Increased belief in vaccination conspiracy theories predicts increases in vaccination hesitancy and powerlessness: Results from a longitudinal study.

RATIONALE: Vaccinations are an important part of a public health strategy against preventable diseases, and uptake is influenced by factors including hesitancy. The belief of vaccine related misinformation including anti-vaccination conspiracy theories has been found to be associated with increased vaccine hesitancy. OBJECTIVE: While research suggests that these conspiracy theory beliefs may arise to satisfy unmet needs such as restoring loss of personal control, somewhat ironically these anti-vaccination conspiracy theories may frustrate these needs. This study examined the causal relationships between vaccination hesitancy, vaccination conspiracy theories, and vaccination related powerlessness. METHODS: Using a stationary random intercepts cross lagged panel model, we investigated the temporal ordering of vaccination hesitancy, powerlessness, and vaccination conspiracy theory beliefs in a sample of Australian adults (N = 500) in a longitudinal study with 5-timepoints over 4-months between June and October 2021. RESULTS: Results from a random intercept cross-lagged model, that separates between-person stability from within-person change, suggested that increased belief in vaccination conspiracy theories was associated with future increases in vaccination hesitancy and powerlessness (but not vice versa). Findings also showed that increases in vaccination hesitancy and conspiracy theory beliefs predicted respective increases from a person's trait-level mean at subsequent timepoints. CONCLUSIONS: Vaccination conspiracy theories appear to increase vaccination powerlessness and hesitancy, rather than satisfying an unmet need for personal control.

Pregnancy Status is Associated With Screening for Alcohol and Other Substance Use in the Emergency Department.

OBJECTIVES: Determine the rates of screening for substance use in pregnant women versus non-pregnant women attending the emergency department (ED). METHODS: We captured all ED visits by women of childbearing age (12-50 years in our study) over a 5-year period (2012-2017) (n = 72,752) from a local community hospital. The 2742 pregnant women were then matched by ethnicity, marital status, and arrival method to 9888 non-pregnant women. We then compared rates of screening for substance use by pregnancy status stratifying by age and diagnosis. RESULTS: The proportion of non-pregnant women who were screened for substance use was 3.66% compared to 1.90% of pregnant women, yielding an odds ratio (OR) of 1.96 (95% CI = 1.44 to 2.67). We then stratified the results by presenting complaint and age. Non-pregnant women 14 to 19 and 30 to 34 had the highest likelihood for screening (OR > 3.0). The presenting complaint showed little effect on screening. CONCLUSION: Pregnant women were screened only 51% as often as non-pregnant women for substance use in the ED. These results are of particular concern as we continue to see a rise in substance use during pregnancy which results in an increased burden on the healthcare system and society. This study replicates a previous study showing that the rates of screening are lower for pregnant women than non-pregnant women presenting to the ED. Earlier recognition of substance use offers increased opportunities for intervention and prevention of adverse outcomes from substance use during both the current pregnancy and future pregnancies.

What Do We Know About Prevalence and Management of Intoxicated Women During Labor and Delivery?

Objective. To review the published literature on women who were intoxicated at delivery and outcomes for their infants. Methods. A systematic literature review was utilized to identify articles meeting our inclusion criteria. After screening using titles and abstracts, we identified 34 articles requiring full-text review. Each of these were reviewed by at least 2 of the authors. We identified 12 articles that met our inclusion criteria. Results. We identified case reports of 16 mothers who delivered with a blood alcohol concentration (BAC) ranging from 42.1 to 473 mg/dL. Three of the pregnancies (18.8%) ended with a stillbirth, 5 (31.3%) were infant deaths, 6 (37.5%) lived, and 2 (12.5%) had no fetal or infant outcome reported. The BAC for the stillborn infants ranged from 120 to 460 mg/dL. The BAC among the infant deaths ranged from 96 to 715 mg/dL. Among surviving infants, the BAC ranged from 38.4 to 246.5 mg/dL. Conclusion. We identified no deaths with a BAC <96 mg/dL. However, it is not clear if this represents the lower level of BAC where mortality risk increases. In this article, we present 9 suggestions to improve detection and management of these mothers and their infants.

Dopamine and benzodiazepine-dependent mechanisms regulate the EtOH-enhanced locomotor stimulation in the GABAA alpha1 subunit null mutant mice.

The present study investigated the role of the alpha1-containing GABA(A) receptors in the neurobehavioral actions of alcohol. In Experiment 1, mice lacking the alpha1 subunit (alpha1 (-/-)) were tested for their capacity to initiate operant-lever press responding for alcohol or sucrose. Alcohol intake in the home cage was also measured. In Experiment 2, the alpha1 (-/-) mice were injected with a range of alcohol doses (0.875-4.0 g/kg; i.p.) to evaluate the significance of the alpha1 subunit in alcohol's stimulant actions. In Experiment 3, we determined if the alcohol-induced stimulant effects were regulated via dopaminergic (DA) or benzodiazepine (BDZ)-dependent mechanisms. To accomplish this, we investigated the capacity of DA (eticlopride, SCH 23390) and BDZ (flumazenil, betaCCt) receptor antagonists to attenuate the alcohol-induced stimulant actions. Compared with wild-type mice (alpha1 (+/+)), the null mutants showed marked reductions in both EtOH and sucrose-maintained responding, and home-cage alcohol drinking. The null mutants also showed significant increases in locomotor behaviors after injections of low-moderate alcohol doses (1.75-3.0 g/kg). betaCCt, flumazenil, eticlopride, and SCH 23390 were able to attenuate the alcohol-induced stimulation in mutant mice, in the absence of intrinsic effects. These data suggest the alpha1 receptor plays an important role in alcohol-motivated behaviors; however, it also appears crucial in regulating the reinforcing properties associated with normal ingestive behaviors. Deleting the alpha1 subunit of the GABA(A) receptor appears to unmask alcohol's stimulatory effects; these effects appear to be regulated via an interaction of both DA- and GABA(A) BDZ-dependent mechanisms.

Selective GABAA alpha5 benzodiazepine inverse agonist antagonizes the neurobehavioral actions of alcohol.

BACKGROUND: Previous research has implicated the alpha5-containing GABAA receptors of the hippocampus in the reinforcing properties of alcohol. In the present study, a selective GABAA alpha5 benzodiazepine inverse agonist (e.g., RY 023) was used in a series of in vivo and in vitro studies to determine the significance of the alpha5-receptor in the neurobehavioral actions of alcohol. METHODS: In experiment one, systemic injections of RY 023 (1 to 10 mg/kg IP) dose-dependently reduced ethanol-maintained responding by 52% to 86% of controls, whereas bilateral hippocampal infusions (0.3 to 20 microg) reduced responding by 66% to 84% of controls. Saccharin responding was reduced only with the highest intraperitoneal (e.g., 10 mg) and microinjected (e.g., 20 microg) doses. In experiment two, RY 023 (3.0 to 15 mg/kg IP) reversed the motor-impairing effects of a moderate dose of alcohol (0.75 g/kg) on an oscillating bar task in the absence of intrinsic effects. In the open field, RY 023 (3.0 to 7.5 mg/kg) produced intrinsic effects alone but attenuated the suppression of the 1.25 g/kg ethanol dose. Because the diazepam-insensitive receptors (e.g., alpha4 and alpha6) have been suggested to play a role in alcohol motor impairing and sedative actions, experiment three compared the efficacy of RY 023 with Ro 15-4513 and two prototypical benzodiazepine antagonists (e.g., flumazenil and ZK 93426) across the alpha4beta3gamma2-, alpha5beta3gamma2-, and alpha6beta3gamma2-receptor subtypes in Xenopus oocytes. RESULTS: RY 023 produced classic inverse agonism at all receptor subtypes, whereas Ro15-4513 and the two antagonists displayed a neutral or agonistic profile at the diazepam-insensitive receptors. CONCLUSIONS: Overall, the results extend our previous findings by demonstrating that an alpha5-subtype ligand is capable of attenuating not only the rewarding action of alcohol but also its motor impairing and sedative effects. We propose that these actions are mediated in part by the alpha5-receptors of the hippocampus. The hippocampal alpha5-receptors could represent novel targets in understanding the neuromechanisms regulating the neurobehavioral actions of alcohol in humans.

Central opioid receptors differentially regulate the nalmefene-induced suppression of ethanol- and saccharin-reinforced behaviors in alcohol-preferring (P) rats.

The exact opioid-sensitive receptors participating in EtOH-seeking behaviors remains unclear. Previous studies have reported higher densities of micro-opioid receptor binding in the nucleus accumbens (NACC) of P relative to NP rats; however, no differences were seen in delta-receptor binding. In contrast to the NACC, substantially lower levels of micro-receptor binding have been observed in the ventral tegmental area (VTA) of both P and NP rats, albeit no line differences have been observed. In the present study, opioid receptors in the NACC, VTA, and hippocampus were evaluated for their capacity to regulate both EtOH- and saccharin-motivated behaviors in the genetically selected alcohol-preferring (P) rat. To accomplish this, nalmefene, an opiate antagonist with preferential binding affinity for the micro-opioid receptor was unilaterally or bilaterally infused during concurrent availability of 1 h daily EtOH (10% v/v) and saccharin (0.025 or 0.050% w/v) solutions. Rats performed under a two-lever fixed ratio (FR) schedule in which four responses on one lever produced the EtOH solution, and four on a second lever produced the saccharin solution. The results demonstrated that when responding maintained by both EtOH and saccharin are matched at basal levels, unilateral (1-60 microg) or bilateral (0.5-10 microg) microinjections of nalmefene into the NACC produced selective dose-dependent reductions on responding maintained by EtOH. Unilateral (40, 60 microg) and bilateral (10 microg) VTA infusions were also observed to selectively reduced EtOH responding; however, greater nalmefene doses were required and the magnitude of suppression on EtOH responding was markedly less compared with the NACC. The greater sensitivity of nalmefene to suppress EtOH responding in the NACC is likely due to the greater number of opioid receptors in the NACC relative to the VTA. Only bilateral infusion of the 40 microg dose in the NACC and VTA suppressed responding maintained by both EtOH and saccharin. In contrast, intrahippocampal infusions dose dependently suppressed EtOH- and saccharin-maintained responding over a range of doses (1-20 microg). The present study provides evidence that nalmefene suppresses EtOH-motivated behaviors via blockade of opioid receptors within the NACC and VTA, and under various dose conditions both reinforcer and neuroanatomical specificity can be observed.

GABA(A) and opioid receptors of the central nucleus of the amygdala selectively regulate ethanol-maintained behaviors.

The present study tested the hypothesis that GABA(A) and opioid receptors within the central nucleus of the amygdala (CeA) regulate ethanol (EtOH), but not sucrose-maintained responding. To accomplish this, betaCCt, a mixed benzodiazepine (BDZ) agonist-antagonist with binding selectivity at the alpha1 subunit-containing GABA(A) receptor, and the nonselective opioid antagonist, naltrexone, were bilaterally infused directly into the CeA of alcohol-preferring rats. The results demonstrated that in HAD-1 and P rat lines, betaCCt (5-60 microg) reduced EtOH-maintained responding by 56-89% of control levels. On day 2, betaCCt (10-40 microg) continued to suppress EtOH maintained responding in HAD-1 rats by as much as 60-85% of control levels. Similarly, naltrexone (0.5-30 microg) reduced EtOH-maintained responding by 56-75% of control levels in P rats. betaCCt and naltrexone exhibited neuroanatomical and reinforcer specificity within the CeA. Specifically, no effects on EtOH-maintained responding were observed following infusion into the caudate putamen (CPu), a locus several millimeters dorsal to the CeA. Additionally, responding maintained by sucrose, when presented concurrently with ethanol (EtOH) or presented alone, was not altered by betaCCt. Naltrexone reduced sucrose-maintained responding only under the 5 microg dose condition when sucrose was presented alone, however, it did not alter sucrose responding when given concurrently with EtOH. These results support the hypothesis that GABA(A) and opioid receptors within the CeA can selectively regulate EtOH-maintained responding. The CeA may represent a novel target site in the development of prototypical GABA(A) and opioidergic receptor ligands, which selectively reduce alcohol abuse in humans.

A high affinity ligand for GABAA-receptor containing alpha5 subunit antagonizes ethanol's neurobehavioral effects in Long-Evans rats.

RATIONALE: Previously, we reported that the GABA(A)receptor containing alpha(5)subunit played a significant role in the reinforcing actions of EtOH in rats selectively bred to consume alcohol. However, the role of the alpha(5) receptor in regulating the neurobehavioral effects of EtOH in outbred rats is not known. OBJECTIVE: In the present study, RY024, a novel benzodiazepine (BDZ) inverse agonist with high affinity (K(d) approximately 0.40 nM) and selectivity (approximately 67.3-fold) for the alpha(5)receptor, was investigated for its capacity to antagonize EtOH's reinforcing, motor impairing, and sedative effects in Long-Evans rats. METHODS: Rats were trained to lever press for EtOH under a fixed-ratio 1 schedule of reinforcement. Subsequent studies evaluated EtOH's motor-impairing effects in an oscillating bar task, while EtOH's sedative effects were measured in the open field. RESULTS: RY024 (0.125-3.5 mg/kg; IP) markedly reduced EtOH-maintained responding with no effects on water responding, except for the highest dose. RY024 (3.0-15 mg/kg; IP) also reversed the motor impairing effects of a moderate (0.75 g/kg), and intoxicating EtOH dose (1.25 g/kg) in the absence of intrinsic effects. Finally, RY024 (7.5 mg/kg) attenuated the sedation produced by the 1.25 g/kg EtOH dose; however, it failed to attenuate the sedation induced by the 0.75 g/kg EtOH dose. Given alone, RY024 exhibited intrinsic effects in the open field. CONCLUSION: The results suggest the GABA(A)receptor containing alpha(5)subtype plays an important role in regulating the reinforcing, motor-impairing, and sedative effects of alcohol in outbred rats.

The reinforcing properties of alcohol are mediated by GABA(A1) receptors in the ventral pallidum.

It has been hypothesized that alcohol addiction is mediated, at least in part, by specific gamma-aminobutyric acid(A) (GABA(A)) receptors within the ventral pallidum (VP). Among the potential GABA(A) receptor isoforms regulating alcohol-seeking behaviors within the VP, the GABA(A) alpha1 receptor subtype (GABA(A1)) appears pre-eminent. In the present study, we developed beta-carboline-3-carboxylate-t-butyl ester (betaCCt), a mixed agonist-antagonist benzodiazepine (BDZ) site ligand, with binding selectivity at the A1 receptor to explore the functional role of VP(A1) receptors in the euphoric properties of alcohol. The in vivo actions of betaCCt were then determined following microinfusion into the VP, a novel alcohol reward substrate that primarily expresses the A1 receptor. In two selectively bred rodent models of chronic alcohol drinking (HAD-1, P rats), bilateral microinfusion of betaCCt (0.5-40 microg) produced marked reductions in alcohol-reinforced behaviors. Further, VP infusions of betaCCt exhibited both neuroanatomical and reinforcer specificity. Thus, no effects on alcohol-reinforced behaviors were observed following infusion in the nucleus accumbens (NACC)/caudate putamen (CPu), or on response maintained by saccharin. Parenteral-administered betaCCt (1-40 mg/kg) was equally effective and selective in reducing alcohol-reinforced behaviors in P and HAD-1 rats. Additional tests of locomotor activity revealed that betaCCt reversed the locomotor sedation produced by both chlordiazepoxide (10 mg/kg) and EtOH (1.25 g/kg), but was devoid of intrinsic effects when given alone. Studies in recombinant receptors expressed in Xenopus oocytes revealed that betaCCt acted as a low-efficacy partial agonist at alpha3beta3gamma2 and alpha4beta3gamma2 receptors and as a low-efficacy inverse agonist at alpha1beta3gamma2, alpha2beta3gamma2, and alpha5beta3gamma2 receptors. The present study indicates that betaCCt is capable of antagonizing the reinforcing and the sedative properties of alcohol. These anti-alcohol properties of betaCCt are primarily mediated via the GABA(A1) receptor. betaCCt may represent a prototype of a pharmacotherapeutic agent to effectively reduce alcohol drinking behavior in human alcoholics.

Prior knowledge and subtyping effects in children's category learning.

Two experiments examined how 5- and 10-year-old children revise their category representations when exposed to exemplars that are congruent or incongruent with existing knowledge. During training children were presented with exemplars containing features that were congruent or incongruent with children's social stereotypes together with a stereotype-neutral feature. In the knowledge-subtyping condition this neutral feature predicted the stereotype-congruence of the other features. In the knowledge-standard condition the neutral feature was uncorrelated with stereotype-congruence. At test children made judgements about feature co-occurrence within the learned category. In each experiment these judgements were influenced by both stereotypical beliefs and exemplar observation. Stereotypical beliefs, however, had a greater influence on co-occurrence judgements in the knowledge-subtyping than in the standard conditions. In Experiment 2 these effects were shown to generalize to judgements about features that were not presented during training. These results challenge current models of knowledge-based categorization by showing that exemplar structure determines whether novel exemplar features are incorporated into category representations.

D1 dopamine receptor regulates alcohol-motivated behaviors in the bed nucleus of the stria terminalis in alcohol-preferring (P) rats.

Recent studies have implicated the bed nucleus of the stria terminalis (BST) as a potential brain substrate for mediating drug-related behaviors. Neuroanatomical studies have demonstrated that reciprocal projections exist from the BST to the ventral tegmental area (VTA), a dopamine reward substrate proposed to play a role in alcohol abuse. In the present study, we evaluated the role of the D(1) and D(2) dopamine receptors of the BST in regulating alcohol and sucrose-motivated behaviors. Alcohol-preferring (P) rats were trained under an FR4 operant schedule to self-administer either EtOH (10% v/v) or sucrose (2% w/v). Following training, we evaluated the capacity of a competitive D(1) (SCH 23390; 0.5-20.0 microg) and a D(2) (eticlopride; 0.5-20.0 microg) dopamine antagonist to selectively reduce EtOH-maintained responding. Naltrexone, (5-30.0 microg), the nonselective opioid antagonist, was used as a reference agent. The results showed that SCH 23390 dose-dependently reduced alcohol-motivated responding. Responding was reduced with the 20.0 microg dose to about 97% of control levels. SCH 23390 also reduced sucrose responding; however, the magnitude of effects was substantially lower with the highest doses (2.5, 20.0 microg) (68-79% of control levels). In contrast, eticlopride failed to significantly alter alcohol responding and reduced sucrose responding only with the 10.0 microg dose. Unlike the dopamine antagonists, all naltrexone doses failed to alter EtOH or sucrose-maintained responding. The results suggest a salient role for the D(1), but not the D(2) and opioid receptors in selectively modulating EtOH-motivated behaviors in the BST.

The GABA(A) receptor alpha1 subtype in the ventral pallidum regulates alcohol-seeking behaviors.

We investigated the potential role of the alpha1-containing GABA(A) receptor in regulating the reinforcing properties of alcohol. To accomplish this, we developed 3-propoxy-beta-carboline hydrochloride (3-PBC), a mixed agonist-antagonist benzodiazepine site ligand with binding selectivity at the alpha1 receptor. We then tested the capacity of 3-PBC to block alcohol-maintained responding in the ventral pallidum (VP), a novel alcohol reward substrate, which primarily expresses the alpha1-receptor isoform. Our results demonstrated that bilateral microinfusion of 3-PBC (0.5-40 microg) in the anterior and medial VP produced marked reductions in alcohol-maintained responding in a genetically selected rodent model of alcohol drinking. The VP infusions showed both neuroanatomical and reinforcer specificity because no effects were seen in sites dorsal to the VP (e.g., nucleus accumbens, caudate putamen). The saccharin-maintained responding was reduced only with the highest dose (40 microg). Parenteral injections of 3-PBC (1-20 mg/kg) also showed a similar selectivity on alcohol-maintained responding. Complementary in vitro studies revealed that 3-PBC exhibited a low partial agonist efficacy profile at recombinant diazepam-sensitive receptors (e.g., alpha1beta3gamma2, alpha2beta3gamma, and alpha3beta3gamma2). The selective suppression of 3-PBC on alcohol-maintained responding after central and parenteral administrations, together with its low-efficacy agonist profile, suggest that the reduction in alcohol-maintained behaviors was not attributable to a general suppression on consummatory behaviors. These results demonstrate that the alpha1-containing GABA(A) receptors in both the anterior and medial VP are important in regulating the reinforcing properties of alcohol. These receptors represent novel targets in the design and development of pharmacotherapies for alcohol-dependent subjects.