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1.
J Res Adolesc ; 33(3): 1011-1022, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37208844

RESUMO

Adolescence is defined in part by heightened exposure and sensitivity to stressors. In a longitudinal cohort of youth at risk for substance use problems, we examined the age-varying relationship between stress exposure and traits that are central to the dual systems model. The positive associations between stress exposure, impulsivity, sensation seeking varied as function of age. Specifically, the influence of stress exposure on impulsivity strengthened during early adolescence and remained stable into early adulthood, while the influence of stress exposure on sensation seeking strengthened from early- to mid-adolescence and weakened thereafter. These findings suggest that the maturational imbalance between the capacity to regulate impulsive tendencies and sensation seeking may be exaggerated for youth who are exposed to a high number of stressors.


Assuntos
Comportamento do Adolescente , Transtornos Relacionados ao Uso de Substâncias , Humanos , Adolescente , Adulto , Assunção de Riscos , Comportamento Impulsivo , Sensação
2.
Health Commun ; 36(5): 540-550, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32091242

RESUMO

Alcohol-impaired driving is a common and costly public health problem associated with alcohol misuse. This investigation aims to understand the role of social support and drinking motives in motivating alcohol-impaired drivers to reduce alcohol use. One hundred nineteen participants with a history of driving-while-intoxicated arrest were recruited from either a correctional treatment facility (n = 59) or the community (n = 60) and asked about their motivation to change alcohol use. Motivation to change was tested in relationships with two types of social support (i.e. Abstinence-Specific Social Support and General Social Support) and drinking motives (Coping, Enhancement, and Social Motives). The results showed: (1) only Abstinence-Specific Social Support was positively associated with motivation to change; (2) Coping and Social Motives had a negative association with motivation to change; (3) the impact of Abstinence-Specific Social Support on motivation to change was greater among those with a stronger Enhancement Motives. In other words, those who drink primarily for pleasure showed a greater increase in motivation to change when more Abstinence-Specific Social Support is available, compared to those with lower Enhancement Motives. The findings of this investigation contribute to our knowledge of the roles of communication in the rehabilitation of alcohol-impaired drivers.


Assuntos
Alcoolismo , Motivação , Adaptação Psicológica , Consumo de Bebidas Alcoólicas , Humanos , Apoio Social
3.
J Res Adolesc ; 30(4): 1051-1066, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32951266

RESUMO

We investigated if the dual systems model could explain the increased rates of substance use among at-risk youth. This study sampled 365 adolescents, 289 of which had a family history of substance use disorder, assessed biannually between the ages 13-16 years old. Growth curve analyses revealed that higher levels of impulsivity were related to higher levels of sensation seeking and a slower rate of decline in impulsivity was related to a faster rate of increase in sensation seeking. Only family history status and sensation seeking were directly associated with substance use (marijuana, alcohol) at age 16, though family history status was also indirectly related to substance use through higher levels of impulsivity to higher levels of sensation seeking.


Assuntos
Comportamento do Adolescente , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Humanos , Comportamento Impulsivo , Assunção de Riscos , Sensação , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
4.
Addict Disord Their Treat ; 19(1): 7-15, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33424458

RESUMO

OBJECTIVE: This program evaluation examined rates of treatment initiation and alcohol related violations among adults who completed a brief motivational interviewing (BMI) session after a driving while intoxicated arrest. METHOD: Adults attending orientation for pretrial bond supervision were assessed for eligibility to receive services by counselors in an outpatient clinic. A total of 118 male and female adults with DWI arrests completed a single BMI session. Treatment initiation was assessed one-week after the BMI session and alcohol-related violations were assessed 6-months later. RESULTS: Fifty-three percent of those with DWI arrests who received the BMI session-initiated treatment and of those who initiated treatment, alcohol-related violations were significantly lower than for those who did not initiate treatment. CONCLUSIONS: The results provide preliminary support that a single session BMI delivered soon after arrest and before pretrial conditions are implemented has promise for spurring clients to take steps to initiate treatment and is related to better rates of compliance with alcohol-related pretrial conditions.

5.
Alcohol Clin Exp Res ; 43(1): 123-134, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30431660

RESUMO

BACKGROUND: Social support has been linked to many therapeutic benefits (e.g., treatment retention, reduced posttreatment relapse) for individuals with alcohol use disorder. However, the positive impacts of social support have not been well understood in the context of alcohol-impaired driving. This article examines the role of social support in motivating those with histories of driving while intoxicated (DWI) arrest to reduce alcohol use by testing 3 major models of social support: the Main-Effects model, the Buffering model, and the Optimal Matching model. METHODS: One hundred and nineteen participants with histories of DWI arrest were recruited from a correctional treatment facility (n = 59) and the local community (n = 60). Participants completed interviews to assess alcohol consumption, psychiatric/physical conditions, and psychosocial factors associated with drinking behavior (e.g., social support, alcohol-related problems, and motivation to change). Hierarchical regression analyses were conducted to test the 3 models. Additionally, the relative magnitude of the effects of general and recovery-specific social support was compared based on the approach of statistical inference of confidence intervals. RESULTS: Overall social support was positively associated with some motivation to change (i.e., importance of change, confidence in change) among alcohol-impaired drivers, supporting the Main-Effects model. However, the impact of overall social support on motivation to change was not moderated by alcohol-related problems of individuals arrested for DWI, which did not confirm the Buffering model. Last, recovery-specific social support, rather than general social support, contributed to increasing motivation to reduce alcohol use, which supported the Optimal Matching model. CONCLUSIONS: These findings highlight the benefits of social support (i.e., increased motivation to change alcohol use) for alcohol-impaired drivers. Regardless of the severity of alcohol-related problems of alcohol-impaired drivers, social support had direct positive impacts on motivation to change. In particular, the results underscore that social support can be more effective when it is matched to the recovery effort of individuals, which is consistent with the Optimal Matching model.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Dirigir sob a Influência/psicologia , Modelos Psicológicos , Motivação , Apoio Social , Adulto , Consumo de Bebidas Alcoólicas/prevenção & controle , Feminino , Humanos , Masculino , Adulto Jovem
6.
Alcohol Clin Exp Res ; 42(5): 851-860, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29505133

RESUMO

BACKGROUND: The purpose of this study was to examine the synthesis and elimination of phosphatidylethanol (PEth) 16:0/18:1 and 16:0/18:2 following the consumption of alcohol among 56 light and heavy drinkers. METHODS: A transdermal alcohol monitor was used to promote alcohol absence 7 days prior, and 14 days after, alcohol consumption in the laboratory. Participants consumed a 0.4 or 0.8 g/kg dose of alcohol in 15 minutes. Blood and breath samples were collected before, at various times up to 360 minutes postconsumption, and 2, 4, 7, 11, and 14 days after alcohol consumption. Initial rates of PEth synthesis, 360 minutes area under the PEth pharmacokinetic curves (AUCs), and elimination half-lives were determined. RESULTS: (i) Nonzero PEth levels were observed before alcohol dosing for most participants, despite 7 days of alcohol use monitoring; (ii) 0.4 and 0.8 g/kg doses of alcohol produced proportional increases in PEth levels in all but 1 participant; (iii) the initial rate of synthesis of both PEth homologues did not differ between the 2 doses, but was greater for PEth 16:0/18:2 than PEth 16:0/18:1 at both doses; (iv) the mean AUC of both PEth homologues was higher at 0.8 g/kg than at 0.4 g/kg; (v) the mean AUC of 16:0/18:2 was greater than that of PEth 16:0/18:1 at both alcohol doses; (vi) the mean half-life of PEth 16:0/18:1 was longer than that of PEth 16:0/18:2 (7.8 ± 3.3 [SD] days and 6.4 ± 5.0 [SD] days, respectively); and (vii) there were no sex differences in PEth 16:0/18:1 or 16:0/18:2 pharmacokinetics. CONCLUSIONS: The results of this study support the use of PEth 16:0/18:1 and 16:0/18:2 as biomarkers for alcohol consumption. Because of consistent pharmacokinetic differences, the levels of these 2 PEth homologues may provide more information regarding the quantity and recentness of alcohol consumption than either alone.


Assuntos
Etanol/farmacocinética , Glicerofosfolipídeos/biossíntese , Glicerofosfolipídeos/sangue , Glicerofosfolipídeos/farmacocinética , Adulto , Biomarcadores/sangue , Testes Respiratórios , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
7.
Alcohol Clin Exp Res ; 42(11): 2094-2099, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30091144

RESUMO

BACKGROUND: The purpose of this study was to characterize the pharmacokinetics of the phosphatidylethanol (PEth) 16:0/20:4 homolog in uncoagulated human blood samples taken from 18 participants in a clinical laboratory setting after consumption of 2 standard doses of ethanol (EtOH). METHODS: Male and female participants received either 0.4 or 0.8 g/kg oral doses of EtOH during a 15-minute period. Blood samples were collected before and throughout 6 hours immediately after alcohol administration and then again at days 2, 4, 7, 11, and 14 of the follow-up period. PEth 16:0/20:4 levels were quantified by high-performance liquid chromatography with tandem mass spectrometry detection. RESULTS: (i) The increase in PEth 16:0/20:4 from baseline to maximum concentration was less than that of PEth 16:0/18:1 or PEth 16:0/18:2 homologs during the 6-hour period after EtOH administration; (ii) the mean half-life of PEth 16:0/20:4 was 2.1 ± 3 (SD) days, which was shorter than the mean half-life of either PEth 16:0/18:1 or PEth 16:0/18:2, 7.6 ± 3 (SD) or 6.8 ± 4 (SD) days, respectively. CONCLUSIONS: The pharmacokinetics of PEth 16:0/20:4 in whole blood samples is detectable after alcohol consumption and differs in amount synthesized and rate of elimination versus PEth 16:0/18:1 and 16:0/18:2. Measuring the concentrations of these 3 homologs has the potential to provide more information about the amount and time frame of alcohol consumption than any one alone.


Assuntos
Depressores do Sistema Nervoso Central/farmacologia , Etanol/farmacologia , Glicerofosfolipídeos/sangue , Glicerofosfolipídeos/farmacocinética , Adulto , Consumo de Bebidas Alcoólicas , Cromatografia Líquida de Alta Pressão , Feminino , Meia-Vida , Humanos , Masculino , Pessoa de Meia-Idade , Espectrometria de Massas em Tandem , Adulto Jovem
8.
Alcohol Alcohol ; 52(1): 35-41, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27522029

RESUMO

AIMS: Monitors of transdermal alcohol concentration (TAC) provide an objective measurement of alcohol consumption that is less invasive than measurements in blood, breath or urine; however, there is a substantial time delay in the onset of TAC compared to blood or breath alcohol concentrations (BrACs). The current study examined the characteristics of the delay between peak TAC and peak BrAC. METHODS: Data was aggregated from three experimental laboratory studies (N = 61; 32 men, 29 women) in which participants wore a TAC monitor and BrAC was monitored while drinking one, two, three, four and five beers in the laboratory. Analyses examined the sex- and dose-related differences in peak BrAC and TAC, the time-to-peak BrAC and TAC, and time lag between the peak BrAC and TAC values. RESULTS: The times-to-peak were an increasing function of the number of beers consumed. At each level of beer consumption the peak TAC averaged lower than peak BrAC and times-to-peak TAC were longer than for BrAC. The time-to-peak BrAC and TAC was longer for women than men. The congruence between peak TAC and BrAC increased as a function of the beers consumed. No sex difference in the time lag between peak BrAC and TAC was detected. CONCLUSIONS: The congruence between TAC and BrAC and time lags between TAC and BrAC are related to the number of beers consumed. Peak values of TAC and BrAC became more congruent with higher doses but the time lag increased as a function of the amount of alcohol consumed. SHORT SUMMARY: The time delay (or lag) and congruence between transdermal vs. BrACs increases as the number of beers increases. Though sex differences are evident in peak transdermal and BrACs, no sex differences were evident in the time lag and the congruence between transdermal and breath alcohol concentrations.


Assuntos
Consumo de Bebidas Alcoólicas/metabolismo , Cerveja/análise , Caracteres Sexuais , Absorção Cutânea/fisiologia , Detecção do Abuso de Substâncias/métodos , Adulto , Testes Respiratórios/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Absorção Cutânea/efeitos dos fármacos , Fatores de Tempo , Adulto Jovem
9.
Alcohol Clin Exp Res ; 40(6): 1228-34, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27130527

RESUMO

BACKGROUND: The purpose of this study was to characterize the pharmacokinetics of 2 homologues of phosphatidylethanol (PEth) and their combined total in uncoagulated, whole blood samples taken from participants in a human clinical laboratory study after consumption of low doses of ethanol (EtOH). METHODS: As part of a larger study, 14 male and 13 female participants received either 0.25 or 0.50 g/kg oral doses of EtOH during a 15-minute period. Blood samples were collected before and throughout 6 hours after each EtOH dose on the day of consumption and then every 3 days during the next 14 days. PEth 16:0/18:1 and PEth 16:0/18:2 levels were quantified in blood samples by HPLC/MS/MS and reported separately or as their combined total (combined PEth). Breath alcohol concentrations (BrACs) were measured concurrently with each blood collection. Transdermal alcohol concentrations were measured every 30 minutes during the entire 22-day study to confirm the absence of drinking during a 7-day period before and the 14-day period after EtOH consumption. RESULTS: (i) Single doses of 0.25 and 0.50 g EtOH/kg produced proportional increases in BrAC and combined PEth levels of all participants; (ii) the areas under the curve (AUCs) for each participant's BrAC levels during the 6-hour period after EtOH administration were correlated with AUCs of cPEth (calculated as the AUC of the increase above baseline for combined PEth); (iii) the mean half-life of combined PEth, determined during the 14-day period after EtOH consumption, was 4.6 ± 3.5 (SD) days (range: 1.0 to 13.1 days). CONCLUSIONS: Combined PEth is a sensitive biomarker for the identification of relatively low levels of EtOH consumption. The measurement of these 2 homologues may provide additional sensitivity to identify low levels of drinking.


Assuntos
Consumo de Bebidas Alcoólicas/sangue , Glicerofosfolipídeos/sangue , Glicerofosfolipídeos/farmacocinética , Adulto , Biomarcadores/sangue , Testes Respiratórios , Relação Dose-Resposta a Droga , Etanol/sangue , Etanol/farmacocinética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
10.
Alcohol Clin Exp Res ; 40(12): 2622-2630, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27706827

RESUMO

BACKGROUND: Problem substance use often begins in adolescence. This vulnerability likely stems, at least partially, from relatively rapid increases in sensation seeking occurring in early to mid-adolescence and more gradual improvements in impulse control occurring through later adolescence. Better understanding how these processes develop in high-risk youth may lead to enhanced substance use disorder treatment and prevention strategies. METHODS: We characterized trajectories of self-reported impulsivity and sensation seeking in 305 FH+ youths who at minimum had a father with a history of alcohol or other drug use disorders and 81 youths with no family histories of substance use disorders (FH-). Assessments started at ages 10 to 12 and continued at 6-month intervals for up to 42 months. In addition, a subset of 58 FH+ youths who began alcohol or other drug use before age 15 (FH+ Users) were compared to 58 FH+ propensity-matched adolescents who did not initiate substance use before age 15 (FH+ Non-Users). RESULTS: Compared to FH- youths at preadolescence, FH+ youths reported higher general impulsivity and higher impulsivity related to poor planning and attention. Over time, there were no differential effects of FH status on changes in impulsivity or sensation seeking across adolescence. FH+ Users had smaller decreases in general impulsivity and impulsivity related to restlessness and fidgeting across adolescence than FH+ Non-Users. FH+ Users also had greater increases in sensation seeking across adolescence than FH+ Non-Users. CONCLUSIONS: Increased impulsivity in FH+ youths may make them less able to regulate sensation seeking drives that peak in adolescence, which may contribute to their high risk for developing substance use disorders. Additionally, FH+ adolescents who initiate early use may be at increased risk in part due to increased impulsivity coupled with greater increases in sensation seeking.


Assuntos
Comportamento do Adolescente/psicologia , Filho de Pais com Deficiência/psicologia , Comportamento Impulsivo , Assunção de Riscos , Adolescente , Feminino , Humanos , Masculino , Transtornos Relacionados ao Uso de Substâncias
11.
J Adolesc ; 53: 222-230, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27816696

RESUMO

Adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and Conduct Disorder (CD) experience deficits in neuropsychological measures of attention, inhibition, and reward processes. Methylphenidate treatment for ADHD and CD has acute effects on these processes. Some of these same aspects of performance are separately described in the Behavioral Model of Impulsivity, which uses a modified approach to measurement. This study characterized the acute effects of methylphenidate attention, initiation, inhibition, and reward processes described in this model of impulsivity. Thirty-one adolescents from the United States of America with comorbid ADHD and CD completed measures of impulsivity (response initiation, response inhibition, and consequence) and attention following placebo, 20 mg, and 40 mg of a long-acting dose of methylphenidate. Methylphenidate effects on attentional performance was more robust than on any of the measures of impulsivity. Adolescent performance from this behavioral perspective is interpreted in the context of divergence from previous neuropsychological tests of acute methylphenidate effects.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Atenção/efeitos dos fármacos , Estimulantes do Sistema Nervoso Central/farmacologia , Transtorno da Conduta/tratamento farmacológico , Comportamento Impulsivo/efeitos dos fármacos , Metilfenidato/farmacologia , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno da Conduta/complicações , Método Duplo-Cego , Feminino , Humanos , Inibição Psicológica , Masculino
12.
Subst Use Misuse ; 51(10): 1264-73, 2016 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-27219839

RESUMO

OBJECTIVE: Previous studies have suggested that maternal characteristics are related to family environment; however, the relation between maternal impulsivity, in particular, and family environment is not well understood. As such, we examined direct relations between maternal impulsivity and family environment, as well as whether the relation between maternal impulsivity and family environment was moderated by child problems for sons and daughters. We hypothesized that child problems would moderate the association between maternal impulsivity and family environment. We also explored whether these associations differ for boys and girls. METHOD: Data from the initial visit of a longitudinal study was used for the current study. Participants included 297 youth (137 boys; 160 girls) of 10 to 12 years of age (M = 10.99, SD = .84) and their mothers. The majority of the sample had a family history of substance use disorder (n = 236). RESULTS: Hierarchical linear regressions showed that for sons there was a significant interaction between maternal impulsivity and child problems on family environment. Maternal impulsivity was positively related to family environment problems among sons with few emotional and behavioral problems, but there was no significant correlation among sons with high problem levels. Among daughters, there was no significant interaction between maternal impulsivity and child emotional and behavioral problems on family environment. CONCLUSIONS: The results suggest that the association between maternal impulsivity and family environment may depend on problem level and child gender. Thus, addressing maternal impulsivity in therapy may benefit some families.


Assuntos
Comportamento Impulsivo , Criança , Feminino , Humanos , Relações Interpessoais , Estudos Longitudinais , Masculino , Mães , Transtornos Relacionados ao Uso de Substâncias
13.
Addict Disord Their Treat ; 15(2): 61-73, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27199616

RESUMO

OBJECTIVES: While early onset of puberty among girls has been related to substance use involvement and other adverse outcomes, less research has examined pubertal development and outcomes in boys. Further, research on puberty has not been conducted in the context of other risk factors for substance use involvement such as impulsivity. To address these gaps, this study characterized boys' pubertal development from preadolescence to mid-adolescence and related it to substance use risk and behavioral impulsivity. METHODS: A sample of 153 boys completed the Pubertal Development Scale to assess perception of their pubertal development relative to same age peers from ages 10 to 16 years, at 6-month intervals. Group-based trajectory modeling identified three distinct patterns of pubertal development: boys with more slowly developing boys with either earlier (n = 54) or later (n = 43) pubertal timing, and boys with faster tempo of pubertal development (n = 56). The groups were compared on demographic and substance use risk characteristics, as well as behavioral measures of impulsivity. RESULTS: Boys who had the accelerated progression through puberty had the highest proportion of family histories of substance use disorder and perform more impulsively on reward choice measures. CONCLUSIONS: Outcomes are consistent within the Maturation Compression Hypothesis and social neuroscience models of adolescent developmental risk.

14.
Addict Disord Their Treat ; 15(1): 17-24, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27034622

RESUMO

Impulsivity is strongly related to the development of adolescent substance use. Therefore, understanding factors that influence impulsive characteristics is important for the development of prevention and intervention programs. Intervention and prevention programs focused on factors that influence impulsive characteristics are especially important for those at particularly high risk for the expression of impulsivity - those with a family history of substance use disorder. A factor of particular interest is family functioning. AIM: To examine family functioning as a mediator of relations between having a family history of substance use disorder and impulsivity. METHODS: Participants included a majority Hispanic sample of pre-adolescent boys and girls (mean age 10.99, SD = .84) recruited from the community who did (FH+) and did not (FH-) have a family history of substance use disorder. FH status and the quality of family functioning were compared at the initial visit with impulsiveness assessed a year later. RESULTS: Results showed FH+ children had worse family functioning; worse family functioning was related to higher levels of impulsivity, and higher levels of impulsivity among FH+ children were due to the influence of family functioning on levels of impulsivity. In other words, family functioning mediated relations between having a family history of substance use disorder and impulsivity. CONCLUSION: These results indicate that higher levels of impulsivity in FH+ children are due in part to worse family functioning.

15.
Addict Disord Their Treat ; 15(3): 120-128, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27746702

RESUMO

OBJECTIVE: The purpose of this study was to determine if behavioral impulsivity under multiple conditions (baseline, after alcohol consumption or after serotonin depletion) predicted naturalistic alcohol use or treatment outcomes from a moderation-based contingency management intervention. METHOD: The current data analysis pulls information from three phases of a large study: 1) Phase 1 examined baseline and the effects of alcohol use and serotonin depletion on three types of behavioral impulsivity: response initiation (IMT task), response inhibition (GoStop task), and delay discounting (SKIP task); 2) Phase 2 involved 28 days of naturalistic drinking; and 3) Phase 3 involved 3 months of contingency management. During phases 2 and 3 alcohol use was measured objectively using transdermal alcohol monitors. The results of each individual phase has been previously published showing that at a group level the effects of alcohol consumption on impulsivity were dependent on the component of impulsivity being measured and the dose of alcohol consumed but serotonin depletion had no effect on impulsivity, and that a moderation-based contingency management intervention reduced heavy drinking. RESULTS: The current analysis combining data from those who completed all three phases (n = 67) showed that impulsivity measured at baseline, after alcohol consumption, or after serotonin depletion did not predict naturalistic drinking or treatment outcomes from a moderation-based CM treatment. CONCLUSIONS: Contingency management interventions may prove to be an effective intervention for impulsive individuals, however, normal variations in measured impulsivity do not seem to relate to normal variations in drinking pattern or response to moderation-based contingency management.

16.
J Child Adolesc Subst Abuse ; 25(4): 327-339, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28936105

RESUMO

This is a descriptive study of the recruitment and clinical/environmental characteristics of a child cohort (ages 10-12) established to test transmission of impulsivity in children with (FH+; n = 305) and without (FH-; n = 81) family history of substance use disorder. Among this cohort FH+ children had more emotional and behavioral symptoms, worse family relationships, and more deviant peers compared to FH- children. This cohort of children was established prior to the initiation of regular substance use and significant clinical problems, which will allow the opportunity to examine reciprocal relations between development of impulse control and substance use development.

17.
Alcohol Clin Exp Res ; 39(4): 743-51, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25833033

RESUMO

BACKGROUND: Treatments for alcohol use disorders typically have been abstinence based, but harm reduction approaches that encourage drinkers to alter their drinking behavior to reduce the probability of alcohol-related consequences, have gained in popularity. This study used a contingency management procedure to determine its effectiveness in reducing alcohol consumption among heavy drinkers. METHODS: Eighty-two nontreatment-seeking heavy drinkers (ages 21 to 54, M = 30.20) who did not meet diagnostic criteria for alcohol dependence participated in the study. The study had 3 phases: (i) an Observation phase (4 weeks) where participants drank normally; (ii) a Contingency Management phase (12 weeks) where participants were paid $50 weekly for not exceeding low levels of alcohol consumption as measured by transdermal alcohol concentrations, <0.03 g/dl; and (iii) a Follow-up phase (12 weeks) where participants (n = 66) returned monthly for 3 months to self-report drinking after the contingencies were removed. Transdermal alcohol monitors were used to verify meeting contingency requirements; all other analyses were conducted on self-reported alcohol use. RESULTS: On average 42.3% of participants met the contingency criteria and were paid an average of $222 during the Contingency Management phase, with an average $1,998 in total compensation throughout the study. Compared to the Observation phase, the percent of any self-reported drinking days significantly decreased from 59.9 to 40.0% in the Contingency Management and 32.0% in the Follow-up phases. The percent of self-reported heavy drinking days reported also significantly decreased from 42.4% in the Observation phase to 19.7% in the Contingency Management phase, which was accompanied by a significant increase in percent days of self-reported no (from 40.1 to 60.0%) and low-level drinking (from 9.9 to 15.4%). Self-reported reductions in drinking either persisted, or became more pronounced, during the Follow-up phase. CONCLUSIONS: Contingency management was associated with a reduction in self-reported episodes of heavy drinking among nontreatment-seeking heavy drinkers. These effects persisted even after incentives were removed, indicating the potential utility of contingency management as a therapeutic intervention to reduce harmful patterns of drinking.


Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Terapia Comportamental , Redução do Dano , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Adulto Jovem
18.
Alcohol Clin Exp Res ; 39(7): 1120-7, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25988708

RESUMO

BACKGROUND: Several studies demonstrate the utility of Alcohol Monitoring Systems' (AMS) transdermal alcohol concentration (TAC) monitor to objectively quantify drinking. AMS standard criteria (i.e., TAC >0.02 g/dl) used for drinking detection are deliberately conservative, but consequently only detect drinking equivalent to 5 or more standard drinks. Our study sought to characterize the sensitivity of TAC measurement to detect low-level drinking defined as the consumption of 1 to 3 beers. METHODS: Data were pooled from 3 studies giving controlled doses of 1, 2, 3, 4, and 5 Corona© beers (12 oz = 0.92 standard units) to 32 male and 29 female research volunteers wearing TAC monitors under controlled conditions. Analyses describe the sensitivity to detect drinking at various peak TAC thresholds beginning with any positive reading >0 g/dl, and then using TAC thresholds of 0.02 and 0.03 g/dl. RESULTS: Nearly 40% of participants drinking 1 beer did not have a positive TAC reading. However, positive TAC readings were observed in more than 95 and in 100% of participants drinking 2 and 3 or more beers, respectively. The probability of peak TAC detection was a positive function of the number of beers consumed and a negative function of the minimum TAC threshold for detection. Drinking was somewhat more likely to be detected in females than males drinking 2 to 5 beers, but not after 1 beer. Use of AMS standard criteria only reliably detected the consumption of 5 beers, and 45.9% of all occasions of drinking 1 to 3 beers were undetected using 0.02 g/dl as a threshold. CONCLUSIONS: Peak TAC levels between 0 and 0.02 g/dl must be considered to detect the low-level drinking of 1 to 3 standard drinks, and such thresholds are necessary when researchers and clinicians want to detect low-level drinking.


Assuntos
Consumo de Bebidas Alcoólicas , Monitoramento de Medicamentos/instrumentação , Etanol/análise , Pele/química , Adulto , Testes Respiratórios , Etanol/administração & dosagem , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
19.
Alcohol Clin Exp Res ; 39(8): 1501-9, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26173617

RESUMO

BACKGROUND: Youths with family histories of alcohol and other drug use disorders (FH+) are at increased susceptibility for developing substance use disorders relative to those without such histories (FH-). This vulnerability may be related to impaired adolescent development of impulse control and elevated risk-taking. However, no previous studies have prospectively examined impulse control and risk-taking in FH+ youth across adolescence. METHODS: A total of 386 pre-adolescents (305 FH+, 81 FH-; aged 10 to 12) with no histories of regular alcohol or other drug use were compared on behavioral measures of impulsivity including delay discounting, response initiation (Immediate Memory Task), response inhibition impulsivity (GoStop Impulsivity Paradigm), and risk-taking (Balloon Analogue Risk Task-Youth). Youths completed these laboratory tasks every 6 months, allowing for the examination of 10- to 15-year-olds. Hierarchical linear modeling was used to characterize the development of impulse control and risk-taking as shown in performance of these tasks throughout adolescence. RESULTS: We found that (i) FH+ youths had increased levels of delay discounting and response inhibition impulsivity at study entry; (ii) regardless of FH status, all youths had relatively stable delay discounting across time, improvements in response inhibition and response initiation impulsivity, and increased risk-taking; and (iii) although FH+ youths had increased response inhibition impulsivity at pre-adolescence, these differences were negligible by mid-adolescence. CONCLUSIONS: Heightened delay discounting in FH+ pre-adolescents coupled with normal adolescent increases in risk-taking may contribute to their increased susceptibility toward problem substance use in adolescence.


Assuntos
Comportamento do Adolescente/psicologia , Comportamento Impulsivo , Assunção de Riscos , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Criança , Desvalorização pelo Atraso , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
20.
Alcohol Alcohol ; 50(4): 413-9, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25770137

RESUMO

AIMS: This study examined the validity of two methods of classifying binge drinkers. METHODS: Adult drinkers (n = 166) completed the Alcohol Use Questionnaire (AUQ) and a Timeline Followback (TLFB) interview to characterize drinking during the past 28 days. Using Townshend and Duka's (2005) recommendations, answers on three AUQ items (average drinks per hour, number of times drunk within the prior 6 months and percentage of times drunk when drinking) were used to derive a binge score that was then used to classify drinkers as Binge, Non-Binge and Unclassifiable. Two methods for calculating binge scores were compared: (a) Participant-derived, using participants' answers on the 3 AUQ items; and (b) Staff-derived, staff used TLFB interview information to answer the 3 AUQ items. Additionally, Participant- and Staff-derived classifications were used to predict future drinking behaviors assessed by a second TLFB interview. RESULTS: Participant- and Staff-derived binge scores had a low concordance rate. Staff-derived classifications were better than Participant-derived classifications at predicting future binge drinking behavior and identifying group differences in drinking behavior reported during the second TLFB interview (average drinks per hour, number of times drunk within the prior 6 months, and percentage of times drunk when drinking). CONCLUSIONS: Classifying drinkers using staff-guided TLFB interview methods instead of self-reported participant generalizations of typical drinking habits better relates to real-world drinking. Classification schemes that rely on dichotomous categorization of drinkers (Binge vs. Non-Binge) may be missing individuals who engage in harmful patterns of drinking. A continuous scale or index characterizing problematic drinking may be more useful.


Assuntos
Consumo Excessivo de Bebidas Alcoólicas/diagnóstico , Entrevista Psicológica , Autorrelato , Adulto , Intoxicação Alcoólica/diagnóstico , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
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