Self-reported Alcohol Use Research Articles

Pathways From Parental Substance Use to Child Internalizing and Externalizing Behaviors in a Child Protective Services Sample

This study examines the role of mediation in the pathway from parental substance use to children developing child internalizing and externalizing behaviors. Using the National Survey of Child and Adolescent Well-Being II, a random half sample (i.e., split-half approach) of children aged 18 months to 17 years who remained in the home following a child welfare investigation (N = 1,633) was used to examine direct and mediated pathways from parental self-reported alcohol and drug use to, separately, parent report of child internalizing and externalizing behaviors. Four parallel mediators were examined: child-reported exposure to violence, child-reported parental monitoring, parent-reported harsh physical discipline, and parent-reported emotional maltreatment. The strongest models for both parental alcohol and drug use to internalizing and externalizing behaviors were single-mediator models through emotional maltreatment. Results suggest emotional maltreatment is a crucial intervention target for families with substance use disorders. Parenting interventions must also strengthen parent-child relationships in order to be effective at improving child outcomes.

A Brief Clinic-Based Intervention to Reduce Alcohol Misuse and Sexual Risk Behavior in Young Women: Results from an Exploratory Clinical Trial.

This exploratory trial determined the feasibility, acceptability, and preliminary efficacy of a brief intervention (BI), supplemented with text messaging and a curated Web site, on alcohol use and sexual risk behavior among young women. Young women seeking care at a reproductive health clinic were screened for alcohol misuse and sexual risk behavior. Those who screened positive and who agreed to participate (N = 48; M = 22.67years) were randomized to either (a) a brief in-person session during which personalized feedback regarding alcohol use and sexual risk taking was provided and discussed, or (b) a control condition. Feasibility was assessed by recruitment and retention rates. Acceptability was assessed with participant ratings of their intervention. Efficacy was measured using self-reported alcohol use and sexual behavior at baseline and during a 3-month follow-up. We supplemented the quantitative data with qualitative data from semi-structured interviews. Feasibility data indicated that 64% of eligible women agreed to participate, 74% of eligible women were enrolled, and 86% of enrolled women were retained through follow-up. Acceptability data showed that women who received the BI reported strong satisfaction with their intervention (M = 4.65 vs. 3.98 on a five-point scale) and also reported that text messaging was helpful (M = 4.73 on a seven-point scale) and acceptable (M = 5.27 on a seven-point scale). Qualitative data provided additional support for BI feasibility and acceptability. Efficacy data showed that women in both conditions reduced alcohol use and sexual risk behavior over time; women who received the BI reduced their maximum daily alcohol intake more than controls (BI from 7.68 to 4.82 standard drinks vs. control from 6.48 to 5.65; Wald χ2 = 4.93, p < .05). Women in the BI reported fewer occasions of condomless sex (median = 2.50) than controls (median = 5.00) at the follow-up, but this difference was not statistically significant (OR = 0.61, 95% CI [0.32, 1.15]). A brief intervention, supplemented with text messaging and a Web site, that targeted alcohol use and sexual behavior was feasible and acceptable to young women and led to lower levels of alcohol misuse and sexual risk behavior.

Multiple Tools Are Needed for the Detection of Prenatal Alcohol Exposure: Findings From a Community Antenatal Setting.

Although the toxic effects of prenatal alcohol exposure (PAE) on children are well established, there is emerging evidence about the dynamics and associated demographics of drinking patterns across pregnancy, with risky drinking more likely to take place in the period before pregnancy awareness. This study investigated the use of complementary measurement tools in the understanding of alcohol use across pregnancy and reports on the rates and patterns of alcohol use in a community antenatal setting. Data on alcohol consumption before and after awareness of pregnancy were collected via multiple measurement tools: anonymous lifestyle questionnaire, TWEAK (Tolerance, Worried, Eye-opener, Amnesia, K/Cut down) screener questionnaire, and Substance Use Inventory interviews across multiple pregnancy timepoints. Additionally, phosphatidylethanol (PEth), a direct biomarker of alcohol metabolism, collected from newborns' dried blood spot cards, was analyzed. The TWEAK screener was more likely to identify risky drinking behavior than the lifestyle questionnaire. When pregnancy was unplanned, women were more likely to find out they are pregnant significantly later (p<0.001) and consume alcohol at moderate-heavy levels (p=0.03), prolonging the risk to the fetus. There was an association between maternal self-reported alcohol use on the lifestyle questionnaire and Substance Use Inventory interviews, but no association between maternal reports of alcohol use and PEth results (p=0.72). Women self-reported moderate-heavy alcohol use in early pregnancy only and a positive PEth screen indicated PAE in late pregnancy, suggesting that these methods may identify different groups of women. Multiple measurement tools and methods are needed to identify PAE at different points across pregnancy. Prospective sensitive interviewing is better suited to detecting PAE in early pregnancy, but not later when social desirability bias is stronger, and the use of an objective biomarker, such a PEth, may be useful for identifying the risk of PAE in late pregnancy.

Does a mindfulness-augmented version of the German Strengthening Families Program reduce substance use in adolescents? Study protocol for a randomized controlled trial

BackgroundMindfulness training (MT) for parents of adolescents has been shown to improve mental health and stress-related outcomes in individuals and their families. Studies of MT among young people are mainly delivered in educational or clinical settings, and there is a need for controlled studies on both parent-directed and adolescent-directed approaches. It is unclear whether MT has preventive effects for substance use outcomes. The primary objective of this trial is to evaluate the effectiveness of family-based MT targeting both adolescents and their parents to prevent adolescent substance use and enhance neurobehavioral self-regulation skills that play a major role in addiction development and mental health.Methods/designThe trial design is a superiority, two-arm, randomized controlled trial in which families will participate either in the full curriculum of the evidence-based Strengthening Families Program 10–14 (SFP 10–14, German adaptation) or in a mindfulness-enhanced version of this program (SFP-Mind). Both seven-session interventions are highly structured and will each be delivered over a period of approximately 7 weeks. The experimental intervention SFP-Mind is a modified version of the SFP 10–14 in which some elements were eliminated or changed to enable the inclusion of additional parent-directed and adolescent-directed mindfulness components. The primary outcome is adolescent self-reported alcohol use based on an alcohol initiation index at 18-month follow-up. Dispositional mindfulness, impulsivity, and emotion regulation will be included as secondary outcomes and potential mechanisms of action. The study will recruit and randomize 216 adolescents, aged 10–14 years, and their parents who will be followed up for 18 months.DiscussionThis trial aims to evaluate the effectiveness of SFP-Mind for family-based prevention of substance use and promoting mental health in adolescence.Trial registrationGerman Register of Clinical Studies, DRKS00015678. Registered on 25 February 2019.

Longitudinal Associations Between Perceptions of Peer Group Drinking Norms and Students' Alcohol Use Frequency Within College Sport Teams.

Students' alcohol use behaviors are shaped by the attitudes and behaviors of others, especially the peers within students' proximal social groups. Explaining the association between perceived drinking norms and alcohol use, researchers propose contradicting pathways that focus on conformity (i.e., social norms predict alcohol use) and projection (i.e., alcohol use predicts perceived norms). The current study examined the extent to which conformity and projection processes were evident in the association between college student alcohol use and the perceived alcohol use norms for students' club sport teams. The sample comprised 1,054 college students (61% female) nested in 35 intact same-sex club sport teams. On 3 separate occasions during a single school year (3-month lag), participants reported drinking frequency and perceptions of descriptive and injunctive group drinking norms. We employed random intercepts cross-lagged panel modeling to estimate prospective within-person associations separately from stable trait-like between-person associations. Descriptive and injunctive group drinking norms were both positively related to students' alcohol use frequency at the between-person level. Individuals nevertheless demonstrated variability at the within-person level. Results revealed a strong contemporaneous association between descriptive norms and alcohol use frequency within each timepoint, but no prospective associations. Models including perceptions of injunctive drinking norms demonstrated similar contemporaneous associations with alcohol use frequency, but also identified significant prospective associations signifying conformity. Findings align with previous research reporting a strong and positive association between student's self-reported alcohol use and subjective peer alcohol use norms. After disentangling within- and between-person effects to probe for conformity and projection processes, the current findings are somewhat contrary to previous research that has reported reciprocal relationships between social norms and alcohol use behavior. Further investigation of the potential conformity and projection mechanisms of social norms is critical to advance norm-based strategies to reduce harm.

Food Insecurity May Be an Independent Risk Factor Associated with Nonalcoholic Fatty Liver Disease among Low-Income Adults in the United States

Nonalcoholic fatty liver disease (NAFLD), considered a "barometer" of metabolic health, is the leading cause of liver disease in the United States. Despite established associations between food insecurity and obesity, hypertension, and diabetes, little is known about the relation between food insecurity and NAFLD. We sought to evaluate the association of food insecurity with NAFLD among low-income adults in the United States. We conducted a cross-sectional analysis of a nationally representative sample of adults from the NHANES (2005-2014 waves). Participants included adults in low-income households (≤200% of the federal poverty level) without chronic viral hepatitis or self-reported heavy alcohol use. Food insecurity was measured using the Household Food Security Survey. Our primary outcome was NAFLD, as estimated by the US Fatty Liver Index, and our secondary outcome was advanced fibrosis, as estimated by the NAFLD fibrosis score. The association between food insecurity (defined as low and very low food security) and hepatic outcomes was assessed using multivariable logistic regression, adjusting for sociodemographic factors. Among 2627 adults included in the analysis, 29% (95% CI: 26%, 32%) were food insecure. The median age was 43 y, 58% were female, and 54% were white. The weighted estimated prevalence of NAFLD did not differ significantly by food security status (food secure 31% compared with food insecure 34%, P=0.21). In the multivariable model, food-insecure adults were more likely to have NAFLD (adjusted OR: 1.38; 95% CI: 1.08, 1.77) and advanced fibrosis (adjusted OR: 2.20; 95% CI: 1.27, 3.82) compared with food-secure adults. Food insecurity may be independently associated with NAFLD and advanced fibrosis among low-income adults in the United States. Future strategies should assess whether improved food access, quality, and healthy eating habits will decrease the growing burden of NAFLD-associated morbidity and mortality among at-risk adults.

Emergency personnel neuroticism, health and lifestyle: A UK Biobank study.

BackgroundEmergency personnel face unpredictable and challenging incidents and their resilience and ability to cope influences their well-being. Personality traits, such as neuroticism, are postulated to be robust predictors of health and health behaviours. Despite evidence in the general population that neuroticism can positively impact health and health behaviours; to date neuroticism in emergency personnel has primarily been associated with adverse health outcomes.AimsTo assess whether neuroticism has a negative or positive impact on subjective and objective health and health behaviours in emergency personnel.MethodsThis study used cross-sectional UK Biobank baseline data of emergency personnel (police, firemen and paramedics). Logistic regression models examined the strength of the associations of neuroticism tertiles with subjective (self-reported overall health and chronic conditions) and objective health (abdominal obesity) and self-reported smoking, sleeping, alcohol use and exercise levels.ResultsHigh neuroticism was positively associated with poorer subjective health outcomes in all emergency personnel (n = 2483). The association between neuroticism and chronic disease/s was significant for police in the second (odds ratio [OR] = 1.93, 95% confidence interval [CI] = 1.15–1.94) and third (OR = 1.62, 95% CI = 1.21–2.16) neuroticism tertiles. Neuroticism in firemen was associated with reduced abdominal obesity (OR = 0.49, 95% CI = 0.25–0.96) and increased exercise (OR = 2.14, 95% CI = 1.07–4.25).ConclusionsWe observed positive and negative associations between neuroticism and health outcomes and behaviours. While differences were observed across the emergency personnel groups, more research is needed to better understand how personality traits may impact health in workers with physically and mentally intense jobs.

Is the Peer Presence Effect on Heightened Adolescent Risky Decision-Making only Present in Males?

Social neurodevelopmental imbalance models posit that peer presence causes heightened adolescent risk-taking particularly during early adolescence. Evolutionary theory suggests that these effects would be most pronounced in males. However, the small but growing number of experimental studies on peer presence effects in adolescent risky decision-making showed mixed findings, and the vast majority of such studies did not test for the above-described gender and adolescent phase moderation effects. Moreover, most of those studies did not assess the criterion validity of the employed risky decision-making tasks. The current study was designed to investigate the abovementioned hypotheses among a sample of 327 ethnically-diverse Dutch early and mid-adolescents (49.80% female; Mage = 13.61). No main effect of peer presence on the employed risky-decision making task (i.e., the stoplight game) was found. However, the results showed a gender by peer presence moderation effect. Namely, whereas boys and girls engaged in equal levels of risks when they completed the stoplight game alone, boys engaged in more risk-taking than girls when they completed this task together with two same-sex peers. In contrast, adolescent phase did not moderate peer presence effects on risk-taking. Finally, the results showed that performance on the stoplight game predicted self-reported real-world risky traffic behavior, alcohol use and delinquency. Taken together, using a validated task, the present findings demonstrate that individual differences (i.e., gender) can determine whether the social environment (i.e., peer presence) affect risk-taking in early- and mid-adolescents. The finding that performance on a laboratory risky decision-making task can perhaps help identify adolescents that are vulnerable to diverse types of heightened risk behaviors is an important finding for science as well as prevention and intervention efforts.

Identifying an accurate self-reported screening tool for alcohol use disorder: evidence from a Swiss, male population-based assessment.

Short screenings for alcohol use disorder (AUD) are crucial for public health purposes, but current self-reported measures have several pitfalls and may be unreliable. The main aim of our study was to provide empirical evidence on the psychometric performance of self-reports currently used. Our research questions were: compared with a gold standard clinical interview, how accurate are (1) self-reported AUD, (2) self-reported alcohol use over time and (3) biomarkers of alcohol use among Swiss men? Finally, we aimed to identify an alternative screening tool. A single-center study with a cross-sectional design and a stratified sample selection. Lausanne University Hospital (Switzerland) from October 2017 to June 2018. We selected participants from the French-speaking participants of the ongoing Cohort Study on Substance Use and Risk Factors (n=233). The sample included young men aged on average 27.0years. We used the Diagnostic Interview for Genetic Studies as the gold standard for DSM-5 AUD. The self-reported measures included 11 criteria for AUD, nine alcohol-related consequences, and previous 12months' alcohol use. We also assessed biomarkers of chronic excessive drinking (ethyl glucuronide and phosphatidylethanol). None of the self-reported measures/biomarkers taken alone displayed both sensitivity and specificity close to 100% with respect to the gold standard (e.g. self-reported AUD: sensitivity=92.3%, specificity=45.8%). The best model combined eight self-reported criteria of AUD and four alcohol-related consequences. Using a cut-off of three, this screening tool yielded acceptable sensitivity (83.3%) and specificity (78.7%). Neither self-reported alcohol use disorder nor heavy alcohol use appear to be adequate to screen for alcohol use disorder among young men from the Swiss population. The best screening alternative for alcohol use disorder among young Swiss men appears to be a combination of eight symptoms of alcohol use disorder and four alcohol-related consequences.

Alcohol use, pregnancy and associated risk factors: a pilot cross-sectional study of pregnant women attending prenatal care in an urban city

BackgroundAlcohol consumption during pregnancy is associated with adverse pregnancy outcomes such as preventable alcohol-related developmental disability fetal alcohol syndrome. In Zambia, alcohol use and associated risk factors have not been investigated, and screening in prenatal care is nonexistent. This study determined individual correlates and the prevalence of alcohol use in pregnant women attending prenatal care at two health clinics in Lusaka, Zambia.MethodsA study adopted a cross-sectional design and recruited 188 pregnant women after seeking their informed consent from July 19 to 31, 2017. Participants aged 18 or over completed the T-ACE (Tolerance, Annoyance, Cut Down and Eye Opener) screening tool and validated alcohol-screening questionnaires on self-reported alcohol use periconceptional and during conception period while at their regular prenatal visit. The T-ACE screening tool assessed the risk of alcohol dependence in four short questions. The questionnaires included demographic questions. Bivariate analyses were performed using the χ2 test for dichotomous variables and the t-test for continuous variables. Mixed-effects linear models were used to evaluate the effect of outcome variables with patient-level variables.ResultsAbout 40 (21.2%) pregnant women were identified by the T-ACE as at-risk for problem drinking during pregnancy. Except for regular prenatal care and distance, there was no difference in the demographic factors between pregnant women who scored < 2 on the T-ACE and those that scored > 2 points (all p’s > 0.05). A small proportional of women at both clinics reported binge drinking during the periconceptional period (12.7% vs. 3.2%, p = 0.003) and beyond periconception period. Excluding employed women, no significant relationships were observed between alcohol use and demographic factors.ConclusionAlcohol consumption is prevalent in the periconceptional period and during pregnancy in pregnant women attending prenatal care in Zambia. Findings underscore the need for targeted alcohol use screening and intervention for pregnant women.

Associations of Parental Marijuana Use With Offspring Marijuana, Tobacco, and Alcohol Use and Opioid Misuse

Marijuana use is increasing among adults and often co-occurs with other substance use; therefore, it is important to examine whether parental marijuana use is associated with elevated risk of substance use among offspring living in the same household. To examine associations of parental marijuana use with offspring marijuana, tobacco, and alcohol use and opioid misuse. This cross-sectional study used survey data from the 2015 through 2018 National Surveys on Drug Use and Health (NSDUH), which provide nationally representative data on adolescents or young adults living with a parent (the mother or the father). Annual average percentages were based on survey sampling weights. Final analyses were conducted September 21 through 23, 2019. Parental marijuana use status. Offspring self-reported use of marijuana, tobacco, or alcohol or misuse of opioids. Survey respondents included 24 900 father-offspring or mother-offspring dyads sampled from the same household. Among mothers living with adolescent offspring, 8.2% (95% CI, 7.3%-9.2%) had past-year marijuana use, while 7.6% (95% CI, 6.2%-9.2%) of mothers living with young adult offspring had past-year marijuana use. Among fathers living with adolescent offspring, 9.6% (95% CI, 8.5%-10.8%) had past-year marijuana use, and 9.0% (95% CI, 7.4%-10.9%) of fathers living with young adult offspring had past-year marijuana use. Compared with adolescents whose mothers never used marijuana, adjusted relative risk (ARR) of past-year marijuana use was higher among those whose mothers had lifetime (without past-year) marijuana use (ARR, 1.3; 95% CI, 1.1-1.6; P = .007), less than 52 days of past-year marijuana use (ARR, 1.7; 95% CI, 1.1-2.7; P = .02), or 52 days or more of past-year marijuana use (ARR, 1.5; 95% CI, 1.1-2.2; P = .02). Compared with young adults whose mothers never used marijuana, adjusted risk of past-year marijuana use was higher among those whose mothers had lifetime (without past-year) marijuana use (ARR, 1.4; 95% CI, 1.1-1.7; P = .001), less than 52 days of past-year marijuana use (ARR, 1.5; 95% CI, 1.0-2.3; P = .049), or 52 days or more of past-year marijuana use (ARR, 1.8; 95% CI, 1.3-2.5; P = .002). Compared with adolescents whose fathers never used marijuana, adolescents whose fathers had less than 52 days of past-year marijuana use were more likely to use marijuana (ARR, 1.8; 95% CI, 1.2-2.7; P = .006). Compared with young adults whose fathers never used marijuana, young adults whose fathers had 52 days or more of past-year marijuana use were more likely to use marijuana (ARR, 2.1; 95% CI, 1.6-2.9; P < .001). Compared with their peers whose parents never used marijuana and after adjusting for covariates, the adjusted risk of past-year tobacco use was higher among adolescents whose mothers had lifetime marijuana use (ARR, 1.3; 95% CI, 1.0-1.6; P = .03), less than 52 days of past-year marijuana use (ARR, 1.5; 95% CI, 1.0-2.1; P = .04), or 52 days or more of past-year marijuana use (ARR, 1.6; 95% CI, 1.1-2.3; P = .03); adolescents whose fathers had lifetime marijuana use (ARR, 1.5; 95% CI, 1.1-1.9; P = .004) or 52 days or more of past-year marijuana use (ARR, 1.8; 95% CI, 1.2-2.7; P = .006); young adults whose mothers had lifetime marijuana use (ARR, 1.2; 95% CI, 1.0-1.4; P = .04); and young adults whose fathers had 52 days or more of past-year marijuana use (ARR, 1.4; 95% CI, 1.0-1.9; P = .046). Compared with their peers whose parents had no past marijuana use and after adjusting for covariates, risk of past-year alcohol use was higher among adolescents whose mothers had lifetime marijuana use (ARR, 1.2; 95% CI, 1.1-1.4; P = .004), less than 52 days of past-year marijuana use (ARR, 1.5; 95% CI, 1.2-1.9; P = .002), or 52 days or more of past-year marijuana use (ARR, 1.3; 95% CI, 1.0-1.7; P = .04). After adjusting for covariates, parental marijuana use was not associated with opioid misuse by offspring. In this cross-sectional study, parental marijuana use was associated with increased risk of substance use among adolescent and young adult offspring living in the same household. Screening household members for substance use and counseling parents on risks posed by current and past marijuana use are warranted.

Genetic evidence for assortative mating on alcohol consumption in the UK Biobank

Alcohol use is correlated within spouse-pairs, but it is difficult to disentangle effects of alcohol consumption on mate-selection from social factors or the shared spousal environment. We hypothesised that genetic variants related to alcohol consumption may, via their effect on alcohol behaviour, influence mate selection. Here, we find strong evidence that an individual’s self-reported alcohol consumption and their genotype at rs1229984, a missense variant in ADH1B, are associated with their partner’s self-reported alcohol use. Applying Mendelian randomization, we estimate that a unit increase in an individual’s weekly alcohol consumption increases partner’s alcohol consumption by 0.26 units (95% C.I. 0.15, 0.38; P = 8.20 × 10−6). Furthermore, we find evidence of spousal genotypic concordance for rs1229984, suggesting that spousal concordance for alcohol consumption existed prior to cohabitation. Although the SNP is strongly associated with ancestry, our results suggest some concordance independent of population stratification. Our findings suggest that alcohol behaviour directly influences mate selection.

“Mixed” Drinking Motivations: A Comparison of Majority, Multiracial, and Minority College Students

Social exclusion is associated with substance use, but the specific link between majority and minority racial group membership and substance use is unknown. We examined how social exclusion among racial majority (White), Multiracial, and racial minority (Native American, Latino, Asian, and Black) college students relates to self-reported alcohol use and motivations. Using the AlcoholEdu for College™ survey, Study 1a reports five factors related to motives for initiating or inhibiting alcohol use. Study 1b analyzes majority, Multiracial, and minority college students’ comparative endorsement of these motivations. Study 2 compares these factors with established belonging scales using a separate undergraduate sample. White, Multiracial, Native American, and Latino students displayed the highest proportion of problematic alcohol use. White students endorsed belonging-based drinking motivations, while Multiracial and Asian students endorsed motivations similar to both majority and minority groups. Native American, Latino, and Black students endorsed abstaining motivations more than other groups.

Social Desirability Bias Impacts Self-Reported Alcohol Use Among Persons With HIV in Uganda.

Self-report is widely used to assess alcohol use in research and clinical practice, but may be subject to social desirability bias. We aimed to determine if social desirability impacts self-reported alcohol use. Among 751 human immunodeficiency virus (HIV)-infected patients from a clinic in southwestern Uganda, we measured social desirability using the Marlowe-Crowne Social Desirability Scale (SDS) Short Form C, self-reported alcohol use (prior 3months) Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), and phosphatidylethanol (PEth), a biomarker of prior 3weeks' drinking. We conducted multiple regression analyses to assess the relationship between SDS score (low, medium, and high levels) and (i) any self-reported recent alcohol use, among those who were PEth-positive (≥8ng/ml), and (ii) continuous AUDIT-C score, among those reporting any recent alcohol use. We controlled for PEth level, age, gender, education, economic assets, marital status, religion, spirituality/religiosity, social support, and study cohort. Of 751 participants, 59% were women; the median age was 31years (interquartile range [IQR]: 26 to 39). Median SDS score was 9 (IQR: 4 to 10). Two-thirds (62%) self-reported any recent alcohol use; median AUDIT-C was 1 (IQR: 0 to 4). Among those who were PEth-positive (57%), 13% reported no recent alcohol use. Those with the highest SDS tertile had decreased odds of reporting any recent alcohol use compared to the lowest tertile, but the association did not reach statistical significance in multivariable analyses (adjusted odds ratio 0.55 [95% confidence interval (CI): 0.25, 1.23]). Among participants self-reporting recent alcohol use, SDS level was negatively associated with AUDIT-C scores (adjusted β: -0.70 [95% CI: -1.19, -0.21] for medium vs. low SDS and -1.42 [95% CI: -2.05, -0.78] for high vs. low SDS). While use of objective measures (e.g., alcohol biomarkers) is desirable for measuring alcohol use, SDS scores may be used to adjust self-reported drinking levels by participants' level of social desirability in HIV research studies.

The association between mother’s alcohol consumption during pregnancy and their child’s educational attainment and risk of hospital admission by age 14

Background Heavy alcohol consumption by mothers during pregnancy is associated with developmental problems in their children. However, the impact of light to moderate consumption on the long-term health and educational attainment up to adolescence has not been established.&#x0D; Main Aim To investigate the association between mother’s alcohol use during pregnancy and health and educational attainment of their children up to age 14 years.&#x0D; Methods Millennium Cohort Study (MCS) children in Wales (1,838), with parental consent, were record-linked to emergency hospital admission data between birth and 14 years (1,795) and National Curriculum Key Stage-Three (KS3) (1,645) records within the Secure Anonymised Information Linkage (SAIL) Databank. Mother’s self-reported alcohol use during pregnancy was classified into a) abstain; b) light (1 - 2 units per week/occasion, 1 unit = 8g ethanol)); c) moderate (3 - 6 units per week/3-5 units per occasion) and d) heavy (&gt; 6, dropped due to a paucity of data). Cox regression estimated the risk of emergency hospital admission and multivariate linear regression models estimated the difference in KS3 scores by exposure group.&#x0D; Results 71% of mothers abstained, 24% were light drinkers and 5% moderate. Light drinking was associated with children’s lower risk of emergency hospital admission (HR = 0.85, 95% CI 0.75 - 0.97) and better KS3 scores (β = 0.14, 95% CI 0.05 - 0.23) by age 14 years, when compared to abstaining mothers. Children of mothers who drank moderately had a comparable risk of emergency hospital admission (HR = 1.07, 95% CI 0.79 - 1.46) and a better KS3 score (β = 0.30, 95% CI 0.11 - 0.49), compared to abstaining mothers.&#x0D; Conclusion Consumption during pregnancy of 1-2 units of alcohol per week/occasion was neither associated with an increased risk of emergency hospital admission nor poor academic attainment in children up to 14 years of age.

White matter connectometry among individuals with self-reported family history of drug and alcohol use disorders

Heredity is an important risk factor for alcoholism. Several studies have been conducted on small groups of alcohol naïve adolescents which show lowered fractional anisotropy of frontal white matter in individuals with a family history of alcohol and substance use disorder (FH+). We compare large adult FH+ and FH− groups using white matter connectometry, different from the previously used global tractography method, as it is more sensitive to regional variability. Imaging and behavioral data from the Human Connectome Project (WU-MINN HCP 1200) was analyzed. Groups of participants were positive (n = 109) and negative (n = 109) for self-reported alcohol and substance use disorders in at least one parent, and stringently matched. Connectometry was performed on diffusion MRI in DSI-Studio using q-space diffeomorphic reconstruction, and multiple regression was completed with 5000 permutations. Analyses showed decreased major tract (>40 mm) connectivity in the FH+ group in left inferior longitudinal fasciculus, bilateral cortico-striatal pathway, left cortico-thalamic pathway, and corpus callosum, compared to the FH− group. For cognitive tasks related to reward processing, inhibition, and monitoring, there were a number of interactions, such that the relationship between identified tracts and behavior differed significantly between groups. Self-reported family history was associated with decreased connectivity in reward signaling pathways, controlling for alcohol consumption and alcohol use disorder. This is the first connectometry study of FH+, and extends the neural basis of the hereditary diathesis of alcoholism beyond that demonstrated with global tractography. Regions associated with FH+ are similar to those associated with alcohol use disorder.

Concordance of Self- and Partner-Reported Alcohol Consumption Among Couples Experiencing Intimate Partner Violence in Zambia.

Hazardous alcohol use is a predictor of intimate partner violence (IPV), and both are increasingly prevalent in sub-Saharan Africa. The accurate measurement of alcohol consumption is therefore critical in IPV intervention studies that target hazardous drinking. Collecting a collateral report in addition to self-report is one convergent validity approach to improve alcohol measurement. We investigated concordance between self- and partner-reported alcohol use among women who reported recent IPV and their male partners in Zambia. Data were from the baseline of a randomized IPV intervention trial of 247 heterosexual couples in which a woman has reported recent IPV and her male partner has recent hazardous alcohol use. Both partners completed the Alcohol Use Disorders Identification Test (AUDIT) in reference to their own drinking and in reference to their partner's drinking. We calculated percent agreement across a range of outcomes: any use, quantity, frequency, and hazardous use. We also compared self- and partner-reported AUDIT scores using t-tests. Concordance was poor across most outcomes. Percent agreement with respect to the women's drinking ranged from 60% to 65% across outcomes and with respect to the men's drinking from 51% to 89%. Women's average partner-reported AUDIT score (20.7) was statistically significantly (p<0.0001) higher than men's average self-reported score (15.8). In contrast to collateral report studies conducted in the United States, concordance between self- and partner-reported alcohol consumption was poor among families experiencing IPV in Zambia. Given the possible biases associated with self-reported alcohol use, findings suggest that a convergent validity approach is useful in this research context.

Risk Factors and Birth Outcomes Associated with Teenage Pregnancy: A Canadian Sample.

To examine the extent to which socioeconomic status, mental health, and substance use are associated with teenage pregnancies in Southwestern Ontario (SWO), and whether these pregnancies are at an elevated risk for adverse birth outcomes, after controlling for medical, behavioral, and socioeconomic status factors. Retrospective cohort study using perinatal and neonatal databases. Tertiary care hospital in SWO. Women residing in SWO who gave birth to singleton infants without congenital anomalies between 2009 and 2014. Teenage pregnancies (19years of age or younger) were compared with pregnancies of women 20-34years and 35years or older. None. Low birth weight (LBW), very LBW, term LBW, preterm birth, very preterm birth, low and very low Apgar score, and fetal macrosomia. Of 25,263 pregnant women, 1080 (4.3%) were 19years of age or younger. Approximately 18% of teenage mothers lived in socioeconomically disadvantaged neighborhoods, compared with 11% of mothers aged 20-34 and 9% of women 35years of age or older (P<.001). Teenage mothers had higher rates of depression during pregnancy (9.8%) than mothers 20-34years (5.8%) and those 35years of age or older (6.8%; P<.001). Young mothers self-reported higher tobacco, marijuana, and alcohol use during pregnancy than adult mothers (P<.001). Teenage pregnancy increased the risk of a low Apgar score (adjusted odds ratio, 1.56; 95% confidence interval, 1.21-2.02), but was not associated with other birth outcomes after adjusting for covariates. Teenage pregnancy is associated with a higher risk of socioeconomic disadvantage, mental health problems, and substance use during pregnancy, but is largely unrelated to adverse birth outcomes in SWO.

Perceived descriptive norms for alcohol use among tribal college students: Relation to self-reported alcohol use, consequences, and risk for alcohol use disorder

This research addressed gaps in the literature by testing relationships between perceived descriptive alcohol use norms and individual’s own alcohol use and consequences among tribal college and university (TCU) students. Survey data were collected from 3239 tribal college students in 22 TCUs across the United States in 2015 and 2016, of whom 3174 provided usable data on the variables of interest for the current manuscript. Results indicated students misperceived the descriptive norms for alcohol use at their TCU, on average estimating students at their college drank more frequently, more per occasion, and more total drinks per week relative to the observed averages on these outcomes. Participants’ own drinking was significantly related to their perceived norms, with higher perceived norms related to more drinking. In addition, higher perceived norms were associated with greater alcohol-related negative consequences and lower likelihood of being a non-drinker. These findings extend research with students at majority-serving colleges and universities, indicating normative misperceptions exist and have similar relationships to alcohol use and consequences among TCU students nationwide. These findings support adaptation of normative feedback interventions for use with TCU students to emphasize healthy alcohol norms and correct misperceptions that support the stereotype that all students drink to excess.

Reconsidering the associations between self-reported alcohol use disorder and mental health problems in the light of co-occurring addictions in young Swiss men.

BackgroundAlcohol use disorder (AUD) is known to co-occur with other addictions, as well as with mental health problems. However, the effects of other addictions co-occurring with AUD on mental health problems were rarely studied and not considering them may bias estimates of the association between AUD and mental health problems. This study investigated which role co-occurring addictions play for the cross-sectional associations between self-reported AUD and mental health problems.MethodParticipants were 5516 young Swiss men (73.0% of those that gave written informed consent) who completed a self-report questionnaire. Using short screening questionnaires, we assessed three substance use disorders (alcohol, cannabis and tobacco), seven behavioural addictions (internet, gaming, smartphone, internet sex, gambling, work, exercise) and four mental health problems (major depression, bipolar disorder, attention deficit hyperactivity disorder (ADHD) and social anxiety disorder). Differences in the proportions of mental health problems were tested using logistic regressions between (1) participants with no AUD and AUD, (2) participants with no AUD and AUD alone and (3) participants with no AUD and AUD plus at least one co-occurring addiction.ResultsOverall, (1) participants with AUD had higher proportions of major depression (Odds ratio (OR [95% confidence interval]) = 3.51 [2.73, 4.52]; ADHD (OR = 3.12 [2.41, 4.03]); bipolar disorder (OR = 4.94 [3.38, 7.21]) and social anxiety (OR = 2.21 [1.79, 2.73])) compared to participants with no AUD. Considering only participants with AUD alone compared to participants with no AUD (2), differences in proportions were no longer significant for major depression (OR = 0.83 [0.42, 1.64]), bipolar disorder (OR = 1.69 [0.67, 4.22]), social anxiety (OR = 1.15 [0.77, 1.73]) and ADHD (OR = 1.65 [1.00, 2.72]) compared to participants with no AUD. In contrast, (3) proportions of mental health problems were considerably higher for participants with AUD plus at least one other addiction when compared to participants with no AUD, with OR’s ranging from 2.90 [2.27, 3.70] for social anxiety, 4.03 [3.02, 5.38] for ADHD, 5.29 [4.02, 6.97] for major depression to 6.64 [4.44, 9.94] for bipolar disorder.ConclusionsAUD was associated with all four measured mental health problems. However, these associations were mainly due to the high proportions of these mental health problems in participants with AUD plus at least one co-occurring addiction and only to a lesser degree due to participants with AUD alone (i.e. without any other co-occurring addictions). Hence, estimates of the association between AUD and mental health problems that do not consider other addictions may be biased (i.e. overestimated). These findings imply that considering addictions co-occurring with AUD, including behavioural addictions, is important when investigating associations between AUD and mental health problems, and for the treatment of AUD and co-morbid disorders.