"A Disease Like Any Other"? A Decade of Change in Public Reactions to Schizophrenia, Depression, and Alcohol Dependence

Clinicians, advocates, and policy makers have presented mental illnesses as medical diseases in efforts to overcome low service use, poor adherence rates, and stigma. The authors examined the impact of this approach with a 10-year comparison of public endorsement of treatment and prejudice.

Modules of the 1996 and 2006 General Social Survey describing individuals meeting DSM-IV criteria for schizophrenia, major depression, and alcohol dependence to explore whether more of the public 1) embraces neurobiological understandings of mental illness; 2) endorses treatment from providers, including psychiatrists; and 3) reports community acceptance or rejection of people with these disorders. Multivariate analyses examined whether acceptance of neurobiological causes increased treatment support and lessened stigma.

In 2006, 67% of the public attributed major depression to neurobiological causes, compared with 54% in 1996. High proportions of respondents endorsed treatment, with general increases in the proportion endorsing treatment from doctors and specific increases in the proportions endorsing psychiatrists for treatment of alcohol dependence (from 61% in 1996 to 79% in 2006) and major depression (from 75% in 1996 to 85% in 2006). Social distance and perceived danger associated with people with these disorders did not decrease significantly. Holding a neurobiological conception of these disorders increased the likelihood of support for treatment but was generally unrelated to stigma. Where associated, the effect was to increase, not decrease, community rejection.

More of the public embraces a neurobiological understanding of mental illness. This view translates into support for services but not into a decrease in stigma. Reconfiguring stigma reduction strategies may require providers and advocates to shift to an emphasis on competence and inclusion.


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Request Reprint E-Mail: pescosol@indiana.edu

Addiction Recovery Peer Service Roles: Recovery Management in Health Reform

Addiction Recovery Peer Service Roles: Recovery Management in Health Reform synthesizes and
integrates the insights, challenges and ideas generated at the July 1, 2010, White House Office of National Drug Control Policy and Faces & Voices of Recovery Roundtable on Peer Recovery Support Services.

Local, state and federal officials are embracing a new orientation toward recovery from addiction as the nation begins to implement health care reform.

The roundtable provided an opportunity to raise the profile of new services developed by recovery community organizations to support people seeking or in recovery from addiction – services that exemplify this new recovery orientation.


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The ISAJE/WHO Young Scholars Award 2010

The ISAJE/WHO Young Scholars Award aims to provide recognition for the contributions to addiction science of young scholars from low and middle income countries and to promote their involvement in the field. The award is given for the best paper published by a young scholar from a low or middle income country on any topic related to addiction. The winner will receive a certificate and financial support to attend an international scientific or clinical meeting in the addiction or substance abuse field, to be chosen by the winner in consultation with the Award Committee.

Applications are invited for the 2010 award. To be eligible, the paper must have been published either online or in print form in a peer-reviewed scholarly journal between 1 July 2007 and 30 June 2010. The research reported should have been carried out predominantly in a low or middle income country, as specified by the World Bank classification. Applicants must be less than 35 years old and should be the lead author in the paper being submitted for the award. They should hold a current academic or research position in a low or middle income country; or should have held such a position at the time the research for the paper was carried out. The deadline for receiving applications is 15 November 2010. > > > >

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‘Alcohol, less is better’ project: outcomes of an Italian community-based prevention programme on reducing per-capita alcohol consumption

To evaluate differences in the individual alcohol consumption after a community-based prevention programme.

‘Alcohol, less is better’ is a controlled intervention trial. The intervention adopted a community approach, based on the active involvement of community leaders and institutional or volunteer organizations. Between 1999 and 2006, 2.5 years of activities aiming at informing and sensitizing the community on the harmful effects of alcohol on social life and health were carried out in 10 selected small Italian communities, involving a total of 123 235 individuals. Eight communities were chosen as control group.

Changes in self-reported individual alcohol consumption before and after the intervention were assessed on a random sample of intervention (n = 3382) and control (n = 2644) populations, using telephone and mailed surveys. Linear and log-linear models for repeated measures were used to evaluate differences between intervention and control samples.

Overall, a significant reduction of individual self-reported alcohol consumption was observed in the intervention sample (−1.1 drinks/week) relative to control sample (+0.3 drinks/week).

The reduction was significantly greater in males than in females . In the young (15–24-year-olds) intervention and control samples showed opposite trends (−0.4 drinks/week and +1.7 drinks/week, respectively).

A coordinated community-based intervention can reduce alcohol consumption in the general population.

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Request Reprint E-Mail: vincenzo.bagnardi@unimib.it

Early temperament, propensity for risk-taking and adolescent substance-related problems: A prospective multi-method investigation

One hundred thirty seven adolescents (M = 15.3 yrs, SD = 1.0 yr, n = 72 girls) were recruited into temperament groups when they were 4 months of age based on reactivity to novel auditory/visual stimuli (Fox, Henderson, Rubin, Calkins, & Schmidt, 2001).

Behavioral inhibition was observed across infancy (14 and 24 months). Additionally, self-reported substance-related problems and behavioral risk-taking was assessed during adolescence.

High behavioral inhibition increased risk for substance-related problems among boys, whereas high behavioral inhibition protected against substance-related problems among girls,

Additionally, high behavioral inhibition protected lower risk-taking children from adolescent substance-related problems whereas high behavioral inhibition increased risk for substance-related problems among higher risk-taking children,

Findings from this prospective, multi-informant, longitudinal study suggest that risk-taking and gender may interact with temperamental traits to place adolescents at differential risk for substance-related related behavior problems.

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Intervention defensiveness as a moderator of drinking outcome among heavy-drinking mandated college students

The efficacy of the Alcohol Skills Training Program (ASTP; Miller, et al., 2000) was evaluated in 204 heavy-drinking college students randomly assigned to either ASTP (n = 119) or an assessment-only control (n = 85) condition.

The volunteer ASTP sample (n = 119) was also compared to a sample of students mandated to ASTP following a first-time sanction (n = 90).

At baseline, mandated students reported lower levels of peak drinking, negative consequences, readiness to change and higher defensiveness than voluntary students.

However, the voluntary sample showed reductions in problem drinking indicators over time such that there were no differences from mandated students at follow-up.

There were no outcome differences between volunteers assigned to ASTP versus assessment-only.

A new measure of defensiveness was evaluated and had a significant moderating effect on ASTP outcome for peak drinking consumed on a peak occasion at follow-up among mandated students.


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I didn't feel like drinking but I don't know why: The effects of evaluative conditioning on alcohol-related attitudes, craving and behavior

The goal of the present research was to test the value of evaluative conditioning (EC) to unobtrusively change alcohol-related attitudes and drinking behavior.

In the EC paradigm, participants had to spot an irrelevant target picture in a series of trials in which many different stimuli were presented. In the experimental condition, beer-related pictures (CSs) were consistently paired with negative words and pictures (USs) in a number of trials. In the control condition, participants were exposed to the same stimuli, but without the critical alcohol-negative pairings.

After the EC task, participants participated in an allegedly second experiment in which we measured beer-related attitudes, craving for beer, and actual drinking behavior both during a bogus taste test and during the week following the experiment.

Compared to participants in the control condition, participants in the experimental condition showed more negative attitudes toward beer, experienced less craving for beer, and consumed less beer both in the lab during the taste test and outside the lab during the week following the manipulation.

These findings suggest that unhealthy drinking behavior may be targeted through EC procedures.

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Request Reprint E-Mail: K.Houben@maastrichtuniversity.nl

How good is fine-grained Timeline Follow-back data? Comparing 30-day TLFB and repeated 7-day TLFB alcohol consumption reports on the person and daily

This study examined the correspondence of two types of Timeline Follow-back (TLFB) methods, a web-based self-administered, repeated 7-day TLFB and an interviewer-administered 30-day TLFB of alcohol consumption.

Participants were first- and second-year college students (n = 323, 58.5% female). Day-to-day correspondence of drinking reports and correspondence of person-level indicators of drinking were assessed.

Results indicated that correspondence between the TLFB-30 and TLFB-7 reports was generally good for summary indicators of drinking, but TLFB-7 data indicated a statistically significantly higher number of total drinks consumed, a higher number of days drinking 4+/5+ drinks per day, and a lower number of abstinent days than TLFB-30. Similarly, day-to-day comparison of drinking reports showed that drinking days were more frequently reported using the TLFB-7, a trend which was more pronounced for distal weekdays than recent weekdays. Correlations between TLFB-7 and TLFB-30 reports of drinks per drinking day were also lower for distal compared to recent weekdays (r = 0.61 vs. r = 0.76). Using a Poisson regression model, a linearly increasing trend in the absolute value of the difference between TLFB-7 and TLFB-30 drinking reports per day as length of recall increases was found.

Our results indicate that participants reported more drinking on the repeated TLFB-7 than on the standard TLFB-30. Furthermore, the result of daily level analyses showed that discrepancies between the methods increased as the length of recall increased.

These findings suggest that TLFB assessments covering longer intervals may have reduced accuracy on a fine-grained scale.

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Request Reprint E-Mail: bhoeppner@partners.org

Discrepancy between how children perceive their own alcohol risk and how they perceive alcohol risk for other children longitudinally predicts alcohol

This paper examined discrepancies between children's self-perceptions of the riskiness of alcohol use versus their perceptions of the riskiness of alcohol use for other children, and whether these discrepancies predicted children's future alcohol use.

Participants included 234 children (M = 11 years, 45.3% female) who completed baseline and one-year follow-up assessments on self-perceived riskiness of alcohol use, perceived riskiness of alcohol use for other same-age children, and own past year alcohol use.

When considering child age and gender, baseline alcohol use, and the individual reports of the riskiness of alcohol use, the interaction between alcohol use riskiness reports prospectively predicted greater odds of alcohol use.

The highest percentage of childhood alcohol use at one-year follow-up came from those children with both low self-perceived riskiness of alcohol use and high perceived riskiness of alcohol use for other children.

Children's perceptions of multiple people's risk from alcohol use result in identifying important subgroups of children at risk for early-onset alcohol use.

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Request Reprint E-Mail: adelosreyes@psyc.umd.edu

Event-level associations between affect, alcohol intoxication, and acute dependence symptoms: Effects of urgency, self-control, and drinking experienc

This study used experience sampling to examine within-person associations between positive affect, anxiety, sadness, and hostility and two outcomes: alcohol intoxication and acute dependence symptoms.

We examined the role of urgency, premeditation, and perseverance in predicting the alcohol outcomes and tested whether the affective associations varied as a function of urgency.

Participants completed baseline assessments and 21 days of experience sampling on PDAs. Hypotheses were partially confirmed.

Positive affect was positively, and sadness inversely, associated with intoxication. Hostility was associated with intoxication for men but not women.

Negative urgency moderated the association between anxiety and intoxication, making it stronger. However, positive urgency did not moderate the effect of positive affect.

Heavier drinkers exhibited the greatest number of symptoms, yet the association between intoxication and acute signs of alcohol disorder was attenuated among these individuals.

Results support the use of experience sampling to study acute signs and symptoms of high risk drinking and dependence.

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Request Reprint E-Mail: jsimons@usd.edu

Addiction: Cracking the code of addiction

Recent studies have started to reveal the contribution of epigenetic regulation to addiction-related behaviours and neuroadaptation. Two new studies focus on the role of the transcriptional repressor methyl CpG-binding protein 2 (MeCP2).


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Request Reprint E-Mail: leonie.welberg@emory.edu

Consumption controversies: alcohol policies in the UK

This briefing paper from the Royal Geographical Society (with IBG) presents an overview of research relating to the current debate, presenting evidence relating to a number of controversial questions. This paper sets out to separate the facts from fiction in these debates, with evidence presented against a series of controversial questions and debates, rom whether the UK actually does have a ‘drinking problem’ right through to assessing the positive role that the British pub still plays in the economy, communities and people’s lives.

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Report of the Substance Use, Abuse, and Addiction Working Group

The National Institutes of Health (NIH) Reform Act of 2006 (Public Law 109-482) reaffirmed certain organizational authorities of agency officials to: (1) establish or abolish national research institutes; (2) reorganize the offices within the Office of the Director, NIH, including adding, removing, or transferring the functions of such offices or establishing or terminating such offices; and (3) reorganize divisions, centers, or other administrative units within an NIH national research institute or national center including adding, removing, or transferring the functions of such units, or establishing or terminating such units. The Reform Act also established the Scientific Management Review Board (hereinafter, SMRB or Board) to advise the NIH Director and other appropriate agency officials on the use of these organizational authorities and identify the reasons underlying the recommendations.

This report distills the deliberations of the Substance Use, Abuse, and Addiction (SUAA) Working Group, a subcommittee of the SMRB, and provides recommendations in response to the question of whether organizational change within NIH could further optimize research into substance use, abuse, and addiction and thereby improve the health and well-being of individuals affected by this significant problem in public health.


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Responsible Drinking Programs

These are just a few of Anheuser-Busch InBev's Responsible Drinking programs.

• Educating young drivers in Germany on the dangers of drinking and driving
• Latin American support for enforcing drinking and driving limits
• Promoting the "don't drink and drive" message in Russia
• Rocking out responsibly with Quilmes
• SunInBev partners with road safety authorities
• "Make a Plan" in Canada

• Beck's THINK! campaign
• Geklärt, wer fährt!
• Anti-Drink driving in China
• Don't drink and drive at Skol Beats in Brazil
• A-B promotes designated drivers in the United States
• Free taxi rides home with "Alert Cab"
• Get a "Tow To Go" in the United States

• A New Focus on Drinking and Driving
• Foldable Scooters Get United States Consumers (and Their Cars) Home Safely
• Designate a Skipper before Cruising United States Waterways
• Washington D.C. Residents Assured a SoberRide™ Home

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Critique 018: Alcohol consumption following diagnosis of early-stage breast cancer may increase risk of recurrence of cancer but not total mortality

In the Life After Cancer Epidemiology (LACE) study, 1,897 participants diagnosed with early-stage breast cancer between 1997 and 2000 and recruited on average 2 years post-breast cancer diagnosis were evaluated for the association between alcohol intake and breast cancer recurrence and death. The women, who were generally light drinkers, were followed for an average of 7.4 years.

The study reported an increase in risk of breast cancer recurrence and breast cancer death, but no effect on total mortality, to be associated with consumption of 3 to 4 or more drinks per week when compared with women not drinking following their cancer diagnosis.

Previous research has been mixed on this topic. Almost all large studies have shown no increase in all-cause mortality for women who drink moderately following a diagnosis of breast cancer (as does this study). As for recurrence of breast cancer, most have shown no increase in risk, although one previous study of women with estrogen-receptor + tumors found an increased risk of a primary cancer developing in the contralateral breast to be associated with alcohol intake of more than 7 drinks per week.

Because of conflicting results among studies on this topic, further research will be needed to determine the extent to which alcohol following a diagnosis of breast cancer may relate to subsequent disease and death.

For the detailed critique of this paper by the International Scientific Forum on Alcohol Research, please click here.

Public Health report identifies will to act on alcohol

The British public wants the Government to take action to make Britain healthier, according to a report published last month by the Faculty of Public Health (FPH). > > > >

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Results from the 2009 National Survey on Drug Use and Health: Volume I. Summary of National Findings

3. Alcohol Use

This chapter is divided into two main sections. Section 3.1 describes trends and patterns of alcohol use among the population aged 12 or older. Section 3.2 is concerned particularly with the use of alcohol by persons aged 12 to 20. These persons are under the legal drinking age in all 50 States and the District of Columbia.

• Slightly more than half of Americans aged 12 or older reported being current drinkers of
alcohol in the 2009 survey (51.9 percent). This translates to an estimated 130.6 million
people, which is similar to the 2008 estimate of 129.0 million people (51.6 percent).

• In 2009, nearly one quarter (23.7 percent) of persons aged 12 or older participated in binge
drinking. This translates to about 59.6 million people. The rate in 2009 is similar to the
estimate in 2008. Binge drinking is defined as having five or more drinks on the same
occasion on at least 1 day in the 30 days prior to the survey.

• In 2009, heavy drinking was reported by 6.8 percent of the population aged 12 or older, or
17.1 million people. This rate was similar to the rate of heavy drinking in 2008. Heavy
drinking is defined as binge drinking on at least 5 days in the past 30 days.

• Among young adults aged 18 to 25 in 2009, the rate of binge drinking was 41.7 percent, and
the rate of heavy drinking was 13.7 percent. These rates were similar to the rates in 2008.

• The rate of current alcohol use among youths aged 12 to 17 was 14.7 percent in 2009, which
is similar to the 2008 rate (14.6 percent). Youth binge and heavy drinking rates in 2009
(8.8 and 2.1 percent) were also similar to rates in 2008 (8.8 and 2.0 percent).

• Past month and binge drinking rates among underage persons (aged 12 to 20) declined
between 2002 and 2008, but then remained unchanged between 2008 (26.4 and 17.4 percent)
and 2009 (27.2 and 18.1 percent).

• Among persons aged 12 to 20, past month alcohol use rates in 2009 were 16.1 percent among
Asians, 20.4 percent among blacks, 22.0 percent among American Indians or Alaska Natives,
25.1 percent among Hispanics, 27.5 percent among those reporting two or more races, and
30.4 percent among whites.

• In 2009, 55.9 percent of current drinkers aged 12 to 20 reported that their last use of alcohol
in the past month occurred in someone else's home, and 29.2 percent reported that it had
occurred in their own home. About one third (30.3 percent) paid for the alcohol the last time
they drank, including 9.0 percent who purchased the alcohol themselves and 21.3 percent
who gave money to someone else to purchase it. Among those who did not pay for the
alcohol they last drank, 37.1 percent got it from an unrelated person aged 21 or older, 19.9
percent from another person younger than 21 years old, and 20.6 percent from a parent,
guardian, or other adult family member.

• In 2009, an estimated 12.0 percent of persons aged 12 or older drove under the influence of
alcohol at least once in the past year. This percentage has dropped since 2002, when it was
14.2 percent. The rate of driving under the influence of alcohol was highest among persons
aged 21 to 25 (24.8 percent).

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Generation alcohol: is drinking damaging childhood? Alcohol Concern Annual Conference and AGM

Event:

Generation alcohol: Is drinking damaging childhood?

Start Date:

Tuesday 02 November 2010

Start Time:

10.00am (9.30am for AGM)

End Time:

4.45pm

Location:

London

Venue Postcode:

SE1 9DD

Cost:

£ 264.38

Why has young people's average consumption risen to nearly 15 units a week? What role does marketing play? Does the rise in home drinking mean more children being affected by parental alcohol use? How can we support the whole family to tackle alcohol-related harms and what support is available for young people who develop a problem with alcohol?

All these issues will be discussed at the 2010 Alcohol Concern conference through a series of high profile, expert presentations and workshops from leading academics, policy experts and practitioners in the field.

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Area of residence and alcohol-related mortality risk: a five-year follow-up study

To examine differences in alcohol-related mortality risk between areas, while adjusting for the characteristics of the individuals living within these areas.

A 5-year longitudinal study of individual and area characteristics of those dying and not dying from alcohol-related deaths.

The Northern Ireland Mortality study.

A total of 720 627 people aged 25–74, enumerated in the Northern Ireland 2001 Census, not living in communal establishments.

Five hundred and seventy-eight alcohol-related deaths.

There was an increased risk of alcohol-related mortality among disadvantaged individuals, and divorced, widowed and separated males. The risk of an alcohol-related death was significantly higher in deprived areas for both males [hazard ratio (HR) 3.70; 95% confidence interval (CI) 2.65, 5.18] and females (HR 2.67 (95% CI 1.72, 4.15); however, once adjustment was made for the characteristics of the individuals living within areas, the excess risk for more deprived areas disappeared. Both males and females in rural areas had a reduced risk of an alcohol-related death compared to their counterparts in urban areas; these differences remained after adjustment for the composition of the people within these areas.

Alcohol-related mortality is higher in more deprived, compared to more affluent areas; however, this appears to be due to characteristics of individuals within deprived areas, rather than to some independent effect of area deprivation per se. Risk of alcohol-related mortality is lower in rural than urban areas, but the cause is unknown.

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Request Reprint E-Mail: sheelah.connolly@qub.ac.uk

High alcohol consumption in middle-aged adults is associated with poorer cognitive performance only in the low socio-economic group. Results from the

To examine the association of alcohol consumption over 10 years with cognitive performance in different socio-economic groups.

Prospective cohort study, the French GAZEL study.

Employees of France's national electricity and gas company.

Alcohol intake was assessed annually, beginning in 1992, using questions on frequency and quantity of alcoholic beverages consumed in a week; used to define mean consumption and trajectory of alcohol intake over 10 years. Cognitive performance among participants aged ≥ 55 years (n = 4073) was assessed in 2002–04 using the Digit Symbol Substitution Test (DSST), a measure of psychomotor speed, attention and reasoning. Occupational position at age 35 and education were used as the markers of socio-economic position. All analyses were stratified by socio-economic position.

In the low occupational group, participants consuming a mean of more than 21 drinks per week had 2.1 points lower (95% CI: −3.9, −0.3) DSST score compared to those consuming four to 14 drinks per week. In participants with primary school education, the corresponding difference was 3.6 points (95% CI: −7.1, −0.0).

No association between alcohol consumption and cognitive performance was observed in the intermediate and high socio-economic groups, defined using either occupation or education.

Analysis of trajectories of alcohol consumption showed that in the low socio-economic groups large increase or decrease in alcohol consumption was associated with lower cognitive scores compared to stable consumption.

Our results suggest that high alcohol consumption is associated with poorer cognitive performance only in the low socio-economic group, due possibly to greater cognitive reserve in the higher socio-economic groups.

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Request Reprint E-Mail: Severine.Sabia@inserm.fr