Adverse Drinking Consequences Research Articles

Patterns of neuronal activation following ethanol-induced social facilitation and social inhibition in adolescent cFos-LacZ male and female rats

Alcohol-associated social facilitation together with attenuated sensitivity to adverse alcohol effects play a substantial role in adolescent alcohol use and misuse, with adolescent females being more susceptible to adverse consequences of binge drinking than adolescent males. Adolescent rodents also demonstrate individual and sex differences in sensitivity to ethanol-induced social facilitation and social inhibition, therefore the current study was designed to identify neuronal activation patterns associated with ethanol-induced social facilitation and ethanol-induced social inhibition in male and female adolescent cFos-LacZ rats. Experimental subjects were given social interaction tests on postnatal day (P) 34, 36, and 38 after an acute challenge with 0, 0.5 and 0.75 g/kg ethanol, respectively, and β-galactosidase (β-gal) expression was assessed in brain tissue of subjects socially facilitated and socially inhibited by 0.75 g/kg ethanol. In females, positive correlations were evident between overall social activity and neuronal activation of seven out of 13 ROIs, including the prefrontal cortex and nucleus accumbens, with negative correlations evident in males. Assessments of neuronal activation patterns revealed drastic sex differences between ethanol responding phenotypes. In socially inhibited males, strong correlations were evident among almost all ROIs (90 %), with markedly fewer correlations among ROIs (38 %) seen in socially facilitated males. In contrast, interconnectivity in females inhibited by ethanol was only 10 % compared to nearly 60 % in facilitated subjects. However, hub analyses revealed convergence of brain regions in males and females, with the nucleus accumbens being a hub region in socially inhibited subjects. Taken together, these findings demonstrate individual and sex-related differences in responsiveness to acute ethanol in adolescent rats, with sex differences more evident in socially inhibited by ethanol adolescents than their socially facilitated counterparts.

Intermittent Exposure to a Single Bottle of Ethanol Modulates Stress Sensitivity: Impact of Age at Exposure Initiation.

Alcohol use during adolescence is a serious public health problem, with binge drinking and high-intensity drinking being particularly harmful to the developing adolescent brain. To investigate the adverse consequences of binge drinking and high-intensity adolescent drinking, adolescent rodents were intermittently exposed to ethanol through intragastric gavage, intraperitoneal injection, or vapor inhalation. These models revealed the long-lasting behavioral and neural consequences of adolescent intermittent ethanol (AIE) exposure. The present study was designed to characterize a different AIE model, namely, intermittent exposure to a single bottle of 10% ethanol as the only source of fluids on a 2 days on/2 days off (water days) schedule, and to determine whether this AIE exposure model would produce changes in hormonal and neuroimmune responsiveness to challenges of differing modalities. Assessments of ethanol intake as well as blood and brain ethanol concentrations (BECs and BrECs, respectively) in adult male and female rats (Experiment 1) revealed that BECs and BrECs peaked following access to ethanol for a 2 h period when assessed 1 h into the dark cycle. Experiment 2 revealed age differences in ethanol intake, BECs, and BrECs following a 2 h access to ethanol (1 h into the dark cycle), with adolescents ingesting more ethanol and reaching higher BECs as well as BrECs than adults. In Experiment 3, intermittent exposure to a single bottle of 10% ethanol for 10 cycles of 2 days on/2 days off was initiated either in early or late adolescence, followed by an acute systemic immune challenge with lipopolysaccharide (LPS) in adulthood. LPS increased corticosterone and progesterone levels regardless of sex and prior ethanol history, whereas an LPS-induced increase in cytokine gene expression in the hippocampus was evident only in ethanol-exposed males and females, with females who underwent early exposure to ethanol being more affected than their later-exposed counterparts. In Experiment 4, intermittent ethanol exposure in females was initiated either in adolescence or adulthood and lasted for 12 ethanol exposure cycles. Then, behavioral (freezing behavior), hormonal (corticosterone and progesterone levels), and neuroimmune (cytokine gene expression in the PVN, amygdala, and hippocampus) responses to novel environments (mild stressors) and shock (intense stressors) were assessed. More pronounced behavioral and hormonal changes, as well as changes in cytokine gene expression, were evident in the shock condition than following placement in the novel environment, with prior history of ethanol exposure not playing a substantial role. Interleukin (IL)-1β gene expression was enhanced by shock in the PVN, whereas shock-induced increases in IL-6 gene expression were evident in the hippocampus. Together, these findings demonstrate that our intermittent adolescent exposure model enhances responsiveness to immune but not stress challenges, with females being more vulnerable to this AIE effect than males.

Development of a Dynamically Tailored mHealth Intervention (What Do You Drink) to Reduce Excessive Drinking Among Dutch Lower-Educated Students: User-Centered Design Approach.

BackgroundThe high prevalence and adverse consequences of excessive drinking among lower-educated adolescents and young adults are public concerns in the Netherlands. Evidence-based alcohol prevention programs targeting adolescents and young adults with a low educational background are sparse.ObjectiveThis study aimed to describe the planned process for the theory- and evidence-based development, implementation, and evaluation of a dynamically tailored mobile alcohol intervention, entitled What Do You Drink (WDYD), aimed at lower-educated students from secondary vocational education and training (Middelbaar Beroepsonderwijs in Dutch).MethodsWe used intervention mapping as the framework for the systematic development of WDYD. It consists of the following six steps: assessing needs (step 1), formulating intervention objectives (step 2), translating theoretical methods into practical applications (step 3), integrating these into a coherent program (step 4), anticipating future implementation and adoption (step 5), and developing an evaluation plan (step 6).ResultsReducing excessive drinking among Dutch lower-educated students aged 16 to 24 years was defined as the desired behavioral outcome and subdivided into the following five program objectives: make the decision to reduce drinking, set realistic drinking goals, use effective strategies to achieve drinking goals, monitor own drinking behavior, and evaluate own drinking behavior and adjust goals. Risk awareness, motivation, social norms, and self-efficacy were identified as the most important and changeable individual determinants related to excessive drinking and, therefore, were incorporated into WDYD. Dynamic tailoring was selected as the basic intervention method for changing these determinants. A user-centered design strategy was used to enhance the fit of the intervention to the needs of students. The intervention was developed in 4 iterations, and the prototypes were subsequently tested with the students and refined. This resulted in a completely automated, standalone native app in which students received dynamically tailored feedback regarding their alcohol use and goal achievement via multiple sessions within 17 weeks based on diary data assessing their alcohol consumption, motivation, confidence, and mood. A randomized controlled trial with ecological momentary assessments will be used to examine the effects, use, and acceptability of the intervention.ConclusionsThe use of intervention mapping led to the development of an innovative, evidence-based intervention to reduce excessive alcohol consumption among lower-educated Dutch adolescents and young adults. Developing an intervention based on theory and empirical evidence enables researchers and program planners to identify and retain effective intervention elements and to translate the intervention to new populations and settings. This is important, as black boxes, or poorly described interventions, have long been a criticism of the eHealth field, and effective intervention elements across mobile health alcohol interventions are still largely unknown.Trial RegistrationNetherlands Trial Registry NTR6619; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6619

Development of a Nonhuman Primate Model of Resistance to Punishment of Ethanol Choice

Several of the diagnostic criteria for alcohol use disorder (AUD) reflect the fact that some people continue to drink despite negative consequences. That is, vulnerable individuals are resistant to punishment. A better understanding of the behavioral and neurobiological factors that underlie this characteristic will lead to better preventive and treatment approaches to AUD. The objective of this study was to extend rodent studies by developing and validating a model of resistance to punishment of alcohol drinking in nonhuman primates. To increase translational relevance, the study was conducted in the context of an ethanol‐water choice procedure. Each day two 800‐ml bottles were hung on the monkey’s home cage for three hours, one containing a 4% ethanol solution and the other containing water. The primary dependent variable was ethanol choice (ml of ethanol consumed divided by total ml consumed x 100). When choice was stable (±10% of the 3‐day mean with no upward or downward trend), several manipulations were made. Experiment 1 characterized choice of several concentrations of ethanol (0%‐8%) versus water by substituting other ethanol concentrations for the 4% solution until choice again stabilized. The relationship between the available ethanol concentration and ethanol choice was characterized by an inverted U‐shaped function. In Experiment 2, the alternative (water) was manipulated to further validate the procedure as a model of choice. For monkeys in whom choice of the 4% ethanol solution was relatively low (<30%), the bitter tastant quinine (0.01‐1.0 g/L) was added to the water solution. For monkeys with higher choice of 4% ethanol (>70%), sucrose (1.0‐5.0%) was added to the water solution. These manipulations predictably increased and decreased, respectively, choice of the 4% ethanol solution. Finally, in Experiment 3, consumption of the 4% ethanol solution was punished by adding quinine (0.01‐5.6 g/L) to the ethanol solution. Increasing quinine concentrations decreased ethanol choice and ethanol intake in all monkeys without decreasing the total volume of fluid consumed. Individual differences were observed in the potency of quinine which can be interpreted as individual differences in sensitivity to punishment. These studies established and validated a novel nonhuman primate model of punishment of ethanol choice which can be used to characterize factors that underlie susceptibility versus resistance to punishing effects of adverse consequences of alcohol drinking.

At-risk drinking, operant demand, and cross-commodity discounting as predictors of drunk driving in underage college women

Behavioral economics offers unique tools for assessing value and motivation associated with college drinking. Tasks that model changes in consumption as a function of price (operant demand) or the decline in an outcome’s subjective value as a function of time-to-occurrence (delay discounting) provide valuable information that may efficiently supplement clinical screening instruments when characterizing alcohol use severity. The first aim of this investigation was to examine the extent to which at-risk drinking, operant demand for alcohol, and single- and cross-commodity discounting of money and alcohol predict adverse consequences of past-month drinking in underage college women (N = 72). The second aim was to determine whether these clinical and behavioral economic measures could significantly predict the odds of past-month drunk driving, a serious public health concern due to the increasing prevalence of heavy episodic drinking among women in their first 1 – 2 years of college. Results showed that higher scores on the consumption factor of the Alcohol Use Disorder Identification Test (AUDIT-C), higher Persistence (consumption amidst constraint) and Amplitude (maximum consumption) of demand, as well as lower rates of discounting for choices between alcohol now or double the amount after a delay (choosing the larger amount of alcohol even when it is delayed) significantly predicted adverse consequences of past-month drinking. Moreover, higher scores on the AUDIT-C, higher Amplitude of demand, and greater discounting for choices between alcohol now and money later (choosing immediately available alcohol at the expense of double the equivalent in delayed money) significantly predicted past-month drunk driving. We contend that operant demand along with single- and cross-commodity discounting can be viewed as intersecting measures of reinforcer value with clinical relevance to college women.

Alcohol and Mortality: An Actuarial Issue

Despite some favorable global trends in the prevalence of heavy episodic drinking, alcohol-related mortality and morbidity since 2010, and the prevalence of youth drinking in certain developed countries, there has been limited progress in reducing total per-capita alcohol consumption. The burden of disease attributable to alcohol remains high, particularly at pre-retirement ages, and is increasing in some countries and for some causes of death. This article describes the status and trends in alcohol consumption, both worldwide and in the United States. It also describes the adverse consequences of heavy and binge drinking, which are significant to the individual, family and friends, and society. Although the overall effect on mortality of moderate alcohol drinking compared with no drinking at all has generally been viewed to be somewhat favorable due to the effect of certain cardiovascular risks, this view is not shared by all—the arguments involved are examined in this article. The recognition and need for active management of the adverse effects of heavy and binge alcohol consumption, remain essential to favorable health and longevity. Possible public interventions are also described. Actuaries involved in assessing mortality trends and product design need to assess trends in drivers and consequences of historical, current, and expected future alcohol-attributable mortality and morbidity patterns on a regular basis.

Multidimensional elements of impulsivity as shared and unique risk factors for food addiction and alcohol misuse

Food addiction (FA) and alcohol misuse tend to co-occur, which suggests shared factors in the etiology and persistence of these health behaviors. One shared factor that has been linked to both is impulsivity, a multidimensional construct reflecting multiple facets of self-regulatory capacity. However, co-occurrence also raises issues of possible confounding if both domains are not considered concurrently, and the intersection between FA, alcohol misuse, and impulsivity has not been well characterized empirically. Therefore, the current study examined the intersection of FA, alcohol consequences, and multiple indicators of impulsivity. Participants were emerging adults reporting regular heavy episodic drinking recruited from Hamilton, Ontario (N = 730; ages 19.5–23). Participants completed measures of FA, alcohol problems, impulsive personality traits (i.e., Barratt Impulsiveness Scales, UPPS-P Impulsive Behavior Scales), impulsive choice (i.e., delay discounting), impulsive action (i.e., Go/NoGo task). Findings revealed a significant association between FA and alcohol-related consequences and both shared similar associations with specific impulsive personality traits (Positive and Negative Urgency, Lack of Premeditation, Motor and Attentional Impulsivity). However, alcohol-related consequences were uniquely associated with other impulsive personality traits (Lack of Perseverance, Sensation Seeking, Non-planning impulsivity) and impulsive choice, and FA was uniquely associated with impulsive action. Beyond alcohol-related consequences, FA was associated with additional variance in measures of impulsive personality traits (Positive and Negative Urgency, Lack of Premeditation, Motor Impulsivity, and Attentional Impulsivity) and impulsive action, but not impulsive choice. Overall, the current study reveals several common self-regulatory processes associated with both adverse drinking consequences and FA, and that the risk of inadvertent confounding appears to be limited.

Intelligence, alcohol consumption, and adverse consequences. A study of young Norwegian men.

Aims:Research suggests that intelligence is positively related to alcohol consumption. However, some studies of people born around 1950, particularly from Sweden, have reported that higher intelligence is associated with lower consumption and fewer alcohol-related problems. We investigated the relationships between intelligence, alcohol consumption, and adverse consequences of drinking in young men from Norway (a neighboring Scandinavian country) born in the late 1970s.Methods:This analysis was based on the population-based Young in Norway Longitudinal Study. Our sample included young men who had been followed from their mid-teens until their late 20s (n = 1126). Measures included self-reported alcohol consumption/intoxication, alcohol use disorders (AUDIT), and a scale measuring adverse consequences of drinking. Controls included family background, parental bonding, and parents’ and peers’ drinking. Intelligence test scores—scaled in 9 “stanines” (population mean of 5 and standard deviation of 2)—were taken from conscription assessment.Results:Men with higher intelligence scores reported average drinking frequency and slightly fewer adverse consequences in their early 20s. In their late 20s, they reported more frequent drinking than men with lower intelligence scores (0.30 more occasions per week, per stanine, age adjusted; 95% CI: 0.12 to 0. 49). Intelligence was not associated with intoxication frequency at any age and did not moderate the relationships between drinking frequency and adverse consequences.Conclusions: Our results suggest that the relationship between intelligence and drinking frequency is age dependent. Discrepancies with earlier findings from Sweden may be driven by changes in drinking patterns.

Patients\u2019 experiences of alcohol screening and advice in primary care: a qualitative study

BackgroundDespite evidence supporting the effectiveness of alcohol screening and brief advice to reduce heavy drinking, implementation in primary healthcare remains limited. The challenges that clinicians experience when delivering such interventions are well-known, but we have little understanding of the patient perspective. We used Normalization Process Theory (NPT) informed interviews to explore patients’ views on alcohol screening and brief advice in routine primary healthcare.MethodsSemi-structured qualitative interviews with 22 primary care patients who had been screened for heavy drinking and/or received brief alcohol advice were analysed thematically, informed by Normalisation Process Theory constructs (coherence, cognitive participation, collective action, reflexive monitoring).ResultsWe found mixed understanding of the adverse health consequences of heavy drinking, particularly longer-term risks. There was some awareness of current alcohol guidelines but these were viewed flexibly, depending on the individual drinker and drinking context. Most described alcohol screening as routine, with clinicians viewed as trustworthy and objective. Patients enacted a range of self-regulatory techniques to limit their drinking but perceived such strategies as learned through experience rather than based on clinical advice. However, most saw alcohol advice as a valuable component of preventative healthcare, especially those experiencing co-occurring health conditions.ConclusionsDespite strong acceptance of the screening role played by primary care clinicians, patients have less confidence in the effectiveness of alcohol advice. Primary care-based alcohol brief advice needs to reflect how individuals actually drink, and harness strategies that patients already commonly employ, such as self-regulation, to boost its relevance.

Cannabis as a factor in the moderating relationship between alcohol, sleep, and adverse drinking consequences

ABSTRACTBackground: Drinking and poor sleep quality combine to produce adverse consequences. As alcohol use may occur in combination with cannabis, and the combination of alcohol consumption, poor sleep quality, and cannabis use was examined with a goal of (1) replicating previous findings in which sleep moderated between drinking and adverse consequences, and (2) expanding this model by examining cannabis as a moderator of the interaction between sleep and alcohol use on adverse substance use consequences.Method: Seventy-five alcohol-using first-year undergraduate students (44 women; 58.7%) completed questionnaires about sleep quality, alcohol and cannabis use, and adverse substance use consequences (Rutgers Alcohol Problems Index; RAPI).Results: Alcohol use was measured as Blood Alcohol Concentration (BAC), Days Drinking (Days), or Drinks per Drinking Day (DDD). Hierarchical regression models that used BAC to predict RAPI replicated prior interaction between alcohol use and sleep; the other models did not. Triple interactions between cannabis, sleep quality, and alcohol (measured as BAC or DDD, but not Days) predicted adverse consequences.Conclusion/Importance: The triple interactions supported the hypothesis that cannabis use increased the deleterious combination of alcohol and poor sleep quality on adverse consequence.

Brief Motivational Intervention for Underage Young Adult Drinkers: Results from a Randomized Clinical Trial.

While there is a substantial literature on the efficacy of brief motivational intervention (BMI) for college student drinkers, research has focused less on young adults who do not attend a 4-year college, despite their elevated risk for excessive alcohol use and associated harmful consequences. This randomized controlled trial (NCT01546025) compared the efficacy of BMI to a time-matched attention control intervention (relaxation training [REL]) for reducing alcohol consumption and related negative consequences in an underage young adult sample. BMI was tailored to the developmental transition out of high school for young adults who were not immediately planning to enroll in a 4-year college. Non-treatment-seeking underage drinkers who reported past-month heavy drinking (N=167; ages 17 to 20; 42% female; 59% non-Hispanic White) were randomly assigned to receive a single session of BMI or REL. Outcomes were evaluated 6weeks and 3months postintervention via in-person assessments. Generalized estimating equationmodels provided strong support for the efficacy of BMI for reducing harmful drinking in these young adults. Compared to REL, and after controlling for baseline covariates including gender, those who received BMI subsequently reported significantly fewer average drinks per week, percent drinking days, percent heavy drinking days, lower peak and typical estimated blood alcohol concentration on drinking days, and fewer adverse consequences of drinking (all ps<0.05). These between-group effects did not weaken over the course of the 3-month follow-up period. These findings demonstrate an efficacious approach to tailoring BMI for non-college-attending young adults. Future research should replicate and extend these findings over a longer follow-up period.

Relationship of drinking motives with alcohol consumption and alcohol-related problems identified in a representative community-based study from Ningxia, China

BackgroundDrinking motives have been linked to alcohol consumption and drinking-related problems in western countries, but evidence about this relationship is largely lacking for Asian countries. We aim to assess the relationship between drinking motives and drinking-related outcomes in China, where alcohol use disorders are an increasingly important contributor to the overall burden of illness. MethodsValidated Chinese versions of the Drinking Motives Questionnaire-Revised (DMQ-R) and the Alcohol Use Disorder Identification Test (AUDIT) were used to assess drinking motives and drinking-related outcomes among 612 current drinkers identified from a cross-sectional survey of a representative sample of 2425 adults living in Ningxia Province in 2013. Structural equation modeling was used to estimate the relationships linking specific drinking motives (‘enhancement’, ‘conformity’, ‘social’ and ‘coping’) to drinking-related outcomes (‘level of alcohol consumption’, ‘alcohol dependence’ and ‘adverse consequences’). FindingsThe enhancement motive is significantly associated with the level of alcohol consumption (β=0.52, 95% CI=0.27, 0.78). The conformity motive is associated with higher levels of alcohol dependence (β=0.74, 95% CI=0.50, 0.98) and adverse consequences of drinking (β=0.43, 95% CI=0.04, 0.81). The social motive and drinking to cope motive are not significantly associated with any of the three drinking outcomes. InterpretationThe relationships between drinking motives and drinking-related outcomes in China are quite different from those reported in western countries. This study highlights the need to consider local context when adapting prevention or intervention strategies developed in western countries to address the problem of the harmful use of alcohol in China.

The impact of civil union legislation on minority stress, depression, and hazardous drinking in a diverse sample of sexual-minority women: A quasi-natural experiment

RationaleA small but growing body of research documents associations between structural forms of stigma (e.g., same-sex marriage bans) and sexual minority health. These studies, however, have focused on a limited number of outcomes and have not examined whether sociodemographic characteristics, such as race/ethnicity and education, influence the relationship between policy change and health among sexual minorities. ObjectiveTo determine the effect of civil union legalization on sexual minority women's perceived discrimination, stigma consciousness, depressive symptoms, and four indicators of hazardous drinking (heavy episodic drinking, intoxication, alcohol dependence symptoms, adverse drinking consequences) and to evaluate whether such effects are moderated by race/ethnicity or education. MethodsDuring the third wave of data collection in the Chicago Health and Life Experiences of Women study (N = 517), Illinois passed the Religious Freedom Protection and Civil Union Act, legalizing civil unions in Illinois and resulting in a quasi-natural experiment wherein some participants were interviewed before and some after the new legislation. Generalized linear models and interactions were used to test the effects of the new legislation on stigma consciousness, perceived discrimination, depression, and hazardous drinking indicators. Interactions were used to assess whether the effects of policy change were moderated by race/ethnicity or education. ResultsCivil union legislation was associated with lower levels of stigma consciousness, perceived discrimination, depressive symptoms, and one indicator of hazardous drinking (adverse drinking consequences) for all sexual minority women. For several other outcomes, the benefits of this supportive social policy were largely concentrated among racial/ethnic minority women and women with lower levels of education. ConclusionsResults suggest that policies supportive of the civil rights of sexual minorities improve the health of all sexual minority women, and may be most beneficial for women with multiply marginalized statuses.

494 – Gender difference in harmful alcohol use and adverse drinking consequences among taiwanese aborigines

Introduction Alcohol consumption is a part of the aboriginal culture. It was found that is a predominant health problem in aboriginal community. There was little research describing whether gender differences in harmful drinking and adverse drinking consequence among aborigines. Thus, it is important to evaluate such differences in order to provide evidence for developing interventions in problem drinking. Aims The aim of the study is to examine the gender differences in the prevalence, correlates, and adverse drinking consequences among harmful alcohol users in Taiwanese aborigines. Methods A cross-sectional survey was conducted. 449 study participants, aged 18-60, were recruited into the study from community-dwelling aborigines in southern Taiwan. Alcohol Use Disorders Identification Test (AUDIT) was used to collect information regarding harmful alcohol drinking. Personal characteristics, related risk factors and adverse drinking consequences were assessed by questionnaire. Results The result revealed that the prevalence of harmful drinking in male users was 71.6%, female users were 49.2%. The results showed that female harmful alcohol users were more likely to have poor mental health, 58% of them with suicidal ideation, 50% with depression, more inactive in religious practice, and unemployed. It was also found that more than half of the male harmful alcohol users have adverse drinking consequence, including accidental injury, quarreled with others, and unable to work. Conclusions Harmful drinking was a predominant health problem in aborigines. This finding suggested that depression and suicidal ideation should be routinely evaluated for female harmful alcohol users by the professional of primary care.

Changes in Alcohol Drinking Patterns and Their Consequences among Norwegian Doctors from 2000 to 2010: A Longitudinal Study Based on National Samples

To describe changes in the patterns and consequences of alcohol use among Norwegian doctors from 2000 to 2010. Longitudinal study based on data from nation-wide postal surveys in 2000 and 2010 among a representative sample of 682 doctors in Norway. The Alcohol Use Disorder Identification Test (AUDIT) was used to measure the changes in drinking patterns (frequency of drinking, frequency of heavy drinking and quantity of drinking), symptoms of alcohol dependence and adverse consequences of drinking. A score above 8 was defined as hazardous drinking. From 2000 to 2010, the proportion of doctors who used alcohol twice a week or more significantly increased from 31.4 (27.9-34.9) % to 48.7 (44.9-48.7) %, and the proportion of those who drank to intoxication weekly or more decreased significantly from 6.6 (4.7-8.6) % to 2.5 (1.3-1.7) %. The proportion who scored above 8 on the AUDIT decreased from 10.7 (8.4-13.0) % in 2000 to 8.2 (6.2-10.3) % in 2010. There was a significant increase in the partial AUDIT-score for drinking patterns (t=2.4; P=0.016), and a significant decrease in the partial AUDIT-score for adverse consequences of drinking (t=-3.6; P<0.001). The partial AUDIT-score for symptoms of alcohol dependence did not change significantly (t=-1.6; P=0.112). There were gender differences in drinking patterns. Females had less frequent alcohol consumption and fewer episodes of heavy and hazardous drinking in 2000 and 2010. The drinking pattern of Norwegian doctors has changed over the past decade towards more moderate alcohol consumption and less negative alcohol-related consequences. Changes in the attitude towards alcohol consumption may to a certain extent explain these findings.

Sociodemographic characteristics associated with binge drinking among Brazilians

BackgroundBinge drinking (BD) is a harmful pattern of alcohol use. This study describes this pattern of drinking and the sociodemographic variables associated with it in a representative sample of Brazilians. MethodsA cross-sectional survey of 3007 individuals using a multistage probabilistic sample was conducted in 143 Brazilian municipalities. The frequency of BD in the year preceding the study was assessed. BD was defined as the consumption of four drinks of alcohol within a two-hour period for women and five drinks in two hours for men. Weighted-ordered logit regression was used to assess the relationship between sociodemographic factors and BD. ResultsMost respondents had not engaged in binge drinking (69.7%; 95% confidence interval (CI) 67.0–72.2%). Binge drinking was more common among participants who were male (odds ratio (OR) 2.9; 95% CI 2.3–3.6) or single (OR 1.5; 95% CI 1.1–2.1) or had higher family income (OR 2.3; 95% CI 1.3–3.8). Individuals between 18 and 44 years of age were four times more likely to engage in binge drinking than adolescents (OR 4.7; 95% CI 3.3–6.8). Evangelicals/Protestants were less likely to engage in binge drinking (OR 0.7; 95% CI 0.2–0.5). ConclusionsOur study, which is the first representative survey of BD in Brazil, showed that the age range of adults who engaged in BD is wider than the age range observed in other countries. These individuals are at increased risk for the adverse consequences of binge drinking, including addiction, car accidents, involvement in crime, absenteeism, and family violence.

Living in the here and now: interrelationships between impulsivity, mindfulness, and alcohol misuse

Impulsivity and mindfulness both emphasize orientation to the present, and both have been linked to alcohol misuse, but the relationship between the two is not clearly understood. The objectives of this study are to examine the relationships between elements of impulsivity and mindfulness and to examine both variables in relation to alcohol misuse. Young adults (N = 116) were assessed for alcohol use, mindfulness, and impulsivity using psychometrically validated measures. Numerous significant associations were present among the facets of impulsivity and mindfulness. All impulsivity facets and three facets of mindfulness were related to alcohol consumption and adverse consequences from drinking. After controlling for other variables, only the impulsivity domains of Negative Urgency (NU), Positive Urgency, and delay discounting were significantly related to alcohol consumption and only Lack of Premeditation and NU were significantly associated with drinking-related consequences. There was considerable overlap between some elements of impulsivity and mindfulness while the overlap was negligible for other facets. The associations between mindfulness and alcohol misuse were entirely a function of impulsivity. In particular, acting on impulses while experiencing a negative affect was significantly associated with level of alcohol consumption and level of alcohol-related risk. Steep discounting of future rewards was associated with alcohol consumption while poor premeditation was associated with adverse drinking consequences. These findings illustrate the importance of jointly studying impulsivity when examining mindfulness traits.

Self‐Reported Alcohol Consumption and the Risk of Alcohol‐Related Problems: A Comparative Risk‐Curve Analysis of the 3 Baltic Countries, Sweden, and Italy

Previous research has suggested a positive risk-relationship between volume of consumption and adverse behavioral and social consequences of drinking. However, because the risk-relationship may be modified by factors such as pattern of drinking, attributes of social drinking contexts, and drunken comportment, the shape of the risk-function appear to be contingent upon the larger cultural context of drinking. In this article, I use graphical risk-curve analyses and model estimations to assess how the risk of experiencing alcohol-related problems is associated with self-reported volume of alcohol consumption in the 3 Baltic countries (Estonia, Latvia, and Lithuania) as well as Sweden and Italy. The analysis utilized data from 2 general population surveys (including Sweden plus Italy and the Baltic countries, respectively) with approximately 1,000 respondents from each country. The risk-curves for the 3 Baltic countries and Sweden were fairly parallel and clearly steeper than that for Italy. In the logistic regression models, the country-specific Baltic estimates were not entirely homogenous; for Estonia and Latvia, the estimates were similar to that for Sweden and significantly larger than that for Italy, whereas the estimate for Lithuania did not differ significantly from that for Italy. However, the negative binominal regression models suggested that increasing volume of consumption is associated with the risk of experiencing a larger number of different problems in all 3 Baltic countries and Sweden than in Italy. Overall, the result thus suggests that there is a significant relationship between volume of consumption and risk of experiencing alcohol-related problems in all countries but that the relationship generally is stronger in the Baltic countries and Sweden than in Italy. The results were largely in line with the hypothesis of a European north to south gradient in the strength of the risk-relationship, but also add that most Baltic countries may be placed alongside the Nordic countries in this context. Because only volume of consumption is considered, the results cannot be used to specify which factors and mechanisms that actually modify the shape of the risk-function in each culture.

Race-specific associations between trauma cognitions and symptoms of alcohol dependence in individuals with comorbid PTSD and alcohol dependence

Posttraumatic Stress Disorder (PTSD) changes the way people think about themselves, others, and the safety of the world. These cognitions may play a role in alcohol dependence, where alcohol dependence is maintained as an attempt to manage posttraumatic anxiety. The current study examined black–white differences in various PTSD cognitions and their relationship to symptoms of alcohol dependence in a dually diagnosed sample (N = 167). Analyses revealed racial differences in trauma cognitions and their impact on symptoms of alcohol dependence, suggesting that trauma cognitions are more strongly associated with adverse consequences of drinking and alcohol craving severity among African Americans than European Americans. Additional relationships between ethnic identification and trauma-related cognitions are described and theoretical and clinical implications of these findings are discussed.

Alcohol‐related negative consequences among drinkers around the world

This paper examines (i) gender and country differences in negative consequences related to drinking; (ii) relative rates of different consequences; and (iii) country-level predictors of consequences. Multi-level analyses used survey data from the Gender, Alcohol, and Culture: An International Study (GENACIS) collaboration. Measures included 17 negative consequences grouped into (i) high endorsement acute, (ii) personal and (iii) social. Country-level measures included average frequency and quantity of drinking, percentage who were current drinkers, gross domestic product (GDP) and Human Development Index (HDI). Overall, the three groupings of consequences were reported by 44%, 12% and 7% of men and by 31%, 6% and 3% of women, respectively. More men than women endorsed all consequences, but gender differences were greatest for consequences associated with chronic drinking and social consequences related to male roles. The highest prevalence of consequences was in Uganda and lowest in Uruguay. Personal and social consequences were more likely in countries with higher usual quantity, fewer current drinkers and lower scores on GDP and HDI. However, significant interactions with individual-level quantity indicated a stronger relationship between consequences and usual quantity among drinkers in countries with lower quantity, more current drinkers and higher scores on GDP and HDI. Both gender and country need to be taken into consideration when assessing adverse drinking consequences. Individual measures of alcohol consumption and country-level variables are associated with experiencing such consequences. Additionally, country-level variables affect the strength of the relationship between usual quantity consumed by individuals and adverse consequences.