Negative Alcohol Research Articles

Blood alcohol level and toxicologic test in drivers killed in road traffic accidents in the coal region of Santa Catarina State, Brazil

To investigate the epidemiological profile and the toxicological analysis among drivers fatally injured in road traffic accidents (RTAs). Methods: Retrospective observational study with 185 fatalities occurred in the coal region of Santa Catarina State during the period 2011-2017. Results: Mean age was 37,34 ± 15,08 years and male gender was the most frequent (92,4%). The most prevalent city was Criciúma (25,4%). The majority presented negative blood alcohol level (49,7%) and negative toxicologic test (61,6%). Among positive toxicologic tests (18,9%), the most frequent drugs were benzodiazepines and cocaine (both with 5,4%). Conclusion: It is important to emphasize the dangers of driving under the influence of alcohol and/or other substances. We also suggest the implementation of toxicologic tests in police blitz and the improvement in these exams to diminish undetermined results.

Maturing out of alcohol and cannabis co-use: A test of patterns and personality predictors.

Reductions in substance involvement into adulthood are thought to represent a normative maturing out of substance use. However, patterns and predictors of maturing out of alcohol and cannabis co-use remain largely unstudied. Therefore, the current study tested developmental trajectories of alcohol and cannabis use from late adolescence into adulthood and whether late adolescent personality traits predicted trajectory class membership. Data come from a longitudinal study of family history of alcohol disorder (N=458). Age bands were created to model trajectories of drinking quantity, negative alcohol consequences, and cannabis use frequency from late adolescence (age 18-22) to young adulthood (age 23-28) and adulthood (age 29-36). Participants reported on their sensation seeking, conscientiousness, and neuroticism during late adolescence and their typical drinking quantity, negative alcohol consequences, and cannabis use frequency at each age band. Three trajectory classes were derived from an initial Parallel Process Growth Mixture Model: (1) low-risk maturing out of alcohol-only use, (2) high-risk maturing out of co-use, and (3) high-risk switchers who increased their cannabis use into adulthood. Late adolescent sensation seeking was associated with higher odds of being in both co-use trajectories, whereas a lack of conscientiousness was associated with higher odds of being a co-use switcher. We identified heterogeneity in trajectories of co-use, which suggests that a lack of maturing out of alcohol involvement may be accompanied by increased cannabis use. Moreover, late adolescent personality traits may predispose individuals toward riskier developmental trajectories of substance use into adulthood.

Posttraumatic stress disorder strengthens the momentary associations between emotion dysregulation and substance use: a micro-longitudinal study of community women experiencing intimate partner violence.

A fast-growing body of literature linking emotion dysregulation to substance use has almost exclusively relied on cross-sectional designs and has generally failed to assess dysregulation stemming from positive emotions. The current study measured the momentary associations between both negative and positive emotion dysregulation and substance use, as well as the moderating role of post-traumatic stress disorder (PTSD). Micro-longitudinal momentary data were collected three times per day for 30 days using phone-based interactive voice recording. Northeastern United States. A total of 145 community women (M, age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances were recruited from 2018 until 2020. Momentary surveys assessed negative and positive emotion dysregulation and alcohol, drug, and cigarette use. PTSD diagnosis was derived from a structured diagnostic interview. Between-person relations that remained significant after covariate adjustment and correction for multiple testing were found for negative emotion dysregulation and both number of drinks (internal rate of return [IRR] = 1.45; 95% CI = 1.07, 1.93; β = 0.37) and drug use (OR = 3.78; 95% CI = 1.86, 7.69; β = 1.33), and positive emotion dysregulation and number of cigarettes (OR = 1.40; 95% CI = 1.07, 1.82; β = 0.34). Of six interactions tests, PTSD was only shown to moderate the within-person relation between positive emotion dysregulation and drug use, even after controlling for relevant covariates and adjusting for multiple testing (OR = 1.26; 95% CI = 1.04, 1.51; β = 0.23), such that women experiencing intimate partner violence with versus without PTSD were more likely to use drugs when experiencing periods of elevated positive emotion dysregulation. Women experiencing intimate partner violence with higher levels of negative dysregulation relative to others may use more alcohol and be more likely to use drugs. Women experiencing intimate partner violence with higher levels of positive dysregulation relative to others may use more cigarettes. Women experiencing intimate partner violence who also have posttraumatic stress disorder may be more likely to use drugs when experiencing momentary elevated levels of positive emotion dysregulation than those who do not also have posttraumatic stress disorder.

Peer sexual harassment, affect, and substance use: Daily level associations among adolescents.

Peer sexual harassment is associated with adolescent substance use at the global level; however, it is unknown whether substance use occurs proximal in time to the sexual harassment experience. This study used daily reports to examine the proximal relations between sexual harassment victimization and affect and substance use. Based on theories of self-medication, we hypothesized that negative affect and substance use (cigarettes, electronic cigarettes, alcohol, and marijuana) would be higher than typical on days when sexual harassment occurred relative to nonvictimization days. A community sample of 13-16-year-old adolescents (N = 204, 55.4% female) from a metropolitan area in the northeastern United States completed 56 days of online reports assessing experiences with peer sexual harassment, substance use (cigarettes, electronic cigarettes, alcohol, and marijuana), and positive and negative affect. Multilevel modeling revealed that experiencing sexual harassment on a given day was associated with higher than typical negative affect on that day, relative to nonvictimization days. The likelihood of cigarette and alcohol use (but not electronic cigarettes, marijuana, or positive affect) was greater on days when sexual harassment occurred. Sexual harassment victimization is proximally associated with negative affect and alcohol and cigarette use, suggesting that adolescents may be using substances to cope with sexual harassment victimization. The co-occurrence of sexual harassment with negative affect and substance use points to the need for prevention efforts that conjointly address sexual harassment victimization, coping, and substance use.

Relations between higher- and lower-order alcohol and cannabis expectancies and simultaneous use frequency among undergraduate dual users

Background Simultaneous alcohol and cannabis (i.e. marijuana; [SAM]) use is prevalent among college students. There is limited research on expectancy effects for SAM use, which are known correlates of use frequency and mediators of treatment outcomes. We examined the unique associations of both positive and negative alcohol and cannabis expectancies with frequency of SAM use among college students. Method Participants were 1012 college students (70.9% female, 51.8% white, M age = 19.63) from seven US universities who reported past-month alcohol and cannabis use (77.2% of the sample reported SAM use). Students completed measures of past-month typical weekly alcohol and cannabis frequency and quantity, alcohol and cannabis expectancies, and SAM frequency through an online self-reported survey. Results A negative binomial regression revealed that higher-order positive, but not negative, alcohol and cannabis expectancies were significant predictors of SAM frequency above and beyond frequency of alcohol and cannabis use, biological sex, and whether the survey was completed pre- or post-COVID-19 campus closures. Specifically, higher frequency SAM use was associated with weaker positive alcohol and stronger positive cannabis expectancies. A second negative binomial regression including lower-order expectancies found that SAM frequency was associated with weaker social and cognitive and behavioral impairment alcohol expectancies and stronger sexual and social facilitation cannabis and liquid courage alcohol expectancies, specifically. Conclusions Results highlight the importance of comprehensively examining both higher- and lower-order alcohol and cannabis expectancies when examining SAM frequency, and provide avenues of targeted intervention to reduce SAM use among dual users.

Impulsivity and Perpetration of Intimate Partner Aggression: The Moderating Effects of Negative Affective State and Alcohol

Background: The goal of this study was to test the interactive effects of negative urgency, state negative affect, and alcohol intoxication on intimate partner aggression (IPA) perpetration. Methods: Heavy drinkers who recently perpetrated IPA completed self-report measures of impulsivity, were administered an alcohol or control beverage, and completed a laboratory aggression task. State negative affect was assessed unobtrusively via the Facial Action Coding System. Results: Consistent with our prediction, negative urgency was significantly and positively related to IPA when state negative affect was also high, but this relation was not significant when state negative affect was low. Conclusions: These results have implications for understanding the role of negative affect and impulsivity in IPA perpetration and for understanding trait models of impulsivity in general.

Indirect and direct effects of simultaneous alcohol and cannabis use on alcohol hangovers

IntroductionSimultaneous use of alcohol and cannabis (i.e., using both on same occasion) is a risk factor for heavier drinking and negative alcohol consequences; however, little research has investigated risk conferred for specific negative consequences. One theoretically relevant negative consequence may be alcohol hangovers; however, no studies have tested cross-sectional or prospective relations between simultaneous use and experiencing alcohol hangovers. MethodThe current study (N = 2,964) used public-access data from the National Longitudinal Study on Adolescent to Adult Health (Add Health) to test whether simultaneous alcohol and cannabis use conferred risk for hangover frequency directly or indirectly through heavier drinking. The current study also tested moderated mediation by depressive symptoms, considering simultaneous users have higher levels of depressive symptoms, and depressive symptoms largely mirror those of a hangover. ResultsIn a cross-sectional model, simultaneous use was associated with more frequent hangovers both directly and indirectly through heavier drinking. In a prospective model, simultaneous use indirectly predicted more frequent hangovers through heavier drinking; however, the direct path was not significant. None of the paths from simultaneous use to drinking or hangovers were moderated by depressive symptoms in either model. ConclusionsThe current study suggests that, both concurrently and prospectively, heavier drinking explained significant variance in the relation between simultaneous use and hangover frequency. The significant direct effect of simultaneous use in the cross-sectional model suggests that simultaneous users may have individual characteristics, outside of depressive symptoms, that confer risk for more frequent hangovers above and beyond heavier drinking.

Comparing Alcohol Use of Pre-COVID-Era and COVID-Era Cohorts of Mandated College Student Drinkers

Studies report mixed findings on the effect of the COVID-19 pandemic on college student alcohol consumption. However, the impact of pandemic restrictions on students referred to an intervention following a campus alcohol violation has not yet been studied. The current study examined alcohol use behaviors and perceived drinking norms among mandated student cohorts enrolled in the pre-COVID-19 era (fall 2019) and COVID-19 era (fall 2020). Participants (N = 228) completed measures focused on alcohol use and associated behaviors. Analytic models controlled for participant age and entailed negative binomial regressions for count outcomes and analyses of covariance for normally distributed continuous outcomes. COVID-era cohort students reported fewer drinks, pregaming occasions (i.e., drinking before a social occasion such as a sports event), and drinks while pregaming. Frequency of heavy episodic drinking (HED) remained consistent between groups; however, the peak number of drinks during HED was significantly lower in the COVID-era group, as were Alcohol Use Disorders Identification Test scores and alcohol-related consequences. Perceived peer norms for frequency and quantity were significantly higher in the COVID-era group. Regression confirmed a significant impact of norms on both frequency and quantity of alcohol use in both cohorts. Mandated college students during the COVID-19 pandemic consumed less alcohol, engaged in less pregaming, consumed fewer drinks while pregaming, and reported fewer negative alcohol consequences than a cohort from the previous year. In this campus case study of residential students who violate campus alcohol policy, COVID restrictions were associated with reduced overall quantity and risky practices.

Modeling reciprocal relations between emotion dysregulation and alcohol use using dynamic structural equation modeling: Amicro-longitudinal study.

Research examining emotion dysregulation and alcohol use has increased exponentially over the past decade. However, these studies have been limited by their use of cross-sectional designs and narrow definitions of emotion dysregulation. To address these significant gaps in the extant literature, this study utilized state-of-the-art methodology (i.e., experience sampling) and statistics (i.e., dynamic structural equation modeling) to examine potential reciprocal associations between negative and positive emotion dysregulation and alcohol use at the momentary level. Participants were 145 community women (mean age=40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances. Surveys assessing negative and positive emotion dysregulation and alcohol use (i.e., number of standard drinks) were administered three times a day for 30 days using phone-based interactive voice recording. Significant contemporaneous effects indicated that negative and positive emotion dysregulation both co-occurred with alcohol use. However, levels of negative and positive emotion dysregulation did not predict later alcohol use, nor did alcohol use predict later levels of negative or positive emotion dysregulation. There was significant variability among participants in cross-lagged effects. Findings showed that negative and positive emotion dysregulation co-occurred with alcohol use and that there was significant interindividual variability in the cross-lagged associations between negative and positive emotion dysregulation and alcohol use. Research using idiographic approaches may identify women experiencing IPV for whom negative and positive emotion dysregulation drive alcohol use and alcohol use drives negative and positive emotion dysregulation.

Alcohol Portrayals on Social Media (Social Media)

Alcohol Portrayals on Social Media (Social Media)

Mechanistic Studies Yield Improved Protocols for Base-Catalyzed Anti-Markovnikov Alcohol Addition Reactions.

The catalytic anti-Markovnikov addition of alcohols to simple alkenes is a longstanding synthetic challenge. We recently disclosed the use of organic superbase catalysis for the nucleophilic addition of alcohols to activated styrene derivatives. This article describes mechanistic studies on this reversible reaction, including thermodynamic and kinetic profiling as well as computational modeling. Our findings show the negative entropy of addition is counterbalanced by an enthalpy that is most favored in nonpolar solvents. However, a large negative alcohol rate order under these conditions indicates excess alcohol sequesters the active alkoxide ion pairs, slowing the reaction rate. These observations led to an unexpected solution to a thermodynamically challenging reaction: use of less alcohol enables faster addition, which in turn allows for lower reaction temperatures to counteract Le Chatelier's principle. Thus, our original method has been improved with new protocols that do not require excess alcohol stoichiometry, enable an expanded alkene substrate scope, and allow for the use of more practical catalyst systems. The generality of this insight for other challenging hydroetherification reactions is also demonstrated through new alkenol cyclization and oxa-Michael addition reactions.

Exposure to Media Messages Portraying Effects of Alcohol Use in a Young Adult Sample

Background: Young adults are prolific media users and tend to use substances, such as alcohol, more than people of other ages. Despite much research on young adults’ exposure to alcohol advertisements and portrayals of alcohol use in the media, much is still unknown about the nuances of young adults’ exposure to and engagement with alcohol-related media content. The present paper examined how college students’ media exposure differed for messages portraying positive and negative alcohol effects, how exposure to alcohol-related content differed across media sources, which themes of alcoholrelated content were seen most, and whether exposure to alcohol-related content was associated with hazardous/harmful drinking. Method: Participants (N=500) were two- and four-year college students (Mage=20.90, SDage=1.70, 63.2% female) recruited for a longitudinal study examining the efficacy of a mobile app intervention for high-risk drinking college students. The data used here comes from the baseline survey. Results: Participants reported the greatest exposure to alcohol-related messages in movies/TV/on-demand streaming shows followed by in social media, and they reported greater exposure to messages portraying positive than negative effects of alcohol. Findings from linear regressions indicated that exposure to messages portraying positive or negative effects of alcohol generally did not predict hazardous/harmful drinking. Conclusion: This sample of high-risk college student drinkers reported seeing alcohol-related content through a variety of media sources, with most content portraying alcohol in a positive light. Future research should assess the effects that messages of different types and from different sources have on use, expectancies, norms, and other outcomes.

Exposure to Alcohol Marketing and Alcohol-Related Consequences in Young Adults

Background: Exposure to alcohol marketing is positively associated with alcohol consumption. However, few research studies have tested alcohol marketing’s effect on other alcohol-related outcomes. Consequently, the current study sought to identify associations between exposure to alcohol marketing and alcohol-related consequences in young adults. Methods: A secondary analysis of the 2020 Rhode Island Young Adult Survey was conducted. Participants were lifetime drinkers (n = 390) who were 18 to 25 years old and lived in Rhode Island for at least part of 2020. Past 30 day exposure to 6 forms of alcohol marketing was assessed. Alcohol consequences were measured using 8 items from the Brief Young Adult Alcohol Consequences Questionnaire. Logistic regression models were adjusted for AUDIT score, age, race/ethnicity, gender, sexual orientation, employment status, and enrollment in school. Results: 92.3% of participants reported past 30 days exposure to any form of alcohol marketing. 43.6% of participants reported experiencing any alcohol-related consequence. Exposure to any form of alcohol marketing was positively associated with experiencing alcohol-related consequences (OR[95% CI] = 3.35 [1.19, 9.44]). After disaggregation by marketing type, only television exposure remained significantly associated with alcohol-related consequences (OR[95% CI] = 1.85 [1.06, 3.24]). Conclusions: Exposure to alcohol advertising on television may be positively associated with experiencing negative alcohol consequences in young adults. If confirmed, the findings may renew interest in strengthening alcohol marketing guidelines and regulations.

A qualitative analysis of transgender and gender nonconforming college students' experiences of gender-based discrimination and intersections with alcohol use.

Transgender and gender-nonconforming (TGNC) emerging adults (EAs) are a vulnerable population at risk for negative mental health and alcohol use outcomes often attributed to unique experiences of discrimination and transphobia, including in colleges/universities through institutionalized transphobia. There are no extant psychosocial interventions that focus on the experiences of EA TGNC undergraduate students. The current study utilized a Community-Based Participatory Research framework and exploratory qualitative approach to better understand the unique experiences of this population (N = 16). Data are presented from an inductive thematic analysis of focus groups and interview transcripts that highlight TGNC experiences of gender-based stressors and substance use and provide feedback on a brief psychosocial intervention to prevent high-risk alcohol use among TGNC. Main themes were TGNC-specific experiences (e.g., pronoun misuse, invalidating interactions with faculty and staff), coping with gender-based discrimination and stressors (e.g., use of alcohol and other drugs), and resources and programs (e.g., lack of TGNC representation in leadership roles). Notable subthemes included the impact of intersecting gender, race, and class divisions, medical and mental health-care concerns, and qualities of interventions perceived as effective versus ineffective. This is one of the first studies to gather information related to the desires of EA TGNC undergraduate students on addressing high-risk alcohol use. Data provide considerations for developing psychosocial interventions to address negative mental health outcomes and risks associated with alcohol and other drug use among EA TGNC undergraduate students, such as creating safe interventions and utilizing a strengths-based approach to teaching coping skills. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Depressive Symptoms and Drinking to Cope in Relation to Alcohol Use Outcomes among White and Black/African American College Students

Objective Prior research shows that Black/African American adults experience more negative alcohol use consequences than White adults, despite lower alcohol consumption. Research also shows that Black/African Americans experience higher rates of depression, which can increase risk for alcohol consumption and alcohol use disorder (AUD) through drinking to cope. We examined associations between depressive symptoms and drinking to cope with alcohol consumption and AUD symptoms among White and Black/African American college students. Methods Participants completed an online survey during the fall and spring semester of their first year of college (N = 2,168, 62.8% female, 75.8% White). Path analyses were conducted to examine whether depressive symptoms and drinking to cope mediated the association between race/ethnicity and alcohol use outcomes, and whether race/ethnicity moderated the associations between depressive symptoms, drinking to cope, and alcohol use outcomes. Results Results indicated that Black/African Americans had lower levels of depressive symptoms, which were associated with lower drinking to cope, and in turn associated with lower alcohol consumption and AUD symptoms. Multigroup analysis indicated that the pattern of associations between depressive symptoms, drinking to cope, and alcohol use outcomes were largely similar between White and Black/African American college students and between males and females, except that the association between depressive symptoms and drinking to cope appeared to be stronger for Whites than for Black/African American students. Conclusion Depressive symptoms and drinking to cope are risk factors in relation to alcohol use outcomes among White and Black/African American college students and partially account for the link between race/ethnicity and alcohol use outcomes. Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2022.2034871 .

Bi+ adults' daily wellbeing: The roles of relationship status and partner gender.

This study examined whether relationship involvement and partner gender were associated with between-person differences and within-person fluctuation in positive and negative affect and alcohol use among people who are attracted to more than one gender or regardless of gender (e.g., bisexual, pansexual, queer; bi+). 198 bi+ individuals (M age 26.97; 73.1% non-Latinx White) completed a 28-day diary study. Multilevel regression analyses modeled between-person differences in daily affect and alcohol use as a function of relationship status and partner gender. ANCOVAs were conducted to examine differences in within-person fluctuation. Results partially support past findings that relationship involvement may not confer benefits for bi+ people, and that mixed-gender partnerships could be particularly challenging. Future research directions are discussed.

Alcohol is not associated with increased mortality in adolescent traumatic brain injury patients

PurposeCompared to adults, there is a paucity of data regarding the association of a positive alcohol screen (PAS) and outcomes in adolescent patients with traumatic brain injury (TBI). We hypothesize adolescent TBI patients with a PAS on admission to have increased mortality compared to patients with a negative alcohol screen.MethodsThe 2017 Trauma Quality Improvement Program database was queried for patients aged 13–17 years presenting with a TBI and serum alcohol screen. Patients with missing information regarding midline shift on imaging and Glasgow Coma Scale (GCS) score were excluded. A multivariable logistic regression analysis for mortality was performed.ResultsFrom 2553 adolescent TBI patients with an alcohol screen, 220 (8.6%) had a PAS. Median injury severity scores and rates of penetrating trauma (all p > 0.05) were similar between alcohol positive and negative patients. Patients with a PAS had a similar mortality rate (13.2% vs. 12.1%, p = 0.64) compared to patients with a negative screen. Multivariate logistic regression controlling for risk factors associated with mortality revealed a PAS to confer a similar risk of mortality compared to alcohol negative patients (p = 0.40).ConclusionAdolescent TBI patients with a PAS had similar associated risk of mortality compared to patients with a negative alcohol screen.

Alexithymia disrupts emotion regulation processes and is associated with greater negative affect and alcohol problems

Alexithymia is common among people who abuse alcohol, yet the mechanisms by which alexithymia exerts its influence remain unclear. This analysis tested a model whereby the three subscales of the Toronto Alexithymia Scale exert an indirect effect on alcohol problems through difficulties with emotion regulation and psychological distress. Men and women (n = 141) seeking alcohol use disorder (AUD) treatment completed the Toronto Alexithymia Scale, the Difficulties with Emotion Regulation Scale, the Brief Symptom Inventory, the Short Inventory of Problems, and the Alcohol Dependence Scale. The Difficulty Identifying Feelings subscale of the Toronto Alexithymia Scale was positively associated with alcohol problems through emotion dysregulation and psychological distress. The other two subscales, Difficulty Describing Feelings and Externally oriented Thinking, were not associated with any other variables. People with alexithymia may consume alcohol to help regulate undifferentiated states of emotional arousal. Given the prevalence of alexithymia among people who abuse alcohol, treatment supplements that enhance the identification of emotions are needed.

Hierarchical and mediated relations between internalizing symptoms, alcohol and cannabis co-use, and AUD

Background Alcohol and cannabis co-use is associated with negative alcohol consequences and alcohol use disorder. However, mediating and distal effects remain largely unstudied. Co-use is associated with alcohol use disorder/negative consequences even when accounting for drinking levels and personality, suggesting that other person-level characteristics may explain relations between co-use and negative outcomes. Method The current study tested whether internalizing symptoms, strong correlates of co-use and alcohol use disorder, explained the effect of co-use on alcohol use disorder. Data from adults (N = 353,000) in the 2008–2019 National Study on Drug Use and Health (NSDUH) were used. Analyses tested whether (1) substance use profiles reduced/dissipated the effect of co-use on alcohol use disorder, (2) internalizing symptoms (anxiety, depression) reduced/dissipated the effect of co-use on alcohol use disorder, and (3) internalizing symptoms were indirectly associated with alcohol use disorder via co-use. Results When accounting for frequency/quantity of use, co-use was still associated with higher odds of alcohol use disorder. Anxiety and depression were related to higher odds of an alcohol use disorder, however, the effect of co-use on higher odds of alcohol use disorder remained. Anxiety and depression scores were indirectly associated with higher odds of alcohol use disorder via co-use. Conclusions Depressive and anxiety symptoms only accounted for a portion of the variance of co-use on alcohol use disorder, and there were indirect effects of internalizing symptoms through co-use. Future longitudinal research is needed to elucidate other person-level characteristics that drive associations between co-use and alcohol use disorder to target via interventions.

Using Ecological Momentary Assessments and Fitbit Data to Examine Daily Associations Between Physical Activity, Affect and Alcohol Cravings in Patients with Alcohol Use Disorder.

Preliminary studies show that structured physical activity (PA) interventions can reduce negative affect and alcohol use in patients recovering from alcohol use disorder (AUD). The current study tested whether the association between PA, affect, and alcohol cravings can be observed in patients' natural environments (i.e., without a structured intervention) as well. Twenty-five participants with AUD completed 3weeks of ecological momentary assessment (EMA) monitoring and wore Fitbit devices to measure physical activity directly after discharge from partial hospitalization treatment for AUD. PA was operationalized as total steps and consecutive 10-min bouts of moderate-intensity exercise (100 steps/minute). Only 56% of participants engaged in any bouts of moderate-intensity physical activity throughout the 3-week study period (mode = 1 bout), and participants logged an average of 8183 steps/day (SD = 5560). Daily steps were associated with a higher positive affect and lower alcohol cravings, and with higher positive affect the next day, but the effects were very small. No relationships were observed between PA and affect or alcohol cravings at the hourly level except a random effect signifying that bouts of PA were either positively associated or not associated with negative affect in the next hour for different participants. Overall, results suggest that naturalistic PA may be beneficial for a small subset of patients in recovery from AUD, but the majority did not engage in regular exercise or experience improvements in affect and cravings as a result of PA.