Search

This study compared the cost-effectiveness of Life Skills Training (LST) to a LST curriculum infusion approach (I-LST) and to control schools. Male and female seventh graders from nine rural schools (3 in each condition) were followed for two years. Path models were used to test the main effect and were modeled separately for males and females. After one year, significant effects were observed only for females on alcohol, marijuana, and inhalant use in LST condition and for tobacco, alcohol, and marijuana use for I-LST females. After year two, only the I-LST program affected female smoking. Costs for the programs included actual expenditures for training and materials as well as estimates of teachers' salaries for their project time. Both programs were almost equally effective after one year, but LST was more cost-effective. Although I-LST had higher costs, it was the only approach with any outcomes in year two and therefore more cost-effective.

BACKGROUND: Video games have rapidly become mainstream in recent decades, with over half of the US population involved in some form of digital gaming. However, concerns regarding the potential harms of excessive, disordered gaming have also risen. Internet gaming disorder (IGD) has been proposed as a tentative psychiatric disorder that requires further study by the American Psychological Association (APA) and is recognized as a behavioral addiction by the World Health Organization. Substance use among gamers has also become a concern, with caffeinated or energy drinks and prescription stimulants commonly used for performance enhancement. OBJECTIVE: This study aimed to identify substance use patterns and health-related concerns among gamers among a population of Reddit users. METHODS: We used the public streaming Reddit application programming interface to collect and analyze all posts from the popular subreddit, r/StopGaming. From this corpus of posts, we filtered the dataset for keywords associated with common substances that may be used to enhance gaming performance. We then applied an inductive coding approach to characterize substance use behaviors, gaming genres, and physical and mental health concerns. Potential disordered gaming behavior was also identified using the tentative IGD guidelines proposed by the APA. A chi-square test of independence was used to assess the association between gaming disorder and substance use characteristics, and multivariable logistic regression was used to analyze whether mental health discussion or the mention of any substance with sufficient sample size was significantly associated with IGD. RESULTS: In total, 10,551 posts were collected from Reddit from June 2017 to December 2022. After filtering the dataset for substance-related keywords, 1057 were included for further analysis, of which 286 mentioned both gaming and the use of ≥1 substances. Among the 286 posts that discussed both gaming and substance use, the most mentioned substances were alcohol (n=132), cannabis (n=104), and nicotine (n=48), while the most mentioned genres were role-playing games (n=120), shooters (n=90), and multiplayer online battle arenas (n=43). Self-reported behavior that aligned with the tentative guidelines for IGD was identified in 66.8% (191/286) posts. More than half, 62.9% (180/286) of the posts, discussed a health issue, with the majority (n=144) cited mental health concerns. Common mental health concerns discussed were depression and anxiety. There was a significant association between IGD and substance use (P

Hazardous alcohol consumption is highly prevalent for men who have sex with men (MSM). The 4 treatments currently approved by the Food and Drug Administration for alcohol use are reaching an alarmingly low percentage of people who would benefit from a reduction in their alcohol use. There is increasing interest in alternative methods of treatment, such as herbal supplements, to address hazardous drinking. However, research on the acceptability of alternative pharmacotherapies among MSM remains limited. We examined the prevalence and correlates of expressing interest in using herbal supplements for alcohol treatment among MSM with hazardous alcohol consumption. We conducted a secondary data analysis from a cross-sectional study of MSM who use alcohol, conducted from March 2015 to July 2017 in San Francisco, California, to assess the overall prevalence of interest in using herbal supplements to help reduce alcohol consumption. Associations between expressing interest in herbal supplements and demographic, social, and clinical characteristics were examined using bivariate and multivariable logistic regression models. One-third (66/200, 33%) of the participants expressed interest in an herbal supplement for reducing alcohol consumption. In the multivariable analyses, weekly binge drinking (adjusted odds ratio [aOR] 2.85, 95% CI 1.17-6.93), interest in abstaining from alcohol use (aOR 5.04, 95% CI 1.46-17.40), higher severity of alcohol dependence score (aOR 1.22, 95% CI 1.04-1.41), and interest in naltrexone (aOR 3.22, 95% CI 2.12-4.91) were independently associated with higher odds of being interested in using an herbal supplement to reduce alcohol consumption, adjusting for age, race or ethnicity, and education. We found that MSM who have hazardous drinking habits, more severe alcohol dependence, and interest in pharmacotherapy were more likely to express interest in using an herbal supplement for reducing alcohol consumption. To our knowledge, this is the first study that has evaluated correlates of interest in herbal supplements for alcohol use among MSM. As researchers implement novel alcohol treatment studies, they should focus on recruitment efforts among MSM with a motivation to reduce their alcohol use patterns.

BackgroundLesbian, gay, bisexual, transgender, queer, intersex, aromantic and asexual (LGBTQIA+) communities in the United States experience higher rates of alcohol use than the general population. While experiencing intimate partner violence (IPV) is thought to lead to increased alcohol use in LGBTQIA+ people, little research has investigated the temporal relationship between IPV and alcohol use in this population.MethodsData from two annual questionnaires of The Population Research in Identity and Disparities for Equality Study (The PRIDE Study) longitudinal cohort (n=3,783) were included. Overall IPV and three sub-types (physical, sexual, and emotional) - measured in 2021 using the extended Hurt, Insult, Threaten, Scream (E-HITS) screening tool - was examined as a predictor of Alcohol Use Disorders Identification Test (AUDIT) score in 2022 using multivariable linear regression to assess linear and quadratic associations. Models were adjusted for sociodemographic characteristics and history of alcohol use.ResultsOne-quarter (24.7%) of respondents reported experiencing past-year IPV in 2021. The mean AUDIT score in 2022 was 3.52 (SD = 4.13). In adjusted models, both linear (B: 0.26, 95% CI: 0.14, 0.38) and quadratic (B: -0.03, 95% CI: -0.04, -0.01) terms for overall IPV were significantly associated with next-year AUDIT score. These patterns were mirrored in each IPV sub-type, were not attenuated when accounting for relationship characteristics, and were heterogeneous across gender identity groups.ConclusionsThese results provide evidence of a temporal relationship between IPV and alcohol use in LGBTQIA+ communities, suggesting that efforts to prevent and mitigate IPV may help reduce alcohol use disparities in this population.

In South Africa, alcohol use during pregnancy is prevalent and associated with increased HIV risk. Developing locally sensitive and contextually appropriate evidence-based interventions to address alcohol use among pregnant and breastfeeding women in South Africa requires comprehensive understanding of the context of perinatal alcohol use and how relationships and lived environments may serve as barriers or supports for alcohol reduction. We conducted twenty in-depth qualitative interviews with isiXhosa speaking women who reported alcohol use during their recent pregnancy and/or recent intimate partner violence in Cape Town, South Africa between September and November 2022. We describe patterns and drivers of ongoing alcohol use during pregnancy and map them onto levels of the socioecological model. Data were analyzed utilizing the interpretivist paradigm and interpretive thematic analysis. Eight women reported alcohol use during pregnancy, sixteen reported experiencing recent IPV, and four women reported both alcohol use during pregnancy and recent IPV. In interviews, commonly cited reasons for continued alcohol use in pregnancy included stress (e.g., due to financial concerns), peer pressure, the central role of alcohol use in socialization and the persistence of misconceptions regarding the safety of alcohol use in pregnancy. Still, despite women reporting social norms that supported continued alcohol use in pregnancy, many altered who they drank with due to fear of judgement from close friends and family, leaving them isolated from their social support system. Interventions aimed at increasing interpersonal support, such as the use of peer mentors, could prove beneficial. Although the clinic provides messaging around the harms of alcohol use in pregnancy, these messages conflict with messaging received from their peers, limiting their impact on behavior. Locally sensitive tailored, relevant programming that intervenes on barriers to reducing alcohol use in pregnancy at multiple levels of the socioeconomic model are vital to effectively addressing this public health issue.

Purpose: Sexual and gender minority (SGM) people are at greater risk for substance use than heterosexual and cisgender people, but most prior work is limited by cross-sectional analyses or the examination of single substance use. This study examined substance use over time among SGM people to identify patterns of polysubstance use at the intersection of sex and gender. Methods: Data were collected annually over 4 years from SGM respondents (n = 11,822) in The Population Research in Identity and Disparities for Equality (PRIDE) Study. Differences in substance use patterns (any prior 30-day use of 15 substances) by gender subgroup were examined with latent class analysis, and multinomial regression models tested relationships between gender subgroup and substance use. Results: Eight classes of substance use were observed. The three most common patterns were low substance use (49%), heavy episodic alcohol use (≥5 alcoholic drinks on one occasion) with some cannabis and tobacco use (14%), and cannabis use with some tobacco and declining heavy episodic alcohol use (13%). Differences observed included lower odds of patterns defined by heavy episodic alcohol use with some cannabis and tobacco use in all gender subgroups relative to cisgender men and persons with low substance use (odds ratios [ORs] 0.26-0.60). Gender expansive people assigned female at birth, gender expansive people assigned male at birth, and transgender men had greater odds of reporting cannabis use with small percentages of heavy episodic alcohol and tobacco use (ORs: 1.41-1.60). Conclusion: This study suggests that there are unique patterns of polysubstance use over time among gender subgroups of SGM people.

BackgroundPrevious investigations that have examined associations between family history (FH) of alcohol/substance use and adolescent brain development have been primarily cross-sectional. Here, leveraging a large population-based sample of youths, we characterized frontal cortical trajectories among 9- to 13-year-olds with (FH+) versus without (FH-) an FH and examined sex as a potential moderator.MethodsWe used data from 9710 participants in the Adolescent Brain Cognitive Development (ABCD) Study (release 4.0). FH+ was defined as having ≥1 biological parents and/or ≥2 biological grandparents with a history of alcohol/substance use problems (n = 2433). Our primary outcome was frontal cortical structural measures obtained at baseline (ages 9-11) and year 2 follow-up (ages 11-13). We used linear mixed-effects models to examine the extent to which FH status qualified frontal cortical development over the age span studied. Finally, we ran additional interactions with sex to test whether observed associations between FH and cortical development differed significantly between sexes.ResultsFor FH+ (vs. FH-) youths, we observed increased cortical thinning from 9 to 13 years across the frontal cortex as a whole. When we probed for sex differences, we observed significant declines in frontal cortical thickness among boys but not girls from ages 9 to 13 years. No associations were observed between FH and frontal cortical surface area or volume.ConclusionsHaving a FH+ is associated with more rapid thinning of the frontal cortex across ages 9 to 13, with this effect driven primarily by male participants. Future studies will need to test whether the observed pattern of accelerated thinning predicts future substance use outcomes.

Objective: To verify the association between exercise and free time sport types and binge drinking in a large sample of adults. Methods: Data of 718,147 adults from the "Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey" were used. We described the demographic and behavioral variables, and negative binomial regression analyzed the association between exercise and free time sport types and binge drinking adjusted by demographics variables, body mass index status, and television time. Results: Outdoor walking/running was the most common exercise reported (20.0%, 95% confidence interval [CI], 19.8%–20.2%), followed by team sports (8.1%; 95% CI, 8.0%–8.2%) and strengthening (8.0%; 95% CI, 7.9%–8.1%). The prevalence of binge drinking for each exercise and free time sport type ranged from 6.9% (water aerobics) to 31.9% (team sports). Participants engaging in strengthening (prevalence ratio = 1.12; 95% CI, 1.04–1.21, P =.002) and team sports (prevalence ratio = 1.11; 95% CI, 1.07–1.17, P <.001) were more likely to binge drink more frequently in the past 30 days than inactive participants. Conclusions: It appears that the participants' profile plays an important role in the underlying social context of this association. Participants with more frequent strengthening and less frequent team sports practice, who were primarily younger and single, were more likely to binge drink frequently. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) occurs at alarmingly high rates towards pregnant women in South Africa. Experiences of emotional, physical, and sexual IPV in pregnancy can adversely impact the health and safety of mother and fetus. Furthermore, IPV is associated with increased risk of HIV, exacerbating the public health impact of violence among pregnant women in this HIV endemic setting. In-depth understanding of cultural and contextual drivers of experiences of IPV is a critical precursor to development of interventions effectively addressing this issue among pregnant women in South Africa. The present study examines factors contributing to IPV among pregnant women to identify potential points of intervention. We conducted twenty in-depth interviews with postpartum women who used oral pre-exposure prophylaxis (PrEP) in pregnancy and reported recent experiences of IPV and/or ongoing alcohol use in a township near Cape Town, South Africa that experiences a heavy burden of both HIV and IPV. Interpretive thematic analysis was used. Several patterns of IPV during pregnancy were identified and violence was frequently described as co-occurring with male partner alcohol use. A majority of women referenced oral PrEP as their preferred method for HIV prevention, highlighting the agency and discretion it provided as beneficial attributes for women experiencing IPV. Fear of judgement from peers for remaining with an abusive partner and a lack of clear community messaging around IPV were identified as barriers to disclosure and support-seeking. Addressing the lack of social support received by women experiencing IPV during pregnancy in South Africa is essential to comprehensive IPV programming.

AbstractBisexual women report higher rates of alcohol use and risky sexual behavior than lesbian and heterosexual women. Impulsivity (i.e., action without considering negative consequences) is a risk factor for greater alcohol use and sexual behavior, but few studies have examined the impact of impulsivity on alcohol use and sexual behavior among cisgender bisexual women. Consequently, the purpose of this study was to examine the moderating role of impulsivity on the association between hazardous alcohol use and sexual risk-taking among cisgender bisexual emerging adults. Participants were 225 self-identified cisgender bisexual women (Mage = 22.77, SD = 3.45) who completed an online survey about their hazardous alcohol use using the Alcohol Use Disorder Identification Test (AUDIT), impulsivity, and sexual behaviors over the past 30 days. A moderated regression model examined main effects of impulsivity and alcohol use severity, and their interaction, on sexual risk-taking. The association between alcohol use severity and sexual risk-taking was moderated by impulsivity. Simple slopes analyses revealed that greater alcohol use severity was associated with greater sexual risk-taking, but this only occurred for participants with average or high scores of impulsivity. These results suggest prevention programs that target alcohol use should address the role that impulsivity may have on risky sexual behaviors among young bisexual women. Future research would benefit from looking at various outcomes related to sexual risk to determine which are most predominantly associated with alcohol use severity and impulsivity. [ABSTRACT FROM AUTHOR]

ObjectivesDesignResultsConclusionAmerican Indian and Alaskan Native (AIAN) populations have the highest rate of alcohol use disorder (AUD). Binge drinking is a known predecessor of AUD and is prevalent in college-attending populations. However, little is known about the prevalence and risk factors related to AIAN college student binge drinking. The current study examines prevalence of binge drinking and association with socio-demographic features, other substance use, exposure to discrimination and feelings of belonging within collegiate institutions.Data were collected by the Healthy Minds Study. Present analyses were restricted to 2- and 4-year college attending students in the 2021–2022 academic year who identified as AIAN (n = 1383). We used descriptive, bivariate and multivariate Poisson weighted models to evaluate distributions and associations of binge drinking, age, gender, socioeconomic status, degree program, military experience, substance use, sexual assault, discrimination, and feelings of belonging within the institution.In the prior 2 weeks, 26.3% of AIAN students reported binge drinking. Binge drinking commonly overlapped with other substance use. AIAN students aged 21–34 reported the highest rates of binge drinking, as did students pursuing bachelor’s degrees. AIAN students who identified as trans or queer gender were less likely to report binge drinking, while across gender identities those reporting sexual assault or racial discrimination were more likely to report binge drinking in multivariate analyses.There are multiple factors associated with binge drinking, representing individual and contextual influences on AIAN students. Developing prevention and intervention activities to address overlap in substance use and high concurrence of sexual assault and binge drinking are critical. Additionally, colleges must make concerted efforts to reduce racial discrimination and be more inclusive of AIAN students to reduce institutional-based features that exacerbate risk. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore sex-specific disparities in rates of deaths of despair across 183 countries from 2000 to 2019. Secondary analysis of cross-sectional population-level data. Data were obtained from the World Health Organization Health Inequality Data Repository. We analysed data on mortality due to alcohol, drug-use disorders, and self-harm (as a proxy for suicide). We calculated the average rate of deaths of despair by year and sex, trends in these rates, and cause-specific mortality trends. We then fitted mixed-effect generalised linear models to compare mortality rates by sex and country. Analyses revealed significant disparities by sex, with a 3.3-fold higher rate among men than among women globally (95% confidence interval: 3.1–3.5, P < 0.001). There was a significant decline in deaths of despair globally and among both sexes during the assessed period (5% per 5 years). Lesotho, Belarus, the US, the Russian Federation, Guyana, and Slovenia ranked among the top 10 countries out of 183 with the highest mortality rates for both sexes. Canada, the Republic of Korea, Belgium, and Finland were countries with the highest mortality rates among women, whereas Ukraine, Lithuania, Mongolia, and Eswatini have the highest rates among men. In the US, 5-year mortality rates increased by 35% for women and 21% for men: drug-use mortality showed a significant increase over time, whereas suicide rates decreased for both sexes in the given country. Additionally, mortality rates from alcohol use decreased among women. This global analysis shed light on health disparities by sex in deaths of despair, especially concerning trends in the US. It identified countries and groups in need of targeted mental health and substance-use programs. Moreover, the disparities by sex revealed in this analysis suggest that mental health and substance-use interventions and programs may need to be more attentive to sex and/or gender, such as inequitable social norms and restrictive forms of masculinities, which have been shown to be contributing factors to deaths of despair. [ABSTRACT FROM AUTHOR]

In this study, we examined rates of insomnia and co-occurring unhealthy alcohol use in a national sample of women Veterans age 50 years and older. We further explored associations between sociodemographic measures, insomnia-related clinical characteristics, and unhealthy alcohol use, and analyzed whether women with insomnia were more likely to report unhealthy alcohol use. Study aims were evaluated using national Veterans Health Administration (VA) electronic health records data from VA's Corporate Data Warehouse. Data were extracted for women Veterans ≥50 years old with ≥1 VA primary care visit in each study year (2018: 3/11/18–3/10/19; 2020: 3/11/20–3/10/21; 2022: 3/11/22–3/10/23). Cases of insomnia were identified via diagnostic codes and prescription medications for insomnia. Unhealthy alcohol use was identified via Alcohol Use Disorders Identification Test-Consumption screening scores indicating unhealthy alcohol use. Annual sample sizes ranged from 240,420–302,047. Over the study timeframe, insomnia rates (diagnosis or medication) among women ≥50 years old ranged from 18.11–19.29%; co-occurring insomnia and unhealthy alcohol use rates ranged from 2.02–2.52%. Insomnia and unhealthy alcohol use rates were highest among women aged 50–59 years old. Depression and physical health comorbidities were consistently associated with insomnia; associations by race and ethnicity were less consistent. Compared to women without insomnia, women Veterans with either concurrent or unremitting insomnia were more likely to endorse unhealthy alcohol use. Findings signal a potential need for assessment and preventative efforts aimed at addressing insomnia and unhealthy alcohol use among women Veterans. [ABSTRACT FROM AUTHOR]

Introduction: We retrospectively studied the societal value of lost health due to alcohol use and compared it with excise taxes on alcohol sales for India in 2019. Methods: We estimated the overall alcohol‐attributable disease burden using disability‐adjusted life‐years (DALY) for India and its 30 states for all causes with alcohol use as a risk factor from the GBD 2019 Study. The societal value of lost health was calculated using value of life‐year (VLY) approach by multiplying region‐specific factors from 'Global Health 2035', 2019–2020 GDP per capita and DALYs. We acquired the national and state‐level (top 10 states) alcohol sales excise taxes from the Reserve Bank of India. Net losses were assessed by subtracting the revenue collected from excise taxes from VLY. All values are in Indian rupees (INR). Results: The societal value of health lost due to alcohol use in India was 6.2 (95% uncertainty interval 4.8, 7.8) trillion INR in 2019. The absolute state‐level values varied from 7.3 (4.7, 10.4) billion INR in Mizoram to 1.1 (0.8, 1.4) trillion INR in Maharashtra. The per capita values ranged from 950.2 (642.9, 1285.3) INR for Bihar to 61,332 (39,273.7, 87,288.5) INR for Mizoram. Nationally, excise tax collection from alcohol sales was 1.8 trillion INR depicting a net loss of 4.4 (3.1, 6.0) trillion. Maharashtra had the largest absolute and per capita net loss. Discussion and Conclusions: These are novel estimates depicting the net losses due to alcohol use in India with direct policy implications to disincentivise sales and adequately raise taxes. [ABSTRACT FROM AUTHOR]

This study examined the influence of adverse childhood experiences (ACEs) on Black sexual minority women's mental health and substance use disorders in adulthood. Secondary data analysis was conducted using N = 149 Black sexual minority women's reports from the Generations Study. Study variables included psychological distress, chronic strains, stressful life events, ACEs, and substance use disorders, including alcohol use disorder and drug use disorder. Quantitative data analysis consisted of descriptives and bivariate correlations. Participants' total ACE scores were positively significantly correlated with increased alcohol misuse, chronic life strains, and stressful life events. Exposure to household interpersonal violence and household mental illness during childhood were significantly correlated with alcohol misuse. Black sexual minority women with ACEs are at higher risk for mental health concerns throughout their lifespan and maladaptive coping strategies (e.g., substance use). Implications for counselors and therapists are provided. [ABSTRACT FROM AUTHOR]

Objective: Firefighters are at risk of experiencing heightened anxiety and alcohol use perhaps due to occupational stress. Mindfulness is related to both anxiety and alcohol use; however, research on the relations of mindfulness with anxiety and alcohol use and drinking motives among firefighters is limited. This study examined (1) whether higher anxiety was positively related to alcohol use severity and drinking related motives (e.g., coping, enhancement, social, and conformity) and (2) whether higher mindfulness would moderate the association between anxiety symptom severity and alcohol use severity and alcohol use coping motives. Methods: Participants included urban firefighters (N = 679; Mage = 38.6; SD = 8.58; 93.5% male) who completed an online survey. Five hierarchical regression analyses were conducted to evaluate the main and interactive effects of anxiety symptom severity and mindfulness on all study outcomes (i.e., alcohol use severity and four drinking motives). Results: Anxiety symptom severity was significantly and negatively associated with mindfulness and, incrementally, positively associated with all alcohol use-related outcome variables. Mindfulness was negatively correlated with alcohol use severity and all alcohol use motives except social motives. Mindfulness moderated the effects of anxiety symptom severity on coping alcohol use motives only. Conclusion: Mindfulness moderated, or attenuated, the positive association between anxiety symptom severity and coping-oriented alcohol use motives among professional firefighters. Results have the potential to inform treatment development and wellness programming for the fire service. [ABSTRACT FROM AUTHOR]

Attention Deficit Hyperactivity Disorder (ADHD) is the most common comorbidity in Autism Spectrum Disorder (ASD). ADHD is a risk factor for alcohol misuse whereas ASD is often regarded as protective; however, research on ASD and alcohol use has yielded conflicting findings, sometimes implicating the role of comorbid ADHD. The possibility that certain transdiagnostic features (i.e., characteristics associated with multiple disorders) may underlie relationships of both disorders to alcohol use in adults was examined in the present study. A nonclinical young adult sample of 248 alcohol users (117 men, 131 women) completed validated self-report measures of ASD and ADHD symptoms as well as the transdiagnostic features alexithymia, impulsivity, and negative moods. ASD and ADHD symptoms were normally distributed, suggesting that the respective disorders represent extreme, dysfunctional ends of population distributions of symptoms. Path analysis indicated that the significant positive association between ASD and ADHD symptom measures was fully mediated by alexithymia, impulsivity, and negative moods. Hierarchical regression and path analysis indicated that the positive relationship between ADHD symptoms and alcohol use severity was fully mediated by transdiagnostic features, particularly alexithymia and impulsivity, whereas the relationship between ASD and alcohol use severity was positively mediated by these features (especially alexithymia), with a highly significant and negative direct effect. Present findings may help reconcile previous conflicting evidence on the relationship of ASD to alcohol use, and the role of comorbid ADHD, by emphasizing the roles of alexithymia and impulsivity in both ASD and ADHD as transdiagnostic traits promoting excessive drinking. • ADHD is the most common comorbidity in ASD and is a risk factor for alcohol misuse. • Alexithymia, impulsivity and negative mood mediated the positive association of ADHD symptoms with alcohol use. • Alexithymia, impulsivity and negative mood also mediated a positive indirect association of ASD symptoms with alcohol use. • The direct effect of ASD symptoms indicated a negative relationship to alcohol use severity. • Findings suggest that alexithymia should be taken into account when investigating the relationship of ASD to alcohol use. [ABSTRACT FROM AUTHOR]

Objective: Early pubertal timing is a risk factor for substance use during adolescence. Fewer studies investigated whether early pubertal timing continues to predict substance use in late adolescence and adulthood, suggesting that long-term effects of pubertal timing vary across substances and by biological sex. Finally, existing studies on pubertal timing and substance use in adulthood involved predominantly White samples. Thus, this longitudinal study examined the concurrent and long-term effects of pubertal timing on alcohol, cigarette, and cannabis use together with sex differences in predominantly Black youth from the United States. Method: The sample included 603 youth (52% male, 80% Black) who were interviewed in early adolescence (mean age: 13.2), late adolescence (mean age: 17.6), and young adulthood (mean age: 27.7). During early adolescence, youth self-reported their physical maturation based on Tanner scores, which were adjusted for age and used as indicators of pubertal timing. Youth self-reported their substance use at each time point. Results: Early pubertal timing was associated with higher odds of alcohol use during early adolescence but did not predict alcohol use during late adolescence or adulthood. While early pubertal timing did not predict cigarette use at any time point, early pubertal timing predicted greater odds for cannabis use during early adolescence and higher rates of cannabis use in adulthood. Moreover, early pubertal timing predicted greater risk for couse of alcohol, cigarettes, and cannabis in adulthood. No effects differed by sex. Conclusions: These findings suggest that links between pubertal timing and substance use vary across substances and developmental periods. Public Health Significance Statement: This study found that early pubertal timing puts youth at higher risk for alcohol use and cannabis use during early adolescence as well as more cannabis use and couse of alcohol, cigarettes, and cannabis in young adulthood. However, early pubertal timing did not predict cigarette use at any time point. [ABSTRACT FROM AUTHOR]

Objective: Alcohol and cannabis are often perceived as pain-relieving. However, minimal work has examined whether people use and co-use these substances following pain in daily life. Method: Forty-six adults reporting weekly use of alcohol and/or cannabis completed a 60-day ecological momentary assessment protocol, answering at least four daily reports on their alcohol and cannabis use and pain (nassessments = 10,769 over 2,656 days). We examined whether self-reported pain so far that day (cumulative-average pain) was associated with subsequent alcohol and cannabis use and same-occasion co-use. Models also addressed whether associations differed for initiating versus continuing a use episode. Hypotheses were preregistered. Results: A multinomial multilevel model found that cumulative-average pain was associated with a greater likelihood of same-occasion co-use in the continuation phase but not the initiation phase, compared to no use (OR = 1.48,95% CI [1.06, 2.06], p =.023) and alcohol use (OR = 1.52, CI [1.03, 2.26], p =.037). Cumulative-average pain was largely not associated with alcohol-only and cannabis-only use. After alcohol use, greater pain was associated with cannabis use (OR = 1.37, CI [1.11, 1.70], p =.004), but not the reverse. Secondary analyses found greater previous-occasion (not cumulative) pain was associated with initiation of alcohol use and number of drinks, and initiation and continuation of cannabis use, but not number of cannabis hits. Conclusions: Although not all hypotheses were supported, pain was associated with subsequent substance use in this sample engaged in regular substance use and not recruited for chronic pain. Cumulative pain may be particularly related to alcohol–cannabis same-occasion co-use, which may increase the risk of substance use-related problems over time. Public Health Significance Statement: Greater accumulated physical pain was associated with subsequent same-occasion co-use of alcohol and cannabis in this sample of community adults engaged in regular substance use and not recruited for experiencing elevated pain. Pain may be an important factor for understanding substance use in daily life, even for people who do not have chronic pain. [ABSTRACT FROM AUTHOR]

Purpose: Intimate partner aggression (IPA) increased after the onset of the COVID-19 pandemic. Following the Vulnerability-Stress-Adaptation (VSA) model, the current study examined associations among emotion regulation (ER) difficulties (an enduring vulnerability), COVID stress (a current stressor), alcohol use (a maladaptive coping strategy), and physical, psychological, and cyber IPA perpetration during the first eight months of the pandemic. Method: Participants were 215 college students in current relationships from three universities across the US. Results: Results of generalized linear models controlling for pre-COVID IPA perpetration showed a main effect of ER difficulties on physical IPA perpetration (b = 0.56, p <.001), an ER difficulties X COVID stress X alcohol use interaction on psychological IPA perpetration (b = 0.01, p =.03), and an ER difficulties X COVID stress interaction on cyber IPA perpetration (b = − 0.02, p =.02). Specifically, when ER difficulties and alcohol use were low, individuals with high levels of COVID stress were at higher risk of perpetrating psychological IPA relative to individuals with low levels of COVID stress. However, the association between COVID stress and psychological IPA perpetration was not statistically significant when ER difficulties and alcohol use were high. Similarly, when ER difficulties were low, individuals with high levels of COVID stress were at higher risk for perpetrating cyber IPA relative to individuals with low levels of COVID stress. However, when ER difficulties were high, the association between COVID stress and cyber IPA perpetration was not statistically significant. Conclusions: The current findings tentatively implicate COVID stress as a critical correlate of IPA perpetration and suggest that individuals who have fewer existing vulnerabilities (i.e., ER difficulties) and maladaptive processes (i.e., alcohol use) should not be overlooked. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine the social gradient in self-reported alcohol-related harm (ARH) among young alcohol consumers by including a largely overlooked group of adolescents. We also explored the extent to which such a gradient could be attributed to differential exposure or differential vulnerability to risk factors. Method: Cross-sectional survey of upper-secondary students (n = 2996) in Sweden. Negative binomial regressions estimated the relationship between academic orientation (higher education preparatory; HEP, vocational; VP and introductory; IP) and ARH. To assess the contribution of explanatory factors, we estimated models that included risk factors such as heavy episodic drinking (HED). Results: A graded association was observed between academic orientation and ARH, with more ARH among students in IP (IRR = 1.79) and VP (IRR = 1.43) than in HEP. Adjustments for risk factors attenuated the estimates by approximately half, but there was still 14% more ARH in VP and 50% more in IP than in HEP. The additive interaction test indicated a positive and significant interaction for students in VP who engaged in HED, versus students in HEP, who did not. Conclusion: The findings suggest a negative gradient in the association between academic orientation and ARH, where the students in IP experienced the highest levels of ARH. While differential exposure and vulnerability to HED account for a significant proportion of the excess risk among VP students, HED seems to be less important relative to other risk factors among IP students. More research is needed to identify the mechanisms underlying the elevated levels of ARH among the most disadvantaged group—students enrolled in IP. [ABSTRACT FROM AUTHOR]

AbstractObjective: Examine predictors of alcohol misuse among university students amid the COVID-19 pandemic. Participants: University students who completed the National College Health Assessment III before, during, and after the pandemic lockdown. Methods: Using multivariable logistic regression, we examined associations between psychological functioning, time spent with family and friends, and problematic alcohol use. Results: Alcohol use decreased, and psychological functioning was poorest one year after COVID-19-related university closures. While indicators of psychological functioning started to improve in the second year after the school closures, alcohol use started to increase. Overall stress, spending more time with friends, and fraternity/sorority residence significantly predicted moderate to high risk for alcohol dependence and binge drinking two years post-pandemic. Severe psychological distress (OR= 1.36, CI = 1.22, 1.52, p < 0.001) predicted moderate to high risk for alcohol dependence but not binge drinking. Conclusion: Innovative mental health interventions are needed to reduce alcohol misuse among university students. [ABSTRACT FROM AUTHOR]

Background and aims Design Setting Participants Measurements Findings Conclusions Research demonstrates that siblings, especially older siblings, make unique contributions to adolescents' substance use above and beyond shared genetics and shared parenting. Older siblings' influences on younger adolescent siblings' alcohol use operate through both direct and indirect pathways. Using three waves of longitudinal data, the present study tested an integrated model of sibling influence processes focused on the linkages between older adolescent siblings' earlier alcohol use and younger adolescent siblings' later alcohol use.Longitudinal study using data collected from families on three occasions: Time 1 (March 2019–February 2020), Time 2 (July 2020–February 2021) and Time 3 (November 2021–February 2022) via online surveys.Families resided in five midwestern states in the US (Illinois, Indiana, Ohio, Pennsylvania and Wisconsin).Participants included two adolescent‐aged siblings and one parent from 682 families (n = 2046 persons).Alcohol use by adolescents and parents was assessed at Time 1; younger siblings' social alcohol expectancies and perceptions of modeling were measured at Time 2; and younger siblings' alcohol use was measured at Time 3.Older siblings' earlier alcohol use predicted younger siblings' later drinking both directly [b = 0.15, standard error (SE) = 0.04, β = 0.17, P < 0.001] and indirectly through younger siblings' social alcohol expectancies [δ = 0.02, SE = 0.008, 95% confidence interval (CI) = 0.003, 0.03]. The direct (δ = −0.14, SE = 0.07, 95% CI = −0.27, −0.01) and indirect (δ = 0.03, SE = 0.02, 95% CI = 0.0001, 0.06) links were further moderated by younger siblings' reports of sibling modeling, but not by gender composition of the sibling dyad or the interaction of modeling and gender composition.Older siblings' alcohol use appears to influence younger siblings' later alcohol use directly, as well as indirectly through younger siblings' expectancies about alcohol. The global context of the sibling relationship, in this case sibling modeling, may further amplify or dampen these pathways of influence. [ABSTRACT FROM AUTHOR]

Background: Cannabis use has been causally linked to violent behaviors in experimental and case studies, but its association with homicide victimization has not been rigorously assessed through epidemiologic research. Methods: We performed a case-control analysis using two national data systems. Cases were homicide victims from the National Violent Death Reporting System (NVDRS), and controls were participants from the National Survey on Drug Use and Health (NSDUH). While the NVDRS contained toxicological testing data on cannabis use, the NSDUH only collected self-reported data, and thus the potential misclassification in the self-reported data needed to be corrected. We took a data fusion approach by concatenating the NSDUH with a third data system, the National Roadside Survey of Alcohol and Drug Use by Drivers (NRS), which collected toxicological testing and self-reported data on cannabis use for drivers. The data fusion approach provided multiple imputations (MIs) of toxicological testing results on cannabis use for the participants in the NSDUH, which were then used in the case-control analysis. Bootstrap was used to obtain valid statistical inference. Results: The analyses revealed that cannabis use was associated with 3.55-fold (95% CI: 2.75–4.35) increased odds of homicide victimization. Alcohol use, being Black, male, aged 21–34 years, and having less than a high school education were also significantly associated with increased odds of homicide victimization. Conclusions: Cannabis use is a major risk factor for homicide victimization. The data fusion with MI method is useful in integrative data analysis for harmonizing measures between different data sources. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsParticipantsResultsConclusionThere are currently no adequate measures to assess bystander intervention for problematic alcohol use (PAU).We developed initial measures of bystander intervention for PAU, that include the constructs of likelihood to intervene, barriers to intervention, and actions taken in response to PAU situation. We sought to confirm the factor structure of the initial measures using confirmatory factor analysis (CFA).We administered the measures in a college student sample (N = 1,270) recruited through Prime Panels.CFA analysis resulted in the following two scales: 1) Bystander Alcohol Likelihood to Intervene (14 items), 2) Overcoming Bystander Alcohol Barriers to Intervene (22 items). The Bystander Alcohol Actions (22 items) was formative, no CFA was conducted. We found that the hypothesized model displayed significantly superior fit to all other models.These measures can be used to inform bystander intervention programs for PAU and as tools to evaluate bystander intervention programs. [ABSTRACT FROM AUTHOR]

Background and Aims Methods Results Conclusions Studies show that higher levels of positive affect (PA) and lower levels of negative affect (NA) are related to craving and alcohol consumption at a daily level in men, but little is known on these associations at a momentary level, and whether they are present in women. This study measured the dynamics of within‐person NA and PA surrounding craving, non‐heavy alcohol use and binge drinking in women with alcohol use disorder (AUD) and female controls without AUD.53 female patients with AUD and 75 female controls, all recruited in Belgium, were included in an experience sampling study where they reported on momentary NA, PA, craving and alcohol use in daily life over a period of 12 months. Assessments occurred eight times a day on Thursdays, Fridays and Saturdays in seven bursts of three weeks.Within‐person NA at a previous assessment (t−1) predicted craving at the current assessment (t0) in patients with AUD in a positive linear [β = 0.043; 95% confidence interval (CI) = 0.002, 0.057; P = 0.041] and quadratic fashion (β = 0.034; CI = 0.011, 0.057; P = 0.004). Within‐person PA at t−1 predicted craving at t0 in patients with AUD with a positive quadratic relation (β = 0.042; CI = 0.08, 0.065; P < 0.001). Within‐person NA at t−1 negatively predicted non‐heavy alcohol use at t0 in a linear fashion in controls (β = −0.495; CI = ‐0.677, ‐0.312; P < 0.001) and patients with AUD (β = −0.276; CI = ‐0.421, ‐0.132; P < 0.001). Within‐person PA at t−1 significantly predicted non‐heavy alcohol use at t0 with a positive linear term (β = 0.470; CI = 0.329, 0.610; P < 0.001) in controls, but with a positive linear term (β = 0.399; CI = 0.260, 0.454; P < 0.001) and a positive quadratic term (β = 0.203; CI = 0.060, 0.347; P = 0.003) in patients with AUD. Within‐person NA at t−1 predicted binge drinking at t0 in patients with AUD with a significant quadratic term (β = 0.236; CI = 0.060, 0.412; P = 0.008), but not for controls. Within‐person PA at t−1 predicted binge drinking at t0 in patients with AUD with a significant quadratic term (β = 0.378; CI = 0.215, 0.542; P < 0.001), and this was also the case for controls (β = 0.487; CI = 0.158, 0.770; P < 0.001). Non‐heavy alcohol use at t0 predicted lower levels of NA at t+1 in both patients with AUD (β = −0.161; SE = 0.044; CI = ‐0.248, 0.074; P = 0.001) and controls (β = −0.114; CI = ‐0.198, ‐0.029; P = 0.010). Non‐heavy alcohol use at t0 also predicted higher levels of PA at t+1 in both patients with AUD (β = 0.181; CI = 0.088, 0.274; P < 0.001) and controls (β = 0.189; CI = 0.101, 0.278; P < 0.001).The momentary relation between affect and craving or alcohol use seems to be non‐linear in female patients with alcohol use disorder, whereby a worse mood predicts subsequent alcohol use, though more for binge drinking than for non‐heavy alcohol use. [ABSTRACT FROM AUTHOR]

Research suggests that religious activity and spiritual experiences are associated with well-being among emerging adults. This research is primarily evaluated on the between-person level, leaving within-person effects largely unexplored. We examined relations between religious activity and spiritual experiences and their relation to life satisfaction and alcohol use among 383 college students at a moderately large university in the southwest USA. Participants completed daily reports of study measures. Multilevel regression indicated that daily religious activities and spiritual experiences were directly, and indirectly through moral emotions, associated with satisfaction with life. Results suggest that students who engage in regular religious activity and spiritual experience see a concomitant increase in life satisfaction. [ABSTRACT FROM AUTHOR]

Objective: The present study examines the network structure and, using Bayesian network analysis, estimates the directional pathways among symptoms of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and levels of alcohol and cannabis use. Method: A sample of 1471 adults in the United States, who reported at least one potentially traumatic event, completed the PTSD Checklist (PCL-5), Patient Health Questionnaire (PHQ-9), and the Alcohol/Cannabis Use Disorders Identification Test (AUDIT/CUDIT). A regularized partial correlation network provided estimates of symptoms clusters and connections. Directional pathways within the network were then estimated using a directed acyclic graph (DAG). Results: Symptoms clustered in theoretically consistent ways. Risky behavior demonstrated the highest strength centrality and bridge strength. Neither alcohol nor cannabis use appeared central in the network, and DAG results suggested that MDD and PTSD symptoms are more likely to lead to substance use than the other way around. Conclusions: Results suggest that cannabis use is largely connected to alcohol use. Consistent with prior research, risky behavior appeared to be the primary bridge between substance use and PTSD. The direction of associations between substance use and psychological symptoms requires further attention. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is a major public health concern among young adults and has shown a consistent association with alcohol use. However, previous research has used cross‐sectional and daily diary designs that may fail to pinpoint the effects of alcohol use within several hours of IPV occurring. The present study used novel ecological momentary assessment (EMA) methods to investigate the bidirectional effect of alcohol use and IPV victimization among young adults with a history of IPV perpetration. Methods: One hundred and sixty‐eight young adults (age 18–25 years) in a dating relationship who reported IPV perpetration in the past year completed 28 days of randomly prompted EMA surveys (four surveys daily). The effect of alcohol use on IPV victimization and the effect of IPV victimization on alcohol use were examined. Results: The results indicated that alcohol use co‐occurs with psychological and physical IPV victimization. Further, alcohol use significantly increased the odds of physical (OR = 4.94; 95% CI = 2.24–10.87) and sexual (OR = 4.66; 95% CI = 1.64–13.22) IPV victimization, but not psychological IPV victimization, in the subsequent EMA survey. Finally, IPV victimization did not significantly increase the odds of reporting alcohol use in the subsequent EMA survey. Conclusions: Using alcohol is proximally related to IPV victimization among those with a history of IPV perpetration. Intervention efforts would benefit from adapting EMA methods to provide resources the moment they are needed. [ABSTRACT FROM AUTHOR]

Background: Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy more frequently found in deceased former football players. CTE has heterogeneous clinical presentations with multifactorial causes. Previous literature has shown substance use (alcohol/drug) can contribute to Alzheimer's disease and related tauopathies pathologically and clinically. Objective: To examine the association between substance use and clinical and neuropathological endpoints of CTE. Methods: Our sample included 429 deceased male football players. CTE was neuropathologically diagnosed. Informant interviews assessed features of substance use and history of treatment for substance use to define indicators: history of substance use treatment (yes vs no, primary variable), alcohol severity, and drug severity. Outcomes included scales that were completed by informants to assess cognition (Cognitive Difficulties Scale, BRIEF-A Metacognition Index), mood (Geriatric Depression Scale-15), behavioral regulation (BRIEF-A Behavioral Regulation Index, Barratt Impulsiveness Scale-11), functional ability (Functional Activities Questionnaire), as well as CTE status and cumulative p-tau burden. Regression models tested associations between substance use indicators and outcomes. Results: Of the 429 football players (mean age = 62.07), 313 (73%) had autopsy confirmed CTE and 100 (23%) had substance use treatment history. Substance use treatment and alcohol/drug severity were associated with measures of behavioral regulation (FDR-p-values<0.05, ΔR2 = 0.04–0.18) and depression (FDR-p-values<0.05, ΔR2 = 0.02–0.05). Substance use indicators had minimal associations with cognitive scales, whereas p-tau burden was associated with all cognitive scales (p-values <0.05). Substance use treatment had no associations with neuropathological endpoints (FDR-p-values>0.05). Conclusions: Among deceased football players, substance use was common and associated with clinical symptoms. [ABSTRACT FROM AUTHOR]

Post-traumatic stress disorder (PTSD) symptoms and hazardous drinking have been linked to lower relationship satisfaction; however, few studies have evaluated these associations over time in a college sample. The current study aimed to examine within-person and between-person longitudinal main and interactive effects of self-reported PTSD symptoms and hazardous drinking on relationship satisfaction in a college sample. We further examined whether individual PTSD symptom clusters (i.e., re-experiencing, avoidance, hyperarousal, and emotional numbing) uniquely predicted relationship satisfaction. College students in current dating relationships (N = 307; 71% cisgender women) completed online self-report measures assessing relationship satisfaction, PTSD symptoms, and hazardous alcohol use on four occasions across 12 months. Multilevel models revealed that students with more severe PTSD symptoms than average had lower relationship satisfaction (i.e., at the between-person level). Additionally, higher hazardous drinking at the between-person and within-person levels was associated with lower relationship satisfaction. When examining specific PTSD symptom clusters, results indicated only emotional numbing symptoms were negatively associated with relationship satisfaction at the between-person and within-person levels after controlling for other PTSD symptom clusters. Collectively, these results underscore the impact of within- and between-person individual differences in PTSD symptoms and hazardous drinking on romantic relationships in college student populations. [ABSTRACT FROM AUTHOR]

Background: People in agriculture face unique stressors and occupational hazards, and relatively little is known about substance use in this population. The purpose of this study was to describe substance use among farmers in Illinois. Methods: We conducted a mail survey of Illinois farmers that included the Brief ASSIST to assess substance use for lifetime and past three-month use of ten different substances. The survey also included questions about farming characteristics, mental health, stress, coping, social support, and demographic characteristics. We used chi-square and non-parametric tests to assess group differences. Results: Alcohol, tobacco, cannabis, and sedatives were most reported as used for a lifetime and in the past three months. About three-quarters of the sample had recently used alcohol. Recent tobacco use was associated with not being married, less education, and less concern about climate-related farm stress. Recent sedative use was associated with greater concern about isolation-related farm stress. People who reported multiple substance use were at a greater risk for suicide and were more likely to meet the criteria for generalized anxiety disorder. None of the participants reported recent use of cocaine, heroin, inhalants, or hallucinogens. Conclusion: Specific social and cultural aspects of farming and farm communities may contribute to substance use among people working in agriculture. Future research can help to better understand this intersection and make recommendations for programs and resources to promote adaptive coping strategies. [ABSTRACT FROM AUTHOR]

Objective: Separately, individuals with criminal legal involvement (CLI) and those who identify as a sexual minority are at heightened risk for experiencing discrimination and engaging in hazardous alcohol use; however, little is known about the prevalence of these experiences and behaviors among sexual minority individuals who also have a history of CLI. Method: We examined experiences of discrimination and hazardous alcohol use reported by individuals with CLI and compared prevalence between those who identify as a sexual minority and those who do not. Baseline, cross-sectional data of cisgender sexual minority individuals from a multisite, prospective cohort study examining pre-exposure prophylaxis acceptability and uptake among criminal legal-involved adults were analyzed (N = 362, 14% sexual minority). Results: Hazardous alcohol consumption was nearly twice as prevalent among participants who identified as a sexual minority compared to heterosexual participants, and a sexual minority identity was associated with higher discrimination scores. Additionally, hazardous drinking was more prevalent among those with higher discrimination scores. Conclusions: This study suggests that sexual minority individuals with a history of CLI are an especially high-risk group given the elevated rates of discrimination and hazardous alcohol use observed. More research is needed to further investigate the risk behaviors of this population and to develop interventions to intervene on their physical and mental health. [ABSTRACT FROM AUTHOR]

Although alcohol use is related to daily affect, findings regarding affect variability—the degree to which individuals exhibit day-to-day fluctuations in affect—and alcohol use have been mixed. The present study assessed whether individuals who use alcohol tend to have higher positive and negative affect variability than individuals who do not, as well as whether higher affect variability is related to more frequent and intense alcohol use among individuals who use alcohol. We also explored whether affect variability differed between individuals who use alcohol and those who concurrently use alcohol and cannabis. College students (N = 1909; M = 20.1, SD = 1.3; 67.7% female; 76.6% white; n = 1147 individuals who use alcohol) completed a 21-day protocol between February-December 2021 in which they reported daily affect, number of drinks consumed, and any cannabis use. As hypothesized, individuals who used alcohol had higher positive and negative affect variability than individuals who did not. Among individuals who used alcohol, individuals with higher negative affect variability drank alcohol more frequently, and both higher positive and negative affect variability were related to more intense alcohol use. No differences emerged between individuals who used alcohol and those who concurrently used alcohol and cannabis. Taken together, higher positive and negative affect variability were related to higher odds of using alcohol and more frequent and intense use among individuals who use alcohol, over and above average affect. Higher affect variability could relate to alcohol use because of difficulties with emotion regulation or heightened sensitivity to the environment. [ABSTRACT FROM AUTHOR]

Introduction: Health literacy (HL) plays an important role in alcohol consumption. Improving alcohol-related HL offers an integrated approach to prevent and reduce high-risk alcohol use. This study aimed to determine the effects of a HL program (HLP) on medical students' drinking behaviors. Methods: A randomized controlled trial was conducted from June 2023 to January 2024 among medical students. One hundred and four students were randomly allocated to the intervention (n = 52) and control (n = 52) groups. The intervention group received the HLP over six sessions, while the control group received standard health education. Data were collected through interviews using a structured interview questionnaire. Independent t -tests, paired sample t -tests, Chi-squared tests, and Chi-square for trend were applied for statistical analysis. Results: Following the HLP, the intervention group exhibited a significant increase in the mean total HL score, cognitive skills, access skills, communication skills, self-management skills, media skills, and decision skills compared to the control group (P < 0.05). Moreover, the intervention group showed a significant decrease in the number of harmful drinkers compared to the control group (P < 0.05). Conclusion: HLPs are effective in improving HL and reducing alcohol consumption among medical students. Our findings suggest incorporating HLPs into adolescents' health education activities. [ABSTRACT FROM AUTHOR]

Friendship-related stress is an understudied factor that may explain variation in coping-motivated and socially-motivated drinking among emerging adults. This study examined chronic and episodic friendship stress as predictors of drinking levels and motivations among emerging adults transitioning to post-college life. College drinkers reported drinking motives and alcohol consumption daily for 30 days using an Internet-based diary in college and five years later (N = 897, 54.2% women, Mage = 24.6 at follow-up, 86.0% White). Post-college, participants completed by phone the UCLA-Life Stress Interview assessing chronic and episodic friendship/social life stress. Chronic friendship/social life stress was positively correlated with mean levels of post-college drinking-to-cope motivation and was negatively related to post-college heavy drinking and social drinking motivation. Emerging adults experiencing friendship stress are more likely to use alcohol as a coping mechanism, elevating their risk for alcohol-related problems. Those with low friendship stress may require public health interventions around the risks of heavy drinking. [ABSTRACT FROM AUTHOR]

Helicopter parenting during emerging adulthood, a developmental period highlighting autonomy and self-reliance, can undermine college students' well-being. The current study examined the mediating role of emotion dysregulation in the association between helicopter parenting and mental health outcomes among college-aged adults. A sample of 790 college students completed questionnaires on perceived helicopter parenting, emotion dysregulation, depression, social anxiety, and alcohol use. Results generally supported the hypothesized mediation model, but associations depended on the specific helicopter parenting behavior, emotion dysregulation dimension, and mental health outcome. Autonomy limiting was particularly detrimental to all emotion dysregulation dimensions and mental health, whereas information-seeking behaviors may be beneficial to emerging adults' outcomes. Impulse control difficulties and lack of emotional clarity emerged as robust mediators. The findings highlight the importance of disentangling specific helicopter parenting behaviors as well as emotion dysregulation as a mechanism of risk, providing useful clinical implications for the improvement of college students' well-being. [ABSTRACT FROM AUTHOR]

Objective: The objective of the present study was to determine the prevalence of addictive behaviors among in-school and out-of-school adolescents of age 13–19 years in Chandigarh, India. Methods: Problem Behavior Theory (PBT) was used to identify the risk and protective factors for addictive problem behaviors among adolescents. Results: A total of 1634 adolescents were included from in-school (n = 1134) and out-of-school (n = 500) categories. The prevalence of addictive behaviors was 19.1% (current smoking 6%, alcohol drinking 6.1%, and drug use 7%) among adolescents aged 13 to 19. Significant predictors of smoking were being male (aOR = 4.43; 95%CI: 1.92,10.20; p <.001) and having a working father (aOR = 3.19; 95%CI: 1.10, 9.20; p <.05). Total protective score [smoking: aOR = 0.99; 95% CI:0.97, 0.99: p <.05; alcohol use: aOR:0.98;95% CI:0.97,0.99; p <.01; drug use: OR:0.99, 95%CI: 0.98,0.99; p <.05] and total risk score [smoking: aOR = 1.14; 95%CI:1.11, 1.17: p <.001; alcohol use: aOR:1.10;95% CI:1.07,1.12; p <.001; drug use: aOR:1.05, 95%CI: 1.04,1.06 p <.001] were significantly associated with all three addictive behaviors. Conclusions: The current study's findings can inform the development of intervention programs focusing on both adolescents and communities (social environment surrounding adolescents) to enhance the protection of adolescents at risk for addictive behaviors. [ABSTRACT FROM AUTHOR]

Background: Research on alcohol-related problems often examines individual problem types in isolation or uses scales that provide a single cumulative severity score for alcohol-related harms. This study aims to assess the patterns of seventeen distinct alcohol-related problems and how they co-occur. Methods: The East Bay Neighborhood Study surveyed a community sample of 864 adults who drank in the past year in Alameda County, California. Participants reported if they experienced each of seventeen alcohol-related problems in the last year. Latent class analysis assessed subgroups of problems. Logistic regression models examined associations between class membership, sociodemographics, and alcohol use. Results: A two-class model best fit the data. The multiple problems class (18% of respondents) was characterized by experiencing problems of all types and almost all experiences of legal, violence, and risky sex-related problems. The none/few problems class (82%) was characterized by a low prevalence of all problem types, with only a small proportion experiencing hangovers. In adjusted models, only older age (AOR = 0.90, 95% CI = 0.88–0.92) had lower odds of multiple problems class membership. Conclusions: Numerous alcohol-related problems co-occurred within a small subgroup of people who drank in the last year, while the majority experienced few problems. Results suggest that focusing on singular alcohol-related problems may overlook patterns of concurrent problems in high-risk groups. [ABSTRACT FROM AUTHOR]

Background: Within the past 30 days, a quarter of U.S. college students reported binge drinking (i.e., consuming ≥ five drinks (male) or ≥ four drinks (female), in about 2 hours). While scholars have refined binge drinking parameters/definitions over time, determining college students' personal characterization of binge drinking is important as misperceptions can directly impact students' alcohol use and associated consequences. Objective: This study explored differences in college students' characterization of binge drinking and the effect of overestimating standardized parameters. Methodology: This study was conducted at a large public university in the Southeast U.S. among college students who violated campus alcohol-use policies (n = 816). Respondents anonymously completed measures of alcohol frequency and quantity, and binge drinking characterization. Analyses explored the relationship between binge drinking parameters and personal alcohol use. Results: Statistically significant differences existed for alcohol consumption between students who underestimated/accurately characterized binge drinking parameters and those who overestimated. Moreover, students who overestimated participated in binge drinking more frequently (p <.001) and were nearly 3.5 times more likely to binge drink than their counterparts. Conclusions: Correcting misperceptions, establishing clear and accurate understandings, and eliminating ambiguity associated with alcohol behaviors and norms should be a priority for college health practitioners and administrators. [ABSTRACT FROM AUTHOR]

Purpose: Previous research on obesity surgery (OS) showed that patients do not only experience weight loss but also improvements in certain mental health outcomes (e.g., depression) after OS. However, self-harm behaviors might increase after OS. Regarding self-harm, the literature is mostly limited to studies using data from hospital or emergency room charts. This longitudinal study examined self-reported self-harm behaviors and potential psychopathological correlates before and after OS. Materials and Methods: Pre-surgery patients (N = 220) filled out a set of questionnaires before and approximately six months after OS. Self-harm behaviors were captured with the Self-Harm Inventory. The assessments further included standardized instruments to measure symptoms of depression, anxiety, eating disorders, alcohol use, and suicidal ideations. Results: Any self-harm was reported by 24.6% before and by 25.0% after OS. No differences in the number of self-harm behaviors or prevalence of any self-harm before and after OS were found. Overall, 11.4% experienced self-harm behaviors at both times. A subset showed self-harm behaviors only before (13.2%) OS and another subset only after OS (13.6%). These two groups were about the same size. Self-harm behaviors showed strong associations with psychopathology after OS, especially with depression and suicidal ideation. Conclusion: No increase in self-harm behaviors after OS emerged. Still, a subgroup showed self-harm behaviors after OS closely linked to further psychopathology. This mirrors the need to implement screening for self-harm before and after OS into OS care. Further studies with longer follow up periods are needed to extend these findings. [ABSTRACT FROM AUTHOR]

Background: Alcohol use is one of the leading public health concerns in the Czech Republic. Drinking motives play a vital role in both initiation and subsequent alcohol use. A revised version of the self-report Drinking Motives Questionnaire (DMQ-R) has been proposed to assess these motives. The present study aims to validate the DMQ-R in the Czech general population. Methods: A total sample of 1,784 Czech participants completed a national survey. For the analysis, only a sub-sample of the past 12 months alcohol users was used: N = 1,123; 52.8% male; mean (SD) age = 40.2 (13.3). Drinking motives were assessed by the adopted Czech version of the DMQ-R. Both confirmatory (CFA) and exploratory factor analysis (EFA) were conducted to examine the factorial structure of the instrument. The age of the participant was additionally considered in the analysis (15–24 years as opposed to 25–64 years). Results: The CFA supported the four-factor model in the 25–64 age group. The analysis supported the construct validity of the Social, Conformity, and Coping factors. The Enhancement factor retained only two items and was found to refer more to a domain of 'Pleasant Feeling'. For the 15–24 age group, the hypothesised four-factor structure was not corroborated. Conclusions: The Czech version of the DMQ-R was found to be a reliable measurement tool of the Social, Conformity, and Coping motives. Future research should investigate the dimensionality of the instrument items presumed to correspond to the Enhancement motives. This should be conducted particularly among adolescents and young adults aged 15–24 years, where administering the DMQ-R with a large enough sample is also needed. [ABSTRACT FROM AUTHOR]

Summary The current exploratory pilot study examined whether social rhythm regularity, as measured by a social rhythm metric, was associated with: (1) the regularity of circadian rhythms and/or sleep regularity metrics; and (2) sleep quality, affective function and alcohol use. Late adolescents (18–22 years old) who drink alcohol (n = 36; 61.1% female, Mage = 21.26 years) completed a 14‐day ecological momentary assessment protocol, wore a wrist actigraph for 14 days, and completed two overnight visits (Thursday and Sunday) to assess dim light melatonin onset. Sleep regularity metrics included standard deviation, composite phase deviation, social jet lag and inter‐daily stability. We used dim light melatonin onset data to calculate the stability of the circadian phase (Sunday minus Thursday). Participants completed surveys and ecological momentary assessments that assessed global and daily sleep quality, affective function, and alcohol use. Correlational analysis and robust regression modelling were used. More regular social rhythms were associated with higher regularities of mid‐sleep timing based on standard deviations, but were not associated with other sleep regularity metrics or stability of the circadian phase. More regular social rhythms were associated with better sleep quality, but were not associated with affective function or alcohol use. Social rhythm regularity is a unique construct compared with existing sleep quality metrics. In contrast with the social zeitgeber hypothesis, social rhythm regularity was not associated with circadian rhythm regularity measured by dim light melatonin onset. However, social rhythm regularity may be an under‐recognized contributor to better sleep quality. [ABSTRACT FROM AUTHOR]

Background: Some studies suggest that elite athletes experience adverse mental health symptoms at rates commensurate with the general population, despite the well-established buffering effects of exercise. Within contact sports, such as ice-hockey, recurrent concussions may be a source of this discrepancy. We compared the point prevalence of various mental health outcomes with other athlete and general population samples, as well as investigated their relationship with concussive events. Methods: We surveyed 648 active ice hockey players from the top two men's tiers and the top women's tier in Swedish elite ice hockey on lifetime concussive events, hazardous alcohol use, problematic social media use, depression, anxiety, and burnout. Results: Hazardous alcohol use was more prevalent among male ice hockey players (29.5% AUDIT-C ≥ 6) compared to other athlete and general population samples, while other mental health symptoms were less common. Female ice hockey players reported higher hazardous alcohol consumption (36.4% AUDIT-C ≥ 4) than another athlete sample and more burnout (19.1%) than the general population. After adjusting for covariates, athletes with 3+ concussive events had 2.1 times the odds of elevated depressive symptoms and 3.5 times the odds of elevated burnout symptoms compared to those with no concussion history. Treating lifetime concussive events as a continuous predictor revealed positive correlations with all outcomes except for hazardous alcohol use. Conclusions: Mental health outcome rates among active elite ice hockey athletes differ from those of other athlete and general population samples, whilst concussive events may be particularly linked to elevated symptoms of depression and burnout. [ABSTRACT FROM AUTHOR]

Background: The use of substances such as alcohol, tobacco, khat, or drugs among young people is becoming a public health concern globally, with particularly high prevalence rates in low and middle-income settings, where socio-cultural and economic factors contribute to distinct challenges in addressing this problem. This review aimed to summarize the current literature on the prevalence of substance use among young people in sub-Saharan Africa (SSA) and identify gaps in the current body of literature. Methods: Seven databases and Google were searched for studies reporting on substance use prevalence among young people (aged 10-24 years) in SSA, published between January 2010 and May 2024. Observational studies were included, assessed for methodological quality, and checked for the presence of heterogeneity and publication bias using standard methods. A random effect model was used to estimate the pooled proportions for substance use among young people. Results: The literature search identified 1,889 hits from the databases and Google. Among these 60 eligible studies involving 83,859 respondents were included in the review. The overall lifetime, 12-month, and current prevalence of any substance use among young people in SSA was found to be 21.0% (95% CI= 18.0, 24.0), 18% (95% CI=10,27), and 15% (95% CI=12,18), respectively. Among young people from SSA, alcohol use problem was the most prevalent (40%), followed by khat use (25%), stimulant use (20%), and cigarette smoking (16%). Other substances used by a smaller proportion of young people included cannabis, cocaine, inhalants, sedatives, shisha, hallucinogens, steroids, and mastics. The prevalence of substance use problems was higher among males compared to females, highest in the southern African region followed byWestern and Eastern regions, and in community-based studies compared to institutional- based studies. Conclusions: In SSA, over a fourth of young people use at least one substance in their lifetime, with higher rates among males than females and in community-based compared to institution-based studies. These results emphasize the need for interventions targeting the wider young population and those in specific subgroups identified as being at higher risk of substance use. This approach allows for the provision of tailored support and resources to those who need it most while also promoting positive health outcomes for the entire population of young people in the region. [ABSTRACT FROM AUTHOR]

Introduction: Co-occurring substance use and other mental health disorders are prevalent among adolescents who access mental health services and substance abuse treatment, reflecting the growing recognition of multimorbidity across all healthcare settings. Young people with concurrent disorders have substantial issues with their mental health as well as their substance use behavior. This makes it difficult for them to function on a daily basis. Objectives: The goal of this systematic review is to review the extent of mental illness and substance use comorbidity in East Africa. Methods: This systematic review and meta-analysis were conducted in line with the PRISMA guidelines. We conducted a search of 5 bibliographic databases (PubMed, science direct, Cochrane library, AAU repository, and Google scholar) from 2005 until December 2023. The results of eligible studies have been summarized descriptively and organized by three broad categories including: studies evaluating the epidemiology of substance use among mentally ill patients, studies evaluating the epidemiology of mental illness among substance use and studies evaluating the epidemiology of comorbidity of substance use and mental illness. The quality of the included studies was assessed with Agency for Healthcare Research and Quality tool. Result: Among the 15 eligible studies, eleven focused on examining the extent of mental illness in individuals with substance use, while nine explored the prevalence of substance use among those with mental illnesses. Almost all articles were published by male researchers. Ten studies delved into the coexistence of substance use and mental illness. Limited research has been conducted on the epidemiology of severe mental illness, perinatal mental illness, hallucinogen use, injectable drug use, and prescription medication. Vulnerable populations, including pregnant women, children, and individuals with physical disabilities, have been inadequately represented. Conclusion and recommendations: The majority of studies indicated there was a significant burden of alcohol use and depression disorder in the adult population. Prioritizing integrated approaches within all rehabilitation centres is crucial to addressing the distinctive needs and challenges encountered by individuals with mental illness. [ABSTRACT FROM AUTHOR]

Adults experiencing homelessness (AEH) are more likely to engage in risky alcohol use compared to adults in the general population. Nonetheless, relatively little is known about the naturalistic settings of alcohol use among AEH. We integrate risk terrain modeling (RTM) with geographically-explicit ecological momentary assessments (GEMAs) to identify the environmental characteristics of drinking locations among AEH in Dallas, Texas. Participants were given a study-provided smartphone pre-installed with the InsightTM application and instructed to self-initiate a GEMA when they were about to consume their first drink of the day over the duration of four weeks. Participants who used this app feature to report alcohol use were included in the analytic sample (N = 22). RTMs estimated the spatial influence of environmental features associated with alcohol availability and risky community features located in the city limits of Dallas, as well as in downtown Dallas. Across the City-Wide and Central Division analyses, proximity to food banks/shelters and public libraries are spatially associated with event locations of AEH alcohol use. Clusters of liquor stores and grocery stores are also significantly related to alcohol event locations. Findings provide insight into the geographical context of alcohol use among AEH and have implications for researchers and practitioners. [ABSTRACT FROM AUTHOR]

AbstractThe American Indian Enculturation Scale (AIES) was developed for American Indian populations to measure connection to traditional culture, but it has not been evaluated in Alaska Native people. While American Indian and Alaska Native individuals are grouped together, significant differences exist between groups. As a part of a randomized controlled trial for contingency management to reduce alcohol use, 160 Alaska Native adults completed the AIES. The confirmatory factor analysis indicated that a one-factor, 15-item version of the AIES, removing items 1 and 2 and correlating items 8 and 10, was a reliable (15 items; α = 0.896) and valid measure in this sample (χ2 [89] = 155.788, p<.001; CFI = 0.903; TLI = 0.886; RMSEA = 0.068 [90% confidence interval {CI} 0.050–0.086]; p<.001; SRMR = 0.060). The study provides limited evidence of enculturation’s structural validity, as measured by the AIES, for Alaska Native adults. Future confirmatory work and potential adaptation is needed to evaluate the empirical utility of the AIES for Alaska Native individuals seeking help to reduce alcohol use. [ABSTRACT FROM AUTHOR]

Background: Sexual behaviors, particularly risky sexual behavior, has become a serious public health concern among adolescents worldwide, presenting a substantial obstacle to the prevention of sexually transmitted infections, including human immunodeficiency virus (HIV). However, there is limited research using consistent and standardized methodology to examine associations between tobacco and alcohol use frequency and both total and risky sexual behaviors among adolescents. We aimed to examine the association between tobacco and/or alcohol use with both total and risky sexual behaviors among adolescents worldwide. Methods: Data were collected from the Global School-based Student Health Survey, which comprised 211,847 adolescents aged 12–17 years from 59 countries. The frequency of tobacco or alcohol use during the past 30 days was categorized as 0, 1–2, 3–5, 6–9, or ≥ 10 days. Tobacco and alcohol use were also categorized as non-use, tobacco use alone, alcohol use alone, and combined use. Multi-variable logistic regression analysis was used to examine both the independent and combined associations of tobacco and alcohol use with total and risky sexual behaviors. Results: Compared with no tobacco use, the odds ratio of engaging in sexual intercourse increased with the frequency of tobacco use from 1 to 2 days to ≥ 10 days (total: 2.03 [95% confidence interval 1.47–2.81] to 3.98[2.63–6.03]; risky: 2.43[1.75–3.38] to 4.21[3.26–5.42]), as well as with the frequency of alcohol use. Overall, combined users had greater likelihood of both total and risky sexual behaviors than tobacco users alone, alcohol users alone, and non-users. Similarly, the association between risky sexual behaviors and tobacco use alone was more pronounced among adolescent girls (vs. adolescent boys), as were those of risky sexual behaviors with alcohol use alone among younger adolescents aged 12–14 years (vs. aged 15–17 years) and with tobacco and/or alcohol use among adolescents in the Western Pacific region (vs. Regions of Africa and Americas). Conclusions: Our findings suggest independent and combined associations between tobacco and/or alcohol use with sexual behaviors among adolescents, with variations across age, sex, and WHO region. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to explore Muslim's perceptions and views of raising awareness on safe alcohol use and counterfeit alcohol harms in Islamic countries. Subject and methods: Qualitative semi-structured interviews with a purposive sample from the Gulf Council Cooperation (GCC) countries. The data were analysed using a reflexive thematic analysis method. Results: Twenty-three participants took part in this study. We have identified five themes from the data, including perceptions on alcohol use in the GCC, community's openness to alcohol discussions, approaches to raising awareness on alcohol use, all forbidden is desirable, and legalisation is the solution. All participants acknowledged the existence of alcohol use in GCC communities and advocated for the need to raise public awareness about the harms of alcohol use. Opinions on approaches to raising awareness varied. Some participants suggested focusing awareness on the religious messages prohibiting alcohol use, emphasising that alcohol is harmful in any quantity. For some, raising awareness of safe alcohol consumption was viewed as accepting and encouraging alcohol use, which goes against Islamic religious beliefs. Some participants attributed alcohol misuse and the consumption of counterfeit alcohol to the ban on alcohol products in some GCC countries. Conclusions: Muslims acknowledge the existence of alcohol use in Muslim communities, yet there is a hesitancy in raising awareness of safe alcohol use. Although challenging, there is a need to combine the public health perspective on safe alcohol use while providing messages that acknowledge the religious aspect. [ABSTRACT FROM AUTHOR]