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BACKGROUND: Alcohol use is a gendered behavior and motherhood is a life stage which may influence drinking motives. However, there are no drinking motive scales uniquely tailored to maternal populations. This work developed a new maternal drinking motives scale (M-DMS) and determined associations between the M-DMS and alcohol-related behavior. METHODS: An online observational survey (n = 534) and online test-retest survey (n = 164) were conducted with adult, UK mothers. From the observational study, data on drinking motives was extracted to determine M-DMS items and factor loading. This was split into two data sets for exploratory and confirmatory factor analyses. Alcohol Use Disorders Identification Test (AUDIT) and Timeline Follow back data, taken from both surveys, were combined to determine the M-DMS's predictive validity. RESULTS: Following a parallel analysis and exploratory factor analysis, a two-factor model (positive reinforcement motives, negative reinforcement motives) was deemed the best fit. Probability functional analysis identified items with problematic responses. These were removed before confirmatory factor analysis (on the second dataset) demonstrated a good fit for the two-factor model. All factor loadings were significant and positive (ßs > 0.56). Reliability of the two subscales was excellent: negative reinforcement (ωT = 0.95), positive reinforcement (ωT = 0.89). Test-retest reliability was good for both negative (ICC = 0.84, 95%CI = 0.80-0.88) and positive (ICC = 0.77, 95% CI = 0.71-0.82) subscales. Both subscales predicted AUDIT and quantity of alcohol consumption (ps < 0.001). CONCLUSION: The first tailored Maternal Drinking Motives Scale (M-DMS) provides a more valid research tool for assessing psychological mechanisms of alcohol use in mothers.
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Background: The stigma and discrimination experienced by individuals with an alcohol/substance use disorder often extends to the family members and friends who provide care, which is known as courtesy stigma. This courtesy stigma can lead to isolation, poor mental health and might impact the quality-of-care these individuals provide. The aim of this study was to examine the frequency of experienced courtesy stigma/discrimination in individuals in a family support service for a loved one's substance use, and to examine any cross-sectional associations with changes in mood, health- and social-related outcomes. Methods: Thirty-six individuals (25 female) with a mean age of 51.91 years took part in an ecological momentary assessment study in which the experience of courtesy stigma/discrimination and measures of mood, health (e.g. alcohol use, nicotine use, healthy eating, sleep, physical activity) and social connections were taken 3 times per day for fourteen days. Results: Across 1029 competed assessments (compliance â¼68%), there were 122 (â¼11%) reports of courtesy stigma/discrimination. The most common sources of stigma/discrimination were from family members (â¼43% of occurrences) and friends (â¼31% of occurrences). Experiencing this stigma/discrimination was associated with increases in alcohol and nicotine use, as well as reductions in healthy eating, physical activity, sleep, social connections, and mood. Conclusions: The experience of courtesy stigma/discrimination was common in a sample of individual's who support a loved one with alcohol or substance use disorder. These experiences are associated with changes in health and social behaviors and may lead to a poorer quality of care.
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Avaliação Momentânea Ecológica , Família , Amigos , Estigma Social , Transtornos Relacionados ao Uso de Substâncias , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Amigos/psicologia , Família/psicologia , Adulto , Transtornos Relacionados ao Uso de Substâncias/psicologia , Comportamento Social , Estudos Transversais , Afeto , Nível de Saúde , Consumo de Bebidas Alcoólicas/psicologiaRESUMO
Background: Recent cognitive neuroscience models of value-based decision-making suggest value-based choices for alcohol are sensitive to various inputs, such as context and social influence. In two online experiments, we tested whether manipulating these inputs influenced proxies for alcohol value. Experiment 1: 157 social drinkers were presented with 4 hypothetical scenarios (drinking alone, with friends who are also drinking, with friends but trying to "cut-down" for health reasons, with friends who aren't drinking) in a within-subjects design, and completed the Brief Assessment of Alcohol Demand after each as a measure of value. Value for alcohol (number of drinks purchased) was greatest when drinking with friends who were also drinking compared to drinking alone (d = 0.95), friends not drinking (d = 1.49) and friends drinking/health related (d = 1.59). Value for alcohol was also greater when drinking alone compared to with friends who were not drinking (d = 0.55), and also with friends drinking/health related (d = 0.62). Experiment 2: 241 participants were randomly allocated to see one of four categories of images in a 2 (context: bar vs house) x 2 (social influence: enjoy vs not enjoy) design, before completing a Concurrent Choice Task for alcohol and Visual Analog Scales. There were no significant effects found on either task, both taken as proxies for value. Conclusion: There was inconclusive evidence that the value for alcohol could be manipulated by social context. This could be explained by greater saliency of the manipulation in asking participants to imagine themselves in a hypothetical situation as opposed to presenting images depicting drinking scenarios.
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Consumo de Bebidas Alcoólicas , Amigos , Humanos , Consumo de Bebidas Alcoólicas/psicologia , Amigos/psicologia , Meio SocialRESUMO
Research shows cognitive and neurobiological overlap between sign-tracking [value-modulated attentional capture (VMAC) by response-irrelevant, discrete cues] and maladaptive behaviour (e.g. substance abuse). We investigated the neural correlates of sign-tracking in 20 adults using an additional singleton task (AST) and functional magnetic resonance imaging (fMRI). Participants responded to a target to win monetary reward, the amount of which was signalled by singleton type (reward cue: high value vs. low value). Singleton responses resulted in monetary deductions. Sign-tracking-greater distraction by high-value vs. low-value singletons (H > L)-was observed, with high-value singletons producing slower responses to the target than low-value singletons. Controlling for age and sex, analyses revealed no differential brain activity across H > L singletons. Including sign-tracking as a regressor of interest revealed increased activity (H > L singletons) in cortico-subcortical loops, regions associated with Pavlovian conditioning, reward processing, attention shifts and relative value coding. Further analyses investigated responses to reward feedback (H > L). Controlling for age and sex, increased activity (H > L reward feedback) was found in regions associated with reward anticipation, attentional control, success monitoring and emotion regulation. Including sign-tracking as a regressor of interest revealed increased activity in the temporal pole, a region related to value discrimination. Results suggest sign-tracking is associated with activation of the 'attention and salience network' in response to reward cues but not reward feedback, suggesting parcellation between the two at the level of the brain. Results add to the literature showing considerable overlap in neural systems implicated in reward processing, learning, habit formation, emotion regulation and substance craving.
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Sinais (Psicologia) , Motivação , Condicionamento Clássico/fisiologia , Retroalimentação , Humanos , RecompensaRESUMO
Altering the quality of episodic meal memories has been shown to affect subsequent food intake. Acute alcohol consumption disrupts memory formation and produces short-term overeating. In two studies, we investigated whether alcohol consumption can affect meal-related memories and later food intake. Study 1 (N = 60, 50% male) investigated how consumption of an alcoholic drink (0.5 g/kg) prior to consumption of a lunch meal affected meal memory of that lunch, and later food intake, compared with a placebo-alcohol. Findings revealed that alcohol consumption did not impair meal memory, and did not affect subsequent food intake. Study 2 (N = 72, 50% male) investigated whether, due to alcohol's retrograde facilitation effect (the enhancement of recall due to reduced interference at the point of exposure) consuming alcohol after consumption of a lunch meal could enhance meal memory, compared with when consumed before a lunch meal (both a dosage of 0.6 g/kg), and compared with consumption of a soft drink. Contrary to prediction, alcohol consumed after a lunch meal did not significantly increase meal memory. But, certain types of meal memory were impaired when alcohol was consumed before the meal, compared with consumption of a soft drink. Subsequent food intake did not differ between conditions. Taken together, findings suggest that alcohol intoxication can impair some forms of meal memory recall, likely due to disruption of memory formation during the encoding phase. However, there was no evidence that this impairment contributes towards alcohol-induced overeating.
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Consumo de Bebidas Alcoólicas , Ingestão de Alimentos , Ingestão de Energia , Rememoração Mental , Feminino , Humanos , Laboratórios , Almoço , Masculino , RefeiçõesRESUMO
Acute alcohol consumption has been shown to increase food intake, and long-term alcohol consumption may be a risk for weight gain. A potential, but under-studied, mechanism for this effect is alcohol's ability to enhance food reward. In two studies, participants consumed an alcoholic drink (Study 1: 0.3 grams of alcohol per kilogram of bodyweight (g/kg); Study 2: 0.6 g/kg) and a placebo-alcohol drink in a within-subjects design. In both studies, food-related appetitive and motivational states, and attentional bias (AB) towards food-related cues were measured. In Study 1 (N = 44), participants completed a visual probe task with concurrent recording of eye-movements which measured AB towards images of palatable foods, unpalatable foods, and non-food control items. Participants also completed measures of appetite and snack urge ratings, salivary response towards palatable foods and an ad libitum food taste test. In Study 2 (N = 84), participants completed a similar procedure, but completed a modified Stroop task which measured differences in food-related and alcohol-related AB across the two drink conditions. In Study 1, there was no difference in food-related AB between drink conditions, and no differences in snack urge, appetite ratings, salivary response, or food intake. In contrast, Study 2 showed an alcohol-induced increase in AB towards food, but not alcohol. Snack urge, alcohol urge ratings and ad libitum food intake were also higher after alcohol consumption, relative to the placebo. Collectively, these findings suggest that alcohol can increase food reward and food intake, but these effects may only occur at a higher dose.
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Consumo de Bebidas Alcoólicas , Viés de Atenção , Comportamento Alimentar , Apetite , Sinais (Psicologia) , Etanol , Humanos , RecompensaRESUMO
AIMS: Information provided on glass labels may be an effective method to reduce alcohol consumption. The aim of this study was to assess the impact of glass labels conveying unit information and a health warning in reducing ad libitum alcohol consumption. METHODS: A cluster-randomized experimental study was conducted to measure the efficacy of a labeled glass in reducing alcohol consumption in a semi naturalistic bar laboratory setting, in a sample of 81 pairs (n = 162) of UK young adult drinkers. Pairs were randomized to receive two 340-ml glasses of beer or wine: labeled or plain (control). Alcohol consumption was assessed in an ad libitum drinking period, and urge to drink was measured at baseline and postdrinking period. Focus groups (n = 2) were conducted, and thematic analysis was used to gain an insight into the acceptability and the perceived effectiveness of the glasses. RESULTS: Mean unit consumption was 1.62 (SD ± 0.83) units in the labeled glass condition and 1.69 (SD ± 0.82) units in the non labeled glass condition. There were no significant effects of the labeled glasses on ad libitum alcohol consumption (95% CI -0.25 to 0.37, p = 0.35), despite participants (85%) noticing the information. Qualitative analysis of focus groups indicated that although participants perceived the glasses as a useful tool for increasing awareness of units and guidelines, they were viewed as limited in their potential to change drinking behavior due to the unappealing design of the glass and a view that unit guidelines were not relevant to drinking patterns or contexts. CONCLUSIONS: Labeled glasses did not change alcohol consumption in the current study, potentially due to ineffectiveness of this type of message in a young adult population. The information on the glasses was attended to, highlighting that glasses could be a feasible tool for providing information.
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Consumo de Bebidas Alcoólicas , Bebidas Alcoólicas , Rotulagem de Produtos/métodos , Adulto , Feminino , Grupos Focais , Humanos , Laboratórios , Masculino , Pesquisa Qualitativa , Distribuição Aleatória , Reino Unido , Adulto JovemRESUMO
AIMS: A pilot randomized controlled trial (RCT) to assess the feasibility and potential efficacy of assertive community treatment (ACT) in adults with alcohol dependence. METHODS: Single blind, individually randomized, pilot RCT of 12 months of ACT plus treatment as usual (TAU) versus TAU alone in adults (age 18+ years) with alcohol dependence and a history of previous unsuccessful alcohol treatment attending specialist community alcohol treatment services. ACT aimed to actively engage participants for 12 months with assertive, regular, minimum weekly contact. ACT was combined with TAU. TAU comprised access to the full range of services provided by the community teams. Primary outcome is mean drinks per drinking day and percent days abstinent at 12 months follow up. Analysis of covariance was conducted using 80% confidence intervals, appropriate in the context of a pilot trial. RESULTS: A total of 94 participants were randomized, 45 in ACT and 49 in TAU. Follow-up was achieved with 98 and 88%, respectively at 12 months. Those in ACT had better treatment engagement, and were more often seen in their homes or local community than TAU participants. At 12 months the ACT group had more problems related to drinking and lower quality of life than TAU but no differences in drinking measures. The ACT group had a higher percentage of days abstinent but lower quality of life at 6 months. The ACT group had less unplanned healthcare use than TAU. CONCLUSIONS: An trial of ACT was feasible to implement in an alcohol dependent treatment population. TRIAL REGISTRATION: ISRCTN22775534.
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Alcoolismo/terapia , Serviços Comunitários de Saúde Mental , Adulto , Feminino , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Projetos Piloto , Método Simples-Cego , Adulto JovemRESUMO
BACKGROUND: Increased levels of cortisol during acute alcohol withdrawal have been linked to cognitive deficits and depression. Preclinical research found that the glucocorticoid Type II receptor antagonist, mifepristone, prevented some of the neurotoxic effects of withdrawal and memory loss. Clinical trials have shown mifepristone effective in the treatment of depression. This study aims to examine the extent to which the glucocorticoid Type II receptor antagonist, mifepristone, when given to alcohol dependent males during the acute phase of alcohol withdrawal, will protect against the subsequent memory loss and depressive symptoms during abstinence from alcohol. METHODS/DESIGN: The study is a Phase 4 therapeutic use, "Proof of Concept" trial. The trial is a double-blind randomised controlled clinical trial of mifepristone versus inactive placebo. The trial aims to recruit 120 participants referred for an inpatient alcohol detoxification from community alcohol teams, who meet the inclusion criteria; 1) Male, 2) Aged 18-60 inclusive, 3) alcohol dependent for 5 or more years. A screening appointment will take place prior to admission to inpatient alcohol treatment units to ensure that the individual is suitable for inclusion in the trial in accordance with the inclusion and exclusion criteria. On admission participants are randomised to receive 600 mg a day of mifepristone (200 mg morning, afternoon and evening) for 7 days and 400 mg for the subsequent 7 days (200 mg morning and evening) or the equivalent number of placebo tablets for 14 days. Participants will remain in the trial for 4 weeks (at least 2 weeks as an inpatient) and will be followed up at 3, 6 and 12 months post randomisation. Primary outcome measures are cognitive function at week 3 and 4 after cessation of drinking and symptoms of depression over the 4 weeks after cession of drinking, measured using the Cambridge Neuropsychological Test Automated battery and Beck Depression Inventory, respectively. Secondary outcome measures are severity of the acute phase of alcohol withdrawal, alcohol craving, symptoms of protracted withdrawal and maintenance of abstinence and levels of relapse drinking at follow-up. DISCUSSION: The current trial will provide evidence concerning the role of glucocorticoid Type II receptor activation in cognitive function and depression during acute alcohol withdrawal and the efficacy of treatment with mifepristone. ISRCTN: ISRCTN54001953, Registered 29th September 2011.
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Consumo de Bebidas Alcoólicas/tratamento farmacológico , Alcoólicos , Alcoolismo/tratamento farmacológico , Transtornos Cognitivos/tratamento farmacológico , Mifepristona/uso terapêutico , Síndrome de Abstinência a Substâncias/etiologia , Adulto , Alcoolismo/complicações , Transtornos Cognitivos/etiologia , Método Duplo-Cego , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome de Abstinência a Substâncias/prevenção & controleRESUMO
BACKGROUND: The Fear of Missing Out (FoMO), which is often experienced over missing opportunities for social gains associated with drinking, has been linked to heavy episodic drinking and experiencing negative consequences. The UK Coronavirus (COVID-19)-related lockdown provided a unique context to study FoMO's ability to predict of alcohol consumption. The aim of the current study was to test if FoMO predicted alcohol consumption during a time of social restrictions. METHODS: One hundred and five UK adults (aged 18-30, 61% female) participated in a study using an ecological momentary assessment design. Surveys were completed on smartphones and assessed FoMO and drinking intentions, three time a day (morning, afternoon, evening) over three consecutive weekends (Friday, Saturday, Sunday). Alcohol consumption was recorded once per day, based on previous day consumption. RESULTS: Repeated mixed model analyses found FoMO significantly predicted quantity of alcohol consumption (b =.05, p =.01) and drinking intentions (b =.47, p <.001), but did not predict frequency of consumption. Being male (b = 2.93, p =.02) and higher intentions (b = 0.5, p <.001) predicted higher quantity of consumption. Drinking intentions was the only variable to predict frequency of consumption (b =.004, p <.001). CONCLUSIONS: The study showed FoMO can predict quantity of alcohol consumption and drinking intentions, which are linked to increased negative consequences. Future studies should assess FoMO against other predictive factors. Results provide an insight into how a social predictor influenced alcohol consumption during a time of restrictions.
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Consumo de Bebidas Alcoólicas , COVID-19 , Medo , Humanos , Masculino , Feminino , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/epidemiologia , Medo/psicologia , Adulto Jovem , Adolescente , COVID-19/psicologia , COVID-19/epidemiologia , Reino Unido/epidemiologia , Intenção , Avaliação Momentânea Ecológica , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Alcohol consumption can prime motivation to continue drinking and may contribute to excessive drinking. Most alcohol administration research assesses the effect of a single alcohol dose on outcome measures; however, this differs from typical drinking occasions in which several drinks are consumed over time. This research tracks priming measures (alcohol urge, latency to first sip, and consumption time) and subjective effects (intoxication, stimulation, and sedation) across consumption of 5 drinks, over a period of 2.5 hours. Alcohol, placebo, and no-alcohol (i.e., soft drink) conditions are compared with isolate the effects of alcohol expectancies and differentiate these from alcohol's pharmacological effects. METHODS: Alcohol urge and subjective state were measured before and after an initial drink was consumed (preload: alcohol, placebo, or no-alcohol). Four additional drinking phases followed whereby participants had access to 2 drinks (alcohol/no-alcohol, or placebo/no-alcohol). Experimental priming (urge, latency to first sip, consumption time) and subjective effect (intoxication, stimulation, and sedation) outcomes were recorded after each drink. RESULTS: The pattern of alcohol urge following placebo drinks differed compared with alcohol and no-alcohol consumption, Fs(1, 90) > 4.10, ps < 0.003. There was a linear decrease in urge in the no-alcohol condition, while in the alcohol condition urge increased after the first few drinks before decreasing. Urge ratings showed the opposite pattern in the placebo condition (a decrease followed by an increase). Alcohol produced the highest ratings of lightheadedness, F(5, 440) = 2.8, p < 0.02, but both alcohol and placebo produced increased sedated feelings, Fs ≥ 19.05, ps ≤ 0.001. After placebo, urge was positively related to liking and enjoying the "alcoholic" drinks and feeling more stimulated (rs ≥ 0.31, ps ≤ 0.01). CONCLUSIONS: In social drinkers, different factors may affect priming during different stages of a drinking episode. For example, the pharmacological effects of alcohol appear involved in priming during the initial stages of drinking. When alcohol expectancies are activated, blocking access to alcohol can increase urge, supporting Tiffany's cognitive processing model of craving.
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Afeto/efeitos dos fármacos , Consumo de Bebidas Alcoólicas/psicologia , Bebidas Alcoólicas , Etanol/administração & dosagem , Motivação/efeitos dos fármacos , Priming de Repetição/efeitos dos fármacos , Afeto/fisiologia , Feminino , Humanos , Masculino , Motivação/fisiologia , Priming de Repetição/fisiologia , Inquéritos e Questionários , Adulto JovemRESUMO
The transition from goal-directed to habitual control over drug-seeking has been experimentally demonstrated in animals, but there have been no comparable reports in humans. Following a recent animal design, the current study employed an outcome-devaluation procedure to test whether goal-directed control over tobacco seeking would be abolished by alcohol expectancy. Eighty smokers first learned that two responses earned tobacco or chocolate points, respectively, before tobacco was devalued by health warnings and smoking satiety. Participants were then presented with either a glass of beer/wine or water with instructions that this item could be consumed after the task (alternative reward). Then choice between the tobacco and chocolate response was measured in extinction to assess goal-directed control of tobacco seeking, in a nominal Pavlovian to instrumental transfer (PIT) test to assess stimulus control of tobacco seeking, and in a reacquisition test to assess the impact of direct feedback from the outcomes. The results showed that alcohol expectancy selectively abolished goal-directed control of tobacco seeking but not stimulus control or the impact of feedback from outcomes. These data suggest that 'endogenous' retrieval of low drug value governing goal-directed regulation of drug seeking is disrupted by conflicting appraisal of an alternative reinforcer, promoting habitual control, which may play a role in relapse.
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Consumo de Bebidas Alcoólicas/psicologia , Comportamento Aditivo/psicologia , Comportamento de Procura de Droga , Objetivos , Reforço Psicológico , Fumar/psicologia , Adolescente , Adulto , Idoso , Análise de Variância , Animais , Antecipação Psicológica , Comportamento de Escolha , Conflito Psicológico , Sinais (Psicologia) , Extinção Psicológica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: Immunocompromised patients with chronic inflammatory disease (CID) may have experienced additional psychosocial burden during the COVID-19 pandemic due to their immunocompromised status. This study was undertaken to determine if vaccination would result in improved patient-reported outcomes longitudinally among individuals with CID undergoing SARS-CoV-2 vaccination regardless of baseline anxiety. METHODS: Data are from a cohort of individuals with CID from 2 sites who underwent SARS-CoV-2 vaccination. Participants completed 3 study visits before and after 2 messenger RNA vaccine doses in the initial vaccination series when clinical data were collected. Patient-reported outcomes were measured using the Patient-Reported Outcomes Measurement Information System 29-item Health Profile and expressed as T scores, with 2 groups stratified by high and low baseline anxiety. Mixed-effects models were used to examine longitudinal changes, adjusting for age, sex, and study site. RESULTS: A total of 72% of the cohort was female with a mean ± SD age of 48.1 ± 15.5 years. Overall, sleep disturbance improved following both doses of SARS-CoV-2 vaccinations, and anxiety decreased after the second dose. Physical function scores worsened but did not meet the minimally important difference threshold. When stratifying by baseline anxiety, improvement in anxiety, fatigue, and social participation were greater in the high anxiety group. Physical function worsened slightly in both groups, and sleep disturbance improved significantly in the high anxiety group. CONCLUSION: Sleep disturbance decreased in a significant and meaningful way in patients with CID upon vaccination. In patients with higher baseline anxiety, social participation increased, and anxiety, fatigue, and sleep disturbance decreased. Overall, results suggest that SARS-CoV-2 vaccination may improve mental health and well-being, particularly among those with greater anxiety.
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COVID-19 , Transtornos do Sono-Vigília , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Vacinas contra COVID-19 , SARS-CoV-2 , Pandemias , COVID-19/prevenção & controle , Vacinação , Transtornos do Sono-Vigília/etiologia , Doença Crônica , Fadiga , SonoRESUMO
OBJECTIVES: Problematic substance use is one of the most stigmatized health conditions leading research to examine how the labels and models used to describe it influence public stigma. Two recent studies examine whether beliefs in a disease model of addiction influence public stigma but result in equivocal findings-in line with the mixed-blessings model, Kelly et al. (2021) found that while the label "chronically relapsing brain disease" reduced blame attribution, it decreased prognostic optimism and increased perceived danger and need for continued care; however, Rundle et al. (2021) conclude absence of evidence. This study isolates the different factors used in these two studies to assess whether health condition (drug use vs. health concern), etiological label (brain disease vs. problem), and attributional judgment (low vs. high treatment stability) influence public stigma toward problematic substance use. METHOD: Overall, 1,613 participants were assigned randomly to one of the eight vignette conditions that manipulated these factors. They completed self-report measures of discrete and general public stigma and an indirect measure of discrimination. RESULTS: Greater social distance, danger, and public stigma but lower blame were ascribed to drug use relative to a health concern. Greater (genetic) blame was reported when drug use was labeled as a "chronically relapsing brain disease" relative to a "problem." Findings for attributional judgment were either inconclusive or statistically equivalent. DISCUSSION: The labels used to describe problematic substance use appear to impact discrete elements of stigma. We suggest that addiction is a functional attribution, which may explain the mixed literature on the impact of etiological labels on stigma to date. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Encefalopatias , Transtornos Relacionados ao Uso de Substâncias , Humanos , Estereotipagem , Estigma Social , Percepção SocialRESUMO
Alcohol is the most used substance by women of childbearing age. Alcohol exposed pregnancies can have serious consequences to the fetus, and the UK has one of the highest rates of drinking during pregnancy. Alcohol use during motherhood is also a public health concern, linked with potential harms to the woman and child. This qualitative study investigated the attitudes and experiences of pregnant/parenting women and healthcare professionals regarding maternal drinking. A semi-structured focus group and interviews were conducted in the North West of England with pregnant women, mothers, and healthcare professionals. Quantitative measures captured demographics, alcohol use, and screened for mental ill-health for pregnant women and mothers. Reflexive thematic analysis was used to analyse narratives. Findings revealed that most participants believed avoiding alcohol during pregnancy is the safest option. However, some pregnant women and mothers stated that there was insufficient evidence to demonstrate the harms of low-level drinking and that abstinence guidelines were patronising. All participants reported that low-level drinking during motherhood was acceptable. Heavy drinking was believed to pose serious harm during pregnancy and motherhood to the baby and mother, in addition to damaging relationships. Strong motives were revealed for choosing and avoiding to drink, such as coping with the difficulties of motherhood and parental responsibilities, respectively. Contradictions were found across quantitative and qualitative self-reports of consumption, reflecting potential underreporting of alcohol use. Additionally, drinking levels were discussed in extremes only (low/heavy) without considering 'grey area' drinking. Clear, consistent advice and guidelines are needed to support women in reducing their alcohol use during pregnancy and motherhood. These should include the unique potential risks regarding maternal drinking, and the harm attributable to non-clinically dependent alcohol use. The maternal participants in this study were middle-class, therefore, research is needed to capture the views and experiences of women of all socioeconomic backgrounds.
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Mães , Gestantes , Gravidez , Lactente , Criança , Humanos , Feminino , Pessoal de Saúde , Poder Familiar , Etanol , Atenção à SaúdeRESUMO
BACKGROUND AND AIMS: An initial dose of alcohol can motivate-or prime-further drinking and may precipitate (re)lapse and bingeing. Lab-based studies have investigated the alcohol priming effect; however, heterogeneity in designs has resulted in some inconsistent findings. The aims of this meta-analysis were to (i) determine the pooled effect size for motivation to drink following priming, measured by alcohol consumption and craving, and (ii) examine whether design characteristics influenced any priming effect. METHODS: Literature searches of PsycINFO, PubMed and Scopus in October 2020 (updated October 2021) identified lab-based alcohol priming studies that assessed effect of priming on motivation to drink. A tailored risk-of-bias tool assessed quality of lab-based studies. Random effects meta-analyses were computed on outcome data from 38 studies comparing the effect of a priming dose of alcohol against control on subsequent alcohol consumption/self-reported craving. Study characteristics that might have affected outcomes were design type (within/between-participant), dose of prime, time of motivation assessment, type of control drink (placebo alcohol/soft drink). RESULTS: Relative to control, alcohol had a small-to-moderate priming effect on subsequent alcohol consumption (standardised mean difference [SMD] = 0.336 [95% CI, 0.171, 0.500]) and craving (SMD = 0.431 [95% CI, 0.306, 0.555]). Aspects of study design differentially affected consumption and craving. The size of the priming dose had no effect on consumption, but larger doses were sometimes associated with greater craving (with craving generally following the blood alcohol curve). Alcohol priming effects for consumption, but not craving, were smaller when compared with placebo, relative to soft drink, control. CONCLUSIONS: Lab-based alcohol priming studies are a valid paradigm from which to investigate the impact of acute intoxication on alcohol motivation. Designs are needed that assess the impact of acute consumption on motivation to drink in more varied and realistic ways.
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Fissura , Motivação , Humanos , Etanol , Consumo de Bebidas Alcoólicas , AutorrelatoRESUMO
Background: There has been media coverage surrounding the dangers of heavy drinking and benefits of moderation, with TV and radio presenter, Adrian Chiles, documenting his experience of moderating alcohol consumption in an online article for the Guardian. By analysing the comments in response to Chiles' article, this study aimed to explore (i) posters' (someone who has posted a comment in response to the article) attitudes or beliefs toward moderating alcohol and (ii) posters' experiences of moderating or abstaining from alcohol. Method: A secondary qualitative analysis of online comments in response to an article about moderating alcohol consumption. Main outcome measures: Comments (n = 784) in response to a United Kingdom online news article about moderating alcohol consumption were extracted and inductive thematic analysis was used. Results: For aim one, two themes were developed; "general attitudes toward drinking" and "general attitudes toward reducing consumption". These themes reflect negative perceptions of alcohol and issues around changing attitudes. For aim two, three themes were developed: "moderation vs. abstention", "reflection on past drinking behaviours", and "current drinking behaviours". These themes represent posters' experiences and implications changing their drinking habits. Conclusion: Our analysis provides a novel insight into perceptions and experiences of moderating or abstaining from alcohol. Alcohol is embedded within United Kingdom culture, creating difficulties for those who choose to moderate or abstain from alcohol. Our analysis highlights the need for public health to focus on shifting the current drinking culture, through clearer drinking guidelines and a wider availability of alcohol-free alternatives.
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The potential to instrumentalize drug use based upon the detection of very many different drug states undoubtedly exists, and such states may play a role in psychiatric and many other drug uses. Nevertheless, nonaddictive drug use is potentially more parsimoniously explained in terms of sensation seeking/impulsivity and drug expectations. Cultural factors also play a major role in nonaddictive drug use.
Assuntos
Usuários de Drogas/psicologia , Comportamento de Procura de Droga , Modelos Psicológicos , Teoria Psicológica , Desempenho Psicomotor/efeitos dos fármacos , Automedicação/psicologia , HumanosRESUMO
Background and aims: Although alcohol research often comments on observed sex differences (i.e. patterns of consumption), there is a lack of investigation into the reasons for these differences. For females, the regular hormonal fluctuations across the menstrual cycle are a potential influencing factor for alcohol consumption. In this pilot we aimed to investigate the relationship between menstrual cycle phase (follicular-phase [FP] and luteal-phase [LP]) and status (naturally-cycling [NC] and hormonal-contraception [HC]) on alcohol consumption and craving of casual drinkers, and identify potential influencing factors in this relationship. Methods: Study One: participants (n â= â28; 15 HC, 13 NC) were either NC or HC (between subject factor: hormonal status) and attended two lab-based sessions corresponding with their FP and LP (within factor: cycle phase [NC] or time [HC]). Participants completed a mock alcohol taste-test, in addition to pre- and post-consumption measures of craving, anxiety, stress, and mood. Study Two: participants (n â= â262; 144 HC, 118 NC) were either NC or HC (between subject factor) and completed an online study assessing menstrual cycle phase, alcohol use, craving, impulsivity, and stress. Results: Study One: A significant effect of cycle phase was found on alcohol craving (p â= â.019): craving was higher during the FP compared to the LP for NC participants, with HC participants showing no difference across sessions. There was no effect of phase or status on alcohol consumption, stress, or mood (ps â> â.05). Study Two: Regression analyses showed that age, craving, impulsivity and stress were significantly associated with alcohol consumption for NC participants (ps â< â.05), however only age and craving were associated with consumption for the HC participants (ps â< â.001). Conclusions: Alcohol craving was higher during the follicular, compared to the luteal, phase for the naturally cycling group, and different factors may be associated with drinking behaviour across women who are NC and those using HC. Future alcohol research should consider the menstrual cycle and contraceptive status for females.
RESUMO
[This corrects the article DOI: 10.1016/j.cpnec.2020.100022.].