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1.
Alcohol Alcohol ; 59(3)2024 Mar 16.
Artículo en Inglés | MEDLINE | ID: mdl-38606931

RESUMEN

AIMS: Among individuals with alcohol use disorder (AUD), sleep disturbances are pervasive and contribute to the etiology and maintenance of AUD. However, despite increased attention toward the relationship between alcohol use and sleep, limited empirical research has systematically examined whether reductions in drinking during treatment for AUD are associated with improvements in sleep problems. METHODS: We used data from a multisite, randomized, controlled trial that compared 6 months of treatment with gabapentin enacarbil extended-release with placebo for adults with moderate-to-severe AUD (N = 346). The Timeline Follow-back was used to assess WHO risk drinking level reductions and the Pittsburgh Sleep Quality Index was used to assess sleep quality over the prior month at baseline and the end of treatment. RESULTS: Sleep problem scores in the active medication and placebo groups improved equally. Fewer sleep problems were noted among individuals who achieved at least a 1-level reduction (B = -0.99, 95% confidence interval (CI) [-1.77, -0.20], P = .014) or at least a 2-level reduction (B = -0.80, 95% CI [-1.47, -0.14], P = .018) in WHO risk drinking levels at the end of treatment. Reductions in drinking, with abstainers excluded from the analysis, also predicted fewer sleep problems at the end of treatment (1-level: B = -1.01, 95% CI [-1.83, -0.20], P = .015; 2-level: B = -0.90, 95% CI [-1.59, -0.22], P = .010). CONCLUSIONS: Drinking reductions, including those short of abstinence, are associated with improvements in sleep problems during treatment for AUD. Additional assessment of the causal relationships between harm-reduction approaches to AUD and improvements in sleep is warranted.


Asunto(s)
Alcoholismo , Adulto , Humanos , Consumo de Bebidas Alcohólicas/terapia , Alcoholismo/complicaciones , Alcoholismo/tratamiento farmacológico , Organización Mundial de la Salud , Ensayos Clínicos Controlados Aleatorios como Asunto
2.
Addict Res Theory ; 31(5): 313-320, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38009087

RESUMEN

The aim of the present study was to conduct a preliminary investigation of the associations between facets of impulsivity and alcohol outcomes through motives for drinking responsibly described by self-determination theory among college students. Participants (N=2,808) were part of a multisite investigation of college student drinking across 10 universities in 8 states in the U.S. who reported past-month drinking. Results of a structural equation model testing all possible indirect associations simultaneously indicated that one-third (20 out of 60) of the indirect associations were statistically significant (p<.01). Facets with higher scores representing higher impulsivity (negative/positive urgency) were negatively associated with more internalized motives (autonomous motivation and introjected regulation) and positively associated with less internalized motives (external regulation and amotivation) for drinking responsibly. Facets with higher scores representing lower impulsivity (perseverance and premeditation) demonstrated opposite patterns of associations with motives for drinking responsibly. In turn, more internalized motives were related to higher frequency of protective behavioral strategies use, lower alcohol use severity, and fewer negative alcohol-related consequences; less internalized motives demonstrated an opposite pattern of associations with these alcohol outcomes. The present findings should be replicated using experimental and longitudinal studies for appropriately testing mediation but offer support for a novel hypothesis for motivational pathways from impulsivity to alcohol outcomes that may provide insight into intervention targets.

3.
Alcohol Clin Exp Res ; 46(7): 1258-1267, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35488452

RESUMEN

BACKGROUND: Progression through the stages of change is a proposed mechanism underlying the effects of treatment for alcohol use disorder (AUD). However, examining stages of change as a mechanism of treatment effects requires that the measure be invariant across patient subgroups, treatment conditions, and time. In this study, we examined measurement invariance of the University of Rhode Island Change Assessment Scale (URICA) in Project MATCH using an exploratory structural equation modeling (ESEM) approach. METHODS: We conducted a secondary analysis of data from Project MATCH (N = 1726; Mage  = 40.2, SD = 10.9; 75.7% male; 80% non-Hispanic white), a multisite randomized clinical trial that tested three AUD treatments: Motivational Enhancement Therapy, Cognitive-Behavioral Therapy, or Twelve-Step Facilitation. Participants completed the 24-item URICA for assessing the stages of change in relation to drinking at baseline and post-treatment (3 months after baseline). RESULTS: A 4-factor ESEM provided a good fit to the data and a better fit to the data than a conventional 4-factor confirmatory factor analysis model. Further, the URICA demonstrated scalar invariance across each patient subgroup at baseline (sex, ethnicity, marital status, education, and parental history of AUD) and treatment condition at follow-up. However, the URICA was not longitudinally invariant as the metric model resulted in a significant decrement in model fit. CONCLUSIONS: Measurement invariance of the URICA over time was not supported. Longitudinally invariant measures of the stages of change are needed to test the proposal that progression through the stages explains treatment effects.


Asunto(s)
Consumo de Bebidas Alcohólicas , Terapia Cognitivo-Conductual , Adulto , Análisis Factorial , Femenino , Humanos , Análisis de Clases Latentes , Masculino , Psicometría
4.
Subst Use Misuse ; 57(1): 47-56, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34735304

RESUMEN

OBJECTIVE: Use of protective behavioral strategies (PBS) has been associated with reduced alcohol-related harms among college students. However, most of this research has been conducted among U.S. samples. The present study examines the use of PBS in an international context. METHOD: Participants (n = 1512) were recruited from universities in Spain (n = 298), Argentina (n = 439), and the U.S. (n = 775) to determine if there are differences in PBS use across countries and/or across sex. Further, we examined whether the association between PBS use and negative consequences differ across country and sex. RESULTS: We found that U.S. students reported the most frequent use of Stopping/Limiting Drinking PBS (M = 3.32, SD = 1.23) compared to Argentine (M = 2.89, SD = 0.97) and Spanish (M = 2.83, SD = 0.94) students. Argentine students reported the least frequent use of Serious Harm Reduction PBS (M = 4.57, SD = 0.99) compared to U.S. (M = 5.09, SD = 0.98) and Spanish (M = 5.03, SD = 0.78) students. Elastic net regression analyses stratified by country indicated most individual PBS predicted decreased negative alcohol-related consequences, although two items consistently predicted increased consequences and we observed some variability in the most predictive specific strategies in each country. Across each subscale and for 32 of 40 individual items, females reported more frequent use of PBS than males (ps<.05). CONCLUSIONS: From the perspective of developing and adapting interventions, we recommend the cultural context in which PBS are used is taken into account. Although future work is needed to delineate cultural factors underlying the country-level differences we found, these findings have implications for the most promising PBS to target for college students in each country.


Asunto(s)
Consumo de Alcohol en la Universidad , Caracteres Sexuales , Consumo de Bebidas Alcohólicas/prevención & control , Femenino , Reducción del Daño , Humanos , Masculino , Estudiantes , Universidades
5.
J Ethn Subst Abuse ; 21(1): 272-283, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-32281908

RESUMEN

The present study investigated the use of protective behavioral strategies (PBS) as moderators of the association between perceived discrimination and alcohol-related problems among Hispanic college students. Participants who were between 18 and 24 years of age (n = 379) completed self-report measures. The results showed that greater perceived discrimination was associated with less frequent PBS use, more problematic alcohol use, and more alcohol-related problems, while greater use of PBS types was associated with fewer alcohol-related problems. Furthermore, serious harm-reduction behaviors moderated the association between perceived discrimination and alcohol-related problems. The findings suggest that serious harm-reduction behaviors may protect against the negative effects of perceived discrimination on alcohol-related problems among Hispanic college students.


Asunto(s)
Consumo de Alcohol en la Universidad , Trastornos Relacionados con Alcohol , Consumo de Bebidas Alcohólicas , Reducción del Daño , Hispánicos o Latinos , Humanos , Discriminación Percibida , Estudiantes , Universidades
6.
Eat Weight Disord ; 26(3): 829-838, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32424560

RESUMEN

PURPOSE: The current study examined the predictive utility of emotional valence (i.e., positive and negative emotions) on weight loss intentions and behaviors, beyond theory of planned behavior constructs (i.e., attitude, subjective norm, and perceived control), among a community sample of people who were overweight (BMI > 25 kg/m2). METHODS: Participants were recruited for a longitudinal study via an online panel. They completed a baseline survey (N = 732) and a follow-up survey 6 months later (N = 526), both administered online. The surveys included measures of attitude, subjective norms, perceived control, positive and negative emotions regarding one's current weight, intentions to engage in weight loss behaviors (time 1), and having engaged in weight loss behaviors in the past 6 months (time 2). RESULTS: Emotion explained additional variance in weight loss intentions (range ΔR2 = 0.03-0.10, all ps < 0.01) and behaviors (range ΔR2 = 0.01-0.02, all ps < 0.05) beyond theory of planned behavior constructs. Negative emotions mainly predicted the intake of unhealthy food and seeking social support, whereas positive emotions predicted physical activity (intention and behavior). These results suggested that the differential relations might be based on whether the strategy is approach or avoidance oriented. CONCLUSIONS: Based on these findings, comprehensive models of weight loss behaviors should consider emotion, and the valence of such emotion, regarding current weight. LEVEL OF EVIDENCE: Level IV, multiple time series without intervention.


Asunto(s)
Intención , Pérdida de Peso , Emociones , Humanos , Estudios Longitudinales , Teoría Psicológica , Encuestas y Cuestionarios
7.
Addict Res Theory ; 29(5): 392-397, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34899111

RESUMEN

The evidence for the efficacy of harm reduction approaches to harmful alcohol use has accumulated over the past 30 years. Self-determination theory (SDT; Ryan and Deci 2017) offers a useful framework for understanding why people engage in alcohol harm reduction behaviors, as well as for delineating active ingredients of harm reduction interventions and individual characteristics that influence response to intervention. In the current paper, we sought to advance a research agenda for applying SDT to alcohol harm reduction behaviors. Specifically, we provide specific examples of the utility of SDT in advancing research on alcohol harm reduction behaviors and provide recommendations for future studies to address issues related to measurement, generalizability, temporal directionality, and causal relationships in examining the constructs of SDT and alcohol harm reduction behaviors. We also suggest that future research apply SDT to advance the understanding of how, why, and for whom harm reduction interventions are most effective. Finally, we provide recommendations for how SDT could potentially be applied to develop novel alcohol interventions.

8.
Alcohol Clin Exp Res ; 44(11): 2361-2372, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32981123

RESUMEN

BACKGROUND: Little is known about the mechanisms of change underlying brief interventions and the patient characteristics that may affect them. The present study tested whether the stages of change mediate the effects of a BMI with and without a telephone booster relative to brief advice (i.e., multiple mediation). Further, the present study tested whether the effects of the BMI conditions on the stages of change were contingent on patients' alcohol use severity (i.e., moderated mediation). METHODS: The present study is a secondary analysis using data from injured adult patients at 3 trauma centers who were screened for inclusion in the study and randomly assigned to brief advice (n = 200), BMI (n = 203), or BMI with a telephone booster (n = 193) (Field et al., 2014). Participants completed a baseline assessment and 3-, 6-, and 12-month follow-up assessments that included self-report measures of the stages of change, alcohol use, and alcohol-related problems, as well as other variables of interest. RESULTS: The results demonstrated significant and consistent mediation at p < 0.05 wherein BMI with a telephone booster increased action at 3-month follow-up leading to reduced likelihood of at-risk drinking, less alcohol use, and fewer alcohol problems at both 6- and 12-month follow-up. However, moderated mediation analyses suggested that the effects of the BMI conditions on the stages of change were not contingent on patients' alcohol use severity. CONCLUSIONS: This study contributes to the understanding of stages of change as potential mechanisms of change in BMI. Directions for future research are discussed.


Asunto(s)
Alcoholismo/prevención & control , Intervención en la Crisis (Psiquiatría)/métodos , Heridas y Lesiones/psicología , Adulto , Alcoholismo/psicología , Alcoholismo/terapia , Femenino , Humanos , Masculino , Entrevista Motivacional/métodos , Heridas y Lesiones/complicaciones , Heridas y Lesiones/etiología
9.
Alcohol Alcohol ; 55(4): 409-415, 2020 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-32318693

RESUMEN

AIMS: This study assessed the factor, concurrent and predictive validity of the revised Readiness to Change Questionnaire [Treatment Version] (RCQ[TV]) among non-treatment-seeking individuals. METHODS: Non-treatment-seeking patients (Mage = 34.8, SD = 12.4) who screened positive for alcohol misuse were recruited from three urban Level I Trauma Centers and completed the RCQ[TV] (Heather et al. [(1999) Development of a treatment version of the Readiness to Change Questionnaire. Addict Res7, 63-83]). RESULTS: A confirmatory factor analysis supported the three-factor structure of the RCQ[TV]. Observed scores for precontemplation, contemplation and action demonstrated concurrent validity, as they were correlated with drinking and alcohol-related problems prior to baseline assessment. Finally, RCQ[TV] scores at baseline added to the predictability of an alcohol consumption composite score at a 3-month follow-up after controlling for baseline alcohol consumption and randomization to treatment arm. CONCLUSIONS: The results of the present study suggest that the RCQ[TV] has desirable psychometric properties and supports the use of the RCQ[TV] among non-treatment-seeking patients with alcohol misuse.


Asunto(s)
Trastornos Relacionados con Alcohol/psicología , Trastornos Relacionados con Alcohol/terapia , Motivación , Encuestas y Cuestionarios , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Actitud Frente a la Salud , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría
10.
Subst Use Misuse ; 55(7): 1097-1105, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32091946

RESUMEN

Background: Although a large body of research has examined the impact of peer influence on substance use, little is known about the psychology of who influences others to use substances and why. The Dark Triad is a set of personality traits that may inform the characteristics of people who influence others to use substances.Objective: The aim of the present two studies was to examine potential associations between Dark Triad personality traits, especially psychopathy, and influencing others to use substances.Methods: Two samples of 162 and 161 Mechanical Turk workers were recruited for Study 1 to complete an online survey that assessed Dark Triad traits, history of influencing others to use substances, and motivations for doing so. Similarly, 303 Mechanical Turk workers were recruited for Study 2 to complete an online survey that assessed personal substance use as well as psychopathy levels of participants' closest friends.Results: Study 1 found that individuals high in psychopathy were more likely to have provided illegal substances to others and indicated a willingness to do so in the future. Study 2 found that participants reported a higher likelihood of using substances if they indicated that their best friend was high in psychopathy and had themselves used substances in the past.Conclusions: Taken together, these findings suggest that psychopathy has a unique association with influencing others to use substances. These findings have implications for intervention targets.


Asunto(s)
Maquiavelismo , Trastornos Relacionados con Sustancias , Trastorno de Personalidad Antisocial , Humanos , Narcisismo , Encuestas y Cuestionarios
11.
Exp Clin Psychopharmacol ; 32(5): 554-565, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38753393

RESUMEN

Self-determination theory (SDT) proposes that people are more likely to engage in behaviors that reduce the harms associated with alcohol use if they do so for more self-determined reasons. There is growing support for this proposal, but the Treatment Self-Regulation Questionnaire (TSRQ), which assesses the self-determination continuum of motivation for engaging in alcohol-related harm reduction behaviors, lacks content coverage. We generated additional items to improve the content coverage of the TSRQ and evaluated its psychometric properties. We also compared two randomly assigned instruction sets that referenced "responsible drinking" or "protective behavioral strategies" (PBS). Participants (n = 2,236) were college students from psychology departments at 10 universities in eight U.S. states who reported past-month alcohol use and completed the revised TSRQ; the online survey was completed for partial course credit. Exploratory factor analysis supported a three-factor structure representing autonomous motivation, controlled motivation, and amotivation for the PBS version. This factor structure was confirmed using exploratory structural equation modeling for both the PBS and responsible drinking versions. Scalar invariance was achieved across instruction sets. Latent mean differences showed that those who received the PBS version had lower autonomous and controlled motivation scores, but higher amotivation scores. Associations of the three TSRQ factors with alcohol-related outcomes were consistent with SDT, and the magnitude of these associations did not differ across instruction sets. More accurate assessment of the self-determination continuum of motivation for alcohol-related harm reduction behaviors will improve research on this topic which has promising implications for alcohol interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Reducción del Daño , Motivación , Autonomía Personal , Psicometría , Humanos , Femenino , Masculino , Encuestas y Cuestionarios , Adulto Joven , Psicometría/métodos , Adulto , Estudiantes/psicología , Consumo de Bebidas Alcohólicas/psicología , Adolescente , Universidades , Autocontrol/psicología
12.
Eat Behav ; 53: 101876, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38754222

RESUMEN

Food and alcohol disturbance (FAD) refers to the intersection of alcohol- and eating-related motives and behaviors, such as restricting food intake before or during alcohol use to offset caloric intake or to enhance intoxication. Valid assessment is critical for advancing research on FAD. We tested the factor structure, group invariance, and concurrent validity of the College Eating and Drinking Behavior Scale (CEDBS) in a large college student sample (n = 2610; Mage = 20.95, SD = 4.65; 71.8% female; 77% White; 86% non-Hispanic). Participants completed measures assessing antecedents of alcohol use (i.e., protective behavioral strategies and drinking motives), negative alcohol-related consequences, alcohol use severity, and risk for eating disorder. The 3-factor model of the 21-item CEDBS provided an adequate fit to the data (e.g., CFI = 0.916). These factors include Alternative Methods (4 items; "Use laxative prior to drinking alcohol"), Offset Calories (7 items; "Restrict calories prior to drinking to help maintain your figure"), and Quicker Intoxication (10 items; "Not eating before drinking alcohol because it gives you the best buzz"). The CEDBS was scalar invariant across subgroups of participants based on age, sex, race/ethnicity, socioeconomic status, sexual orientation, and political orientation. Quicker Intoxication was most strongly related to risk factors and negative consequences for alcohol (r = 0.204-0.379, all ps < 0.01), and Offset Calories was most strongly related to risk for eating disorders (r = 0.349, p < .01). These findings further support the CEDBS to assess FAD among college students.


Asunto(s)
Consumo de Alcohol en la Universidad , Conducta Alimentaria , Estudiantes , Humanos , Femenino , Masculino , Estudiantes/psicología , Adulto Joven , Universidades , Conducta Alimentaria/psicología , Consumo de Alcohol en la Universidad/psicología , Adulto , Estados Unidos , Reproducibilidad de los Resultados , Adolescente , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Encuestas y Cuestionarios , Consumo de Bebidas Alcohólicas/psicología , Psicometría/instrumentación , Motivación , Análisis Factorial
13.
Exp Clin Psychopharmacol ; 32(5): 542-553, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38695808

RESUMEN

Machine learning algorithms hold promise for developing precision medicine approaches to addiction treatment yet have been used sparingly to identify predictors of alcohol-related problems. Recursive partitioning, a machine learning algorithm, can identify salient predictors and clinical cut points that can guide treatment. This study aimed to identify predictors and cut points of alcohol-related problems and to examine result stability in two separate, large data sets of college student drinkers (n = 5,090 and 2,808). Four regression trees were grown using the "rpart" package in R. Seventy-one predictors were classified as demographics (e.g., age), alcohol use indicators (e.g., typical quantity/frequency), or psychosocial indicators (e.g., anxiety). Predictors and cut points were extracted and used to manually recreate the tree in the other data set to test result stability. Outcome variables were alcohol-related problems as measured by the Alcohol Use Disorder Identification Test and Brief Young Adult Alcohol Consequences Questionnaire. Coping with depression, conformity motives, binge drinking frequency, typical/heaviest quantity, drunk frequency, serious harm reduction protective behavioral strategies, substance use, and psychosis symptoms best predicted alcohol-related problems across the four trees; coping with depression (cut point range: 1.83-2.17) and binge drinking frequency (cut point range: 1.5-2.5) were the most common splitting variables. Model fit indices suggest relatively stable results accounting for 17%-30% of the variance. Results suggest the nine salient predictors, particularly coping with depression motives scores around 2 and binge drinking frequency around two to three times per month, are important targets to consider when treating alcohol-related problems for college students. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Consumo de Alcohol en la Universidad , Estudiantes , Humanos , Femenino , Masculino , Adulto Joven , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Consumo de Alcohol en la Universidad/psicología , Universidades , Aprendizaje Automático , Trastornos Relacionados con Alcohol/psicología , Trastornos Relacionados con Alcohol/epidemiología , Adolescente , Adulto , Encuestas y Cuestionarios
14.
Stigma Health ; 9(3): 303-310, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39099891

RESUMEN

Shame is one of the leading barriers to successful recovery in substance use treatment settings. This secondary analysis study examined measurement invariance of the Internalized Shame Scale (ISS) and explored changes in shame during treatment. Participants (N=105) in the parent study were recruited from a nonprofit residential treatment center for justice-involved women and were randomized to receive mindfulness-based relapse prevention or relapse prevention treatment. A series of confirmatory factor analyses were used to assess measurement invariance in a one-factor measurement model of the ISS. Latent growth curve modeling was used to examine change in shame over time. Our findings support the assumption of measurement invariance across multiple time points and across treatment conditions, supporting comparisons of stigma scores across groups and over time. Although we observed significant reductions in shame from pre- to post-treatment, there were no differences across treatment conditions. Additional research is needed to determine how distinct treatment components relate to reductions in shame among individuals receiving treatment for a substance use disorder.

15.
J Addict Med ; 18(4): 418-424, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38606854

RESUMEN

OBJECTIVES: This study aimed to evaluate the validity of World Health Organization (WHO) risk drinking level reductions as meaningful endpoints for clinical practice and research. This study examined whether such reductions were associated with a lower likelihood of a current alcohol use disorder (AUD) diagnosis and fewer AUD criteria. METHODS: We conducted a secondary data analysis to address these objectives using data from a multisite randomized controlled trial of gabapentin enacarbil extended release in treating moderate to severe AUD among adults (N = 346). Participants received gabapentin enacarbil extended release or placebo for 6 months. The timeline follow-back was used to assess WHO risk drinking level reductions, and the Mini-International Neuropsychiatric Interview was used to assess Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) AUD diagnosis and criteria at baseline (past year) and end of treatment (past month). RESULTS: Most participants (80.1%) achieved at least a 1-level reduction in the WHO risk drinking levels from baseline to end of treatment, and nearly half of participants (49.8%) achieved at least a 2-level reduction. At least a 1-level reduction or at least a 2-level reduction in WHO risk drinking level predicted lower odds of an active AUD diagnosis (1-level: odds ratio, 0.74 [95% confidence interval (CI), 0.66-0.84]; 2-level: odds ratio, 0.71 [95% CI, 0.64-0.79]) and fewer AUD criteria (1-level: B , -1.66 [95% CI, -2.35 to -0.98]; 2-level: B , -1.76 [95% CI, -2.31 to -1.21]) at end of treatment. CONCLUSIONS: World Health Organization risk drinking level reductions correlate with Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) AUD diagnosis and criteria, providing further evidence for their use as endpoints in alcohol intervention trials, which has potential implications for broadening the base of AUD treatment.


Asunto(s)
Alcoholismo , Organización Mundial de la Salud , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Alcoholismo/diagnóstico , Alcoholismo/tratamiento farmacológico , Consumo de Bebidas Alcohólicas , Resultado del Tratamiento , Preparaciones de Acción Retardada
16.
Alcohol Clin Exp Res (Hoboken) ; 48(2): 420-429, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38149364

RESUMEN

BACKGROUND: Abstinence has historically been considered the preferred goal of alcohol use disorder (AUD) treatment. However, most individuals with AUD do not want to abstain and many are able to reduce their drinking successfully. Craving is often a target of pharmacological and behavioral interventions for AUD, and reductions in craving may signal recovery. Whether reductions in drinking during AUD treatment are associated with reductions in craving has not been well examined. METHODS: We conducted secondary analyses of data from three AUD clinical trials (N's= 1327, 346, and 200). Drinking reductions from baseline to the end of treatment were measured as changes in World Health Organization (WHO) risk drinking levels; alcohol craving was measured using validated self-report measures. Regression analyses tested whether drinking reductions were associated with end-of-treatment craving reductions; moderation analyses tested whether associations between drinking reduction and end-of-treatment craving differed across AUD severity. RESULTS: Reductions of at least 1 or at least 2 WHO risk drinking levels were associated with lower craving (all p's < 0.05). Results were substantively similar after removing abstainers at the end-of-treatment. Associations between drinking reductions and craving were generally not moderated by AUD severity. CONCLUSIONS: Individuals with WHO risk drinking level reductions reported significantly lower craving, as compared to those who did not achieve meaningful reductions in drinking. The results demonstrate the utility of WHO risk drinking levels as AUD clinical trial endpoints and provide evidence that drinking reductions mitigate craving.

17.
Addict Behav ; 146: 107789, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37467629

RESUMEN

Concurrent use of alcohol and cannabis among college students is common and confers greater harms than the use of either of these substances alone. Large and growing bodies of literature have demonstrated the independent utility of behaviors used before, during, after, or instead of alcohol and cannabis use that minimize related harms (i.e., protective behavioral strategies [PBS]). However, little is known about the relationship between alcohol and cannabis PBS and their joint influence on harms among college students who concurrently use alcohol and cannabis. In the present study, we used data from two large, multi-site samples of college students, and restricted analyses to those who reported at least one episode of alcohol and cannabis use in the past 30 days (Study 1: N = 1104[Mage = 20.3, SD = 3.8; 70.0 % female; 79.5 % white]; Study 2: N = 2034[Mage = 20.2, SD = 3.2; 69.1 % female; 76.6 % white]). A latent profile analysis supported a 4-profile solution that was largely consistent across samples: Profile 1 (low alcohol/cannabis PBS; 8.8-11.9 %), Profile 2 (average alcohol/cannabis PBS; 33.1-37.7 %), Profile 3 (average alcohol PBS/low cannabis PBS; 16.3-25.2 %), and Profile 4 (high alcohol/cannabis PBS; 29.8-37.2 %). Profile 4 reported the least alcohol/cannabis use, fewest negative alcohol-/cannabis-related consequences, and lowest alcohol/cannabis use severity. In contrast, Profile 1 was the opposite for alcohol-related outcomes, and Profile 3 was the opposite for cannabis-related outcomes. These findings are preliminary but may suggest that targeting both alcohol and cannabis PBS in intervention is generally beneficial except some groups at risk for a particular substance may benefit from increased focus on that substance in intervention.


Asunto(s)
Consumo de Alcohol en la Universidad , Cannabis , Humanos , Femenino , Adulto Joven , Adulto , Masculino , Consumo de Bebidas Alcohólicas/epidemiología , Estudiantes , Universidades
18.
Assessment ; : 10731911231195834, 2023 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-37694379

RESUMEN

Commensurate measures of alcohol-related consequences across countries and cultures are critical for addressing the global burden of hazardous alcohol use. The Rutgers Alcohol Problem Index (RAPI), developed and validated in the United States, is a popular measure of alcohol problems. This study examined measurement invariance of the RAPI across samples of U.S. and Swedish high school seniors. Latent mean differences in alcohol problems across countries and differences in associations between alcohol problems with alcohol use and protective behavioral strategies (PBS) were also examined. The RAPI was scalar invariant. Swedish students reported fewer problems than U.S. students (latent mean difference = -0.19, p = .047). In both samples, the RAPI was positively correlated with alcohol use frequency and quantity (ps < .001), and negatively correlated with PBS use (ps < .05). Overall, the RAPI demonstrated measurement invariance, and we found evidence for its validity across samples of U.S. and Swedish high school seniors.

19.
Int J Drug Policy ; : 104216, 2023 Oct 05.
Artículo en Inglés | MEDLINE | ID: mdl-37802721

RESUMEN

Research supports protective behavioral strategies (PBS) as effective in reducing substance use, intoxication, and/or related risks/harms. However, despite the predominance of polysubstance use and common co-occurrence of different substance use disorders (SUDs), previous PBS research has been limited in terms of substance-specific measurement. This study sought to develop and validate a measure of PBS that is not substance-specific. Building from initial pilot work, we tested the psychometric properties of the Substance Use Protective Strategies Scale (SUPSS) in a large sample of young adults (N = 7325, aged 18-30), who reported using multiple psychoactive substances (other than alcohol and nicotine), recruited via social media in Poland. By splitting the sample, we conducted exploratory (n = 3709) and confirmatory factor analysis (n = 3614), which supported a 4-factor structure with 19 items (7 items dropped): Preparation for use (α = 0.66), Manner of use (α = 0.85), Additional concerns (α = 0.74), and Setting (α = 0.62). Configural, metric and scalar invariance were supported across sex, age, and user status for most substance types (cannabis, dissociatives, etc.). Further, the SUPSS factors were strongly associated with substance-related harms (R-squared = 0.495) and SUD symptoms (DUDIT, R-squared = 0.570). Our model fit was adequate (but not excellent), and two subscales had low internal consistency, highlighting the need for further improvement of the SUPSS. Despite its limitations, we found the SUPSS to have strong psychometric properties and it holds promise to enhance PBS research and harm reduction-oriented interventions.

20.
J Psychoactive Drugs ; : 1-10, 2023 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-36966350

RESUMEN

Psychological need satisfaction and need frustration, proposed by self-determination theory, may serve as conditions that foster health-promoting and health-impairing behaviors related to cannabis use. In the present study, we examined the measurement model of psychological need satisfaction and need frustration and their associations with cannabis protective behavioral strategies use, negative cannabis-related consequences, and cannabis use severity. Data were from 1394 college students from 10 universities across the U.S. who reported past-month cannabis use. A higher-order factor model representing general psychological need satisfaction and need frustration provided a good fit to the data. Regressing the three observed cannabis outcome variables onto these higher-order latent factors, we found that greater need satisfaction was associated with more frequent cannabis protective behavioral strategies use and fewer negative cannabis-related consequences. Greater need frustration was associated with greater negative cannabis-related consequences and cannabis use severity. Further, an interaction effect between need satisfaction and need frustration emerged for each cannabis outcome such that greater need satisfaction attenuated the associations between need frustration and cannabis outcomes and greater need frustration strengthened the associations between need satisfaction and cannabis outcomes. Implications for the roles of need satisfaction and need frustration in cannabis use and future intervention development are discussed.

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