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A meta-analysis on racial discrimination and alcohol use among Asian Americans. 关于种族歧视和亚裔美国人饮酒情况的荟萃分析。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-11-10 DOI: 10.1111/acer.15475
Melissa A Liu, Taylor Fox, Michelle Salyers, Tamika Zapolski, Melissa A Cyders

Background: Racial discrimination has been identified as a contributing risk factor for alcohol use among racially minoritized individuals. The aims of this study were to quantify the relationship between racial discrimination and alcohol use among Asian Americans, examine gender, age and generational status as moderators, and characterize ethnic group representation across the literature.

Methods: A systematic literature search was conducted using PsycINFO, CINAHL, Web of Science, PubMed, Embase, and OpenDissertations. A random effects model using Pearson's r effect sizes was conducted on separate alcohol outcomes. Meta-regression analyses tested for moderating effects, and heterogeneity was examined by identifying outliers and subgroup differences. Risk of bias was assessed using a funnel plot and Egger's regression test.

Results: Twenty-two effect sizes were extracted from 18 studies, representing 8926 participants. A significant positive association was found between racial discrimination and alcohol consumption (k = 9, r = 0.13, 95% CI = [0.07, 0.19], I2 = 80.7%, p = 0.002) and problematic alcohol use (k = 12, r = 0.27, 95% CI = [0.12, 0.40] I2 = 93.7%, p = 0.002), but not binge use (k = 3, r = 0.08, 95% CI = [-0.49, 0.60], I2 = 95.0%, p = 0.64). Age, gender, and generational status were not significant moderators (p's > 0.10). When ethnic groups were reported, Chinese Americans were most represented (36.9%), while Indian Americans were notably underrepresented (1.18%).

Conclusions: There is a small positive association between racial discrimination and alcohol consumption and problematic alcohol use among Asian Americans. Research should seek to fill gaps identified by this review, including the dearth of longitudinal work needed to establish temporal precedence, the limited understanding of racial discrimination on binge use and underrepresented ethnic groups in this field of research, and reducing heterogeneity between studies.

背景:种族歧视已被确定为导致少数种族人群酗酒的一个风险因素。本研究的目的是量化种族歧视与亚裔美国人饮酒之间的关系,研究作为调节因素的性别、年龄和代际状况,并描述文献中各民族群体的代表性:利用 PsycINFO、CINAHL、Web of Science、PubMed、Embase 和 OpenDissertations 进行了系统的文献检索。对不同的酒精结果采用皮尔逊r效应大小随机效应模型。元回归分析检验了调节效应,并通过识别异常值和亚组差异检验了异质性。使用漏斗图和 Egger 回归检验评估偏倚风险:从代表 8926 名参与者的 18 项研究中提取了 22 个效应大小。研究发现,种族歧视与酒精消费(k = 9,r = 0.13,95% CI = [0.07,0.19],I2 = 80.7%,p = 0.002)和问题性饮酒(k = 12,r = 0.27,95% CI = [0.12,0.40],I2 = 93.7%,p = 0.002),但不包括酗酒(k = 3,r = 0.08,95% CI = [-0.49,0.60],I2 = 95.0%,p = 0.64)。年龄、性别和代际状况不是重要的调节因素(P>0.10)。在报告的种族群体中,华裔美国人的比例最高(36.9%),而印裔美国人的比例明显偏低(1.18%):结论:在亚裔美国人中,种族歧视与酒精消费和问题酒精使用之间存在微小的正相关。研究应努力填补本综述中发现的空白,包括缺乏建立时间先例所需的纵向工作、对种族歧视对酗酒的影响以及在该研究领域代表性不足的种族群体的了解有限,以及减少研究之间的异质性。
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引用次数: 0
Uncovering the sex steroid hormone secrets in alcohol. 揭开酒精中性类固醇激素的秘密。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-11-10 DOI: 10.1111/acer.15479
Gian Rodriguez Franco, Christine C Hsu
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引用次数: 0
Articles of Public Interest 公益文章。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-11-09 DOI: 10.1111/acer.15480
<p>Adults aged 35 to 60 are drinking at unprecedented rates, with those who binge drank in high school reporting more past 30-day high-risk drinking in midlife. And this link may be especially strong for women, according to a study just published in <i>Alcohol: Clinical and Experimental Research</i> Health. These trends are particularly concerning as health conditions, and biological processes common with aging put adults in midlife at greater health risk from alcohol use.</p><p>Twenty to 30 percent of all the 35- to 60-year-olds in the study reported binge drinking (four or more drinks for women, five for men), and one out of ten reported high-intensity drinking—having eight to ten drinks in one sitting. Compared to people who did not binge drink in high school, people in the study who binge drank at age 18 had higher rates of alcohol use on a range of alcohol use measures—typical number of drinks, maximum number of drinks, number of binge drinking episodes and number of high-intensity drinking episodes. For example, among those who didn't binge at age 18, only 20% reported binge drinking in midlife compared with 40% among those who did binge at age 18.</p><p>Alcohol use is one of the biggest contributors to illness and death for all adults, and alcohol use conveys even more risk for adults in midlife. Decreases in muscle mass and metabolism that are a part of the aging process may inhibit the body's ability to process alcohol. People at this age more commonly have health conditions that are made worse by heavier drinking, such as diabetes, high blood pressure, cardiovascular disease, and osteoporosis.</p><p>While men drank more than women on all measures, the association between binge drinking in high school and high-intensity drinking in midlife was stronger for women. Women who reported binge drinking at age 18 were three times more likely to report high-intensity drinking in midlife; men were twice as likely to report high-intensity drinking if they binge drank at age 18. The researchers noted that alcohol use among women in midlife has risen steadily in recent years, while alcohol use among men has not.</p><p>Age and race/ethnicity were associated with drinking behaviors. Although alcohol use declined with age, still, one in five 60-year-olds reported binge drinking. And the link between high school binge drinking and maximum drinks was stronger at age 60 than at age 35. White participants reported higher typical and maximum drinks than other racial or ethnic groups. Previous studies have found that non-White drinkers may experience greater adverse outcomes from alcohol use, despite their lower rates of alcohol use frequency, quantity, and alcohol use disorder compared to whites.</p><p>For the study, researchers examined data from more than 5000 surveys of adults aged 35, 40, 45, 50, 55, and 60 who have been participating in a national longitudinal study since twelfth grade to understand whether there were long-term connections between bing
虽然 CBT-I 可能不会使每个人的情绪都得到改善,但它可以与其他可能影响情绪的干预措施相结合,如正念或情绪调节技能训练。需要进行更多的研究,包括更广泛的试验。M. B. Miller、R. Carpenter、M. Nance、L. K. Freeman、J. Metrik、B. Borsari、C. McCrae、J. Merrill、K. Carey、J. McGeary。(https://doi.org/10.1111/acer.15436)一项新的研究显示,与没有接触过酒精的人相比,在子宫内接触过酒精的人在中年时会出现更多和更频繁的身体健康问题。众所周知,产前压力和艰难的早期生活经历会增加成年后早期发病的风险。一种关于健康和疾病发展起源的理论认为,怀孕期间发生的风险暴露可能会增加后代受后续不利影响的脆弱性。产前酒精暴露(PAE)可能就是这样一种暴露。提高对 PAE 长期影响的认识可改善对受影响人群的临床护理。确定需要关注的领域还可以为早期干预提供信息,以减少 PAE 的长期影响。在《酒精:研究人员从亚特兰大和西雅图的长期研究中招募了 357 名患有或不患有 PAE 的中年人。研究人员从亚特兰大和西雅图的长期研究中招募了 357 名患有和未患有 PAE 的中年人,这些人最初是通过母亲在怀孕期间的自我报告确定的,或者是在童年时被诊断患有胎儿酒精综合症(FAS)或胎儿酒精暴露(FAE)。他们被分为三组:无 PAE、无 FAS 或相关面部畸形症状的 PAE,以及有 FAS 或畸形症状的 PAE。参与者参加了一项综合健康调查,其中包括有关癌症、视力、听力、免疫功能、牙科、皮肤或睡眠问题,以及影响心血管、泌尿、肠胃或内分泌功能的问题。调查人员比较了三组人报告的健康问题发生率,同时使用统计分析来解释人口特征和对健康的其他影响,包括不良童年经历。此外,PAE 与听力、泌尿和肠胃问题的风险增加有关,在对其他因素进行统计控制后,这些问题似乎直接受到酒精暴露的影响。其他健康问题发生频率的增加表明,PAE 导致身体多个系统更加脆弱,加剧了其他社会决定因素(如社会经济困境和不良饮食习惯)的负面影响。还有一种可能是,与 PAE 相关的残疾使人们维持健康行为的能力降低,与残疾相关的压力进一步扩大了对健康的负面影响。健康状况还与年龄、种族、性别和不良童年经历有关:早期生活逆境较多的老年白人妇女报告的健康问题较多。这项研究是首次研究 PAE 患者中年健康状况的研究,其结果表明,早期酒精暴露会对健康产生长期影响。PAE 很可能与具有累积健康影响的复杂风险因素模式有关。这一新观点有可能通过促进对高风险患者的全面健康评估,改善对 PAE 患者的临床治疗,并为他们提供更广泛的支持。要了解早期酒精暴露的影响,下一步应开展更多的研究,通过临床调查和更大样本的客观健康测量来验证患者的自我报告:产前酒精暴露与中年健康:两个队列中自我报告的健康结果。C. Coles、Z. Shapiro、J. Kable、S. Stoner、G. Ritfield、T. Grant。(https://doi.org/10.1111/acer.15441)
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引用次数: 0
Santa Claus, the Tooth Fairy, and purported lifetime nondrinkers: Ramifications for observational evidence about alcohol and health. 圣诞老人、牙仙和所谓的终生不饮酒者:对酒精与健康观察证据的影响。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-11-05 DOI: 10.1111/acer.15478
Timothy S Naimi, Tanya Chikritzhs
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引用次数: 0
Impact of phosphatidylethanol in the surveillance for alcohol use in post-liver transplant population: A retrospective study. 磷脂酰乙醇对肝移植后人群饮酒监测的影响:一项回顾性研究。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-10-31 DOI: 10.1111/acer.15474
Sergio A De La Torre, Brittney Ibrahim, Katherine Meneses, Sammy Saab, Akshay Shetty

Background: Alcohol-related liver disease (ALD) is the leading indication for liver transplantation in the United States. The aim of this study was to describe the impact of phosphatidylethanol (PEth) in the surveillance for alcohol use after liver transplantation.

Methods: We conducted a single-center retrospective study to assess the impact of phosphatidylethanol (PEth) for the surveillance of alcohol use and its correlation to health outcomes. We compared orthotopic liver transplant (OLT) recipients for ALD transplanted between 2016 and 2018, before the introduction of PEth, to those transplanted between 2019 and 2022, after the introduction of PEth. Alcohol relapse versus nonrelapse cohorts were also compared. Follow-up time for all cohorts was limited to 3 years post-OLT. Continuous variables were analyzed with an independent t-test and categorical variables with Fischer's exact test and chi-square test. The Kaplan-Meier method and log-rank test were used to assess alcohol-free survival.

Results: We reviewed 263 patients who were transplanted for ALD; 46 (17.5%) patients were noted to have at least one episode of alcohol relapse after their transplant. Patients with alcohol relapse had more frequent episodes of elevated liver enzymes compared with nonrelapsed patients (4.35 episodes vs. 2.46 episodes respectively, p < 0.001). The number of hospitalizations was also noted to be elevated among relapsed versus nonrelapsed patients; however, this was not statistically significant (2.85 vs. 2.50 respectively, p = 0.307). When comparing relapse rates before and after the introduction of PEth, relapses were notably detected more frequently after the introduction of PEth (17% vs. 7%, p = 0.012). No difference was noted in rates of mortality between patients who did or did not relapse.

Conclusions: Overall, PEth is an effective surveillance tool in the postliver transplant population to monitor for alcohol relapse. Early detection of relapse can lead to opportunities for early intervention to avoid alcohol-related complications.

背景:酒精相关肝病(ALD)是美国肝移植的主要适应症。本研究旨在描述磷脂酰乙醇(PEth)对肝移植后酒精使用监测的影响:我们进行了一项单中心回顾性研究,以评估磷脂酰乙醇(PEth)对酒精使用监测的影响及其与健康结果的相关性。我们比较了2016年至2018年(PEth引入之前)移植的ALD正位肝移植(OLT)受者和2019年至2022年(PEth引入之后)移植的ALD受者。同时还比较了酒精复发与非复发队列。所有队列的随访时间均限制在OLT 后 3 年。连续变量采用独立t检验,分类变量采用费舍尔精确检验和卡方检验。采用卡普兰-梅耶法和对数秩检验评估无酒精生存率:我们对 263 例因 ALD 而接受移植的患者进行了回顾性分析,发现 46 例(17.5%)患者在移植后至少复发过一次酒精中毒。与未复发的患者相比,酒精复发的患者肝酶升高的频率更高(分别为 4.35 次和 2.46 次,P 结论:总体而言,PEth 是一种有效的肝病预防方法:总体而言,PEth 是肝移植后人群监测酒精复发的有效监测工具。早期发现酒精复发可为早期干预提供机会,避免酒精相关并发症的发生。
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引用次数: 0
Association of bone turnover markers and craving reduction in patients with alcohol use disorder during withdrawal: Exploring the role of bone-brain axis. 戒酒期间酒精使用障碍患者骨转换标志物与渴求减少的关系:探索骨脑轴的作用
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-10-30 DOI: 10.1111/acer.15472
Hsuan Megan Tsao, Ming-Chyi Huang, Tung-Hsia Liu, Hu-Ming Chang, Ren-Hua Chung, Hsiang-Wei Kuo, Andrew C H Chen, Rong-Sen Yang, Yu-Li Liu

Background: Alcohol use disorder (AUD) is associated with imbalanced bone turnover and psychological symptoms, but the relationship between bone and brain remains unclear. The study analyzed serum levels of a bone formation marker, procollagen type 1 N-terminal propeptide (P1NP), and bone resorption marker, C-terminal telopeptide of type I collagen (CTX-1), in AUD patients before and after 2 weeks of alcohol withdrawal and investigated their correlation with psychological symptoms.

Methods: Ninety patients with AUD and 117 healthy controls were recruited. P1NP and CTX-1 levels were measured using Enzyme-Linked Immunosorbent Assay. The Penn Alcohol Craving Scale (PACS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were assessed in the AUD group at baseline, week 1, and week 2 of withdrawal.

Results: Baseline CTX-1 levels, along with the CTX-1/P1NP and P1NP/CTX-1 ratio, were higher in the AUD group than controls. Over the 2-week withdrawal, PACS, BDI, and BAI scores demonstrated significant reductions. P1NP (p < 0.001) and P1NP/CTX-1 ratio increased (p < 0.001), while CTX-1/P1NP ratio decreased (p < 0.001), indicating a propensity toward bone formation. Univariate analysis revealed that reductions in PACS, BDI, and BAI scores during withdrawal correlated with increased P1NP levels and decreased CTX-1/P1NP ratios. However, multivariate analysis indicated that only PACS score reductions correlated with these changes.

Conclusions: Bone metabolism shifted toward increased bone formation and decreased bone resorption during 2-week alcohol withdrawal. The correlation between improvements in bone turnover markers and reduction in craving scores during withdrawal supports the concept of the bone-brain axis.

背景:酒精使用障碍(AUD)与骨转换失衡和心理症状有关,但骨骼和大脑之间的关系仍不清楚。本研究分析了 AUD 患者在戒酒 2 周前和戒酒 2 周后血清中骨形成标志物--1 型胶原蛋白 N 端前肽(P1NP)和骨吸收标志物--I 型胶原蛋白 C 端端肽(CTX-1)的水平,并研究了它们与心理症状的相关性:方法:招募了 90 名 AUD 患者和 117 名健康对照者。方法:招募了 90 名 AUD 患者和 117 名健康对照者,采用酶联免疫吸附测定法检测 P1NP 和 CTX-1 水平。宾州酒精渴求量表(PACS)、贝克抑郁量表(BDI)和贝克焦虑量表(BAI)分别在基线、戒断第一周和第二周对 AUD 组进行了评估:结果:AUD 组的 CTX-1 基线水平、CTX-1/P1NP 和 P1NP/CTX-1 比率均高于对照组。在为期两周的戒断过程中,PACS、BDI 和 BAI 评分均有显著下降。P1NP(P在两周的戒酒过程中,骨代谢转向骨形成增加和骨吸收减少。戒酒期间骨转换标志物的改善与渴求评分的降低之间的相关性支持了骨-脑轴的概念。
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引用次数: 0
Probenecid as a pharmacotherapy for alcohol use disorder: A randomized placebo-controlled alcohol interaction trial. 丙磺舒作为治疗酒精使用障碍的药物疗法:随机安慰剂对照酒精相互作用试验。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-10-29 DOI: 10.1111/acer.15470
Rivkah Hornbacher, Brian J Gully, Zoe E Brown, Joshua C Brown, Molly Magill, Patricia A Cioe, Robert M Swift, Pietro Paolo Sanna, Carolina L Haass-Koffler

Background: This study shows the first evidence for pannexin 1 channels as a new target to develop medications for alcohol use disorder (AUD). Due to its history of long-term safe clinical use and preclinical evidence of reducing excessive alcohol intake in rodents, probenecid has clinical potential for AUD.

Methods: We conducted a Phase I/IIa randomized, double-blind, placebo-controlled, crossover trial investigating the safety, tolerability, and efficacy of an oral dose of probenecid (2 g) when administered with alcohol (0.08 g/dL) in individuals who regularly consume alcohol to the 0.08 g/dL level (N = 35) and in individuals with mild to severe AUD. Alcohol pharmacokinetics and subjective responses were evaluated to assess potential interactions between probenecid and alcohol. Alcohol craving, inflammatory biomarkers, cognitive assessments, and hemodynamics were assessed as additional alcohol research domains. All outcomes were assessed both in the ascending and descending limb of alcohol intoxication using Generalized Estimating Equation.

Results: Probenecid did not exert any significant effect on alcohol pharmacokinetics and did not affect alcohol stimulation or sedation. Probenecid, compared to placebo, significantly decreased alcohol craving during the alcohol ascending limb. Inflammatory biomarkers, cognitive performance following alcohol ingestion, and hemodynamics were likewise not affected by probenecid administration. Analysis of sex as a biological variable revealed no differences of probenecid compared to placebo.

Conclusions: Taken together, our data support the potential of probenecid for treatment of AUD and suggest that pannexin 1 channels represent a novel emerging therapeutic target for the development of new pharmacotherapies for treating AUD.

背景:这项研究首次证明了潘nexin 1通道是开发治疗酒精使用障碍(AUD)药物的新靶点。由于丙磺舒具有长期安全临床使用的历史和减少啮齿类动物过量酒精摄入的临床前证据,因此丙磺舒具有治疗 AUD 的临床潜力:我们进行了一项 I/IIa 期随机、双盲、安慰剂对照、交叉试验,研究了口服剂量的丙磺舒(2 克)与酒精(0.08 克/分升)同时服用的安全性、耐受性和疗效,试验对象为经常饮酒至 0.08 克/分升水平的人(35 人)和轻度至重度 AUD 患者。对酒精药代动力学和主观反应进行了评估,以评估丙磺舒和酒精之间潜在的相互作用。酒精渴求、炎症生物标志物、认知评估和血液动力学作为额外的酒精研究领域进行了评估。所有结果均采用广义估计方程对酒精中毒的上升肢和下降肢进行评估:结果:丙磺舒对酒精药代动力学无明显影响,也不影响酒精刺激或镇静作用。与安慰剂相比,丙磺舒明显降低了酒精上升肢体对酒精的渴求。炎症生物标志物、摄入酒精后的认知能力和血液动力学同样不受丙磺舒的影响。作为生物变量的性别分析表明,丙磺舒与安慰剂相比没有差异:综上所述,我们的数据支持丙磺舒治疗 AUD 的潜力,并表明泛奈辛 1 通道是开发治疗 AUD 的新药物疗法的新兴治疗靶点。
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引用次数: 0
Prenatal alcohol exposure and health at midlife: Self-reported health outcomes in two cohorts 产前酒精暴露与中年健康:两个队列中自我报告的健康结果。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-10-29 DOI: 10.1111/acer.15441
C. D. Coles, Z. R. Shapiro, J. A. Kable, S. A. Stoner, G. J. Ritfeld, T. M. Grant

Background

The Developmental Origins of Health and Disease Hypothesis (DOHaD) suggests prenatal alcohol exposure (PAE) should have implications for adult physical and mental health. Since the health profile of older adults with PAE and diagnoses of fetal alcohol spectrum disorder (FASD) is unknown, the current study evaluates self-reported health problems of midlife adults with and without a history of PAE to describe these outcomes.

Methods

Participants (N = 357) recruited from longitudinal cohorts in Atlanta, GA and Seattle, WA completed a health survey assessing a range of physical conditions. Initial analysis compared the frequency of conditions between alcohol-exposed and nonexposed groups. To identify patterns within groups, 10 problem areas were subjected to latent class analysis (LCA). Finally, the direct effect of PAE on health outcomes was evaluated using multilevel modeling, controlling for effects of other factors.

Results

Compared with unexposed controls, individuals with PAE reported significantly higher frequencies of problems with hearing, dentition, heart, cancer, gastritis, kidney stones, bladder, diabetes, thyroid, skin, and seizures. LCA found that controls yielded two classes, with 45% reporting sleep and vision problems and 55% reporting sleep, vision, cardiovascular, endocrine, immune, and dental problems. The PAE group yielded three classes, with 13% endorsing few health problems, 43% reporting sleep, vision, immune, and dental problems, and 43% reporting sleep, vision, cardiovascular, urinary, endocrine, skin, immune, dental, and gastrointestinal problems. With multivariate analysis, controlling for other influences, PAE was associated directly with hearing, urinary, dental, and gastrointestinal problems. A similar pattern was found for alcohol-exposed individuals who did and did not meet criteria for fetal alcohol syndrome (FAS).

Discussion

Patients affected by alcohol may report greater frequency and range of health adversity. That PAE was only uniquely associated with a limited set of problems suggests that many health outcomes in midlife result from an initial vulnerability potentiated by postnatal stress resulting from other associated factors.

背景:健康与疾病的发展起源假说(DOHaD)认为,产前酒精暴露(PAE)会对成人的身心健康产生影响。由于患有产前酒精暴露和胎儿酒精谱系障碍(FASD)诊断的老年人的健康状况尚不清楚,本研究评估了有和没有产前酒精暴露史的中年人自我报告的健康问题,以描述这些结果:从佐治亚州亚特兰大市和华盛顿州西雅图市的纵向队列中招募的参与者(N = 357)完成了一项健康调查,评估了一系列身体状况。初步分析比较了接触酒精组和未接触酒精组的身体状况发生频率。为了确定组内的模式,对 10 个问题领域进行了潜类分析(LCA)。最后,使用多层次模型评估了 PAE 对健康结果的直接影响,并控制了其他因素的影响:结果:与未接触 PAE 的对照组相比,报告 PAE 患者在听力、牙齿、心脏、癌症、胃炎、肾结石、膀胱、糖尿病、甲状腺、皮肤和癫痫发作方面出现问题的频率明显更高。LCA 发现,对照组产生了两类问题,其中 45% 报告了睡眠和视力问题,55% 报告了睡眠、视力、心血管、内分泌、免疫和牙科问题。PAE 组有三个类别,13% 的人很少有健康问题,43% 的人有睡眠、视力、免疫和牙科问题,43% 的人有睡眠、视力、心血管、泌尿、内分泌、皮肤、免疫、牙科和肠胃问题。通过多变量分析,在控制了其他影响因素后,PAE 与听力、泌尿、牙科和胃肠道问题直接相关。讨论:受酒精影响的患者可能会报告更频繁地出现听力、泌尿、牙科和胃肠道问题:讨论:受酒精影响的患者可能会报告更多频率和范围的健康问题。PAE仅与有限的一组问题有独特的关联,这表明中年时期的许多健康结果都是由其他相关因素导致的产后压力所增强的最初脆弱性造成的。
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引用次数: 0
Insomnia treatment effects on negative emotionality among veterans in treatment for alcohol use disorder 失眠治疗对接受酒精使用障碍治疗的退伍军人负面情绪的影响。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-10-28 DOI: 10.1111/acer.15436
Mary Beth Miller, Ryan W. Carpenter, Melissa Nance, Lindsey K. Freeman, Jane Metrik, Brian Borsari, Christina S. McCrae, Jennifer E. Merrill, Kate B. Carey, John E. McGeary

Background

Insomnia symptoms are pervasive and persistent in alcohol use disorder (AUD), though little is known about the mechanisms that underlie this association. We previously found that cognitive behavioral therapy for insomnia (CBT-I) reduced alcohol-related problems among veterans by improving insomnia severity (NCT03806491). In this planned secondary analysis of the same clinical trial data, we tested negative emotionality as one potential mechanism to explain this effect. Specifically, we tested the change in negative emotionality as a mediator of the association between change in insomnia symptoms and alcohol-related outcomes (craving, heavy drinking frequency, and alcohol-related problems).

Methods

Participants were 67 veterans in treatment for AUD who also met the criteria for insomnia disorder (91% male, 84% White, average age = 46.3 years). Participants were randomized to five sessions of CBT-I or a single-session sleep hygiene control. Assessments occurred at baseline, immediately posttreatment (~6 weeks after baseline), and at 6-week follow-up. Measures included the Insomnia Severity Index, Penn Alcohol Craving Scale, Timeline Followback, and Short Inventory of Problems. We created a latent negative emotionality indicator based on five validated and reliable measures of negative emotionality.

Results

Contrary to hypotheses, CBT-I did not improve negative emotionality relative to sleep hygiene control. However, across both treatment conditions, decreases in insomnia symptoms from baseline to posttreatment were associated with concurrent decreases in negative emotionality, which in turn predicted reductions in alcohol craving and heavy drinking.

Conclusion

Negative emotionality may help explain links between insomnia symptoms and alcohol-related outcomes.

背景:失眠症状在酒精使用障碍(AUD)患者中普遍存在且持续存在,但人们对这种关联的机制知之甚少。我们之前发现,失眠认知行为疗法(CBT-I)通过改善失眠严重程度,减少了退伍军人中与酒精相关的问题(NCT03806491)。在计划对同一临床试验数据进行的二次分析中,我们测试了负性情绪作为解释这种效应的一种潜在机制。具体来说,我们测试了负性情绪变化作为失眠症状变化与酒精相关结果(渴求、大量饮酒频率和酒精相关问题)之间关联的中介因素的作用:参与者为 67 名正在接受 AUD 治疗的退伍军人,他们也符合失眠症的标准(91% 为男性,84% 为白人,平均年龄为 46.3 岁)。参与者被随机分配到五个疗程的 CBT-I 或一个疗程的睡眠卫生对照组。分别在基线、治疗后(基线后约 6 周)和 6 周随访时进行评估。评估项目包括失眠严重程度指数、宾州酒精渴求量表、时间轴回溯和问题简表。我们根据五种经过验证的可靠负性情绪测量方法创建了一个潜在负性情绪指标:与假设相反,与睡眠卫生控制相比,CBT-I 并未改善负性情绪。然而,在两种治疗条件下,失眠症状从基线到治疗后的减少与负性情绪性的同时减少有关,而负性情绪性的减少又预示着酒精渴求和大量饮酒的减少:结论:负性情绪可能有助于解释失眠症状与酒精相关结果之间的联系。
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引用次数: 0
Links between adolescent binge drinking and midlife alcohol use behaviors by age, sex, and race/ethnicity 按年龄、性别和种族/民族分列的青少年暴饮与中年酒精使用行为之间的联系。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-10-27 DOI: 10.1111/acer.15435
Megan E. Patrick, Sarah J. Peterson, Yuk C. Pang, Yvonne M. Terry-McElrath

Background

Alcohol use is increasing among adults in midlife (i.e., ages 35–60), but few studies examine specific alcohol use behaviors in this age group. We examined measures of typical drinks, maximum drinks, binge drinking, and high-intensity drinking by age, sex, and race/ethnicity among midlife adults, as well as the prospective association between age 18 binge drinking and midlife behaviors.

Methods

Data from 5180 respondents participating in the national Monitoring the Future Panel study who were aged 35–60 in 2022 (followed since they were in 12th grade in 1980–2005) were used to estimate past 30-day midlife drinking behaviors (i.e., typical drinks, maximum drinks, binge, and high-intensity drinking) by age group, sex, and race/ethnicity. Associations between age 18 binge drinking status and midlife drinking outcomes were examined, as well as moderation by sociodemographic characteristics.

Results

Across ages 35–60, the mean typical number of drinks on drinking days within the past month ranged from 1.4 to 1.8; the mean maximum drinks ranged from 2.3 to 3.2. Past-month binge and high-intensity drinking prevalence ranged from 19.1% to 31.2% and 3.6% to 8.1%, respectively. Estimates of drinking behaviors were generally higher among respondents aged 35–40 (vs. older age groups), males (vs. females), those identifying as White (vs. other racial/ethnic groups), and those who reported age 18 binge drinking (vs. not). Adolescent binge drinking was a stronger predictor of high-intensity drinking among females than males and of typical and maximum drinks among older (age 60) than younger (age 35) respondents.

Conclusion

Binge and high-intensity drinking were reported by a meaningful percentage of the US midlife adults. Binge drinking in adolescence was a predictor of subsequent alcohol-related risks. These long-term connections were especially strong among females. Age 18 binge drinking was a stronger predictor of high-intensity drinking at age 60 than earlier in midlife, underscoring that adolescent binge drinking is a key indicator of risk across the lifespan.

背景:中年成年人(即 35-60 岁)的饮酒量正在增加,但很少有研究对这一年龄组的具体饮酒行为进行调查。我们研究了中年成年人中按年龄、性别和种族/民族划分的典型饮酒量、最高饮酒量、暴饮暴食量和高强度饮酒量,以及 18 岁暴饮暴食与中年行为之间的前瞻性关联:方法:利用参与全国 "监测未来小组 "研究的 5180 名 2022 年 35-60 岁受访者的数据(自 1980-2005 年 12 年级开始跟踪),按年龄组、性别和种族/民族对过去 30 天的中年饮酒行为(即典型饮酒、最多饮酒、酗酒和高强度饮酒)进行估计。研究了18岁暴饮状态与中年饮酒结果之间的关系,以及社会人口特征的调节作用:结果:在 35-60 岁的人群中,过去一个月内饮酒日的平均典型饮酒量在 1.4-1.8 之间;平均最高饮酒量在 2.3-3.2 之间。过去一个月的暴饮和高强度饮酒率分别为 19.1%至 31.2%和 3.6%至 8.1%。饮酒行为的估计值在以下人群中普遍较高:35-40 岁(相对于更大年龄组)、男性(相对于女性)、白人(相对于其他种族/民族)以及报告 18 岁暴饮(相对于未报告)的人群。青春期暴饮对女性高强度饮酒的预测作用强于男性,对年龄较大(60 岁)的受访者典型饮酒量和最高饮酒量的预测作用强于年龄较小(35 岁)的受访者:结论:在美国的中年人中,有相当比例的人报告了暴饮和高强度饮酒。青少年时期的酗酒是日后酒精相关风险的预测因素。这些长期联系在女性中尤为明显。与中年早期相比,18 岁时的酗酒更能预测 60 岁时的高强度饮酒,这表明青少年时期的酗酒是整个生命周期中风险的关键指标。
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引用次数: 0
期刊
Alcohol (Hanover, York County, Pa.)
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