Pub Date : 2026-04-01Epub Date: 2026-01-06DOI: 10.1016/j.addbeh.2026.108608
Luka Todorovic, Janina Baumer, Helle Larsen
This study examined the relationship between ADHD symptoms and problematic social media use (PSMU) and problematic gaming (PG) in a community sample of emerging adults. Cognitive deficits underlying ADHD – inhibitory control deficits, reward sensitivity, and temporal processing deficits – were investigated as potential mechanisms linking ADHD symptoms to PSMU and PG. In a sample of 111 emerging adults (Mage = 21.2, SD = 2.7; 84% female), ADHD symptoms, PSMU, and PG were assessed using self-report scales, while cognitive deficits were evaluated through both self-report scales and behavioural tasks. Parallel mediation analyses revealed significant positive direct effects between ADHD symptoms and both PSMU and PG, but found no significant mediating effects of the hypothesised mechanisms. Exploratory analyses suggested that inhibitory control and temporal processing deficits may play a role in linking hyperactivity/impulsivity symptoms to PSMU, and inhibitory control deficits emerged as a possible transdiagnostic factor for concurrent ADHD symptoms and PSMU. Nonetheless, the main analyses did not support mediation by cognitive deficits, indicating no evidence that they explained the associations between ADHD symptoms and problematic digital media use. Future research may explore such prospective mechanisms in longitudinal designs with representative samples to inform interventions which may reduce problematic digital media use in individuals with elevated ADHD symptoms.
{"title":"ADHD symptoms and problematic digital media use in emerging adults: Investigating the role of cognitive deficits as mediators","authors":"Luka Todorovic, Janina Baumer, Helle Larsen","doi":"10.1016/j.addbeh.2026.108608","DOIUrl":"10.1016/j.addbeh.2026.108608","url":null,"abstract":"<div><div>This study examined the relationship between ADHD symptoms and problematic social media use (PSMU) and problematic gaming (PG) in a community sample of emerging adults. Cognitive deficits underlying ADHD – inhibitory control deficits, reward sensitivity, and temporal processing deficits – were investigated as potential mechanisms linking ADHD symptoms to PSMU and PG. In a sample of 111 emerging adults (<em>M</em><sub>age</sub> = 21.2, <em>SD</em> = 2.7; 84% female), ADHD symptoms, PSMU, and PG were assessed using self-report scales, while cognitive deficits were evaluated through both self-report scales and behavioural tasks. Parallel mediation analyses revealed significant positive direct effects between ADHD symptoms and both PSMU and PG, but found no significant mediating effects of the hypothesised mechanisms. Exploratory analyses suggested that inhibitory control and temporal processing deficits may play a role in linking hyperactivity/impulsivity symptoms to PSMU, and inhibitory control deficits emerged as a possible transdiagnostic factor for concurrent ADHD symptoms and PSMU. Nonetheless, the main analyses did not support mediation by cognitive deficits, indicating no evidence that they explained the associations between ADHD symptoms and problematic digital media use. Future research may explore such prospective mechanisms in longitudinal designs with representative samples to inform interventions which may reduce problematic digital media use in individuals with elevated ADHD symptoms.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108608"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-09DOI: 10.1016/j.addbeh.2026.108614
Min Wang , Zhao Liu , Xinmei Zhou , Yuxin Shi , Tingfen Ji , Jiahui He , Anqi Cheng , Liang Zhao , Dan Xiao , Chen Wang
Introduction
Smoking is a major preventable cause of morbidity and premature death worldwide. Both bupropion and NRT help achieve smoking cessation. However, evidence on whether the combination of bupropion and NRT is more effective than bupropion alone remains uncertain. The aim of this study was to compare the efficacy and safety of bupropion combined with NRT with bupropion monotherapy.
Methods
The Cochrane Library, Embase, PubMed, and Web of Science were systematically searched for original articles published in English. Randomized controlled trials (RCTs) that compared bupropion plus NRT therapy with bupropion were included. Qualitative and quantitative analyses were conducted and the risk of bias was assessed using the Cochrane Risk of Bias 2 tool.
Results
Nine RCTs involving 4005 participants (53.8% female) were included in this study. The mean age across studies ranged from 27 to 55 years. The risk of bias results showed that two RCTs were rated as high, one was low, and six were unclear. Pooled analysis indicated that bupropion combined with NRT significantly improved biochemically validated 7-day point prevalence abstinence at the end of treatment [risk ratio (RR) = 1.35, 95% confidence interval (CI): 1.22–1.50, I2 = 21%]. At long-term follow-up (≥6 months), bupropion plus NRT showed a non-significant benefit over bupropion monotherapy (RR = 1.10, 95% CI: 0.90–1.34, I2 = 52%). Adverse events were generally comparable between groups, except for a higher incidence of nausea in the combination therapy group (10.9% vs. 7.3%; RR = 1.42, 95% CI 1.04–1.94, I2 = 0%). No significant subgroup differences were found based on the types of NRT (nicotine patch, gum, or lozenge) (χ2 = 0.89, p = 0.64).
Conclusion
Combination therapy of bupropion and NRT was associated with superior short-term smoking cessation outcome compared with bupropion alone, with a comparable safety profile except for increased risk of nausea. However, the long-term benefit of combination therapy over bupropion monotherapy was attenuated and non-significant. Further high-quality RCTs with adequate long-term follow- up are needed to confirm these findings.
吸烟是世界范围内可预防的发病和过早死亡的主要原因。安非他酮和NRT都有助于戒烟。然而，关于安非他酮和NRT联合使用是否比单独使用安非他酮更有效的证据仍不确定。本研究的目的是比较安非他酮联合NRT与安非他酮单药治疗的疗效和安全性。方法系统检索Cochrane Library、Embase、PubMed、Web of Science等网站的英文原创文章。随机对照试验（rct）比较安非他酮加NRT治疗与安非他酮。进行定性和定量分析，并使用Cochrane risk of bias 2工具评估偏倚风险。结果共纳入9项随机对照试验，共4005名受试者，其中女性53.8%。研究对象的平均年龄从27岁到55岁不等。偏倚风险结果显示，2项rct被评为高，1项被评为低，6项不清楚。合并分析显示，安非他酮联合NRT显著改善了治疗结束时经生化验证的7天点患病率戒无[风险比(RR) = 1.35, 95%可信区间（CI）： 1.22-1.50, I2 = 21%]。在长期随访（≥6个月）中，安非他酮联合NRT比安非他酮单药治疗无显著性获益（RR = 1.10, 95% CI: 0.90-1.34, I2 = 52%）。除了联合治疗组恶心发生率较高（10.9% vs. 7.3%; RR = 1.42, 95% CI 1.04-1.94, I2 = 0%）外，两组间不良事件一般具有可比性。NRT类型（尼古丁贴片、口香糖或含片）的亚组差异无统计学意义（χ2 = 0.89, p = 0.64）。结论与单独使用安非他酮相比，安非他酮和NRT联合治疗具有更好的短期戒烟效果，除了恶心风险增加外，安全性相当。然而，与安非他酮单药治疗相比，联合治疗的长期获益减弱且不显著。需要进一步的高质量随机对照试验和足够的长期随访来证实这些发现。
{"title":"Efficacy of combined nicotine replacement therapy (NRT) and bupropion compared to bupropion alone for smoking cessation: a systematic review and meta-analysis","authors":"Min Wang , Zhao Liu , Xinmei Zhou , Yuxin Shi , Tingfen Ji , Jiahui He , Anqi Cheng , Liang Zhao , Dan Xiao , Chen Wang","doi":"10.1016/j.addbeh.2026.108614","DOIUrl":"10.1016/j.addbeh.2026.108614","url":null,"abstract":"<div><h3>Introduction</h3><div>Smoking is a major preventable cause of morbidity and premature death worldwide. Both bupropion and NRT help achieve smoking cessation. However, evidence on whether the combination of bupropion and NRT is more effective than bupropion alone remains uncertain. The aim of this study was to compare the efficacy and safety of bupropion combined with NRT with bupropion monotherapy.</div></div><div><h3>Methods</h3><div>The Cochrane Library, Embase, PubMed, and Web of Science were systematically searched for original articles published in English. Randomized controlled trials (RCTs) that compared bupropion plus NRT therapy with bupropion were included. Qualitative and quantitative analyses were conducted and the risk of bias was assessed using the Cochrane Risk of Bias 2 tool.</div></div><div><h3>Results</h3><div>Nine RCTs involving 4005 participants (53.8% female) were included in this study. The mean age across studies ranged from 27 to 55 years. The risk of bias results showed that two RCTs were rated as high, one was low, and six were unclear. Pooled analysis indicated that bupropion combined with NRT significantly improved biochemically validated 7-day point prevalence abstinence at the end of treatment [risk ratio (RR) = 1.35, 95% confidence interval (CI): 1.22–1.50, I<sup>2</sup> = 21%]. At long-term follow-up (≥6 months), bupropion plus NRT showed a non-significant benefit over bupropion monotherapy (RR = 1.10, 95% CI: 0.90–1.34, I<sup>2</sup> = 52%). Adverse events were generally comparable between groups, except for a higher incidence of nausea in the combination therapy group (10.9% vs. 7.3%; RR = 1.42, 95% CI 1.04–1.94, I<sup>2</sup> = 0%). No significant subgroup differences were found based on the types of NRT (nicotine patch, gum, or lozenge) (χ<sup>2</sup> = 0.89, p = 0.64).</div></div><div><h3>Conclusion</h3><div>Combination therapy of bupropion and NRT was associated with superior short-term smoking cessation outcome compared with bupropion alone, with a comparable safety profile except for increased risk of nausea. However, the long-term benefit of combination therapy over bupropion monotherapy was attenuated and non-significant. Further high-quality RCTs with adequate long-term follow- up are needed to confirm these findings.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108614"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-03DOI: 10.1016/j.addbeh.2026.108595
Laurel P. Gibson , Michael J. Parks , Heather L. Kimmel , Carlos Blanco , Joseph T. Ciccolo , MeLisa R. Creamer , Colm Everard , Neal D. Freedman , Melissa Garcia , John H. Kingsbury , Youn Ok Lee , Daniela Marshall , Wilson M. Compton , Annette Kaufman
Given recent increases in cannabis and tobacco co-use, alongside the rapidly evolving cannabis and tobacco use landscapes in the United States (US), updated national estimates of current co-use that account for route of administration are needed. Using data from Wave 7 (2022/2023) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study (N = 39,947), this study estimates the prevalence of current co-use among US youth and adults aged 12 years and older and examines the specific routes (e.g., combustible, vaping, oral) through which individuals co-use both substances. Data were weighted to produce representative estimates. An estimated 8.2 % of US youth and adults reported current (past 30-day) co-use between 2022 and 2023. Co-use of combustible tobacco and combustible cannabis products was the most common form of co-use, accounting for nearly one third of all co-using individuals. Co-use involving combustible tobacco and combustible cannabis was most common among co-using individuals aged 25–39 and 40+, while co-use involving nicotine vaping was most common among those aged 12–24. Use of multiple tobacco and/or cannabis administration routes was also common. These findings provide the first nationally representative estimates of co-use that account for specific administration routes for both tobacco and cannabis. Findings highlight the need for surveillance and intervention strategies that account for the full range of tobacco and cannabis administration routes available today.
{"title":"Tobacco and cannabis co-use by route of administration in the United States, 2022/2023","authors":"Laurel P. Gibson , Michael J. Parks , Heather L. Kimmel , Carlos Blanco , Joseph T. Ciccolo , MeLisa R. Creamer , Colm Everard , Neal D. Freedman , Melissa Garcia , John H. Kingsbury , Youn Ok Lee , Daniela Marshall , Wilson M. Compton , Annette Kaufman","doi":"10.1016/j.addbeh.2026.108595","DOIUrl":"10.1016/j.addbeh.2026.108595","url":null,"abstract":"<div><div>Given recent increases in cannabis and tobacco co-use, alongside the rapidly evolving cannabis and tobacco use landscapes in the United States (US), updated national estimates of current co-use that account for route of administration are needed. Using data from Wave 7 (2022/2023) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study (<em>N</em> = 39,947), this study estimates the prevalence of current co-use among US youth and adults aged 12 years and older and examines the specific routes (e.g., combustible, vaping, oral) through which individuals co-use both substances. Data were weighted to produce representative estimates. An estimated 8.2 % of US youth and adults reported current (past 30-day) co-use between 2022 and 2023. Co-use of combustible tobacco and combustible cannabis products was the most common form of co-use, accounting for nearly one third of all co-using individuals. Co-use involving combustible tobacco and combustible cannabis was most common among co-using individuals aged 25–39 and 40+, while co-use involving nicotine vaping was most common among those aged 12–24. Use of multiple tobacco and/or cannabis administration routes was also common. These findings provide the first nationally representative estimates of co-use that account for specific administration routes for both tobacco and cannabis. Findings highlight the need for surveillance and intervention strategies that account for the full range of tobacco and cannabis administration routes available today.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108595"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alcohol use typically peaks during adolescence and early adulthood, when its social reinforcement value is high, and then decreases as individuals take on more adult-like responsibilities. The present study investigates whether social attunement (SA) plays a role in higher alcohol use in adolescence as well as a lower alcohol use when aging.
Methods
This online study included an international sample of 683 alcohol users (16 – 81yrs). Participants completed a SA Questionnaire, an Implicit SA task (ISAT), and measures of alcohol use. The ISAT measured SA as the change in willingness to drink in response to peer feedback between two blocks of images representing social alcohol, social non-alcohol, and social non-drinking settings. Linear regressions were conducted to assess the association between SA and alcohol use, and the role of age and gender in these associations.
Results
Unlike expected, interactions between age and SA did not predict alcohol use across social situations regardless of feedback condition. However, exploratory post-hoc analyses using the total SA score per social condition showed significant interactions between age and SA in predicting alcohol use in social situations involving non-alcoholic or no drinks. In social non-alcohol drinking settings, SA was positively associated with alcohol use among younger participants, but this association became negative in older individuals. Contrastingly, in the social non-drinking condition, SA was negatively associated with alcohol use among younger participants, but this association became positive in older individuals.
Discussion
Depending on age and social setting, SA can both be a risk- or protective factor for alcohol use.
{"title":"Social attunement and alcohol use: The role of age and gender","authors":"Christophe Romein , Karis Colyer-Patel , Emese Kroon , Helle Larsen , Hanan El Marroun , Janna Cousijn","doi":"10.1016/j.addbeh.2025.108587","DOIUrl":"10.1016/j.addbeh.2025.108587","url":null,"abstract":"<div><h3>Background</h3><div>Alcohol use typically peaks during adolescence and early adulthood, when its social reinforcement value is high, and then decreases as individuals take on more adult-like responsibilities. The present study investigates whether social attunement (SA) plays a role in higher alcohol use in adolescence as well as a lower alcohol use when aging.</div></div><div><h3>Methods</h3><div>This online study included an international sample of 683 alcohol users (16 – 81yrs). Participants completed a SA Questionnaire, an Implicit SA task (ISAT), and measures of alcohol use. The ISAT measured SA as the change in willingness to drink in response to peer feedback between two blocks of images representing social alcohol, social non-alcohol, and social non-drinking settings. Linear regressions were conducted to assess the association between SA and alcohol use, and the role of age and gender in these associations.</div></div><div><h3>Results</h3><div>Unlike expected, interactions between age and SA did not predict alcohol use across social situations regardless of feedback condition. However, exploratory post-hoc analyses using the total SA score per social condition showed significant interactions between age and SA in predicting alcohol use in social situations involving non-alcoholic or no drinks. In social non-alcohol drinking settings, SA was positively associated with alcohol use among younger participants, but this association became negative in older individuals. Contrastingly, in the social non-drinking condition, SA was negatively associated with alcohol use among younger participants, but this association became positive in older individuals.</div></div><div><h3>Discussion</h3><div>Depending on age and social setting, SA can both be a risk- or protective factor for alcohol use.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108587"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-12-22DOI: 10.1016/j.addbeh.2025.108592
Jaqueline C. Avila , Nirotma Tripathi , Caylin J. Marotta , Caitlin E. McCann , Michele Reyen , Jennifer S. Haas , Elyse R. Park , Nancy A. Rigotti
Introduction
Lung cancer screening (LCS) provides an opportunity to offer tobacco cessation treatment, but most people who smoke are unable to quit, even with support. They might benefit from switching to electronic cigarettes (EC), but their perceptions and interest in EC use are unknown.
Methods
Adults who participated in a smoking cessation clinical trial offered at LCS and still smoked at trial completion were surveyed about their interest in trying EC (primary outcome). Independent variables were EC use history and perceptions of health risks and benefits of EC vs combustible cigarettes (CC). Logistic regression models tested the association of EC use and perceptions with interest in trying EC, adjusting for covariates.
Results
204/359 eligible participants (56.8 %) completed the survey. 56.4 % had never tried EC, and 30.9 % were interested in trying EC in the future. 60.3 % believed EC to be as or more harmful than CC, but 60.8 % thought that EC were likely to help people cut down smoking. Interest in trying EC was positively associated with previous EC experience (OR: 2.08, 95 %CI:1.1–3.9), and the belief that EC were less harmful than CC (OR: 8.9, 95 %CI: 3.2–24.9), or that EC can help people cut down on smoking (OR: 8.6, 95 %CI: 3.5–21.2).
Conclusions
Adults undergoing LCS who smoke after cessation treatment ends believe that EC can help people cut down, but they overestimate EC health risks. A positive perception of EC is associated with greater interest in trying EC. Education to correct EC misperceptions might increase interest in trying EC as a harm reduction tool among those who smoke.
{"title":"Are older adults scheduled for lung cancer screening interested in trying electronic cigarettes when conventional smoking cessation treatment fails? A cross-sectional survey","authors":"Jaqueline C. Avila , Nirotma Tripathi , Caylin J. Marotta , Caitlin E. McCann , Michele Reyen , Jennifer S. Haas , Elyse R. Park , Nancy A. Rigotti","doi":"10.1016/j.addbeh.2025.108592","DOIUrl":"10.1016/j.addbeh.2025.108592","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung cancer screening (LCS) provides an opportunity to offer tobacco cessation treatment, but most people who smoke are unable to quit, even with support. They might benefit from switching to electronic cigarettes (EC), but their perceptions and interest in EC use are unknown.</div></div><div><h3>Methods</h3><div>Adults who participated in a smoking cessation clinical trial offered at LCS and still smoked at trial completion were surveyed about their interest in trying EC (primary outcome). Independent variables were EC use history and perceptions of health risks and benefits of EC vs combustible cigarettes (CC). Logistic regression models tested the association of EC use and perceptions with interest in trying EC, adjusting for covariates.</div></div><div><h3>Results</h3><div>204/359 eligible participants (56.8 %) completed the survey. 56.4 % had never tried EC, and 30.9 % were interested in trying EC in the future. 60.3 % believed EC to be as or more harmful than CC, but 60.8 % thought that EC were likely to help people cut down smoking. Interest in trying EC was positively associated with previous EC experience (OR: 2.08, 95 %CI:1.1–3.9), and the belief that EC were less harmful than CC (OR: 8.9, 95 %CI: 3.2–24.9), or that EC can help people cut down on smoking (OR: 8.6, 95 %CI: 3.5–21.2).</div></div><div><h3>Conclusions</h3><div>Adults undergoing LCS who smoke after cessation treatment ends believe that EC can help people cut down, but they overestimate EC health risks. A positive perception of EC is associated with greater interest in trying EC. Education to correct EC misperceptions might increase interest in trying EC as a harm reduction tool among those who smoke.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108592"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-12-19DOI: 10.1016/j.addbeh.2025.108590
Andrea M. Wycoff , Timothy J. Trull
Negative reinforcement is a major component of etiologic models of addiction. Recent work using ecological momentary assessment (EMA) implicates subjective substance-contingent relief as a negative reinforcer of substance use rather than improvements in negative affect. This pre-registered secondary data analysis tested predictors of subjective alcohol- and cannabis-contingent relief to understand what factors contribute to perceived relief, if not actual improvements in negative affect. Adults (N = 87, mean age 25.2 years, 60.2% female, 85.2% white) who reported using alcohol and cannabis simultaneously at least twice per week completed 14 days of EMA. Morning surveys assessed hypothetical relief expectancies for that day. All surveys assessed affect, craving, alcohol and cannabis use, and subjective relief and pleasure from use. Multilevel models tested predictors of subjective relief. During alcohol use moments (n = 868), drinking-contingent pleasure (b = 0.25, SE = 0.06, p < .001) and relief expectancy reported that morning (b = 0.29, SE = 0.10, p = .005) predicted higher drinking-contingent relief. During cannabis use moments (n = 1519), cannabis-contingent pleasure (b = 0.29, SE = 0.06, p < .001) and relief expectancy reported that morning (b = 0.33, SE = 0.11, p = .004) predicted higher cannabis-contingent relief. Changes in affect and craving were not associated with relief. Results highlight subjective pleasure, which is more consistent with positive reinforcement, as a potential driver of perceived relief. Future work should disentangle the predictive direction of relief and pleasure to inform reinforcement mechanisms. Results also highlight the role of expectancies in subjective perceptions of use, above and beyond measurable changes in mood and craving. Collectively, findings add to a growing body of work seeking to articulate reinforcement processes in the natural environment.
负强化是成瘾病因学模型的主要组成部分。最近使用生态瞬时评估（EMA）的工作暗示主观物质-偶然缓解是物质使用的负强化物，而不是消极影响的改善。这项预先注册的二级数据分析测试了主观酒精和大麻缓解的预测因子，以了解哪些因素有助于感知缓解，如果不是负面影响的实际改善。每周至少两次同时使用酒精和大麻的成年人（N = 87，平均年龄25.2岁，60.2%女性，85.2%白人）完成了14天的EMA。上午的调查评估了当天的假设救济预期。所有调查都评估了情感、渴望、酒精和大麻的使用，以及使用后的主观缓解和愉悦。多水平模型测试了主观缓解的预测因子。在饮酒时刻（n = 868），饮酒附带快感(b = 0.25, SE = 0.06, p
{"title":"Perceptions of negative reinforcement in the natural environment: Characterizing subjective alcohol- and cannabis-contingent relief","authors":"Andrea M. Wycoff , Timothy J. Trull","doi":"10.1016/j.addbeh.2025.108590","DOIUrl":"10.1016/j.addbeh.2025.108590","url":null,"abstract":"<div><div>Negative reinforcement is a major component of etiologic models of addiction. Recent work using ecological momentary assessment (EMA) implicates subjective substance-contingent relief as a negative reinforcer of substance use rather than improvements in negative affect. This pre-registered secondary data analysis tested predictors of subjective alcohol- and cannabis-contingent relief to understand what factors contribute to perceived relief, if not actual improvements in negative affect. Adults (<em>N</em> = 87, mean age 25.2 years, 60.2% female, 85.2% white) who reported using alcohol and cannabis simultaneously at least twice per week completed 14 days of EMA. Morning surveys assessed hypothetical relief expectancies for that day. All surveys assessed affect, craving, alcohol and cannabis use, and subjective relief and pleasure from use. Multilevel models tested predictors of subjective relief. During alcohol use moments (<em>n</em> = 868), drinking-contingent pleasure (<em>b</em> = 0.25, <em>SE</em> = 0.06, <em>p</em> < .001) and relief expectancy reported that morning (<em>b</em> = 0.29, <em>SE</em> = 0.10, <em>p</em> = .005) predicted higher drinking-contingent relief. During cannabis use moments (<em>n</em> = 1519), cannabis-contingent pleasure (<em>b</em> = 0.29, <em>SE</em> = 0.06, <em>p</em> < .001) and relief expectancy reported that morning (<em>b</em> = 0.33, <em>SE</em> = 0.11, <em>p</em> = .004) predicted higher cannabis-contingent relief. Changes in affect and craving were not associated with relief. Results highlight subjective pleasure, which is more consistent with positive reinforcement, as a potential driver of perceived relief. Future work should disentangle the predictive direction of relief and pleasure to inform reinforcement mechanisms. Results also highlight the role of expectancies in subjective perceptions of use, above and beyond measurable changes in mood and craving. Collectively, findings add to a growing body of work seeking to articulate reinforcement processes in the natural environment.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108590"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-12-28DOI: 10.1016/j.addbeh.2025.108593
Jordan P. Davis , Shaddy K. Saba , Daniel Leightley , Eric R. Pedersen , John Prindle , Jonathan Cantor , Bistra Dilkina , Emily Dworkin , Angeles Sedano
Background and aims. Cannabis use is increasingly prevalent among U.S. veterans, with high rates of both recreational and problematic use. Veterans often use cannabis to manage symptoms associated with mental health problems such as depression and posttraumatic stress disorder (PTSD). Prior work has noted mixed results on the longitudinal associations between cannabis use and depression. Studying these associations at the daily level can lead to improved clarity. Design. The present study examined the daily associations between cannabis use and depression in veterans using dynamic structural equation modeling (DSEM). We also explored these associations for those veterans who screened positive for posttraumatic stress disorder (PTSD) compared to those who did not. Setting. All participants were recruited using advertisements from BuildClinical, an NIH approved recruitment vendor. Participants. The sample consisted of 74 veterans who provided daily data for 87 consecutive days. Measurement. Cannabis was assessed asking how many hours each individual spent high each day, depressed mood was assessed using a sliding scale from not depressed to very depressed each day, and PTSD was assessed using the PTSD checklist. Findings. Among the full veteran sample results revealed a bidirectional, negative, association. Specifically, on days when veterans reported greater depression, they reported fewer hours “high” the next day. Conversely, on days when veterans reported a greater number of hours high, they reported less depression the next day. Among veterans screening positive for PTSD, on days when they reported more depression, they reported fewer hours high the next day (no association was noted for cannabis use predicting depression). However, for those who did not screen positive for PTSD, on days when veterans reported greater number of hours high, they reported less depression the next day. Conclusions. These results highlight the need for further research on the effect of individual differences in cannabis use patterns among veterans with PTSD on health outcomes. Clinically, these results highlight the importance of targeting the pros and cons of cannabis use for depression symptom relief. Future research should incorporate daily objective measures of cannabis use to refine treatment strategies for veterans managing PTSD or depressive related distress.
{"title":"More high, less low? PTSD and the complex daily associations between cannabis use and depression in veterans","authors":"Jordan P. Davis , Shaddy K. Saba , Daniel Leightley , Eric R. Pedersen , John Prindle , Jonathan Cantor , Bistra Dilkina , Emily Dworkin , Angeles Sedano","doi":"10.1016/j.addbeh.2025.108593","DOIUrl":"10.1016/j.addbeh.2025.108593","url":null,"abstract":"<div><div><strong>Background and aims</strong>. Cannabis use is increasingly prevalent among U.S. veterans, with high rates of both recreational and problematic use. Veterans often use cannabis to manage symptoms associated with mental health problems such as depression and posttraumatic stress disorder (PTSD). Prior work has noted mixed results on the longitudinal associations between cannabis use and depression. Studying these associations at the daily level can lead to improved clarity. <strong>Design</strong>. The present study examined the daily associations between cannabis use and depression in veterans using dynamic structural equation modeling (DSEM). We also explored these associations for those veterans who screened positive for posttraumatic stress disorder (PTSD) compared to those who did not. Setting. All participants were recruited using advertisements from BuildClinical, an NIH approved recruitment vendor. <strong>Participants</strong>. The sample consisted of 74 veterans who provided daily data for 87 consecutive days. <strong>Measurement</strong>. Cannabis was assessed asking how many hours each individual spent high each day, depressed mood was assessed using a sliding scale from not depressed to very depressed each day, and PTSD was assessed using the PTSD checklist. <strong>Findings</strong>. Among the full veteran sample results revealed a bidirectional, negative, association. Specifically, on days when veterans reported greater depression, they reported fewer hours “high” the next day. Conversely, on days when veterans reported a greater number of hours high, they reported less depression the next day. Among veterans screening positive for PTSD, on days when they reported more depression, they reported fewer hours high the next day (no association was noted for cannabis use predicting depression). However, for those who did not screen positive for PTSD, on days when veterans reported greater number of hours high, they reported less depression the next day. <strong>Conclusions</strong>. These results highlight the need for further research on the effect of individual differences in cannabis use patterns among veterans with PTSD on health outcomes. Clinically, these results highlight the importance of targeting the pros and cons of cannabis use for depression symptom relief. Future research should incorporate daily objective measures of cannabis use to refine treatment strategies for veterans managing PTSD or depressive related distress.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108593"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-12-14DOI: 10.1016/j.addbeh.2025.108586
Marissa G. Hall , Phoebe R. Ruggles , Carolyn Chelius , Cristina J.Y. Lee , Callie Whitesell , Allison J. Lazard , Noel T. Brewer , Thomas K. Greenfield , Anna H. Grummon
Background
The US has had the same health warning on alcohol containers since 1989. We sought to estimate consumer noticing, reading, and recall of the current US alcohol health warning.
Methods
We recruited a nationally representative sample of 1,036 US alcohol consumers ages 21 + years. Participants completed an online survey in 2024 that assessed whether they had noticed or read the current US alcohol health warning, as well as aided recall of the topics in the warning. Analyses used multivariable logistic regression to examine correlates of reading the warning.
Results
About half of participants (52 %) reported noticing the alcohol health warning the last time they saw an alcohol container and 27 % reported reading the warning in the past month. Reading the warning was more common among Black people (vs. white, 43 % vs. 23 %, p = 0.02). When prompted with a list of possible warning topics, only 4 % of participants correctly recalled all five topics in the warning. Most (60 %) recalled that the warning discussed pregnancy, but less than half recalled the remaining topics in the warning (46 % driving a car, 44 % operating machinery, 41 % birth defects, and 33 % health problems). Recall was modestly higher among those who read the warning in the past month (improvements of 5–16 percentage points) compared to those who did not. However, fewer than two-thirds of people who said they had read the warning recalled each topic.
Conclusions
The current US alcohol warning fails to actively engage many alcohol consumers. The US should require new, rotating alcohol warnings designed to heighten engagement and better inform consumers.
自1989年以来，美国在酒精容器上也有同样的健康警告。我们试图估计消费者对当前美国酒精健康警告的注意、阅读和召回情况。方法：我们招募了1036名年龄在21岁以上的美国酒精消费者的全国代表性样本。参与者在2024年完成了一项在线调查，评估他们是否注意到或阅读了当前的美国酒精健康警告，以及帮助回忆警告中的主题。分析使用多变量逻辑回归来检验阅读警告的相关性。大约一半的参与者（52%）报告说，他们最后一次看到酒精容器时注意到了酒精健康警告，27%的人报告说，在过去一个月里阅读了警告。阅读警告的黑人更常见（43% vs. 23%, p = 0.02）。当提示一个可能的警告主题列表时，只有4%的参与者正确地记住了警告中的所有五个主题。大多数（60%）的人回忆起警告讨论了怀孕，但只有不到一半的人回忆起警告中的其他话题（46%的人驾驶汽车，44%的人操作机器，41%的人出生缺陷，33%的人健康问题）。在过去的一个月里，那些读过警告的人的记忆力比没有读过警告的人略高（提高了5-16个百分点）。然而，只有不到三分之二的人说他们读过警告，记住了每个主题。目前的美国酒精警告未能积极吸引许多酒精消费者。美国应该要求新的、循环的酒精警告，旨在提高消费者的参与度，更好地告知消费者。
{"title":"Consumer engagement with the US alcohol health warning: A nationally representative study","authors":"Marissa G. Hall , Phoebe R. Ruggles , Carolyn Chelius , Cristina J.Y. Lee , Callie Whitesell , Allison J. Lazard , Noel T. Brewer , Thomas K. Greenfield , Anna H. Grummon","doi":"10.1016/j.addbeh.2025.108586","DOIUrl":"10.1016/j.addbeh.2025.108586","url":null,"abstract":"<div><h3>Background</h3><div>The US has had the same health warning on alcohol containers since 1989. We sought to estimate consumer noticing, reading, and recall of the current US alcohol health warning.</div></div><div><h3>Methods</h3><div>We recruited a nationally representative sample of 1,036 US alcohol consumers ages 21 + years. Participants completed an online survey in 2024 that assessed whether they had noticed or read the current US alcohol health warning, as well as aided recall of the topics in the warning. Analyses used multivariable logistic regression to examine correlates of reading the warning.</div></div><div><h3>Results</h3><div>About half of participants (52 %) reported noticing the alcohol health warning the last time they saw an alcohol container and 27 % reported reading the warning in the past month. Reading the warning was more common among Black people (vs. white, 43 % vs. 23 %, <em>p</em> = 0.02). When prompted with a list of possible warning topics, only 4 % of participants correctly recalled all five topics in the warning. Most (60 %) recalled that the warning discussed pregnancy, but less than half recalled the remaining topics in the warning (46 % driving a car, 44 % operating machinery, 41 % birth defects, and 33 % health problems). Recall was modestly higher among those who read the warning in the past month (improvements of 5–16 percentage points) compared to those who did not. However, fewer than two-thirds of people who said they had read the warning recalled each topic.</div></div><div><h3>Conclusions</h3><div>The current US alcohol warning fails to actively engage many alcohol consumers. The US should require new, rotating alcohol warnings designed to heighten engagement and better inform consumers.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108586"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-26DOI: 10.1016/j.addbeh.2026.108624
Anna M. Langener , Dawson Haddox , Daniel M. Mackin , George D. Price , Damien Lekkas , Amanda C. Collins , Tess Z. Griffin , Michael V. Heinz , Matthew D. Nemesure , Subigya Nepal , Arvind Pillai , Andrew T. Campbell , Nicholas C. Jacobson
Major Depressive Disorder (MDD) is one of the most prevalent psychological disorders and frequently co-occurs with alcohol use disorders, increasing the risk of functional impairment. Monitoring alcohol use during depression treatment is therefore critical for early intervention. Passively collected data via devices like smartphones and smartwatches, offers a low-burden method for monitoring behavior in real time. This study investigated whether deep learning models trained on passively collected data (i.e., accelerometer, heart rate, respiratory rate, screen usage, and GPS data) could detect and predict alcohol use in individuals with MDD. Data were collected from 300 clinically depressed individuals who were enrolled in the Tracking Depression Study, a 90-day longitudinal study. Participants self-reported their alcohol use every week by completing the Timeline FollowBack. We trained models to predict same-day and next-day alcohol use. To validate these models, we split the data by participant, so that predictions were made on individuals who were not included in the training set. The models achieved moderate performance (mean AUC = 0.67 for both prediction tasks) when capturing both interindividual (between-person) and intraindividual (within-person) variability. Similar performances were observed when evaluating the model exclusively on predicting intraindividual variability (AUCs = 0.69 same-day, 0.68 next-day). However, model performance remained comparable to a baseline using only the day of week as predictor. These findings suggest that much of the predictive signal derives from temporal patterns. This indicates that interventions aligned with such temporal cues may already be effective, and that the added value of our model appears limited.
{"title":"Passive data do not improve prediction or detection of alcohol consumption beyond temporal patterns in major depression: A 90-day cross-validated study","authors":"Anna M. Langener , Dawson Haddox , Daniel M. Mackin , George D. Price , Damien Lekkas , Amanda C. Collins , Tess Z. Griffin , Michael V. Heinz , Matthew D. Nemesure , Subigya Nepal , Arvind Pillai , Andrew T. Campbell , Nicholas C. Jacobson","doi":"10.1016/j.addbeh.2026.108624","DOIUrl":"10.1016/j.addbeh.2026.108624","url":null,"abstract":"<div><div>Major Depressive Disorder (MDD) is one of the most prevalent psychological disorders and frequently co-occurs with alcohol use disorders, increasing the risk of functional impairment. Monitoring alcohol use during depression treatment is therefore critical for early intervention. Passively collected data via devices like smartphones and smartwatches, offers a low-burden method for monitoring behavior in real time. This study investigated whether deep learning models trained on passively collected data (i.e., accelerometer, heart rate, respiratory rate, screen usage, and GPS data) could detect and predict alcohol use in individuals with MDD. Data were collected from 300 clinically depressed individuals who were enrolled in the Tracking Depression Study, a 90-day longitudinal study. Participants self-reported their alcohol use every week by completing the Timeline FollowBack. We trained models to predict same-day and next-day alcohol use. To validate these models, we split the data by participant, so that predictions were made on individuals who were not included in the training set. The models achieved moderate performance (mean AUC = 0.67 for both prediction tasks) when capturing both interindividual (between-person) and intraindividual (within-person) variability. Similar performances were observed when evaluating the model exclusively on predicting intraindividual variability (AUCs = 0.69 same-day, 0.68 next-day). However, model performance remained comparable to a baseline using only the day of week as predictor. These findings suggest that much of the predictive signal derives from temporal patterns. This indicates that interventions aligned with such temporal cues may already be effective, and that the added value of our model appears limited.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108624"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-09DOI: 10.1016/j.addbeh.2025.108584
Charles A. Manzler , Ben Lewis , Scott Teitelbaum , Robert C. Schlauch
Many individuals turn to religion in their efforts to deal with difficult times in their lives, and research has consistently linked indices of religious coping to measures of health and well-being. The Brief Religious Coping Scale (Brief RCOPE) is the most commonly used measure of religious coping in the literature; however, relatively little has been reported about the psychometric properties of the brief version. Moreover, the examination of this scale among individuals with a substance use disorder (SUD), a disorder highly associated with major life stressors for which religious coping may serve as a principle form of coping, has been largely overlooked. Therefore, the current study sought to examine the psychometric properties of the Brief RCOPE in a sample of 1290 adults undergoing residential treatment for SUD. Results from confirmatory factor analyses supported the theorized two-factor structure of positive (PRC) and negative (NRC) religious coping, as well as measurement invariance across sex and across time. Validity was established through significant, differential associations between PRC and NRC at pre-treatment and a range of psychosocial outcomes at pre- and post-treatment. This study provides evidence that the Brief RCOPE is a reliable and valid tool for assessing religious coping among adults with SUD. Its strong psychometric performance supports its potential for use in clinical settings to help clinicians understand and address patients’ spiritual experiences in recovery.
许多人在努力应对生活中的困难时期时求助于宗教，研究一直将宗教应对指数与健康和幸福措施联系起来。简要宗教应对量表（Brief Religious Coping Scale，简称RCOPE）是文献中最常用的宗教应对量表；然而，关于简短版本的心理测量特性的报道相对较少。此外，在物质使用障碍（一种与主要生活压力源高度相关的障碍，宗教应对可能是应对的主要形式）患者中对该量表的检查在很大程度上被忽视了。因此，目前的研究试图在1290名接受SUD住院治疗的成年人样本中检查简短RCOPE的心理测量特性。验证性因子分析的结果支持积极（PRC）和消极（NRC）宗教应对的理论双因素结构，以及跨性别和跨时间的测量不变性。通过PRC和NRC在治疗前以及治疗前和治疗后一系列社会心理结果之间的显著差异关联，建立了有效性。本研究提供了证据，证明简短的RCOPE是评估成人宗教应对的可靠和有效的工具。其强大的心理测量性能支持其在临床环境中使用的潜力，以帮助临床医生理解和解决患者在康复中的精神体验。
{"title":"Investigation into the psychometric properties of the Brief Religious Coping Scale (Brief RCOPE) in adults with substance use disorder","authors":"Charles A. Manzler , Ben Lewis , Scott Teitelbaum , Robert C. Schlauch","doi":"10.1016/j.addbeh.2025.108584","DOIUrl":"10.1016/j.addbeh.2025.108584","url":null,"abstract":"<div><div>Many individuals turn to religion in their efforts to deal with difficult times in their lives, and research has consistently linked indices of religious coping to measures of health and well-being. The Brief Religious Coping Scale (Brief RCOPE) is the most commonly used measure of religious coping in the literature; however, relatively little has been reported about the psychometric properties of the brief version. Moreover, the examination of this scale among individuals with a substance use disorder (SUD), a disorder highly associated with major life stressors for which religious coping may serve as a principle form of coping, has been largely overlooked. Therefore, the current study sought to examine the psychometric properties of the Brief RCOPE in a sample of 1290 adults undergoing residential treatment for SUD. Results from confirmatory factor analyses supported the theorized two-factor structure of positive (PRC) and negative (NRC) religious coping, as well as measurement invariance across sex and across time. Validity was established through significant, differential associations between PRC and NRC at pre-treatment and a range of psychosocial outcomes at pre- and post-treatment. This study provides evidence that the Brief RCOPE is a reliable and valid tool for assessing religious coping among adults with SUD. Its strong psychometric performance supports its potential for use in clinical settings to help clinicians understand and address patients’ spiritual experiences in recovery.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"174 ","pages":"Article 108584"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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