drinkers with different help-seeking experiences (N = 144). As hypothesized, stable resolutions over a 2-year follow-up were associated with proportionally more preresolution discretionary expenditures on savings and less on alcohol compared with unstable resolutions. The relationship held regardless of help-seeking history, and preresolution drinking practices, problems, and income were similar across outcomes. The findings extend experimental work on behavioral economics and indicate that measuring monetary allocation improves prediction of outcomes. Keywords: alcohol problems, drinking resolutions, behavioral economics, time horizons

Influences on seeking help from professional alcohol treatment and from Alcoholics Anonymous (AA) were investigated using problem drinkers (N = 167) with different help-seeking experiences (no assistance, AA only, or treatment plus AA) and current drinking statuses (sustained abstinence for > 2 years or active problem drinking). Depending on their help-seeking experiences, participants rated barriers to or reasons for seeking help from treatment and AA, which were factor analyzed. Common impediments to help-seeking included privacy concerns and participants' beliefs that they could solve their problem on their own and that it was not serious enough to seek help. Common reasons for help-seeking included social and other functional problems related to drinking. There were also influences unique to treatment (e.g., cost) and to AA (e.g., group format). Help-seeking factors did not vary by drinking status. The implications for increasing help-seeking among problem drinkers are discussed.

Objective: The present study meta-analyzed studies examining changes in alcohol consumption during the coronavirus disease (COVID-19) pandemic and systematically reviewed contextual and individual difference factors related to these changes.Method: Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) protocol, studies were gathered via PsycINFO, PubMed/MEDLINE, and preprint databases (published April 29, 2021) that examined individual-level changes in consumption during the initial COVID-19 mitigation measures (before October 2020). Next, sample proportion increases and decreases in consumption, in addition to mean change in consumption variables from pre- to during-COVID, were meta-analyzed, and contextual and individual difference variables related to consumption changes during the pandemic were summarized.Results: One hundred and twenty-eight studies provided data from 58 countries (M n = 3,876; Mdn n = 1,092; aggregate sample n = 492,235). The average mean change in alcohol consumption was nonsignificant (Cohen's d = -0.01, p = .68); however, meta-analysis revealed that 23% of participants reported increases in consumption and 23% reported decreases. These changes were moderated by per capita gross domestic product and country. Narrative synthesis revealed multiple predictors of increased drinking, including contextual changes (e.g., children at home, income loss, working remotely), individual difference variables (being female, a young-to-middle aged adult, or Black), and mental health/alcohol-related risk factors (e.g., depression).Conclusions: The identified factors associated with increased alcohol consumption should be considered in planning behavioral health services during future crisis events that abruptly alter everyday environments in ways that increase stress and decrease access to naturally occurring rewards. (PsycInfo Database Record (c) 2022 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

Objective: Although emerging adult risky drinkers are generally unmotivated to change their drinking, use of protective behavioral strategies (PBS) to minimize drinking risks is associated with decreased alcohol-related harms. However, research on social influences on PBS use and associations with drinking outcomes is limited and relevant to informing interventions for this priority population. This study investigated whether emerging adults' drinking-related behaviors were associated with social network encouragement, discouragement, or mixed messages about their drinking and with PBS use.Method: Risky drinkers ages 21-29 years (N = 356; 228 women; mean age = 23.6 years) were recruited from the community using digitally implemented respondent-driven sampling. A web-based survey assessed social network drinking feedback, PBS use, drinking practices and problems, and behavioral allocation of time and money to drinking.Results: Negative binomial generalized linear models indicated that friend and spouse/ partner discouragement of drinking was associated with greater PBS use, whereas mixed messages were associated with lower use (ps < .05). Greater PBS use was associated with fewer alcohol-related negative consequences and lower behavioral allocation to drinking (ps < .05); the latter association was most consistent for serious harm reduction PBS (e.g., use of a designated driver). Mixed drinking messages from all relationship types had direct negative associations with drinking outcomes, particularly time and money allocated to drinking.Conclusions: Assessing social network features may guide interventions to increase PBS use and reduce drinking-related harms among emerging adult risky drinkers. [ABSTRACT FROM AUTHOR]

The authors examine the temporal relationship between the onset of alcohol-related problems and seeking assistance from professionals or self-help groups. Topics include identification of pathological drinking, psychosocial problems, and the role denial of problems plays in the recover process.

Objective: This study investigated whether similar environmental contexts surround abstinent resolutions associated with different intervention experiences, including no assistance. Method: Participants were selected in a 3 x 2 design (25-30 per group, N = 167) according to their help-seeking experiences (no assistance, Alcoholics Anonymous [AA] only, treatment plus AA) and current drinking status (resolved abstinent [RA] for >2 years or nonresolved [NR] controls). Life events were assessed retrospectively over a 4-year period that spanned the 2 years before and 2 years after the initiation of stable abstinence by RA participants or over a matched interval for NR participants. Collateral or reliability interviews were conducted for 84% of the sample as checks on participant reports. Results: Across help-seeking groups, RA participants reported decreased negative events and increased positive events from the pre- through the post-resolution period. Interventions, especially treatment, enhanced the postresolution improvements in RA participants' life circumstances. This pattern was absent among NR participants. Conclusions: The findings suggest that a similar molar environmental context surrounds resolutions achieved with and without interventions and that interventions are associated with enhanced improvements during maintenance., FEWER THAN 25% of individuals with drinking problems utilize intervention services, but some untreated persons nevertheless resolve their problems (Tucker, 2001). Resolutions clearly can occur in the absence of interventions, [...]

Alcohol use and related problems often increase during emerging adulthood and are influenced by social networks. Investigating alcohol-specific feedback from network members may be useful for understanding social influences and designing interventions to reduce risky drinking among emerging adults. Purpose/Objectives: This study examined whether drinking practices and consequences among emerging adult risky drinkers living in disadvantaged urban communities were influenced by receipt of encouragement, discouragement, or mixed messages about drinking from network members. Risky drinkers ages 21–29 (N = 356; 228 females; mean age = 23.6 years) residing in the community were recruited using digitally implemented Respondent Driven Sampling, a peer-driven chain referral method. A web-based survey assessed drinking practices, negative alcohol-related consequences, and drinking feedback from social network members including friends, spouse/partner, and other family members. Negative binomial generalized linear modeling showed that discouragement of drinking by friends was associated with fewer drinking days and negative consequences, whereas discouragement by family members (excluding spouse/partner) was associated with more drinks per drinking day. Mixed feedback (sometimes encouraging, sometimes discouraging drinking) from friends and spouse/partner was associated with more drinking days and negative consequences. Conclusions/Importance: Social network feedback had both risk and protective associations with drinking practices and problems among emerging adults, with discouragement to drink by friends appearing to serve a protective function. The findings suggest the utility of interventions delivered through social networks that amplify the natural protective function of friend discouragement of drinking, in addition to addressing established risks associated with peers. [ABSTRACT FROM AUTHOR]

Prior research on recovery from alcohol use disorder (AUD) has often focused on individual-level factors that promote recovery. Given systemic health inequities, it is also important to study community-level social determinants of health (SDOH) that may promote recovery from AUD. This study extended prior work examining individual profiles of recovery from AUD to assess how individual and community SDOH at the time of treatment entry were associated with recovery from AUD three years after treatment. Data were utilized from the COMBINE study (n = 664), a multisite randomized clinical trial evaluating pharmacological and behavioral treatments for AUD. Public community data sources associated with participants' study sites were used to measure community SDOH. Multilevel latent profile analyses with individual- and community-level variables as predictors of recovery profiles were estimated. Four profiles were identified based on participants' alcohol consumption and functioning. Individual SDOH variables, such as fewer years of education and lower income, and community SDOH, including lower rates of health insurance, lower income, and greater income inequality, were each associated with lower functioning profiles. The findings highlight the importance of community SDOH in AUD recovery and the value of including both individual and community SDOH variables in research on long-term recovery. [ABSTRACT FROM AUTHOR]

The resolution of alcoholism without treatment was elucidated by examining the environmental events affecting the achievement of moderation drinking or stable abstinence over a multi-year time period. Results of the analysis of variance suggested that the subjects were more inclined to report more positive effects over time. Moreover, ameliorated life conditions after the initial change in behavior are linked with long-term success and may contribute to sustained maintenance.

A preliminary retrospective investigation of events surround natural recovery from obesity was undertaken, modeled on similar research on alcohol abuse. Natural recovery from obesity was found to be linked with a unique pattern of surrounding events, with recovered participants reporting a fall in negative events during and after weight loss, with positive events peaking during active weight loss. This adds to evidence that stable weight loss can be attained without intervention.

Objective: The role of problem drinkers' social contexts in help-seeking patterns was investigated using recent entrants into outpatient alcoholism treatment or Alcoholics Anonymous (AA). Untreated, active problem drinkers served as controls. Method: Subjects (N = 45, with 15 per group; 62% male) were recruited from the community. Habitual drinking practices, social network characteristics, social support, help-seeking barriers and incentives, and event occurrences during the 2 years prior to help-seeking were assessed during structured interviews. Collaterals verified subject reports. Results: Alcohol-related psychosocial problems and social network characteristics specific to drinking and help-seeking differentiated the groups, whereas drinking practices, general measures of social support and event occurrences did not. Both groups who sought help reported less network encouragement to drink, more network encouragement to seek help and greater alcohol-related psychosocial problems compared to untreated problem drinkers. AA participants also received more conflicting messages about seeking help than did treatment participants, and features of AA variously attracted and repelled different problem drinkers. Conclusions: The findings indicate the importance of separating alcohol-specific social influences on help-seeking from more general social contextual variables and provide a social basis for distinguishing the appeal of AA from that of formal treatment. The results generally concur with studies of help-seeking for other medical and psychological disorders and support a common approach that emphasizes the social nature of help-seeking and focuses on functional rather than structural influences. (J. Stud. Alcohol 57: 449-457, 1996), The decision of problem drinkers to join alcoholism treatment or Alcoholics Anonymous (AA) is affected by the kind of support given by their social networks and psychosocial alcohol-related problems. The social networks of both groups are more supportive for help-seeking and less encouraging for drinking. Individuals who join AA get conflicting views about help-seeking while those who undergo treatment get consistent support. The decision is unaffected by drinking practice and occurrence of negative events., BECAUSE most problem drinkers do not participate in alcoholism treatment programs or AA (Regier et al., 1993), understanding influences on help-seeking patterns is important for increasing service utilization. Help-seeking for [...]

Objective: Four decades ago, the "controlled drinking" controversy roiled the alcohol field. Data have subsequently accumulated indicating that nonabstinent alcohol use disorder (AUD) recovery is achievable, but questions remain whether it is sustainable long-term. This study examined whether nonabstinent recovery at 3 years after AUD treatment is associated with better functioning at 10 years after treatment. Methods: Data were from the 10-year follow-up of Project MATCH (New Mexico site only, n=146; 30.1% female, 58.6% non-White). Recovery was defined by latent profile analyses based on psychosocial functioning and alcohol consumption 3 years after treatment. Drinking practices and consequences, depression, purpose in life, and anger were assessed 10 years after treatment. Distal outcome analyses examined differences in drinking and functional outcomes at 10 years as a function of the 3-year latent profiles. Analyses were preregistered at https://osf.io/3hbxr. Results: Four latent profiles identified at 3 years after treatment (ie, low functioning frequent heavy drinkers, low functioning infrequent heavy drinkers, high functioning heavy drinkers, and high functioning infrequent nonheavy drinkers) were significantly associated with outcomes 10 years after treatment. The 2 high functioning profiles at 3 years had the highest level of psychological functioning at 10 years posttreatment, regardless of alcohol consumption level. Abstinence at 3 years did not predict better psychological functioning at 10 years. Conclusions: Nonabstinent AUD recovery is possible and is sustainable for up to 10 years after treatment. The current findings align with recent proposals to move beyond relying on alcohol consumption as a central defining feature of AUD recovery. [ABSTRACT FROM AUTHOR]