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Background and Aims: Behavioral economic theory predicts that high alcohol demand and high proportionate alcohol‐related reinforcement are important determinants of risky alcohol use in emerging adults, but the majority of research to date has been cross‐sectional in nature. The present study investigated prospective and dynamic relationships between alcohol demand and proportionate alcohol‐related reinforcement in relation to heavy drinking days and alcohol problems. Design: Longitudinal cohort with assessments every 4 months for 20 months. Setting: Ontario, Canada. Participants: Emerging adults reporting regular heavy episodic drinking (n = 636, Mage = 21.44; 55.8% female). Measurements Heavy drinking days (HDD; Daily Drinking Questionnaire), alcohol problems (Brief Young Adult Alcohol Consequences Questionnaire), alcohol demand (Alcohol Purchase Task) and proportionate alcohol‐related reinforcement (Activity Level Questionnaire). Findings Linear mixed effects models revealed that behavioral economic indicators and alcohol‐related outcomes significantly decreased over the study, consistent with 'aging out' of risky alcohol use. Random intercept cross‐lagged panel models revealed significant between‐person relationships, such that higher alcohol demand and alcohol‐related reinforcement were positively associated with HDD and alcohol problems (random intercepts = 0.187–0.534, Ps < 0.01). Moreover, alcohol demand indicators (particularly the rate of change in elasticity of the demand curve, as measured by α, and the maximum expenditure, Omax) and proportionate alcohol‐related reinforcement significantly forecasted changes in HDD at all time points (|βs| = 0.063–0.103, Ps < 0.05) in cross‐lagged relationships, with bidirectional associations noted for the rate of change in elasticity (βs = −0.085 to −0.104, Ps < 0.01). Proportionate alcohol‐related reinforcement also significantly forecasted changes in alcohol problems at all time points (βs = 0.072–0.112, Ps < 0.01). Conclusions: Multiple behavioral economic indicators (demand elasticity, maximum expenditure and reinforcement ratio) forecast changes in heavy episodic drinking and alcohol problems over the course of emerging adulthood. These results further implicate alcohol demand and proportionate alcohol‐related reinforcement as etiologically and developmentally important mechanisms in alcohol use trajectories. [ABSTRACT FROM AUTHOR]

Aims This study uses a high-resolution phenome-wide approach to evaluate the motivational mechanisms of polygenic risk scores (PRSs) that have been robustly associated with coarse alcohol phenotypes in large-scale studies. Methods In a community-based sample of 1534 Europeans, we examined genome-wide PRSs for the Alcohol Use Disorders Identification Test (AUDIT), drinks per week, alcohol use disorder (AUD), problematic alcohol use (PAU), and general addiction, in relation to 42 curated phenotypes. The curated phenotypes were in seven categories: alcohol consumption, alcohol reinforcing value, drinking motives, other addictive behaviors, commonly comorbid psychiatric syndromes, impulsivity, and personality traits. Results The PRS for each alcohol phenotype was validated via its within-sample association with the corresponding phenotype (adjusted R2s = 0.35–1.68%, P s = 0.012–3.6 × 10−7) with the exception of AUD. All PRSs were positively associated with alcohol reinforcing value and drinking motives, with the strongest effects from AUDIT-consumption (adjusted R2s = 0.45–1.33%, P s = 0.006–3.6 × 10−5) and drinks per week PRSs (adjusted R2s = 0.52–2.28%, P s = 0.004–6.6 × 10−9). Furthermore, the PAU and drinks per week PRSs were positively associated with adverse childhood experiences (adjusted R2s = 0.6–0.7%, P s = 0.0001–4.8 × 10−4). Conclusions These results implicate alcohol reinforcing value and drinking motives as genetically-influenced mechanisms using PRSs for the first time. The findings also highlight the value of dissecting genetic influence on alcohol involvement through diverse phenotypic risk pathways but also the need for future studies with both phenotypic richness and larger samples. [ABSTRACT FROM AUTHOR]

Few multi-wave longitudinal studies have examined changes in drinking across extended periods of the coronavirus 2019 (COVID-19) pandemic. Using multiple indicators over three years, the current study examined: a) overall drinking changes; b) sex, income, age, and pre-COVID drinking level as moderators of changes; and c) the clinical significance of the observed changes. Using a longitudinal observational cohort design with nonclinical adults from the general community (N = 1395), assessments were collected over nine waves, two pre-COVID (April 2019 and October 2019) and seven intra-COVID (April 2020–April 2022). Drinking was measured as percent drinking days, percent heavy drinking days, and the Alcohol Use Disorders Identification Test (AUDIT) score. Clinically significant changes were defined based on the World Health Organization risk levels. All indicators exhibited significant changes from pre-pandemic to intra-pandemic periods, with drinking changes comprising early pandemic increases followed by subsequent decreases and AUDIT scores consistently declining. Pre-pandemic drinking level substantially moderated all changes. Heavier drinkers exhibited larger decreases compared to other drinking groups. In terms of clinically important changes, ∼10% of pre-pandemic abstinent or low-risk drinkers transitioned to medium- or high-risk status during the pandemic. In contrast, 37.1% of medium-risk drinkers and 44.6% of high-risk drinkers exhibited clinically significant decreases during the intra-pandemic period. Collectively, these findings highlight the multifarious impacts of the pandemic on drinking over time, comprising both increases and decreases in drinking behaviour. [ABSTRACT FROM AUTHOR]

Impulsivity refers to a number of conceptually related phenotypes reflecting self‐regulatory capacity that are considered promising endophenotypes for mental and physical health. Measures of impulsivity can be broadly grouped into three domains, namely, impulsive choice, impulsive action, and impulsive personality traits. In a community‐based sample of ancestral Europeans (n = 1534), we conducted genome‐wide association studies (GWASs) of impulsive choice (delay discounting), impulsive action (behavioral inhibition), and impulsive personality traits (UPPS‐P), and evaluated 11 polygenic risk scores (PRSs) of phenotypes previously linked to self‐regulation. Although there were no individual genome‐wide significant hits, the neuroticism PRS was positively associated with negative urgency (adjusted R2 = 1.61%, p = 3.6 × 10−7) and the educational attainment PRS was inversely associated with delay discounting (adjusted R2 = 1.68%, p = 2.2 × 10−7). There was also evidence implicating PRSs of attention‐deficit/hyperactivity disorder, externalizing, risk‐taking, smoking cessation, smoking initiation, and body mass index with one or more impulsivity phenotypes (adjusted R2s: 0.35%–1.07%; FDR adjusted ps = 0.05–0.0006). These significant associations between PRSs and impulsivity phenotypes are consistent with established genetic correlations. The combined PRS explained 0.91%–2.46% of the phenotypic variance for individual impulsivity measures, corresponding to 8.7%–32.5% of their reported single‐nucleotide polymorphism (SNP)‐based heritability, suggesting a non‐negligible portion of the SNP‐based heritability can be recovered by PRSs. These results support the predictive validity and utility of PRSs, even derived from related phenotypes, to inform the genetics of impulsivity phenotypes. [ABSTRACT FROM AUTHOR]

• This is the first study to examine cannabis use changes across clinical ED groups. • A general decrease in regular cannabis use occurred between 2004 and 2014. • In 2014 a breakpoint occurred, whereafter regular cannabis use rates began to rise. • Relaxation of medical cannabis laws coincides with increasing cannabis use rates. • Comorbid psychiatric diagnoses did not increase the odds of regular cannabis use. Regular cannabis use (CU), defined as "weekly or more often", is associated with a number of negative mental health outcomes. In the last decade, Canada legalized first medical and then recreational CU. Despite higher prevalence in mental health populations, little research has documented changes in frequency of CU with progressive legalization of cannabis. This study examined rates of CU in a sample of 843 treatment-seeking patients with eating disorders (ED) in an outpatient setting between 2004 and 2020. Across ED diagnoses, segmented regression indicated a significant break-point in regular CU in 2014, commensurate with the relaxation of medical cannabis laws. Regular CU increased from 4.9 % to 23.7 % from 2014 to 2020; well above the stable 6 % found in the general population. No significant break-point was observed in either alcohol or illicit substance use over the same time period. Significant increases in regular CU were found in patients with anorexia nervosa and binge eating disorder, while regular use remained stable in patients with bulimia nervosa. Comorbid psychiatric diagnoses did not increase odds of regular CU. Findings suggest certain patient groups with mental illness may be at risk of engaging in high frequency use in the context of legislation implying medical benefits of cannabis. [ABSTRACT FROM AUTHOR]

• The MPT reliably measures demand for legal and illegal cannabis in Spanish young adults. • Legal and illegal demand was elevated in hazardous vs. non-hazardous cannabis users. • Hazardous users exhibited higher breakpoint and Omax for illegal cannabis. • Breakpoint and Pmax discriminated well between cannabis users. In October 2021, a legal framework that regulates cannabis for recreational purposes in Spain was proposed, but research on its potential impacts on cannabis use is currently limited. This study examined the reliability and discriminant validity of two Marijuana Purchase Tasks (MPTs) for measuring hypothetical legal and illegal cannabis demand, and to examine differences in demand of both commodities in young adults at hazardous vs. non-hazardous cannabis use risk levels. A total of 171 Spanish young adults [M age = 19.82 (SD = 1.81)] with past-month cannabis use participated in a cross-sectional study from September to November 2021. Two 27-item MPTs were used to estimate hypothetical demand for legal and illegal cannabis independently. The Cannabis Use Disorder Identification Test (CUDIT-R) was used to assess hazardous cannabis use and test for discriminant validity of the MPTs. Reliability analyses were conducted using Classical Test Theory (Cronbach's alpha) and Item Response Theory (Item Information Functions). The MPT was reliable for measuring legal (α = 0.94) and illegal (α = 0.90) cannabis demand. Breakpoint (price at which demand ceases), and P max (price associated with maximum expenditure) were the most sensitive indicators to discriminate participants with different levels of the cannabis reinforcing trait. No significant differences between legal and illegal cannabis demand in the whole sample were observed, but hazardous vs. non-hazardous users showed higher legal and illegal demand, and decreased Breakpoint and P max if cannabis were legal vs illegal. The MPT exhibits robust psychometric validity and may be useful to inform on cannabis regulatory science in Spain. [ABSTRACT FROM AUTHOR]

Background: There are concerns that the coronavirus disease 2019 (COVID‐19) pandemic may increase drinking, but most accounts to date are cross‐sectional studies of self‐attributions about alcohol‐related impacts and the accuracy of those perceptions has not been investigated. The current study examined the correspondence between self‐attributions of pandemic‐related changes in drinking and longitudinally‐measured changes in drinking and alcohol‐related consequences in a sample of emerging adults. Methods: In an existing ongoing longitudinal study on alcohol misuse (≥1 heavy episodic drinking day/month) in emerging adults, 473 individuals (Mage = 23.8; 41.7% male) received a supplemental assessment from June 17th to July 1st, 2020, during public health restrictions in Ontario, Canada. These intrapandemic data were matched to the most recent assessment prior to the pandemic (~8 months earlier). Self‐attributions about changes in drinking were assessed globally (i.e., increases/decreases/no change) and with higher resolution questions clarifying the magnitude of changes. Results: Global self‐attributions about changes in drinking substantively paralleled longitudinal changes in weekly drinking days (DD). In the longitudinal data, individuals' who self‐reported increases in drinking exhibited significant increases; individuals' who self‐reported decreases exhibited significant decreases; and individuals who self‐reported no change exhibited nonsignificant changes. Higher resolution items likewise revealed longitudinal patterns of weekly drinking that were substantively consistent with self‐attributions. Heavy DD and alcohol‐related consequences exhibited similar patterns, but only individuals who self‐reported large increases in drinking exhibited increases on these outcomes. Individuals who reported large increases in drinking also exhibited significant increases in depression and posttraumatic stress disorder symptoms. Conclusions: Self‐attributions about drinking closely corresponded to longitudinal changes in drinking, supporting the validity of self‐attributions in population‐level surveys, particularly in young adults. Notably, a subgroup was identified that exhibited pronounced increases for all alcohol‐related outcomes and concurrent increases in internalizing psychopathology. [ABSTRACT FROM AUTHOR]

Background: There are significant concerns that the COVID‐19 pandemic may have negative effects on substance use and mental health, but most studies to date are cross‐sectional. In a sample of emerging adults, over a two‐week period during the pandemic, the current study examined: (1) changes in drinking‐related outcomes, depression, anxiety, and posttraumatic stress disorder and (2) differences in changes by sex and income loss. The intra‐pandemic measures were compared to pre‐pandemic measures. Methods: Participants were 473 emerging adults (Mage = 23.84; 41.7% male) in an existing longitudinal study on alcohol misuse who were assessed from June 17 to July 1, 2020, during acute public health restrictions in Ontario, Canada. These intra‐pandemic data were matched to participant pre‐pandemic reports, collected an average of 5 months earlier. Assessments included validated measures of drinking, alcohol‐related consequences, and mental health indicators. Results: Longitudinal analyses revealed significant decreases in heavy drinking and adverse alcohol consequences, with no moderation by sex or income loss, but with substantial heterogeneity in changes. Significant increases in continuous measures of depression and anxiety were present, both of which were moderated by sex. Females reported significantly larger increases in depression and anxiety. Income loss >50% was significantly associated with increases in depression. Conclusions: During the initial phase of the pandemic, reductions in heavy drinking and alcohol consequences were present in this sample of emerging adults, perhaps due to restrictions on socializing. In contrast, there was an increase in internalizing symptoms , especially in females, highlighting disparities in the mental health impacts of the pandemic. [ABSTRACT FROM AUTHOR]

• Intra-COVID PTSD symptomatology changes differed by pre-pandemic severity and symptom cluster. • Intra-COVID, the pre-pandemic low-PTSD subgroup exhibited increases overall and in Clusters B and C. • Intra-COVID, the pre-pandemic high-PTSD subgroup exhibited decreases overall and for all clusters. • Clinically important decreases were present in 42% of the pre-pandemic high-PTSD subgroup. Few studies have examined changes in posttraumatic-stress disorder (PTSD) symptomatology across an extended time period during the COVID-19 pandemic. This study used a longitudinal cohort design to examine: (1) changes in overall PTSD symptoms and symptom clusters; (2) moderators of change; (3) the clinical significance of observed changes; and (4) correlates of clinically meaningful changes. Community adults (N = 1412) were assessed using the PTSD Checklist for DSM-5 (PCL-5) at 10 timepoints (October 2018 - April 2022). Changes in overall PCL-5 score and symptom clusters were substantially moderated by pre-pandemic clinical severity (i.e., above/below PCL-5 cut-off). Pre-pandemic non-clinical participants exhibited increases in overall scores, Cluster D (negative cognitions), and Cluster E (arousal), while clinically elevated participants exhibited decreases overall and in all clusters. Regarding clinical significance, 12% of pre-pandemic non-clinical participants exhibited clinically meaningful increases, and 4% exhibited decreases. Conversely, 42% of the pre-pandemic elevated group exhibited clinically meaningful decreases, while 6% exhibited increases. Pandemic impacts in numerous psychosocial domains were associated with clinically meaningful change. Collectively, these findings reveal substantively divergent trajectories by pre-pandemic severity and PTSD symptom cluster. The large proportion of pre-pandemic high-severity participants exhibiting sizable decreases was an unexpected notable observation. [ABSTRACT FROM AUTHOR]

• Examined changes in depression and anxiety prior to and during the COVID-19 pandemic. • Depression and anxiety significantly increased initially, followed by subsequent decreases. • Pre-pandemic lower severity was associated with modest intra-pandemic increases. • Pre-pandemic higher severity was associated with higher intra-pandemic decreases. • Pre-pandemic higher severity had the highest rates of clinically important decreases. Few multi-wave longitudinal studies have examined mental health changes across the coronavirus 2019 (COVID-19) pandemic. The current study examined: (a) overall changes in depression and anxiety over 10-waves of data collection; (b) subgroup moderators of changes; (c) clinical severity of the changes via minimally important differences (MIDs); and (d) correlates of clinically important changes. Using a longitudinal observational cohort design, 1412 non-clinical adults (Mage=36; 60% female) were assessed for depression and anxiety via the PHQ-9 and GAD-7 from October 2018 to April 2022 (3 pre-pandemic, 7 intra-pandemic waves; M retention = 92%). Depression and anxiety exhibited significant intra-pandemic changes, reflecting initial increases, followed by decreases. Pre-pandemic severity moderated changes, with low severity participants exhibiting increases and high severity participants exhibiting non-significant change or decreases. For depression and anxiety, respectively, 10% and 11% exhibited MID increases, while 4% and 6% exhibited MID decreases. Divergent patterns were present by severity subgroup, with the lowest severity exhibiting higher rates of MID increases and the highest severity subgroup exhibiting higher rates of MID decreases. These findings illuminate the periodicity of depression and anxiety during the COVID-19 pandemic and reveal an unexpected inverse relationship between increases and decreases based on pre-pandemic severity. [ABSTRACT FROM AUTHOR]

Background: Canada legalized cannabis for non-medical purposes federally in October 2018. This study examined changes in cannabis use over the following year in a sample of general community adults. A secondary aim was to examine forecasted cannabis use following legalization in relation to actual post-legalization cannabis use.Methods: Participants were 1502 community adults (61 % female; age M = 34.60 ± 13.95), with approximately half reporting any cannabis use in the six months prior to legalization (Cannabis+ group [48 %]/Cannabis- group [52 %]). Self-report assessments were conducted in the month before cannabis legalization, 6-months post-legalization and 12-months post-legalization. Primary outcomes were frequency of cannabis use, grams of dried flower cannabis on days used, and level of misuse (Cannabis Use Disorder Identification Test - Revised). Secondary analyses examined pre-legalization personal forecasts in relation to post-legalization cannabis use.Results: Statistically significant main effects of time (ps<.001), cannabis use status (ps<.001), and time × cannabis use status interactions (ps<.001) were present for cannabis frequency, quantity, and level of misuse. In each case, the interactions reflected significant decreases in the Cannabis+ group, but significant increases in the Cannabis- group. Approximately 15 % of participants erroneously forecasted their personal post-legalization cannabis use, with discrepancies most commonly being individuals who were not using prior to legalization subsequently using cannabis.Conclusions: In this cohort of community adults, we observed significant changes over the first year following Canadian legalization, with divergent trajectories based on pre-legalization cannabis use. These findings suggest multifarious impacts of legalization in adults, with meaningfully different trajectories among subgroups. [ABSTRACT FROM AUTHOR]

Background and aims: The Marijuana Purchase Task (MPT) is increasingly used to measure cannabis reinforcing value and has potential use for cannabis etiological and regulatory research. This meta‐analysis sought to evaluate for the first time the MPT's concurrent validity in relation to cannabis involvement. Methods: Electronic databases and pre‐print repositories were searched for MPT studies that examined the cross‐sectional relationship between frequency and quantity of cannabis use, problems, dependence, and five MPT indicators: intensity (i.e. unrestricted consumption), Omax (i.e. maximum consumption), Pmax (i.e. price at which demand becomes elastic), breakpoint (i.e. first price at which consumption ceases), and elasticity (i.e. sensitivity to rising costs). Random effects meta‐analyses of cross‐sectional effect sizes were conducted, with Q tests for examining differences by cannabis variables, meta‐regression to test quantitative moderators, and publication bias assessment. Moderators included sex, number of MPT prices, variable transformations, and year of publication. Populations included community and clinical samples. Results: The searches yielded 14 studies (n = 4077, median % females: 44.8%: weighted average age = 29.08 [SD = 6.82]), published between 2015 and 2022. Intensity, Omax, and elasticity showed the most robust concurrent validity (|r's| = 0.147–325, ps < 0.014) with the largest significant effect sizes for quantity (|r| intensity = 0.325) and cannabis dependence (|r| Omax = 0.320, |r| intensity = 0.305, |r| elasticity = 0.303). Higher proportion of males was associated with increased estimates for elasticity‐quantity and Pmax‐problems. Higher number of MPT prices significantly altered magnitude of effects sizes for Pmax and problems, suggesting biased estimations if excessively low prices are considered. Methodological quality was generally good, and minimal evidence of publication bias was observed. Conclusions: The marijuana purchase task presents adequate concurrent validity to measure cannabis demand, most robustly for intensity, Omax, and elasticity. Moderating effects by sex suggest potentially meaningful sex differences in the reinforcing value of cannabis. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has been associated with major psychosocial disruptions and there is particular concern for individuals with substance use disorders. Objectives: This study characterized the psychosocial and experiential impacts of the pandemic on individuals seeking alcohol use disorder (AUD) recovery, including pandemic impacts on self-reported drinking, heavy drinking, tobacco, cannabis, and stimulant use. Methods: Participants were 125 AUD+ individuals (% males: 57.60; Mage = 49.11, SD = 12.13) reporting on substance use from January 1st–24th March, 2020 (pre-pandemic) and since the stay-at-home orders commenced, 24th March–June 28th 2020 (intra-pandemic). Within-subjects changes were examined and a latent profile analysis was performed to identify subgroups differentially impacted by the pandemic. Results: Large proportions reported psychosocial impacts of COVID-19, but drinking and other substance use did not reveal significant changes. Latent profile analyses revealed two subgroups: Profile 1 (n = 41/125), "Moderately Impacted") and Profile 2 (n = 84/125), "Severely Impacted"). Compared to the pre-pandemic period, the group that was moderately impacted by the pandemic exhibited significantly fewer heavy drinking days (p =.02) during the intra-pandemic period, but no other substance use changes. The group showing severe pandemic impacts did not exhibit changes in alcohol or other drug use but evidenced more severe anxiety and depression (ps <.001). Conclusions: We found heterogeneous subtypes of pandemic-related impacts in AUD recovery patients. There is need to provide psychosocial support to this particular population and further monitoring substance use and mental health. [ABSTRACT FROM AUTHOR]