Alcohol Use Severity Research Articles

The impact of alcohol misuse in trauma patients: A scoping review protocol.

Alcohol use is a contributing factor in many cases of traumatic injury. There is conflicting evidence on the impact of alcohol use at the time of physical trauma on severity of injury and hospital course. Similarly, the significance of alcohol use disorder on outcomes in hospitalized trauma patients is unclear. This scoping review aims to provide a concise overview of the current literature surrounding peri-trauma alcohol use and alcohol use disorder on injury severity, in-hospital complications, patient outcomes, and long-term health impact of alcohol use in trauma. We will also explore the associated healthcare costs of this patient population. A systematic search of the following databases MEDLINE, EMBASE, and Cochrane Library will be completed to extract all studies that meet our inclusion criteria from January 2000 onwards. Case reports will be excluded. Two reviewers will screen all citations, abstracts, and full text articles. A third reviewer will act as tiebreaker at each stage of the screening process. A narrative synthesis without meta-analysis will be conducted and assessed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. This review will contribute to the literature by providing a concise overview of the current data on the impact of alcohol on outcomes following trauma. We will explore the overall themes in the literature, limitations, and future directions to focus forthcoming research in this patient population. This project is registered via the Open Science Framework. The public registration is uniquely identified with the following DOI: https://doi.org/10.17605/OSF.IO/Z84WK. There were no funders or sponsors involved in the development of this protocol.

The inter-related effects of alcohol use severity and sleep deficiency on semantic processing in young adults

BackgroundBoth alcohol misuse and sleep deficiency are associated with deficits in semantic processing. However, alcohol misuse and sleep deficiency are frequently comorbid and their inter-related effects on semantic processing as well as the underlying neural mechanisms remain to be investigated. MethodsWe curated the Human Connectome Project data of 973 young adults (508 women) to examine the neural correlates of semantic processing in link with the severity of alcohol use and sleep deficiency. The latter were each evaluated using the first principal component (PC1) of principal component analysis of all drinking metrics and the Pittsburgh Sleep Quality Index (PSQI). We employed path modeling to elucidate the interplay among clinical, behavioral, and neural variables. ResultsAmong women, we observed a significant negative correlation between the left precentral gyrus (PCG) and PSQI scores. Mediation analysis revealed that the left PCG activity fully mediated the relationship between PSQI scores and word comprehension in language tasks. In women alone also, the right middle frontal gyrus (MFG) exhibited a significant negative correlation with PC1. The best path model illustrated the associations among PC1, PSQI scores, PCG activity, and MFG activation during semantic processing in women. ConclusionsAlcohol misuse may lead to reduced MFG activation while sleep deficiency hinder semantic processing by suppressing PCG activity in women. The pathway model underscores the influence of sleep quality and alcohol consumption severity on semantic processing in women, suggesting that sex differences in these effects need to be further investigated.

Resilience and Vulnerability: Understanding Distress Tolerance and Mindfulness among Tribals with Alcohol Use Disorder in India

Background: Alcohol use disorder may be directly or indirectly related to mindfulness and distress tolerance, and these factors are often targeted in treatment. However, such evidence has yet to be established among tribal. The research aimed to investigate the levels and relationships of mindfulness, distress tolerance, and dependence severity among tribal individuals with alcohol use disorder. Methodology: Two hundred tribals with alcohol use disorder were recruited at three tertiary health-care centers in three districts and assessed with the sociodemographic and clinical pro forma, Cognitive and Affective Mindfulness Scale-Revised (CAMSR), the Severity of Dependence Scale (SDS), and Distress Tolerance Scale (DTS). Results: The mean score on the SDS, CAMSR, and DTS was 4.99, 23.52, and 33.44, respectively. There were no statistically significant relationships between the measure of mindfulness scores and dependence severity scores. However, the perceived capacity to endure emotional suffering and negative emotions consuming one’s focus was significantly inversely linked to the severity of dependence. Conclusion: There are lower distress tolerance and mindfulness levels among tribals with alcohol use disorder. The severity of alcohol use has no significant link with mindfulness, but has inversely linked with emotional distress tolerance and attention absorption by negative emotions.

Multi-modal neuroimaging reveals differences in alcohol-cue reactivity but not neurometabolite concentrations in adolescents who drink alcohol

BackgroundThe objective of this multi-modal neuroimaging study was to identify neuroscience-informed treatment targets for adolescent alcohol use disorder (AUD) by examining potential neural alterations associated with adolescent alcohol use. MethodsAdolescents (ages 17–19) who heavily used (n=49) or did not use alcohol (n=22) were recruited for a multi-modal neuroimaging protocol, including proton magnetic resonance spectroscopy within the dorsal anterior cingulate cortex (dACC) and an fMRI alcohol cue-reactivity task. The alcohol cue-reactivity task was analyzed across 11 a priori regions-of-interest (ROI), including the dACC, and in an exploratory whole-brain approach. Correlations were run between neurometabolite levels and alcohol cue-reactivity in the dACC. ResultsThere were no significant group differences in absolute neurometabolite concentrations. Compared to the control group, the alcohol-using group exhibited heightened alcohol cue reactivity in the left amygdala ROI (p=0.04). The whole-brain approach identified higher alcohol cue reactivity in the alcohol-using group compared to controls in the amygdala and occipital regions, and lower reactivity in the parietal lobe. Whole-brain sex effects were noted, with females displaying higher reactivity regardless of group. No significant correlations were found between neurometabolite levels and alcohol cue-reactivity in the dACC. ConclusionsThe null neurometabolic findings may be due to age, relatively low severity of alcohol use, and non-treatment-seeking status of the participants. Females showed overall higher reactivity to alcohol cues, indicating a sex effect regardless of alcohol use history. Higher amygdala reactivity in alcohol-using adolescents suggests that emotional processing related to alcohol cues may be a useful target for future adolescent AUD interventions.

Deficient sleep, altered hypothalamic functional connectivity, depression and anxiety in cigarette smokers

BackgroundDeficient sleep is implicated in nicotine dependence as well as depressive and anxiety disorders. The hypothalamus regulates the sleep-wake cycle and supports motivated behavior, and hypothalamic dysfunction may underpin comorbid nicotine dependence, depression and anxiety. We aimed to investigate whether and how the resting state functional connectivities (rsFCs) of the hypothalamus relate to cigarette smoking, deficient sleep, depression and anxiety. MethodsWe used the data of 64 smokers and 198 age- and sex-matched adults who never smoked, curated from the Human Connectome Project. Deficient sleep and psychiatric problems were each assessed with Pittsburgh Sleep Quality Index (PSQI) and Achenbach Adult Self-Report. We processed the imaging data with published routines and evaluated the results at a corrected threshold, all with age, sex, and the severity of alcohol use as covariates. ResultsSmokers vs. never smokers showed poorer sleep quality and greater severity of depression and anxiety. In smokers only, the total PSQI score, indicating more sleep deficits, was positively associated with hypothalamic rsFCs with the right inferior frontal/insula/superior temporal and postcentral (rPoCG) gyri. Stronger hypothalamus-rPoCG rsFCs were also associated with greater severity of depression and anxiety in smokers but not never smokers. Additionally, in smokers, the PSQI score completely mediated the relationships of hypothalamus-rPoCG rsFCs with depression and anxiety severity. ConclusionsThese findings associate hypothalamic circuit dysfunction to sleep deficiency and severity of depression and anxiety symptoms in adults who smoke. Future studies may investigate the roles of the hypothalamic circuit in motivated behaviors to better characterize the inter-related neural markers of smoking, deficient sleep, depression and anxiety.

Look away now! Defensive processing and unrealistic optimism by level of alcohol consumption

Objective Health risk information is insufficient as a means of reducing alcohol use, particularly when it evokes negative emotional states amongst those for whom it is most personally relevant. Appraisal biases, or ‘defensive processing’, may be employed to mitigate the psychological discomfort posed by such information. Few studies have evaluated the role of defensive processing in people with different levels of alcohol consumption. Design Online participants (n = 597) completed measures of defensive processing of a health risk infographic, perceived susceptibility and severity of alcohol use, efficacy for resisting alcohol use, unrealistic optimism, the Alcohol Use Disorder Identification Test – Consumption (AUDIT-C) and demographics. Results AUDIT-C scores were positively and linearly associated with all defensive processing measures (Pearson’s correlation r from.16 to .36), threat and susceptibility (r = .16) and unrealistic optimism (r = .50). AUDIT-C scores were also negatively associated with efficacy for controlling alcohol use (r = −0.48). Conclusion People with alcohol use disorder (AUD) engaged in much more defensive processing of alcohol-related messages, offering an explanation for why such messages are limited at eliciting behaviour change. High levels of unrealistic optimism in people with alcohol use disorder may reflect low problem recognition in order to maintain a problem-free drinking identity.

Alcohol use disorder and fitness to drive: Discrepancies between health professionals' evaluations and objective measures of alcohol use and cognitive functioning.

Aims: In this study, we investigated if health professionals' evaluations of driving ability corresponded with measures of severity of alcohol use and measures of cognitive functions necessary for safely driving a car. Methods: A total of 90 participants from a multicentre study were included. Participants were categorised into three groups: (1) the group judged fit to drive (FIT); (2) the group judged not fit to drive (UNFIT); and (3) the group who had lost their driver's licence due to legal sanctions (LEGAL). The participants' AUDIT scores, earlier treatment episodes and results from neuropsychological tests of reaction time, attention and visuospatial ability were included in the analyses. Results: We found a significant difference in the severity of alcohol use disorder (AUD) and visuospatial abilities between the FIT and UNFIT groups. Half of the UNFIT group had at least mild visuospatial difficulties, compared to only a quarter in the FIT group. There were no group differences in reaction time or attentional measures. The LEGAL group had more severe AUD than the other groups. Conclusion: The FIT group did not perform differently from the UNFIT group on attention and reaction time measures. The UNFIT group had more visuospatial impairments, but even half of this group had normal scores. It is uncertain whether the differences between the two groups are of practical significance. The quality of health professionals' evaluations may be questioned, and the results highlight the need for more reliable and valid criteria for doing fitness to drive evaluations.

Increased risk for alcohol- and other substance-exposed pregnancies among women who smoke tobacco: A secondary analysis of a primary care-based intervention.

Among women at risk for alcohol-exposed pregnancies (AEP), smoking tobacco may be associated with increased severity of alcohol use, and risk for tobacco-exposed and other substance-exposed pregnancies (TEPs/SEPs). Our secondary data analysis of the 'CHOICES Plus' intervention trial explored AEP and SEP risk by smoking status. Eligible women (N=261) were recruited from 12 primary care clinics in a public healthcare system, not pregnant, aged 18-44 years, drinking >3 drinks/day or >7 drinks/week, sexually active, and not using effective contraception. We compared women who did and did not smoke tobacco on alcohol and drug severity, and psychological distress (e.g. anxiety) at baseline. Participants were primarily Hispanic (47.1%) or non-Hispanic Black (41.8%) and reported incomes <$20000/year (69.3%). Tobacco smoking prevalence was 45.2%. Compared to non-smokers, those who smoked drank more days/week (mean=3.3, SD=2.0 vs mean=2.7, SD=1.8, p<0.01), had higher alcohol use disorders identification test (AUDIT) scores (mean=12.1, SD=7.6 vs mean=9.8, SD=7.1, p<0.05), were more likely to report current drug use (66.1% vs 48.3%, p<0.01), and had a greater number of (lifetime) drugs used (mean=3.0, SD=2.0 vs mean=2.0, SD=1.5 days, p<0.0001). Also, those who smoked reported greater levels of anxiety (mean=5.9, SD=5.6 vs mean=4.5, SD=4.9, p<0.05), lower confidence to not drink (mean=2.8, SD=0.8 vs mean=3.1, SD=1.0, p<0.01), lower confidence to reduce risky drinking (mean=6.3, SD=3.1 vs mean=7.3, SD=2.8, p<0.0001), greater drinking temptations (mean=3.0, SD=0.9 vs mean=2.6, SD=0.9, p<0.01), and, yet greater readiness to reduce alcohol use (mean=6.2, SD=3.0 vs mean=5.2, SD=3.0, p<0.05). Women who drink and smoke may have the highest AEP, TEP, and other SEP risk. Primary care providers should screen for alcohol and tobacco co-use and provide brief intervention and/or treatment referral. The study was registered on the official website of ClinicalTrials.gov. ID NCT01032772.

Associations among Trauma Exposure, Post-Traumatic Stress Symptoms and Alcohol Use in Black/African American Treatment-Seeking Adults

Objective Black/African American (AA) individuals are a group at risk for co-occurring posttraumatic stress disorder (PTSD) symptoms and alcohol use due to unique cultural and system-level barriers. Although associations between trauma exposure, PTSD symptoms, and alcohol use are well established across various populations, Black/AA individuals are underrepresented in this literature, and related findings in this population are inconclusive. Thus, the goal of this study was to examine the associations among trauma exposure, PTSD symptoms, and alcohol use in a sample of treatment-seeking, Black/AA adults. We hypothesized that trauma exposure and alcohol use would be positively associated and that this relationship would be mediated by PTSD symptoms. Methods This study conducted secondary analysis of screening data from a PTSD and alcohol use disorder clinical trial. Participants were 96 Black/AA adults (57.3% male; 2.0% Hispanic; M age = 44.73, SD = 11.83) who were seeking treatment for alcohol use and endorsed trauma exposure. Associations between trauma exposure, PTSD symptom severity, and quantity and frequency of alcohol use were tested using bivariate correlations and linear regressions. Hypothesized indirect effects were tested using IBM SPSS Statistics Version 27 PROCESS model 4 with bootstrapping. Results Findings illustrated a significant positive association between trauma exposure and PTSD symptoms and between PTSD symptoms and drinks per typical drinking day. PTSD symptoms were not significantly associated with number of drinking days. Tests of indirect effects were significant for trauma exposure on drinks per typical drinking day through PTSD symptoms. Conclusions Results from the test of indirect effects suggest that among Black/AA adults with heavy alcohol use and trauma exposure, trauma exposure is associated with PTSD symptoms, which in turn is associated with quantity of alcohol use. These findings are consistent with research conducted with White/mixed groups and align with tenets of the self-medication model of PTSD-AUD comorbidity. These findings support current practices that highlight the importance of screening for and addressing PTSD and alcohol use in individuals exposed to trauma. Findings from this paper provide initial data on understudied relationships in an underserved sample and several suggestions are made to generate future research and improve clinical care for Black/AA adults.

Associations between methamphetamine and alcohol use disorder, suicidal ideation, and lowered quality of life in methamphetamine users

Aim: There is a strong comorbidity between methamphetamine (MA) and alcohol use whereby MA use may contribute to increased alcohol consumption. This study aims to determine the associations between alcohol drinking and MA-associated behaviors among MA users in relation to mood disorders, suicidal ideation, and health-related quality of life (HR-QoL). Methods: Substance use characteristics were obtained in 106 participants with MA use at a substance abuse treatment center by using the Severity of Dependence Scale (SDS) and the Thai version of the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). Current alcohol drinking behaviors were estimated using the Substance Outcomes Profile (SOP), which was developed and translated from the Treatment Outcomes Profile, by computing the number of alcohol units x days per month of alcohol use. The Mini-International Neuropsychiatric Interview (M.I.N.I.) was used to estimate lifetime histories of mood disorders and substance abuse and current suicidal ideation. Results: Current suicidal ideation in MA users is to a large extent predicted by the severity of current alcohol and MA use, female gender, and a lifetime history of mood disorders (major depression, dysthymia, and hypo-mania). Moreover, a lifetime history of mood disorders is positively associated with the severity of MA, but not with alcohol use. Partial least squares (PLS) path modeling shows that lowered HR-QoL in MA users is predicted by the SDS score and alcohol dosing (both inversely) and that lifetime diagnoses of mood disorders and MA use (both inversely) and alcohol dependence (positively) have significant effects on HR-QoL which are completely mediated via the SDS score. Conclusions: In MA users, the severity of dependence, and MA and/or alcohol use exert adverse effects on current suicidal ideation and HR-QoL. Mechanistic explanations are given which may explain the inverse associations between the severity of MA and alcohol use in MA abusers.

Unhealthy alcohol use and brief intervention rates among high and low complexity veterans seeking primary care services in the Veterans Health Administration

IntroductionBrief intervention (BI) is recommended for all primary care (PC) patients who screen positive for unhealthy alcohol use; however, patients with multiple chronic health conditions who are at high-risk of hospitalization (i.e., “high complexity” patients) may face disparities in receiving BIs in PC. The current study investigated whether high complexity and low complexity patients in the Veterans Health Administration (VHA) differed regarding screening positive for unhealthy alcohol use, alcohol-use severity, and receipt of BI for those with unhealthy alcohol use. MethodsPatients were veterans receiving PC services at the VHA in a mid-Atlantic region of the United States. The study extracted VHA administrative and clinical data for a total of 282,242 patients who had ≥1 PC visits between 1/1/2014 and 12/31/2014, during which they were screened for unhealthy alcohol use by the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C). The study defined high complexity patients as those within and above the 90th percentile of risk for hospitalization per the VHA's Care Assessment Need Score. Logistic regression models assessed if being a high complexity patient was associated with screening positive for unhealthy alcohol use (AUDIT-C ≥ 5), severity of unhealthy alcohol use in those who screened positive (AUDIT-C score range 5–12), and receipt of BI in those who screened positive. ResultsOur sample was 94.5% male, 83% White, 13% Black, 4% other race, and 1.7% Hispanic. A total of 10,813 (3.8%) patients screened positive for unhealthy alcohol use from which we identified 569 (5.3%) high complexity and 10,128 (93.6%) low complexity patients (n = 116 removed due to missing complexity data). Relative to low complexity patients, high complexity patients were less likely to screen positive for unhealthy alcohol use (3.3% vs. 4.1%, AOR = 0.59, p < .001); however, in patients who screened positive, high complexity patients had higher AUDIT-C scores (Mean AUDIT-C = 7.75 vs. 6.87, AOR = 1.46, p < .001) and were less likely to receive a BI (78.0% vs. 92.6%, AOR = 0.42, p < .001). ConclusionsDisparities in BI exist for highly complex patients despite having more severe unhealthy alcohol use. Future research should examine the specific patient- and/or clinic-level factors impeding BI delivery for complex patients.

Biopsychosocial predictors of drug dependence among Filipino drug users in community-based drug rehabilitation

This study examines the biopsychosocial predictors of drug use and dependence among Filipino drug users enrolled in community-based drug rehabilitation. Data from 925 clients revealed that the severity of drug use, cigarette and alcohol use, recovery skills, and mental health problems predict drug dependence. Family support, life skills, and psychological well-being are indirect predictors of severity of use. Results also revealed differences in predictors by sex, level of use, and type of clients. These findings highlight the importance of a client-centered approach to treatment and suggest what might be critical elements in a community-based drug rehabilitation program in the Philippines.

0305 Use of Sleep Medication Increases with Greater Severity of Hazardous Alcohol Use

Abstract Introduction Hazardous alcohol use correlates with greater insomnia, potentially leading to increased use of sleep medications. However, combining sleep medications with alcohol can yield serious and even fatal health consequences. We examined the relationship between alcohol use and sleep medication use during the first year of the COVID-19 pandemic and hypothesized that greater alcohol use would correlate with increased use of sleep medication. Methods N=3,930 English-speaking adults from across the U.S. (Mage=37.2, SD=12.4) completed the Pittsburgh Sleep Quality Index (PSQI) and the Alcohol Use Disorders Identification Test (AUDIT) at one of four timepoints (April, July, and October of 2020 and in January of 2021). Individual use of sleep aids was measured by ranking them from 0 (none) to 2 (once or twice a week or more). Additionally, alcohol use was ranked from 0-3 where a higher score indicated higher alcohol dependence. Results Alcohol use was modestly but positively correlated with sleep medication use (r = 0.183, p&amp;lt; 0.001). A chi-square analysis showed that the proportion of people reporting heavy use of sleep medications increased among those reporting greater severity of hazardous alcohol use (p&amp;lt; 0.001). Specifically, 21.8% of those in the non-hazardous drinking category reported heavy use of sleep medications, while 25.3% of those in the hazardous drinking group described heavy sleep medication use. For those meeting criteria for probable alcohol dependence, 39.7% reported heavy sleep medication use, and 57.3% meeting criteria for severe alcohol dependence reported heavy sleep medication use. Conclusion We found that individuals who scored higher on alcohol use scored higher on sleep medication use, consistent with our hypothesis. These results show that during the COVID-19 pandemic, hazardous alcohol use and sleep medication use were significantly associated. Such findings are concerning, because when combined, alcohol and sleep medications can lead to serious health consequences, including impaired neurocognitive functioning, sleep disruption, parasomnias, risk of overdose, and even death. Given the potential severe risks associated with this behavior, increased clinical assessment, monitoring, and counseling about the dangers of mixing sleep medication with alcohol is warranted. Further work should identify the causal direction and potential mediating factors driving these associations. Support (if any)

Spontaneous Changes in Attentional Capabilities and Reasoning After an Alcohol Rehabilitation Treatment: Evidence About the Role of Age and Alcohol Use.

In this study, we evaluated changes in attentional capabilities and reasoning among early abstinent alcohol-dependent individuals after a 28-day residential rehabilitation program (not including cognitive treatment). Furthermore, we explored the role of individual characteristics and disease-related factors (i.e., length of alcohol use, history of polysubstance dependence, severity of alcohol use) on spontaneous cognitive recovery. Fifty-five patients with a diagnosis of Alcohol Use Disorder (AUD) were consecutively recruited from a residential rehabilitation hospital in Northern Italy. The majority were male (67.3%) with a mean age of 47.83 years (SD = 8.21). The computerized Psychology Experiment Building Language Test Battery was used to assess the performance at the Posner Cueing Test, Go/no-go Task, Trail Making Test (TMT), Tower of London (TOL), and Balloon Analog Risk Scale. The evaluation was performed twice: at the beginning (T0) and at its end (T1, before the hospital discharge). We observed statistically improvements over time in the performance at the: 1) TOL in the time amount required to solve the task (p < 0.001); and 2) TMT in the indexes relative to the number of errors (p = 0.003) and the total time required to solve the task (p < 0.001). Age played a significant role on the changes observed in the score relative to the time amount used by participants to solve the task in TMT (test (p = 0.03) and in TOL (p = 0.02). Moreover, the length of alcohol dependence had an effect on the change observed for the time amount to solve the TMT (time) (p = 0.01). We found spontaneous recovery after alcohol detoxification on some, but not all, cognitive functions assessed in our study. The neuropsychological assessment and the identification of patients with cognitive impairment and specific risk factors (e.g., older age and longer history of alcohol use) is important to orient cognitive rehabilitation and increase the efficacy of AUD treatments.

Perceived barriers to seeking treatment for alcohol use disorders among the general Danish population – a cross sectional study on the role of severity of alcohol use and gender

BackgroundA minority of all individuals with alcohol use disorders (AUD) seek treatment. Since the suffering from AUD has severe consequences for both the individual and for society, it is important to improve the understanding of barriers to seeking treatment. Most studies of barriers thus far have been conducted in the United States of America or the United Kingdom. There is a need for studies from other contexts. The overall aim is to investigate barriers to treatment seeking for AUD. The specific aims are to: 1) describe barriers to AUD treatment at different levels of alcohol use. 2) compare gender differences regarding barriers to AUD treatment.MethodsStudy design: Cross-sectional. Participants: 1594 representative Danish adults from the general population aged 30–65 years. An online questionnaire was administrated by a market research company. The questionnaire covered demographic data, barriers to treatment and level of alcohol use. Analyses were performed by means of chi-2 test and logistic regression.ResultsThe most common barriers were related to stigma and shame: admitting to others of having a problem, being labelled, fear of the consequences and that others would find out. Participants with higher severity of alcohol use were more likely to endorse a wish to handle alcohol problems themselves and to report barriers related to treatment services. Women with high severity of alcohol use, endorsed higher level of fear of the consequences than men.ConclusionsThere is an urgent need to reduce stigma around AUD. Individuals with higher severity of alcohol use report a lower willingness to seek professional treatment if a problem occurs. Especially among individuals with high severity of alcohol use there is a need to address gender specific barriers.

Psychopathic Traits Are Associated with Lifetime History of Nicotine Dependence among Incarcerated Offenders

Background: Individuals scoring high on psychopathy engage in problematic patterns of alcohol and illicit substance use. However, our understanding regarding the association between psychopathy and nicotine use remains limited, which is surprising, given the detrimental consequences associated with such use. Previous studies have observed significant correlations between psychopathic traits (particularly Factor 2 scores assessing lifestyle/behavioral and antisocial traits from the Psychopathy Checklist - Revised [PCL-R]) and increased frequency of nicotine use. However, no study has investigated whether individuals scoring high on psychopathy are characterized by problematic patterns of nicotine use, including lifetime history of nicotine dependence. Objectives: The current study aimed to address this gap, specifically investigating whether PCL-R scores were associated with higher total scores from the Fagerström Test for Nicotine Dependence (FTND). Results: Across both incarcerated men and women, PCL-R total, Factor 2, and Facet 3 (measuring lifestyle/behavioral psychopathic traits) scores were positively correlated with FTND total scores. Additionally, across both samples, hierarchical linear regression analyses revealed these same psychopathy scores remained associated with higher FTND total scores when controlling for additional covariate measures (e.g., age, severity of alcohol and illicit substance use, race, ethnicity, and IQ). Conclusions/Importance: Though associated with small effect sizes, our results support the notion that lifestyle/behavioral psychopathic traits represent a general risk factor for engaging in risky behavior associated with deleterious health consequences, including nicotine use. Our results hold implications for the development of treatment approaches, designed to reduce problematic levels of substance use among individuals scoring high on psychopathy.

A Study of Psychological Impact on Adolescent Children of Parents with Alcohol Use Disorder

Abstract Context: Children of alcoholics face risks of problem behavior during childhood and mental health problems in adult life. Identifying these problems at the earliest can significantly reduce the problems in future. Aim: We aimed to study psychological impact on adolescent children of parents with alcohol use disorder. Settings and Design: This is a cross-sectional study done at a tertiary care hospital in Maharashtra. Materials and Methods: Convenience sampling technique was used. One hundred adolescent children of alcohol use disorder patients were evaluated for problem behavior and perceived stress using the Child Behavior Checklist (CBCL) and Perceived Stress Scale, respectively. Current status of severity of alcohol use in parents was assessed using the Severity of Alcohol Dependence Questionnaire. Statistical Analysis Used: Data were analyzed using the Statistical Package for the Social Sciences Software Package (version 20.0). Results: In our study, we found that children whose fathers had severe alcohol dependence were exhibiting more externalizing behavior on CBCL and higher perceived stress and it was statistically significant. Conclusion: A positive correlation was found between severity of alcohol use in fathers and problem behavior in children.

Association of supply sources of alcohol and alcohol-related harms in adolescent drinkers: the baseline characteristics of a high school cohort across Thailand

BackgroundThe main objective of this study was to investigate the association between parental supply of alcohol, alcohol–related harms, and the severity of alcohol use disorder in Thai 7th grade middle school students.MethodsA cross–sectional descriptive study obtained the baseline data from the project named the Thailand Parental Supply and Use of Alcohol, Cigarettes & Drugs Longitudinal Study Cohort in Secondary School Students in 2018. The sample size was 1187 students who have ever sipped or drank alcohol in the past 12 months. Pearson’s Chi square, binary logistic regression, and ordinal logistic regression are applied in the analysis.ResultsA single source of parental supply is not significantly associated with any alcohol-related harm and the severity of alcohol use disorder, while parental supply with peers and siblings supply of alcohol plays an important role in both outcomes. The increasing number of sources of alcohol supply increases the risk of alcohol–related harm and the severity of alcohol use disorder. Other risk factors found in both associations included binge drinking, alcohol flushing, low household economic status, distance from the student’s family, and poor academic performance. Gender, exposure to alcohol ads on social media and location of residency were not associated with alcohol–related harms or severity of alcohol use disorder.ConclusionsThe results did not support parental guidance in teaching or giving children a drink or sip of alcohol within family to prevent related harms when drinking outside with their peers.

Clinical utility of benzodiazepine in the management of alcohol withdrawal syndrome in a tertiary care teaching hospital

Background: Alcohol dependence is one of the common psychiatric disorder which is characterized by a pathological pattern of alcohol use, effecting mental health. Patients show severe symptoms, requiring clinical intervention. Benzodiazepines treatment can decrease the severity of withdrawal symptoms, and incidence of seizures and delirium tremens after abrupt cessation of alcohol. Objectives: To check the severity of alcohol use and assess the alcohol withdrawal symptoms, and to monitor the efficacy of different Benzodiazepines in alcohol detoxification. Methodology: A prospective study of eight months’ duration, conducted in the de-addiction unit attached to Psychiatric department (in-patients). A suitable data collection form was designed. All patients were screened using AUDIT scale and CIWA-Ar scale was used to assess the duration and severity of AWS. Data were analysed using descriptive statistics. Results: 220 patients were included in the study. Mean AUDIT score was 25.74, all the patients scored 8 or more on AUDIT. Majority of the patients were observed to have an AUDIT score between 25-32. A gradual decrease of signs and symptoms in each patient were observed. All patients were prescribed with Benzodiazepine, among which 135 (61.36%) patients were prescribed with Lorazepam followed by 85 (38.63%) patients with Diazepam and Chlordiazepoxide. Conclusion: Even though both Lorazepam and Diazepam are equally effective Benzodiazepines, in the present study, we observed that Lorazepam is the most commonly prescribed. The choices of drugs differ for each patient, and is patient specific. The management works best when it is individualized with the help of rating scales.

Determinants of Treatment Outcome, Follow-Up, and Abstinence Rates Among Patients With Alcohol Use Disorder: A Prospective Study.

Background The treatment of alcohol use problems needs to have a multidimensional approach for early recovery and better outcome. Objective The study aimed to study the socio-demographic, clinical, and psychological factors associated with the three-month clinical outcomes among patients with alcohol use disorder treated in a tertiary care general hospital psychiatric unit in southern India. Methods This is a prospective three-month follow-up study. Patients fulfilling the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria for alcohol use disorder were selected for the study. The baseline severity of alcohol use was assessed by the Severity of Alcohol Dependence Questionnaire, alcohol craving by Alcohol Craving Questionnaire (ACQ), impulsivity by Barratt Impulsiveness Scale, anxiety and depression by Hospital Anxiety and Depression Scale and personality traits by Personality inventory for DSM-5. Craving was assessed at 2, 4, 8 and 12 weeks post-discharge. Results A total of 110 patients participated in the study. After 3 months of follow-up, 75.5% of the patients remained abstinent throughout the follow-up period. The sample was divided into two groups based on the abstinent status at 12 weeks. Both the abstinent and relapsed users were compared based on socio-demographic, marital, family, illness-related, alcohol-usage, and psychological characteristics, the baseline and follow-up craving indices. There were no statistically significant differences between the two groups based on socio-demographic characteristics. Compared to the relapsed group, the abstinent individuals displayed increased adherence to follow-up visits and attended more frequent individual therapy sessions, however, there were no significant differences between the two groups in the number of group therapy sessions attended.Also, the abstinent group demonstrated lower subjective craving at both the baselineand during follow-up. The relapsed users had reported a significantly greater proportion of history of suicide in the family. Further correlational analyses were done to find the direction of associations between psychological characteristics and alcohol-usage characteristics. High attentional impulsivityand motor impulsivitywere associated with early age of first use. High attentional impulsivity, motor impulsivityand impulsive planningwere associated with early age of dependence. Early age of dependence was associated with increased levels of antagonism and psychoticism. Younger onset of alcohol use was associated with increased levels of craving at baseline. The baseline alcohol use severity and the baseline craving towards alcohol were positively correlated with follow-up craving indices as per ACQ and craving index (CI) scales. Conclusion The patients who were abstinent displayed reduced subjective craving towards alcohol at baseline and were more adherent in attending individual and group therapy sessions. Among the relapsed users, most relapsed before four weeks and had a family history of alcohol dependence, family history of psychosis, and suicide, which is indicative of high genetic loading of substance abuse leading to early initiation and early onset of alcohol dependence. The effects of genetic loading could be possibly mediated by traits of high impulsivity, psychoticism, and antagonism.