Aims

To support the free and open dissemination of research findings and information on alcoholism and alcohol-related problems. To encourage open access to peer-reviewed articles free for all to view.

For full versions of posted research articles readers are encouraged to email requests for "electronic reprints" (text file, PDF files, FAX copies) to the corresponding or lead author, who is highlighted in the posting.

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Wednesday, January 9, 2013

Demos re-iterates importance of parenting style in preventing problem drinking



The think-tank Demos has produced a follow up report further emphasising the influence of parenting style on children’s drinking as teenagers and later in life. Demos claim that ‘tough love’ parenting – a parenting style that combines warmth with consistent discipline – is the best protection against young people developing later life alcohol problems.

Download Feeling the Effects and see a summary blog piece by one of the authors. An NHS Choices review of the report is also available. > > > >  Read More
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Tuesday, January 8, 2013

January 2013 Vital Signs Issue: Binge Drinking



Binge drinking is a dangerous behavior but is not widely recognized as a women’s health problem. Drinking too much – including binge drinking* - results in about 23,000 deaths in women and girls each year. Binge drinking increases the chances of breast cancer, heart disease, sexually transmitted diseases, unintended pregnancy, and many other health problems. Drinking during pregnancy can lead to sudden infant death syndrome and fetal alcohol spectrum disorders.

 Read Full Issue  (PDF)
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Blacks And Hispanics Are Less Likely Than Whites To Complete Addiction Treatment, Largely Due To Socioeconomic Factors



More than one-third of the approximately two million people entering publicly funded substance abuse treatment in the United States do not complete treatment. Additionally, racial and ethnic minorities with addiction disorders, who constitute approximately 40 percent of the admissions in publicly funded substance abuse treatment programs, may be particularly at risk for poor outcomes. 

 Using national data, we found that blacks and Hispanics were 3.5–8.1 percentage points less likely than whites to complete treatment for alcohol and drugs, and Native Americans were 4.7 percentage points less likely to complete alcohol treatment. Only Asian Americans fared better than whites for both types of treatment. 

Completion disparities for blacks and Hispanics were largely explained by differences in socioeconomic status and, in particular, greater unemployment and housing instability. However, the alcohol treatment disparity for Native Americans was not explained by socioeconomic or treatment variables, a finding that warrants further investigation.
The Affordable Care Act could reduce financial barriers to treatment for minorities, but further steps, such as increased Medicaid funding for residential treatment and better cultural training for providers, would improve the likelihood of completing treatment and increase treatment providers’ cultural competence.




Read Full Abstract

Request Reprint E-Mail:     saloner@wharton.upenn.edu
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FASD News - 1/2013





NEWS and ARTICLES
Sky News (South Africa) - South Africa: Women Drinking To Harm Babies
Mothers in one of South Africa's poorest areas are drinking heavily to deliberately damage their unborn babies - just so they can claim disability benefit.
Globe and Mail - Unplanned parenthood: how drinking while pregnant changes lives forever
Crystal Piquette is 31 and ripped, her biceps and flat tummy a testament to the rigours of her factory job. Her life seems ordinary – she has a boyfriend and five cats, does handicrafts and dreams of buying a home – but it’s a quantum leap for someone who ran away from home at 17 to live on the street.
Globe and Mail (Canada) - Educating Austin: supporting kids with fetal alcohol syndrome
School can be a problem for children like Austin Layte. He was in Grade 3 last year, but spent most of May and June, not in class but in the principal’s office – visits that mystified a boy who always seem to have a storm brewing inside.
Scientific American - How Much Alcohol Is Safe for Expectant Mothers?
On the night of my 32nd birthday, my husband and I enjoyed a delicious dinner while on vacation in Orvieto, Italy. To complement my pasta, I enjoyed a single glass of red wine, my first since learning I was pregnant four months earlier. Even now my indulgence inspires periodic pangs of guilt: Did I stunt my son’s potential by sipping that Sangiovese?
Wadena Pioneer Journal (USA) - Public Health Matters: January is National Birth Defects Prevention Month
Wadena County Public Health wants to let you know that January is National Birth Defects Prevention Month. Together, with the National Birth Defects Prevention Network (NBDPN), we work to make information available on how to prevent birth defects and also give support to families who are dealing with a child born with a birth defect.
Glasgow Evening Times (Wales) - 88% of pregnant women who tried to quit smoking started again within 4 weeks
Figures show the message is still not getting through to women about the dangers of prenatal smoking. A total of 1270 women were referred to NHS Greater Glasgow and Clyde's Smokefree Pregnancy Service from From April 1 to September 30 this year.
U.S. News & World Report (USA) - Thousands of U.S. Babies Born With Cleft Lip, Palate Each Year
It's not clear exactly what causes oral clefts, according to the March of Dimes. Some factors that have been associated with an increased risk for cleft lip and palate include changes in some genes, a deficiency of folic acid before pregnancy, taking certain medications while pregnant, drinking alcohol during pregnancy and having certain infections during pregnancy.
The Delta Discovery - The Difference Between FAS and FAE
Originally, FAS was an acronym for Fetal Alcohol Syndrome and FAE for Fetal Alcohol Effect. In the early years of research on the effects of alcohol on the developing fetus, the terms FAS and FAE were used to distinguish between a syndrome that could be detected by observation and less noticeable effects from the alcohol upon the developing nervous system.
USA TODAY - Parents plead for easier route to help mentally ill kids
Starting at age 7, Teddy Shuman would transform at a moment's notice from a sweet-natured boy who struggled with developmental disabilities to a child driven by uncontrollable rages.
Health-e (South Africa) - Headway in the fight against FAS
A far-flung Northern Cape town has been making world headlines over the last few years. Unfortunately for the wrong reasons - a 2002-study revealed that more than one in 10 (12.2%) children in the De Aar community had foetal alcohol syndrome (FAS), giving the town the highest reported rate in the world.
The Observer - Drinking While Pregnant: Her Baby, Your Problem?
It’s your first day as a waiter or waitress. You walk up to one of your customers, a woman with an oddly familiar glow to her skin. She looks up, smiling, and orders a glass of pinot noir. Seems normal, right? Until you look down and notice something odd: the woman is pregnant. What do you do?
Pix11 (USA) - Outrage as hospitals test pregnant moms for drugs near low-income neighborhoods
Expecting moms in New York are being drug tested in hospitals near low income neighborhoods. But pregnancy advocates are calling the practice racist and discriminatory.

UPCOMING
FASD Throughout the Lifespan: from prevention to lifelong support
The FASD Association of Newfoundland & Labrador is inviting you to the FACE Research Roundtable and our conference FASD Throughout the Lifespan.
FASD Learning series 2012-2013
Sessions are available via live webcast.
College of New Caledonia - FASD Advanced Diploma Online / FASD Online Courses
This post-diploma program is designed for professionals who are working with individuals or families affected by FASD. Classes are provided in a supportive, fully online environment. Join our team of nationally recognized experts in this field and gain university credits that can be used toward social, justice, education and health professions.
MOFAS - Video Project Night for Young Adults Affected by an FASD
We invite young adults affected by an FASD to join us in creating short videos that feature you, talking about your experiences. You can talk about what services have been beneficial for you, what is most frustrating or what would have been more helpful in making you feel supported and successful. The videos will be short, easy and fun to make.

MATERIALS
Community Living - Supporting Success for Adults with FASD
CLBC’s new Fetal Alcohol Spectrum Disorder (FASD) Resource Supporting Success for Adults with FASD is designed to be used by CLBC staff, service providers, community members, family members and others who work with adults with FASD.

RESEARCH
Annals of Neurology - Prenatal Alcohol Exposure Affects Vasculature Development in the Neonatal Brain
In mice, prenatal alcohol exposure induced a reduction of cortical vascular density, loss of the radial orientation of microvessels, and altered expression of VEGF receptors. Time-lapse experiments performed on brain slices revealed that ethanol inhibited glutamate-induced calcium mobilization in endothelial cells, affected plasticity, and promoted death of microvessels.
Alcoholism - Investigating the Influence of Prenatal Androgen Exposure and Sibling Effects on Alcohol Use and Alcohol Use Disorder in Females from Opposite-Sex Twin Pairs
There are robust sex differences for alcohol phenotypes, with men reporting more drinking and alcohol use disorder (AUD) symptoms than women. However, the sources of these effects are not completely understood. Sex hormones, a substantial biological sex difference, exert neurobehavioral influences and are candidates for influencing sex differences in alcohol phenotypes. This study investigated the effects of prenatal androgens based on the hypothesis of prenatal hormone transfer, which posits that hormones from one twin influence the development of a cotwin.


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Monday, January 7, 2013

The 2008–2009 Recession and Alcohol Outcomes: Differential Exposure and Vulnerability for Black and Latino Populations





We examined whether race/ethnicity was related to exposure to acute economic losses in the 2008–2009 recession, even accounting for individual-level and geographic variables, and whether it influenced associations between economic losses and drinking patterns and problems.

Data were from the 2010 National Alcohol Survey (N = 5,382). Surveys assessed both severe losses (i.e., job and housing loss) and moderate losses (i.e., reduced hours/pay and trouble paying the rent/mortgage) attributed to the 2008–2009 recession. Alcohol outcomes included total annual volume, monthly drunkenness, drinking consequences, and alcohol dependence (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). 

 Compared with Whites, Blacks reported significantly greater exposure to job loss and trouble paying the rent/mortgage, and Latinos reported greater exposure to all economic losses. However, only Black–White differences were robust in multivariate analyses. Interaction tests suggested that associations between exposure to economic loss and alcohol problems were stronger among Blacks than Whites. Given severe (vs. no) loss, Blacks had about 13 times the odds of both two or more drinking consequences and alcohol dependence, whereas the corresponding odds ratios for Whites were less than 3. Conversely, associations between economic loss and alcohol outcomes were weak and ambiguous among Latinos. 

 Results suggest greater exposure to economic loss for both Blacks and Latinos (vs. Whites) and that the Black population may be particularly vulnerable to the negative effects of economic hardship on the development and/or maintenance of alcohol problems. Findings extend the economic literature and signal policy makers and service providers that Blacks and Latinos may be at special risk during economic downturns.
Read Full Abstract

Request Reprint E-Mail:      szemore@arg.org
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Role of Tobacco Smoking in Hangover Symptoms Among University Students





Although hangover results from excessive alcohol consumption, the specific pathways through which hangover symptoms arise have not been elucidated. Research on predictors of hangover sensitivity may provide clues about such mechanisms. The present study investigated whether tobacco smoking on days of heavy drinking affects next-day hangover incidence and severity. 

 The study drew on diary data from a study on smoking and drinking among 113 students at a midwestern university in the United States. Participants completed a daily, web-based, 26-item survey for 8 weeks to assess prior-day alcohol and tobacco use as well as current-day hangover symptoms. Hierarchical linear modeling was used to test the hypothesis that amount of smoking is related to hangover, controlling for amount of alcohol consumed, sex, and other individual characteristics. Analyses were conducted after selecting only days with alcohol consumption levels that typically elicit hangover, then repeated on lighter drinking days for comparison. Validity of the hangover items was checked by comparing reports after such heavy drinking days with days of lighter drinking. 

 Across all possible person-days, 92% of daily reports were obtained. When selecting only events where an estimated blood alcohol concentration of 110 mg/dl was attained, smoking significantly increased the odds of hangover incidence and hangover severity while controlling for number of drinks consumed and sex. Additional analyses controlling for age first smoked regularly, frequency of drug use, type of drug involvement, or smoking status resulted in findings that were unchanged.

Smoking more on heavy drinking days affects hangover sensitivity and severity, possibly because of acute pharmacological effects.
Read Full Article   (PDF)
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Varying Impacts of Alcohol Outlet Densities on Violent Assaults: Explaining Differences Across Neighborhoods





Groups of potentially violent drinkers may frequent areas of communities with large numbers of alcohol outlets, especially bars, leading to greater rates of alcohol-related assaults. This study assessed direct and moderating effects of bar densities on assaults across neighborhoods. 

 We analyzed longitudinal population data relating alcohol outlet densities (total outlet density, proportion bars/pubs, proportion off-premise outlets) to hospitalizations for assault injuries in California across residential ZIP code areas from 1995 through 2008 (23,213 space-time units). Because few ZIP codes were consistently defined over 14 years and these units are not independent, corrections for unit misalignment and spatial autocorrelation were implemented using Bayesian space-time conditional autoregressive models. 

 Assaults were related to outlet densities in local and surrounding areas, the mix of outlet types, and neighborhood characteristics. The addition of one outlet per square mile was related to a small 0.23% increase in assaults. A 10% greater proportion of bars in a ZIP code was related to 7.5% greater assaults, whereas a 10% greater proportion of bars in surrounding areas was related to 6.2% greater assaults. The impacts of bars were much greater in areas with low incomes and dense populations. 

The effect of bar density on assault injuries was well supported and positive, and the magnitude of the effect varied by neighborhood characteristics. Posterior distributions from these models enabled the identification of locations most vulnerable to problems related to alcohol outlets.
Read Full Abstract

 Request Reprint E-Mail:   cmair@prev.org.
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Developmental Prediction Model for Early Alcohol Initiation in Dutch Adolescents



Multiple factors predict early alcohol initiation in teenagers. Among these are genetic risk factors, childhood behavioral problems, life events, lifestyle, and family environment. We constructed a developmental prediction model for alcohol initiation below the Dutch legal drinking age (16 years), elaborating on the pathways identified by earlier studies. 

A set of 22 prospectively measured variables, previously associated with alcohol initiation, was examined by path analytic techniques in a sample of 1,804 Dutch adolescents (ages 13–15 years, 56% girls). The predictors included genetic risk for alcohol initiation and behavioral/emotional problems; prenatal and childhood stressors and childhood behavioral/emotional problems; and adolescent behavioral/emotional problems, lifestyle, family functioning, and peer-related factors. 

 The model explained 66% of variance in early alcohol initiation. Subjects at higher genetic risk of alcohol initiation who had friends who drank alcohol and who had started smoking at an early age were at increased risk of initiating alcohol use before age 16. Behavioral (externalizing) problems were moderately and indirectly associated with early alcohol initiation, and emotional (internalizing) problems were marginally and indirectly associated with alcohol initiation. 

 The Netherlands has relatively lenient alcohol laws. In this permissive environment, early alcohol initiation is explained by alcohol-specific genetic risk, smoking initiation, and peer-related factors, whereas behavioral and emotional problems are only indirectly related to early alcohol initiation.
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 Request Reprint E-Mail:   L.M.Geels@vu.nl
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Evaluation of Timing and Dosage of a Parent-Based Intervention to Minimize College Students' Alcohol Consumption




The study evaluated the timing and dosage of a parent-based intervention to minimize alcohol consumption for students with varying drinking histories. 

First-year students (N = 1,900) completed Web assessments during the summer before college (baseline) and two follow-ups (fall of first and second years). Students were randomized to one of four conditions (pre-college matriculation [PCM], pre-college matriculation plus boosters [PCM+B], after college matriculation [ACM], and control conditions). Seven indicators of drinking (drink in past month, been drunk in past month, weekday [Sunday to Wednesday] drinking, Thursday drinking, weekend [Friday, Saturday] drinking, heavy episodic drinking in past 2 weeks, and peak blood alcohol concentration <.08) were used in a latent transition analysis (LTA) to examine a stage-sequential model of drinking. LTA models with dummy-coded intervention variables were used to examine the effects of the intervention conditions on changes in drinking patterns. 

 Results indicated that four patterns of drinking were present at all waves: (a) nondrinkers, (b) weekend light drinkers, (c) weekend heavy episodic drinkers, and (d) heavy drinkers. Results indicated that the PCM condition was most effective at influencing baseline heavy drinkers' transition out of this pattern to lower risk patterns at first follow-up, whereas the ACM condition was not effective at preventing drinking escalation for baseline nondrinkers at first follow-up. No decay of effects was observed at long-term follow-up for the PCM condition. Finally, the results also indicated that increased dosage of the parental intervention was not significantly associated with either reduction or escalation of use.


The results underscore the value of pre-college parental interventions and targeted efforts to reduce high-risk drinking among college students. 

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 Request Reprint E-Mail:   rjt13@psu.edu
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Patterns of Alcohol Use and Related Consequences in Non-College-Attending Emerging Adults





Among emerging adults, those who do not attain postsecondary education are at highest risk for experiencing long-term problems related to alcohol use, including alcohol dependence. The purpose of the current study was to identify latent classes of alcohol users among non-college-attending youth and examine correlates of class membership. 

 Screening criteria were used to select emerging adults between ages 18 and 22 years with no postsecondary education (N = 264) from a prerecruited probability-based Web panel. Latent class analysis (LCA) was used to identify common patterns of alcohol use. Grouping variables and demographic variables were added to the LCA model, and rates of alcohol-related consequences across the LCA classes were compared. 

 Four classes of drinking patterns were identified: (a) current nondrinkers (34%), (b) weekend light drinkers (38%), (c) weekend risky drinkers (23%), and (d) daily drinkers (5%). Class membership was associated with early onset of alcohol use (age 14 or younger), marital status, employment status, and urban residency (area populated by 50,000 or more people). The number of latent classes did not differ across sex and legal drinking age status, although proportions of subjects within classes varied by age. Weekend risky drinkers were most likely to report sickness and feelings of guilt because of drinking, whereas daily drinkers were most likely to report getting into fights, driving a car after drinking, and missing work. 

 Similar to college samples of emerging adults, most of this noncollege sample belonged to latent classes defined by rare or moderate alcohol use. Nevertheless, nearly a quarter of the sample reported high-risk drinking behaviors, and a small number reported drinking alcohol on a daily basis. Both of these classes were at elevated risk for experiencing a number of alcohol-related consequences.
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 Request Reprint E-Mail:    mcleveland@psu.edu
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C-SIDE: Drinking Simulation for College Students





Our goals were to develop a realistic simulation of collegiate drinking contexts and evaluate the predictive validity of this methodology. 

 After methods development, 88 incoming students (61% women) completed measures of alcohol consumption, alcohol expectancies and motives, and the Collegiate-Simulated Intoxication Digital Elicitation (C-SIDE). Eight months later, students reported recent drinking behavior and alcohol-related consequences. 

 Willingness to drink alcohol on the C-SIDE predicted high-risk drinking at the end of the students' first year above and beyond baseline consumption. Accepting offers of food/nonalcoholic beverages across contexts predicted lower scores on the Alcohol Use Disorders Identification Test 8 months later. Drinking game contexts elicited different levels of behavioral willingness; a game with explicit heckling elicited less drinking willingness than one in a smaller and more casual environment. 

 These findings support the integration of social context into the assessment of alcohol-related decision making and the further development of strategies to understand context-dependent phenomena.
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 Request Reprint  E-Mail:    Kristen.Anderson@reed.edu
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Similarities in Adolescent Siblings' Substance Use: Testing Competing Pathways of Influence





An accumulating body of work indicates that siblings uniquely influence each other's alcohol and substance use behaviors during adolescence. The mechanisms underlying these associations, however, are unknown because most studies have not measured sibling influence processes. The present study addressed this gap by exploring the links between multiple influence processes and sibling similarities in alcohol and substance use. 

 The sample included one parent and two adolescent siblings (earlier born age: M = 17.17 years, SD = 0.94; later born age: M = 14.52 years, SD = 1.27) from 326 families. Data were collected via telephone interviews with parents and the two siblings. 

 A series of logistic regressions revealed that, after parents' and peers' use as well as other variables including parenting was statistically controlled for, older siblings' alcohol and other substance use was positively associated with younger siblings' patterns of use. Furthermore, sibling modeling and shared friends were significant moderators of these associations. For adolescents' alcohol use, the links between sibling modeling and shared peer networks were interactive, such that the associations between modeling and similarity in alcohol use were stronger when siblings shared friends. 

 Future research should continue to investigate the ways in which siblings influence each other because such processes are emerging targets for intervention and prevention efforts. 
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 Requerst Reprint E-Mail:    sdwhitem@purdue.edu
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Alcohol Use and Drunk Driving: The Modifying Effect of Impulsivity





The aim of this study was twofold: (a) to examine how an increase in the frequency of heavy drinking episodes affects the incidence of drunk driving and (b) to examine whether the effect of alcohol use on drunk driving is contingent on impulsivity. 

 Two waves of the Young in Norway Longitudinal Study were applied (N = 2,603; response rate: 67%), when the respondents were on average 17 (1994) and 28 (2005) years of age. Measurements consisted of self-reported heavy episodic drinking, drunk driving, and impulsivity. 

 The first difference method was applied to estimate the association between heavy episodic drinking and drunk driving. This means that changes in the frequency of drunk driving were regressed on changes in the frequency of drinking. In this way, the effects of time-invariant confounders were eliminated. The results showed that every additional episode of heavy drinking was associated with a 2.6% increase in the frequency of drunk driving. The increase for males was significantly higher than among females. The analyses supported the hypothesis that impulsivity modifies the association between alcohol use and drunk driving. 

 The association between drinking and drunk driving is significantly stronger among those with a high score on impulsivity compared with those who have a low score.
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Request Reprint E-Mail:     ism@sirus.no
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Type D Personality, Alcohol Dependence, and Drinking Motives in the General Populationadaa



The current study had two key aims: (a) to determine if Type D personality (the synergistic effect of negative affect and social inhibition) is associated with alcohol consumption in social drinkers and (b) to examine if this relationship is mediated by drinking motives. 

 In a cross-sectional study, 862 participants (206 men, 656 women, mean age 26.1 years) completed the Type D Personality Scale, the Drinking Motives Questionnaire, and the Severity of Alcohol Dependence Questionnaire.


Correlation analysis revealed that Type D personality was significantly and positively correlated with alcohol dependence (r = .11, p < .001). In addition, regression analyses demonstrated that this relationship was fully mediated by coping and conformity drinking motives. 

 The present study has identified a positive relationship between Type D personality and alcohol dependence in the general population. We have also shown that this relationship is mediated by coping and conformity drinking motives.

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 Request Reprint E-Mail:     gillian.bruce@uws.ac.uk
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The Overlap of Youth Violence Among Aggressive Adolescents with Past-Year Alcohol Use—A Latent Class Analysis: Aggression and Victimization in Peer and Dating Violence in an Inner City Emergency Department Sample





The purpose of this study was to identify overlap and violence types between peer and dating aggression and victimization using latent class analysis (LCA) among a sample of aggressive adolescents with a history of alcohol use and to identify risk and protective factors associated with each violence class. 

 From September 2006 to September 2009, a systematic sample of patients (14–18 years old) seeking care in an urban emergency department were approached. Adolescents reporting any past-year alcohol use and aggression completed a survey using validated measures including types of violence (severe and moderate aggression, severe and moderate victimization with both peers and dating partners). Using LCA, violence classes were identified; correlates of membership in each LCA class were determined. 

 Among this sample (n = 694), LCA identified three classes described as (a) peer aggression (PA) (52.2%), (b) peer aggression + peer victimization (PAPV) (18.6%), and (c) multiple domains of violence (MDV) (29.3%). Compared with those in the PA class, those in the PAPV class were more likely to be male, report injury in a fight, and have delinquent peers. Compared with the PA class, those in the MDV class were more likely to be female, African American, report injury in a fight, carry a weapon, experience negative consequences from alcohol use, and have delinquent peers and more family conflict. Compared with the PAPV class, those in the MDV class were likely to be female, African American, receive public assistance, carry a weapon, experience negative consequences from alcohol use, and use marijuana. 

 There is extensive overlap of victimization and aggression in both peer and dating relationships. Also, those with high rates of violence across relationships have increased alcohol misuse and marijuana use. Thus, violence-prevention efforts should consider addressing concomitant substance use. 
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 Request Reprint E-Mail:    laurenkw@u.washington.edu.
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Psychiatric Morbidity is Linked to Problem Drinking in Midlife Among Alcohol-Dependent Men: A Co-Twin Control Study





Prior research on predictors of problem drinking has been limited because of an inability to attribute an unambiguous environmental explanation to observed findings. Using a prospective co-twin control design, we examined the extent to which a history of psychiatric symptoms exerts an environmental influence on problem drinking in midlife that is unconfounded by genetic underpinnings. 

 Participants were 367 complete male twin pairs (208 monozygotic, 159 dizygotic) from the Vietnam Era Twin Registry who were assessed in midlife as part of the Family Twin Study (mean age = 51.4 years, SD = 2.8). Twin pairs who were concordant for a lifetime diagnosis of an alcohol use disorder (AUD) in 1992 were selected for participation and were reinterviewed in 2001 to measure symptoms of AUD (i.e., problem drinking) since the prior assessment (past 10 years). 

 Within-pair differences in lifetime symptom counts of several psychiatric disorders measured in 1992 (i.e., major depression, dysthymia, generalized anxiety disorder, panic disorder, antisocial personality, mania, and posttraumatic stress disorder) were significantly associated with within-pair differences in AUD symptoms in the subsequent 10 years. 

 A history of psychiatric problems, particularly one marked by internalizing symptoms, appears to be linked to problem drinking in midlife above and beyond the confounding influence of genetic effects and underscores the potential value of integrated interventions for comorbidity to address problem drinking among individuals during this period of the life course. 
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 Request Reprint E-Mail:    dmblonigen@gmail.com
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Behavioral Control in Alcohol Use Disorders: Relationships With Severity





The current study examined the relationship between severity of alcohol use disorders (AUDs) and the neural circuits that underlie response inhibition and error monitoring. In addition, we explored pre- and post-inhibition trial processes to determine the potential causal mechanisms responsible for disinhibition in AUDs. 

 One hundred sixty-four individuals with a range of drinking from non-treatment-seeking adults with problematic alcohol use to treatment-seeking adults with alcohol dependence completed a Go/NoGo task while undergoing functional magnetic resonance imaging. 

 Correlations between signal change during response inhibition and a composite measure of AUD severity revealed significant negative relationships in right insula/inferior frontal gyrus, pregenual anterior cingulate cortex, and inferior parietal lobe. Relationships with error monitoring-related response largely overlapped with that of correct inhibitions but also included rostral anterior cingulate cortex and left inferior frontal gyrus, such that more severe AUDs were associated with reduced response in these regions. Last, examination of pre- and post-inhibition processes suggested that more severe AUDs are associated with greater engagement of motor response circuits before inhibition trials, suggesting greater pre-potent tendencies that may lead to disinhibition. 

 The current results extend previous work by examining how variation in AUD severity is related to neural response during response inhibition and potential causal mechanisms responsible for impaired inhibitory control. More severe AUDs were associated with reduced engagement of neural circuits involved in behavioral control and enhanced pre-potent responding. This altered control may contribute to the progression of AUDs, as well as relapse after treatment. 
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 Request Reprint E-Mail:    eclaus@mrn.org
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Positive Affect and Stress Reactivity in Alcohol-Dependent Outpatients



Reactivity to stress is a common feature of alcohol dependence and is associated with poorer treatment outcome among alcohol-dependent patients. Despite the importance of stress reactivity in alcohol dependence, little is known about markers of resilience to stress in this population. The current study examined whether positive affect buffered the effect of stress on negative affect and alcohol craving in an alcohol-dependent sample. 

 Outpatients (N = 1,375) enrolled in a large, randomized controlled trial for alcohol dependence (the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence [COMBINE] Study) completed measures of stress, positive affect, negative affect, and alcohol craving. In this secondary analysis, we hypothesized that positive affect would moderate the association between stress and negative affect and that positive affect would be negatively associated with craving. 

 Results supported these hypotheses, such that patients with higher levels of positive affect exhibited a weaker relationship between stress and negative affect relative to those with low positive affect. Positive affect was negatively associated with craving but did not moderate the association between stress and craving. 

 These results replicate studies suggesting a protective effect of positive affect on stress reactivity and extend this effect to an alcohol-dependent sample. If positive affect can aid in resilience to stress, the utilization of interventions that enhance positive affect may be of particular utility for alcohol-dependent patients. Future experimental studies testing the causality of this association as well as studies examining the effect of interventions to enhance positive affect are needed.
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 Request Reprint E-Mail:    kmchugh@mclean.harvard.edu

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Protective Behavioral Strategies as a Mediator of the Generalized Anxiety and Alcohol Use Relationship Among Lesbian and Bisexual Women






Alcohol use disorders and anxiety disorders often co-occur; moreover, lesbian and bisexual women appear at higher risk for both alcohol and anxiety disorders. Although research among college student samples has found direct effects of increased use of protective behavioral strategies on decreasing alcohol use and alcohol-related negative consequences, this has yet to be demonstrated among lesbian and bisexual women. Furthermore, it is unclear whether generalized anxiety influences the use of such strategies, which in turn predict alcohol consumption and related negative consequences. The primary objective of the present study was to examine the mediating role of protective behavioral strategies on the relationships between generalized anxiety and alcohol consumption and related negative consequences among a young adult sample of lesbian and bisexual women. 

 A national sample of 1,083 lesbian and bisexual women between the ages of 18 and 25 years completed an online survey that assessed the constructs of interest. 

 Results showed support for mediation such that lesbian and bisexual women who reported having higher levels of generalized anxiety were less likely to use drinking protective behavioral strategies, which in turn led to higher levels of alcohol consumption as well as negative alcohol-related consequences.

 These findings highlight the importance of examining who is at risk for alcohol use disorders as well as why they are at risk. Results indicate that interventions for high-risk drinking among younger lesbian and bisexual women may need to specifically address factors such as affect management or coping with anxiety, at least for the proportion of women who are endorsing significant symptoms of anxiety. 
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 Request Reprint E-Mail:   dlitt@uw.edu
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Saturday, January 5, 2013

Alcohol consumption in men is influenced by qualitatively different genetic factors in adolescence and adulthood




Alcohol consumption is influenced by genetic factors. Previous studies have examined the heritability of alcohol consumption, or related phenotypes, from adolescence into adulthood, frequently finding that total heritability changes over time. However, it remains unclear whether the same genes underlie liability to alcohol consumption across development versus whether novel risk genes become important over time.

 A population-based study of adult male twins (n=1790) born in Virginia, USA, retrospectively reported on their average monthly alcohol consumption from early adolescence through adulthood. We used twin modeling methods to explore genetic and environmental influences on alcohol consumption over time.

 One latent genetic factor accounted for the majority of the heritability in alcohol consumption during mid- to late adolescence, but its influence declined thereafter; from young adulthood forward, heritability was largely attributable to a second genetic factor. The total heritability of alcohol consumption increased from 0 at ages 12–14 years to 0.40 by ages 18–21 years. Shared environmental factors declined in influence over time.

 The heritability of alcohol consumption over time is dynamic both quantitatively and qualitatively. These results have important implications for gene identification endeavors. Furthermore, these findings could inform efforts to elucidate developmentally dynamic behaviors, such as antisocial behavior.
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Request Reprint E-Mail:   aedwards5@vcu.edu








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Genetic Markers of Comorbid Depression and Alcoholism in Women





Alcohol dependence (AD) is often accompanied by comorbid depression. Recent clinical evidence supports the benefit of subtype-specific pharmacotherapy in treating the population of alcohol-dependent subjects with comorbid major depressive disorder (MDD). However, in many alcohol-dependent subjects, depression is a reactive response to chronic alcohol use and withdrawal and abates with a period of abstinence. Genetic markers may distinguish alcohol-dependent subjects with MDD not tied chronologically and etiologically to their alcohol consumption. In this work, we investigated the association of adenylyl cyclase genes (ADCY1–9), which are implicated in both AD and mood disorders, with alcoholism and comorbid depression.

Subjects from Vienna, Austria (n = 323) were genotyped, and single nucleotide polymorphisms (1,152) encompassing the genetic locations of the 9 ADCY genes were examined. The Vienna cohort contained alcohol-dependent subjects differentiated using the Lesch Alcoholism Typology. In this typology, subjects are segregated into 4 types. Type III alcoholism is distinguished by co-occurrence of symptoms of depression and by affecting predominantly fem

We identified 4 haplotypes associated with the phenotype of Type III alcoholism in females. One haplotype was in a genomic area in proximity to ADCY2, but actually within a lincRNA gene, 2 haplotypes were within ADCY5, and 1 haplotype was within the coding region of ADCY8. Three of the 4 haplotypes contributed independently to Type III alcoholism and together generated a positive predictive value of 72% and a negative predictive value of 78% for distinguishing women with a Lesch Type III diagnosis versus women designated as Type I or II alcoholics.

Polymorphisms in ADCY8 and ADCY5 and within a lincRNA are associated with an alcohol-dependent phenotype in females, which is distinguished by comorbid signs of depression. Each of these genetic locations can rationally contribute to the polygenic etiology of the alcoholism/depression phenotype, and the use of these genetic markers may aid in choosing appropriate and beneficial treatment strategies.
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