Women's use of alcohol: Neurobiobehavioral concomitants and consequences.

In this narrative review, we draw from historical and contemporary literature to explore the impact of alcohol consumption on brain and behavior among women. We examine three domains: 1) the impact of alcohol use disorder (AUD) on neurobiobehavioral outcomes, 2) its impact on social cognition/emotion processing, and 3) alcohol's acute effects in older women. There is compelling evidence of alcohol-related compromise in neuropsychological function, neural activation, and brain structure. Investigations of social cognition and alcohol effects in older women represent emerging areas of study. Initial analyses suggest that women with AUD show significant deficits in emotion processing, a finding also observed in older women who have consumed a moderate dose of alcohol. Critically, despite the long-recognized need for programmatic interrogation of alcohol's effect in women, studies with sufficient numbers of women for meaningful analysis represent a small proportion of the literature, constraining interpretation and generalization.

Impact of Pre-Adolescent Substance Familiarity on Subsequent Use: Longitudinal Analysis of Risk by Latent Classes in the Adolescent Brain Cognitive Development Sample.

BACKGROUND: Predicting substance use in adolescence is a difficult yet important task in developing effective prevention. We aim to extend previous findings on the linear associations between familiarity with (knowledge of) substances in childhood and subsequent substance use in adolescence through a latent class analysis (LCA) to create risk profiles based on substance familiarity. METHOD: Using the ABCD Study® sample, we conducted an LCA using 18 binary substance familiarity variables (n = 11,694 substance-naïve youth). Complementary analyses investigated the relationship between LCA groups and (1) longitudinal use, (2) use initiation, and (3) early use. RESULTS: The optimal LCA resulted in a four-class solution: Naïve, Common, Uncommon, and Rare, with each group increasing in both the number and rarity of known substances. Analysis 1 revealed an increased risk in use over time among both the Uncommon and Rare groups (ORs = 2.08 and 5.55, respectively, p's < 0.001) compared to the Common group. Analysis 2 observed a decreased risk for initiation between the Naïve and Common groups (OR = 0.61, p = 0.009); however, the Uncommon and Rare groups were at an increased risk compared to the Common group (ORs = 2.08 and 3.42, respectively, p's < 0.001). Analysis 3 found an increased risk of early use between the Common and Uncommon groups (OR = 1.92, p < 0.001) with a similar trend between the Common and Rare groups (OR = 1.90, p = 0.06). CONCLUSION: These results highlight distinct risk profiles for adolescent substance use based on substance familiarity in middle childhood. Current work could be applied as an early screening tool for clinicians to identify those at risk for adolescent substance use.

Retrospective Hair Cortisol Concentrations from Pretreatment to Early Recovery in Alcohol Use Disorder.

Cortisol profiles are known to vary across phases of alcohol use disorder (AUD; e.g. chronic use, withdrawal and early/sustained recovery). These patterns have largely been established through between-subjects contrasts. Using a segmental hair cortisol concentrations (HCC) approach, retrospective longitudinal analyses are feasible. Here, we examine monthly cortisol secretion in treatment-seekers with AUD from alcohol use to abstinence. At ~6 weeks of recovery we collected hair samples from individuals with moderate-to-severe AUD. We examined HCC from three consecutive segments; proximal to the scalp representing the most recent month (sustained abstinence from alcohol), the midsegment representing the previous month in which abstinence was attained, and the distal segment representing 2 months prior during active drinking. Analyses examined main and interactive effects of segment and sex, controlling for monthly alcohol consumption. Best fit by a quadratic shape, within-subject change was significant (F1,15 = 5.27, P = 0.04, ηpartial2 = 0.26). The distal and midsegments did not differ from one another (P = 0.51). The proximal segment was significantly lower than both the distal (M∆ = 0.200, P = 0.004) and mid (M∆ = 0.175, P < 0.001) segments. An effect of sex approached significance suggesting women had modestly higher HCC than men (MWOMEN = 1.37 vs. MMEN = 1.02, P = 0.10). Consistent with previous cross-sectional reports, these data confirm nonlinear patterns of cortisol accumulation with elevations apparent during periods of alcohol consumption and a decrease in abstinence. Capturing these within-subject patterns via HCC trajectories may serve as a valuable resource in identifying profiles associated with increased risk and post-treatment outcomes.

Acute Alcohol Intake Produces Widespread Decreases in Cortical Resting Signal Variability in Healthy Social Drinkers.

BACKGROUND: Acute alcohol intoxication has wide-ranging neurobehavioral effects on psychomotor, attentional, inhibitory, and memory-related cognitive processes. These effects are mirrored in disruption of neural metabolism, functional activation, and functional network coherence. Metrics of intraregional neural dynamics such as regional signal variability (RSV) and brain entropy (BEN) may capture unique aspects of neural functional capacity in healthy and clinical populations; however, alcohol's influence on these metrics is unclear. The present study aimed to elucidate the influence of acute alcohol intoxication on RSV and to clarify these effects with subsequent BEN analyses. METHODS: 26 healthy adults between 25 and 45 years of age (65.4% women) participated in 2 counterbalanced sessions. In one, participants consumed a beverage containing alcohol sufficient to produce a breath alcohol concentration of 0.08 g/dl. In the other, they consumed a placebo beverage. Approximately 35 minutes after beverage consumption, participants completed a 9-minute resting-state fMRI scan. Whole-brain, voxel-wise standard deviation was used to assess RSV, which was compared between sessions. Within clusters displaying alterations in RSV, sample entropy was calculated to assess BEN. RESULTS: Compared to the placebo, alcohol intake resulted in widespread reductions in RSV in the bilateral middle frontal, right inferior frontal, right superior frontal, bilateral posterior cingulate, bilateral middle temporal, right supramarginal gyri, and bilateral inferior parietal lobule. Within these clusters, significant reductions in BEN were found in the bilateral middle frontal and right superior frontal gyri. No effects were noted in subcortical or cerebellar areas. CONCLUSIONS: Findings indicate that alcohol intake produces diffuse reductions in RSV among structures associated with attentional processes. Within these structures, signal complexity was also reduced in a subset of frontal regions. Neurobehavioral effects of acute alcohol consumption may be partially driven by disruption of intraregional neural dynamics among regions involved in higher-order cognitive and attentional processes.

Neurophysiological and Interpersonal Correlates of Emotional Face Processing in Alcohol Use Disorder.

BACKGROUND: A growing literature suggests deficient emotional facial expression (EFE) processing among recently abstinent individuals with alcohol use disorders (AUDs). Further investigation is needed to clarify valence-related discrepancies and elucidate neural and psychosocial correlates. We examined neurobehavioral indices of EFE processing and interpersonal problems in treatment seekers with AUDs and healthy community controls (CCs). METHODS: Thirty-four individuals with AUDs and 39 CCs completed an emotion judgment task (EJT), requiring discrimination between happy, angry, and sad EFEs. A second task requiring discrimination of male and female faces with neutral expressions served as the control task (i.e., sex judgment task, SJT). Neurophysiological (i.e., N170 and P3) and behavioral measures were analyzed using generalized linear mixed models (GLMM). Interpersonal problems were assessed with the Inventory of Interpersonal Problems-64 (IIP-64). The relationship of IIP-64 and EJT performance was investigated via within-group correlations. RESULTS: Analysis of the SJT revealed no group differences in behavioral measures, N170 amplitude, or P3 latency. P3 amplitudes, however, were significantly lower in the AUD group. For the EJT, initial observations of group differences in P3 amplitude were accounted for by differences in the control task. Behavioral analyses indicated that the AUD group was significantly less accurate than the CC group. Hypothesis-driven analyses using GLMM-estimated group differences indicated that anger processing was affected to a greater degree than were other emotions. Significant EJT/IIP-64 correlations were observed for anger processing within the AUD group and were confined to IIP-64 subscales with relatively high ratings on the affiliation dimension. CONCLUSIONS: Findings provide partial support for an emotion-specific processing deficit in persons with AUDs. Anger processing was more robustly affected than other emotions and was associated with interpersonal problems characterized by being overly needy, nonassertive, and overly accommodating. Results extend prior reports and reinforce the need for comprehensive study of emotion processing and its real-world implications.

Emotional Face Processing among Treatment-Seeking Individuals with Alcohol Use Disorders: Investigating Sex Differences and Relationships with Interpersonal Functioning.

BACKGROUND: Individuals in treatment for alcohol use disorder (AUD) display deficits across a broad range of cognitive processes. Disruptions in affective processing are understudied, but may be particularly important for interpersonal functioning and post-treatment adaptation. In particular, the role of sex in AUD-associated emotion processing deficits remains largely unaddressed and was a focus of the current investigation. METHODS: Fifty-six treatment seekers with AUD and 54 healthy community controls (N = 110) were administered an emotional face discrimination task. Non-affective tasks included a sex-discrimination task and two brief measures of executive functioning. Two measures of interpersonal function were included. RESULTS: Emotion processing deficits were evident among women with AUD relative to other groups. This sex-contingent relationship was not observed in measures of executive function, sex-discrimination or interpersonal problems, although individuals with AUD performed more poorly on these measures. CONCLUSIONS: Results were consistent with extant literatures examining cognitive, affective and interpersonal functioning among individuals with AUD, and provided novel evidence of vulnerability to alcohol-associated deficits in emotion processing among women. While similar sex-contingent effects were not apparent among other measures, results support modest interrelationships, specifically including the import of emotion processing to interpersonal functioning in AUD. These data offer guidance for further systematic investigation and highlight important considerations for future relapse-prevention and recovery-facilitation efforts.

Race and socioeconomic status in substance use progression and treatment entry.

This study examined trajectories of progression from early substance use to treatment entry as a function of race, among inpatient treatment seekers (N = 945). Following primary race-contingent analyses of use progression, secondary analyses were conducted to investigate the effects of socioeconomic status (SES) on the observed differences. African Americans reported significant delays in treatment entry relative to Caucasians. Racial differences in alcohol, marijuana, and cocaine use trajectories were observed. Accounting for SES rendered observations of accelerated use among African Americans nonsignificant. However, inclusion of SES failed to mitigate the marked racial disparity in treatment entry.

Characterizing Anxiety Among Individuals Receiving Treatment for Alcohol and Substance Use Disorders.

BACKGROUND: Despite high prevalence of generalized anxiety disorder (GAD) substance use disorder (SUD) comorbidity, little is known regarding demographic characteristics associated with GAD in SUD treatment seekers. OBJECTIVE: To characterize demographic differences between inpatient SUD treatment seekers reporting varying levels of GAD symptomatology. DESIGN: General linear models, chi-square test, t test, and correlational analyses were utilized to assess group differences. Groups included those with no history of significant anxiety (No GAD; n = 256), subclinical anxiety (Subclinical; n = 85), and those meeting GAD diagnostic criteria (GAD; n = 61). RESULTS: The No GAD group differed substantially from Subclinical and GAD individuals. With the exception of polysubstance use, no differences were found regarding Subclinical and GAD groups. CONCLUSION: Individuals with subclinical GAD symptoms and those meeting diagnostic criteria were nearly identical regarding precursors to problematic substance use, severity of use, and key mental health indicators. Findings suggest subclinical levels of GAD should not be overlooked when assessing and treating SUDs.

Opioid Misuse Trends in Treatment Seeking Populations: Revised Prescription Opioid Policy and Temporally Corresponding Changes.

BACKGROUND: Over the last two decades, U.S. rates of prescription opioid (PO) misuse have risen drastically. In response, federal and state governments have begun to implement new PO policies. Recent legislative changes warrant up-to-date assessments of today's misuse rates. OBJECTIVE: To explore potential changes in opioid misuse trends among substance-using treatment seekers, in temporal relation to legislative response. METHODS: Substance-use data were collected from two cross-sectional Florida-based inpatient cohorts during periods preceding (pre-policy; n = 647) and following (post-policy; n = 396) statewide PO policy initiatives. Participants provided information concerning their most frequently used drugs before treatment. PO and illicit opioid (IO) use prevalence, frequency and route of administration were examined for pre-policy vs. post-policy cohort differences. RESULTS: Relative to the pre-policy cohort, a greater percentage of the post-policy cohort reported recent misuse, daily use, and intravenous administration of POs. IO use was also more frequently reported post-policy. Non-opioid drug use prevalence did not significantly differ between cohorts. Among the opioid-using subsample, equivalent percentages of the pre- and post-policy cohorts reported the use of POs without IOs, IOs without POs, and POs/IOs concurrently. Conclusions/Importance: Florida's PO policy amendments were temporally accompanied by a higher prevalence of PO misuse and IO use among treatment-seekers assessed in this study. Whether our data reflect increased awareness of and treatment seeking for opioid use disorders or insufficient efficacy of new policies to reduce opioid misuse remains in question. Regardless, findings suggest the need for enhanced emphasis on mitigating hazardous PO-use behaviors (e.g., IV use).

Effects of Age and Acute Moderate Alcohol Administration on Electrophysiological Correlates of Working Memory Maintenance.

BACKGROUND: Previous studies suggest older adults may be differentially susceptible to the acute neurobehavioral effects of moderate alcohol intake. To our knowledge, no studies have addressed acute moderate alcohol effects on the electrophysiological correlates of working memory in younger and older social drinkers. This study characterized alcohol-related effects on frontal theta (FTP) and posterior alpha power (PAP) associated with maintenance of visual information during a working memory task. METHODS: Older (55 to 70 years of age; n = 51, 29 women) and younger (25 to 35 years of age; n = 70, 39 women) community-dwelling moderate drinkers were recruited for this study. Participants were given either placebo or an active dose targeting breath alcohol concentrations (BrACs) of 0.04 or 0.065 g/dl. Following absorption, participants completed a visual working memory task assessing cue recognition following a 9-s delay. FTP and PAP were determined via Fourier transformation and subjected to 2 (age group) × 3 (dose) × 2 (repeated: working memory task condition) mixed models analysis. RESULTS: In addition to expected age-related reductions in PAP, a significant age group × dose interaction was detected for PAP such that 0.04 g/dl dose level was associated with greater PAP in younger adults but lower PAP in their older counterparts. PAP was lower in older versus younger adults at both active doses. Further mixed models revealed a significant negative association between PAP and working memory efficiency for older adults. No effects of age, dose, or their interaction were noted for FTP. CONCLUSIONS: Results bolster the small but growing body of evidence that older adults exhibit differential sensitivity to the neurobehavioral effects of moderate alcohol use. Given the theoretical role of PAP in attentional and working memory function, these findings shed light on the attentional mechanisms underlying effects of acute moderate alcohol on working memory efficiency in older adults.

Effects of Age and Acute Moderate Alcohol Administration on Neurophysiology During Simulated Driving.

BACKGROUND: Driver age and blood alcohol concentration are both important factors in predicting driving risk; however, little is known regarding the joint import of these factors on neural activity following socially relevant alcohol doses. We examined age and alcohol effects on brain oscillations during simulated driving, focusing on 2 region-specific frequency bands implicated in task performance and attention: parietal alpha power (PAP; 8 to 12 Hz) and frontal theta power (FTP; 4 to 7 Hz). METHODS: Participants included 80 younger (aged 25 to 35 years) and 40 older (aged 55 to 70 years) community-dwelling, moderate drinkers. Participants consumed placebo, low, or moderate doses of alcohol designed to achieve target peak breath alcohol concentrations of 0, 0.04, or 0.065 g/dl, respectively. Electrophysiological measures were recorded during engagement in a simulated driving task involving 4 scenarios of varied environmental complexity. RESULTS: A main effect of age was detected in FTP, but neither an alcohol effect nor interactions were observed. For PAP, an age-by-alcohol interaction was detected. Relative to placebo controls, older and younger participants receiving low-dose (0.04 g/dl) alcohol evinced divergent PAP alterations, with a pattern of higher power among older participants and lower power among younger participants. This interaction was noted across the varied environmental contexts. CONCLUSIONS: These findings are consistent with the hypothesis that compared with younger individuals, older drivers may be differentially susceptible to alcohol effects. While these age-by-alcohol interactions in neural activity are provocative, further investigation exploring the mechanisms and behavioral correlates of these effects will be crucial in determining their behavioral impact.

The wellness incentives and navigation project: design and methods.

BACKGROUND: About 35 % of non-elderly U.S. adult Medicaid enrollees have a behavioral health condition, such as anxiety, mood disorders, substance use disorders, and/or serious mental illness. Individuals with serious mental illness, in particular, have mortality rates that are 2 to 3 times higher as the general population, which are due to multiple factors including inactivity, poor nutrition, and tobacco use. 61 % of Medicaid beneficiaries with behavioral health conditions also have multiple other co-occurring chronic physical health conditions, which further contributes to morbidity and mortality. The Wellness Incentives and Navigation (WIN) project is one of 10 projects under the Centers for Medicare and Medicaid Services "Medicaid Incentives for the Prevention of Chronic Diseases" Initiative, to "test the effectiveness of providing incentives directly to Medicaid beneficiaries of all ages who participate in prevention programs, and change their health risks and outcomes by adopting healthy behaviors." METHODS/DESIGN: WIN is a three-year randomized pragmatic clinical trial designed to examine the comparative effectiveness of the combined use of personal navigators, motivational interviewing, and a flexible wellness account on cardiovascular risk reduction among individuals in Medicaid with co-occurring physical and mental health conditions or serious mental illness alone relative to the usual care provided within Medicaid Managed Care. 1250 individuals, identified through Medicaid claims data, were recruited and randomly assigned to an intervention group or control group with outcomes tracked annually. A comparison group was also recruited to help assess the study's internal validity. DISCUSSION: The primary outcomes are physical and mental health related quality-of-life as measured by the SF-12, and BMI, blood pressure, LDL-C, and Hba1c results for those who are diabetic measured clinically. The purpose of this paper is to present the unique design of the WIN trial prior to results becoming available in hopes of assisting other researchers in conducting community-based randomized pragmatic trials. Outcomes will be assessed through the linkage of patient reported outcomes, health care claims, and electronic health record data. TRIAL REGISTRATION: NCT02440906.

Characterizing gender differences in treatment seekers.

BACKGROUND: Available evidence suggests women may be more vulnerable to the effects of chronic alcohol consumption than men. The few investigations of gender differences in treatment-seeking populations have often involved study samples restricted by selection criteria (e.g., age, education). The current study examined gender differences in a heterogeneous sample of individuals seeking treatment for a substance use disorder. We examined alcohol drinking levels, age at drinking milestones (e.g., first drink, first intoxication), and progression from milestones to alcohol problems or treatment. Additionally, family history, spousal alcoholism, and nicotine use were analyzed. METHODS: Participants included men (n = 274) and women (n = 257) in substance abuse treatment facilities. Participants completed inventories quantifying affect, intellectual ability, and drinking consequences. A family tree for substance use and personal histories for alcohol and nicotine use, including chronicity, frequency, and regularity, were collected. RESULTS: Telescoping was not observed when progression from drinking milestones to alcoholism or alcohol problems was compared between men and women. In contrast, when considered as progression to treatment, marked telescoping effects were detected, with women entering treatment more rapidly by approximately 4 years. Familial differences included a greater proportion of women reporting alcoholic parents (73% women; 61% men) and alcoholic spouses (58% women; 38% men). Smoking behaviors were similar between genders; however, men reporting higher levels of alcohol consumption reported greater intensity of chronic smoking. Smoking and drinking behaviors were correlated among men, but not women. Rates of pretreatment drug problems were equivalent between genders. CONCLUSIONS: When contrasted with the available literature, our data were only partially supportive of gender-contingent telescoping. While women did not experience alcohol problems or alcoholism earlier than men, they progressed to treatment more quickly. These results highlight the importance of carefully considering the sample and specific outcome variables when interpreting gender differences.

Age-related effects of alcohol from adolescent, adult, and aged populations using human and animal models.

BACKGROUND: This review incorporates current research examining alcohol's differential effects on adolescents, adults, and aged populations in both animal and clinical models. METHODS: The studies presented range from cognitive, behavioral, molecular, and neuroimaging techniques, leading to a more comprehensive understanding of how acute and chronic alcohol use affects the brain throughout the life span. RESULTS: Age of life is a significant factor in determining the effect of alcohol on brain functioning. Adolescents and aged populations may be more negatively affected by heavy alcohol use when compared to adults. CONCLUSIONS: Investigations limiting alcohol effects to a single age group constrains understanding of differential trajectories and outcomes following acute and chronic use. To meaningfully address the sequencing and interaction effects of alcohol and age, the field must incorporate collaborative and integrated research efforts focused on interdisciplinary questions facilitated by engaging basic and applied scientists with expertise in a range of disciplines including alcohol, neurodevelopment, and aging.

The Effects of Adverse Life Events on Brain Development in the ABCD Study®: A Propensity-weighted Analysis.

Longitudinal studies of the effects of adversity on human brain development are complicated by the association of stressful events with confounding variables. To counter this bias, we apply a propensity-weighted analysis of the first two years of The Adolescent Brain Cognitive DevelopmentSM (ABCD) Study® data, employing a machine learning analysis weighted by individuals' propensity to experience adversity. Data included 338 resting-state functional connections from 7190 youth (46% female), divided into a training group (80%) and an independent testing group (20%). Propensity scores were computed using 390 variables to balance across two-year adverse life event exposures. Using elastic net regularization with and without inverse propensity weighting, we developed linear models in which changes in functional connectivity of brain connections during the two-year period served as predictors of the number of adverse events experienced during that same period. Haufe's method was applied to forward-transform the backward prediction models. We also tested whether brain changes associated with adverse events correlated with concomitant changes in internalizing or externalizing behaviors or to academic achievement. In the propensity-weighted analysis, brain development significantly predicted the number of adverse events experienced during that period in both the training group (ρ=0.14, p<0.001) and the independent testing group (ρ=0.10, p<0.001). The predictor indicated a general pattern of decreased functional connectivity between large-scale networks and subcortical brain regions, particularly for cingulo-opercular and sensorimotor networks. These network-to-subcortical functional connectivity decreases inversely associated with the development of internalizing symptoms, suggesting adverse events promoted adaptive brain changes that may buffer against stress-related psychopathology. However, these same functional connections were also associated with poorer grades at the two-year follow-up. Although cortical-subcortical brain developmental responses to adversity potentially shield against stress-induced mood and anxiety disorders, they may be detrimental to other domains such as academic success.

Neurophysiological correlates of moderate alcohol consumption in older and younger social drinkers.

BACKGROUND: Nearly 40% of adults aged 65 and older in the United States consume alcohol. Research in older adults has largely examined potential health effects of a moderate drinking lifestyle. Examination of acute effects in this population is generally lacking. To investigate alcohol-induced alteration of electrophysiological correlates of attention in this population, we employed a covert attentional task. We hypothesized that moderate alcohol administration as well as older age would reduce P3 amplitude and increase latency. We anticipated an interaction such that, relative to their age-matched controls, older adults receiving alcohol would be more affected than their younger counterparts. METHODS: Participants included healthy older (aged 50 to 67; n = 20; 9 men) and younger (aged 25 to 35; n = 12; 5 men) moderate drinkers. Participants received either a moderate dose of alcohol (breath alcohol concentration ~50 mg/dl) or a placebo beverage. Following absorption, the task was administered and neurophysiological measures were obtained. P3 amplitude and latency were separately subjected to ANOVA across cue conditions using age and dose as independent variables. RESULTS: As predicted, P3 amplitude in older adults was significantly lower than in younger adults across cue conditions. An age by alcohol interaction was detected, revealing that older adults receiving alcohol showed lower P3 amplitudes than any other group. An age effect for P3 latency was found, with older adults having longer latencies than their younger counterparts. A significant age by alcohol interaction for P3 latency was detected, revealing that older adults receiving alcohol displayed delayed P3 latencies relative to older adults receiving placebo. In contrast, younger adults receiving alcohol had reduced latency compared to those receiving placebo, although this effect did not reach significance. CONCLUSIONS: Results suggest that older adults demonstrated alcohol-related shifts in P3 characteristics during an intentional attention task, whereas younger adults failed to demonstrate this pattern.

Age as a potential modulator of alcohol-related deficits.

Although their individual significance is well-documented, the interaction effects of age, sex, and alcohol use disorder (AUD) have undergone little systematic investigation. Here, we extend prior work interrogating sex and group (AUD vs. community comparison [CC]) by probing the main and interaction effects of age on emotion processes as well as two conventional neuropsychological tests. Main effects for age and group were anticipated; however, interaction effects comprise our primary focus. While sex differences in AUD prevalence are commonly reported, sex differences within AUD samples are inconsistently found. Therefore, we pose our inquiry regarding sex as exploratory. In this study, 54 CC (n = 30 women) and 55 AUD (n = 14 women) subjects completed a battery that included an emotional face discrimination task, the Trail-Making Test-B (TMT-B), and the Digit Symbol Substitution Test (DSST). The initial/full models included the main and interaction effects of age (as a continuous variable; 25-59 years of age), sex, and group (AUD, CC). In analysis of the emotional face discrimination task, performance on a non-affective face discrimination task was entered as a covariate. Analysis of emotion identification revealed group and age main (p = .02; d = .53 & .003; d = .50, respectively) and interaction effects (p = .05; d = .41). The latter suggested that age and emotion processing performance were positively correlated in the AUD group, but unrelated in the CC group. Notably, neither sex, main, nor interaction effects achieved significance. Using the full model, analysis of the TMT-B and DSST failed to show sex effects or reveal expected performance decrement in the AUD group. To clarify the latter, simple models including only group as well as correlations between age and performance by group for each task were conducted. These analyses demonstrated the expected AUD-related deficits and suggested differential relationships between age and neurocognitive performance as a function of both group and task. Outcomes across tasks emphasize the need to reframe aging effects, particularly in the context of AUD.

Substance familiarity in middle childhood and adolescent substance use.

BACKGROUND: Childhood familiarity with (knowledge of) substances is a potentially important, currently understudied adolescent substance use risk factor. We aimed to describe changes in childhood familiarity with substances and to test whether baseline familiarity predicts early adolescent substance use. METHODS: Utilizing the Substance Use Module of the longitudinal cohort study, Adolescent Brain Cognitive Development (ABCD; US youth aged 9-10 years followed for 10 years) through Data Release 4 (n=7896; individuals who completed all six assessments in the first three years), we conducted longitudinal mixed models and survival analyses to describe changes in familiarity and to determine the adjusted odds of substance use by age 13 based on number of familiar substances at baseline. RESULTS: The sample consisted of 3754 females and 4142 males, aged 9-10 at baseline, with majority White individuals (68.9%). Unconditional time models indicated age significantly predicted familiarity (B=0.08, p<0.001; R2=0.288) with ~3.59 familiar substances at 9 years increasing to ~7.43 substances at 13 years. Family history, home use, peer use, and neighborhood availability predicted familiarity, accounting for 1% of additional variance (R2=0.299; ∆R2=0.011). For each additional familiar substance at baseline, adjusted odds of future use increased 1.28 times (95% CI 1.22, 1.34). CONCLUSIONS: This is the first study to characterize substance familiarity in this age range as a predictor of future substance use. Familiarity increases with age (age being the most predictive indicator). Familiarity at age 9-10 predicts early adolescent substance use. As such, childhood familiarity may represent an easily implemented screening tool for at-risk youth.

Differential effects of moderate alcohol consumption on performance among older and younger adults.

BACKGROUND: Studies exploring differential effects of acute alcohol consumption on younger and older adults are lacking within the field of alcohol research, especially those using moderate doses. Previous studies addressing this question have tended to use complex behavioral tasks too broad to isolate specific neurocognitive processes affected by both alcohol and aging. Compromises in cognitive efficiency (i.e., the ability to respond both quickly and accurately) have previously been identified in both elderly and acutely intoxicated individuals. METHODS: The present study employed a visual-spatial, 2-choice reaction time (RT) task to evaluate the interactive effects of aging and alcohol on cognitive efficiency. Our primary outcome measure was an efficiency ratio derived from each participant's response accuracy (ACC) and mean RT (%correct/RT). Younger (25 to 35; n = 22) and older (55 to 74; n = 37) participants were randomly assigned to receive either a placebo or moderate alcohol dose intended to produce a peak breath alcohol concentration of 0.04%. Participants performed the task at peak alcohol levels. RESULTS: A significant interaction between age group and dose assignment was observed, F(3, 55) = 4.86, p = 0.03, for the efficiency ratio. Younger participants who received alcohol performed significantly better than did their older counterparts regardless of alcohol condition and despite no differences in performance between the 2 age groups in the placebo condition. Additional correlation analyses between ACC and RT suggested that moderately intoxicated older adults become more accurate as response times increase. This relationship was not observed in older adults in the placebo condition. CONCLUSIONS: These data suggest that healthy individuals exhibit a differential susceptibility to the effects of alcohol depending on their age. Unfortunately, because of the presumed safety of moderate alcohol doses and a lack of studies investigating the interactive effects of acute alcohol consumption and aging, most individuals are unlikely to be aware of this relationship between alcohol consumption and age.

Racially invariant stimuli may bias outcomes in assessment of emotion processing.

OBJECTIVE: Difficulties identifying emotional facial expressions are commonly observed in alcohol use disorder (AUD). Critically, this work utilizes single-race stimulus sets, although study samples are not similarly constrained. This is particularly concerning given evidence among community samples showing the impact of racial incongruity, giving rise to interpretative caveats. METHOD: Community controls (n = 55, 12 Black) and individuals with AUD (n = 46, 9 Black) completed a two-choice emotion judgment task. A similar nonaffective sex judgment task was employed as a covariate. Repeated measures mixed-model analyses were conducted with race, AUD status (AUD vs. control), and their interaction as fixed effects. Accuracy and reaction time (RT) were primary dependent measures. A post hoc analysis was conducted on efficiency (accuracy/RT). RESULTS: In addition to lower accuracy by individuals with AUD (p = .02), Black participants were less accurate than White participants (p = .0001) overall. Significant interactions between race and AUD were also detected for accuracy (p = .002), RT (p = .05), and efficiency (p = .01), wherein Black participants with AUD identified emotional expressions most poorly. This latter finding suggests that AUD-associated differences may be biased under racial incongruity. CONCLUSION: Taken together, these preliminary findings do not reflect a deficit among Black respondents. Instead, our results reflect the need for greater attention to stimulus diversity and sensitivity to respondent demographics in emotion-processing examinations. Given the purported role of emotion processing in alcohol-related problems and the increase in racial minority representation in the U.S., elucidating these differences remains critical. (PsycInfo Database Record (c) 2022 APA, all rights reserved).