A lifestyle physical activity intervention for women in alcohol treatment: A pilot randomized controlled trial.

INTRODUCTION: Compared to men, women with alcohol use disorder (AUD) are more likely to drink to manage stress and negative affect. Given women's risk for poor drinking outcomes, it is critical to develop and test interventions that target these affective factors. Physical activity improves negative affect and has emerged as a promising adjunct to AUD treatment and, thus, may be especially valuable for women. METHODS: Fifty women with AUD (49.9 ± 12.0 years of age) participated in either a 12-week telephone-delivered lifestyle physical activity plus Fitbit (LPA + Fitbit) or a health education contact (HEC) control intervention following a partial hospital addictions treatment program. The study examined changes in drinking behaviors, mental health outcomes, and physical activity engagement post-intervention using both conventional test statistics and standard effect sizes. RESULTS: Higher rates of continuous abstinence during the 12-week period were observed in the LPA + Fitbit condition (55.6 %) than in the HEC condition (33.6 %); odds ratio = 2.97. However, among women who drank any alcohol during the 12-weeks, slightly higher rates of heavy drinking and drinks/day were observed among women in the LPA + Fitbit condition. Significant differences for improved mental health outcomes (including depression, anxiety, negative affect, positive affect, perceived stress, and behavioral activation) and increased self-reported physical activity were consistently observed among participants in the LPA + Fitbit condition, relative to HEC. CONCLUSIONS: The LPA + Fitbit program had a positive impact on alcohol abstinence, mental health, and physical activity in adult women receiving treatment for AUD. Future research should continue to investigate the optimal implementation strategies, duration, and intensity of LPA interventions in the context of a fully-powered RCT.

College Women's Perceptions of a Friend-Based Intervention to Prevent Alcohol-Involved Sexual Assault.

Sexual assault (SA), particularly alcohol-involved SA, remains prevalent among college women. Because SA often begins in social contexts, bystander intervention has become a popular approach to prevention. Bystander interventions train individuals to intervene on behalf of others, including strangers, despite research indicating that intervention is more likely to occur when the bystander has a relationship with the target. Shifting the focus to friends as potential bystanders capitalizes on the qualities of relationship and responsibility that facilitate intervention. College women (N = 35) participated in focus groups (N = 8) during which they viewed a video prototype of a friend-based motivational interviewing (FMI) intervention session conducted with a friend dyad and provided feedback about the relevance and feasibility of using such an approach to reduce SA among friends who drink together in social settings. Content analysis of focus group transcripts yielded three themes: a) Friends as Natural Bystanders; b) The Role of Alcohol in Intervention, and c) Receptivity to FMI intervention. Women indicated that they feel responsible for keeping their friends safe, and that this sense of responsibility facilitates helping behaviors. Women also described ways through which alcohol intoxication can affect helping behavior. Women expressed enthusiasm for the FMI intervention approach and identified its emphasis on friendship and flexible approaches to personal safety as strengths. Findings highlight the promise of FMI intervention approaches that capitalize on the strengths of women's friendship to create safety goals that align with participants' values and overcome barriers to intervention, including alcohol intoxication.

Self-Compassion and Self-Forgiveness in Alcohol Risk, Treatment and Recovery: A Systematic Review.

INTRODUCTION: Self-compassion and self-forgiveness are two self-focused, positive coping approaches that may reduce risk of problem drinking and/or aid in treatment/recovery from alcohol use disorder. The present systematic review aimed to evaluate support for the unique and complementary roles of self-compassion and self-forgiveness in alcohol outcomes. METHODS: A systematic literature search yielded 18 studies examining self-compassion, 18 studies examining self-forgiveness and 1 study examining both constructs in alcohol outcomes. RESULTS: Findings suggest greater self-compassion and self-forgiveness relate to lower likelihood of problem drinking. Self-forgiveness was considerably more researched in treatment/recovery outcomes than self-compassion; self-forgiveness-based interventions appear able to improve drinking-adjacent outcomes, and self-forgiveness may increase across various alcohol treatments. Finally, research suggests that associations of self-compassion and/or self-forgiveness with alcohol outcomes could be driven by numerous factors, including coping-motivated drinking, depression, psychache, social support perceptions, mental health status and/or psychiatric distress. CONCLUSIONS: Self-compassion and self-forgiveness both appear protective against harmful alcohol outcomes. Nevertheless, many questions remain about the role of self-forgiveness and, particularly, self-compassion in alcohol treatment and recovery outcomes. Future research should examine whether targeted interventions and/or adjunctive therapeutic supports designed to increase self-compassion or self-forgiveness can reduce alcohol use disorder symptoms to facilitate alcohol treatment and recovery success.

Development and validation of the perceived approval of Risky Drinking Inventory in undergraduate students.

OBJECTIVE: Undergraduates frequently engage in risky drinking (i.e., drinking alcohol in ways that may result in problems). The reasoned action approach identifies injunctive norms (i.e., perceptions that others approve of risky drinking) as central in predicting engagement in risky drinking. However, research linking injunctive norms and risky drinking is equivocal, possibly because of extensive variability in the operationalization of injunctive norms across studies. This study describes the development and validation of the Perceived Approval of Risky Drinking Inventory (PARDI), designed according to best practice guidelines in questionnaire development. METHOD: Undergraduate students (N = 1,313) participated in one of the three phases of data collection, including focus group interviews for item generation (n = 31), self-report questionnaires for scale refinement (n = 407), and self-report questionnaires for scale validation (n = 875). RESULTS: Exploratory and confirmatory factor analyses supported a 20-item four-factor solution (Heavy Drinking, Drinking-Related Problems, Coping-Related Drinking, and Sexual-Risk Taking) across the three assessed referent groups (friends, parents, and typical students), all of which present satisfactory estimates of scale score and composite reliability. The results also provided preliminary support for the convergent validity of scores obtained on the PARDI, as demonstrated through correlations with other measures of perceived norms, alcohol use, alcohol-related problems, and coping-motivated drinking. Finally, the results supported the generalizability of the PARDI factor structure by demonstrating its measurement invariance across gender and drinking status (i.e., alcohol use and problems). CONCLUSIONS: The PARDI represents a reliable, valid, yet nuanced measure of injunctive norms that can be used to support further theory development and intervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Development and Initial Testing of a Brief, Integrated Intervention Aimed at Reducing Heavy Alcohol Use and PTSD among Military Veterans in Primary Care.

There is a need for integrated treatment approaches that address heavy alcohol use and posttraumatic stress disorder (PTSD) concurrently among Veterans as interactions between heavy drinking and PTSD are frequent. Veteran engagement in specialty mental health services after referral is limited with poorer outcomes following empirically-supported, exposure-based PTSD treatments that do not explicitly address alcohol use. The current project aimed to incorporate two evidenced-based interventions: Brief Motivational Intervention (BMI) with Prolonged Exposure for Primary Care (PE-PC) for Veterans with heavy drinking and PTSD. Delphi methodology was applied to adapt an intervention protocol using subject matter expert (SME) feedback to guide the refinement of a preliminary treatment manual. The newly developed brief intervention (PC-TIME) was then tested in an open trial (n=9) to gather Veteran participant feedback to modify the treatment manual.Two rounds of SME feedback resulted in 80% agreement that manual content was "acceptable as-is" across all intervention domains. The resulting protocol is a five-session, integrated intervention with session 1 primarily focused on alcohol use reduction and sessions 2-5 consisting of narrative exposure and in-vivo exercises for PTSD symptoms with brief alcohol use check-ins. Open trial results indicated high Veteran acceptance of PC-TIME structure and content, and reductions in heavy drinking and PTSD symptoms. Preliminary data suggest PC-TIME to be a promising approach for treatment of heavy alcohol use and PTSD. A pilot randomized controlled trial is necessary to demonstrate the intervention's efficacy with Veterans in a PC setting.

Do Risk Factors for Incapacitated and Other Sexual Assault Differ for Black and White College Women? A Preliminary Investigation.

Heavy episodic drinking (HED) and hookups are risk factors for college women's sexual assault (SA). Black women engage in these behaviors less frequently than White women. We prospectively examined HED and hookups as mechanisms of incapacitated SA (ISA) and other SA (OSA) risks for Black and White first-year college women and sociocontextual factors that may contribute differentially to risk. In mediation analyses, Black women's less frequent HED predicted lower ISA. SA characteristics (e.g., setting) also differed by race. Mechanisms and types of assault risk may not be the same for all college women, an important consideration for intervention efforts.

The daily association between affect and alcohol use: A meta-analysis of individual participant data.

Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.

Prospective Pathways from Affect to Drug Outcomes: Refusal Self-Efficacy in the Context of Peer Influences.

Objective: Non-alcohol drug (NAD) use and its associated consequences remain a prevalent problem among young adults. Both positive and negative affect play etiological roles in NAD. The perception of one's ability to refuse a drug in different situations (drug refusal self-efficacy) could be an important mediator between such affect and NAD outcomes (use and consequences). This study examined mediational pathways from affect to NAD use and NAD-related consequences via drug refusal self-efficacy. We also examined the moderating role of normative perceptions of peer NAD involvement. Method: Across three time points (September, February, April) of their first college year, students (N = 355) completed an online self-report questionnaire to assess affect, refusal self-efficacy, NAD use frequency, NAD-related problems, and peer norms. Data were analyzed using longitudinal structural path models. Results: Refusal of self-efficacy for situations involving negative affect significantly mediated the relationship between negative affect and NAD use but not consequences, supporting a negative reinforcement pathway. Greater perceptions of peer drug use moderated the mediated negative reinforcement pathway. No significant pathways were found for the refusal self-efficacy positive reinforcement pathways. Conclusions: This study provides support for a negative reinforcement pathway to NAD use in which refusal self-efficacy plays an important mechanistic role. These findings may have implications for intervention, as targeting refusal self-efficacy for those with NAD use and addressing peer influences could be helpful in reducing NAD risk. Replication of these findings and extension using daily assessment and more fine-grained assessment of individual NAD types will be important next steps.

Utility of the Brief Young Adult Alcohol Consequences Questionnaire to Identify College Students At-Risk for Alcohol Related Problems: Relative Operating Characteristics across Seven Countries.

Background: It is important to identify students who would benefit from early interventions to reduce harmful drinking patterns and associated consequences. the Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ) could be particularly useful as a screening tool in university settings. Objectives. The present study examined the utility of the B-YAACQ to distinguish among students at-risk for problematic alcohol use as measured by the AUDIT. Objectives: The present study examined the utility of the B-YAACQ to distinguish among students at-risk for problematic alcohol use as measured by the AUDIT. Methods: A sample of 6382 students (mean age=20.28, SD=3.75, 72.2% females) from seven countries (i.e., U.S., Canada, South-Africa, Spain, Argentina, Uruguay, England) completed the B-YAACQ, the AUDIT and different measures of alcohol use. Results: ROC analyses suggested that a cutoff score of 5 maximized the YAACQ's discrimination utility to differentiate between students at low versus moderate/high risk in the total sample and across countries (except in Canada, where the cutoff was 4). In addition, a cutoff of 7 differentiated between students at low/moderate versus high risk in the total sample, while cutoffs of 10, 9, 8 and 7 differentiate between students at low/moderate versus high risk in Uruguay, U.S and Spain (10), Argentina (9), England (8), and Canada and South-Africa (7), respectively. Students classified at the three risk levels (i.e., low, moderate and high) differed in age (i.e., a younger age was associated with higher risk) and drinking patters (i.e., higher drinking frequency, quantity, binge drinking and AUDIT and B-YAACQ scores in the higher risk groups). Conclusions: This study suggest that the B-YAACQ is a useful tool to identify college students at-risk for experiencing problematic patterns of alcohol use.

The morphological diversity of Mymaridae (Hymenoptera): an atlas of scanning electron micrographs. Part 1. General overview and structure of the head.

This is the first in a series of studies that aim to provide a comprehensive overview of the morphological diversity of Mymaridae (Hymenoptera), a monophyletic family of small parasitic wasps that are postulated as the sister group of other Chalcidoidea. The external cranial morphology of 65-75 genera and subgenera of Mymaridae (fairyflies) is described and illustrated with almost 430 scanning electron micrographs, including 73 micrographs of the anterior, 68 of the posterior, 75 of the dorsal, 75 of the lateral, and 67 of the ventral views of the head, plus 71 micrographs of the ventral view of the mouthparts. Twenty-one annotated figures illustrate the terms used for morphological structures. Two appendices list the 64 morphological terms and 5 measurements that are defined and illustrated, and the 116 currently recognized valid genera and subgenera of Mymaridae, including collection localities for those that are illustrated. Discussion of head morphology characteristic of Mymaridae is preceded by an overview that includes discussion of best practices for taxonomic descriptions and why these and accurate identifications require well preserved and imaged specimens. Aspects of intraspecific variation, colour, secondary sexual dimorphism, setation (chaetotaxy), surface sculpture and morphometrics are also treated as all of these are often important for describing and distinguishing species. Many of the features illustrated have not previously been used in Mymaridae systematics but may prove to be useful for helping to identify and describe genera and species.

Effectiveness of Sexual Assault Protective Behaviors on the Daily Level: The Roles of Intoxication and Executive Control.

Young adult women engage in a variety of behaviors aimed at reducing their risk of sexual assault (SA), termed sexual assault protective behavioral strategies (SA-PBS), yet the evidence demonstrating the effectiveness of SA-PBS in reducing SA risk has been relatively sparse and inconclusive. The current study examined the use of SA-PBS, the factor structure of a diverse array of SA-PBS, and their association with the occurrence of SA. The influence of state- and trait-level moderators on the association between SA-PBS and SA events was also examined. In a sample of community young adult women (N = 174), use of SA-PBS and the occurrence of same night SA were examined with a longitudinal burst design over 1 year that spanned 27 weekend nights when women were out in social contexts. We also examined the influence of state intoxication of alcohol use and trait effortful control (EC) on the relationship between SA-PBS factors and SA events. We found that SA-PBS cluster into two factors representing Proactive and Reactive SA-PBS. While Proactive PBS was not associated with SA, Reactive PBS were positively associated with a SA event occurring. There was no evidence in the current sample to support a moderating role of intoxication on the relationship between Proactive or Reactive PBS and SA. However, there was a marginal interaction effect found for the moderating role of EC on the relationship between Proactive PBS and SA. Our findings identify important differences in SA-PBS, and perhaps most importantly, suggest that not all strategies are created equal with respect to reducing risk.

Efficacy of a novel online integrated treatment for problem gambling and tobacco smoking: Results of a randomized controlled trial.

Background and aims: Problem gambling and tobacco use are highly comorbid among adults. However, there are few treatment frameworks that target both gambling and tobacco use simultaneously (i.e., an integrated approach), while also being accessible and evidence-based. The aim of this two-arm open label RCT was to examine the efficacy of an integrated online treatment for problem gambling and tobacco use. Methods: A sample of 209 participants (Mage = 37.66, SD = 13.81; 62.2% female) from North America were randomized into one of two treatment conditions (integrated [n = 91] or gambling only [n = 118]) that lasted for eight weeks and consisted of seven online modules. Participants completed assessments at baseline, after treatment completion, and at 24-week follow-up. Results: While a priori planned generalized linear mixed models showed no condition differences on primary (gambling days, money spent, time spent) and secondary outcomes, both conditions did appear to significantly reduce problem gambling and smoking behaviours over time. Post hoc analyses showed that reductions in smoking and gambling craving were correlated with reductions in days spent gambling, as well as with gambling disorder symptoms. Relatively high (versus low) nicotine replacement therapy use was associated with greater reductions in gambling behaviours in the integrated treatment condition. Discussion and conclusions: While our open label RCT does not support a clear benefit of integrated treatment, findings suggest that changes in smoking and gambling were correlated over time, regardless of treatment condition, suggesting that more research on mechanisms of smoking outcomes in the context of gambling treatment may be relevant.

Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) outbreaks in nursing homes involving residents who had completed a primary coronavirus disease 2019 (COVID-19) vaccine series-13 US jurisdictions, July-November 2021.

Among nursing home outbreaks of coronavirus disease 2019 (COVID-19) with ≥3 breakthrough infections when the predominant severe acute respiratory coronavirus virus 2 (SARS-CoV-2) variant circulating was the SARS-CoV-2 δ (delta) variant, fully vaccinated residents were 28% less likely to be infected than were unvaccinated residents. Once infected, they had approximately half the risk for all-cause hospitalization and all-cause death compared with unvaccinated infected residents.

Coping-motivated escalations in adolescent alcohol problems following early adversity.

OBJECTIVE: The present study examined whether early stressful events precipitate drinking risks across adolescence and whether coping-motivated drinking mediates such relations. METHOD: Families comprised 387 adolescents (55% female, 83% White) recruited for a longitudinal study. Caregivers reported on adolescents' experience of potentially stressful events, including conflict (i.e., disruption of harmonious family relations) and separation (i.e., decreased contact with important persons) events, over the past year when adolescents were approximately 14 years of age. Adolescents reported on their drinking motives, alcohol use, and alcohol problems annually from 18 to 20 years of age. Growth curve models tested associations of stressful events with latent coping and enhancement/social drinking motives growth factors and subsequent alcohol outcomes. RESULTS: Most adolescents experienced at least one potentially stressful event. Growth modeling suggested no change in coping motives, but increases in enhancement/social motives over time. Greater conflict events predicted higher frequency of drinking for coping reasons (i.e., coping intercept), which in turn predicted increases in alcohol problems as adolescents began transitioning into young adulthood. Conflict, separation, or total stressful events were not significantly associated with initial level or change in enhancement/social motives, suggesting specificity of mediation by coping-motivated drinking. CONCLUSIONS: Findings support enduring elevations in drinking risk over 6 years following disruptive family relations in early adolescence. Such risks appear to be driven by negative affect regulation mechanisms through coping-motivated drinking. Future work should assess generalizability of these findings across diverse samples and could test similar negative reinforcement mechanisms of drinking following exposure to clinically impairing traumatic experiences. Public Health Significance Statement: This study demonstrated that disruptive family relations in early adolescence are linked to greater motivation to drink to cope with negative affect up to 6 years later. Greater coping motives, in turn, were related to increases in alcohol problems over time, even when controlling for alcohol consumption. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Self-compassion buffers the internalized alcohol stigma and depression link in women sexual assault survivors who drink to cope.

BACKGROUND: Depression is strongly implicated in drinking to cope and the development of alcohol use disorders (AUD) in women, particularly among women with a history of sexual assault victimization (SAV). Alcohol use in women is heavily stigmatized, and substance use stigma is associated with depression. This study examined the link between internalized alcohol stigma (AS) and depression and tested whether self-compassion buffered (i.e., moderated) this association in a sample of women with a history of SAV and unhealthy drinking to cope. METHOD: Women sexual assault survivors (N = 288; 82 % White, 91.2 % Non-Hispanic, 20.2 % sexual minority) reporting unhealthy drinking (Alcohol Use Disorders Inventory Test-C ≥ 4) and drinking to cope (Drinking Coping Motives Questionnaire-Revised ≥ 2) completed online self-report surveys. Hierarchical regression analyses tested associations between internalized-AS and self-compassion with depression after controlling for covariates (age, income, education, AUD symptoms, and posttraumatic stress disorder) and then, whether self-compassion moderated the Internalized-AS and depression link. RESULTS: Internalized-AS accounted for 1.4 % of variance in depression (p < .01); self-compassion accounted for added variance when subsequently modeled (8.2 %, p < .001). Moderation analyses revealed self-compassion to buffer the internalized-AS and depression link. Among participants reporting high levels of self-compassion, there was no association between internalized-AS and depression (p = .894). DISCUSSION: While findings are modest, they align with the previously observed link between internalized-AS and depression and extend these findings to women with a history of SAV endorsing elevated coping motives and unhealthy drinking. Self-compassion may protect against this link, pending further research sampling greater diversity of participants and longitudinal and controlled designs.

The morphological diversity of Mymaridae (Hymenoptera): an atlas of scanning electron micrographs. Part 2. Structure of the mesosoma.

This is the second in a series of studies that aim to provide a comprehensive overview of the morphological diversity of Mymaridae (Hymenoptera) or fairyflies, a monophyletic family of small parasitic wasps postulated to be the sister group of all other Chalcidoidea. The external morphology of the mesosoma of about 6575 taxa, representing 5565% of the 115 currently valid described genera and subgenera, is described and illustrated with almost 269 scanning electron micrographs, including 77 micrographs of the dorsal, 71 micrographs of the lateral, 59 micrographs of the ventral, 53 micrographs of the anterior, and 9 micrographs of the posterior views of the mesosoma. Twenty annotated figures of the external and major internal structures are given. Two appendices list the morphological terms used, and names of the 75 genera and subgenera of Mymaridae illustrated. The variety of characters and their features that could be used to help define morphologically the genera, and possibly also the species, of Mymaridae is discussed.

Social influences on alcohol outcome expectancy development from childhood to young adulthood: A narrative review.

Purpose of Review: Alcohol outcome expectancies emerge in early childhood, develop throughout adolescence, and predict alcohol outcomes well into adulthood. Social factors shape how expectancies are learned in myriad ways, yet such social learning influences seldom are examined in the context of developmental factors. This review summarized literature on the social origins of alcohol expectancies through vicarious (observational) and experiential (direct) alcohol-related learning from childhood to young adulthood within a social learning framework. Recent Findings: Young children primarily endorse negative expectancies, which decline rapidly with age amidst escalations in positive expectancies across adolescence. Parents and peers can contribute to vicarious learning about alcohol and facilitate experiential learning in different ways and to varying degrees across development. Media and social media, which children are increasingly exposed to as they mature, often depict alcohol-outcome relations that may further contribute to expectancy development in later adolescence and young adulthood. Summary: Social influences on alcohol expectancy learning are complex and change over time, although this dynamic complexity typically is not depicted in extant literature. Developmentally-informed research capturing co-occurring shifts in social influences and alcohol expectancies is needed.

Coping Flexibility and Alcohol-Related Outcomes: Examining Coping Motives as Mediators.

Background: Coping has been implicated in the etiology and treatment of problem drinking. Traditional, static measurement of coping styles (e.g., approach, avoidance, social support) may fail to capture how adaptive a given coping style may be. Coping flexibility is an emerging construct, associated with psychological health, and one that may shed light on coping's role in drinking risk. Coping flexibility includes (1) discontinuation of an ineffective coping strategy ("Discontinuation") and (2) production of an alternative strategy ("Implementation"). This study is the first to our knowledge to examine its association to drinking outcomes. Further, because coping deficits are theorized to lead to drinking through coping motives, we also examined mediated pathways from coping flexibility to alcohol outcomes via coping motives. Methods: College students (N = 528) completed an online assessment. Data were analyzed using path analysis. Control variables included sex and coping styles. Results: In path analytic models, Implementation was negatively associated with alcohol use and, indirectly via coping motives, negatively associated with alcohol consequences. The direct effect on alcohol use remained when controlling for coping styles and sex, but the mediational pathway was no longer significant. Conclusions: This study provides some evidence for the protective role of coping flexibility in alcohol use behavior, which may have implications for how best to address coping skills in alcohol interventions. The direct effect of Implementation on drinking suggests that there may be utility in teaching clients a flexible approach to coping in treatment. Replication, particularly with longitudinal designs, is needed.

Conceptualization of Alcohol Use Disorder (AUD): Can Theoretical or Data Driven Approaches Improve the Construct Validity of AUD?

The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) definition of alcohol use disorder (AUD) has been criticized on the ground that it leads to high prevalence rates and a highly heterogeneous group. Failure of the DSM to consider development may exacerbate these issues (e.g., conflating experimentation with problematic drinking). Wakefield and Schmitz (2015) proposed a definition of AUD that comports to the harmful dysfunction (HD) theory of mental disorders while data-driven approaches have suggested that key symptoms like craving, failure to fulfill obligations, hazardous use, and alcohol use despite interpersonal consequences are optimal (OPT) criteria for AUD (Stevens et al., 2019). Prior work suggests both may reduce the likelihood of conflating experimentation with problematic drinking during key developmental periods. Continuous and categorical structural equation models of DSM, HD, and OPT criteria were compared on A) prevalence, B) patterns of alcohol use in adolescence (age 10-18 years) C) early AUD symptoms in adolescence (age 13-15) and D) concurrent alcohol use and alcohol consequences to assess prospective and concurrent convergent validity using a longitudinal design (N = 765; ages 10-21 years). Results supported prior literature that the HD and OPT criteria produced a smaller diagnostic class than the DSM. Furthermore, the HD and OPT criteria had larger and more consistent effects with validators than the DSM with the OPT criteria having the largest effects and the least criteria. Future work should consider whether the OPT or HD criteria better reflect AUD severity than the DSM across development.