Evaluating a novel 24-hour rest/activity rhythm marker of preclinical ß-amyloid deposition.

STUDY OBJECTIVES: To compare sleep and 24-hour rest/activity rhythms (RARs) between cognitively normal older adults who are ß-amyloid-positive (Aß+) or Aß- and replicate a novel time-of-day-specific difference between these groups identified in a previous exploratory study. METHODS: We studied 82 cognitively normal participants from the Baltimore Longitudinal Study of Aging (aged 75.7 ±â€…8.5 years, 55% female, 76% white) with wrist actigraphy data and Aß+ versus Aß- status measured by [11C] Pittsburgh compound B positron emission tomography. RARs were calculated using epoch-level activity count data from actigraphy. We used novel, data-driven function-on-scalar regression analyses and standard RAR metrics to cross-sectionally compare RARs between 25 Aß+ and 57 Aß- participants. RESULTS: Compared to Aß- participants, Aß+ participants had higher mean activity from 1:00 p.m. to 3:30 p.m. when using less conservative pointwise confidence intervals (CIs) and from 1:30 p.m. to 2:30 p.m. using more conservative, simultaneous CIs. Furthermore, Aß+ participants had higher day-to-day variability in activity from 9:00 a.m. to 11:30 a.m. and lower variability from 1:30 p.m. to 4:00 p.m. and 7:30 p.m. to 10:30 p.m. according to pointwise CIs, and lower variability from 8:30 p.m. to 10:00 p.m. using simultaneous CIs. There were no Aß-related differences in standard sleep or RAR metrics. CONCLUSIONS: Findings suggest Aß+ older adults have higher, more stable day-to-day afternoon/evening activity than Aß- older adults, potentially reflecting circadian dysfunction. Studies are needed to replicate our findings and determine whether these or other time-of-day-specific RAR features have utility as markers of preclinical Aß deposition and if they predict clinical dementia and agitation in the afternoon/evening (i.e. "sundowning").

Associations of externalizing polygenic scores with externalizing disorders among Mexican youth.

Several studies have examined the association of externalizing polygenic scores (PGS) with externalizing symptoms in samples of European ancestry. However, less is known about the associations of externalizing polygenic vulnerability in relation to phenotypic externalizing disorders among individuals of different ancestries, such as Mexican youth. Here, we leveraged the largest genome-wide association study on externalizing behaviors that included over 1 million individuals of European ancestry to examine associations of externalizing PGS with a range of externalizing disorders in Mexican adolescents, and investigated whether adversity exposure in childhood moderated these associations. Participants (N = 1064; age range 12-17 years old; 58.8% female) were adolescents recruited for a general population survey on adolescent mental health in the Mexico City Metropolitan region and were genotyped. Childhood adversity exposure and externalizing disorders, specifically attention-deficit hyperactivity disorder (ADHD), conduct disorder, oppositional defiant disorder, and substance use disorder, were assessed via the computer-assisted World Mental Health Composite International Diagnostic Interview for adolescents. A greater externalizing PGS was associated with a greater odds of any externalizing disorder (OR = 1.29 [1.12, 1.48]; p < 0.01) and ADHD (OR = 1.40 [1.15, 1.70]; p < 0.01) in the whole sample, and in females in particular. There were no main effects of the externalizing PGS on conduct disorder, oppositional defiant disorder, or substance use disorder, nor did adversity exposure moderate these associations. Our results suggest that greater genetic propensity for externalizing disorders is associated with increased odds of any externalizing disorders and ADHD among Mexican adolescents, furthering our understanding of externalizing disorder manifestation in this population.

Knowledge, Preference, and Adverse Effects of Xylazine Among Adults in Substance Use Treatment.

This cross-sectional study evaluates aspects of xylazine adulteration of opioids among individuals entering substance use disorder treatment.

Designing and Validating a Novel Method for Assessing Delay Discounting Associated With Health Behaviors: Ecological Momentary Assessment Study.

BACKGROUND: Delay discounting quantifies an individual's preference for smaller, short-term rewards over larger, long-term rewards and represents a transdiagnostic factor associated with numerous adverse health outcomes. Rather than a fixed trait, delay discounting may vary over time and place, influenced by individual and contextual factors. Continuous, real-time measurement could inform adaptive interventions for various health conditions. OBJECTIVE: The goals of this paper are 2-fold. First, we present and validate a novel, short, ecological momentary assessment (EMA)-based delay discounting scale we developed. Second, we assess this tool's ability to reproduce known associations between delay discounting and health behaviors (ie, substance use and craving) using a convenience-based sample. METHODS: Participants (N=97) were adults (age range 18-71 years), recruited on social media. In phase 1, data were collected on participant sociodemographic characteristics, and delay discounting was evaluated via the traditional Monetary Choice Questionnaire (MCQ) and our novel method (ie, 7-item time-selection and 7-item monetary-selection scales). During phase 2 (approximately 6 months later), participants completed the MCQ, our novel delay discounting measures, and health outcomes questions. The correlations between our method and the traditional MCQ within and across phases were examined. For scale reduction, a random number of items were iteratively selected, and the correlation between the full and random scales was assessed. We then examined the association between our time- and monetary-selection scales assessed during phase 2 and the percentage of assessments that participants endorsed using or craving alcohol, tobacco, or cannabis. RESULTS: In total, 6 of the 7 individual time-selection items were highly correlated with the full scale (r>0.89). Both time-selection (r=0.71; P<.001) and monetary-selection (r=0.66; P<.001) delay discounting rates had high test-retest reliability across phases 1 and 2. Phase 1 MCQ delay discounting function highly correlated with phase 1 (r=0.76; P<.001) and phase 2 (r=0.45; P<.001) time-selection delay discounting scales. One or more randomly chosen time-selection items were highly correlated with the full scale (r>0.94). Greater delay discounting measured via the time-selection measure (adjusted mean difference=5.89, 95% CI 1.99-9.79), but not the monetary-selection scale (adjusted mean difference=-0.62, 95% CI -3.57 to 2.32), was associated with more past-hour tobacco use endorsement in follow-up surveys. CONCLUSIONS: This study evaluated a novel EMA-based scale's ability to validly and reliably assess delay discounting. By measuring delay discounting with fewer items and in situ via EMA in natural environments, researchers may be better able to identify individuals at risk for poor health outcomes.

Polymorphisms in the A118G SNP of the OPRM1 gene produce different experiences of opioids: A human laboratory phenotype-genotype assessment.

Allelic variations in the A118G SNP of the OPRM1 gene change opioid signaling; however, evaluations of how allelic differences may influence opioid effects are lacking. This human laboratory paradigm examined whether the AA versus AG/GG genotypes determined opioid response profiles. Individuals with limited opioid exposure (N = 100) completed a five-day within-subject, double-blind, placebo-controlled, residential study. Participants were admitted (Day 1), received 4 mg hydromorphone (Day 2) and 0 mg, 2 mg and 8 mg hydromorphone in randomized order (Days 3-5) and completed self-reported visual analog scale (VAS) ratings and Likert scales, observed VAS, and physiological responses at baseline and for 6.5 h post-dose. Outcomes were analysed as peak/nadir effects over time as a function of genotype (available for N = 96 individuals; AG/GG = 13.5%, AA = 86.4%). Participants with AG/GG rated low and moderate doses of hydromorphone as significantly more positive (e.g., Good Effects VAS, coasting, drive, friendly, talkative, stimulation) with fewer negative effects (e.g., itchy skin, nausea, sleepiness), and were also observed as being more talkative and energetic relative to persons with AA. Persons with AG/GG were less physiologically reactive as determined by diastolic blood pressure and heart rate, but had more changes in core temperature compared with those with AA. Persons with AA also demonstrated more prototypic agonist effects across doses; persons with AG/GG showed limited response to 2 mg and 4 mg. Data suggest persons with AG/GG genotype experienced more pleasant and fewer unpleasant responses to hydromorphone relative to persons with AA. Future studies should replicate these laboratory findings in clinical populations to support a precision medicine approach to opioid prescribing.

A brief measure of non-drug reinforcement: Association with treatment outcomes during initial substance use recovery.

BACKGROUND: Translational research demonstrates that drug use is inversely associated with availability and engagement with meaningful non-drug reinforcers. Evaluation of non-drug reinforcement in treatment-receiving clinical populations is limited, likely owing to the time intensive nature of existing measures. This study explores the association of non-drug reinforcers with treatment outcomes using a novel, brief measure of past month non-drug reinforcement quantifying three elements: relative frequency, access, and enjoyability. METHODS: Respondents enrolled in substance use treatment (residential, intensive outpatient, and medically managed withdrawal) in clinics across the United States (N = 5481) completed standardized assessments of non-drug reinforcement and treatment outcomes (i.e., return to use and life satisfaction) one-month after treatment discharge. Non-drug reinforcement measures (availability, engagement, enjoyability) were used as predictors of return to use and life satisfaction using generalized linear models. RESULTS: Non-drug reinforcement indices were associated with return to use and life satisfaction in unadjusted models (e.g., 12.4 % versus 58.3 % return to use for those with the highest and lowest availability, respectively). Consistent results were observed in models adjusted for sociodemographic variables and risk factors (i.e., sleep disturbance, anhedonia, stress). Comparisons by drug class generally showed lower non-drug reinforcement among patients reporting heroin or methamphetamine as their primary drug. CONCLUSIONS: Results highlight the importance of non-drug reinforcement during the first month following treatment. Rapid measurement of non-drug reinforcement in stepped care settings may illuminate critical deficits in early stages of behavior change, identify those at greatest risk for return to use, and provide targets for treatment to improve recovery trajectories.

Age moderates the association of optimism on craving during substance use disorder treatment.

BACKGROUND: Optimism, characterized by a positive expectancy toward future outcomes, has garnered attention for its potential role in influencing well-being and may be a protective factor in substance use disorder (SUD) treatment. This study evaluated the relationship of optimism and craving among those in substance use disorder SUD treatment. METHODS: Drawing from a cohort of 4201 individuals in residential SUD treatment programs, this study used both cross-sectional and longitudinal assessment to examine tonic (steady-state) and cue-induced (phasic) cravings across individuals primarily using eight classes of substances. Previous research established that optimism increases during adulthood and peaks during an individual's 50s. This study sought to establish if the association between optimism and craving is moderated by age during the first week of treatment and if that relationship changes over the course of treatment both within and between-person. RESULTS: This study found a negative correlation between optimism and craving intensity. Elevated optimism scores correlated with substantially reduced levels of both tonic (ß = -0.31, p < 0.001) and cue-induced (ß = -0.29, p < 0.001) cravings. Age was a significant moderator of the relationship between optimism and craving such that as individuals age, the potency of optimism in mitigating cravings gradually attenuates (interaction for tonic craving: ß = 0.06, p < 0.001; interaction for cue-induced craving: ß = 0.05, p < 0.001). Reflected in the fact that in older individuals' cravings tended to converge toward lower or moderate levels, regardless of their optimism scores. CONCLUSIONS: By delineating the contemporaneous association between high optimism and lower cravings, the study suggests that interventions aimed at fostering optimism may represent an avenue to improve the effectiveness of SUD treatment, especially in emerging adults.

Comparison of sleep parameters from wrist-worn ActiGraph and Actiwatch devices.

Sleep and physical activity, two important health behaviors, are often studied independently using different accelerometer types and body locations. Understanding whether accelerometers designed for monitoring each behavior can provide similar sleep parameter estimates may help determine whether one device can be used to measure both behaviors. Three hundred and thirty one adults (70.7 ±â€…13.7 years) from the Baltimore Longitudinal Study of Aging wore the ActiGraph GT9X Link and the Actiwatch 2 simultaneously on the non-dominant wrist for 7.0 ±â€…1.6 nights. Total sleep time (TST), wake after sleep onset (WASO), sleep efficiency, number of wake bouts, mean wake bout length, and sleep fragmentation index (SFI) were extracted from ActiGraph using the Cole-Kripke algorithm and from Actiwatch using the software default algorithm. These parameters were compared using paired t-tests, Bland-Altman plots, and Deming regression models. Stratified analyses were performed by age, sex, and body mass index (BMI). Compared to the Actiwatch, the ActiGraph estimated comparable TST and sleep efficiency, but fewer wake bouts, longer WASO, longer wake bout length, and higher SFI (all p < .001). Both devices estimated similar 1-min and 1% differences between participants for TST and SFI (ß = 0.99, 95% CI: 0.95, 1.03, and 0.91, 1.13, respectively), but not for other parameters. These differences varied by age, sex, and/or BMI. The ActiGraph and the Actiwatch provide comparable absolute and relative estimates of TST, but not other parameters. The discrepancies could result from device differences in movement collection and/or sleep scoring algorithms. Further comparison and calibration is required before these devices can be used interchangeably.

The Social Environment Matters for Telomere Length and Internalizing Problems During Adolescence.

Depression and anxiety symptoms are on the rise among adolescents. With increasing evidence that cellular aging may be associated with depressive and anxiety symptoms, there is an urgent need to identify the social environment context that may moderate this link. This study addresses this research gap by investigating the moderating role of the social environment on the relation between telomere length and emotional health among adolescents. Participants were 411 non-Hispanic (88.56%) Black (100%) adolescents (M = 14.23 years, SD = 1.85, female = 54%) in a major metropolitan city. Youth and parents reported on an array of social risk and protective factors, and youth provided DNA samples for telomere length measurement. Results demonstrated that the association of telomere length and anxiety symptoms was stronger among youth with higher perceived stress or lower school belongingness, and the association of telomere length with depressive symptoms was stronger under conditions of higher parent inter-partner psychological aggression. The results enhance our understanding of the complex associations between biological aging, the social environment, and mental health in adolescence.

Correlates of Informant Discrepancies in Self-Harm Among Youth Involved in Child Protective Services.

Youth involved with child protective services (CPS) are at elevated risk for engaging in self-harm. Participation in interventions or treatments that may reduce youths' self-harm behaviors often depends on the accurate reporting of their self-injurious behaviors. However, informants often disagree on the presence or severity of self-harm engagement, making the identification of youth in need of treatment more challenging. The current study aims to characterize discrepancies between youth and caregiver reports of children's self-harm among a sample of youth with a history of CPS involvement, and to identify factors (e.g., demographics, youth and caregiver psychological impairments, aspects of the caregiving environment) associated with these discrepancies. Participants (N = 258) were drawn from a large, nationally representative sample of youth under the age of 18 (mean age = 13.8) and their caregivers who were investigated by CPS. Multinomial logistic regressions were used to examine correlates of discrepancies in caregiver and youth reports of youth self-harm. Results indicated that 10% of caregiver-child dyads agreed on children's engagement in self-harm. In 33% of cases, only the child reported self-harm and in 57% of cases, only the caregiver reported youth self-harm. Being a biological caregiver, child female sex, higher levels of internalizing symptoms; higher post-traumatic stress disorder (PTSD) symptoms; and greater caregiver alcohol use was associated with a lower likelihood of caregivers reporting self-harm only. Older child age; lower externalizing symptoms; higher PTSD symptoms, and greater levels of caregiver emotional security and structure were linked to lower odds of children reporting self-harm only. These results underscore important factors to consider when assessing self-harm among youth involved with CPS and have potential implications for practice guidelines in this population.

Alcohol use polygenic risk score, social support, and alcohol use among European American and African American adults.

Alcohol use is influenced by genetic and environmental factors. We examined the interactive effects between genome-wide polygenic risk scores for alcohol use (alc-PRS) and social support in relation to alcohol use among European American (EA) and African American (AA) adults across sex and developmental stages (emerging adulthood, young adulthood, and middle adulthood). Data were drawn from 4,011 EA and 1,274 AA adults from the Collaborative Study on the Genetics of Alcoholism who were between ages 18-65 and had ever used alcohol. Participants completed the Semi-Structured Assessment for the Genetics of Alcoholism and provided saliva or blood samples for genotyping. Results indicated that social support from friends, but not family, moderated the association between alc-PRS and alcohol use among EAs and AAs (only in middle adulthood for AAs); alc-PRS was associated with higher levels of alcohol use when friend support was low, but not when friend support was high. Associations were similar across sex but differed across developmental stages. Findings support the important role of social support from friends in buffering genetic risk for alcohol use among EA and AA adults and highlight the need to consider developmental changes in the role of social support in relation to alcohol use.

24 h Rest/Activity Rhythms in Older Adults with Memory Impairment: Associations with Cognitive Performance and Depressive Symptomatology.

Little is known about links of circadian rhythm alterations with neuropsychiatric symptoms and cognition in memory impaired older adults. Associations of actigraphic rest/activity rhythms (RAR) with depressive symptoms and cognition are examined using function-on-scalar regression (FOSR). Forty-four older adults with memory impairment (mean: 76.84 ± 8.15 years; 40.9% female) completed 6.37 ± 0.93 days of actigraphy, the Beck depression inventory-II (BDI-II), mini-mental state examination (MMSE) and consortium to establish a registry for Alzheimer's disease (CERAD) delayed word recall. FOSR models with BDI-II, MMSE, or CERAD as individual predictors adjusted for demographics (Models A1-A3) and all three predictors and demographics (Model B). In Model B, higher BDI-II scores are associated with greater activity from 12:00-11:50 a.m., 2:10-5:50 p.m., 8:40-9:40 p.m., 11:20-12:00 a.m., higher CERAD scores with greater activity from 9:20-10:00 p.m., and higher MMSE scores with greater activity from 5:50-10:50 a.m. and 12:40-5:00 p.m. Greater depressive symptomatology is associated with greater activity in midafternoon, evening, and overnight into midday; better delayed recall with greater late evening activity; and higher global cognitive performance with greater morning and afternoon activity (Model B). Time-of-day specific RAR alterations may affect mood and cognitive performance in this population.

Associations of polygenic risk scores for smoking heaviness and lifetime cannabis use with tobacco and cannabis co-use trajectories among African Americans.

BACKGROUND: We aimed to identify distinct trajectories of tobacco, cannabis, and their co-use among African Americans, and to investigate whether these patterns were associated with polygenic risk scores (PRS) for tobacco and cannabis use. METHOD: Participants (N=428 participants; 50.9% male) were initially recruited for an elementary school-based prevention in a Mid-Atlantic city when they were in first grade. From ages 14-26, participants reported on their frequency of tobacco and cannabis use in the past year during annual assessments. DNA was collected from participants at age 21. PRS for smoking heaviness (i.e., cigarettes per day) and lifetime cannabis use were created based on genome-wide association study results derived from Liu et al. (2019) and Pasman et al. (2018), respectively. RESULTS: We identified five distinct trajectories of tobacco and cannabis co-use, including (1) Low Tobacco and Cannabis Use, (2) Adolescent Limited Tobacco and Cannabis Use, (3) Experimental Cannabis, Young Adult Increasing Tobacco, (4) Experimental Tobacco, Young Adult Increasing Cannabis, and (5) High, Chronic Tobacco and Cannabis Use. Compared to the Low Tobacco and Cannabis Use subgroup, individuals in the High, Chronic Tobacco and Cannabis Use subgroup had greater PRS for smoking heaviness, and individuals in the Experimental Cannabis, Young Adult Increasing Tobacco subgroup had higher PRS for lifetime cannabis use. CONCLUSIONS: Polygenic risk for lifetime cannabis use and smoking heaviness is associated with the developmental progression of tobacco and cannabis co-use among African Americans, furthering knowledge on the etiology of co-use in this population.

The impact of opioid-stimulant co-use on tonic and cue-induced craving.

The twin opioid-stimulant epidemics have led to increased overdose deaths and present unique challenges for individuals entering treatment with opioid-stimulant polysubstance use. This study examined tonic and cue-induced craving as a primary outcome among persons in substance use treatment who reported primary substances of opioids, methamphetamine, or cocaine. The sample consisted of 1974 individuals in 55 residential substance-use treatment centers in the United States in 2021. Weekly surveys were delivered via a third-party outcomes tracking system, including measures of tonic and cue-induced craving. Initial comparisons on tonic and cue-induced craving were made among those who primarily used opioids, cocaine, or methamphetamine. Further, the effect of opioid/stimulant polysubstance use on tonic and cue-induced craving was evaluated using marginal effect regression models. Primary methamphetamine use was associated with decreased tonic craving compared to primary opioid use (ß = -5.63, p < 0.001) and primary cocaine use was also associate with decreased tonic craving compared to primary opioid use (ß = -6.14, p < 0.001). Primary cocaine use was also associated with lower cue-induced cravings compared to primary opioid use (ß = -0.53, p = 0.037). Opioid-methamphetamine polysubstance use was associated with higher tonic craving (ß = 3.81, p = <0.001) and higher cue-induced craving (ß = 1.55, p = 0.001); however, this was not the case for opioid-cocaine polysubstance use. The results of this study indicate that individuals who primarily use opioids and have secondary methamphetamine use experience higher cue-induced and tonic-induced craving, suggesting that these individuals may benefit from additional interventions that target craving and mitigate relapse risk and other negative sequelae.

Patterns of demoralization and anhedonia during early substance use disorder treatment and associations with treatment attrition.

BACKGROUND: Although depressive symptoms represent a promising therapeutic target to promote recovery from substance use disorders (SUD), heterogeneity in their diagnostic presentation often hinders the ability to effectively tailor treatment. We sought to identify subgroups of individuals varying in depressive symptom phenotypes (i.e., demoralization, anhedonia), and examined whether these subgroups were associated with patient demographics, psychosocial health, and treatment attrition. METHODS: Patients (N = 10,103, 69.2 % male) were drawn from a dataset of individuals who presented for admission to SUD treatment in the US. Participants reported on their demoralization and anhedonia approximately weekly for the first month of treatment, and on their demographics, psychosocial health, and primary substance at intake. Longitudinal latent profile analysis examined patterns of demoralization and anhedonia with treatment attrition as a distal outcome. RESULTS: Four subgroups of individuals emerged: (1) High demoralization and anhedonia, (2) Remitting demoralization and anhedonia, (3) High demoralization, low anhedonia, and (4) Low demoralization and anhedonia. Relative to the Low demoralization and anhedonia subgroup, all the other profiles were more likely to discontinue treatment. Numerous between-profile differences were observed with regard to demographics, psychosocial health, and primary substance. LIMITATIONS: The racial and ethnic background of the sample was skewed towards White individuals; future research is needed to determine the generalizability of our findings to minoritized racial and ethnic groups. CONCLUSIONS: We identified four clinical profiles that varied in the joint course of demoralization and anhedonia. Findings suggest specific subgroups might benefit from additional interventions and treatments that address their unique mental health needs during SUD recovery.

Predictors of Suicidal Ideation During Residential Substance Use Treatment.

Background: Individuals with substance use disorders (SUDs) and co-occurring chronic health and/or psychiatric conditions face unique challenges in treatment and may be at a greater risk for suicidal ideation relative to persons with SUD alone.Methods: In a sample of individuals entering residential SUD treatment in 2019 and 2020 (N = 10,242), we tested adjusted and unadjusted associations between suicidal ideation and (1) psychiatric symptoms and (2) chronic health conditions at treatment intake and during treatment using logistic and generalized logistic models.Results: Over a third of the sample endorsed suicidal ideation at intake, though the prevalence of suicidal ideation decreased during treatment. In both adjusted and unadjusted models, individuals who reported past-month self-harm, those who reported a lifetime suicide attempt, and individuals who screened positive for co-occurring anxiety, depression, and/or posttraumatic stress disorder were at elevated risk of endorsing suicidal ideation at intake and during treatment (P values < .001). In unadjusted models, chronic pain (odds ratio [OR] = 1.51, P < .001) and hepatitis C virus (OR = 1.65, P < .001) were associated with an elevated risk for suicidal ideation at intake, and chronic pain was associated with elevated risk for suicidal ideation during treatment (OR = 1.59, P < .001).Conclusions: Increasing accessibility to integrated treatments (ie, those that address psychiatric and chronic health conditions) for patients experiencing suicidal ideation may be beneficial in residential SUD treatment settings. Developing predictive models to identify those most at risk of suicidal ideation in real time remains a relevant direction for future work.

Temporal reliability and stability of delay discounting: A 2-year repeated assessments study of the Monetary Choice Questionnaire.

The Monetary Choice Questionnaire (MCQ) is one of the most commonly used measures to assess delay discounting of reward. Reliable measurement by the MCQ is necessary for use in experimental settings or prognostic validity within clinical contexts. The present analysis expands prior work to evaluate temporal reliability and stability over an extended period, including repeated measurements, a larger and more broadly representative sample, and demonstrations of covariation with clinically significant health behaviors (e.g., cigarette use, COVID-19 vaccination, body mass index). Participants (N = 680; 55.6% female) were recruited through crowdsourcing and completed the MCQ approximately quarterly over 2 years. Measures of reliability, stability, and correlations with clinical constructs were determined for each timepoint and pairwise comparison. Test-retest reliabilities were high across all pairwise comparisons (all rxx > .75; range = .78-.86; mean = .83). Stability was also high with within-subject effect size differences all within a less-than-small effect size range (range dz = -0.09 to 0.19; mean = 0.04). Positive associations between smoking status and delay discounting rates were observed consistent with prior clinical studies. These findings of test durability support the use of MCQ administration for repeated measurement of delay-constrained choice as a stable respondent characteristic and illustrate its association with important health behaviors over extended time periods. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Latent patterns of sleep disturbance, pain impact, and depressive symptoms in residential substance use treatment.

AIM: Sleep disturbance, clinically significant pain, and depressive symptoms commonly occur together among individuals with substance use disorders. The purposes of the present study were to 1) identify subgroups of individuals with heterogenous patterns of pain, sleep disturbance, and depressive symptoms, and 2) identify demographic and clinical correlates of profile membership. MATERIAL AND METHODS: The present study assessed a sample (N = 8621) of individuals seeking residential substance use treatment in 2020 and 2021 in the United States. We examined whether unique sub-groups could be identified based on patterns of sleep disturbance, pain impact, and depressive symptoms during the first four weeks of treatment, using longitudinal latent profile analysis. Next, we explored demographic, substance use, and clinical correlates (i.e., distress intolerance) of profile membership, as well as whether profile membership was associated with treatment attrition. RESULTS: The identified classes were: 1) Low sleep disturbance, pain impact, and depressive symptoms, 2) High pain, remitting depressive symptoms, and mild sleep disturbance, 3) High depressive symptoms, low pain, and remitting sleep disturbance, and 4) High sleep disturbance, pain impact, and depressive symptoms. Individuals with high pain, depressive symptoms, and sleep disturbance were more likely to be older, use opioids as their primary substance, have high distress intolerance, and discontinue treatment. CONCLUSION: Results highlight the importance of comprehensive care and management of physical health conditions, particularly among older adults. Further, results highlight that distress intolerance may be a modifiable risk factor for co-occurring sleep disturbance, pain impact, and depressive symptoms.

Association of common infections with cognitive performance in the Baltimore Epidemiologic Catchment Area study follow-up.

INTRODUCTION: Growing evidence suggests that some common infections are causally associated with cognitive impairment; however, less is known about the burden of multiple infections. METHODS: We investigated the cross-sectional association of positive antibody tests for herpes simplex virus, cytomegalovirus (CMV), Epstein-Barr virus (EBV), varicella zoster virus (VZV), and Toxoplasma gondii (TOX) with Mini-Mental State Examination (MMSE) and delayed verbal recall performance in 575 adults aged 41-97 from the Baltimore Epidemiologic Catchment Area Study. RESULTS: In multivariable-adjusted zero-inflated Poisson (ZIP) regression models, positive antibody tests for CMV (p = .011) and herpes simplex virus (p = .018) were individually associated with poorer MMSE performance (p = .011). A greater number of positive antibody tests among the five tested was associated with worse MMSE performance (p = .001). DISCUSSION: CMV, herpes simplex virus, and the global burden of multiple common infections were independently associated with poorer cognitive performance. Additional research that investigates whether the global burden of infection predicts cognitive decline and Alzheimer's disease biomarker changes is needed to confirm these findings.

Patterns of polysubstance use and clinical comorbidity among persons seeking substance use treatment: An observational study.

INTRODUCTION: Polysubstance use is common among individuals seeking treatment for substance use disorders (SUD). However, we know less about patterns and correlates of polysubstance use among treatment-seeking populations. The current study aimed to identify latent patterns of polysubstance use and associated risk factors in persons entering SUD treatment. METHODS: Patients (N = 28,526) being admitted for substance use treatment reported on their use of thirteen substances (e.g., alcohol, cannabis, cocaine, amphetamines, methamphetamines, other stimulants, heroin, other opioids, benzodiazepines, inhalants, synthetics, hallucinogens, and club drugs) in the month before treatment and prior to the month before treatment. Latent class analysis (LCA) determined the relationship between class membership and gender, age, employment status, unstable housing, self-harm, overdose, past treatment, depression, generalized anxiety disorder, and/or post-traumatic stress disorder (PTSD). RESULTS: Identified classes included: 1) Alcohol primary, 2) Moderate probability of past-month alcohol, cannabis, and/or opioid use; 3) Alcohol primary, Lifetime cannabis and cocaine use; 4) Opioid primary, Lifetime use of alcohol, cannabis, hallucinogens, club drugs, amphetamines, and cocaine; 5) Moderate probability of past-month alcohol, cannabis, and/or opioid use, Lifetime use of various substances; 6) Alcohol and cannabis primary, Lifetime use of various substances; and 7) High past-month polysubstance use. Individuals who engaged in past-month polysubstance use attended to face elevated risk of screening positive for recent unstable housing, unemployment, depression, anxiety, PTSD, self-harm, and overdose. CONCLUSIONS: Current polysubstance use is associated with significant clinical complexity. Tailored treatments that reduce harms resulting from polysubstance use and related psychiatric comorbidity may improve treatment outcomes in this population.