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Objective: The aim of the present studies was to provide a psychometric evaluation of a version of the Treatment Self-Regulation Questionnaire (TSRQ) for assessing motivations derived from self-determination theory for responsible drinking among college students. Methods: A convenience sample of 308 college student drinkers (71.7% female) were recruited for Study 1 and a random sample of 192 college student drinkers (58.9% female) were recruited for Study 2. Participants completed the TSRQ and other self-report measures in both studies. Results: In Study 1, confirmatory factor analyses supported a revised four-factor structure of the TSRQ. In Study 2, correlation analyses generally provided support for the concurrent validity of the TSRQ subscales. Conclusion: The present studies provide some initial support for the TSRQ for assessing motivations for responsible drinking. Directions for future research and implications of a measure for assessing motivations for responsible drinking among college students are discussed.

Commensurate measures of alcohol-related consequences across countries and cultures are critical for addressing the global burden of hazardous alcohol use. The Rutgers Alcohol Problem Index (RAPI), developed and validated in the United States, is a popular measure of alcohol problems. This study examined measurement invariance of the RAPI across samples of U.S. and Swedish high school seniors. Latent mean differences in alcohol problems across countries and differences in associations between alcohol problems with alcohol use and protective behavioral strategies (PBS) were also examined. The RAPI was scalar invariant. Swedish students reported fewer problems than U.S. students (latent mean difference = −0.19, p =.047). In both samples, the RAPI was positively correlated with alcohol use frequency and quantity (ps <.001), and negatively correlated with PBS use (p s <.05). Overall, the RAPI demonstrated measurement invariance, and we found evidence for its validity across samples of U.S. and Swedish high school seniors. [ABSTRACT FROM AUTHOR]

Aims Among individuals with alcohol use disorder (AUD), sleep disturbances are pervasive and contribute to the etiology and maintenance of AUD. However, despite increased attention toward the relationship between alcohol use and sleep, limited empirical research has systematically examined whether reductions in drinking during treatment for AUD are associated with improvements in sleep problems. Methods We used data from a multisite, randomized, controlled trial that compared 6 months of treatment with gabapentin enacarbil extended-release with placebo for adults with moderate-to-severe AUD (N  = 346). The Timeline Follow-back was used to assess WHO risk drinking level reductions and the Pittsburgh Sleep Quality Index was used to assess sleep quality over the prior month at baseline and the end of treatment. Results Sleep problem scores in the active medication and placebo groups improved equally. Fewer sleep problems were noted among individuals who achieved at least a 1-level reduction (B  = −0.99, 95% confidence interval (CI) [−1.77, −0.20], P  = .014) or at least a 2-level reduction (B  = −0.80, 95% CI [−1.47, −0.14], P  = .018) in WHO risk drinking levels at the end of treatment. Reductions in drinking, with abstainers excluded from the analysis, also predicted fewer sleep problems at the end of treatment (1-level: B  = −1.01, 95% CI [−1.83, −0.20], P  = .015; 2-level: B  = −0.90, 95% CI [−1.59, −0.22], P  = .010). Conclusions Drinking reductions, including those short of abstinence, are associated with improvements in sleep problems during treatment for AUD. Additional assessment of the causal relationships between harm-reduction approaches to AUD and improvements in sleep is warranted. [ABSTRACT FROM AUTHOR]

Psychological need satisfaction and need frustration, proposed by self-determination theory, may serve as conditions that foster health-promoting and health-impairing behaviors related to cannabis use. In the present study, we examined the measurement model of psychological need satisfaction and need frustration and their associations with cannabis protective behavioral strategies use, negative cannabis-related consequences, and cannabis use severity. Data were from 1394 college students from 10 universities across the U.S. who reported past-month cannabis use. A higher-order factor model representing general psychological need satisfaction and need frustration provided a good fit to the data. Regressing the three observed cannabis outcome variables onto these higher-order latent factors, we found that greater need satisfaction was associated with more frequent cannabis protective behavioral strategies use and fewer negative cannabis-related consequences. Greater need frustration was associated with greater negative cannabis-related consequences and cannabis use severity. Further, an interaction effect between need satisfaction and need frustration emerged for each cannabis outcome such that greater need satisfaction attenuated the associations between need frustration and cannabis outcomes and greater need frustration strengthened the associations between need satisfaction and cannabis outcomes. Implications for the roles of need satisfaction and need frustration in cannabis use and future intervention development are discussed. [ABSTRACT FROM AUTHOR]

Background: Abstinence has historically been considered the preferred goal of alcohol use disorder (AUD) treatment. However, most individuals with AUD do not want to abstain and many are able to reduce their drinking successfully. Craving is often a target of pharmacological and behavioral interventions for AUD, and reductions in craving may signal recovery. Whether reductions in drinking during AUD treatment are associated with reductions in craving has not been well examined. Methods: We conducted secondary analyses of data from three AUD clinical trials (N's= 1327, 346, and 200). Drinking reductions from baseline to the end of treatment were measured as changes in World Health Organization (WHO) risk drinking levels; alcohol craving was measured using validated self‐report measures. Regression analyses tested whether drinking reductions were associated with end‐of‐treatment craving reductions; moderation analyses tested whether associations between drinking reduction and end‐of‐treatment craving differed across AUD severity. Results: Reductions of at least 1 or at least 2 WHO risk drinking levels were associated with lower craving (all p's < 0.05). Results were substantively similar after removing abstainers at the end‐of‐treatment. Associations between drinking reductions and craving were generally not moderated by AUD severity. Conclusions: Individuals with WHO risk drinking level reductions reported significantly lower craving, as compared to those who did not achieve meaningful reductions in drinking. The results demonstrate the utility of WHO risk drinking levels as AUD clinical trial endpoints and provide evidence that drinking reductions mitigate craving. [ABSTRACT FROM AUTHOR]

Abstract Abstinence self-efficacy, belief in one’s ability to abstain, has been identified as a predictor of substance use behavior change. Yet, many people who use substances do not want to abstain. Self-efficacy for achieving a range of goals (i.e. abstinence or harm reduction) would be more widely applicable and might also predict substance use behavior change. The current study reports on the development of the Harm Reduction Self-Efficacy Scale (HRSES), adapted from the Situational Confidence Questionnaire and other measures of behavioral regulation, to assess one’s self-efficacy to limit their substance use consistent with their own substance use goals. Participants were recruited from online support groups for individuals with varied personal goals for substance use. The current primary analyses included 226 individuals who completed the HRSES. Using exploratory factor analysis, we found support for a four-factor solution reflecting self-efficacy in different situations that might promote substance use: negative emotions and situations, positive social situations, low self-regulation, and pleasant emotions. Each subscale was generally negatively correlated with substance use and positively correlated with quality of life, indicating greater self-efficacy was associated with less substance use and greater quality of life. Additional work is needed to test the psychometric properties of the HRSES, particularly confirmation of the factor structure in larger and more racially and ethnically diverse samples. The HRSES has promising psychometric properties and high clinical utility with wider applicability to a range of substance use goals. [ABSTRACT FROM AUTHOR]

The aim of this study was to conduct a preliminary investigation of the associations between facets of impulsivity and alcohol outcomes through motives for drinking responsibly described by self-determination theory (SDT) among college students. Participants (N = 2808) were part of a multisite investigation of college student drinking across 10 universities in 8 states in the USA who reported past-month drinking. Results of a structural equation model testing all possible indirect associations simultaneously indicated that one-third (20 out of 60) of the indirect associations were statistically significant (p<.01). Facets with higher scores representing higher impulsivity (negative/positive urgency) were negatively associated with more internalized motives (autonomous motivation and introjected regulation) and positively associated with less internalized motives (external regulation and amotivation) for drinking responsibly. Facets with higher scores representing lower impulsivity (perseverance and premeditation) demonstrated opposite patterns of associations with motives for drinking responsibly. In turn, more internalized motives were related to higher frequency of protective behavioral strategies use, lower alcohol use severity, and fewer negative alcohol-related consequences; less internalized motives demonstrated an opposite pattern of associations with these alcohol outcomes. The present findings should be replicated using experimental and longitudinal studies for appropriately testing mediation but offer support for a novel hypothesis for motivational pathways from impulsivity to alcohol outcomes that may provide insight into intervention targets, if further supported by future research. [ABSTRACT FROM AUTHOR]

Objective: Psychosocial intervention and Alcoholics Anonymous (AA)/mutual help organization attendance are both associated with alcohol use disorder (AUD) outcomes. However, no research has explored the relative or interactive associations of psychosocial intervention and AA attendance with AUD outcomes. Method: This was a secondary analysis of data from the Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) outpatient arm participants (N = 952), who were randomly assigned to complete 12-session cognitive-behavioral therapy (CBT, n = 301), 12-session 12-step facilitation (TSF, n = 335), or 4-session motivational enhancement therapy (MET, n = 316). Regression analyses tested the association of psychosocial intervention attendance only, AA attendance only (measured as past-90-day attendance immediately after psychosocial intervention, as well as 1 and 3 years after intervention), and their interaction with the percentage of drinking days and percentage of heavy drinking days after intervention, 1 year after intervention, and 3 years after intervention. Results: When accounting for AA attendance and other variables, attending more psychosocial intervention sessions was consistently associated with fewer drinking days and heavy drinking days after intervention. AA attendance was consistently associated with a lower percentage of drinking days at 1 and 3 years after intervention, when accounting for psychosocial intervention attendance and other variables. Analyses failed to identify an interaction between psychosocial intervention attendance and AA attendance with AUD outcomes. Conclusions: Psychosocial intervention and AA attendance are robustly associated with better AUD outcomes. Replication studies comprising samples of individuals who attend AA more than once per week are needed to further test the interactive association of psychosocial intervention attendance and AA attendance with AUD outcomes. [ABSTRACT FROM AUTHOR]

We tested measurement invariance of the Readiness to Change Questionnaire (RCQ) to evaluate its utility in assessing the stages of change in the context of brief intervention for alcohol use in opportunistic settings. Participants (N = 596) were patients admitted from three Level I trauma centers who were randomly assigned to one of three brief alcohol interventions. The RCQ was administered at baseline and 3-month follow-up. The RCQ was scalar invariant across biological sex and partially scalar invariant across race/ethnicity and alcohol use severity. Hispanic participants were higher on contemplation and action and Black participants were higher on action than White participants. Hazardous drinkers were lower in precontemplation and higher in contemplation and action than nonhazardous drinkers. The RCQ was scalar invariant across intervention conditions and time. Brief motivational intervention with a booster increased action from baseline to 3 month. These findings provide further support for the use of the RCQ. [ABSTRACT FROM AUTHOR]

Cannabis use continues to escalate among emerging adults and college attendance may be a risk factor for use. Severe cases of cannabis use can escalate to a cannabis use disorder, which is associated with worse psychosocial functioning. Predictors of cannabis use consequences and cannabis use disorder symptom severity have been identified; however, they typically employ a narrow set of predictors and rely on linear models. Machine learning is well suited for exploratory data analyses of high-dimensional data. This study applied decision tree learning to identify predictors of cannabis user status, negative cannabis-related consequences, and cannabis use disorder symptoms. Undergraduate college students (N = 7000) were recruited from nine universities in nine states across the U.S. Among the 7 trees, 24 splits created by 15 distinct predictors were identified. Consistent with prior research, one's beliefs about cannabis were strong predictors of user status. Negative reinforcement cannabis use motives were the most consistent predictors of cannabis use disorder symptoms, and past month cannabis use was the most consistent predictor of probable cannabis use disorder. Typical frequency of cannabis use was the only predictor of negative cannabis-related consequences. Our results demonstrate that decision trees are a useful methodological tool for identifying targets for future clinical research. [ABSTRACT FROM AUTHOR]

Objective: The high rate of statistically significant findings in the sciences that do not replicate in a new sample has been described as a "replication crisis." Few replication attempts have been conducted in studies of alcohol use disorder (AUD), and the best method for determining whether a finding replicates has not been explored. The goal of the current study was to conduct direct replications within a multisite AUD-randomized controlled trial and to test a range of replication metrics. Method: We used data from a large AUD clinical trial (Project Matching Alcoholism Treatments and Client Heterogeneity [Project MATCH], n = 1,726) to simulate direct replication attempts. We examined associations between drinking intensity and negative alcohol-related consequences (Model 1), sex differences in drinking intensity (Model 2), and reductions in drinking following treatment (Model 3). We treated each of the 11 data collection sites as unique studies such that each subsample was treated as an "original" study, and the remaining 10 subsamples were viewed as "replication" studies. Replicability metrics included the consistency of statistical significance, overlapping confidence intervals, and consistency of the direction of the effect. We also tested effect replication and heterogeneity using meta-analysis. Results: We observed between 0% and 100% replicability across the replicability metrics depending on which subsample was treated as the "original" study. Meta-analyses indicated results were more similar across subsamples with no significant heterogeneity for Models 1 and 2. Conclusions: We recommend researchers focus on effect sizes and use meta-analysis to evaluate the level of replicability. We also encourage direct replication attempts and sharing of data and code to facilitate direct replication. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to examine tests of interaction effects between cannabis protective behavioral strategies use and a range of risk/protective factors for negative cannabis-related consequences. We recruited 2,226 college students (Mage = 20.28, SD = 3.37; 68.8% female; 75.4% White) from 10 universities throughout the U.S. who reported using cannabis in the past month to complete an online survey. Measures assessed cannabis use, negative cannabis-related consequences, cannabis protective behavioral strategies use, and 35 risk/protective factors (including socio-demographic characteristics). Cannabis protective behavioral strategies use was negatively correlated with negative cannabis-related consequences while including the risk/protective factors as covariates. Most importantly, 33% and 54% of the interaction effects tested were statistically significant, depending on the covariates entered into the model. The interaction effects had a consistent pattern such that the positive association between greater risk and negative cannabis-related consequences was weaker as cannabis protective behavioral strategies use increased. Findings suggest that the nature of these interaction effects is not specific for any given risk/protective factor. We draw parallels to research on alcohol protective behavioral strategies and offer suggestions for moving the cannabis protective behavioral strategies field forward. [ABSTRACT FROM AUTHOR]