Modeling the Therapeutic Process of Patients with Cocaine Use Disorders: A Guide for Predicting Readmission.

INTRODUCTION: Patients with cocaine use disorders have very high readmission rates. Our aim was to model the relationships between attributes of patients with cocaine use disorder at the beginning of treatment, therapeutic process indicators of time in treatment or proportion of appointments attended, and treatment outcomes, including outcomes at discharge and non-readmissions posttreatment as indicators of therapeutic success. METHOD: A retrospective observational design was used with 10,298 cocaine use disorder patients. Electronic health records were used for statistical analysis of the data. Randomized subsample 1 (n = 5,150) was used for exploratory analysis and subsample 2 (n = 5,148) for modeling relationships between the variables. RESULTS: Patients attributes at intake (e.g., legal services as the source of referral) were of limited significance in explaining time in treatment, proportion of appointments attended, and treatment outcomes. Time in treatment and proportion of appointments attended emerged as significant factors in explaining outcomes at discharge. However, readmissions were primarily explained by time in treatment and outcomes at discharge, although referrals to addiction centers by health services also appeared to be relevant for explaining readmission. DISCUSSION/CONCLUSION: Our study has shown that maintaining a sufficient appointment attendance rate and remaining in treatment for a longer duration are critical therapeutic process indicators for explaining outcomes at the point of discharge and therapeutic success, as indicated by a reduced likelihood of readmissions. Patients who remained in treatment for an extended period were found to have a reduced risk of future readmissions. In addition, our study highlights the importance of maintaining a satisfactory appointment attendance rate to attain successful short- and medium-term therapeutic discharge outcomes. These guidelines could help to increase the efficiency of patient treatment and alleviate the suffering of both patients and their families.

Comparison of Emotional Processing Between Patients with Substance Use Disorder and Those with Dual Diagnosis: Relationship with Severity of Dependence and Use During Treatment.

This study analyzed, in a Spanish sample, the differences in emotional processing in patients diagnosed with substance use disorder (SUD) and patients with a dual diagnosis (DD), and tested whether alterations in emotional regulation were related to the severity of dependence and consumption during treatment. A descriptive follow-up study was conducted with 88 adult outpatients (83% men) who were receiving treatment for alcohol and cocaine SUD. Of the sample, 43.2% presented dual diagnosis according to DSM-IV-TR criteria. Emotional processing was assessed with the IAPS, and dependence severity with the SDSS. Consumption was determined with self-reports and toxicological tests. Regression analyses revealed that the DD group had more difficulties in identifying the valence and arousal of the images than patients with SUD. Patients with DD presented more difficulty in identifying images in which valence was manipulated, but not in those in which arousal was manipulated. Cocaine use during treatment was associated with difficulties in identifying unpleasant (U = 734.0; p < .05) and arousing (U = 723.5; p < .05) images. Although these results are preliminary, findings suggest that impaired emotional processing is aggravated in dual patients, although it may be a common transdiagnostic factor in SUD and other comorbid mental disorders. Findings highlight the importance of evaluating emotional regulation to better understand its possible role in the maintenance of substance use.

Intervenciones de mHealthpara reducir el impacto del consumo de sustancias en jóvenes: una revisión sistemática / mHealthinterventions to reduce the impact of substance use on youths: a systematic review

El objetivo de la presente revisión sistemática fue examinar las características de las interven-ciones centradas en reducir el consumo de sustancias, sus potenciales consecuencias negativas o incrementar el uso de estrategias de protección en jóvenes impartidas a través de medios tecnológicos. Las intervenciones fueron categorizadas según el formato de implementación (i. e., mensajes, páginas webs o apps). Se identificaron 29 intervenciones. Las intervenciones por mensajes y páginas web impactaron positivamente en las tres variables dependientes analiza-das. Ninguna de las intervenciones por apps mostró cambios significativos. La mayoría de las in-tervenciones estuvieron dirigidas a estudiantes universitarios y centradas en el consumo de al-cohol. Esto destaca la necesidad de desarrollar y evaluar intervenciones dirigidas a población no-universitaria y centradas en sustancias diferentes al alcohol. La síntesis proporcionada po-dría ser útil para guiar el diseño de intervenciones mediadas por tecnologías para reducir el impacto del consumo de sustancias en jóvenes. (AU)

The aim of the present systematic review was to examine the characteristics of mHealth in-terventions focused on reducing substance use, negative consequences or increasing protective behavioural strategies use in young adult population. Interventions were categorized accord-ing to the format of implementation (i. e., messages, web page or apps). We identified 29 in-terventions. Interventions delivered by messages and web pages impacted on the three de-pendent variables analysed. None of the interventions delivered by app showed significant changes. Most of the interventions were intended for college students and focused on alcohol consumption. Our results stand out the need to develop and evaluate interventions for non-college population and focused on substances different to alcohol. The evidence provided could be a useful for designing mHealth interventions focused on reduce substance use among young people. (AU)

The theory of planned behavior and alcohol protective behavioral strategies: a prospective study examining the role of habit and gender invariance.

OBJECTIVES: Alcohol Protective Behavioral Strategies (PBS) have consistently shown to be effective in reducing alcohol use and its associated consequences. We aimed to examine the explanatory value of the Theory of Planned Behavior (TPB) for using five PBS, studying the role of habit, and its potential variation across genders. METHODS: Targeted sampling was used to recruit 339 young adults in the community (women = 50.7%; mean age = 2.21[SD = 2.21]), who completed baseline and 2-month follow-up questionnaires. RESULTS: The explained variance of the TPB ranged from 58-68% for intention to use PBS, and 18-50% for behavior. The inclusion of habit produced increases of 17-26% in explained variance in intention, while explained variance in behavior remained similar. Habit was the strongest predictor of intention to use PBS, followed by attitude. Except for one behavior (drinking slowly), habits did not moderate the intention-behavior relationship, and the explanatory value of the TPB did not differ across genders. CONCLUSIONS: Our findings support the utility of the TPB as an explanatory model of alcohol PBS, along with the need to include habits within the framework of dual-process models. Interventions aimed at promoting alcohol PBS could be optimized by targeting attitudes towards PBS and habits.

Operational definitions and measurement of externalizing behavior problems: An integrative review including research models and clinical diagnostic systems.

Measurement of externalizing disorders such as antisocial disorders, attention-deficit/hyperactivity disorder or borderline disorder have relevant implications for the daily lives of people with these disorders. While the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) have provided the diagnostic framework for decades, recent dimensional frameworks question the categorical approach of psychopathology, inherent in traditional nosotaxies. Tests and instruments develop under the DSM or ICD framework preferentially adopt this categorical approach, providing diagnostic labels. In contrast, dimensional measurement instruments provide an individualized profile for the domains that comprise the externalizing spectrum, but are less widely used in practice. Current paper aims to review the operational definitions of externalizing disorders defined under these different frameworks, revise the different measurement alternatives existing, and provide an integrative operational definition. First, an analysis of the operational definition of externalizing disorders among the DSM/ICD diagnostic systems and the recent Hierarchical Taxonomy of Psychopathology (HiTOP) model is carried out. Then, in order to analyze the coverage of operational definitions found, a description of measurement instruments among each conceptualization is provided. Three phases in the development of the ICD and DSM diagnosis systems can be observed with direct implications for measurement. ICD and DSM versions have progressively introduced systematicity, providing more detailed descriptions of diagnostic criteria and categories that ease the measurement instrument development. However, it is questioned whether the DSM/ICD systems adequately modelize externalizing disorders, and therefore their measurement. More recent theoretical approaches, such as the HiTOP model seek to overcome some of the criticism raised towards the classification systems. Nevertheless, several issues concerning this model raise mesasurement challenges. A revision of the instruments underneath each approach shows incomplete coverage of externalizing disorders among the existing instruments. Efforts to bring nosotaxies together with other theoretical models of psychopathology and personality are still needed. The integrative operational definition of externalizing disorders provided may help to gather clinical practice and research.

Drunkenness and Regretted Online Social Risk Behaviors: The Role of Social Drinking Motives and Positive Urgency.

Background: Alcohol use and the use of social media and other forms of digital communications is characteristic of young adults. The present study prospectively examined the relationship between social drinking motives and positive urgency and the engagement in regretted online social risk behaviors while drunk (having posted on social media, called or texted someone, or been visibly drunk in a photo) among a community sample of young adults. Methods: Using a targeted sampling procedure, we accessed a baseline sample of 360 young adults aged 18-25 years old from the community. Of these, 339 (mean age: 21.1 [SD = 2.21]; female = 50.7%) completed 2-month follow-up measures. Results: Social drinking motives and the tendency to act impulsively under conditions of positive affect (i.e. positive urgency) were measured at baseline, and frequency of regretted online social risk behaviors were measured at follow-up. Results showed that baseline social drinking motives were positively associated with all three regretted online social risk behaviors examined at follow-up. Higher baseline positive urgency scores were associated with a higher frequency of regretted posting on social media and calling or texting someone while drunk at follow-up. Conclusions: Our findings support the inclusion of positive urgency and social drinking motives as key components of preventive interventions aimed at reducing potential negative consequences of using social media and other forms of digital communications while under the effects of alcohol.

Peer and Parental Social Norms as Determinants of Gambling Initiation: A Prospective Study.

PURPOSE: Despite the potential consequences of gambling during adolescence, the factors involved in the initiation of this behavior are relatively understudied. Using a longitudinal design, the present study analyzed the contribution of parental and peer norms to adolescent gambling initiation. METHODS: A sample of 440 adolescent non-gamblers (50.9% males, meanage = 14.85 [standard deviation = 1.41]) completed a baseline survey and a 1-year follow-up questionnaire. The baseline survey included assessments of perceived descriptive and injunctive norms from parents and peers, perceived parent and peer gambling severity, and susceptibility to peer pressure. A multivariate hierarchical logistic regression model was used to assess the contribution of baseline measures to adolescent gambling initiation at follow-up. RESULTS: Of the 440 non-gamblers assessed at baseline, 160 (36.4%) reported initiating gambling at follow-up. All the peer factors were prospectively associated with gambling initiation, while only the perceived injunctive norms of parents were associated with initiation. Higher susceptibility to peer pressure, perceived gambling by peers, and peer and parental approval of gambling at baseline were associated with higher odds of adolescent gambling initiation at follow-up. In contrast, the likelihood of gambling initiation among adolescents decreased as the perception of peer gambling severity increased. DISCUSSION: The identification of parental and peer factors associated with adolescent gambling initiation may provide support for relevant preventative interventions aimed at avoiding or delaying gambling initiation among adolescents. Specifically, to reduce the initiation of gambling, preventative programs should focus on helping adolescents to find strategies for resisting peer influences.

Monitoring adherence and abstinence of cannabis use disorder patients: Profile identification and relationship with long-term treatment outcomes.

BACKGROUND: Patients with cannabis use disorder (CUD) show heterogeneous sociodemographic and consumption patterns. Although previous studies, focused on identifying subgroups of CUD patients using input variables, have yielded useful results for planning individualized treatments, no published research has analyzed the profiles of CUD patients according to their therapeutic progress. This study therefore aims to identify subgroups of patients using adherence and abstinence indicators and to explore whether these profiles are associated with sociodemographic characteristics, consumption variables, and long-term therapeutic outcomes. METHODS: This was a retrospective observational study with a multisite sample of 2055 CUD outpatients who were beginning treatment. The study monitored patient data at two-year follow-up. We conducted latent profiles analysis on the appointment attendance ratio and percentage of negative cannabis tests. RESULTS: A three profile solution emerged: i) moderate abstinence/moderate adherence (n = 997); ii) high abstinence/moderate adherence (n = 613); and iii) high abstinence/high adherence (n = 445). The study found the most marked differences at the beginning of treatment for education level (chi2 (8) = 121.70, p < .001), source of referral (chi2 (12) = 203.55, p < .001), and frequency of cannabis use (chi2 (10) = 232.39, p < .001). Eighty percent of patients from the "high abstinence/high adherence" group were relapse-free at two year follow-up. This percentage decreased to 24.3 % in the "moderate abstinence/moderate adherence" group. CONCLUSIONS: Research has shown adherence and abstinence indicators to be useful for identifying subgroups of patients with different prognoses regarding long-term success. Recognizing the sociodemographic and consumption variables associated with these profiles at the beginning of treatment could help to inform the design of more individualized interventions.

Psychometric properties of the Spanish adaptation of the Externalizing Spectrum Inventory-Brief Form (ESI-BF).

The Externalizing Spectrum Inventory-Brief Form (ESI-BF) measures tendencies toward disinhibition, lack of control, aggression, and substance use. This study adapts the ESI-BF to the Spanish population and assesses its psychometric properties. The study included 742 community adults obtained by stratified random sampling with proportional allocation according to gender, age, and geographical area of the Spanish territory and a clinical sample consisting of 333 patients. All participants completed the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (PID-5) and the Alcohol Substance Dependence Severity Scale, in addition to the Spanish version of the ESI-BF. Reliability was quantified using McDonald's omega and Cronbach's α reliability coefficients. Validity evidences were studied applying confirmatory factor analysis (CFA) and correlations. Results indicated adequate reliability of scores on the ESI-BF's general factors and most of its facets. Regarding internal structure, and in line with previous studies, both symmetric and S-1 hierarchical two-subfactor (bifactor) emerged as the best-fitting models. Considering both criticisms of symmetric models and parsimony, the S-1 bifactor model, which showed configural invariance across gender and samples, was retained. Validity evidence based on the relationship with other measures of personality and alcohol consumption show correlations values theoretically expected in both clinical and community samples. Findings suggest that the Spanish adaptation of the ESI-BF shows functional near-equivalence to the original version. Its effective psychometric properties make it useful instrument for further research related to the externalizing spectrum. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Retention in treatment and therapeutic adherence: How are these associated with therapeutic success? An analysis using real-world data.

INTRODUCTION: Treatment retention and adherence are used as outcomes in numerous randomized clinical trials and observational studies conducted in the addiction field. Although usual criteria are 3/6 months of treatment retention or number of sessions attended, there is not a methodological support for conclusions using these criteria. This study analyzed the usefulness of retention and adherence to predict therapeutic success. METHODS: Retrospective observational study using real-world data from electronic health records of 11,907 patients in treatment diagnosed with cocaine, alcohol, cannabis and opiate use disorders or harmful use. RESULTS: Moderate effect size relations were found between the different type of clinical discharge and months in retention (η2  = 0.12) and proportion of attendance (η2  = 0.10). No relationship was found with the number of sessions attended. Using cut-off points (i.e., 3 or 6 months in treatment or attending 6 therapy sessions) worsens the ability to predict the type of discharge. DISCUSSIONS/CONCLUSION: Treatment retention and adherence are indicators moderately related to therapeutic success. Research using these indicators to assess the effectiveness of therapies should complement their results with other clinical indicators and quality of life measures.

Alcohol Protective Behavioral Strategies in Young Spanish Adults in the Community: A Prospective Study of Perceived Efficacy and Social Norms.

BACKGROUND: Protective behavioral strategies (PBS) have been shown to be useful for reducing excessive alcohol use and alcohol-related problems. However, research on the explanatory factors of PBS is limited. This paper prospectively examines the contribution of perceived efficacy of PBS in reducing alcohol-related consequences and perceived descriptive norms of close peers´ PBS use in young adults. The mediating role of perceived efficacy of PBS between descriptive norms of PBS use and personal PBS use is also examined. METHOD: Targeted sampling was used to recruit a community-based sample of 339 young Spanish adults aged 18-25 years, who completed baseline and two-month follow-up questionnaires. Three types of PBS (serious harm reduction-SHR, manner of drinking-MOD, and stopping/limiting drinking-SLD) were measured. RESULTS: Both perceived efficacy and descriptive norms at baseline were positively associated with personal PBS use (SHR, MOD and SLD) at follow-up. A partial mediation effect of perceived efficacy between descriptive norms and personal PBS use was found for the three PBS subscales. CONCLUSIONS: Our findings support the usefulness of correcting misperceptions of PBS use by peers in interventions aimed at reducing excessive drinking and alcohol-related consequences in young adults in the community. Moreover, PBS perceived efficacy should be included as a component of these interventions.

Harm Reduction Strategies among University Students Who Use Alcohol and Cannabis, and Related Psychological Variables: A Systematic Review.

This systematic review identifies the psychological variables associated with the use of harm reduction strategies (HRS) among university students who use alcohol or cannabis. The reviewed studies are categorized according to the psychological variables studied and the different analytic approaches used (direct effects, mediation, and moderation). Among the empirical peer-reviewed studies identified (n = 76), most (94.7%) were cross-sectional studies conducted in the US (90.8%) with samples of alcohol-using university students (86.8%). Five categories were identified: mental health, motives/expectancies, personality, social cognition, and self-efficacy. The most studied constructs were motives, anxiety and depression, impulsivity, and social norms. Most studies conducted mediation or moderation analyses including psychological variables, HRS and alcohol outcomes. Social, enhancement and coping motives, impulsivity, and social norms of alcohol use were associated with lower use of HRS, which, in turn, was associated with a higher number of alcohol/cannabis outcomes. The results of moderation studies consistently suggest that HRS use was more protective for students with poor mental health, high impulsivity, and low self-regulation. The synthesis of evidence provided in this review could be useful for guiding future research and informing the design of interventions aimed at promoting the use of HRS among university students who use alcohol and/or cannabis.

A longitudinal study among young adults into the predictive effect of perceived efficacy of behavioural strategies and the moderating role of drinking motives on use of protective behavioural strategies.

INTRODUCTION: Although protective behavioural strategies (PBS) have shown to be effective in minimising alcohol-related negative consequences, research on the explanatory factors of their use is very scarce. Perceived efficacy has been demonstrated to be one of the most relevant explanatory factors in the use of health-related protective behaviours. The present study prospectively examines the relationship between the perceived efficacy of PBS in reducing alcohol-related negative consequences and the use of PBS in a community-based sample of young adults. In addition, the moderating role of drinking motives in this relationship is also examined. METHODS: Prospective design with a baseline assessment and a 2-month follow up. Using a targeted sampling procedure, 339 young adults were recruited from the community [mean age: 21.1 (SD = 2.21); female = 50.7%] and completed questionnaires to measure perceived efficacy of PBS and drinking motives at baseline and PBS use at follow up. RESULTS: Perceived efficacy of PBS at baseline was positively associated with PBS use at follow up, and these relationships were weaker as social, enhancement and coping motives scores increased. DISCUSSION AND CONCLUSIONS: Our findings support the need to include the perceived efficacy of PBS to reduce alcohol-related negative consequences in future interventions aimed at promoting PBS use. Moreover, these interventions should be personalised according to the initial levels of participants' drinking motives, incorporating elements that allow for neutralising their negative effects on PBS use (e.g. training in coping skills for those with strong coping motives).

Changes in Drug-Related Implicit Associations during Substance Use Disorder Treatment: The Role of the Therapeutic Context.

BACKGROUND: Implicit cognition has been linked to relapse in substance use disorder (SUD). Studies on attentional bias have found different outcomes related to the therapeutic context, finding an association with relapse in inpatients but not in outpatients. There are no similar studies that use associations in semantic memory as a measure of implicit cognition. OBJECTIVES: (i) to analyze the relationship between a measure of associations in semantic memory and relapse in inpatients and outpatients; (ii) to compare the evolution of these associations between inpatients and outpatients after 3 months of treatment. METHODS: Eighty nine outpatients and 94 inpatients with SUD for cocaine and alcohol participated in this study. We employed a longitudinal design with a baseline evaluation and follow-up after three months, using the Word Association Task for Drug Use Disorder (WAT-DUD). RESULTS: The choice of drug-related words predicted relapse in cocaine (odds ratio = 1.97, z = 2.01, p = .045) and alcohol-cocaine (odds ratio = 2.39, z = 2.55, p = .011) use. Follow-up at 3 months revealed a reduction in the choice of drug-related words in inpatients (Z = 2.031, p = .042). CONCLUSIONS: A greater choice of drug-associated words in the presence of ambiguous images was related to relapse in inpatients but not in outpatients. The inpatients group showed a reduction in the semantic association with drugs during the first three months of treatment.

Alcohol Protective Behavioral Strategies in Young Spanish Adults in the Community: A Prospective Study of Perceived Efficacy and Social Norms / Uso de Estrategias Conductuales de Protección Entre Jóvenes-Adultos Españoles: un estudio Prospectivo de la Eficacia Percibida y las Normas Sociales

Background: Protective behavioral strategies (PBS) have been shown tobe useful for reducing excessive alcohol use and alcohol-related problems. However, research on the explanatory factors of PBS is limited. This paperprospectively examines the contribution of perceived efficacy of PBS inreducing alcohol-related consequences and perceived descriptive normsof close peers ́ PBS use in young adults. The mediating role of perceivedefficacy of PBS between descriptive norms of PBS use and personal PBS use is also examined. Method: Targeted sampling was used to recruit acommunity-based sample of 339 young Spanish adults aged 18-25 years,who completed baseline and two-month follow-up questionnaires. Threetypes of PBS (serious harm reduction-SHR, manner of drinking-MOD, andstopping/limiting drinking-SLD) were measured. Results: Both perceivedefficacy and descriptive norms at baseline were positively associated withpersonal PBS use (SHR, MOD and SLD) at follow-up. A partial mediationeffect of perceived efficacy between descriptive norms and personal PBS use was found for the three PBS subscales.Conclusions: Our findingssupport the usefulness of correcting misperceptions of PBS use by peersin interventions aimed at reducing excessive drinking and alcohol-relatedconsequences in young adults in the community. Moreover, PBS perceivedefficacy should be included as a component of these interventions.

Antecedentes: las estrategias conductuales de protección (ECP)han mostrado utilidad para reducir el consumo excesivo de alcohol y sus problemas asociados, aunque la investigación sobre sus factores explicativos es escasa. Este trabajo examina la contribución de la eficacia percibida delas ECP para reducir las consecuencias negativas del alcohol, y la norma descriptiva percibida del uso de PBS de los iguales, en adultos jóvenes. Además, analiza el papel mediador de la eficacia percibida entre norma descriptiva y ECP. Método: mediante muestreo dirigido a poblacionesdiana, 339 jóvenes españoles (18-25 años) comunitarios cumplimentaron cuestionarios basal y de seguimiento (dos meses), midiéndose tres tipos deECP (reducción de daños-RR, forma de beber-FB, parar/limitar el consumo-PLC). Resultados: eficacia y norma se asociaron positivamente con el uso deECP (RR/FB/PLC) en el seguimiento. Para los tres tipos de ECP se detectóun efecto de mediación parcial de la eficacia percibida entre la norma y el usode ECP. Conclusiones: corregir percepciones erróneas del uso de ECP de losiguales puede ser útil en las intervenciones dirigidas a reducir el uso excesivode alcohol y sus consecuencias en adultos jóvenes comunitarios, al igual quela inclusión de la eficacia percibida como uno de sus componentes.

Changes in Alcohol Use during the COVID-19 Pandemic among Young Adults: The Prospective Effect of Anxiety and Depression.

Health measures instantiated to reduce the spread of COVID-19 have imposed significant constraints for the population and impacted on drinking habits and mental health. This study longitudinally compared changes in alcohol consumption before and after the COVID-19 outbreak and the impact of sociodemographic and mental health variables on such changes among a community sample of young adults. Data were collected in the context of a larger, ongoing longitudinal study. The sample consisted of 305 young adults from Spain aged between 18 and 26 years (mean age = 21.27, (SD = 2.21), female = 53.4%; college students = 61.6%) who completed first (November-2019 and February-2020; i.e., before the outbreak of COVID-19) and second follow-up questionnaires (March 2021, a year after the COVID-19 outbreak). Alcohol use (quantity and drinking frequency), depression and anxiety symptoms were measured. Quantity and frequency of alcohol use decreased from the pre- to post-COVID-19 period. A decrease in drinking frequency was observed among college students, but not in noncollege peers. Although we found no effect of pre-COVID-19 anxiety on alcohol use changes, those with more depressive symptoms at the pre-COVID assessment were more resistant to decreasing their drinking quantity and frequency after the COVID-19 outbreak. This information will be of value when designing interventions aimed at reducing harmful alcohol use and highlights the role of mental health status when identifying high risk populations of young-adults during this, and future, public health crises.

Predictive Utility of Protective Behavioral Strategies for Alcohol-Related Outcomes in a Community Sample of Young Adults.

OBJECTIVE: Although previous studies have shown that protective behavioral strategies (PBS) predict alcohol use and its related consequences in college students, it is not known whether a broader population of young adults also benefit from PBS use. We longitudinally examined the relationship between PBS use and alcohol-related outcomes in a community sample of young adults composed of college students and noncollege individuals. METHOD: Targeted sampling was used to access 339 young adults in the community (mean age = 21.1 [SD = 2.21], 50.7% female; 59.0% college students) who completed baseline and 2-month follow-up measures. Three types of PBS were examined: manner of drinking, stopping/limiting drinking, and serious harm reduction. Regression analyses were conducted to test the predictive utility of PBS use on alcohol-related consequences, frequency and quantity of alcohol used, and binge drinking. RESULTS: Manner of drinking strategies were the strongest predictors of decreased alcohol consumption and alcohol-related negative consequences. Baseline manner of drinking scores were negatively associated with quantity of alcohol used, binge drinking, and alcohol-related consequences at follow-up. Serious harm reduction was longitudinally related to a lower frequency of alcohol consumption, stopping/limiting drinking was not associated with any outcome, and total PBS score was associated with all study outcomes. CONCLUSIONS: Our findings could benefit health promotion by informing the design of preventive interventions for reducing alcohol use and attendant health-related negative consequences in the young adult community. These results may also be of value in extending the applicability of PBS findings to a broader alcohol-using population of young adults beyond those exclusively composed of college students.

Impact of Cluster B Personality Disorders in Drugs Therapeutic Community Treatment Outcomes: A Study Based on Real World Data.

BACKGROUND: The impact of dual pathology on treatment outcomes is unclear, with the literature reporting both favorable and unfavorable evidence. The main aim of this study was to determine how dual pathology affects treatment outcomes using real world data obtained from inpatients that began treatment in therapeutic communities. METHOD: The data of 2458 inpatients were used. Clinical information was obtained from electronic medical records. Reliability of diagnosis was checked and revealed a mean kappa value of 0.88. RESULTS: Of the sample, 41.8% were discharged after achieving the therapeutic objectives. Patients diagnosed with Cluster B personality disorders were found to have a higher risk of dropping out of treatment (HR = 1.320; z = 2.61; p = 0.009). CONCLUSIONS: Personality traits exhibited by Cluster B patients can interfere with treatment in therapeutic communities. There is a need to develop specific interventions for these inpatient groups, which could be implemented in therapeutic communities.

Harm Reduction Strategies and Drug-Related Negative Consequences in the Dance Music Scene: The Moderating Role of Polysubstance Use.

INTRODUCTION: Although simultaneous polysubstance use (SPU) is associated with greater harms than concurrent polysubstance use (CPU), no previous research has examined the effectiveness of harm reduction strategies in reducing drug-related harms in people who use drugs simultaneously and whether these strategies have a differential impact on drug-related negative consequences according to SPU patterns. Objectives: to examine the relationship between SPU patterns, harm reduction strategies and drug-related consequences experienced among people who attend dance music settings, and to examine the moderating role of SPU patterns in the relationship between harm reduction strategies and drug-related negative consequences Methods: a web-based survey was used to gather data from 649 substance-using attendees at dance music settings (mean age = 26.2, 68% male). The survey collected data on: settings of last party attended, drug use, harm reduction strategies used and drug-related negative consequences experienced during last party attended. Results: Latent class analysis identified two SPU profiles: Moderate SPU and Severe SPU. Participants in the severe SPU class experienced more drug-related negative consequences at their last party in comparison with those in the moderate SPU class. Regardless of SPU pattern, avoiding binge drinking was related to fewer drug-related negative consequences, whilst avoiding mixing stimulants was related to fewer drug-related negative consequences only among those participants in the severe simultaneous polysubstance use class. Conclusions: These findings could help to inform the design of messages and tailored interventions aimed at minimizing drug-related negative consequences among people who use multiple substances in the dance music scene.

Coordinated treatment between addiction and mental health services vs. uncoordinated treatment for patients with dual diagnosis: higher dropout rates but lower impairement of functional disability.

Dual pathology is often found in addiction and mental health centers. Although there are integrated services for these patients, most countries have developed joint action protocols between addiction and mental health centers. The objective is to analyze the progress of patients diagnosed with dual pathology, comparing the therapeutic outcomes of those who exclusively attend either addiction or mental health centers with those patients who follow a program in which the two services are coordinated. It is hypothesized that patients assisted in coordinate manner will present a better evolution on psychopathological symptomatology, drug use and functional impairment.