The nomological network of drinker identity: A scoping review.

BACKGROUND: Despite the growing interest in the construct of drinker identity and empirical evidence for its role in drinking behavior, there is a paucity of papers that evaluate and integrate the results of studies on drinker identity, leaving a gap in our knowledge of the importance of the drinker identity construct. The current paper addresses this gap by reviewing and integrating the results of the studies of drinker identity. METHODS: The scoping review identified, retrieved, and evaluated the existing literature regarding drinker identity. English language studies from EBSCOHost, PubMed, ScienceDirect, and Scopus databases were reviewed. Studies were included in the review if they were data-based studies or theoretical publications with drinker identity as the primary topic published in peer-reviewed journals. Studies were reviewed and coded based on their reported methodology and findings and codes were used to integrate and present findings. RESULTS: This review advances this line of research in four ways. First, the operationalization of drinker identity is evaluated by examining the theoretical frameworks defining the construct. Second, the conceptualization and measurement of drinker identity is assessed, with suggestions for future measurement research. Third, an integrated framework of predictors, outcomes, moderators, and mediators is presented. Finally, the research gaps, future recommendations, and clinical implications are discussed. CONCLUSIONS: There is a need for continued research, specifically research which aims to standardize and improve measurement of drinker identity, considers longitudinal and developmental processes, and broadens the research samples and settings.

An exploration of multivariate symptom clusters of cannabis use disorder in young adults.

AIMS: Since the release of the DSM-V, CUD has been understood as a unidimensional construct. However, continued research has identified separate symptom clusters relating to consumption, loss of control, and withdrawal within substance use disorder criteria that may pose separate risk factors and functional difficulties. The current study aims to examine how symptom clusters commonly manifest in young adults that use cannabis using a latent class analysis (LCA) and explore how these clusters are related to co-occurring psychological constructs. METHODS: 1174 (aged 18-34) participants completed a battery of assessments on substance use and other psychological constructs. LCA was conducted on 17 symptoms corresponding with DSM-V CUD criteria. Multinomial regressions were used to examine class membership and commonly co-occurring psychopathology and psychological constructs. RESULTS: LCA results identified a 'No problems' class, a 'Moderate consumption' class characterized by moderate probability of endorsing consumption items, a 'Consumption with Moderate Loss of Control' class, characterized by endorsing consumption and loss of control items but minimal endorsement of withdrawal items, a 'Consumption with Moderate Withdrawal' class characterized by moderate probability of endorsing all item types, and 'High Consumption, Loss of Control, Withdrawal' class characterized by high probability of endorsing all items. Multinomial regressions indicated some class differences in psychological constructs. CONCLUSIONS: Symptom clusters differed in terms of CUD criteria, especially for those in our sample with moderate/severe problems. Findings suggest intervention efforts may benefit from treatment targeted at various presentations of CUD.

Applying network analysis to investigate substance use symptoms associated with drug overdose.

BACKGROUND: Drug overdose deaths have been increasing over the last several decades. While single substance classes, such as opioids, have been implicated in this rise, less is known about the contributions of polysubstance use (PSU) and other combinations of specific substances and symptoms that may be a risk factor for drug overdose. METHODS: Symptoms of alcohol, cannabis, and other drug use disorders, as well as co-substance use indicators, were assessed and then examined via network analysis in a sample of young adults (N = 1540). Features of the estimated symptom network were investigated, including topology and node centrality, as well as bridge centrality, which further examines node centrality while accounting for the nodes belonging to discrete communities. RESULTS: Individual symptoms were more strongly associated with other symptoms within the same substance class than across substance classes. Tolerance and withdrawal symptoms were the most central items in the network. However, when accounting for symptoms belonging to discrete substance classes, drug overdose emerged as a strong bridge symptom, among others. CONCLUSIONS: As a strong bridge symptom, drug overdose had many connections with a variety of substances and symptoms, which might suggest that risk for drug overdose may be a function of overall substance use severity. Altogether, examining alcohol and substance use symptoms using a network analytic framework provided novel insights into the role PSU might play in conferring risk for drug overdose.

A New Perspective on "Drinking" Self: A Network Approach to Characterizing Drinking-Related Changes in Personality.

BACKGROUND: Previous research suggests that self-knowledge, particularly perceptions of oneself as a "drinker," may influence the development and progression of alcohol use and related problems, such as binge drinking. While existing studies have provided empirical evidence for the importance of assessing drinking self-perception within the five-factor model of personality framework, further examination with novel analytic methods, such as network analyses, could improve understanding of the drinker self-concept. Methods: Five factor traits of openness to experience, conscientiousness, extraversion, agreeableness, and emotional stability were assessed among a large sample of young adults (n = 423) across "general" and "drinking" contexts. Features of the personality networks were investigated, including topology, network centrality, stability of the network across "general" and "drinking" assessments, as well as differences in the network across the two assessments. Results: Individual personality items were more related to other items within the same trait than to other traits. There was no most central item in the networks, but item strength was uncorrelated to mean-level of the item. The network structure was stable across both assessments, although the overall strength of item relationships significantly increased in the drinking personality network. Conclusions: Examining drinking personality using a network analytic framework provided novel insights into drinker self-concept and the role drinking contexts might play in self-perception of personality in those contexts.Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2022.2034874 .

Is lower severity alcohol use disorder qualitatively different than more severe manifestations? An evaluation of multivariate symptom clusters.

BACKGROUND AND AIMS: Alcohol use disorder (AUD), since the release of DSM-V, is conceptualized and studied as a unidimensional construct. However, previous research has identified clusters of AUD symptoms related to excessive consumption/tolerance, loss of control/social dysfunction and withdrawal/craving that have shown differential genetic risks, personality associations and predictive ability. Although past 'variable-centered' (e.g. factor-analytic) studies have demonstrated the importance of these clusters, the current study aimed to examine how these clusters commonly manifest using a 'person-centered' approach (e.g. latent class). DESIGN: Cross-sectional in-person assessment. SETTING: Indiana, USA. PARTICIPANTS: A convenience sample of 1390 young adults (mean age = 21.43, SD = 2.47) recruited for an over-representation of alcohol problems (65% with AUD). MEASUREMENTS: Latent class analysis (LCA) was conducted on 23 criteria from the Semi-Structured Interview on the Genetics of Alcoholism (SSAGA) that align with DSM-V AUD symptoms. Identified latent classes were characterized using multinomial regressions to examine the association of class and measures of alcohol use, other externalizing psychopathology, internalizing problems and personality. FINDINGS: LCA results identified a 'Low Problems' class (34% of sample), a 'Heavy Consumption' class (26%) characterized by high endorsement probabilities of essentially only consumption/tolerance symptoms, a 'Consumption and Loss of Control' class (31%) characterized by endorsing consumption/tolerance and loss of control/social dysfunction symptoms, and finally a 'Consumption, Loss of Control and Withdrawal' class (9%) characterized by high endorsement probabilities of all symptom clusters. Multinomial regression results indicated an increasing spectrum of severity in terms of psychological impairment. CONCLUSIONS: AUD appears to manifest as different clusters of symptoms at different severity levels.

The effects of a working memory load on drinking-related decisions: The role of incentives, disincentives, and lifetime alcohol problems.

BACKGROUND: This study extends this literature on effects of working memory (WM) load on impulsive and disadvantageous decision-making by investigating the impact of WM load on drinking-related decisions in different incentive and disincentive contexts in a large sample (n = 821, 373 women) of young adults, 558 of whom had an alcohol use disorder (AUD). METHODS: Decisions to attend and drink at hypothetical party events that varied in terms of alcohol party incentives (high vs low) and next day responsibility disincentives (high vs moderate vs low) were assessed. Subjects were randomly assigned to either a WM load (n = 387) or no load condition (n = 434). RESULTS: Analyses revealed that the WM load reduced the degree to which a high disincentive deterred attendance decisions; attendance decisions were more likely under WM load in the high disincentive contexts. This effect was not found in the moderate or low disincentive contexts. Additionally, a WM load increased the effects of high alcohol party incentives on both decisions to attend and drink. The WM load also resulted in faster attendance decision reaction times, suggesting that subjects were more impulsive under load. CONCLUSIONS: These results suggest that a WM load had a general effect of disrupting the decision-making process, reducing the inhibitory effects of high disincentives, amplifying the facilitating effects of high party incentives on alcohol-related decisions, and reducing decision deliberation times (reaction times). This suggests that individuals under significant cognitive load engage in more impulsive and riskier decisions when deciding to attend and drink at party events.