Alcohol Use Disorder Symptoms Research Articles

Parental Influences on Substance Use Among First-Year College Students: A Latent Profile Analysis and Racial/Ethnic Differences

This study took a person-centered approach to examine parental influences on alcohol and cannabis use among White and Hispanic/Latinx college students. 704 college students (74.4% female; 34.7% Hispanic/Latinx) completed an online survey. Latent profile analysis identified four parenting profiles characterized by different patterns of perceived parent-child relationship quality, parental monitoring, and parental disapproval of substance use: low disapproval (4.1%), low paternal quality and monitoring (25.8%), low quality and monitoring (12.5%), and high quality monitoring and disapproval (57.6%). Students in the High Quality Monitoring and Disapproval profile had the lowest levels of alcohol consumption and alcohol use disorder (AUD) symptoms. Students in the Low Disapproval profile had the highest frequency of cannabis use than students in other parenting profiles. Among Hispanic/Latinx students only, the High-Quality Monitoring and Disapproval profile was associated with fewer AUD symptoms compared to the Low Paternal Quality and Monitoring profile and the Low Quality and Monitoring profile.

Elevations in interleukin-8 levels in individuals with alcohol use disorder and clinical insomnia symptoms.

Insomnia commonly co-occurs with alcohol use disorder (AUD) and predicts poorer outcomes for those with AUD. Insomnia and AUD are individually associated with increases in systemic inflammation. Insomnia and inflammation both serve as risk factors for relapse in AUD. However, little is known about the relationship between insomnia and systemic inflammation in individuals with AUD. Therefore, the present study examined the relationship between the severity of insomnia symptoms and plasma levels of inflammatory cytokines in a sample of treatment-seeking individuals with an AUD. This secondary analysis included 101 (61M/40F) individuals with an AUD. Participants were categorized into groups based on their scores on the Insomnia Severity Index: no insomnia (n = 47), subthreshold insomnia (n = 37), and clinical insomnia (n = 17). Participants provided blood samples to measure plasma levels of four peripheral markers of inflammation (IL-6, IL-8, TNF-α, and CRP). Inflammatory marker levels were compared between groups. Interactive effects of sex and AUD severity were examined. There was a significant main effect of insomnia group on log IL-8 levels (F = 6.52, p = 0.002), such that individuals with AUD and clinical insomnia had higher log IL-8 levels compared to both the no insomnia and subthreshold insomnia groups (ps ≤ 0.05). Sex and AUD severity interacted with this relationship, such that men with clinical insomnia and AUD and individuals with severe AUD had higher log IL-8 levels. There were no significant effects of insomnia on IL-6, TNF-α, or CRP levels. The present study identified a specific elevation in IL-8 levels in individuals with an AUD and clinical insomnia that was not identified in other markers of peripheral inflammation (IL-6, TNF-α, CRP). Sex and AUD severity interacted with insomnia symptoms, indicating that those with clinical insomnia and severe AUD or male sex may be the most vulnerable to the inflammatory consequences associated with AUD and clinical insomnia symptoms.

Ethanol drinking sex-dependently alters cortical IL-1β synaptic signaling and cognitive behavior in mice.

Individuals with alcohol use disorder (AUD) struggle with inhibitory control, decision making, and emotional processing. These cognitive symptoms reduce treatment adherence, worsen clinical outcomes, and promote relapse. Neuroimmune activation is a key factor in the pathophysiology of AUD, and targeting this modulatory system is less likely to produce unwanted side effects compared to directly targeting neurotransmitter dysfunction. Notably, the cytokine interleukin-1β (IL-1β) has been broadly associated with the cognitive symptoms of AUD, though the underlying mechanisms are not well understood. Here we investigated how chronic intermittent 24-hour access two bottle choice ethanol drinking affects medial prefrontal cortex (mPFC)-related cognitive function and IL-1 synaptic signaling in male and female C57BL/6J mice. In both sexes, ethanol drinking decreased reference memory and increased mPFC IL-1 receptor 1 (IL-1R1) mRNA levels. In neurons, IL-1β can activate either pro-inflammatory or neuroprotective intracellular pathways depending on the isoform of the accessory protein (IL-1RAcP) recruited to the IL-1R1 complex. Moreover, ethanol drinking sex-dependently shifted mPFC IL-1RAcP isoform gene expression and IL-1β regulation of mPFC GABA synapses, both of which may contribute to female mPFC resiliency and male mPFC susceptibility. This type of signaling bias has become a recent focus of rational drug development. Therefore, in addition to increasing our understanding of how IL-1β sex-dependently contributes to mPFC dysfunction in AUD, our current findings also support the development of a new class of pharmacotherapeutics based on biased IL-1 signaling.

Drinking motives and alcohol sensitivity mediate multi-dimensional genetic influences on alcohol use behaviors.

Genetic influences account for a substantial proportion of individual differences in alcohol use behaviors (AUBs). However, multiple distinct sets of genes are linked to different AUBs, which may explain their dramatic variability in risk factors and manifestations. In this study, we explore whether intermediate neurobiological traits and alcohol-related cognitions mediate the relationship between polygenic scores (PGS) and multiple AUBs, with the aim to better understand processes captured by different genetic profiles. Using results from prior genome-wide association studies, we derived PGS for 6 AUBs in participants from Spit for Science, a longitudinal study of college students in the U.S. (n=4,549). Self-report measures included personality traits, alcohol expectancies, drinking motivations, and alcohol sensitivity measures as well as drinking frequency, drinking quantity, alcohol use disorder (AUD) symptoms, and maximum drinks in 24 hours. Using linear regression and multiple mediation models, we investigated the direct and indirect effects of PGS on AUBs. In univariable regression results, PGSs indexing broad AUB dimensions such as drinks per week (DPW) and AUD predicted higher levels of sensation-seeking and multiple drinking motives, while BeerPref PGSs (indexing a variable pattern of alcohol problems associated with a preference for beer) predicted higher negative urgency and lower alcohol sensitivity. Mediational models indicated strong direct and indirect effects of DPW PGSs on multiple AUBs via social/enhancement drinking motives and alcohol sensitivity, indirect effects of AUD PGSs on AUD symptoms via coping motives, and indirect effects of BeerPref PGS on all AUBs via the joint effect of mediators including alcohol sensitivity. These findings provide initial evidence that the genetic influences on different AUBs are associated with and partially mediated by intermediate neurobiological and cognitive factors, which may be more amenable to intervention. Greater focus on drinking motives and alcohol sensitivity is warranted in genetic research, as well as attention to the heterogeneous pathways linking genes to alcohol use outcomes.

Genetic Risk for Alcohol Use Disorder in Relation to Individual Symptom Criteria: Do Polygenic Indices Provide Unique Information for Understanding Severity and Heterogeneity?

Alcohol Use Disorder (AUD) is a heterogenous category with many unique configurations of symptoms. Previous investigations of AUD heterogeneity using molecular genetics methods studied the association between genetic liability and individual AUD symptoms at the latent level or focusing on a small number of genetic variants. Notably, these studies did not investigate potential severity differences between symptoms in their genetic analyses. Therefore, the current study aimed to examine the genetic risk for individual AUD symptom criteria by using a polygenic risk score (PRS) approach to assess the relative severity of each AUD symptom and test for associates with AUD symptoms above and beyond a unidimensional AUD construct. An AUD PRS was created using summary statistics obtained from published genome-wide association studies (GWAS), and Multiple Indicators Multiple Causes (MIMIC) models were employed to examine the effect of the PRS on overall AUD severity as well as on individual symptoms after accounting for this overall effect. The phenotypic severity of AUD symptoms was highly correlated with the genetic severity of AUD symptoms (r = 0.78). Results of MIMIC models indicated that the AUD PRS significantly predicted the AUD factor. Regression paths testing the unique, direct effects of the PRS on individual AUD symptoms, independent of the latent AUD factor, were not significant. These results imply that PRSs derived from GWAS of AUD influence symptom expression through a single genetic factor that is highly correlated with the relative severity of individual symptoms when measured at the phenotypic level. Item-level GWAS of AUD symptoms are needed to further parse heterogeneous symptom expression and allow for more nuanced tests of these conclusions.

Implications of the shift to DSM-5 for alcohol use disorder prevalence estimates in the National Survey on Drug Use and Health.

The Substance Abuse and Mental Health Services Administration's annual National Survey on Drug Use and Health (NSDUH) is a commonly used source for estimating trends in alcohol use disorders (AUD) in the United States. From 2015 to 2019 the annual prevalence of people diagnosed with either Diagnostic and Statistical Manual 4th edition (DSM-IV) alcohol abuse or dependence ranged from 5.3 to 5.9%. More recent estimates, using the DSM 5th edition (DSM-5) AUD diagnostic formulation, have been higher, with AUD base rates ranging from 10.1 to 10.7% from 2020 to 2022. This study aimed to compare the past 12-month base rates of AUD in the United States general population when using the DSM-5 versus DSM-IV AUD (i.e. abuse or dependence) and assess the AUD severity of individuals captured with each diagnostic formulation using DSM-5 AUD symptom counts. We examined descriptive trends in the rate of past-year NSDUH AUD diagnoses from 2015 to 2022. We contrasted them with trends in drinking behavior: the percentage of individuals who had ever reported drinking and the number of drinking days and binge drinking days for those who drink. We also analyzed the concordance between DSM-IV and DSM-5 AUD diagnoses in the 2020 NSDUH, which concurrently assessed AUD with both diagnostic formulations. The transition to DSM-5 AUD formulation coincided with a drastic increase in AUD prevalence rates that occurred without increases in drinking behavior. In 2020 NSDUH data, the estimated past-year DSM-5 AUD prevalence rate was 10.1% compared with a 5.4% rate of past-year DSM-IV abuse or dependence. The DSM-5 AUD formulation captured more mild-severity individuals than the DSM-IV formulation. Higher recent base rates of alcohol use disorders (AUD) in the National Survey on Drug Use and Health are likely, at least partially, explained by measurement changes in AUD; specifically, the shift from DSM-IV abuse or dependence to DSM-5 AUD. The DSM-5 formulation appears substantially more inclusive than the DSM-IV formulation, leading to a larger number of mild severity individuals being captured.

Examination of the mild, moderate, and severe alcohol use disorder severity indicators using a nationally representative sample.

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition conceptualizes alcohol use disorder (AUD) as a single continuum with indicators to denote the level of severity along this spectrum with the presence of 2-3, 4-5, or 6 + symptoms indicating mild, moderate, and severe AUD, respectively. However, despite the labels of these indicators, it remains unclear how individuals compare across these indicators, both in terms of AUD severity, but also risk for other related problems (e.g., depression). Confirmatory factor analysis was conducted on past year AUD symptoms to obtain estimates of latent AUD severity using data from the 2020 National Survey on Drug Use and Health (unweighted n = 31,941). The range and distribution of latent trait estimates were then compared across AUD diagnostic statuses (i.e., no AUD, mild, moderate, and severe). Multinomial regressions were then used to compare diagnostic groups based on alcohol use, problems with other substances, treatment utilization, and mental/physical health. Results indicated very limited overlap in latent severity estimates between individuals with different severity indicators. Multinomial regression results demonstrated that some measures increased in a roughly stepwise fashion across AUD indicators (e.g., alcohol use and drinking behavior), while many did not. Results partially support the current AUD indicators as AUD severity and co-occurring problems did broadly increase across the indicators. However, the present study also explores several ways to improve these indicators in future AUD formulations. For example, having indicators that account not only for the quantitative but also the qualitative differences in AUD presentation at different severity levels. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Self-esteem mediates child abuse predicting adulthood anxiety, depression, and substance use symptoms 18 years later

According to biopsychosocial models, experiencing parental child abuse increases susceptibility to adulthood psychopathology. However, there is a paucity of studies examining potential mechanisms of the parental child abuse and adulthood psychopathology relationship. The purpose of the current study was to determine if Time 2 (T2) trait self-esteem mediated levels of Time 1 (T1) retrospectively recalled parental child abuse predicting (T3) past-year major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder (PD), alcohol use disorder (AUD), and substance use disorder (SUD) symptoms. The 18-year Midlife Development in the United States (MIDUS) study included participants (N = 3294; T1 average age of 45.62 years) assessed at three different time points, each spaced about nine years apart. We performed structural equation mediation modeling analyses to determine how maternal and paternal child abuse at T1 would independently predict T3 MDD, GAD, PD, AUD, and SUD symptoms. We also examined whether T2 self-esteem mediated these relations while controlling for adulthood T1 psychopathology symptoms, demographics, socioeconomic status, somatic symptoms, and parental psychopathology. Consistent with our hypotheses, higher T1 maternal and paternal abuse predicted increased T3 GAD, PD, AUD, and SUD symptoms via diminished T2 self-esteem as the mediator (% proportion mediated = 33.0–100). However, childhood paternal, but not maternal, abuse predicted adulthood MDD symptoms via reduced self-esteem. Findings remained after adjusting for covariates. Our research highlights the importance of understanding retrospectively recalled parental child abuse–adulthood psychopathology relations, their potential mechanisms, and self-esteem as a malleable treatment target for adults with heightened child abuse.

Anxiety sensitivity is associated with heightened intolerance of uncertainty in individuals with alcohol use disorder.

Alcohol use disorder (AUD) is a highly prevalent, yet heterogenous condition linked to anxiety, reward sensitivity, and cognitive biases. Understanding cognitive mechanisms of specific AUD symptoms is crucial for developing tailored, effective interventions. This pilot study sought to assess whether two potential cognitive correlates of AUD-intolerance of uncertainty and delay discounting-differentially influence the relationship between AUD, anxiety sensitivity, and drinking motives. Individuals with mild-to-moderate AUD (n = 31) and healthy control participants (n = 31) completed a single-session lab study in which they performed a decision making under uncertainty task as a behavioral measure of uncertainty tolerance, completed a delay discounting task as a measure of reward sensitivity, and responded to surveys related to anxiety sensitivity, state and trait anxiety, intolerance of uncertainty, and drinking motives. Hierarchical regression results demonstrated a significant interaction between AUD status (AUD vs. control) on both self-reported (β = 0.687, p = .020) and behavioral (β = 0.777, p = .012) intolerance of uncertainty. Greater anxiety sensitivity was associated with heightened intolerance of uncertainty in those with AUD but not controls. Correlations showed that the coping drinking motive was significantly positively associated with anxiety sensitivity (r = 0.462, p = .010), self-reported (r = 0.535, p = .002), and behavioral intolerance of uncertainty (r = 0.396, p < .027) in participants with AUD but not controls. No significant associations between anxiety sensitivity, drinking motives, and delay discounting were observed in either the AUD or the control group. Intolerance of uncertainty may therefore represent a cognitive bias in which individuals with AUD and anxiety sensitivity drink to cope with environmental and internal uncertainty. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Vicarious heterosexism-based stress induces alcohol, nicotine, and cannabis craving and negative affect among sexual minority young adults: An experimental study

PurposeSexual minority young adults are at increased risk for hazardous drinking and alcohol use disorder compared to heterosexual adults. Heterosexism-based stressors contribute and often explain inequities in alcohol outcomes. However, the extant research primarily relies on correlational designs, and often neglects the importance of alcohol craving, despite its foundational role in addiction. Leveraging a novel experimental mood induction paradigm, this study examined the effects of exposure to vicarious heterosexism-based stress on alcohol craving and negative affect among sexual minority young adults who drink heavily. We also examined its effects on cannabis and nicotine craving among participants who used cannabis and nicotine, respectively. Lastly, we examined moderating factors that could influence the impact of exposure to heterosexism-based stress on alcohol craving. MethodsParticipants were 101 heavy drinking sexual minority young adults, ages 20–35 (M = 26.46 years old; SD = 3.49), recruited from the community (51.5% female sex assigned at birth; 76.3% cisgender; 51.5% plurisexual; and 42.6% racial and ethnic minorities). They completed three mood induction trials counterbalanced over three visits on different days: heterosexism stress, general stress, and neutral. Structured interviews assessed criteria for DSM-5 alcohol use disorder (AUD) and substance use, and self-report measures assessed lifetime traumatic stressors. ResultsMost participants met criteria for past-year AUD (74.7%). Exposure to heterosexism stress produced more negative affect and substance craving than the neutral mood induction, even while controlling for demographic variables and lifetime exposure to traumatic and heterosexism stressors. Exposure to heterosexism-based stress had large effects on alcohol craving among participants who had greater drinking to cope motives and heterosexism-specific rejection sensitivity, whereas the effects were small for those who had lower drinking to cope motives and heterosexism-specific rejection sensitivity. Demographic, lifetime stress, prior alcohol use, and AUD symptom severity variables were not significant moderators. Greater substance craving induced by heterosexism-based stress in the laboratory was associated with greater recent and current substance use. ConclusionsThis study findings show that vicarious exposure to heterosexism elicits negative mood and alcohol, cannabis, and nicotine craving among sexual minority young adults who engaged in heavy drinking. The effects for alcohol craving were largest among those who endorse high levels of drinking to cope motives and heterosexism-based rejection sensitivity. These findings have implications for oppression-based stress and motivational models of addiction.

Assessment of depression, anxiety, stress, alcohol dependence, and resilience in migrant workers during COVID-19 crisis.

During the COVID-19 pandemic, migrant workers in India have gone through many hardships. After the lockdown, many construction sites, factories, and workplaces shut down, and innumerable migrant workers faced a loss of income, shortage of food, and uncertain future. This massive change in their living conditions made them vulnerable to psychological problems. To screen for depression, anxiety, stress, alcohol dependence, and resilience in migrant workers during the COVID-19 crisis. Migrant workers at seven camps in the Pimpri Chinchwad Municipal Corporation, Maharashtra, were surveyed with the help of the Depression Anxiety Stress (DASS-21) Scale to assess depression, anxiety, and stress levels, AUDIT C for assessing alcohol use disorders, and Connor-Davidson resilience scale short form (CD RISC) for assessing resilience. A total of 1053 migrant workers were surveyed. It showed that 57.54% of workers had depressive symptoms, 64.96% had anxiety symptoms, and 39.32% had subjective stress. Female migrant workers had more severe depression, anxiety, and stress symptoms as compared to males while male workers were more at risk of alcohol use disorder as compared to females. Migrants without family had more symptoms of severe depression and alcohol use disorder as compared to those with family. Regression analysis showed that levels of anxiety were independently associated with female gender, unmarried status, stress, depression, and alcohol use disorder while resilience negatively predicted anxiety in these migrant workers. During the COVID-19 pandemic, migrant workers were at risk of depression, anxiety, stress, and alcohol use disorder. Females and migrants without families came out to be more vulnerable to these psychological problems. Hence during the pandemic situation, identifying this vulnerable population and special preventive or therapeutic programs for them can be of crucial importance.

Triple network resting-state functional connectivity patterns of alcohol heavy drinking.

Previous neuroimaging research in alcohol use disorder (AUD) has found altered functional connectivity in the brain's salience, default mode, and central executive (CEN) networks (i.e. the triple network model), though their specific associations with AUD severity and heavy drinking remains unclear. This study utilized resting-state fMRI to examine functional connectivity in these networks and measures of alcohol misuse. Seventy-six adult heavy drinkers completed a 7-min resting-state functional MRI scan during visual fixation. Linear regression models tested if connectivity in the three target networks was associated with past 12-month AUD symptoms and number of heavy drinking days in the past 30days. Exploratory analyses examined correlations between connectivity clusters and impulsivity and psychopathology measures. Functional connectivity within the CEN network (right and left lateral prefrontal cortex [LPFC] seeds co-activating with 13 and 15 clusters, respectively) was significantly associated with AUD symptoms (right LPFC: β = .337, p-FDR = .016; left LPFC: β = .291, p-FDR = .028) but not heavy drinking (p-FDR > .749). Post-hoc tests revealed six clusters co-activating with the CEN network were associated with AUD symptoms-right middle frontal gyrus, right inferior parietal gyrus, left middle temporal gyrus, and left and right cerebellum. Neither the default mode nor the salience network was significantly associated with alcohol variables. Connectivity in the left LPFC was correlated with monetary delay discounting (r =.25, p = .03). These findings support previous associations between connectivity within the CEN network and AUD severity, providing additional specificity to the relevance of the triple network model to AUD.

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.

Predictors of National Institute on Alcohol Abuse and Alcoholism (NIAAA) Alcohol Recovery among Individuals in Alcohol Treatment: Implications for Social Work.

The National Institute on Alcohol Abuse and Alcoholism's (NIAAA) definition of alcohol use disorder (AUD) recovery stipulates two criteria: remission from DSM-5 AUD and cessation of heavy drinking. Importantly, these criteria allow for consideration of nonabstinent alcohol treatment outcomes. However, researchers have yet to assess potential predictors of the NIAAA recovery outcome. The current study examined associations between mental health and coping predictors of NIAAA recovery status in an AUD treatment sample. At baseline (BL) and end-of-treatment (EOT) research interviews in a clinical trial, participants (N = 118) completed questionnaires assessing alcohol dependence, mental health, and confidence levels in reducing heavy drinking, as well as alcohol use and DSM-5 AUD symptom endorsement. Logistic regression models tested the associations between chosen predictors and the odds of achieving NIAAA recovery. Twenty-four percent of individuals (n = 28) met both criteria for NIAAA recovery at EOT. Higher levels of BL state anxiety and anxiety sensitivity predicted lower odds of achieving NIAAA recovery, while greater confidence to reduce heavy drinking predicted increased odds of NIAAA recovery. Social workers are encouraged to continue assessing and addressing mental health in AUD treatment to help individuals with alcohol problems achieve their AUD recovery goals.

One-Year Follow-Up: Schema Therapy for Patients With Borderline Personality Disorder and Comorbid Alcohol Use Disorder.

This article describes the 1-year follow-up of a study into the effectiveness of Schema Therapy (ST) for borderline personality disorder (BPD) and comorbid alcohol use disorder (AUD). In the original study, 20 of these patients participated in a multiple baseline case series design study. The results of the original study were promising (a significant decrease of BPD and AUD symptoms). The present study is aimed at examining the longer term benefits of ST for BPD and comorbid AUD. One year after the cessation of the investigational therapy, 17 of the original participants agreed to participate in this follow-up study. T- or Wilcoxon signed rank tests were performed to compare 1-year follow-up to start of therapy (baseline). The results suggest that the main therapeutic improvements were generally preserved at 1-year follow-up. These findings add to the idea that integrated ST for BPD and comorbid AUD might be effective, also in the long term. A randomized clinical trial is indicated to substantiate this idea.

Assessing NIAAA’s Definition of Recovery from Alcohol Use Disorder: A Latent Class Analysis of a Heterogeneous Online Sample

ABSTRACT NIAAA’s 2022 definition of recovery from alcohol use disorder (AUD) includes two core components, remission of DSM-5 AUD criteria and cessation of heavy drinking. This study’s purpose was to assess patterns of AUD symptoms and heavy drinking in a heterogeneous national sample, in order to clarify the utility of the definition. Participants who self-reported having resolved an alcohol problem for at least 6 months were recruited through Amazon Mechanical Turk (N = 386) and surveyed about their problem severity, current drinking, and AUD symptomology. We used latent class analysis to discern meaningful clusters of AUD symptoms and heavy drinking, as well as factors associated with class membership. A two-class model was the best fit for the data. The first class, which we termed Less Symptomatic, included 83.4% of the sample. Individuals in this class were unlikely to endorse any of the 10 AUD criteria (<2.5% of the time) and 24.3% reported heavy drinking. In the second class (16.6% of the sample), termed Symptomatic, 45% of respondents endorsed at least one AUD criterion and 88.2% reported heavy drinking. These findings suggest that some individuals in recovery may continue to drink heavily with minimal problems, while others continue to experience AUD symptoms.

Simultaneous use of alcohol and cannabis and attenuated age-related declines in alcohol and cannabis use disorder symptoms across young adulthood

Most young adults naturally mature out of high-risk substance use patterns, but it is important to identify factors that may impede normative declines. Use of alcohol and cannabis simultaneously (i.e., simultaneous alcohol and marijuana/cannabis [SAM]) is cross-sectionally associated with alcohol and cannabis concerns, and SAM use increases acute risks at the daily level. However, less is known about long-term risks of SAM use and, specifically, how SAM use relates to maturing out of alcohol and cannabis use. Using four consecutive years of survey data from young adults who reported SAM use (N=409; 1636 responses; aged 18–25 at baseline), we first estimated age-related changes in symptoms of alcohol and cannabis use disorder (AUD/CUD) using multilevel growth modeling. Findings supported a maturing out process, as both AUD and CUD symptom severity significantly declined across young adulthood, on average (4 % and 5 % per year respectively, with significant acceleration). Cross-level interactions tested whether participants’ mean SAM use frequency across all four timepoints moderated age-related trajectories in AUD/CUD symptom severity. Significant interactions indicated that, relative to less-frequent SAM use, participants with more frequent SAM use showed less steep declines in AUD (1 % decrease per year vs. 6 % per year) and CUD symptoms (0 % decrease per year vs. 7 % per year); thus, SAM frequency was associated with slower/delayed maturing out of hazardous alcohol and cannabis use. Findings highlight that SAM use may be a correlate or risk-factor for prolonged high-risk substance use during young adulthood that relates to deviations from maturing out processes.

The key role of specific DSM-5 diagnostic criteria in the early development of alcohol use disorder: Findings from the RADAR prospective cohort study.

Prevention and early intervention of alcohol use disorder (AUD) is a public health priority, yet there are gaps in our understanding of how AUD emerges, which symptoms of AUD come first, and whether there are modifiable risk factors that forecast the development of the disorder. This study investigated potential early-warning-sign symptoms for the development of AUD. Data were from the RADAR study, a prospective cohort study of contemporary emerging adults across Australia (n = 565, mean age = 18.9, range = 18-21 at baseline, 48% female). Participants were interviewed five times across a 2.5-year period. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) AUD criteria and diagnoses were assessed by clinical psychologists using the Structured Clinical Interview for DSM-IV (SCID-IV), modified to cover DSM-5 criteria. Hazard analyses modeled the time from first alcoholic drink to the emergence of any AUD criteria and determined which first-emergent AUD criteria were associated with a faster transition to disorder. By the final time point, 54.8% of the sample had experienced at least one DSM-5 AUD criterion and 26.1% met criteria for DSM-5 AUD. The median time from first AUD criterion to a diagnosis of AUD was 4 years. Social problems from drinking (hazard ratio [HR] = 3.24, CI95 = 2.14, 4.92, p < 0.001), major role (HR = 2.53, CI95 = 1.58, 4.06, p < 0.001), and drinking larger amounts/for longer than intended (HR = 2.04, CI95 = 1.20, 3.46, p = 0.008) were first-onset criteria associated with a faster transition to AUD. In the context of a prospective general population cohort study of the temporal development of AUD, alcohol-related social problems, major role problems, and using more or for longer than intended are key risk factors that may be targeted for early intervention.

Alcohol use disorder as a moderator of the relationship between posttraumatic stress disorder and suicidality among military personnel.

Alcohol use disorder (AUD), posttraumatic stress disorder (PTSD), and suicide are substantial public health concerns among military service members, yet the nature of their relationships is not well understood. Here, we tested the hypothesis that AUD moderates the relationship between PTSD symptom severity and suicidal ideation. This secondary analysis uses data collected at baseline for a randomized clinical trial. The sample consists of 160 active-duty service members from three service branches (Army, Air Force, and Navy). All participants met diagnostic criteria for PTSD and were not engaged in evidence-based PTSD treatment at the time of enrollment. Zero-inflated Poisson generalized linear regression models were used to test the associations of PTSD and AUD symptom severity with the presence and severity of suicidal ideation. Findings suggest that AUD symptom severity moderates (i.e., amplifies) the relationship between PTSD symptoms and severity of suicidal ideation among military personnel with untreated PTSD. Among service members with mild or absent AUD, we found no significant association between PTSD symptoms and the severity of suicidal ideation. However, when AUD severity was average (i.e., sample mean) or high (mean + 1SD), PTSD symptoms were significantly positively associated with the severity of suicidal ideation. This study highlights the importance of assessing AUD and PTSD as a part of suicide risk evaluations of veterans. The results also provide strong support for the maintenance and further development in the military health system of treatment programs that simultaneously address AUD and PTSD comorbidity.

From childhood trauma to alcohol use disorder severity - significance of depressive symptoms and expectations towards analgesic effects of alcohol.

The objective of the current study was to describe and analyse associations between childhood emotional abuse, severity of depressive symptoms, and analgesic expectations of drinking in individuals with alcohol use disorder (AUD). A total of 240 individuals aged 43.85 ± 11.0 with severe AUD entering an inpatient, abstinence-based, and drug-free treatment program were assessed. The data on AUD severity, depressive symptoms, expectations towards the analgesic effects of alcohol and childhood emotional trauma was collected using questionnaire measures. The PROCESS SPSS macro for serial mediation with bootstrapping was used to test whether current severity of depressive symptoms and expectations towards analgesic effects of alcohol use serially mediated the association between childhood emotional abuse on AUD symptom severity. There was evidence for two simple mediated effects, whereby the severity of depressive symptoms mediated the association between childhood emotional abuse on AUD symptom severity, and expectations towards analgesic effects of alcohol mediated the association between childhood emotional abuse on AUD symptom severity. There was also evidence to support serial mediation whereby both severity of depressive symptoms and expectations towards analgesic effects of alcohol mediated the association between childhood emotional abuse on AUD symptom severity. It might be clinically relevant to address experiences of childhood emotional trauma, as well as individual expectations of analgesic effects of alcohol, in AUD treatment programs.