Psychometric Validation of the Gambling Craving Scale in a Treatment-Seeking Sample.

The Gambling Craving Scale (GACS) is a multifaceted measure of gambling craving. Initial validation work by Young and Wohl (2009) in university student samples showed that the GACS had a three-factor structure capturing dimensions of Desire, Anticipation, and Relief. Despite its potential clinical utility as a measure of craving, the GACS has yet to be validated in people seeking treatment for gambling problems. Accordingly, we examined the psychometric properties in a sample of people (N = 209; Mage = 37.66; 62.2% female) participating in a randomized controlled trial testing a novel online treatment for problem gambling. We predicted the GACS would have a three-factor structure. In addition, we also examined measurement invariance across sex and problem gambling risk status. Finally, we assessed concurrent validity of the factors with other measures of problem gambling severity and involvement. Exploratory structural equation modeling findings supported a three-factor structure that was invariant across the groups tested. Each of the Desire, Anticipation, and Relief subscales were significant positive predictors of problem gambling severity and symptoms, and some form of gambling behaviour. Findings show the GACS is a promising scale to assess multidimensional craving experiences among people in treatment for gambling problems.

Coping and Conformity Motives Mediate the Joint Effects of the Behavioral Inhibition and Approach Systems on Alcohol Problems in Young Adults.

Background: Gray's original Reinforcement Sensitivity Theory (RST) posits that an oversensitive behavioral inhibition system (BIS) may increase risk for negative-reinforcement-motivated drinking, given its role in anxiety. However, existing data provides mixed support for the BIS-alcohol use association. The inconsistent evidence is not surprising, as the revised RST predicts that the behavioral approach system (BAS) should moderate the effect of the BIS on alcohol use. A strong BAS is thought to bring attention to the negatively reinforcing effects of alcohol, leading to problem drinking among those with a strong BIS. While emerging results support this interaction, we still have much to learn about the mechanisms underlying this effect on alcohol use. Accordingly, we examined motives for alcohol use as mediators of the joint associations of the BIS and the BAS on drinking behaviors. Specifically, our central hypothesis was that individuals with a strong BIS and a strong BAS would endorse increased negative reinforcement motives for drinking (coping and conformity motives), which in turn would predict heavy drinking and alcohol problems. Method: Participants (N=346; 195 women) completed study measures as part of the baseline assessment for a larger study. Results: Overall, results partially supported the hypotheses. Mediated moderation analyses showed that the indirect effect of the BIS on alcohol problems, through coping and conformity motives, was strongest at high levels of the BAS. This effect was not supported for alcohol use. Conclusions: Our findings suggest that clinical interventions should target coping and conformity reasons for drinking among anxious, reward responsive, young adults.

Clinical outcomes and adverse events in patients hospitalised with COVID-19, treated with off-label hydroxychloroquine and azithromycin.

AIMS: To assess clinical outcomes and adverse drug events in patients hospitalised with COVID-19 treated with off-label hydroxychloroquine (HCQ) and azithromycin (Az). METHODS: We performed a retrospective analysis of hospitalised patients who had a positive polymerase chain reaction test for SARS-CoV-2 and received HCQ plus Az or no targeted therapy. The primary end point was clinical improvement on day 7 defined as either hospital discharge or an improvement of 2 points on a 6-category ordinal scale. Secondary outcomes included mortality at day 28, intensive care admission, requirement for mechanical ventilation and incidence of adverse events. RESULTS: Data from a total of 134 patients were evaluated; 82 patients received HCQ/Az and 52 patients received no targeted therapy. Clinical improvement was seen in 26.8% of patients who received HCQ/Az but this was not significant. The rates of intensive care transfer and mechanical ventilation were higher in the treatment group, but these differences were not significant. Mortality at day 28 was significantly higher in the treatment group (P = .03). Hypoglycaemia elevated liver function tests and QT prolongation were monitored in both groups. The risk of QT prolongation was significantly higher in the treatment group. Treatment was stopped early in 6 (7.3%) patients due to adverse events. CONCLUSION: Although patients who received HCQ/Az were more severely ill the administration of these repurposed drugs did not result in clinical improvement and was associated with a significant increase in toxicity. This descriptive study highlights the importance of monitoring all repurposed agents for adverse events.

Substance Use Research with Indigenous Communities: Exploring and Extending Foundational Principles of Community Psychology.

Many Indigenous communities are concerned with substance use (SU) problems and eager to advance effective solutions for their prevention and treatment. Yet these communities also are concerned about the perpetuation of colonizing, disorder-focused, stigmatizing approaches to mental health, and social narratives related to SU problems. Foundational principles of community psychology-ecological perspectives, empowerment, sociocultural competence, community inclusion and partnership, and reflective practice-provide useful frameworks for informing ethical community-based research pertaining to SU problems conducted with and by Indigenous communities. These principles are explored and extended for Indigenous community contexts through themes generated from seven collaborative studies focused on understanding, preventing, and treating SU problems. These studies are generated from research teams working with Indigenous communities across the United States and Canada-inclusive of urban, rural, and reservation/reserve populations as well as adult and youth participants. Shared themes indicate that Indigenous SU research reflects community psychology principles, as an outgrowth of research agendas and processes that are increasingly guided by Indigenous communities. At the same time, this research challenges these principles in important ways pertaining to Indigenous-settler relations and Indigenous-specific considerations. We discuss these challenges and recommend greater synergy between community psychology and Indigenous research.

Changes in coping and social motives for drinking and alcohol consumption across the menstrual cycle.

BACKGROUND: Alcohol use has been reported to fluctuate over women's menstrual cycles (MCs), with increased intake occurring premenstrually/menstrually (phases characterized by heightened negative affect) and during the ovulatory phase (a phase characterized by positive affect). This suggests women may drink for particular emotion-focused reasons at specific points in their cycles. However, no research had yet examined MC variability in drinking motives, or links between cycle-related changes in drinking motives and alcohol consumption. METHODS: Ninety-four normally cycling women (Mage  = 22.9 years old, SDage  = 4.7) completed daily diary measures (via Smartphone surveys), with questions pertaining to state drinking motives and quantity of alcohol consumed for the course of a full MC. RESULTS: Drinking motives differed by cycle phase. Women reported a slight increase in drinking to self-medicate for negative affect premenstrually, with drinking to cope peaking in the menstrual phase and declining mid-cycle. Women reported a slight increasing trend across the cycle in social motives for drinking, while enhancement motives remained relatively stable across the cycle. Cycle-related changes in drinking motives predicted increases in the quantity of alcohol consumed. Drinking to cope with negative affect predicted a greater number of drinks menstrually (days 1-5). While social motives predicted a greater number of drinks during the follicular and ovulatory phases (days 5-16), enhancement motives were unrelated to drinking quantity across cycle phase. CONCLUSIONS: Clinicians should be attentive to cycle phase when treating reproductive-aged women with alcohol disorders (e.g., encouraging the use of healthier means of coping with negative affect during menses).

Testing the Implicit and Explicit Cognitions Underlying Behavioral Inhibition System-Related Drinking in Young Adults.

BACKGROUND: There is great interest in the role of the behavioral inhibition system (BIS) and the behavioral approach system (BAS) in the etiology of alcohol use because of the strong links of these systems to neuroscience and cognitive models of addiction. The revised Reinforcement Sensitivity Theory suggests that the strength of the BIS and BAS jointly influences behavior, so-called the joint systems hypothesis. Yet, relatively little work has examined this hypothesis, particularly with respect to alcohol information processing. Grounded in dual-process theories of alcohol information processing, this study aimed to clarify the roles of implicit (i.e., automatic processes) and explicit (i.e., controlled processes) cognitions in BIS-related drinking. When anxious and presented with an alcohol (vs. neutral) cue, we expected those with an elevated BIS to have increased implicit and explicit alcohol cognitions related to tension reduction, but only at elevated BAS. Shifts in cognitions following cue exposure were expected to positively correlate with alcohol misuse. METHODS: Students (N = 110) completed baseline measures followed by the Trier Social Stress Test. This was followed by a cue exposure (random assignment to alcohol or water cue), during which participants completed postmood assessments of implicit/explicit alcohol cognitions. RESULTS: Overall, participants' implicit alcohol cognition was negative. The effect of BIS on implicit and explicit cognitions was moderated by BAS; however, results were not as hypothesized. In the alcohol condition only (when controlling for baseline implicit cognition), BIS predicted relatively weak implicit negative alcohol cognition, but only at low BAS. Interestingly, in the alcohol condition only, BIS predicted increased explicit reward (but not relief) expectancies, but only at high BAS. Changes in explicit reward expectancies positively correlated with alcohol misuse. CONCLUSIONS: Our results suggest that explicit cognitions may be relevant to drinking among anxious individuals who are also reward responsive. Cognitive behavioral interventions should target reward expectancies to reduce anxiety-related drinking.

Replication and Validation of the Young Adult Alcohol Consequences Questionnaire in a Large Sample of Canadian Undergraduates.

BACKGROUND: Undergraduate students experience diverse problems because of alcohol use. Accordingly, the Young Adult Alcohol Consequences Questionnaire (YAACQ) was developed to assess multiple domains of alcohol-related problems. A preliminary psychometric evaluation in a U.S. college sample showed support for 8 factors that were invariant across gender and that loaded onto a single higher-order alcohol-related problems factor. Supporting concurrent validity, this preliminary work also found that YAACQ total scores correlated with heavy alcohol use. While these results are promising, the factor structure of the YAACQ has yet to be replicated. This goal of this study was to test the psychometrics of the YAACQ in a large Canadian student sample. Invariance across gender, year of study, place of residence, and relative drinking level was examined. Correlations between the YAACQ subscales and alcohol use measures were investigated to test concurrent validity. METHODS: Students (N = 1,103, 80% women) completed online self-reports. RESULTS: Results from a confirmatory factor analysis (CFA) supported an 8-factor lower-order structure, with all factors loading onto a single higher-order alcohol-related problems factor. Multigroup CFAs supported measurement invariance across gender, year of study, place of residence, and relative drinking level. YAACQ subscales were positively correlated with weekly alcohol use and binge drinking. CONCLUSIONS: Our study provides an important replication of the psychometrics of the YAACQ in a new sample, and we extend previous work by presenting novel tests of measurement invariance across meaningful groups in young adulthood. Overall, our study suggests that the 48-item YAACQ is a valid measure of alcohol-related problems in Canadian students.

Impulsivity increases risk for coping-motivated drinking in undergraduates with elevated social anxiety.

According to theory, those high in social anxiety (SA) are at risk for drinking alcohol for coping and conformity motives, which in turn lead to alcohol use and related problems. Empirical tests of this risk pathway in non-clinical samples have produced mixed results. Although those high on SA may drink to cope with anxiety and to reduce the likelihood of social rejection, they may also avoid drinking for fear of embarrassing themselves when intoxicated. Central to alcohol use by those high in SA is a temporary disregard of alcohol's potentially negative consequences. Accordingly, we hypothesized that SA would positively predict alcohol use and problems, but only at high levels of impulsivity (IMP). We expected these interactive effects to be mediated by coping and conformity motives. Undergraduates (N = 461) completed self-reports. Partially supporting hypotheses, IMP moderated the association between SA and alcohol-related problems (but not use), such that SA predicted problems only at high IMP. This interactive effect was mediated by coping (but not conformity) motives, such that SA positively predicted coping motives (especially at high IMP), which in turn predicted problems. Results suggest that IMP and coping motives clarify SA-related drinking. Clinical interventions may consider targeting IMP.

Clarifying the measurement and the role of the behavioral inhibition system in alcohol misuse.

BACKGROUND: In response to conflicting reward (Behavioral Approach System [BAS]) and/or punishment cues (Fight-Flight-Freeze System [FFFS]) the Behavioral Inhibition System (BIS) inhibits behavior, leading to increased attention to threat, high anxiety, and behavioral ambivalence. The role of BIS in alcohol misuse is complex, as anxiety promotes self-medication drinking, while attention to threat (e.g., negative outcomes of heavy drinking) may reduce risk. Theory suggests that a concurrent strong BAS may bias BIS-conflict in favor of alcohol approach, while a concurrent strong FFFS may increase the likelihood of alcohol avoidance. However, few studies measure BIS as a conflict system, and no studies incorporate such a measure into examinations of alcohol misuse. Our study goals were to (i) test the Motivational Flanker Task (MFT) as a new laboratory measure of the BIS, BAS, and FFFS; and (ii) use the MFT, in conjunction with self-report measures, to test BAS and FFFS as moderators of the BIS-alcohol misuse relation. We hypothesized that an elevated BIS would predict heavy drinking and alcohol-related problems, but only when BAS was high. Further, we expected an elevated BIS to be associated with reduced alcohol misuse, but only when FFFS was high. METHODS: Students (N = 198) completed self-reports of BIS/BAS/FFFS and drinking behavior, and 2 reaction time tasks: MFT and Point Scoring Reaction Time Task (PSRTT). The PSRTT is a published measure of the revised BIS. RESULTS: MFT BIS conflict was associated with self-report and PSRTT measures. MFT BAS, but not FFFS, was associated with self-reports. As expected, elevated BIS was associated with heavy drinking, but only when BAS-Drive and BAS-Fun Seeking was also high. FFFS was not supported as a moderator of the BIS-alcohol misuse association. CONCLUSIONS: Results support the MFT as a promising measure of the revised BIS. Considering the joint effects of BIS and BAS clarified risk for alcohol misuse.

Development and validation of the perceived approval of Risky Drinking Inventory in undergraduate students.

OBJECTIVE: Undergraduates frequently engage in risky drinking (i.e., drinking alcohol in ways that may result in problems). The reasoned action approach identifies injunctive norms (i.e., perceptions that others approve of risky drinking) as central in predicting engagement in risky drinking. However, research linking injunctive norms and risky drinking is equivocal, possibly because of extensive variability in the operationalization of injunctive norms across studies. This study describes the development and validation of the Perceived Approval of Risky Drinking Inventory (PARDI), designed according to best practice guidelines in questionnaire development. METHOD: Undergraduate students (N = 1,313) participated in one of the three phases of data collection, including focus group interviews for item generation (n = 31), self-report questionnaires for scale refinement (n = 407), and self-report questionnaires for scale validation (n = 875). RESULTS: Exploratory and confirmatory factor analyses supported a 20-item four-factor solution (Heavy Drinking, Drinking-Related Problems, Coping-Related Drinking, and Sexual-Risk Taking) across the three assessed referent groups (friends, parents, and typical students), all of which present satisfactory estimates of scale score and composite reliability. The results also provided preliminary support for the convergent validity of scores obtained on the PARDI, as demonstrated through correlations with other measures of perceived norms, alcohol use, alcohol-related problems, and coping-motivated drinking. Finally, the results supported the generalizability of the PARDI factor structure by demonstrating its measurement invariance across gender and drinking status (i.e., alcohol use and problems). CONCLUSIONS: The PARDI represents a reliable, valid, yet nuanced measure of injunctive norms that can be used to support further theory development and intervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Interactive effects of alcohol and cannabis quantities in the prediction of same-day negative consequences among young adults.

BACKGROUND: Simultaneous alcohol and cannabis use is common, but observational studies examining negative consequences of simultaneous use have rarely considered dose-related interactions between alcohol and cannabis. This study examined interactions between quantities of cannabis and alcohol consumed in predicting negative consequences on simultaneous use days. METHODS: Young adults (N = 151; 64% female; 62% White) reporting recent simultaneous use and at least weekly alcohol and cannabis use completed 21 daily, smartphone-based surveys assessing previous day quantities of cannabis and alcohol used, types of cannabis used (flower, concentrates, edibles), and negative substance-related consequences. Multilevel models examined: (1) whether negative consequences differed within-person across simultaneous use days and single-substance use days; and (2) whether quantities of alcohol and cannabis consumed on simultaneous use days interacted, within-person, to predict negative consequences. We focused on quantities of cannabis flower (grams) in primary analyses and explored quantities of other forms of cannabis (concentrates, edibles) in supplementary analyses. RESULTS: Participants reported fewer negative consequences on alcohol-only (243 observations) and cannabis-only (713 observations) days than they did on simultaneous use days (429 observations). On simultaneous use days involving cannabis flower use (313 observations across 81 participants), the within-person association between number of standard drinks and negative consequences was weaker on days during which larger (vs. smaller) amounts of cannabis flower were consumed. Inspection of simple slopes revealed that decreased alcohol use was associated with less of a decline in negative consequences when combined with relatively greater amounts of cannabis flower. CONCLUSIONS: Although simultaneous use was associated with more negative consequences than alcohol-only and cannabis-only use, negative consequences on simultaneous use days varied as a function of the interaction between alcohol and cannabis quantities. As findings suggest that using larger amounts of cannabis may attenuate declines in negative consequences associated with lighter drinking, interventions for higher-risk simultaneous use patterns may benefit from a focus on quantities of both alcohol and cannabis.

Negative Affect and Drinking among Indigenous Youth: Disaggregating Within- and Between-Person Effects.

Negative affect (depression/anxiety) and alcohol use among Indigenous youth in Canada remain a concern for many communities. Disparate rates of these struggles are understood to be a potential outcome of colonization and subsequent intergenerational trauma experienced by individuals, families, and communities. Using a longitudinal design, we examined change in alcohol use and negative affect, and reciprocal associations, among a group of Indigenous adolescents. Indigenous youth (N = 117; 50% male; Mage=12.46-16.28; grades 6-10) from a remote First Nation in northern Quebec completed annual self-reported assessments on negative affect (depression/anxiety) and alcohol use. A Latent Curve Model with Structured Residuals (LCM-SR) was used to distinguish between- and within-person associations of negative affect and alcohol use. Growth models did not support change in depression/anxiety, but reports of drinking increased linearly. At the between-person level, girls reported higher initial levels of depression/anxiety and drinking; depression/anxiety were not associated with drinking. At the within-person level, drinking prospectively predicted increases in depression/anxiety but depression/anxiety did not prospectively predict drinking. When Indigenous adolescents reported drinking more alcohol than usual at one wave of assessment, they reported higher levels of negative affect than expected (given their average levels of depression/anxiety) at the following assessment. Our findings suggest that when Indigenous youth present for treatment reporting alcohol use, they should also be screened for negative affect (depression/anxiety). Conversely, if an Indigenous adolescent presents for treatment reporting negative affect, they should also be screened for alcohol use.

Explanatory pathways linking anxiety sensitivity and alcohol (mis)use: A prospective state-trait analysis among emerging adults.

OBJECTIVE: Alcohol use and related problems increase during adolescence and peak in early adulthood. Tension reduction theories suggest that those high in anxiety sensitivity (AS) may be at risk for misusing alcohol for its anxiolytic effects. Cognitive theories point to drinking motives and alcohol expectancies as explanatory mechanisms of this risk pathway. This study examined AS risk for prospective alcohol misuse, as explained by an unfolding cognitive process, among those transitioning out of Collège d'enseignement général et professionnel (CEGEP, i.e., junior college equivalent in Quebec, Canada). We hypothesized that there would be trait-like (average levels over time), positive associations between AS, coping motives, tension-reduction alcohol expectancies, and alcohol use and problems, and that AS would lead to state-like (occasion-specific, reciprocal associations) bidirectional and positive associations between alcohol cognitions and outcomes. METHOD: Final-year CEGEP students (N = 193) completed three online questionnaires at 6-month intervals assessing AS, drinking motives (coping, enhancement), alcohol expectancies (tension reduction, sociability/liquid courage), and alcohol use/problems. State-trait modeling was used for hypothesis testing. RESULTS: Consistent with hypotheses, at the "trait" level, drinking motives and alcohol expectancies were positively associated, and drinking motives and sociability/liquid courage expectancies were positively associated with alcohol problems. At the "state" level, AS positively predicted coping motives and alcohol use, tension-reduction expectancies positively predicted coping motives, and coping motives and sociability/liquid courage expectancies positively predicted alcohol use. CONCLUSIONS: Results suggest that AS is a risk factor for coping-motivated drinking, and that there is interplay between cognitions that may help understand emerging adult alcohol risk pathways. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Circulating tumour cells: The Good, the Bad and the Ugly.

This review is an overview of the current knowledge regarding circulating tumour cells (CTCs), which are potentially the most lethal type of cancer cell, and may be a key component of the metastatic cascade. The clinical utility of CTCs (the "Good"), includes their diagnostic, prognostic, and therapeutic potential. Conversely, their complex biology (the "Bad"), including the existence of CD45+/EpCAM+ CTCs, adds insult to injury regarding their isolation and identification, which in turn hampers their clinical translation. CTCs are capable of forming microemboli composed of both non-discrete phenotypic populations such as mesenchymal CTCs and homotypic and heterotypic clusters which are poised to interact with other cells in the circulation, including immune cells and platelets, which may increase their malignant potential. These microemboli (the "Ugly") represent a prognostically important CTC subset, however, phenotypic EMT/MET gradients bring additional complexities to an already challenging situation.

The impact of cultural identity, parental communication, and peer influence on substance use among Indigenous youth in Canada.

Heavy drinking and smoking have been found to be among the leading causes of morbidity and mortality within Indigenous youth in North America. The focus of this study was to examine the relative roles of cultural identity, parent-child communication about the harms of substance use (SU), and perception about peers' opinions on heavy drinking and cigarette smoking among Indigenous youth. Strong Indigenous cultural identity, parent-child communication about SU, and affiliation with peers who do not use and/or who disapprove of substance use were all expected to reduce risk for heavy drinking and smoking. Substance use beliefs were hypothesized to mediate these effects. Youth (N = 117; Mage = 14.07; grades 6-11) from two Indigenous communities in Quebec completed self-reports. Consistent with the hypotheses, strong cultural identity predicted increased negative beliefs about substance use, which predicted reduced drinking and smoking. Similarly, affiliating with peers who did not use alcohol predicted decreased positive beliefs about alcohol use, which predicted reduced drinking. Affiliating with peers who did not smoke cigarettes predicted reduced cigarette smoking. Parental influences were not supported in this model. Intervention strategies may benefit from targeting cultural identity, peer groups, and substance use beliefs among Indigenous youth.

Aberrant protein expression of Appl1, Sortilin and Syndecan-1 during the biological progression of prostate cancer.

Diagnosis and assessment of patients with prostate cancer is dependent on accurate interpretation and grading of histopathology. However, morphology does not necessarily reflect the complex biological changes occurring in prostate cancer disease progression, and current biomarkers have demonstrated limited clinical utility in patient assessment. This study aimed to develop biomarkers that accurately define prostate cancer biology by distinguishing specific pathological features that enable reliable interpretation of pathology for accurate Gleason grading of patients. Online gene expression databases were interrogated and a pathogenic pathway for prostate cancer was identified. The protein expression of key genes in the pathway, including adaptor protein containing a pleckstrin homology (PH) domain, phosphotyrosine-binding (PTB) domain, and leucine zipper motif 1 (Appl1), Sortilin and Syndecan-1, was examined by immunohistochemistry (IHC) in a pilot study of 29 patients with prostate cancer, using monoclonal antibodies designed against unique epitopes. Appl1, Sortilin, and Syndecan-1 expression was first assessed in a tissue microarray cohort of 112 patient samples, demonstrating that the monoclonal antibodies clearly illustrate gland morphologies. To determine the impact of a novel IHC-assisted interpretation (the utility of Appl1, Sortilin, and Syndecan-1 labelling as a panel) of Gleason grading, versus standard haematoxylin and eosin (H&E) Gleason grade assignment, a radical prostatectomy sample cohort comprising 114 patients was assessed. In comparison to H&E, the utility of the biomarker panel reduced subjectivity in interpretation of prostate cancer tissue morphology and improved the reliability of pathology assessment, resulting in Gleason grade redistribution for 41% of patient samples. Importantly, for equivocal IHC-assisted labelling and H&E staining results, the cancer morphology interpretation could be more accurately applied upon re-review of the H&E tissue sections. This study addresses a key issue in the field of prostate cancer pathology by presenting a novel combination of three biomarkers and has the potential to transform clinical pathology practice by standardising the interpretation of the tissue morphology.

The daily association between affect and alcohol use: A meta-analysis of individual participant data.

Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.

Prediction of Prostate Cancer Biochemical and Clinical Recurrence Is Improved by IHC-Assisted Grading Using Appl1, Sortilin and Syndecan-1.

Gleason scoring is used within a five-tier risk stratification system to guide therapeutic decisions for patients with prostate cancer. This study aimed to compare the predictive performance of routine H&E or biomarker-assisted ISUP (International Society of Urological Pathology) grade grouping for assessing the risk of biochemical recurrence (BCR) and clinical recurrence (CR) in patients with prostate cancer. This retrospective study was an assessment of 114 men with prostate cancer who provided radical prostatectomy samples to the Australian Prostate Cancer Bioresource between 2006 and 2014. The prediction of CR was the primary outcome (median time to CR 79.8 months), and BCR was assessed as a secondary outcome (median time to BCR 41.7 months). The associations of (1) H&E ISUP grade groups and (2) modified ISUP grade groups informed by the Appl1, Sortilin and Syndecan-1 immunohistochemistry (IHC) labelling were modelled with BCR and CR using Cox proportional hazard approaches. IHC-assisted grading was more predictive than H&E for BCR (C-statistic 0.63 vs. 0.59) and CR (C-statistic 0.71 vs. 0.66). On adjusted analysis, IHC-assisted ISUP grading was independently associated with both outcome measures. IHC-assisted ISUP grading using the biomarker panel was an independent predictor of individual BCR and CR. Prospective studies are needed to further validate this biomarker technology and to define BCR and CR associations in real-world cohorts.

Restrained eating and alcohol use: Testing drinking to cope and impulsivity as moderators.

The association between restrained eating and alcohol use remains poorly understood among undergraduates. Consistent with tension reduction theory, individuals with disordered eating may be motivated to drink alcohol to cope with negative emotionality. Perhaps what pushes them to drink despite restriction goals is impulsivity. The combined impact of drinking to cope and impulsivity on the theoretically complex link between restrained eating and alcohol outcomes has not been previously examined. The current study tested the moderating effect of drinking to cope and impulsivity on the association between restrained eating and alcohol use and problems. Undergraduates (N = 1,619) self-reported on eating disorder symptoms, alcohol use motives, impulsivity, and alcohol outcomes. A moderation model revealed that restrained eating predicted past 30-day alcohol use, but only for women high in both drinking to cope and impulsivity. These findings help characterize alcohol misuse risk among young adults who restrict their eating, thereby, results may inform interventions.