Noninvasive detection of human dehydroepiandrosterone, progesterone and testosterone using LC-MS/MS revealed effects of birth control pills/devices and body weight on ovulatory prediction.

Liquid chromatography-tandem mass spectrometry (LC-MS/MS) has been increasingly used to measure steroids in human saliva. We studied the performance of a conventional LC-MS/MS for measuring dehydroepiandrosterone (DHEA), testosterone and progesterone in human saliva. These three steroids were co-extracted by liquid-liquid extraction and derivatized. Derivatives were resolved on a C18 column and quantified using an LC-MS/MS (AB Sciex API 2000) instrument. The assay's limits of quantification were 0.03 ng/mL for all three steroids. Inter-assay coefficients of variation were 16.6-18.8% (DHEA), 12.0-15.8% (testosterone), and 12.7-19.3% (progesterone). Assay linearity analysis showed R2 of 0.9926, 0.9750 and 0.9949 for DHEA, testosterone and progesterone, respectively. No carry-over between samplings was observed. An ion-enhancement effect of 11.6% for DHEA determination and ion-suppression effects of 13.9% and 20.7% for analysis of progesterone and testosterone, respectively, were determined. No interferences by 9 steroid analogs were detected. Spiked recoveries were 85.5% (DHEA), 86.5% (testosterone), and 92.6% (progesterone). Comparison with laboratory developed test (LDT)-LC-MS/MS methods by other New York State Department of Health certified laboratories revealed R2 = 0.9425 (DHEA, LC-MS/MS = 1.0267 LDT + 21.989), R2 = 0.9849 (testosterone, LC-MS/MS = 0.9447 LDT + 9.8037), and R2 = 0.9736 (progesterone, LC-MS/MS = 1.1196 LDT + 0.0985). Reference intervals for the 3 steroids in saliva for young males and females were estimated. Results of intra-individual salivary progesterone analysis indicated that caution should be exercised when using progesterone concentrations in predicting ovulation for females who are under treatment with birth control pills/devices or has body a weight of > 90 kg.

Stress responding and stress-related changes in cue reactivity in heavy smokers, problem gamblers, and healthy controls.

Addictions, both substance and behavioral, have been conceptualized as involving similar biopsychosocial processes with different opportunistic expressions. A maladaptive stress response in combination with craving or urges to engage in the addictive behavior may be among the underlying factors common to behavioral and substance addictions. The current study compared the neuroendocrine (cortisol) and subjective responses to stress of gamblers and smokers to healthy controls. We assessed if participants responded differently to smoking or gambling cues before and after a psychosocial stressor. To this end, the subjective urges/cravings of all participants were measured in response to smoking or gambling cues versus neutral cues, once under normal conditions and again after exposure to a stressor. Salivary cortisol was measured prior to, immediately following, and 10 minutes after conclusion of the stressor. Smokers and gamblers showed a similar blunted cortisol response to the acute stressor that differed from the control group's response. Following a stressor, subjective craving in smokers increased whereas gamblers' urges decreased. In smokers, a blunted cortisol and subjective stress response were related to increased urges. In contrast, for gamblers, changes in cortisol levels were unrelated to urges, and higher subjective stress was associated with decreased urges. In conclusion, individuals with a substance and a behavioral addiction share common patterns of reactivity to stress. However, while the stressor enhanced cue-related craving in smokers, it generally had the opposite effect on gamblers. Further research is necessary to elucidate the complicated patterns of similarities and differences that underlie substance and behavioral addictions.

Fluctuations in progesterone moderate the relationship between daily mood and alcohol use in young adult women.

BACKGROUND: Research has demonstrated associations between hormonal fluctuations during the menstrual cycle and women's alcohol use. This association has been explained by mood changes that, for some women, accompany decreasing levels of progesterone during the menstrual cycle, particularly during the late luteal/premenstrual phase. The current study examined whether participants' daily ratings of mood interact with changing levels of progesterone to predict alcohol use. METHOD: Young adult women attended two sessions scheduled two weeks apart, during which they completed questionnaires and provided salivary samples for the assay of progesterone levels. In the intervening two weeks, participants completed daily logs of their mood, alcohol use, and menses. Ordered Generalized Linear Mixed Models assessed the effects of daily mood (examined as both a within- and between-subject variable) on the likelihood of drinking, as a function of menstrual cycle phase and changes in progesterone across the two weeks. RESULTS: One standard deviation increase in progesterone corresponded to a 1.61 decrease in the odds of drinking. This main effect was moderated by daily mood. Women were more likely to drink during a decrease in progesterone on days they rated their mood as negative, whereas during an increase in progesterone they were more likely to drink on days they reported a positive mood. Between-subject analyses showed that women who reported lower overall mood during the two-week period were more likely to drink with an increase in progesterone and less likely with a decrease. CONCLUSIONS: Women's likelihood to drink increased when they experienced negative mood in the context of decreasing levels of progesterone, whereas the negative-mood/drinking association was mitigated among those with increasing levels of progesterone. However, compared to women who on average had an overall more positive mood, women with an overall lower mood (and corresponding higher levels of depression and anxiety at baseline) did not experience the protective effects of rising progesterone levels on drinking.

Debiasing of gambling beliefs and behaviors using a digital gambling accelerator.

Problem gamblers tend to adhere to rigid rules about the chances of winning and are resistant to counterfactual information. To promote a more accurate understanding of the odds of scratch-off ticket gambling, we created a brief debiasing intervention consisting of a digital gambling accelerator program that offers demonstrations of the long-term outcomes of gambling. Using a sample of nontreatment seeking scratch-off lottery gamblers recruited from the community (42 subclinical and 45 probable pathological gamblers), we compared the accelerator intervention to brief motivational interviewing (MI) and a control condition. Participants rated their chances of winning, urge to gamble, and readiness to change before and after the interventions. Self-reported dollar amount spent on scratch-off tickets and number of days gambled were assessed at baseline and again at 2- and 4-week follow-ups. Following the active interventions, gamblers in both conditions reported greater readiness to change than controls, and those in the accelerator condition also gave lower ratings of their chances of winning and urge to gamble. Marginal models showed participants in the accelerator condition gambled fewer days at the 2-week follow-up and spent less money at both the 2- and 4-week follow-ups compared to controls; no other between-subjects differences achieved statistical significance. Digital gambling accelerators can impact several clinically relevant domains of gambling and may be useful as stand-alone or adjunct interventions to treat gambling problems. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Noninvasive determination of human cortisol and dehydroepiandrosterone sulfate using liquid chromatography-tandem mass spectrometry.

Liquid chromatography-tandem mass spectrometry (LC-MS/MS) for measurements of steroids in human saliva has garnered increased interest in the area of clinical psychoneuroendocrinological research. However, performance characteristics of LC-MS/MS methods for the analysis of steroids in saliva are limited. Human saliva samples were collected via passive drool. Cortisol and dehydroepiandrosterone sulfate (DHEA-S) in the samples were extracted together, resolved on a C18-A column, and analyzed using tandem mass spectrometry. The LC-MS/MS method had limits of quantitation of 0.03 and 0.06 ng/mL for DHEA-S and cortisol, respectively. Method evaluations showed coefficient variation (%CV) of inter-assay ranging 4.6-17.9% for DHEA-S and cortisol, recoveries of 102.4-109.5% for DHEA-S and 94.6-98.3% for cortisol, and assay linearity with R2 = 0.9964 for DHEA-S (1.0-25.0 ng/mL) and R2 = 0.997 (1.0-25.0 ng/mL) for cortisol. No cross contamination among samples was observed. Human saliva showed 20% and 18% ion enhancement effect for DHEA-S and cortisol assay, respectively. No interference by ten common steroids was detected. Regression analysis of method comparisons with laboratory-developed test (LDT) method revealed R2 = 0.9688 (LC-MS/MS = 0.9665 LDT-LC-MS/MS - 0.7355) for cortisol, and R2 = 0.9039 (LC-MS/MS = 1.0173 LDT-LC-MS/MS + 3.6797) for DHEA-S. Reference ranges for young adults were determined to be 0.3-5.9 ng/mL for females and 0.1-5.6 ng/mL for males for salivary cortisol, and 0.6-7.4 ng/mL for females and 0.6-10.1 ng/mL for males for salivary DHEA-S. An LC-MS/MS method for quantifying cortisol and DHEA-S in human saliva was developed and validated for clinical and psychoneuroendocrinological research that require noninvasive means of measuring these hormones.

Internalizing Risk Factors for College Students' Alcohol use: A Combined Person- and Variable-Centered Approach.

BACKGROUND: Most studies that investigate internalizing problems (i.e., depression and anxiety symptoms) and alcohol use disorders use variable-centered approaches, losing important information about differences among individuals. OBJECTIVES: To group college students by different profiles of alcohol-use risk factors using a person-centered cluster analysis in two separate samples. METHODS: Questionnaires were used in both studies to assess positive expectancies regarding alcohol use, coping motives for alcohol use, and symptoms of depression and anxiety. In the first study (2012), we collected information about past month alcohol use, including frequency and binge drinking episode (n = 171). In the second study (2013), we also included measures of externalizing behaviors and negative alcohol-related consequences (n = 526). RESULTS: In Study 1, the cluster analysis identified four groups of students who displayed different patterns of risk: a low-risk group, moderate cognitions/low internalizing cluster, a high internalizing/low coping motives group of drinkers, and a high internalizing/high coping motives cluster of drinkers. This fourth group showed high levels of depression, moderate anxiety, high positive expectancies and coping motives for alcohol use, and reported the highest frequency of alcohol use. Study 2 replicated the findings from the previous study. Three groups of individuals were identified, replicating the low-risk cluster, the moderate cognitions/low internalizing cluster, and the internalizing cluster of drinkers from Study 1. Participants in the latter cluster endorsed the highest number of negative consequences of alcohol use. CONCLUSIONS: Results from both studies highlight the importance of tailoring alcohol abuse prevention efforts to a subgroup young adult who endorse internalizing symptoms.

Distress tolerance and physiological reactivity to stress predict women's problematic alcohol use.

Research has shown that measures of reactivity to distress-including distress tolerance and physiological reactivity to stress-are dysregulated in women who misuse alcohol. These variables may interact and create a risk profile for young adult women, reflecting patterns of stress reactivity that confer a risk for alcohol misuse. The current study tested this hypothesis by examining the independent and interactive associations of subjective distress tolerance, behavioral distress tolerance, and physiological stress reactivity with women's alcohol misuse. The study was conducted with a sample of 91 college women recruited on a large northeastern university campus. Results showed that subjective levels of distress tolerance and physiological reactivity to stress (skin conductance reactivity, SCR), but not behavioral distress tolerance, were independently associated with alcohol misuse. In addition, subjective distress tolerance moderated the relationship between SCR and negative alcohol-related consequences. Specifically, women with low physiological reactivity (SCR) to a stressful task and greater urge to quickly rid themselves of distress (low subjective distress tolerance) endorsed a significantly greater number of adverse consequences from their alcohol use. These results extend prior findings by showing that, even among a nonclinical sample of women, lower stress reactivity in combination with low subjective distress tolerance is associated with increased risk for various drinking-related negative consequences. (PsycINFO Database Record

Effects of Acute Stress on Decision Making.

The study examined the effects of a social stressor (Trier Social Stress Test) on 24 male and 32 female college students' affective and physiological reactivity and their subsequent performance on a decision-making task (Iowa Gambling Task). The 56 participants were randomly assigned to a social stressor or a control condition. Compared to controls, participants in the stress condition responded with higher heart rates and skin conductance responses, reported more negative affect, and on the decision-making task made less advantageous choices. An exploratory regression analysis revealed that among men higher levels of heart rate were positively correlated with riskier choices on the Iowa Gambling Task, whereas for women this relationship was curvilinear. Exploratory correlational analyses showed that lower levels of skin conductance within the stress condition were associated with greater levels of substance use and gambling. The results suggest that the presence of a stressor may generally result in failure to attend to the full range of possible consequences of a decision. The relationship pattern between the degree of stress responding and successful decision making may be different for men and women.

Poor body image and alcohol use in women.

Two studies were conducted to examine the association between body image and alcohol use. Of interest was the extent to which alcohol outcome expectancies act as a moderator in this relationship, particularly in women. In Study 1, 421 college students (175 men, 246 women) provided self-report data on body image, social expressiveness expectancies, and average weekly alcohol use; the data were examined using a moderation model. Results showed that women with poor body image and high social expressiveness expectancies reported a significantly greater amount of average weekly alcohol consumption, whereas no such interaction was observed for men. Study 2 tested the same moderation model with 67 female participants; however, this second study utilized an in-lab behavioral measure of alcohol consumption as the outcome variable. The second study replicated results from Study 1, showing that women with overweight body image and alcohol-related high social expressiveness expectancies consumed significantly more beer during a taste rating task than women with other combinations of these variables. Taken together, the results of Studies 1 and 2 indicate that, specifically for women, an overweight body image and positive expectancies about the social, confidence-enhancing benefits of alcohol act as risk factors for excessive drinking.

Treatment-seeking precipitators in problem gambling: analysis of data from a gambling helpline.

Although research on treatment precipitators for problem gambling is scarce, telephone surveys have consistently shown that financial and emotional problems resulting from problem gambling are the factors which recovered or active gamblers most frequently report as treatment precipitators. The present study sought to build on previous evidence by analyzing the demographic and gambling-related information provided by gamblers calling the helpline operated by the New Mexico Council on Problem Gambling and receiving a referral to private counseling. Specifically we examined the differences between the callers who initiated treatment with a private counselor after receiving the referral (n = 223), and those who were likewise referred to counseling but did not attend the first appointment (n = 231). The 2 groups could only be distinguished by the fact that the therapy-initiating group cited family or financial problems as the reason for calling the helpline. Further analyses revealed that helpline staff also had an influence on counseling initiation. These findings, along with other differences between groups call for further research on the most effective ways of targeting problem gamblers who call a helpline so as to facilitate their progression to the action stage of change.

The relationship between parental alcohol use and college students' alcohol-related cognitions.

This study examined how parental and cognitive factors are structurally related to college students' intention to drink alcohol as well as possible gender differences in these relationships. Multiple-group comparison was used in structural equation modeling to assess data-to-model fit of the hypothesized model. Perceived parental alcohol use, positive expectancies, abstinence self-efficacy in social situations, and intent to drink alcohol were structurally modeled and examined in 714 college students based on self-report measures. Results showed good fit of the hypothesized model in both men and women. Invariance of model fit was found across genders, although a more detailed analysis of the results suggested gender-specific influence of parental alcohol use over students' cognitions. Perceptions of greater parental alcohol use were associated with higher positive expectancies for alcohol use, which, in turn, were significantly related to lower drink refusal self-efficacy. Both higher expectancies and lower refusal self-efficacy were related to the intention for future use. Results of the study shed light on the development of alcohol-related cognitions in male and female college students and contribute to our understanding of the structural relationship between expectancies and self-efficacy in alcohol use.

Problematic Internet use and other risky behaviors in college students: an application of problem-behavior theory.

Given the widespread use of the Internet, researchers have begun to examine the personal and social consequences associated with excessive online involvement. The present study examined college students' problematic Internet use (PIU) behaviors within the framework of Jessor and Jessor's (1977) problem-behavior theory. Its specific aim was to investigate the links between PIU with both internalizing (depression, social anxiety) and externalizing (substance use and other risky behaviors) problems. Relevant variables from the perceived environmental system, the personality system, and the behavioral system were entered in a canonical correlation analysis. The analysis yielded two distinct functions: the first function, titled traditional problem-behavior syndrome, characterized students who are impulsive, hold socially deviant attitudes and show a propensity to use tobacco and illicit drugs. The second function, titled problematic Internet-behavior syndrome, characterized students who are socially anxious, depressed, report conflictive family relations, and show a propensity toward PIU. Thus, PIU did not share the characteristics typically associated with the traditional problem-behavior syndrome consistent with problem-behavior theory, but showed correlates more consistent with internalizing rather than externalizing problems.

The use of messages in altering risky gambling behavior in experienced gamblers.

The present study was an experimental analogue that examined the relationship between gambling-related irrational beliefs and risky gambling behavior. Eighty high-frequency gamblers were randomly assigned to four conditions and played a chance-based computer game in a laboratory setting. Depending on the condition, during the game a pop-up screen repeatedly displayed either accurate or inaccurate messages concerning the game, neutral messages, or no messages. Consistent with a cognitive-behavioral model of gambling, accurate messages that correctly described the random contingencies governing the game decreased risky gambling behavior. Contrary to predictions, inaccurate messages designed to mimic gamblers' irrational beliefs about their abilities to influence chance events did not lead to more risky gambling behavior than exposure to neutral or no messages. Participants in the latter three conditions did not differ significantly from one another and all showed riskier gambling behavior than participants in the accurate message condition. The results suggest that harm minimization strategies that help individuals maintain a rational perspective while gambling may protect them from unreasonable risk-taking.

The effects of realistic reward and risk on simulated gambling behavior.

Laboratory studies on gambling may not represent an accurate analog of actual gambling behavior because they typically fail to model a meaningful level of risk and reward that is given in real-world settings. The current study sought to address this problem. One hundred and twenty college students were given the opportunity to bet valued experimental credits required for passing an introductory psychology course on the outcome of a videotaped horse race while their heart rate was monitored. Of those, 67 decided to wager, whereas 53 did not. Individuals who wagered course credits demonstrated a larger increase in heart rate and reported more subjective excitement during the race compared to individuals who did not bet. While the bettors' heart rates remained elevated after the end of the race, reports of subjective excitement depended on whether individuals had won or lost their wager. Significant gender differences and differences in personality were also found between the groups of bettors and nonbettors. These findings demonstrate that arousal in response to gambling is related to the potential for both risk and reward.

Effects of alcohol priming on social disinhibition.

Recent studies have suggested that exposure to rudimentary alcohol cues activates mental representations of alcohol expectancies in long-term memory, thereby promoting expectancy-consistent behavior changes. However, reliance in these previous studies on self-report measures raises the possibility that prior findings were an artifact of experimental demand. The present study was aimed at ruling out this alternative explanation by reinvestigating the effects of alcohol priming on nonconsumptive behavior using an implicit measure of social disinhibition. In three experiments, participants were exposed to either alcohol or control beverage images, then asked to type as quickly as possible the first word that came to mind in response to a series of provocative (e.g., feces) and neutral (e.g., chair) stimulus words. Participants' response times were surreptitiously measured. Results revealed that participants exposed to images of alcohol, relative to control beverages, were faster to generate free associations to provocative, but not neutral, words, suggesting enhanced social disinhibition. This effect was limited to conditions of heightened evaluation, ruling out alternative explanations based on knowledge activation or arousal. Participants reported no suspicions regarding the connection between the image viewing and free association tasks nor any awareness that their response times had been collected. Results suggest that the behavioral effects of alcohol priming do not result from demand characteristics and offer the first evidence that exposure to rudimentary alcohol-related stimuli may suffice to influence social disinhibition in a manner akin to that expected to result from actual or placebo alcohol consumption.

Cue reactivity in active pathological, abstinent pathological, and regular gamblers.

Twenty-one treatment-seeking pathological gamblers, 21 pathological gamblers in recovery, and 21 recreational gamblers watched two video-taped exciting gambling scenarios and an exciting roller-coaster control scenario while their arousal (heart rate and subjective excitement) and urge to gamble were being measured. The gamblers did not differ significantly in cue-elicited heart rate elevations or excitement. However, the active pathological gamblers reported significantly greater urges to gamble across all cues compared to the abstinent pathological gamblers and, with marginal significance (p = 0.06), also compared to the social gamblers. Further exploration of these findings revealed that active pathological gamblers experience urges to gamble in response to exciting situations, whether or not they are gambling related, whereas abstinent and social gamblers only report urges to an exciting gambling-related cue. This suggests that for pathological gamblers excitement itself, irrespective of its source, may become a conditioned stimulus capable of triggering gambling behavior. Implications for treatment and future research are discussed.

Sex differences in salivary cortisol in response to acute stressors among healthy participants, in recreational or pathological gamblers, and in those with posttraumatic stress disorder.

Sex differences in incidence and severity of some stress-related, neuropsychiatric disorders are often reported to favor men, suggesting that women may be more vulnerable to aberrant hypothalamic-pituitary-adrenal (HPA) axis responses to stress. In this review, we discuss several investigations that we, and others, have conducted assessing salivary cortisol as a measure of HPA function. We have examined basal cortisol among healthy men and women and also following acute exposure to stressors. Among healthy participants, men had higher basal cortisol levels than did women. In response to acute stressors, such as carbon dioxide or noise, respectively, cortisol levels were comparable between men and women or higher among women. We have also examined cortisol levels among those with problem eating, gambling, or posttraumatic stress disorder (PTSD). Women with restrained eating habits have higher basal cortisol levels than do women without restrained eating habits. Pathological gamblers have more aberrant stress response to gambling stimuli than do recreational gamblers, and these effects are more prominent among men than women. Men who have motor vehicle accident related PTSD, demonstrate more aberrant cortisol function, than do their female counterparts. Although these sex differences in cortisol seem to vary with type of stress exposure and/or pathophysiological status of the individual, other hormones may influence cortisol response. To address this, cortisol levels among boys and girls with different stress-related experiences, will be the subject of future investigation.

Cue-specific reactivity in experienced gamblers.

To examine whether gambling cue reactivity is cue-specific, 47 scratch-off lottery players and 47 horse race gamblers were presented with video clips of their preferred and nonpreferred modes of gambling, and two control stimuli including an exciting car race and a mental stressor task while heart rates, excitement, and urge to gamble were being measured. Heart rates for both groups of gamblers were highest to the mental stressor and did not differ in response to the other three cues. Excitement for both groups was highest in response to the action cues (horse race and car chase). Urge to gamble was significantly higher for each group to their preferred mode of gambling. A post hoc exploratory analysis comparing social gamblers (n = 54) and probable pathological gamblers (n = 40) revealed a similar pattern of responses. However, pathological gamblers reported overall significantly higher urges to gamble than social gamblers. As urges have been shown to play a pivotal role in addictive behaviors and relapse, the current findings may have implications for the development of gambling problems and relapse after successful treatment.

The co-occurrence of alcohol use and gambling activities in first-year college students.

OBJECTIVE: Both alcohol use and gambling are behaviors that can be problematic for many college students; however, it is not clear whether the relationship between the 2 exists for students who have recently entered college. PARTICIPANTS: The sample included 908 first-year college students who were surveyed in fall 2005, approximately 1 month after entering college. METHODS: Participants completed Web-based surveys on alcohol use and gambling behaviors. RESULTS: Alcohol use and alcohol-related risks were significantly related to both gambling frequency and peak gambling loss. CONCLUSIONS: These findings have implications for researchers and clinicians working in the area of addictive behaviors among college students, suggesting that those presenting with problems in 1 domain may also be at risk for problems in the other.

The use of messages in altering risky gambling behavior in college students: an experimental analogue study.

This study examined the effects of messages on altering risky gambling behavior in college students. While playing a chance-based computerized game with play money, three groups of participants either viewed occasional accurate messages that correctly described the contingencies of the game, neutral messages unrelated to the contingencies, or no messages. Participants in the accurate message condition spent overall less money gambling, played fewer trials in the final phase of the game when all trials resulted in losses, and were more likely to quit the game while they still had money remaining in the bank. The findings suggest that "reminders" about the random nature of games and the overall negative rate of return might lead to more responsible gaming.