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Background: Preference-based utility ratings for health conditions are important components of cost-utility analyses and population burden of disease estimates. However, utility ratings for alcohol problems have not been determined.Objectives: The objectives of this study were to directly measure utility ratings for a spectrum of alcohol-related health states and to compare different methods of utility measurement.Design, Setting, and Subjects: The authors conducted a cross-sectional interview of 200 adults from a clinic and community sample.Methods: Subjects completed computerized visual analog scale (VAS), time tradeoff (TTO), and standard gamble (SG) utility measurement exercises for their current health, a blindness scenario, and for 6 alcohol-related health state scenarios presented in random order. The main outcome measures were the utility ratings, scaled from 0 to 1, and anchored by death (0) and perfect health (1).Results: The 200 subjects were middle-aged (mean, 41 +/- 14 years), 61% women, and racially diverse (48% black, 43% white). Utility ratings decreased as the severity of the alcohol-related health state increased, but differed significantly among the VAS, TTO, and SG methods within each health state. Adjusted mean (95% confidence interval) utility ratings for alcohol dependence (VAS, 0.38 [0.34-0.41]; TTO, 0.54 [0.48-0.60]; SG, 0.68 [0.63-0.73]) and alcohol abuse (VAS, 0.53 [0.49-0.56]; TTO, 0.71 [0.65-77]; SG, 0.76 [0.71-0.81]) were significantly lower than utility ratings for nondrinking, moderate drinking, at-risk drinking, current health, and blindness.Conclusions: Utility ratings for alcohol-related health states decrease as the severity of alcohol use increases. The low utility ratings for alcohol abuse and alcohol dependence are similar to those reported for other severe chronic medical conditions. [ABSTRACT FROM AUTHOR]

This special series presents six different articles addressing the roles of implicit cognition and automatic processing in the treatment of psychopathology. Although each article addresses a very different clinical population, the articles all offer concrete examples of how the study of implicit cognition may enhance real-world clinical assessment and treatment. In addition, they explain how cognitive psychology methods may be utilized to avoid response biases, identify dysfunctional cognitive processes, and specify the nature of mental representations in various disorders. The ultimate aim of this special series is to make a compelling case for translating research on implicit cognition into instruments and intervention techniques with clinical utility. [Copyright &y& Elsevier]

Objective: Despite the well-established finding from questionnaire studies that positive expectancies are associated with drinking behavior, there is comparatively little known about the mechanisms through which they may affect drinking behavior. Incentive motivation models suggest that alcohol itself may alter the value of the expected outcomes of drinking. The current study was designed to examine the influence of low-dose alcohol on the activation of alcohol outcome expectancy value. Method: Forty-eight hazardous drinkers (34 men) between the ages of 21 and 35 years were recruited from advertisements in local newspapers for a social drinking study. Participants, whose most frequently consumed beverage was beer, were administered a dose of either alcoholic (8.5%) beer, based on gender and weight to reach a blood alcohol concentration of 40 mg/dl, or an equivalent volume of placebo been Following an absorption phase, a computerized evaluative priming task was completed in which participants made a series of judgments about the value of positive and negative outcomes following either alcohol or neutral word primes. Results: Those who consumed alcohol made faster evaluative responses to positive relative to negative outcomes, compared with individuals who consumed the placebo beverage. Conclusions: These findings suggest that moderate doses of alcohol may influence the incentive value of positive relative to negative outcome expectancies. It is suggested that these processes may play a role in patterns of hazardous alcohol use. [ABSTRACT FROM AUTHOR]

This study examined the association between smoking outcome expectancy accessibility and smoking behavior. Daily smokers completed a smoking expectancy accessibility task in which they made timed judgments to a series of positive consequences of smoking either after 6 hr deprivation or within 10 min of smoking. Participants then completed a questionnaire battery that contained assessments of smoking behavior and smoking outcome expectancies. Results of hierarchical regression analyses showed that expectancy accessibility was associated with the number of cigarettes smoked per day even when controlling for corresponding questionnaire measures of smoking expectancies. Moreover, smoking expectancy accessibility predicted urge to smoke ratings following exposure to a smoking cue after controlling for the effects of deprivation. Findings suggest that smoking expectancy accessibility may play a central role in smoking behavior and that individual differences in this attribute may be assessed directly through reaction time assessment. [ABSTRACT FROM AUTHOR]

The present study examined the role of action orientation in health behavior change. Eighty-six binge drinking college students completed measures of alcohol use, alcohol-related consequences (e.g., driving drunk), motivation to change drinking, and action orientation. Alcohol use and consequences were reassessed 1 month later. Results showed that, although there was no significant change in alcohol quantity per occasion, students reported a significant decline in alcohol-related problems over time. Hierarchical regression analyses were conducted to examine whether action orientation was associated with changes in alcohol involvement. Controlling for alcohol problems and motivation to change at Time 1, those with higher dispositional action orientation showed fewer alcohol-related consequences at Time 2. These results suggest that those who are low in action orientation may have more difficulty enacting intentions to modify harmful health behaviors. The findings underscore the importance of volitional skills in interventions to promote change in health behavior. [ABSTRACT FROM AUTHOR]

Examines individual differences in temptation and responses to alcohol cues. Details about the Research on the Temptation and Restraint Inventory; Association of temptation with higher levels of alcohol involvement; Prediction of responses to alcohol cues.

Time-accuracy functions were derived for younger and older adults for recognition of line drawings of common objects, words of high imagery values, and figures (i.e., Chinese characters). We found that in the line drawing and word conditions, older adults were slower than younger adults, but were able to reach the same asymptotic level of performance. In the Chinese character condition, however, an age difference in asymptotic performance appeared. These results are incompatible with either general or process-specific theories of aging of episodic memory, and point at different aging trajectories for memory that utilizes the preexisting semantic network versus memory for representations that have to be built anew. [ABSTRACT FROM AUTHOR]

Urgency, the tendency to act rashly under extreme emotions, has been associated with higher rates of hazardous/harmful drinking. Moreover, previous work suggests that the association between urgency and hazardous/harmful drinking may be mediated by drinking motives. The current study sought to replicate and extend this research to men who have sex with men (MSM), a population that has shown increased alcohol-related health risk behavior.Methods: Two-hundred-and-fifty-six moderate-to-heavy drinking MSM completed questionnaires assessing urgency, drinking motives, and hazardous/harmful drinking. Regression models were conducted to examine the direct effect of Urgency on heavy episodic drinking and alcohol-related consequences and its indirect effects on these outcomes through drinking motives.Results: Urgency was significantly associated with heavy episodic drinking and alcohol-related consequences. Bootstrapping procedures indicated significant indirect effects through coping and enhancement motives for both outcomes and also conformity for consequences.Conclusions: These results indicate urgency may be an important risk factor for hazardous/harmful drinking among adult MSM that may operate in part through its effects on coping and enhancement motives. [ABSTRACT FROM AUTHOR]

This pilot study sought to test the feasibility of screening and delivering a web-based intervention to reduce marijuana use and consequences among graduate student presenting to a Student Health Center (SHC). Graduate students completed a 9-item electronic health screening instrument during their visit to the SHC. Those who reported monthly or greater marijuana use were eligible for participation in the pilot trial. Forty-nine students completed baseline assessments and were randomly assigned to an electronic screening and brief intervention (eSBI) for marijuana (eCHECKUPTOGO-marijuana; [BI]) or a control condition (CTL) that consisted of minimal general health information. Participants completed measures of marijuana use frequency and negative consequences at baseline, 3- and 6-months. Latent growth modeling was used to provide effect size estimates for the influence of the intervention on 6-month outcomes. Effect size estimates showed a small-to-medium effect of BI on marijuana use frequency at 6-months; there was no evidence of the BI on consequences. Results suggest that BI may hold promise as a method to reduce marijuana use among graduate students who present to primary care settings. Future research should test the efficacy of this approach in a full-scale randomized controlled trial. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the effects of alcohol intoxication and its interaction with contextual or situation (partner familiarity) and individual differences variables (effortful control, urgency, and whether taking pre-exposure prophylaxis (PrEP) medication) on sexual behaviors in men who have sex with men (MSM), a subgroup for whom HIV continues to be a major public health problem in the U.S. The participants were 236 men recruited from two northeastern U.S. cities and aged 21–50 years, M = 27.8). These men participated in a 6-week (two 3-week sampling bursts) experience sampling method (ESM) study. The ESM data were collected via use of software installed on the participant's own or study-provided mobile phone. Individual differences variables were measured by participants' completing questionnaires measuring effortful control and urgency, and the participant's self-report of whether he was currently taking PrEP. The ESM data pertained to sexual behavior as well as situation variables of familiarity of relevant sexual partners and number of standard alcohol drinks consumed. The results generally were consistent with hypotheses, as alcohol intoxication showed a curvilinear relation to the occurrence of condomless anal intercourse. Furthermore, the likelihood of occurrence of condomless anal sex increased with increased familiarity of the sexual partner. Similarly, taking PrEP increased the likelihood of occurrence of condomless anal sex. At the same time, alcohol's effects were moderated by all three individual differences variables as expected, but the prediction that partner familiarity would moderate alcohol's effects on the occurrence of condomless sex was not supported. Clinical implications of the findings center on the application of the data to HIV prevention programs toward inclusion of more empirically supported, nuanced information on the relation between acute alcohol intoxication and sexual behavior. Directions for further research address the need for additional testing and refinement of a person × situation approach to alcohol and sexual behavior. Furthermore, it is argued that it is important to refine further the concept of sexual risk in the context of taking PrEP and to conduct more detailed, multivariate studies of the relation between taking PrEP and patterns of sexual behavior. [ABSTRACT FROM AUTHOR]

Background: Chronic pain and heavy drinking commonly co-occur and can influence the course of HIV. There have been no interventions designed to address both of these conditions among people living with HIV (PLWH), and none that have used telehealth methods. The purpose of this study was to better understand pain symptoms, patterns of alcohol use, treatment experiences, and technology use among PLWH in order to tailor a telehealth intervention that addresses these conditions. Subjects: Ten participants with moderate or greater chronic pain and heavy drinking were recruited from a cohort of patients engaged in HIV-care (Boston Alcohol Research Collaborative on HIV/AIDS Cohort) and from an integrated HIV/primary care clinic at a large urban hospital. Methods: One-on-one interviews were conducted with participants to understand experiences and treatment of HIV, chronic pain, and alcohol use. Participants' perceptions of the influence of alcohol on HIV and chronic pain were explored as was motivation to change drinking. Technology use and treatment preferences were examined in the final section of the interview. Interviews were recorded, transcribed and uploaded into NVivo® v12 software for analysis. A codebook was developed based on interviews followed by thematic analysis in which specific meanings were assigned to codes. Interviews were supplemented with Likert-response items to evaluate components of the proposed intervention. Results: A number of themes were identified that had implications for intervention tailoring including: resilience in coping with HIV; autonomy in health care decision-making; coping with pain, stress, and emotion; understanding treatment rationale; depression and social withdrawal; motives to drink and refrain from drinking; technology use and capacity; and preference for intervention structure and style. Ratings of intervention components indicated that participants viewed each of the proposed intervention content areas as "helpful" to "very helpful". Videoconferencing was viewed as an acceptable modality for intervention delivery. Conclusions: Results helped specify treatment targets and provided information about how to enhance intervention delivery. The interviews supported the view that videoconferencing is an acceptable telehealth method of addressing chronic pain and heavy drinking among PLWH. [ABSTRACT FROM AUTHOR]

Background: Prevalence of unhealthy alcohol use among medical inpatients is high.Objective: To characterize the course and outcomes of unhealthy alcohol use, and factors associated with these outcomes.Design: Prospective cohort study.Participants: A total of 287 medical inpatients with unhealthy alcohol use.Main Measures: At baseline and 12 months later, consumption and alcohol-related consequences were assessed. The outcome of interest was a favorable drinking outcome at 12 months (abstinence or drinking "moderate" amounts without consequences). The independent variables evaluated included demographics, physical/sexual abuse, drug use, depressive symptoms, alcohol dependence, commitment to change (Taking Action), spending time with heavy-drinking friends and receipt of alcohol treatment (after hospitalization). Adjusted regression models were used to evaluate factors associated with a favorable outcome.Key Results: Thirty-three percent had a favorable drinking outcome 1 year later. Not spending time with heavy-drinking friends [adjusted odds ratio (AOR) 2.14, 95% CI: 1.14-4.00] and receipt of alcohol treatment [AOR (95% CI): 2.16(1.20-3.87)] were associated with a favorable outcome. Compared to the first quartile (lowest level) of Taking Action, subjects in the second, third and highest quartiles had higher odds of a favorable outcome [AOR (95% CI): 3.65 (1.47, 9.02), 3.39 (1.38, 8.31) and 6.76 (2.74, 16.67)].Conclusions: Although most medical inpatients with unhealthy alcohol use continue drinking at-risk amounts and/or have alcohol-related consequences, one third are abstinent or drink "moderate" amounts without consequences 1 year later. Not spending time with heavy-drinking friends, receipt of alcohol treatment and commitment to change are associated with this favorable outcome. This can inform efforts to address unhealthy alcohol use among patients who often do not seek specialty treatment. [ABSTRACT FROM AUTHOR]

While trait self-control has typically been conceptualized as the ability to successfully inhibit responses to temptation, recent research has suggested that those who report higher levels of self-control may also experience less responsivity to tempting cues. To explore the question of whether the association between trait self-control and alcohol use among drinkers may be a function of weakened appetitive responses to alcohol cues, we utilized an alcohol-specific Implicit Association Task. One hundred twenty-two undergraduate drinkers completed the Brief Self-Control Scale, the alcohol-approach Implicit Association Test, and the Daily Drinking Questionnaire. Hierarchical regression analyses were conducted to examine the direct and indirect effects (through automatic appetitive responses to alcohol) of self-control on drinking outcomes, controlling for gender. Consistent with the hypothesis, automatic alcohol associations were found to partially mediate the relationship between trait self-control and both per-occasion alcohol use and the frequency of heavy drinking episodes. These results support the idea that those who exhibit high levels of trait self-control may drink less, in part, because they experience weaker automatic alcohol-approach associations in response to alcohol-related cues. [ABSTRACT FROM AUTHOR]

Cross-sectional and intervention research have shown that mindfulness is inversely associated with difficulties in controlling alcohol use. However, little is known regarding the mechanisms through which mindfulness is related to increased control over drinking. One potential mechanism consists of the way individuals represent their drinking behaviour. Action identification theory proposes that self-control of behaviour is improved by shifting from high-level representations regarding the meaning of a behaviour to lower-level representations regarding "how-to" aspects of a behaviour. Because mindfulness involves present-moment awareness, it may help to facilitate such shifts. We hypothesized that an inverse relation between mindfulness and dyscontrolled drinking would be partially accounted for by the way individuals mentally represent their drinking behaviour - i.e., reduced levels of high-level action identification and increased levels of low-level action identification. One hundred and twenty five undergraduate psychology students completed self-report measures of mindful awareness, action identification of alcohol use, and difficulty in controlling alcohol use. Results supported the hypothesis that high-level action identification partially mediates the relation between mindfulness and dyscontrolled drinking but did not support a mediating role for low-level action identification. These results suggest that mindfulness can improve self-control of alcohol by changing the way we think about our drinking behaviour. [ABSTRACT FROM AUTHOR]

Introduction: Individuals with opioid use disorder (OUD) who smoke cigarettes have high tobacco-related comorbidities, lack of access to tobacco treatment, lack of inclusion in smoking cessation trials, and remain understudied in the mobile health field. The purpose of this study was to understand patients' with OUD perceptions of 1) text message programs to promote smoking cessation, 2) content and features to include in such a program, and 3) how message content should be framed.Methods: From December 2018 to February 2019, we recruited 20 hospitalized individuals with a concurrent diagnosis of OUD and tobacco dependence at Boston Medical Center (BMC), the largest safety-net hospital in New England. We surveyed participants' cell phone use, their interest in a text message program to promote smoking cessation, and their reactions to and ratings of a series of 26 prototype texts. We then conducted open-ended interviews to elicit content and suggestions on how text message interventions can improve motivation to increase smoking cessation among individuals with OUD. The interviews also included open-ended inquiries exploring message ratings and message content, inquiries about preferences for message duration, frequency, and personalization.Results: Quantitative analysis of questionnaire data indicated that the majority of participants owned a cell phone (95%, 19/20). Most participants (60%, 12/20) reported that they would be interested or very interested in receiving text messages about smoking cessation. Text messages about the health benefits of quitting were rated the highest among various categories of text messages. Qualitative analysis showed that almost every participant felt that text messages would help motivate smoking cessation given the support it would provide.Conclusions: This study demonstrates that individuals with OUD who smoke cigarettes perceive that a text message program designed to promote smoking cessation would motivate and support smoking cessation efforts. Our findings demonstrate that such a program is feasible as participants own cell phones, frequently send and receive text messages, and have unlimited text message plans. Findings from this study provide valuable insight into content and features to include when developing text message programs to address barriers to smoking cessation in individuals who have OUD and smoke cigarettes. [ABSTRACT FROM AUTHOR]

Abstract: We studied whether readiness to change predicts alcohol consumption (drinks per day) 3 months later in 267 medical inpatients with unhealthy alcohol use. We used 3 readiness to change measures: a 1 to 10 visual analog scale (VAS) and two factors of the Stages of Change Readiness and Treatment Eagerness Scale: Perception of Problems (PP) and Taking Action (TA). Subjects with the highest level of VAS-measured readiness consumed significantly fewer drinks 3 months later [Incidence rate ratio (IRR) and 95% confidence interval (CI): 0.57 (0.36, 0.91) highest vs. lowest tertile]. Greater PP was associated with more drinking [IRR (95%CI): 1.94 (1.02, 3.68) third vs. lowest quartile]. Greater TA scores were associated with less drinking [IRR (95%CI): 0.42 (0.23, 0.78) highest vs. lowest quartile]. Perception of Problems'' association with more drinking may reflect severity rather than an aspect of readiness associated with ability to change; high levels of Taking Action appear to predict less drinking. Although assessing readiness to change may have clinical utility, assessing the patient''s planned actions may have more predictive value for future improvement in alcohol consumption. [Copyright &y& Elsevier]

Presents information on a study which examined the effects of alcohol outcome expectancy on panic symptoms, subjective anxiety and heart rate after a carbon dioxide panic challenge in patients with panic disorder. Methodology; Results; Discussion.

Aims: The efficacy of screening and brief intervention for lower-risk drug use is unknown. This pilot study tested the efficacy of two brief interventions (BIs) for drug use compared to no BI in primary care patients with lower-risk drug use identified by screening.Methods: We randomly assigned participants identified by screening with Alcohol Smoking and Substance Involvement Screening Test (ASSIST) drug specific scores of 2 or 3 to: no BI, a brief negotiated interview (BNI), or an adaptation of motivational interviewing (MOTIV). Primary outcome was number of days use of main drug in the past 30 as determined by validated calendar method at 6 months. Analyses were performed using negative binomial regression adjusted for baseline use and main drug.Results: Of 142 eligible adults, 61(43 %) consented and were randomized. Participant characteristics were: mean age 41; 54 % male; 77 % black. Main drug was cannabis 70 %, cocaine 15 %, prescription opioid 10 %; 7% reported injection drug use and mean days use of main drug (of 30) was 3.4. At 6 months, 93 % completed follow-up and adjusted mean days use of main drug were 6.4 (no BI) vs 2.1 (BNI) (incidence rate ratio, IRR 0.33[0.15-0.74]) and 2.3 (MOTIV) (IRR 0.36[0.15-0.85]).Conclusions: BI appears to have efficacy for preventing an increase in drug use in primary care patients with lower-risk use identified by screening. These findings raise the potential that less severe patterns of drug use in primary care may be uniquely amenable to brief intervention and warrant replication. [ABSTRACT FROM AUTHOR]

Objective: This study tested a motivational text message treatment adjunct for individuals with eating disorders (EDs) who exhibited high dietary restraint/restriction.Method: A replicated single-case alternating treatment design was used to examine (a) the feasibility of combining a brief motivational interview with subsequent text messages and (b) the influence of the text messages on eating behaviors and motivation to change in individuals with EDs (N=12). The protocol was 8weeks and the text messages were adjunctive to cognitive-behavioral therapy.Results: The intervention was well accepted (mean rating=7/10) and feasible within the context of monetary compensation (mean daily monitoring compliance =91%). Text messages did not impact behavioral outcomes: dietary restraint and kilocalorie intake. They had mixed effects on motivation to change dietary restraint, measured by the Readiness and Motivation Questionnaire (RMQ). When receiving text messages, RMQ precontemplation scores (desire to restrict) significantly increased, indicating decreased motivation; however, action scores (effort toward reducing dietary restraint) significantly increased, indicating increased motivation. These effects were moderated by weight status. Underweight individuals (n=4; body mass index [BMI]<19.0) reported increased ambivalence-that is, an increased desire to restrict and increased action toward reducing restriction-in response to the text messages. Normal weight participants (n=8; BMI>19.0) reported only increased action toward reducing restriction in response to the text messages.Discussion: These data demonstrate text messages are a potentially feasible and acceptable treatment adjunct and may be effective at increasing motivation to change for normal weight individuals, while their influence on underweight patients is more complex. These findings provide a foundation for future research in technology-based motivational interventions for EDs and offer preliminary evidence for using these methods among normal weight individuals. [ABSTRACT FROM AUTHOR]

Aims To test (1) whether abstinence and reduction in illicit psychoactive drug use were associated with changes in health outcomes in primary care patients and (2) whether these associations varied by drug type. Design Secondary analysis of data from a randomized controlled trial that tested a brief intervention for drug use in primary care patients (589 enrolled, 574 completed a 6-month assessment). Analyses were conducted overall and stratified by the most commonly self-identified main drugs (marijuana, cocaine and opioids). Setting and Participants Patients who screened positive for illicit drug use at an urban primary care clinic in Boston, Massachusetts, USA. Measurements Differences in past-month main drug use at baseline and 6-month outcome were categorized as continued or increased use, decreased use without abstinence and abstinence. Primary outcomes were 6-month changes in drug use consequences [Short Inventory of Problems scores (range 0-45)], depressive symptoms and health-related quality of life (HRQol). Findings Abstinence was associated with a greater decrease in adverse drug use consequences than continued or increased use among the full sample and cocaine and opioids subgroups (adjusted means, full sample: -8.11 versus -0.05, P < 0.001; cocaine: -13.33 versus +1.09, P < 0.001, opioids; -16.84 versus -2.10, P < 0.001). Differences were not significant between those who decreased use compared with those who continued or increased use. There were no significant associations between drug use and depressive symptoms or HRQol. Neither abstinence nor decreased use was associated significantly with consequences in the marijuana subgroup. Conclusions Among primary care patients in the United States who use illicit psychoactive drugs, abstinence but not reduction in use without abstinence appears to be associated with decreased adverse drug use consequences. [ABSTRACT FROM AUTHOR]

Aims This study assessed the effectiveness of HERMITAGE ( HIV's Evolution in Russia- Mitigating Infection Transmission and Alcoholism in a Growing Epidemic), an adapted secondary HIV prevention intervention, compared with an attention control condition in decreasing sexually transmitted infections ( STIs) and sex and drug risk behaviors among Russian HIV-infected heavy drinkers. Design We conducted a single-blinded, two-armed, randomized controlled trial with 12-month follow-up. Setting The study was conducted in St Petersburg, Russia. Participants were recruited from four HIV and addiction clinical sites. The intervention was conducted at Botkin Infectious Disease Hospital. Participants HIV-infected individuals with past 6-month risky sex and heavy alcohol consumption ( n = 700) were randomized to the HERMITAGE intervention ( n = 350) or an attention control condition ( n = 350). Intervention A Healthy Relationships Intervention stressing disclosure of HIV serostatus and condom use, adapted for a Russian clinical setting with two individual sessions and three small group sessions. Measurements The primary outcome was incident STI by laboratory test at 12-month follow-up. Secondary outcomes included change in unprotected sex and several alcohol and injection drug use ( IDU) variables. Findings Participants had the following baseline characteristics: 59.3% male, mean age 30.1, 60.4% past year IDU, 15.4% prevalent STI and mean CD4 cell count 413.3/μl. Assessment occurred among 75 and 71% of participants at 6 and 12 months, respectively. STIs occurred in 20 subjects (8.1%) in the intervention group and 28 subjects (12.0%) in the control group at 12-month follow-up; logistic regression analyses found no significant difference between groups (adjusted odds ratio 0.63; 95% confidence interval = 0.34-1.18; P = 0.15). Both groups decreased unsafe behaviors, although no significant differences were found between groups. Conclusions The HERMITAGE HIV risk reduction intervention does not appear to reduce sexually transmitted infections and HIV risk behaviors in Russian HIV-infected heavy drinkers compared with attention controls. [ABSTRACT FROM AUTHOR]

Abstract: The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), a 19-item instrument developed to assess readiness to change alcohol use among individuals presenting for specialized alcohol treatment, has been used in various populations and settings. Its factor structure and concurrent validity has been described for specialized alcohol treatment settings and primary care. The purpose of this study was to determine the factor structure and concurrent validity of the SOCRATES among medical inpatients with unhealthy alcohol use not seeking help for specialized alcohol treatment. The subjects were 337 medical inpatients with unhealthy alcohol use, identified during their hospital stay. Most of them had alcohol dependence (76%). We performed an Alpha Factor Analysis (AFA) and Principal Component Analysis (PCA) of the 19 SOCRATES items, and forced 3 factors and 2 components, in order to replicate findings from Miller and Tonigan (Miller, W. R., & Tonigan, J. S., (1996). Assessing drinkers'' motivations for change: The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). Psychology of Addictive Behavior, 10, 81–89.) and Maisto et al. (Maisto, S. A., Conigliaro, J., McNeil, M., Kraemer, K., O''Connor, M., & Kelley, M. E., (1999). Factor structure of the SOCRATES in a sample of primary care patients. Addictive Behavior, 24(6), 879–892.). Our analysis supported the view that the 2 component solution proposed by Maisto et al. (Maisto, S.A., Conigliaro, J., McNeil, M., Kraemer, K., O''Connor, M., & Kelley, M.E., (1999). Factor structure of the SOCRATES in a sample of primary care patients. Addictive Behavior, 24(6), 879–892.) is more appropriate for our data than the 3 factor solution proposed by Miller and Tonigan (Miller, W. R., & Tonigan, J. S., (1996). Assessing drinkers'' motivations for change: The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). Psychology of Addictive Behavior, 10, 81–89.). The first component measured Perception of Problems and was more strongly correlated with severity of alcohol-related consequences, presence of alcohol dependence, and alcohol consumption levels (average number of drinks per day and total number of binge drinking days over the past 30 days) compared to the second component measuring Taking Action. Our findings support the view that the SOCRATES is comprised of two important readiness constructs in general medical patients identified by screening. [Copyright &y& Elsevier]

Abstract: The goal of this study was to examine the association between interpersonal violence exposure and utilization of alcohol treatment after medical hospitalizations among adults with alcohol dependence. We analyzed data collected from a prospective cohort of 238 adults with alcohol dependence who were inpatients in a large urban hospital. Participants who reported interpersonal violence victimization had 1.6 times the odds (adjusted odds ratio = 1.64, 95% confidence interval = 0.92–2.91) of receiving alcohol treatment during the year after hospitalization compared to participants with no violence exposure. Recent (past 3 months) exposure to violence was not more strongly related to receipt of treatment than any lifetime violence exposure. Results suggest that a history of interpersonal violence victimization may be associated with an increased odds of alcohol treatment utilization following a medical hospitalization. Therefore, clinicians should be optimistic about identifying and referring patients who have experienced interpersonal violence to alcohol treatment. Moreover, given the potentially high prevalence of interpersonal violence exposure among inpatient populations at large urban hospitals, alcohol treatment providers should develop methods to address both alcohol dependence and violence recovery. [Copyright &y& Elsevier]

Abstract: Explicit expectations of the negative and positive social consequences of smoking are likely to have substantial influence on decisions regarding smoking. However, among smokers trying to quit, success in smoking cessation may be related not only to the content of expectancies about smoking''s social effects but also to the ease with which these cognitive contents come to mind when confronted with smoking stimuli. To examine this possibility, we used the implicit association test (IAT) [Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. K. (1998). Measuring individual differences in implicit cognition: The implicit association test. Journal of Personality and Social Psychology, 74, 1464–1480] to assess implicit cognitive associations between smoking and negative vs. positive social consequences among 67 heavy social drinkers seeking smoking cessation treatment in a randomized clinical trial. Results showed that the relative strength of implicit, negative, social associations with smoking at baseline predicted higher odds of smoking abstinence during treatment over and above the effects of relevant explicit measures. The only variable that significantly correlated with IAT scores was the density of smokers in participants’ social environment; those with more smoking in their social environment showed weaker negative social associations with smoking. Results suggest implicit cognition regarding the social consequences of smoking may be a relevant predictor of smoking cessation outcome. [Copyright &y& Elsevier]

Background: Unhealthy alcohol use is prevalent among people living with HIV/AIDS (PLWH) and contributes to impaired functioning, diminished quality of life, and poorer HIV outcomes. Common cooccurring conditions such as chronic pain may be associated with negative outcomes both directly and through its influence on unhealthy drinking itself. However, there is relatively little known about how pain influences unhealthy drinking among PLWH over time. The current study examined whether pain was associated with indices of unhealthy alcohol use, namely heavy drinking and alcohol use disorder (AUD) assessed 12 months later., Methods: The study sample (n = 207) was from the Boston Alcohol Research Collaboration on HIV/AIDS (ARCH) Cohort, a prospective cohort of PLWH with a history of illicit substance or unhealthy alcohol use. We conducted logistic regression analyses to examine the associations between pain and both heavy drinking and AUD status (DSM-5 criteria) (yes/no) over time. In secondary analyses, we examined whether pain was associated with greater AUD severity and whether pain interference was associated with heavy drinking and AUD outcomes., Results: We found that pain at baseline was associated with greater odds of AUD [aOR = 2.29 (95% CI: 1.13, 4.64), p = 0.02] but not heavy drinking [aOR = 0.91 (95% CI: 0.44, 1.88), p = 0.79] at 12 months. Pain was also associated with more severe AUD. Analyses of pain interference showed similar results., Conclusions: Pain is prospectively associated with higher odds of AUD among PLWH with a substance/unhealthy alcohol use history. Providers should routinely address pain among PLWH to improve AUD outcomes., (© 2024 Research Society on Alcohol.)

Background: Unhealthy alcohol use represents a significant risk for morbidity and mortality among people living with HIV (PLWH), in part through its impact on HIV management. Chronic pain, a common comorbidity, exacerbates suboptimal engagement in the HIV care continuum and has reciprocal detrimental effects on alcohol outcomes. There are no integrated, accessible approaches that address these comorbid conditions among PLWH to date. This paper describes a research study protocol of an integrated telehealth intervention to reduce unhealthy drinking and chronic pain among PLWH (Motivational and Cognitive-Behavioral Management for Alcohol and Pain [INTV])., Methods: Two-hundred and fifty PLWH with unhealthy drinking and chronic pain will be recruited nationally via online advertisement. Informed consent and baseline assessments occur remotely, followed by 15 days of ecological momentary assessment to assess alcohol use, chronic pain, functioning, and mechanisms of behavior change. Next, participants will be randomized to either the INTV or Control (CTL) condition. Individuals in both conditions will meet with a health counselor through videoconferencing following randomization, and those in the INTV condition will receive 6 additional sessions. At 3- and 6-months post-baseline, participants will complete outcome assessments. It is hypothesized that the INTV condition will result in reduced unhealthy alcohol use and pain ratings compared to the CTL condition., Conclusion: This protocol paper describes a randomized controlled trial which tests the efficacy of a novel, integrated telehealth approach to reduce unhealthy alcohol use and chronic pain for PLWH, two common comorbid conditions that influence the HIV treatment cascade., Gov Identifier: NCT05503173., (© 2024. The Author(s).)

Despite advances in prevention and treatment, the transmission of human immunodeficiency virus remains a significant problem in the United States, especially among men who have sex with men (MSM). Alcohol use can promote risky sexual decisions, and alcohol expectancies may influence the role of alcohol in decision making. The present secondary analysis tests the moderating role of sexual alcohol expectancies (SAEs) in the relation between daily alcohol intoxication and sexual behavior in a sample of 248 moderate- to heavy-drinking MSM. SAEs were assessed with the Sexual Alcohol Expectancies Questionnaire at baseline, followed by two 23-day bursts of ecological momentary assessment including self-initiated morning assessments of sexual behavior and the prior night's perceived intoxication, as well as nine daily random alcohol assessments. Multilevel modeling showed that SAEs moderated a curvilinear association between intoxication and anal intercourse with a condom such that the relation between daily intoxication and anal intercourse with a condom is a more pronounced inverted u-shape among individuals with strong SAEs, and this moderation effect was not seen for condomless anal intercourse (CAI). While SAEs do appear to influence the association between intoxication and sexual behavior in MSM, they do not appear to moderate the association between alcohol intoxication and CAI., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Heavy episodic drinking (HED) is common among college students and poses risks for negative consequences. Evidence suggests that HED is more frequent among those with stronger implicit alcohol associations, and the impact of these implicit associations on drinking may be moderated by executive functioning. This study examined the role of two executive function components-working memory (WM) and planning-as moderators of implicit alcohol-approach associations and HED among college students who drink alcohol. One hundred forty-one participants completed measures of alcohol use, implicit alcohol-approach associations, WM, and planning. Regression analyses were conducted to examine the respective two-way and three-way interactions between implicit alcohol associations, WM, and planning on HED. Results showed that WM and planning each moderated the relation between alcohol implicit association test (IAT) and HED. IAT scores were positively associated with HED when WM and planning were low (-1 SD) but not high (+1 SD ). Although results from the three-way interaction exhibited a nonsignificant trend, the pattern of results showed that the association between IAT and HED was stronger at lower levels of WM, but only when planning was also low, not high. Findings support the view that HED among college students who drink alcohol may be a function of automatic alcohol associations and that these associations may be stronger among those with lower WM and planning abilities. These results replicate and extend our understanding of how executive functioning may moderate the impact of implicit alcohol cognitions on risky drinking and suggests potential intervention targets. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: HIV transmission remains a significant health concern for men who have sex with men (MSM) in the United States. Heavy episodic drinking (HED) is related to increased rates of condomless anal intercourse (CAI) among MSM, though evidence suggests that this association may vary by individual difference factors. The present secondary analysis tested whether sexual alcohol expectancies (SAEs) moderate the associations between frequency of HED and anal intercourse (AI) with and without a condom among moderate-to-heavy drinking HIV- MSM., Methods: Two hundred and forty-eight moderate-to-heavy drinking MSM completed self-report questionnaires including the Sexual Behavior Questionnaire, the Modified Daily Drinking Questionnaire, and the Sexual Alcohol Expectancies Questionnaire., Results: Negative binomial regressions indicated that SAEs moderated the association between frequency of HED and AI with a condom, but not between the frequency of HED and condomless AI (CAI)., Conclusions: These results suggest that stronger SAEs play a role in alcohol-related sexual behavior among MSM, but do not provide evidence that SAEs are associated with increased risk for HIV transmission through CAI., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)