Sayre E. Wilson, Hannah A. Lavoie, Benjamin L. Berey, Tessa Frohe, Bonnie H. P. Rowland, Liana S. E. Hone, Robert F. Leeman
Background
Mobile health (mHealth) technology use may reduce alcohol use and related negative consequences; however, little is known about its efficacy without prompting from researchers or pay-per-use. This exploratory analysis assessed relationships between mHealth technology use frequency and alcohol-use outcomes.
Methods
Young adults who drink heavily (N = 97, Mage= 23, 51% male, 64% non-Hispanic White, Mdrinks/week = 21) had the option to use three mHealth technologies (breathalyzer device/app, blood alcohol content estimator app, drink counting via text message) while drinking for 2 weeks. Relationships between alcohol-related outcomes and any, multiple, and specific mHealth technology use across study days and drinking days were evaluated via bivariate correlations and multiple regressions.
Results
Participants used one or more mHealth technologies on approximately 68% of drinking days (33% of field days), with multiple technologies used on 34% of drinking days. Bivariate correlations revealed that a higher percentage of study days with any mHealth technology use was related to higher mean weekly drinks. However, a higher percentage of drinking days with any mHealth technology use was related to lower mean weekly drinks, percent of heavy and high-intensity drinking days, and negative consequences. There were several significant, inverse correlations between alcohol variables and using the mHealth technologies that provided personalized feedback. Multiple regression analyses (holding sex and baseline alcohol variables constant) indicated that a higher percentage of drinking days with any mHealth technology use was related to lower mean weekly drinks and lower percentage of heavy drinking days.
Conclusions
Using mHealth technologies to moderate drinking without direct prompting from the research team or per-use incentives was related to less overall alcohol use and heavy drinking. This indicates potential real-world engagement with mHealth apps to assist with in-the-moment drinking. Normalizing mHealth technology use during drinking could help curb the public health crisis around harmful alcohol use in young adult populations.
{"title":"Exploratory analysis of blood alcohol concentration-related technology use and drinking outcomes among young adults","authors":"Sayre E. Wilson, Hannah A. Lavoie, Benjamin L. Berey, Tessa Frohe, Bonnie H. P. Rowland, Liana S. E. Hone, Robert F. Leeman","doi":"10.1111/acer.15455","DOIUrl":"10.1111/acer.15455","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mobile health (mHealth) technology use may reduce alcohol use and related negative consequences; however, little is known about its efficacy without prompting from researchers or pay-per-use. This exploratory analysis assessed relationships between mHealth technology use frequency and alcohol-use outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Young adults who drink heavily (<i>N =</i> 97, <i>M</i><sub>age</sub> <i>=</i> 23, 51% male, 64% non-Hispanic White, <i>M</i><sub>drinks/week</sub> = 21) had the option to use three mHealth technologies (breathalyzer device/app, blood alcohol content estimator app, drink counting via text message) while drinking for 2 weeks. Relationships between alcohol-related outcomes and any, multiple, and specific mHealth technology use across study days and drinking days were evaluated via bivariate correlations and multiple regressions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants used one or more mHealth technologies on approximately 68% of drinking days (33% of field days), with multiple technologies used on 34% of drinking days. Bivariate correlations revealed that a higher percentage of study days with any mHealth technology use was related to higher mean weekly drinks. However, a higher percentage of drinking days with any mHealth technology use was related to lower mean weekly drinks, percent of heavy and high-intensity drinking days, and negative consequences. There were several significant, inverse correlations between alcohol variables and using the mHealth technologies that provided personalized feedback. Multiple regression analyses (holding sex and baseline alcohol variables constant) indicated that a higher percentage of drinking days with any mHealth technology use was related to lower mean weekly drinks and lower percentage of heavy drinking days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Using mHealth technologies to moderate drinking without direct prompting from the research team or per-use incentives was related to less overall alcohol use and heavy drinking. This indicates potential real-world engagement with mHealth apps to assist with in-the-moment drinking. Normalizing mHealth technology use during drinking could help curb the public health crisis around harmful alcohol use in young adult populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 11","pages":"2188-2199"},"PeriodicalIF":3.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.15455","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prenatal alcohol exposure poses significant risks to offspring mental health. However, the interplay between genetic predispositions to mental health disorders and prenatal alcohol exposure remains incompletely understood, limiting our ability to develop effective interventions for these conditions.
Methods
Data from the Adolescent Brain and Cognitive Development (ABCD) Study were analyzed to explore associations between polygenic risk scores (PRS) for mental disorders and maternal alcohol consumption during pregnancy. Logistic regression and structural equation modeling were utilized to assess these relationships.
Results
Maternal alcohol consumption after pregnancy awareness was significantly associated with an increased genetic risk for specific mental health disorders, particularly bipolar disorder in offspring. The relationship between maternal alcohol consumption and mental health outcomes was influenced by polygenic risk scores, with both externalizing and internalizing problems being affected.
Conclusions
Our findings highlight the specific interaction between increased genetic risk for bipolar disorder and prenatal alcohol exposure in shaping offspring mental health outcomes. The significant associations we observed underscore the importance of considering both polygenic risk scores and prenatal alcohol exposure when assessing mental health risks in children. These insights emphasize the need for targeted interventions that address both genetic predispositions and environmental exposures to better understand and mitigate the impact on offspring mental health.
{"title":"Exploring the intersection of polygenic risk scores and prenatal alcohol exposure: Unraveling the mental health equation","authors":"Lazer Gerlikhman, Dipak K. Sarkar","doi":"10.1111/acer.15456","DOIUrl":"10.1111/acer.15456","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prenatal alcohol exposure poses significant risks to offspring mental health. However, the interplay between genetic predispositions to mental health disorders and prenatal alcohol exposure remains incompletely understood, limiting our ability to develop effective interventions for these conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the Adolescent Brain and Cognitive Development (ABCD) Study were analyzed to explore associations between polygenic risk scores (PRS) for mental disorders and maternal alcohol consumption during pregnancy. Logistic regression and structural equation modeling were utilized to assess these relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Maternal alcohol consumption after pregnancy awareness was significantly associated with an increased genetic risk for specific mental health disorders, particularly bipolar disorder in offspring. The relationship between maternal alcohol consumption and mental health outcomes was influenced by polygenic risk scores, with both externalizing and internalizing problems being affected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings highlight the specific interaction between increased genetic risk for bipolar disorder and prenatal alcohol exposure in shaping offspring mental health outcomes. The significant associations we observed underscore the importance of considering both polygenic risk scores and prenatal alcohol exposure when assessing mental health risks in children. These insights emphasize the need for targeted interventions that address both genetic predispositions and environmental exposures to better understand and mitigate the impact on offspring mental health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 11","pages":"2035-2044"},"PeriodicalIF":3.0,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.15456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Min Young Chun, Hyungmi An, Hye Ah Lee, Sungeun Hwang, Seungwon Chung, Na-Young Kim, Hyang Woon Lee
Background
Alcohol withdrawal is widely recognized as a trigger for acute symptomatic seizures among individuals with chronic alcohol consumption. While most alcohol withdrawal seizures occur shortly after cessation, chronic alcohol consumption can be associated with the development of epilepsy, necessitating anti-epileptic drug (AED) therapy. This study aimed to investigate the clinical characteristics, seizure recurrence, and epilepsy development in patients with alcohol-related seizures and to identify prognostic factors for epilepsy.
Methods
In a retrospective analysis at Ewha Womans University Mokdong Hospital, 206 patients with alcohol-related seizures were examined and 15 were excluded due to preexisting epilepsy. Demographic and clinical data, including alcohol withdrawal duration, seizure recurrence, types, and comorbidities, were investigated. Logistic regression models were used to analyze the risk factors for seizure recurrence and epilepsy development. The performance of the final models was evaluated based on the area under the receiver operating characteristic curve (AUC) and validated using calibration plots and leave-one-out cross-validation.
Results
Of the 191 patients (146 males; mean age 48.3 ± 12.1 years) with alcohol-related seizures, 99 patients (51.8%) experienced seizure recurrence and 79 patients (41.4%) developed epilepsy. Factors associated with seizure recurrence included alcohol consumption levels, occurrence of focal impaired awareness seizure, anxiety, and headache. The number of recurrent seizures, semiology, status epilepticus, electroencephalogram findings, and brain imaging findings was associated with epilepsy development. The predictive models showed strong diagnostic performance, with AUCs of 0.833 for seizure recurrence and 0.939 for epilepsy development.
Conclusion
High alcohol consumption and specific clinical and diagnostic features are significant predictors of seizure recurrence and the development of epilepsy among patients with alcohol-related seizures. These findings underscore the importance of early identification and intervention to prevent seizure recurrence and the onset of epilepsy, emphasizing the importance of AED treatment in managing these conditions.
{"title":"Clinical characteristics of seizure recurrence and epilepsy development in patients with alcohol-related seizures","authors":"Min Young Chun, Hyungmi An, Hye Ah Lee, Sungeun Hwang, Seungwon Chung, Na-Young Kim, Hyang Woon Lee","doi":"10.1111/acer.15449","DOIUrl":"10.1111/acer.15449","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alcohol withdrawal is widely recognized as a trigger for acute symptomatic seizures among individuals with chronic alcohol consumption. While most alcohol withdrawal seizures occur shortly after cessation, chronic alcohol consumption can be associated with the development of epilepsy, necessitating anti-epileptic drug (AED) therapy. This study aimed to investigate the clinical characteristics, seizure recurrence, and epilepsy development in patients with alcohol-related seizures and to identify prognostic factors for epilepsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a retrospective analysis at Ewha Womans University Mokdong Hospital, 206 patients with alcohol-related seizures were examined and 15 were excluded due to preexisting epilepsy. Demographic and clinical data, including alcohol withdrawal duration, seizure recurrence, types, and comorbidities, were investigated. Logistic regression models were used to analyze the risk factors for seizure recurrence and epilepsy development. The performance of the final models was evaluated based on the area under the receiver operating characteristic curve (AUC) and validated using calibration plots and leave-one-out cross-validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 191 patients (146 males; mean age 48.3 ± 12.1 years) with alcohol-related seizures, 99 patients (51.8%) experienced seizure recurrence and 79 patients (41.4%) developed epilepsy. Factors associated with seizure recurrence included alcohol consumption levels, occurrence of focal impaired awareness seizure, anxiety, and headache. The number of recurrent seizures, semiology, status epilepticus, electroencephalogram findings, and brain imaging findings was associated with epilepsy development. The predictive models showed strong diagnostic performance, with AUCs of 0.833 for seizure recurrence and 0.939 for epilepsy development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>High alcohol consumption and specific clinical and diagnostic features are significant predictors of seizure recurrence and the development of epilepsy among patients with alcohol-related seizures. These findings underscore the importance of early identification and intervention to prevent seizure recurrence and the onset of epilepsy, emphasizing the importance of AED treatment in managing these conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 11","pages":"2113-2125"},"PeriodicalIF":3.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.15449","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sofia Hemrage, Stephen Parkin, Nicola Kalk, Naina Shah, Paolo Deluca, Colin Drummond
Background
Effective interventions for the management of alcohol-related liver disease (ARLD) remain a gap in clinical practice, and patients' engagement with alcohol services is suboptimal. Based upon the principles of operant conditioning, contingency management (CM) is a psychosocial intervention th at involves gradual, increasing incentives upon completion of treatment-related goals such as treatment attendance.
Methods
A pilot feasibility trial was conducted with 30 adult patients recruited from an inpatient clinical setting. Consecutive sampling was used to recruit patients presenting comorbid alcohol use disorder (AUD) and ARLD. Participants were randomized to integrated liver care (ILC), receiving hepatology and AUD care, or ILC with a voucher-based CM intervention (intervention arm). A longitudinal qualitative approach was adopted to explore anticipated (Stage 1) and experienced acceptability (Stage 2). The Theoretical Framework of Acceptability (TFA) guided semi-structured in-depth interviews and deductive analysis.
Results
Thirty participants were enrolled in the pilot trial, and interviews were conducted with 24 participants at Stage 1 and seven at Stage 2. Over half of the cohort (54.2%, n = 13) presented decompensated liver disease, and an average of 179 units of alcohol were consumed per week. Overall positive views toward voucher-based CM were noted, and explanatory data emerged across five TFA domains (intervention coherence, ethicality, self-efficacy, perceived effectiveness, and affective attitude). The core aspects of the voucher-based CM intervention matched participants' preferences and needs. Participants regarded CM as having a symbolic value and strengthening the therapeutic alliance with healthcare providers.
Conclusion
The data support the scope of voucher-based CM intervention to promote engagement with treatment services, and its potential to address the gaps in the care continuum in ARLD. The findings are of practical significance for developing person-centered, tailored interventions for this clinical population. The outcomes of this investigation can inform decision-making among stakeholders and healthcare providers and improve health outcomes for this clinical population.
{"title":"Voucher-based contingency management to promote treatment engagement in comorbid alcohol use disorder and alcohol-related liver disease: A pilot theory-informed qualitative study with service users","authors":"Sofia Hemrage, Stephen Parkin, Nicola Kalk, Naina Shah, Paolo Deluca, Colin Drummond","doi":"10.1111/acer.15450","DOIUrl":"10.1111/acer.15450","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Effective interventions for the management of alcohol-related liver disease (ARLD) remain a gap in clinical practice, and patients' engagement with alcohol services is suboptimal. Based upon the principles of operant conditioning, contingency management (CM) is a psychosocial intervention th\tat involves gradual, increasing incentives upon completion of treatment-related goals such as treatment attendance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A pilot feasibility trial was conducted with 30 adult patients recruited from an inpatient clinical setting. Consecutive sampling was used to recruit patients presenting comorbid alcohol use disorder (AUD) and ARLD. Participants were randomized to integrated liver care (ILC), receiving hepatology and AUD care, or ILC with a voucher-based CM intervention (intervention arm). A longitudinal qualitative approach was adopted to explore anticipated (Stage 1) and experienced acceptability (Stage 2). The Theoretical Framework of Acceptability (TFA) guided semi-structured in-depth interviews and deductive analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty participants were enrolled in the pilot trial, and interviews were conducted with 24 participants at Stage 1 and seven at Stage 2. Over half of the cohort (54.2%, <i>n</i> = 13) presented decompensated liver disease, and an average of 179 units of alcohol were consumed per week. Overall positive views toward voucher-based CM were noted, and explanatory data emerged across five TFA domains (<i>intervention coherence</i>, <i>ethicality, self-efficacy, perceived effectiveness, and affective attitude</i>). The core aspects of the voucher-based CM intervention matched participants' preferences and needs. Participants regarded CM as having a symbolic value and strengthening the therapeutic alliance with healthcare providers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The data support the scope of voucher-based CM intervention to promote engagement with treatment services, and its potential to address the gaps in the care continuum in ARLD. The findings are of practical significance for developing person-centered, tailored interventions for this clinical population. The outcomes of this investigation can inform decision-making among stakeholders and healthcare providers and improve health outcomes for this clinical population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 11","pages":"2160-2174"},"PeriodicalIF":3.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.15450","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edward P. Riley, Adolf Pfefferbaum, Edith V. Sullivan, Michael E. Charness
<p>Kenneth R. Warren passed away on August 21, 2024, after a brief bout with cancer. Ken was 81 years old and lived a fulfilling life of service to others. He was committed to the alcohol research community and was one of the nation's most steadfast and consequential supporters of research on fetal alcohol spectrum disorder (FASD). Indeed, his career spanned the entire half century encompassing the first description of fetal alcohol syndrome, the first public health actions to prevent FASD, and the enormous growth of research on FASD mechanisms, prevention, diagnosis, and interventions. Remarkably, Ken played a major role in this progress.</p><p>A graduate of the City College of New York, Ken went on to earn his doctorate in biochemistry from Michigan State University in 1970. He served as postdoctoral fellow at the University of California, Los Angeles, and at the University of Michigan Mental Health Research Institute before joining the Federal government at the Walter Reed Army Institute of Research in 1974. Two years later, he began his nearly 40-year career at the National Institute on Alcohol Abuse and Alcoholism (NIAAA). He rose rapidly through the ranks, serving as Health Science Administrator in the Division of Extramural Research, Executive Secretary of Alcohol Biomedical Review, and Chief of the Biomedical Research Branch. His career culminated in appointments as Deputy Director and then Acting Director of NIAAA, a position he held from 2008 until 2014. He retired as Deputy Director in 2015.</p><p>Ken was both a chronicler of NIAAA's past and an advocate for its future. As Acting Director of NIAAA, he shepherded the institute through a tumultuous period when efforts to reorganize the NIH threatened the existence of NIAAA. In 2012, a decision was reached to preserve NIAAA as an independent institute and to undertake a functional, rather than structural, integration, which resulted in the establishment of the Collaborative Research on Addiction at NIH (CRAN) the following year.</p><p>For 40 years, Ken championed public awareness of the impact of FASD on individuals, families, and communities in the United States and globally. Fetal alcohol syndrome was identified in 1973, and just 4 years later, Ken authored the first health advisories warning against the use of alcohol during pregnancy (<span>1977</span>). He then authored the initial (<span>1981</span>) and updated (<span>2005</span>) Surgeon General's Advisories on Alcohol and Pregnancy. Among his many papers, three on FASD are especially notable: Each has over 500 citations, placing them in the top 1% of cited papers in the field (<i>Prevalence of fetal alcohol spectrum disorders in 4 US communities</i>, <i>JAMA</i>, <span>2018</span>; <i>Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders</i>, <i>Pediatrics</i>, <span>2016</span>; and <i>Fetal alcohol spectrum disorders: An overview</i>, <i>Neuropsychology Review</i>, <span>2011</span>).</p><p>Ken was also th
{"title":"Memorial of Kenneth R. Warren, 1943–2024","authors":"Edward P. Riley, Adolf Pfefferbaum, Edith V. Sullivan, Michael E. Charness","doi":"10.1111/acer.15452","DOIUrl":"10.1111/acer.15452","url":null,"abstract":"<p>Kenneth R. Warren passed away on August 21, 2024, after a brief bout with cancer. Ken was 81 years old and lived a fulfilling life of service to others. He was committed to the alcohol research community and was one of the nation's most steadfast and consequential supporters of research on fetal alcohol spectrum disorder (FASD). Indeed, his career spanned the entire half century encompassing the first description of fetal alcohol syndrome, the first public health actions to prevent FASD, and the enormous growth of research on FASD mechanisms, prevention, diagnosis, and interventions. Remarkably, Ken played a major role in this progress.</p><p>A graduate of the City College of New York, Ken went on to earn his doctorate in biochemistry from Michigan State University in 1970. He served as postdoctoral fellow at the University of California, Los Angeles, and at the University of Michigan Mental Health Research Institute before joining the Federal government at the Walter Reed Army Institute of Research in 1974. Two years later, he began his nearly 40-year career at the National Institute on Alcohol Abuse and Alcoholism (NIAAA). He rose rapidly through the ranks, serving as Health Science Administrator in the Division of Extramural Research, Executive Secretary of Alcohol Biomedical Review, and Chief of the Biomedical Research Branch. His career culminated in appointments as Deputy Director and then Acting Director of NIAAA, a position he held from 2008 until 2014. He retired as Deputy Director in 2015.</p><p>Ken was both a chronicler of NIAAA's past and an advocate for its future. As Acting Director of NIAAA, he shepherded the institute through a tumultuous period when efforts to reorganize the NIH threatened the existence of NIAAA. In 2012, a decision was reached to preserve NIAAA as an independent institute and to undertake a functional, rather than structural, integration, which resulted in the establishment of the Collaborative Research on Addiction at NIH (CRAN) the following year.</p><p>For 40 years, Ken championed public awareness of the impact of FASD on individuals, families, and communities in the United States and globally. Fetal alcohol syndrome was identified in 1973, and just 4 years later, Ken authored the first health advisories warning against the use of alcohol during pregnancy (<span>1977</span>). He then authored the initial (<span>1981</span>) and updated (<span>2005</span>) Surgeon General's Advisories on Alcohol and Pregnancy. Among his many papers, three on FASD are especially notable: Each has over 500 citations, placing them in the top 1% of cited papers in the field (<i>Prevalence of fetal alcohol spectrum disorders in 4 US communities</i>, <i>JAMA</i>, <span>2018</span>; <i>Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders</i>, <i>Pediatrics</i>, <span>2016</span>; and <i>Fetal alcohol spectrum disorders: An overview</i>, <i>Neuropsychology Review</i>, <span>2011</span>).</p><p>Ken was also th","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 11","pages":"2200-2201"},"PeriodicalIF":3.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.15452","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tibor P. Palfai, Michael R. Winter, Kara M. Magane, Timothy C. Heeren, Lauren B. Bernier, Grace E. Murray, Richard Saitz, Theresa W. Kim, Michael D. Stein
Background
Unhealthy alcohol use is prevalent among people living with HIV/AIDS (PLWH) and contributes to impaired functioning, diminished quality of life, and poorer HIV outcomes. Common cooccurring conditions such as chronic pain may be associated with negative outcomes both directly and through its influence on unhealthy drinking itself. However, there is relatively little known about how pain influences unhealthy drinking among PLWH over time. The current study examined whether pain was associated with indices of unhealthy alcohol use, namely heavy drinking and alcohol use disorder (AUD) assessed 12 months later.
Methods
The study sample (n = 207) was from the Boston Alcohol Research Collaboration on HIV/AIDS (ARCH) Cohort, a prospective cohort of PLWH with a history of illicit substance or unhealthy alcohol use. We conducted logistic regression analyses to examine the associations between pain and both heavy drinking and AUD status (DSM-5 criteria) (yes/no) over time. In secondary analyses, we examined whether pain was associated with greater AUD severity and whether pain interference was associated with heavy drinking and AUD outcomes.
Results
We found that pain at baseline was associated with greater odds of AUD [aOR = 2.29 (95% CI: 1.13, 4.64), p = 0.02] but not heavy drinking [aOR = 0.91 (95% CI: 0.44, 1.88), p = 0.79] at 12 months. Pain was also associated with more severe AUD. Analyses of pain interference showed similar results.
Conclusions
Pain is prospectively associated with higher odds of AUD among PLWH with a substance/unhealthy alcohol use history. Providers should routinely address pain among PLWH to improve AUD outcomes.
{"title":"Pain and unhealthy alcohol use among people living with HIV: A prospective cohort study","authors":"Tibor P. Palfai, Michael R. Winter, Kara M. Magane, Timothy C. Heeren, Lauren B. Bernier, Grace E. Murray, Richard Saitz, Theresa W. Kim, Michael D. Stein","doi":"10.1111/acer.15447","DOIUrl":"10.1111/acer.15447","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Unhealthy alcohol use is prevalent among people living with HIV/AIDS (PLWH) and contributes to impaired functioning, diminished quality of life, and poorer HIV outcomes. Common cooccurring conditions such as chronic pain may be associated with negative outcomes both directly and through its influence on unhealthy drinking itself. However, there is relatively little known about how pain influences unhealthy drinking among PLWH over time. The current study examined whether pain was associated with indices of unhealthy alcohol use, namely heavy drinking and alcohol use disorder (AUD) assessed 12 months later.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study sample (<i>n</i> = 207) was from the Boston Alcohol Research Collaboration on HIV/AIDS (ARCH) Cohort, a prospective cohort of PLWH with a history of illicit substance or unhealthy alcohol use. We conducted logistic regression analyses to examine the associations between pain and both heavy drinking and AUD status (DSM-5 criteria) (yes/no) over time. In secondary analyses, we examined whether pain was associated with greater AUD severity and whether pain interference was associated with heavy drinking and AUD outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found that pain at baseline was associated with greater odds of AUD [aOR = 2.29 (95% CI: 1.13, 4.64), <i>p</i> = 0.02] but not heavy drinking [aOR = 0.91 (95% CI: 0.44, 1.88), <i>p</i> = 0.79] at 12 months. Pain was also associated with more severe AUD. Analyses of pain interference showed similar results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Pain is prospectively associated with higher odds of AUD among PLWH with a substance/unhealthy alcohol use history. Providers should routinely address pain among PLWH to improve AUD outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 11","pages":"2089-2098"},"PeriodicalIF":3.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Closing the gaps in alcohol behavior change: A real-world study of a digital intervention","authors":"Brian Suffoletto","doi":"10.1111/acer.15454","DOIUrl":"10.1111/acer.15454","url":null,"abstract":"","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 11","pages":"2007-2009"},"PeriodicalIF":3.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William Mellick, Lisa McTeague, Sara Hix, Raymond Anton, James J. Prisciandaro
Background
Alcohol use disorder (AUD) is thought to bias the neurocircuitry underlying reward processing and motivation to preferentially attend to conditioned alcohol cues over natural rewards. The present case–control pilot study evaluated this hypothesis using novel natural reward paradigms.
Methods
Twenty-eight participants (AUD, n = 14, light drinkers, n = 14) were recruited—AUD participants reported 44.0% heavy drinking days (%HDD) and 4.67 drinks/day over the preceding 90 days. Functional magnetic resonance imaging (fMRI) data were acquired during the administration of three separate picture-viewing paradigms of alcohol cues, food scenes, and social reward, respectively. Independent samples t-tests were performed to compare groups' fMRI data and exploratory correlation analyses were performed to examine associations with clinical characteristics of AUD.
Results
Food scenes elicited abnormally low reward-related activation, within the superior frontal gyrus and caudate bilaterally, among AUD participants. Lower activation to food scenes within the superior frontal gyrus was, in turn, associated with higher levels of past-month %HDD among AUD participants, specifically, along with craving and alcohol dependence severity when examined across the full sample. Contrasting reward types (e.g., alcohol cues vs. food scenes) did not reveal “preferential” activation to differentiate groups.
Conclusions
Heavy drinking appears associated with reduced responsivity to natural rewards, specifically food rather than social cues. Neural mechanisms underlying the high prevalence of malnutrition among individuals with AUD may involve some combination of blunted approach-related affect and reduced craving-related motivation to eat when food is present, resulting in limited engagement of cortico-striato-thalamic motor circuitry supporting food acquisition. However, given the preliminary nature of this pilot study, such formulations remain tentative until larger follow-up studies can be conducted. From a potential translational standpoint, the ability of promising therapeutics to demonstrate increased responsivity to natural rewards, specifically nutritive reward may serve as a valuable complementary efficacy indicator for future clinical neuroimaging trials in AUD.
{"title":"Blunted reward-related activation to food scenes distinguishes individuals with alcohol use disorder in a pilot case–control fMRI pilot study","authors":"William Mellick, Lisa McTeague, Sara Hix, Raymond Anton, James J. Prisciandaro","doi":"10.1111/acer.15419","DOIUrl":"10.1111/acer.15419","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alcohol use disorder (AUD) is thought to bias the neurocircuitry underlying reward processing and motivation to preferentially attend to conditioned alcohol cues over natural rewards. The present case–control pilot study evaluated this hypothesis using novel natural reward paradigms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-eight participants (AUD, <i>n</i> = 14, light drinkers, <i>n</i> = 14) were recruited—AUD participants reported 44.0% heavy drinking days (%HDD) and 4.67 drinks/day over the preceding 90 days. Functional magnetic resonance imaging (fMRI) data were acquired during the administration of three separate picture-viewing paradigms of alcohol cues, food scenes, and social reward, respectively. Independent samples <i>t</i>-tests were performed to compare groups' fMRI data and exploratory correlation analyses were performed to examine associations with clinical characteristics of AUD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Food scenes elicited abnormally low reward-related activation, within the superior frontal gyrus and caudate bilaterally, among AUD participants. Lower activation to food scenes within the superior frontal gyrus was, in turn, associated with higher levels of past-month %HDD among AUD participants, specifically, along with craving and alcohol dependence severity when examined across the full sample. Contrasting reward types (e.g., alcohol cues vs. food scenes) did not reveal “preferential” activation to differentiate groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Heavy drinking appears associated with reduced responsivity to natural rewards, specifically food rather than social cues. Neural mechanisms underlying the high prevalence of malnutrition among individuals with AUD may involve some combination of blunted approach-related affect and reduced craving-related motivation to eat when food is present, resulting in limited engagement of cortico-striato-thalamic motor circuitry supporting food acquisition. However, given the preliminary nature of this pilot study, such formulations remain tentative until larger follow-up studies can be conducted. From a potential translational standpoint, the ability of promising therapeutics to demonstrate increased responsivity to natural rewards, specifically nutritive reward may serve as a valuable complementary efficacy indicator for future clinical neuroimaging trials in AUD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 10","pages":"1866-1875"},"PeriodicalIF":3.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer E. Merrill, Nioud Mulugeta Gebru, Roselyn Peterson, Gabriela López, Cathy Lau-Barraco, Nancy P. Barnett, Kate B. Carey
Background
Young adults drink heavily and experience negative alcohol consequences. To capitalize on mornings after drinking as an optimal time to intervene, we developed a novel, theory-based personalized feedback intervention (PFI) called Alcohol Feedback, Reflection, and Morning Evaluation (A-FRAME), to reduce heavy drinking. An initial prototype was refined via feedback from college students who drink heavily. The goal of the present study was to conduct an open trial to establish feasibility and acceptability of the refined PFI.
Methods
The refined PFI was delivered for 4 weeks to 18 heavy-drinking young adults (Mage = 22.61, 44% women, 66.7% White, 27.8% Black, 16.7% Asian, 5.6% Native American/Alaskan Indian, 22.2% Hispanic/Latino). Participants completed a goal-setting procedure, followed by 28 daily surveys. Surveys indicating prior-day drinking were followed by the option to view personalized feedback (e.g., goal attainment, blood alcohol concentration [BAC], peer norms, protective behaviors). Aggregated feedback was also delivered at the 14- and 28-day marks. Participants completed a post-test acceptability survey and individual interviews to inform further refinement.
Results
The response rate to daily surveys was 93.8% and all participants completed study procedures, demonstrating feasibility. Daily feedback was reviewed about half (45.5%) of the time it was offered (i.e., following drinking days). Biweekly feedback was viewed 50% and 56% of the time at 14- and 28-day marks, respectively. Other benchmarks for acceptability were supported by survey and interview results.
Conclusions
Open trial results support the feasibility and acceptability of this theory-based intervention for heavy-drinking young adults. A planned randomized controlled trial will evaluate efficacy.
{"title":"Alcohol Feedback, Reflection, and Morning Evaluation (A-FRAME): Refining and testing feasibility and acceptability of a smartphone-delivered alcohol intervention for heavy-drinking young adults","authors":"Jennifer E. Merrill, Nioud Mulugeta Gebru, Roselyn Peterson, Gabriela López, Cathy Lau-Barraco, Nancy P. Barnett, Kate B. Carey","doi":"10.1111/acer.15424","DOIUrl":"10.1111/acer.15424","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Young adults drink heavily and experience negative alcohol consequences. To capitalize on mornings after drinking as an optimal time to intervene, we developed a novel, theory-based personalized feedback intervention (PFI) called Alcohol Feedback, Reflection, and Morning Evaluation (A-FRAME), to reduce heavy drinking. An initial prototype was refined via feedback from college students who drink heavily. The goal of the present study was to conduct an open trial to establish feasibility and acceptability of the refined PFI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The refined PFI was delivered for 4 weeks to 18 heavy-drinking young adults (<i>M</i><sub>age</sub> = 22.61, 44% women, 66.7% White, 27.8% Black, 16.7% Asian, 5.6% Native American/Alaskan Indian, 22.2% Hispanic/Latino). Participants completed a goal-setting procedure, followed by 28 daily surveys. Surveys indicating prior-day drinking were followed by the option to view personalized feedback (e.g., goal attainment, blood alcohol concentration [BAC], peer norms, protective behaviors). Aggregated feedback was also delivered at the 14- and 28-day marks. Participants completed a post-test acceptability survey and individual interviews to inform further refinement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The response rate to daily surveys was 93.8% and all participants completed study procedures, demonstrating feasibility. Daily feedback was reviewed about half (45.5%) of the time it was offered (i.e., following drinking days). Biweekly feedback was viewed 50% and 56% of the time at 14- and 28-day marks, respectively. Other benchmarks for acceptability were supported by survey and interview results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Open trial results support the feasibility and acceptability of this theory-based intervention for heavy-drinking young adults. A planned randomized controlled trial will evaluate efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 10","pages":"1951-1964"},"PeriodicalIF":3.0,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kevin Houston, Spencer Harris, Adonay Teklezghi, Scott Silvey, Andrew D. Snyder, Albert J. Arias, Jasmohan S. Bajaj
Background
Alcohol use disorder (AUD) is a multifaceted disease, and integration of AUD treatment between mental health and hepatology is necessary to improve outcomes. We aimed to ascertain whether patients with excessive alcohol use (EAU) and high FIB-4, which is a non-invasive method to identify advanced liver disease, are appropriately referred to hepatology and detect which clinical barriers, if any, might pertain.
Methods
Records of patients with excessive alcohol use between 2013 and 2023 were extracted from a large public system. Demographics, alcohol-related hospitalizations, mental health conditions, Charlson comorbidity index (CCI) and referral patterns were evaluated. Comparisons were made between those referred to hepatology versus not.
Results
1131 subjects showed evidence of EAU but on further review, 189 were in alcohol-remission. The remaining 942 (636 men, age 55.7 ± 14.5 years, 548 white, 363 black, 19 Hispanic) subjects with CCI 2.61 ± 2.23 were further analyzed for FIB-4 score and referral patterns. 316 patients had active EAU and a high FIB-4, of whom only 116 (37%) were referred to hepatology. Patients with alcohol-related mental health concerns and admitted for trauma were less likely to be referred. Logistic regression showed referral was higher with alcohol-related liver hospitalizations (OR: 9.25, 95% CI: 4.90–17.47, p < 0.001), higher CCI (OR: 6.23, 95% CI: 3.00–12.94, p < 0.0001) and lower with mental health admissions (OR: 0.36, 95% CI: 0.15–0.48, p < 0.001) or mental health diagnoses (OR: 0.36, 95% CI: 0.15–0.82, p = 0.02) and increasing age (OR: 0.95, 95% CI: 0.92–0.97, p < 0.001).
Conclusions
In a large public health system, almost 63% of patients with EAU and FIB-4 >2.67 are not referred to hepatology for evaluation. Patients not referred were more likely to have alcohol-related mental-health hospitalizations and mental health diagnoses, while those with liver-related hospitalizations and comorbidities were more likely to be referred. Greater education of mental health providers and for teams taking care of inpatients admitted with alcohol-related mental health concerns would better integrate care and improve outcomes for patients with higher risk for advanced liver disease.
{"title":"Referral to hepatology is lower in patients with excessive alcohol use who have mental health disorders despite a high fibrosis-4 index","authors":"Kevin Houston, Spencer Harris, Adonay Teklezghi, Scott Silvey, Andrew D. Snyder, Albert J. Arias, Jasmohan S. Bajaj","doi":"10.1111/acer.15422","DOIUrl":"10.1111/acer.15422","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alcohol use disorder (AUD) is a multifaceted disease, and integration of AUD treatment between mental health and hepatology is necessary to improve outcomes. We aimed to ascertain whether patients with excessive alcohol use (EAU) and high FIB-4, which is a non-invasive method to identify advanced liver disease, are appropriately referred to hepatology and detect which clinical barriers, if any, might pertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Records of patients with excessive alcohol use between 2013 and 2023 were extracted from a large public system. Demographics, alcohol-related hospitalizations, mental health conditions, Charlson comorbidity index (CCI) and referral patterns were evaluated. Comparisons were made between those referred to hepatology versus not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>1131 subjects showed evidence of EAU but on further review, 189 were in alcohol-remission. The remaining 942 (636 men, age 55.7 ± 14.5 years, 548 white, 363 black, 19 Hispanic) subjects with CCI 2.61 ± 2.23 were further analyzed for FIB-4 score and referral patterns. 316 patients had active EAU and a high FIB-4, of whom only 116 (37%) were referred to hepatology. Patients with alcohol-related mental health concerns and admitted for trauma were less likely to be referred. Logistic regression showed referral was higher with alcohol-related liver hospitalizations (OR: 9.25, 95% CI: 4.90–17.47, <i>p</i> < 0.001), higher CCI (OR: 6.23, 95% CI: 3.00–12.94, <i>p</i> < 0.0001) and lower with mental health admissions (OR: 0.36, 95% CI: 0.15–0.48, <i>p</i> < 0.001) or mental health diagnoses (OR: 0.36, 95% CI: 0.15–0.82, <i>p</i> = 0.02) and increasing age (OR: 0.95, 95% CI: 0.92–0.97, <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a large public health system, almost 63% of patients with EAU and FIB-4 >2.67 are not referred to hepatology for evaluation. Patients not referred were more likely to have alcohol-related mental-health hospitalizations and mental health diagnoses, while those with liver-related hospitalizations and comorbidities were more likely to be referred. Greater education of mental health providers and for teams taking care of inpatients admitted with alcohol-related mental health concerns would better integrate care and improve outcomes for patients with higher risk for advanced liver disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 10","pages":"1898-1904"},"PeriodicalIF":3.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.15422","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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