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The relation is investigated between situational drinking norms which accept heavier drinking and the experience of harm from others' drinking. How does the experience of such harm relate to the acceptance of heavier drinking in drinking situations? Respondents in a 2021 combined sample from random digitally dialed mobile phones and a panel survey of Australian adults (n = 2,574) were asked what level of drinking is acceptable in 11 social situations, including 3 "wet" situations where drinking is generally acceptable. Besides their own drinking patterns, respondents were also asked about their experience of harm from others' drinking in the last 12 months. Focussing on respondents' answers concerning the wetter situations, regression analyses were used to examine the relation between experiencing such harm and views on how much drinking was acceptable in the situations. Heavier drinkers were more likely to have experienced harm from others' drinking. Among heavier drinkers, those who experienced such harm generally did not differ significantly in their normative acceptance of any drinking in "wet" situations but were more accepting of drinking enough to feel the effects. From these cross-sectional results, experiencing harm from others' drinking does not seem to result in less acceptance of drinking to intoxication; rather, experiencing such harm was associated with more acceptance of heavy drinking. However, these findings may be the net result of influences in both directions, with the acceptance of intoxication in wet situations being more common among heavier drinkers, whose drinking exposes them to harm from others' drinking. [ABSTRACT FROM AUTHOR]

Objectives: Risky drinking is a concern among UK-based middle-aged adults. We aimed to explore the relationship between risky drinking, drinking motives, wellbeing, and mental health literacy (MHL). Method: Cross-sectional analysis of online survey data completed by 193 UK-based adults aged 40–65 who drank alcohol, incorporating the Alcohol Use Disorders Identification Test (AUDIT); Drinking Motives Questionnaire-Revised (DMQ-R); Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS); Mental Health Literacy Scale (MHLS) and demographic questions. Results: Coping, enhancement and conformity motives and gender significantly predicted higher AUDIT scores (measuring risky drinking). Enhancement motives were found to mediate the relationship between the self-help component of MHL and AUDIT scores, while coping motives mediated the association between wellbeing and AUDIT scores. Conclusion: Findings support research emphasising the influence of drinking motives on risky drinking and highlights how low wellbeing may interact with coping motives to explain risky drinking among middle-aged adults, particularly men. Interventions supporting individuals to understand the relationship between drinking motives and risky drinking, develop adaptive coping strategies, and address the causes of low wellbeing, may be beneficial. However, as the sample was 84% ethnically White, 64% women, 85% educated to at least undergraduate level, and reported a relatively high mean socioeconomic status (6.98 out of 10), the results may not generalise beyond these groups. Future research should use stratified sampling to increase generalisability, as well as exploring whether alcohol-specific, component-specific, or disorder-specific MHL is associated with risky drinking and wellbeing. [ABSTRACT FROM AUTHOR]

Problem-drinking among university students is common and poses serious health-related risks. Therefore, identifying and addressing associated factors is important. A large cross-sectional online-survey with 12,914 university students from Berlin was conducted from November 2016 to August 2017. Relative-risk- and correlation-analysis was used to identify factors associated with problem-drinking and regular heavy-drinking. Independent t-tests compared impulsivity and personality traits, chi-square-tests compared drinking motives between risk- and non-risk-drinkers. Male gender, tobacco-smoking, illegal substance use, impulsivity and various sociodemographic and psychosocial variables were significantly related to problem/heavy-drinking. Extraversion was a risk, conscientiousness and agreeableness were protective factors. Drinking-motives did not differ significantly between risk- and non-risk-drinkers. Generally, the main drinking-motives were to feel elated, relax and social purposes. The identified markers and related problem behaviors may serve as a tool to enhance the identification of student subgroups at risk for problem/heavy-drinking, and hence improve targeted health-intervention-programs. [ABSTRACT FROM AUTHOR]

Background: Relations among attention-deficit/hyperactivity disorder (ADHD), sleep, and substance-related negative consequences are largely unknown. In this cross-sectional study, we examined associations among ADHD diagnosis, sleep, and alcohol-related consequences. We also evaluated the independent and interactive effects of sleep and ADHD on alcohol-related negative consequences, above and beyond levels of alcohol use. Methods: College students who drink alcohol with (n = 51) and without (n = 50) ADHD completed an assessment that included a diagnostic interview assessing ADHD, and questionnaire measures of sleep quality, substance use, and associated consequences. Analyses utilized a series of hierarchical linear regression models and explored these aims for cannabis use in a subset of participants (n = 52 participants that used cannabis). Results: College students who drink alcohol with ADHD reported significantly worse sleep quality and more alcohol-related consequences, relative to those without ADHD. When ADHD and sleep quality were included in the model, ADHD—but not sleep quality—was independently associated with alcohol consequences, but not cannabis consequences. There were no moderating effects of ADHD on the associations between sleep and substance-related consequences. Conclusions: Students who drank alcohol with ADHD may be particularly vulnerable to experiencing poor sleep and consequences from their substance use, compared to their heavy drinking peers without ADHD. Future, larger scale studies should consider longitudinal effects as well as underlying mechanisms of risk. [ABSTRACT FROM AUTHOR]

Background: Psychoeducation constitutes a routine therapeutic practice in most treatment settings for severe alcohol use disorder (sAUD). This technique is considered an efficient way to help patients to learn more about their disease and achieve therapeutic objectives. However, this approach capitalizes on three untested assumptions: namely, that (1) patients with sAUD possess insufficient knowledge about sAUD at treatment entry; (2) patients with sAUD have the cognitive resources to learn new information and benefit from psychoeducation; and (3) psychoeducation positively impacts clinical outcomes. Methods: We tested these assumptions in two experimental studies. In the first experiment in 66 recently detoxified patients with sAUD and 102 matched healthy controls, we measured baseline knowledge on sAUD through self‐reported questionnaires, determined whether an up‐to‐date psychoeducation program can improve this knowledge, explored the role of cognitive abilities in such learning, and established the impact of psychoeducation on relapse rates. In a second experiment in 23 patients and 17 healthy controls, we examined whether the increased knowledge following psychoeducation is alcohol specific, and whether the motivation to change influences the relation between psychoeducation and clinical outcomes. Results: At treatment entry, patients with sAUD presented with more sAUD‐related knowledge than healthy controls, and were able to increase this knowledge following psychoeducation, independently of their cognitive status. However, psychoeducation did not impact either the motivation to change or relapse rates. Conclusions: Psychoeducation can increase patients' knowledge about sAUD, but it does not increase the likelihood of abstinence or controlled low consumption after discharge. Thus, clinicians should question whether psychoeducation should occupy a central position in the therapeutic programs and reconsider what can be expected from psychoeducation in terms of achieving therapeutic objectives. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorder (AUD) is commonly associated with distressing psychological symptoms. Pathologic changes associated with AUD have been described in both the gut microbiome and brain, but the mechanisms underlying gut‐brain signaling in individuals with AUD are unknown. This study examined associations among the gut microbiome, brain morphometry, and clinical symptoms in treatment‐seeking individuals with AUD. Methods: We performed a secondary analysis of data collected during inpatient treatment for AUD in subjects who provided gut microbiome samples and had structural brain magnetic resonance imaging (MRI; n = 16). Shotgun metagenomics sequencing was performed, and the morphometry of brain regions of interest was calculated. Clinical symptom severity was quantified using validated instruments. Gut‐brain modules (GBMs) used to infer neuroactive signaling potential from the gut microbiome were generated in addition to microbiome features (e.g., alpha diversity and bacterial taxa abundance). Bivariate correlations were performed between MRI and clinical features, microbiome and clinical features, and MRI and microbiome features. Results: Amygdala volume was significantly associated with alpha diversity and the abundance of several bacteria including taxa classified to Blautia,Ruminococcus, Bacteroides, and Phocaeicola. There were moderate associations between amygdala volume and GBMs, including butyrate synthesis I, glutamate synthesis I, and GABA synthesis I & II, but these relationships were not significant after false discovery rate (FDR) correction. Other bacterial taxa with shared associations to MRI features and clinical symptoms included Escherichia coli and Prevotella copri. Conclusions: We identified gut microbiome features associated with MRI morphometry and AUD‐associated symptom severity. Given the small sample size and bivariate associations performed, these results require confirmation in larger samples and controls to provide meaningful clinical inferences. Nevertheless, these results will inform targeted future research on the role of the gut microbiome in gut‐brain communication and how signaling may be altered in patients with AUD. [ABSTRACT FROM AUTHOR]

Background The popularity of temporary abstinence challenges (TACs) concerning alcohol consumption is increasing. Support is found to be essential for participants to help them get through a challenge. This study aimed to evaluate the additional effect of a self-help guide, based on health behaviour theories and behaviour change techniques, on (i) successful completion of a TAC and (ii) changes in drinking refusal self-efficacy (DRSE), behavioural automaticity, craving, and alcohol consumption. Methods A randomized controlled trial was performed (OSF registries: OSF.IO/B95VU). NoThanks participants received a questionnaire before the TAC (T0) and 8 months after the TAC (T1). Out of a subgroup of 1308 respondents who were interested in additional support, 652 were randomly assigned to receive the guide (experimental group), and 656 did not receive any additional support (control group). Logistic regressions and (generalized) linear mixed model analyses were used. Results After 8 months, all participants showed a significant decrease in behavioural automaticity, craving, and alcohol consumption, irrespective of group assignment. No significant changes were observed in the DRSE. This degree of change over time in behavioural automaticity, craving, and alcohol consumption did not differ between the experimental and control group. Sensitivity analyses with participants in the experimental group, who differed in exposure to the guide, did not show differences either. Conclusion The self-help guide, and how it was designed, added no value to the TAC. Future research should focus on more bottom-up, customized support and explore what (different subgroups of) participants think they need as extra support during a TAC. [ABSTRACT FROM AUTHOR]

Aims The objective of the current study was to describe and analyse associations between childhood emotional abuse, severity of depressive symptoms, and analgesic expectations of drinking in individuals with alcohol use disorder (AUD). Methods A total of 240 individuals aged 43.85 ± 11.0 with severe AUD entering an inpatient, abstinence-based, and drug-free treatment program were assessed. The data on AUD severity, depressive symptoms, expectations towards the analgesic effects of alcohol and childhood emotional trauma was collected using questionnaire measures. The PROCESS SPSS macro for serial mediation with bootstrapping was used to test whether current severity of depressive symptoms and expectations towards analgesic effects of alcohol use serially mediated the association between childhood emotional abuse on AUD symptom severity. Results There was evidence for two simple mediated effects, whereby the severity of depressive symptoms mediated the association between childhood emotional abuse on AUD symptom severity, and expectations towards analgesic effects of alcohol mediated the association between childhood emotional abuse on AUD symptom severity. There was also evidence to support serial mediation whereby both severity of depressive symptoms and expectations towards analgesic effects of alcohol mediated the association between childhood emotional abuse on AUD symptom severity. Conclusions It might be clinically relevant to address experiences of childhood emotional trauma, as well as individual expectations of analgesic effects of alcohol, in AUD treatment programs. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol and substance use are increasing in older adults, many of whom have depression, and treatment in this context may be more hazardous. We assessed alcohol and other substance use patterns in older adults with treatment‐resistant depression (TRD). We examined patient characteristics associated with higher alcohol consumption and examined the moderating effect of alcohol on the association between clinical variables and falls during antidepressant treatment. Methods: This secondary and exploratory analysis used baseline clinical data and data on falls during treatment from a large randomized antidepressant trial in older adults with TRD (the OPTIMUM trial). Multivariable ordinal logistic regression was used to identify variables associated with higher alcohol use. An interaction model was used to evaluate the moderating effect of alcohol on falls during treatment. Results: Of 687 participants, 51% acknowledged using alcohol: 10% were hazardous drinkers (AUDIT‐10 score ≥5) and 41% were low‐risk drinkers (score 1–4). Benzodiazepine use was seen in 24% of all participants and in 21% of drinkers. Use of other substances (mostly cannabis) was associated with alcohol consumption: it was seen in 5%, 9%, and 15% of abstainers, low‐risk drinkers, and hazardous drinkers, respectively. Unexpectedly, use of other substances predicted increased risk of falls during antidepressant treatment only in abstainers. Conclusions: One‐half of older adults with TRD in this study acknowledged using alcohol. Use of alcohol concurrent with benzodiazepine and other substances was common. Risks—such as falls—of using alcohol and other substances during antidepressant treatment needs further study. Key points: Approximately half of older adults with treatment‐resistant depression acknowledged drinking alcoholAmong drinkers, 24% were also using benzodiazepine and 10% were using other substances like cannabisUse of other substances (mostly cannabis) was associated with alcohol consumption [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorder (AUD), posttraumatic stress disorder (PTSD), and suicide are substantial public health concerns among military service members, yet the nature of their relationships is not well understood. Here, we tested the hypothesis that AUD moderates the relationship between PTSD symptom severity and suicidal ideation. Methods: This secondary analysis uses data collected at baseline for a randomized clinical trial. The sample consists of 160 active‐duty service members from three service branches (Army, Air Force, and Navy). All participants met diagnostic criteria for PTSD and were not engaged in evidence‐based PTSD treatment at the time of enrollment. Zero‐inflated Poisson generalized linear regression models were used to test the associations of PTSD and AUD symptom severity with the presence and severity of suicidal ideation. Results: Findings suggest that AUD symptom severity moderates (i.e., amplifies) the relationship between PTSD symptoms and severity of suicidal ideation among military personnel with untreated PTSD. Among service members with mild or absent AUD, we found no significant association between PTSD symptoms and the severity of suicidal ideation. However, when AUD severity was average (i.e., sample mean) or high (mean + 1SD), PTSD symptoms were significantly positively associated with the severity of suicidal ideation. Conclusions: This study highlights the importance of assessing AUD and PTSD as a part of suicide risk evaluations of veterans. The results also provide strong support for the maintenance and further development in the military health system of treatment programs that simultaneously address AUD and PTSD comorbidity. [ABSTRACT FROM AUTHOR]

Existing measures of reasons for limiting alcohol use are over 30 years old or don't distinguish between limiting drinking/abstinence and limiting heavy drinking. The present study describes the development and evaluation of the Reasons for Limiting Heavy Drinking (RFLHD), a 15-item measure assessing reasons to limit heavy drinking. Participants were 591 college students from two southern universities identifying primarily as White (68%) and female (82.3%) who completed the RFLHD, Protective Behavioral Strategies Survey-20, US-Alcohol Use Disorder Identification Test Consumption scale, and the Brief Young Adult Alcohol Consequences Questionnaire. Exploratory factor analyses supported a two-factor solution – Avoiding Consequences (i.e., limiting use to reduce alcohol related negative consequences) and – Personal and Other's Values (i.e., limiting use in accordance with personal, or other people's values, regarding alcohol consumption). Generally, the RFLHD was negatively correlated with measures of alcohol use measures and positively correlated with measures of alcohol harm reduction. The RFLHD displayed promising preliminary psychometric properties in this study. Harm reduction interventions aimed at the behavioral component of alcohol use may benefit from using the RFLHD to examine cognitive motivations for limiting heavy drinking. Further investigation of the RFLHD is needed to advance the measure. [ABSTRACT FROM AUTHOR]

Introduction: Self‐compassion and self‐forgiveness are two self‐focused, positive coping approaches that may reduce risk of problem drinking and/or aid in treatment/recovery from alcohol use disorder. The present systematic review aimed to evaluate support for the unique and complementary roles of self‐compassion and self‐forgiveness in alcohol outcomes. Methods: A systematic literature search yielded 18 studies examining self‐compassion, 18 studies examining self‐forgiveness and 1 study examining both constructs in alcohol outcomes. Results: Findings suggest greater self‐compassion and self‐forgiveness relate to lower likelihood of problem drinking. Self‐forgiveness was considerably more researched in treatment/recovery outcomes than self‐compassion; self‐forgiveness‐based interventions appear able to improve drinking‐adjacent outcomes, and self‐forgiveness may increase across various alcohol treatments. Finally, research suggests that associations of self‐compassion and/or self‐forgiveness with alcohol outcomes could be driven by numerous factors, including coping‐motivated drinking, depression, psychache, social support perceptions, mental health status and/or psychiatric distress. Conclusions: Self‐compassion and self‐forgiveness both appear protective against harmful alcohol outcomes. Nevertheless, many questions remain about the role of self‐forgiveness and, particularly, self‐compassion in alcohol treatment and recovery outcomes. Future research should examine whether targeted interventions and/or adjunctive therapeutic supports designed to increase self‐compassion or self‐forgiveness can reduce alcohol use disorder symptoms to facilitate alcohol treatment and recovery success. [ABSTRACT FROM AUTHOR]

Objective: Compared to their male counterparts, women with alcohol use disorders (AUD) alone and those with symptoms of co-occurring emotional disorders (posttraumatic stress disorder, PTSD, and depression) are particularly likely to have increased alcohol craving in response to negative affect and daily stressors. Emotion dysregulation is one transdiagnostic construct that may underlie heightened craving in response to stress within this population. In a secondary data analysis, the current study examined emotion dysregulation as a mediator of the associations of posttraumatic stress symptoms (PTSS) and depression symptoms with heightened stress-induced alcohol craving, as measured in the lab. Given the overlap in symptoms, the relative associations of PTSD and depression symptom clusters with stress-induced craving were explored. Method: 50 women Veterans (84% White, 88% Non-Hispanic, Mage=45.68) attended two in-lab sessions. Self-report measures of emotion dysregulation, PTSD, and depression symptoms were administered at baseline. During session two, participants reported on alcohol craving and negative affect at baseline and again after a personalized stress induction procedure. Results: Emotion dysregulation mediated the association of greater PTSS with heightened stress-induced craving, although emotion dysregulation was not a mediator of the association between depression and stress-induced craving. Greater alcohol craving after the stress induction was positively associated with cognitive-affective symptoms in PTSD and depression (and not with other symptom clusters of these diagnoses, e.g., avoidance, somatic-vegetative symptoms). Conclusions: Emotion dysregulation may be a transdiagnostic factor that helps to explain greater alcohol cravings and drinking in stressful contexts among women Veterans with heightened symptoms of co-occurring emotional disorders. [ABSTRACT FROM AUTHOR]

Excessive alcohol consumption is often followed by feelings of regret. This study aimed to explore country differences in experiences of drunkenness and regrets and predictors of experiencing a greater number of regrettable drinking occasions. This study draws on a sample of 82,821 respondents from 31 countries who completed the 2020 Global Drug Survey. Respondents were asked to report how many times in the last year they had been drunk, how many of those times they felt regret afterwards and to complete a range of sociodemographic measures. In the last 12 months, the median times drunk was 6 and the median number of regretted occasions was 2. There was an inverse relationship between times drunk and regret. Respondents who got drunk more often regretted it a smaller percentage of the time than those who got drunk less often. Respondents from Argentina and Colombia regretted being drunk the most and Denmark the least. Being younger, in higher AUDIT categories were associated with more times drunk. Being a woman, having mental health conditions were associated with more regretted occasions. Discussion and conclusions: Country variations may reflect relative acceptability of being drunk. Those who drink more, per occasion, may become accustomed to the consequences and feel fewer regrets. Interventions promoting reduced alcohol consumption may benefit from encouraging people to consider their future regret following a drinking occasion but should account for lower levels of regret in those who get drunk more often. [ABSTRACT FROM AUTHOR]

Background: Drinking commonly occurs in social settings and may bolster social reinforcement. Laboratory studies suggest that subjective effects and mood are mechanisms through which the social context influences alcohol consumption. Ecological momentary assessment (EMA) may be useful for extending these findings to the natural environment. This pre-registered secondary analysis of EMA data investigated the influence of the social environment on: (1) stimulating and sedating subjective effects of alcohol, (2) contentedness and negative affect, and (3) next-day evaluations of the drinking occasion. Methods: Nontreatment seeking adults reporting past-month heavy drinking (N = 131; Mage = 28.09; 42% female) completed 7 days of EMA (in the morning, at random, and following drinking prompts), which included questions on their social context (drinking in the presence of known others or alone), contemporaneous stimulating and sedating effects, contentedness and negative affect, alcohol consumption, and next-day evaluations of a prior day's drinking event (how satisfying/pleasant was drinking). We used multi-level models in SAS 9.4 M7 software to examine relations among the variables. Results: Contemporaneous subjective effects (stimulating or sedating), negative affect, and contentedness did not significantly depend on the social context. For next-day evaluations of pleasure/satisfaction from drinking, context effects were dependent on consumption totals. As the total number of standard drinks consumed increased, recollections of pleasure/satisfaction were higher when drinking had occurred with others, relative to alone. At lower consumption totals, next-day evaluations did not appear to depend on social context. Conclusions: When reported contemporaneously, subjective effects and affect do not appear dependent upon the presence of known others. However, heavier drinking events, relative to lighter drinking events, are appraised more favorably the following day when occurring within social contexts. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorder (AUD) is highly prevalent among veterans in the United States. Self-regulation skills (e.g., coping and emotion regulation) are important biopsychosocial factors for preventing relapse. However, how variation in self-regulation skills supports abstinence based on contextual demands is understudied in veterans with AUD. Methods: In a prospective longitudinal design, treatment-seeking veterans (n = 120; 29 females) aged 23-91 with AUD completed the Alcohol Abstinence Self-Efficacy Scale to assess temptation to drink across several high-risk situations (i.e., negative affect, social/positive emotions, physical concerns, and craving/urges) as well as the Brief-COPE and Emotion Regulation Questionnaire to assess self-regulation skills. Abstinence status was assessed at 6 months. T-tests were used to identify self-regulation skills that differed between abstinent and non-abstinent individuals. Multivariate regression with model selection was performed using all possible interactions between each high-risk situation and the self-regulation skills that significantly differed between groups. Results: Overall, 33.3% of participants (n = 40; nine females) were abstinent at 6 months. Abstinent individuals reported significantly higher use of suppression (p = 0.015), acceptance (p = 0.005), and planning (p = 0.045). Multivariate regression identified significant interactions between (1) planning and physical concerns (p = 0.010) and (2) acceptance, suppression, and craving/urges (p = 0.007). Greater planning predicted abstinence in participants with higher temptation to drink due to physical concerns (e.g., pain). For individuals with lower temptation to drink due to cravings/urges, simultaneous higher suppression and acceptance increased the likelihood of abstinence. Conversely, for participants with higher cravings, greater acceptance with lower suppression was linked to a higher probability of abstinence. Conclusions: Results suggest that the adaptiveness of self-regulation skills in predicting AUD recovery is dependent on contextual demands and highlight the need for culturally sensitive treatments. Collectively, these findings indicate that further research on coping and regulatory flexibility may be an important avenue for tailoring AUD treatment for veterans. [ABSTRACT FROM AUTHOR]

The purpose of the current study is to examine college student status (international vs. domestic) across alcohol social norms perception. Undergraduates (n = 3081) were recruited for the study. Most participants were female (69.9%) and White (98.2%), with the average age of participants was 19.97 (SD = 1.61). Approximately 17.3% (n = 534) of the students were international (i.e., nonresident alien who are in the US for a bachelor's degree). It is a cross-sectional study. International students reported significantly lower social norms than domestic students. International students in later college years reported norms closer to domestic students. International women endorsed social norms at a higher level than international men. Assimilation into U.S. drinking culture may be linked with increased support of drinking norms among International students. This study shows the importance of incorporating drinking norms prevention strategy and cultural diversity awareness training to increase international students' knowledge and prevent misconceptions. International students' social norms should be examined for future drinking interventions. Interventions for college drinking should target specific events and context with short-term increase in hazardous drinking behavior but long-lasting effects. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the impact of a culturally based intervention, the Intertribal Talking Circle program, compared to a standard alcohol and drug abuse education, the Be A Winner program. Community‐based participatory research was used to implement a two‐condition, quasi‐experimental study. The sample included 540 Native American youth ages 10−12 years old from three tribal areas in the United States. Data were collected at baseline, 6 and 12‐months post‐intervention for both the intervention and control groups using demographic, cultural identity, alcohol use, and drug use questionnaires. Regression models evaluated participants' improvement in decreasing alcohol and drug use and increasing cultural identity. Findings revealed that alcohol and drug use decreased more significantly among youth who participated in the Intertribal Talking Circle (ITC) intervention program than youth who participated in a standard alcohol and drug abuse education Be A Winner (BAW) program. Cultural identity also increased more significantly among participants who completed the Talking Circle intervention program. Native American youth ages 10−12 years old respond positively to a culturally based intervention for the reduction of alcohol and drug use. The findings highlight the importance of cultural values and identity and their significance in preventing and reducing alcohol and drug use among Native American youth. [ABSTRACT FROM AUTHOR]

This study extends the limited research on predictors of completion of adolescent residential drug and alcohol program. A Queensland, Australia, five-bed state-wide voluntary adolescent drug and alcohol withdrawal service collected routine clinical pre-entry data over a period of 9 years (2000–2009) on 524 subjects. Potential predictors of program completion included socio-demographic, family functioning, past mental health history, mental health problems on admission, and patterns of drug use variables. The chi-square analysis identified significant predictors with subsequent multivariate logistic regression modeling. Given the loss of data, additional multiple imputation logistic regression analysis was utilized. Initial predictors were aged 17 and over; a past history of psychiatric treatment or violence or assault; mental health problems identified on entry; absence of current alcohol use or ecstasy use. After regression and multiple imputation modeling, predictors were a history of psychiatric treatment and of violence/assault. A history of co-morbidity rather than traditional markers of good outcomes such as sex, ethnic background, income support, and housing support predicted program retention. The study reinforces the important role of non-substance psychiatry co-morbidity in the treatment of substance use disorder. [ABSTRACT FROM AUTHOR]

High compliance is a priority for successful ecological momentary assessment (EMA) research, but meta-analyses of between-study differences show that reasons for missed prompts remain unclear. We examined compliance data from a 14-week, 182-survey EMA study of undergraduate alcohol use to test differences over time and across survey types between participants with better and worse compliance rates, and to evaluate the impact of incentives on ongoing participation. Participants were N = 196 students (65.8% female; M age = 20.6). Overall compliance was 76.5%, declining gradually from 88.9% to 70% over 14 weeks. Declines were faster in participants with lower overall compliance, but we found no demographic, personality, mental health, or substance use differences between participants with better versus worse compliance rates. Compliance varied by survey type, and unannounced bonus incentives did not impact compliance rates. Participants completed fewer surveys the week after winning a gift card. We offer recommendations for designing future EMA studies. [ABSTRACT FROM AUTHOR]

Background and aims: Alcohol use disorder (AUD) is one of the strongest predictors of suicidal behavior. Here, we measured risk of suicide attempt and death as a function of AUD typologies. Design: We used AUD typologies from previous latent class analysis: (i) externalizing subtype (characterized by externalizing symptomatology and early age of onset; individuals in this group have lower education and higher familial/social difficulties); (ii) subtype described by minimal psychopathology; and (iii) internalizing subtype (characterized by internalizing symptomatology and later age of onset; individuals in this group have higher education). We used class membership to predict distal outcomes (attempt and death) and performed regressions to evaluate whether differences in suicidal behavior were explained by the group characteristics (sex, age of onset, number and type of AUD registrations, familial/genetic risk for AUD, externalizing and internalizing behaviors, socio‐economic indicators, marital status and childhood family status). We also evaluated the effect of suicide attempt prior to AUD. Setting and participants: Based on longitudinal Swedish registry data, we included 217 074 individuals with AUD born 1950–80. Measurements Suicide attempts were identified using medical registers and deaths using the mortality register. Findings Individuals with the externalizing subtype had higher risks of suicidal behavior than other groups [attempt: externalizing versus minimal psychopathology: odds ratio (OR) = 1.35, 95% confidence interval (CI) = 1.35, 1.35; externalizing versus internalizing: OR = 1.47, 95% CI = 1.46, 1.48; death: externalizing versus minimal psychopathology: OR = 1.57, 95% CI = 1.57, 1.58; externalizing versus internalizing: OR = 1.99, 95% CI = 1.93, 2.06]. Individuals with minimal psychopathology had higher risks than those with internalizing symptomatology (attempt: OR = 1.09, 95% CI = 1.08, 1.10, death: OR = 1.26, 95% CI = 1.23, 1.30). These differences were explained by age at registration and were related to the number of registrations, sex, education, family disruption and suicide attempt prior to AUD. Conclusions: Among people in Sweden, considering alcohol use disorder (AUD) heterogeneity appears to be a meaningful way to evaluate suicide risk. The highest risk of suicide attempt and death occurs in the externalizing subtype of AUD, followed by the minimal psychopathology subtype, and then the internalizing subtype. [ABSTRACT FROM AUTHOR]

Recovery coaches are individuals with lived experience with recovery from substance use disorder who typically engender a greater sense of trust than found with other types of healthcare providers. However, there currently are no validated tools that measure the connection between recovery coaches and their participants. The purpose of this study was to describe the initial development of the Scales for Participant Alliance with Recovery Coach (SPARC) to measure recovery coach connection or alliance, including initial psychometric analyses. Measurement development began with five scales of the Client Evaluation of Self Treatment (treatment participation, treatment satisfaction, rapport, peer support, and social support). Adapted items were pre-tested with focus groups (n = 8) to ensure they were meaningful and accurately reflected the domains (Study 1). After modifications, the SPARC has six scales (engagement, satisfaction, rapport, motivation and encouragement, role model and community linkage). The survey was piloted with 100 individuals (Study 2) age 18 or over who had met with a recovery coach within the last six months. Most study participants were male (60%) and white (87%) with less than two years in recovery. After removing two low performing items, the items for five of the domains had acceptable internal consistency. The items for the engagement domain had a slightly lower reliability. Findings suggest that items cover relevant recovery coach roles, are internally consistent within domains, and can be easily administered to individuals engaging in recovery coaching services. Additional research is needed with a larger, more heterogenous sample to further refine items. [ABSTRACT FROM AUTHOR]

Background: Sexual minority women (SMW) use alcohol at higher rates and experience greater alcohol‐related harms than their heterosexual counterparts. Evidence from observational studies suggests that minority stress (i.e., stress experienced due to marginalization in society) is an important risk factor among SMW, yet there is a lack of experimental evidence to establish a direct causal role of minority stress on alcohol use in this population. We adapted the preexisting personalized guided stress induction paradigm to conduct a pilot study of how minority stress is related to stress response (assessed via subjective measures and salivary cortisol) and mechanisms of alcohol use (craving, demand, and risky decision making) in SMW. Methods: Using a within‐subjects design (N = 8) cisgender SMW who endorsed high‐risk drinking (≥1 heavy drinking episode in the past 30 days) completed three study visits: a script development session and two in‐person imagery induction appointments (minority stress and neutral). Analyses examined feasibility and acceptability, stress response, and mechanisms of alcohol use. Results: The paradigm significantly increased subjective stress response (g = 1.32). Data supported the feasibility, acceptability, and appropriateness of the paradigm for use with SMW. While the paradigm did not significantly change scores on minority stress and alcohol outcomes measures, effect sizes for craving and minority stress outcomes were in the small‐to‐medium range (gs = 0.24–0.54). Conclusions: The adapted minority stress paradigm appears to be feasible and appropriate for use with SMW to induce stress in laboratory settings. Future research can use this paradigm to understand the causal effects of minority stress on alcohol use and related outcomes. [ABSTRACT FROM AUTHOR]

The aim of this study was to estimate the level of empathy among primary care (PC) health professionals and its relationship with their approach to patients at risk due to alcohol consumption. This is an observational, descriptive, and multicenter study that included 80 PHC professionals. The professionals completed a questionnaire comprising socio-occupational questions and inquiries regarding their actions when dealing with patients suspected of risky alcohol consumption. The Jefferson Scale of Empathy was used to measure their level of empathy and was completed by 80 professionals, of whom 57.5% were family physicians, 10% were nurses, and 32.5% were family- and community-medicine residents. The mean age was 39.5 ± 13.1 (SD) (range of 24–65 years) and 71.3% were females. The mean empathy level score was 112.9 ± 11.1 (95% CI: 110.4–115.4; range: 81–132 points). Actions that stood out for their frequency were providing health advice in the general population, offering advice to pregnant women, and recommending abstinence to users of hazardous machinery or motor vehicles. The level of empathy was associated with age (p = 0.029), the health center's scope (p = 0.044), systematic alcohol exploration (p = 0.034), and follow-ups for patients diagnosed with risky consumption (p = 0.037). The mean score obtained indicated a high level of empathy among professionals. Professionals with greater empathy more frequently conducted systematic screening for risky alcohol consumption. [ABSTRACT FROM AUTHOR]

Whilst research has demonstrated the influence of individual and social identities on drinking‐related beliefs and behaviours, none evaluates how identities' incompatibilities are associated with mental health, current drinking status nor intentions, and motivations to change drinking behaviour. The current study explored how variability in incompatibilities between the social identities of being a drinker and a Christian related to mental health, alcohol use behaviour, and intentions to change drinking behaviour. A cross‐sectional online survey (via a recruitment platform, Prolific) recruited n = 180 US resident Christians who drank alcohol (56.4% male, 46.6% female, mean age = 37 years). Increased incompatibility between identities moderated the effect of current Christian identity on drinking change motivations—with the strongest links amongst those with the highest levels of incompatibility. A similar effect was also shown for increasing incompatibility between perceptions of the self as an individual and drinking behaviour (self/drinker incompatibility). The relationship between Christian identity on current drinking behaviour was also shown to be moderated by decreased Christian/drinker identity incompatibility but not self/drinker incompatibility. No relationships were identified for general mental well‐being. The study highlights that differences in the protective role of religious identities likely depend on how they relate to others, and the key role of identity incompatibility. [ABSTRACT FROM AUTHOR]

Background: Preoperative risky alcohol use is one of the most common surgical risk factors. Accurate and early identification of risky alcohol use could enhance surgical safety. Artificial Intelligence‐based approaches, such as natural language processing (NLP), provide an innovative method to identify alcohol‐related risks from patients' electronic health records (EHR) before surgery. Methods: Clinical notes (n = 53,629) from pre‐operative patients in a tertiary care facility were analyzed for evidence of risky alcohol use and alcohol use disorder. One hundred of these records were reviewed by experts and labeled for comparison. A rule‐based NLP model was built, and we assessed the clinical notes for the entire population. Additionally, we assessed each record for the presence or absence of alcohol‐related International Classification of Diseases (ICD) diagnosis codes as an additional comparator. Results: NLP correctly identified 87% of the human‐labeled patients classified with risky alcohol use. In contrast, diagnosis codes alone correctly identified only 29% of these patients. In terms of specificity, NLP correctly identified 84% of the non‐risky cohort, while diagnosis codes correctly identified 90% of this cohort. In the analysis of the full dataset, the NLP‐based approach identified three times more patients with risky alcohol use than ICD codes. Conclusions: NLP, an artificial intelligence‐based approach, efficiently and accurately identifies alcohol‐related risk in patients' EHRs. This approach could supplement other alcohol screening tools to identify patients in need of intervention, treatment, and/or postoperative withdrawal prophylaxis. Alcohol‐related ICD diagnosis had limited utility relative to NLP, which extracts richer information within clinical notes to classify patients. [ABSTRACT FROM AUTHOR]

Purpose: Farming is a high‐pressure occupation. Populations of farmers face significant health risks, including injury, mental illness, and in some cases, heavy alcohol use. However, there is little research on farmers' use of substances beyond alcohol. This study examines factors relating to Irish farmers' disordered alcohol and substance use. Methods: In accordance with STROBE guidelines for cross‐sectional research and reporting, we examined disordered alcohol and substance use in 351 Irish farmers using the Alcohol Use Disorders Identification Tool (AUDIT) and Drug Use Disorders Identification Tool (DUDIT). Findings: While 28% of farmers did not drink, 40% of those who did drink exceeded the AUDIT threshold for disordered use. Similarly, while 95% of farmers did not use substances, 78% of farmers who did use substances exceeded the DUDIT threshold for disordered use. Age was the most important risk factor for disordered alcohol and substance use and correlated with other main risk factors: lower income, no children, part‐time farmer, and full‐time off‐farm roles. Disordered drinking was highest in farmers engaged in full‐time education. Conclusions: This population of Irish farmers report broadly healthy alcohol and substance use behaviors. Irish farmers may serve as a model group whose strengths can be utilized in interventions within and beyond the Irish farming community. Our results confirm the importance of analyzing demographic factors in farmers' drinking and identify younger farmers as especially at‐risk for harmful alcohol and substance use. [ABSTRACT FROM AUTHOR]

Research suggests participant engagement is a key mediator of mHealth alcohol interventions' effectiveness in reducing alcohol consumption among users. Understanding the features that promote engagement is critical to maximizing the effectiveness of mHealth-delivered alcohol interventions. The purpose of this study was to identify facilitators and barriers to mHealth alcohol intervention utilization among hazardous-drinking participants who were randomized to use either an app (Step Away) or Artificial Intelligence (AI) chatbot-based intervention for reducing drinking (the Step Away chatbot). We conducted semi-structured interviews from December 2019 to January 2020 with 20 participants who used the app or chatbot for three months, identifying common facilitators and barriers to use. Participants of both interventions reported that tracking their drinking, receiving feedback about their drinking, feeling held accountable, notifications about high-risk drinking times, and reminders to track their drinking promoted continued engagement. Positivity, personalization, gaining insight into their drinking, and daily tips were stronger facilitator themes among bot users, indicating these may be strengths of the AI chatbot-based intervention when compared to a user-directed app. While tracking drinking was a theme among both groups, it was more salient among app users, potentially due to the option to quickly track drinks in the app that was not present with the conversational chatbot. Notification glitches, technology glitches, and difficulty with tracking drinking data were usage barriers for both groups. Lengthy setup processes were a stronger barrier for app users. Repetitiveness of the bot conversation, receipt of non-tailored daily tips, and inability to self-navigate to desired content were reported as barriers by bot users. To maximize engagement with AI interventions, future developers should include tracking to reinforce behavior change self-monitoring and be mindful of repetitive conversations, lengthy setup, and pathways that limit self-directed navigation. [ABSTRACT FROM AUTHOR]

Objective: To compare the ratio of the right and left second and fourth digits (2D:4D), aggression, and impulsivity levels in opiate use disorder (OUD), alcohol use disorder (AUD), and healthy controls. Methods: Eighty-four patients diagnosed with OUD, 58 patients diagnosed with AUD, and 58 healthy volunteers were included. Participants administered the sociodemographic data form, Barratt Impulsivity Scale (BIS-11), and Buss-Perry Aggression Questionnaire (BPAQ). Results: Healthy controls’ right-hand 2D:4D ratio was higher than the OUD and AUD groups (respectively; p < .001, p < .001). The right-hand 2D:4D ratio was similar between OUD and AUD (p = .542). Left-hand 2D:4D ratio of healthy controls was higher than OUD and AUD groups (respectively; p < .001, p < .001). The lefthand 2D:4D ratio was similar between OUD and AUD (p = .429). The BIS-11 scores of the healthy controls were lower than OUD and AUD groups (respectively; p < .001, p < .001). It was found similar in the AUD and OUD groups (p = .264). The BPAQ scores of the healthy controls were lower than the OUD group and the AUD group (respectively; p < .001, p < .001). It was found similar in the AUD and OUD groups (p = .973). Conclusion: It was found that the 2D:4D ratio of both hands in OUD and AUD patients is lower than that of healthy volunteers. The 2D:4D ratio can be an indicator of addiction, regardless of the type of substance used. [ABSTRACT FROM AUTHOR]

Background: Behavioral economic research has revealed significant increases in alcohol demand following exposure to alcohol‐related cues. Prior research has focused exclusively on nontreatment‐seeking heavy drinkers, included only male participants, or used heterogeneous methods. The current studies sought to replicate and extend existing findings in treatment‐seeking and nontreatment‐seeking heavy drinkers while also examining sex effects and moderation by alcohol use disorder (AUD) severity. Methods: Study 1 included 117 nontreatment‐seeking heavy drinkers (51.5% women; M age 34.69; 56.4% AUD+), and Study 2 included 89 treatment‐seeking heavy drinkers with AUD (40.4% women; M age = 41.35). In both studies, alcohol demand was measured using a hypothetical alcohol purchase task (APT), and subjective alcohol craving was measured using visual analog scales. Measures were collected following exposure to neutral (water) cues in a standard room and alcohol cues in a bar lab. Results: Alcohol demand (intensity, Omax, breakpoint, and elasticity) and craving were significantly increased following alcohol cues compared to neutral cues (ps < 0.005) with effect sizes ranging from small to large (ηp2 = 0.074–0.480). Participants with AUD (Study 1) or with higher AUD severity (Study 2) reported higher craving and higher demand for most indices (i.e., main effects; ps < 0.032, ηp2 = 0.043–0.239). A larger alcohol cue increase in Omax was found for AUD+ participants in Study 1 compared to non‐AUD participants (p = 0.028, ηp2 = 0.041) but not for any other indices in Study 1 or Study 2. There were no significant sex effects. Conclusions: These findings replicate and extend prior research by offering additional insight into alcohol cue effects on the reinforcing value of alcohol and subjective motivation to drink. The results also suggest that sex and AUD severity do not meaningfully impact cue effects across most indices of demand. [ABSTRACT FROM AUTHOR]

Substantial racial/ethnic disparities exist in adolescent alcohol use and related consequences. Although many protective and risk factors influence adolescent alcohol use across racial/ethnic groups, some determinants of alcohol use are more salient among adolescents of color. Understanding the determinants of alcohol use that are most relevant to adolescents of color is critical to informing the content of culturally sensitive prevention programs. This paper focuses on two categories of determinants of alcohol use that are often targeted in culturally sensitive prevention programs: alcohol-specific behavioral determinants and socio-cultural determinants. The paper also reviews the literature on how socio-cultural determinants influence alcohol use through alcohol-specific determinants among adolescents of color, and concludes by discussing implications for future research, prevention, and social work education. [ABSTRACT FROM AUTHOR]

This study examines the factors contributing to early-age alcohol initiation among adolescents, focusing on the Indian context. The research is based on qualitative data collected in a senior secondary school and analyzes adolescents' attitudes, situations, and experiences when making decisions related to alcohol initiation. The study found that adolescents are influenced by various factors such as parental alcohol consumption, availability of leftover drinks, family environment, parenting approach, and peer pressure, which collectively contribute to their inclination toward alcohol. The findings suggest that curiosity and expectancy play significant roles in alcohol-related choices, and peers strongly influence adolescents for alcohol initiation. Familial factors, including parental relationship, conflict and family dynamics, also contribute to adolescents' alcohol-related decisions. The study highlights the importance of understanding these factors to effectively address the issue and mitigate the associated risks and consequences. [ABSTRACT FROM AUTHOR]

Background: Mutual‐help organizations (MHOs) play a crucial role for many individuals with alcohol use disorder (AUD) or other substance use disorders in achieving stable remission. While there is now substantial research characterizing who uses 12‐step MHOs, very little is known about who becomes affiliated with newer and rapidly growing MHOs, such as Self‐Management and Recovery Training ("SMART" Recovery). More research could inform knowledge regarding who may be best engaged by these differing pathways. Methods: We conducted a cross‐sectional analysis of participants (N = 361) with AUD recruited mostly from the community who were starting a new recovery attempt and self‐selected into one of four different recovery paths: (1) SMART Recovery ("SMART‐only"; n = 75); (2) Alcoholics Anonymous ("AA‐only"; n = 73); (3) Both SMART and AA ("Both"; n = 53); and (4) Neither SMART nor AA ("Neither"; n = 160). We compared the groups on demographics, clinical history, treatment and recovery support service use, and indices of functioning and well‐being. We computed descriptives and conducted inferential analyses according to the data structure. Results: Compared to study participants choosing AA‐only or Both, SMART‐only participants were more likely to be White, married, have higher income and more education, be full‐time employed, and evince a pattern of lower clinical severity characterized by less lifetime and recent treatment and recovery support services usage, lower alcohol use intensity and fewer consequences, and less legal involvement. AUD symptom levels, lifetime psychiatric diagnoses, psychiatric distress, and functioning were similar across MHO‐engaged groups. Conclusion: SMART Recovery appears to attract individuals with greater psychosocial stability and economic advantage and less severe histories of alcohol‐related impairment and legal involvement. Findings suggest that certain aspects specific to the SMART Recovery group approach, format, and/or contents may appeal to individuals exhibiting this type of profile. As such, SMART appears to provide an additional resource that expands the repertoire of options for individuals with AUD who seek recovery. [ABSTRACT FROM AUTHOR]

Alcohol use is a major public health issue. It is also associated with a range of family, social, and economic problems. This led multiple countries worldwide to adopt national policies for alcohol regulation. Over the years, alcohol use and related problems have increased in India. The existing regulatory framework on alcohol varies greatly across states in terms of government sanctions, pricing, and legal drinking age, resulting in variations in its availability and prevalence of alcohol use disorder and related harms. Despite alcohol use being mentioned in several national policies and plans, a comprehensive national policy addressing alcohol is lacking. In this manuscript, the need for a dedicated national alcohol policy is underscored, emphasizing its potential to mobilize resources, prioritize interventions, and guide various stakeholders. The timely implementation of such a policy is crucial to address the multifaceted challenge of alcohol use effectively. [ABSTRACT FROM AUTHOR]

Background: There is no known risk-free level of alcohol use in pregnancy. Despite this, many still believe that occasional drinking is safe. To-date, there is limited evidence of the influences on women's decisions about low to moderate alcohol use in pregnancy. The aim of this study was to explore alcohol use intentions during pregnancy, using variables from the theory of planned behavior, the prototype/willingness model and personality variables. The study also investigated whether priming participants with exposure to prototypes describing different alcohol use behaviors had an impact on intentions. Methods: Participants, 746 women aged 20 to 45 years, were randomized to be prompted to think of one of two different "types" of behaviors, i.e., small level of alcohol use in pregnancy and ambiguous level of alcohol use in pregnancy. They then completed measures of theoretical variables, impulsivity, venturesomeness, and self-efficacy. Participants then answered whether they intended to use alcohol during a future pregnancy. Results: Over half of the variance in intentions to consume alcohol while pregnant were predicted by the final model (R2=.527, F (1, 438) = 13.201, p <.001). Positive attitudes toward alcohol use in pregnancy, from the theory of planned behavior, were the most significant predictor of intentions and intentions did not differ between groups according to prototype exposure. Conclusions: Future research should aim to explore the efficacy of interventions to reduce low to moderate alcohol use in pregnancy that utilize both the theory of planned behavior and prototype/willingness model to target determinants of intentions. [ABSTRACT FROM AUTHOR]

Background and aims: Alcohol use disorder is comorbid with numerous other forms of psychopathology, including externalizing disorders (e.g. conduct disorder) and, to a lesser extent, internalizing conditions (e.g. depression, anxiety). Much of the time, overlap among alcohol use disorder and other conditions is explored at the disorder level, assuming that criteria are co‐equal indicators of other psychopathology, even though alcohol use disorder criteria span numerous varied domains. Emerging evidence suggests that there are symptom clusters within the construct of alcohol use disorder that relate differentially with important external criteria, including psychopathology and allied personality traits (e.g. impulsivity, novelty‐seeking). The present study mapped individual alcohol use disorder criteria onto internalizing and externalizing dimensions. Design and participants: We used multivariate and factor analytical modeling and data from two large nationally representative samples of past year drinkers (n = 25 604; 19 454). Setting: United States. Measurements: Psychopathology was assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule, yielding alcohol use disorder criteria, internalizing diagnoses (i.e. major depressive disorder, dysthymia, social anxiety disorder, generalized anxiety disorder, specific phobia, agoraphobia and panic disorder) and externalizing diagnoses and symptoms (i.e. antisocial personality disorder, conduct disorder and three impulsivity items drawn from borderline personality disorder criteria). Alcohol consumption was assessed in terms of past‐year drinking frequency, usual amount of alcohol consumed on drinking days, binge drinking frequency, intoxication frequency, and maximum number of drinks in a 24‐hour period. Findings Four different patterns emerged. First, several alcohol use disorder criteria were relatively weakly associated with externalizing and internalizing. Secondly, withdrawal was associated with internalizing, but this association was not specific to distress. Thirdly, there was a general lack of specificity between alcohol use disorder criteria and narrower forms of internalizing, despite what might be predicted by modern models of addiction. Fourthly, recurrent use in hazardous situations reflected higher degrees of externalizing and lower internalizing liability. Conclusions: Different symptom combinations appear to yield differential expressions of alcohol use disorder that are disorder‐specific, or reflect broader tendencies toward externalizing, internalizing or both. [ABSTRACT FROM AUTHOR]

Objective: Interventions to address alcohol use during pregnancy need to target underlying determinants of the behaviour. Using the theory of planned behaviour as a theoretical framework, the aim of this study was to identify behavioural, normative and control beliefs regarding alcohol use during pregnancy among a sample of women. Design: 435 women completed a 15-minute online questionnaire designed to identify beliefs about alcohol use during pregnancy. Data were categorised according to type of belief and then summarised and described. Results: The majority of respondents saw few advantages of consuming alcohol during pregnancy and believed that most people would disapprove of alcohol use during pregnancy. Although most women endorsed alcohol abstinence during pregnancy, views on the perceived risk of different levels of alcohol use and perceptions of the 'typical' person who drinks while pregnant varied between participants. Conclusion: This work contributes to the understanding of women's beliefs about alcohol use during pregnancy. Future research should explore how women's beliefs inform their decision making about different levels of alcohol use in pregnancy. Additionally, further research or messaging about alcohol use in pregnancy must also consider the potential for contributing to stigmatising beliefs. [ABSTRACT FROM AUTHOR]

Aims Studies examining the use of specific emotion regulation (ER) strategies in patients with severe alcohol use disorder (AUD) are mainly focused on intergroup comparisons to the detriment of intragroup variability. Yet, these patients are in fact characterized by emotional deficits of varying severity, and we seek to identify different patterns of ER strategies in people with AUD during their first year of abstinence. Methods Based on the ER strategies used by a large sample of patients with AUD, we applied cluster analysis to identify the existence of subgroups using distinct patterns of adaptive and nonadaptive strategies. To characterize these groups, we compared their clinical characteristics and then their emotional regulation strategies to those of control consumers. Results A first cluster, representing 61% of the sample, is constituted by individuals with high adaptive strategy scores and high nonadaptive strategy scores; a second cluster, representing 39% of the sample, corresponds to individuals with low adaptive strategy scores and high nonadaptive strategy scores. The individuals in these two clusters differed in terms of anxiety level and abstinence time. Compared with control consumers, the use of nonadaptive ER strategies remained lower for the two clusters, while the use of adaptative strategies differed. Conclusions Our results support the idea of considering the heterogeneity of emotional capacities in individuals with AUD during the first year of abstinence. The identification of these profiles suggests either the existence of different adaptive ER capacities at baseline or a specific recovery of adaptive strategies over this period. [ABSTRACT FROM AUTHOR]

Background: Alcohol consumption creates various psychosocial issues among families. Spouses of individuals with alcohol dependence syndrome are more affected. Marital conflict and the quality of life of individuals and family members are hampered. Aim: The aim of the present study was to assess the relationship between quality of life and marital adjustment in individuals with alcohol dependence syndrome. Methodology: This study used a cross-sectional, hospital-based descriptive research design. The total sample size of the study was 100, and participants were selected using a purposive sampling technique. Measurements used in this study included: a) a self-prepared socio-demographic data sheet, b) the Quality of Life Questionnaire (WHOQOL-BRIEF), and c) the Marital Adjustment Questionnaire. Results: The correlation between marital adjustment and quality of life was found to be significant. Conclusion: The present study found a significant relationship between alcohol intake and poor quality of life, indicating poor marital satisfaction that needs to be addressed. [ABSTRACT FROM AUTHOR]

Background: Studies on psychosocial functioning and quality of life (QOL) of Bipolar Affective disorder (BPAD) patients with comorbid alcohol dependence syndrome (ADS), during BPAD remission and sobriety from alcohol, are sparse. Objectives: To assess the psychosocial functioning, QOL and associated factors in remitted males with dual diagnosis of BPAD and ADS. Methods: 132 males aged 18-60 years on psychiatry outpatient department follow-up from a tertiary care center, having BPAD-Currently in remission (F31.7) and co-morbid ADS (F10.2) according to the International classification of mental and behavioral disorders, Diagnostic Criteria for Research (ICD-10 DCR) were enrolled. Semi-structured proforma, Kuppuswamy's Socioeconomic status Scale, Functioning Assessment Short Test (FAST), and WHO QOL-BREF scales were administered. Statistical analysis was performed using R software (EZR). Results: 68.94% had moderate impairment in psychosocial functioning (FAST score 21-40). The median WHO QOL-BREF total score was 72 (interquartile range 68, 77) - lowest scores were for social relationships and psychological domain. Age (P = 0.014), residential area (P = 0.031), age of onset of ADS (P = 0.038), duration of ADS (P = 0.003), and total duration of BPAD (P = 0.05) showed significant association with FAST scores. Binge-drinking pattern was significantly associated with WHO QOL-BREF total scores. The total FAST scores showed a weak negative correlation with WHO QOL-BREF total scores (rs = -0.15, P = 0.01). Conclusion: Psychosocial functioning and QOL of dual diagnosis patients with BPAD and ADS were significantly impaired, even while in remission from both the disorders, which makes the elucidation of the associated factors a pressing priority. [ABSTRACT FROM AUTHOR]

Background: Alcohol abuse is a significant global burden. Many families have been affected, and many are victims of its abuse. The effect ripple down not only in the life of the person abusing alcohol but also to the immediate and extended family members, which can be multiple and detrimental. Depression is one of the effects which can lead to further alcohol abuse. A vicious cycle is observed among the individual abusing alcohol, which in turn affects the other family members of the individual. Depression symptoms are common in alcohol abusing patients of all ages and are much more common than the diagnosable depressive disorder. Aims and Objectives: The current study aims to assess the prevalence of depression among alcoholics, among inpatients and also find the associations between the prevalence of depression and selected socio and clinical demographic variables. Materials and Methods: The method adopted by the study was descriptive study method using the total enumerative sampling technique. The CAGE questionnaire was used to screen out the patients for level of dependence. The tool used is the Patient Health Questionnaire-9 (PHQ-) to assess the prevalence. Descriptive and inferential statistics were used to analyze the study. Results: The study results revealed that 74.2% of the participants were depressed widely distributed in all the levels with severity assessed by the PHQ9 questionnaire. The study also indicated that a family history of alcohol abuse is significantly associated with the prevalence of depression among alcoholics. The study result strongly indicates that depression is very much prevalent among alcoholics, along with other multiple co morbidities. Conclusion: Patients abusing alcohol needs continuous and regular assessment for early identification and adopts strategies for the management of the same. The management of depressive symptoms through the adoption of various therapies such as psychotherapy, other alternative systems of therapies and recreational therapies are much recommended. The treating health care team should consider strongly the use of pharmacological means, if the patient is found to be having depression, in the course of treatment in the hospital. [ABSTRACT FROM AUTHOR]

Background: Several personality traits predict future alcohol problems but also relate to demographic and substance‐related variables that themselves correlate with later adverse alcohol outcomes. Few prospective studies have evaluated whether personality measures predict alcohol problems after considering current demographic and substance‐related variables. Methods: Data from 414 drinkers without alcohol use disorder (AUD) from the Collaborative Study on the Genetics of Alcoholism (average age 20, 44% male) were followed over an average of 9 years. Time 1 (baseline) demography, AUD family history (FH), substance use and problems, and psychiatric histories were gathered using a standardized interview; the Level of Response (LR) to alcohol was measured by the Self‐Report of the Effects of alcohol (SRE) questionnaire; and seven personality dimensions were extracted from the NEO Five‐Factor Personality, Barratt, and Zuckerman scales. Analyses involved product–moment correlations of each baseline measure with the highest number of DSM‐IV AUD criteria endorsed in any follow‐up period, and hierarchical regression analyses evaluated whether the personality domains added significantly to the prediction of the outcome after adjusting for other baseline variables. Results: Significant correlations with the outcome were observed for baseline age, sex, length of follow‐up, AUD family history, past cannabis use, and all alcohol‐related baseline variables, including SRE‐based LR, but not prior mood or anxiety disorders. All personality characteristics except extraversion also correlated with outcomes. A hierarchical regression analysis that included all relevant personality scores together demonstrated significant contributions to the prediction of future alcohol problems for demographics in Step 1; demographics and most baseline alcohol items, including response level, in Step 2; and cannabis use in Step 3; after which demographics, LR, baseline alcohol problems, cannabis use, and higher sensation seeking added significantly in Step 4. Regression for each personality domain separately revealed significant contributions to Step 4 for all personality domains except openness. Lower levels of response to alcohol added significantly to all regression analyses. Conclusions: Most tested personality scores and lower levels of response to alcohol contributed to predictions of later alcohol problems even after considering baseline demographic and substance use measures. [ABSTRACT FROM AUTHOR]

The present qualitative study explores local meanings and modes of interpretation of alcohol use among people with problem drinking in the Peruvian Andean highlands. We conducted individual interviews with 19 people in two districts of Ayacucho region identified as having engaged in problem drinking, using McGill Illness Narrative Interview Schedule. Participants articulated multi-layered associations between alcohol and the body, emotions, social relations, and shared cultural practices and understandings. In the explanatory model of physical distress, participants' problem drinking was often identified as one of the perceived causes or consequences. Moreover, many participants shared their experiences of interpersonal difficulties, such as family disintegration, separation from wife/girlfriend, and conjugal infidelity. These experiences resulted in psychological distress, often described by idioms of distress such as "pensamiento" (constant thinking) and "preocupación" (worrying thought), and the engagement with alcohol. At the same time, alcohol use is situated in participants' daily experience, where past and current interpersonal afflictions intersect with persistent economic hardship and injustice at a larger socio-economic level. Alcohol was seen as instrumental in navigating their social relations as well. Decisions and attitudes toward alcohol use in Ayacucho are shaped in the course of searching for opportunities to build, develop, and maintain interpersonal relationships with friends, colleagues, families, and community members. This study illustrates the importance of understanding the patients' life histories in clinical communication as well as the need for social policies to address the socio-economic determinants of hardship and illness that precipitate alcohol use in the south-central Andean highlands of Peru. [ABSTRACT FROM AUTHOR]

Although stigma can jeopardize the recovery efforts of people who formerly misused substances, potentially leading to relapse, how people in recovery for alcoholism manage stigma has not been comprehensively or systematically examined. Using stigma management communication theory (SMC) and in-depth interviews of 22 adults in recovery, this investigation uncovered the six main strategies participants used to negotiate the stigma of being an alcoholic. Consistent with the tenets of SMC, interviewees accepted, evaded responsibility for, reduced offensiveness of, avoided, denied, and/or ignored/displayed the stigma, depending on whether they accepted or challenged that the stigma of being an alcoholic applied to themselves and/or the public's perception. Findings inform practical strategies to help individuals in recovery effectively manage stigma while sustaining their sobriety. The study also suggests ways programs such as Alcoholics Anonymous and treatment centers can use communication to break down recovery barriers. [ABSTRACT FROM AUTHOR]

Background: Greater alcohol accessibility, for example in the form of a high density of alcohol outlets or low alcohol taxation rates, may be associated with increased risk of suicidal behavior. However, most studies have been conducted at the aggregate level, and some have not accounted for potential confounders such as socioeconomic position or neighborhood quality. Methods: In a Swedish cohort of young adults aged 18 to 25, we used logistic regressions to evaluate whether living in a neighborhood that included bars, nightclubs, and/or government alcohol outlets was associated with risk of suicide attempt (SA) or suicide death (SD) during four separate 2‐year observation periods. Neighborhoods were defined using pre‐established nationwide designations. We conducted combined‐sex and sex‐stratified analyses, and included as covariates indicators of socioeconomic position, neighborhood deprivation, and aggregate genetic liability to suicidal behavior. Results: Risk of SA was increased in some subsamples of individuals living in a neighborhood with a bar or government alcohol outlet (odds ratios [ORs] = 1.05 to 1.15). Risk of SD was also higher among certain subsamples living in a neighborhood with a government outlet (ORs = 1.47 to 1.56), but lower for those living near a bar (ORs = 0.89 to 0.91). Significant results were driven by, but not exclusive to, the male subsample. Individuals with higher aggregate genetic risk for SA were more sensitive to the effects of a neighborhood government alcohol outlet, pooled across observation periods, in analyses of the sexes combined (relative excess risk due to interaction [RERI] = 0.05; 95% confidence intervals [CI] 0.01; 0.09) and in the male subsample (RERI = 0.06; 95% CI 0.001; 0.12). Conclusions: Although effect sizes are small, living in a neighborhood with bars and/or government alcohol outlets may increase suicidal behavior among young adults. Individuals with higher genetic liability for SA are slightly more susceptible to these exposures. [ABSTRACT FROM AUTHOR]

Individuals who are family history positive (FHP) for substance use problems have increased risk for substance use, substance use disorders (SUDs), and psychopathology. Links between FHP status and prescription drug misuse (PDM) have not been well investigated; this study examined PDM in adults 50 and older by FHP status. Data were from the US NESARC-III (n = 14,667). Participants reported their opioid PDM, tranquilizer/sedative PDM, SUD, psychopathology, and family history status (i.e. first- and second-degree relatives with alcohol/substance use problems). Prevalence rates were estimated by FHP status, and logistic regressions compared FHP and family history negative (FHN) groups. FHP status was associated with significantly higher rates of PDM (e.g. past-year opioid PDM, FHP: 3.8%, FHN: 1.5%) and SUD from PDM (e.g. past-year SUD, FHP: 1.2%, FHN: 0.2%); also, prevalence varied by family history density, with the highest rates in those with three or more relatives with substance use problems (e.g. past-year opioid PDM: 5.5%). Overall, 32.2% of FHP individuals with past-year PDM had past-year co-occurring SUD and psychopathology diagnoses, versus 11.0% of FHN individuals. FHP status could inform treatment decisions in adults 50 and older with conditions for which prescription opioids or tranquilizer/sedatives are indicated. [ABSTRACT FROM AUTHOR]

Social model recovery is a peer centered approach to alcohol and drug problems that is gaining increased attention. This approach is well-suited to services in residential settings and typically includes living in a shared alcohol- and drug-free living environment where residents give and receive personal and recovery support. Sober Living Houses (SLHs) are recovery residences that explicitly use a social model approach. This paper describes recent research on SLHs, including new measures designed to assess their social and physical environments. We conclude that our understanding of social model is rapidly evolving to include broader, more complex factors associated with outcomes. [ABSTRACT FROM AUTHOR]

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BACKGROUND: This study described how adolescents and the parents saw their moral responsibilities with regard to adolescents using alcohol. METHODS: This was a deductive secondary analysis, based on Hart's taxonomy of moral responsibility. The primary studies were based on 19 group interviews with 87 adolescents aged 14‐16 and 17 interviews with 20 parents. Voluntary participants were recruited by purposive sampling from two public schools in Finland. RESULTS: Role responsibilities comprised of adolescents taking care of themselves and parents providing authority figures and helping adolescents to make rational decisions about alcohol. Capacity responsibilities referred to adolescents' abilities to make independent decisions on using alcohol and their developing abilities to control their actions. Parents required abilities to get involved in and show an interest in their children's everyday lives. Causal responsibilities focused on ensuring that adolescents did not cause harm when they used alcohol, and parents had to acknowledge and react to the consequences. Liability responsibilities were about the law on alcohol use and responsibilities for any legal consequences. The role schools could play was important. CONCLUSIONS: Adolescents and parents had wide‐ranging responsibilities related to the adolescents' using alcohol and school nurses could play an important role in healthy decisions. [ABSTRACT FROM AUTHOR]