Disaggregating within- and between-person associations to test the aversive transmission of alcohol use in late adolescence through adulthood.

OBJECTIVE: The theory of aversive transmission posits that children of parents who have an alcohol use disorder (AUD) may abstain or limit their own alcohol use because they believe themselves to be at risk of developing problems with alcohol. The present study examined relationships among parental AUD, perceived parental AUD, perceived risk for AUD, addiction avoidance reasons for limiting alcohol use, and alcohol use using a random intercept cross-lagged panel model. METHOD: Participants (N = 805; 48% female; 28% Latinx) were from a longitudinal study investigating intergenerational transmission of AUD. Parental AUD, perceived parental AUD, perceived risk for AUD, addiction avoidance reasons for limiting alcohol use, and alcohol use (quantity, frequency, and frequency of heavy drinking) were measured every 5 years from late adolescence (Mage = 20) to adulthood (Mage = 32). Random intercept cross-lagged panel models tested whether there were stable between-person relations or time-varying within-person relations among these variables. RESULTS: At the between-person level, perceived parental AUD predicted greater addiction avoidance reasons for limiting alcohol use and greater perceived risk. Those with greater addiction avoidance reasons for limiting alcohol use were less likely to use any alcohol and drank less frequently. Parental AUD was associated with higher levels of alcohol use as well as perceived risk. No consistent cross-lagged paths were found at the within-person level. CONCLUSIONS: Study findings were at the between-person level rather than the within-person level. Future work on aversive transmission is needed to better understand this subgroup of children of parents with AUD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Event-level risk for negative alcohol consequences in emerging adults: The role of affect, motivation, and context.

OBJECTIVE: Decades of research has found support for the motivational model of alcohol use at the between-person level, yet research on event-level drinking motives is in its nascent stage. Similarly, drinking context has been largely ignored in studies of day-level motives. Therefore, the present study sought to test whether drinking context mediates the relation between affect and motivation on drinking outcomes at both day and person levels. METHOD: Emerging adults who drank in solitary and social settings (N = 107; 61.2% female) completed 21 days ecological momentary assessments. Affect was assessed during morning/afternoon reports; drinking motives were assessed during afternoon reports; and past-night drinking context, drinking quantity, and negative consequences were assessed during next morning reports. Two-level multilevel structural equation models tested whether within-person and between-person levels of predrinking affect were indirectly associated with negative consequences through predrinking motives, drinking context (social vs. solitary), and drinking quantity. RESULTS: At the day and person levels, positive affect was associated with higher social and enhancement motives. At the day level, positive affect indirectly predicted consequences through social motives, social (vs. solitary) drinking, and drinking quantity, whereas positive affect indirectly predicted consequences through enhancement motives and drinking quantity above and beyond context. At the day and person levels, negative affect was associated with coping motives, but coping was not associated with context, drinking quantity, nor consequences. CONCLUSIONS: Findings suggest that positive affect was linked to drinking outcomes through motives (enhancement and social) and contexts (social), whereas negative affect was not. Findings suggest that positively valenced drinking motives may be an important just-in-time intervention target. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Do Subjective Effects from Alcohol and Cannabis Predict Simultaneous Use During a Decision-Making Task?

Background: Simultaneous alcohol and cannabis use is associated with negative outcomes, yet little is known about what motivates the decision of simultaneous use. One possibility is that early-episode subjective effects motivate simultaneous use to complement or replace the first substance's effects. The current study used a hypothetical decision-making task to test this hypothesis. Objectives: College students (N = 486) were presented eight scenarios characterized by alcohol/cannabis subjective effects (i.e., high/low arousal positive [e.g., excited, relaxed], high/low arousal negative [e.g., aggressive, dizzy]) and asked their likelihood of simultaneously using the other substance per scenario. Multilevel modeling tested whether subjective effect scenarios predicted a higher likelihood of simultaneous use and whether ordering moderated this association. Results: Task-based simultaneous use likelihood was associated with self-reported simultaneous use, showing task validity. Scenarios characterized by high/low arousal positive effects were associated with higher likelihood of simultaneous use, whereas high/low arousal negative scenarios were associated with lower likelihood. Alcohol vs. cannabis-first scenarios were associated with higher likelihood of simultaneous use, and significant interactions were observed for high/low arousal positive and high arousal negative effects. High arousal positive scenarios were associated with higher likelihood of simultaneous use when cannabis was used first, low arousal positive scenarios with higher likelihood when alcohol was used first, and high arousal negative scenarios with lower likelihood when cannabis was used first. Conclusions: Beginning-of-episode subjective substance effects may be a promising event-level predictor of simultaneous use, and just-in-time interventions may benefit from targeting the ordering and subjective experiences of alcohol and cannabis use.

Differentiating action from inaction: Longitudinal relations among impulsive personality traits, internalizing symptoms, and drinking behavior.

BACKGROUND: Impulsive personality traits are strong, consistent risk factors for heavy drinking, and modern theories suggest that impulsive traits may also confer risk for internalizing symptoms. However, it remains unclear which specific impulsive traits are linked with heavy drinking versus internalizing symptoms, and whether heavy drinking and internalizing symptoms are mechanisms of risk for negative alcohol consequences in impulsive individuals. METHOD: Data are from a longitudinal study of young adults (N = 448, Mage = 22.27, 43.5 % female) assessed at baseline (T1), 6 months (T2), and one year later (T3). Longitudinal path models tested whether T1 impulsive traits (i.e., lack of premeditation, lack of perseverance, sensation seeking, positive urgency, negative urgency) were indirectly associated with T3 negative alcohol consequences through heavy T2 drinking and T2 internalizing symptoms (i.e., depression, anxiety, stress). Separate models were tested for positive and negative urgency given strong correlations between these measures. RESULTS: Across models, T1 lack of premeditation indirectly predicted more T3 negative alcohol consequences through heavy T2 drinking. When tested separately, T1 negative urgency indirectly predicted more T3 negative consequences through higher T2 stress and depressive (but not anxiety) symptoms, and T1 positive urgency predicted higher T2 anxiety symptoms, but T2 anxiety was unrelated to T3 negative consequences. Across models, T1 sensation seeking indirectly predicted less T3 negative consequences through decreased T2 depression. CONCLUSIONS: Distinct impulsive traits prospectively predicted heavy drinking and internalizing symptoms, both of which conferred risk for negative alcohol consequences. Findings underscore the importance of targeted interventions based on personality and suggest that decreases in drinking may be more effective prevention for those who lack premeditation, whereas decreases in internalizing, particularly depression/stress, may be critical for those high in negative urgency.

Modeling momentary reciprocal associations between negative affect and craving for alcohol and cannabis using dynamic structural equation modeling.

OBJECTIVE: Negative reinforcement models suggest that negative affect should predict event-level substance use, however, supporting daily-life evidence is lacking. One reason may be an emphasis in ecological momentary assessment (EMA) research on use behavior, which is subject to contextual and societal constraints that other substance outcomes, such as craving, may not be subject to. Therefore, the present study tested momentary, within-person reciprocal relations among negative affect and craving for alcohol and cannabis in daily life. METHOD: Adults (N = 48) completed 60 days of EMA, consisting of four daily reports spanning 7 a.m.-11 p.m. assessing current negative affect and alcohol/cannabis craving. Preregistered analyses used dynamic structural equation modeling to test whether (a) within-person increases in negative affect co-occurred with within-person increases in alcohol and cannabis craving, and (b) within-person increases in negative affect predicted later within-person increases in craving (and vice versa), and (c) relations differed by substance use frequency. RESULTS: Within-person increases in negative affect were contemporaneously associated with within-person increases in alcohol and cannabis craving. However, increases in negative affect did not prospectively predict increases in craving, and within-person increases in craving did not prospectively predict within-person increases in negative affect. Within-person relations were not moderated by substance use frequency. CONCLUSIONS: Negative affect and craving were associated in community adults. However, results advance a growing body of EMA work suggesting that the association of daily-life negative affect and substance use is, at best, not straightforward. Careful attention is needed to better translate existing negative reinforcement theory to the realities of daily life. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Too Tired to Think: Within and Between-Person Relations Among Impulsive Traits, Sleep Duration, and Mental Health Outcomes.

Heavier drinking and depression are common mental health concerns in the USA, yet few studies have sought to understand transdiagnostic risk factors for both. Two health-focused risk factors are impulsive personality traits and sleep duration, but research typically separates the two, precluding additive and interactive relations. The current study sought to test a theoretical model where risk conferred from impulsive traits is heightened when individuals have reduced sleep. Public-access data from the National Longitudinal Study on Adolescent to Adult Health (Add Health) were used to test study hypotheses. Participants reported on impulsive traits (i.e., lack of premeditation, sensation seeking), sleep duration, depression, and drinking across three waves spanning adolescence, emerging adulthood, and adulthood. Multilevel models distinguished risk processes at the between- vs. within-person level. At the between-person level, sensation seeking predicted drinking whereas premeditation predicted depression. Additionally, within-person deviations in both traits were associated with drinking, whereas within-person deviations in premeditation were associated with depression. Sleep duration was protective against outcomes at both levels. However, main effects were qualified by interactions at both levels, such that having below average sleep duration heightened the effects of premeditation at the between-person level, whereas within-person decreases in sleep heightened the effects of sensation seeking at the within-person level. Findings support a theoretical model where poor sleep exacerbates risk conferred from impulsive traits. Risk conferred from impulsive traits diverged based upon level of analysis, suggesting that global and just-in-time interventions may benefit from targeting specific impulsive traits as well as sleep.

Longitudinal Relations Among Parental Substance Use Disorder and Adolescent Drinking Behavior: The Role of Temperament, Negative Urgency, and Maternal Parenting.

Research suggests that parental substance use disorder is associated with adolescent drinking indirectly through negative urgency, a form of impulsivity that is particularly associated with high-risk drinking. Moreover, childhood mechanisms of risk may play a role in this developmental chain such that childhood temperament and parenting may be mechanisms through which parental substance use disorder is associated with adolescent negative urgency and drinking behavior. Therefore, the current study tested whether parental substance use disorder was indirectly associated with adolescent drinking frequency through childhood temperament (i.e., "dysregulated irritability") and adolescent negative urgency, and whether relations differed by levels of maternal support and consistency of discipline. Data come from a multigenerational, longitudinal study of familial substance use disorder (N = 276, Mage in childhood = 6.28 (SD = 1.16), Mage in adolescence = 15.86 (SD = 1.56), 45.3% female). Findings indicated that parental substance use disorder indirectly predicted adolescent drinking through both childhood dysregulated irritability and adolescent negative urgency (mediated pathways). This indirect relation was stronger at higher vs. lower levels of maternal support but did not vary by maternal consistency of discipline. Parental substance use disorder also indirectly predicted adolescent drinking separately through childhood dysregulated irritability and negative urgency. Findings thus suggest that childhood dysregulated irritability may be an early marker of risk toward high-risk personality traits and behavior in adolescence that are associated with having a parental history of substance use disorder. Findings also suggest that increased maternal support may only be helpful in buffering risk for those with low levels of dysregulated irritability. Prevention efforts focused on childhood emotion regulation and emotion-based action may be useful in preventing adolescent risk behavior.

Parent-child separation and intergenerational transmission of substance use and disorder: Testing across three generations.

There is evidence for intergenerational transmission of substance use and disorder. However, it is unclear whether separation from a parent with substance use disorder (SUD) moderates intergenerational transmission, and no studies have tested this question across three generations. In a three-generation study of families oversampled for familial SUD, we tested whether separation between father (G1; first generation) and child (G2; second generation) moderated the effect of G1 father SUDs on G2 child SUDs. We also tested whether separation between father (G2) and child (G3; third generation) moderated the effect of G2 SUDs on G3 drinking. Finally, we tested whether G1-G2 or G2-G3 separation moderated the mediated effect of G1 SUDs on G3 drinking through G2 SUDs. G1 father-G2 child separation moderated intergenerational transmission. In families with G1-G2 separation, there were no significant effects of father SUD on G2 SUD or G3 drinking. However, in nonseparated families, greater G1 father SUDs predicted heightened G2 SUDs and G3 grandchild drinking. In nonseparated families, G1 father SUDs significantly predicted G2 SUDs, which predicted G3 drinking. However, G2-G3 separation predicted heightened G3 drinking regardless of G2 and G1 SUDs. Parental separation may introduce risk for SUDs and drinking among youth with lower familial risk.

Daily Relations Among Alcohol and Cannabis Co-Use, Simultaneous Use, and Negative Consequences: A Day-Level Latent Profile Analysis.

Objective: Concurrent and simultaneous cannabis and alcohol co-use confers risk for daily negative alcohol consequences. However, studies often treat co-use as a dichotomy, precluding examination of higher- and lower-risk co-use days. Additionally, little is known about specific alcohol consequences associated with daily co-use. Therefore, the current study 1) differentiated days based upon alcohol consumption, co-use, and simultaneous use, and 2) tested whether certain day-level use patterns conferred risk for daily alcohol consequences. Methods: College student co-users (N=489) completed an online Timeline Followback, reporting daily alcohol consumption, negative alcohol consequences, concurrent cannabis and alcohol co-use, and simultaneous co-use (SAM) on drinking days over the past month. Day-Level Latent Profile Analysis differentiated days based upon drinking quantity, co-use, and simultaneous use, and tested whether patterns of use conferred risk for overall and specific negative alcohol consequences. Results: Four day-level profiles emerged, including moderate consumption of alcohol-only days (57.5%), moderate consumption SAM use days (29.1%), higher consumption alcohol-only days (7.4%), and higher consumption SAM use days (6%). Higher consumption SAM use days were associated with more negative alcohol consequences than all other days; however, higher consumption SAM use days differed from higher consumption alcohol-only days in acute dependence symptoms. Higher consumption alcohol-only days were associated with more negative alcohol consequences than moderate consumption SAM days, particularly those that were action-oriented (i.e., dependence symptoms, blackout drinking, impaired control, risky behavior, social/interpersonal consequences). Conclusions: Findings suggest that there are in fact lower-risk co-use days, and that links with unique negative alcohol consequences depend on levels of alcohol consumption and co-use.

Pregaming potentiates risk between UPPS-P impulsivity and day-level drinking behavior: A test of person-environment transactions theory.

Pregaming represents a uniquely high-risk drinking event for young adults, and subfacets of impulsivity are robust predictors of alcohol use and related negative outcomes. Further, it is likely that pregame events contain social and physical stimuli that are particularly appealing for impulsive individuals, thus exacerbating risk for negative outcomes. However, no prior studies have investigated the extent to which impulsive personality traits interact with pregame events to confer alcohol-related risk. Thus, the present study examined the extent to which UPPS-P (urgency-perseverance-premeditation-sensation seeking-positive urgency) subfacets of impulsivity interact with the occurrence of pregaming to predict relations between pregaming, drinking quantity, and negative alcohol-related outcomes. College students (N = 737) completed a modified, online version of the 30-day Timeline Followback in which they reported drinking quantity, negative consequences, and whether they engaged in pregaming on a given day. Results indicated that sensation seeking and a lack of premeditation moderated relations between pregaming and drinking quantity such that those who are higher in sensation seeking and lower in their ability to plan ahead drank more on pregaming days. Sensation seeking and positive urgency moderated relations between pregaming and negative consequences such that those who are higher in positive urgency experience more consequences on pregaming days whereas those who are higher in sensation seeking experience less consequences. Future studies may benefit from more granular assessments of pregame-related risk as subfacets of impulsivity may confer momentary risk. Prevention efforts targeting the reduction of pregaming frequency, particularly among impulsive individuals, may lower overall risk for heavy drinking. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Indirect Associations between Impulsivity and Alcohol Outcomes through Motives for Drinking Responsibly among U.S. College Students: An Integration of Self-Determination Theory and the Acquired Preparedness Model.

The aim of the present study was to conduct a preliminary investigation of the associations between facets of impulsivity and alcohol outcomes through motives for drinking responsibly described by self-determination theory among college students. Participants (N=2,808) were part of a multisite investigation of college student drinking across 10 universities in 8 states in the U.S. who reported past-month drinking. Results of a structural equation model testing all possible indirect associations simultaneously indicated that one-third (20 out of 60) of the indirect associations were statistically significant (p<.01). Facets with higher scores representing higher impulsivity (negative/positive urgency) were negatively associated with more internalized motives (autonomous motivation and introjected regulation) and positively associated with less internalized motives (external regulation and amotivation) for drinking responsibly. Facets with higher scores representing lower impulsivity (perseverance and premeditation) demonstrated opposite patterns of associations with motives for drinking responsibly. In turn, more internalized motives were related to higher frequency of protective behavioral strategies use, lower alcohol use severity, and fewer negative alcohol-related consequences; less internalized motives demonstrated an opposite pattern of associations with these alcohol outcomes. The present findings should be replicated using experimental and longitudinal studies for appropriately testing mediation but offer support for a novel hypothesis for motivational pathways from impulsivity to alcohol outcomes that may provide insight into intervention targets.

Cannabis use in context: Relations among impulsive personality traits, context, and cannabis problems.

INTRODUCTION: Impulsive personality traits are associated with cannabis problems. Person-Environment Transactions Theory suggests that highly impulsive individuals behave differently in certain contexts, however little research has focused on the context in which cannabis is used. Therefore, the current study tested whether impulsive traits moderated relations between cannabis use contexts (social vs. solitary) and cannabis problems. METHOD: In this cross-sectional study, college student who use cannabis (N = 435; 60.7% female) reported on their impulsive traits (i.e., negative urgency, positive urgency, premeditation, perseverance, and sensation seeking), typical cannabis use context (i.e., alone, with friends), typical cannabis use frequency, and past 30-day cannabis problems. RESULTS: Both solitary cannabis use and negative urgency were associated with more cannabis problems. There were significant interactions between negative urgency and solitary cannabis use and lack of perseverance and solitary cannabis use, such that high and mean (but not low) levels of both negative urgency and lack of perseverance were associated with more cannabis problems the more frequently an individual used cannabis alone. There was also a significant interaction between sensation seeking and social cannabis use, such that high and mean (but not low) levels of sensation seeking were associated with cannabis problems for individuals who used cannabis more socially. CONCLUSIONS: Findings suggest that impulsivity may potentiate risk for cannabis problems depending on the context in which cannabis is used. Prevention efforts may benefit from targeting protective strategy use in certain cannabis use contexts based upon an individual's personality traits.

Relations Among Adolescent Alcohol and Cannabis Co-Use, Adolescent Impulsive Traits, and Prospective Change in Impulsive Traits into Emerging Adulthood.

Models of personality suggest that adolescent substance use may be associated with adolescent impulsive traits as well as changes in impulsive traits from adolescence into emerging adulthood. However, little research has focused on how adolescent alcohol and cannabis co-use, an increasingly popular and risky substance use pattern, may relate to adolescent impulsive traits as well as changes in impulsive traits from adolescence to emerging adulthood. Therefore, the current study tested patterns of adolescent co-use and their links with adolescent impulsive traits and changes in impulsive traits into emerging adulthood. Data come from the Add Health study and encompassed two timepoints spanning adolescence (age 13-18) and emerging adulthood (age 19-25). A combination of latent profile analysis, mean comparisons, and latent difference scores were estimated. Results suggested that four profiles of co-users and alcohol-only users emerged, and profiles differed in levels of adolescent personality and prospective personality change. Importantly, frequent adolescent co-users had higher levels of adolescent sensation seeking and impulsivity, but also reported the steepest decline in both traits into emerging adulthood. Findings are discussed in terms of personality theory and public health implications.

Dynamic relations among simultaneous alcohol and cannabis use, subjective responses, and problem drinking during naturally occurring drinking episodes.

BACKGROUND: Simultaneous alcohol and cannabis use (SAM) is associated with riskier drinking. However, little is known regarding mechanisms of risk during drinking episodes. The current study tested whether subjective responses to simultaneous vs. alcohol-only use (i.e., high arousal positive/reward, high arousal negative/aggression, low arousal positive/relaxation, low arousal negative/impairment) were mechanisms through which SAM use was associated with daily drinking. METHODS: Emerging adults who co-use alcohol and cannabis (N=85) completed 21 days of ecological momentary assessment with drink-contingent reports during drinking episodes. Participants reported on their simultaneous use and current subjective effects during drink reports and past-night total drinks consumed and negative consequences experienced the next morning. Three-level multilevel models (momentary, daily, person level) tested whether SAM use predicted subjective responses, and whether subjective responses mediated associations between SAM use, heavier drinking and negative consequences. RESULTS: At the momentary and day-level, SAM (vs. alcohol-only) use predicted increased high arousal positive/rewarding, low arousal positive/relaxing, and low arousal negative/impairing subjective effects. SAM use indirectly predicted heavier day-level drinking and further negative consequences through high arousal positive/rewarding response. SAM use also indirectly predicted day-level negative consequences through low arousal negative/impairing response. At the person-level, more frequent SAM use predicted higher person-average high arousal positive/rewarding and low arousal positive/relaxing responses, and high arousal positive/rewarding response mediated relation between SAM frequency and heavier drinking. CONCLUSIONS: Simultaneous use was associated with reward, relief, and impairment, and reward and impairment were mechanisms of risk between SAM use and riskier drinking. Findings may inform theory and just-in-time interventions seeking to reduce alcohol misuse.

Disentangling between- and within-person alcohol and expectancy effects on acute alcohol craving.

OBJECTIVE: Alcohol craving is a predictor of continued drinking and a diagnostic criterion for alcohol use disorder. Rewarding subjective effects potentiate craving, but it remains unclear if relations are expectancy-driven vs. alcohol-induced. In addition, it remains unclear if relations operate solely at the person level, or if there is also within-person dynamic change. METHODS: Participants (N = 448) come from a placebo-controlled alcohol administration study. Participants in the alcohol condition reported subjective effects and alcohol craving on ascending (BAC = .068), peak (BAC = .079), and descending (BAC = .066) BAC limbs. Participants in the placebo condition were yoked to alcohol condition participants. Multilevel models tested whether (1) within-person deviations in subjective effects predicted within-person deviations in craving, (2) between-person levels of subjective effects predicted between-person levels of craving, and (3) effects were dependent upon experimental condition. RESULTS: At the within-person level, increases in high arousal positive/stimulant effects were associated with within-person increases in alcohol craving, regardless of experimental condition. At the between-person level, interactions were observed between high arousal positive/stimulant (and low arousal positive/relaxing) effects and condition. Probing suggested that the association between person-level high arousal positive/stimulant effects and craving was statistically significant in the alcohol but not the placebo condition. Conversely, the association between person-level low arousal positive/relaxing effects and craving was positive and statistically significant in the placebo but negative in the alcohol condition. CONCLUSIONS: Findings suggest expectancy-like relations among high arousal positive/stimulant effects and craving within-person. However, alcohol-induced positive reinforcement (i.e., stimulation) facilitated heightened person-level craving, whereas expectancy-like negative reinforcement (i.e., relaxation) attenuated person-level craving.

Multilevel longitudinal relations among impulsive traits, positive expectancies, and binge drinking from late adolescence to adulthood: A developmental test of acquired preparedness.

BACKGROUND: The Acquired Preparedness Model (APM) posits that highly impulsive individuals develop stronger positive alcohol expectancies, which in turn predicts heavier drinking. However, most acquired preparedness studies have focused solely on between-person relations, despite the theory suggesting that there are potential developmental-specific within-person relations. Thus, the current study tested the APM from late adolescence into adulthood, while disaggregating within- from between-person relations. METHODS: Data come from a multigenerational study of familial alcohol use disorder (N=653) spanning three waves 5 years apart. Participants reported their lack of conscientiousness, sensation seeking, positive alcohol expectancies, and binge drinking at each wave. First, missing data techniques were used to create a "ghost timepoint," allowing the specification of four developmental-specific timepoints representing late adolescence (age 18 to 20), emerging adulthood (age 21 to 25), young adulthood (age 26 to 29), and adulthood (age 30 to 39). Second, a Random-Intercept Cross-Lagged Panel Model tested between-person and within-person relations among variables. RESULTS: At the between-person level, lower conscientiousness and sensation seeking were correlated with higher positive expectancies, and positive expectancies were correlated with more binge drinking. There were no within-person prospective relations among conscientiousness, sensation seeking, and positive expectancies. However, within-person increases in lack of conscientiousness during late adolescence predicted within-person increases in emerging adult binge drinking, and within-person increases in late adolescent and emerging adult binge drinking predicted within-person increases in lack of conscientiousness during emerging and young adulthood, respectively. Similarly, within-person increases in late adolescent and young adult sensation seeking predicted within-person increases in binge drinking during emerging adulthood and adulthood, respectively. Binge drinking did not reciprocally predict sensation seeking. CONCLUSIONS: Findings suggest that acquired preparedness effects may be between persons rather than within persons. However, several within-person developmental-specific relations among conscientiousness, sensation seeking, and binge drinking were observed, outside of expectancies. Findings are discussed in terms of theory and prevention.

A preliminary investigation of salivary α-amylase as a novel biomarker of subjective response to alcohol: A brief report.

Alcohol misuse represents a universal public health concern that spans multiple demographics. As such, understanding shared, biological indicators of alcohol-related risk is vital to implementing targeted prevention and intervention efforts. Self-report measures of subjective response to alcohol (SR) capture both psychological and pharmacological effects of alcohol and robustly predict patterns of alcohol use, negative consequences, and the development of alcohol use disorders. Importantly, several biological markers of alcohol's sedating effects, including cortisol, have been identified and complement subjective response assessments. However, biological markers of alcohol's stimulating effects are less understood. Studies have implicated alcohol-induced changes in heart rate as a viable marker, but heart rate measurements are susceptible to measurement error. Salivary α-amylase, a reliable indicator of sympathetic nervous system activation, represents a promising alternative biomarker of alcohol-induced stimulation. Using data from a large, placebo-controlled alcohol administration study (N = 448), the present study examined the extent to which α-amylase is a viable marker of alcohol-induced stimulation. To test this, a measurement model was estimated in which baseline and ascending limb subjective stimulation latent variables were created using two validated measures of subjective response. Ascending self-reports of stimulation and levels of α-amylase were then regressed onto beverage conditions and allowed to correlate with each other. Findings indicated that α-amylase is sensitive to acute alcohol consumption and is positively, but not statistically reliably, related to the ascending limb stimulant SR. Future studies should consider including salivary α-amylase as a noninvasive physiological indicator of alcohol's stimulating effects. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Subjective effects of simultaneous alcohol and cannabis versus alcohol-only use: A qualitative analysis.

OBJECTIVE: Theoretical models of addictive behavior suggest that subjective effects serve as a mechanism through which substance use disorders develop. However, little is known about the subjective effects of simultaneous alcohol and cannabis use, particularly whether simultaneous use (a) heightens specific subjective effects or (b) is related to unique subjective effects relative to single-substance effects. The present study used formative, qualitative data analysis to examine patterns of responses within open-answer text response data on subjective effects of simultaneous use. METHOD: College students who simultaneously use alcohol and cannabis (N = 443; 68.2% female) were asked to describe how alcohol effects differ on simultaneous alcohol and cannabis use versus alcohol-only use days. RESULTS: Conventional content analysis revealed nine concepts related to simultaneous (vs. alcohol-only) use subjective effects including as follows: (a) increased/decreased impairment, (b) low arousal/relaxation, (c) balancing/replacement effects, (d) "cross-faded" effects, (e) little-to-no differences, (f) altered sensation and perception, (g) increased negative affective states, (h) increased appetite, and (i) increased/decreased negative consequences. Increased impairment (N = 191) and increased relaxation (N = 110) were the most often endorsed subjective effects, followed by decreased impairment (N = 55), balancing/replacement effects (N = 50) and cross-faded/enhancement effects (N = 44). CONCLUSIONS: Subjective effects from simultaneous use largely map onto domains of single-substance alcohol and cannabis effects (e.g., relaxation, sociability, cognitive/behavioral impairment), but also include distinct domains related to simultaneous use (e.g., balancing/replacement effects, altered sensation and perception). Future quantitative research is needed to validate measures of subjective effects from simultaneous use and their relations with use behavior. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The effects of the 4/20 cannabis holiday and adult-use cannabis legalization on medical cannabis sales and medical cannabis patient registration in Arizona.

BACKGROUND: This study examined whether the 4/20 cannabis holiday was associated with increases in medical cannabis sales from licensed dispensaries in Arizona from 2018-2021, and whether adult-use cannabis legalization (the vote in November 2020 and retail sales in January 2021) was associated with declines in medical cannabis sales and in the number of registered medical patients. METHODS: Data came from the Arizona Medical Marijuana Program monthly reports from January 2018-December 2021. The reports show daily sales from licensed medical cannabis dispensaries (i.e., the number of medical cannabis dispensary transactions and the amount of cannabis sold in pounds), which we averaged by week, and show the number of registered medical cannabis patients each month. Autoregressive integrated moving average models were used to test changes in these outcomes associated with the 4/20 cannabis holiday and with legalization of adult-use cannabis. RESULTS: During the week of the 4/20 cannabis holiday, medical cannabis dispensary transactions abruptly increased by an average of 2,319.4 transactions each day (95% CI: 1636.1, 3002.7), and the amount of medical cannabis sold increased by an average of 120.3 pounds each day (95% CI: 99.3-141.3). During the first week of adult-use cannabis sales in late January 2021, medical cannabis dispensary transactions abruptly decreased by an average of 5,073 transactions each day (95% CI: -5,929.5, -4216.7), and the amount of medical cannabis sold decreased by an average of 119.1 pounds each day (95% CI: -144.2, -94.0). Moreover, medical cannabis sales continued to gradually decline each week after the start of adult-use retail sales, with declines in sales preceding declines in registered patients. By December 2021, slightly over a year after the vote to legalize adult-use cannabis, the actual number of registered medical cannabis patients fell short of the forecasted number, had adult-use not been legalized, by 36.5%. Moreover, the number of medical dispensary transactions and the amount of medical cannabis sold fell short of expectations, had adult-use cannabis not been legalized, by 58% and 53%, respectively. CONCLUSIONS: Findings document the blurred boundary between medical and non-medical cannabis use and are consistent with the possibility that medical cannabis legalization contributes to increases in adult cannabis use and dependence.

An Ecological Examination of Indica Versus Sativa and Primary Terpenes on the Subjective Effects of Smoked Cannabis: A Preliminary Investigation.

Background: The legal cannabis landscape has greatly outpaced scientific knowledge. Many popular cannabis claims, such as cultivar (colloquially referred to as strain) classification and terpene content producing different subjective effects, are unsubstantiated. This study examined, for the first time, whether cultivar classification (sativa/indica) and terpene content (caryophyllene, limonene, myrcene, pinene, and terpinolene) were associated with subjective cannabis effects (i.e., pain levels, low-arousal ["indica-like"] effects, high-arousal ["sativa-like"] effects, and negative effects). Methods: Regular cannabis users (n=101) took part in a 2-week long ecological momentary assessment study in which they responded to questions about their cannabis use, stated their preference for sativa versus indica, and reported their in-the-moment subjective effects within 30 min of smoking cannabis. Cultivars were coded for sativa versus indica classification and primary terpene content using Leafly, a popular search engine. Linear mixed-effect models then examined subjective response by sativa/indica and primary terpene. Covariates included demographics (age, sex, race, income), cannabis use (medical use, cannabis use frequency, stated preference for sativa/indica, global expected cannabis effects), morning pain ratings, and specific smoked cannabis occasions (hour of day, minutes since use, context, number of hits, and tetrahydrocannabinol). Results: The majority of participants (78.3%) had a preference for either sativa or indica and reported reasons for their preference that aligned with industry claims. After controlling for covariates, findings revealed that cultivars classified as indica dominant were associated with greater low-arousal (e.g., sluggish, slow) effects relative to the unweighted mean of all cannabis cultivars (b = 0.44, SE=0.16, p=0.01). Cultivars with primary caryophyllene were associated with greater pain ratings (b = 0.53, SE=0.24, p=0.03) and negative effects (b = 0.22, SE=0.08, p=0.01) relative to the mean of all other terpene types. Cultivars with primary pinene were associated with less negative effects (b = -0.35, SE=0.18, p=0.04). Conclusions: Cultivars classified as indica dominant were associated with greater low-arousal effects in models that accounted for both within- and between-person variation, despite the scientific challenges distinguishing between sativa and indica. Preliminary findings also suggest terpenes may play a role in subjective effects. These results emphasize the need for further research, particularly controlled lab studies.