Problem Drinking Research Articles

Associations of childhood poly-adversity with alcohol problems among undergraduates: adolescent alcohol use trajectories and drinker self-schema

Objective Undergraduate drinking is associated with childhood adversity, early alcohol experience, and drinker self-schema. However, the pathway linking childhood adversity to undergraduate drinking problems remains undefined. This study aimed to identify the effects of childhood poly-adversity on the sequelae of adolescent alcohol-use trajectory, drinker self-schema, and alcohol problems among undergraduates. We also examined whether adolescent alcohol-use trajectory and drinker self-schema mediated the effects of childhood poly-adversity on undergraduate alcohol problems. Methods Baseline data from an ongoing prospective study, which included 851 first- and second-year full-time college students in Taiwan, were used. An anonymous online questionnaire was administered. Results The results showed that low poly-adversity and high poly-adversity were associated with the mean of initial alcohol use frequency during adolescence and further alcohol problems at college than those with no adversity. High poly-adversity was also associated with the increase in alcohol use frequency during adolescence. Both initial and increase in alcohol use frequency were associated with higher drinker self-schema scores and further alcohol problems. The indirect effects of high poly-adversity on undergraduate alcohol problems were mediated through adolescent alcohol-use trajectories and drinker self-schema. Conclusion Findings suggest that early identification of childhood poly-adversity and interventions to decrease adolescent drinking may prevent the formation of drinker self-schema and reduce undergraduate drinking problems.

Effects of the Phosphodiesterase 10A Inhibitor MR1916 on Alcohol Self-Administration and Striatal Gene Expression in Post-Chronic Intermittent Ethanol-Exposed Rats.

Alcohol use disorder (AUD) requires new neurobiological targets. Problematic drinking involves underactive indirect pathway medium spiny neurons (iMSNs) that subserve adaptive behavioral selection vs. overactive direct pathway MSNs (dMSNs) that promote drinking, with a shift from ventromedial to dorsolateral striatal (VMS, DLS) control of EtOH-related behavior. We hypothesized that inhibiting phosphodiesterase 10A (PDE10A), enriched in striatal MSNs, would reduce EtOH self-administration in rats with a history of chronic intermittent ethanol exposure. To test this, Wistar rats (n = 10/sex) with a history of chronic intermittent EtOH (CIE) vapor exposure received MR1916 (i.p., 0, 0.05, 0.1, 0.2, and 0.4 µmol/kg), a PDE10A inhibitor, before operant EtOH self-administration sessions. We determined whether MR1916 altered the expression of MSN markers (Pde10a, Drd1, Drd2, Penk, and Tac1) and immediate-early genes (IEG) (Fos, Fosb, ΔFosb, and Egr1) in EtOH-naïve (n = 5-6/grp) and post-CIE (n = 6-8/grp) rats. MR1916 reduced the EtOH self-administration of high-drinking, post-CIE males, but increased it at a low, but not higher, doses, in females and low-drinking males. MR1916 increased Egr1, Fos, and FosB in the DLS, modulated by sex and alcohol history. MR1916 elicited dMSN vs. iMSN markers differently in ethanol-naïve vs. post-CIE rats. High-drinking, post-CIE males showed higher DLS Drd1 and VMS IEG expression. Our results implicate a role and potential striatal bases of PDE10A inhibitors to influence post-dependent drinking.

Examination of factors related to problem drinking among the working population: The Japanese civil servants study

Problem drinking affects not only the health of a population but also the productivity of a nation, especially if it is rampant among the working population. This study examines the association between problem drinking and work characteristics, work-family status, and social situations among the Japanese working population. Multivariable logistic regression analysis was performed on the basis of gender on 3136 participants (men: 65.1%, women: 34.9%) adopted from the Japanese Civil Servants Study in 2014 (response rate: 87.8%), to examine the factors related to problem drinking, after adjusting for frequency and quantity of drinking. Problem drinking was assessed using the Cutdown, Annoyed, Guilty, and Eye-opener (CAGE) questionnaire. The presence of problem drinking was found in 24.3% of men and 10.3% of women. The analysis showed that in men, poor work performance (OR: 1.34, 95% CI: 1.00–1.79), high family-to-work conflict (OR: 1.54, 95% CI: 1.14–2.09), and high work-to-family conflict (OR: 1.63, 95% CI: 1.14–2.34) were significantly associated with problem drinking, whereas in women, high work-to-family conflict (OR: 2.45, 95% CI: 1.21–4.95) was significantly associated with problem drinking. Although the number of close friends is negatively associated with problem drinking in women, the significance disappeared in the fully adjusted model. It can be concluded that it is important for both men and women to strike a balance between work and family life. Moreover, owing to gender differences, work performance may be important for men, and the presence of close friends may be important for women, in reducing the risk of problem drinking.

Perceived Pressure for Perfection Within Friendships Triggers Conflict Behaviors, Depressive Symptoms, and Problematic Drinking: A Longitudinal Actor–Partner Interdependence Model

Friendships are important for the mental well-being of emerging adults. Socially prescribed perfectionism, where individuals feel pressured to be perfect by others, can be destructive, leading to conflict with others, depressive symptoms, and problematic drinking. However, its impact on friendships is not well-explored. This study examined 174 emerging adult friendship dyads using a 4-wave, 4-month dyadic design. Data were analyzed using longitudinal actor–partner interdependence models. Using a novel friend-specific measure of socially prescribed perfectionism, we found that an individual’s perceived expectation to be perfect from a friend was positively associated with increased conflict between friends, as well as with higher levels of depressive symptoms and problematic drinking in the individual. Findings lend credence to longstanding theoretical accounts and case histories suggesting socially prescribed perfectionism leads to harmful individual and relational outcomes and extends them to the specific context of friendships.

Stress and alcohol-related coping mechanisms linking lifetime suicide ideation and attempt to multidimensional quality of life

BackgroundSuicide ideation and attempt are linked to adverse mental health outcomes, but few studies have examined their associations with quality of life (QoL). This study examined the impact of lifetime history of suicidal ideation and attempt on four QoL domains via perceived stress and problematic drinking. MethodsParticipants were drawn from the National Institute on Alcohol Abuse and Alcoholism Natural History Protocol (N = 1055), including those with no history of suicidality (78.6 %), suicidal ideation only (15.3 %), and a history of suicide attempt (6.2 %). Structural equation modeling (SEM) was utilized to test perceived stress and drinking as mediational pathways to multidimensional QoL. ResultsIndividuals with a history of suicide ideation and/or attempt reported higher perceived stress in the past month, more problematic drinking in the past year, and lower QoL domains in the past two weeks. SEM showed significant mediation effects through dimensions of perceived stress (helplessness, lack of self-efficacy) and alcohol problems. When these mediators were considered simultaneously, the mediation effects through alcohol problems were attenuated, while several direct effects of suicidality on physical, psychological, and social QoL were weakened but remained significant. LimitationsCross-sectional data with retrospective report of suicidality history. ConclusionsA lifetime history of suicidality was associated with lower multidimensional QoL. These associations were partially explained by stress and alcohol-related coping mechanisms such as feeling helpless or inadequate when encountering stressors and problematic drinking. Perceived stress and drinking to cope may be important intervention targets to improve QoL among those with a history of suicidality.

A serial Mediation Model of Depression and Drinking Motives Underlying Problem Drinking Among Hispanic College Women Following Rape.

Problem drinking and depression are common following sexual assault. The current study applied a coping motives model of drinking and examined the association between rape experiences and problem drinking serially mediated by depression symptoms and coping-depression drinking motives among Hispanic college women. A total of 330 college women were classified into a single rape experience (SGL) group (n = 44), a multiple rape experiences (MLT) group (n = 70), and a no sexual assault experience group (n = 221). Participants completed self-report measures online. Serial mediation analyses with multi-categorical predictors found that significantly increased alcohol consumptions in rape survivors compared to individuals with no sexual assault experience were largely explained by the serially connected underlying mechanisms of depression symptoms and coping-depression drinking motives. The prevalence rates of rape experiences in this Hispanic female sample are alarming, suggesting Hispanic college women as a particularly vulnerable group for rape. The current results contribute to a greater understanding of the effects of rape experiences on behavioral and emotional outcomes among young Hispanic women who have been underrepresented in sexual victimization research. The findings emphasize the importance of assessing depression symptoms and coping-depression drinking motives in Hispanic rape survivors to reduce risks for hazardous drinking behavior.

Sex-specific negative affect-like behaviour and parabrachial nucleus activation induced by BNST stimulation in adult mice with adolescent alcohol history.

Adolescent alcohol use is a strong predictor for the subsequent development of alcohol use disorders later in life. Additionally, adolescence is a critical period for the onset of affective disorders, which can contribute to problematic drinking behaviours and relapse, particularly in females. Previous studies from our laboratory have shown that exposure to adolescent intermittent ethanol (AIE) vapour alters glutamatergic transmission in the bed nucleus of the stria terminalis (BNST) and, when combined with adult stress, elicits sex-specific changes in glutamatergic plasticity and negative affect-like behaviours in mice. Building on these findings, the current work investigated whether BNST stimulation could substitute for stress exposure to increase the latency to consume a palatable food in a novel context (hyponeophagia) and promote social avoidance in adult mice with AIE history. Given the dense connections between the BNST and the parabrachial nucleus (PBN), a region involved in mediating threat assessment and feeding behaviours, we hypothesized that increased negative affect-like behaviours would be associated with PBN activation. Our results revealed that the chemogenetic stimulation of the dorsolateral BNST induced hyponeophagia in females with AIE history, but not in female controls or males of either group. Social interaction remained unaffected in both sexes. Notably, this behavioural phenotype was associated with higher activation of calcitonin gene-related peptide and dynorphin cells in the PBN. These findings provide new insights into the neurobiological mechanisms underlying the development of negative affect in females and highlight the potential involvement of the BNST-PBN circuitry in regulating emotional responses to alcohol-related stimuli.

The Moderation Effect of Disability Status on the Associations Among ACEs, Mental Health, and Binge Drinking

ABSTRACT Purpose Mental health and substance use social workers must be prepared to work with people with disabilities, as this population has higher rates of adverse childhood experiences (ACEs), and ACEs can lead to mental health and substance use problems. The study’s purpose is to assess the moderating effect of disability on the interrelationships among ACEs, mental health, and binge drinking. Materials and Methods Using data from the 2021 Behavioral Risk Factor Surveillance System (BRFSS) survey, we first used multigroup confirmatory factor analysis to establish the underlying factor structure of the ACEs questionnaire for respondents with and without disabilities. Next, we used multigroup structural equation modeling to assess the mediating effect of mental health difficulties on the association between ACEs and binge drinking for respondents with and without disabilities. Results A three-factor measurement model (emotional or physical abuse, sexual abuse, and household dysfunction) demonstrated excellent model fits. Mental health difficulties significantly mediated the association between ACEs and binge drinking for all respondents. Disability status was a statistically significant moderator of a few associations, with more mental health variance explained by ACEs for the disabled respondents. Direct paths showed household dysfunction and sexual abuse had greater impacts on mental health for disabled respondents, and indirect paths showed these factors also had greater impacts on binge drinking among disabled respondents. Discussion and Conclusion To prevent mental health and binge drinking problems among disabled individuals, we need evidence-based interventions to identify their ACEs and provide accessible, trauma-informed treatments to them.

Food and Alcohol Disturbance in High School Adolescents: Prevalence, Characteristics and Association with Problem Drinking and Eating Disorders.

Food and alcohol disturbance (FAD) is characterized by the association of alcohol use with compensatory behaviors such as restricting calories, physical activity and purging. Despite not being part of the current nosography, research has grown in the past 10 years, mostly on college students' samples. In this study, we aim to describe the prevalence, characteristics and association of FAD with problem drinking (PD) and eating disorder risk (EDR) in a sample of Italian high school students. Participants were 900 high school students (53.6% males; mean age = 16.22) that were administered standardized questionnaires. Students who screened positive for PD, EDR and both were, respectively, 17.3%, 5.9% and 1.3%. Approximately one out four students reported FAD behaviors, mostly to control weight and by restricting calories, with higher prevalence and severity among those who screened positive for PD. Purging behaviors were rare overall (15.5%), but significantly more frequent in participants who screened positive for both PD and EDR (41.7%). FAD was more strongly associated with alcohol use severity than with ED symptom severity across all subgroups. FAD behaviors appear to be common in the Italian high school population and more strongly associated with PD. Future studies should investigate FAD's impact on adolescents' functioning and possible early interventions.

Evaluating distress as a moderator of the relationship between drinking identity and hazardous drinking during the post-college transition

Drinking identity (the extent to which one associates the self with drinking alcohol) is a robust predictor of young adult hazardous drinking (HD; heavy drinking and alcohol-related problems), and decreases in drinking identity have been linked to the decline in HD that often occurs following college graduation. Identifying moderators is key to recognizing who is most at risk for continued HD given a drinking identity vulnerability. Using data from a longitudinal study of graduating college students from the U.S., we evaluated distress (depression, anxiety, stress symptoms) as a potential moderator. Between- and within-person components of drinking identity and distress were evaluated to consider both individual differences and variations within a person across time and changing contexts. Study hypotheses and data analysis plan were preregistered. Graduating college students who met HD criteria (N = 422) completed implicit and explicit drinking identity measures (assessed using reaction time and self-report measures, respectively), distress symptom questionnaires, and self-reported alcohol consumption and problems at four-month intervals for 2.5 years. Results supported moderation at the between-person level for alcohol consumption, with higher levels of implicit drinking identity and distress linked to greater subsequent alcohol consumption. Only between-person main effects for (explicit) identity and distress were linked to more subsequent alcohol-related problems. Though moderation findings were mixed, having a stronger drinking identity and/or greater distress was linked to continued HD risk in this sample. Individuals with these risk factors may benefit from enhanced prevention efforts to help graduates transition out of HD post-college.

Assessing the acceptability of implementing a Screening, Brief Intervention and Referral to Treatment for alcohol use among transgender women in Bangkok, Thailand: A mixed-method pre-implementation study using the Consolidated Framework for Implementation Research.

Health inequities related to alcohol use exist for transgender individuals. While the Thailand Ministry of Public Health recently published a clinical guideline to implement a Screening, Brief Intervention and Referral to Treatment (SBIRT) in primary care, there has been no study regarding transgender women's (TGW) alcohol use and the acceptability of implementing SBIRT in a Thai context, a gap this study aimed to fill. A mixed-method approach was used. In the first phase, TGW service users and health-care providers (HCPs) completed a survey on the acceptability of prospective implementation of SBIRT. TGW service users completed the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C). In the second phase, TGW service users, HCPs, clinic administrators and national-level alcohol, HIV and transgender health policymakers participated in in-depth qualitative interviews. The Tangerine Clinic, a transgender-led sexual health clinic in Bangkok, Thailand. In the first phase, TGW service users (n = 100) and HCP (n = 8) were surveyed. In the second phase, 22 stakeholders (n = 10 TGW service users; n = 8 HCP; n = 1 clinic administrator; n = 3 policymakers) were interviewed. Simple proportions were calculated for each survey item. Differences in acceptability by various demographic factors were calculated using univariate analysis. The qualitative data were coded using thematic analysis and a deductive approach. The results were mapped to the Consolidated Framework for Implementation Research domains and constructs. The quantitative and qualitative results were triangulated to expand understanding. Fifty per cent of the TGW participants exhibited problematic drinking levels (AUDIT-C ≥ 4). Implementing SBIRT was highly acceptable, as more than 95% of participants reported agreeing or completely agreeing to receive SBIRT for alcohol use. Barriers, such as complexity, time constraint and lack of knowledge and skills, were anticipated. Adaptability, such as tailoring the content of brief intervention to suit TGW health needs and SBIRT to fit with existing clinic procedures, might facilitate successful implementation. Screening, Brief Intervention and Referral to Treatment (SBIRT) for alcohol use has the potential to be successfully implemented in transgender-led sexual health clinic settings, with some adaptations to overcome anticipated barriers.

A longitudinal study of the influence of work characteristics, work-family status, and social activities on problem drinking: the Japanese civil servants study.

Problem drinking causes a decline in labor productivity among working population. This study examined whether work characteristics, work-family status, and social activities are associated with future problem drinking behavior among Japanese civil servants. A total of 1,535 participants (men: 63.1%, women: 36.9%) with no problem drinking behavior were followed up from 2014 to 2019. A multivariable logistic regression analysis was performed to examine the factors associated with future problem drinking behavior. During the five-year follow-up period, the cumulative incidence of problem drinking was 9.6% and 5.8% in men and women, respectively. In both men and women, frequent drinking around three times a week or more and alcohol consumption of two units or more at baseline were associated with future problem drinking. In men, compared with low-grade employees, high-grade employees were less likely to become problem drinkers (OR: 0.56, 95% CI: 0.33-0.95). Shift workers were significantly associated with the incidence of problem drinking (OR: 2.96, 95% CI: 1.46-6.00). In women, poor own work performance was significantly associated with problem drinking (OR: 5.30, 95% CI: 1.57-17.86). In conclusion, disadvantaged work characteristics are associated with the development of problem drinking. To prevent problem drinking, attention should be paid to poor work characteristics.

Alcohol, HMGB1, and Innate Immune Signaling in the Brain.

Binge drinking (i.e., consuming enough alcohol to achieve a blood ethanol concentration of 80 mg/dL, approximately 4-5 drinks within 2 hours), particularly in early adolescence, can promote progressive increases in alcohol drinking and alcohol-related problems that develop into compulsive use in the chronic relapsing disease, alcohol use disorder (AUD). Over the past decade, neuroimmune signaling has been discovered to contribute to alcohol-induced changes in drinking, mood, and neurodegeneration. This review presents a mechanistic hypothesis supporting high mobility group box protein 1 (HMGB1) and Toll-like receptor (TLR) signaling as key elements of alcohol-induced neuroimmune signaling across glia and neurons, which shifts gene transcription and synapses, altering neuronal networks that contribute to the development of AUD. This hypothesis may help guide further research on prevention and treatment. The authors used the search terms "HMGB1 protein," "alcohol," and "brain" across PubMed, Scopus, and Embase to find articles published between 1991 and 2023. The database search found 54 references in PubMed, 47 in Scopus, and 105 in Embase. A total of about 100 articles were included. In the brain, immune signaling molecules play a role in normal development that differs from their functions in inflammation and the immune response, although cellular receptors and signaling are shared. In adults, pro-inflammatory signals have emerged as contributing to brain adaptation in stress, depression, AUD, and neurodegenerative diseases. HMGB1, a cytokine-like signaling protein released from activated cells, including neurons, is hypothesized to activate pro-inflammatory signals through TLRs that contribute to adaptations to binge and chronic heavy drinking. HMGB1 alone and in heteromers with other molecules activates TLRs and other immune receptors that spread signaling across neurons and glia. Both blood and brain levels of HMGB1 increase with ethanol exposure. In rats, an adolescent intermittent ethanol (AIE) binge drinking model persistently increases brain HMGB1 and its receptors; alters microglia, forebrain cholinergic neurons, and neuronal networks; and increases alcohol drinking and anxiety while disrupting cognition. Studies of human postmortem AUD brain have found elevated levels of HMGB1 and TLRs. These signals reduce cholinergic neurons, whereas microglia, the brain's immune cells, are activated by binge drinking. Microglia regulate synapses through complement proteins that can change networks affected by AIE that increase drinking, contributing to risks for AUD. Anti-inflammatory drugs, exercise, cholinesterase inhibitors, and histone deacetylase epigenetic inhibitors prevent and reverse the AIE-induced pathology. Further, HMGB1 antagonists and other anti-inflammatory treatments may provide new therapies for alcohol misuse and AUD. Collectively, these findings suggest that restoring the innate immune signaling balance is central to recovering from alcohol-related pathology.

Are behavioural risk factors clusters associated with self-reported health complaints? University students in Finland.

No previous research of university students in Finland assessed lifestyle behavioural risk factors (BRFs) and categorized students into clusters, explored the associations of the clusters with self-reported health complaints (HCs), whilst controlling for potential confounders. The current study undertook this task. Students at the University of Turku (1,177) completed an online well-being questionnaire that assessed socio-demographic variables, 5 BRFs - problematic alcohol consumption, smoking, illicit drug use, food consumption habits, moderate-to-vigorous physical activity (MVPA), and 22 HCs. A food frequency questionnaire assessed students' consumption of a range of foods, and a dietary guideline adherence score was computed based on WHO dietary recommendations for Europe. Three separate regression models appraised the associations between the cluster membership and HCs factors, adjusting for sex, income sufficiency and self-rated health. Mean age was 23 ± 5.2 years, 77% had never smoked and 79% never used illicit drug/s. Factor analysis of HCs resulted in four-factors (psychological, circulatory/breathing, gastro-intestinal, pains/aches); cluster analysis of BRFs identified two distinctive student clusters. Cluster 1 represented more healthy students who never smoked/used illicit drugs, had no problematic drinking, and undertook MVPA on 4.42 ± 3.36 days/week. As for cluster 2 students, half the cluster smoked occasionally/daily, used illicit drug/s, and > 50% had problematic drinking and students undertook MVPA on 4.02 ± 3.12 days/week. More cluster 2 students adhered to healthy eating recommendations, but the difference was not significant between clusters. Regression analysis revealed that females, those with sufficient income, and with excellent/very good self-rated general health were significantly less likely to report all four HCs. Cluster 2 students were significantly more likely to report psychological complaints, circulatory/breathing and gastro-intestinal complaints. There was no significant association between BRFs clusters and pains/aches factor. Risk taking students with less healthy lifestyles and behaviour were consistently associated with poorer psychological and somatic health.

DEVELOPMENTAL CHANGE IN PROBLEM DRINKING ACROSS THE LIFESPAN: BETWEEN- VERSUS WITHIN-PERSON AGE EFFECTS IN NATIONAL DATA

Abstract When considering problem drinking from a lifespan developmental perspective, an often-stated underlying premise is that problem drinking peaks around early young adulthood and then declines throughout the remainder of the lifespan. However, relative to adolescence and young adulthood, the supposed later declines in midlife and older adulthood are less firmly established and based primarily on cross-sectional data. Thus, this study contrasted cross-sectional versus longitudinal age effects on problem-drinking changes across the adult lifespan. Analyses used two waves of longitudinal data from a U.S.-representative sample. We generated descriptive “porcupine figures” graphically depicting both cross-sectional and longitudinal age effects simultaneously. In addition, we used multilevel models to partition, test, and contrast cross-sectional versus longitudinal age effects on problem drinking in different age periods of the adult lifespan. While age effects were consistent in young adulthood across the cross-sectional and longitudinal tests, key discrepancies were shown in midlife and older adulthood. Specifically, the supposed continuation of problem-drinking reductions throughout midlife and older adulthood was observed cross-sectionally but not longitudinally. These findings call into question the notion of normative drinking-related declines that continue beyond young adulthood and throughout the remainder of the adult lifespan. We will discuss plausible alternative explanation for how cross-sectional data can lead to spurious conclusion about developmental change (e.g., age-confounded cohort effects). If replicated in future research, our evidence for relative stability or even increases in problem drinking in midlife and older adulthood can contribute to a more lifespan-developmentally-informed understanding of risky behaviors and thereby guide lifespan-developmental tailoring of interventions.

Association between alcohol use and frailty among elder adults in three Chinese cities.

Frailty is often described as a condition of the elderly and alcohol use is associated with frailty. The aim of this study is to examine the associations between alcohol use and frailty in three cities in elder adults. A cross-sectional study was conducted in three cities in China from June 2017 to October 2018. In total, 2888 residents aged ≥65years old were selected by using a multi-level stage sampling procedure. Alcohol use was assessed by Focusing on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers (CAGE) four-item questionnaire. Frailty was measured by a validated Chinese version of the Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL) scale. Multinomial logistic regressions were used to examine the association of alcohol use with pre-frailty and frailty after controlling for varied covariates. In general, the prevalence of pre-frailty and frailty was 38.64 and 20.26%, respectively. After controlling for covariates and interaction of age and problematic drinking, non-problematic drinkers neither had association with pre-frailty (OR: 1.15, 95%CI:0.86-1.52) nor with frailty (OR:0.90, 95%CI:0.60-1.36), and problematic drinkers neither had association with frailty (OR: 1.21, 95%CI:0.83-1.76), while problematic drinkers had high odd ratios of frailty (OR:3.28, 95%CI:2.02-5.33) compared with zero-drinker. Our study found a positive association between problematic drinking and frailty, no relationship between non-problematic drinking and (pre-)frailty compared with zero-drinking among Chinese elder adults. Based on previous findings and ours, we conclude it is important for the prevention of frailty to advocate no problematic drinking among elder adults.

ACCULTURATION, ALCOHOL USE, AND SLEEP AMONG LATINX ADULTS AT RISK FOR ALZHEIMER’S DISEASE AND RELATED DEMENTIAS

Abstract Background Excessive alcohol use can negatively impact sleep. In the U.S., Latinx people are most likely to engage in problematic drinking when compared to other racial/ethnic groups. Acculturation in U.S. society has been suggested as a contributing factor to problematic drinking. Excessive alcohol use and poor sleep are known risk factors for developing Alzheimer’s disease and related dementias (ADRD). Little is known about the interaction between acculturation and alcohol use on sleep outcomes in Latinx adults, especially among those at risk of ADRD. The current study explored whether acculturation to the U.S. moderated the relationship between alcohol use and sleep. Methods A secondary analysis of a community-based sample of 113 Latinx adults, ages 40-60, was conducted. Participants had a parent diagnosed with ADRD. Measures included surveys gauging alcohol use (WHO ASSIST V.30), acculturation (Bicultural Involvement Questionnaire), subjective sleep (Pittsburgh Sleep Quality Index), and objective sleep measures using actigraphy (ActiGraph). A multiple regression analysis was performed to evaluate whether acculturation moderated the relationship between alcohol use and sleep outcomes Results The sample was predominantly female (92%), people born outside the US (74%), with approximately 83% of participants reported lifetime alcohol use. Americanism acculturation (b= 0.30, SE= 0.21, p=0.007) and biculturalism (-b= 0.30, SE= 0.13, p=0.003) significantly moderated the relationship between alcohol use and sleep duration. Implications: Expanded, targeted research and intervention focused on sociocultural factors impacting alcohol use for Latinx people at risk of ADRD must be further explored to identify and intervene in sleep disparities occurring among this population.

IDENTIFYING RESILIENT PERSONALITY THROUGH LATENT PROFILE ANALYSIS IN SEXUAL MINORITY MIDDLE-AGED AND OLDER ADULTS

Abstract Research has found evidence of resilience in sexual minority (i.e., lesbian, gay, bisexual) adults, despite experiencing higher rates of poorer health and facing additional stressors such as discrimination and victimization. Yet, very limited research has been conducted on resilience in this marginalized group. Utilizing data from the Midlife in the United States study, this study conducted latent profile analysis (LPA) using the Big Five personality traits (i.e., openness, conscientiousness, extraversion, agreeableness, neuroticism) to identify distinct personality profiles in a sample of sexual minority and propensity-score matched heterosexual middle-aged and older adults (n=477, mean age= 57.3, SD= 10.9 years, age range= 40-83 years). Additionally, the associations between the personality profiles and health-risk/promoting behaviors were assessed. Four profiles were identified: Average (35.2%), Resilient (47%), Overcontrolled (7.3%), and Undercontrolled (10.5%). The results found that Resilient sexual minority participants were significantly more likely to engage in problematic drinking but were also more likely to have a routine physical exam than Resilient heterosexual participants. Both sexual minority and heterosexual participants with a Resilient personality profile were more likely to engage in moderate physical activity than their counterparts with other personality profiles. These results suggest that sexual minority adults have the potential for resilience which is often overlooked in research. This is one of the first studies to use LPA to identify personality profiles in a sample with a focus on sexual minority participants. Most previous research using LPA to identify personality profiles did not include data on sexual orientation.

A LIFESPAN DEVELOPMENTAL ANALYSIS OF RECIPROCAL RELATIONS BETWEEN HEAVY DRINKING AND SLEEP PROBLEMS

Abstract In recent years, numerous studies have begun to explore the ways in which problem drinking behavior is affected by different lifespan developmental changes. However, while there currently exists a plethora of research on adolescence and young adulthood, there is far less research with midlife and older adults examining lifespan developmental changes and problem drinking. As part of larger NIAAA-funded project investigating aging, health, and alcohol use, the current study investigated cross-sectional and longitudinal associations among heavy drinking and sleep problems in a sample of midlife and older adults. One particularly noteworthy analysis used path analysis in Mplus to test a longitudinal moderated mediation model involving sleep problems, sleep-related motives for drinking, and heavy drinking. Results showed an interaction between sleep problems and sleep-related drinking motives. Interestingly, sleep problems appear to significantly reduce the risk for heavy drinking among most participants. However, when combined with high sleep-related drinking motives, sleep problems appear to significantly increase risk for heavy drinking. This phenomenon may help explain the occasionally contradictory results found in previous studies examining the impact of sleep disturbances on drinking behavior and may prove to be an area worth investigating in future studies. From a lifespan-developmental perspective, these findings highlight how there are likely important differences across stages of adulthood in the most relevant factors that affect heavy drinking. Health-related factors including sleep problems, coupled with motives to use alcohol to cope with such problems, appear to be a pathway to heavy drinking that increases in importance across the adult lifespan.

HEAVY DRINKING, MENTAL HEALTH PROBLEMS AND RECOVERY IN OLDER ADULTS: EXPLORING SUPPORT NEEDS

Abstract Many older adults who consume alcohol at harmful levels experience mental health problems. Common life events such as retirement, bereavement, and declining health, can contribute to anxiety and depression, with alcohol consumption being used as a coping mechanism. Tailored support is crucial to address the unique needs of older adults facing both alcohol misuse and mental health problems. These patients often fall into gaps between services (family practice/alcohol/mental health), which are unable to meet their complex support needs. This qualitative study aimed to understand the lived experiences of older adults with co-occurring heavy drinking and mental health problems, support received and unmet needs. We conducted semi-structured interviews with 14 older adults living in the North of England (completed Summer 2023). Thematic analysis and constant comparison were employed in data analysis. Findings highlighted the importance of age-tailored initiatives such as access to mental health support while actively drinking, supervised detoxification, increased peer support and services that are age inclusive and friendly. Risk factors such as grief, loneliness, financial problems and undiagnosed trauma in older adults contributed to development of these conditions. Older adults need services to work together, integrated around patient needs and addressing heavy drinking and mental health concerns at the same time. Future research should focus on improving mental health literacy and, developing holistic and preventive interventions to address risk factors for co-occurring alcohol and mental health problems in older adults.