Psychology of Addictive Behaviors最新文献

Objective: Compared with men, women are disproportionately affected by alcohol, including greater risks of behavioral impairment and relapse from abstinence-based treatments. One potential mechanism underlying this disparity is ovarian hormone fluctuations across menstrual cycle phases, particularly estradiol (E2). Preclinical and clinical studies have shown that E2 levels positively correlate with alcohol consumption, suggesting E2 modulates drinking. Rewarding properties of alcohol are thought to mediate this relationship. The present study tested the degree to which women report increased rewarding effects from alcohol and heightened attention to alcohol-related cues when E2 was elevated during the late follicular phase of the menstrual cycle.

Method: Fifty women aged 21-29 participated in a within-subjects placebo-controlled study examining how menstrual cycle phase alters the rewarding properties of alcohol and alcohol-associated cues when sober and intoxicated, as measured by their attentional bias toward alcohol-associated cues and subjective reports. Measures were obtained following 0.60 g/kg alcohol and placebo during the early follicular phase when E2 was low and the late follicular phase (i.e., ovulation) when E2 was elevated.

Results: Attentional bias to alcohol-associated cues was greater during the late follicular phase in both sober and intoxicated states. Women reported rewarding effects from alcohol, but no effects of phase were observed.

Conclusions: The findings suggest that the rewarding properties of alcohol-associated cues might be enhanced during the late follicular phase of the menstrual cycle when E2 is elevated, possibly increasing the risk for excessive drinking in women during this phase. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The Alcohol Addiction Research Domain Criteria (AARDoC) is an organizational framework for assessing heterogeneity in addictive disorders organized across the addiction cycle domains of incentive salience, negative emotionality, and executive functioning and may have benefits for precision medicine. Recent work found pretreatment self-report items mapped onto the addiction cycle domains and predicted 1- and 3-year alcohol use disorder treatment outcomes. Given the potential utility of the addiction cycle domains for predicting relevant treatment outcomes, this study sought to evaluate the longitudinal measurement invariance of the domains.

Method: We conducted a secondary analysis of individuals with alcohol use disorder (n = 1,383, 30.9% female, 76.8% non-Hispanic White, 11.2% Hispanic) who participated in the COMBINE study. Eleven items assessed at pre- and posttreatment were included in exploratory structural equation modeling (ESEM) and longitudinal invariance analyses.

Results: The pre- and posttreatment ESEM models had factor loadings consistent with the three addiction cycle domains and fit the data well. The ESEM factor structure was invariant from pre- to posttreatment (representing configural invariance) and metric invariance (factor loadings) was largely supported, but analyses failed to support scalar invariance (item-level thresholds) of the addiction cycle domains.

Conclusions: A three-factor structure representing addiction cycle domains can be modeled using brief self-report measures pre- and posttreatment. Individuals demonstrated a downward shift in the level of item endorsement, indicating improvement with treatment. Although this 11-item measure might be useful at baseline for informing treatment decisions, results indicate the need to exercise caution in comparing the addiction cycle domains pre- to posttreatment within persons. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Lower sensitivity to the acute effects of alcohol is known to confer risk for the development of alcohol use disorder. Alcohol sensitivity, or level of response to alcohol's subjective effects, is heritable but also can change as a result of persistent alcohol exposure (i.e., acquired tolerance). Here, we examined how changes over time in four indices of alcohol involvement affected scores on two validated, retrospective self-report measures of alcohol response-the Self-Rating of the Effects of Alcohol (SRE) form and the Alcohol Sensitivity Questionnaire (ASQ)-in a sample of emerging adult drinkers.

Method: Participants (N = 173; M_age = 19.5 years; 60% assigned female at birth) completed the ASQ, SRE, and measures of alcohol use and problems at two time points separated by a median of 0.77 years (range: 0.30-2.54 years).

Results: Multiple linear regression showed that increases in drinking over this period accounted for increases in SRE and ASQ scores (i.e., in reported numbers of drinks needed to experience subjective effects of alcohol). Increased drinking accounted for more variance in the number of drinks needed to experience lighter drinking versus heavier drinking effects, and increases in the number of drinks consumed per occasion had a larger effect than did changes in total numbers of drinks consumed, number of binge-drinking occasions, or drinking-related problems.

Conclusions: Findings suggest that both SRE and ASQ capture some stable, trait-like variability in alcohol response as well as some state-dependent, within-person variability in alcohol response acquired through increases in alcohol involvement. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Population drinking trends show clear developmental periodicity, with steep increases in harmful alcohol use from ages 18 to 22 followed by a gradual decline across the 20s, albeit with persistent problematic use in a subgroup of individuals. Cross-sectional studies implicate behavioral economic indicators of alcohol overvaluation (high alcohol demand) and lack of alternative substance-free reinforcers (high proportionate alcohol-related reinforcement) as potential predictors of change during this developmental window, but longitudinal evidence is sparse.

Method: Using a sample of emerging adults (N = 497, M_age = 22.61 years, 62% female, 48.69% White, 40.44% Black), this study examined prospective, bidirectional relations between both past-week heavy drinking days (HDD) and alcohol problems and proportionate alcohol-related reinforcement (reinforcement ratio), alcohol demand intensity (consumption at zero price), alcohol demand O_max (maximum expenditure), and change in demand elasticity (rate of change in consumption across escalating price) over five assessments (every 4 months) using random intercept cross-lagged panel models.

Results: Alcohol problems and HDD decreased across assessments. Significant between-person effects indicated that each behavioral economic variable was associated with increased drinking risk. Change in reinforcement ratio was positively associated with decreases in alcohol problems. Multigroup invariance modeling revealed distinct risk pathways in that change in demand intensity and O_max predicted change in alcohol problems for male participants and change in intensity predicted change in alcohol problems for non-White participants.

Conclusion: The study provides consistent support for proportionate alcohol-related reinforcement and mixed support for demand as within-person predictors of reductions in drinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: A severe and long-term alcohol use can have adverse effects on lower limb function. Over time, some individuals may develop gait ataxia, which refers to the impairment of controlled lower body movements that are important for walking and maintaining proper gait. Gait ataxia is well-documented in patients who have been diagnosed with alcohol-related Wernicke-Korsakoff syndrome (WKS); however, less is known on how common ataxia is among patients with alcohol use disorder (AUD) without WKS. To date, no study has systematically reviewed the evidence focusing on patients suffering only from AUD. Our aim was to perform a qualitative synthesis of the existing literature examining behavioral signs of gait ataxia among abstinent patients with AUD.

Method: Two facets were created encompassing keywords for "alcohol use disorder" and "measures of gait ataxia." Databases, including EMBASE, APA PsycInfo, Medline, and Cochrane Library, were searched for studies, and a quality assessment was performed.

Results: Ten studies were identified (37 ≥ ns ≤ 247), which were all rated as being of moderate (N = 7) to good quality (N = 3). The age range was 31.4-53.4 years (weighted mean age: 53.6 years), and 78.3% of the participants were male. Eight studies found that patients with AUD and without WKS exhibited behavioral signs of gait ataxia.

Conclusions: Although there is evidence of gait ataxia among patients with AUD, heterogeneous results and methodological shortcomings such as lack of screening for neurocognitive deficits deem these findings preliminary and highlight the need for more research in the future. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: From 2022, the International Classification of Diseases, eleventh edition (ICD-11) includes the first mental disorder based on digital technology, "gaming disorder," which was previously suggested as a condition for further examination in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). In this cross-sectional study, we provide the first large-scale network analysis of various symptom structures for these constructs to understand the complex interconnections between their proposed symptoms.

Method: Culturally diverse samples of 2,846 digital game players (M = 25.3 years) and 746 esports players (M = 23.5 years) were recruited. A network approach was applied to explore a multiverse of gaming disorder symptom structures, effects of item operationalization, and possible external moderators. Gaming disorder was measured using the Internet Gaming Disorder Scale 9-Short Form (IGDS9-SF), Gaming Disorder Test, and several items borrowed from Chinese Internet Gaming Disorder Scale, Personal Internet Gaming Disorder Evaluation-9, and Clinical Video game Addiction Test 2.0 scales.

Results: Two symptoms (loss of control and continued use despite problems) present in both, the DSM-5 and ICD-11, were systematically central to most of the analyzed networks. Alternative operationalizations of single items systematically caused significant network differences. Networks were invariant across groups of play style, age, gender, gaming time, and most of the psychosocial characteristics.

Conclusions: Our results caution practitioners and researchers when studying and interpreting gaming disorder symptoms. The data indicate that even minor operational changes in symptoms can lead to significant network-level changes, thus highlighting the need for careful wording. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Land-based gambling venues remain predominantly cash-based despite broader consumer trends toward digital payments. Little prior literature directly investigates the role of payment methods in gambling; however, digital payment systems offer a key intervention point for gambling harm minimization. This study explores the perspectives of electronic gaming machine (EGM) gamblers regarding the concept of cashless gambling-the ability to gamble without using physical currency.

Method: Twenty-six Australian EGM gamblers (10 females, 16 males; aged 24-76 years) participated in four online focus group discussions. Using content analysis and a pragmatic approach, data were organized thematically in relation to consumer perceptions about the benefits and risks of cashless gambling, factors potentially influencing uptake of cashless gambling, and recommendations about harm reduction features that could be incorporated into the system.

Results: Cashless gambling was perceived to present important opportunities for more useful and meaningful harm reduction measures based on the ability to track a user's complete gambling activity. However, participants reported reluctance toward adoption of cashless gambling, tending to perceive such systems as being overly restrictive and invasive, and potentially facilitating (over)spending, depending on design and implementation. Participants commonly perceived systems as offering little value to individuals who gamble without experiencing significant harms.

Conclusions: Perceived irrelevance and privacy concerns appear to be major barriers to adoption of a cashless gambling system with strong harm reduction features. Our findings provide insights for policy makers considering the optimal design, implementation, and marketing of cashless gambling from a harm reduction perspective. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Remission from problem gambling (PG) continues to be a priority of clinicians and researchers. Data from cross-sectional studies indicate that some correlates are more predictive of PG, and existing longitudinal studies have exclusively examined risk factors that predict emergence of PG. This study's objective is to fill in the remaining pieces of the puzzle by identifying factors that might facilitate remission from PG.

Method: A stratified sample of 10,199 Canadian adult gamblers were recruited from an online panel. Respondents who screened positively for PG at baseline and completed a follow-up assessment 1 year later (n = 468) were assessed on a series of modifiable gambling, psychosocial, mental health, and substance use variables. A forward stepwise logistic regression was conducted to identify the strongest predictors of remission from PG at follow-up. A Least Absolute Shrinkage and Selection Operator regression was also conducted to confirm the most relevant predictors.

Results: Out of 75 candidate variables, 10 were retained by the regression model. Two were related to cessation of specific gambling activities, two were related to gambling motivations, two were psychosocial in nature, two were related to substance use while gambling, and one was related to remission from a mental health disorder. The final and strongest predictor was PG severity at baseline.

Conclusions: Although PG remission predictors were mostly gambling-related, psychosocial aspects may also be targeted by stakeholders aiming to reduce PG. Ceasing to use tobacco while gambling and diversifying leisure activities may be promising targets. Other mental health and substance use predictors may still possibly be relevant, but only for a subset of people with PG. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Despite rates of alcohol misuse being higher among emerging adults experiencing homelessness compared to those who are stably housed, there are few brief evidence-based risk reduction programs for this population that focus on alcohol use and assess outcomes for more than 1 year. This study examines alcohol outcomes from a 24-month evaluation of AWARE, a brief motivational interviewing-based group risk reduction intervention for emerging adults experiencing homelessness.

Method: In a cluster randomized crossover trial, 18- to 25- year-olds received AWARE (n = 132) or standard care (n = 144) at one of three drop-in centers serving young people experiencing homelessness in Los Angeles County. We evaluated intervention effects on past month alcohol use, consequences, and related cognitions such as motivation to change behavior.

Results: AWARE participants showed significant reductions over 24 months in alcohol use and negative consequences from drinking and reported significant increases in their use of drinking protective strategies. Except for drinking frequency, control group participants did not show a significant change in these outcomes.

Conclusions: Findings build on earlier work by demonstrating that AWARE is effective in reducing alcohol use and related problems among emerging adults experiencing homelessness over a 2-year period. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This study investigated the impact of relational provocation on intimate partner violence (IPV) perpetration as a function of alcohol intoxication and individuals' emotion differentiation (ED; i.e., the ability to differentiate between positive and negative emotions). We hypothesized that provocation and acute intoxication would be associated with lower ED, such that individuals would demonstrate lower ED following provocation and while intoxicated. We also hypothesized an intoxication-by-ED interaction, such that only individuals who were intoxicated and undifferentiated would perpetrate IPV.

Method: Two hundred fifty community-based adults completed an aggression paradigm ostensibly with their romantic partners where they were randomly assigned to an alcohol or no-alcohol condition. Participants' ED across positive and negative subscales was calculated at baseline (Time 1), postprovocation and intoxication (Time 2), and postbehavioral aggression (Time 3). IPV was operationalized as the strength and duration of shocks issued to their partner during the aggression paradigm.

Results: Both sober and intoxicated participants experienced lower ED following provocation, suggesting a main effect of provocation but no main effect of intoxication. There was a significant alcohol-by-ED interaction in the predicted direction. For intoxicated participants, low ED was associated with greater IPV perpetration. For sober participants, low ED was associated with less IPV perpetration.

Conclusions: Consistent with hypotheses, low ED is associated with greater IPV perpetration among intoxicated individuals. In contrast to prior research, low ED was associated with less IPV perpetration among sober individuals. Alcohol-related cognitive impairments may increase the likelihood of IPV perpetration by disrupting the ED process that may otherwise inhibit impulsive aggression. (PsycInfo Database Record (c) 2024 APA, all rights reserved).