Adult Alcohol Research Articles

The Burden of Alcohol and Substance Use Disorders in Adolescents and Young Adults

The Burden of Alcohol and Substance Use Disorders in Adolescents and Young Adults

Differences and similarities in adolescents accessing emergency care for acute alcohol intoxication in three urban regions in Italy, Belgium, and The Netherlands

Abstract Background Excessive drinking among adolescents in Western Europe is prevalent, posing significant health risks and societal costs. Early initiation of alcohol use and binge drinking are associated with adult alcohol use disorders. Collecting comprehensive data on adolescent drinking patterns is crucial for developing effective prevention strategies. Methods To gain insight into the demographic and clinical characteristics of acute alcohol intoxication (AAI), we analysed emergency department access data of adolescents aged 14-17 years presenting with AAI symptoms from 2015-2023. Three urban regions were included: the Reinier de Graaf Gasthuis in Delft (The Netherlands), eight combined hospitals in Antwerp (Belgium) and the IRCCS San Martino Hospital in Genoa (Italy). Results A total of 1841 patients with symptoms of AAI were included. The mean age of patients in the Netherlands was statistically significant younger than in Italy and Belgium (15.7 compared to 15.9 and 16.0 years old, respectively). Moreover, the blood alcohol concentration was higher in the Netherlands and Belgium compared to Italy (2.0‰ compared to 1.95‰ and 1.8‰ respectively). The distribution of sex was nearly equal in the Netherlands, while statistically significant differences were observed with a higher proportion of males in Italy (54.8%) and Belgium (56.8%). Combined drug use was lower in Belgium with 10.0%, compared to 13.4% in The Netherlands and 14.7% in Italy. The most common reason for admission was ‘reduced consciousness’ in the total population (45.2%). Conclusions This is one of the first international studies which combines data on AAI in minors. In the future, efforts should be made to establish a common European database where records of AAI can be stored and analysed more efficiently for prevention purposes.

To study impact of drug abuse in adolescence

Adolescent drug usage can lead to a variety of outcomes that are different from those associated with adult drug use. Alcohol is a common illicit substance in youth, and the molecular mechanisms behind alcohol-induced neuro inflammation, brain injury, and behavioural dysfunction caused by ethanol are not fully understood. In the adult brain, alcoholism is associated with a higher chance of neuropsychiatric diseases. Adolescent alcohol use can cause long-lasting modifications to the control of cytokines and the sensitivity of the hypothalamic-pituitary-adrenal (HPA) axis, which can impact neuropathology and behaviour long into adulthood... Synthetic androgens used for muscle and strength gain, especially in adolescence, are called alcoholic androgenic steroids (AAS). Adult neuropathology and alcoholism can be prevented and treated using AAS, an anabolic steroid.

Alcohol and brain structure across the lifespan: A systematic review of large-scale neuroimaging studies.

Alcohol exposure affects brain structure, but the extent to which its effects differ across development remains unclear. Several countries are considering changes to recommended guidelines for alcohol consumption, so high-quality evidence is needed. Many studies have been conducted among small samples, but recent efforts have been made to acquire large samples to characterize alcohol's effects on the brain on a population level. Several large-scale consortia have acquired such samples, but this evidence has not been synthesized across the lifespan. We conducted a systematic review of large-scale neuroimaging studies examining effects of alcohol exposure on brain structure at multiple developmental stages. We included studies with an alcohol-exposed sample of at least N = 100 from the following consortia: ABCD, ENIGMA, NCANDA, IMAGEN, Framingham Offspring Study, HCP and UK BioBank. Twenty-seven studies were included, examining prenatal (N = 1), adolescent (N = 9), low-to-moderate-level adult (N = 11) and heavy adult (N = 7) exposure. Prenatal exposure was associated with greater brain volume at ages 9-10, but contemporaneous alcohol consumption during adolescence and adulthood was associated with smaller volume/thickness. Both low-to-moderate consumption and heavy consumption were characterized by smaller volume and thickness in frontal, temporal and parietal regions, and reductions in insula, cingulate and subcortical structures. Adolescent consumption had similar effects, with less consistent evidence for smaller cingulate, insula and subcortical volume. In sum, prenatal exposure was associated with larger volume, while adolescent and adult alcohol exposure was associated with smaller volume and thickness, suggesting that regional patterns of effects of alcohol are similar in adolescence and adulthood.

Alcohol and arterial stiffness in middle-aged and older adults: Cross-sectional evidence from the UK Biobank study.

The association between arterial stiffness and alcohol consumption is still controversial. We investigated this relationship by performing continuous analysis in men drinking only beer/cider, and women drinking only red wine. This cross-sectional study involved participants aged 40-69 years consisting of 9029 men who drank only beer/cider, and 6989 women drinking only red wine. Alcohol consumption was captured by self-reported questionnaire and reported as units per week, where one unit is equal 10 mL pure ethanol. Arterial stiffness index (ASI) was estimated using photoplethysmography. In men consuming a mean 17.8 (5th and 95th percentiles, 2.6-76.7) units/week, ASI increased by heptiles (sevenths) of alcohol captured from beer/cider consumption and after adjusting for age (9.14, 9.40, 9.51, 9.53, 9.80, 9.80, 10.00 m/s; p-trend < 0.001) and after full adjustment (9.29, 9.46. 9.55, 9.55, 9.73, 9.73, 9.75 m/s; p-trend = 0.013). Similarly, in women consuming a mean 8.1 (1.6-29.3) units/week, ASI increased by heptiles of alcohol captured from red wine consumption and after adjusting for age (8.05, 8.05, 8.05, 8.11, 8.17, 8.30, 8.45 m/s; p-trend = 0.012) and borderline significant after full adjustment (8.05, 8.07, 8.05, 8.07, 8.11, 8.22, 8.43 m/s; p-trend = 0.055). These associations were confirmed in multivariable-adjusted regression analysis in all men, men younger and older than 50 years, and when consuming more than 14 units per week. Similarly, these associations were confirmed in all women, women older than 50 years, and in those consuming more than 14 units per week. Positive linear relationships exist between arterial stiffness and alcohol, irrespective of whether captured from beer/cider consumption in men or red wine consumption in women. No evidence existed to support the notion that our arteries benefit from any level of alcohol consumption.

Clinical profiles of people enrolling in alcohol and other drug treatment in Australia: Do youth differ from young adults and adults?

To examine and compare age groups on socio-demographic, substance use, mental health, social and risk behaviour profiles of people entering alcohol and other drug (AOD) treatment in a large non-government organisation (NGO) in Queensland and New South Wales, Australia. Design-Cross-sectional study; analysis of baseline routine outcome measures (ROM) and AOD minimum datasets for drug and alcohol treatment services. Setting and participants-People enrolling in Lives Lived Well, a large NGO AOD service between November 2020 and October 2022. Main outcome measures-Socio-demographic, substance use, mental health, social factors and risk behaviours, by youth (≤24 years), young adults (25-35 years) and adults (>35 years). Between November 2020 and October 2022, 9413 clients enrolled in Lives Lived Well (LLW) AOD services and completed baseline ROMs. Over one-fifth (21.9%) were youth (n = 2066), one-third (32.4%) were young adults (n = 3052) and just under half (45.6%) were adults >35 years (n = 4295). The most common primary drug of concern was cannabis for youth, methamphetamine for young adults and alcohol for adults >35 years. Nearly two-thirds (61.3%) reported moderate to severe symptoms of depression and 55.0% reported moderate to severe anxiety. Just under half (47.2%) screened positive for PTSD and two-in-five (40.4%) reported recent suicidal ideation. Co-occurring mental health symptoms were more common in youth compared with young adults and adults >35 years. Co-occurring mental health symptoms were high in the sample, particularly among youth. All age groups present with unique and complex socio-demographic and clinical profiles that are important to understand to provide the most appropriate and effective treatment.

Performance of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool in Screening Older Adults for Unhealthy Substance Use

Objective This analysis evaluated the validation results of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) tool for older adults. Methods We performed a subgroup analysis of older adults aged ≥65 (n = 184) from the TAPS tool validation study conducted in 5 primary care clinics. We compared the interviewer and self-administered versions of the TAPS tool at a cutoff of ≥1 for identifying problem use with a reference standard measure, the modified World Mental Health Composite International Diagnostic Interview. Results The mean age was 70.6 ± 5.9 years, 52.7% were female, and 49.5% were non-Hispanic Black. For identifying problem use, the self-administered TAPS tool had sensitivity of 0.91 (95% CI: 0.75–0.98) and specificity of 0.91 (95% CI: 0.85–0.95) for tobacco; sensitivity of 0.68 (95% CI: 0.45–0.86) and specificity of 0.88 (95% CI: 0.82–0.93) for alcohol; and sensitivity 0.86 (95% CI: 0.42–1.00) and specificity 0.94 (95% CI: 0.90–0.97) for cannabis. The interviewer-administered TAPS tool had similar results. We were unable to evaluate its performance for identifying problem use of individual classes of drugs other than cannabis in this population due to small sample sizes. Conclusions While the TAPS had excellent sensitivity and specificity for identifying tobacco use among older adults, the results for other substances lack precision, and we were unable to evaluate its performance for prescription medications and individual illicit drugs in this sample. This analysis underlines the critical need to adapt and validate screening tools for unhealthy substance use, specifically for older populations who have unique risks.

Irresponsibility Stereotypes Exacerbate Effects of Sexual Violence on Cisgender Bisexual Women's Coping Drinking Motives.

Bisexual women experience disparities in alcohol use outcomes compared to both lesbian and heterosexual women. Bisexual women also experience higher rates of sexual violence (SV) and alcohol use following SV. We examined whether coping drinking motives mediate the link between adult SV severity and alcohol use and whether dimensions of binegativity (i.e., hostility, instability, irresponsibility) moderate the effects of SV. The sample consisted of 355 young (ages 18-35) cisgender bisexual women drinkers (Mage=25.8, 84.2% White) recruited via MTurk. Measures included: Sexual Experiences Survey-Short Form Victimization (Koss et al., 2007), Anti-Bisexual Experiences Scale (Brewster & Moradi, 2010), Modified Drinking Motives Questionnaire-Revised (Grant et al., 2007), and Alcohol Use Disorders Identification Test Consumption subscale (Babor et al., 2001). The PROCESS macro for SPSS was used. There was an interaction between SV severity and irresponsibility stereotypes in predicting coping motives. SV severity related to greater coping motives at mean and high, but not low, levels of irresponsibility stereotypes. Indirect effects of SV severity on alcohol use via coping motives were significant at mean and high, but not low, levels of irresponsibility stereotypes. Hostility and instability dimensions of binegativity did not interact with SV severity in predicting coping motives. Results identified SV severity and irresponsibility stereotypes as compounding experiences that may explain greater alcohol use. Bisexual women exposed to this dimension of binegativity may be particularly vulnerable to drink alcohol to cope with distress following SV. Interventions for alcohol use may be enhanced by helping bisexual women cope with SV-related distress and irresponsibility stereotypes.

Voluntary adolescent alcohol exposure does not robustly increase adulthood consumption of alcohol in multiple mouse and rat models

Adolescence is a period of increased risk taking, including increased alcohol and drug use. Multiple clinical studies report a positive relationship between adolescent alcohol consumption and risk of developing an alcohol use disorder (AUD) in adulthood. However, few preclinical studies have attempted to tease apart the biological contributions of adolescent alcohol exposure, independent of other social, environmental, and stress factors, and studies that have been conducted show mixed results. Here we use several adolescent voluntary consumption of alcohol models, conducted across four labs in three institutes and with two rodent species, to investigate the ramifications of adolescent alcohol consumption on adulthood alcohol consumption in controlled, pre-clinical environments. We consistently demonstrate a lack of robust increases in adulthood alcohol consumption. This work highlights that risks seen in both human datasets and other murine drinking models may be due to unique social and environmental factors – some of which may be unique to humans.

Alcohol Dependence Among Adult Males in Chengalpattu District, South India: A Mixed Methods Study.

Introduction Post-pandemic alcohol consumption is on the rise due to people starting to adapt themselves to the practice of consuming alcoholic beverages at home. In addition to the direct effects of intoxication and addiction, estimates suggest that alcohol contributes to approximately 20-30% of global cases of oesophagal cancer, liver cancer, cirrhosis of the liver, homicide, epilepsy, and motor vehicle accidents. In India, one-fifth of alcohol consumers were found to be alcohol dependent. The study was done with the primary objective of finding out the prevalence of alcohol dependence among alcohol users and exploring the reasons for alcohol dependence among alcohol users in an urban area of Chengalpattu District, Tamil Nadu. Methodology The study design is an explanatory sequential mixed-methods study. It was done among 624 adult male alcohol consumers in the Chennai district, selected by the cluster sampling method in a community setting. The Alcohol Use Disorders Identification Test (AUDIT) was used to diagnose alcohol dependence. Using the purposive sampling method, in-depth interviews were conducted among 24 alcohol-dependent people to explore and understand their experiences, identify common themes, and provide insights into the problem. Quantitative data were analysed using Statistical Package for Social Sciences (SPSS) version 26 (IBM Corp., Armonk, NY), and qualitative data were analysed using deductive content analysis using Qualcoder software. Results The mean age of the study participants was 38±7 years. Among current alcohol consumers, 16.9% (106/624) were found to be suffering from alcohol dependence. The significant predictors of alcohol dependence were found to be unskilled occupation (adjusted odds ratio [AOR] = 2.09), having suicidal ideation (AOR = 2.4), alcohol consumption by family members (AOR = 1.90), depression (AOR = 3.98), drinking pattern-affected interpersonal relationships (AOR = 2.29), and not receiving health education about alcohol use in school/college (AOR = 1.74). The major themes and codes identified among alcohol dependents were factors related to mental health, physical health, and social factors. Conclusion This study provides essential points of reference for policymakers and primary care physicians to develop prevention strategies for people to understand and overcome the problem of alcohol addiction, and it also sheds light on the burden of alcohol dependence and their lived experiences.

A cue reactivity experiment: Exposure to images of alcoholic beverages and social contexts on alcohol cravings, motivations, attitudes, approval, and behavior

The incentive-sensitization theory of addiction postulates that relevant cues can trigger alcohol cravings, tendencies, and related outcomes. Additionally, consistent with the encoding specificity principle and social impact theory, social contexts depicting people can activate pro-alcohol reactions and tendencies. This randomized experiment tested the cue reactivity effects of exposure to images depicting variations in the number of people consuming alcoholic or nonalcoholic beverages on alcohol-related cravings and outcomes. The sample consisted of 594 adult alcohol users who passed manipulation checks. Participants were randomly assigned to a condition in a 2 (beverage type cue manipulation: alcoholic vs. nonalcoholic) × 3 (social context cue manipulation: beverage-only [no people] vs. solitary drinking [1 person] vs. social drinking [2 or more people]) factorial design and primed with a series of photographs. Dependent variables measured alcohol cravings, alcohol motives, alcohol attitudes, alcohol approval, and alcohol behavior. Factorial MANCOVA and ANCOVAs were performed. Main effects for the social context manipulation were found. Specifically, the social drinking condition compared to the beverage-only condition induced significantly higher pro-alcohol cravings, attitudes, and behaviors. The beverage type manipulation did not influence the dependent variables. The findings offer insights that visual cues depicting social drinking scenarios activated alcohol-related cravings and outcomes, regardless of whether the beverages shown were alcoholic or nonalcoholic. This priming experiment helps to understand the social mechanisms underlying cue reactivity and offers implications for advancing cue-based alcohol interventions.

Risk factors of acute pancreatitis in young adults: a Nationwide population-based cohort study in South Korea.

This study aimed to identify the risk factors for acute pancreatitis (AP) in young adults in their 20s based on data from the nationwide cohort in South Korea. From the 2009 national health examination database of South Korea, total 471,098 individuals between the ages of 20 and 29 were analyzed. To identify the newly developed AP, the linked claims database was used. The incidence rates of AP were 18.8 and 9.8 per 100,000 person-years in male and female participants, respectively. Alcohol consumption and smoking were associated with the heightened risk of AP. The risk of AP development was increased as daily alcohol consumption increased. Also, ex-smokers and current smokers showed higher AP risk than never smokers. Hypertriglyceridemia and obesity were associated with the increased AP risk as well. Compared to female participants, male participants showed a higher risk of AP in univariate analysis, but showed a lower risk of AP in multivariate analysis. In the young adult population, alcohol consumption, smoking, hypertriglyceridemia, and obesity were associated with an elevated risk of developing AP. It is important to identify and manage the modifiable AP risk factors in young adults to minimize the socioeconomic burden of AP.

Voluntary adolescent alcohol exposure does not robustly increase adulthood consumption of alcohol in multiple mouse and rat models.

Adolescence is a period of increased risk taking, including increased alcohol and drug use. Multiple clinical studies report a positive relationship between adolescent alcohol consumption and risk of developing an alcohol use disorder (AUD) in adulthood. However, few preclinical studies have attempted to tease apart the biological contributions of adolescent alcohol exposure, independent of other social, environmental, and stress factors, and studies that have been conducted show mixed results. Here we use several adolescent voluntary consumption of alcohol models, conducted across four labs in three institutes and with two rodent species, to investigate the ramifications of adolescent alcohol consumption on adulthood alcohol consumption in controlled, pre-clinical environments. We consistently demonstrate a lack of robust increases in adulthood alcohol consumption. This work highlights that risks seen in both human datasets and other murine drinking models may be due to unique social and environmental factors - some of which may be unique to humans.

Level of Physical Activity and Relationship with Alcohol Use Among Youth: A Cross-sectional Study

Background: Alcohol use and physical inactivity are major risk factors for noncommunicable diseases. Adequate physical activity keeps one healthy, but a sedentary lifestyle may contribute to other unhealthy practices like Alcohol use. They address them more strategically. Objectives: To assess the level of physical activity and identify its association with Alcohol use among college-going youth at Rama University, Kanpur. Material &amp; Methods: Data on physical activity and Alcohol use were collected from students aged 18-24 studying medical and non-medical courses at Rama University through an online questionnaire. We used a self-modified questionnaire based on the Global Adult Alcohol Survey (GATS) to assess Alcohol use status and the GPAQ (Global Physical Activity Questionnaire) to assess physical activity. Results: The chance of consuming Alcohol is significantly lower among physically active respondents. Conclusions: Our findings indicate a significant relationship between physical activity and Alcohol use among youth. Promotion of physical activity may be a useful educational tool for reducing Alcohol use.

Developmental trajectories of child and adolescent emotional problems: associations with early adult alcohol use behaviors.

Whether emotional problems during childhood and adolescence are longitudinally associated with adult alcohol use behaviors is unclear. This study examined associations between developmental trajectories of emotional problems and early adult alcohol use behaviors, while considering co-occurring conduct problems, developmental change/timing, sex differences, and potential confounds. Participants were from the Twins Early Development Study (analytic N = 19,908 individuals). Emotional and conduct problems were measured by parent reports at child ages 4, 7, and 9 years and via self-reports at ages 9, 11, and 16 years on the Strengths and Difficulties Questionnaire. Alcohol use behaviors (alcohol consumption and alcohol-related problems) were self-reported by the twins on the Alcohol Use Disorders Identification Test at age 22 years. Piecewise latent growth curve models described nonlinear developmental trajectories of emotional and conduct problems from ages 4 to 16. At age 22, alcohol use was regressed on emotional and conduct problems' intercepts and slopes from piecewise latent growth curve model and sex differences in regression coefficients were tested. Using twin modeling, Cholesky decompositions and direct path models were compared to test whether significant phenotypic associations were best explained by direct phenotypic influences or correlated genetic and environmental influences. Emotional problems had different associations with alcohol-related problems versus alcohol consumption. After accounting for direct influences from conduct problems, emotional problems were not associated with alcohol-related problems, while emotional problems at age 9 were negatively associated with alcohol consumption in males. Overall, findings did not support emotional problems as prospective risk factors for severe alcohol use above and beyond risks associated with conduct problems. Sex- and age-specific links between emotional problems and alcohol consumption in early adulthood may be worthy of further exploration, particularly as twin analyses improved our confidence that such links may be underpinned by causal mechanisms.

TEMPORARY REMOVAL: Zero Alcohol Products and Adolescents: A Tool for Harm Reduction or a Trojan Horse?

IntroductionZero alcohol products (ZAPs) could reduce alcohol-related harms by acting as a substitute for alcoholic beverages. However, concerns have been raised regarding the potential for these products to expose young people to additional alcohol-related stimuli, further normalising alcohol use and acting as a gateway to underage alcohol consumption. Scarce research has examined whether these concerns are warranted. MethodThis project comprised two parts involving Australian adolescents aged 15-17 years. Part 1 was a series of 5 online focus groups (n=44) that provided initial insights into perceptions of and experiences with ZAPs. Part 2 was a national online survey (n=679) that assessed the generalisability of the focus group findings and identified factors associated with ZAP-related attitudinal and behavioural outcomes. ResultsZAPs were found to be salient and attractive to Australian adolescents. Over a third of surveyed adolescents (37%) had tried ZAPs. The focus group participants and survey respondents generally perceived ZAPs in a positive light, seeing them as a useful alternative to alcohol for both adolescents and adults who want to circumvent social expectations to use alcohol. Some of the study participants acknowledged the potential for ZAPs to serve as a gateway to alcohol use and recommended reducing their visibility and accessibility. ConclusionZAPs are likely exposing minors to additional alcohol-related stimuli potentially increasing their risk of underage alcohol consumption. Regulatory responses to ZAPS need to protect young people from the potential adverse consequences of ZAPs exposure while enabling the products to be used by adults as an alcohol substitute.

Alcohol and substance use in older adults with treatment-resistant depression.

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

Negative Affect, Harassment and Problematic Alcohol Use in Young Adults

Background: While research suggests that both negative affect and alcohol use are impacted by exposure to harassment (i.e., sexual harassment, generalized harassment or bullying), less is known about the effect of harassment on negative affect subsequently leading to alcohol consumption, particularly in young adults. We examined the mediating role of negative affect on the relationships between sexual and generalized harassment at school and alcohol misuse. Methods: Participants were 2899 incoming freshmen in fall of 2011 who completed a Web-based survey assessing demographics (T0), sexual and generalized harassment at school (T0-T2), negative affect (T3), and problems associated with drinking, binge drinking, and drinking to intoxication (T0, T4, T5). Separate hybrid path models were fitted in Mplus v.8.8 for generalized harassment and sexual harassment and each outcome. Results: Mediation analyses showed a small but significant indirect effect for the sexual harassment model (beta = 0.05, S.E. = 0.01, p < 0.001) and generalized harassment (beta = 0.03, S.E. = 0.01, p < 0.01), indicating that negative affect partially mediated the associations between harassment early in students’ college experience and later problems associated with drinking. No significant indirect effects were found for the binge drinking or intoxication models. Conclusions: High levels of negative affect associated with harassment may contribute to longer term impact on problematic use of alcohol in young adults, providing evidence that the effects of harassment on drinking may partly stem from harassment’s lingering effects on negative affective pathways.

Emotion Recognition and Self-Reported Emotion Processing in Alcohol and Cannabis Co-Using Young Adults.

Alcohol and cannabis use are each associated with impairments in emotion recognition accuracy, which may promote interpersonal problems. It is unclear if emotion recognition or self-reported emotion processing differs between young adult alcohol and cannabis co-users (ACCs) and healthy controls (HCs). This study examined whether ACCs and HCs differed in their emotion recognition across two different behavioral tasks with static or dynamic faces and determined if there were differences in self-reported socio-emotional processing and alexithymia. 22 ACCs (mean age = 21.27 ± 1.75) and 25 HCs (mean age = 21.48 ± 2.68), matched on age, sex, and IQ, completed the Metrisquare Emotion Recognition Task and CANTAB Emotion Recognition Task. The ACCs and HCs were compared on task accuracy and self-reported measures, including the Social Emotional Questionnaire (SEQ) and the Perth Alexithymia Questionnaire (PAQ). No significant main effects of the Group variable or the Emotion-Group interaction variable were present for either task. The ACCs had lower SEQ (p = 0.014) and higher PAQ (p = 0.024) scores relative to the HCs, indicating greater difficulties in socio-emotional processing and identifying one's own emotions, respectively. Understanding the behavioral correlates of the self-reported difficulties in emotion processing reported by ACCs is needed to develop interventions to reduce these symptoms and promote healthy socio-emotional functioning in this population.

The burden of alcohol-related cardiovascular complications in young and middle-aged adults: rising burden of atrial fibrillation and hypertensive heart disease

Background and Aims The burden of alcohol-related complications is high and rising. However, there are notable deficiencies in comprehensive epidemiological study focusing on cardiovascular complications from alcohol, especially among young and middle-aged adults. We thus aimed to determine the burden of these conditions in young and middle-aged adults globally. Methods and Results We used data from the Global Burden of Disease Study 2019 and analysed the mortality and disability-adjusted life years of alcohol-associated cardiovascular complications in young and middle-aged adults. The findings were classified by sex, region, country, and Sociodemographic Index (SDI). The highest age-standardized death rates (ASDR) were observed in stroke 0.84 (95% UI 0.60–1.09), followed by alcoholic cardiomyopathy 0.57 (95% UI 0.47–0.66) per 100,000 population. The overall burden of alcohol-associated cardiovascular complications decreased globally but increased in atrial fibrillation and hypertensive heart disease. Regionally, most regions underwent a decrease in ASDR, but an increase was observed in Southeast Asia (+2.82%), Western Pacific (+1.48%), low-middle (+1.81%), and middle SDI (+0.75%) countries. Nevertheless, the ASDR and ASDALYs were highest in Europe. Conclusions The impact of alcohol-associated atrial fibrillation and hypertensive heart disease has increased over the last decades. Regarding region, the burden in Europe and the rising burden in Asia, require immediate public health policy to lessen these cardiovascular complications from alcohol in young and middle-aged adults.