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Friday, March 6, 2009

Longitudinal Trends in Hazardous Alcohol Consumption Among Women With Human Immunodeficiency Virus Infection, 1995–2006
American Journal of Epidemiology Advance Access published online on March 6, 2009

Hazardous alcohol consumption among women with human immunodeficiency virus (HIV) infection is associated with several adverse health and behavioral outcomes, but the proportion of HIV-positive women who engage in hazardous drinking over time is unclear.
The authors sought to determine rates of hazardous alcohol consumption among these women over time and to identify factors associated with this behavior. Subjects were 2,770 HIV-positive women recruited from 6 US cities who participated in semiannual follow-up visits in the Women's Interagency HIV Study from 1995 to 2006. Hazardous alcohol consumption was defined as exceeding daily (4 drinks) or weekly (>7 drinks) consumption recommendations.

Over the 11-year follow-up period, 14%–24% of the women reported past-year hazardous drinking, with a slight decrease in hazardous drinking over time. Women were significantly more likely to report hazardous drinking if they were unemployed, were not high school graduates, had been enrolled in the original cohort (1994–1995), had a CD4 cell count of 200–500 cells/mL, were hepatitis C-seropositive, or had symptoms of depression. Approximately 1 in 5 of the women met criteria for hazardous drinking.

Interventions to identify and address hazardous drinking among HIV-positive women are urgently needed.

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Thursday, March 5, 2009

Role of the HPA Axis and the A118G Polymorphism of the µ-Opioid Receptor in Stress-Induced Drinking Behavior
Alcohol and Alcoholism Advance Access published online on February 24, 2009

The present study sought to investigate the relationship between the HPA axis reactivity to stress, the endogenous opioid system and stress-induced drinking behavior.

In the present study, 74 non-treatment-seeking alcohol-dependent subjects were tested under two mood conditions, neutral and stress, in separate testing sessions. Salivary cortisol measurements were obtained following stress induction and during the neutral control condition. Multiple measurements of alcohol intake, latency to access the alcohol cue and craving for alcohol were obtained during cue-availability testing. In addition, 52 of the study subjects were genotyped for the µ-opioid receptor.

A blunted cortisol response to stress was significantly correlated with increased alcohol intake following stress exposure compared to alcohol intake during the neutral session. There was not a clear correlation between the change in cortisol in response to stress and the change in latency to access alcohol or alcohol craving in response to stress. Carriers of the Asp40 variant of the µ-opioid receptor exhibited a dampened cortisol response to stress, higher alcohol intake and greater craving in response to stress compared to Asn40 homozygotes, although these differences were not statistically significant.

The results of the present study indicate that a blunted biological stress response was correlated with increased drinking in response to stress. The Asp40 variant of the µ-opioid receptor may be associated with this HPA axis hyporeactivity although the small sample size used in the present study did not permit adequate evaluation of this association.

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Television-supported self-help for problem drinkers: A randomized pragmatic trial
Addictive Behaviors Volume 34, Issue 5, May 2009, Pages 451-457

To test the effectiveness of a television-supported self-help intervention for problem drinking.

Dutch television viewers (N = 181) drinking in excess of the guidelines for low-risk alcohol use were randomly assigned either to the Drinking Less TV self-help course (consisting of five televised sessions supplemented by a self-help manual and a self-help website) or to a waitlisted control group. To ensure trial integrity, intervention delivery was mimicked beforehand by sending intervention participants weekly DVDs in advance of the actual telecasts in 2006. Pre-post assessments were carried out on both groups, as well as a 3-month follow-up assessment on the intervention group to study effect maintenance. The primary outcome measure was low-risk drinking.

The intervention group was more successful than the waitlist group in achieving low-risk drinking at post-intervention (OR = 9.4); the effects were maintained in the intervention group at 3-month follow-up.

The low-threshold television-based course Drinking Less appears effective in reducing problem drinking.

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Alcohol criteria endorsement and psychiatric and drug use disorders among DUI offenders: Greater severity among women and multiple offenders
Addictive Behaviors Volume 34, Issue 5, May 2009, Pages 432-439

Data from the Collaborative Study on the Genetics of Alcoholism (COGA), a high-risk family study of alcohol dependence, were used to examine differences in alcohol diagnostic criteria endorsement and psychiatric and drug use disorders by gender and by number of DUI offenses.

Individuals with two or more DUIs exhibited greater severity of alcohol dependence than those with none or one DUI. This severity was characterized in three ways: (1) higher endorsement of alcohol diagnostic criterion items, with evidence of greater severity among women, (2) higher prevalence of co-occurring lifetime psychiatric disorders, and (3) higher rates of drug use and of dependence on cocaine, stimulants, and, for women only, marijuana and opiates.

By examining gradations of disorder within a combination of two high-risk indicators, DUI and family vulnerability, this study provides useful information for clinical research about individuals with chronic and severe alcohol problems. In addition, the observed gender differences in this high-risk sample will contribute to the literature on alcohol dependence among women at the more severe end of the dependence spectrum.

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Family history of alcohol abuse moderates effectiveness of a group motivational enhancement intervention in college women
Addictive Behaviors Volume 34, Issue 5, May 2009, Pages 415-420
This study examined whether a self-reported family history of alcohol abuse (FH+) moderated the effects of a female-specific group motivational enhancement intervention with first-year college women.
First-year college women (N = 287) completed an initial questionnaire and attended an intervention (n = 161) or control (n = 126) group session, of which 118 reported FH+. Repeated measures ANCOVA models were estimated to investigate whether the effectiveness of the intervention varied as a function of one's reported family history of alcohol abuse.
Results revealed that family history of alcohol abuse moderated intervention efficacy. Although the intervention was effective in producing less risky drinking relative to controls, among those participants who received the intervention, FH+ women drank less across five weeks of follow-up than FH− women.
The current findings provide preliminary support for the differential effectiveness of motivational enhancement interventions with FH+ women.
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Validation of the Dutch version of the brief young adult alcohol consequences questionnaire (B-YAACQ)
Addictive Behaviors Volume 34, Issue 5, May 2009, Pages 411-414

The purpose of this study was to validate the Dutch version of the Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ).

Data from 667 undergraduate and graduate students (184 men and 483 women) who reported alcohol use during the past year was used in the analysis. On average, students in this study report 4.7 alcohol-related consequences. The Dutch B-YAACQ was shown to have a high reliability and validity: Cronbach's Alpha was 0.816, and B-YAACQ scores correlated significantly with AUDIT-PC scores (r = 0.747). B-YAACQ scores correlated significantly
The Dutch B-YAACQ is a useful new tool for screening of alcohol-related consequences.

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Sunday, March 1, 2009

New insights into the genetics of addiction
Nature Reviews Genetics, advance online publication, 24 February 2009

Drug addiction is a common brain disorder that is extremely costly to the individual and to society. Genetics contributes significantly to vulnerability to this disorder, but identification of susceptibility genes has been slow. Recent genome-wide linkage and association studies have implicated several regions and genes in addiction to various substances, including alcohol and, more recently, tobacco. Current efforts aim not only to replicate these findings in independent samples but also to determine the functional mechanisms of these genes and variants.

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