Bridging the Gap: Can Group Interventions Assist Addiction Consult Services in Providing Integrated, Comprehensive Healthcare for Patients Hospitalized for Opioid-Related Infections?

Few healthcare systems provide integrated, comprehensive addiction treatment for patients with opioid-related infections (e.g., endocarditis) requiring long-term intravenous antibiotic treatment. Accordingly, this study outlines preliminary findings from a psychosocial intervention provided to patients hospitalized for opioid-related infections. Twenty-seven (56.5% female) patients aged 23-64 [M(SD) = 40.43(11.72)] years inducted on medication-assisted therapy by an addiction consult service participated in a weekly group intervention while hospitalized. These patients demonstrated gains in relevant knowledge from admission to discharge, 100% identified a follow-up plan at discharge, and 81.5% followed up in outpatient the next day. Immediate, 1-month, 3-month, and 6-month retention rates are presented, as well as comparisons to historical patients who did not receive the group intervention in the year prior to the study. This preliminary research outlines a group intervention that may be implemented into existing addiction consult services to improve integrated, comprehensive addiction treatment for patients with opioid-related infections.

Nonmedical prescription stimulant use for suppressing appetite and controlling body weight is uniquely associated with more severe eating disorder symptomatology.

OBJECTIVE: Nonmedical prescription stimulant use (NPS; i.e., use without a prescription or in ways other than prescribed) to suppress appetite or control weight appears to be associated with eating disorder (ED) symptomatology among college students. However, it remains unknown if this relationship is motive-specific and uniquely related to ED symptomatology. This research examined whether engaging in NPS specifically for appetite/weight-related purposes is associated with ED symptomatology and a unique indicator of more severe symptomatology. METHOD: A nonclinical sample of college students (N = 668; 79% female) reported eating disorder symptoms via the Eating Pathology Symptoms Inventory and Eating Disorder Examination-Questionnaire, and lifetime history of NPS and corresponding motives. RESULTS: Binge eating, body dissatisfaction, negative attitudes towards obesity, restricting, purging, and cognitive restraint were reported more frequently by students who endorsed NPS for weight/appetite-related purposes than by those who used for other purposes or denied lifetime NPS. Additionally, NPS for appetite/weight-related purposes was uniquely associated with ED symptomatology after adjusting for gender, lifetime NPS, and past-month binge eating and purging. DISCUSSION: Engaging in NPS for appetite/weight-related purposes is a unique indicator of ED symptomatology, highlighting the need to query for this behavior among individuals with an ED. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:813-816).

Alcohol use and alcohol-related consequences: associations with emotion regulation difficulties.

BACKGROUND: Understanding factors associated with alcohol-related consequences is an important area of research. Emotional functioning has been associated with alcohol-related consequences but there is less research examining a comprehensive underlying model of emotional regulation. The Difficulties in Emotion Regulation Scale (DERS) is a recent measure developed to assess six facets of emotion regulation difficulties that contribute to overall emotional functioning. OBJECTIVES: The current study examines associations between these six facets of emotion regulation difficulties and problematic alcohol use. METHODS: Participants (n = 1758 college students) were recruited as part of a larger study and were asked to complete online questionnaires assessing demographics, alcohol use and problems, and emotion regulation difficulties. RESULTS: Negative binomial hurdle models for alcohol use and alcohol-related consequences were estimated. Impulse control difficulties were positively related to the number of drinks consumed during the week among active drinkers. Non-acceptance of emotional responses, impulse control difficulties, lack of emotional clarity, and difficulties engaging in goal-directed behavior were all positively associated with number of consequences endorsed. Difficulty engaging in goal-directed behavior was also positively associated with the likelihood of experiencing any alcohol-related consequences. CONCLUSIONS: The findings support previous research indicating that emotion-regulation difficulties are broadly associated with alcohol-related consequences. Results suggest exposure and/or mindfulness based prevention/interventions with emotion focused psychoeducation may offer one path to reducing alcohol-related consequences among college students.

Sex-related impelling cues uniquely predict event-level alcohol-related sexual behavior that poses heightened risk for negative consequences among college women.

The occurrence of sexual behavior that poses heightened risk for negative outcomes (e.g., condomless sex, sex with new or unfamiliar partners) often involves drinking alcohol for social and enhancement purposes, with female college students being particularly at-risk for resulting consequences. This study examined whether alcohol use, drinking motives, and sex-related impelling cues (i.e., cues that may impel one toward engaging in sexual activity) could predict sexual behaviors that pose heightened risk for negative consequences among female undergraduates. A total of 251 drinking episodes from 56 female college students (M age = 19.66) were obtained via surveys assessing alcohol use, drinking motives, sex-related impelling cues, and sexual behaviors at the event level. Relationships between variables were examined via main effect and factorial generalized estimating equations for social, enhancement, coping, and conformity drinking motives. In each main effects model, sex-related impelling cues were the only significant predictor. Significant three-way interactions were found in the social and enhancement factorial models, such that sexual behaviors that pose heightened risk for negative consequences occurred 58.81% and 55.81% of the time, respectively, under conditions of high drinks, motives, and sex-related impelling cues. This study provides a more nuanced understanding of the circumstances under which these sexual behaviors are most likely to occur, necessitating the consideration of sex-related impelling cues in addition to previously known predictors (i.e., alcohol use and drinking motives). This knowledge may assist in developing targeted interventions designed to reduce sexual behavior that poses heightened risk for negative consequences and ultimately improve the lives of college women. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Heightened Sexual Misconduct Victimization Rates among Reserve Officers' Training Corps Women: Results From a Campus Climate Survey.

Sexual assault, harassment, and stalking are commonplace among college students, with identified subgroups being particularly at risk (e.g., Greek-life organizations and intercollegiate athletics). Despite higher rates of sexual misconduct among active-duty military and service academy women, no research has examined the risk for Reserve Officers' Training Corps (ROTC) women. A total of N = 1,562 college women were sampled from a sexual misconduct campus climate survey. ROTC women reported higher victimization rates for all variants of sexual misconduct and violence relative to the broader student population, as well as previously established high-risk groups. Directions for future research and implications for prevention programming/response are presented and discussed.

A qualitative examination of college students' perceptions of cannabis: insights into the normalization of cannabis use on a college campus.

ObjectiveThis study aimed to qualitatively examine how perceptions of cannabis differ among college students in an effort to better understand the changing landscape of cannabis on college campuses. Participants: Forty-six predominantly male (69.9%; Mage = 23.15, SD = 4.11) college students attending a border state university (i.e., a state that has not yet legalized cannabis but borders a state that has). Methods: Participants engaged in facilitated focus group discussions (N = 5) about cannabis-related issues. Results: Thematic analysis uncovered three primary themes and six subthemes. Main themes included: 1) User Heterogeneity and Identity, 2) Relative Benefits and Harms of Cannabis, and 3) Social Position of Cannabis on Campus Culture. Conclusions: Cannabis has quickly integrated into the college social environment, with social stigmatization and identification with cannabis impacting decisions to use. Findings inform existing college health programs on how to approach conversations about cannabis with students.

Cannabis Use Is Differentially Associated with Individual Facets of Impulsivity through Expectancy Effects: A Comprehensive Application of the Acquired Preparedness Model.

The acquired preparedness model (APM) posits that the relationship between impulsivity and substance use is mediated by drug effect expectancies. Though the APM has been utilized to explain college student cannabis use, a comprehensive model conceptualizing impulsivity as a multidimensional construct has not been examined. Guided by the APM, the current study examined facets of impulsivity as simultaneous predictors of cannabis use through positive and negative expectancies. College students (N = 478) completed an online survey assessing frequency of past-month cannabis use, facets of impulsivity, and cannabis expectancies. Using a bootstrapped path analysis, five facets of impulsivity were modeled as predictors of past-month cannabis use via positive and negative expectancies. A zero-inflated Poisson distribution was used, wherein dichotomous past-month cannabis use was examined independently of frequency. There was a significant indirect effect of sensation seeking on both increased likelihood and frequency of use through strong positive expectancies. Additionally, both negative and positive urgency were associated with a decreased likelihood of use through stronger negative expectancies, while lack of premeditation was associated with an increased likelihood of use through weaker negative expectancies. These results underscore the importance of examining impulsivity as a multi-dimensional construct in the understanding of college student cannabis use behavior.

Practices and concerns related to naloxone use among emergency medical service providers in a rural state: A mixed-method examination.

The rate of opioid misuse and overdose continues to increase in rural areas of the U.S. In response, access to naloxone hydrochloride ("naloxone"), an opioid antagonist used to reverse opioid overdose, has increased among both first responders and laypeople. While plenty of research has examined naloxone use among laypeople, little remains known about practices and concerns related to naloxone among emergency medical services (EMS) providers. This is particularly true among those serving rural areas that are disproportionately affected by opioid overdoses and the underutilization of naloxone. Accordingly, a mixed-method approach consisting of a quantitative Internet survey (N = 854) and qualitative focus groups (N = 20) was utilized to examine practices and concerns related to naloxone among EMS providers in a rural state. Participants represented a range of EMS licensure levels and years of experience. Findings from the focus groups can be summarized under two major themes: 1) variance in naloxone use and 2) concerns about naloxone use. In addition, meaningful information on practices of and concerns related to naloxone use, including rates of naloxone administration, knowledge about naloxone use/overdose, confidence in administering naloxone and providing follow-up care, and perceptions of rural impact, were obtained from rural EMS. Information obtained from this study can help inform policy and prevention efforts specific to EMS providers serving rural areas, including providing further evidence for permitting all EMS providers, regardless of licensure level, to administer naloxone and ensuring that education about naloxone use is effectively disseminated to these providers.

Differentiating motives for nonmedical prescription stimulant use by personality characteristics.

Nonmedical prescription stimulant use (NPS) is increasing, particularly among college students. College students typically engage in NPS for cognitive enhancement, recreational, and appetite/weight-related purposes; however, little research has used these motives to identify specific risk for, or consequences of, NPS. Moreover, there may be unique risk factors for motive-specific NPS that have yet to be explored, such as relevant personality traits (i.e., distress tolerance, impulsivity, and perfectionism) that are associated with NPS in general. Therefore, this study aimed to examine whether NPS users and nonusers could be differentiated via facets of impulsivity, perfectionism, and distress tolerance, and whether users could be further differentiated by reported motive for use based on these traits. Midwestern university undergraduate students (N = 668) who were enrolled in a psychology research pool completed an online survey assessing demographics, NPS and motives, and measures of distress tolerance, impulsivity, and perfectionism. Participants were primarily female (78%) and aged 18-54 (M = 20.10, SD = 3.19) years. Univariate and multivariate analysis of variance tests revealed associations between lifetime NPS and higher impulsivity, higher perfectionism, and lower distress tolerance. Further tests revealed NPS for appetite/weight-related purposes was associated with lower distress tolerance, while NPS for recreational purposes was associated with higher impulsivity. These findings contribute novel information regarding NPS motives and personality constructs. This information may aid in comprehensive identification of high-risk individuals for NPS and inform the development of specialized prevention and intervention efforts.

"Not for Human Consumption": A Descriptive Investigation into User Characteristics, Motives, and Consequences Associated with Bath Salt Use.

Synthetic cathinones, commonly referred to as "bath salts," are recreational designer drugs that recently emerged as a drug of abuse. However, little is known about bath salt users, particularly in the United States (US). This descriptive study aims to better characterize users and user behavior, including common motives for and consequences of use. Individuals with a lifetime history of bath salt use (BSU; n = 110) completed an Internet survey. Participants (50.9% male) were aged 18 to 58 (M = 31.21, SD = 10.25) years and were from 32 US states. Most participants reported past-year BSU, via intranasal use, obtained from a friend or acquaintance. Recreational motives (e.g., to get high, experimentation) were commonly reported, as was use due to drug availability. Participants reported experiencing an average of 5.50 consequences, with both physical (e.g., rapid heartbeat) and psychological (e.g., anxiety) negative outcomes commonly reported. This descriptive information on BSU from a small but diverse sample of users may inform efforts to reduce use and negative consequences, such as eliminating riskier routes of administration (e.g., injection) and targeting specific motives for use (e.g., providing alternative methods for mood expansion).

Alcohol-related protective behavioral strategies as a mediator of the relationship between drinking motives and risky sexual behaviors.

Risky sexual behaviors (RSB) frequently occur in the context of alcohol use and are associated with distinct drinking motives among college students. Use of alcohol protective behavioral strategies (PBS) is associated with reductions in alcohol use and related problems, which may extend to alcohol-related RSB. Moreover, as PBS use mediates the relationship between positive reinforcement drinking motives and alcohol-related problems, the same may be true for alcohol-related RSB, specifically. The current study examined whether PBS mediates the relationship between drinking motives and RSB among college students. Participants (N = 2039, 72.8% female, Mage = 19.79) from ten universities across ten U.S. states completed an online survey assessing past-month drinking motivation, alcohol PBS, alcohol consumption, and RSB. To test study aims, a saturated path model in which drinking motives were modeled as predictors of RSB via PBS use subscales and alcohol consumption was conducted. Several double mediation effects were found, such that stronger endorsement of motives (i.e., social, enhancement, conformity, coping for depression) were associated with lower PBS (particularly manner of drinking and serious harm reduction), which was associated with higher alcohol use, which was associated with higher RSB. Multi-group models found the mediation effects to be gender invariant, although several differences in direct associations were found across genders. For college students high in positive reinforcement motives (i.e., social or enhancement) for drinking, interventions that aim to increase PBS use, specifically related to modifying the manner in which one drinks and avoiding very dangerous consequences, may be effective in reducing alcohol-related RSB.

Predicting risky sexual behaviors among college student drinkers as a function of event-level drinking motives and alcohol use.

BACKGROUND: Risky sexual behaviors (e.g., sex without protection against pregnancy or sexually transmitted infections, sexual coercion, sex with unknown partners) are common among college students. To effectively decrease these behaviors, it is necessary to further understand factors associated with their occurrence. Drinking motives are a known predictor of both alcohol use and alcohol-related consequences, which may theoretically include risky sex. This study aimed to understand how drinking motivation interacts with alcohol use to predict risky sexual behaviors among college student drinkers. METHODS: One-hundred and eight primarily female (83.3%) college students (age: M=19.09, SD=1.16) who endorsed past-month alcohol use and lifetime history of sexual activity completed up to four weekly Internet surveys assessing daily quantity of alcohol use, drinking motives (i.e., social, enhancement, coping, conformity), and engagement in risky sexual behavior. From 403 reported drinking episodes, four Generalized Estimating Equations were used to predict risky sex from person-centered drinking quantity and drinking motives. RESULTS: Strong social motives significantly increased the odds of engaging in risky sexual behaviors (p=0.004). Additionally, there was a significant interaction, such that the relationship between risky sex and drinking depends on enhancement motives (p=0.021). CONCLUSIONS: Interventions targeting social and enhancement motives for drinking may be particularly effective in reducing the occurrence of risky sexual behaviors among college students, which may result in a reduction of the negative physical and psychological health outcomes accompanying these behaviors.

Deviance regulation theory and drinking outcomes among Greek-life students during spring break.

Alcohol use among college students increases during spring break, which often results in more alcohol-related consequences. Given the rates of heavy alcohol use among Greek-life college students, this population may be particularly at risk for experiencing negative outcomes during this time. Thus, the current study utilized a Deviance Regulation Theory (DRT)-based approach to increase the use of protective behavioral strategies (PBS) among Greek-life college students during spring break. Greek-life college students going on spring break (n = 89) completed a screening before being randomly assigned to a pre-spring break condition (i.e., either a positively or negatively framed message about peers who do or do not use PBS during spring break). Participants then completed a post-spring break assessment of alcohol and PBS use over spring break (n = 70). There were no observed DRT effects on manner of drinking or stopping/limiting PBS use during spring break. However, there were effects on Harm Reduction PBS (HR PBS). In the positive frame, HR PBS use was positively associated with PBS norm discrepancy (the difference between spring break specific PBS norms and typical PBS norms). While these associations did not result in lower alcohol consumption, HR PBS was inversely associated with risk-related alcohol problems, but not other types of alcohol problems. A brief DRT-based approach may increase specific PBS types during spring break and may reduce risk-related alcohol-related problems among Greek-life students during spring break. (PsycINFO Database Record

Tension reduction and affect regulation: An examination of mood indices on drinking and non-drinking days among university student drinkers.

Several theories posit problematic alcohol use develops through mechanisms of positive and negative reinforcement. However, the literature on these mechanisms remains inconsistent. This may be due to a number of issues including a failure to disaggregate negative mood or a failure to account for mood functioning (i.e., stability in mood). Alternatively, there may be differences in typical postdrinking/evening mood on drinking and nondrinking days, however, this has yet to be fully explored. We examined multiple indices of distinct mood states prior to and after typical drinking onset times on drinking and nondrinking days using ecological momentary assessment. College student drinkers (n = 102) carried personal data devices for 15 days. They reported on mood and alcohol use several times per day. Tonic positive mood was higher on drinking days than nondrinking days prior to typical drinking initiation. After typical drinking times, positive mood was higher on drinking days than nondrinking days. Similarly, negative moods (anxiety, stress, anger, and stress instability) indicated a pattern of lower levels relative to both predrinking mood on drinking days, and matched mood time-points on nondrinking days; though, not all of these differences were statistically different. Results suggest positive and negative reinforcing mechanisms may be at play-though the negative reinforcement effects may manifest through subjectively "better" mood on drinking versus nondrinking days. (PsycINFO Database Record

Interventions for alcohol-related risky sexual behaviors among college students: A systematic review.

Alcohol-related risky sexual behaviors are common among college students. Though various interventions targeting these behaviors have been examined, the literature does not currently include a review of these strategies. A comprehensive literature search was conducted, yielding 7 randomized controlled trials. Relevant outcome variables included unprotected sex, alcohol in conjunction with sex, and number of sexual partners. Findings suggested that interventions utilizing reminder cues or motivational interviewing-based techniques were largely found to be effective in increasing condom use behaviors among intoxicated individuals, while support for personalized normative feedback (PNF) for the same outcome was mixed. However, PNF interventions were generally effective in reducing alcohol use in conjunction with sex. Finally, though few studies examined number of sexual partners, there are mixed findings for interventions (i.e., motivational interviewing, PNF) targeting this outcome. Overall, there is promising, albeit mixed, evidence of the effectiveness of interventions targeting various alcohol-related risky sexual behaviors among college students. Strengths, limitations, and implications of the findings of this systematic review for future research are discussed. (PsycINFO Database Record

An application of deviance regulation theory to reduce alcohol-related problems among college women during spring break.

Spring break (SB) can lead to heavy episodic drinking and increased alcohol-related risks. This may be especially relevant for women. The current study utilized deviance regulation theory to increase the use of protective behavioral strategies (PBSs) among female college students on SB. Female college students going on SB (n = 62) completed a screening, a pre-SB intervention (where they were randomly assigned to receive either a positively or negatively framed message about individuals who do or do not use PBS), and a post-SB assessment that provided alcohol and PBS use data for each day of SB (n = 620 person-days). Data were analyzed using a multilevel structural equation model. In the negative frame, SB PBS use was higher among those who perceived SB PBS norms to be more common on SB relative to non-SB. In the positive frame, SB PBS use was higher among those who perceived SB PBS norms to be less common on SB relative to non-SB. These associations did not result in lower alcohol consumption, but did result in a lower likelihood of experiencing alcohol-related problems during SB. These results suggest that a brief online intervention, that utilizes targeted messages based on normative perceptions of SB PBS use, could be an effective strategy for reducing alcohol-related consequences among college student women during SB. (PsycINFO Database Record

Are drinking motives associated with sexual "hookups" among college student drinkers?

OBJECTIVE: This study examined associations between drinking motivation, alcohol use, and sexual hookups among college students. PARTICIPANTS: Participants (n = 755 Midwest college student drinkers; 61% female) ranged in age from 18 to 24. METHODS: Participants completed online measures of alcohol involvement (use and motives) and sexual activity. RESULTS: Alcohol use was positively linked to sexual hookups. Social and enhancement motives were positively and indirectly associated with sexual hookups via alcohol use. Drinking to cope had a direct association with sexual hookups. Social drinking was more strongly associated with hookups in men than in women, but both groups exhibited a positive association. CONCLUSIONS: This study is the first to highlight the relationships between distinct drinking motives and sexual risk behavior. The results indicate that specific motives may increase risk of sexual hookups both indirectly via alcohol use, as well as directly, at least among those that drink to cope with negative mood.

Mania and sexual risk: associations with behavioral self-regulation.

INTRODUCTION: Risky sexual behavior among young adults is a central public health concern. Hallmark cognitive effects of mania involve grandiose extrinsic goal-setting, which may be part of a tendency to approach rewarding cues while underestimating potential negative consequences. Poor impulse control also reflects a tendency to seek reward and rely on emotional decision-making. In contrast, effortful control is associated with adaptive decision making. METHODS: Participants (n=595) completed measures of impulsivity, risk for mania, and risky sexual behavior. Relationships between risk for mania, behavioral self-regulation, and risky sexual behavior were examined in a negative binomial hurdle model. RESULTS: For the hurdle portion, sensation-seeking was positively associated with the likelihood of engaging in risky sexual behavior. Effortful control was inversely associated with the likelihood of engaging in risky sexual behavior, but only among those high in risk for mania. Among those endorsing engagement in risky sex, urgency was positively, and effortful control negatively, associated with frequency of risky sex. Risk for mania was positively associated with frequency of risky sex, but only for those low in effortful control. LIMITATIONS: Findings were among a homogeneous, young adult, nonclinical population, limiting generalizability. Examining these associations among a clinical population in an active manic episode is warranted. CONCLUSION: Results suggest high levels of effortful control may diminish the hallmark effects of mania on cognition thereby reducing engagement in risky sexual behavior. Treatments targeting emotion-based rash action and effortful decision making may be particularly important for those experiencing manic symptoms.