Points to consider when initiating clinical investigations in autistic paediatric populations-A White Paper.

Many individuals with autism spectrum disorder (ASD) experience various degrees of impairment in social interaction and communication, restricted, repetitive behaviours, interests/activities. These impairments make a significant contribution to poorer everyday adaptive functioning. Yet, there are no pharmacological therapies to effectively treat the core symptoms of ASD. Since symptoms of ASD likely emerge from a complex interplay of vulnerabilities, environmental factors and compensatory mechanisms during the early developmental period, pharmacological interventions arguably would have the greatest impact to improve long-term outcomes when implemented at a young age. It is essential therefore, that clinical development programmes of investigational drugs in ASD include the paediatric population early on in clinical trials. Such trials need to offer the prospect of direct benefit (PDB) for participants. In most cases in drug development this prospect is supported by evidence of efficacy in adults. However, the effectiveness of treatment approaches may be age-dependent, so that clinical trials in adults may not provide sufficient evidence for a PDB in children. In this white paper, we consolidate recommendations from regulatory guidelines, as well as advice from the Food and Drug Administration, USA (FDA) and the Committee for Human Medicinal Products (CHMP) consultations on various development programmes on: 1) elements to support a PDB to participants in early paediatric clinical trials in ASD, including single-gene neurodevelopment disorders, 2) aspects of study design to allow for a PDB. This white paper is intended to be complementary to existing regulatory guidelines in guiding industry and academic sponsors in their conduct of early paediatric clinical trials in ASD.

Examining the Factor Structure and Correlates of Motives to Drink Before Attending a Virtual Social Event During COVID-19 Among University Students.

Background: Many university students pregame or drink before a social event. Pregaming carries some risk due to its link to heavy drinking. During the COVID-19 pandemic, there was limited access to many drinking venues (e.g., bars/clubs). Moreover, universities shifted to a virtual format and imposed restrictions on in-person gatherings resulting in the reliance on virtual platforms for class instruction, meetings, and social events. The pandemic facilitated changes in students' drinking behaviors, stress levels, and how they maintained social contact with others. Thus, it is conceivable that during an academic pandemic year, students may have engaged in the act of drinking before attending a virtual social event. Objectives: In the present study, we examined the factor structures/item loadings of the Pregaming Motives Measure-Virtual (PGMM-V) among students (N = 283; Mage = 21.38; women = 69.3%; White = 45.4%, Hispanic = 40.8%) from seven universities who completed an online questionnaire (Spring/Summer-2021). Items from the original Pregaming Motives Measure (Bachrach et al., 2012) were modified to reflect motives to drink before attending a virtual social event. Results: We found evidence for a 2-factor structure model of the PGMM-V which includes social/enhancement and social ease/stress. Bivariate correlations indicated that social/enhancement and social ease/stress were (a) positively associated with frequency of drinking and alcohol consumption prior to attending virtual social events, and (b) general drinking motives (social/enhancement/coping) that align with these motives. Conclusions: The PGMM-V is a promising instrument that could be used in future research designed to understand students' pregaming behaviors for virtual social events as the use of such platforms are increasingly relied upon for social engagement.

The influence of negative urgency and mood inductions on alcohol cognitions.

BACKGROUND: Negative urgency (NU), the tendency to act rashly during negative emotional states, is a robust risk factor for alcohol misuse that is posited to function in part through alcohol-related cognitions. Nonetheless, relatively little research has examined mood-based fluctuations in such cognitions, which could help to explain how the trait of NU translates to impulsive alcohol-related behaviors. We examined how NU impacted several alcohol cognitions (positive/negative alcohol expectancies, positive/negative alcohol valuations, and alcohol craving for positive/negative emotional reinforcement) before and after negative, neutral, or positive mood inductions. We hypothesized that NU would predict greater and more favorable endorsement of alcohol and its effects following negative (vs. positive or neutral) mood induction. METHODS: Participants (N = 428) were southern-midwestern college students recruited for an online experiment. Following the provision of consent, participants rated NU and preinduction alcohol cognitions, and were then randomly assigned to one of three (negative, neutral, or positive) mood inductions; subsequently, postinduction alcohol-cognition ratings were immediately obtained. We conducted six robust multilevel linear models (one per DV) examining NU's influence on within-person changes in alcohol cognitions across each mood induction. RESULTS: No three-way interactions were identified and only one two-way interaction involving NU was identified. There were main effects across mood induction conditions and time points for NU predicting greater endorsement of positive and negative alcohol outcome expectancies, and greater alcohol craving for positive and negative emotional reinforcement. CONCLUSIONS: Greater NU predicts greater perceived likelihood of alcohol's effects, alongside greater desire for mood improvement from alcohol. The absence of three-way interactive effects indicates NU's influence on mood-dependent fluctuations in alcohol cognitions may manifest over longer timescales (e.g., months and years), involve alternative cognitive processes (e.g., drinking motives and implicit alcohol cognitions), and apply more broadly to desires for mood improvement than purely negative emotional reinforcement.

Comparing Drinking Game Motives, Behaviors, and Consequences Among Varsity Athletes, Recreational Athletes, and Non-Student-Athletes: A Multisite University Study.

OBJECTIVE: Among college students, student-athletes are at increased risk for heavy alcohol consumption, participation in risky drinking practices (e.g., playing drinking games [DG]), and adverse alcohol-related consequences relative to non-student-athletes. Within the student-athlete population, level of sports participation (e.g., recreational or varsity sports) can affect alcohol use behaviors and consequences, but our understanding of the extent to which level of sports participation influences engagement in DG is limited. Thus, in the present study, we examined differences in frequency of participation in DG, typical drink consumption while playing DG, negative DG consequences, and motives for playing DG among varsity, recreational, and non-student-athletes. METHOD: College students (n = 7,901 across 12 U.S. colleges/universities) completed questionnaires on alcohol use attitudes, behaviors, and consequences. RESULTS: Student-athletes (recreational or varsity sports) were more likely to have participated in DG within the past month than non-student-athletes. Among students who reported past-month DG play, recreational athletes played more often and endorsed more enhancement/thrills motives for playing DG than non-student-athletes, and student-athletes (recreational or varsity) endorsed higher levels of competition motives for playing DG than non-student-athletes. CONCLUSIONS: These findings shed light on some risky drinking patterns and motives of recreational athletes who are often overlooked and under-resourced in health research and clinical practice. Recreational and varsity student-athletes could benefit from alcohol screening and prevention efforts, which can include provision of competitive and alcohol-free social activities and promotion of alcohol protective behavioral strategies to help reduce recreational athletes' risk for harm while playing DG.

Business as usual? Drinking games participation before and during an academic pandemic (COVID-19) year among university students.

Objective: A drinking game (DG) is a risky social drinking activity that is prevalent among university students and promotes rapid alcohol consumption. We examined university students' DG behaviors before and during the COVID-19 pandemic. Method: Students (N = 368; Mage=21.12; women = 72.6%; Hispanic = 44.7%) from seven universities completed an online survey in 2021 (spring/summer). Results: 57% played DGs in-person before the pandemic and continued to play during the pandemic. These students were less worried about their health/symptoms if they were to contract COVID-19, had lower confidence in wearing a mask properly/socially distancing while under the influence of alcohol, consumed more alcohol during the pandemic, and endorsed higher enhancement drinking motives than students who played DGs before but stopped playing during the pandemic (30%). Conclusions: College health practitioners could pay close attention to students who endorse high enhancement motives as they are susceptible to risky DG play.

The Effects of Alcohol Intoxication on Perceptions of Consent and Refusal Indicators in a Fictional Alcohol-Involved Sexual Encounter.

Alcohol intoxication may influence how bystanders interpret other people's consent and refusal cues. We examined the effects of alcohol intoxication on participants' perceptions of characters' consent and refusal indicators in a fictional vignette depicting an alcohol-involved sexual encounter. Young adults (n = 119, 52% women) participated in an alcohol administration experiment examining the influence of acute intoxication on bystander perceptions during a vignette depicting a character who is intoxicated and declines a sexual advance from another character, who ignores her refusal and continues to pursue sexual activity. Participants were randomly assigned to an alcohol or non-alcohol condition and then guided through a semi-structured interview in which we asked about the characters' consent and refusal cues. Interviews were analyzed using both inductive and deductive coding. Most participants eventually indicated the encounter was nonconsensual, but approximately 9% of participants described the encounter as entirely consensual and another 42% of participants described the interaction as initially consensual and then nonconsensual. Participants discussed nuanced accounts of consent and refusal cues, including indicators related to alcohol consumption. Disregarding intoxication and gender, participants eventually recognized the situation as nonconsensual and thus potentially risky. However, some participants recognized this risk earlier in the encounter than others. Consequently, bystanders who recognize risk later in a situation may have fewer opportunities to intervene before a situation escalates. We recommend sexual assault prevention educators take a more nuanced approach when discussing consent and refusal indicators, emphasizing contextual factors that may indicate risk.

The Association of Acute Intoxication and Threats to Masculinity on Laboratory-Based Sexual Aggression.

OBJECTIVE: Men's alcohol intoxication and perceptions of their masculinity as precarious (i.e., viewing masculinity as easily threatened) are independently related to men's perpetration of sexual aggression. Yet, the interactive effects of these constructs on sexual aggression are unclear. The goal of this study was to assess if precarious masculinity-measured as a static trait-and acute alcohol intoxication-measured in a laboratory setting-were positively associated with men's perpetration of laboratory-based sexual aggression after their masculinity is threatened. METHOD: Cisgender heterosexual men (n = 120, ages 21-30 years) completed a self-report measure of precarious masculinity, were randomly assigned to consume an alcoholic or nonalcoholic beverage, and engaged in the Sexual Imposition Paradigm, which assessed laboratory-based sexual aggression perpetration toward a female confederate. Immediately before the Sexual Imposition Paradigm, all participants' masculinity was threatened via feedback from an ostensible personality test that indicated they are less masculine than other men. RESULTS: Self-reported precarious masculinity and the Precarious Masculinity × Beverage Condition interaction were not associated with laboratory-based sexual aggression. However, intoxicated men showed higher levels of laboratory-based sexual aggression than sober men. CONCLUSIONS: Acute alcohol intoxication facilitated men's sexually aggressive responding toward women when their masculinity was threatened. Consistent with pertinent theory and research, this effect suggests that acute intoxication facilitates men's focus on salient cues (i.e., threatened masculinity), which then may proximally motivate sexual aggression. Sexual aggression prevention programs should continue to address alcohol in their programming.

Victim Centered, Aggressor Focused, and Bystander Friendly: A Qualitative Analysis of Bystander Intervention Strategies and Outcomes for Sexual Harassment or Assault.

Limited qualitative research has been conducted to understand the experiences of victims of sexual harassment or assault (SHA) when a bystander intervenes. Even less research has focused on the consequences of bystander actions from the victim's perspective, particularly regarding the aggressor's subsequent behavior toward the victim and occurrence of verbal or physical harm to those involved. This qualitative study aimed to address these limitations with the following research questions: (a) what strategies did victims of SHA identify bystanders use when intervening? (b) what strategies were present when the aggressor's behavior was stopped, paused, or continued toward the victim? and (c) what strategies were present when verbal or physical harm occurred to someone involved? Adult women between the ages of 18 to 30 (N = 25, college student = 80%) were interviewed about one situation of bystander intervention during SHA since the age of 16 years. Findings suggest that victims identified direct, distance, distract, delegate, and proximity strategies by bystanders. Most participants reported that the aggressor's behavior stopped or paused following bystander action, and in these cases, at least one distance or direct strategy was reportedly used most frequently. Approximately, 24% and 8% of participants reported verbal or physical harm, respectively, to at least one party. Direct and distance strategies were most frequently mentioned in experiences of SHA that involved harm. When the aggressor's behavior continued (i.e., was not altered during the event) despite bystander actions, strategies most frequently reported included distract, delegate, and proximity. Together, results suggest that bystander intervention training programs and future research may be needed to understand under what contexts certain strategies successfully prevent or thwart SHA while maintaining emotional and physical safety for those involved.

Distress tolerance, coping motives, and alcohol craving and consumption: Two experiments testing momentary responses to a mood induction.

BACKGROUND: The current studies examined the relationship between state and trait distress tolerance (DT), drinking-related variables (alcohol craving and consumption), and the moderating role of drinking to cope with negative affect (i.e., coping motives). METHODS: Study 1 was a laboratory-based experiment. Participants (n=71) completed measures of trait DT, craving, coping motives, and affect valence prior to a negative mood induction task. Post-mood induction, participants completed measures of affect valence, alcohol craving, and state DT. Next, participants completed an alcohol taste task, measuring alcohol consumption. Study 2 was completed online. Participants (n=592) completed the same pre- and post-mood induction measures as study 1, but were randomized to a mood condition (neutral, negative, or positive). Study 2 did not include alcohol consumption. RESULTS: Negative mood induction lowered reported affect in both studies. In study 1, higher coping motives predicted increased craving in response to negative mood induction but state and trait DT did not predict craving change alone. Contrary to our hypothesis, individuals with higher coping motives showed a positive relationship between trait DT and craving. Analyses predicting alcohol consumption were not significant. In study 2, lower trait DT predicted post-mood induction craving prior to inclusion of interactions in the model. Higher coping motives were the strongest and most consistent predictor of craving. Other predictors (state DT, mood condition) and interaction terms were not significant. CONCLUSIONS: Findings broadly align with previous research suggesting that coping motives are predictive of craving and indicate that trait DT may also impact craving.

Shame and guilt for alcohol-related transgressions and hazardous drinking among male and female college students.

Objective: Shame and guilt are often present prior to and consequent to alcohol use among college students. Little is known about the propensity to experience these emotions in the context of transgressions that occur while drinking alcohol. We examined the association between shame and guilt propensity for alcohol-related transgressions with hazardous drinking, and the role of gender in these relationships. Participants: College student drinkers (N = 130; Mage=19.39; 68% females; 86% White) from a Mid-south college. Methods: An online confidential survey included measures of hazardous drinking, guilt and shame propensity, and guilt and shame propensity specific to alcohol-related transgressions. Results: Our preliminary findings suggest that experiencing guilt (but not shame) after alcohol-related transgressions was related to less hazardous drinking when controlling for general guilt and shame propensity for male and female students. Conclusions: Targeting components of guilt (e.g., reparative behaviors) after alcohol-related transgressions may help to reduce problematic drinking among college students.

Examining the Moderating Role of Heavy Drinking Behaviors and Precarious Masculinity on Sexual Aggression Among Young Adult Men.

OBJECTIVE: Men's heavy drinking behaviors are related to their engagement in sexual aggression and may be amplified by other factors, such as precarious masculinity (i.e., perceiving masculinity as tenuous in nature). Yet, researchers' understanding of how alcohol consumption, in combination with precarious masculinity, may increase risk of sexual aggression is lacking. The goal of this study was to assess if precarious masculinity moderated the relationship between men's heavy drinking and their sexual aggression. METHOD: Young adult men (958 men, M age = 21.1 years, SD = 3.1) completed a web-administered questionnaire assessing sexual aggression, heavy drinking, and precarious masculinity. RESULTS: We ran a logistic regression examining the association between heavy drinking, precarious masculinity, and their interactive effect on men's engagement in sexual aggression. Heavy drinking (odds ratio [OR] = 1.17) and precarious masculinity (OR = 1.73) were independently and positively associated with men's sexual aggression; however, the interaction was not significant. CONCLUSIONS: In line with prior research, men's heavy drinking behaviors continue to be positively associated with sexual aggression. Building on masculinity literature, men viewing their masculinity as precarious and vulnerable appears to be associated with sexual aggression, potentially because engaging in sexual aggression can offset men's masculinity insecurities. Collectively, results suggest that both alcohol consumption and masculinity should be targeted in sexual assault prevention programs.

The role of personal identity as a resource for college students during COVID-19.

Objective: We examined the role of personal identity vis-à-vis COVID-related outcomes among college students from seven U.S. campuses during spring/summer 2021. Participants: The present sample consisted of 1,688 students (74.5% female, age range 18-29). The sample was ethnically diverse, and 57.3% were first-generation students. Procedures: Students completed an online survey assessing personal identity synthesis and confusion, COVID-related worries, general internalizing symptoms, positive adaptation, and general well-being. Results: Personal identity synthesis was negatively related to COVID-related worries and general internalizing symptoms, and positively related to positive adaptation, both directly and indirectly through life satisfaction and psychological well-being. Personal identity confusion evidenced an opposing set of direct and indirect associations with outcome variables. Conclusions: Personal identity may potentially be protective against pandemic-related distress among college students, in part through its association with well-being. Reducing identity confusion and promoting identity synthesis are essential among college students during this and future pandemics.

Trait- and State-Fear of Missing Out: Influences on Alcohol Craving and Drinking Likelihood.

OBJECTIVE: A growing body of research implicates Fear of Missing Out (FoMO) as a risk factor for collegiate alcohol use. However, little research has explored the causal mechanisms of this association, which may depend on examining FoMO at both trait and state levels. We therefore examined how predispositions toward experiencing FoMO (i.e., trait-FoMO) interacted with state-level cues indicating that one was "missing out" (i.e., state-FoMO) and cues indicating the presence or absence of alcohol. METHOD: College students (n = 544) participating in an online experiment completed a measure of trait-FoMO and were then randomly assigned to one of four guided-imagery script conditions (FoMO/Alcohol cue, FoMO/No Alcohol cue, No FoMO/Alcohol cue, No FoMO/No Alcohol cue). Participants then completed measures of alcohol craving and drinking likelihood for the given scenario. RESULTS: Two hierarchical regressions (one per dependent variable) revealed significant two-way interactions. Greater trait-FoMO demonstrated the strongest, positive associations with alcohol craving following scenarios with FoMO cues present. Reported drinking likelihood was strongest when state-level cues for FoMO and alcohol were both present, moderate when either cue was independently present, and lowest when both cues were absent. CONCLUSIONS: FoMO's impact on alcohol craving and drinking likelihood varied across trait/state levels. Although trait-FoMO was associated with alcohol craving, state-level cues indicating "missing out" affected both alcohol-related variables and interacted with alcohol cues in imagery scenarios to predict drinking likelihood. Although additional research is needed, targeting psychological variables related to meaningful social connection may reduce collegiate alcohol use with respect to FoMO.

Social Connectedness and Negative Emotion Modulation: Social Media Use for Coping Among College Students During the COVID-19 Pandemic.

Using a cross-sectional survey study with undergraduate students (N = 1257; M age = 20; 908 women) in the United States, this paper examined college students' use of social media for coping and its association with COVID-19-related worries (loneliness, interpersonal stress, anxiety) and mental health outcomes (depression, generalized anxiety, and life satisfaction). Undergraduate students were found to use social media frequently during the pandemic to socially connect with others online and to modulate negative emotions. Structural equation modeling revealed that COVID-19-related worries were positively related to social media use for coping and that coping using social media was negatively related to general mental health concerns (depression, generalized anxiety) and positively associated with general mental health wellness (i.e., life satisfaction). Implications of using social media for coping during the pandemic for college student mental health are discussed.

Stratifying the autistic phenotype using electrophysiological indices of social perception.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social communication, but also great heterogeneity. To offer individualized medicine approaches, we need to better target interventions by stratifying autistic people into subgroups with different biological profiles and/or prognoses. We sought to validate neural responses to faces as a potential stratification factor in ASD by measuring neural (electroencephalography) responses to faces (critical in social interaction) in N = 436 children and adults with and without ASD. The speed of early-stage face processing (N170 latency) was on average slower in ASD than in age-matched controls. In addition, N170 latency was associated with responses to faces in the fusiform gyrus, measured with functional magnetic resonance imaging, and polygenic scores for ASD. Within the ASD group, N170 latency predicted change in adaptive socialization skills over an 18-month follow-up period; data-driven clustering identified a subgroup with slower brain responses and poor social prognosis. Use of a distributional data-driven cutoff was associated with predicted improvements of power in simulated clinical trials targeting social functioning. Together, the data provide converging evidence for the utility of the N170 as a stratification factor to identify biologically and prognostically defined subgroups in ASD.

Mental Health Risk Profiles and Related Substance Use During Coronavirus Pandemic Among College Students Who Use Substances.

College students have shown elevated mental distress during the coronavirus disease of 2019 (COVID-19). The extent and persistence of mental distress as COVID-19 restrictions have continued is unclear. This study used latent profile analysis to identify student mental health risk subgroups and to evaluate subgroups in relation with substance use. A four-profile solution was supported with a sample of 930 college students (69.6% female, 58.1% White) from 11 US-based institutions. Students were characterized by slight mental health symptoms, mild mental health symptoms, moderate-to-severe mental health symptoms with mild psychosis/substance use, and severe mental health symptoms. The severe profile comprised more ethnoracial or sexual minorities and students impacted from COVID-19. Whereas the severe profile had more alcohol-related consequences, the slight profile had fewer cannabis-related consequences. COVID-19 has exacerbated college student risks for psychiatric disorders. Students of diverse backgrounds and more impacted by COVID-19 show disproportionately more mental distress and related substance use.

BYSTANDER INTERVENTION AMONG DRINKING GAMERS Bystander Intervention Among College Student Drinking Gamers: Sexual Assault Attitudes, Self-Efficacy, and Intent to Intervene.

Heavy drinking and sexual assault warrant significant concern on U.S. college campuses as emerging evidence suggests that the risk for sexual victimization is amplified in the context of high-risk drinking behavior. Despite recent attention to sexual assault (e.g., MeToo Movement), rates of perpetration remain largely unchanged. In applying the bystander intervention framework, our understanding of the relation between key factors that may facilitate or prevent behavioral action, or when and how these factors are most salient, is limited. The present study examined whether bystander attitudes and bystander self-efficacy interact to predict bystander intent to intervene. Hypotheses were tested among college student drinking gamers, a group at particular risk for involvement in situations of sexual violence. Participants (N = 964) were traditional college-aged student drinking gamers recruited from three universities across the East and Southern Central United States. After controlling for Greek affiliation, prior intervention training and social desirability, hypotheses were partially supported. Higher rape supportive attitudes (rape myth acceptance) were negatively associated with bystander intent to intervene across all participants, but bystander self-efficacy significantly moderated the relation between bystander attitudes (rape myth acceptance) and bystander intent to intervene only among women college student drinking gamers. The interaction effect was not significant among men. For all participants, there was a significant relation between bystander self-efficacy and bystander intent to intervene such that as self-efficacy increases, bystander intent to intervene increases. The discussion addresses implications for sexual assault prevention programs on college campuses and directions for future research.

Playing Drinking Games as a Typical Form of Prepartying among Young Adults.

Prepartying, or drinking prior to going out, and playing drinking games (DG) can increase young adults' risk of heavy alcohol consumption. In the present study, we examined whether playing DG as a typical form of prepartying can increase alcohol consumption risk when compared with prepartying alone or with friends, and whether the type of DG played while prepartying can increase this risk. Participants consisted of young adults from Amazon's Mechanical Turk (N = 482, Mage=22.56, 44.2% women, 74.3% White, 62.7% were current college students) who played a DG within the past month and completed an anonymous online survey about their prepartying and DG behaviors. Results indicated that team games (e.g. beer pong) are the most commonly played type of DG while prepartying. Controlling for alcohol use on drinking occasions when DGs were not played, gender, and college status, those who played DG as a form of prepartying (n = 163) consumed more alcohol while prepartying than those who prepartied alone or with friends. Finally, those who played card games (e.g. Kings) while prepartying also consumed more preparty drinks than those who do not typically play card games. Implications for prevention and intervention as well as future research directions are briefly discussed.

Bystander Intoxication and Appraisal of Sexual Assault Risk: A Field Study of Emerging Adult Bargoers.

Emerging adults are especially vulnerable to experiencing alcohol-related sexual assault. While bystanders play a critical role in preventing sexual assault, little is known about how bystander alcohol intoxication affects the intervention process-particularly in naturalistic settings. We recruited 315 emerging adult bargoers ages 21-29 (46% women; 28% non-college attending; 81% White) from a high-density bar area to provide responses to a sexual assault vignette and complete a breath alcohol concentration test. In this field-based study, we found a negative direct association between intoxication and appraisal of risk in the hypothetical sexual assault situation. We also found a negative indirect relation of intoxication on perceptions of personal responsibility to intervene and confidence in the ability to intervene, statistically mediated through reduced risk appraisal. Findings add to the limited literature in laboratory-based settings suggesting that bystander intoxication interferes with sexual assault intervention and help inform effective bystander intervention programming for emerging adults.

Gender moderates the association between acute alcohol intoxication and facial emotion recognition in a naturalistic field study setting.

BACKGROUND: Alcohol intoxication is associated with significant negative social consequences. Social information processing theory provides a framework for understanding how the accurate decoding and interpretation of social cues are critical for effective social responding. Acute intoxication has the potential to disrupt facial emotion recognition. If alcohol impairs the processing and interpretation of emotional cues, then the resultant behavioral responses may be less effective. The current study tested the association between alcohol intoxication and facial emotion recognition in a naturalistic field study of intoxicated participants. METHODS: 114 participants (59.4% men; Mage  = 24.2 years) who had been consuming alcohol were recruited in the downtown area of a mid-size town surrounded by several drinking establishments in the mid-southern United States. Participants were shown images depicting 5 facial displays of emotions (happy, sad, anger, disgust, and no emotion) portrayed by 1 male and 1 female actor per emotion and breath alcohol concentration (BrAC) was measured by the field breathalyzer test (M = 0.078%, SD = 0.052). RESULTS: BrAC was significantly negatively associated with emotion recognition accuracy when controlling for average alcohol use, B = -.35, t = -2.08, p < 0.05, F(3, 110) = 5.28, p < 0.01, R2  = 0.13. A significant BrAC × gender interaction was revealed, B = -0.39, t = -2.07, p = 0.04, ΔR2  = 0.033, p = 0.04, such that men (but not women) displayed a significant negative association between BrAC and emotion recognition accuracy. CONCLUSIONS: Acute intoxication was associated with impaired facial emotion recognition, particularly for men, in a field study context. Findings support and extend some previous experimental laboratory-based research and suggest that intoxication can impair the decoding stage of social information processing.