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Nicholas J Bush,1 Melissa R Schick,1 Nichea S Spillane,1 Jeff Boissoneault2 1Department of Psychology, University of Rhode Island, Kingston, RI, USA; 2Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USACorrespondence: Nichea S Spillane, Department of Psychology, University of Rhode Island, 130 Flagg Road, Kingston, RI, 02881, USA, Tel +1 401-874-4252, Email nspillane@uri.eduBackground: Alcohol use in young adults is highly prevalent and associated with numerous consequences, including academic difficulties and motor vehicle accidents. Pain is one factor that has been increasingly shown to be associated with higher rates of alcohol consumption and riskier patterns of drinking among undergraduate students. Although pain has traditionally been viewed as a lesser concern for young adults, current research demonstrates that pain may be more prevalent in younger populations than originally thought. However, little is known about how common psychosocial factors, such as stress and subjective social status (SSS), influence the association between pain and alcohol consumption in college students.Objective: The study’s goal was to examine the effect of stress and SSS on the relationship between pain and alcohol consumption.Participants and Methods: Participants (N = 445, 39.3% women, Mage= 22.98) were 18- to 25-year-old college students who completed an online questionnaire.Results: Pain was significantly associated with total weekly alcohol consumption (r(445) = .22, p < 0.001); this association was significantly mediated by stress (b = 0.15, SE = 0.04, 95% CI = [.07,0.23]). SSS was significantly positively associated with alcohol consumption (r(445) = .22, p < 0.001) but was not found to significantly moderate the relationship between stress and alcohol use.Conclusion: Results suggest that efforts to reduce college student alcohol use should include assessment of pain and stress given their association with alcohol consumption. Further, findings suggest that future studies are warranted to prospectively examine pain as an antecedent for alcohol use and to examine the utility of incorporating stress management techniques in pain-focused interventions to indirectly target alcohol use.Keywords: alcohol, stress, pain, college students

Background: To address enduring age-related tobacco disparities, it is critical to promote cessation treatment among older adults (aged 65+ years). Digital health platforms offer opportunities for wide dissemination of evidence-based behavioral cessation support. However, existing digital cessation treatments are not tailored to unique aging-related needs and preferences, resulting in low uptake. Detailed information is needed about how to best adapt these treatments for this age group., Objective: We aimed to collect detailed, hypothesis-generating information about expectations and preferences for cessation digital treatment among older adults who smoke cigarettes., Methods: Semistructured interviews were conducted with adults aged 65+ years currently smoking or who had quit within the past month. Interviews included open-ended questions regarding prior experiences with digital health platforms and expectations and preferences for cessation treatment via various modalities (app-delivered, texting-based, or videoconferencing counseling). Interviews also elicited questions regarding digital modalities that integrated social components (app-delivered social forums and group videoconferencing counseling). Using an iterative, team-based approach, the thematic analysis identified meaningful themes. Interviews were supplemented with quantitative measures assessing sociodemographics, digital literacy, and physical health symptoms., Results: Participants (12/20, 60% men; 15/20, 75% White; 4/20, 20% Black or African American; 1/20, 5% Asian) were currently smoking (17/20, 85%) or had recently quit (3/20, 15%). Thematic analysis identified 3 meaningful themes across all digital modalities: convenience, accessibility, and personalization. Expected benefits of digital platforms included convenient treatment access, without reliance on transportation. Participants preferred treatments to be personalized and deliver content or strategies beyond standard education. Most (17/20, 85%) were unfamiliar with cessation apps but found them appealing given the potential for offering a novel quitting strategy. App ease of use (eg, easy navigation) was preferred. Half (10/20, 50%) would try a texting-based intervention, with many preferring texting with a counselor rather than automated messaging. Most (17/20, 85%) would use videoconferencing and expected this modality to deliver better quality counseling than via telephone. Expected videoconferencing challenges included looking presentable onscreen, technological difficulties, and privacy or security. Videoconferencing was regarded as the most personalized digital treatment, yet benefits unique to app-delivered and texting-based treatments included anonymity and access to treatment 24/7. Participants expected integrating social components into digital treatment to be useful for quit success and social connection, yet were concerned about possible interpersonal challenges., Conclusions: Because a long history of quit attempts and familiarity with standard quitting advice is common among older adults who smoke cigarettes, digital platforms might offer appealing and novel strategies for cessation that are accessible and convenient. Overall, this population was open to trying digital cessation treatments and would prefer that these platforms prioritize ease of use and personalized content. These findings challenge the bias that older adults are uninterested or unwilling to engage with digital treatments for behavioral health., (©Margaret C Fahey, Mathew J Carpenter, Riley O'Neal, Kinsey Pebley, Melissa R Schick, Emily Ware, Benjamin A Toll, Jennifer Dahne. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 28.08.2024.)

Introduction: Substance use is highly prevalent among women experiencing intimate partner violence (IPV) and has been associated with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and resulting cortisol response. Posttraumatic stress disorder (PTSD) symptoms may play an important role in exacerbating the association between cortisol levels and substance use behaviors., Purpose: This study examined the role of PTSD symptoms in the relation between cortisol and past month substance use behaviors. The current study used hair cortisol as an index of past 30-day HPA-axis functioning and ecological momentary assessment (EMA) to characterize substance use behaviors more accurately over a 30-day period., Method: Participants were 90 community women who had experienced physical or sexual IPV in the past 30 days by their current male partner and used any amount of alcohol or drugs (M age = 40.71; 54.4 % white). Participants completed (a) a baseline interview, (b) EMA for 30-days, and (c) a follow up interview where they were asked to provide a hair sample for cortisol analyses. Data collection took place from 2018 to 2020., Results: PTSD severity moderated the relations between cortisol and days of drinking and binge drinking. In the context of high PTSD symptomology, women with high cortisol levels spent, on average, an additional 7.4 days drinking and 8.1 days binge drinking in the past 30 days compared to women with low cortisol levels, in a model adjusted for age., Conclusions: Results highlight the prominent role of PTSD symptoms in the association between cortisol and alcohol use among women experiencing IPV., Competing Interests: Declaration of Competing Interest No conflict declared., (Copyright © 2024. Published by Elsevier B.V.)

Recent national estimates suggest that 1 in 2 women will experience intimate partner violence (IPV) in their lifetime. Given the high prevalence of posttraumatic stress disorder (PTSD) among women experiencing IPV, it is necessary to consider whether PTSD assessments function adequately for this population. Thus, the present study aimed to evaluate the psychometric properties of the past-month version of the PTSD Checklist for DSM-5 (PCL-5), one of the most widely used self-report measures of PTSD symptoms, in a sample of community women experiencing IPV. Participants were 158 women who had experienced IPV in the past 6 months (M age = 40.14 years, 39.9% White). The PCL-5 demonstrated good internal consistency, Cronbach's α = .97, and scores were significantly positively correlated with theoretically related constructs (i.e., PTSD symptom count on the SCID-5, IPV severity, substance use, depression, anxiety, and emotion dysregulation); however, it demonstrated poor 30-day stability, r = .38, ICC = .55. The ability of the PCL-5 to discriminate with respect to a PTSD diagnosis was acceptable, AUC = .74. A cutoff score of 21 maximized sensitivity (82.5%) and specificity (55.4%); this is lower than typical cutoffs (i.e., 31-33). Although the PCL-5 has generally demonstrated adequate psychometric properties, findings suggest that it does not function optimally for women experiencing IPV relative to its functioning for other trauma-exposed populations. The lower-than-typical cutoff suggests that the PCL-5 may underestimate PTSD prevalence among women experiencing IPV., (© 2024 International Society for Traumatic Stress Studies.)

Background: The objective of this study was to pilot test newly developed personalized imagery procedures to investigate the impact of racial stress on alcohol craving and emotional and physiological response in Black adults with alcohol use disorder (AUD)., Methods: Twenty Black adults (45% women, mean age =37.05, SD age =13.19) with AUD participated in two sessions. In the first, participants described a stressful personal event involving their race and a neutral relaxing situation and these descriptions were used to develop scripts for the subsequent laboratory exposure session. The second session was an experimental provocation session in which participants reported on alcohol craving and emotional response before and after imagined exposure to stress and neutral conditions using personalized racial stress and neutral/relaxing scripts. Conditions were randomized and counterbalanced across subjects, and heart rate and blood pressure were assessed before and after each image., Results: Alcohol craving and negative emotions significantly increased, and positive emotions decreased following the racial stress script relative to the neutral/relaxing script. We found no differences in physiological response. Exploratory analyses found that increase in alcohol craving was correlated with racial identity exploration but not racial identity commitment, men reported greater reductions in anger than women in the neutral condition only, and income was correlated with fear in the racial stress condition only., Conclusions: This study provides evidence that personalized racial stress procedures elicit a stress response and increases alcohol craving and emotional response but not physiological response among Black adults with AUD. These findings warrant replication in a larger study., Competing Interests: Declaration of Competing Interest There are no conflicts of interest related to this work., (Copyright © 2024. Published by Elsevier B.V.)

Introduction: To understand the influence of phenotypic characteristics, such as stress, on substance use treatment outcomes, measures must function equivalently across groups to allow for interpretable comparisons of effects. The present study evaluated measurement invariance of the Perceived Stress Scale (PSS) across race, sex, and time, examined its association with cocaine use disorder (CUD) treatment outcomes, and tested whether associations were moderated by race and/or sex., Methods: Data from four clinical trials evaluating behavioral and/or pharmacological treatments for cocaine use were combined providing a total sample of 302 participants with DSM-IV cocaine abuse/dependence (57.6 % Black, 42.4 % White, 43.7 % females, M age  = 40.22 years, SD = 9.26)., Results: Factor analyses support a two-factor model (i.e., general stress, self-efficacy to cope with stressors) that demonstrated configural, metric, and scalar invariance across race and sex and configural and metric invariance across time. End-of-treatment stress and coping were both related to treatment outcomes, but not treatment retention. Interactions between baseline and end-of-treatment stress and coping self-efficacy with race and sex predicting treatment retention and outcomes were not significant., Conclusions: Results support the utility of the PSS to examine between-group differences among individuals with CUD and suggest that sociodemographic groups differ in the extent to which stress and self-efficacy to cope influence treatment outcomes., Competing Interests: Declaration of competing interest The authors report no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Noncompletion of ecological momentary assessment (EMA) surveys is a common issue and may yield bias in results if not properly handled. Using data observed at scheduled times as well as data retrieved later to fill missing responses, this study aims to investigate predictors of EMA completion, including demographic characteristics, time-related factors, and momentary experiences/behaviors. Data were from a 30-day EMA study including 145 women currently experiencing intimate partner violence (IPV) and using substances. The average rate of EMA completion was initially 51.4% at the scheduled times and increased to 72.6% after incorporating data from later-retrieved surveys. Participants who were younger, had more children, or had lower mean levels of negative affect dysregulation showed lower completion rates. At the momentary survey level, more days into the study and afternoon/evening reports (vs. morning reports) were associated with lower completion; lower levels of negative affect dysregulation, less smoking or alcohol use, and experiencing IPV were linked to lower momentary completion. Implications of the results for handling missing data in EMA are discussed and have important ramifications for future research, practice, and theory., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Literature underscores the importance of emotion dysregulation in clinical research. However, one critical limitation of the existing investigations in this area involves the lack of psychometrically valid measures for assessing emotion dysregulation in individuals' daily lives. This study examined the factor structure and psychometric properties of momentary versions of the Difficulties in Emotion Regulation Scale (mDERS) and the Difficulties in Emotion Regulation Scale-Positive (mDERS-P)., Methods: Participants were 145 community women ( M age = 40.66, 40.7% white) experiencing intimate partner violence and using substances who participated in a baseline interview and then completed surveys three times a day for 30 days., Results: Analyses supported the reliability of the mDERS and the mDERS-P. The two-state, two-trait model, with separate factors for negative and positive emotion dysregulation at both the within-and between-levels, fit the data best. Momentary negative, but not positive, emotions were positively related to the mDERS; both momentary negative and positive emotions were positively related to the mDERS-P. Baseline trait negative, but not positive, emotion dysregulation, was related to greater variability in momentary negative and positive emotion dysregulation., Conclusion: Findings advance our understanding and measurement of emotion dysregulation using intensive longitudinal approaches.

Background: Minoritized racial/ethnic and sex assigned at birth/gender groups experience disproportionate substance-related harm. Focusing on reducing substance-related harm without requiring abstinence is a promising approach. Objectives: The purpose of this meta-epidemiologic systematic review was to examine inclusion of racial/ethnic and sex assigned at birth/gender in published studies of nonabstinence-inclusive interventions for substance use. Methods: We systematically searched databases (PubMed and PsycINFO) on May 26, 2022 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Articles were eligible for inclusion if they: 1) reported in English language, 2) had a primary goal of investigating a nonabstinence-inclusive intervention to address substance use, 3) used human subjects, and 4) only included adults aged 18 or older. Two coders screened initial articles and assessed eligibility criteria of full text articles. A third consensus rater reviewed all coding discrepancies. For the remaining full-length articles, an independent rater extracted information relevant to study goals Results: The search strategy yielded 5,759 records. 235 included articles remained. Only 73 articles (31.1%) fully reported on both racial/ethnic and sex assigned at birth/gender, and only seven articles (3.0%) reported subgroup analyses examining treatment efficacy across minoritized groups. Nine articles (3.8%) mentioned inclusion and diversity regarding both racial/ethnic and sex assigned at birth/gender in their discussion and four articles (1.7%) broadly mentioned a lack of diversity in their limitations Conclusion: Findings highlight that little is known about nonabstinence-inclusive interventions to address substance use for individuals from minoritized racial/ethnic and sex assigned at birth/gender groups.

Introduction: Young adults exhibit high rates of concurrent alcohol and cannabis use, which is associated with more negative alcohol-related consequences. Positive psychological interventions have successfully been leveraged to target alcohol, cannabis, and nicotine use, as well as substance use disorders, and may be a useful harm reduction approach to reduce alcohol-related consequences. This pilot study sought to generate effect sizes for two positive psychological interventions, Savoring and Three Good Things, on frequency of alcohol use, quantity of alcohol use, and alcohol-related consequences., Methods: The current study used data from a pilot study testing positive psychological interventions to reduce cannabis use and cannabis-related consequences in young adults (ages 18 to 25) who used cannabis at least once per week within the prior month (N = 50, M age  = 22.72, 72 % men, 40 % White). Participants reported baseline alcohol and cannabis use and alcohol-related consequences, then the study randomized them to complete a daily Savoring intervention, Three Good Things, or a control exercise, and completed daily text message surveys for two weeks (i.e., the intervention period) and a follow-up survey., Results: Analyses revealed no significant differences across experimental conditions on alcohol use frequency, alcohol use quantity, or alcohol-related consequences at baseline or follow-up. Paired samples t-tests demonstrated that participants in the Savoring group showed large, significant decreases in alcohol-related consequences (t[16] = 2.28, p = .04, g av  = 0.54); no decreases occurred in frequency or quantity of alcohol use. The Three Good Things group showed no significant decreases in alcohol-related consequences, frequency of alcohol use, or quantity of alcohol use., Conclusions: Results suggest that a larger scale clinical trial is warranted to determine whether Savoring and Three Good Things might function as harm reduction interventions to reduce alcohol-related consequences in young adults who concurrently use alcohol and cannabis. Future research should use a larger sample, a longer intervention administration period, and a longer follow-up period to examine these positive psychological interventions more rigorously., Competing Interests: Declaration of competing interest None., (Copyright © 2023. Published by Elsevier Inc.)

Introduction: Females, versus males, have shown a slower decline in smoking prevalence, greater smoking-related mortality and morbidity, and tend to have more difficulty achieving and maintaining abstinence. Identifying sex-specific risk factors is needed to improve outcomes. Though ovarian hormones have been evaluated for their role in smoking and relapse, measures tend to be static and infrequent, failing to capture the influence of increasing or decreasing levels., Aims and Methods: The present study evaluated the effect of static and fluctuating levels of ovarian hormones (ie, progesterone, estradiol, and estrogen to progesterone [E/P] ratio) on stress reactivity, cigarette craving, and smoking during a laboratory relapse paradigm. Female participants (assigned female at birth) reporting daily cigarette smoking (N = 91, ages 18-45) were recruited from the community. Participants provided daily salivary ovarian hormone levels leading up to a laboratory session, in which stress was induced and stress reactivity, cigarette craving, latency to smoke, and ad-libitum smoking were measured., Results: Static levels of estradiol were associated with stress reactivity (β = 0.28, SE = 0.13) and static E/P ratio was associated with smoking in the laboratory (HR = 1.4). Preceding 3-day changes in estradiol and E/P ratio, but neither static levels nor preceding 3-day changes in progesterone were associated with stress reactivity, cigarette craving, or smoking in a relapse paradigm., Conclusions: Ovarian hormones are among several sex-specific factors involved in the complex neuroendocrine response to stress, and their interaction with other biological, social, and psychological factors in the real-world environment is not yet fully understood., Implications: Findings of the present study provide novel information regarding the role of ovarian hormones among female participants who smoke daily in stress reactivity and smoking in the context of a laboratory relapse paradigm and highlight several avenues for future research. We found that same-day estradiol levels were associated with increased subjective stress reactivity and same-day estrogen to progesterone ratio was associated with increased likelihood of smoking in a relapse paradigm. Ovarian hormones are among several sex-specific factors contributing to the complex neuroendocrine response to stress, and their interaction with other biological, social, and psychological factors in the real-world environment is not yet fully understood., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Posttraumatic stress disorder (PTSD) is one of the most prominent negative health consequences that women experiencing intimate partner violence (IPV) may develop. However, research on PTSD among women experiencing IPV has largely relied on retrospective reporting methods, which are vulnerable to bias and may consequently misrepresent PTSD symptoms. This study evaluated the concordance between PTSD symptoms assessed via retrospective self-report and experience sampling methods (ESM), which involve repeated within-day sampling of experiences in near real-time and in natural environments. Community women ( N  = 134) experiencing IPV ( M age  = 40.7, 30.4% Black) responded to ESM surveys three times a day for 30 days and then completed a follow-up interview. Retrospective self-report of PTSD symptoms, which were assessed during the follow-up interview, were compared to ESM reports of PTSD symptoms. Retrospective reports of PTSD symptoms were significantly different from PTSD symptoms reported during the ESM period, but most closely resembled peak PTSD symptoms. Notably, retrospective reports of PTSD symptoms were significantly different, with a very large effect size, from average PTSD symptoms reported during the ESM period. Discordance scores were significantly negatively associated with the number of days on which any IPV occurred, suggesting that as the frequency of IPV experiences increased, differences between retrospective PTSD symptoms and each ESM symptom pattern decreased. This study provides an important contribution to the literature by highlighting meaningful differences in PTSD symptoms assessed via retrospective self-report versus ESM and the role of IPV context. Findings emphasize the importance of utilizing ESM in PTSD research with women experiencing IPV., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Introduction: Providing doctoral internship stipends below living wages may harm interns, the clinical services they provide, and the field of health service psychology as a whole. This study evaluated the extent to which doctoral psychology internship stipends from the 2021-2022 training year for APA-accredited, APPIC-member programs in the US are consistent with living wages in the geographic region where sites are located., Methods: We obtained data reflecting internship sites' geographic location and stipends for the 2021-2022 academic year. Using the Massachusetts Institute of Technology Living Wage Calculator, we computed a living wage for the county in which each internship site is located. Descriptive statistics, discrepancies, ratios, and correlations were calculated to reflect the associations between internship sites' stipends and their local living wages., Results: The average internship stipend was $31,783, which was lower than the average living wage by $2,091. Stipends ranged widely, from a low of $15,000 to a high of $94,595-reflecting a six-fold difference in wages. Although internship sites in higher cost of living areas paid higher stipends, over two-thirds (67.0%) of sites did not pay a stipend that equaled or exceeded a living wage. Ninety-eight sites (15.3%) had deficits of over $10,000 when comparing their stipends to local living wages, with $33,240 as the highest deficit., Discussion: Eliminating obstacles to educating health service psychologists by decreasing the financial burden of training will likely have subsequent critical benefits towards bridging the workforce gap between mental healthcare service needs and available providers, ultimately leading to improved population health.

Peer review represents the foundation and gatekeeper to scientific dissemination, making it among the most important points to improve the representation of members of diverse gender, racial/ethnic, and other sociodemographic groups. The American Psychological Association (APA) highlights equity, diversity, and inclusion among its guiding principles. APA journals publish a large volume of cutting-edge psychological research (processing 20,000 + submissions per year) and reach a wide audience and have the unique opportunity to contribute to APA's mission by disseminating data on the diversity of those involved in the production of psychological science. In this commentary, we highlight recommendations for actionable steps to promote greater equity in the peer review process. While our recommendations are not exhaustive, we hope that they are steps in the right direction and will contribute to conversations that have already begun regarding actions to address underrepresentation in the scientific process. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The current study explored the role of self-compassion on the relationship between perceived stress and resilience among college students experiencing different levels of anxiety symptomatology., Participants: Three hundred and forty-five undergraduate students ( M age = 19.66; 74.8% female) were recruited from a public university in the northeastern United States., Methods: Participants completed self-report measures assessing perceived stress, self-compassion, anxiety symptomatology, and resilience., Results: Self-compassion was found to indirectly affect the association between perceived stress and resilience at both low ( b = -0.06, 95% CI [-0.08, -0.04]) and high levels ( b = -0.03, 95% CI [-0.05, -0.01]) of anxiety symptomatology. The index of moderated mediation was significant ( b  = 0.005, 95% CI [0.001, 0.01])., Conclusions: Results of the present study suggest that interventions to enhance resilience should incorporate strategies aimed at managing stress and anxiety and increasing self-compassion.

Introduction: Positive psychological characteristics have been found to be associated with discrimination and school outcomes separately; however, no work has examined these associations together or in North American Indigenous (NAI) populations. NAI adolescents experience high rates of racial discrimination. Because discrimination has a detrimental impact on academic outcomes it is critical to identify factors that could buffer this impact. The purpose of this study was to examine the indirect effect of racial discrimination on three distinct school outcomes (i.e., attitudes toward school, grades, and educational attainment goals) through the pathway of three positive psychological characteristics (i.e., satisfaction with life, subjective happiness, and self-compassion)., Methods: First Nation adolescents living on a rural reserve in Eastern Canada (N = 106, M age  = 14.6 years, 50.0% female) completed a pencil-and-paper survey in Spring 2017 as part of a larger community-based participatory research study., Results: In the model examining school attitudes, indirect effects through subjective happiness (b = -0.21, 95% confidence interval (CI): [-0.53, -0.03]) and self-compassion (b = -0.19, 95% CI: [-0.39, -0.04]), but not satisfaction with life, were significant. In the model examining grades, only the specific indirect effect through subjective happiness was significant (b = -0.27, 95% CI: [-0.59 -0.07]). Similarly, in the model examining school goals, only the indirect effect through subjective happiness was significant (b = -0.40, 95% CI: [-0.94, -0.08]). The direct effects of discrimination on school attitudes (b = 0.02, 95% CI: [-0.52, 0.56]), grades (b = 0.16, 95% CI: [-0.39, 0.71]), and school goals (b = -0.03, 95% CI: [-0.90, 0.84]) were not significant after controlling for positive psychological characteristics., Discussion: Schools should foster positive emotions to enhance academic outcomes, especially for NAI youth who are more likely to experience racial discrimination., (© 2023 Foundation for Professionals in Services to Adolescents.)

Substance use has been identified by Indigenous populations as contributing to health disparities facing their communities. Rates of trauma exposure and post-traumatic stress disorder are higher in Indigenous, compared to non-Indigenous, populations and have been linked to substance use. Historical trauma is thought to be one mechanism underlying substance use and related disorders. The purpose of the present study is to summarize the current state of the literature focusing on the association between trauma (historical and lived) and substance use among Indigenous populations in the United States and Canada. Databases were systematically searched using the preferred reporting items for systematic reviews and meta-analyses statement. The search strategy initially yielded 4,026 articles. After exclusion of ineligible articles, 63 articles remained for synthesis. Results of the present review provide evidence for a positive link between substance use and both historical trauma (i.e., 86.4% of studies) and lived trauma (i.e., 84.7% of studies). Indigenous participants reported that historical trauma and pain related to loss of cultural identity contributed to substance use in their communities. Indigenous participants also consistently described an association between lived trauma and substance use. Despite heterogeneity among Indigenous communities, findings suggest a significant association between trauma and substance use across many different tribes and settings (e.g., reservation/reserve, rural/urban). Indigenous participants identified healing from trauma and reconnecting with culture as necessary components for reducing substance use and maintaining sobriety. With this, the development and implementation of interventions should partner with Indigenous communities in a manner that promotes and enhances cultural values for healing., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose of Review: The aim is to review recent literature on sex and gender differences in patterns of use, motives, pharmacological effects, and consequences of simultaneous alcohol and cannabis use (SAC)., Recent Findings: Men engage in SAC more frequently than women. Women may have more substance-specific motives for use, while men tend to consistently endorse social/enhancement motives for both alcohol and cannabis. Regarding pharmacological effects, women experience the same subjective effects as men do at lower levels of use, with some evidence that women modulate cannabis use during simultaneous use episodes to avoid greater subjective intoxication. Finally, women appear more vulnerable to experiencing a range of positive and negative consequences from SAC relative to men., Summary: Research has identified several important sex/gender differences in SAC and its correlates and consequences. However, research has primarily focused on white and cisgender populations, with a need for more research among racial/ethnic and gender minorities., Competing Interests: Rachel Tomko has provided consultation to the American Society of Addiction Medicine, Kevin Gray has provided consultation to Jazz Pharmaceuticals and has received research support from Aelis Farma, and Aimee McRae-Clark has received research support from Pleo Pharma. The other authors have no relationships to disclose.

Young adults exhibit high rates of cannabis use and are at heightened risk of experiencing negative cannabis-associated consequences. The purpose of the present study was to replicate and extend to prior work on savoring, the ability to experience positive experiences/emotions, and cannabis use frequency on cannabis-associated consequences. Young adults (18-25 years old, N  = 122, 36.1% women) who reported weekly cannabis use completed self-report surveys. Savoring was significantly associated with cannabis use frequency ( r  = .28, p  < .01) and cannabis-associated consequences ( r  = -.20, p  < .05). Cannabis use frequency was significantly and negatively associated with cannabis-associated consequences ( r  = -.24, p  < .01). However, the interaction between cannabis use frequency and savoring on cannabis-associated consequences was not significant ( b  = 0.0004, p  = .91, 95% CI [-0.007, 0.008]). When the interaction was removed, neither cannabis use frequency ( b  = -0.14, p  = .08, CI [-0.29, -0.02]) nor savoring ( b  = -0.05, p  = .16, CI [-0.13, 0.02]) were associated with cannabis-associated consequences. Results did not replicate previous findings regarding the moderating role of savoring in the relationship between cannabis use frequency and cannabis-associated consequences. Future research may explore why findings did not replicate by using more fine-grained assessment methods and comprehensive measures of cannabis use.

Background: Young adults experience high rates of cannabis use and consequences. Cross-sectional work has linked positive psychological constructs (e.g., savoring) to less cannabis use and consequences, and positive psychological interventions (PPIs) have shown promise in targeting other substance use behaviors. This pilot study sought to provide an initial test of PPIs to reduce young adult cannabis use and consequences., Methods: Adults (18-25 years old) who endorsed at least weekly past-month cannabis use (N = 59, 69.6% men, 41.1% White) reported their baseline cannabis use and consequences. Participants were randomized to complete one of three daily exercises (Savoring, Three Good Things, or a control) along with daily text message surveys for two weeks, then completed a follow-up survey at the end of the two weeks., Results: Paired samples t-tests indicated that participants in the Three Good Things group showed medium to large reductions in frequency of weekly cannabis use (p = .08, g av  = -0.57) and cannabis-associated consequences (p = .08, g av  = -0.57) from baseline to follow-up. In the Savoring and control groups, there were not significant changes in frequency of weekly cannabis use (Savoring: p = .39, g av  = 0.20; Control: p = .96, g av  = 0.01) nor cannabis-associated consequences (Savoring: p = .84, g av  = 0.05; Control: p = .45, g av  = -0.18). Participants in both positive psychology conditions reported the exercises were easy to complete, providing evidence for acceptability., Discussion: Results provide initial support for the feasibility and potential promise of a text-message based PPI as a harm reduction approach for cannabis users. A larger clinical trial is warranted to test the effects of such interventions with adequate statistical power., Competing Interests: Declaration of Competing Interest The authors report no conflicts of interest., (Copyright © 2023. Published by Elsevier Inc.)

Background: Previous studies have identified common trajectories of single type substance use over the course of adolescence; however, no study to date has examined joint trajectories of cannabis and alcohol concurrent use. Given that expansion of legal cannabis has increased availability, it is important to understand patterns of concurrent use in adolescents and factors that place male and female youth at risk for harmful trajectories of concurrent use. The current study sought to identify joint trajectories of cannabis and alcohol use - and predictors of harmful use trajectories - among male and female adolescents., Method: We used 4 waves of data from 6997 early adolescent participants (age 12-14 years at Wave 1) in the Population Assessment of Tobacco and Health, a nationally representative longitudinal study in the United States. Participants reported their cannabis and alcohol use reassessed yearly for 5 years (2013-2018). We used joint trajectory growth mixture modeling to identify trajectory groups as defined by changes in alcohol and cannabis use over time., Results: Five classes of alcohol and cannabis concurrent use trajectories were identified. Both internalizing and externalizing symptoms at Wave 1 increased the odds of membership in trajectory groups characterized by more harmful use trajectories. Internalizing symptomatology was a stronger predictor of membership in escalating use trajectories among girls, whereas externalizing symptomatology stronger predictor among boys., Conclusions: These findings underscore the utility of jointly considering alcohol and cannabis use when describing common developmental trajectories of use and identifying risk factors for trajectories characterized by harmful use., Competing Interests: Declaration of Competing Interest No conflict declared., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: North American Indigenous (NAI) communities have identified alcohol use as a primary health concern. Experiences of racial discrimination are associated with greater alcohol use, but findings are mixed regarding the role of culture in this relationship. The goal of the present study was to examine the role of culture in the association between racial discrimination and alcohol use., Methods: Across two studies (Study 1: N = 52; Study 2: N = 1743), NAI adolescents living on or near NAI reservations who reported recent alcohol use completed self-report measures of racial discrimination, cultural affiliation, and alcohol use (e.g., frequency)., Results: Bivariate correlations revealed a significant positive association between racial discrimination and alcohol use (Study 1: r = 0.31, p = 0.029; Study 2: r = 0.14, p < 0.001) but not between cultural affiliation and alcohol use. Racial discrimination and cultural affiliation were significantly positively correlated in Study 1 (r = 0.18, p < 0.001), but not in Study 2. Across both studies, the interactions between racial discrimination and cultural affiliation significantly predicted alcohol use in unadjusted models (Study 1: b = 0.70, SE = 0.32, p = 0.033, 95% CI [0.06, 1.33]; Study 2: b = 0.01, SE = 0.01, p = 0.041, 95% CI [0.001, 0.03]), such that the association between racial discrimination and alcohol use was stronger for adolescents reporting high (vs. low) levels of cultural affiliation. In adjusted models controlling for age and sex, the interaction between racial discrimination and cultural affiliation remained significant in Study 2 (b = 0.01, SE = 0.01, p = 0.0496, 95% CI [0.00002, 0.03]) but was no longer significant in Study 1., Conclusions: Findings speak to the need to reduce racial discrimination against NAI youth and to consider youths' different needs based on level of cultural affiliation to reduce subsequent alcohol consumption., (© 2023 Research Society on Alcohol.)

American Indian (AI) adolescents experience disproportionate alcohol-related consequences. The present study evaluated the psychometric properties and application of the American Drug and Alcohol Survey (ADAS™) alcohol-related consequence scale for AI adolescents through a secondary analysis of a large population-based sample of adolescents living on or near AI reservations. We found support for the ADAS alcohol-related consequence scale as a one-factor model, invariant discretely across race, sex assigned at birth, and age, and with good internal consistency. Evidence for construct validity was found through significant positive correlations between frequency of past 12 months of drinking, frequency of past 12 months of intoxication, and lifetime alcohol-related consequences. AI adolescents were significantly more likely to report more alcohol-related consequences than their non-Hispanic White peers. Race significantly interacted with frequency of drinking in predicting alcohol-related consequences such that these associations were stronger for AI adolescents. However, race did not significantly interact with frequency of intoxication in predicting alcohol-related consequences. Results from this study demonstrate the utility of the ADAS alcohol-related consequence scale for use across demographic groups with little risk of measurement bias.

Objectives: Depression, alcohol use, and alcohol-related consequences are experienced disproportionately by American Indian (AI) adolescents. The co-occurrence of depression and alcohol use is clinically relevant, as it is associated with increased risk for suicide, among other negative consequences. Understanding how the association between depressive symptoms and alcohol use and related consequences is influenced by gender is important to understand for whom intervention efforts might be particularly relevant. Thus, the present study seeks to evaluate gender differences in these associations among AI adolescents., Methods: Participants were a representative sample of AI adolescents ( N  = 3,498, M age =14.76, 47.8% female) residing on or near reservations who completed self-report questionnaires in school classrooms. Study activities were approved by IRB, school boards, and tribal authorities., Results: The interaction of depressive symptoms and gender was significant in predicting past-year alcohol use frequency ( b =.02, p =.02) and, among youth reporting lifetime alcohol use, alcohol-related consequences ( b =.03, p =.001). Analysis of simple slopes revealed that, for females, depressive symptoms were significantly associated with past-year alcohol use frequency ( b =.02, p <.001) and alcohol-related consequences ( b =.05, p <.001). For males, depressive symptoms were only significantly associated with alcohol-related consequences ( b =.02, p =.04), and this effect was weaker than for females., Conclusions: Results of the present study may inform the development of gender-sensitive recommendations for the assessment and treatment of alcohol use and alcohol-related consequences among AI adolescents. For instance, results suggest that treatments focusing on depressive symptoms may subsequently reduce alcohol use and related consequences for female AI adolescents.

An experimental paradigm with subjective and objective assessments was used to further explicate the role of positive emotion dysregulation on risky behavior. Participants were 151 community women currently experiencing intimate partner violence and using substances ( M age = 40.81, 43.0% white). Participants were randomly assigned to positive, negative, and neutral idiographic emotion inductions. Subjective (state self-report) and objective (high frequency heart rate variability [hfHRV], skin conductance response, and salivary cortisol) markers of emotion dysregulation were assessed, following which participants completed subjective (state urges for substances) and objective (Balloon Analogue Risk Task) measures of risky behavior. Results showed (a) greater self-reported state emotion dysregulation and lower hfHRV predicted more urges for substances in the positive (versus negative and neutral) emotion induction conditions; and (b) lower hfHRV predicted more behavioral risk-taking propensity in the positive (versus neutral) emotion induction condition. Findings provide additional support for the influence of positive emotion dysregulation on risky behavior.

Despite the well-documented association between experiences of substance use stigma and adverse mental health outcomes, little is known about the mechanisms underlying this association. Utilizing a community sample of substance-using adults who have experienced at least one traumatic event in their lifetime, the current study examined the role of dysregulation stemming from both negative and positive emotions in the relation between substance use stigma and depressive symptoms. Community participants ( N = 320, 46.9% women) completed self-report measures of substance-use-related stigma experiences, negative and positive emotion dysregulation, and depressive symptoms. Results showed that, adjusting for gender and substance use severity, substance use stigma was positively associated with emotion dysregulation, which in turn related to depressive symptoms. Substance use stigma was also found to be indirectly associated with depressive symptoms through emotion dysregulation, suggesting that emotion dysregulation accounted for the significant association between substance use stigma and depressive symptoms. These findings provide initial support for the role of emotion dysregulation as a mechanism through which stigma operates to undermine the mental health of substance-using, trauma-exposed individuals. Results underscore the potential utility of targeting emotion dysregulation in intervention efforts that are designed to facilitate stigma coping among individuals who use alcohol and/or drugs.

Objective: The COVID-19 pandemic has led to substantial changes in college student alcohol use. Changes in drinking motives may explain some of these changes in drinking patterns. The purpose of the present study is to explore how drinking motives and alcohol use have changed amongst college students considering the timeframes before and after the onset of COVID-19 pandemic (i.e., March 2020) in the United States. We hypothesized that there would be significant changes in drinking motives after March 2020, which would be significantly related to changes in alcohol use., Methods: Participants for the current study were undergraduate students reporting lifetime alcohol use ( n = 198, M age = 21.3, 66.7% female, 86.4% White) recruited through online advertisements in classes to complete an online survey in April 2020. Participants were asked to report on their drinking motives and alcohol use considering the timeframes before and after the onset of closures and stay-at-home orders during the COVID-19 pandemic (i.e., before and since March 2020)., Results: Paired samples t -tests revealed that endorsement of social ( t [171) = 12.79, p < .001, d = 1.16) and conformity motives significantly decreased ( t [170] = 4.46, p < .001, d = 0.31), while endorsement of coping motives significantly increased ( t [172] = -2.70, p = .008, d = .15) after the onset of COVID-19. Linear regression analyses, controlling for drinking motives before March 2020, revealed that changes in enhancement ( β = -.47, p < .001) and coping motives ( β = -.22, p = .04) were significantly associated with changes in alcohol use quantity., Conclusions: Findings of the present study support the need for interventions to target coping and social drinking to reduce risk for alcohol use.

Women experiencing intimate partner violence (IPV) experience a heightened prevalence of alcohol use disorder (AUD). Hypothalamic-pituitary-adrenal (HPA)-axis functioning has been associated with increased risk for AUD in other populations, including individuals with posttraumatic stress disorder (PTSD) symptoms. The goal of the present study was to determine whether PTSD symptom severity exacerbates the relationship between HPA-axis functioning and AUD. Participants were 151 community women who had experienced physical or sexual IPV in the past 30 days by their current male partners and used any amount of alcohol or drugs. A two-phase emotion induction protocol was utilized: Neutral mood induction followed by randomly assigned negative, positive, or neutral emotion induction. Saliva cortisol samples were obtained immediately following the neutral mood induction (baseline HPA-axis functioning), 20 min following the individualized emotion induction script (HPA-axis reactivity), and 40 min post the emotionally evocative cue (HPA-axis recovery). Findings revealed that PTSD symptom severity moderated the relations between baseline HPA-axis functioning and HPA-axis recovery and log odds of meeting criteria for AUD. Specifically, baseline HPA-axis functioning was positively associated with log odds of meeting criteria for AUD at high (but not low) PTSD symptom severity, whereas HPA-axis recovery was negatively associated with log odds of meeting criteria for AUD at high (but not low) PTSD symptom severity. Results contribute to our understanding of the biological processes involved in the etiology and maintenance of AUD among women experiencing IPV-specifically the prominent role of PTSD symptom severity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sexual and gender minority (SGM) individuals are at increased risk for experiencing sexual violence. Bystander intervention training programs are a first-line prevention recommendation for reducing sexual and dating violence on college campuses. Little is known regarding the extent to which SGM individuals are represented in the content of bystander intervention programs or are included in studies examining the effectiveness of bystander intervention programs. The present critical review aimed to fill this gap in knowledge. Twenty-eight empirical peer-reviewed evaluations of bystander intervention programs aimed at reducing dating violence or sexual assault on college campuses were examined. Three studies (10.7%) described including content representing SGM individuals in the program. Personal communication with study authors indicated that-although not mentioned in the publication-many programs describe rates of violence among SGM students. When describing the study sample, six studies (21.4%) indicated that transgender, nonbinary, or students classified as "other" were included in the research. Approximately two thirds of studies (67.9%) did not describe participants' sexual orientation. No studies reported outcomes specifically among SGM individuals, and two (7.1%) mentioned a lack of SGM inclusion as a study limitation. Work is needed to better represent SGM individuals in the content of bystander intervention programs and ensure adequate representation of SGM individuals in studies examining the effectiveness of bystander intervention programs.

Intentions to use substances are a robust risk factor for future substance use. Primary Socialization Theory (PST), with its focus on relational factors, is well-suited to provide insight into American Indian adolescents' intentions to use substances given the importance of relationships in American Indian communities. The goal of the present study was to examine the role of PST-related factors (i.e., parental monitoring, peer pressure, attitudes toward school) on likelihood of intending to use substances (i.e., alcohol, cigarettes, cannabis, other drugs) among American Indian adolescents., American Indian participants ( N  = 8,950, 50.7% females) were recruited as a part of the Our Youth, Our Future survey, an ongoing surveillance of substance use among 7th-12th graders attending school on or near reservations., Parental monitoring was found to be associated with decreased likelihood of intending to use alcohol (aOR = 0.97, 95% CI [0.96, 0.99]), cigarettes (aOR = 0.96, 95% CI [0.94, 0.98]), cannabis (aOR = 0.95, 95% CI [0.94, 0.96]), and other drugs (aOR = 0.94, 95% CI [0.92, 0.96]). Peer pressure was associated with increased likelihood of intending to use alcohol (aOR = 1.68, 95% CI [1.59, 1.78]), cigarettes (aOR = 1.73, 95% CI [1.60, 1.86]), cannabis (aOR = 1.81, 95% CI [1.71, 1.92]), and other drugs (aOR = 1.40, 95% CI [1.26, 1.56]). More positive attitudes toward school were associated with decreased likelihood of intending to use alcohol (aOR = 0.93, 95% CI [0.91, 0.94]), cigarettes (aOR = 0.92, 95% CI [0.90, 0.94]), cannabis (aOR = 0.90, 95% CI [0.88, 0.91]), and other drugs (aOR = 0.96, 95% CI [0.93, 0.99])., Results support incorporating social relationships into interventions aiming to prevent substance use initiation, including promoting positive parental monitoring, peer interactions, and school attitudes.

Objective: To examine the associations among stress, positive affect, binge drinking, and coping drinking motives., Participants: Students ( n  = 351, M age =19.7, 74.6% female) at a northeastern public university., Methods: Participants completed an online survey assessing perceived stress, frequency of experiencing positive emotions, frequency of binge drinking, and coping drinking motives., Results: Stress and positive emotions were not significantly related to frequency of binge drinking but were significantly correlated with coping motives for drinking. Regression analyses with all predictors, age, and gender in the model revealed the same: stress and positive emotion were not significantly related to binge drinking but were significantly related to coping motives. The interaction between stress and positive emotions predicting frequency of binge drinking or coping motives was nonsignificant., Conclusions: Findings suggest the utility of exploring positive emotions in risk and resilience research focused on college student drinking and of targeting positive emotions to decrease students' coping-related alcohol use.

Objective: North American Indigenous youth experience disproportionate harm associated with alcohol and cigarette use compared to other racial/ethnic groups. The Acquired Preparedness Model (APM), developed and tested in primarily White samples, hypothesizes that urgency contributes to risk for substance use by influencing the degree to which adolescents attend to positive aspects of substance use, leading to the development of more positive expectations about the consequences of substance use, and increasing subsequent substance use. The purpose of the present study was to provide an initial test of whether the APM generalizes to understanding alcohol and cigarette use among high-risk First Nation adolescents., Method: First Nation adolescents ( n = 106, M age = 14.6, 50.0% female) recruited from reserve communities in Eastern Canada completed self-report measures as part of a larger community-based participatory research project. Procedures were approved by tribal chief, council, and university IRB., Results: The hypothesized model demonstrated excellent fit for alcohol use, χ²(1) = 1.07, p = .30, CFI = 0.99, RMSEA = .03, SRMR = .02, and adequate fit for cigarette use, χ²(1) = 2.58, p = .11, CFI = 0.98, RMSEA = 0.12, SRMR = 0.03. The indirect effects of urgency on alcohol consumption and cigarette smoking through alcohol and cigarette expectancies were each significant., Conclusions: Findings of the present study provide initial support for the generalizability of the APM in understanding risk for alcohol and cigarette use among reserve-dwelling First Nation youth. The next important step is to replicate this finding in a prospective sample. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background and Aims: A fast-growing body of literature linking emotion dysregulation to substance use has almost exclusively relied on cross-sectional designs and has generally failed to assess dysregulation stemming from positive emotions. The current study measured the momentary associations between both negative and positive emotion dysregulation and substance use, as well as the moderating role of post-traumatic stress disorder (PTSD)., Design: Micro-longitudinal momentary data were collected three times per day for 30 days using phone-based interactive voice recording., Setting: Northeastern United States., Participants: A total of 145 community women (M, age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances were recruited from 2018 until 2020., Measurements: Momentary surveys assessed negative and positive emotion dysregulation and alcohol, drug, and cigarette use. PTSD diagnosis was derived from a structured diagnostic interview., Findings: Between-person relations that remained significant after covariate adjustment and correction for multiple testing were found for negative emotion dysregulation and both number of drinks (internal rate of return [IRR] = 1.45; 95% CI = 1.07, 1.93; β = 0.37) and drug use (OR = 3.78; 95% CI = 1.86, 7.69; β = 1.33), and positive emotion dysregulation and number of cigarettes (OR = 1.40; 95% CI = 1.07, 1.82; β = 0.34). Of six interactions tests, PTSD was only shown to moderate the within-person relation between positive emotion dysregulation and drug use, even after controlling for relevant covariates and adjusting for multiple testing (OR = 1.26; 95% CI = 1.04, 1.51; β = 0.23), such that women experiencing intimate partner violence with versus without PTSD were more likely to use drugs when experiencing periods of elevated positive emotion dysregulation., Conclusions: Women experiencing intimate partner violence with higher levels of negative dysregulation relative to others may use more alcohol and be more likely to use drugs. Women experiencing intimate partner violence with higher levels of positive dysregulation relative to others may use more cigarettes. Women experiencing intimate partner violence who also have posttraumatic stress disorder may be more likely to use drugs when experiencing momentary elevated levels of positive emotion dysregulation than those who do not also have posttraumatic stress disorder., (© 2022 Society for the Study of Addiction.)

The present study utilized survey assessments to examine correlates of bystander intervention intentions among heavy drinking college men ( N  = 210). Intentions to engage in bystander intervention were associated with fewer heavy drinking days, lower alcohol-related consequences, greater use of strategies to limit drinking, and lower endorsement of alcohol expectancies. A range of constructs commonly associated with perpetration of sexual aggression demonstrated a negative association with intentions to engage in bystander intervention. Multivariate analyses revealed that greater use of strategies to limit drinking and lower pornography use emerged as predictors of intentions to engage in bystander intervention.

Background: Adolescent alcohol use is a significant public health concern and rates of alcohol use are higher among American Indian (AI) adolescents than national samples of non-AI youth. A potential factor in understanding AI alcohol use is cultural identity, which can vary widely based on experiences of historical trauma. We used latent class analysis to examine cultural identity in AI and White adolescents and their alcohol use outcomes in relation to the latent class solutions., Methods: The samples included 3189 AI adolescents (M age  = 14.76, 48.9% female) and 1579 White adolescents (M age  = 15.56, 48.7% female) living on or near a reservation. Participants completed self-report measures of AI and White cultural identity affiliation, alcohol use, and alcohol-related problems. We examined (1) the best-fitting latent class solution with respect to American Indian (AI) and White cultural identity; (2) equivalence of the latent class solution; and (3) alcohol use outcomes across the optimal latent class solution., Results: Latent profile analyses indicated an optimal 3-class solution in both the AI and White samples, which differed by level of affiliation with AI and White cultural identity. While the optimal number of classes were similar across racial groups (configural profile similarity), the nature of the classes differed (structural profile dissimilarity). The three classes represented low overall scores on AI and White cultural identity (Marginalized), a mixture of high and low scores on AI and White cultural identity (Third Culture), and overall high scores on AI and White cultural identity (Bicultural). Alcohol-related problems predicted membership in the Third Culture class compared with the Marginalized class and the Bicultural class. Specifically, youth in the Third Culture class reported significantly fewer alcohol-related problems than youth in the Marginalized and Bicultural classes. Alcohol use did not predict latent class membership., Conclusions: The future-oriented nature of the Third Culture class may provide protection against adverse alcohol-related outcomes. Research is needed to test interventions that target greater future orientation and future plans to integrate culture into adolescents' lives., (© 2022 Research Society on Alcoholism.)

Introduction: Poor sleep health is common among individuals in early treatment for substance use disorders (SUDs) and may serve an important role in predicting SUD outcomes. However, sleep parameters have been inconsistently linked with risk of relapse, perhaps because previous research has focused on mean values of sleep parameters (e.g., total sleep time [TST], sleep efficiency [SE], and sleep midpoint [SM]) across multiple nights rather than night-to-night fluctuations (i.e., intraindividual variability [IIV]). The current study assessed sleep across the first week of SUD treatment, with the aim of prospectively examining the relationship between mean and IIV of TST, SE, and SM and treatment completion and relapse within one-month post-treatment., Methods: Treatment-seeking adults (N = 23, M age  = 40.1, 39% female) wore an actigraph to assess sleep for one week at the beginning of an intensive outpatient program treatment. Electronic medical record and follow-up interviews were utilized to determine treatment outcomes., Results: Greater IIV in TST was associated with higher odds of relapse (OR = 3.55, p =.028). Greater IIV in SM was associated with lower odds of treatment completion, but only when removing mean SM from the model (OR = 0.75, p =.046)., Discussion: Night-to-night variability in actigraphy-measured TST is more strongly associated with SUD treatment outcomes than average sleep patterns across the week. Integrating circadian regulation into treatment efforts to improve SUD treatment outcomes may be warranted. Given the small sample size utilized in the present study, replication of these analyses with a larger sample is warranted., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Research examining emotion dysregulation and alcohol use has increased exponentially over the past decade. However, these studies have been limited by their use of cross-sectional designs and narrow definitions of emotion dysregulation. To address these significant gaps in the extant literature, this study utilized state-of-the-art methodology (i.e., experience sampling) and statistics (i.e., dynamic structural equation modeling) to examine potential reciprocal associations between negative and positive emotion dysregulation and alcohol use at the momentary level., Methods: Participants were 145 community women (mean age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances. Surveys assessing negative and positive emotion dysregulation and alcohol use (i.e., number of standard drinks) were administered three times a day for 30 days using phone-based interactive voice recording., Results: Significant contemporaneous effects indicated that negative and positive emotion dysregulation both co-occurred with alcohol use. However, levels of negative and positive emotion dysregulation did not predict later alcohol use, nor did alcohol use predict later levels of negative or positive emotion dysregulation. There was significant variability among participants in cross-lagged effects., Conclusions: Findings showed that negative and positive emotion dysregulation co-occurred with alcohol use and that there was significant interindividual variability in the cross-lagged associations between negative and positive emotion dysregulation and alcohol use. Research using idiographic approaches may identify women experiencing IPV for whom negative and positive emotion dysregulation drive alcohol use and alcohol use drives negative and positive emotion dysregulation., (© 2022 Research Society on Alcoholism.)

Alcohol use disorders (AUDs) are among the most prevalent behavioral and mental health diagnoses. Individuals with an AUD are at increased risk for numerous consequences across their social, health, and psychological functioning. Research suggests that differences may exist in the prevalence and consequences of AUD and in the efficacy of AUD treatment across demographic characteristics (i.e., sex/gender and race/ethnicity). This meta-epidemiologic review examined the inclusion of diverse groups (sex/gender and race/ethnicity) in published randomized controlled trials of nonpharmacological treatments for AUD since 1994, following passage of the National Institutes of Health Revitalization Act of 1993. We systematically searched databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement criteria. The initial search strategy yielded 7931 articles. After excluding ineligible articles, 155 were included in the present review for synthesis. Of the articles included in this review, only 57 (36.8%) fully reported on both their sample's sex/gender and racial/ethnic breakdown. Of the total sample, seven articles specifically examined one racial/ethnic group and 32 specifically examined one sex/gender group. Six articles (3.9%) reported no information regarding the racial/ethnic breakdown of their sample and five articles (3.2%) reported no information regarding the sex/gender breakdown of their participants. Only two articles (1.3%) reported on subgroup analyses that examined differences in treatment outcomes by both sex/gender and race/ethnicity, despite guidelines set forth by NIH. Only 46 articles (29.7%) described the failure to include diverse sex/gender or racial/ethnic groups or concerns about the generalizability of study findings given their sample's sex/gender or racial/ethnic composition as methodological limitations. These results indicate that substantial efforts must be put forth by the scientific community to ensure the inclusion, analysis, and reporting of data focused on women/females and members of minoritized racial/ethnic groups., (© 2022 by the Research Society on Alcoholism.)

Background: Despite efforts towards gender parity and some improvement over time, gender bias in peer review remains a pervasive issue. We examined gender representation and homophily in the peer review process for Drug and Alcohol Dependence (DAD)., Methods: We extracted data for papers submitted to DAD between 2004 and 2019, inclusive. Inferred gender was assigned to handling editors and reviewers using the NamSor gender inference Application Programming Interface (API)., Results: Men and women handling editors were approximately equally likely to invite women reviewers over time, with only a few exceptions. Over time, 47.1% of editors were women, and 42.6% of review invitations were sent to women. Men were largely consistent over time in their likelihood of accepting a review invitation, while the likelihood of women accepting a review invitation was more variable over time. Gender differences in rates of accepting a review invitation were minimal; however, as women approached half of all invited reviewers in recent years, there has been a greater trend for women, relative to men, to decline review invitations. Evidence of homophily on the part of reviewers accepting invitations was minimal, but in certain years, a tendency to accept review invitations at higher rates from editors of the same gender was observed., Discussion: Given the benefits of diversity in scientific advancement, these results underline the importance of continuing efforts to increase gender diversity among editors and in reviewer pools, and the need for reviewers to be mindful of their own reviewing practices., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Military sexual harassment (MSH) and assault (MSA) are associated with serious mental and physical health outcomes among military personnel and veterans. However, less is known about how these experiences relate to risky, impulsive, and health-compromising behaviors. The goal of the current study was to assess MSH and MSA in relation to a wide range of risky behaviors. Participants were 512 veterans in the community ( M age = 41.36, 71.3% male, 71.3% white) who completed an online survey via Amazon's Mechanical Turk (MTurk). Compared to veterans who reported MSH only or no history of MST, veterans with a MSA history reported greater past-month risky behavior engagement, both overall and for specific behaviors, including problematic use of alcohol, drugs, gambling, technology, risky sexual behaviors, eating behaviors, illegal behaviors, reckless spending, physically aggressive behaviors, verbally aggressive behaviors, property destruction, reckless driving, non-suicidal self-injury, and suicidal behavior. Our findings emphasize the importance of differentiating between MSH and MSA when detecting and intervening with veterans at risk for engaging in risky behaviors.

Background: American Indian (AI) adolescents report disproportionate higher rates of alcohol use and alcohol-related consequences than adolescents from other racial/ethnic groups. Trauma exposure is also reported at high rates among AI individuals and likely confers risk for alcohol use. The purpose of the present study was to examine the effects of assaultive trauma experiences (e.g., physical assault, sexual assault) on alcohol use and alcohol-related consequences in AI adolescents., Methods: We conducted a secondary analysis of self-reported data on trauma exposure, alcohol consumption, and lifetime alcohol-related consequences provided by AI 7th to 12th graders residing on or near a reservation (n = 3498, M age  = 14.8; 49.5% female). Institutional Review Boards, tribal authorities, and school boards approved the study protocols prior to beginning data collection., Results: Nearly half (49.3%, n = 1498) of AI adolescents reported having experienced at least one assaultive trauma in their lifetime. Those who had experienced assaultive trauma were more likely to report lifetime alcohol use (χ 2  = 111.84, p < 0.001) and experienced greater alcohol-related consequences (t(1746) = 12.21, p < 0.001) than those with no assaultive trauma exposure. Multilevel regression analyses indicated that a greater number of assaultive traumatic events was significantly associated with greater odds of lifetime alcohol use (p < 0.001, OR = 1.81, 95% CI [1.65, 2.00]) and having experienced a greater number of alcohol-related consequences (b = 0.36, SE = 0.04, t = 16.95, p < 0.001, 95% CI [0.31, 0.46])., Conclusions: Findings of the present study highlight the relevance of exposure to assaultive trauma to AI adolescents' use of alcohol and experiences of alcohol-related consequences. These findings support the need for trauma-informed interventions in addressing alcohol use among AI adolescents., (© 2022 by the Research Society on Alcoholism.)

Objective: Emotion regulation is a transdiagnostic mechanism with relevance to the etiology, maintenance, and treatment of a wide range of clinically relevant outcomes. This study applied systematic review methods to summarize the existing literature examining racial and ethnic differences in emotion regulation., Methods: We systematically searched four electronic databases (PsycINFO, Embase, MEDLINE, and CINAHL Plus) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines., Results: Of the initial 1253 articles, 25 met the inclusion criteria. Findings for emotion regulation strategies generally provide evidence for racial/ethnic differences (71% of reviewed studies), with ethnoracial minorities largely exhibiting greater use of emotion regulation strategies. Whereas the results for emotion regulation potential were slightly more mixed (63% of reviewed studies found racial/ethnic differences), ethnoracial minorities were also largely found to report lower emotion regulation potential., Conclusion: This review advances the literature by providing additional support for racial and ethnic differences in emotion regulation., (© 2021 Wiley Periodicals LLC.)

Objective: Theoretical and empirical evidence links emotional avoidance to the development and maintenance of posttraumatic stress disorder (PTSD) symptoms. However, few studies have tested whether these findings extend to positive emotional avoidance. Addressing this important gap in the literature, the current study examined the moderating role of PTSD symptom severity in the relation between positive emotional intensity and positive emotional avoidance., Method: Participants were 465 trauma-exposed veterans recruited from the community ( M age = 38.00, 71.6% male, 69.5% White)., Results: The interaction between positive emotional intensity and PTSD symptom severity on positive emotional avoidance was significant. Analysis of simple slopes revealed that positive emotional intensity was significantly positively associated with positive emotional avoidance when participants endorsed high, but not low, levels of PTSD symptom severity., Conclusions: Veterans with more severe PTSD symptoms may utilize avoidance strategies in the context of intense positive emotions. These findings may suggest the potential need for addressing positive emotional avoidance in interventions to reduce PTSD symptom severity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Alcohol and drug misuse is prevalent and problematic among women who experience intimate partner violence (IPV). Emotional dysfunction has been identified as a key mechanism in the etiology, maintenance, and treatment of alcohol and drug misuse. However, existing research has not considered the role of race/ethnicity in the relations between emotional dysfunction and alcohol and drug misuse. Furthermore, past research in this area has focused almost exclusively on emotional dysfunction stemming from negative (vs. positive) emotions. The goals of the current study were as follows: (a) to explore whether levels of difficulties regulating positive emotions differ among Latina, African American, and White IPV-victimized women, and (b) to examine the moderating role of race/ethnicity in the relations between difficulties regulating positive emotions and alcohol and drug misuse. Participants were 197 IPV-victimized women recruited through the criminal justice system ( M age = 36.14; 51.8% African American, 31.5% White, and 16.8% Latina). Difficulties regulating positive emotions did not differ as a function of race/ethnicity. However, relations among difficulties regulating positive emotions and alcohol and drug misuse were significant for Latina and White but not African American IPV-victimized women. Moreover, race/ethnicity moderated an association between difficulties regulating positive emotions and drug misuse; this relation was significant and positive for White (compared with African American) IPV-victimized women. While preliminary, these results may inform culturally sensitive interventions for alcohol and drug misuse that are tailored to the unique needs of Latina, African American, and White IPV-victimized women.

Objective: The present study examines how perceptions of peer use, risks of use, and benefits to oneself and others from marijuana use are associated with past-month marijuana use and intentions to use marijuana socially among American Indian (AI) youth., Method: The American Drug and Alcohol Survey (ADAS), a measure of substance use and related factors, was administered to AI youth living on or near reservations across six geographic regions (n = 3,498, 49.5% female, M age = 14.8)., Results: Greater perceived peer use was significantly associated with more frequent past-month marijuana use (b = .05, p = .038) and intentions to use marijuana socially (b = .74, p < .001). Greater benefits to oneself were associated with greater marijuana use intentions (b = .35, p < .001). Greater perceived risks and benefits to others were significantly associated with less frequent past-month use (b = -.02, p = .002; b = -.01, p = .007, respectively) and intentions to use marijuana socially (b = -.05, p = .001; b = -.03, p = .002, respectively). Multilevel moderation analyses revealed that the effects of perceived peer use and benefits to oneself were related to intentions to use although stronger for those who had used; however, the effects of perceived risks and benefits to others were only significantly related to intentions to use marijuana for those who had used marijuana., Conclusions: Results suggest that perceived benefits to others and risks are malleable factors that may be effective components of treatment programs for youth who report lifetime marijuana use, but that perceived peer use and benefits to oneself may be useful in both treatment and prevention efforts for youth who have or have not used marijuana. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background: Previous research has linked the internalization of shame and negative stereotypes associated with substance use to increased severity of substance use problems (i.e., negative consequences associated with alcohol and drug use, including occupational or relational difficulties and illegal behavior). However, little work has examined how other aspects of substance-use-related stigma (e.g., encounters with and anticipation of discrimination) might be related to the severity of substance use problems. Further, the psychological mechanisms through which stigma drives substance use problems remain poorly understood. Addressing these key limitations, the current study examined the role of executive functioning (EF) deficits in the relation between substance-use-related stigma and severity of substance use problems. Methods: In fall 2019, adults exposed to trauma who use substances were recruited via Amazon's Mechanical Turk ( N  = 320, 46.9% women) and completed self-report measures of substance-use-related stigma, EF deficits, and substance use problems. Results: Substance-use-related stigma was positively associated with EF deficits, which in turn related to substance use problems. Substance-use-related stigma was also indirectly associated with substance use problems through EF deficits, suggesting that EF deficits accounted for the significant association between substance-use-related stigma and substance use problems. Conclusions: These findings provide initial support for the role of EF deficits as a mechanism through which stigma drives substance use problems among individuals exposed to trauma. Results underscore the potential utility of addressing stigma coping and EF deficits in interventions aimed at preventing and treating substance use disorders.

Given the disproportionate alcohol-related consequences experienced by North American Indigenous youth, there is a critical need to identify related risk and protective factors. Self-compassion, which has been found to mitigate the effects of trauma exposure, may serve as one such protective factor given the high-degree of historical trauma and contemporary discrimination identified as contributing to the alcohol-related disparities experienced by Indigenous communities. However, no research has examined how self-compassion (i.e., the ability to be kind and accepting and to extend compassion towards oneself) plays a unique role in Indigenous peoples' experiences with alcohol. First Nation adolescents between the ages of 11 and 18 living on a reserve in Eastern Canada ( N =106, M age =14.6, 50.0% female) completed a pencil-and-paper survey regarding their alcohol use, alcohol-related problems, and self-compassion. Self-compassion was significantly inversely associated with alcohol-related problems ( b =-.51, p =.01, 95% CI [-.90, -.12], and significantly interacted with frequency of alcohol use in predicting alcohol-related problems ( b =-.42, p =.04, 95% CI [-.82, -.03]). Simple slopes analyses revealed that the association between frequency of alcohol use and frequency of experiencing alcohol-related problems was significant and positive at low ( b =4.68, p <.001, 95% CI [2.62, 6.73]), but was not significant at high ( b =-.29, p =.89, 95% CI [-4.35, 3.77]) levels of self-compassion. Binary logistic regression revealed that higher scores of self-compassion were associated with a lower odds of being in the high-risk group for AUD (OR=0.90, 95% CI [0.83, 0.98], p =.02). Our results suggest self-compassion may be protective against experiencing alcohol problems in Indigenous youth and thus may be a target for behavioral interventions.

Background North American Indigenous (NAI) adolescents experience disproportionate harm related to substance use compared to non-Indigenous adolescents. Strengths-based approaches to substance use prevention and treatment are consistent with Indigenous conceptualizations of health, which tend to be holistic and incorporate more spirituality and community than mainstream Western conceptualizations. Despite this, little is known about how positive psychological characteristics that might confer protection relate to substance use among NAI adolescents. Thus, the present study aims to examine the relations among life satisfaction, subjective happiness, self-compassion, and cigarette, marijuana, alcohol, and other drug use. Methods Participants were 106 reserve-dwelling First Nation adolescents located in Eastern Canada (M age = 14.6 years, 50.0% female) who completed a paper-and-pencil survey regarding their substance use and psychological characteristics for a larger community-based participatory research project. Results Greater life satisfaction was significantly associated with decreased odds of lifetime ( OR  = 0.88, 95% CI [0.81, 0.96]) and current cigarette smoking ( OR  = 0.90, 95% CI [0.82, 0.99]). Greater subjective happiness was significantly associated with decreased odds of current marijuana use ( OR  = 0.83, 95% CI [0.71, 0.97]). Although significantly correlated with lower lifetime use of other drugs, self-compassion was not significantly associated with lifetime or current odds of substance use after controlling for age, gender, and other positive characteristics. Discussion This is one of the first studies to evaluate positive characteristics and substance use in NAI adolescents. Results point to positive characteristics that may be useful in substance use prevention and suggest the need for further research to further elucidate these associations.