Association of genetic variants in CYP3A5, DRD2 and NK1R with opioid overdose.

In 2023, 3651 Ohioans died because of an opioid overdose. Of those opioid overdoses, 3579 (98%) of which were attributed to fentanyl. We evaluated the association between 180 candidate single nucleotide polymorphisms (SNPs) and self-reported, nonfatal opioid overdose history from a prospective sample of 1301 adult patients (≥18 years of age) seen in three urban emergency departments in Ohio. Candidate SNPs included 120 related to the dopamine reward pathway and 60 related to pharmacokinetics. Of the 821 patients who reported having been exposed to opioids in their lifetime, 95 (11.6%) also reported having experienced an opioid-related overdose. Logistic regression, adjusting for age and biologic sex, was used to characterize the association between each SNP and opioid overdose, correcting for multiple comparisons. Three SNPs, located in three different genes were associated with opioid overdose: increased odds with CYP3A5 (rs776746) and DRD2 (rs4436578), and decreased odds with NKIR (rs6715729). Homozygotic CYP3A5 (rs776746) had the highest adjusted odds ratio (OR) of 6.96 (95% CI [2.45, 29.23]) and homozygotic NK1R (rs6715729) had the lowest OR of 0.28 (95% CI [0.14, 0.54). Given that CYP3A5 (rs776746) has been associated with increased plasma concentrations of fentanyl, rs776746 could potentially be utilized as a prognostic risk indicator for the potential of an opioid overdose. NK1R regulates the expression of the neurokinin-1 receptor, a regulator of respiration and NK1R (rs6715729) represents a novel genetic marker for a decreased risk of opioid overdose risk.

State program enables the identification of factors associated with naloxone awareness, self-efficacy, and use for overdose reversal: A cross-sectional, observational study in an urban emergency department population.

INTRODUCTION: To assist the state of Ohio in addressing the opioid epidemic, the Ohio Attorney General appointed experts in a variety of academic disciplines to the Scientific Committee on Opioid Prevention and Education (SCOPE). The focus of SCOPE is the application of scientific principles to the development of prevention and educational strategies for reducing substance use disorder and related harms (e.g., promoting naloxone awareness). Naloxone awareness is a step in the naloxone cascade, which is a useful model for understanding the sequential steps laypeople must take to prepare themselves to intervene using naloxone; other steps include training and previous administration experience. Prior work has explored correlates of these steps among individuals with risky substance use, but fewer studies have focused on broader populations containing potential bystanders (e.g., family and community members). METHODS: This study was a secondary data analysis of patients from three urban emergency departments. Subsamples differed across five models (n = 479-1208) and included opioid-exposed and -naïve participants. Logistic regression characterized clinically useful sociodemographic predictors (e.g., race, ethnicity, education, employment, housing status) of naloxone awareness, self-efficacy (which relates to training), and previous-overdose administration. Two additional logistic regressions tested associations between risk factors for witnessing an opioid overdose and two cascade steps (awareness and self-efficacy). RESULTS: Non-White race, Hispanic ethnicity, and lower education predicted not being aware of naloxone; non-White race also predicted lower naloxone self-efficacy, and older age predicted lack of previous-overdose administration. Having family members with risky opioid use was heavily associated with awareness, while personal substance-use behaviors and previous overdose witnessing were associated with both awareness and higher naloxone self-efficacy. CONCLUSIONS: Characteristics associated with lower likelihood of completing each cascade step highlight opportunities for targeted interventions. Specifically, findings indicated the importance of expanding naloxone education and training programs to more diverse populations and to family members of individuals with risky opioid use. Further, these findings demonstrate how a state-funded program such as SCOPE can have a positive impact on identifying strategies that may assist in reducing mortality associated with opioid overdose.

Motives for alcohol use across the 24 hours prior to a suicide attempt.

OBJECTIVE: Acute alcohol use is a risk factor for suicidal behavior. This study examined sources of variance (between-person, within-person) in hour-to-hour self-reported alcohol consumption and drinking motives and assessed the interrelations of different motives for alcohol use across the 24 hr preceding a suicide attempt. METHOD: This multisite study utilized interview data obtained retrospectively from adult patients hospitalized following a suicide attempt. The current analysis examined participants (n = 110) who reported using alcohol within 24 hr of the attempt (Mage = 39.59; 48.2% female, 72.7% White; 4.5% Hispanic/Latinx). Participants reported suicide-facilitative drinking motives using three items from the Suicide Facilitative Drinking Motives Scale and reported typical, nonfacilitative motives using three items from the Drinking Motives Questionnaire-Revised. Data were analyzed using hierarchical linear modeling. RESULTS: Most variance in reported drinking motives occurred between participants, though there was substantial within-person variability. Within-person increases in alcohol use were associated with suicide-facilitative motives for alcohol use, but not nonfacilitative motives. Social and enhancement motives were consistently negatively associated with facilitative motives, while coping motives were positively associated with reported drinking to reduce fear regarding suicide. CONCLUSIONS: Results suggest the assessment of motives for alcohol use in at-risk patients may provide key clinical targets (i.e., the function of drinking) for preventing suicidal behavior. When alcohol is consumed for coping motives or used to facilitate suicidal behavior, it is particularly concerning and warrants clinical intervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Can profiles of behaviors occurring within 48 h of a suicide attempt predict future severity of suicidal thoughts and reattempt?: An examination of hospitalized patients 12 Months post-discharge.

Behavioral warning signs (WS) are near-term changes within individuals, which aid in determining imminent risk for suicide attempts. However, those who attempt suicide differ in their engagement of WS, and it is unclear if these differences relate to future risk of suicidal behavior. Using a sample of 132 adults presenting to a hospital following a suicide attempt, the current study sought to determine if differences in engagement in WS for the index attempt prospectively predicted suicide attempt, frequency of ideation, and intensity of suicide ideation 12 months post discharge. Latent class analyses (LCAs) conducted on 6 behaviors (i.e., alcohol use, nightmares, interpersonal negative life events, suicide communication, risky behavior, low sleep, and high sleep) found a 5-class solution optimally fit the data. One identified class, characterized by engagement in risky behaviors the hours before an attempt differed from other identified classes in terms of risk for future suicidal ideation and behaviors. More specifically, participants in "High Risky Behavior" class had higher rates of 12-month suicide reattempt, significantly more frequent suicide ideation, and significantly worse intensity of suicide ideation during the 12 months following their index attempt compared to participants endorsing typical patterns of WS. These results held when adjusting for various traditional baseline covariates (e.g., depressive symptoms). The current study demonstrates that patterns of behavioral WS may be utilized as their own prognostic indicator of future suicidal ideation and behaviors among high-risk individuals reporting a recent suicide attempt, which can inform post-discharge clinical intervention and prevention efforts.

Warning signs in a period of acute risk for suicide attempt: The utility of count- and combination-based classification.

OBJECTIVE: This study sought to establish if models involving the specific combinations of identifiable behavioral warning signs (WS; i.e., alcohol use, suicidal communications, preparation of personal affairs, experiencing negative interpersonal life events) for a suicide attempt outperformed a simpler count model of WS to distinguish an acute risk period (the six hours prior to a suicide attempt) from a control period (a matched six-hour period the day prior). METHOD: Generalized linear mixed models tested all logical combinations of four behavioral WS in addition to a count variable of the number of behavioral warning signs. For the count variable, receiver operating characteristic curve analysis was utilized to determine the optimal cut point for the number of endorsed WS. RESULTS: Area under the curve (AUC) compared classification across all models, with the count model demonstrating similar classification performance to the best multivariate model (AUCs of 0.72 and 0.73, respectively), with an optimal cut point of endorsing one or more WS. CONCLUSION: Although determinations of acute risk should be informed by multiple sources of information, this study suggests a relatively simple count-based approach that considers the presence of one (or more) behavioral WS may be used as a potential indication of increased acute risk for suicide attempt.

A comparison of retrospectively reported and ecological momentary assessment-reported perceived social support in predicting ecological momentary assessment-reported non-suicidal self-injury.

INTRODUCTION: Non-suicidal self-injury (NSSI) urges and behaviors are associated with lower perceived social support and related constructs (e.g., perceived rejection). However, no studies have examined the concordance of retrospective (baseline) and ecological momentary assessment (EMA) perceived social support assessments. Retrospective and EMA reports are often only weakly to moderately correlated; measurement approaches may, therefore, impact observed associations between variables. We tested whether average EMA-reported perceived emotional social support uniquely predicts EMA-reported NSSI urges and behaviors above baseline-reported retrospective self-report of perceived emotional social support alone. METHODS: 93 young adults (ages 18-34) with past-month NSSI urges or behaviors and lifetime NSSI behaviors completed a semi-structured interview, self-report surveys, and a 2-week EMA protocol. RESULTS: Baseline- and EMA-reported perceived emotional social support were positively correlated (Kendall's tau-b = 0.51). Average EMA-reported social support was uniquely associated with EMA-reported NSSI urges but not NSSI behaviors. CONCLUSIONS: EMA-reported perceived emotional social support captured information not represented by baseline reports alone, but improvement in model fit was modest. EMA-reported social support may further improve the estimation of EMA-reported NSSI urges if modeled as a proximal predictor of NSSI. Further work is needed to clarify temporal directions between social support and NSSI urges. Limitations are discussed.

Caregiver adverse childhood experiences and preschool externalizing problems: The role of factors that contribute to caregiver resilience.

BACKGROUND: Preschool children with externalizing problems are at risk for short- and long-term difficulties and preschool externalizing problems (PEP) are influenced by several caregiver factors. One such factor is caregiver adverse childhood experiences (ACEs). Researchers have investigated how caregiver ACEs are related to PEP by identifying risk factors to account for this association. However, research on caregiver factors associated with fewer PEP is limited. Particularly, factors that contribute to caregiver resilience may be adaptive caregiver characteristics that negatively relate to PEP, even when adjusting for caregiver ACEs. OBJECTIVE: The present study sought to address a gap in the literature by examining the impact of different types of factors that contribute to caregiver resilience (e.g., caregiver social-ecological factors or caregiver positive childhood experiences) as promotive factors of lower PEP. PARTICIPANTS AND SETTING: Participants included 125 caregiver-child dyads recruited from the community. METHOD: Participating caregivers completed measures of their own and their child's demographic information, caregiver ACEs, caregiver social-ecological factors, caregiver positive childhood experiences, and PEP. RESULTS: Overall, positive caregiver childhood experiences (r = -0.25, p < .01), and not caregiver social-ecological factors (r = -0.13, p = .15), demonstrated a significant negative association with PEP. However, this relation became statistically non-significant when adjusting for caregiver ACEs (ß = -0.12, p = .20). CONCLUSIONS: Given the association between caregiver ACEs and PEP, this study highlights the importance of assessing a caregiver's ACEs, specifically when working with caregivers seeking parent training for disruptive child behaviors. There should be a continued focus on ecological and family strengths and differential impacts as they relate to PEP.

Evaluation of the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Questionnaire and its Relations to Cannabis-Related Problems.

Cannabis use and the prevalence of cannabis use disorder (CUD) among emerging adults are on the rise. Several indicators of cannabis use (e.g., quantity, frequency) as they relate to negative outcomes have been posited in the extant literature. Despite research examining links between indicators and cannabis outcomes, few assessments of cannabis use indicators exist. The Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQ-CU) was developed to assess cannabis use across a range of factors. However, the factor structure of the DFAQ-CU has not been replicated. Further, the DFAQ-CU was modeled using reflective strategies despite formative strategies being conceptually appropriate. The present study utilized principal components analyses (PCA) and principal axis factoring (PAF) to evaluate the structure of the DFAQ-CU. PCA yielded a four-component solution; PAF resulted in a five-factor solution. Linear regression found significant relations between PCA components and PAF factors with CUD symptoms and cannabis-related problems; however, effect sizes were larger for the PAF suggesting possible misdisattenuation. The PCA components demonstrated evidence of discriminant and convergent validity with measures of cannabis and alcohol behavior. The study informs research and clinical work through the refinement of cannabis use assessment and enhancing our understanding of the importance of model selection.

The Relations Between an Inventory-Based Measure of Executive Function and Impulsivity Factors in Alcohol- and Cannabis-Relevant Outcomes.

OBJECTIVE: While the lack of relation between performance- and inventory-based executive function (EF) measures is well documented, there remains ambiguity between self-report EFs and closely related constructs (e.g., impulsivity) assessed via the same method. The degree of convergence between purported EF measures with similar yet distinct constructs contain important theoretical implications for available EF assessment strategies and their construct validity. A newer measure of EF, the Behavior Regulation Inventory of Executive Functions-Adult (BRIEF-A), allows for more direct comparisons to self-reported measures of impulsivity, such as the commonly used Urgency, Planning, Perseverance, Sensation Seeking-Positive Urgency (UPPS-P) assessment. METHOD: The present study used factor analysis and hierarchical regression to explore the associations between the BRIEF-A and UPPS-P, using alcohol and cannabis consumption across various outcomes (i.e., quantity-frequency and consequences) as an external criterion. Participants were 339 undergraduate students (Mage = 19.35; Female = 63%) from a large southwestern university. RESULTS: The BRIEF-A and UPPS-P demonstrated strong correlations at both higher- and lower order facets. While the BRIEF-A was a significant correlate to many substance use outcomes, these relations were generally weaker than those seen with the UPPS-P. Hierarchical regression suggested limited contributions of the BRIEF-A over and above the UPPS-P. CONCLUSIONS: Overall, this study suggested substantial overlap between impulsigenic factors and EFs when measured by self-report, and limited utility of EF measures to account for unique variance with substance use outcomes in this sample.

A controlled examination of acute warning signs for suicide attempts among hospitalized patients.

BACKGROUND: Near-term risk factors for suicidal behavior, referred to as 'warning signs' (WS), distinguish periods of acute heightened risk from periods of lower risk within an individual. No prior published study has examined, using a controlled study design, a broad set of hypothesized WS for suicide attempt. This study addressed this gap through examination of hypothesized behavioral/experiential, cognitive, and affective WS among patients recently hospitalized following a suicide attempt. METHODS: Participants were recruited during hospitalization from five medical centers across the USA including two civilian hospitals and three Veterans Health Administration facilities (n = 349). A within-person case-crossover study design was used, where each patient served as her/his own control. WS were measured by the Timeline Follow-back for Suicide Attempts Interview and were operationalized as factors that were present (v. absent) or that increased in frequency/intensity within an individual during the 6 h preceding the suicide attempt (case period) compared to the corresponding 6 h on the day before (control period). RESULTS: Select WS were associated with near-term risk for suicide attempt including suicide-related communications, preparing personal affairs, drinking alcohol, experiencing a negative interpersonal event, and increases in key affective (e.g. emptiness) and cognitive (e.g. burdensomeness) responses. CONCLUSIONS: The identification of WS for suicidal behavior can enhance risk recognition efforts by medical providers, patients, their families, and other stakeholders that can serve to inform acute risk management decisions.

A life span developmental investigation of marriage and problem-drinking reduction.

While prior literature has largely focused on marriage effects during young adulthood, it is less clear whether these effects are as strong in middle adulthood. Thus, we investigated age differences in marriage effects on problem-drinking reduction. We employed parallel analyses with two independent samples (analytic-sample Ns of 577 and 441, respectively). Both are high-risk samples by design, with about 50% of participants having a parent with lifetime alcohol use disorder. Both samples have been assessed longitudinally from early young adulthood to the mid-to-late 30s. Separate parallel analyses with these two samples allowed evaluation of the reproducibility of results. Growth models of problem drinking tested marriage as a time-varying predictor and thereby assessed age differences in marriage effects. For both samples, results consistently showed marriage effects to be strongest in early young adulthood and to decrease somewhat monotonically thereafter with age, reaching very small (and nonsignificant) magnitudes by the 30s. Results may reflect that role transitions like marriage have more impact on problem drinking in earlier versus later adulthood, thereby highlighting the importance of life span developmental research for understanding problem-drinking desistance. Our findings can inform intervention strategies aimed at reducing problem drinking by jumpstarting or amplifying natural processes of adult role adaptation.

Relations among CRFR1 and FKBP5 genotype, cortisol, and cognitive function in aging humans: A Project FRONTIER study.

Here we use the glucocorticoid cascade hypothesis framework to address the role of baseline cortisol on changes in cognitive function over a 3-year span in non-demented rural Americans. We also determine if genotype at 4 different single nucleotide polymorphisms (SNPs) relates to change in cognitive function. We predicted 1) over time, increases in baseline cortisol will be associated with decline in cognitive function, 2) individuals homozygous for 3 CRFR1 SNP rare alleles (AA rs110402, TT rs7209436, and TT rs242924 vs. others) will show less cognitive decline and this will be particularly pronounced in those with lower baseline cortisol, and 3) FKBP5 T carriers (TT or CT vs. CC homozygotes) will have decreased cognitive performance and this will be particularly pronounced in individuals with higher baseline cortisol. Collectively, our data do not robustly support the glucocorticoid cascade hypothesis. In several cases, higher baseline cortisol related to better cognitive performance over time, but within individuals, increased cortisol over time related to decreased performance on some cognitive domains over time. Contrary to our predictions, individuals with the rare CRFR1 haplotype (AA, TT, TT) performed worse than individuals with the common haplotype across multiple domains of cognitive function. FKBP5 genotype status had minimal impacts on cognitive outcomes. Genotype effects were largely not dependent on cortisol. The Project FRONTIER dataset is supported by Texas Tech University Health Sciences Center Garrison Institute on Aging.

Introduction to special section for Angela K. Stevens.

This special section is dedicated to some of the recent work by Dr. Angela Stevens, who passed away unexpectedly last year. She is dearly missed by those fortunate enough to have known her, but her legacy lives on through the lives she touched and her research. Since the beginning of her undergraduate training, Dr. Angela Stevens has dedicated her professional life to improving the lives of people who use drugs and alcohol through research. During her doctoral training at Texas Tech University, her research program focused on risk and protective factors which influence alcohol and cannabis use based on the theory of planned behavior. Dr. Stevens' master's thesis utilized daily diary methodology to examine the within-person intention-behavior relation for alcohol use among a sample of young adults (Stevens et al., 2017). This work indicated that individuals higher in phenotypes related to problematic drinking (i.e., impulsigenic traits) had stronger intentions to drink, which in turn predicted higher levels of alcohol consumption. Building on this work, her dissertation (Stevens et al., 2020) involved a psychometric evaluation of a momentary impulsivity scale across two intensive longitudinal samples using ecological momentary assessment (EMA). This work informed the assessment of state-level factors relevant to substance use. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Modeling the Adverse Childhood Experiences Questionnaire-International Version.

Adverse childhood experiences (ACEs) are related to a host of deleterious physical and mental health outcomes. The ACE-International Questionnaire (ACE-IQ) was developed to assess categories of ACEs (e.g., sexual, emotional, and physical abuse) in internationally representative samples. Though the ACE-IQ has been used world-wide, little work has examined the structure of this measure. Further, much of the modeling techniques implemented lacked theoretical rationale. The present work used two principal components analyses (PCA) to evaluate the ACE-IQ structure using both the identified ACE categories as defined by the World Health Organization (WHO) and using the ACE-IQ items as individual indicators. Using the WHO method, a two-component structure was indicated. Alternatively, a PCA of the individual items yielded a six-component structure. Results highlight the importance of theoretically grounded measure evaluation and the potential distinctions amongst types of ACEs. Implications and future directions for research and practice are discussed.

Limitations of cross-lagged panel models in addiction research and alternative models: An empirical example using project MATCH.

OBJECTIVE: Models of addiction often posit bidirectional and dynamic associations between constructs relevant to the etiology and maintenance of addictive behaviors. The cross-lagged panel model (CLPM) is commonly used in addiction research but has been critiqued for not appropriately adjusting for between-person variance. Alternatives to the CLPM have been suggested but remain underutilized. The primary purpose of this article is to highlight interpretational limitations of the CLPM and to provide examples of alternative models. METHOD: We specified CLPM, Random-Intercept CLPM, and a Latent Curve Model with Structured Residuals using four waves of data from Project MATCH (n = 1,201). We modeled prospective relations among depression symptoms and temptation to drink. Substantive inferences and assumptions across models were compared. RESULTS: The CLPM provided the most evidence of significant cross-lagged paths but the poorest fit to the data compared to other models. Alternative models found little evidence of prospective within-person associations, and more evidence for between-person associations and wave-specific within-person relations between depression symptoms and temptation to drink. CONCLUSIONS: This study highlights shortcomings of the CLPM and details alternative models to consider. Addiction researchers should consider alternatives to the CLPM to more optimally delineate relations among constructs across time. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Identifying Specific Emotion Regulation Deficits that Associate with Nonsuicidal Self-injury and Suicide Ideation in Adolescents.

It is not known how emotion regulation deficits and strategies may differentially relate to nonsuicidal self-injury (NSSI) and suicide ideation in samples of community-based adolescents. The current study examined emotion regulation using comprehensive multi-method assessment to identify which specific deficits are uniquely related to NSSI and suicide ideation in a sample of high school students. Regarding specific deficits, it was expected that lack of emotional awareness, lack of access to emotion regulation strategies, poor cognitive reappraisal, and poorer automatic emotion processing would uniquely associate with past-year NSSI engagement. It was also predicted that lack of access to strategies, lack of impulse control, lack of awareness, and nonacceptance of emotion would uniquely associate with past-year presence of suicide ideation and suicide ideation severity. The sample included 696 adolescents (54.8% female; ages 14-17; mean age = 15.5) recruited from public high schools. Self-report measures were administered assessing suicide ideation, NSSI engagement, dimensions of emotion regulation, and automatic emotion processing (Emotion Stroop). Emotion suppression was the only unique and significant predictor of past-year NSSI engagement, and lack of access to emotion regulation strategies was the strongest predictor of both past-year presence of suicide ideation and recent suicide ideation severity when accounting for all deficits in the same model. Acquiring emotion regulation skills during the period of adolescence has great potential to buffer from occurrence of NSSI and severity of suicide ideation.

Alcohol and Cannabis Cross Motives, Class Analysis, and Substance Use among Concurrent Users.

Background: Substance use motives refer to an individual's reasons for engaging in substance use. Although the respective alcohol and cannabis literatures have linked specific substance-use motives to indices of use, less is known about motives in concurrent users, particularly examination of cross-motives (e.g., cannabis motives predicting alcohol use). Methods: The present work examined motives for use in a sample of concurrent users to assess relations between motives and alcohol and cannabis outcomes (quantity, frequency, and use disorder symptoms) using both variable- and person-centered approaches. Finally, the present work aimed to discern the impact of timeframe selection for defining concurrent use (i.e., past year, past two weeks). Participants (N = 524) consisted of individuals that endorsed having used both alcohol and cannabis in the past year with subsample (N = 192) of individuals endorsing past two-week concurrent use. Results: Univariate linear regression analyses revealed small to medium positive relations between all alcohol motives and alcohol outcomes and small to medium positive relations between cannabis social, coping, enhancement, and expansion motives and cannabis use. Regressions examining cross-motives and multivariate models revealed wide variability in relations. Mixture analyses revealed a three-class solution (i.e., High Motives, Positive Alcohol, and Low Conformity) for past year concurrent users and a two-class solution (i.e., Low Motives and High Motives) for past two-week concurrent users. Discussion: Examination of motive classes revealed differences in substance, particularly cannabis, outcomes as a function of class membership. Findings are useful in classifying concurrent users' motives and highlight the importance of timeframe selection.

Individual and COVID-19-Specific Indicators of Compliance with Mask Use and Social Distancing: The Importance of Norms, Perceived Effectiveness, and State Response.

COVID-19 is a global pandemic that has resulted in widespread negative outcomes. Face masks and social distancing have been used to minimize its spread. Understanding who will engage in protective behaviors is crucial for continued response to the pandemic. We aimed to evaluate factors that are indicative of mask use and social distancing among current and former college students prior to vaccine access. Participants (N = 490; 67% female; 60% White) were current and former U.S. undergraduate college students. Perceived effectiveness and descriptive norms regarding COVID-19 safety measures, COVID-19-related news watching and seeking, state response timing to stay-at-home mandates, impulsivity-like traits, affect (mood), and demographic variables were assessed. Results found that greater perceived effectiveness indicated increased personal compliance within and across behaviors. Greater norms related to compliance within behaviors (e.g., indoor norms related to indoor compliance). Increased perceived stress, anxiety, and negative affect indicated greater compliance. More positive affect was associated with less compliance. Being non-White, compared to White (p < 0.001), and female, compared to male (p < 0.001), were associated with greater compliance. Overall, early implementation of stay-at-home orders, exposure to COVID-19-related news, and increased perceived effectiveness are crucial for health safety behavior compliance. Findings are important for informing response to health crises, including COVID-19.

Differences in alcohol-related protective behavioral strategies among female and male college students.

Alcohol use is prevalent among college students, and some are at risk for developing alcohol use disorders. However, many students report using alcohol without experiencing negative consequences, which may be due, in part, to use of protective behavioral strategies (PBS). Although evidence of PBS effectiveness on reducing alcohol use and negative consequences is mixed, gender/sex differences in PBS use remain a consistent finding. To further explore these associations, we used item response theory models and assessed item-level PBS correlations with alcohol outcomes separately for female and males. Results indicated specific items exhibited significant sex differences in the amount of information and location of information across the latent trait. Some items provided little information across females and males, suggesting these items can be removed. All PBS items significantly associated with alcohol outcomes were negative in direction, but effects ranged from small to large in magnitude. These findings suggest strategies that are effective against alcohol-related harms vary across females and males, and PBS measurement may be improved by establishing sex-specific norms and analyzing females and males separately when studying PBS. Future research priorities include examining PBS among intersex, trans, and nonbinary people.

Using categorical data analyses in suicide research: Considering clinical utility and practicality.

OBJECTIVE: Categorical data analysis is relevant to suicide risk and prevention research that focuses on discrete outcomes (e.g., suicide attempt status). Unfortunately, results from these analyses are often misinterpreted and not presented in a clinically tangible manner. We aimed to address these issues and highlight the relevance and utility of categorical methods in suicide research and clinical assessment. Additionally, we introduce relevant basic machine learning methods concepts and address the distinct utility of the current methods. METHOD: We review relevant background concepts and pertinent issues with references to helpful resources. We also provide non-technical descriptions and tutorials of how to convey categorical statistical results (logistic regression, receiver operating characteristic [ROC] curves, area under the curve [AUC] statistics, clinical cutoff scores) for clinical context and more intuitive use. RESULTS: We provide comprehensive examples, using simulated data, and interpret results. We also note important considerations for conducting and interpreting these analyses. We provide a walk-through demonstrating how to convert logistic regression estimates into predicted probability values, which is accompanied by Appendices demonstrating how to produce publication-ready figures in R and Microsoft Excel. CONCLUSION: Improving the translation of statistical estimates to practical, clinically tangible information may narrow the divide between research and clinical practice.