The College and Noncollege Experience: A Review of the Factors That Influence Drinking Behavior in Young Adulthood

To place college drinking within its larger developmental context, we reviewed studies that compare drinking behavior among college students with that of their age-matched non-student peers.

Among the recurrent themes identified across these studies, we particularly noted discrepancies in the conceptualization and operationalization of both college status and noncollege status. These discrepancies, and other methodological variations, were then examined because they influence conclusions about drinking outcomes.

Eighteen studies directly comparing college students with nonstudents were reviewed. 

College students drank more than noncollege peers and, in general, drank more frequently than did noncollege peers, although these differences were likely the result of factors other than college attendance itself.

Younger people drank more than older peers in both groups. College students also tended to be more at risk for alcohol-related problems, including alcohol abuse and alcohol dependence, again likely the result of factors other than college attendance per se. 

This review highlights the lack of consensus in the conceptualization and operationalization of college and noncollege status across studies, as well as the importance of variables such as living situation, age, full-time and part-time status, and type of college, which may be more directly related to variations in alcohol consumption than is college status itself.

Future investigations of college drinking should place this phenomenon within the larger context of developmental processes associated with this time of life.

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Request Reprint E-Mail: goldman@cas.usf.edu. 

Developmental cascades: Linking adolescent substance use, affiliation with substance use promoting peers, and academic achievement to adult substance use disorders

Using a high-risk community sample (N = 405), the current study examined developmental cascades among substance use, affiliation with substance use promoting peers, and academic achievement over an 18-year period and tested whether these pathways mediated the influence of parental alcoholism on adult alcohol and drug use disorders.

Results showed that the influence of parental alcoholism on adult drug disorders was mediated by developmental cascades across all three domains, whereas the influence of parental alcoholism on adult alcohol disorders was mediated through affiliation with substance use promoting peers and persistence in binge drinking.

Adolescent drug use had more implications for adult outcomes than did adolescent alcohol use, which was less likely to spill over into other domains of functioning.

Findings indicated that adolescent risk factors had indirect rather than unique effects on adult substance use disorders, suggesting that adolescent risk is not immutable and is largely mediated by later influences.



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Request Reprint E-Mail:  moira.haller@asu.edu. 

Substance use changes and social role transitions: Proximal developmental effects on ongoing trajectories from late adolescence through early adulthood

Substance use changes rapidly during late adolescence and early adulthood. This time in the life course is also dense with social role changes, as role changes provide dynamic context for individual developmental change.

Using nationally representative, multiwave longitudinal data from age 18 to 28, we examine proximal links between changes in social roles and changes in substance use during the transition to adulthood.

We find that changes in family roles, such as marriage, divorce, and parenthood, have clear and consistent associations with changes in substance use.

With some notable exceptions, changes in school and work roles have weaker effects on changes in substance use compared to family roles.

Changes in socializing (i.e., nights out for fun and recreation) and in religiosity were found to mediate the relationship of social role transitions to substance use.

Two time-invariant covariates, socioeconomic background and heavy adolescent substance use, predicted social role status, but did not moderate associations, as within-person links between social roles and substance use were largely equivalent across groups.

This paper adds to the cascading effects literature by considering how, within individuals, more proximal variations in school, work, and family roles relate to variations in substance use, and which roles appear to be most influential in precipitating changes in substance use during the transition to adulthood.

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Request Reprint E-Mail: jus25@psu.edu 

Testing a developmental cascade model of adolescent substance use trajectories and young adult adjustment

Developmental models highlight the impact of early risk factors on both the onset and growth of substance use, yet few studies have systematically examined the indirect effects of risk factors across several domains, and at multiple developmental time points, on trajectories of substance use and adult adjustment outcomes (e.g., educational attainment, mental health problems, criminal behavior).

The current study used data from a community epidemiologically defined sample of 678 urban, primarily African American youth, followed from first grade through young adulthood (age 21) to test a developmental cascade model of substance use and young adult adjustment outcomes.

Drawing upon transactional developmental theories and using growth mixture modeling procedures, we found evidence for a developmental progression from behavioral risk to adjustment problems in the peer context, culminating in a high-risk trajectory of alcohol, cigarette, and marijuana use during adolescence.

Substance use trajectory membership was associated with adjustment in adulthood. These findings highlight the developmental significance of early individual and interpersonal risk factors on subsequent risk for substance use and, in turn, young adult adjustment outcomes.



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Request Reprint E-Mail:  slynne@jhsph.edu.

Cerebral Palsy and Alcohol Consumption during Pregnancy: Is There a Connection?

Fetal alcohol syndrome (FAS) is a clinically identifiable diagnosis, consisting of pre- and/or postnatal growth retardation (below the third percentile), characteristic facial features, including a thin upper lip, indistinct philtrum and short palpebral fissures (two standard deviations below normal for age), and neurobehavioral abnormalities (Abel, 1998; Jones et al., 1973; Plant, 1987; Sokol et al., 2003).

Although FAS is the leading known cause of mental retardation in the USA (Abel and Sokol, 1986), brain injury involving milder forms of cognitive dysfunction, and more subtle and complex patterns of neurological impairment, occur in ∼30–40% of children born to heavy drinkers, with or without the classic diagnostic features of FAS (Koren et al., 2003; Mattson et al., 1997). 

These neurodevelopmental disorders and other wide-ranging physical and behavioral problems occurring in conjunction with or in the absence of classic FAS features, are now subsumed under the broader umbrella term, fetal alcohol spectrum disorder (FASD). 

Many of these alcohol-related neurological impairments, e.g. hypotonia, clumsiness, unsteady gait, fine motor impairment, poor eye-hand coordination (Abel, 1998; Aronson et al., 1985; Barr et al., 1990; Jones et al., 1973; Marcus, 1987), stiff muscles and muscle spasms characterized as ‘spasticity’ (Beattie et al., 1983) are also hallmarks of cerebral palsy(CP; Lin, 2003). Despite these commonalities, the American College of Obstetricians and Gynecologists (ACOG) and  > > > >

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Request Reprint E-Mail:  eabel@wayne.edu  

Brain neuropeptide Y and corticotropin-releasing hormone in mediating stress and anxiety

Neuropeptides such as neuropeptide Y (NPY) and corticotropin-releasing hormone (CRH) have been implicated not only in acute regulation of stress/anxiety-related behaviors, but adaptations and changes in these neuropeptide systems may also participate in the regulation of behavior and endocrine responses during chronic stress. NPY is an endogenous anxiolytic neuropeptide, while CRH has anxiogenic properties upon central administration.

Changes in these neuropeptide systems may contribute to disease states and give us indications for putative treatment targets for stress/anxiety disorders as well as alcohol/drug dependence.

In this review, we briefly present these two systems and review their involvement in mediating the responses to acute and chronic stressors, as well as their possible roles in the development and progression of stress/anxiety disorders.

We suggest that neuropeptides may be attractive in treatment development for stress/anxiety disorders, as well as for alcohol/drug dependence, based on their specificity and activity following exposure to external challenges, i.e. stressors, and their differential adaptations during transition from an acute to a chronic stress exposure state.


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Request Reprint E-Mail:   thorsella@mail.nih.gov  

Light-to-moderate alcohol consumption and risk of sudden cardiac death in women

Moderate alcohol intake is associated with lower risk of coronary heart disease (CHD), but the association with sudden cardiac death (SCD) is less clear. In men, heavy alcohol consumption may increase risk of SCD, whereas light-to-moderate alcohol intake may lower risk. There are no parallel data among women.

 

The purpose of this study was to assess the association between alcohol intake and risk of SCD among women and to investigate how this risk compared to other forms of CHD.

 

We conducted a prospective cohort study among 85,067 women from the Nurses' Health Study who were free of chronic disease at baseline. Alcohol intake was assessed every 4 years through questionnaires. Primary endpoints included SCD, fatal CHD, and nonfatal myocardial infarction.

 

We found a U-shaped association between alcohol intake and risk of SCD, with the lowest risk among women who drank 5.0–14.9 g/day of alcohol (P for quadratic trend = 0.02). Compared to abstainers, the multivariate relative risk (95% confidence interval) for SCD was 0.79 (0.55–1.14) for former drinkers, 0.77 (0.57-1.06) for 0.1–4.9 g/day, 0.64 (0.43–0.95) for 5.0–14.9 g/day, 0.68 (0.38–1.23) for 15.0–29.9 g/day, and 1.15 (0.70–1.87) for ≥30.0 g/day. In contrast, the relationship of alcohol intake and nonfatal and fatal CHD was more linear (P for linear trend <.001).

 

In this cohort of women, the relationship between light-to-moderate alcohol intake and SCD is U-shaped, with a nadir at 5.0–14.9 g/day. Low levels of alcohol intake do not raise the risk of SCD and may lower risk in women.

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News Release - Alcohol consumers are becoming the norm, UT Southwestern analysis finds

More people are drinking than 20 years ago, according to a UT Southwestern Medical Center analysis of national alcohol consumption patterns. Gathered from more than 85,000 respondents, the data suggests that a variety of factors, including social, economic and ethnic influences and pressures, are involved in the increase.

“The reasons for the uptick vary and may involve complex sociodemographic changes in the population, but the findings are clear: More people are consuming alcohol now than in the early 1990s,” said Dr. Raul Caetano , dean of the Southwestern School of Health Professions and lead author of the paper available online and in the October issue of Alcoholism: Clinical & Experimental Research.   > > > >

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Can stand-alone computer-based interventions reduce alcohol consumption? A systematic rev

To determine the effects of computer-based interventions aimed at reducing alcohol consumption in adult populations.

The review was undertaken following standard Cochrane and PRISMA guidance for systematic reviews. The literature was searched until December 2008, with no restrictions on language. Randomised trials with parallel comparator groups were identified in the form of published and unpublished data. Two authors independently screened abstracts and papers for inclusion. Data extraction and bias assessment was undertaken by one author and checked by a second author. Studies that measured total alcohol consumption and frequency of binge drinking episodes were eligible for inclusion in meta-analyses. A random-effects model was used to pool mean differences.

Twenty-four studies were included in the review (19 combined in meta-analyses). The meta-analyses suggested that computer-based interventions were more effective than minimally active comparator groups (e.g. assessment-only) at reducing alcohol consumed per week in student and non-student populations. However, most studies used the mean to summarise skewed data, which could be misleading in small samples. A sensitivity analysis of those studies that used suitable measures of central tendency found there was no difference between intervention and minimally active comparator groups in alcohol consumed per week by students. Few studies investigated non-student populations or compared interventions with active comparator groups.

Computer-based interventions may reduce alcohol consumption compared with assessment only the conclusion remains tentative because of methodological weaknesses in the studies.

Future research should consider that the distribution of alcohol consumption data is likely to be skewed and that appropriate measures of central tendency are reported.


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Request Reprint E-Mail: z.khadjesari@ucl.ac.uk   

Response to commentaries

Paul Meehl, a brilliant human, major figure in psychological science and occasional mentor in my formative
years in training commented more than once on back and-forth arguments, regardless of their intellectual merit. He ‘suggested’ one convey ones perspective, listened to the counterpoint(s) and then go off to ponder the merits of each position. This, rather than continued debate (usually at louder volume, or with more vociferous
comment) he mused, would generate rational development
in any arena. Occasionally I have had the will and wisdom to follow this dictum and this would seem an apt opportunity.    > > > >

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Commentary on Grabowski (2010): Our map should correspond with the territory

Having recently chaired a policy study group in theWhite House Office of National Drug Control Policy (ONDCP), which concluded unanimously that a merger of the US National Institute on Drug Abuse (NIDA) and National Institute on Alcohol Abuse and Alcoholism would benefit research and public health [1], I was cheered to see Grabowski [2] come to the same conclusion. Both of us are echoing an earlier recommendation from the Institute of Medicine [3]. In this commentary, I supplement Grabowski’s case for a combined institute with some historical evidence on the changing face of substance use in
the United States. Because support of the proposed merger is often attributed to being the inbuilt bias of ‘NIDA people’, let me aver for the record that I have never applied for a grant from NIDA, nor served on any NIDA committee. Indeed, I have in fact been extensively funded by and involved in the operations of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) for many years (e.g. study section member, research portfolio advisor, center grant advisory board member and reviewer).   


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Commentary on Grabowski (2010): A dissenting view from one who has known both NIDA and NIAAA

There may be pros and cons associated with retaining or changing the present structure of separate institutes for alcoholism and drug addiction at the US National Institutes of Health (NIH), but the position paper by Dr John Grabowski [1] is unhelpful to a consideration of the issues. His piece includes attacks on the accomplishments of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) [relative to the National Institute on Drug Addiction (NIDA)], as well as some major and minor historical inaccuracies and personal criticism of two past directors of the National Institute on Alcohol Abuse and Alcoholism and current staff at the Institute.  > > > >


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Commentary on Grabowski (2010): ‘The Name Game’

Dr Grabowski’s [1] provocative article supports the integration of the National Institutes on Alcohol Abuse and
Alcoholism (NIAAA) and the National Institute on Drug Addiction (NIDA) and even proposes a name for this new agency. My response is both on  of caution and trepidation. I suspect that there are more factors in this complex matter that must be considered, and I fear that the arguments for the National Institute on Substance Use Disorders (NISUD) focus mainly upon the disorders and addiction side of NIDA and NIAAA at the serious
diminution of environmental and other social forces that continue to impact significantly substance use and abuse.   > > > > 


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Commentary on Grabowski (2010): NISUD—progress, backlash or sidetrack?

In his paper, Grabowski [1] argues that the organization
of US alcohol and drug research in separate National Institutes of Health (NIH) institutes is obsolete. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Addiction (NIDA) have different historical origins, different roles in
policy development and research agendas. Currently, however, the situation is characterized by overlapping scientific methods, research questions and projects. Competing training programs drain insufficient resources. Cost–benefit and cost-effectiveness considerations would favor joint organization. One should build an integrated organization logically and possibly save costs needed for research activities. There is a potential for ‘stunning synergy’. 
  > > > > 


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Personal, family and social functioning among older couples concordant and discordant for high-risk alcohol consumption

This study compares the personal, family and social functioning of older husbands and wives concordant or discordant for high-risk alcohol consumption and identifies predictors of changes in concordance and high-risk consumption.

Three groups of couples were identified at baseline and followed 10 years later: (i) concordant couples in which husbands and wives engaged in low-risk alcohol consumption (n = 54); (ii) concordant couples in which husbands and wives engaged in high-risk alcohol consumption (n = 38); and (iii) discordant couples in which one partner engaged in high-risk alcohol consumption and the other partner did not (n = 75). At each follow-up, husbands and wives completed an inventory that assessed their personal, family and social functioning.

Compared to the low-risk concordant group, husbands and wives in the high-risk concordant group were more likely to rely on tension-reduction coping, reported more friend approval of drinking, and were less involved in religious activities; however, they did not differ in the quality of the spousal relationship.

The frequency of alcohol consumption declined among husbands in discordant couples, but not among husbands in concordant couples.

Predictors of high-risk drinking included tension-reduction coping, friend approval of drinking and, for husbands, their wives' level of drinking.

High-risk and discordant alcohol consumption do not seem to be linked to decrements in family functioning among older couples in long-term stable marriages. The predictors of heavy alcohol consumption among older husbands and wives identify points of intervention that may help to reduce their high-risk drinking.


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Request Reprint E-Mail:  rmoos@stanford.edu 

Impulsivity-related brain volume deficits in schizophrenia-addiction comorbidity

Despite a high prevalence of schizophrenia patients with comorbid substance abuse, little is known about possible impacts on the brain. 

Hence, our goal was to determine whether addicted and non-addicted schizophrenic patients suffer from different brain deficits. We were especially interested to determine if grey matter volumes were affected by impulsivity. 

We hypothesized that (comorbid) substance abuse would be associated with enhanced impulsivity and that this enhanced impulsivity would be related to grey matter volume deficits in prefrontal areas.

We employed a voxel-based morphometry approach as well as neuropsychological assessment of executive functions and trait impulsivity in 51 participants (age range 23–55). The schizophrenia group comprised 24 patients (12 patients with paranoid schizophrenia and 12 with additional comorbid substance use disorders). The comparison group comprised 27 non-schizophrenic individuals, matched by age and education (14 healthy individuals and 13 patients with substance use disorders).

Total grey matter volume deficits were found in all patient groups as compared with healthy controls but were largest (∼8%) in both addicted groups. While grey matter volume losses in lateral orbitofrontal and temporal regions were affected by schizophrenia, volume decreases of the medial orbitofrontal, anterior cingulate and frontopolar cortex were associated with addiction. 

Compared with non-addicted schizophrenics, comorbid patients showed significant volume decreases in anterior cingulate, frontopolar and superior parietal regions.

Additionally, they showed an increased non-planning impulsivity that was negatively related to grey matter volumes in the same regions, except for parietal ones.

The present study indicates severe grey matter volume and functional executive deficits in schizophrenia, which were only partially exacerbated by comorbid addiction. However, the relationship between non-planning impulsivity and anterior cingulate and frontopolar grey matter volumes points to a specific structure–function relationship that seems to be impaired in schizophrenia-addiction comorbidity. 

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Request Reprint E-Mail:  boris.schiffer@uni-due.de 

Early Release of Selected Estimates Based on Data From the January-March 2010 National Health Interview Survey

9. Alcohol consumption 

• Figure 9.1. Percentage of adults aged 18 years and over who had five or more drinks in 1 day at least once in the past year: United States, 1997-March 2010
• Figure 9.2. Percentage of adults aged 18 years and over who had five or more drinks in 1 day at least once in the past year, by age group and sex: United States, January-March 2010
• Figure 9.3. Age-sex-adjusted percentage of adults aged 18 years and over who had five or more drinks in 1 day at least once in the past year, by race/ethnicity: United States, January-March 2010
• Data tables for Figures 9.1-9.3
• 
  

PDF Version

First European Conference on FASD

Fetal Alcohol Spectrum Disorders: Growing Awareness in Europe

Wednesday through Friday, November 3 to 5, 2010

The aim of this conference is to bring together European researchers, public health workers, and FAS-related NGOs for the first time in order to share knowledge and promote collaborations. Presentations will cover latest developments worldwide, with an emphasis on European experience:

* Latest research on FASD in Europe

* Public health and preventions

* Diagnosis and intervention

* Consequences for justice and politics

Conference Website

The Next Step Towards a Better Life

Describes the stages of recovery from alcohol and drug abuse and what to expect after leaving detoxification services. Offers guidance in adjusting to sobriety just after detox and through long-term recovery; discusses legal issues; and lists resources.


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Substance Abuse Treatment for Persons With Co-Occurring Disorders

Quick Guide for Mental Health Professionals Based on TIP 42

Guides mental health professionals in the management of clients with co-occurring disorders. Discusses intake/screening and assessment; lists five guiding principles, and describes models and techniques for working effectively with clients. 


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Incorporating Alcohol Pharmacotherapies Into Medical Practice

KAP Keys for Clinicians Based on TIP 49

 

Provides clinicians with quick reference information about three FDA-approved medications to help patients achieve abstinence from alcohol: acamprosate, disulfiram, and naltrexone (oral and extended-release). Includes patient management tips.


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Incorporating Alcohol Pharmacotherapies Into Medical Practice

Quick Guide for Physicians Based on TIP 49

Guides physicians in the use of medications to help patients achieve abstinence from alcohol. Describes how the medications work, whom they benefit, and side effects for three FDA-approved medications: acamprosate, disulfiram, and naltrexone.


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Incorporating Alcohol Pharmacotherapies Into Medical Practice

Quick Guide for Counselors Based on TIP 49

Guides counselors in the use of medications to help clients achieve abstinence from alcohol. Describes how the medications work, whom they benefit, and side effects for three FDA-approved medications: acamprosate, disulfiram, and naltrexone. 

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Alcohol, Other Drugs, and Health: Current Evidence

 

Current Issue: July–August 2010

Interventions and Assessments

• Can a Single Question Detect Drug Use and Drug Use Disorders?
• Brief Interventions May Increase Entry into Specialty Addiction Treatment
• Patients with HIV infection and Opioid Use Who Receive Methadone Maintenance Are More Likely to Initiate and Adhere to Antiretroviral Therapy
• Promoting Access to Hepatitis C Treatment via Integration with Methadone Maintenance Programs
• Effect of Opioid Agonist Treatment on Survival and Cessation among Patients with Injection Drug Use
• Does Naltrexone Treatment for Alcohol Disorders Reduce Health-Care Costs?
• Methadone Treatment Reduces Overall Health-Care Costs for Commercially Insured Patients with Opioid Dependence
• Effectiveness of Opioid-Treatment Agreements and Urine Testing in Reducing Opioid Misuse among Patients with Chronic Noncancer Pain

Health Outcomes

• Misuse and Diversion of Methadone and Buprenorphine Are Increasing, but Buprenorphine Appears to Have a Better Safety Profile
• Sustained Virologic Response in Hepatitis C Treatment May be Similar for Patients Who Drink Alcohol and Those Who Abstain
• Does Early Cannabis Use Lead to Psychosis?
• Cutaneous Necrosis, Purpura, and Neutropenia: Think Contaminated Cocaine
• Prescription Opioid Abuse and Dependence Increases as Younger Nonmedical Users Grow Older
• Alcohol Consumption Is Associated with Other Healthy Lifestyle Factors
• Effects of Alcohol Intake on Mortality among Older Adults

Slide Presentations

• Update on Alcohol, Other Drugs, and Health
• Journal Club 
•  
•  
• Read Full Newsletter   (PDF)

NIAAA 40th Anniversary Symposium – October 4, 2010

This year marks a major milestone for NIAAA—40 years of supporting alcohol-related research and working to improve public health. NIAAA will commemorate this landmark event by hosting a special 40th Anniversary Symposium.

Join us as we review the current state of alcohol research and explore the future of the field.

NIAAA 40th Anniversary Symposium

AGENDA

October 4, 2010, 9:00 AM – 3:30 PM
5635 Fishers Ln, Terrace Level
Bethesda, MD 20852

9:00 – 9:15	Introduction	Kenneth R. Warren, Ph.D.
PANEL 1
9:15 – 9:45	Genetic Research: Who is at Risk For Alcoholism?	Tatiana Foroud, Ph.D. Indiana University School of Medicine
9:45 – 10:15	Neuroscience of Alcohol Abuse	Edith V. Sullivan, Ph.D. Stanford University School of Medicine
10:15 – 10:30	Break
10:30 – 11:00	Fetal Alcohol Spectrum Disorders	Jennifer Thomas, Ph.D. San Diego State University
11:00 – 11:30	Preventing Alcohol-Related Problems Through Policy Research	Robert B. Voas, Ph.D. Pacific Institute for Research and Evaluation
11:30 – 12:00	Panel Discussion
12:00 – 12:45	Lunch
PANEL 2
12:45 – 1:15	Alcohol, Immunity, and Health	Pranoti Mandrekar, Ph.D. University of Massachusetts Medical Center
1:15 – 1:45	Drinking, Binge Drinking, and Associated Consequences Among U.S. Ethic Minorities	Raul Caetano, M.D., Ph.D. University of Texas School of Public Health
1:45 – 2:00	Break
2:00 – 2:30	Reducing Underage and Young Adult Drinking	Michael Windle, Ph.D. Emory University
2:30 – 3:00	Focus on Comorbid Mental Health Disorders	Robert M. Anthenelli, M.D. University of Cincinnati College of Medicine Cincinnati Veterans Affairs Medical Center
3:00 – 3:30	Panel Discussion
3:30	Wrap up	Kenneth R. Warren, Ph.D.

The impact of introducing a minimum price on alcohol in Britain

In this Briefing Note, we use detailed data on the grocery shopping of more than 25,000 households during 2007 to provide descriptive evidence of alcohol purchases from supermarkets and other off-licensed premises retailers. 

We calculate the impact of a 45p per unit minimum price and describe how different households and retailers would be affected. Our calculations are based on a number of assumptions about consumer and firm behaviour which we discuss; more precise estimates would require estimation of a detailed model of household purchasing and firm pricing decisions. Our figures are based on a sample of households from Great Britain and we consider a minimum price that is applied nationally. 

We estimate that if a policy like this were rolled out across Britain it could transfer £700 million from alcohol consumers to retailers and manufacturers. This contrasts to increases in alcohol taxes, which largely result in transfers to government in the form of much needed tax revenue.

In the long-term, it would be desirable to restructure alcohol taxes so that they were based on alcohol strength, thus allowing the tax system to mimic the impact of a minimum price but ensuring the additional revenues went to the Government rather than firms. 

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Alcohol expectancy changes over a 12-week cognitive–behavioral therapy program are predictive of treatment success

This study examines if outcome expectancies (perceived consequences of engaging in certain behavior) and self-efficacy expectancies (confidence in personal capacity to regulate behavior) contribute to treatment outcome for alcohol dependence.  Few clinical studies have examined these constructs.

The Drinking Expectancy Profile (DEP), a psychometric measure of alcohol expectancy and drinking refusal self-efficacy, was administered to 298 alcohol-dependent patients (207 males) at assessment and on completion of a 12-week cognitive–behavioral therapy alcohol abstinence program.

Baseline measures of expectancy and self-efficacy were not strong predictors of outcome. However, for the 164 patients who completed treatment, all alcohol expectancy and self-efficacy factors of the DEP showed change over time. The DEP scores approximated community norms at the end of treatment. 

Discriminant analysis indicated that change in social pressure drinking refusal self-efficacy, sexual enhancement expectancies, and assertion expectancies successfully discriminated those who successfully completed treatment from those who did not. 

Future research should examine the basis of expectancies related to social functioning as a possible mechanism of treatment response and a means to enhance treatment outcome.


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Request Reprint E-Mail:   r.young@qut.edu.au

The Obsessive Compulsive Drinking Scale Is a Valid Measure of Alcohol Craving in Young Adults

Alcohol craving is associated with greater alcohol-related problems and less favorable treatment prognosis. The Obsessive Compulsive Drinking Scale (OCDS) is the most widely used alcohol craving instrument. The OCDS has been validated in adults with alcohol use disorders (AUDs), which typically emerge in early adulthood. 

This study examines the validity of the OCDS in a nonclinical sample of young adults.

Three hundred and nine college students (mean age of 21.8 years, SD = 4.6 years) completed the OCDS, Alcohol Use Disorders Identification Test (AUDIT), and measures of alcohol consumption. Subjects were randomly allocated to 2 samples. Construct validity was examined via exploratory factor analysis (n = 155) and confirmatory factor analysis (n = 154). Concurrent validity was assessed using the AUDIT and measures of alcohol consumption. A second, alcohol-dependent sample (mean age 42 years, SD 12 years) from a previously published study (n = 370) was used to assess discriminant validity.

A unique young adult OCDS factor structure was validated, consisting of Interference/Control, Frequency of Obsessions, Alcohol Consumption and Resisting Obsessions/Compulsions. 

The young adult 4-factor structure was significantly associated with the AUDIT and alcohol consumption. 

The 4 factor OCDS successfully classified nonclinical subjects in 96.9% of cases and the older alcohol-dependent patients in 83.7% of cases. Although the OCDS was able to classify college nonproblem drinkers (AUDIT <13, n = 224) with 83.2% accuracy, it was no better than chance (49.4%) in classifying potential college problem drinkers (AUDIT score ≥13, n = 85).

Using the 4-factor structure, the OCDS is a valid measure of alcohol craving in young adult populations. In this nonclinical set of students, the OCDS classified nonproblem drinkers well but not problem drinkers. 

Studies need to further examine the utility of the OCDS in young people with alcohol misuse.


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Gerald_Feeney@health.qld.gov.au

A Comparison of Methods for Estimating Change in Drinking following Alcohol Treatment

The ultimate goal of alcohol treatment research is to develop interventions that help individuals reduce their alcohol use. 

To determine whether a treatment is effective, researchers must then evaluate whether a particular treatment affects changes in drinking behavior after treatment. Importantly, drinking following treatment tends to be highly variable between individuals and within individuals across time.

Using data from the COMBINE study (COMBINE Study Group, 2003), the current study compared 3 commonly used and novel methods for analyzing changes in drinking over time: latent growth curve (LGC) analysis, growth mixture models, and latent Markov models.

Specifically, using self-reported drinking data from all participants (n = 1,383, 69% male), we were interested in examining how well the 3 estimated models were able to explain observed changes in percent heavy drinking days during the 52 weeks following treatment.

The results from all 3 models indicated that the majority of individuals were either abstinent or reported few heavy drinking days during the 52-week follow-up and only a minority of individuals (10% or fewer) reported consistently frequent heavy drinking following treatment.

All 3 models provided a reasonably good fit to the observed data with the latent Markov models providing the closest fit. 

The observed drinking trajectories evinced discontinuity, whereby individuals seem to transition between drinking and nondrinking across adjacent follow-up assessment points. 

The LGC and growth mixture models both assumed continuous change and could not explain this discontinuity in the observed drinking trajectories, whereas the latent Markov approach explicitly modeled transitions between drinking states.
 

The 3 models tested in the current study provided a unique look at the observed drinking among individuals who received treatment for alcohol dependence. 

Latent Markov modeling may be a highly desirable methodology for gaining a better sense of transitions between positive and negative drinking outcomes.


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Request Reprint E-Mail: katie.witkiewitz@wsu.edu  

Aversive Effects of Ethanol in Adolescent Versus Adult Rats: Potential Causes and Implication for Future Drinking

Many people experiment with alcohol and other drugs of abuse during their teenage years. Epidemiological evidence suggests that younger initiates into drug taking are more likely to develop problematic drug seeking behavior, including binge and other high-intake behaviors.

The level of drug intake for any individual depends on the balance of rewarding and aversive effects of the drug in that individual.

Multiple rodent studies have demonstrated that aversive effects of drugs of abuse are reduced in adolescent compared to adult animals. 

In this study, we addressed 2 key questions: First, do reduced aversive effects of ethanol in younger rats correlate with increased ethanol consumption? Second, are the reduced aversive effects in adolescents attributable to reduced sensitivity to ethanol’s physiologic effects?

Adolescent and adult rats were tested for ethanol conditioned taste aversion (CTA) followed by a voluntary drinking period, including postdeprivation consumption. Multivariate regression was used to assess correlations. In separate experiments, adolescent and adult rats were tested for their sensitivity to the hypothermic and sedative effects of ethanol, and for blood ethanol concentrations (BECs).

We observed that in adolescent rats but not adults, taste aversion was inversely correlated with postdeprivation consumption. 

Adolescents also exhibited a greater increase in consumption after deprivation than adults. 

Furthermore, the age difference in ethanol CTA was not attributable to differences in hypothermia, sedation, or BECs.

These results suggest that during adolescence, individuals that are insensitive to aversive effects are most likely to develop problem drinking behaviors.

These results underscore the importance of the interaction between developmental stage and individual variation in sensitivity to alcohol.


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Do Smooth Waters Run Deep? Alcohol Intoxication and the Effects of Water Consumption on Driving-Related Cognitions and Behavior

The present study tested the effect of the combined use of alcohol and water on driving-related cognitions and behavior. 

Seventy-four female students performed a driving simulator task after having consumed alcohol or a placebo. Additionally, half of the participants consumed 0.5 liter of water.

It was hypothesized that combining alcohol and water could lead to an underestimated perceived intoxication level resulting in more favorable driving cognitions and increased risk behavior.

Our findings showed that the combined use of water and alcohol did not affect cognitions or behavior.

Surprisingly, in the placebo condition, water intake increased risky driving cognitions and behavior in women with a history of accident involvement.

Lacking a clear counterproductive effect when combined with alcohol, water could be a useful tool in limiting alcohol use among female drinkers.

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n.spijkerman@pwo.ru.nl

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