Alcohol-related Outcomes Research Articles

A multi-omics Mendelian randomization study identifies new therapeutic targets for alcohol use disorder and problem drinking.

Integrating proteomic and transcriptomic data with genetic architectures of problematic alcohol use and alcohol consumption behaviours can advance our understanding and help identify therapeutic targets. We conducted systematic screens using genome-wise association study data from ~3,500 cortical proteins (N = 722) and ~6,100 genes in 8 canonical brain cell types (N = 192) with 4 alcohol-related outcomes (N ≤ 537,349), identifying 217 cortical proteins and 255 cell-type genes associated with these behaviours, with 36 proteins and 37 cell-type genes being new. Although there was limited overlap between proteome and transcriptome targets, downstream neuroimaging revealed shared neurophysiological pathways. Colocalization with independent genome-wise association study data further prioritized 16 proteins, including CAB39L and NRBP1, and 12 cell-type genes, implicating mechanisms such as mTOR signalling. In addition, genes such as SAMHD1, VIPAS39, NUP160 and INO80E were identified as having favourable neuropsychiatric profiles. These findings provide insights into the genetic landscapes governing problematic alcohol use and alcohol consumption behaviours, highlighting promising therapeutic targets for future research.

Severe alcohol withdrawal during pregnancy or early postpartum: maternal and fetal outcomes.

Alcohol withdrawal syndrome (AWS) during pregnancy is under-researched despite growing concerns about increased alcohol use among pregnant women. This study aims to explore the severity of AWS and its impact on maternal and fetal outcomes. This retrospective study reviewed the medical records of patients admitted to the Mayo Clinic who underwent the CIWA-Ar protocol for AWS from June 2019 through June 2022. Pregnant women identified in this cohort had their pregnancy, labor, and neonatal data analyzed for alcohol-related complications and outcomes. Out of the medical records reviewed, 8 cases involved pregnant women experiencing AWS. These cases showed a high severity of withdrawal symptoms, with a median peak CIWA-Ar score of 17 (IQR = 14). Maternal complications included a high rate of ICU admissions (37.5%; n = 3) and significant rates of miscarriage and stillbirth (37.5%; n = 3). Fetal outcomes were concerning, with 1 out of 5 (20%) neonates requiring NICU admission and experiencing conditions such as respiratory failure and neonatal abstinence syndrome. Developmental problems were noted in 2 out of 5 (40%) newborns. The findings highlight the severe implications of AWS during pregnancy, impacting both maternal and fetal health. The severity of AWS requires attentive clinical management and preventative interventions. Future research should focus on larger, prospective studies to better understand and address the risks associated with AWS in pregnant women and to improve health outcomes for mothers and their children. • Severe AWS during pregnancy leads to high ICU admissions and adverse neonatal outcomes. • 37.5% of pregnant women with AWS experienced miscarriage or stillbirth. • 20% of newborns from mothers with AWS required NICU admission for serious conditions; 40% of newborns had developmental problems. • Findings underscore the need for specialized treatment protocols to improve outcomes for pregnant women and their newborns.

An experimental investigation into the impact of acute stress on alcohol craving.

Drinking to cope is associated with many negative alcohol-related outcomes among college students, such as increased alcohol use, drinking-related problems, and alcohol use disorders. Previous experimental studies have shown that students exposed to a stressor, compared to those not exposed to a stressor, drink more and have stronger urges to drink, presumably to cope with the stressor. However, no such study has tested this effect using a remote-based stressor, which may be more common for students because of the recent increase in online learning. As such, the present study aimed to (a) test the impact of an acute stressor on state anxiety and alcohol craving and (b) investigate trait-level drinking characteristics as potential moderators of the impact of the acute stressor. Participants were 137 (Mage = 19.9, SDage = 2.0; 82.5% female; 41.6% White) college students who consumed alcohol in the past month. Using a between-subjects experimental design, we assigned participants randomly to an experimental (i.e., acute stress) condition or control (i.e., neutral) condition, and they completed a premanipulation battery of alcohol-related attitudes and behaviors and a postmanipulation measure of alcohol craving. On average, participants in the experimental condition reported greater increases in anxiety than those in the control condition, but there were no differences found in alcohol craving. However, for both anxiety and craving, greater increases from pre- to postmanipulation were found when trait-level anxiety and trait-level drinking were high, respectively. Thus, heavier drinking college students may be at greater risk for craving alcohol in response to stress than those who typically drink less. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An investigation of multimodal predictors of adolescent alcohol initiation

BackgroundEarly alcohol initiation is associated with negative, alcohol-related outcomes. While previous work identifies numerous risk factors for early use, the relative contributions of known predictors remains understudied. The current project addresses this gap by 1) prospectively predicting early alcohol initiation using measures of inhibition control, reward sensitivity, and contextual risk factors and 2) interrogating the relative importance of each domain. MethodThis study leverages multimodal data from substance-naïve youth enrolled in the Adolescent Brain Cognitive Development (ABCD) Study® (n=11,694). Early initiation was defined as consuming a full standard drink containing alcohol prior to age 16. Propensity scores were used to match alcohol initiators (n=348) with demographically similar non-initiators at a 1:2 ratio (n=696). Independent logistic regressions were conducted for each domain followed by additive, hierarchical models. ResultsThe model of contextual factors (pseudo-R2=0.086, AUC=0.67) outperformed inhibition control (pseudo-R2=0.021, AUC=0.58) and reward sensitivity measures (pseudo-R2=0.020, AUC=0.59). The hierarchical model containing all measures (pseudo-R2=0.106, AUC=0.69) did not significantly improve the model of contextual factors alone (p>0.05). Examples of significant predictors (p<0.05) include externalizing behaviors, number of substances known, and non-religious alcohol sipping. ConclusionContextual risk factors were the strongest predictors of early alcohol use; however, more work is needed to understand the causal nature of this relationship. Measures of inhibition control and reward sensitivity were not adequate in distinguishing initiators from non-initiators. These findings add to a body of evidence that contextual factors play a major role in alcohol initiation while highlighting specific predictor variables that could inform youth alcohol prevention.

Insomnia treatment effects on negative emotionality among veterans in treatment for alcohol use disorder.

Insomnia symptoms are pervasive and persistent in alcohol use disorder (AUD), though little is known about the mechanisms that underlie this association. We previously found that cognitive behavioral therapy for insomnia (CBT-I) reduced alcohol-related problems among veterans by improving insomnia severity (NCT03806491). In this planned secondary analysis of the same clinical trial data, we tested negative emotionality as one potential mechanism to explain this effect. Specifically, we tested the change in negative emotionality as a mediator of the association between change in insomnia symptoms and alcohol-related outcomes (craving, heavy drinking frequency, and alcohol-related problems). Participants were 67 veterans in treatment for AUD who also met the criteria for insomnia disorder (91% male, 84% White, average age = 46.3 years). Participants were randomized to five sessions of CBT-I or a single-session sleep hygiene control. Assessments occurred at baseline, immediately posttreatment (~6 weeks after baseline), and at 6-week follow-up. Measures included the Insomnia Severity Index, Penn Alcohol Craving Scale, Timeline Followback, and Short Inventory of Problems. We created a latent negative emotionality indicator based on five validated and reliable measures of negative emotionality. Contrary to hypotheses, CBT-I did not improve negative emotionality relative to sleep hygiene control. However, across both treatment conditions, decreases in insomnia symptoms from baseline to posttreatment were associated with concurrent decreases in negative emotionality, which in turn predicted reductions in alcohol craving and heavy drinking. Negative emotionality may help explain links between insomnia symptoms and alcohol-related outcomes.

Exploratory analysis of blood alcohol concentration-related technology use and drinking outcomes among young adults.

Mobile health (mHealth) technology use may reduce alcohol use and related negative consequences; however, little is known about its efficacy without prompting from researchers or pay-per-use. This exploratory analysis assessed relationships between mHealth technology use frequency and alcohol-use outcomes. Young adults who drink heavily (N = 97, Mage = 23, 51% male, 64% non-Hispanic White, Mdrinks/week = 21) had the option to use three mHealth technologies (breathalyzer device/app, blood alcohol content estimator app, drink counting via text message) while drinking for 2 weeks. Relationships between alcohol-related outcomes and any, multiple, and specific mHealth technology use across study days and drinking days were evaluated via bivariate correlations and multiple regressions. Participants used one or more mHealth technologies on approximately 68% of drinking days (33% of field days), with multiple technologies used on 34% of drinking days. Bivariate correlations revealed that a higher percentage of study days with any mHealth technology use was related to higher mean weekly drinks. However, a higher percentage of drinking days with any mHealth technology use was related to lower mean weekly drinks, percent of heavy and high-intensity drinking days, and negative consequences. There were several significant, inverse correlations between alcohol variables and using the mHealth technologies that provided personalized feedback. Multiple regression analyses (holding sex and baseline alcohol variables constant) indicated that a higher percentage of drinking days with any mHealth technology use was related to lower mean weekly drinks and lower percentage of heavy drinking days. Using mHealth technologies to moderate drinking without direct prompting from the research team or per-use incentives was related to less overall alcohol use and heavy drinking. This indicates potential real-world engagement with mHealth apps to assist with in-the-moment drinking. Normalizing mHealth technology use during drinking could help curb the public health crisis around harmful alcohol use in young adult populations.

A Novel Mouse Home Cage Lickometer System Reveals Sex- and Housing-Based Influences on Alcohol Drinking.

Alcohol use disorder (AUD) is a significant global health issue. Despite historically higher rates among men, AUD prevalence and negative alcohol-related outcomes in women are rising. Loneliness in humans has been associated with increased alcohol use, and traditional rodent drinking models involve single housing, presenting challenges for studying social enrichment. We developed LIQ PARTI (Lick Instance Quantifier with Poly-Animal RFID Tracking Integration), an open-source tool to examine home cage continuous access two-bottle choice drinking behavior in a group-housed setting, investigating the influence of sex and social isolation on ethanol consumption and bout microstructure in C57Bl/6J mice. LIQ PARTI, based on our previously developed single-housed LIQ HD system, accurately tracks drinking behavior using capacitive-based sensors and RFID technology. Group-housed female mice exhibited higher ethanol preference than males, while males displayed a unique undulating pattern of ethanol preference linked to cage changes, suggesting a potential stress or novelty-related response. Chronic ethanol intake distinctly altered bout microstructure between male and female mice, highlighting sex and social environmental influences on drinking behavior. Social isolation with the LIQ HD system amplified fluid intake and ethanol preference in both sexes, accompanied by sex- and fluid-dependent changes in bout microstructure. However, these effects largely reversed upon resocialization, indicating the plasticity of these behaviors in response to social context. Utilizing a novel group-housed home cage lickometer device, our findings illustrate the critical interplay of sex and housing conditions in voluntary alcohol drinking behaviors in C57Bl/6J mice, facilitating nuanced insights into the potential contributions to AUD etiology.

Are long-term alcohol health harms overlooked in individuals with illicit drug problems? Alcohol-related morbidity and mortality in a Danish cohort of clients in residential rehabilitation for drug use disorders

Abstract Aims This study described the burden of alcohol-related morbidity and mortality among those who had been enrolled in residential treatment for drug use disorders in Denmark and investigated whether self-reported information on alcohol use provided at treatment admission can be used to assess risk for future serious alcohol-related harms. Methods At baseline (entry in drug use disorder treatment during 2000–10), clients completed a European adaptation of the Addiction Severity Index-5. We tracked 4981 clients through 2018 using multiple national registers to identify fully (100%) alcohol-attributable hospital contacts and deaths. Results The death rate due to fully alcohol-attributable causes was 411 per 100 000 person-years, with an average of 0.18 fully alcohol-attributable hospital contacts per person-year. Using the Addiction Severity Index-5 alcohol composite score as a predictor in an adjusted competing risks regression model, a higher score was associated with a higher risk of alcohol-related death. The alcohol composite score was a significant predictor of alcohol-related hospital contacts in an adjusted recurrent events model. Conclusions A substantial proportion of people originally identified as experiencing drug use disorders have alcohol problems that need to be monitored and managed to prevent serious complications. By demonstrating the predictive power of self-reported data, our study concludes that the Addiction Severity Index-5 can be used to identify individuals with drug use disorders at risk for severe long-term alcohol-related health outcomes.

Differences in alcohol-related variables between individuals who engage in food and alcohol disturbance (FAD) behaviors and those who only use alcohol: The role of FAD motives.

Food and alcohol disturbance (FAD) is the use of any compensatory behavior (e.g., skipping meals) within the context of a drinking episode. FAD has two underlying motives: to enhance the effects of alcohol (FAD-AE) and/or compensate for calories consumed from alcohol (FAD-CC). Prior work finds that FAD is positively associated with alcohol-related outcomes; however, it is unclear whether FAD confers increased risk above alcohol use alone, and whether there are differences in alcohol outcomes by FAD motive. Thus, the present study evaluated alcohol use patterns (i.e., past-month quantity/frequency, binge use, consequences, and drinking motives) by FAD status and FAD motives. Data were from the Stimulant Norms and Prevalence 2 (SNAP2) study, which included 5,809 undergraduates from six US universities. Participants were grouped into four categories: Alcohol-Only, FAD-AE, FAD-CC, and FAD-both (i.e., both FAD-AE and FAD-CC motives). Ordinary least squares regression was used for drinking motives and quasi-Poisson regressions were used for other outcomes. Alcohol use quantity, frequency, binge use, and consequences were all greatest in the FAD-both group and lowest in the alcohol-only group, with the FAD-AE and FAD-CC groups intermediate and not significantly different from each other. To illustrate, the FAD-both group had 47%, 33%, and 25% greater alcohol-related consequences than the Alcohol-Only, FAD-CC, and FAD-AE groups, respectively. This stepwise pattern held for drinking motives, with fewer significant differences. Engagement in FAD is linked to increased likelihood of poor alcohol outcomes versus alcohol use alone, and FAD for both motives represents the highest risk group.

Acceptance versus distraction as coping strategies for acute pain and pain-induced alcohol urge and approach inclinations.

Experimental research has identified pain as a determinant of alcohol urge mediated via negative affect. This study aimed to test acceptance coping (vs. distraction) as a moderator of this relationship. Using a randomized 2 × 2 between-subjects repeated-measures experimental design, pain-free hazardous drinkers (N = 135) were randomly assigned to receive acceptance or distraction coping training. They were asked to use the strategy while receiving an acutely painful or nonpainful stimulus. It was hypothesized that the effects of pain on negative affect would be weaker among those who received acceptance training, resulting in lower ratings on alcohol urge and approach inclinations. There were no moderating effects of Pain Condition × Coping Condition on negative affect. Given this, the moderator was removed and a simple mediation model was tested. Results showed significant indirect effects for alcohol urge through negative affect. Results suggested no differences between acceptance and distraction coping in ameliorating acute pain effects on negative affect and alcohol-related outcomes. The mediation model was partially replicated. Findings provide information that may accelerate the design of interventions to curtail drinking for pain coping by better understanding the utility of acceptance training and the pain-alcohol relation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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.

Initiation of high-intensity drinking and subsequent substance use in young adulthood

High-intensity drinking (HID; 10+ drinks/occasion) is associated with acute and long-term risks, including use of other substances. Earlier HID initiation is associated with high-risk alcohol use in young adulthood. Less is known about when HID initiation occurs relative to other substances and how it is associated with subsequent substance use. This study examined survey data from 468 respondents (35.5% female, 65.5% non-Hispanic white) who reported initiating HID by age 20. Weighted descriptive statistics of year of initiation for HID, marijuana, and nicotine were obtained. Weighted linear and logistic regressions examined associations between year and order of HID initiation and age 20 substance use (i.e., nicotine vaping, cigarette use, other tobacco use, marijuana use, marijuana vaping, simultaneous alcohol and marijuana use, and other illicit drug use) and alcohol use disorder (AUD) symptoms. Over half of participants initiated HID after marijuana (54.6%) and nicotine (54.4%). Later HID initiation was associated with fewer AUD symptoms and lower odds of all outcomes except marijuana and other illicit drug use. Initiating HID before marijuana was associated with lower odds of marijuana use outcomes and other illicit drug use at age 20. Initiating HID before nicotine was associated with lower odds of all substance use outcomes at age 20. Earlier HID initiation was associated with risk for subsequent substance use, but initiating HID earlier than other substances was not. Given its association with both alcohol-related outcomes and other substance use in young adulthood, earlier HID initiation is an important target for screening and intervention.

Impact of hospital-administered extended-release naltrexone on readmission rates for patients with alcohol use disorder.

Alcohol use disorder (AUD) is a persistent public health concern, contributing significantly to mortality and morbidity. This study aims to evaluate the impact of in-hospital extended-release naltrexone (XR-NTX) administration on alcohol-related outcomes. This retrospective cohort study, conducted at an academic medical centre, included 141 adult patients with AUD who received XR-NTX between December 2020 and June 2021. Primary and secondary outcomes were assessed 90 days before and after XR-NTX administration to identify number of alcohol-related hospitalisations, emergency department (ED) visits and average length of hospital stay. Subgroup analyses assessed outcomes in high hospital utilisers and marginally housed or unhoused populations. There was a significant decrease in ED visits and length of hospital stay post XR-NTX and no significant difference in the number of rehospitalisations. Subgroup analysis showed significant reduction in hospital readmissions and ED visits among high hospital utilisers. Our sample was a predominantly middle-aged, male and white patient population. In-hospital initiation of XR-NTX for AUD was associated with a significant decrease in ED visits and length of hospital stay. While no significant impact on the number of hospitalisations was observed overall, there was a substantial reduction in hospital readmissions and ED visits among high utilisers. Our findings suggest the potential benefits of in-hospital XR-NTX, emphasising the need for further research to establish causal relationships, assess cost-effectiveness and explore effectiveness across diverse patient populations. Effective in-hospital interventions, such as XR-NTX, hold promise for improving patient outcomes and reducing the healthcare burden associated with AUD.

Whole exome sequencing analysis identifies genes for alcohol consumption

Alcohol consumption is a heritable behavior seriously endangers human health. However, genetic studies on alcohol consumption primarily focuses on common variants, while insights from rare coding variants are lacking. Here we leverage whole exome sequencing data across 304,119 white British individuals from UK Biobank to identify protein-coding variants associated with alcohol consumption. Twenty-five variants are associated with alcohol consumption through single variant analysis and thirteen genes through gene-based analysis, ten of which have not been reported previously. Notably, the two unreported alcohol consumption-related genes GIGYF1 and ANKRD12 show enrichment in brain function-related pathways including glial cell differentiation and are strongly expressed in the cerebellum. Phenome-wide association analyses reveal that alcohol consumption-related genes are associated with brain white matter integrity and risk of digestive and neuropsychiatric diseases. In summary, this study enhances the comprehension of the genetic architecture of alcohol consumption and implies biological mechanisms underlying alcohol-related adverse outcomes.

Esketamine combined with a mindfulness-based intervention for individuals with alcohol problems.

Alcohol use disorder (AUD) is a major public health issue, posing harmful consequences for individuals and society. Recent advances in addiction research have highlighted the therapeutic potential of ketamine-assisted therapy for AUD. However, the exact mechanisms underlying its effectiveness remain unknown. This double-blind, pilot study aimed to investigate esketamine combined with mindfulness-based intervention (MBI) to examine whether esketamine enhances engagement in MBI for individuals with alcohol misuse problems and whether enhanced engagement has any impact on alcohol-related outcomes. In all, 28 individuals with alcohol problems were randomly assigned to receive sublingual esketamine hydrochloride (AWKN002: 115.1 mg) or vitamin C (placebo) in an oral thin film and took part in 2 weeks of daily MBI. Participants were assessed on various self-report measures, including mindfulness, engagement in MBI (physical and psychological), alcohol cravings and consumption. Esketamine enhanced psychological engagement with a daily MBI, compared to placebo, and led to transient decreases in alcohol cravings. Esketamine also resulted in significantly greater mystical experiences and dissociative states compared to placebo. The findings suggest that esketamine may improve treatment outcomes when combined with mindfulness-based therapies through its ability to increase engagement with meditative practice.

Pregaming potentiates risk between UPPS-P impulsivity and day-level drinking behavior: A test of person-environment transactions theory.

Pregaming represents a uniquely high-risk drinking event for young adults, and subfacets of impulsivity are robust predictors of alcohol use and related negative outcomes. Further, it is likely that pregame events contain social and physical stimuli that are particularly appealing for impulsive individuals, thus exacerbating risk for negative outcomes. However, no prior studies have investigated the extent to which impulsive personality traits interact with pregame events to confer alcohol-related risk. Thus, the present study examined the extent to which UPPS-P (urgency-perseverance-premeditation-sensation seeking-positive urgency) subfacets of impulsivity interact with the occurrence of pregaming to predict relations between pregaming, drinking quantity, and negative alcohol-related outcomes. College students (N = 737) completed a modified, online version of the 30-day Timeline Followback in which they reported drinking quantity, negative consequences, and whether they engaged in pregaming on a given day. Results indicated that sensation seeking and a lack of premeditation moderated relations between pregaming and drinking quantity such that those who are higher in sensation seeking and lower in their ability to plan ahead drank more on pregaming days. Sensation seeking and positive urgency moderated relations between pregaming and negative consequences such that those who are higher in positive urgency experience more consequences on pregaming days whereas those who are higher in sensation seeking experience less consequences. Future studies may benefit from more granular assessments of pregame-related risk as subfacets of impulsivity may confer momentary risk. Prevention efforts targeting the reduction of pregaming frequency, particularly among impulsive individuals, may lower overall risk for heavy drinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An Application of the Stressor-Vulnerability Model of Drinking in College Student Drinkers

Background: The stressor vulnerability model provides theoretical support for conditions under which drinking to cope (DTC) is likely to occur (i.e., decreased adaptive coping, increased positive alcohol expectancies). However, research has only tested this model in a college sample reporting trauma. Generalizability to a non-trauma-specific sample college drinkers would support applications of the model and inferences about coping-related drinking across a broader group of young adults. Objectives: Our sample included 565 college student drinkers (M age = 20.3 years; SD age = 2.0 years; 77.0% female; 54.2% White) from a large southeastern university. Mediation analyses examined DTC as a mediator between negative affect and alcohol-related outcomes (i.e., drinking quantity, drinking frequency, binge drinking frequency, and alcohol-related consequences). Moderated mediation models tested the influence of tension reduction expectancies and cognitive reappraisal on mediation pathways. Results: Drinking to cope was found to be a full mediator for associations between negative affect and drinking-related outcomes. For associations between negative affect and alcohol-related consequences, DTC was a partial mediator. For all alcohol outcomes, results indicated the mediation between negative affect and outcomes through DTC is strongest for individuals with greater cognitive reappraisal use. Positive alcohol expectancies did not moderate any indirect effects. Conclusions: Although cognitive reappraisal is typically considered an adaptive emotion regulation technique, our results suggest that this may not always be the case with drinking outcomes. Given our findings, further research is needed to discern the conditions wherein cognitive reappraisal may and may not be adaptive. This could be useful in informing interventions to reduce harmful DTC behaviors.

Measurement of the self-determination continuum of motivation for engaging in alcohol-related harm reduction behaviors: Improved content coverage of the Treatment Self-Regulation Questionnaire.

Self-determination theory (SDT) proposes that people are more likely to engage in behaviors that reduce the harms associated with alcohol use if they do so for more self-determined reasons. There is growing support for this proposal, but the Treatment Self-Regulation Questionnaire (TSRQ), which assesses the self-determination continuum of motivation for engaging in alcohol-related harm reduction behaviors, lacks content coverage. We generated additional items to improve the content coverage of the TSRQ and evaluated its psychometric properties. We also compared two randomly assigned instruction sets that referenced "responsible drinking" or "protective behavioral strategies" (PBS). Participants (n = 2,236) were college students from psychology departments at 10 universities in eight U.S. states who reported past-month alcohol use and completed the revised TSRQ; the online survey was completed for partial course credit. Exploratory factor analysis supported a three-factor structure representing autonomous motivation, controlled motivation, and amotivation for the PBS version. This factor structure was confirmed using exploratory structural equation modeling for both the PBS and responsible drinking versions. Scalar invariance was achieved across instruction sets. Latent mean differences showed that those who received the PBS version had lower autonomous and controlled motivation scores, but higher amotivation scores. Associations of the three TSRQ factors with alcohol-related outcomes were consistent with SDT, and the magnitude of these associations did not differ across instruction sets. More accurate assessment of the self-determination continuum of motivation for alcohol-related harm reduction behaviors will improve research on this topic which has promising implications for alcohol interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Association between telomere length with alcohol use disorder and internalizing/externalizing comorbidities in a Brazilian male sample

BackgroundShortening telomere length (TL) is an important ageing marker associated with substance use disorder (SUD). However, the influence of psychiatric and clinical comorbidities and alcohol-related outcomes has not been much explored in the context of TL in individuals with alcohol use disorder (AUD) and may be a source of heterogeneity in AUD studies. Therefore, our aim was to investigate the influence of AUD, alcohol-related outcomes, and common psychiatric comorbidities on TL in men with AUD and healthy controls (HC). MethodsMen with AUD (n = 108, mean age = 52.4, SD = 8.6) were recruited in a detoxification unit, and HC (n = 80, mean age = 50.04, SD = 9.1) from the blood bank, both located in Brazil. HC had no current or lifetime diagnosis of any substance use disorder. Psychiatric comorbidities were assessed using SCID-I. TL ratio was measured in triplicates using quantitative multiplex PCR. ResultsTelomere length did not differ between individuals with AUD and HC (p = 0.073) or was associated with AUD-related outcomes, trauma, or clinical comorbidities. Individuals with externalizing disorders had longer TL when comparing with those with internalizing disorders (p = 0.018) or without comorbidity (p = 0.018). ConclusionOur findings indicate that TL was influenced by the presence of psychiatric comorbidity rather than case or control status. These results were adjusted for potential confounders, such as age.

'Everywhere I call, there's nothing available': Understanding the alcohol treatment landscape and needs among unstably housed people who use alcohol in Rhode Island.

Alcohol is a leading cause of morbidity and mortality in the United States and people who are unstably housed are disproportionately impacted by adverse alcohol-related health outcomes. Addressing the needs of unstably housed people with high-intensity alcohol use (i.e., heavy episodic use or binge drinking), including those whose goal is not abstinence, is critical to reducing harms among this population. This study explores the alcohol-related treatment and support needs among unstably housed people who use alcohol. Data collection included participant observation and semi-structured interviews (n = 25) with unstably housed people with high-intensity alcohol use. Data were analysed thematically, with attention to structural vulnerability and social-structural forces at shaping perceptions of and experiences with alcohol treatment. Participants underscored how housing instability was critical in precipitating and maintaining heavy alcohol use, with alcohol often used to manage the stress and anxiety related to housing instability. While participants regularly engaged with alcohol treatment programs, program design and barriers to access undermined the effectiveness of these services for participants. Participants described the need for a range of program and service options across a continuum of care to be implemented to support participants in meeting their diverse needs and identified goals regarding alcohol use. Alcohol treatment and supports need to be modified so that they include a range of harm reduction and abstinence-based models to better meet people's diverse needs. Furthermore, treatment must be paired with permanent and affordable housing to address underlying drivers of alcohol-related harm for unstably housed people.