A high-resolution PheWAS approach to alcohol-related polygenic risk scores reveals mechanistic influences of alcohol reinforcing value and drinking motives.

AIMS: This study uses a high-resolution phenome-wide approach to evaluate the motivational mechanisms of polygenic risk scores (PRSs) that have been robustly associated with coarse alcohol phenotypes in large-scale studies. METHODS: In a community-based sample of 1534 Europeans, we examined genome-wide PRSs for the Alcohol Use Disorders Identification Test (AUDIT), drinks per week, alcohol use disorder (AUD), problematic alcohol use (PAU), and general addiction, in relation to 42 curated phenotypes. The curated phenotypes were in seven categories: alcohol consumption, alcohol reinforcing value, drinking motives, other addictive behaviors, commonly comorbid psychiatric syndromes, impulsivity, and personality traits. RESULTS: The PRS for each alcohol phenotype was validated via its within-sample association with the corresponding phenotype (adjusted R2s = 0.35-1.68%, Ps = 0.012-3.6 × 10-7) with the exception of AUD. All PRSs were positively associated with alcohol reinforcing value and drinking motives, with the strongest effects from AUDIT-consumption (adjusted R2s = 0.45-1.33%, Ps = 0.006-3.6 × 10-5) and drinks per week PRSs (adjusted R2s = 0.52-2.28%, Ps = 0.004-6.6 × 10-9). Furthermore, the PAU and drinks per week PRSs were positively associated with adverse childhood experiences (adjusted R2s = 0.6-0.7%, Ps = 0.0001-4.8 × 10-4). CONCLUSIONS: These results implicate alcohol reinforcing value and drinking motives as genetically-influenced mechanisms using PRSs for the first time. The findings also highlight the value of dissecting genetic influence on alcohol involvement through diverse phenotypic risk pathways but also the need for future studies with both phenotypic richness and larger samples.

Problematic Alcohol Use Trajectories in U.S. Military Veterans during a Public Health Crisis: Results from a 3-year, Nationally Representative, Longitudinal Study.

A growing number of studies have examined alcohol use during the COVID-19 pandemic. However, few longitudinal studies evaluated the prevalence and correlates of different trajectories of problematic alcohol use in vulnerable segments of the population, such as US veterans, over the 3-year course of the COVID-19 pandemic. Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative, longitudinal study of 2,441 US veterans. Latent growth mixture modeling was used to identify the trajectories and correlates of problematic alcohol use. Four trajectories were identified: consistent (N = 170, weighted 7.2%), decreasing (N = 38, weighted 2.2%), increasing (N = 22, weighted 1.2%), and low (N = 2,211, weighted 89.4%) problematic alcohol use. Greater household income, pre-pandemic drug use disorder (DUD), lower social support, and COVID-19 infection to self or non-household members were associated with an increasing relative to decreasing problematic alcohol use trajectory. Greater household income, adverse childhood experiences (ACEs), pre-pandemic DUD, lower social support, and greater COVID-related social restriction stress were associated with an increasing relative to a low problematic alcohol use trajectory. Younger age, male sex, ACEs, pre-pandemic DUD, lower pre-pandemic and greater decline in protective psychosocial characteristics, COVID-19 infection to non-household member, and lower COVID-related financial stress were associated with a consistent relative to a low problematic alcohol use trajectory. Overall, pre-pandemic greater income, DUD, and lower social support were associated with an increase in problematic alcohol use among US veterans during the COVID-19 pandemic. Results may help inform prevention efforts to mitigate problematic alcohol use during prolonged crises in this population.

Identifying the most important research, policy and practice questions for substance use, problematic alcohol use and behavioural addictions in autism (SABA-A): A priority setting partnership.

BACKGROUND: Autistic people are more likely to report problematic alcohol and other substance use when compared to the general population. Evidence suggests that up to one in three autistic adults may have an alcohol or other substance use disorder (AUD/SUD), although the evidence base for behavioural addictions is less clear. Autistic people may use substances or engage in potentially addictive behaviours as a means of coping with social anxiety, challenging life problems, or camouflaging in social contexts. Despite the prevalence and detrimental effects of AUD, SUD and behavioural addictions in community samples, literature focusing on the intersection between autism and these conditions is scarce, hindering health policy, research, and clinical practice. METHODS: We aimed to identify the top 10 priorities to build the evidence for research, policy, and clinical practice at this intersection. A priority-setting partnership was used to address this aim, comprising an international steering committee and stakeholders from various backgrounds, including people with declared lived experience of autism and/or addiction. First, an online survey was used to identify what people considered key questions about Substance use, alcohol use, or behavioural addictions in autistic people (SABA-A). These initial questions were reviewed and amended by stakeholders, and then classified and refined to form the final list of top priorities via an online consensus process. OUTCOMES: The top ten priorities were identified: three research, three policy, and four practice questions. Future research suggestions are discussed.

Trajectory and course of problematic alcohol use after the Great East Japan Earthquake: Eight-year follow-up of the Higashi-Matsushima cohort study.

BACKGROUND: Problematic alcohol use (PAU) after natural disasters is an unignorable public health issue. However, the long-term trajectory and course of PAU after an earthquake disaster remain unknown. METHODS: The Higashi-Matsushima cohort study was conducted between 2012 (time 1) and 2019 (time 8) in areas affected by the Great East Japan Earthquake in 2011. In the annual health checks, participants responded to self-report questionnaires on PAU, traumatic experiences (e.g., house damage), resources (e.g., social support), and other covariates (e.g., gender, psychological distress). The trajectory and course of PAU were estimated by latent growth model and latent class analyses. Risk factors for the long-term course of PAU were calculated by multinomial logistic regression analysis with multiple imputation. The analytical sample comprised 8929 residents who participated in at least one survey across the eight time points. RESULTS: The trajectory of PAU showed a sustained trend (slope <0.001). Three potential courses of PAU (No PAU course: 84.3%, Subthreshold PAU course: 12.4%, and Persistent PAU course: 3.4%) were estimated. The long-term course of PAU, especially the persistent PAU course, was predicted by house damage (OR = 1.43, 95% CI 1.06 to 1.92), less social support (OR = 0.71, 95% CI 0.53 to 0.96), gender (male) (OR = 16.86, 95% CI 9.42 to 30.20), and psychological distress (OR = 1.15, 95% CI 1.09 to 1.20). CONCLUSIONS: Long-term support is needed after an earthquake disaster, especially for residents who in early phases of the disaster suffer from PAU, males, and those in vulnerable situations resulting from conditions such as severe house damage, low social support, or high psychological distress.

Problematic alcohol use in young adults during the COVID-19 lockdown in Italy.

This study investigated the individual and contextual correlates of problematic alcohol use among young adults during COVID-19 lockdown in Italy. Participants were 1533 young adults aged 18 to 26 (Mage = 23.12, SDage = 2.11; 73.2% women), who completed an online survey during national lockdown. Inclusion criteria for this study were the age-range (18-26 y. o.), and living in Italy during COVID-19 lockdown. Participants with low or very low socioeconomic levels (vs. higher levels) were more at risk for problematic alcohol use, as well as participants who lived alone or with roommates/friends during lockdown. Conversely, participants who spent the lockdown with their family or partner were less at risk for problematic alcohol use. Finally, participants who had their job suspended due to pandemic (vs. other job conditions) were more at risk for problematic alcohol use during lockdown. Implications for research and clinical practice are discussed.

Effectiveness of a digital alcohol moderation intervention as an add-on to depression treatment for young adults: study protocol of a multicentre pragmatic randomized controlled trial.

BACKGROUND: Depressive disorders and problematic drinking often co-occur, also among young adults. These co-occurring conditions are associated with various negative health outcomes compared to both conditions alone. Early intervention by addressing alcohol use and depressive symptoms simultaneously in the same treatment might improve both conditions. However, evidence on the (cost-) effectiveness of digital combined depression and alcohol interventions for young adults is currently insufficient. We therefore developed an add-on digital alcohol moderation adherence-focussed guided intervention to complement treatment as usual (TAU) for depressive disorders. The digital intervention is a web-app, including 6 modules based on motivational interviewing and cognitive behavioural therapy. This study aims to evaluate the (cost-)effectiveness of a digital alcohol moderation intervention + TAU compared to TAU on alcohol and depression outcomes among young adults with co-occurring depressive disorders and problematic alcohol use. METHODS: One hundred fifty-six participants, aged 18-35 years, with problematic alcohol use and a diagnosed depressive disorder will participate in a pragmatic multicentre two-arm randomized controlled trial. Problematic alcohol use is operationalised as scoring ≥5 for women and ≥ 8 for men on the Alcohol Use Disorder Identification Test (AUDIT). Participants will be randomized to either the experimental group (digital alcohol intervention + TAU) or control group (TAU only). Participants will be recruited at three Dutch mental health care centres and through social media. Assessments take place at baseline and after 3, 6 and 12 months post-randomization. The primary outcome is treatment response at 6-month follow-up, operationalized as a composite score that combines alcohol use and depression measures and indicates whether treatment has been successful or not. Secondary outcomes are depressive symptoms and alcohol use (i.e. number of weekly standard drinks and AUDIT score). An economic evaluation will be conducted alongside the trial. DISCUSSION: This study evaluates the (cost-) effectiveness of an add-on digital alcohol moderation intervention for young adults who are in treatment for depressive disorders. If proven effective, the digital intervention could be implemented in mental health care and improve treatment for people with co-occurring depressive disorders and problematic alcohol use. TRIAL REGISTRATION: Pre-registered on October 29, 2019 in The Netherlands Trial Register ( NL8122 ).

Psychometric properties of the short version of the children of alcoholics screening test (CAST-6) among Swedish adolescents.

AIMS: The Children of Alcoholics Screening Test (CAST-6) is a brief screening instrument developed to identify children with parents having problematic alcohol use. The aim of this study was to evaluate the psychometric properties of the CAST-6 among adolescents aged 15-18 years, and also to identify an optimal cut-off score for this age group. METHODS: A total of 3000 15 to18 year-olds were randomly selected from a register of postal addresses in Sweden. An invitation letter, including access information to the electronic questionnaire, was sent out by regular mail and 1450 adolescents responded with baseline data. Test-retest reliability within a 2-3-week period was calculated based on the 111 respondents who answered the same questionnaire twice. To determine an optimal cut-off score, a small treatment-seeking sample (n = 22) was recruited from a support group agency to be used as a reference group. RESULTS: The six items of the CAST-6 screening test loaded onto one latent factor with good internal consistency (alpha = 0.88), and excellent test-retest reliability (ICC = 0.93, 95% CI 0.90-0.95). The optimal cut-off score among adolescents was 2 points with a sensitivity of 55% and specificity of 79% (AUROC = 0.71, 95% CI 0.58-0.83). CONCLUSIONS: The CAST-6 has good to excellent psychometric properties among adolescents. The identified optimal cut-off score of 2 points should be treated with caution due to study limitations. The CAST-6 can be used in various settings to identify a vulnerable at-risk group of children and adolescents that may be in need of support.

Distress tolerance and special alcohol metacognitions behave differently in the association of negative affect with alcohol-related patterns in men with problematic alcohol use in the abstinence phase.

Negative affect may be related to alcohol-related patterns (e.g., craving and problematic alcohol use). Distress intolerance and positive and negative alcohol-related metacognitions may be underlying mechanisms in this link. This study aimed to evaluate the effect of negative affect including depressive, anxious, and stress symptoms on alcohol craving and problematic alcohol use via the paths of distress tolerance and both positive and negative alcohol-related metacognitions. Three hundred men with problematic alcohol use during the abstinence phase completed psychological and clinical measures. Results showed that craving and negative alcohol metacognitions mediated the relationship between negative affect and problematic alcohol use. Negative affect had a direct and positive effect on craving and indirect effect via distress intolerance and positive alcohol metacognitions. In turn, distress intolerance and positive alcohol metacognitions indirectly and positively affected problematic alcohol use via craving. The study indicates that distress tolerance and distinct alcohol metacognitions may be differently related to various patterns of alcohol-related problems, such that alcohol drinkers with high levels of negative affect, distress intolerance, and positive alcohol metacognitions show higher levels of craving, while high negative affect in relation to high negative alcohol metacognitions and alcohol craving is related to the perpetuation of alcohol use or problematic alcohol use.

Novel characterization of the multivariate genetic architecture of internalizing psychopathology and alcohol use.

Genetic correlations suggest that the genetic relationship of alcohol use with internalizing psychopathology depends on the measure of alcohol use. Problematic alcohol use (PAU) is positively genetically correlated with internalizing psychopathology, whereas alcohol consumption ranges from not significantly correlated to moderately negatively correlated with internalizing psychopathology. To explore these different genetic relationships of internalizing psychopathology with alcohol use, we performed a multivariate genome-wide association study of four correlated factors (internalizing psychopathology, PAU, quantity of alcohol consumption, and frequency of alcohol consumption) and then assessed genome-wide and local genetic covariance between these factors. We identified 14 significant regions of local, largely positive, genetic covariance between PAU and internalizing psychopathology and 12 regions of significant local genetic covariance (including both positive and negative genetic covariance) between consumption factors and internalizing psychopathology. Partitioned genetic covariance among functional annotations suggested that brain tissues contribute significantly to positive genetic covariance between internalizing psychopathology and PAU but not to the genetic covariance between internalizing psychopathology and quantity or frequency of alcohol consumption. We hypothesize that genome-wide genetic correlations between alcohol use and psychiatric traits may not capture the more complex shared or divergent genetic architectures at the locus or tissue specific level. This study highlights the complexity of genetic architectures of alcohol use and internalizing psychopathology, and the differing shared genetics of internalizing disorders with PAU compared to consumption.

Explaining the Immigrant Paradox: The Influence of Acculturation, Enculturation, and Acculturative Stress on Problematic Alcohol Consumption.

The present study explored the Immigrant Paradox (IP), generational differences in problematic alcohol use (alcohol consumption and alcohol-related consequences), among immigrants and US born groups from a number of ethnic minority backgrounds. Our approach separates group differences in problematic alcohol consumption in a counterfactual manner for immigrants and the US born to answer the following counterfactual question: "What would problematic alcohol use levels be for the US born had they been exposed to the alcohol use generation (or protective) processes of immigrants and vice versa?" Multidimensional measures of enculturation (involvement with heritage culture), acculturation (involvement with US culture), acculturative stress, and demographic covariates were used to statistically explain these differences. The sample consisted of Asian American (n = 1,153), Black American (n = 833), and Latinx (n = 1,376) college students from 30 universities. Results indicated significant generational differences in mean levels of alcohol consumption but not alcohol-related consequences. Differences in measured characteristics (endowments) marginally explained differences between immigrants and the US born. On the other hand, endowments significantly explained generational differences and represented an increase in alcohol consumption among immigrants if they had the endowments of the U.S. born. Results are discussed in light of cultural and social factors that contribute to the IP.

Outpatient Addiction Treatment for Problematic Alcohol Use: What Makes Patients Who Dropped Out Different from Those Who Did Not?

BACKGROUND: A minority of individuals with problematic alcohol use effectively seek help. Moreover, dropouts from care are not uncommon. It remains a major concern for health professionals, as adherence to treatment is significantly associated with better physical and psychological outcomes. OBJECTIVES: The main aim of this research was to assess what factors could distinguish patients with problematic alcohol use who dropped out from those who did not. METHODS: The sample included 150 patients followed-up in an outpatient treatment center in France for a problematic alcohol use. Two measurement times were planned: at the first appointment and after six month of treatment. A large set of individual, environmental and institutional variables were considered to compare both subgroups. RESULTS: Patients who dropped out mostly differ from patients who did not with a higher level of alcohol-related problems, ambivalence, inclinations to use the substance, number of missed appointments. Significant results were also observed regarding a lower time gap between the first contact with the center and the first appointment, as well as the season of the last appointment. CONCLUSIONS: Tailored motivational interventions could be offered to ambivalent patients, especially during the beginning of the treatment and some significant periods of the year. A particular focus should be brought on patients presenting such profiles in terms of level of alcohol problems, inclinations to drink and motivation to change. Overall, the study provides elements to better understand what may bring one patient to drop out of the treatment, and to improve the continuity of care.

Neuroticism and Negative Urgency in Problematic Alcohol Use: A Pilot Study.

BACKGROUND: Problematic alcohol use is common among university students and personality might account for individual differences in developing this maladaptive behavior. Two personality dispositions implicated in problematic alcohol use are negative urgency and neuroticism. However, the relationship of these traits to problematic alcohol use is unclear. In college students high neuroticism is not directly linked to problematic alcohol use. On the other hand, the experience of emotional distress in people high in neuroticism could impair the capacity for impulse control. Loss of impulse control under conditions of negative affect could trigger impulsive drinking and problematic alcohol use in the long run. OBJECTIVES: We investigated this idea by testing whether negative urgency mediates the relationship of neuroticism to problematic alcohol use. METHODS: Participants were 60 undergraduate university students who completed the Urgency subscale of the Urgency, (lack of) Premeditation, (lack of) Perseverance, Sensation Seeking, and Positive Urgency Impulsive Behaviour scale (UPPS-P), the Alcohol Use Disorders Identification Test (AUDIT), and the Neuroticism subscale of the Eysenck Personality Questionnaire Revised short form (EPQ-RSS). RESULTS: The results confirmed our hypothesis as we found an indirect effect of negative urgency on the relationship between neuroticism and problematic alcohol use. CONCLUSIONS/IMPORTANCE: It appears that it is not distress but the tendency to act rashly when distressed that is important in developing problematic alcohol drinking in university students.

[Psychosocial Characteristics of Adolescents Treated for Alcohol Intoxication in Emergency Departments]. / Psychosoziale Merkmale von Jugendlichen, die wegen einer Alkoholintoxikation im Krankenhaus behandelt wurden.

Psychosocial Characteristics of Adolescents Treated for Alcohol Intoxication in Emergency Departments In Germany, every year a substantial number of adolescents is treated in emergency departments for acute alcohol intoxication. Until now, only few studies have been published investigating psychosocial aspects in this group of adolescents. In the present study 316 adolescents were surveyed in the emergency department regarding their problematic use of alcohol and illicit drugs, their patterns of alcohol consumption, their alcohol-related and mental problems. We reported results for the whole sample. Additionally, the sample was divided in two groups based on the result in an established screening instrument for problematic alcohol use (CRAFFT-d). To compare the two groups we conducted unpaired t tests, chi-square tests and logistic regression analyses. Compared to the other group the adolescents exceeding the cut-off value of the CRAFFT-d reported a statistically significant higher past 30-day binge drinking frequency and number of standard-drinks consumed on a typical drinking occasion, more alcohol-related problems, more frequently a problematic use of illicit drugs and more mental problems (regarding antisocial behavior, anger control problems and self-esteem). Antisocial behavior was the most important factor for the affiliation to one of the two groups. The application of the screening instrument for problematic alcohol use (CRAFFT-d) in the emergency department seems to be a promising approach to identify adolescents with a general higher psychosocial burden.

Positive and Negative Pathways Linking Depressive Symptoms to Problematic Alcohol Use Among Argentinian College Students: An Examination of Positive and Negative Urgency Traits and Internal Drinking Motives.

Growing evidence suggests the tendency to act rashly under positive and negative emotions and affect-related drinking motives connect symptoms of mood disorders with alcohol-related problems. However, studies examining this sequence are scarce in Latin-American samples. The present study evaluated, in Argentinian college students (n = 403; 68.2% women; Mage = 21.03 ± 4.90), a sequential model of symptoms of depression, urgency traits, internal drinking motives, and problematic alcohol use. Path analysis was conducted to examine the direct and indirect associations between symptoms of depression and problematic alcohol use (heavy episodic drinking and alcohol-related negative consequences) via positive and negative urgency traits and internal drinking motives. Findings revealed indirect associations from depressive symptoms to problematic alcohol use via urgency traits and drinking motives (e.g. depression symptoms→positive [negative] urgency→enhancement [coping]→drinking problems). This suggests that students who experience more symptoms of depression may be more likely to react to these experiences of negative affect by engaging in heavy drinking episodes and encounter more alcohol-related problems. This seems to stem from a higher propensity to act rashly during intense emotional experiences and a greater motivation to drink as a means of regulating their mood. Future interventions aimed at preventing or reducing problematic alcohol use (especially among Argentinian young adults) might consider targeting these specific impulsivity traits as well as affect-related drinking motivations.

The Prediction Model of Non-Suicidal Self-Injury in Psychiatric Patients Using Decision Tree Analysis.

PURPOSE: The prevalence rate of non-suicidal self-injury (NSSI) in the clinical population is higher than that in the community sample, necessitating the need to investigate the predicting factors of NSSI in this group. The present study aimed to develop a prediction model of NSSI among psychiatric patients in Korea. MATERIALS AND METHODS: Decision tree analysis was conducted on a sample of 224 psychiatric patients. Emotion regulation strategies (rumination, cognitive reappraisal, and expressive suppression), impulsivity, problematic alcohol use, working memory, depressive mood, and gender were included in the model as predictors of NSSI. RESULTS: Results indicated that rumination, problematic alcohol use, and working memory predicted lifetime NSSI engagement among psychiatric patients. The best predictor of lifetime NSSI engagement was rumination. Specifically, when the level of rumination was high, the level of working memory was lower, and the risk of NSSI was higher. In the case of low levels of rumination, the higher the level of problematic alcohol use, the higher the risk of NSSI. The highest prevalence of lifetime NSSI engagement was found in a subgroup of patients with high levels of rumination and low levels of working memory. CONCLUSION: The major contribution of this study is finding a combination of factors to predict the high-risk group of NSSI among psychiatric patients in Korea. This study provides evidence on the effect of rumination, working memory, and problematic alcohol use on NSSI. It is suggested that clinicians and researchers should pay more attention to emotion regulation and related vulnerabilities in preventing and treating NSSI.

Alcohol Exposure and Disease Associations: A Mendelian Randomization and Meta-Analysis on Weekly Consumption and Problematic Drinking.

Alcohol consumption significantly impacts disease burden and has been linked to various diseases in observational studies. However, comprehensive meta-analyses using Mendelian randomization (MR) to examine drinking patterns are limited. We aimed to evaluate the health risks of alcohol use by integrating findings from MR studies. A thorough search was conducted for MR studies focused on alcohol exposure. We utilized two sets of instrumental variables-alcohol consumption and problematic alcohol use-and summary statistics from the FinnGen consortium R9 release to perform de novo MR analyses. Our meta-analysis encompassed 64 published and 151 de novo MR analyses across 76 distinct primary outcomes. Results show that a genetic predisposition to alcohol consumption, independent of smoking, significantly correlates with a decreased risk of Parkinson's disease, prostate hyperplasia, and rheumatoid arthritis. It was also associated with an increased risk of chronic pancreatitis, colorectal cancer, and head and neck cancers. Additionally, a genetic predisposition to problematic alcohol use is strongly associated with increased risks of alcoholic liver disease, cirrhosis, both acute and chronic pancreatitis, and pneumonia. Evidence from our MR study supports the notion that alcohol consumption and problematic alcohol use are causally associated with a range of diseases, predominantly by increasing the risk.

The bystander intervention for problematic alcohol use model (BIPAUM).

Objective: The study aimed to identify phases of bystander intervention (BI) for problematic alcohol use (PAU) among college students. Participants: Twenty focus groups and nine interviews were conducted. Methods: Transcripts were thematically analyzed. Results: The phases of the Bystander Intervention for Problematic Alcohol Use Model (BIPAUM) include: (1) plan in advance, (2) notice and interpret a sign, (3) decide (i.e., assume responsibility, assess support/feasibility to intervene, and identify intervention strategy), (4) intervene, and (5) assess outcomes. Assessing outcomes loops to influence future behavior and each phase is influenced by barriers and facilitators. Conclusions: These unique phases should be considered when designing and evaluating intervention programs for PAU to meet students' needs and better reduce PAU. Future research should empirically test the BIPAUM. The results of the current study demonstrate a promising opportunity for applying BI to PAU, with the goal of reducing risky drinking among college students.

A longitudinal test of problematic alcohol use and binge eating among college women: The moderating role of shame.

Problematic alcohol use and binge eating frequently co-occur. High levels of negative affect, negative urgency, and/or shame may increase the likelihood that problematic alcohol use and binge eating co-occur over time. OBJECTIVE: Examine (1) the temporal relationship between problematic alcohol use and binge eating among college women, who are at high risk for both, and (2) the additive and moderating effects of shared, emotion-based risk factors in models involving both problematic alcohol use and binge eating. METHOD: In n = 302 college women assessed at two time points across 8 months, we used hierarchical linear regression to investigate our objectives. RESULTS: Baseline problematic alcohol use and baseline shame independently predicted increases in follow-up binge eating, controlling for baseline binge eating. In addition, the interaction between problematic alcohol use and shame accounted for further variance in subsequent binge eating (the influence of baseline problematic alcohol use on follow-up binge eating was stronger at higher levels of baseline shame). The reciprocal relationship was not significant: baseline binge eating did not predict follow-up problematic alcohol use independently or in conjunction with risk factors. Neither negative affect nor negative urgency showed predictive effects beyond prior behavior and shame. Results support (1) problematic alcohol use as a prospective risk factor for binge eating, (2) shame as an additive predictor of binge eating, and (3) shame as a positive moderator of prediction from problem drinking. CONCLUSION: Addressing shame and problematic alcohol use may be warranted in binge eating interventions for college women.

The relationship between suicidal behavior and perceived stress: The role of cognitive emotional regulation and problematic alcohol use in Spanish adolescents.

Suicidal behavior has become an important public health problem, correlating with stress and emotional deficits in recent research. This study examined the relationship between perceived stress and suicidal behavior risk, testing the mediating roles of cognitive emotion regulation and impulsivity, and the moderating role of problematic alcohol use in stress-suicidal behavior association in a sample of 121 Spanish adolescents surveyed online. Results showed positive and significant associations between perceived stress and suicidal behavior risk, as well a mediation role of adaptive cognitive emotion regulation strategies and a moderation role of problematic alcohol use between perceived stress and suicidal behavior risk, supporting stress as an influential factor in suicidal behavior. Our findings emphasize adaptive emotional regulation strategies in stressful situations, as well as the importance of promoting responsible alcohol consumption to decrease suicide risk in adolescents. Additionally, they contribute to effective educational suicide prevention programs for young people.

Preferences of young adults on the development of a new digital add-on alcohol intervention for depression treatment: A qualitative study.

Aim: To explore the preferences of young adults with regard to the development of a new digital add-on alcohol intervention to complement depression treatment. Methods: This qualitative study included young adults (18-35 years) with experience of either problematic alcohol use or depression or both (n = 29). Two rounds of focus groups were conducted, with two focus groups in each round. All focus groups were recorded, transcribed and analysed deductively and inductively on the basis of qualitative content analysis of the intervention type, features and design. Results: Young adults preferred a mobile health application with a clear and simple objective and navigation which was also accessible on a computer. With regard to intervention features, participants indicated a preference for in-depth, gain-framed information on alcohol use and a main feature enabling them to record their alcohol use and mood, which would be rewarded. Other preferences included personal goal-setting and monitoring, an activity list, experience stories, peer contact, guidance from experts by experience or volunteers and receiving notifications from the application. In terms of design, participants preferred short, animated videos and animation figure illustrations to complement written text. Moreover, participants rated the design of the intervention as highly important, yet very personal. Generally, participants preferred a light pastel colour scheme. Once again, participants indicated a need for a clear dashboard using pictograms to reduce the amount of text and fast, easy-to-use navigation. Conclusion: The preferences indicated by young adults with regard to the intervention type, features and design may enhance the development of a new digital add-on alcohol intervention to complement depression treatment.