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1.
J Consult Clin Psychol ; 89(8): 707-716, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34472897

RESUMO

Objective: Change talk has been proposed as a mechanism of change in motivational interviewing (MI) by mediating the link between MI technical skills and behavioral outcomes. We tested the influence of therapists' relational skills on this mediation model. Method: Secondary analysis of a randomized controlled trial of individual brief MI for heavy drinking among 20-year-old-Swiss young men, where the MI group (n = 179) significantly reduced drinking compared to an assessment-only control. We coded MI sessions and derived: therapists' MI technical skills, clients' change talk (CT) and sustain talk (ST), and global relational ratings (empathy and MI spirit). We tested moderated mediation models with technical skills as the independent variable, CT and ST as parallel mediators, predicting drinking at 3-month follow-up (controlling for baseline drinking), and relational skills as moderators of the path from technical skills to client mediators. Results: Conditional indirect effects were significant for overall MI technical skills, open questions, and simple reflections (i.e., more of these behaviors related to more ST, which was related to more drinking) when relational skills were low. In contrast, there was a significant conditional indirect effect for complex reflections when relational skills were high (i.e., more complex reflections related to less ST). Conclusions: This study provides partial support for the MI technical and relational process models. Interestingly, support was found regarding the negative side of client ambivalence (ST) in this highly precontemplative sample. Accordingly, MI therapists should work cautiously with ST when clients are at early stages of motivational readiness. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/terapia , Alcoolismo/psicologia , Alcoolismo/terapia , Análise de Mediação , Entrevista Motivacional , Consumo de Bebidas Alcoólicas/prevenção & controle , Alcoolismo/prevenção & controle , Empatia , Humanos , Masculino , Motivação , Suíça , Adulto Jovem
3.
Nutrients ; 13(9)2021 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-34579051

RESUMO

(1) Introduction: The university period may increase the risk of different unhealthy habits, such as low adherence to the Mediterranean diet, high alcohol consumption and eating in response to specific emotions. The aim of this study was to detect early-risk alcohol consumption and alcohol dependence (ADS), the degree of adherence to the Mediterranean diet and emotional eating in university students of the Madrid community. (2) Methods: For each individual, anthropometric parameters, the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-Consumption (AUDIT-C), the Mediterranean Diet Adherence Screener (MEDAS) and the Emotional Eater Questionnaire (EEQ) were assessed. (3) Results: A total of 584 university students aged 20.5 (sex ratio = 0.39) were enrolled in a cross-sectional study. In total, 63.6% of students showed low adherence to the Mediterranean diet, with no differences by sex (64.3% female versus 61.5% male, p = 0.19). According to the AUDIT questionnaire, 26.2% of participants were categorized as high-risk drinkers and 7.7% as ADS. About 38.6% of the students were categorized as eating very emotionally or eating emotionally, and 37.2% were categorized as low emotional eaters. A weak positive correlation was observed between the EEQ and BMI in female students (rho= 0.15, p = 0.03). (4) Conclusions: University students in our sample showed a low adherence to the Mediterranean diet, an important high-risk alcohol consumption and low emotional eating.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Dieta Mediterrânea , Comportamento Alimentar/psicologia , Estudantes/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Estudos Transversais , Dieta Mediterrânea/psicologia , Dieta Mediterrânea/estatística & dados numéricos , Emoções , Feminino , Humanos , Masculino , Espanha/epidemiologia , Estudantes/psicologia , Inquéritos e Questionários , Universidades , Adulto Jovem
4.
Nutrients ; 13(7)2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34371928

RESUMO

The "drunken monkey" hypothesis posits that attraction to ethanol derives from an evolutionary linkage among the sugars of ripe fruit, associated alcoholic fermentation by yeast, and ensuing consumption by human ancestors. First proposed in 2000, this concept has received increasing attention from the fields of animal sensory biology, primate foraging behavior, and molecular evolution. We undertook a review of English language citations subsequent to publication of the original paper and assessed research trends and future directions relative to natural dietary ethanol exposure in primates and other animals. Two major empirical themes emerge: attraction to and consumption of fermenting fruits (and nectar) by numerous vertebrates and invertebrates (e.g., Drosophila flies), and genomic evidence for natural selection consistent with sustained exposure to dietary ethanol in diverse taxa (including hominids and the genus Homo) over tens of millions of years. We also describe our current field studies in Uganda of ethanol content within fruits consumed by free-ranging chimpanzees, which suggest chronic low-level exposure to this psychoactive molecule in our closest living relatives.


Assuntos
Consumo de Bebidas Alcoólicas , Evolução Biológica , Exposição Dietética , Etanol/metabolismo , Fermentação , Frutas/microbiologia , Leveduras/metabolismo , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/metabolismo , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/metabolismo , Alcoolismo/psicologia , Animais , Exposição Dietética/efeitos adversos , Etanol/efeitos adversos , Comportamento Alimentar , Frutas/metabolismo , Humanos , Pan troglodytes
5.
Afr Health Sci ; 21(1): 123-131, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34394289

RESUMO

Background: Previous studies have associated certain risk factors with hazardous drinking in students. However, big cultural and geographical differences exist regarding alcohol use. Objectives: To determine whether or not there was a difference in hazardous drinking between Belgian and South African university students and to establish the risk factors that contribute to hazardous drinking in university students (calculated using the AUDIT-C) from a developing country (South Africa) and a developed country (Belgium). Methods: An online survey assessing hazardous drinking among university students in South Africa (University of KwaZulu-Natal, UKZN) and Belgium (University of Antwerp, UoA) was conducted, using the shortened version of the Alcohol Use Disorder Identification Test (AUDIT-C). Risk factors in males and females for hazardous drinking were explored using multivariate logistic regression analysis. Results: In total, 499 students were included in the study (250 UoA and 249 UKZN students). A significant higher amount of male (94.8%) as well as female (92.4%) UoA students drank alcohol in the last year compared to the male (66.2%) and female (67.8%) UKZN students (p<0.001). Additionally, a significant higher amount of UoA students were hazardous drinkers, compared to the UKZN students (p<0.001). Multivaiate analysis showed that male UoA students were almost 6 times more likely to be hazardous drinkers than male UKZN students (OR=5.611, p=0.005). Female UoA students were more than twice as likely to be hazardous drinkers than female UKZN students (OR=2.371, p=0.016). Conclusion: This study found a significant difference in hazardous drinking between Belgian and South African university students.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Estudantes/psicologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Bélgica/epidemiologia , Comparação Transcultural , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Risco , Fatores Sexuais , África do Sul/epidemiologia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Universidades , Adulto Jovem
6.
PLoS One ; 16(8): e0255626, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34339461

RESUMO

BACKGROUND: Alcohol use disorder (AUD) is a chronic disease with a higher recurrence rate than that of other mental illnesses. Moreover, it requires continuous outpatient treatment for the patient to maintain abstinence. However, with a low probability of these patients to continue outpatient treatment, predicting and managing patients who might discontinue treatment becomes necessary. Accordingly, we developed a machine learning (ML) algorithm to predict which the risk of patients dropping out of outpatient treatment schemes. METHODS: A total of 839 patients were selected out of 2,206 patients admitted for AUD in three hospitals under the Catholic Central Medical Center in Korea. We implemented six ML models-logistic regression, support vector machine, k-nearest neighbor, random forest, neural network, and AdaBoost-and compared the prediction performances thereof. RESULTS: Among the six models, AdaBoost was selected as the final model for recommended use owing to its area under the receiver operating characteristic curve (AUROC) of 0.72. The four variables affecting the prediction based on feature importance were the length of hospitalization, age, residential area, and diabetes. CONCLUSION: An ML algorithm was developed herein to predict the risk of patients with AUD in Korea discontinuing outpatient treatment. By testing and validating various machine learning models, we determined the best performing model, AdaBoost, as the final model for recommended use. Using this model, clinicians can manage patients with high risks of discontinuing treatment and establish patient-specific treatment strategies. Therefore, our model can potentially enable patients with AUD to successfully complete their treatments by identifying them before they can drop out.


Assuntos
Alcoolismo/epidemiologia , Algoritmos , Aprendizado de Máquina , Pacientes Ambulatoriais/psicologia , Medição de Risco/métodos , Adulto , Alcoolismo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Redes Neurais de Computação , Curva ROC , República da Coreia/epidemiologia , Estudos Retrospectivos , Adulto Jovem
7.
Sci Rep ; 11(1): 15583, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34341419

RESUMO

Cognitive reserve (CR) is the capability of an individual to cope with a brain pathology through compensatory mechanisms developed through cognitive stimulation by mental and physical activity. Recently, it has been suggested that CR has a protective role against the initiation of substance use, substance consumption patterns and cognitive decline and can improve responses to treatment. However, CR has never been linked to cognitive function and neurotrophic factors in the context of alcohol consumption. The present cross-sectional study aims to evaluate the association between CR (evaluated by educational level), cognitive impairment (assessed using a frontal and memory loss assessment battery) and circulating levels of brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) in patients with alcohol use disorder (AUD). Our results indicated that lower educational levels were accompanied by earlier onset of alcohol consumption and earlier development of alcohol dependence, as well as impaired frontal cognitive function. They also suggest that CR, NT-3 and BDNF may act as compensatory mechanisms for cognitive decline in the early stages of AUD, but not in later phases. These parameters allow the identification of patients with AUD who are at risk of cognitive deterioration and the implementation of personalized interventions to preserve cognitive function.


Assuntos
Alcoolismo/sangue , Fator Neurotrófico Derivado do Encéfalo/sangue , Disfunção Cognitiva/sangue , Escolaridade , Neurotrofina 3/sangue , Abstinência de Álcool/psicologia , Consumo de Bebidas Alcoólicas/sangue , Alcoolismo/psicologia , Disfunção Cognitiva/psicologia , Reserva Cognitiva , Comorbidade , Feminino , Humanos , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina/sangue , Fator de Crescimento Insulin-Like I/metabolismo , Fator de Crescimento Insulin-Like II/metabolismo , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Componente Principal , Curva ROC
8.
Nutrients ; 13(7)2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34202492

RESUMO

The classic ketogenic diet is a diet high in fat, low in carbohydrates, and well-adjusted proteins. The reduction in glucose levels induces changes in the body's metabolism, since the main energy source happens to be ketone bodies. Recent studies have suggested that nutritional interventions may modulate drug addiction. The present work aimed to study the potential effects of a classic ketogenic diet in modulating alcohol consumption and its rewarding effects. Two groups of adult male mice were employed in this study, one exposed to a standard diet (SD, n = 15) and the other to a ketogenic diet (KD, n = 16). When a ketotic state was stable for 7 days, animals were exposed to the oral self-administration paradigm to evaluate the reinforcing and motivating effects of ethanol. Rt-PCR analyses were performed evaluating dopamine, adenosine, CB1, and Oprm gene expression. Our results showed that animals in a ketotic state displayed an overall decrease in ethanol consumption without changes in their motivation to drink. Gene expression analyses point to several alterations in the dopamine, adenosine, and cannabinoid systems. Our results suggest that nutritional interventions may be a useful complementary tool in treating alcohol-use disorders.


Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Alcoolismo/dietoterapia , Dieta Cetogênica/psicologia , Ingestão de Alimentos/genética , Ingestão de Alimentos/psicologia , Adenosina/metabolismo , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Animais , Canabinoides/metabolismo , Modelos Animais de Doenças , Dopamina/metabolismo , Etanol , Expressão Gênica/fisiologia , Masculino , Camundongos , Motivação/genética
9.
Exp Clin Psychopharmacol ; 29(3): 261-271, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34264737

RESUMO

Two recent randomized controlled efficacy trials showed that harm-reduction treatment for alcohol use disorder (AUD)-or patient-driven treatment that does not require abstinence and instead supports decreased alcohol-related harm and improved quality of life (QoL)-is efficacious for adults experiencing homelessness and AUD. The present study provides qualitative and quantitative analysis of one component of harm-reduction treatment, participants' harm-reduction goal-setting, within these two trials. Aims of this secondary, dual-trial study (Trial 1 N = 208, Trial 2 N = 86) were to describe participant-generated harm-reduction goals and determine whether aspects of harm-reduction goal-setting predict treatment outcomes. Across both trials, qualitative findings indicated improving QoL, meeting basic needs, improving physical and mental health, and changing drinking behavior were participants' top four goals. Only 2%-6% of goals centered on attaining alcohol abstinence. Regarding quantitative findings, Trial 1 showed statistically significant increases in goals generation over the course of treatment, while proportion of achieved goals stayed constant. In Trial 2, number of goals generated remained constant, while proportion of goals achieved increased. Trial 2 findings showed greater goal generation over time was associated with better physical health-related QoL, and drinking-related goals predicted improved alcohol outcomes. Overall, this secondary, dual-trial study suggests patient-driven goal-setting in harm-reduction treatment is feasible: Participants generated diverse, personalized, and clinically relevant goals. This study built on positive efficacy trial findings, indicating participants' generation of goals was associated with improved treatment outcomes. More research is needed to further understand more nuanced relationships between harm-reduction goal-setting and treatment outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Alcoolismo/terapia , Terapia Comportamental/métodos , Objetivos , Redução do Dano , Pessoas em Situação de Rua/psicologia , Adulto , Idoso , Alcoolismo/psicologia , Feminino , Pessoas em Situação de Rua/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Adulto Jovem
10.
Alcohol Clin Exp Res ; 45(7): 1479-1493, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34241905

RESUMO

BACKGROUND: Clinical research indicates that successful posttraumatic stress disorder (PTSD) treatment does not lead to improvements in alcohol use outcomes in comorbid PTSD and alcohol use disorder (AUD). Emerging theory suggests that treating PTSD may not disrupt an association between negative affect and alcohol craving, which underlies negative reinforcement drinking. The goal of the current study was to determine the respective influences of PTSD symptoms, coping motives, and negative affect on trauma and alcohol cue reactivity to inform theoretical models of co-occurring PTSD and AUD. METHODS: The sample consisted of 189 young adults (50.3% women; 49.2% current PTSD; 84.0% current AUD) who endorsed interpersonal trauma (e.g., sexual/physical assault) and current weekly alcohol use. Participants completed a trauma and alcohol cue reactivity assessment, in which subjective (e.g., craving, affect) and physiological (i.e., salivation) measures were recorded in response to 4 narrative (i.e., personalized trauma or standard neutral) and in vivo beverage (i.e., personalized alcohol or water) cue combinations. RESULTS: Forward-fitted linear mixed-effects (LME) models confirmed that trauma cue-elicited craving was elevated among those high but not low in PTSD symptoms, consistent with prior research and theory. Trauma cue-elicited craving was fully explained by increases in negative affect, with no evidence of a direct effect of trauma cue on craving. PTSD symptoms moderated an association between trauma cue and negative affect (but not negative affect and craving), and coping motives for alcohol moderated an association between negative affect and craving (but not trauma cue and negative affect). CONCLUSIONS: This study provides novel laboratory evidence for the respective contributions of negative affect, PTSD symptoms, and coping motives on alcohol craving in trauma-exposed drinkers. It offers a methodological framework in which to evaluate novel strategies that aim to disrupt negative reinforcement drinking in individuals with co-occurring PTSD and AUD.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Fissura/fisiologia , Reforço Psicológico , Transtornos de Estresse Pós-Traumáticos/psicologia , Adaptação Psicológica , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Sinais (Psicologia) , Feminino , Humanos , Masculino , Salivação , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto Jovem
11.
Psychol Addict Behav ; 35(5): 501-513, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34110841

RESUMO

BACKGROUND: Family history of alcohol use disorder; AUD (FH +) and impulsivity-related traits are known risk factors for problem drinking that have been investigated in predominately White samples. This cross-sectional study examined whether these risk factors vary by sex in the overall, majority White sample and in a Black subsample. METHOD: A model building regression procedure was used to investigate the combined effect of FH + and impulsivity-related traits on alcohol quantity, frequency, and problems by sex (overall sample: N = 757, 50% female, 73% White, agemean = 33.74, SD = 11.60; Black subsample: n = 138, 47% female, agemean = 33.60, SD = 9.87). RESULTS: Overall Sample. No sex differences were found in the compounding effects of FH + and impulsivity-related traits on alcohol outcomes. Males reported more physical, social, and overall alcohol-related problems than females. FH + was positively associated with all alcohol-related consequences. Poor self-regulation was the only trait associated with all alcohol outcomes. Black Subsample: A three-way interaction suggested a negative association between inhibition and frequency of alcohol use among FH + males only. A two-way interaction also suggested impulse control was associated with more interpersonal alcohol-related problems among males only. Main effects were also found in the expected direction such that higher impulsivity and FH + were associated with poorer alcohol outcomes. CONCLUSION: These findings suggest no sex differences in the overall sample in the interactive effects of established risk factors for AUD on alcohol outcomes, and that poor self-regulation may be key for personality-targeted alcohol prevention and intervention programs. Preliminary findings of sex differences in the Black subsample should be replicated. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Transtornos Relacionados ao Uso de Álcool , Alcoolismo , Individualidade , Adulto , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Transtornos Relacionados ao Uso de Álcool/etnologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Alcoolismo/epidemiologia , Alcoolismo/etnologia , Alcoolismo/psicologia , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Comportamento Impulsivo , Masculino , Anamnese/estatística & dados numéricos , Fatores de Risco , Distribuição por Sexo
12.
Alcohol Clin Exp Res ; 45(7): 1448-1457, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34081349

RESUMO

BACKGROUND: There are significant concerns that the COVID-19 pandemic may have negative effects on substance use and mental health, but most studies to date are cross-sectional. In a sample of emerging adults, over a two-week period during the pandemic, the current study examined: (1) changes in drinking-related outcomes, depression, anxiety, and posttraumatic stress disorder and (2) differences in changes by sex and income loss. The intra-pandemic measures were compared to pre-pandemic measures. METHODS: Participants were 473 emerging adults (Mage  = 23.84; 41.7% male) in an existing longitudinal study on alcohol misuse who were assessed from June 17 to July 1, 2020, during acute public health restrictions in Ontario, Canada. These intra-pandemic data were matched to participant pre-pandemic reports, collected an average of 5 months earlier. Assessments included validated measures of drinking, alcohol-related consequences, and mental health indicators. RESULTS: Longitudinal analyses revealed significant decreases in heavy drinking and adverse alcohol consequences, with no moderation by sex or income loss, but with substantial heterogeneity in changes. Significant increases in continuous measures of depression and anxiety were present, both of which were moderated by sex. Females reported significantly larger increases in depression and anxiety. Income loss >50% was significantly associated with increases in depression. CONCLUSIONS: During the initial phase of the pandemic, reductions in heavy drinking and alcohol consequences were present in this sample of emerging adults, perhaps due to restrictions on socializing. In contrast, there was an increase in internalizing symptoms , especially in females, highlighting disparities in the mental health impacts of the pandemic.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , COVID-19/psicologia , Saúde Mental/tendências , Caracteres Sexuais , Classe Social , Consumo de Bebidas Alcoólicas/economia , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/economia , Alcoolismo/epidemiologia , COVID-19/economia , COVID-19/epidemiologia , Estudos de Coortes , Estudos Transversais/métodos , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtornos Mentais/economia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Saúde Mental/economia , Ontário/epidemiologia , Adulto Jovem
13.
PLoS One ; 16(6): e0248831, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34106934

RESUMO

Inclusion of women in research on Alcohol Use Disorder (AUD) has shown that gender differences contribute to unique profiles of cognitive, emotional, and neuropsychological dysfunction. We employed functional magnetic resonance imaging (fMRI) of abstinent individuals with a history of AUD (21 women [AUDw], 21 men [AUDm]) and demographically similar non-AUD control (NC) participants without AUD (21 women [NCw], 21 men [NCm]) to explore how gender and AUD interact to influence brain responses during emotional processing and memory. Participants completed a delayed match-to-sample emotional face memory fMRI task, and brain activation contrasts between a fixation stimulus and pictures of emotional face elicited a similar overall pattern of activation for all four groups. Significant Group by Gender interactions revealed two activation clusters. A cluster in an anterior portion of the middle and superior temporal gyrus, elicited lower activation to the fixation stimulus than to faces for the AUDw as compared to the NCw; that abnormality was more pronounced than the one observed for men. Another cluster in the medial portion of the superior frontal cortex elicited higher activation to the faces by AUDm than NCm, a difference that was more evident than the one observed for women. Together, these findings have added new evidence of AUD-related gender differences in neural responses to facial expressions of emotion.


Assuntos
Alcoolismo/psicologia , Encéfalo/fisiopatologia , Reconhecimento Facial , Alcoolismo/fisiopatologia , Encéfalo/diagnóstico por imagem , Estudos de Casos e Controles , Expressão Facial , Feminino , Neuroimagem Funcional , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Fatores Sexuais
14.
Psico USF ; 26(2): 229-240, Apr.-June 2021. tab
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1287608

RESUMO

Objetivou-se caracterizar uma amostra de adolescentes em conflito com a lei em relação ao consumo de substâncias e possíveis problemas associados. Participaram 120 adolescentes do sexo masculino, entre 13 e 18 anos, custodiados na Unidade de Atendimento Inicial da Fundação CASA, que responderam ao Drug Use Screening Inventory - Revised (DUSI-R). Análises descritivas indicaram que a maioria dos adolescentes teria feito uso de maconha (84%) e álcool (54%). Em relação ao padrão de consumo, 52% foram categorizados em uso abusivo ou de provável dependência. Quanto aos problemas associados ao consumo, os participantes possuem densidade média superior aos da população normativa nos dez domínios investigados pelo DUSI-R, com destaque aos Transtornos (M = 42), Escola (M = 50) e Pares (M = 55). Vale observar que 37% da amostra se declararam abstêmios, e que os desvios das densidades de problemas sugerem alta heterogeneidade nos níveis de necessidades/dificuldades, o que implica ultrapassar discursos que propalam a uniformidade dessa população. (AU)


This study aimed to characterize a sample of adolescents in conflict with the law regarding substance use and potential associated problems. The sample consisted of 120 male adolescents aged 13 to 18 in custody at the Initial Care Unit from Fundação CASA (Center for Adolescent Socio-Educational Care) in the state of São Paulo, who responded to the Drug Use Screening Inventory - Revised (DUSI-R). Descriptive analyses indicated that most adolescents were reported to have used marijuana (84%) and alcohol (54%). Regarding the pattern of consumption, 52% were categorized as abusive use or probable dependence. Regarding the problems associated with consumption, participants showed a higher mean density than the normative population in the ten domains investigated by the DUSI-R, with emphasis on Disorders (M = 42), School (M = 50), and Peers (M = 55). It is worth noting that 37% of the sample declared themselves abstainers and that the deviations of the problem densities suggest high heterogeneity in the levels of needs/difficulties, which implies overcoming discourses that promote the uniformity of this population. (AU)


Este estudio tuvo como objetivo caracterizar una muestra de adolescentes en conflicto con la ley por el consumo de sustancias y posibles problemas asociados. Participaron de la muestra 120 adolescentes varones de 13 a 18 años en custodia de la Unidad de Atención Inicial de la Fundación CASA, quienes respondieron al Drug Use Screening Inventory - Revised (DUSI-R). Los análisis descriptivos indicaron que la mayoría de los adolescentes habrían consumido marihuana (84%) y alcohol (54%). Respecto al patrón de consumo, el 52% fue categorizado como uso abusivo o probable dependencia. En cuanto a los problemas asociados con el consumo, los participantes tuvieron una densidad media/superior a la población normativa en los diez dominios investigados por DUSI-R, con énfasis en los Trastornos (M=42), la Escuela (M=50) y Parejas (M=55). Cabe destacar que el 37% de la muestra se declaró abstencionista y que las desviaciones de las densidades del problema sugieren una alta heterogeneidad en los niveles de necesidades/dificultades, lo que implica la superación de discursos que promueven la uniformidad de esta población. (AU)


Assuntos
Humanos , Masculino , Adolescente , Drogas Ilícitas , Adolescente Institucionalizado/psicologia , Delinquência Juvenil/psicologia , Fatores Socioeconômicos , Abuso de Maconha/psicologia , Inquéritos e Questionários , Alcoolismo/psicologia
15.
Curr Opin Psychiatry ; 34(4): 376-385, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34016817

RESUMO

PURPOSE OF REVIEW: To understand the effect of COVID-19 pandemic and lockdown on persons with alcohol use disorders. RECENT FINDINGS: From a total of 455 titles on COVID-19 and alcohol, 227 abstracts were screened, and 95 articles were reviewed (on November 25th, 2020). The immediate effect was an increase in alcohol related emergencies including alcohol withdrawal, related suicides, and methanol toxicity. Although there are mixed findings with respect to changes in the quantity of drinking, there are reports of binge/heavy drinking during the lockdown as well as relapse postlockdown. Psychological, social, biological, economic and policy-related factors appear to influence the changes in drinking. Although preliminary data suggest no change in alcohol use among persons with comorbid mental illness, findings in this population are presently limited. Among patients with alcohol related liver disease, outcomes appear worse and caution is warranted with the use of medications. Alcohol also appears to increases the risk of COVID-19 infection and complicates its course.Although some nations banned alcohol sales completely during lockdown, others declared it as an essential commodity, resulting in different problems across countries. Alcohol use has added to the burden of the problem particularly among vulnerable groups like the adolescents, elderly, patients with cancer, as well as health professionals. Services for patients with alcohol use disorders have been affected. SUMMARY: The COVID-19 pandemic has had considerable impact on alcohol use, with an increase in alcohol related emergencies, changes in alcohol use patterns, increased risk of contracting COVID-19, effect on alcohol policies and sales, and an effect on vulnerable groups. It is essential to understand and respond to the current situation, intervene early, and prevent further repercussions of the pandemic.Video abstract link: https://drive.google.com/file/d/1IJWtIs6e554PryKWhdma4VB--mjSZq1C/view?usp=sharing.


Assuntos
Alcoolismo/epidemiologia , Alcoolismo/psicologia , COVID-19/prevenção & controle , COVID-19/psicologia , Distanciamento Físico , Quarentena/psicologia , Adolescente , Idoso , Humanos , Pandemias , SARS-CoV-2
16.
Psychol Addict Behav ; 35(4): 444-457, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33956473

RESUMO

OBJECTIVE: Recent studies have examined the extent to which alcohol dependence (AD) criteria prospectively predict the course of AD. Critically, these studies have lacked a developmental perspective. However, the differential performance of criteria by age might indicate overendorsement in younger individuals. The current study examined AD criteria in terms of persistence and prediction of AD course and alcohol use by age in order to identify criteria that are likely to be overly endorsed by younger individuals. METHOD: The current study used longitudinal data from the National Epidemiologic Survey on Alcohol and Related Conditions to depict age differences in rates of new onset, recurrence, and persistence for each AD criterion, thereby showing how these three factors contribute to the overall age-prevalence curve of each criterion. Additionally, we tested age moderation of the predictive association between each criterion at baseline and new onset, recurrence, and persistence of syndromal AD. RESULTS: Some criteria (particularly, persistent desire or unsuccessful efforts to cut down or control drinking, and drinking despite physical/psychological problems) are both less persistent and less predictive of AD course among younger adults compared to older adults. CONCLUSIONS: These findings raise the possibility of elevated rates of false-positive AD among younger adults and suggest ways to improve the assessment of AD criteria. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Etanol/efeitos adversos , Adolescente , Adulto , Fatores Etários , Alcoolismo/diagnóstico , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Recidiva , Adulto Jovem
17.
Exp Clin Psychopharmacol ; 29(2): 166-177, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34043400

RESUMO

Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are highly comorbid with complex and often unclear associations. Working memory deficits may represent a shared mechanism implicated in emotion regulation and control over impulsive alcohol use. Here we test whether PTSD symptoms and working memory correlated with performance on a behavioral economic assessment of alcohol demand. 113 veterans (mean age 51 years; 89% male) completed an Alcohol Purchase Task (APT) and were assessed for PTSD, alcohol use, and working memory. We examined the interaction of PTSD symptoms and working memory on four indices of alcohol demand measured from the APT; specifically, we used separate models to test whether associations between working memory and intensity (consumption at $0), Omax (maximum expenditure), Pmax (price at maximum expenditure), and elasticity (price sensitivity), differed as a function of PTSD symptoms. In a model controlling for hazardous drinking, average drinking levels, age, sex, marital status, occupation, and education, we observed a significant interaction between PTSD symptoms and working memory on elasticity, whereby greater working memory capacity was associated with greater elasticity for veterans with lower PTSD symptoms. Follow-up analyses regarding specific PTSD symptom domains indicated that this effect was strongest for avoidance symptoms. Taken together, working memory abilities correlated with subjective valuations of alcohol in a laboratory setting for veterans with less severe PTSD symptoms. This work highlights the conditions under which working memory may be a potential target for interventions geared toward reducing alcohol use in veterans with co-occurring PTSD and AUD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Memória de Curto Prazo , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Veteranos/psicologia
18.
Clin Nutr ; 40(5): 2673-2682, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33933733

RESUMO

BACKGROUND & AIMS: Chronic alcohol consumption can cause malnutrition that may contribute to alcohol-induced organ injury and psychological disorders. We evaluated the link between nutrient intake, especially dietary fibers (DF) and different parameters reflecting mental health and well being, namely anxiety, depression, alcohol craving, sociability, fatigue and intestinal comfort in alcohol use disorder (AUD) patients. METHODS: Cross-sectional data from 50 AUD patients, hospitalized for a 3-week detoxification program were used. Three 24-h recalls allowed to calculate dietary habits and nutrient intakes, that was also assessed in healthy subjects (HS). Diet quality was measured using the NOVA score. Psychological factors and intestinal discomfort were evaluated using validated self-administered questionnaires. RESULTS: Energy intake (excluding alcoholic beverage), total fat, monounsaturated and polyunsaturated fatty acids, protein and DF intakes were lower in AUD subjects compared to HS. Ninety percent of patients had a DF intake below the recommendation. AUD patients consumed more than twice as much ultra-processed food than HS. Fructan intake was negatively associated with anxiety (p = 0.04) adjusted for main confounders. Total DF, insoluble, soluble DF and galacto-oligosaccharide intakes were associated with higher sociability score. Soluble DF intake was associated with better satisfaction of bowel function (p = 0.02) and a lower intestinal discomfort (p = 0.04). CONCLUSIONS: This study reveals that insufficient DF intake is part of AUD-related malnutrition syndrome, and is associated with higher anxiety, lower sociability score and intestinal discomfort. Our results suggest that an adequate intake of DF might be beneficial for recovery from AUD. TRIAL REGISTRATION: NCT03803709, https://clinicaltrials.gov/ct2/show/NCT03803709.


Assuntos
Alcoolismo/psicologia , Fibras na Dieta/deficiência , Desnutrição/etiologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
19.
J Clin Psychiatry ; 82(2)2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-34033270

RESUMO

The choice from among approved treatments for relapse prevention in alcohol use disorder (AUD) is not symptom-driven. It is reasonable to speculate that the discomfort and distress associated with the experience of alcohol withdrawal symptoms (AWS) discourage abstinence and prompt continuation of or relapse into drinking. Adrenergic mechanisms may underlie many of the commonly experienced AWS. This allows the further speculation that drugs with antiadrenergic properties may attenuate AWS and thereby improve treatment outcomes in patients with AUD who attempt to quit drinking. In this context, the α1 adrenoceptor antagonist prazosin is a possible symptom-driven choice for patients with AUD who experience high AWS. Randomized controlled trial (RCT) results with prazosin and doxazosin have however been mixed, perhaps because the role of AWS was not considered in these. In this context, a recent large (n = 100) RCT found that prazosin, uptitrated to 16 mg/d, reduced drinking days, heavy drinking days, and average drinks per day; the benefits were observed only in patients with high AWS at baseline, operationalized as a Clinical Institute Withdrawal Assessment for Alcohol-Revised score of 3 or higher. Concerns about the internal and external validity of this study are discussed. How and when high AWS is determined is also a point of debate. If high AWS is a valid target for the symptom-driven choice of pharmacologic intervention for AUD, then a wide range of drugs merits study; in the long run, some of these drugs may be better tolerated than prazosin.


Assuntos
Alcoolismo/tratamento farmacológico , Prazosina/uso terapêutico , Alcoolismo/prevenção & controle , Alcoolismo/psicologia , Tomada de Decisão Clínica , Humanos , Prevenção Secundária/métodos , Resultado do Tratamento
20.
PLoS One ; 16(5): e0251733, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34029320

RESUMO

Alcohol craving has been described as a strong subjective desire to drink, being considered highly valuable in the clinical practice, as it is recognized as a strong predictor of alcohol relapse in alcohol-dependent individuals. However, to date, there is not a multifactorial questionnaire available for assessing short-term acute craving experience in Portugal. The aim of the present study was to validate a swift and efficient tool for the assessment of acute alcohol craving in a sample of Portuguese citizens. For that purpose, the Alcohol Craving Questionnaire-Short Form-Revised (ACQ-SF-R) was translated into European Portuguese and administered to a sample of 591 college participants with ages between 18 and 30 years. Results suggested that a three-factor model (i.e., Emotionality, Purposefulness, and Compulsivity) proved to be most suitable for the Portuguese sample. Overall, the ACQ-SF-R exhibited good psychometric properties, having a good internal consistency both for the general craving index (Cronbach's α = 0.85) and each subscale (Cronbach's α = 0.66-0.83), as well as an appropriate convergent validity with the Penn Alcohol Craving Scale (r = 0.65, p<0.001), suggesting a good construct validity. In addition, the ACQ-SF-R also showed a good concurrent validity with the Alcohol Use Disorders Identification Test (r = 0.57, p<0.001), indicating that risky alcohol use patterns are associated with increased craving scores in the ACQ-SF-R. Collectively, these findings suggest that the Portuguese version of the ACQ-SF-R can accurately measure alcohol craving at a multifactorial level, being a valid and reliable tool to use in Portuguese samples in research settings.


Assuntos
Alcoolismo/diagnóstico , Fissura , Psicometria/métodos , Adolescente , Adulto , Alcoolismo/psicologia , Feminino , Humanos , Masculino , Portugal , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes , Estudantes/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Tradução , Adulto Jovem
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