M. Schuckit, Tom L. Smith, D. Clarke, L. A. Mendoza, Mari Kawamura, Lara Schoen
BACKGROUND The 35-year-long San Diego Prospective Study documented 2-fold increases in alcohol problems and alcohol use disorders (AUDs) in young-adult drinking offspring compared to rates in their fathers, the original probands. The current analyses use the same interviews and questionnaires at about the same age in members of the 2 generations to explore multiple potential contributors to the generational differences in adverse alcohol outcomes. METHODS Using data from recent offspring interviews, multiple cross-generation differences in characteristics potentially related to alcohol problems were evaluated in 3 steps: first through direct comparisons across probands and offspring at about age 30; second by backward linear regression analyses of predictors of alcohol problems within each generation; and finally third through R-based bootstrapped linear regressions of differences in alcohol problems in randomly matched probands and offspring. RESULTS The analyses across the analytical approaches revealed 3 consistent predictors of higher alcohol problems in the second generation. These included the following: (i) a more robust relationship to alcohol problems for offspring with a low level of response to alcohol; (ii) higher offspring values for alcohol expectancies; and (iii) higher offspring impulsivity. CONCLUSIONS The availability of data across generations offered a unique perspective for studying characteristics that may have contributed to a general finding in the literature of substantial increases in alcohol problems and AUDs in recent generations. If replicated, these results could suggest approaches to be used by parents, healthcare workers, insurance companies, and industry in their efforts to mitigate the increasing rates of alcohol problems in younger generations.
{"title":"Predictors of Increases in Alcohol Problems and Alcohol Use Disorders in Offspring in the San Diego Prospective Study.","authors":"M. Schuckit, Tom L. Smith, D. Clarke, L. A. Mendoza, Mari Kawamura, Lara Schoen","doi":"10.1111/acer.14164","DOIUrl":"https://doi.org/10.1111/acer.14164","url":null,"abstract":"BACKGROUND\u0000The 35-year-long San Diego Prospective Study documented 2-fold increases in alcohol problems and alcohol use disorders (AUDs) in young-adult drinking offspring compared to rates in their fathers, the original probands. The current analyses use the same interviews and questionnaires at about the same age in members of the 2 generations to explore multiple potential contributors to the generational differences in adverse alcohol outcomes.\u0000\u0000\u0000METHODS\u0000Using data from recent offspring interviews, multiple cross-generation differences in characteristics potentially related to alcohol problems were evaluated in 3 steps: first through direct comparisons across probands and offspring at about age 30; second by backward linear regression analyses of predictors of alcohol problems within each generation; and finally third through R-based bootstrapped linear regressions of differences in alcohol problems in randomly matched probands and offspring.\u0000\u0000\u0000RESULTS\u0000The analyses across the analytical approaches revealed 3 consistent predictors of higher alcohol problems in the second generation. These included the following: (i) a more robust relationship to alcohol problems for offspring with a low level of response to alcohol; (ii) higher offspring values for alcohol expectancies; and (iii) higher offspring impulsivity.\u0000\u0000\u0000CONCLUSIONS\u0000The availability of data across generations offered a unique perspective for studying characteristics that may have contributed to a general finding in the literature of substantial increases in alcohol problems and AUDs in recent generations. If replicated, these results could suggest approaches to be used by parents, healthcare workers, insurance companies, and industry in their efforts to mitigate the increasing rates of alcohol problems in younger generations.","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"11 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87570436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christine J. Fontaine, Cristina Pinar, Waisley Yang, Angela F Pang, Konrad E Suesser, James S. J. Choi, B. Christie
BACKGROUND The hippocampus is particularly vulnerable to the teratogenic effects of prenatal ethanol exposure (PNEE), and hippocampal structural and functional deficits are thought to contribute to the learning and memory deficits that are a hallmark feature of fetal alcohol spectrum disorders (FASDs). METHOD Sprague-Dawley dams were exposed to a liquid diet that contained EtOH (35.5% EtOH-derived calories) throughout gestation, and then PNEE juvenile (P21-28) male and female offspring were used for in vitro electrophysiological recordings. We examined long-term potentiation (LTP), long-term depression (LTD) and depotentiation in the medial perforant path (MPP) input to the dentate gyrus (DG) to determine the impact of PNEE on the dynamic range of bidirectional synaptic plasticity in both sexes. RESULTS PNEE reduced the responsiveness of the DGs of male but not in female offspring, and this effect was no longer apparent when GABAergic signalling was inhibited. There was also a sex-specific LTD impairment in males, but increasing the duration of the conditioning stimulus could overcome this deficit. The magnitude of LTP was also reduced, but in both sexes following PNEE. This appears to be an increase in the threshold for induction, not in capacity, as the level of LTP induced in PNEE animals was increased to control-levels when additional conditioning stimuli were administered. CONCLUSIONS These data are the first to describe, in a single study, the impact of PNEE on the dynamic range of bidirectional synaptic plasticity in the juvenile DG in both males and in females. The data suggest that PNEE increases the threshold for LTP in the DG in both sexes, but produces a sex-specific increase in the threshold for LTD in males These alterations reduce the dynamic range for synaptic plasticity in both sexes. This article is protected by copyright. All rights reserved.
{"title":"Impaired bidirectional synaptic plasticity in juvenile offspring following prenatal ethanol exposure.","authors":"Christine J. Fontaine, Cristina Pinar, Waisley Yang, Angela F Pang, Konrad E Suesser, James S. J. Choi, B. Christie","doi":"10.1111/acer.14170","DOIUrl":"https://doi.org/10.1111/acer.14170","url":null,"abstract":"BACKGROUND\u0000The hippocampus is particularly vulnerable to the teratogenic effects of prenatal ethanol exposure (PNEE), and hippocampal structural and functional deficits are thought to contribute to the learning and memory deficits that are a hallmark feature of fetal alcohol spectrum disorders (FASDs).\u0000\u0000\u0000METHOD\u0000Sprague-Dawley dams were exposed to a liquid diet that contained EtOH (35.5% EtOH-derived calories) throughout gestation, and then PNEE juvenile (P21-28) male and female offspring were used for in vitro electrophysiological recordings. We examined long-term potentiation (LTP), long-term depression (LTD) and depotentiation in the medial perforant path (MPP) input to the dentate gyrus (DG) to determine the impact of PNEE on the dynamic range of bidirectional synaptic plasticity in both sexes.\u0000\u0000\u0000RESULTS\u0000PNEE reduced the responsiveness of the DGs of male but not in female offspring, and this effect was no longer apparent when GABAergic signalling was inhibited. There was also a sex-specific LTD impairment in males, but increasing the duration of the conditioning stimulus could overcome this deficit. The magnitude of LTP was also reduced, but in both sexes following PNEE. This appears to be an increase in the threshold for induction, not in capacity, as the level of LTP induced in PNEE animals was increased to control-levels when additional conditioning stimuli were administered.\u0000\u0000\u0000CONCLUSIONS\u0000These data are the first to describe, in a single study, the impact of PNEE on the dynamic range of bidirectional synaptic plasticity in the juvenile DG in both males and in females. The data suggest that PNEE increases the threshold for LTP in the DG in both sexes, but produces a sex-specific increase in the threshold for LTD in males These alterations reduce the dynamic range for synaptic plasticity in both sexes. This article is protected by copyright. All rights reserved.","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"379 2 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75710633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND Poor functioning among Concerned Others (COs; family and friends of an individual with an alcohol or other substance use disorder) is a significant public health problem. The purpose of this study was to inform interventions for COs by examining potential correlates of three aspects of functioning: quality of life, mental health, and knowledge of how to handle problems related to their drinker. METHODS This study collected data from 277 COs when their friend or family member (their "drinker") was entering treatment for an alcohol use disorder. Potential correlates were the drinker's substance use severity, the CO-drinker relationship and communication, and COs' coping and perceived stigma related to involvement with their drinker. RESULTS In a summary analysis, only stressors in the CO-drinker relationship (the drinker's criticism, disagreement, anger, and demands) were consistently associated with poorer functioning as indicated by COs' poorer quality of life and mental health. In contrast, only COs' use of approach coping was associated with COs' knowing how to handle problems related to the drinker. CONCLUSIONS Because reducing both relationship stressors and the link between stressors and poor functioning can be achieved through CO and drinker education and intervention, these findings inform how to effectively support COs' goals for better functioning. This article is protected by copyright. All rights reserved.
{"title":"Functioning of Concerned Others When Adults Enter Treatment for an Alcohol Use Disorder.","authors":"C. Timko, Kathleen M. Grant, Michael A. Cucciare","doi":"10.1111/acer.14153","DOIUrl":"https://doi.org/10.1111/acer.14153","url":null,"abstract":"BACKGROUND\u0000Poor functioning among Concerned Others (COs; family and friends of an individual with an alcohol or other substance use disorder) is a significant public health problem. The purpose of this study was to inform interventions for COs by examining potential correlates of three aspects of functioning: quality of life, mental health, and knowledge of how to handle problems related to their drinker.\u0000\u0000\u0000METHODS\u0000This study collected data from 277 COs when their friend or family member (their \"drinker\") was entering treatment for an alcohol use disorder. Potential correlates were the drinker's substance use severity, the CO-drinker relationship and communication, and COs' coping and perceived stigma related to involvement with their drinker.\u0000\u0000\u0000RESULTS\u0000In a summary analysis, only stressors in the CO-drinker relationship (the drinker's criticism, disagreement, anger, and demands) were consistently associated with poorer functioning as indicated by COs' poorer quality of life and mental health. In contrast, only COs' use of approach coping was associated with COs' knowing how to handle problems related to the drinker.\u0000\u0000\u0000CONCLUSIONS\u0000Because reducing both relationship stressors and the link between stressors and poor functioning can be achieved through CO and drinker education and intervention, these findings inform how to effectively support COs' goals for better functioning. This article is protected by copyright. All rights reserved.","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"54 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74807468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Anton, K. Witkiewitz, Daniel E. Falk, R. Litten, D. Hasin, K. Mann, S. O'Malley
We wish to thank Dr. Mark Litt for his very thoughtful and comprehensive commentary (Litt 2019) on our body of work describing the potential use of the World Health Organization (WHO) risk drinking levels (World Health Organization, 2000) for judging success/efficacy in clinical trials generally, but in pharmacotherapy trials in particular. Importantly, Dr. Litt highlights the importance of this work for clinical practice. He rightly describes the issue that many clinicians face, the fact that many treatment-seekers do not desire complete abstinence, both because it is a goal that is difficult to achieve and because many social situations that involve alcohol can be difficult to navigate for non-drinkers. This article is protected by copyright. All rights reserved.
{"title":"Response to Dr. Mark Litt's Commentary.","authors":"R. Anton, K. Witkiewitz, Daniel E. Falk, R. Litten, D. Hasin, K. Mann, S. O'Malley","doi":"10.1111/acer.14160","DOIUrl":"https://doi.org/10.1111/acer.14160","url":null,"abstract":"We wish to thank Dr. Mark Litt for his very thoughtful and comprehensive commentary (Litt 2019) on our body of work describing the potential use of the World Health Organization (WHO) risk drinking levels (World Health Organization, 2000) for judging success/efficacy in clinical trials generally, but in pharmacotherapy trials in particular. Importantly, Dr. Litt highlights the importance of this work for clinical practice. He rightly describes the issue that many clinicians face, the fact that many treatment-seekers do not desire complete abstinence, both because it is a goal that is difficult to achieve and because many social situations that involve alcohol can be difficult to navigate for non-drinkers. This article is protected by copyright. All rights reserved.","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"11 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88673143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marie Grønkjær, T. Flensborg-Madsen, M. Osler, H. Sørensen, U. Becker, E. L. Mortensen
Background Existing studies on intellectual consequences of alcohol‐related disorders are primarily cross‐sectional and compare intelligence test scores of individuals with and without alcohol‐related disorders, hence mixing the influence of alcohol‐related disorders and predisposing factors such as premorbid intelligence. In this large‐scale study, the primary aim was to estimate associations of alcohol‐related disorders with changes in intelligence test scores from early adulthood to late midlife. Methods Data were drawn from a follow‐up study on middle‐aged men, which included a re‐examination of the same intelligence test as completed in young adulthood at military conscription (total analytic sample = 2,499). Alcohol‐related hospital diagnoses were obtained from national health registries, whereas treatment for alcohol problems was self‐reported at follow‐up. The analyses included adjustment for year of birth, retest interval, baseline intelligence quotient (IQ) score, education, smoking, alcohol consumption, and psychiatric and somatic comorbidity. Results Individuals with alcohol‐related hospital diagnoses (8%) had a significantly lower baseline IQ score (95.0 vs. 100.5, p < 0.001) and a larger decline in IQ scores from baseline to follow‐up (−8.5 vs. −4.8, p < 0.001) than individuals without such diagnoses. The larger decline in IQ scores with alcohol‐related hospital diagnoses remained statistically significant after adjustment for all the covariates. Similar results were revealed when IQ scores before and after self‐reported treatment for alcohol problems (10%) were examined. Conclusions Individuals with alcohol‐related disorders have a lower intelligence test score both in young adulthood and in late midlife, and these disorders, moreover, seem to be associated with more age‐related decline in intelligence test scores. Thus, low mean intellectual ability observed in individuals with alcohol‐related disorders is probably a result of both lower premorbid intelligence and more intellectual decline.
{"title":"Intelligence Test Scores Before and After Alcohol‐Related Disorders—A Longitudinal Study of Danish Male Conscripts","authors":"Marie Grønkjær, T. Flensborg-Madsen, M. Osler, H. Sørensen, U. Becker, E. L. Mortensen","doi":"10.1111/acer.14174","DOIUrl":"https://doi.org/10.1111/acer.14174","url":null,"abstract":"Background Existing studies on intellectual consequences of alcohol‐related disorders are primarily cross‐sectional and compare intelligence test scores of individuals with and without alcohol‐related disorders, hence mixing the influence of alcohol‐related disorders and predisposing factors such as premorbid intelligence. In this large‐scale study, the primary aim was to estimate associations of alcohol‐related disorders with changes in intelligence test scores from early adulthood to late midlife. Methods Data were drawn from a follow‐up study on middle‐aged men, which included a re‐examination of the same intelligence test as completed in young adulthood at military conscription (total analytic sample = 2,499). Alcohol‐related hospital diagnoses were obtained from national health registries, whereas treatment for alcohol problems was self‐reported at follow‐up. The analyses included adjustment for year of birth, retest interval, baseline intelligence quotient (IQ) score, education, smoking, alcohol consumption, and psychiatric and somatic comorbidity. Results Individuals with alcohol‐related hospital diagnoses (8%) had a significantly lower baseline IQ score (95.0 vs. 100.5, p < 0.001) and a larger decline in IQ scores from baseline to follow‐up (−8.5 vs. −4.8, p < 0.001) than individuals without such diagnoses. The larger decline in IQ scores with alcohol‐related hospital diagnoses remained statistically significant after adjustment for all the covariates. Similar results were revealed when IQ scores before and after self‐reported treatment for alcohol problems (10%) were examined. Conclusions Individuals with alcohol‐related disorders have a lower intelligence test score both in young adulthood and in late midlife, and these disorders, moreover, seem to be associated with more age‐related decline in intelligence test scores. Thus, low mean intellectual ability observed in individuals with alcohol‐related disorders is probably a result of both lower premorbid intelligence and more intellectual decline.","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"43 1","pages":"2187 - 2195"},"PeriodicalIF":3.2,"publicationDate":"2019-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82093679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kathryn M. Harper, D. Knapp, R. K. Butler, Cory A. Cook, H. Criswell, G. Stuber, G. Breese
BACKGROUND Chronic ethanol exposure induces neurobehavioral maladaptations in the brain though the precise changes have not been fully explored. The central amygdala (CEA) regulates anxiety-like behavior induced by withdrawal from chronic intermittent ethanol (CIE) exposure and the arginine vasopressin (AVP) system within the CEA regulates many anxiety-like behaviors. Thus, adaptations occur in the CEA AVP system due to chronic ethanol exposure which lead to anxiety-like behaviors in rats. METHODS Chronic exposure to a low dose ethanol (4.5% wt/vol) induces anxiety-like behavior in rats. Wistar or Sprague-Dawley rats were exposed to a modified CIE or CIE while intra-CEA microinjections of AVP or a V1b receptor antagonist were used to elicit or block withdrawal induced anxiety. Additionally, AVP microinjections into the CEA were given 24 hours following 15 days of continuous high dose ethanol (7% wt/vol), a time period when rats no longer express anxiety. Chemogenetics was also used to activate the basolateral amygdala or deactivate the dorsal periaqueductal grey (dm/dlPAG) to elicit or block withdrawal induced anxiety. RESULTS AVP microinjected into the CEA in lieu of exposure to the first two cycles of CIE was sufficient to induce anxiety-like behavior in these commonly used rat strains. The V1b receptor antagonist, but not an oxytocin receptor agonist, into the CEA during the first two withdrawal cycles suppressed anxiety. However, activation of the basolateral amygdala in lieu of exposure to the first two cycles of CIE was insufficient to induce anxiety-like behavior. AVP microinjection into the CEA 24 hours into withdrawal re-elicited anxiety-like behavior and deactivation of the dm/dlPAG reduced this effect of CEA AVP. CONCLUSIONS Taken together, this study demonstrates a role of CEA AVP and a CEA-dm/dlPAG circuit in the development of anxiety induced by CIE. Such information is valuable for identifying novel therapeutic targets for alcohol and anxiety associated disorders. This article is protected by copyright. All rights reserved.
{"title":"Amygdala arginine vasopressin modulates chronic ethanol withdrawal anxiety-like behavior in the social interaction task.","authors":"Kathryn M. Harper, D. Knapp, R. K. Butler, Cory A. Cook, H. Criswell, G. Stuber, G. Breese","doi":"10.1111/acer.14163","DOIUrl":"https://doi.org/10.1111/acer.14163","url":null,"abstract":"BACKGROUND\u0000Chronic ethanol exposure induces neurobehavioral maladaptations in the brain though the precise changes have not been fully explored. The central amygdala (CEA) regulates anxiety-like behavior induced by withdrawal from chronic intermittent ethanol (CIE) exposure and the arginine vasopressin (AVP) system within the CEA regulates many anxiety-like behaviors. Thus, adaptations occur in the CEA AVP system due to chronic ethanol exposure which lead to anxiety-like behaviors in rats.\u0000\u0000\u0000METHODS\u0000Chronic exposure to a low dose ethanol (4.5% wt/vol) induces anxiety-like behavior in rats. Wistar or Sprague-Dawley rats were exposed to a modified CIE or CIE while intra-CEA microinjections of AVP or a V1b receptor antagonist were used to elicit or block withdrawal induced anxiety. Additionally, AVP microinjections into the CEA were given 24 hours following 15 days of continuous high dose ethanol (7% wt/vol), a time period when rats no longer express anxiety. Chemogenetics was also used to activate the basolateral amygdala or deactivate the dorsal periaqueductal grey (dm/dlPAG) to elicit or block withdrawal induced anxiety.\u0000\u0000\u0000RESULTS\u0000AVP microinjected into the CEA in lieu of exposure to the first two cycles of CIE was sufficient to induce anxiety-like behavior in these commonly used rat strains. The V1b receptor antagonist, but not an oxytocin receptor agonist, into the CEA during the first two withdrawal cycles suppressed anxiety. However, activation of the basolateral amygdala in lieu of exposure to the first two cycles of CIE was insufficient to induce anxiety-like behavior. AVP microinjection into the CEA 24 hours into withdrawal re-elicited anxiety-like behavior and deactivation of the dm/dlPAG reduced this effect of CEA AVP.\u0000\u0000\u0000CONCLUSIONS\u0000Taken together, this study demonstrates a role of CEA AVP and a CEA-dm/dlPAG circuit in the development of anxiety induced by CIE. Such information is valuable for identifying novel therapeutic targets for alcohol and anxiety associated disorders. This article is protected by copyright. All rights reserved.","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"58 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2019-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81167132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND Web-based alcohol screenings and brief interventions have been shown to be effective methods for changing drinking behavior. This study evaluated the efficacy of the online-based Brief Empowerment Program for Alcohol Use Monitor (on-BEAM), a brief intervention applying personalized normative feedback (PNF) and components of motivational interviewing (MI) techniques. METHODS A community-based, double-blind, parallel-group randomized controlled trial with individual randomization was conducted in Korea (registered at Clinical Research Information Service-KCT0003050). An e-mail about participating in a survey on drinking behavior was sent to 5,684 individuals, aged 20-40, that were registered as part of a research panel. Male and female participants with AUDIT-C scores of ≥ 4 and ≥ 3, respectively, were randomly assigned to either an intervention (received a drinking behavior assessment and the results with normative feedback) or control group (assessment and results without normative feedback). To evaluate the effects of the intervention with two sessions over the course of a month, a follow-up assessment was performed online 4-weeks after completion of the intervention. The main outcome was the number of standard drinks consumed during the past week measured using the timeline followback method. The rate ratios (RRs) were calculated to test the effects of the intervention. RESULTS In total, 1,496 participants were randomized and 93% of them followed up. The intervention group reported consuming less alcohol during the past week (RR=0.13; P=0.012) than the control group. Additionally, the intervention group had fewer binge drinkers (RR=0.69; P<0.001) and a lower AUDIT-C score (RR=0.59; P=0.009) than the control group. CONCLUSIONS The web-based intervention, on-BEAM, which applies PNF and MI components related to high-risk drinking reduced the amount of alcohol consumption in our study population. Further research is needed to determine the duration of on-BEAM's effects and evaluate its effectiveness in the real world. This article is protected by copyright. All rights reserved.
{"title":"Efficacy of a web-based screening and brief intervention to prevent problematic alcohol use in Korea: Results of a randomized controlled trial.","authors":"S. Jo, H. Lee, Kyonghwa Kang, K. Joe, S. Lee","doi":"10.1111/acer.14169","DOIUrl":"https://doi.org/10.1111/acer.14169","url":null,"abstract":"BACKGROUND\u0000Web-based alcohol screenings and brief interventions have been shown to be effective methods for changing drinking behavior. This study evaluated the efficacy of the online-based Brief Empowerment Program for Alcohol Use Monitor (on-BEAM), a brief intervention applying personalized normative feedback (PNF) and components of motivational interviewing (MI) techniques.\u0000\u0000\u0000METHODS\u0000A community-based, double-blind, parallel-group randomized controlled trial with individual randomization was conducted in Korea (registered at Clinical Research Information Service-KCT0003050). An e-mail about participating in a survey on drinking behavior was sent to 5,684 individuals, aged 20-40, that were registered as part of a research panel. Male and female participants with AUDIT-C scores of ≥ 4 and ≥ 3, respectively, were randomly assigned to either an intervention (received a drinking behavior assessment and the results with normative feedback) or control group (assessment and results without normative feedback). To evaluate the effects of the intervention with two sessions over the course of a month, a follow-up assessment was performed online 4-weeks after completion of the intervention. The main outcome was the number of standard drinks consumed during the past week measured using the timeline followback method. The rate ratios (RRs) were calculated to test the effects of the intervention.\u0000\u0000\u0000RESULTS\u0000In total, 1,496 participants were randomized and 93% of them followed up. The intervention group reported consuming less alcohol during the past week (RR=0.13; P=0.012) than the control group. Additionally, the intervention group had fewer binge drinkers (RR=0.69; P<0.001) and a lower AUDIT-C score (RR=0.59; P=0.009) than the control group.\u0000\u0000\u0000CONCLUSIONS\u0000The web-based intervention, on-BEAM, which applies PNF and MI components related to high-risk drinking reduced the amount of alcohol consumption in our study population. Further research is needed to determine the duration of on-BEAM's effects and evaluate its effectiveness in the real world. This article is protected by copyright. All rights reserved.","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"146 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2019-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80551595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The Alcohol Use Disorders Identification Test (AUDIT) was developed for use in primary health care settings to identify hazardous and harmful patterns of alcohol consumption, and is often used to screen for alcohol use disorders (AUDs). This study examined the AUDIT as a screening tool for AUDs. Methods A systematic literature search was performed of electronic bibliographic databases (CINAHL, Embase, ERIC, MEDLINE, PsycINFO, Scopus, and Web of Science) without language or geographic restrictions for original quantitative studies published before September 1, 2018, that assess the AUDIT's ability to screen for AUDs. Random‐effects meta‐regression models were constructed by sex to assess the potential determinants of the AUDIT's specificity and sensitivity. From these models and ecological data from the Global Information System on Alcohol and Health, the true‐ and false‐positive and true‐ and false‐negative proportions were determined. The number of people needed to be screened to treat 1 individual with an AUD was estimated for all countries globally where AUD data exist, using a specificity of 0.95. Results A total of 36 studies met inclusion criteria for the meta‐regression. The AUDIT score cut‐point was significantly associated with sensitivity and specificity. Standard drink size was found to affect the sensitivity and specificity of the AUDIT for men, but not among women. The AUDIT performs less well in identifying women compared to men, and countries with a low prevalence of AUDs have higher false‐positive rates compared to countries with a higher AUD prevalence. Conclusions The AUDIT does not perform well as a screening tool for identifying individuals with an AUD, especially in countries and among populations with a low AUD prevalence (e.g., among women), and thus should not be used for this purpose.
背景:酒精使用障碍鉴定试验(AUDIT)是为在初级卫生保健机构中使用而开发的，用于鉴定危险和有害的酒精消费模式，通常用于筛查酒精使用障碍(AUDs)。本研究检验了审计作为aud的筛选工具。方法系统检索电子书目数据库(CINAHL、Embase、ERIC、MEDLINE、PsycINFO、Scopus和Web of Science)，检索2018年9月1日之前发表的原始定量研究，不受语言和地理限制，评估审计筛选aud的能力。随机效应元回归模型按性别构建，以评估审计的特异性和敏感性的潜在决定因素。从这些模型和来自全球酒精与健康信息系统的生态数据中，确定了真阳性和假阳性以及真阴性和假阴性的比例。在全球所有存在AUD数据的国家中，估计治疗1例AUD患者需要筛查的人数，特异性为0.95。结果共有36项研究符合meta回归的纳入标准。审计评分切点与敏感性和特异性显著相关。标准饮料量对男性的敏感性和特异性有影响，但对女性没有影响。与男性相比，审计在识别女性方面表现不佳，与AUD患病率较高的国家相比，AUD患病率较低的国家有更高的假阳性率。结论:审计不能很好地作为识别AUD患者的筛查工具，特别是在AUD患病率较低的国家和人群中(例如，在女性中)，因此不应用于此目的。
{"title":"Facilitating Screening and Brief Interventions in Primary Care: A Systematic Review and Meta‐Analysis of the AUDIT as an Indicator of Alcohol Use Disorders","authors":"S. Lange, K. Shield, M. Monteiro, J. Rehm","doi":"10.1111/acer.14171","DOIUrl":"https://doi.org/10.1111/acer.14171","url":null,"abstract":"Background The Alcohol Use Disorders Identification Test (AUDIT) was developed for use in primary health care settings to identify hazardous and harmful patterns of alcohol consumption, and is often used to screen for alcohol use disorders (AUDs). This study examined the AUDIT as a screening tool for AUDs. Methods A systematic literature search was performed of electronic bibliographic databases (CINAHL, Embase, ERIC, MEDLINE, PsycINFO, Scopus, and Web of Science) without language or geographic restrictions for original quantitative studies published before September 1, 2018, that assess the AUDIT's ability to screen for AUDs. Random‐effects meta‐regression models were constructed by sex to assess the potential determinants of the AUDIT's specificity and sensitivity. From these models and ecological data from the Global Information System on Alcohol and Health, the true‐ and false‐positive and true‐ and false‐negative proportions were determined. The number of people needed to be screened to treat 1 individual with an AUD was estimated for all countries globally where AUD data exist, using a specificity of 0.95. Results A total of 36 studies met inclusion criteria for the meta‐regression. The AUDIT score cut‐point was significantly associated with sensitivity and specificity. Standard drink size was found to affect the sensitivity and specificity of the AUDIT for men, but not among women. The AUDIT performs less well in identifying women compared to men, and countries with a low prevalence of AUDs have higher false‐positive rates compared to countries with a higher AUD prevalence. Conclusions The AUDIT does not perform well as a screening tool for identifying individuals with an AUD, especially in countries and among populations with a low AUD prevalence (e.g., among women), and thus should not be used for this purpose.","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"35 1","pages":"2028 - 2037"},"PeriodicalIF":3.2,"publicationDate":"2019-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77903253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND A major tenet of the Alcohol Myopia Model is that intoxication results in a narrowing of attention to the most central environmental cues, at the cost of more peripheral information. Though long hypothesized, no known study of alcohol myopia has demonstrated differential immediate recall of central and peripheral cues using a standardized task. To address this gap, we conducted an alcohol administration study with a clear, standardized focus-a trauma film. METHODS Ninety-eight female social drinkers completed self-report measures, and then were randomized to consume a placebo beverage, a low dose of alcohol (mean Breath Alcohol Concentration [BrAC] = .04%), or a high dose of alcohol (mean BrAC = .11%). Participants then moved to a staged room where they viewed a film clip depicting a sexual assault. After leaving the room, participants completed a written free recall task of the film and the room. RESULTS The distinction between recall of central and peripheral details was supported by confirmatory factor analysis. Consistent with the Alcohol Myopia Model, relative to placebo, a high dose of alcohol led to impaired recall of peripheral (but not central) details. Although the interaction between BrAC and information type (central vs. peripheral) was not statistically significant, simple effects revealed a strong association between BrAC and peripheral information, and no association between BrAC and central information. Bolstering myopia as an explanation for our findings, neither central nor peripheral information correlated with self-reported tendencies to dissociate or distract oneself, or typical alcohol consumption or expectancies. CONCLUSIONS Alcohol myopia can be observed through an immediate free recall task following a stressful film. Additional research is needed to continue evaluating dose-dependent differential recall in larger samples. This task may be useful for clarifying the role of alcohol myopia in clinical phenomena, such as aggressive behavior and processing traumatic events. This article is protected by copyright. All rights reserved.
{"title":"Observing Alcohol Myopia in the Context of a Trauma Film Paradigm: Differential Recall of Central and Peripheral Details.","authors":"Anna E. Jaffe, C. Harris, D. DiLillo","doi":"10.1111/acer.14156","DOIUrl":"https://doi.org/10.1111/acer.14156","url":null,"abstract":"BACKGROUND\u0000A major tenet of the Alcohol Myopia Model is that intoxication results in a narrowing of attention to the most central environmental cues, at the cost of more peripheral information. Though long hypothesized, no known study of alcohol myopia has demonstrated differential immediate recall of central and peripheral cues using a standardized task. To address this gap, we conducted an alcohol administration study with a clear, standardized focus-a trauma film.\u0000\u0000\u0000METHODS\u0000Ninety-eight female social drinkers completed self-report measures, and then were randomized to consume a placebo beverage, a low dose of alcohol (mean Breath Alcohol Concentration [BrAC] = .04%), or a high dose of alcohol (mean BrAC = .11%). Participants then moved to a staged room where they viewed a film clip depicting a sexual assault. After leaving the room, participants completed a written free recall task of the film and the room.\u0000\u0000\u0000RESULTS\u0000The distinction between recall of central and peripheral details was supported by confirmatory factor analysis. Consistent with the Alcohol Myopia Model, relative to placebo, a high dose of alcohol led to impaired recall of peripheral (but not central) details. Although the interaction between BrAC and information type (central vs. peripheral) was not statistically significant, simple effects revealed a strong association between BrAC and peripheral information, and no association between BrAC and central information. Bolstering myopia as an explanation for our findings, neither central nor peripheral information correlated with self-reported tendencies to dissociate or distract oneself, or typical alcohol consumption or expectancies.\u0000\u0000\u0000CONCLUSIONS\u0000Alcohol myopia can be observed through an immediate free recall task following a stressful film. Additional research is needed to continue evaluating dose-dependent differential recall in larger samples. This task may be useful for clarifying the role of alcohol myopia in clinical phenomena, such as aggressive behavior and processing traumatic events. This article is protected by copyright. All rights reserved.","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"16 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2019-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89525008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah L. Olguin, Amber J. Zimmerman, Haikun Zhang, A. Allan, K. Caldwell, J. Brigman
BACKGROUND Fetal Alcohol Spectrum Disorders (FASD) commonly includes deficits in learning, memory and executive control that can have a severe negative impact on quality of life across the lifespan. It is still unclear how prenatal alcohol exposure (PAE) affects executive control processes, such as control over reward seeking, that lead to inappropriate behavior later in life. Learning and reinstatement of a previously learned response after extinction is a simple, well validated, measure of both acquisition of a rewarded instrumental response, and sensitivity to reward and reward-associated cues. We investigated the effects of PAE on learning, extinction and reinstatement of a simple instrumental response for food reward. Next, we assessed the effectiveness of an early intervention, communal nest (CN) housing, on increased reinstatement of an extinguished response seen after PAE. METHODS To assess the effects of PAE on control over reward seeking, we tested male and female PAE and saccharine (SAC) controls raised in a standard nest (SN) on the acquisition, extinction, and food reward induced reinstatement of an instrumental response utilizing a touch-screen based paradigm. Next, in order to examine the effects of an early life intervention on these behaviors, we tested PAE and SAC mice raised in a communal nest (CN) early life environment on these behaviors. RESULTS PAE mice readily acquired and extinguished a simple touch response to a white square stimulus. However, PAE mice showed significantly increased and persistent reinstatement compared to controls. Increased maternal care via rearing in CN slowed acquisition and sped extinction learning, and rescued the significantly increased reinstatement responding in PAE mice. CONCLUSIONS Together these results demonstrate that even moderate PAE is sufficient to alter control over reward seeking as measured by reinstatement. Importantly, an early life intervention previously shown to improve cognitive outcomes in PAE mice was sufficient to ameliorate this effect. This article is protected by copyright. All rights reserved.
{"title":"Increased maternal care rescues altered reinstatement responding following moderate prenatal alcohol exposure.","authors":"Sarah L. Olguin, Amber J. Zimmerman, Haikun Zhang, A. Allan, K. Caldwell, J. Brigman","doi":"10.1111/acer.14149","DOIUrl":"https://doi.org/10.1111/acer.14149","url":null,"abstract":"BACKGROUND\u0000Fetal Alcohol Spectrum Disorders (FASD) commonly includes deficits in learning, memory and executive control that can have a severe negative impact on quality of life across the lifespan. It is still unclear how prenatal alcohol exposure (PAE) affects executive control processes, such as control over reward seeking, that lead to inappropriate behavior later in life. Learning and reinstatement of a previously learned response after extinction is a simple, well validated, measure of both acquisition of a rewarded instrumental response, and sensitivity to reward and reward-associated cues. We investigated the effects of PAE on learning, extinction and reinstatement of a simple instrumental response for food reward. Next, we assessed the effectiveness of an early intervention, communal nest (CN) housing, on increased reinstatement of an extinguished response seen after PAE.\u0000\u0000\u0000METHODS\u0000To assess the effects of PAE on control over reward seeking, we tested male and female PAE and saccharine (SAC) controls raised in a standard nest (SN) on the acquisition, extinction, and food reward induced reinstatement of an instrumental response utilizing a touch-screen based paradigm. Next, in order to examine the effects of an early life intervention on these behaviors, we tested PAE and SAC mice raised in a communal nest (CN) early life environment on these behaviors.\u0000\u0000\u0000RESULTS\u0000PAE mice readily acquired and extinguished a simple touch response to a white square stimulus. However, PAE mice showed significantly increased and persistent reinstatement compared to controls. Increased maternal care via rearing in CN slowed acquisition and sped extinction learning, and rescued the significantly increased reinstatement responding in PAE mice.\u0000\u0000\u0000CONCLUSIONS\u0000Together these results demonstrate that even moderate PAE is sufficient to alter control over reward seeking as measured by reinstatement. Importantly, an early life intervention previously shown to improve cognitive outcomes in PAE mice was sufficient to ameliorate this effect. This article is protected by copyright. All rights reserved.","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"45 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2019-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83230964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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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