Higher Alcohol Use Disorder Research Articles

Childhood Trauma and Dissociation Correlates in Alcohol Use Disorder: A Cross-Sectional Study in a Sample of 587 French Subjects Hospitalized in a Rehabilitation Center.

This study aimed to determine whether dissociative symptoms and childhood trauma (CT) may help identify a specific subgroup of patients among those hospitalized for alcohol use disorder (AUD). We assessed 587 patients hospitalized for an AUD in a French addiction rehabilitation center (cross-sectional study) regarding dissociative symptoms (DES-taxon), childhood trauma (CTQ), depression (BDI), anxiety (STAI-state and STAI-trait), posttraumatic stress disorder (PTSD; PCL-5), and AUD symptoms (AUDIT). We ran a hierarchical cluster analysis and compared the clusters in terms of dissociation and CT, as well as AUD, depressive, anxiety, and PTSD symptoms. We identified three clusters of patients: (1) patients with low AUD severity and low dissociation (LALD); (2) patients with high AUD severity and low dissociation (HALD); (3) patients with high AUD severity and high dissociation (HAHD). Patients from the HAHD group had significantly higher dissociation and more severe depression, anxiety, and PTSD symptoms than those with LALD and HALD. They also reported more emotional and sexual abuse than those with LALD. Among patients with an AUD, those with high dissociation may constitute an independent subgroup that exhibits a higher prevalence for CT and higher AUD severity, as well as higher depression, anxiety, and PTSD symptoms. Patients with more severe AUD and associated psychiatric symptoms should be systematically screened for dissociation and provided with tailor-based treatments.

Identification of Latent Alcohol Use Groups and Transitions over Time Using a 9-Year Follow-Up Study in the Adult General Population

Introduction: Studies investigating latent alcohol use groups and transitions of these groups over time are scarce, while such knowledge could facilitate efficient use of screening and preventive interventions for groups with a high risk of problematic alcohol use. Therefore, the present study examines the characteristics, transitions, and long-term stability of adult alcohol use groups and explores some of the possible predictors of the transitions. Methods: Data were used from the baseline, 3-, 6-, and 9-year follow-up waves of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a representative study of Dutch adults aged 18–64 at baseline (N = 6,646; number of data points: 20,574). Alcohol consumption, alcohol use disorder (AUD), and mental disorders were assessed with the Composite International Diagnostic Interview 3.0. Latent Markov Modelling was used to identify latent groups based on high average alcohol consumption (HAAC) and AUD and to determine transition patterns of people between groups over time (stayers vs. movers). Results: The best fitting model resulted in four latent groups: one nonproblematic group (91%): no HAAC, no AUD; and three problematic alcohol use groups (9%): HAAC, no AUD (5%); no HAAC, often AUD (3%); and HAAC and AUD (1%). HAAC, no AUD was associated with a high mean age (55 years) and low educational level (41%), and no HAAC, often AUD with high proportions of males (78%) and people with high educational level (46%). Eighty-seven percent of all respondents – mostly people with no HAAC, no AUD – stayed in their original group during the whole 9-year period. Among movers, people in a problematic alcohol use group (HAAC and/or AUD) mostly transitioned to another problematic alcohol use group and not to the nonproblematic alcohol use group (no HAAC, no AUD). Explorative analyses suggested that lack of physical activity possibly plays a role in transitions both from and to problematic alcohol use groups over time. Conclusion: The detection of three problematic alcohol use groups – with transitions mostly between the different problematic alcohol use groups and not to the group without alcohol problems – points to the need to explicitly address both alcohol consumption and alcohol-related problems (AUD criteria) in screening measures and interventions in order not to miss and to adequately treat all problematic alcohol users. Moreover, explorative findings suggest that prevention measures should also include physical activity.

17.3 ASSOCIATIONS BETWEEN CHILDHOOD MALTREATMENT, ALCOHOL USE DISORDER, AND NEURO-COMPUTATIONAL IMPAIRMENTS IN REWARD PREDICTION ERROR (RPE) REPRESENTATION

This part of the Symposium will focus on a series of novel studies that investigate gaps in the current literature on neurocomputational impairments in childhood maltreatment, substance use, and conduct disorder (CD). Prior work has found that trauma exposure is associated with impairments in reward prediction error (RPE) representation in adolescents. Despite the association between trauma and CD, the impact of maltreatment on RPE representation in individuals with CD is unclear. Further, the extent to which maltreatment-related dysfunction in RPE representation relates to alcohol use disorder (AUD) vs cannabis use disorder (CUD) is unclear. A total of 156 adolescents participated in a 3-armed bandit instrumental learning task in which they learn to select novel or nonnovel stimuli associated with a certain monetary value. A mixed reinforcement learning/logistic regression method was used to calculate individual novelty propensity (NP) during the task. Functional MRI data were analyzed within the general linear model framework. In Study 1, maltreatment was measured with the Childhood Trauma Questionnaire (CTQ) in a subsample of adolescents with CD (N = 89). In Study 2, AUD severity was measured with the Alcohol Use Disorders Identification Test (AUDIT), and CUD severity was measured with the Cannabis Use Disorder Identification Test (CUDIT) within the full sample (N = 156). In Study 1, there was CTQ-by-NP interaction on RPE representation during selection of novel stimuli within dorsolateral prefrontal cortex (dlPFC) and inferior frontal gyrus (iFG) (p < 0.05, corrected). In Study 2, AUD severity was associated with alterations in RPE representation within striatum, anterior insular cortex, iFG, dlPFC, and anterior cingulate cortex (ACC), particularly when exploring novel stimuli (p < 0.05, corrected) and with behavioral impairments on the task (p < 0.05). Our findings show that trauma is related to neural representation of RPE within dlPFC and iFG in individuals with CD. These regions also overlap with regions associated with impaired RPE representation in individuals with high AUD severity. Future work should investigate the relationships between maltreatment and AUD in individuals with and without CD.

Correlates of emotional intelligence among Lebanese adults: the role of depression, anxiety, suicidal ideation, alcohol use disorder, alexithymia and work fatigue

BackgroundRelationship between emotional intelligence and emotional variables such as stress, depression, anxiety and mental health has been well documented in child and adult samples. New insights into the association between emotional intelligence and different components of mental health in one study (cognitive, emotional and behavioral dimensions) can help patients, therapists, relatives, and friends to understand, explain, and cope with symptoms. There have been no studies assessing the association between the emotional intelligence (EI) with various factors in Lebanon. This study principal aim was to evaluate how EI is related to mental health issues: social anxiety, depression, alcohol use disorders (AUD), work fatigue, stress and alexithymia in Lebanon.Methods789 participants were enrolled in a cross-sectional study between November 2017 and March 2018. A cluster analysis was used to evaluate participants’ profiles with the help of emotional intelligence subscales, to separate the Lebanese population into equal limited units with different characteristics using the K-mean technique.ResultsThree clusters were computed dividing participants into low EI (cluster 1; 24.5%), moderate EI (cluster 2; 43.7%) and high EI (cluster 3; 31.7%) respectively. Fitting into the cluster 1 (low EI) was significantly associated with higher AUD, alexithymia, anxiety, depression, perceived stress, social phobia, emotional, mental and physical work fatigue, suicidal ideation compared to cluster 3 (high EI). Fitting into the cluster 2 (moderate EI) was significantly correlated with higher AUD, depression, alexithymia, anxiety, perceived stress, social phobia, mental work fatigue and suicidal ideation compared to cluster 3 (high EI).ConclusionThis study results suggest that emotional intelligence is related to different variables, warranting interventions to limit/decrease alcohol abuse and mental/psychological illnesses as much possible.

Interaction between behavioral inhibition and neural alcohol cue-reactivity in ADHD and alcohol use disorder

RationaleCompared to the general population, adult Attention-Deficit / Hyperactivity Disorder (ADHD) is more prevalent in patients with Alcohol Use Disorder (AUD). Impaired behavioral inhibition is a common characteristic in both ADHD and AUD. Relapse risk is increased in patients with AUD and comorbid, untreated ADHD and in AUD patients with increased neural cue-reactivity.ObjectivesIn this study, we examined the interaction between neural correlates of behavioral inhibition and alcohol cue-reactivity with a hybrid imaging task.MethodsOut of 69 adult study participants, we included n = 49 in our final analyses: Individuals had a diagnosis of either AUD (n = 13), ADHD (n = 14) or both (n = 5), or were healthy controls (HC; n = 17). The functional magnetic resonance imaging paradigm aimed to examine the combined effects of both an interference-inhibition task (“Simon-task”) and an alcohol cue-reactivity task. Instead of segregating by diagnostic group, we pursued a dimensional approach in which we compared measures of AUD and ADHD severity, as well as the interaction of both, using multiple regression analyses.ResultsThe four groups did not differ on the behavioral level on either the inhibition task or the alcohol cue-reactivity task. However, brain activation in frontal control and reward-related regions during completion of the combined tasks were related to ADHD and AUD severity (symptom load). During presentation of both alcohol cues and the inhibition task, participants with higher AUD and ADHD symptom load exhibited greater BOLD (blood oxygen level dependent) responses in subcortical reward-related regions.ConclusionsOur findings support the hypothesis that ADHD additionally diminishes inhibition ability in individuals with AUD. This may increase relapse risk when confronted with alcohol cues. Further, it is crucial for patients with comorbid AUD and ADHD to take into account not only reduced cognitive control over behavioral inhibition but also simultaneously heightened alcohol cue-reactivity.

Genetic Selection for Alcohol Preference in Mice Alters Dorsal Striatum Neurotransmission.

Although it is widely acknowledged that the risk of developing an alcohol use disorder (AUD) is strongly influenced by genetic factors, very little is known about how this genetic predisposition may alter neurotransmission in a way that promotes AUD susceptibility. The dorsal striatum has garnered increased attention as a brain region of interest in AUD development given its significant roles in goal-directed and habitual behavior. In the present work, dorsal striatal neurotransmission parameters were measured in preclinical mouse models of high and low AUD risk. We performed brain slice whole-cell patch clamp electrophysiological recordings from medium spiny neurons (MSNs) in the dorsomedial (DMS) and dorsolateral (DLS) striatum of naïve adult male and female selectively bred high- and low-alcohol-preferring lines of mice (HAP and LAP). We found that MSNs of HAP mice were significantly more excitable than those of LAP mice, specifically in the DLS. Additionally, the frequencies of spontaneous glutamate- and GABA-mediated currents were both elevated in HAP mice relative to LAP mice in both dorsal striatal subregions, whereas amplitude differences were more variable between lines and subregions. AMPAR/NMDAR current ratios were significantly lower in HAP mice in both DLS and DMS. Collectively, these results suggest that genetic predisposition for high or low alcohol consumption produces significantly different basal functional states within both DLS and DMS which may be important factors in the behavioral phenotypes of HAP and LAP mice.

Impact of the interaction between alexithymia and the adult attachment styles in participants with alcohol use disorder.

The current study aims to investigate the effect of the interaction between adult attachment styles and alexithymia among participants with alcohol use disorder (AUD). This study is cross-sectional, conducted between November 2017 and March 2018, which enrolled 789 community-dwelling participants. The interaction between alexithymia and secure relationship tended to significance (p=0.057). Higher interaction between alexithymia and a fearful relationship style (β=0.04) were significantly associated with higher AUD. The interaction model revealed the importance of stratifying the results according to presence/absence of alexithymia. Being a female and having a secure relationship style were significantly associated with lower AUD in both groups. Being divorced was significantly associated with higher AUD in both groups. Increasing age (β=-1.48), secondary (β=-4.65), and university level of education (β=-6.46) were significantly associated with lower AUD in the non-alexithymic group. Intermediate monthly income (β=2.69) and being widowed (β=8.24) were significantly associated with higher AUD in the non-alexithymic group. High monthly income (β=3.46) was significantly associated with higher AUD in the alexithymic group. The results of this study showed that the consideration of the combination between attachment styles and alexithymia is of significance in the diagnosis and therapy of alcohol use disorders.

Facilitating Screening and Brief Interventions in Primary Care: A Systematic Review and Meta-Analysis of the AUDIT as an Indicator of Alcohol Use Disorders.

BackgroundThe Alcohol Use Disorders Identification Test (AUDIT) was developed for use in primary health care settings to identify hazardous and harmful patterns of alcohol consumption, and is often used to screen for alcohol use disorders (AUDs). This study examined the AUDIT as a screening tool for AUDs.MethodsA systematic literature search was performed of electronic bibliographic databases (CINAHL, Embase, ERIC, MEDLINE, PsycINFO, Scopus, and Web of Science) without language or geographic restrictions for original quantitative studies published before September 1, 2018, that assess the AUDIT's ability to screen for AUDs. Random‐effects meta‐regression models were constructed by sex to assess the potential determinants of the AUDIT's specificity and sensitivity. From these models and ecological data from the Global Information System on Alcohol and Health, the true‐ and false‐positive and true‐ and false‐negative proportions were determined. The number of people needed to be screened to treat 1 individual with an AUD was estimated for all countries globally where AUD data exist, using a specificity of 0.95.ResultsA total of 36 studies met inclusion criteria for the meta‐regression. The AUDIT score cut‐point was significantly associated with sensitivity and specificity. Standard drink size was found to affect the sensitivity and specificity of the AUDIT for men, but not among women. The AUDIT performs less well in identifying women compared to men, and countries with a low prevalence of AUDs have higher false‐positive rates compared to countries with a higher AUD prevalence.ConclusionsThe AUDIT does not perform well as a screening tool for identifying individuals with an AUD, especially in countries and among populations with a low AUD prevalence (e.g., among women), and thus should not be used for this purpose.

Genetic and environmental influences on the codevelopment among borderline personality disorder traits, major depression symptoms, and substance use disorder symptoms from adolescence to young adulthood.

Although borderline personality disorder (BPD) traits decline from adolescence to adulthood, comorbid psychopathology such as symptoms of major depressive disorder (MDD), alcohol use disorder (AUD), and drug use disorders (DUDs) likely disrupt this normative decline. Using a longitudinal sample of female twins (N = 1,763), we examined if levels of BPD traits were correlated with changes in MDD, AUD, and DUD symptoms from ages 14 to 24. A parallel process biometric latent growth model examined the contributions of genetic and environmental factors to the relationships between developmental components of these phenotypes. Higher BPD trait levels predicted a greater rate of increase in AUD and DUD symptoms, and higher AUD and DUD symptoms predicted a slower rate of decline of BPD traits from ages 14 to 24. Common genetic influences accounted for the associations between BPD traits and each disorder, as well as the interrelationships of AUD and DUD symptoms. Both genetic and nonshared environmental influences accounted for the correlated levels between BPD traits and MDD symptoms, but solely environmental influences accounted for the correlated changes between the two over time. Results indicate that higher levels of BPD traits may contribute to an earlier onset and faster escalation of AUD and DUD symptoms, and substance use problems slow the normative decline in BPD traits. Overall, our data suggests that primarily genetic influences contribute to the comorbidity between BPD features and substance use disorder symptoms. We discuss our data in the context of two major theories of developmental psychopathology and comorbidity.

A Prospective 5-Year Re-examination of Alcohol Response in Heavy Drinkers Progressing in Alcohol Use Disorder

BackgroundThe main neurobiological theories of the development of addiction, including tolerance, sensitization, incentive-sensitization, and allostasis, have not been tested in longitudinal human alcohol response research. To address this issue, we conducted the first controlled prospective investigation of subjective and neuroendocrine responses to alcohol measured over a 5-year interval in at-risk young adult heavy drinkers (HD) and light drinker control subjects. MethodsParticipants were 156 individuals, 86 heavy drinkers and 70 light drinkers, undergoing an initial oral alcohol challenge testing (.8 g/kg alcohol vs. placebo) and an identical re-examination testing 5 to 6 years later. Alcohol use disorder (AUD) symptoms and drinking behaviors were assessed in the interim follow-up period. ResultsAt re-examination, HD continued to exhibit higher sensitivity on alcohol’s stimulating and rewarding effects with lower sensitivity to sedative effects and cortisol reactivity, relative to light drinkers. In HD with high AUD symptom trajectories over follow-up, heightened alcohol stimulation and reward persisted at re-examination. HD with low AUD symptoms showed reduced alcohol stimulation over time and lower reward throughout compared with the HD with high and intermediate AUD symptoms. ConclusionsResults support the early stage phase of the allostasis model, with persistently heightened reward sensitivity and stimulation in heavy drinkers exhibiting AUD progression in early mid-adulthood. While there are multiple pathways to development of a disorder as complex as AUD, maintenance of alcohol stimulatory and rewarding effects may play an important role in the continuation and progression of alcohol addiction.

High-Risk Drinking Among Female College Drinkers at Two Reporting Intervals: Comparing Spring Break to the 30 Days Prior

Alcohol use has increased among college women in the past decade, and although event-specific high-risk drinking is common among college students, few studies have focused on Spring Break-specific high-risk drinking and other risk behaviors among female college drinkers. As such, we compared substance use (e.g., alcohol and marijuana use) and engagement in other risk behaviors (e.g., riding with an impaired driver) in the 30 days prior (T1) and during Spring Break (T2) in a sample of 86 female college drinkers (mean age = 19.9, SD = 1.3, 18–23 years). Participants were recruited on a public beach during their Spring Break vacation and were administered a survey that included the TWEAK, a brief screener to identify alcohol use disorder (AUD) risk. Initial results indicated that heavy alcohol use, riding with an alcohol-impaired driver, and marijuana use were high during T1 and increased significantly during T2. The TWEAK results indicated that 78% of respondents were at high AUD risk, yet only 25% felt the need to reduce their alcohol consumption. OLS regression results indicated significant relationships between changes in engagement in risk behaviors at T2 as compared to T1 across a number of sample characteristics and TWEAK indicators (e.g., age at first drink; age at first sex). Implications for prevention programming targeting female college drinkers are discussed.