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Purpose: We aimed to evaluate changes in the frequency of drinking, alcohol dependence and alcohol-related harm in freshman college students from 2005, 2012 and 2016, and identify riskassociated factors. Method: A cross-sectional study involving 5009 freshman students was carried out in Spain in 2005, 2012 and 2016. The Dimensions of Alcohol Use Disorders Identification Test (frequency of drinking, symptoms of dependence and alcohol-related harm) was analysed. Adjusted relative risks (RRs) and their 95% confidence intervals were estimated using negative binomial regression. Results: Place of residence, positive expectancies and early onset of alcohol consumption continue to be crucial conditions for developing patterns of risky consumption, alcohol dependence and harm. Women and men were more vulnerable to alcohol harm and dependence when living away from home, having higher economic status and positive alcohol expectancies. Cohorts from 2012 and 2016 were at lower risk of risky alcohol consumption. Men belonging to the 2012 and 2016 cohorts were at lower risk of alcohol negative consequences compared with the 2005 cohort. However, women remained vulnerable over time to alcohol dependence and harm. Starting drinking after 16 protects them both from alcohol dependence and harm. Conclusions: Women are more vulnerable to alcohol dependence and harm in recent cohorts of freshmen. Limiting access to alcohol at a younger age and working on false positive expectancies could benefit freshmen by avoiding alcohol damage and alcohol dependence Funding for this study was provided by the AES: Strategic Action in Health (PI20/00131). AES played no further role in this study SI

Objective: We aimed to evaluate changes in the prevalence of Heavy Episodic Drinking (HED) and Risky Consumption (RC) in freshman college students between 2005, 2012 and 2016, and to identify the explanatory variables of these patterns of consumption using individual and pooled analyses. Methods: A cross-sectional study involving 5260 students was carried out in Spain in 2005, 2012 and 2016. HED and RC were determined using the Alcohol Use Disorders Identification Test. Another questionnaire was used to measure parental education level and alcohol use, alcohol-related problems, age of onset of alcohol use and alcohol-related expectancies. Adjusted Odds Ratios (ORs) of RC and HED and their 95% Confidence Intervals were estimated using logistic regression. Results: An increase in the prevalence rates of HED and RC was observed among women during the three-study periods, nonetheless there was no statistically significant difference in the prevalence rates among men. High maternal educational level, living away from parental home, initiating drinking before the age of 15 and having positive expectancies about drinking are associated with higher prevalence of RC in both genders. High positive expectancies and early onset of alcohol use are associated with higher rates of HED among men and women. Students recruited in 2012 and 2016 are protected against RC in comparison to those recruited in 2005. Conclusions: The age of alcohol consumption onset is the most influencing factor on HED and RC for both genders in the three-study periods. Alcohol prevention campaigns targeting youth at early ages can reduce risky drinking behaviors.

The alcohol use perceptions young people have of those close to them can affect their expectations regarding alcohol and, thus, their own drinking. We aim to identify the predictive ability of own and significant others' perceived drinking at age 18-19 in the alcohol use patterns at 27-28. A cohort study was carried out among university students in Spain (n=1,382). Binge Drinking (BD) and Risky Consumption (RC) were measured with the Alcohol Use Disorders Identification Test at ages 18, 20, 22, 24 and 27. Multilevel logistic regression for repeated measures was used to calculate the adjusted Odds Ratios (ORs). College students perceive their family's alcohol consumption as very low or nothing, while the perception of their own alcohol use or that of their friends is higher. Perceiving higher alcohol use among their siblings and friends increases the risk of BD for both sexes and RC for women. Living away from the parental home increases the risk of RC and BD. In conclusion, the perception of their friend's alcohol use at age 18-19 is the most influential variable in BD among both sexes and in RC among men throughout 10 years of follow-up. Parental alcohol consumption does not affect college student drinking patterns when friends and siblings are considered. Living with one's family acts as a protective factor. Preventive measures focused on young people should take a contextual approach and include those closest to them.El consumo percibido por los jóvenes de sus allegados puede afectar a las expectativas respecto al consumo de alcohol y de este modo, a su propio consumo. El objetivo del estudio ha sido identificar la capacidad predictiva de la percepción de consumo de alcohol propio y de los allegados al inicio del periodo universitario, en los patrones de consumo observados a lo largo de 10 años de seguimiento. Se ha llevado a cabo un estudio de cohortes en universitarios en España (n=1.382). Consumo Intensivo de Alcohol (CIA) y Consumo de Riesgo de alcohol (CRA) se midieron con el Test de Identificación de los Trastornos debidos al Uso de Alcohol (AUDIT) a los 18, 20, 22, 24 y 27 años. Se calcularon las Odds Ratios (ORs) con regresión logística multinivel para medidas repetidas. Los universitarios percibían bajo o nulo consumo de alcohol de sus familiares y mayor de sus amigos. Percibir mayor consumo de sus hermanos y amigos aumentó el riesgo de CIA en ambos géneros y de CRA en mujeres. Vivir fuera del domicilio familiar aumentó el riesgo de ambos patrones. En conclusión, la percepción del consumo de alcohol de amigos a los 18-19 años resultó la variable más influyente para el CIA en ambos géneros y el CRA en mujeres a lo largo de 10 años de seguimiento. El consumo de alcohol de los padres al inicio del periodo universitario parece no afectar a los patrones de consumo practicados durante la juventud, una vez se ajusta por el consumo de amigos y hermanos. Vivir en el domicilio familiar actúa como factor protector. Las medidas preventivas en los jóvenes deben tener un enfoque contextual incluyendo a sus allegados.

The alcohol use perceptions young people have of those close to them can affect their expectations regarding alcohol and, thus, their own drinking. We aim to identify the predictive ability of own and significant others' perceived drinking at age 18-19 in the alcohol use patterns at 27-28. A cohort study was carried out among university students in Spain (n=1,382). Binge Drinking (BD) and Risky Consumption (RC) were measured with the Alcohol Use Disorders Identification Test at ages 18, 20, 22, 24 and 27. Multilevel logistic regression for repeated measures was used to calculate the adjusted Odds Ratios (ORs). College students perceive their family's alcohol consumption as very low or nothing, while the perception of their own alcohol use or that of their friends is higher. Perceiving higher alcohol use among their siblings and friends increases the risk of BD for both sexes and RC for women. Living away from the parental home increases the risk of RC and BD. In conclusion, the perception of their friend's alcohol use at age 18-19 is the most influential variable in BD among both sexes and in RC among men throughout 10 years of follow-up. Parental alcohol consumption does not affect college student drinking patterns when friends and siblings are considered. Living with one's family acts as a protective factor. Preventive measures focused on young people should take a contextual approach and include those closest to them.

Background: Binge Drinking (BD), a highly prevalent drinking pattern among youth, has been linked with anomalies in inhibitory control. However, it is still not well characterized whether the neural mechanisms involved in this process are compromised in binge drinkers (BDs). Furthermore, recent findings suggest that exerting inhibitory control to alcohol-related stimuli requires an increased effort in BDs, relative to controls, but the brain regions subserving these effects have also been scarcely investigated. Here we explored the impact of BD on the pattern of neural activity mediating response inhibition and its modulation by the motivational salience of stimuli (alcohol-related content). Methods: Sixty-seven (36 females) first-year university students, classified as BDs (n = 32) or controls (n = 35), underwent fMRI as they performed an alcohol-cued Go/NoGo task in which pictures of alcoholic or non-alcoholic beverages were presented as Go or NoGo stimuli. Results: During successful inhibition trials, BDs relative to controls showed greater activity in the bilateral inferior frontal gyrus (IFG), extending to the anterior insula, a brain region usually involved in response inhibition tasks, despite the lack of behavioral differences between groups. Moreover, BDs displayed increased activity in this region restricted to the right hemisphere when inhibiting a prepotent response to alcohol-related stimuli. Conclusions: The increased neural activity in the IFG/insula during response inhibition in BDs, in the absence of behavioral impairments, could reflect a compensatory mechanism. The findings suggest that response inhibition-related activity in the right IFG/insula is modulated by the motivational salience of stimuli and highlight the role of this brain region in suppressing responses to substance-associated cues. This investigation was supported by grants from the Spanish Ministerio de Sanidad, Servicios Sociales e Igualdad, Plan Nacional sobre Drogas (PNSD 2015/034), Ministerio de Economía y Competitividad (PSI2015-70525-P) co-funded for European Regional Development Fund and Xunta de Galicia (GRC ED431C 2017/06). SS-S was supported by a predoctoral fellowship from the Spanish Ministerio de Economía y Competitividad (BES-2016-076298). JP-G was supported by the FPU program from the Spanish Ministerio de Educación, Cultura y Deporte (FPU16/01573) SI

Binge drinking (BD) is a public health concern with serious implications for brain development. This review is the first in which neuropsychological studies of healthy young BDs are synthesized following PRISMA guidelines. We conducted a literature search in PsycINFO, Web of Science, and PubMed. Articles were screened using strict inclusion criteria. Two authors independently assessed the methodological quality. Of the 27 studies included, 14 (52%) were of intermediate quality, 7 (26%) of poor quality and 6 (22%) of high quality. BD is associated with deficits in verbal memory and executive functions, principally poor inhibitory control. Tentatively, BD may be related to deficits in cognitive flexibility and monitoring of information in working memory. Further studies are needed to determine potential impairments in prospective memory and decision-making. BDs do not seem to show difficulties in planning, short-term memory, attention, processing speed or visuospatial construction. The evidence does not seem to support greater vulnerability in females. Future longitudinal studies should identify the characteristics of extreme trajectories, explore recovery deficits and design intervention programs., panish Ministry of Health, Social Services and Equality (Plan Nacional sobre Drogas 2015/034), the Ministry for Innovation (PSI2011-22575) and the Ministry of Economy, Industry and Competitiveness (PSI2015-70525-P) and was co-funded by the European Regional Development Found. Carina Carbia was supported by the FPU program (FPU13/04569) of the Spanish Ministry of Education. Eduardo López-Caneda was supported by the SFRH/BPD/109750/2015 Postdoctoral Fellowship of the Portuguese Foundation for Science and Technology as well as by the Psychology Research Centre (UID/PSI/01662/2013), co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653)

Expectations regarding alcohol consumption are the implicit or explicit beliefs that a person has on the consequences of his/her own consumption. Despite referring to the consequences of self-consumption, Miller et al. remind us that a person’s expectations regarding alcohol use are created even before the actual consumption has started (Miller, Smith & Goldman, 1990), probably generated from observation and deeply influenced by cultural norms. Having positive expectations regarding alcohol use has been related to higher levels of alcohol consumption, and the maintenance of them, while the opposite effect has been found for negative expectations (Carey, 1995; Linden, Lau-Barraco & Milletich, 2014).

Background Heightened emotionality and overrepresentation of memories are typical features of adolescence. Binge drinking (BD) during emerging adulthood has been linked to cognitive difficulties such as deficits in episodic memory. Despite that impairments in emotional functioning have been associated with the development of alcohol use disorders, particularly in females, the emotional sphere has been relatively unexplored in BDs. Therefore, the purpose of this study is to examine the effects of BD in emotional episodic memory from a gender perspective. Methods One hundred and eighty (96 females) university students were followed during two years (18–20 years old) and their alcohol use was recorded. In the last assessment, participants completed an emotional list-learning task. Generalized linear mixed models were applied separately for males and females, in accordance with sex differences in the development of emotion circuitry. Results In females, BD was associated with an emotional memory bias in favour of negative information and lower recall of positive and neutral words. In addition, females BDs showed more false alarms for negative distractors. Whereas in males, no alcohol-related effects were found. Conclusions Female BDs present a negative memory bias, poor learning and delayed episodic recall linked to the interference of negative content, which suggests difficulties in disengaging attention to salient negative stimuli and a reduction of inhibitory capacities. This might result in greater vulnerability to alcohol-related emotional disturbances among women. Further research is needed to understand the role of emotional regulation in the escalation of alcohol abuse from a gender perspective.

Binge drinking is a common pattern of alcohol consumption in adolescence and youth. Neurocognitive dual-process models attribute substance use disorders and risk behaviours during adolescence to an imbalance between an overactivated affective-automatic system (involved in motivational and affective processing) and a reflective system (involved in cognitive inhibitory control). The aim of the present study was to investigate at the electrophysiological level the degree to which the motivational value of alcohol-related stimuli modulates the inhibition of a prepotent response in binge drinkers. First-year university students (n = 151, 54 % females) classified as binge drinkers (n = 71, &ge, 6 binge drinking episodes, defined as 5/7 standard drinks per occasion in the last 180 days) and controls (n = 80, &lt, 6 binge drinking episodes in the last 180 days) performed a beverage Go/NoGo task (pictures of alcoholic and nonalcoholic drinks were presented according to the condition as Go or NoGo stimuli, Go probability = 0.75) during event-related potential recording. In binge drinkers but not controls, the amplitude of the anterior N2-NoGo was larger in response to nonalcohol than in response to alcohol pictures. No behavioural difference in task performance was observed. In terms of dual-process models, binge drinkers may require increased activation to monitor conflict in order to compensate for overactivation of the affective-automatic system caused by alcohol-related bias.

Purpose: Investigations suggest non-medical use of prescription drugs (NMUPD) is associated with heavy drinking and polydrug use among university students. Our aim is to determine the prevalence of NMUPD among university students and to analyze its association with alcohol, tobacco, and cannabis use, and to study the role of the age of drinking onset. Methods: Cohort study among university Spanish students (n = 1382). Heavy drinking (HED) and risky consumption (RC) were measured with the Alcohol Use Disorders Identification Test. Questions related to tobacco and cannabis consumption were also formulated. NMUPD refers to sedative, anxiety, or pain medication intake within the last 15 days without medical prescription. All variables were measured at 18, 20, and 27 years. Multilevel logistic regression for repeated measures was used to obtain adjusted OR (odds ratios). We analyzed the results from a gender perspective. Results: Prevalence of NMUPD were higher in students who already partook in NMUPD at the beginning of the study. NMUPD in women at 27 is 3 times higher than at 18, while in men it is twice. Among females, RC (OR = 1.43) and cannabis consumption (OR = 1.33) are risk factors for NMUPD, while later onset of alcohol use (OR = 0.66) constitutes a protective factor. No significant differences were found for males. Conclusions: NMUPD is prevalent among university students. RC and early onset of alcohol use were associated with higher prevalence of NMUPD in females. The prevalence of NMUPD increased with age in both sexes. Strategies for reducing risky drinking and delaying onset of drinking should be provided for university students. Pharmacists and parents should be alerted to the risk of NMUPD Plan Nacional sobre Drogas (Spain) (2005/PN014) and Fondo de Investigación Sanitaria (Spain) (PI15/00165) SI

AimTo identify differences in Risky Consumption (RC) and Binge drinking (BD) trends in students who already followed these patterns of alcohol consumption on starting university and those who did not, and also to try to understand what leads students to engage in these types of behaviour at university.Material and methodsCohort study among university students in Spain (n = 1382). BD and RC were measured with the Alcohol Use Disorders Identification Test at ages 18, 20, 22, 24 and 27 years. Multi-level logistic regression for repeated measures was used to calculate the adjusted Odds Ratios (ORs).ResultsThe prevalence rates of RC and BD were lower throughout the study in students who did not follow these patterns of consumption at age 18. For RC and BD, the differences at age 27 years, expressed as percentage points (pp), were respectively 24 pp and 15 pp in women and 29 pp and 25 pp in men. Early age of onset of alcohol use increased the risk of engaging in RC and BD patterns at university, for men (OR = 2.91 & 2.80) and women (OR = 8.14 & 5.53). The same was observed in students living away from the parental home for BD (OR = 3.43 for men & 1.77 for women). Only women were influenced by having positive expectancies for engaging in RC (OR = 1.82) and BD (OR = 1.96).ConclusionsThe prevalence rates of both RC and BD at age 27 years were much higher among university students who already followed these patterns of consumption at age 18 years, with the differences being proportionally higher among women. Focusing on the age of onset of alcohol consumption and hindering access to alcohol by minors should be priority objectives aimed at preventing students from engaging in these patterns of alcohol consumption at university., This work was supported by grants awarded by the Plan Nacional sobre Drogas (Spain) (2005/PN014) and the Fondo de Investigacion Sanitaria (Spain) (PI15/00165). Carina Carbia was supported by the FPU program (FPU13/04569) of the Spanish Ministry of Education. Eduardo Lopez-Caneda was supported by the SFRH/BPD/109750/2015 Postdoctoral Fellowship of the Portuguese Foundation for Science and Technology.

Background Binge Drinking (BD) generally declines once students have left university. However, many individuals continue to partake in BD into adulthood, constituting a scarcely investigated high-risk group towards whom interventions should be prioritized. Following the dual-process model, we examined the relationship between BD and both the reflective system (executive functions) and the affective system (alcohol bias) in young adults with a consistent BD trajectory. We considered impulsivity as a moderator in the relationship between BD and alcohol bias. Methods A cohort of 63 (31♀) young adults were followed for eleven years (18–29 years old). In the last assessment, participants, with high and low drinking trajectories underwent neuropsychological assessment of executive functions (working memory [SOPT], cognitive flexibility [TMT −Verbal Fluency], inhibition [Stroop]) and alcohol bias (Addiction Stroop). The Barratt Impulsivity Scale measured impulsivity. Generalized linear mixed models and regression-based moderation models were applied. Results BD was associated with weak inhibitory control, poor working memory and greater alcohol bias moderated by non-planning impulsivity. At moderate levels of non-planning impulsivity, BD was associated with greater alcohol bias. This association was not found at high levels of impulsivity. These deficits were related to loss of control over drinking and severity of alcohol use. Conclusions The imbalance between poor cognitive control and greater alcohol bias may contribute to the persistence of BD into adulthood. The findings highlight the complexities of the dual-process model, with intervention implications.

Aim: The objective of this study is to assess the effects of Heavy Episodic Drinking (HED) on the incidence of alcohol-related injuries among university students in Spain, taking sex into consideration. Methods: We carried out an open cohort study among college students in Spain (992 women and 371 men). HED and alcohol-related injuries were measured by question 3rd and 9th of Alcohol Use Disorders Identification Test to every participant at the ages of 18, 20, 22, 24 and 27. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for alcohol and cannabis use. Results: The incidence rate of alcohol-related injuries was 0.028 year−1 for females and 0.036 year−1 for males. The multivariate analysis showed that among females a high frequency of HED and use of cannabis are risk factors for alcohol-related injuries (Odds Ratio [OR] = 2.64 and OR = 3.68), while being more than 23 is a protective factor (OR = 0.34). For males, bivariate analysis also showed HED like risk factor (OR = 4.69 and OR = 2.51). Finally, the population attributable fraction for HED among females was 37.12%. Conclusions: HED leads to an increase of alcohol-related injuries in both sexes and being over 23 years old acts as a protective factor among women. Our results suggest that about one third of alcohol-related injuries among women could be avoided by removing HED This work was supported by the Spanish National Plan on Drugs (N.P.D)(grant number 2005/PN014), and MICINN (grant number PSI2011-22575) SI

Objective: Impaired affective decision-making has been consistently related to alcohol dependence. However, less is known about decision-making and binge drinking (BD) in adolescents. The main goal of this longitudinal study was to determine the association between BD and decision-making from late adolescence to early adulthood. A second aim is to assess developmental changes and performance differences in males and females. Method: An initial sample of 155 1st-year university students, (76 non-BDs, 40 females; and 79 BDs, 39 females), was followed prospectively over a 4-year period. The students were classified as stable non-BDs, stable BDs and ex-BDs according to their scores in item 3 of the AUDIT and the speed of alcohol consumption. Decision-making was assessed by the Iowa Gambling Task (IGT) three times during the study. Dependent variables were net gain and net loss. Results were analyzed using generalized linear mixed models. Results: A stable BD pattern was not associated with either disadvantageous decisionmaking or sensitivity to loss frequency. Performance improved significantly in both genders over the study period, especially in the last blocks of the task. Females showed a higher sensitivity to loss frequency than males. No gender-related differences were observed in gains. Conclusion: Performance in affective decision-making continues to improve in late adolescence, suggesting neuromaturational development in both genders. Females are more sensitive to loss frequency. Stable BD during late adolescence and emerging adulthood is not associated with deficits in decision-making. Poor performance of the IGT may be related to more severe forms of excessive alcohol consumption The study was supported by grants from the Spanish Ministerio de Sanidad, Servicios Sociales e Igualdad (Plan Nacional sobre Drogas), Ministerio de Ciencia e Innovacíon (PSI2011-22575) and Ministerio de Economía y Competitividad (PSI2015-70525-P) co-funded by the European Regional Development Found. Carina Carbia was supported by the FPU program (FPU13/04569) of the Spanish Ministerio de Educacion SI

Adolescence and early adulthood are periods of particular vulnerability to the neurotoxic effects of alcohol. Young people with alcohol-use disorders display deficits in working memory (WM). This function is supported by the prefrontal cortex, a late-maturing brain region. However, little is known about the progression of cognitive dysfunctions associated with a binge-drinking (BD) pattern of alcohol consumption among non-clinical adolescents. The objective of this study was to analyze the relationship between BD trajectory and WM in university students. An initial sample of 155 male and female first-year university students was followed prospectively over 6 years. The participants were classified as stable non-BDs, stable BDs, and ex-BDs, according to the third item of the Alcohol Use Disorders Identification Test (AUDIT). WM was assessed using the Self-Ordered Pointing Task. Generalized linear mixed models were applied. The results showed that stable BDs committed more total perseverative errors and showed a lower WM span in the difficult blocks than stable non-BDs. Difficulties in WM span showed some improvement, whereas perseveration errors remained constant throughout the follow-ups in the stable BDs. There were no significant differences between ex-BDs and non-BDs. In conclusion, stable BD is associated with WM deficits, particularly perseverations and low WM span in demanding trials, when compensatory mechanisms may no longer be successful. The partial improvement in WM span may support the notion of a neuromaturational delay, whereas the temporal stability of perseveration deficits may reflect either neurotoxic effects of alcohol or premorbid characteristics. Abandoning the BD pattern of alcohol consumption may lead to partial recovery., The study was supported by grants from the Spanish Ministerio de Ciencia e Innovacion, Plan Nacional (PSI2011-22575) and Plan Nacional Sobre Drogas (exp 2010/134) and (exp 2015/034). Carina Carbia was supported by the FPU program (FPU13/04569) of the Spanish Ministerio de Educacion.

Objective: The main objective of this study is to evaluate the effect of heavy drinking on alcohol-related injuries. Material and methods: We carried out an open cohort study among university students in Spain (n = 1,382). Heavy drinking and alcohol-related injuries were measured by administrating AUDIT questionnaires to every participant at the ages of 18, 20, 22 and 24. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for consumption of alcohol and cannabis. Results: The response rate at the beginning of the study was 99.6% (1,369 students). The incidence rate of alcohol-related injuries was 3.2 per 100 students year. After adjusting for alcohol consumption and cannabis use, the multivariate model revealed that a high frequency of heavy drinking was a risk factor for alcohol-related injuries (Odds Ratio = 3.89 [95%CI: 2.16 – 6.99]). The proportion of alcohol-related injuries in exposed subjects attributable to heavy drinking was 59.78% [95%CI: 32.75 – 75.94] while the population attributable fraction was 45.48% [95%CI: 24.91 – 57.77]. Conclusion: We can conclude that heavy drinking leads to an increase of alcohol-related injuries. This shows a new dimension on the consequences of this public concern already related with a variety of health and social problems. Furthermore, our results allow us to suggest that about half of alcohol-related injuries could be avoided by removing this consumption pattern. The study was funded by a grant from the Spanish National Plan on Drugs (N.P.D) (2005/PN014) and by a grant from MICINN PSI2011-22575 SI

Adolescent brain may be particularly vulnerable to alcohol.nbsp; Plus, psychopathological disorders tend to emerge in this period. Consequently, early alcohol use may increase the risk of psychopathological disorders, with time and sex-dependent effects. However, few studies have analyzed the relationship between alcohol consumption and adolescent psychopathology in the general population. The objective was to determine the association between age of onset of alcohol use and psychopathological symptoms in university students, separately for both sexes.A cross-sectional study involving first-year university students (n = 3,696) was conducted. Symptoms were measured by the Symptom Checklist-R (SCL-90-R). The independent variable was age of first alcohol use. Dependent variables were the SCL-90-R dimensions, dichotomized. Alcohol consumption was considered a mediator variable. Data were analyzed separately for males and females.The findings showed that a younger age of onset is a risk factor for the following global indexes: Global Severity Index, Positive Symptom Total for females, and Positive Symptom Distress Index, for males. Alcohol consumption showed a higher mediator effect for females than for males.Early age of alcohol use is associated with increased psychopathological symptomatology in both sexes during the college freshman year. The pattern of symptomatology is different in each sex.

Aim To evaluate the prevalence of alcohol consumption among university students during late adolescence and young adulthood and to identify the associated factors. Material and Methods Cohort study among university students in Spain (n = 1382). Heavy Episodic Drinking (HED) and Risky Consumption (RC) were measured with the Alcohol Use Disorders Identification Test (AUDIT) at ages 18, 20, 22, 24 and 27 years. Data on potential factors associated with alcohol use were obtained with an additional questionnaire. Multilevel logistic regression for repeated measures was used to obtain adjusted OR (Odds Ratios). Results The rates of prevalence of RC were lower, but not statistically significant, in women. The age-related changes in these rates were similar in both genders, and the prevalence of RC peaked at 20 years. By contrast, the prevalence of HED was significantly lower in women and peaked at 18 years in women and at 22 years in men. Multivariate models showed that early age of onset of alcohol use (OR = 10.6 and OR = 6.9 for women; OR = 8.3 and OR = 8.2 for men) and positive expectations about alcohol (OR = 7.8 and OR = 4.5 for women; OR = 3.6 and OR = 3.3 for men) were the most important risk factors for RC and HED. Living away from the family home was also a risk factor for both consumption patterns among women (OR = 3.16 and OR = 2.34), while a high maternal education level was a risk factor for RC among both genders (OR = 1.62 for women; OR = 2.49 for men). Conclusions Alcohol consumption decreases significantly at the end of youth, with higher rates of prevalence and a later peak among men. Prevention strategies should focus on beliefs and expectations about alcohol and on delaying the age of onset. Women are at particular risk for these consumption patterns if they live away from their parents. Belonging to a highincome family is a strong risk factor for RC Funding for this study was provided by the Spanish National Plan on Drugs (PND, SPI/ 3462/2010). PND played no further role in this study SI

To determine the incidence of unsafe sex among university students and its association with heavy episodic drinking (HED) and cannabis use.A cohort study was carried out from 2005 to 2011 among university students of the Compostela Cohort (n=517). HED was measured using the third question of the Alcohol Use Disorders Identification Test (AUDIT). Unsafe sex was considered to be sex under the influence of alcohol (SUA) and sex without a condom (SWC). Logistic regression models were created.The incidence of SUA was 40.9% for women and 53.0% for men, while the SWC incidence ranged from 13.7% for women to 25.7% for men. HED and cannabis use were associated with SUA in both women (OR=2.08, 95% CI: 1.03-4.21; OR=2.78, 95%CI: 1.57-4.92) and men (OR=4.74 (95%CI: 1.49-15.09; OR=4.37, 95%CI: 1.17- 16.36). Moreover, cannabis use in women was associated with SWC (OR=2.96, 95%CI: 1.52-5.75). The population attributable fractions of SUA for HED were 24.7% and 52.9% for women and men, respectively.HED and cannabis use represent a public health problem due to their association with a variety of problems, including engagement in unsafe sex. Our results suggest that a significant proportion of unsafe sex could be avoided by reducing this consumption pattern of alcohol.

Aims The objective of this study was to examine brain activity, with particular attention to prefrontal function, during response execution and inhibition in youths who have engaged in binge drinking (BD) for at least 2 years. Design Event-related potentials (ERPs) were recorded twice within 3 years, during performance of a Go/NoGo task. Setting The study was part of a longitudinal study of the neurocognitive effects of BD. Participants A total of 48 undergraduate students, 25 controls (14 females) and 23 binge drinkers (10 females), with no personal or family history of alcoholism or psychopathological disorders. Measurements The Go-P3 and NoGo-P3 components of the ERPs were examined by principal component analysis and exact low-resolution tomography analysis (eLORETA). Findings Binge drinkers showed larger Go-P3 amplitudes than controls in the first and second evaluations (P=0.019). They also showed larger NoGo-P3 amplitude in the second evaluation (P=0.002). eLORETA analyses in the second evaluation revealed significantly greater activation of the right inferior frontal cortex (rIFC) in binge drinkers than in controls during successful inhibition (P

Background: Binge drinking (BD) is prevalent among college students. Studies on alcoholism have shown that the prefrontal cortex is vulnerable to the neurotoxic effects of alcohol. The prefrontal cortex undergoes both structural and functional changes during adolescence and young adulthood. Sex differences have been observed in brain maturation and in alcohol-induced damage. The objective of the present study was to analyze the relationship between BD and cognitive functions subserved by the prefrontal cortex in male and female university students. Methods: The sample comprised 122 undergraduates (aged 18 to 20 years): 62 BD (30 females) and 60 non-BD (29 females). Executive functions were assessed by WMS-III (Backward Digit Span and Backward Spatial Span), SOPT (abstract designs), Letter Fluency (PMR), BADS (Zoo Map and Key Search) and WCST-3. Results: BD students scored lower in the Backward Digit Span Subtest and generated more perseverative responses in the SOPT In relation to interaction BD by sex, BD males scored lower in the Backward Digit Span test than BD females and non-BD males. Conclusions: BD is associated with poorer performance of executive functions subserved by the dorsolateral prefrontal cortex. The results do not support enhanced vulnerability of women to alcohol neurotoxic effects. These difficulties may reflect developmental delay or frontal lobe dysfunction. This research was financially supported by Consellería de Innovación e Industria of Xunta de Galicia, grant number PGIDIT05CS021103PR and INCITE08PXIB211015PR, by Plan Nacional sobre Drogas of Ministerio de Salud y Consumo of Spain, grant number 2005/PN014, and by Ministerio de Ciencia e Innovación of Spain, grant number EDU2008-03440 SI

Resumen Fundamento y objetivo Determinar el efecto de la reserva cognitiva (RC) en el funcionamiento cognitivo de los pacientes con epilepsia del lobulo temporal (ELT). Pacientes y metodo Se evaluo con una bateria neuropsicologica que incluia medidas de memoria, atencion, habilidades visuoconstructivas y lenguaje a 28 pacientes con ELT admitidos en un programa de cirugia de la epilepsia. Las puntuaciones directas, ajustadas segun los baremos correspondientes, se transformaron en puntuaciones normalizadas (puntuaciones z). La RC se determino a partir del cociente intelectual premorbido, el nivel educativo y el nivel ocupacional. Resultados No se observaron diferencias significativas entre los grupos de alta y baja RC en las variables sociodemograficas y clinicas relevantes. Los pacientes con baja RC obtuvieron un rendimiento significativamente menor que los pacientes con alta RC en los test de memoria verbal (p Conclusiones Los pacientes epilepticos con baja RC muestran mayor morbilidad cognitiva que los pacientes con alta RC. Estos hallazgos indican que una mayor RC puede reducir la vulnerabilidad o retrasar la manifestacion clinica del deterioro cognitivo asociado a la ELT.

Objective: The purpose of this study was to determine the prevalence of risky consumption (RC) and heavy episodic drinking (HED) in Spanish university students and their associated factors. Method: We conducted a cross-sectional analysis (target N = 2,700) within the framework of a cohort study designed to evaluate the neu-ropsychological and psychophysiological consequences of alcohol consumption. Alcohol consumption was measured with the Alcohol Use Disorders Identification Test (AUDIT). The following independent variables were also collected by questionnaire: gender, place of residence, parents' education, alcohol consumption in the family, age at onset of use, and alcohol expectancies. We constructed logistic regression models using two dichotomous variables: (1) RC, dichotomizing the AUDIT score and (2) HED, dichotomizing the AUDIT question about consumption of six or more drinks on a single occasion. Results: The response rate on enrolled students was 50.7% (99% on students present in class the day of the survey). The prevalence of RC was 37.1%, the prevalence of HED was 12.2%, and the prevalence of abstainers was 12.6%. In relation to RC, the multivariate model showed that high expectancies (odds ratio [OR] = 4.77), early age at onset of use (OR = 4.75), and high maternal educational level (OR = 1.56) constituted risk factors. In contrast, living with parents constituted a protective factor (OR = 0.39). For HED, early age at onset of use (OR = 7.16), high expectancies (OR = 2.89), and being male (OR = 3.41) were risk factors. Conclusions: Results suggest that, to decrease consumption among adolescents in Spain, strategies should focus on modifying expectancies, limiting access to alcohol at young ages, and targeting students of higher socioeconomic status and those living away from home.

Considerable controversy exists about the role of education in the risk of dementia. Individual studies have not been conclusive so far. To examine the hypothesis that lower education is associated with a higher risk of dementia, we carried out a meta-analysis. Observational studies published as of October 2005 that examined the association between education and risk of dementia were systematically reviewed. Relative risks (RRs) and odds ratios were extracted from cohort and case-control studies. We first compared the risk of dementia in subjects with high level of education with the risk of dementia in those with low educational level. In a subsequent analysis, we compared the risk of persons with high education with the risk of subjects with education level other than high (medium, low). We weighted log RRs for cohort studies or odds ratios by the inverse of their variances. Nineteen studies were included in our meta-analysis (13 cohort and 6 case-control studies). RRs for low versus high education level were: Alzheimer’s disease (AD) 1.80 (95% CI: 1.43–2.27); non-AD dementias, 1.32 (95% CI: 0.92–1.88), and all dementias 1.59 (95% CI: 1.26–2.01). For low and medium versus high education level, the RRs were: AD 1.44 (95% CI: 1.24–1.67); non-AD 1.23 (95% CI: 0.94–1.61), and all dementias 1.33 (95% CI: 1.15–1.54). These results confirm that low education may be a risk factor for dementia, especially for AD.

El consumo intensivo de alcohol o binge drinking (BD) constituye la forma de consumo problemático más común durante la adolescencia y juventud. Al mismo tiempo, es éste un período marcado por profundos cambios, tanto en la estructura como en el funcionamiento cerebral, que pueden verse afectados por el consumo intensivo de alcohol. En los últimos años, se ha publicado un importante número de estudios que tratan de caracterizar los efectos del BD sobre el cerebro. Sin embargo, no existe hasta la fecha ninguna revisión crítica en lengua española de la investigación sobre las consecuencias neuroestructurales, neurofuncionales y cognitivas que pueden derivarse del mantenimiento de un patrón de consumo intensivo de alcohol durante la adolescencia y juventud. El propósito de esta revisión es hacer un resumen crítico de los principales resultados de la investigación sobre los efectos del BD en el cerebro. Para ello, se realizó una búsqueda bibliográfica en las bases de datos Web of Knowledge, PubMed y PsycINFO para el periodo 2000-2013. En general, los trabajos coinciden en señalar que el BD se asocia a 1) menor rendimiento en tareas que evalúan procesos cognitivos como la atención, la memoria o las funciones ejecutivas, 2) alteraciones estructurales (en sustancia blanca y en sustancia gris) en distintas regiones cerebrales y 3) anomalías neurofuncionales (hiper- y/o hipoactivación neural) ligadas a distintos procesos cognitivos. Estos resultados, si bien aún necesitan ser contrastados, alertan sobre las importantes consecuencias que podría tener la persistencia del BD sobre un cerebro joven y todavía en maduración., Binge drinking (BD) is the most common problematic drinking pattern during adolescence and youth. At the same time, it is a period marked by profound structural and functional brain changes, which may be affected by heavy alcohol consumption. In recent years, a considerable number of studies that attempt to characterize the effects of BD on the brain has been published. However, to date there is not any critical review in Spanish language on neurostructural, neurophysiological and cognitive consequences that may result from the maintenance of a BD pattern of alcohol consumption during adolescence and youth. The purpose of this review is to critically summarize the main research results on the effects of BD on the brain. To this end, a literature search in databases Web of Knowledge, PubMed and PsycINFO for the period 2000-2013 was performed. In general, studies agree that BD is associated with 1) lower performance on tasks assessing cognitive processes such as attention, memory and executive functions, 2) structural changes (in white matter and gray matter) in different brain regions and 3) neurophysiological abnormalities (hyper/hypoactivation) linked to different cognitive processes. These results, although still need to be contrasted, warn about important consequences that could result from the persistence of BD on a young and still maturing brain., Este trabajo ha sido financiado por el Plan Nacional de Formación de Profesorado Universitario (FPU) (referencia AP2008-03433) del Ministerio de Educación, por el programa nacional de bolsas posdoctorales de la Fundação para a Ciência e a Tecnologia (FCT) de Portugal (referencia SFRH/ BPD/91440/2012), por la Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (referencia 111.030/2013), por el Ministerio de Ciencia e Innovación, Plan Nacional de I+D (PSI2011-22575) y por el Ministerio de Sanidad y Política Social, Plan Nacional sobre Drogas (exp 2010/134).

Aims: Adolescence is usually the time when individuals first drink alcohol and this has been associated with relatively weak or immature inhibitory control. This review examines the changes on brain development and inhibitory function that take place during adolescence and youth as well as the relationship between inhibitory control and alcohol use at this early age. Methods: Narrative review of the chief studies related to (a) the development of inhibitory control during adolescence, (b) the deficits in the inhibitory ability in alcohol use disorders and (c) the effects of acute alcohol intake and binge drinking on inhibitory control in adolescents and young adults. Results: Inhibitory control processes are developing during adolescence and youth. Poor inhibitory functions may predispose the individual to alcohol misuse. Likewise, acute and binge alcohol drinking may impair the inhibitory control and compromise the ability to prevent or stop behaviour related to alcohol use. Conclusion: Poor inhibitory control can be both the cause and the consequence of excessive alcohol use. Adolescence and young adulthood may be a particularly vulnerable period due to (a) the weak or immature inhibitory functioning typical of this stage may contribute to the inability of the individual to control alcohol use and (b) alcohol consumption per se may alter or interrupt the proper development of inhibitory control leading to a reduced ability to regulate alcohol intake. Further longitudinal research is needed to evaluate the interaction between inhibitory control dysfunction and alcohol use in both situations The study was supported by grants from the Spanish Ministerio de Ciencia e Innovación (PSI2011-22575) and the Ministerio de Sanidad y Política Social, Plan Nacional sobre Drogas (exp 2010/134) SI

It is well known that alcohol impairs response inhibition and that adolescence is a critical period of neuromaturation where cognitive processes such as inhibitory control are still developing. In recent years, growing evidence has shown the negative consequences of alcohol binge drinking on the adolescent and young human brain. However, the effects of cessation of binge drinking on brain function remain unexplored. The objective of the present study was to examine brain activity during response execution and inhibition in young binge drinkers in relation to the progression of their drinking habits over time. Event-related potentials (ERPs) elicited by a Go/NoGo task were recorded twice within a 2- year interval in 57 undergraduate students (25 controls, 22 binge drinkers, and 10 ex-binge drinkers) with no personal or family history of alcoholism or psychopathological disorders. The results showed that the amplitude of NoGo-P3 over the frontal region correlated with an earlier age of onset of regular drinking as well as with greater quantity and speed of alcohol consumption. Regression analysis showed that NoGo-P3 amplitude was significantly predicted by the speed of alcohol intake and the age of onset of regular drinking. The group comparisons showed that, after maintaining a binge drinking pattern for at least 2 years, binge drinkers displayed significantly larger NoGo-P3 amplitudes than controls, whereas ex-binge drinkers were in an intermediate position between the two other groups (with no significant differences with respect to controls or binge drinkers). These findings suggest that binge drinking in young people may impair the neural functioning related to inhibitory processes, and that the cessation of binge drinking may act as a brake on the neurophysiological impairments related to response inhibition The study was supported by grants from the Consellería de Educación e Ordenación Universitaria, Xunta de Galicia (CN 2012/024), the Spanish Ministerio de Ciencia e Innovación (PSI2011-22575) and the Ministerio de Sanidad y Política Social, Plan Nacional sobre Drogas (exp 2010/134). SI

Binge drinking or heavy episodic drinking is a high prevalent pattern of alcohol consumption among young people in several countries. Despite increasing evidence that binge drinking is associated with impairments in executive aspects of working memory (i.e. self-ordered working memory), processes known to depend on the mid-dorsolateral prefrontal cortex (Brodmann areas 46 and 9), less is known about the impact of binge drinking on prefrontal gray matter integrity. Here, we investigated the effects of binge drinking on gray matter volume of mid- dorsolateral prefrontal cortex in youths. We used voxel-based morphometry on the structural magnetic resonance images of subjects reporting a persistent (at least three years) binge drinking pattern of alcohol use (n = 11; age 22.4361.03) and control subjects (n = 21; age 22.1861.08) to measure differences in gray matter volume between both groups. In a region of interest analysis of the mid-dorsolateral prefrontal cortex, after co-varying for age and gender, we observed significantly larger gray matter volume in the left middorsolateral prefrontal cortex (Brodmann areas 46 and 9) in binge drinkers in comparison with control subjects. Furthermore, there was a significant positive correlation between left mid-dorsolateral prefrontal cortex volume and Self-Ordered Pointing Test (SOPT) total errors score in binge drinkers. The left mid-dorsolateral prefrontal cortex volume also correlated with the quantity and speed of alcohol intake. These findings indicate that a repeated exposure to alcohol -that does not meet criteria for alcohol dependence- throughout post-adolescent years and young adulthood is linked with structural anomalies in mid-dorsolateral prefrontal regions critically involved in executive aspects of working memory This study was supported by a grant from the ConsellerÍa de Industria e InnovaciÓn, Xunta de Galicia (INCITE08PXIB211015PR) and by two grants from the Ministerio de Ciencia e InnovaciÓn of Spain (EDU2008-03400; PSI2011-22575). SD was supported by a postdoctoral contract from the Isidro Parga Pondal program (Xunta de Galicia, Spain). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript SI

Aims: The objective of this study was to examine brain activity related to visual attention processes in youths who had maintained a binge drinking (BD) pattern of alcohol consumption for > 2 years. Methods: The participants were 57 university students (26 binge drinkers: BDs) with no personal or family history of alcoholism or psychopathological disorders in first-degree relatives. Event-related potentials (ERPs) were recorded while participants performed a visual oddball task (twice within a 2-year interval). The latency and amplitude of the P3b component of the ERPs were analysed. Results: The P3b amplitude was larger in young BDs than in aged-matched controls at both evaluation times, and the difference was more pronounced after 2 years of maintenance of a BD pattern of consumption. The larger P3b amplitude was associated with an earlier onset of regular drinking and with a greater quantity and intensity of consumption. Conclusions: These findings suggest that young BDs exhibit anomalies in neural activity involved in attentional/working memory processes, which increase after 2 years of maintenance of BD. This anomalous neural activity may reflect underlying dysfunctions in neurophysiological mechanisms as well as the recruitment of additional attentional/working memory resources to enable the binge drinkers to perform the task adequately., The study was supported by a grant from the Galician Regional R&D Autorithy, Xunta de Galicia, (INCITE08PXIB211015PR) and two grants from the Spanish Ministerio de Ciencia e Innovacion (EDU2008-03400; PSI2011-22575). Eduardo Lopez-Caneda was supported by the FPU program (AP2008-03433) of the Spanish Ministerio de Educacion; S.D. was supported by a postdoctoral contract from the Isidro Parga Pondal program (Xunta de Galicia, Spain), and A.F.G. was supported by the FPI program (CG2008-0461-C02-01) of the Spanish Ministerio de Ciencia e Innovacion.

Background: Adolescence is a time of considerable neurodevelopment. Binge drinking (BD) during this period increases the vulnerability to its neurotoxic effects. This longitudinal study aimed to investigate the relationship between BD trajectory over university years and neuropsychological functioning.Methods: Cohort-study. Two-year follow-up. A total of 89 university students were assessed: 40 Non-BD (at Initial and Follow-up), 16 Ex-BD (BD at Initial but not at Follow-up) and 33 BD (at both times). Neuropsychological assessment of working memory, episodic memory and executive abilities was carried out during their first (Initial) and third (Follow-up) academic year at the University of Santiago de Compostela.Results: BD subjects performed less well on the Wechsler Memory Scale-III (WMS-III) Logical Memory Subtest (immediate theme recall, P=.034; delayed theme recall, P=.037; and percent retention, P=.035) and committed more perseverative errors on the Self-Ordered Pointing Task (SOPT) (P=.021) than Non-BD. There were no differences between Ex-BD and Non-BD.Conclusions: Binge drinking trajectory during adolescence is associated with neuropsychological performance. Persistent BD, but not Ex-BD, is associated with verbal memory and monitoring difficulties. This is compatible with the hypothesis that heavy alcohol use during adolescence may affect cognitive functions that rely on the temporomesial and dorsolateral prefrontal cortex., Funding for this study was provided by Ministerio de Ciencia e Innovacion and Xunta de Galicia of Spain; they had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.