Mediational Analyses of the Effects of Social Behaviour and Network Therapy on Alcohol Use.

INTRODUCTION: Social behaviour and network therapy involves an active participation of the practitioner in recruiting a supportive network to change the client's alcohol use. Despite achieving beneficial effects on alcohol consumption, its possible mechanisms of change are a relatively under-studied topic compared to those of other alcohol treatment interventions. This study aimed to explore therapist skills through which social behaviour and network therapy may achieve effects on alcohol consumption in comparison with motivational enhancement therapy. METHODS: This study was secondary analysis of data from the UK Alcohol Treatment Trial, a multicentre, pragmatic, randomized controlled trial. The sample comprised 376 participants randomized to motivational enhancement therapy or social behaviour and network therapy. We used the UK Alcohol Treatment Trial Process Rating Scale to assess therapist skills. Outcomes drinks per drinking day and percentage of days abstinent were assessed 12 months after treatment initiation. Analyses were conducted in a simple mediation framework. RESULTS: Therapist skills score (combining frequency and quality) for involving others in behaviour change mediated social behaviour and network therapy effects on percentage of days abstinent (b = 0.06, 95% CI: 0.02; 0.10, p = 0.01). The frequency with which therapists acted as an active agent for change also mediated the effects of social behaviour and network therapy on percentage of days abstinent (b = 0.03, 95% CI: 0.003; 0.05, p = 0.03). The frequency with which the therapist stressed social support as a key factor in achieving change unexpectedly mediated an increase in drinks per drinking day (b = 0.10, 95% CI: 0.01; 0.18, p = 0.02). The two latter mediation effects were not sustained when quality was considered. All other indirect effects tested were non-significant. DISCUSSION/CONCLUSIONS: How social behaviour and network therapy exerts effects on alcohol outcomes is not yet well understood and in this study was not attributable to observed ratings of therapist treatment-specific skills. Therapist skill in planning the involvement of others during treatment, however, warrants further study. We suggest that the present findings should be regarded as hypothesis generating as it identifies specific targets for further investigation in alcohol treatment process studies.

Protective strategies and motivations to control drinking among Brazilian college students: a qualitative study.

BACKGROUND: To develop prevention programs or early interventions to reduce alcohol consumption and related problems among college students, it is essential to understand their motivations for drinking and the spontaneous (effective and non-effective) strategies they employ to control, considering the social and cultural contexts influence. This study aimed to explore these factors and the student's application of selfcare in different situations and environments, as well as to identify their reasons for not drinking. METHODS: The students were invited to participate using a snowball sampling, up to the theoretical saturation point. Qualitative individual semi-structured interviews were carried out and the interviews contents were analyzed using the NVivo software. The participants were 23 college students between 18 and 24 years old, with diverse patterns of alcohol use (low-risk to suggestive of dependence). RESULTS: Data analysis highlighted three main themes: (a) Contexts (such as bars, "open bar" parties and others) and consumption patterns; (b) Protective Strategies (such as stop-drinking intervals, eating before or during drinking, returning home in the company of a friend); (c) Motivations to control drinking (such as sense of responsibility, bad previous experiences, family and religious issues). Protective strategies and motivation to control drinking were perceived to be less prominent in specific contexts that favor high alcohol consumption, as open bar parties. CONCLUSIONS: Motivations and protective strategies varied according to the drinkers' profile, social situations and settings in which they consumed alcohol. The results highlight the need for preventive interventions planned for specific drinking patterns and contexts.

Ethanol combined with energy drinks: Two decades of research in rodents.

Many studies raised concerns on alcoholic beverages consumption mixed with energy drinks (AmED), which can induce higher rates of binge drinking and earlier development of alcohol use disorders. After 20 years of research, few studies with laboratory animals have focused on the effects of this mixture and the neurobiological and pharmacological mechanisms underlying them. We found 16 articles on AmED administration to rodents evaluating its effects on voluntary consumption, locomotion, anxiety-like behavior, memory, influence on the onset time of seizures, biochemical and neurochemical measures. Some of these studies indicated energy drinks (ED) can alter the pattern of use and motivation to consume ethanol (EtOH); increase the expression of sensitization to EtOH stimulant effect and the proportion of sensitized mice; decrease the aversiveness of high concentrations of EtOH, among other effects. In addition AmED hastens the loss of righting reflex and its effects on memory are controversial. After acute administration no difference was found in blood ethanol concentration (BEC) of rodents which received EtOH with or without ED, but after 60 days of treatment, AmED group had lower BEC levels than EtOH group. Data on biochemical and neurochemical parameters after AmED are not consistent. Although the AmED group presented higher glucose levels than the EtOH group when drugs were administered by gavage, this was not observed in a self-administration protocol. AmED may induce higher kidney damage, higher levels of plasma urea, uric acid and creatinine when compared to EtOH. Chronic consumption of AmED causes an inflammatory response and oxidative stress, which may induce cell death in the cortex and hypothalamus of adult rats. These controversial results show that AmED diverse effects depend on sex, age and lineage of the animals, duration of the treatment and route of administration. Further research is necessary to evaluate the mechanisms underlying AmED biological effects.

The Effectiveness of a Web-Based Self-Help Program to Reduce Alcohol Use Among Adults With Drinking Patterns Considered Harmful, Hazardous, or Suggestive of Dependence in Four Low- and Middle-Income Countries: Randomized Controlled Trial.

BACKGROUND: Given the scarcity of alcohol prevention and use disorder treatments in many low- and middle-income countries (LMICs), the World Health Organization has launched an eHealth portal that includes the web-based self-help program "Alcohol e-Health." OBJECTIVE: We aimed to test the effectiveness of the Alcohol e-Health program in a randomized controlled trial. METHODS: This was a two-arm, individually randomized, and controlled trial across four LMICs comparing the self-help program and a psychoeducation and internet access as usual waiting list. Participants were broadly recruited from community samples in Belarus, Brazil, India, and Mexico from January 2016 through January 2019. The primary outcome measure was change in the Alcohol Use Disorders Identification Test (AUDIT) score with a time frame of 6 months between baseline and follow-up. Secondary outcomes included self-reported numbers of standard drinks over the previous week and cessation of harmful or hazardous drinking (AUDIT score <8). RESULTS: For this study, we recruited 1400 predominantly male (n=982, 70.1%) at least harmful or hazardous alcohol drinkers. The mean age was 37.6 years (SD 10.5). The participants were recruited from Brazil (n=587), Mexico (n=509), India (n=212), and Belarus (n=92). Overall, complete case analysis identified higher AUDIT changes in the intervention group (B=-4.18, 95% CI -5.42 to -2.93, P<.001, d=0.56) that were mirrored by changes in weekly standard drinks (B=-9.34, 95% CI -15.90 to -2.77, P=.005, d=0.28) and cessation rates for harmful or hazardous drinking (χ21=14.56, N=561, P<.001). The supplementary intention-to-treat analyses largely confirmed these initial results. CONCLUSIONS: The expansion of the Alcohol e-Health program to other LMICs with underdeveloped alcohol prevention and treatment systems for alcohol use disorders should be considered after successful replication of the present results. TRIAL REGISTRATION: ISRCTN ISRCTN14037475; https://www.isrctn.com/ISRCTN14037475. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1111/add.14034.

Association between polymorphism in gene related to the dopamine circuit and motivations for drinking in patients with alcohol use disorder.

The development of alcohol use disorder (AUD) is influenced by genetic, psychological, and social factors. However, the identification of the load of each of these factors and the association between them is still debatable. This study aimed to explore the load of the association between AUD and polymorphisms in genes of the dopaminergic system, as well as with drinking triggers. The study comprised 227 inpatients with AUD and 174 controls. The pattern and motivations for drinking were evaluated using the Alcohol Use Disorders Identification Test (AUDIT) and the Inventory of Drinking Situations (IDS). Analyses of genetic variation in genes encoding dopaminergic were performed using next generation sequencing. We observed an significant association between a polymorphism in DDC (rs11575457) and AUD. Positive reinforcement factors as urges/temptations to drink and pleasant emotion, in isolation, were the significantly related elements to drinking. In addition, negative (physical discomfort) and positive reinforcement factors (testing personal control; pleasant time with others) significantly reinforced the interaction with DDC genetic variant for increased odds of an individual presenting AUD. These results indicated a complex relationship between the dopaminergic system and the drug-seeking behavior profiles.

Alcohol e-Help: study protocol for a web-based self-help program to reduce alcohol use in adults with drinking patterns considered harmful, hazardous or suggestive of dependence in middle-income countries.

BACKGROUND AND AIMS: Given the scarcity of alcohol prevention and alcohol use disorder treatments in many low and middle-income countries, the World Health Organization launched an e-health portal on alcohol and health that includes a Web-based self-help program. This paper presents the protocol for a multicentre randomized controlled trial (RCT) to test the efficacy of the internet-based self-help intervention to reduce alcohol use. DESIGN: Two-arm randomized controlled trial (RCT) with follow-up 6 months after randomization. SETTING: Community samples in middle-income countries. PARTICIPANTS: People aged 18+, with Alcohol Use Disorders Identification Test (AUDIT) scores of 8+ indicating hazardous alcohol consumption. INTERVENTION AND COMPARATOR: Offer of an internet-based self-help intervention, 'Alcohol e-Health', compared with a 'waiting list' control group. The intervention, adapted from a previous program with evidence of effectiveness in a high-income country, consists of modules to reduce or entirely stop drinking. MEASUREMENTS: The primary outcome measure is change in the Alcohol Use Disorders Identification Test (AUDIT) score assessed at 6-month follow-up. Secondary outcomes include self-reported the numbers of standard drinks and alcohol-free days in a typical week during the past 6 months, and cessation of harmful or hazardous drinking (AUDIT < 8). ANALYSIS: Data analysis will be by intention-to-treat, using analysis of covariance to test if program participants will experience a greater reduction in their AUDIT score than controls at follow-up. Secondary outcomes will be analysed by (generalized) linear mixed models. Complier average causal effect and baseline observations carried forward will be used in sensitivity analyses. COMMENTS: If the Alcohol e-Health program is found to be effective, the potential public health impact of its expansion into countries with underdeveloped alcohol prevention and alcohol use disorder treatment systems world-wide is considerable.

Country-wide distance training for delivery of screening and brief intervention for problematic substance use: A pilot evaluation of participant experiences and patient outcomes.

BACKGROUND: In this study, the authors evaluated if the 120-hour distance learning (DL) course SUPERA (an acronym in Portuguese meaning "System for detection of excessive use or dependence on psychoactive substances: brief Intervention, social reinsertion and follow-up") was an effective way to train health professionals and social workers to apply screening and brief intervention (SBI) for patients with substance use disorders. METHODS: In the first phase, 2420 health professionals or social workers, who had completed the course, answered an online survey about their use of the SBI. In the second phase, 25 of those professionals applied the ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) followed by a brief intervention (BI) to patients with substance use disorders. Three months after the SBI delivery, independent researchers followed up 79 patients who had received SBI, reapplying the ASSIST and a questionnaire to evaluate the patients'/clients' satisfaction with the intervention they received. RESULTS: In the first phase, it was found that most health professionals and social workers who completed the course applied the SBI in their work and felt very motivated to do it. In the second phase of the study, at a 3-month follow-up, most patients had significantly reduced their ASSIST scores in respect of alcohol and cocaine/crack in relation to their baseline levels. Those patients classified by their ASSIST score as "suggestive of dependence" presented a significant reduction in their scores regarding alcohol, tobacco, and cocaine/crack, whereas those classified as "at risk" presented a reduction in respect of alcohol problems only. Patients associated changes in their substance use with the SBI received. CONCLUSIONS: A reduction in substance use-related problems was associated with the SBI applied by the health professionals or social workers trained by the DL course SUPERA. Two significant limitations of this study were the small number of participants (professionals and patients in the follow-up) and the absence of a control group in the second phase of the study.

Web-based self-help intervention reduces alcohol consumption in both heavy-drinking and dependent alcohol users: A pilot study.

As part of a multicenter project supported by the World Health Organization, we developed a web-based intervention to reduce alcohol use and related problems. We evaluated the predictors of adherence to, and the outcomes of the intervention. Success was defined as a reduction in consumption to low risk levels or to <50% of the baseline levels of number of drinks. From the 32,401 people who accessed the site, 3389 registered and 929 completed the full Alcohol Use Disorders Identification Test (AUDIT), a necessary condition to be considered eligible to take part in the intervention. Based on their AUDIT scores, these participants were classified into: low risk users (LRU; n=319) harmful/hazardous users (HHU; n=298) or suggestive of dependence users (SDU; n=312). 29.1% of the registered users (LRU=42; HHU=90; SDU=82) completed the evaluation form at the end of the six-week period, and 63.5% reported low-risk drinking levels. We observed a significant reduction in alcohol consumption in the HHU (62.5%) and SDU (64.5%) groups in relation to baseline. One month after the intervention, in the follow-up, 94 users filled out the evaluation form, and their rate of success was similar to the one observed in the previous evaluation. Logistic regression analyses indicated that HHU participants presented higher adherence than LRU. Despite a relatively low adherence to the program, its good outcomes and low cost, as well as the high number of people that can be reached by a web-based intervention, suggest it has good cost-effectiveness.

Who seeks public treatment for substance abuse in Brazil? Results of a multicenter study involving four Brazilian state capitals / Quem procura tratamento para abuso de substância na rede pública no Brasil? Resultados de um estudo multicêntrico envolvendo quatro capitais brasileiras

OBJECTIVE: To assess the characteristics of alcohol and drug users who seek treatment at the Brazilian Unified Health System in Brazil. METHOD: A multicenter cross-sectional study involving five clinical and research centers located in four Brazilian state capitals was conducted with 740 in- and outpatients. The only exclusion criterion was the presence of neurological or severe psychiatric symptoms at the moment of the interview. The Addiction Severity Index (ASI-6) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were used to assess the severity of substance use and the problems related. RESULTS: There were significantly more men than women in the sample; mean age was 36 years. The drug most frequently used at all sites was alcohol (78%), followed by cocaine/crack (51%). Alcohol was the drug that most commonly motivated treatment seeking, at all centers. ASI-6 Summary Scores for Recent Functioning (SS-Rs) were quite similar among centers. SS-Rs were compared between users who had never received treatment for psychoactive substance abuse (n = 265, 36.1%) and those who had already been treated at one or more occasions (n = 470, 63.9%). This analysis revealed significant differences between the groups in the drug, psychiatric symptoms, legal, and family/social problems areas (p < 0.05). CONCLUSION: Our findings confirm previous evidence suggesting that the management of patients seeking drug abuse treatment should take several different aspects into consideration, e.g., education, employment, and family relationships, which often appear as areas of concern for these individuals (AU)

OBJETIVO: Avaliar as características dos usuários de álcool e drogas que procuram tratamento no Sistema Único de Saúde. MÉTODO: Estudo transversal multicêntrico envolvendo cinco centros clínicos/de pesquisa localizados em quatro capitais brasileiras foi realizado com 740 pacientes hospitalizados e ambulatoriais. O único critério de exclusão foi a presença de sintomas neurológicos ou psiquiátricos graves no momento da entrevista. A Escala de Gravidade de Dependência (Addiction Severity Index, ASI-6) e o teste ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) foram utilizados para avaliar a severidade do uso de substância e problemas relacionados. RESULTADOS: Houve significativamente mais homens do que mulheres na amostra; a idade média foi de 36 anos. A droga mais usada em todos os centros foi o álcool (78%), seguido de cocaína/crack (51%). O álcool foi a droga que mais motivou procura por tratamento, em todos os centros. Os Escores Resumidos da ASI-6 para Funcionamento Recente (SS-Rs) foram bastante similares nos centros. SS-Rs foram comparados entre usuários que nunca haviam recebido tratamento para abuso de substâncias (n = 265, 36,1%) e aqueles que já haviam sido tratados uma ou mais vezes (n = 470, 63,9%). Foram observadas diferenças significativas entre os grupos nas áreas de droga, sintomas psiquiátricos e problemas legais e familiares/sociais (p < 0,05). CONCLUSÕES: Nossos dados confirmam evidências prévias de que o manejo de pacientes que procuram tratamento para abuso de substância deve levar em conta vários aspectos, como educação, emprego e relações familiares, que normalmente geram preocupação nesses indivíduos (AU)

Individual differences in ethanol locomotor sensitization are associated with dopamine D1 receptor intra-cellular signaling of DARPP-32 in the nucleus accumbens.

In mice there are clear individual differences in the development of behavioral sensitization to ethanol, a progressive potentiation of its psychomotor stimulant effect. Variability in the behavioral responses to ethanol has been associated with alcohol preference. Here we investigated if the functional hyperresponsiveness of D1 receptors observed in ethanol sensitized mice leads to an increased activation of DARPP-32, a central regulatory protein in medium spiny neurons, in the nucleus accumbens - a brain region known to play a role in drug reinforcement. Swiss Webster mice received ethanol (2.2 g/kg/day) or saline i.p. administrations for 21 days and were weekly evaluated regarding their locomotor activity. From those treated with ethanol, the 33% with the highest levels of locomotor activity were classified as "sensitized" and the 33% with the lowest levels as "non-sensitized". The latter presented similar locomotor levels to those of saline-treated mice. Different subgroups of mice received intra-accumbens administrations of saline and, 48 h later, SKF-38393, D1 receptor agonist 0.1 or 1 µg/side. Indeed, sensitized mice presented functional hyperresponsiveness of D1 receptors in the accumbens. Two weeks following the ethanol treatment, other subgroups received systemic saline or SKF 10 mg/kg, 20 min before the euthanasia. The nucleus accumbens were dissected for the Western Blot analyses of total DARPP-32 and phospho-Thr34-DARPP-32 expression. D1 receptor activation induced higher phospho-Thr34-DARPP-32 expression in sensitized mice than in non-sensitized or saline. The functionally hyperresponsiveness of D1 receptors in the nucleus accumbens is associated with an increased phospho-Thr34-DARPP-32 expression after D1 receptor activation. These data suggest that an enduring increase in the sensitivity of the dopamine D1 receptor intracellular pathway sensitivity represents a neurobiological correlate associated with the development of locomotor sensitization to ethanol.

Who seeks public treatment for substance abuse in Brazil? Results of a multicenter study involving four Brazilian state capitals.

OBJECTIVE: To assess the characteristics of alcohol and drug users who seek treatment at the Brazilian Unified Health System in Brazil. METHOD: A multicenter cross-sectional study involving five clinical and research centers located in four Brazilian state capitals was conducted with 740 in- and outpatients. The only exclusion criterion was the presence of neurological or severe psychiatric symptoms at the moment of the interview. The Addiction Severity Index (ASI-6) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were used to assess the severity of substance use and the problems related. RESULTS: There were significantly more men than women in the sample; mean age was 36 years. The drug most frequently used at all sites was alcohol (78%), followed by cocaine/crack (51%). Alcohol was the drug that most commonly motivated treatment seeking, at all centers. ASI-6 Summary Scores for Recent Functioning (SS-Rs) were quite similar among centers. SS-Rs were compared between users who had never received treatment for psychoactive substance abuse (n = 265, 36.1%) and those who had already been treated at one or more occasions (n = 470, 63.9%). This analysis revealed significant differences between the groups in the drug, psychiatric symptoms, legal, and family/social problems areas (p < 0.05). CONCLUSION: Our findings confirm previous evidence suggesting that the management of patients seeking drug abuse treatment should take several different aspects into consideration, e.g., education, employment, and family relationships, which often appear as areas of concern for these individuals.

The effects of ADHD in adult substance abusers.

The aim of this study was to evaluate the psychiatric comorbidities and different areas of life functioning in substance abusers with attention deficit hyperactivity disorder symptoms. A cross-sectional, multi-center study involving 285 adult substance abusers from outpatient and inpatient clinics was performed. The Adult ADHD Self-Report Scale, the sixth version of the Addiction Severity Index, and the Mini International Neuropsychiatry Interview were used for data collection. Individuals with comorbid attention deficit hyperactivity disorder and substance use disorders showed increased addiction severity when compared with individuals without attention deficit hyperactivity disorder (53.3 ± 7.3 vs. 48.4 ± 8.4, respectively). Our results suggest that comorbid attention deficit hyperactivity disorder and substance use disorders is associated with a more severe course of substance use and with social and psychiatric impairment.

Alpha1-adrenergic drugs affect the development and expression of ethanol-induced behavioral sensitization.

BACKGROUND: According to the incentive sensitization theory, addiction is caused primarily by drug-induced sensitization in the brain mesocorticolimbic systems. After repeated ethanol administration, some animals develop psychomotor sensitization, a phenomenon which occurs simultaneously with the incentive sensitization. Recent evidence suggests the involvement of norepinephrine (NE) in drug addiction, with a critical role in the ethanol reinforcing properties. In this study we evaluated the influence of an agonist (phenylephrine) and an antagonist (prazosin) of alpha1-adrenergic receptors on the development and expression of behavioral sensitization to ethanol. Male Swiss mice, previously treated with ethanol or saline, were challenged with the combined administration of ethanol (or saline) with alpha1-adrenergic drugs. Prazosin (0.1; 0.5 and 1.0 mg/kg) and phenylephrine (1.0 and 2.0 mg/kg) administration blocked the expression of behavioral sensitization to ethanol. In another set of experiments, mice treated with 0.5mg/kg of prazosin+ethanol did not present the development of behavioral sensitization. However, when challenged with ethanol alone, they showed the same sensitized levels of locomotor activity of those presented by mice previously treated with ethanol and saline. Phenylephrine (1.0 mg/kg) treatment did not affect the development of behavioral sensitization. Based on this data, we concluded that the alteration of alpha1-adrenergic receptors functioning, by the administration agonists or antagonists, affected the locomotor sensitization to the stimulant effect of ethanol, suggesting that the normal functioning of the noradrenergic system is essential to its development and expression.

Expression of behavioral sensitization to ethanol is increased by energy drink administration.

Alcohol abuse and dependence are important medical, social and economical problems, affecting millions of people. A relatively recent habit among young people is mixing alcohol with energy drinks (ED), in spite of the risks involved may be higher than those associated with alcohol consumption alone. The mixture of alcohol and energy drinks, both with stimulant properties, may alter the perception of intoxication and could lead individuals to believe they are less drunk and can drink more or for longer periods of time. In animals, the repeated administration of ethanol can lead to a progressive increase of the locomotor stimulant effect, known as behavioral sensitization, a drug-dependent behavioral plasticity associated with vulnerability to addiction. As well as for addiction, there are clear individual differences in the level of sensitization to ethanol among species and even among individuals from the same strain. The present study assessed how ED affects the expression of ethanol sensitization. Female mice chronically treated with ethanol (2.4 g/kg) were classified as low-sensitized or high-sensitized. Two days later, different groups of mice were submitted to saline+water, ethanol+water or ethanol+ED systemic challenges. As expected, only the high-sensitized group expressed clear sensitization after ethanol administration. However, the administration of ethanol+ED triggered the sensitization expression in the low-sensitized group. These data indicate that the combined use of ED and ethanol can potentiate the stimulant and, consequently, the reward effects of ethanol in previously treated mice. If a similar process occurs in human beings, the use of ED can increase the risk of developing alcohol abuse or dependence.

Relationship between stress symptoms and drug use among secondary students.

The aim of this study was to evaluate the relationship between drug use and four kinds of stress symptoms in 954 Brazilian students from the 6th to the 11th grades, in 4 public and 5 private schools in the city of Sao Paulo. Based on their answers to the Drug Use Screening Inventory (DUSI-R) and to the Stress Scale for Adolescents (SSA), we compared regular drug users with non/occasional drug users regarding the frequency of four kinds of stress symptoms (psychological, cognitive, physiological, interpersonal), and the period in which it happened. When compared to non/occasional drug users, regular drug users presented higher levels of psychological, cognitive and physiological symptoms of stress and these symptoms were in the most severe spectrum of severity (near to exhaustion and exhaustion). The association between drug use and stress was even stronger in the youngest age group (11 to 13 years old). Most of the regular drug users were 16 years old and over, from upper-middle class families, had poor family relationships and more academic problems. These results confirm the association between drug use and stress in adolescents and highlight the need for early screening and intervention in both drug use and stressful situations.

Locomotor sensitization to ethanol impairs NMDA receptor-dependent synaptic plasticity in the nucleus accumbens and increases ethanol self-administration.

Although alcoholism is a worldwide problem resulting in millions of deaths, only a small percentage of alcohol users become addicted. The specific neural substrates responsible for individual differences in vulnerability to alcohol addiction are not known. In this study, we used rodent models to study behavioral and synaptic correlates related to individual differences in the development of ethanol locomotor sensitization, a form of drug-dependent behavioral plasticity associated with addiction vulnerability. Male Swiss Webster mice were treated daily with saline or 1.8 g/kg ethanol for 21 d. Locomotor activity tests were performed once a week for 15 min immediately after saline or ethanol injections. After at least 11 d of withdrawal, cohorts of saline- or ethanol-treated mice were used to characterize the relationships between locomotor sensitization, ethanol drinking, and glutamatergic synaptic transmission in the nucleus accumbens. Ethanol-treated mice that expressed locomotor sensitization to ethanol drank significantly more ethanol than saline-treated subjects and ethanol-treated animals resilient to this form of behavioral plasticity. Moreover, ethanol-sensitized mice also had reduced accumbal NMDA receptor function and expression, as well as deficits in NMDA receptor-dependent long-term depression in the nucleus accumbens core after a protracted withdrawal. These findings suggest that disruption of accumbal core NMDA receptor-dependent plasticity may represent a synaptic correlate associated with ethanol-induced locomotor sensitization and increased propensity to consume ethanol.

Avanços na psicometria: da Teoria Clássica dos Testes à Teoria de Resposta ao Item / Advances in psychometrics: from Classical Test Theory to Item Response Theory

No século XX, o desenvolvimento e avaliação das propriedades psicométricas dos testes se embasou principalmente na Teoria Clássica dos Testes (TCT). Muitos testes são longos e redundantes, com medidas influenciáveis pelas características da amostra dos indivíduos avaliados durante seu desenvolvimento, sendo algumas destas limitações consequências do uso da TCT. A Teoria de Resposta ao Item (TRI) surgiu como uma possível solução para algumas limitações da TCT, melhorando a qualidade da avaliação da estrutura dos testes. Neste texto comparamos criticamente as características da TCT e da TRI como métodos para avaliação das propriedades psicométricas dos testes. São discutidas as vantagens e limitações de cada método.(AU)

In the 20th century, development and evaluation of psychometric properties of tests was mainly based on the Classical Test Theory (CTT). Many tests are long and redundant, with measures influenced by the characteristics of the sample of the individuals being evaluated. Some of the limitations are a consequence of the use of the CTT. The Item Response Theory (IRT) has been proposed as a solution to some limitations of the CTT, improving the quality of assessment of the tests structure. In this paper we critically compare the characteristics of CTT and IRT methods in determining the psychometric properties of tests. We discuss the advantages and limitations of each method.(AU)

Relationship between Stress Symptoms and Drug use among Secondary Students

The aim of this study was to evaluate the relationship between drug use and four kinds of stress symptoms in 954 Brazilian students from the 6th to the 11th grades, in 4 public and 5 private schools in the city of Sao Paulo. Based on their answers to the Drug Use Screening Inventory (DUSI-R) and to the Stress Scale for Adolescents (SSA), we compared regular drug users with non/occasional drug users regarding the frequency of four kinds of stress symptoms (psychological, cognitive, physiological, interpersonal), and the period in which it happened. When compared to non/occasional drug users, regular drug users presented higher levels of psychological, cognitive and physiological symptoms of stress and these symtoms were in the most severe spectrum of severity (near to exhaustion and exhaustion). The association between drug use and stress was even stronger in the youngest age group (11 to 13 years old). Most of the regular drug users were 16 years old and over, from upper-middle class families, had poor family relationships and more academic problems. These results confirm the association between drug use and stress in adolescents and highlight the need for early screening and intervention in both drug use and stressful situations (AU)

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Avanços na psicometria: da Teoria Clássica dos Testes à Teoria de Resposta ao Item / Advances in psychometrics: from Classical Test Theory to Item Response Theory

No século XX, o desenvolvimento e avaliação das propriedades psicométricas dos testes se embasou principalmente na Teoria Clássica dos Testes (TCT). Muitos testes são longos e redundantes, com medidas influenciáveis pelas características da amostra dos indivíduos avaliados durante seu desenvolvimento, sendo algumas destas limitações consequências do uso da TCT. A Teoria de Resposta ao Item (TRI) surgiu como uma possível solução para algumas limitações da TCT, melhorando a qualidade da avaliação da estrutura dos testes. Neste texto comparamos criticamente as características da TCT e da TRI como métodos para avaliação das propriedades psicométricas dos testes. São discutidas as vantagens e limitações de cada método...

In the 20th century, development and evaluation of psychometric properties of tests was mainly based on the Classical Test Theory (CTT). Many tests are long and redundant, with measures influenced by the characteristics of the sample of the individuals being evaluated. Some of the limitations are a consequence of the use of the CTT. The Item Response Theory (IRT) has been proposed as a solution to some limitations of the CTT, improving the quality of assessment of the tests structure. In this paper we critically compare the characteristics of CTT and IRT methods in determining the psychometric properties of tests. We discuss the advantages and limitations of each method...

Behavioral sensitization to ethanol results in cross-sensitization to MK-801 but not to NMDA administered intra-accumbens.

In mice, repeated ethanol administration may induce behavioral sensitization - a process of progressive potentiation of its stimulant effects, associated with neuroadaptations in the brain reward system. Few studies have directly investigated the subsequent neuroadaptations in the nucleus accumbens (NAc), the central area of the brain reward system, after chronic ethanol administration. The goal of the present study was to analyze the involvement of accumbal glutamate NMDA receptors in the locomotion behavioral response to an NMDA agonist or to an NMDA antagonist in mice previously treated with ethanol. Swiss Albino mice received repeated daily administrations of 2.2 g/kg ethanol or saline for 21 days. According to their locomotor response on the last day of treatment, ethanol-treated mice were classified into sensitized or non-sensitized groups. They were then submitted to a surgical procedure to implement intra-NAc cannulae. After recovery, mice were challenged with intra-NAc administration of saline and, two days later, with NMDA (NMDA agonist) or MK-801 (NMDA antagonist), having their locomotor activity recorded for 1 h. The administration of NMDA induced similar locomotor behavior in all groups. On the other hand, the administration of 3 µg/side MK-801 induced a significant stimulant effect which was more prominent during the first 15 min in the sensitized group than in the non-sensitized or saline groups. Despite no effect of the agonist administration, only in sensitized mice did we observe cross-sensitization between repeated ethanol treatment and the intra-NAc administration of MK-801.