Journal of studies on alcohol and drugs最新文献

Objective: Research shows that a high proportion of college seniors experience alcohol problems repeatedly. The present study examined associations between behavioral willingness to experience alcohol consequences, protective behavioral strategies (PBS) to reduce harmful drinking, drinking, and repeated alcohol problems (RAP) early in the senior year, and how these constructs influenced behavioral willingness, PBS, drinking, and RAP later in the senior year.

Method: The sample included randomly selected first-year students from a large northeastern university who met the inclusion criterion of consuming alcohol before enrollment. Students were followed each semester across 4 years. The study (N = 1,753; 58% female) focused on the assessments in the fall (Time 1 [T1]) and spring (T2) semesters of their senior year (mean age = 21). A longitudinal path model examined associations among behavioral willingness, PBS, drinking, and RAP at both waves.

Results: Behavioral willingness, drinking, and PBS had direct, concurrent associations with RAP at T1 and T2. The nature of the associations was positive for behavioral willingness and drinking and negative for PBS. Prospective analyses revealed significant independent, positive associations between T1 RAP and T2 behavioral willingness, drinking, and RAP, whereas a negative independent association between T1 RAP and PBS was observed at T2.

Conclusions: Findings show evidence for a cycle of alcohol use behavior between behavioral willingness, drinking, and RAP. Based on the findings, interventions targeting college seniors seem warranted to reduce the development of further alcohol problems in adulthood.

Objective: Psychosocial stress increases the risk for subsequent episodes of alcohol use disorder (AUD) and drug use disorder (DUD), with most studies assessing stress exposure by questionnaire or interview methods. We developed an environmental risk score (ERS) using multiple classes of stressful life events (SLEs) obtained from national Swedish registries.

Method: We assessed, in the entire adult population of Sweden (N = 7,105,712), the occurrence of 51 categories of SLEs derived from registry information for the 6 months before September 1, 2010, and the risk for AUD and DUD registration over the subsequent 18 months. Weights for these two ERSs were obtained from a random half of our sample, and the relationship of ERS to AUD and DUD was evaluated in the second half.

Results: The ERS strongly predicted subsequent AUD and DUD episodes. Men were more sensitive to the pathogenic effect of the ERS than women. Those with prior episodes of AUD and DUD had larger absolute increases in ERS-associated AUD and DUD risk than those without previous episodes. Genetic risk for AUD and DUD was associated with greater sensitivity to the pathogenic effects of the ERS. A co-sibling control analysis suggested that a large proportion of the ERS-AUD and ERS-DUD associations were causal.

Conclusions: Valid measures of environmental risks that predispose to AUD and DUD can be assessed from SLEs obtained from high-quality national registry data. Importantly, this method avoids prior assessment problems of accurate dating and recall bias and can be performed in large samples.

Objective: The prevalence of binge drinking among U.S. college students has decreased over the last two decades but remains high. We examined the extent to which state-level alcohol policies and drinking environments are associated with excessive and underage alcohol use among college students.

Method: Repeated cross-sectional surveys were administered to 902,486 college students ages 18-24 years from 591 4-year institutions in 47 states biannually from 2008 to 2019. Time-varying, state-level Alcohol Policy Scale (APS) scores and population-level binge drinking and alcohol consumption rates were examined in relation to students' 30-day alcohol use (1+ days) and frequent use (20+ days), and 2-week binge drinking (5+ drinks in a sitting).

Results: More restrictive state-level policy environments were associated with lower odds of students' alcohol use, frequent use, and binge drinking; for a 10-point increase in APS, odds ratios [95% confidence interval] were .92 [.88, .95], .91 [.87, .96], and .94 [.91, .98], respectively (p < .01). Associations were significant for underage students (ages 18-20 years) but significantly stronger for older students (ages 21-24 years). State population levels of binge drinking and alcohol consumption were only positively associated with drinking outcomes for students age 21 years and older.

Conclusions: Alcohol use and binge drinking were less prevalent among young adults attending college in states with more restrictive alcohol policies and among students age 21 and older in states with lower state rates of binge drinking and alcohol consumption. Lifelong patterns of alcohol use can begin in college, and findings indicate that state alcohol policies are a foundation on which community- and campus-level preventive efforts can build.

Objective: This article describes the development of an online and text-messaging intervention aimed at augmenting protective behavioral strategies (PBS) utilization at the daily level among young adults engaged in alcohol and cannabis use. PBS, encompassing tips and strategies to moderate alcohol and cannabis use and reduce associated risks, have been integral components of personalized feedback interventions. The quality and consistency of PBS use have been underexplored in intervention frameworks.

Method: We describe six initial focus groups and 13 cognitive interviews that were conducted with young adults who use alcohol and cannabis to learn the motivations underpinning alcohol and cannabis PBS utilization, barriers impeding PBS use, and PBS use with high quality and consistency. This step served as the cornerstone for crafting targeted intervention strategies. Drawing from the insights from the focus groups and cognitive interviews, we developed an interactive online intervention and text message platform. We then conducted three additional focus groups and nine cognitive interviews with young adults who use alcohol and cannabis to gain insight into intervention content, and we implemented any needed changes.

Results: We present the final iteration of the intervention, which consisted of a brief, web-based intervention followed by text messages 3 days a week for 8 consecutive weeks, as well as two monthly daily-level summaries of behaviors reported across 8 weeks.

Conclusions: This article shares our process for designing an intervention using daily-level data, aimed at reducing alcohol and cannabis use among young adults and fostering quality and consistent use of PBS.

Objective: Hypertension is highly prevalent in primary care. Unhealthy alcohol use can impact its management and associated cardiovascular disease risks. Alcohol screening and brief intervention (ASBI) in primary care is effective for early intervention for unhealthy use, yet its effectiveness in heterogeneous populations in real-world settings remains unclear. Using electronic health records, we emulated a pragmatic clinical trial to evaluate the effects of receiving ASBI on drinking and blood pressure (BP) outcomes among primary care patients with hypertension and unhealthy alcohol use.

Method: This observational study identified 72,979 patients with hypertension who screened positive for unhealthy drinking between January 1, 2014, and December 31, 2017. We used a target trial framework to compare the effects of receiving ASBI (intervention) to not receiving brief intervention (comparison) on drinking (change in heavy drinking days and drinks/week) and BP outcomes (changes in diastolic and systolic BP) from baseline to 2- and 5-year follow-ups. Treatment effect estimates were obtained using inverse probability-weighted models.

Results: At 2 years, the intervention condition had about 0.2 fewer heavy drinking days and about 0.1 fewer drinks/week than the comparison condition. The intervention condition had an additional 0.5 mmHg and 0.7 mmHg decline in diastolic and systolic BP, and 8% and 6% higher odds of having a ≥3 mmHg reduction in diastolic and systolic BP, respectively, than the comparison condition. Between-group differences in both outcomes diminished at 5 years.

Conclusions: The modest changes in drinking and BP we found contribute to the emerging evidence that brief intervention may benefit broader health outcomes at the population level.

Objective: Women who have experienced sexual assault report higher rates of alcohol use. Sexual objectification experiences, such as sexualized body gazes, gestures, commentary, and physical contact, have been linked with greater alcohol use and may represent a particular stressor for women who have experienced sexual assault, potentially leading to craving and alcohol use to cope. This study used a 3-week ecological momentary assessment design to test whether experiencing sexual objectification indirectly predicted the likelihood of later alcohol use through heightened craving. Further, because sexual minority women may be disproportionately targeted by objectification and are more likely to report alcohol misuse, we explored whether sexual minority women experienced more objectification than heterosexual women and, in turn, greater craving and alcohol use.

Method: Participants were 82 women who had experienced sexual assault and reported probable alcohol misuse and posttraumatic stress symptoms. Women were predominantly heterosexual and bisexual. Participants reported on daily objectification experiences and momentary craving each evening, as well as past-day alcohol use each morning. A multilevel structural equation model was estimated in Mplus.

Results: As hypothesized, there was an indirect effect of experiencing objectification on a given day on later alcohol use endorsement via greater alcohol craving. There was not an indirect effect of sexual minority identity on average alcohol use frequency via objectification and craving, but sexual minority women experienced greater average craving than heterosexual women.

Conclusions: Findings support daily objectification experiences as a novel proximal risk factor for heightened craving and drinking among sexual assault survivors with diverse sexual identities.