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This study tested a theoretical model of alcohol use, markers of extreme intoxication, and risk behavior as a function of trait affect, distress tolerance, and affect-based behavior dysregulation. Positive affective pathways to risk behavior were primarily expected to be indirect via high levels of alcohol use, while negative affect paths were expected to be more directly associated with engagement in risk behavior. In addition, we expected trait affectivity and distress tolerance would primarily exhibit relationships with alcohol use and problems through behavioral dysregulation occurring during extreme affective states. To evaluate these hypotheses, we tested a SEM with three alcohol-related outcomes: "Typical" alcohol use, "blackout" drinking, and risk behavior. High trait negative affect and low tolerance for affective distress contribute to difficulty controlling behavior when negatively aroused and this is directly associated with increased risk behavior when drinking. In contrast, associations between positive urgency and risk behaviors are indirect via increased alcohol consumption. Positive affectivity exhibited both inverse and positive effects in the model, with the net effect on alcohol outcomes being insignificant. These findings contribute important information about the distinct pathways between affect, alcohol use, and alcohol-involved risk behavior among college students. [ABSTRACT FROM AUTHOR]

Affect regulation models posit that aversive affective states drive binge-eating behavior, which then regulates negative emotions. However, recent findings among individuals with binge-eating disorder (BED) suggest that food-related anticipatory processes may precede and potentially explain the negative affect thought to drive binge eating. Specifically, studies using ecological momentary assessment (EMA) demonstrate that the negative affective state of "Guilt" (from the Positive and Negative Affect Schedule) most strongly predicts later binge eating in the natural environment, and it has been hypothesized that planning a binge or feeling that a binge-eating episode is inventible may account for the increases in Guilt observed prior to binge episodes. In the present study, we tested the hypothesis that binge planning or inevitability may contribute to feelings of shame (a key facet of the broader Guilt construct), which then predict binge-eating episodes, using EMA in 43 individuals with BED. Consistent with hypotheses, feelings of binge inevitability and planning prospectively predicted binge-eating episodes. Further, binge planning predicted subsequent increases in shame. However, shame did not predict subsequent increases in binge planning. Finally, a mediation model revealed that binge planning (Time 1) predicted future binge eating (Time 3) directly and indirectly through increases in shame (Time 2). The results provide novel evidence that individuals with BED anticipate and actively plan for binge-eating episodes, and that binge planning may explain the increased shame/guilt typically observed before binge eating. Overall, accruing evidence suggests that negative affect, although predictive of binge eating, may be better conceptualized as a consequence of the anticipatory processes that lead to binge eating, rather than the starting point, at least among some individuals with BED. Future experimental research is needed to more conclusively test this hypothesis., Competing Interests: Declaration of competing interest None. The lead author has full access to the data reported in the manuscript. These data are available upon reasonable request., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Studies indicate that physical appearance changes affect a significant proportion of breast cancer survivors, often leading to post-surgical distress. Both reconstructive surgery and medical tattoos are associated with patient-reported satisfaction, yet further research is necessary to understand their combined impact on aesthetic outcomes from the patient perspective. This study examined how breast cancer survivors evaluated the cosmetic and decision satisfaction of other patients who made various cosmetic intervention choices post-mastectomy., Methods: Breast cancer survivor support networks (n = 180) across 20 states agreed to share information about the online survey to their members. Participants (n = 251) rated the cosmetic outcome and decision satisfaction of images depicting other patients who had received mastectomy with three types of intervention: reconstruction alone, medical tattooing alone (flat closure), and reconstruction and medical tattooing combined., Results: A factorial MANOVA produced significant within-subjects effects indicating participants consistently rated images of patients with a combination of reconstruction and medical tattooing highest in cosmetic quality, lowest in scar visibility, and highest in treatment decision satisfaction., Conclusions: The findings suggest that medical tattooing serves as a valuable complementary cosmetic intervention, with many survivors expressing interest and recognizing potential benefits once informed about the option. However, the study's limitations, such as the need for a more diverse range of patient images for evaluation, should be acknowledged. Future research should address these gaps by incorporating photographs of patients across varying demographics, including age, body weight, disease severity, and surgical procedures, to minimize bias. Despite these limitations, this study highlights the significant role that medical tattooing can play in enhancing aesthetic outcomes after surgery, particularly from a patient-centered perspective., Level of Evidence Iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://link.springer.com/journal/00266 ., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Sexual minority youth are more likely to engage in Non-Suicidal Self-Injury (NSSI) than their heterosexual peers, and sexual minority women demonstrate greater risk of NSSI than their sexual minority male counterparts. However, a lack of research exists on NSSI among young sexual minority women, particularly their NSSI disclosure experiences. We used a descriptive-interpretive, qualitative design with semi-structured interviews to examine young sexual minority women's lived experiences disclosing NSSI and of others' responses to these disclosures. The sample included 65 sexual minority women aged 14-30 recruited via paid social media advertising from across the U.S. We performed an inductive thematic analysis of transcripts from 58 participants (89%) who reported a history of NSSI. Participants shared reasons for disclosure (wanting help, communicating distress) or nondisclosure (cultural stigmas), types of disclosure (accidental/involuntary, and direct/voluntary), and recipients of a disclosure (friends, partners, mental health providers, and parents). They also described responses to, and feelings after, NSSI disclosure, revealing two themes: i) Unhelpful/stigmatizing responses (based on fear, anger, and apathy) and ii) Helpful/destigmatizing responses (expressions of concern, emotional support, and alternative coping strategies). Overall, young sexual minority women's disclosure experiences were consistent with those of other populations, highlighting the need to further reduce stigma about NSSI, as well as sexual minority identities, and provide universal education promoting helpful responses to NSSI disclosure., Competing Interests: Conflict of interest: The authors declare no potential conflict of interest, and all authors confirm accuracy., (Copyright © 2024, the Author(s).)

Objective: Prior research has indicated that outcome expectancies, sensitivity to punishment, and sensitivity to reward may predict harmful health behaviors concurrently, including disordered eating. Loss-of-control eating (LOCE), feeling unable to resist eating or stop once one has started, is associated with expectancies that eating alleviates negative affect (NA reduction expectancies) and expectancies that eating is rewarding (reward expectancies)., Method: A survey battery was administered examining LOCE pathology, sensitivity to punishment, sensitivity to reward, and eating expectancies to a sample of 1660 adults in the United States ( M age  = 39.24 (14.51), 73.86% assigned female at birth). It was hypothesized that sensitivity to punishment would have a potentiating effect on the relationship between NA reduction expectancies and LOCE (a two-way interactive effect). This relationship was theorized to be moderated by the effect of reward sensitivity (a three-way interactive effect), as reward sensitivity has been found to interact with punishment sensitivity. Similarly, reward expectancies on LOCE were thought to be potentiated by sensitivity to reward (a two-way interactive effect) and this relationship was also thought to be influenced by sensitivity to punishment (a three-way interactive effect)., Results: Hypotheses were partially supported. Sensitivity to punishment significantly moderated a two-way interactive relationship between reward sensitivity and reward expectancies on LOCE, attenuating this two-way interaction at low sensitivity to punishment. Similarly, the interaction between sensitivity to punishment and NA reduction expectancies on LOCE was only significant when reward sensitivity was low or at its mean., Conclusion: Sensitivity to punishment and sensitivity to reward evince nuanced interactions with each other and eating expectancies to predict LOCE. Findings have treatment implications for cognitive interventions in LOCE.

Alcohol protective behavioral strategies (PBS) are commonly conceptualized with a three-factor model, as used in the Protective Behavioral Strategies Scale-20 (PBSS-20). However, inconsistencies exist between factors and drinking outcomes. The current study used factor analysis to test a two-factor structure directly via controlled consumption (Direct/CC) and indirectly via harm reduction (Indirect/HR) using the PBSS-20 among a combined sample of n  = 4,883 drinkers. Both the two- and three-factor structures evince similar model fit. A two-factor model yielded more concise PBS measurement. Negative associations were observed with consumption (Direct/CC PBS) and problems (Indirect/HR). A condensed, eight-item, two-factor model accounted for less variance in alcohol consumption, however more variance in alcohol-related problems. A more consistent framework for understanding the impact of PBS on alcohol-related outcomes is provided., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Older adults are increasingly using medical cannabis (MC). It is unclear if therapeutic effects increase problematic use patterns. The current study addresses this issue by examining symptom trajectories across the day and using trajectories to predict problematic use., Methods: One-hundred six older adults (age range 55-74) who endorsed medical conditions approved for treatment using MC were recruited online. Participants received six text messages/day to assess momentary symptoms for 15 days., Results: Participants provided 5,156 momentary assessments across 1,106 use days. Symptom trajectories were examined across the day. There was a decline in all symptoms following use. Negative affect, pain, and nausea evinced momentary negative reinforcement associations with cannabis intoxication. Momentary negative reinforcement was associated with adverse cannabis outcomes. Declines in post-use trauma symptoms and momentary negative reinforcement effects for negative affect were both associated with cannabis use disorder symptoms., Discussion: These data suggest that MC may be effective in reducing common symptom clusters. However, the negative reinforcing effect (i.e., the link between use and symptom relief at the event level) may complicate the therapeutic nature (i.e., symptom reduction). Identifying interventions to maximize benefits while minimizing costs may increase the efficacy and safety of MC in older adults., Competing Interests: Declaration of competing interest This work was supported by a grant to RDD from the Consortium for Medical Marijuana Clinical Outcomes Research. The Consortium had no influence in the conduct of the study, the analysis, or the interpretation of the results., (Copyright © 2024 Elsevier B.V. All rights reserved.)

College students are at a heightened risk of experiencing depression and anxiety symptomatology and engaging in maladaptive alcohol use. Understanding how alcohol interventions impact emotional functioning is essential. One such intervention uses Deviance Regulation Theory (DRT), which posits that behavior can be modified using targeted messaging as a function of perceived norms. DRT has been shown to be effective at increasing responsible drinking behaviors and decreasing alcohol-related consequences. However, it is unclear if this intervention influences emotional functioning. The current examines the impact of a DRT intervention on emotional functioning. Participants ( n  = 147) were recruited from a large Southeastern university. The study included a screening phase, intervention, and six-week follow-up. Participants were randomly assigned to one of three conditions: a positive message condition about people who drink responsibly, a negative message condition about people who do not drink responsibly, and an active control condition. During the study, all participants reported on depression/anxiety symptoms, alcohol use, responsible drinking, and alcohol-related consequences. Mixed-effects regression was used to analyze the data. Results suggest an overall reduction of depressive and anxiety symptomatology in the intervention conditions but not in the control condition. In the positive condition, there was a decrease in depressive and anxiety symptomatology. The messaging was not moderated by normative beliefs. The negative condition also led to decreases in depression and anxiety symptomatology over time. In addition, perceived norms moderated the negative message in the first week after the intervention, an effect consistent with DRT. Prior research indicates this intervention is efficacious for the reduction of adverse alcohol outcomes; these data show that the intervention may also have positive effects on downstream mental health outcomes., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Alcohol consumption and related problems are common among college students. Prior research links behavioral economic (BE) constructs of alcohol demand and relative reinforcement (RR), and alcohol expectancies, with alcohol consumption/problems. However, research has yet to examine the associations between BE, expectancy theory, and alcohol use outcomes. In this study, college students ( n  = 287) completed a single online survey assessing demand, RR, alcohol expectancies, and alcohol use/problems. We examined the cross-sectional indirect association of expectancies and drinking on the relationship between demand and alcohol problems and between RR and alcohol problems. The final model showed adequate fit, χ 2 (26) = 67.23, RMSEA = .07, CFI = .95, SRMR = .06. Higher demand and RR were associated with stronger alcohol expectancies, which demonstrated an indirect association on the relationship between demand, and RR, and alcohol problems. Findings suggest that demand and RR may be directly related to alcohol expectancies; a relationship that has not been previously identified. Moreover, alcohol expectancies may impact the associations among demand, RR, and alcohol problems. Thus, alcohol expectancies may be an important intervention target for reducing alcohol problems. Future longitudinal research is needed to evaluate this association over time and assess if these findings have potential impact for intervention research., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: A review of the literature revealed a high incidence of body-image distress among breast cancer survivors who had surgery. This cross-sectional study examined the relationship between medical tattooing as a complementary cosmetic intervention and body-image distress and mental health outcomes among breast cancer survivors following surgery., Methods: We examined 330 post-surgical breast cancer survivors collected through a nationwide online survey in the U.S., pursuing two main objectives. First, we investigated body-image distress, depression and anxiety symptoms, and perceived stress in survivors who underwent breast cancer surgery, comparing those with medical tattooing (n = 89) and those without (n = 226). Second, we assessed the influence of the participant's surgery type on body-image distress, depression and anxiety symptoms, and perceived stress. Additionally, we evaluated whether individual factors, such as appearance investment, satisfaction with decision, and cosmetic expectation discrepancy, predicted the participant's body-image distress., Results: Findings suggest that participants with medical tattoos reported significantly lower body-image distress, depression and anxiety symptoms, and perceived stress compared to those without medical tattoos. The participant's surgery type did not significantly predict body-image distress, depression or anxiety symptoms, or perceived stress. However, participants who reported greater appearance investment endorsed higher body-image distress. Participants who reported higher satisfaction with their treatment decisions and lower cosmetic expectation discrepancy endorsed lower body-image distress., Conclusion: Medical tattooing may be a valuable tool in improving body-image distress and mental health for those who wish to pursue it, but more research is needed. Empirical studies supporting the mental health benefits of medical tattooing among survivors are crucial to standardize insurance coverage and promote its inclusion as a complementary intervention across insurance providers nationwide. This complementary intervention should be considered using a patient-centered approach that aligns with the patient's values and preferences., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Adverse sexual experiences are highly prevalent among college students and associated with increased mental health symptoms and decreased use of protective behavioral strategies (PBS). The current study developed and validated a measure of dating and sexual PBS: the Sexual and Negative Dating Inventory (SANDI). Participants (64.28% female, 19.59 [2.90 SD] years old, 68.90% non-Hispanic, 71.42% white, and 76.06% heterosexual) responded to baseline ( n  = 1,298) and one-month ( n  = 336) surveys. Exploratory Structural Equation Modeling identified a 24-item measure with five-factors: Location Sharing, Assertiveness, Self-Protection, Risk Reduction, and Privacy. The model revealed good fit: χ 2 (242) = 2115.52, p  < .001, CFI = .977, RMSEA = .077 (90% CI = .074, .080), SRMR = .043. Test-retest reliability revealed acceptable reliability of 0.74 at follow-up. Overall, SANDI showed acceptable reliability and adequate convergent and discriminant validity among college students.

Objectives: Hispanic/Latinx drinkers have been found to experience more adverse alcohol-related consequences than any other racial/ethnic group. Due to this, researchers have looked at the connection between drinking and cultural factors, alongside discrimination, to further analyze what sociocultural factors lead to negative outcomes when drinking., Design: Researchers used a sample of Hispanic/Latinx young adult drinkers ( n  = 710) with an average age of 22.43 (SD = 6.69), recruited through social media and assessed on several factors, including protective behavioral strategies (PBS), alcohol use severity, bicultural self-efficacy, discrimination, acculturation, and enculturation., Results: Utilizing an observed variable path analysis, results showed perceived discrimination to have a significant effect on all variables in the model (bicultural self-efficacy, acculturation, enculturation, PBS self-efficacy, PBS use, and alcohol use severity). Acculturation was positively associated with PBS self-efficacy, while enculturation was positively associated with PBS use. PBS self-efficacy was positively correlated with PBS use and negatively associated with alcohol use severity. There was a significant total indirect effect from perceived discrimination to alcohol use severity through various paths (i.e. PBS self-efficacy, acculturation, and bicultural self-efficacy), with the strongest path to occur through PBS self-efficacy., Conclusions: Findings showcase the risk and protective effects of various sociocultural factors on drinking behaviors among young adults. PBS self-efficacy was found to have robust protective effects against alcohol use severity. Future research should continue to investigate these sociocultural and behavioral factors in order to develop efforts to mitigate hazardous alcohol use among Hispanic/Latinx young adult drinkers.

Objective: Research shows that alcohol use is linked to suicidal ideation (SI), while depression is strongly associated with SI. Protective behavioral strategies (PBS) are safe drinking strategies. PBS are broadly protective across alcohol-related problems; however, it is unclear if these effects extend to those at risk for SI. We hypothesized that alcohol use and depressive symptoms would be risk factors for SI, and that these factors would moderate the effects of PBS. PBS was hypothesized to be protective for individuals with elevated depressive symptoms and alcohol use. Participants: College student drinkers ( n  = 990; M age = 19.97, SD = 3.75) from a Southeastern University. Methods: Participants completed an online survey inquiring about demographics, depressive symptoms, SI, alcohol use, and PBS use. Results: Depressive symptoms were associated with an increased likelihood of SI; however, alcohol use was not. PBS were most protective for individuals with high levels of alcohol use and/or depressive symptoms. Conclusions: PBS may be protective for heavier drinkers who are at heightened risk for SI.

ObjectiveAdverse sexual experiences (ASE), including sexual violence, sexual risk behaviors, and regretted sex, are highly prevalent among sexual and gender minorities (SGM) compared to cisgender and heterosexual individuals. Research indicates ASEs are associated with increased mental health symptomatology and decreased subsequent protective behavior use. The Sexual and Negative Dating Inventory (SANDI) measures dating and sexual protective strategies and includes five factors: Location Sharing, Assertiveness, Self-Protection, Risk Reduction and Privacy. SANDI total scores are linked to lower ASEs in heteronormative samples. Method: SANDI was previously validated in a sample of n  = 1,289 college students. Data were examined from n  = 313 (24.28%) SGM individuals at baseline, and n  = 95 at one-month follow-up. Individuals were 19.70 (2.98 SD) years old, and 25% were non-white. Model fit was adequate for SGM: χ 2 (484) = 1729.621, p  < .001, CFI = .947, RMSEA = .063 (90% CI = .060, .066), SRMR = .048. Results: Non-cisgender men and non-heterosexual individuals endorse using more of the SANDI at the factor level. Using logistic regression, SANDI was not associated with history of sexual violence or sexual violence over the next month. SANDI is inversely associated with history of sexual risk and prospectively associated with less sexual risk over the next month. Negative binomial regression analyses showed SANDI was not associated with a history of regretted sex; however, SANDI was moderately associated with decreased regretted sex over the next month. Conclusion: Findings highlight the importance of dating and sexual protective behaviors across dimensions of gender and sexual orientation.

ObjectiveCollege students consume more alcohol and engage in binge drinking more frequently than their non-college attending peers, and prevalence of alcohol-related consequences (e.g., drinking and driving; taking avoidable risks) has not decreased proportionally with decreases in consumption. Social anxiety and alcohol expectancies, or beliefs about the effects of alcohol, have been found to be significantly related to alcohol use and account for significant variance in alcohol use and related consequences. Few studies, however, have examined how other social variables such as need to belong and social connectedness may fit into existing models of increased and risky alcohol use. Methods: Students at a large state university (n = 1,278) completed an online survey measuring alcohol expectancies, need to belong, social anxiety, and social connectedness. Mean age of participants was 19.65 years, and 59.5% self-identified as female, 39.8% male, and 0.7% identified as transgender. Structural equation modeling supported hypothesized relationships between need to belong, social anxiety, social connectedness, alcohol expectancies, and alcohol use, a mean centered variable that included binge drinking, drinking frequency, and amount of consumption. Results: Positive alcohol expectancies related to tension reduction, sociability, and sexuality, were positively related to drinking, such that increased alcohol expectancies were associated with increased drinking. Alcohol expectancies mediated the relationship between need to belong and increased alcohol use, as well as social connectedness and increased alcohol use. Similarly, social anxiety also mediated these relationships. No direct relationships were found between need to belong or social connectedness and alcohol use, suggesting previous research exploring these relationships may have excluded control variables (e.g., biological sex, race/ethnicity) that better explain the impact of need to belong and social connectedness on alcohol use. Conclusion : Prevention and intervention efforts might be more effective in reducing alcohol use if social factors are more broadly targeted.

The incentive-sensitization theory (IST) has emerged as a potentially useful theory in explaining substance addiction. IST postulates that the prolonged use of a substance can alter neural systems that are often involved in incentive motivation and reward processes, leading to an increased "sensitization" to the substance and associated stimuli. However, this increased sensitization is thought to mediate only the individual's craving of the substance (e.g., their "wanting"), not their enjoyment of the substance (e.g., their "liking"), a process that may involve unconscious implicit changes in cognitive networks linked to specific substances. Consequently, IST may better explain the real-world dissonance reported for individuals who want to accomplish long-term substance cessation but fail to do so, a phenomenon that is common in adolescent smokers. Thus, the present study aimed to examine the principles of IST in a sample of 154 adolescent ad libitum smokers ( M age = 16.57, SD age = 1.12, 61.14% male) utilizing ecological momentary assessment. Data were analyzed utilizing a multilevel structural equation model examining changes in positive affect (PA), negative affect (NA), and stress from Time 1 (T1) and Time 2 (T2) as a function of smoking and tested the influence of implicit cognition (specifically, implicit attitudes about smoking [Implicit Association Test (IAT)]) on these associations. Consistent with the principles of IST, results found a modest significant negative association between smoking status at T1 and PA at T2 ( B = -0.11, p = .047). This association was further moderated by IAT ( B = -0.19, p = .029) and was particularly potentiated at high levels of IAT (B = -0.44, p < .001), compared to low ( B = -0.05, p = .663) or mean levels of IAT ( B = -0.25, p = .004). Findings from this study provide additional support to the principles underlying IST and indicate that, in adolescents, smoking may result in thwarted PA indicative of a transition from "liking" toward "wanting," and this is especially pronounced among those with stronger implicit smoking cognitions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Altered reward processing has been implicated in the onset and maintenance of binge-eating disorder (BED). However, it is unclear which precise neurocognitive reward processes may contribute to BED. In the present study, 40 individuals with BED and 40 age-, sex-, and BMI-matched controls completed a reward (incentive delay) task while their neural activity was recorded using electroencephalography (EEG). Individuals with BED also completed a 10-day ecological momentary assessment (EMA) protocol assessing binge-eating behavior in the natural environment. Event-related potential (ERP) analysis of the EEG indicated that individuals with BED had stronger anticipatory (CNV) and outcome-related (RewP) neural reward activity to food and monetary rewards, compared to controls. However, within the BED group, greater frequency of binge eating during the EMA protocol was associated with stronger anticipatory (CNV) but weaker outcome-related (RewP) neural reward activity. These associations within the BED group were unique to food, and not monetary, rewards. Although preliminary, these results suggest that both anticipatory ("wanting") and outcome ("liking") reward processes may be generally amplified in BED. However, they also suggest that among individuals with BED, disorder severity may be associated with increased anticipatory reward processes ("wanting"), but relatively decreased reward-outcome processing ("liking"), of food rewards specifically., Competing Interests: Declaration of competing interest None, (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: College students continue to report problematic alcohol use. To mitigate adverse outcomes, recent studies have employed harm reduction strategies known as Protective Behavioral Strategies (PBS). Deviance Regulation Theory (DRT), an impression management intervention, has been used to promote the use of PBS. DRT relies on impression management to modify behavior. This may be especially important for individuals with higher levels of trait narcissism. Method: College student drinkers ( n =  132) were randomly assigned to receive a positive message about PBS users, a negative message about non-PBS users, or control. Participants reported on current PBS use norms, daily alcohol use, PBS use, and any alcohol-related problems experienced during the previous week for the next 10 weeks. Results: Data were analyzed using multilevel regression to examine PBS use across time by condition. When PBS norms were low, narcissism was strongly associated with lower rates of PBS use in the control group. If individuals received a positive or negative message, the association between narcissism and PBS use was diminished, among individuals with low PBS norms. There were no significant differences at mean or high levels of norms, indicating the messaging was only important for the highest risk group (i.e., those with low PBS norms). Discussion: The results of this study suggest that message framing may be effective at reducing the robust negative association between narcissism and PBS use for individuals with low PBS norms. Positive messages about individuals that use PBS may be one approach to mitigating problematic alcohol consumption in this at-risk group.

Objective : Suicidal ideation (SI) is highly prevalent among college students. Research has shown that college students are also more likely to experience low distress tolerance, affect lability, and experiential avoidance, which have been linked to SI. There is a critical need to examine the mechanisms that increase the risk of SI among college students. It is hypothesized that distress tolerance will be a strong predictor of SI, and affect lability as well as experiential avoidance will mediate this relationship. Participants and Methods : Participants ( n = 820) from a Southeastern University completed an online survey, inquiring about demographic information, affect lability, SI, experiential avoidance, and distress tolerance. Data were analyzed utilizing structural equation modeling. Results : Distress tolerance was not directly related to SI. However, affect lability and experiential avoidance were found to mediate this relationship. Conclusions : Affect lability and experiential avoidance may be important predictors of SI among college students., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: The goal of the current study was to better understand affect-drinking relations among those diagnosed with an alcohol use disorder (AUD), as recent meta-analytic work suggests that daily negative affect may not universally predict subsequent alcohol consumption in those nondependent on alcohol. Specifically, we investigated the between- and within-person effects of positive and negative affects on drinking., Method: Participants (n = 92) who met AUD diagnostic criteria completed a 90-day daily assessment of drinking behavior and positive and negative affects., Results: Time-lagged multilevel modeling revealed that within-person elevations in negative affect predicted increased odds and quantity of drinking later in the day. Relations between positive affect and drinking were nonsignificant., Conclusions: These findings are in contrast to recent meta-analytic findings and highlight the complexity of affect-drinking relations among those diagnosed with AUD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Affect regulation models hypothesize that aversive affective states drive binge-eating behavior, which serves to regulate unpleasant emotions. Research using ecological momentary assessment (EMA) demonstrates that increases in guilt most strongly predict subsequent binge-eating episodes, raising the question: why would individuals with binge-eating pathology engage in a binge-eating episode when they feel guilty? Food craving is a robust predictor of binge eating and is commonly associated with subsequent feelings of guilt. The current study used EMA to test the hypothesis that food craving may promote increased feelings of guilt, which then predict an increased risk of binge eating within a sample of 109 individuals with binge-eating disorder. Multilevel mediation models indicated that increased momentary craving at Time 1 directly predicted a greater likelihood of binge eating at Time 2, and craving also indirectly predicted binge eating at Time 2 through momentary increases in guilt at Time 2. In other words, experiencing food craving at one time point was related to an increased likelihood of binge eating at the next time point, and a portion of this influence was attributable to increasing feelings of guilt. These results challenge simple affect regulation models of binge eating, suggesting that food-related anticipatory reward processes (i.e., craving) may be the primary driver of binge-eating risk and account for the increases in guilt commonly observed prior to binge-eating episodes. Although experimental studies are needed to confirm this possibility, these results suggest the importance of addressing food cravings within interventions for binge-eating disorder. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Reward-related processes are an increasing focus of eating disorders research. Although evidence suggests that numerous distinct reward processes may contribute to eating pathology (e.g., reward learning and delay discounting), existing etiological models of reward dysfunction tend to focus on only a limited number of reward processes, and frequently lack specificity when identifying the individual reward processes hypothesized to contribute to dysregulated eating behavior. Moreover, existing theories have been limited in their integration of reward-related processes with other demonstrated risk and maintenance factors for eating disorders (e.g., affect and cognition), potentially contributing to underdeveloped models of eating pathology. In this article, we highlight five distinct reward processes with theorized or demonstrated relevance to eating disorders involving binge-eating, followed by a review of two well-established risk/maintenance factors for binge-eating pathology. We then introduce two novel models of binge eating onset and maintenance that integrate these factors (i.e., the Affect, Reward, Cognition models), and discuss methods for testing each of the models in future research. Ultimately, we hope that the proposed models provide a springboard for the continued evolution of more precise and comprehensive theories of reward dysfunction in the eating disorders, as well as the development of novel intervention approaches. PUBLIC SIGNIFICANCE STATEMENT: Eating disorders are associated with abnormalities in multiple domains of reward functioning. However, models of reward dysfunction within the eating disorders have not been well-integrated with prominent models of affect and cognition. This article presents two novel models of onset and maintenance for binge-eating pathology, which attempt to integrate observed reward abnormalities with other affective and cognitive processes implicated in binge-type eating disorders., (© 2023 Wiley Periodicals LLC.)

Cannabis is increasingly accessible and use is increasing rapidly among older adults as laws change and cannabis becomes more frequently prescribed in healthcare settings. Past research identified cognitive effects of cannabis use among adolescents and young adults that can persist for several weeks after intoxication, though little is known about how these effects generalize to older adults. Participants ( N = 1348) were drawn from the Health and Retirement Study (HRS) and were categorized as current occasional users (up to once/week in the past year, n = 36), current frequent users (once per week or more in the past year, n = 92), past users ( n = 334), and non-users ( n = 886). Participant ages ranged from 50 to 98 ( M = 67.25, SD = 10.68). Uncontrolled, one-way ANOVAs and controlled ANCOVAs were used to examine between-group differences on immediate and delayed wordlist memory and working memory (serial sevens). When controlling for age, gender, education, and minority status, current frequent users demonstrated significantly worse immediate memory performance compared to past and non-users. However, this difference could have been the result of acute, residual effects of past-month cannabis use among current users. In controlled analyses, there were no differences between groups on delayed or working memory. Findings indicate that greater than weekly cannabis use may result in attentional and short-term memory deficits. Further, these effects may be mitigated by sustained abstinence. Limitations including sample size and measures of cannabis use warrant future studies to replicate and build upon these findings., Competing Interests: The Authors have no conflicts of interest to disclose., (© 2023 Authors et al.)

Recent research shows a link between identity and behavior change. Despite the existence of several measures that assess components of drinking identity, no measures examine the idiosyncrasies of a "Responsible Drinking Identity," though responsible drinking is an aim of many alcohol-related interventions. The present study created a measure of responsible drinking identity, the Personal Assessment of Responsible Drinking Identity (PARDI). Two cross-sectional designs and a prospective follow-up were used to develop and assess the psychometric properties of the PARDI. Study 1 used a U.S. national sample of college students who endorsed alcohol use ( n = 911) to conduct an Exploratory Factor Analysis. Study 2 consisted of college students from a Southeastern University ( n = 1,096) and was used to conduct a Confirmatory Factor Analysis, as well as evaluate convergent, discriminant, concurrent, and incremental validity. A subsample from Study 2 was then assessed after 1 month ( n = 194). The follow-up examined test-retest reliability and predictive validity. The PARDI consists of four identity-based factors that are indicative of responsible drinking. The measure had adequate validity across all domains and good test-retest reliability. The measure appears to predict future protective behaviorial strategies (safe drinking behaviors), which mediates the relationship between the PARDI and both future alcohol use and consequences, suggesting safe or responsible drinking identity may drive a key behavioral target of substance use interventions. The PARDI may offer a tool to aid in quantifying underlying constructs of identity and behavior change in substance use interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The COVID-19 pandemic resulted in global monumental upheaval. Many people were displaced from their jobs and sources of income. COVID-19 was also linked to increased mental health difficulties and increased alcohol consumption and problems. The current study aims to identify the indirect effect of depression, stress, and anxiety on the relations between the economic burden of COVID-19 and alcohol problems. Participants ( N = 344) were recruited via Amazon's Mechanical Turk (MTurk). Participants completed a questionnaire about substance use, mood, and the economic burden of COVID-19. Eligible participants were 18 years or older, consumed alcohol or cannabis within the past week, and verified through Amazon. Results indicated significant indirect effects of depression, stress, and anxiety on the association between the economic burden of COVID-19 and alcohol problems regardless of use. Findings revealed large effect sizes, suggesting that mental health symptomatology may have a large impact on the association between COVID-19's economic burden and alcohol-related problems. Findings suggest mental health difficulties indirectly effect the association between COVID-19's economic burden and alcohol-related problems. Intervention efforts targeting mental health may be beneficial in reducing alcohol problems among individuals experiencing distress due to large-scale public health impact, such as the COVID-19 pandemic., Competing Interests: We have no conflicts of interest to declare.

Loss-of-control eating (LOCE) is highly prevalent in college students and may be driven by enduring personality traits. Narcissism is often conceptualized with two broad domains: grandiose and vulnerable. The association between narcissism and LOCE has not been directly assessed, nor the potential influence of emotion regulation deficits, which are differentially associated with grandiosity and vulnerability. This study hypothesized an association between vulnerable narcissism and LOCE in college students by way of emotion regulation difficulties, extending prior findings. Participants (n = 704) completed a survey on pathological eating and body image disturbance, emotion regulation difficulties, and narcissistic traits. Results supported a full mediation effect, such that vulnerable narcissism was positively associated with LOCE by way of emotion regulation difficulties. Present findings suggest the mechanism primarily predictive of LOCE is emotion regulation difficulties, and predisposition to deficits in emotion regulation associated with vulnerable narcissism may increase the odds of LOCE. Additionally, it was noted that grandiose narcissism evinced a fully mediated inverse association with LOCE. Clinical implications and directions for future research are discussed., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

College students are at an increased risk for problematic alcohol use. To address this health concern, several interventions have used protective behavioral strategies (PBS). However, interventions promoting PBS remain underdeveloped and underutilized. Counterfactual thinking is a type of postmortem cognitive strategy that highlights causal links between a behavior and a negative outcome. Recent research demonstrates the effectiveness of applying counterfactuals for increasing PBS use intentions. The present study examines the effect of a brief counterfactual-based intervention for increasing PBS use and decreasing adverse alcohol outcomes. Undergraduate students ( n = 73) completed an online multiweek (baseline and five weekly follow-ups) intervention. At baseline, participants completed demographics, PBS use, and alcohol use and consequences. They were then randomly assigned to one of three conditions: a control (negative event only), sham (negative event with detailed description), or counterfactual ( If only … then …) condition. At weekly follow-up sessions, participants completed PBS use and alcohol use and consequences from the previous week. The counterfactual condition was presented with their counterfactuals generated at baseline. Relative to the active control, the counterfactual condition reported greater use of PBS across the five-week follow-ups. This in turn resulted in decreases in alcohol consumed and alcohol-related consequences. This study highlights the effectiveness of counterfactual thinking as a relevant harm-reduction strategy for alcohol-related outcomes in college students. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The prevalence of eating pathology among college students has increased significantly in recent years. This coincides with increases in the use of cannabis, both nationally, but also among college students. Problematic cannabis use has been linked to eating pathology in prior research. Research also shows that cannabis may affect appetitive drives linked to food consumption. The current study tested the hypothesis that the association between problem cannabis use and eating pathology was mediated by greater loss of control eating. Cross-sectional data were collected from a sample of 805 college student cannabis users at a large Southeastern university in the U.S. The sample were primarily Caucasian (76%) and female (65.22%) with an average age of 20.15 ( SD = 3.91). Participants completed surveys assessing eating outcomes (loss of control eating and eating pathology), cannabis use, and cannabis-related problems. The analysis used an observed variable path model. After controlling for cannabis use, cannabis-related problems were indirectly linked to eating pathology via loss of control eating ( B = 0.109, SE = 0.025, p < .001), supporting the primary hypothesis. The direct relationship between cannabis-related problems and eating pathology was fully accounted for ( B = 0.010, SE = 0.028, p = .724) by the indirect effect of loss of control eating. These data suggest that the association between problematic forms of cannabis use and eating pathology may be due to the association between cannabis problems and loss of control eating. While this may be due to changes in appetite and food evaluation as a function of more problematic use patterns, it may also be that individuals with problematic cannabis use have more problematic eating patterns due to deficits in adaptive coping strategies. Future research should seek to parse out these different potential explanations.

Objective : Alcohol use continues to be prevalent and problematic among young adult samples. Protective behavioral strategies (PBS), which are harm reduction strategies utilized while drinking, have been linked to decreased alcohol use and subsequent alcohol-related problems. An individual's likelihood of adopting PBS and other health behaviors, according to The Health Belief Model (HBM), is dependent on perceived susceptibility to and severity of adverse health outcomes, as well as perceived benefits and barriers related to implementing those behaviors. The present study examined whether the perceived effectiveness of PBS in the context of the HBM leads to an increase in PBS use. Method : The analytic sample ( n =694 college students, M age =20.21, SD =4.37, 63.26% female, 72.05% Caucasian) self-reported demographics, weekly alcohol consumption (i.e., frequency, intensity, and quantity), alcohol-related problems, use of PBS, and perceived effectiveness of PBS use. A latent variable model was used to test the effect of perceived PBS effectiveness on PBS use, alcohol consumption, and alcohol-related problems. Results : Perceived PBS effectiveness was associated with a higher likelihood of using PBS subtypes (Manner of Drinking, Stopping/Limiting Drinking, and Serious Harm Reduction), which in turn was associated with reductions in alcohol consumption and problems. Conclusions : These findings suggest that increasing perceptions of PBS effectiveness may lead to more PBS use, decreased alcohol consumption, and fewer alcohol-related problems. Future research could implement longitudinal methodology to assess attempts to increase perceived effectiveness of PBS use and potentially establish a causal link between these perceptions, PBS use, and alcohol-related outcomes.

Objectives: Loss-of-control eating (LOCE) is often conceptualized as a negative reinforcement mechanism. However, LOCE does not consistently reduce negative affect (NA). One explanation for continued LOCE, despite a lack of NA reduction, may be expectations of NA reduction. Emotion regulation difficulties and low distress tolerance often predict LOCE, but have not been examined in the context of NA reduction expectancies., Design: This study examined the main and interactive relationships between emotion regulation difficulties, distress tolerance and NA reduction expectancies on LOCE in US adults (n = 3331)., Method: This study consisted of a battery of surveys administered to a national sample of US adults., Results: Results indicate NA reduction expectancies are robust, eclipsing the predictive effects of other emotion regulation variables. Distress tolerance was only able to attenuate the relationship between emotion regulation difficulties and LOCE when NA reduction expectancies were low., Conclusions: These findings identify NA reduction expectancies as having a strong relationship with LOCE, such that the protective factor of distress tolerance is only relevant when such expectancies are low. Clinical implications suggest that targeting NA reduction expectancies in eating interventions that bolster emotion regulation difficulties and distress tolerance may improve the effectiveness of said interventions. Additionally, stand-alone expectancy interventions should be assessed for the purpose of LOCE reduction. Directions for future research are discussed., (© 2022 The British Psychological Society.)

Background: Discrimination is a pervasive societal issue that monumentally impacts people of color (POC). Many Black, Asian, and Hispanic/Latinx individuals report experiencing race-based discrimination in their lifetime. Discrimination has previously been linked to adverse health outcomes among POC, including stress, depressive, and posttraumatic stress disorder symptoms. These health disparities are posited to have become exacerbated by COVID-19 and the racial awakening of 2020. The current study examined the short- and long-term effects of discrimination on stress, depression, and oppression-based trauma among POC., Methods: Participants were (n = 398) who identified as Black, Indigenous, Hispanic/Latinx, and Asian completed an online self-report survey assessing discrimination, depression, stress, and oppression-based trauma collected at 3 time points: (T1) beginning of the COVID-19 pandemic (May 2020), (T2) 6 weeks later during the racial awakening of 2020 (June 2020), (T3) one year later (June 2021)., Results: Significant positive paths were revealed from T1 discrimination to T2 depression, T2 stress, and T3 oppression-based trauma. The association between T1 discrimination and T3 oppression-based trauma was partially mediated by T2 depression, but not by stress; total and total indirect effects remained significant. The final model accounted for a significant proportion of the variance in T3 oppression-based trauma, T2 depression, and T2 stress., Conclusion: Findings are consistent with prior research linking discriminatory experiences with mental health symptomatology and provide evidence that race-based discrimination poses harmful short-and long-term mental health consequences. Further research is necessary to better understand oppression-based trauma to improve the accuracy of clinical diagnosis and treatment of POC., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Loss-of-control eating (LOCE, the subjective inability to refrain from eating or cease eating), is highly mood-driven. Mood-related eating motives and eating expectancies have been identified as contributors to binge eating. However, little is known about how these factors relate to LOCE, much less their relationship with daily-level LOCE. This study assessed the impact of trait eating expectancies and daily eating motives on the relationship between daily affective states and LOCE. United States adults (n = 109) reporting recent LOCE participated in a ten-day diary study, completing two surveys per day regarding eating behaviors, mood, and motives. Data were analyzed at the within- and between-subject levels utilizing a Bayesian approach to examine pathways from mood to LOCE, mediated by eating motives and accounting for a moderating impact of baseline eating expectancies on the path leg between mood and motives. Negative mood was associated with LOCE at both the within- and between-subjects level by way of coping motives, and directly at the within-subjects level. Negative affect (NA) reduction expectancies did not moderate the indirect pathway. Positive mood was only associated with LOCE at the within-subjects level, via pleasure motives. This relationship was potentiated via reward expectancies. Therefore, although negative mood appears be a robust predictor of LOCE regardless of trait NA reduction expectancies, positive mood appears to have a specific set of conditions under which individuals are at increased likelihood of LOCE at the within-subjects level. These findings suggest that eating expectancies and motives for eating may be meaningful targets in LOCE interventions., Competing Interests: Declaration of competing interest All authors have no competing interests or conflict of interest to declare., (Copyright © 2022. Published by Elsevier Ltd.)

Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies ( N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use., Competing Interests: Competing interests: Authors declare that they have no competing interests.

Background : Despite modest reductions in alcohol use among college students, drinking-related harms continue to be prevalent. Group-delivered programs have had little impact on drinking except for experiential expectancy challenge interventions that are impractical because they rely on alcohol administration. Expectancy Challenge Alcohol Literacy Curriculum (ECALC), however, offers a non-experiential alternative suitable for widespread implementation for universal, selective, or indicated prevention. Objectives : ECALC has been effective with mandated students, fraternity members, and small classes of 30 or fewer first-year college students. Larger universities, however, typically have classes with 100 students or more, and ECALC has not yet been tested with groups of this size. To fill this gap, we conducted a group randomized trial in which five class sections with over 100 college students received either ECALC or an attention-matched control presentation and completed follow-up at four weeks. Results : ECALC was associated with significant changes on six subscales of the Comprehensive Effects of Alcohol Scale (CEOA), post-intervention expectancies predicted drinking at four-week follow-up, and there were significant expectancy differences between groups. Compared to the control group, students who received ECALC demonstrated significant expectancy changes and reported less alcohol use at follow-up. Conclusions : Findings suggest ECALC is an effective, single session group-delivered intervention program that can be successfully implemented in large classes.

Background: Psychopathy has been an increasing area of clinical and personality research and is associated with numerous problematic outcomes, including pathological gambling, though this area of research is limited. The most common conceptualization of psychopathy is a two-factor model of primary and secondary psychopathy, with primary psychopathy comprising more interpersonal traits and secondary psychopathy encompassing more antisocial behaviors. Previous research has linked psychopathy to greater urgency and lower utilization of harm reduction strategies., Objectives: The current study examines the relationship between primary psychopathy, secondary psychopathy, and problematic gambling, as well as the possible mechanisms of these relationships., Method: College student gamblers ( n  = 308) completed surveys on psychopathy, impulsivity, protective behavioral strategies regarding gambling, and possible gambling problems., Results: Primary psychopathy was inversely related to gambling protective behavioral strategies (PBS) and secondary psychopathy was positively associated with higher levels of urgency. Secondary psychopathy, via urgency, was a strong predictor of whether an individual will experience gambling problems, while primary psychopathy via PBS better predicts the number of gambling problems one experiences., Conclusion: This study extends an overall under-researched area of gambling and personality and highlights the importance of delineating different factors of psychopathy regarding problematic gambling outcomes.

Objective: First-time-in-college (FTIC) students are relatively inexperienced with alcohol and have pressure to assimilate to new norms, and, therefore, are at a heightened risk of alcohol-related consequences. The present study investigates the use of a brief deviance regulation theory (DRT) intervention to increase the use of protective behavioral strategies (PBS) among FTIC students., Method: Participation took place completely online. Participants were first-year college students ( n = 147, M age = 18.11, 77.68% female) at a large southwest U.S. university. Participants were randomly assigned one of three conditions: (a) a positive message about individuals who use PBS, (b) a negative message about individuals who do not use PBS, or (c) an assessment-only control group. Participants then completed weekly assessments for 5 weeks, examining alcohol use and consequences, PBS use, and perceived PBS norms. Contrasting previous research, the present study investigated weekly effects of the intervention. In addition, norm type (quantity vs. frequency) was examined as moderators of intervention messaging., Results: Across conditions, both quantity and frequency norms increased over time. The positive message produced immediate and lasting effects on SLD PBS among those with higher (+ 1 SD ) frequency norms. The intervention effects for the negative message, using the quantity norm, grew across time on all PBS., Conclusions: These results provide initial support for the use of a DRT prevention program for FTIC students. Negative messages may promote long-term PBS use, while positive messages may be most effective in addressing immediate and lasting changes in the use of alcohol protective strategies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective : The most common conceptualization of psychopathy is a two-factor model of primary psychopathy and secondary psychopathy. Primary psychopathy consists of interpersonally abusive behavior, and callousness. Secondary psychopathy includes impulsive and risky decision making. Past research has found that psychopathy is related to negative outcomes, including increased alcohol consumption and problems, and is inversely related to harm reduction behaviors. Protective behavioral strategies (PBS), behaviors designed to reduce alcohol consumption and associated problems, may mediate the relationship between psychopathy and alcohol pathology. The current study examined the relationship between psychopathy, each subtype of PBS use (serious harm reduction (SHR), manner of drinking (MD) and stopping/limiting drinking (SLD)), alcohol consumption, and alcohol problems. Method : Participants were n = 967 (61.22% female) college students. Participants completed measures assessing psychopathy, PBS use, alcohol consumption, and alcohol problems. A path analysis was conducted to examine the relationships between psychopathy, subtypes of PBS, and alcohol consumption and problems. Results : Results indicated an inverse relationship between primary psychopathy and both SHR PBS and MD PBS, while secondary psychopathy was inversely associated with all three PBS subtypes. SHR PBS was inversely associated with alcohol problems while MD PBS was inversely associated with alcohol consumption. Conclusion : These findings suggest specific PBS subtypes mediate the relationship between primary and secondary psychopathy and alcohol consumption and problems. It may be clinically pertinent to consider targeting PBS use, such as with motivational interviewing, when working with patients exhibiting psychopathy traits. Future research should consider these findings when examining alcohol use.

Prevention programs may have contributed to modest declines in alcohol use among college students in recent years, but negative consequences continue to be pervasive. First year college students (FYCS) are particularly vulnerable, and there is clearly a need for more effective methods to reduce risk. Meta-analyses focused on expectancy challenge (EC) have found this approach to be effective, but "experiential" EC that includes a drinking exercise is not suitable for most FYCS, many of whom are underage. A non-experiential alternative, the Expectancy Challenge Alcohol Literacy Curriculum (ECALC), is practical for widespread implementation. ECALC has been effective with mandated students and members of fraternities, and in the present study, we focused on evaluating effects with FYCS. In a group randomized trial, 48 class sections of a course designed for FYCS received either ECALC or an attention-matched control presentation. ECALC was associated with significant changes on six expectancy subscales of the Comprehensive Effects of Alcohol Scale (CEOA). Structural equation modeling was used to examine the mediated effects of the intervention on alcohol-related harms via alcohol expectancies. There were significant indirect effects from condition to alcohol use (IND = -0.04, p <.001) and alcohol harms (IND = -0.07, p <.001). This model accounted for 54% of the variance in alcohol use and 46% of the variance in alcohol-related harms. These findings suggest ECALC is an effective, single session group-delivered program that can be incorporated into classroom curricula., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Attentional bias (AB) has been linked to alcohol use, mood, and alcohol craving, with key differences across different types of mood and biological sex. However, further exploration of the role of AB across these alcohol variables is needed. The current study examined the relationship between mood and AB as predictors of alcohol craving using ecological momentary assessment (EMA). Exploratory analysis examined these effects as a function of biological sex., Methods: Participants (n = 69) from a Midwestern University carried a mobile device for 15 days and provided ratings of momentary mood (positive mood, anxious mood, and sad mood), alcohol craving, and AB. Data were analyzed using a two-level multilevel regression model, with associations between craving, mood, and AB examined at both the momentary and between-subjects levels., Results: Across assessments, positive and negative moods were positively associated with momentary craving, with AB found to operate differently between men and women. At the within-subjects level, increases in positive mood among men strengthened the AB-craving association, while women showed stronger AB-craving associations when positive mood decreased. At the between-subjects level, trait-like sadness led to positive AB-craving associations for men, however, this was the opposite for women. Similarly, AB-craving associations were positive and robust for men with trait-like positive mood but again the opposite was observed for women., Conclusions: The findings highlight the importance and nuances of biological sex in the context of mood, AB, and craving. Interventions targeting AB and/or emotion regulation may yield different outcomes for men and women., (© 2022 Research Society on Alcoholism.)

The acquired preparedness (AP) model of eating disorder (ED) risk suggests transaction between impulsive traits and eating expectancies, though there remains a lack of research investigating distinct facets of impulsivity within this framework. This study examined how different facets of impulsivity moderate associations between eating expectancies and binge-eating severity in daily life. Women with binge-eating symptoms ( N = 40) completed surveys followed by 10 days of ecological momentary assessment (EMA). Generalized estimating equations examined the independent and interactive effects of impulsivity facets and eating expectancies on EMA-measured binge-eating severity. Significant interactions were found between eating expectancies and emotional and behavioral impulsivity, but not a cognitive facet. Results suggest that among women high in emotional impulsivity, those with greater eating expectancies report higher binge-eating severity. Conversely, among those with lower behavioral impulsivity, those with lower eating expectancies report lower binge-eating severity. Future prospective work is needed with non-clinical samples.

Objectives: Despite numerous drinking interventions, alcohol use among college students remains a significant problem. Typically activated after negative events, counterfactual thinking is a cognitive process that contrasts reality with an imagined better alternative. As a result, counterfactual thinking highlights potential causal links between problematic behaviours and negative outcomes, which can strengthen intentions to change behaviour. Recent research has found that modifying behavioural intentions to engage in protective behavioural strategies (PBS) has led to increased PBS use and reduced alcohol outcomes. The current study evaluated counterfactual thinking as a way to increase PBS use intentions., Design: Intervention US study with college student drinkers., Methods: A sample of college students (n = 466) completed a web-based assessment of demographics, drinking, alcohol consequences, and PBS use. Those who endorsed an adverse drinking event were randomly assigned to an intervention condition (Control, Negative event only, Negative event with description, or Negative event with counterfactual). Following the intervention, participants reported intentions to engage in each PBS subtype over the next week., Results: Relative to control, the counterfactual condition resulted in greater PBS use intentions across all subtypes. Neither the negative event only nor the negative event with description resulted in higher PBS use intentions, relative to control. Importantly, the control group did not report whether they experienced a negative event; thus, we cannot definitively determine the effect this may have on the data., Conclusions: This study provides a new theory-driven avenue for alcohol use interventions utilizing counterfactual thinking to enhance safe drinking intentions., (© 2021 British Psychological Society.)

Introduction: Loss-of-control eating (LOCE), inability to refrain from or cease eating, may contribute to significant distress and dysfunction, yet research is lacking specificity on vulnerabilities contributing to LOCE as an independent construct. Preliminary evidence indicates potential roles of distress tolerance, emotion regulation, and affective lability, but the relationship between these variables and LOCE has been under-assessed., Material and Methods: A sample (N = 3968) consisting of university students completed an assessment of pathological eating and affiliated affective vulnerabilities. A latent variable structural equation model (SEM) was generated to predict LOCE by way of affective lability and indirectly, emotion regulation difficulties and low distress tolerance, controlling for general eating pathology., Results: Findings indicated a significant direct effect of affective lability on LOCE, as well as significant indirect effects of emotion regulation difficulties and distress tolerance on LOCE, via affect lability. Additionally, distress tolerance moderated the relationship between emotion regulation difficulties and affective lability, such that lower ability to tolerate distress strengthened the relationship and higher distress tolerance capability attenuated it., Discussion: Findings suggest an influence of distress tolerance on the relationship between poor emotion regulation and affective lability, which in turn may affect LOCE. Clinical implications and suggestions for future research are discussed., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Findings regarding relationships between social anxiety and subtypes of empathy have been mixed, and one study suggested that this may be due to moderation by biological sex. The present study examined whether accounting for general anxiety and biological sex clarifies these relationships. Undergraduates ( N  = 701, 76% female) completed online self-report measures of cognitive and affective empathy, social and general anxiety severity, and a behavioral measure of cognitive empathy (Reading the Mind in the Eyes Task; MIE). Path analysis examined relationships among social and general anxiety severity and affective and cognitive empathy. Model modification indices showed a significant influence of sex on the path from social anxiety severity to MIE accuracy. When the model was re-estimated with this path freed, more socially anxious women, but not men, showed greater MIE accuracy. Across both sexes, general anxiety severity related negatively to self-reported and behavioral (MIE) cognitive empathy. Affective empathy did not relate to either type of anxiety. The use of path analysis to simultaneously account for overlapping variance among measures of anxiety and empathy helps clarify earlier mixed findings on relationships between social anxiety and empathy subtypes.

Harm reduction is a framework that places substance use on a spectrum from total abstinence to continued controlled use. Protective behavioral strategies (PBS) are a set of individually implemented harm reduction strategies that have shown to reduce the rate of use and severity of consequences from risky behaviors. Previous research has shown that PBS use effectively reduces negative consequences. The present study provides an overview of the literature on PBS measures for various risk behaviors, and common interventions used in conjunction with PBS. Of the articles reviewed, 15 validated PBS measures were found and eight distinct categories of PBS interventions. The 15 measures reviewed included risk factors such as alcohol use/consequences (n = 8), dating and sexual behaviors (n = 4), gambling (n = 1), cannabis (n = 1), and condom use (n = 1). A survey of the literature produced eight distinct categories of interventions with varying degrees of effectiveness: (a) Brief Motivational Interventions, (b) Personalized Normative Feedback, (c) PBS Skills Training, (d) PBS Instruction, (e) Deviance Regulation Theory Interventions, (f) Behavioral Economic Based Interventions, (g) Counterfactual Thinking and (h) Episodic Future Thinking. Findings from the present study corroborate the notion that PBS effectively reduce negative consequences associated with behaviors, such as negative alcohol-related consequences, harmful cannabis use, and adverse sexual outcomes. Research on interventions targeting PBS is lacking in areas outside of alcohol use. Within alcohol use, the utility of interventions varies widely. Understanding the reason for this discrepancy is an important area for future research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

One of the most pervasive forms of regret, often connected to alcohol use, is sexual regret. Lifetime rates of regretted sexual experiences (RSE) for college students is between 29%-71.9%, with 31.8% endorsing past year RSE and 31.7% stating alcohol negatively influenced decision making. While past research has focused on psychological symptoms following sexual assault, psychological effects and subsequent outcomes of RSE remains under-studied. Whether a history of sexual regret is associated with mental health symptoms, alcohol use, and protective behavioral strategy (PBS) use in the past month was analyzed. Participants (n = 1,394; 57.68% females, 26.96% racial/ethnic minority) reported on internalizing symptoms (anxiety, depression, trauma symptoms, and suicidal ideation) and externalizing and protective behaviors (problematic alcohol use and PBS). It was hypothesized that those with a history of RSE would report heightened current psychological symptoms compared to those without a history of RSE, regardless of when the RSE occurred. Of the n = 1,394 participants, 39.96% reported sexual regret and 26.11% endorsed a history of sexual victimization. Results indicate that among participants with an RSE, past month symptoms of anxiety, depression, trauma, and suicidal ideation were heightened. A similar pattern emerged for problematic alcohol use, as those with a history of RSE engaged in more problematic alcohol use in the past month. For PBS, those with a history of RSE engaged in fewer PBS than those without. Understanding these factors may provide novel insight for mental health prevention efforts and intervention targets for individuals who experience sexual regret., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Adolescents' exposure to negative life events (NLEs) and potentially traumatic events is highly prevalent and increases their risk of developing psychological disorders considerably. NLE exposure has also been linked to the development of social anxiety disorder (SAD) among older children and young adolescents. Despite the relatively low treatment efficacy reported for children and adolescents suffering from SAD, few studies have addressed the extent to which resilience factors, such as social support and social self-efficacy, are associated with SAD symptoms. This study examined whether social support and social self-efficacy predict, and buffer against SAD symptoms using a large, population-based sample of adolescents, among whom a large proportion have experienced NLEs. The results reveal that NLEs are significantly associated with SAD symptoms, while social support and social self-efficacy are both negatively associated with SAD symptoms. Only the NLEs × social support interaction significantly predicted SAD symptoms, with social support attenuating the association between NLEs and SAD symptoms. Moreover, increases in both social self-efficacy and social support were associated with reduced SAD symptoms, over and above variance explained by social support alone. Our cumulative results suggest that interventions that can modify both social support and social self-efficacy may help reduce SAD symptoms in at-risk adolescents.

Difficulties in emotion regulation are an important theoretical construct implicated in the maintenance of loss of control eating. In this study, 45 community and college participants who reported loss of control eating at least once per week carried tablets for 2 weeks, responding to random assessments throughout each day. We compared trajectories of emotion regulation abilities before and after loss of control eating episodes (using average loss of control eating episode time to divide non-loss-of-control eating days). Emotion regulation abilities remained stable on non-loss-of-control eating days, but there was a significant increase in emotion regulation difficulties after loss of control eating episodes. These results suggest that increases in emotion regulation difficulties are not responsible for initiation of loss of control eating.

Background: Social anxiety has been associated with higher rates of negative alcohol use consequences, and this relationship appears to be accounted for by coping drinking motives. Dissociation is commonly present in anxiety disorders, including social anxiety disorder, and may serve to unconsciously reduce negative emotions when more effortful coping strategies are not effective. Objectives : The present study examined whether the relationship between social anxiety, coping motives, and alcohol consequences was moderated by dissociative symptoms. It was hypothesized that coping motives would mediate the relationship between social anxiety and alcohol consequences, and that dissociation would moderate the relationship between social anxiety and coping motives. Undergraduate students who endorsed alcohol use within the past 30 days ( n  = 320) were recruited from a large public university. Participants completed measures of social anxiety, dissociation, alcohol motives, and alcohol consequences as part of a larger online questionnaire. Results: Coping motives were found to mediate the relationship between social anxiety and alcohol consequences. Dissociation did not moderate the relationship between social anxiety and coping motives. Dissociation was significantly associated with alcohol consequences via coping motives. Conclusions: Future research should include longitudinal research designs or ecological momentary assessment designs and should examine these relationships in clinical and community samples.

High prevalence rates for depression, anxiety, and gastrointestinal (GI) symptoms are found in emerging adults. However, the consequences of mood, anxiety, and GI health on health-related quality of life (HRQOL) are not well established. The biopsychosocial model and the gut-brain axis (GBA) explains the interactions of these psychological phenomenon on social and biological functioning. Following this theoretical framework, it was hypothesized that pathways between depression, anxiety, and HRQOL would be mediated by GI health. Data was cross-sectional. Undergraduates in psychology courses ( N  = 956) were recruited for course credit as part of ongoing research monitoring physical and psychological health of students at a major southeastern university. Participants were between 18 and 25 years old and measures were administered online. Pathways between depression, anxiety, and HRQOL were investigated using SEM analysis. The SEM was tested and specified for mediating effects. A well-fitting latent variable of GI health was created from the PROMIS-GI ® scales, advancing its utility. The mediation model demonstrated anxiety and depression have significant consequences for HRQOL in emerging adults. Direct pathways from GAD7 and PHQ9 scores were found between Physical and Mental HRQOL. Notably, the path from anxiety to Physical HRQOL was fully mediated by GI health. The direct path from depressive symptoms to Physical and Mental HRQOL was partially mediated by GI health, and anxiety to Mental HRQOL was partially mediated by GI health. Findings were consistent with the biopsychosocial model and GBA. The mediation model tested here has treatment and conceptual implications. Individuals presenting with anxiety or depression should be assessed for GI symptoms and conversely, those presenting with GI complaints should be evaluated for anxiety and depression. Research is needed to develop a scoring approach to combine the PROMIS-GI ® scales, so the latent construct of GI health may be used in related applications., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)