Back to the basics and fast forward to multiculturalism.

OBJECTIVE: This article reviews and comments on the contributions to the special issue, Brief Alcohol Interventions for Young Adults: Strengthening Effects and Disentangling Mechanisms to Build Personalized Interventions for Widespread Uptake, and proposes next steps to strengthen effects and promote widespread uptake. METHOD: The articles of the special issue were reviewed simultaneously through the lenses of addiction and multicultural sciences to provide further insight into subsequent research that may help to advance the field. RESULTS: The needs of early adults seem to have changed significantly in 30 years. Although significant advances have occurred, many important research questions remain unanswered and many subpopulations continue to be understudied. Common themes discussed in this article emerged from the special issue for potentially improving effects and promoting greater uptake of efficacious interventions. CONCLUSION: Researchers must pivot to advance understandings concerning early adult substance use interventions among minoritized populations and in the context of intersectionality in order to promote broader uptake. Multicultural psychology may offer novel conceptualizations that would help to diversify early adult interventions as well as help to address gaps in understanding the intervention needs of minoritized early adults. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Negative life events and incident alcohol use disorders among ethnic minorities.

The association of negative life events (NLEs) with incident alcohol use disorders (AUDs) was examined among Blacks, Hispanics, and Whites in the second wave of the National Comorbidity Survey (NCS) among 3,679 participants without AUDs at the first wave. The number of past-year NLEs at NCS-2 was higher for Black than White participants, but the rates of incident AUDs did not differ by racial/ethnic group (14.2% among all participants). Past-year NLEs were associated with increased odds of incident AUDs for Whites and Hispanics but not Blacks. The implications of racial/ethnic differences in life events and AUDs are discussed.

Partnering with Native Communities to Develop a Culturally Grounded Intervention for Substance Use Disorder.

Studies have documented serious disparities in drug and alcohol-related morbidity and mortality among American Indians and Alaska Natives (AI/ANs) compared to other ethnic groups in the U.S. despite high rates of abstinence in these groups. Further complicating these health disparities are barriers to accessing evidence-based treatments that are culturally appropriate and acceptable. As part of a research program to promote health equity in rural communities, we developed an academic-community partnership to create a culturally grounded intervention for adults with substance use disorder (SUD) residing on a rural AI reservation. We describe the early phases of our long-term Community Based Participatory Research project and report findings from the first study we conducted. This key informant interview study consisted of in-depth qualitative interviews with 25 tribal members knowledgeable about substance use and recovery on the reservation. The goal was to understand social norms and cultural conceptualizations of substance use to inform the development of a sustainable, community-driven intervention. Participants reported that a holistic approach to recovery that emphasizes spiritual, cultural, and interpersonal harmony and connectedness was important to the community and would be necessary for the intervention to succeed. They also emphasized the need for a multi-level intervention targeting individuals, families, and the community as a whole. Through this initial study, we not only gained valuable information that will be used to guide future research and treatment efforts, but we also strengthened our partnership and built trust with the community. In this manuscript we tell the story of the development of our project and describe our shared vision for future directions.

Understanding the link between racial trauma and substance use among American Indians.

Historians and scholars from various disciplines have documented the pervasive influence of racism on American society and culture, including effects on the health and well-being of American Indian (AI) people. Among the many health problems affected by racial discrimination and oppression, both historical and current, are substance use disorders. Epidemiological studies have documented greater drug and alcohol-related morbidity and mortality among AI/AN Alaska Natives compared to other ethnic groups, and culturally appropriate, effective interventions are sorely needed. We collected, as part of a larger community-based participatory research project to address substance use disparities in rural AI communities, qualitative interview data from 25 AI key informants from a frontier reservation in Montana. Using a semistructured interview guide, we asked participants to discuss their perceptions of the causes of substance use problems and barriers to recovery on the reservation. Although no questions specifically asked about discrimination, key informants identified stress from racism as an important precipitant of substance use and barrier to recovery. As one participant stated: "Oppression is the overarching umbrella for all sickness with drugs and alcohol." Participants also identified historical trauma resulting from colonization as a manifestation of race-based stress that drives behavioral health problems. Findings suggest that interventions for AIs with substance use disorders, and possibly other chronic health problems, may be more effective if they address social determinants of health such as racial discrimination and historical trauma. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Advances in Substance Abuse Prevention and Treatment Interventions Among Racial, Ethnic, and Sexual Minority Populations.

Substance abuse research among racial, ethnic, and sexual minority populations historically has lagged behind that conducted with majority samples. However, interesting and potentially important advances in prevention, brief interventions, and treatment have been made in the last few years, at least among some minority populations, such as American Indian youth. New prevention efforts have focused on point-of-sale interventions for alcohol, as well as on family-unit interventions designed with subpopulation cultural values in mind. In addition, previously established evidence-based and culturally relevant interventions are being combined with computer technology. Empirical data support using brief interventions with patients of color in medical settings, capitalizing on teachable and reachable moments during a physical trauma or other health crisis. Finally, use of empirically supported treatment may be helpful, with a caveat that these interventions must appropriately match cultural traditions and respect the values of the clients. More research clearly is needed, especially among certain minority populations in the United States. A greater emphasis should be placed on developing novel, culturally grounded interventions in partnership with communities, in addition to adapting existing mainstream interventions for use by other cultures.

The privilege and burden of peer review.

OBJECTIVES: Peer review is a core value and method of quality control in psychological research, academic psychology, and other disciplines, but little is known about the peer-reviewing behavior of ethnic minority reviewers in particular. The purpose of this study was to examine the self-identified ethnicity of those invited to peer review articles for 76 journals that utilized the American Psychological Association's Journals Back Office (JBO) system from 2003 to 2012. It was hypothesized that a modest increase in the ratio of requests for reviews from self-identified ethnic minority reviewers would be observed over time, that self-identified ethnic minority reviewers would be less likely to refuse a review request than those who do not self-identify as an ethnic minority, and finally that increases in reviewer burden would be evident in significant increases in declines to requests by all reviewers. METHOD: Reviewer requests and responses were examined among the 76 journals that used the JBO system over a 10-year period. RESULTS: Using hierarchical linear models, the percentage of review invitations extended to ethnic minorities was found to significantly increase over time: Initially, an estimated 8.34% of review requests were made to ethnic minority reviewers, and that percentage increased an average of 0.41% per year. CONCLUSIONS: Ethnic minority reviewers were significantly less likely to refuse a review request than ethnic majority reviewers. Results are discussed in terms of perceived pressure to demonstrate scholastic impact and the disproportionate service burden often borne by ethnic minority psychologists.

Categories of alcohol outcome expectancies and their relationships to alcohol related consequences.

Extensive research has generally supported a significant and positive relationship of positive outcome expectancies with the amount of alcohol consumed among young adult drinkers, a group generally considered at high risk. Researchers have also naturally been interested in the relationships between these beliefs about drinking and the negative consequences experienced among those who abuse alcohol. Interestingly, those studies found significant positive associations of the number of alcohol outcome expectancies with drinking related consequences, independent of the amount of alcohol being consumed, suggesting that some consequences may be a function of beliefs rather than chemical effects. In addition, there has been evidence that age related differences may exist in the experience of positive outcome expectancies and their associations with consumption. One area that has not been examined is how different categories of alcohol outcome expectancies may be associated with different types of consequences among young adults. Young adults between ages 18-30 were assessed for different categories of alcohol outcome expectancies as well as different types of alcohol consequences. Study hypotheses were partially supported in that specific categories of expectancies were significantly associated with different types of consequences in multiple regression models, but not in the pattern that was predicted from a review of the literature. Expectancies with themes of personal power were consistently found to be significantly and positively associated with various types of consequences after controlling for alcohol consumption. The paper discusses the clinical relevance of these findings with regard to young adult drinkers.

Ethnic identity, drinking motives, and alcohol consequences among Alaska Native and non-Native college students.

This research involves the examination of drinking motives, alcohol consequences, and ethnic identity in a sample of Native and non-Native college student drinkers in Alaska. Although more Alaska Native students are abstinent from alcohol compared to any other ethnic group, Native students who do drink experience greater alcohol consequences and dependence symptoms. Therefore, we attempted to examine the influence of ethnic identity on alcohol consequences in a diverse sample of Native and non-Native students in Alaska. Findings showed that drinking motives, as measured by the Drinking Motives Questionnaire (social, coping, enhancement, and conformity), significantly predicted alcohol consequences after controlling for frequency of monthly binge drinking. In addition, after controlling for depression, binge drinking, and drinking motives, one aspect of ethnic identity (Affirmation, Belonging, and Commitment) was significantly negatively related to alcohol consequences, whereas another aspect of ethnic identity (Ethnic Identity Search) was not. Taken together, these findings suggest that interventions for college student alcohol misuse that target Native students should be culturally grounded and focused on enhancing the Affirmation, Belonging, and Commitment to one's ethnic heritage and should address drinking motives, especially drinking to cope, as a way to reduce alcohol related harm.

The relationship of microaggressions with alcohol use and anxiety among ethnic minority college students in a historically White institution.

Little is known about how microaggressions may impact the health and mental health of college students of color attending historically White universities. In this study, students provided self-report of the number of racial and ethnic microaggressions they had experienced over the previous month, as well as data on anxiety symptoms (Beck Anxiety Inventory), alcohol consumption (Daily Drinking Questionnaire) and consequences (Rutgers Alcohol Problem Index), and self-efficacy to cope with daily hassles (General Self-efficacy Scale) and with high risk drinking situations (Situational Confidence Questionnaire). As expected, students of color reported significantly more microaggressions than their European American counterparts. Microaggressions and self-efficacy were significantly associated with anxiety (Full Model R² = .20; p < .001), microaggressions and self-efficacy were significantly associated with binge drinking (Full Model R² = .10; p < .01), and microaggressions, binge drinking events, self-efficacy, and microaggressions × self-efficacy interaction were significantly associated with alcohol related consequences (Full Model R² = .28; p < .001) among the students of color. Results suggest that microaggressions may represent a health and mental health risk to students of color. Implications of study results and future research directions are discussed.

Readiness to change and post-intervention drinking among Hispanic college students living on the US/Mexico border.

OBJECTIVE: The purpose of the present study was to examine readiness to change as a predictor of post-intervention alcohol consumption among Hispanic college student drinkers taking part in a brief harm reduction intervention. METHOD: Participants of the intervention study were 109 Hispanic college students residing on the US/Mexico border who self-identified as regular drinkers. This manuscript reports findings from a subset of participants who had complete data at 3-month follow-up (N=84). Participants completed the Readiness to Change Questionnaire, the Rutgers Alcohol Problem Index, and the Form-90 Steady Pattern drinking assessment prior to receiving an intervention. RESULTS: Hierarchical least-squares regression was used to predict baseline readiness to change scores from alcohol consumption and related consequences, and then to predict 3-month post-intervention drinking from baseline drinking and readiness to change. Alcohol consumption and consequences significantly predicted readiness to change at baseline, and follow-up drinking was significantly predicted from baseline drinking, readiness to change, and an interaction between the two variables. Findings indicated that readiness to change may function differently in people with varying levels of alcohol involvement. CONCLUSIONS: Greater readiness to change predicted reduced alcohol consumption only among the heaviest drinkers; among lighter drinkers, greater readiness to change predicted increased alcohol consumption. Possible explanations for this finding are discussed.

Stress and alcohol use among soldiers assessed at mobilization and demobilization.

Excessive alcohol use may have negative consequences, including less force readiness among military personnel. The identification of variables associated with alcohol use may inform early intervention efforts to decrease negative consequences. This longitudinal prospective study examined the associations of demographic and stress variables with alcohol use among 876 soldiers that were mobilized and demobilized through an Army installation during a 9-month period in 2003. Participants reported a moderate level of general stress at mobilization and demobilization, and a minority reported significant combat stress. Alcohol use in the 2 weeks before the demobilization evaluation was associated with younger age, nonactive duty status before mobilization, and more general stress. Male gender was associated with more drinks per drinking day. The results suggest that younger, nonactive duty male personnel experiencing stress may be a group at risk for increased drinking after deployment and for whom intervention may be helpful.

Empowering the disempowered: harm reduction with racial/ethnic minority clients.

Harm-reduction principles, such as empowerment of clients and goals for moderation, align well with the cultural worldviews of many clients of color. Empirically supported harm-reduction strategies often work well with ethnic minority clients. However, clients of color require special clinical considerations. A case study illustrates the use of the community participatory model, which combines harm reduction, cultural sensitivity, and community support. Treatment services can be provided under one roof to eliminate barriers to seeking and receiving services. Harm-reduction therapists can carefully assess and diagnose clients of color to minimize the potential shortcomings and cultural biases in assessment tools. Therapy will include the family and incorporate traditional practices as desired by clients. Use of these methods will empower and support clients of color as they seek their treatment goals.

Ethics instruction increases graduate students' responsible conduct of research knowledge but not moral reasoning.

The purpose of this study was to assess the short-term effectiveness of ethics courses in enhancing responsible conduct of research (RCR) knowledge and moral judgment among graduate students in health-related disciplines. Forty-eight graduate students completed a questionnaire about research experience, knowledge and judgments about appropriate research practices, and a standardized test of moral judgment at the beginning and end of a semester-long ethics course. Knowledge about RCR but not moral judgment increased significantly in some areas. The results are discussed in terms of implications for RCR instruction and of future research designed to improve RCR instruction.

Alcohol use and comorbid anxiety, traumatic stress, and hopelessness among Hispanics.

Little is known about the comorbidity of alcohol use, anxiety, hopelessness, and trauma among Mexican Americans, especially those living in impoverished and often isolated communities or neighborhoods (colonias in Spanish) along the U.S.-Mexico border that may be particularly vulnerable due to stressful living conditions. The current study utilized a community participatory model to investigate the relationships of alcohol use, acculturation, anxiety, hopelessness, and trauma in 100 Mexican origin colonia residents. Significant comorbidity was expected and that anxiety, hopelessness, and post-traumatic symptoms were hypothesized to be associated with the severity of the alcohol use disorders of participants. Participants who met DSM-IV criteria for alcohol dependence reported significantly more symptoms of anxiety and post-traumatic stress, and symptoms of anxiety were significantly associated with alcohol use disorders. This study provides evidence of the need for further investigation of stress, trauma, anxiety, hopelessness, and alcohol abuse in Mexican American residents and to inform future prevention and treatment efforts to improve both the physical and mental health of this population.

The role of executive cognitive functions in changing substance use: what we know and what we need to know.

BACKGROUND: Executive cognitive functions (ECF) have been linked to skills such as planning, organizing, problem solving, decision-making, initiating and self-regulating behavior, working memory, and motivation; critical activities needed to monitor and change substance use behavior. PURPOSE: The purpose of this study is to investigate how ECF may impact important variables associated with changing substance use behavior. METHODS: This study is a critical review of the extant literature about how ECF may influence substance abuse treatment outcomes and behavior change. RESULTS: A review of the literature found evidence that poorer ECF likely hinders substance use behavior change and is often associated with behavior labeled as denial. However, the relationship between ECF and substance abuse appears to be highly complex. CONCLUSIONS: Traditional methods of substance abuse assessment, interpretation of behavior, and intervention may need to be reconsidered in light of new research about executive cognitive dysfunction. Implications for future research are discussed.

Knowledge about health risks and drinking behavior among Hispanic women who are or have been of childbearing age.

In this study, 99 Mexican American women colonia residents who are or had been of childbearing age were assessed for English language skills, alcohol use, beliefs about health risks related to drinking, and awareness of warning labels on alcohol beverage containers. English language skills significantly predicted participants' ability to remember health warnings on beverage containers whereas greater awareness of nutritional information on labels was associated with lesser amounts of alcohol consumed. Beliefs that drinking during pregnancy is helpful and not associated with liver and cognitive problems were significantly associated with higher alcohol consumption, and beliefs that drinking helps when pregnant along with a reported history of drinking during a previous pregnancy significantly predicted self-reported drinking during a most recent pregnancy. The study represents a first step toward understanding how beliefs about drinking risks may be associated with alcohol use among Hispanic women.

Predictors of aversive alcohol consequences in a military sample.

The purpose of this study was to identify predictors of risky alcohol use and alcohol-related consequences among postdeployment soldiers. Demobilizing soldiers completed an assessment packet that included questions about demographic factors, relationships, stress, and alcohol-related consequences. Significant predictors of greater alcohol-related consequences, as assessed with the CAGE questionnaire, included fewer years of formal education, male gender, not being in an intimate relationship, racial/ethnic minority status, enlisted rank, having been deployed to the continental United States, and greater stress, whereas significant predictors of drinking and driving included male gender, not being in an intimate relationship, and greater stress. Identifying the predictors of alcohol consequences that occur upon demobilization may aid in determining which soldiers are at risk for such consequences before deployment and may help to maintain military readiness.

Variables associated with intimate partner violence in a deploying military sample.

Variables associated with intimate partner violence (IPV) were examined within a sample of military personnel preparing to deploy. Soldiers with intimate relationships processed for mobilization through Fort Bliss, Texas, completed a questionnaire that queried demographic information, relationship satisfaction, stress, risky alcohol use behaviors, and tactics used during intimate relationship conflict. Four hundred forty-nine deploying soldiers (15.8% of 2,841 with usable data) reported IPV in the past year. Younger age, less education, less relationship satisfaction, more stress, and risky alcohol use behaviors were significant individual predictors of engaging in IPV. The results of this study are discussed in terms of their implications for targeting efforts to reduce IPV among military personnel.

Mindfulness meditation and substance use in an incarcerated population.

Despite the availability of various substance abuse treatments, alcohol and drug misuse and related negative consequences remain prevalent. Vipassana meditation (VM), a Buddhist mindfulness-based practice, provides an alternative for individuals who do not wish to attend or have not succeeded with traditional addiction treatments. In this study, the authors evaluated the effectiveness of a VM course on substance use and psychosocial outcomes in an incarcerated population. Results indicate that after release from jail, participants in the VM course, as compared with those in a treatment-as-usual control condition, showed significant reductions in alcohol, marijuana, and crack cocaine use. VM participants showed decreases in alcohol-related problems and psychiatric symptoms as well as increases in positive psychosocial outcomes. The utility of mindfulness-based treatments for substance use is discussed.

Recent drinking consequences, motivation to change, and changes in alcohol consumption over a three month period.

Little is known about what type of drinking related consequences may enhance motivation to change or may hinder behavior change over time. In order to examine this research question, 120 adult participants abusing alcohol were administered the Drinker Inventory of Consequences-Recent (DrInC-R), the Brief Readiness to Change Questionnaire (BRTC), and the Steady Pattern Chart (SP). Subscale scores from the DrInC-R and the BRTC; and alcohol consumption as assessed by the SP at baseline and three month follow-up were retained for data analyses. Greater intrapersonal DrInC-R consequences scores significantly predicted greater contemplation stage scores (R2=.37, p<.001), and lower precontemplation stage scores (R2=.32, p<.001), and DrInC-R impulse control and interpersonal consequences scores significantly predicted alcohol consumption at three month follow-up after controlling for baseline consumption (R2=.50, p<.001). Increased awareness of intrapersonal drinking related consequences may motivate change, whereas numbers of impulse control and interpersonal consequences may predict changes in drinking behavior over the short-term.