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IntroductionThere is increasing recognition that non-daily cigarette smoking is common in early adulthood but less is known about its stability over time, or what influences transitions to heavier or nonsmoking. We examined the stability of non-daily smoking in a sample of young adults, and tested whether social and cognitive factors predicted transitions to other smoking patterns over time.Aims and methodsParticipants were 579 young adults (18-24 years old at enrollment, 52% male) who were non-daily and never-daily cigarette smokers and California residents. Participants completed 13 waves of assessment over 3 years. We used descriptive statistics to evaluate the frequency of consistent abstinence, defined as no cigarette use at two consecutive waves and no cigarette use at any subsequent waves. Cox and logistic regression were used to test predictors of consistent abstinence.ResultsWe found that 55% of participants smoked intermittently throughout the study, while 43% were consistently abstinent by the end of the study; few transitioned to daily smoking. Stopping smoking was associated with having fewer smoking friends, smoking less in social situations, having lower positive reinforcement expectancies for smoking, and having stronger intent to quit. Post hoc analyses indicated those who stopped smoking tended to report reductions in positive reinforcement expectancies and increased intent to quit in the 6 months before stopping.ConclusionsFindings suggest a substantial minority of young adult non-daily smokers may stop on their own, but that the majority continue smoking and may require intervention. Interventions for this population should address social motives and reinforcement expectancies.ImplicationsThe majority of young adults who are non-daily cigarette smokers appear to maintain this habit over an extended period and may require intervention. Interventions that focus on reducing expectancies for positive effects of and social motives for cigarette use and on increasing intent to quit smoking may be most effective.

The factor structure of neuropsychological functioning among a large sample (N = 831) of American youth (ages 12-21 at baseline) was investigated in order to identify an optimal model. Candidate models were selected based on their potential to provide service to the study of adolescent development and the effects of heavy episodic alcohol consumption. Data on neuropsychological functioning were obtained from the NCANDA study. This is a longitudinal community study of the effects of alcohol exposure on neurodevelopment. Three conceptually motivated and one empirically motivated factor analysis model of neuropsychological domains were compared based on penalized-likelihood selection criteria and model fit statistics. Two conceptually-motivated models were found to have adequate fit and pattern invariance to function as a measurement model for the Penn Computerized Neurocognitive Battery (Penn CNB) anchored neuropsychological battery in NCANDA. Corroboration of previous factor analysis models was obtained, in addition to the identification of an alternative factor model that has higher discriminant capacity for neuropsychological domains hypothesized to be most sensitive to alcohol exposure in human adolescents. The findings support the use of a factor model developed originally for the Penn CNB and a model developed specifically for the NCANDA project. The NCANDA 8-Factor Model has conceptual and empirical advantages that were identified in the current and prior studies. These advantages are particularly valuable when applied in alcohol research settings.

ObjectivePatients with posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are often not offered exposure therapy for PTSD due to concerns that symptoms may worsen. This study examined whether initiating exposure would cause exacerbation of PTSD, alcohol use, depression, or suicidal ideation (SI) among patients with PTSD/AUD participating in exposure therapy for PTSD.MethodVeterans were randomized to either concurrent treatment of PTSD and substance use disorders using prolonged exposure (COPE) or seeking safety, a nonexposure intervention, and were included in this study if they had data to at least Session 5 available (n = 81). They completed measures of PTSD, alcohol use, and depression/SI symptom severity throughout treatment and posttreatment. The reliable exacerbation method examined the number of participants who demonstrated clinically meaningful symptom exacerbation from Sessions 3 to 5 (capturing the prepost window for the start of exposure in COPE). Hierarchical/logistic regressions examined whether treatment condition predicted exacerbation of symptoms. T tests/chi-square analyses examined whether clinical exacerbation led to worse posttreatment outcomes.ResultsFew participants endorsed exacerbation in symptoms of PTSD (15.8%), alcohol use (5.1%), depression (10.2%), or SI (12.8%). No significant treatment condition differences existed. Participants who experienced symptom exacerbation had higher rates of depression posttreatment compared to those who did not experience symptom exacerbation, but there were no differences in PTSD, alcohol use, or SI.ConclusionsExposure therapy did not lead to more clinical exacerbation than nonexposure therapy during the course of treatment, providing support that exposure therapy should not be withheld from patients with PTSD/AUD. This was a secondary analysis. and future studies that are sufficiently powered may demonstrate different results. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Posttraumatic stress disorder (PTSD) and alcohol use disorder commonly co-occur. Little is known about how symptoms of one affect subsequent week symptoms of the other during the course of integrated treatment for both disorders. The sample included 107 veterans who were randomized to receive either Concurrent Treatment of PTSD and Substance Use Disorder Using Prolonged Exposure (COPE; an exposure-based trauma focused treatment) or Seeking Safety (SS; a present-focused coping skills-based treatment) and completed measures of PTSD and alcohol use at every other session. Multilevel models estimated the prospective associations between PTSD and alcohol use during treatment. Results indicated that greater PTSD symptom severity was associated with greater future alcohol use (b = 0.20, p = .024), and greater alcohol use was associated with greater future PTSD symptom severity (b = 0.13, p = .003). The effect size for PTSD symptoms to future alcohol use was larger than the reciprocal relationship. When using lagged PTSD severity to predict future drinking, results revealed that clinically significant differences in PTSD severity levels were associated with comparably large differences in drinking. Treatment condition did not moderate the effect of PTSD symptom severity on alcohol use (or the reciprocal relationship). Findings lend support to the mutual maintenance model of addiction. Integrated treatments that treat both PTSD and alcohol use may be preferential to sequential model of care where individuals are expected to achieve abstinence or reduced use prior to receiving trauma-focused treatment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background and objectivesThe acquired preparedness model (APM) integrates personality trait research and psychosocial learning, which are theorized to ultimately increase risk for problematic substance use outcomes.MethodsThe present study uses the APM to examine the potential mediational role of positive and negative expectancies on the relationship between impulsivity and two marijuana outcomes (ie, frequency of use and marijuana use disorder [MUD] symptom count) among an at-risk sample of young adults with history of antisocial behavior and substance use in adolescence and their siblings (n = 312).ResultsResults suggest a significant indirect effect of sensation seeking on recent marijuana use through positive marijuana expectancies. There also was a significant indirect effect of sensation seeking on past-year MUD symptoms through positive expectancies. No significant indirect effects through negative expectancies were found for either outcome.Discussion and conclusionsOur findings are consistent with the APM and suggest that higher sensation seeking is related to increased positive beliefs about marijuana outcomes, which is related to higher marijuana use and more MUD symptoms.Scientific significanceThese findings suggest that positive expectancies are an important risk factor for marijuana use and misuse, particularly for at-risk individuals with elevated rates of sensation seeking. Positive marijuana expectancies may be important to address in interventions for at-risk individuals. (Am J Addict 2018;XX:1-6).

Impulsivity is a personality-based risk factor that has been well studied in relation to risky sexual behavior. Recent conceptualizations of impulsivity have proposed multidimensional facets comprised of premeditation, perseverance, sensation seeking, negative urgency, and positive urgency (UPPS-P model). Prior studies have found that these facets are associated with risky sexual behavior in adolescent and college student samples, but no prior studies have evaluated them in clinical samples. The current study examined how impulsivity-related traits related to two different risky sexual behaviors in a clinical sample of at-risk young adults who had both conduct disorder and substance use disorder symptoms as adolescents (n = 529). Lack of premeditation was also tested as a moderator of the relationship between facets of impulsivity and both risky sex outcomes. Results demonstrated that sensation seeking, negative urgency, and positive urgency were correlated with risky sex behaviors. Additionally, multiple regression analyses indicated that sensation seeking was uniquely associated with the number of sexual partners in the past 5 years, whereas positive urgency was uniquely associated with unprotected sex while under the influence. Finally, a significant interaction between lack of premeditation and negative urgency suggests that at-risk young adults with both high negative urgency and lack of premeditation were the likeliest to have the most sexual partners in the past 5 years. This study adds to the current understanding of the relationship between reward- and affect-driven facets of impulsivity and risky sexual behaviors and may lend utility to the development of interventions for at-risk populations.

Risky driving behaviors are disproportionately high among young adults and impulsivity is a robust risk factor. Recent conceptualizations have proposed multidimensional facets of impulsivity comprised of negative urgency, premeditation, perseverance, sensation seeking, and positive urgency (UPPS-P model). Prior studies have found these facets are associated with risky driving behaviors in college student samples, but no prior studies have examined these facets in clinical samples. This study examined the unique and interactive effects of UPPS-P impulsivity facets on past-year risky driving behaviors in a sample of high-risk young adults (ages 18-30 years) with a history of substance use and antisocial behavior and their siblings (n=1,100). Multilevel Poisson regressions indicated that sensation seeking and negative urgency were uniquely and positively associated with both frequency of past-year reckless driving and driving under the influence. Moreover, lack of premeditation was uniquely and positively associated with reckless driving, whereas lack of perseverance was uniquely and positively associated with driving under the influence. Furthermore, lack of premeditation moderated and strengthened the positive association between sensation seeking and driving under the influence. These study findings suggest that assessing multiple facets of trait impulsivity could facilitate targeted prevention efforts among young adults with a history of externalizing psychopathology.

PurposeTo examine the associations between substance use and antisocial behavior trajectories and seven risky behaviors over time.MethodData were collected from a high-risk sample of adolescents followed into young adulthood. Five trajectory classes, identified based on dual development of substance use and antisocial behavior symptoms, were used to predict three risky driving and four risky sexual behaviors.ResultsIn this high-risk sample (n=530), participants reported notably high overall rates of reckless driving (55.5%) and unprotected sex under the influence (44.8%) in the past year. Risky behaviors that are typically of low base rates in population-based studies were also elevated, with 8.8% reporting past-year driving under the influence (DUI) charge, 17.6% reporting lifetime sexually transmitted infection (STI), and 10.4% reporting lifetime injection drug use. The Dual Chronic class had the highest levels of all seven risky behaviors, and were 3-4 times more likely to report risky driving, lifetime STI, and injection drug use than the Relatively Resolved class. Rates of past-year reckless driving and DUI were elevated among classes with persistent antisocial behavior, whereas rates of DUI, DUI charge, and unprotected sex under the influence were elevated among classes with persistent substance use.ConclusionsYoung adults with persistent co-occurring substance use and antisocial behavior engage in multiple very costly risky behaviors. Differential associations between risky behaviors and trajectory classes highlight the need for targeted interventions.

Objectives: Buprenorphine, a medication for opioid use disorder (OUD), is underutilized in general medical settings. Further, it is inequitably received by racialized groups and persons with comorbidities. The Veterans Health Administration launched an initiative to increase buprenorphine receipt in primary care. The project's objective was to identify patient-related factors associated with buprenorphine receipt and retention in primary care clinics (n = 18) participating in the initiative. Methods: Retrospective cohort quality improvement evaluation of patients 18 years or older with 2 or more primary care visits in a 1-year period and an OUD diagnosis in the year before the first primary care visit (index date). Buprenorphine receipt was the proportion of patients with OUD who received 1 or more buprenorphine prescriptions from primary care providers during the post–index year and retention the proportion who received buprenorphine for 180 days or longer. Results: Of 2880 patients with OUD seen in primary care, 11.7% (95% confidence interval [CI], 10.6%–12.9%) received buprenorphine in primary care, 58.2% (95% CI, 52.8%–63.3%) of whom were retained on buprenorphine for 180 days or longer. Patients with alcohol use disorder (adjusted odds ratio [AOR], 0.39; 95% CI, 0.27–0.57), nonopioid drug use disorder (AOR, 0.64; 95% CI, 0.45–0.93), and serious mental illness (AOR, 0.60; 95% CI, 0.37–0.97) had lower buprenorphine receipt. Those with an anxiety disorder had higher buprenorphine receipt (AOR, 1.42; 95% CI, 1.04–1.95). Buprenorphine receipt (AOR, 0.55; 95% CI, 0.35–0.87) and 180-day retention (AOR, 0.40; 95% CI, 0.19–0.84) were less likely among non-Hispanic Black patients. Conclusions: Further integration of addiction services in primary care may be needed to enhance buprenorphine receipt for patients with comorbid substance use disorders, and interventions are needed to address disparities in receipt and retention among non-Hispanic Black patients. [ABSTRACT FROM AUTHOR]

Major depressive disorder (MDD) is a prevalent and frequently comorbid psychiatric disorder. This study evaluates the development of depressive symptoms, MDD diagnosis, and suicidal ideation in a high-risk sample (N=524) diagnosed with conduct disorder (CD) and substance use disorder (SUD) symptoms as youth and re-assessed approximately 6.5 years later. Dual trajectory classes of both alcohol and other drug use (AOD) and antisocial behavior (ASB), previously identified using latent class growth analyses (LCGA), were used to predict depression outcomes. The Dual Chronic, Increasing AOD/Persistent ASB, and Decreasing Drugs/Persistent ASB classes had higher past-week depression scores, more past-year MDD symptoms, and were more likely to have past-year MDD than the Resolved class. The Dual Chronic and Decreasing Drugs/Persistent ASB classes also had more past-year MDD symptoms than the Persistent AOD/Adolescent ASB class. Youth at highest risk for developing or maintaining depression in adulthood had the common characteristic of persistent antisocial behavior. This suggests young adulthood depression is associated more with persistent antisocial behavior than with persistent substance use in comorbid youth. As such, interventions targeting high-risk youth, particularly those with persistent antisocial behavior, are needed to help reduce the risk of severe psychosocial consequences (including risk for suicide) in adulthood.

The comorbidity of substance use disorder (SUD), depression, and PTSD is common among veterans. Prior research has shown that among veterans with SUD and depression, those with PTSD did not maintain cognitive-behavioral treatment gains as well as those without PTSD. Thus, the current study was designed to evaluate whether adding trauma-focused treatment following an initial group-based integrated cognitive behavioral treatment (ICBT) for SUD and depression improved treatment outcomes. Participants were 123 veterans (89% male) recruited from the VA San Diego Healthcare System. All participants received ICBT in twice weekly, group-delivered sessions for 12 weeks (Phase 1). Participants were then randomized to receive 12 sessions of individual follow-up sessions (Phase 2) utilizing either ICBT or cognitive processing therapy that was modified to integrate SUD treatment (CPT-M). Results indicated that PTSD and depression symptoms slightly improved at the end of Phase 1 group ICBT and further improved through Phase 2 individual treatment (except for participants without PTSD who received CPT-M), with treatment gains maintained one year later. Substance use significantly improved at the end of Phase 1 group ICBT and these improvements were maintained through Phase 2 and the one year follow-up. Participants in the trauma-focused Phase 2 treatment (CPT-M) exhibited similar levels of symptom reduction and maintenance of treatment gains as those in the non-trauma-focused Phase 2 treatment (ICBT). However, there was a slight advantage for Phase 2 CPT-M over Phase 2 ICBT with respect to heavy drinking outcomes for individuals with PTSD. Overall, the combination of group ICBT followed by either CPT-M or ICBT individual therapy appears to be effective for veterans with depression, SUD, and trauma history.

BackgroundYoung adult use of alternative nicotine and tobacco products (ANTPs) has increased dramatically since 2000. While recent studies address ANTP prevalence, relatively little is known about predictors of use. This secondary analysis examined demographic, personality, and other substance use factors as predictors of past month ANTP use.MethodsCommunity participants (n=319; 51% female) completed an online survey during the initial stage of a larger study, for which all were required to have smoked cigarettes and consumed alcohol in the past month. The survey assessed demographics, impulsivity, and past-month frequency of cigarette, alcohol, and marijuana use.ResultsThe majority (61%) of participants endorsed ANTP use in the past 30days. The odds of ANTP use were associated with Caucasian ethnicity, younger age, more frequent alcohol use, and with the sensation seeking and positive urgency components of impulsivity.ConclusionThese data suggest that ANTP use among young adults is a substantial problem, and that there is a need for interventions that target tobacco use generally rather than cigarette smoking only.

Substance use and antisocial behavior are complex, interrelated behaviors. The current study identified model trajectory classes defined by concurrent substance use and antisocial behavior and examined trajectory associations with emerging adult outcomes. Participants from a high-risk sample of youth (n=536; 73% male) completed interviews at baseline (mean age= 16.1 years) and followup (mean age= 22.6 years). Latent class growth analyses identified five trajectory classes based on alcohol/drug use (AOD) and antisocial behavior (ASB): Dual Chronic, Increasing AOD/Persistent ASB, Persistent AOD/Adolescent ASB, Decreasing Drugs/Persistent ASB, and Resolved. Many individuals (56%) exhibited elevated/increasing AOD, and most (91%) reported ASB decreases. Those associated with the Dual Chronic class had the highest rates of substance dependence, antisocial personality disorder (ASPD), and negative psychosocial outcomes. There were no differences in adult role attainment across classes. Conjoint examination of these behaviors provides greater detail regarding clinical course and can inform secondary prevention and intervention efforts.

Proximal personal and environmental factors typically predict outcomes of treatment for alcohol or drug dependence (AODD), but longitudinal treatment studies have rarely examined these factors in adults with co-occurring psychiatric disorders. In adults with AODD and major depression, the aims of this study were to: (a) disaggregate person-and time-level components of network substance use and self-efficacy, (b) examine their prospective effects on posttreatment alcohol/drug use, and (c) examine whether residential environment moderated relations between these proximal factors and substance use outcomes. Veterans (N = 201) enrolled in a trial of group psychotherapy for AODD and independent MDD completed assessments every 3 months during 1 year of posttreatment follow-up. Outcome variables were percent days drinking (PDD) and using drugs (PDDRG). Proximal variables included abstinence self-efficacy and social network drinking and drug use. Self-efficacy and network substance use at the person-level prospectively predicted PDD (ps < .05) and PDDRG (ps < .05). Within-person, time-level effects of social networks predicted future PDD (ps < .05) but not PDDRG. Controlled environments moderated person-level social network effects (ps < .05), such that greater time in controlled settings attenuated the association between a heavier drinking/using network and posttreatment drinking and drug use. Both individual differences and time-specific fluctuations in proximal targets of psychosocial interventions are related to posttreatment substance use in adults with co-occurring AODD and MDD. More structured environmental settings appear to alleviate risk associated with social network substance use, and may be especially advised for those who have greater difficulty altering social networks during outpatient treatment.

Compared to socially housed (SH) rats, adult isolation-reared (IR) rats exhibit phenotypes relevant to schizophrenia (SZ), including reduced prepulse inhibition (PPI) of startle. PPI is normally regulated by the medial prefrontal cortex (mPFC) and nucleus accumbens (NAC). We assessed PPI, auditory-evoked local field potentials (LFPs) and expression of seven PPI- and SZ-related genes in the mPFC and NAC, in IR and SH rats. Buffalo (BUF) rats were raised in same-sex groups of 2-3 (SH) or in isolation (IR). PPI was measured early (d53) and later in adulthood (d74); LFPs were measured approximately on d66. Brains were processed for RT-PCR measures of mPFC and NAC expression of Comt, Erbb4, Grid2, Ncam1, Slc1a2, Nrg1 and Reln. Male IR rats exhibited PPI deficits, most pronounced at d53; male and female IR rats had significantly elevated startle magnitude on both test days. Gene expression levels were not significantly altered by IR. PPI levels (d53) were positively correlated with mPFC expression of several genes, and negatively correlated with NAC expression of several genes, in male IR but not SH rats. Late (P90) LFP amplitudes correlated significantly with expression levels of 6/7 mPFC genes in male rats, independent of rearing. After IR that disrupts early adult PPI in male BUF rats, expression levels of PPI- and SZ-associated genes in the mPFC correlate positively with PPI, and levels in the NAC correlate negatively with PPI. These results support the model that specific gene-behavior relationships moderate the impact of early-life experience on SZ-linked behavioral and neurophysiological markers.

Background: Near-term risk factors for suicidal behavior, referred to as 'warning signs' (WS), distinguish periods of acute heightened risk from periods of lower risk within an individual. No prior published study has examined, using a controlled study design, a broad set of hypothesized WS for suicide attempt. This study addressed this gap through examination of hypothesized behavioral/experiential, cognitive, and affective WS among patients recently hospitalized following a suicide attempt. Methods: Participants were recruited during hospitalization from five medical centers across the USA including two civilian hospitals and three Veterans Health Administration facilities (n = 349). A within-person case-crossover study design was used, where each patient served as her/his own control. WS were measured by the Timeline Follow-back for Suicide Attempts Interview and were operationalized as factors that were present (v. absent) or that increased in frequency/intensity within an individual during the 6 h preceding the suicide attempt (case period) compared to the corresponding 6 h on the day before (control period). Results: Select WS were associated with near-term risk for suicide attempt including suicide-related communications, preparing personal affairs, drinking alcohol, experiencing a negative interpersonal event, and increases in key affective (e.g. emptiness) and cognitive (e.g. burdensomeness) responses. Conclusions: The identification of WS for suicidal behavior can enhance risk recognition efforts by medical providers, patients, their families, and other stakeholders that can serve to inform acute risk management decisions. [ABSTRACT FROM AUTHOR]

This study examined relationships among drinking intentions, environments, and outcomes in a random sample of 566 undergraduate college students. Telephone interviews were conducted with respondents before and after a single weekend assessing drinking intentions for the coming weekend related to subsequent drinking behaviors. Latent class analyses found evidence for four distinct drinking environments distinguished by private/public setting and presence of few/many intoxicated people. There was evidence that the drinking environment mediated the relationship between drinking intentions and heavy episodic drinking in this young adult sample. Future research might focus on examining person/environment interactions as they relate to heavy episodic drinking. (Contains 4 tables.)

This issue of Alcohol Research: Current Reviews (ARCR) delves into studies on co-occurring alcohol use disorder (AUD) and mental health conditions, exploring how this co-occurrence affects symptom severity, prognosis, and [...]

Objective: To identify predictors of error in estimated blood alcohol concentration (eBAC) in a sample of bar patrons. Method: Six hundred sixty-six patrons (43.6% female) were randomly sampled from 32 bars. Patrons were asked to provide a breath sample into a handheld breath alcohol concentration test unit upon entrance and exit from the bar. Patrons also completed a brief survey at entrance and exit. For analyses, this sample was stratified by whether patrons consumed alcohol before attending the bar. Estimates of BAC were calculated using Matthews and Miller's formula (1979). A three-category dependent variable was created based on the estimation accuracy of eBAC relative to breath alcohol concentration: accurate (within .02), underestimate of BAC, and overestimate of BAC. Results: Of those that drank before arriving at the bar, 29% of eBACs were accurate, 32.3% were underestimates, and 38.8% were overestimates. For those who drank only at the bar, 42.0% were accurate, 20.8% were underestimates, and 37.7% were overestimates. Among those who drank before attending the bar, the number of drinks consumed before attending the bar was significantly related to eBAC underestimate. Among those who drank only at the bar, predictors of overestimate included being female, drinking more, and drinking longer. Conclusions: The accuracy of eBAC is poor at best. In an earlier study of parties, eBACs were often underestimated; in the bar setting, eBACs were often overestimated. More research is needed to understand the role of setting on eBAC calculations., THE BULK OF THE EPIDEMIOLOGICAL literature on alcohol consumption is based on self-reports of drinking quantity, frequency, variability, or heavy episodic drinking (Gruenewald and Nephew, 1994; Wechsler et al., 2002). [...]

Objective: The low level of response (LR) to alcohol is an endophenotype related to heavier drinking and alcohol problems. Structural equation models (SEMs) indicate LR affects alcohol outcomes (ALCOUT) both directly and through mediation by drinking in peers (PEER), alcohol expectancies (EXPECT), and drinking to cope with stress (COPE), with some variation depending on the sample tested. This article presents the first full test of this LR-based model in young subjects from the Collaborative Study on the Genetics of Alcoholism (COGA). Method: Data were generated from 325 12- to 22-year-old (47.4% male) drinking offspring from COGA families, using the Self-Report of the Effects of Alcohol questionnaire to determine LR early in the drinking career and a validated, structured interview for demography and alcohol use/problem patterns. Standardized questionnaires were used to measure PEER, EXPECT, and COPE, with the model tested through the maximum likelihood estimation for analyses of the variance/covariance matrix using both Amos and Mplus. Results: The SEM yielded good fit characteristics and explained 59% of the variance, with LR relating both directly to ALCOUT and as partially mediated by PEER and COPE. Although GENDER related to both LR and ALCOUT in the model, and AGE related to ALCOUT, the SEM results were invariant across both AGE and GENDER, with generally similar invariant results regarding the presence or absence of an alcohol-use disorder diagnosis. Conclusions: The results support the applicability of the LR-based model of heavy drinking and alcohol problems in the COGA offspring, a group with different demography compared with the two other samples of adolescents tested to date. The modest differences observed across samples will be evaluated in future research to enhance understanding of how the model operates across socioeconomic groups., THE IDENTIFICATION OF RISK FACTORS for alcohol-use disorders can offer important clues for their early identification and prevention (Schuckit, 2002). In recent years, several genetically influenced intermediate characteristics (or phenotypes) [...]

Objective: There is conflicting evidence regarding the impact of neighborhood socioeconomic status (SES) on adolescent alcohol use. The current study tested whether the prospective effects of neighborhood SES on adolescent alcohol outcomes varied across parental alcoholism subgroups. Method: Data from a group of adolescents (N = 361) from an ongoing longitudinal study of children of alcoholics (COAs) and matched controls were collected at three initial annual assessments. Latent growth models were estimated with a range of related time-invariant and time-varying predictors. Results: Among non-COAs, higher neighborhood SES predicted increased rates in alcohol use and consequences, whereas among COAs, lower neighborhood SES was predictive of increased rates in alcohol use and marginally predicted rates of consequences. There were also time-specific effects of family mobility on alcohol outcomes. Conclusions: The current study provides evidence for differential effects of neighborhood SES on adolescent alcohol use and consequences for non-COAs and COAs. The group differences found in this study may help explain the equivocal findings from previous neighborhood studies, which may use samples with an unmeasured mix of high- and low-risk adolescents. Future research should identify pathways to alcohol use and problems for high- and low-risk adolescents living in neighborhoods that span the range of the socioeconomic spectrum., FOR SEVERAL DECADES, social scientists have examined the impact of physical and social characteristics of neighborhoods on its residents (e.g., Jencks and Meyer, 1990; Shaw and McKay, 1942; Wilson, 1987). [...]

Objective: The low level of response (LR) to alcohol, an endophenotype related to heavy drinking and alcohol problems, influences the risk for alcoholism in the context of additional life domains. This article evaluates an LR-based model of drinking patterns in 113 drinking offspring, ages 12 to 24 years, from the San Diego Prospective Study. Method: Correlations and structural equation models (SEMs) were evaluated using LR as measured from the Self-Report of the Effects of Alcohol questionnaire in the offspring. The expectations of the effects of alcohol (EXPECT), the perception of drinking in peers (PEER), the use of alcohol to cope with stress (COPE), and the drink ing quantities and alcohol-related problems (ALCOUT) were evaluated in the SEM. Results: The LR-based model worked well, with good fit characteristics and 78% of the variance of outcome explained. LR related directly to ALCOUT, with additional mediation of that relationship through EXPECT and COPE. Conclusions: The LR-based model performed well in adolescents from the San Diego Prospective Study. Knowledge of which domains mediate how LR impacts alcohol-related outcomes may be useful in developing more focused and potentially more effective prevention approaches. (J. Stud. Alcohol Drugs 69: 571-579, 2008), MULTIPLE GENETIC AND ENVIRONMENTAL influences contribute to the risk for heavy drinking, alcohol problems, and alcohol-use disorders (Goldman, 1996; Schuckit, 2002). The genetic factors are likely to be mediated by [...]

Objective: This article expands on the results from a 1997 report from the Collaborative Study on the Genetics of Alcoholism (COGA), using a new phase of the protocol to evaluate the prevalence and characteristics of substance-induced and independent major depressive episodes (MDEs) in a population of alcoholics and nonalcoholics. Method: Data were evaluated from Phase II of the six-center-wide COGA investigation using information gathered beginning in January 1997. Data were generated through face-to-face evaluations using the updated version of the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA-II) interview, with distinctions between substance-induced and independent MDEs based on the chronology of development of full depressive syndromes. The analyses focused on the 2,548 men and women who were divided into 351 individuals who had only an independent MDE (Group 1), 238 subjects who experienced only substance-induced MDEs, and 1,959 individuals with no MDE history. Results: The two MDE groups were similar in age, marital status, and religion; but those with substance-induced depressions (Group 2) were more likely to be original alcoholic probands, be males, be nonwhite, and have less education. They were also more likely to have alcohol, drug, or antisocial personality diagnoses and to report higher maximum drinks. In addition, only Group 2 subjects reported an elevated family history of alcohol diagnoses compared with the nondepressed Group 3. Subjects with independent MDEs were different from the comparison Group 3 regarding the family histories of independent MDEs. However, symptoms during the worst depressive episode were quite similar across Groups 1 and 2. Conclusions: This study corroborates a high rate of substance-induced MDEs among alcoholics, with these disorders explaining about half of the lifetime depressive episodes. The results also support the validity of the distinction between substance-induced and independent depressions regarding external validators of gender, substance-use patterns, and family histories of independent MDEs. (J Stud. Alcohol Drugs 68:805-812, 2007), THE ALCOHOL-USE DISORDERS (AUDs) and substance-use disorders (SUDs) of abuse and dependence are often accompanied by symptoms of additional psychiatric syndromes. This is especially true regarding psychotic symptoms among stimulant-dependent [...]

Objective: Previous research has found that siblings resemble each other in terms of alcohol use but has not examined sibling influence in young adult or high-risk siblings. The current study tested whether siblings prospectively influenced each other's alcohol use and how gender matching, age differences, and family conflict might moderate such effects. Method: Data from sibling pairs (n = 169 pairs) in an ongoing longitudinal study of children of alcoholics and matched controls were collected at two time points 5 years apart. Results: Older sibling alcohol use predicted younger sibling alcohol use, even after controlling for membership in a shared peer group and for parental alcoholism. However, moderator variables qualified this effect, such that older sibling influence was significant only among sibling pairs who were of the same gender, closer in age, and from higher conflict families. Younger sibling influence was significant only for sibling pairs close in age, suggesting the presence of reciprocal peer-like effects in this subgroup. Conclusions: The current study provides evidence for sibling influence on alcohol use into adulthood, but the extent of this influence depends on sibling similarity in age and gender and on levels of family conflict. Implications for family-based theory and intervention efforts are discussed., SIBLINGS HAVE BEEN SHOWN to resemble each other in terms of alcohol use (Ary et al., 1993; Conger and Rueter, 1996), expectancies about alcohol use (D'Amico and Fromme, 1997), and [...]

Objective: Previous research has found drinking restraint to be a risk factor for alcohol use and alcohol-related problems in normative populations, but has not tested these relations in high-risk populations. The current study tested whether drinking restraint predicted alcohol-related outcomes in the same way for high-risk and low-risk individuals and tested whether there was a quadratic effect of drinking restraint on alcohol-related outcomes. Method: Data from an ongoing longitudinal study of children of alcoholics (COAs; n = 189) and controls (n = 192) were collected at two time points 5 years apart. Results: The prospective findings extended previous cross-sectional literature by replicating the main effects of drinking restraint as a risk factor for sub sequent drinking for controls. For COAs, however, higher levels of drinking restraint were associated with lower levels of later drinking. There was also a quadratic effect of drinking restraint in the prediction of alcohol dependence diagnoses, suggesting that those at the extreme levels of drinking restraint were least likely to develop alcohol dependence. Conclusions: The relation of drinking restraint to alcohol-related outcomes may be more complex than previously hypothesized because it may work in different directions for high- and low-risk individuals and may have a nonlinear relationship to diagnostic outcomes. (J. Stud. Alcohol 65: 122-125, 2004), DRINKING RESTRAINT has been defined as a cognitive preoccupation with control over drinking (Ruderman and McKirnan, 1984). Restrained drinkers consciously set limits on their consumption, and this limit setting may [...]