Computer Assessment of Simulated Patient Interviews (CASPI): Psychometric Properties of a Web-Based System for the Assessment of Motivational Intervie

Benefits of empirically supported interventions hinge on clinician skill, particularly for motivational interviewing (MI). Existing MI skill assessments are limited with respect to validity (e.g., self-report) and practicality (e.g., coding session tapes). To address these limitations, we developed and evaluated two versions of a web-based assessment of MI skills, the Computer Assessment of Simulated Patient Interviews (CASPI).

Ninety-six counselors from the community and 24 members of the Motivational Interviewing Network of Trainers (MINT) completed the CASPI (N = 120), in which they verbally responded via microphones to video clips comprising three 9-item vignettes. Three coders used an emergent coding scheme, which was compared with alternative MI skills measures.

CASPI demonstrated excellent internal consistency when averaging across two or three vignettes (α's = .86–.89). Intraclass correlations were above .40 for most items. Confirmatory factor analyses supported a correlated three-factor model: MI-consistent, resistance-engendering, and global change talk orientation rating. Means and factor loadings were invariant across forms (i.e., the two alternative versions of CASPI), and factor loadings were invariant across subgroup (i.e., community counselor or MINT member). Test–retest reliability was good for MI-consistent and resistance-engendering scores (r = .74 and .80, respectively) but low for change talk orientation (r = .29) unless coder was taken into account (r = .69). CASPI showed excellent construct and criterion-related validity.

CASPI represents a promising method of assessing MI skills. Future studies are needed to establish its performance in real-world contexts.



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Sources of Biased Inference in Alcohol and Drug Services Research: An Instrumental Variable Approach

This study examined the potential for biased inference due to endogeneity when using standard approaches for modeling the utilization of alcohol and drug treatment.

Results from standard regression analysis were compared with those that controlled for endogeneity using instrumental variables estimation. Comparable models predicted the likelihood of receiving alcohol treatment based on the widely used Aday and Andersen medical care–seeking model. Data were from the National Epidemiologic Survey on Alcohol and Related Conditions and included a representative sample of adults in households and group quarters throughout the contiguous United States.

Findings suggested that standard approaches for modeling treatment utilization are prone to bias because of uncontrolled reverse causation and omitted variables. Compared with instrumental variables estimation, standard regression analyses produced downwardly biased estimates of the impact of alcohol problem severity on the likelihood of receiving care.

Standard approaches for modeling service utilization are prone to underestimating the true effects of problem severity on service use. Biased inference could lead to inaccurate policy recommendations, for example, by suggesting that people with milder forms of substance use disorder are more likely to receive care than is actually the case.



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Request Reprint E-Mail: laura.schmidt@ucsf.edu

Implicit Cognition and Substance Use: The Role of Controlled and Automatic Processes in Children

Most cognitive models of substance abuse and dependence posit that controlled and automatic processes are central to substance use. Tests of these models rely on methods that are interpreted to measure one or the other of these processes. There has been growing interest in the use of implicit substance use tasks, which are posited to reflect automatic processes. Recent model advancements suggest that behavior is determined by multiple cognitive processes and that dual-process models may provide an overly simplistic account of the cognitive process involved in the assessment of implicit cognition. The goal of the current study was to apply the Quad Model to children's performance on implicit substance use tasks and consider associations with early substance use.

Children (N = 378; 52% girls) ranging from 10 to 12 years old completed alcohol and cigarette Single Category Implicit Association Tests (SC-IATs) and self-reports of substance use.

Four distinct cognitive processes were found to influence SC-IAT performance, one of which reflected automatic activation, the process typically viewed as central to IAT performance. Differences across drinking status revealed weaker automatic activation of negative alcohol associations for those who had (vs. had not) initiated drinking, and a strong likelihood to overcome biased attitudes was supported for all children. The low prevalence of cigarette use in our young sample prohibited examination of the model across smoking status.

Findings suggest that performance on implicit substance use tasks is not process pure. Quantifying and interpreting the multiple influencing processes are crucial for further development and evaluation of cognitive risk models of substance use.


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Request Reprint E-Mail: roisin.oconnor@concordia.ca

Use of the Screening Suggested by the National Institute on Alcohol Abuse and Alcoholism and of a Newly Derived Tool for the Detection of Unhealthy Al

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has developed a two-question tool for the detection of unhealthy drinking (NIAAA-2Q) that investigates excessive alcohol consumption per single occasion. NIAAA-2Q can be commuted into a four-question tool (NIAAA-4Q) by the addition of two questions aimed at investigating excessive weekly alcohol intake. NIAAA-2Q and NIAAA-4Q may prove useful in busy settings such as an anesthesiological environment. However, to date, no study has evaluated their efficacy in a surgical setting. The purpose of this study was to evaluate the accuracy of NIAAA-2Q and NIAAA-4Q in detecting unhealthy drinking among surgical patients using the more complex Alcohol Use Disorders Identification Test (AUDIT) comprising 10 questions as the criterion method.

NIAAA-4Q and AUDIT were administered to 200 surgical patients by three anesthetists.

A total of 23.5%, 12.5%, and 28.5% surgical patients were unhealthy drinkers according to AUDIT, NIAAA-2Q, and NIAAA-4Q, respectively. NIAAA-2Q negative and positive predictive values were 0.78 and 0.36, respectively, and positive and negative likelihood ratios were 1.80 and 0.90, respectively. NIAAA-4Q negative and positive predictive values were 0.93 and 0.65, respectively, and positive and negative likelihood ratios were 6.00 and 0.24, respectively.

NIAAA-4Q demonstrated a better satisfactory agreement than NIAAA-2Q with AUDIT in detecting unhealthy alcohol drinking among surgical patients. These results suggest that the detection of unhealthy alcohol drinking may be increased by the administration of questions aimed at assessing the weekly average of alcohol intake. The modest time required for NIAAA-4Q administration is a major advantage in clinical practice with respect to AUDIT. Further research will compare NIAAA-2Q and NIAAA-4Q with other brief alcohol screening tests.



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Request Reprint E-Mail: agabio@unica.it

Hispanic Americans Baseline Alcohol Survey (HABLAS): Effects of Container Size Adjustments on Estimates of Alcohol Consumption Across Hispanic Nationa

This study was conducted to examine discrepancies in alcohol consumption estimates between a self-reported standard quantity–frequency measure and an adjusted version based on respondents' typically used container size.

Using a multistage cluster sample design, 5,224 Hispanic individuals 18 years of age and older were selected from the household population in five metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey-weighted response rate was 76%. Personal interviews lasting an average of 1 hour were conducted in respondents' homes in either English or Spanish.

The overall effect of container adjustment was to increase estimates of ethanol consumption by 68% for women (range across Hispanic groups: 17%–99%) and 30% for men (range: 14%–42%). With the exception of female Cuban American, Mexican American, and South/Central American beer drinkers and male Cuban American wine drinkers, all percentage differences between unadjusted and container-adjusted estimates were positive. Second, container adjustments produced the largest change for volume of distilled spirits, followed by wine and beer. Container size adjustments generally produced larger percentage increases in consumption estimates for the higher volume drinkers, especially the upper tertile of female drinkers.

Self-reported alcohol consumption based on standard drinks underreports consumption when compared with reports based on the amount of alcohol poured into commonly used containers.



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Request Reprint E-Mail: raul.caetano@UTSouthwestern.edu

Dynamics of Friendship Networks and Alcohol Use in Early and Mid-Adolescence

Similarity in alcohol consumption among adolescent friends could be caused by the influence of friends or by the selection of friends who consume similar levels of alcohol. This article aims to disentangle influence and selection processes while specifically examining changes over time in these processes and possible differences between reciprocal and nonreciprocal friendships.

The design was longitudinal with four
observations (Time 1–Time 4 [T1–T4]). Data consisted of a longitudinal sample of 1,204 Finnish adolescents in 10 junior high schools. The main measurements were adolescents' friendship networks and alcohol consumption. For three successive periods, T1–T2, T2–T3, and T3–T4, actor-based models for the co-evolution of networks and behavior were analyzed (mean age: T1 = 13.6 years, T2 = 14.6 years, T3 = 15.6 years, T4 = 16.1 years).

Selection, as well as influence processes, played an important role in adolescent alcohol consumption. Influence was found during the first period (T1–T2), whereas support for selection was found during the last two periods (T2–T3 and T3–T4). The strength of influence and selection processes did not differ for reciprocal and nonreciprocal friendships.

The impact of selection and influence processes changed over time such that influence was only present during early adolescence, whereas selection was present during mid-adolescence. During early adolescence, youngsters would benefit from learning to resist social influence. Alcohol-consumption prevention programs targeting mid-adolescence should consider peer selection processes. These findings stress the importance of considering changes over time in future practice and research.



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Request Reprint E-Mail: Liesbeth.Mercken@GVO.unimaas.nl

Alcohol Use and Friendship Dynamics: Selection and Socialization in Early-, Middle-, and Late-Adolescent Peer Networks

This study examined developmental trends of peer selection and socialization related to friends' alcohol use in early-, middle-, and late-adolescent peer networks, with the primary goal of identifying when these mechanisms emerge, when these mechanisms exert their strongest effects, and when (or if) they decrease in importance. Gender and reciprocity are also tested as moderators of selection and socialization.

Cross-sequential study (three age cohorts assessed at three annual measurements) of 950 youth (53% male) initially attending classrooms in Grade 4 (n = 314; M = 10.1 years), Grade 7 (n = 335; M = 13.1 years), and Grade 10 (n = 301; M = 16.2 years).

Similarity between friends' drinking behaviors emerged in Grade 6, peaked in Grade 8, and decreased throughout late adolescence. Adolescents in all three age groups selected peers with similar drinking behaviors, with effects being more robust for early-adolescent males and for late-adolescent females. Peers' alcohol use emerged as a significant predictor of middle-adolescent alcohol use and remained a significant predictor of individual drinking behaviors throughout late adolescence. Socialization did not differ as a function of gender or reciprocity.

Alcohol-related peer selection was relatively more important than socialization in early-adolescent friendship networks; both mechanisms contributed to explaining similarity between the drinking behaviors of friends in middle and late adolescence. Effects of peer socialization emerged in middle adolescence and remained throughout late adolescence.



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Request Reprint E-Mail: wburk@fsw.leidenuniv.nl

Investigating Associations Between Perceived Parental Alcohol-Related Messages and College Student Drinking

A debate remains regarding whether parents should teach their children harm-reduction tips for using alcohol while in college or whether they should maintain a zero-tolerance policy. Which type of alcohol-related communication parents should endorse is not empirically clear. The current study made use of a longitudinal measurement-burst design to examine this issue.

The sample consisted of 585 second-year students from a large university in the northeastern United States. Participants completed a baseline survey and 14 daily web-based surveys. Students were assessed for perceptions of parental alcohol-related messages and their own alcohol use. Multilevel models were estimated using HLM 6.04.

The data indicate that zero-tolerance messages appeared most protective against alcohol use and consequences. Harm-reduction messages were most risky, even when compared with mixed messages or the absence of a message.

Findings indicate that a zero-tolerance approach was associated with safer outcomes than other messages, even if students were already using alcohol.


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Request Reprint E-Mail: cabar@psu.edu

Intergenerational Relations for Drinking Motives: Invariant for Same- and Opposite-Sex Parent–Child Dyads?

The purpose of this study was to investigate the similarity or dissimilarity of same-sex (e.g., mother–daughter) and opposite-sex (e.g., mother–son) associations for drinking motives across four pairings of parent–young adult child dyads.

Three waves of data spanning approximately 10 years in early to late young adulthood were used in conjunction with mother and father data to examine same-and cross-sex associations for drinking motives. Multiple group structural equation modeling was used to statistically model and evaluate these parent–young adult associations.

Findings indicated strong same-sex intergenerational transmission patterns for mother-daughter dyads relative to father–daughter dyads. The strength of relationships for father–son dyads was also stronger and significantly different than those for father–daughter dyads. There were no statistically significant differences between sex-specific intergenerational patterns for mother–son and father–son dyads or for mother–daughter and mother–son dyads. Although there was some generality and some specificity in the sex-specific intergenerational transmission patterns of drinking motives, when statistically significant, the transmission pattern generalized across all three drinking motives (coping, social, and enhancement).

Intergenerational factors contributing to alcohol phenotypes may not be limited to the modeling of alcohol use or the occurrence of alcohol disorders but may also include cognitive–motivational systems of affective regulation related to the use of alcohol. Future research would benefit by focusing on how biogenetic and socialization factors contribute to same- and opposite-sex intergenerational patterns and how to use this information to strengthen intervention programs.



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Request Reprint E-Mail: mwindle@emory.edu

Editorial - Addiction is a disease: We must change our attitudes toward addicts

Health professionals, like the rest of society, often think and behave negatively toward addiction and the people who suffer from it. We must acknowledge and consciously overcome these negative attitudes if we are to succeed in treating addiction as we do other chronic diseases. > > > > Read More

Wine Consumption and 20-Year Mortality Among Late-Life Moderate Drinkers

This study examined level of wine consumption and total mortality among 802 older adults ages 55–65 at baseline, controlling for key sociodemographic, behavioral, and health status factors. Despite a growing consensus that moderate alcohol consumption is associated with reduced total mortality, whether wine consumption provides an additional, unique protective effect is unresolved.

Participants were categorized in three subsamples: abstainers, high-wine-consumption moderate drinkers, and low-wine-consumption moderate drinkers. Alcohol consumption, sociodemographic factors, health behavior, and health problems were assessed at baseline; total mortality was indexed across an ensuing 20-year period.

After adjusting for all covariates, both high-wine-consumption and low-wine-consumption moderate drinkers showed reduced mortality risks compared with abstainers. Further, compared with moderate drinkers for whom a high proportion of ethanol came from wine, those for whom a low proportion of ethanol came from wine were older, were more likely to be male, reported more health problems, were more likely to be tobacco smokers, scored lower on socioeconomic status, and (statistical trend) reported engaging in less physical activity. Controlling only for overall ethanol consumption, compared with moderate drinkers for whom a high proportion of ethanol came from wine, those for whom a low proportion of ethanol came from wine showed a substantially increased 20-year mortality risk of 85%. However, after controlling for all covariates, the initial mortality difference associated with wine consumption was no longer significant.

Among older adults who are moderate drinkers, the apparent unique effects of wine on longevity may be explained by confounding factors correlated with wine consumption.



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Request Reprint E-Mail: holahan@psy.utexas.edu

Increases in Typical Quantities Consumed and Alcohol-Related Problems During a Decade of Liberalizing Alcohol Policy

The aim of this study was to assess trends in drinking patterns and alcohol-related problems among age and gender groups in the context of a liberalized alcohol policy environment.

Eleven comparable general population alcohol surveys were conducted between 1990 and 2000 in Auckland, New Zealand, during which a substantial number of liberalizing alcohol policy changes occurred. Measurements included typical-occasion quantity and frequency of drinking in the last 12 months. Self-reported alcohol-related problems in the last 12 months were divided into two groups based on risk curve analysis: threshold problems (experienced only once a high level of consumption is reached) and nonthreshold problems (those exhibiting a dose-response relationship). Age groups were 14–19, 20–24, 25–39, and 40–65 years.

Significant increases in typical-occasion quantity were found for young men and young women ages 14–19 years and for women 20–24 and 40–65 years. The increase was most marked among those 14–19 years old. Only women ages 25–39 years increased how often they drank. The prevalence of threshold problems significantly increased among male drinkers ages 14–19 and 40–65 years. The proportion of 14- to 19-year-olds experiencing threshold problems was observed to be higher in each year compared with those 40–65 years old, and the 14- to 19-year-olds experienced a greater year-on-year increase. Increases in nonthreshold alcohol-related problems occurred for the youngest and oldest males and for most female age groups (14–19, 25–39, and 40–65 years). The increase was most marked among those 14–19 years old.

Increases in quantities consumed and alcohol-related problems were found predominantly among young people and women. The youngest age group, those 14–19 years old, experienced the most marked increases in quantity consumed and problems including, for males, the experience of more serious problems such as "had hands shake in the morning" (experienced only once a high level of consumption is reached).



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Request Reprint E-Mail: t.huckle@massey.ac.nz

Gender and Extroversion as Moderators of the Association Between Alcoholics Anonymous and Sobriety

Although women make up one third of Alcoholics Anonymous (AA) membership, research on gender and AA has been limited. Findings in the literature are mixed, with few empirical investigations of factors that may moderate any gender differences found. AA is highly interpersonal, and research has found that women are more extroverted than men. The current study explores the impact of AA on sobriety, gender differences in the relationship between AA and sobriety, and whether extroversion can inform our understanding of gender differences.

A sample of 276 alcohol-dependent adults (180 men, 96 women) was recruited from four sites and followed prospectively for 2.5–3 years. Participants completed the Timeline Followback interview. AA membership was assessed by an item from the Alcoholics Anonymous Involvement scale. Multiple logistic regression analyses were conducted to determine whether gender, extroversion, AA membership, and their interaction would predict sobriety status at follow-up.

AA membership significantly increased the odds of achieving a year of sobriety, and this relationship was stronger for women than men (odds ratio [OR] = 4.42, 95% CI [1.14, 17.18]). There were no main or interactive effects of extroversion on sobriety.

AA was founded by men, and early in its history it was exclusively attended by men. Some have criticized AA for women because of its emphasis on "powerlessness." Despite its historical beginnings and such debate, this study joins others in finding evidence that women fare better in AA than do men. In this sample, extroversion did not moderate the association between gender and sobriety. Further research is needed on gender differences in AA and its explanatory factors.



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Request Reprint E-Mail: amykrent@med.umich.edu

Alcohol Milestones, Risk Factors, and Religion/Spirituality in Young Adult Women

The alcoholism research literature has long reported a significant, reliable, and inverse association between alcohol use disorders and religion/spirituality (R/S), and this is also evident in the period of highest risk—adolescence and young adulthood. In the treatment area, both clinical and mutual-help programs for alcohol use disorders often include a spiritual component, and outcome studies validate the efficacy of such programs. Even so, the alcoholism–R/S relationship is little understood.

The current study examined data from an existing sample of 4,002 female adolescents/young adults and their families. Data analyses examined five demographic, nine R/S, and eight risk-factor variables as predictors of five alcohol milestones: initial drink, first intoxication, regular use, heavy consumption, and alcohol dependence.

Results affirmed the known association between alcoholism risk factors and alcohol use milestones and also found moderate to strong associations between most R/S variables and these risk factors and milestones. A multivariate model simultaneously examining both sets of variables found that specific risk factors and specific R/S variables remained significant predictors of alcohol use milestones after accounting for all other variables. Mediation and moderation tests did not find evidence that R/S accounted for or qualified the relationship between alcohol risk factors and alcohol milestones.

This study confirmed the multidimensional role of R/S influences within the etiological network of alcoholism risk and protective factors in adolescents/young adults and found R/S dimensions to be independent and substantial influences on alcohol use disorders rather than mediators or moderators of other risks.



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Request Reprint E-Mail: randyhaber@gmail.com

Naturally Occurring Changes in Women's Drinking From High School to College and Implications for Sexual Victimization

The current study examined the natural trajectories of alcohol use among women as they transitioned from high school to college, considering changes in drinking for students at initially different levels of drinking. We examined the hypothesis that the association between college drinking and sexual victimization would be stronger for women with less high school drinking experience.

Female, college-bound, high school seniors were recruited from the community at the time of graduation (N = 437). Alcohol consumption and sexual victimization were assessed at the time of high school graduation (Time 0 [T0]) and at the end of the first (T1) and second (T2) semesters of college.

Abstainers and light drinkers increased alcohol consumption from T0 to T1; however, consumption by those already engaging in heavy episodic drinking remained stable. Consumption did not increase for any group from T1 to T2. As expected, maximum consumption in college was strongly associated with experiencing incapacitated rape or other sexual victimization during the same semester; however, prior drinking experience did not moderate the relationship.

Occasions of heavy drinking in college are a significant risk factor for sexual victimization for both experienced and inexperienced drinkers. Findings point toward universal prevention, ideally before college entry, as a strategy for reducing heavy episodic drinking and hence, college sexual victimization.


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Is the Density of Alcohol Establishments Related to Nonviolent Crime?

We examined the associations between the density of alcohol establishments and five types of nonviolent crime across urban neighborhoods.

Data from the city of Minneapolis, MN, in 2009 were aggregated and analyzed at the neighborhood level. We examined the association between alcohol establishment density and five categories of nonviolent crime: vandalism, nuisance crime, public alcohol consumption, driving while intoxicated, and underage alcohol possession/consumption. A Bayesian approach was used for model estimation accounting for spatial auto-correlation and controlling for relevant neighborhood demographics. Models were estimated for total alcohol establishment density and then separately for off-premise establishments (e.g., liquor and convenience stores) and on-premise establishments (e.g., bars and restaurants).

We found positive associations between density and each crime category. The association was strongest for public consumption and weakest for vandalism. We estimated that a 3.3%–10.9% increase across crime categories would result from a 20% increase in neighborhood establishment density. Similar results were seen for on- and off-premise establishments, although the strength of the associations was lower for off-premise density.

Our results indicate that communities should consider the potential increase in nonviolent crime associated with an increase in the number of alcohol establishments within neighborhoods.



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Request Reprint E-Mail: toome001@umn.edu

Case-Control Study in China of Risk Factors for Suicide in Men With Alcohol Use Disorders

This secondary analysis of China's National Psychological Autopsy Study assesses the risk factors for suicide among men with alcohol use disorders (AUDs)—the second most common psychiatric diagnosis among suicide decedents in China.

Based on data collected from family members and close associates, the characteristics of 68 men with AUDs who died by suicide and 51 men with AUDs who died of other injuries at 23 geographically representative locations in China were compared using univariate and multivariate logistic regression models. Interactions between AUDs and other risk factors for suicide were explored using data from 448 male suicide decedents and 521 men who died from accidental injuries.

After adjusting for covariates, risk factors for suicide among men with AUDs were history of previous suicide attempts (odds ratio [OR] = 46.72, 95% CI [4.70, 464.89]), acute negative life events in the 2 days before death (OR = 18.92, 95% CI [3.32, 107.88]), and comorbid major depressive disorder (OR = 14.65, 95% CI [2.93, 73.31]). These three factors accounted for 54.3% of the variance in outcome. There was a statistically significant interaction between AUDs and major depression; the association between major depression and suicide risk was weaker in men with AUDs than in men without AUDs.

Among men with AUDs in China, prior suicidal behavior, acute life events, and major depression confer risk for suicide. However, the risk associated with depression in men with AUDs is somewhat less than the risk of suicide associated with depression in men without AUDs.



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Request Reprint E-Mail: zhang_bsrpc@hotmail.com

Substance Use Disorders and Homicide Death in Veterans

The present study examined the association between a diagnosis of an alcohol use disorder or a drug use disorder and death by homicide over the course of 6 years.

This was a cohort study that included all patients seen for medical treatment by the Veterans Health Administration during fiscal year (FY) 2001. Treatment records were used to identify all patients with a diagnosis of a substance use disorder in FY01 (n = 3,942,932). The National Death Index data provided information on the timing and cause of death between FY02 and the end of 2007. Analyses examined the association between substance use disorders and the time to homicide, after controlling for age and gender.

Veterans Health Administration patients who were diagnosed with an alcohol use disorder were more likely to die by homicide than those without a substance use disorder (hazard ratio [HR] = 3.3, 95% CI [2.6,4.1]). This finding also was true for those with drug use disorders (HR = 4.3, 95% CI [3.4, 5.4]) and for those with both an alcohol use disorder and a drug use disorder (HR = 4.6, 95% CI [3.9, 5.4]), compared with those without a substance use disorder.

In this observational study of veterans, a diagnosis of a substance use disorder was significantly associated with death by homicide. Alcohol and drug treatment programs may have an important role to play in reducing the burden of homicide as a public health problem



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Request Reprint E-Mail: Chermack@umich.edu

Alcohol News - 50/2011

Mindshare (Lithuania) - Alcohol advertising ban denied

Lithuanian Parliament has abjured complete ban of alcohol advertising. Alcohol advertising details are in constant questioning, as the latter plan oversaw a complete ban of outdoor, internet and print advertising.

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ERR News (Estonia) - Temperance Activists Seek Warning Labels for Pregnant Women on Booze Bottles

The Temperance Union is participating in a Pan-European initiative which aims to introduce labels on liquor bottles, warning women of the hazards of consuming alcohol during pregnancy.

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Copenhagen Post (Denmark) - Drunken Danes

At a friend’s recent birthday party, I had the pleasure of being told by an intoxicated teenager that young Danes hold the record for drinking to excess in Europe. His face lit up as he bragged that his generation drank even more than the Brits and that this was an achievement to celebrate.

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The Independent (UK) - Alcohol diseases double in 7 years

The Health Minister Andrew Lansley was forced to defend his controversial "hands off" approach to public health yesterday as new figures revealed hospital admissions for alcohol-related diseases have doubled in the past seven years.

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Examiner.com - Alcohol leads to unsafe sex – it is now official

Some things in life are a matter of common sense. The idea that the consumption of alcohol would lead to a higher incidence of unsafe sex is such a commonsense concept.

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Wall Street Journal (USA) - New Distracted Driving Measure Shows Alcohol Is Still The Bigger Threat

The safety threat posed by drivers who text and talk behind the wheel generates a lot of heat, but drinking and driving remains the bigger problem, according to the latest highway fatality statistics from the U.S. government.

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AllAfrica.com (Liberia) - Consumers Council Warns Children Against Alcohol

The National Consumers Council of Liberia (NCCL) has warned Liberian children to stay far from alcohol during the Christmas and the New Year seasons. The NCCL said its attention has been drawn to the continuous intake of alcoholic beverages by children despite the Ministry of Commerce and Industry's regulation, prohibiting the sale of alcoholic beverages to children.

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The Press Association (Scotland) - Sales of alcohol down since ban

Alcohol sales have fallen since the ban on multi-buy deals was introduced in October, new figures suggest. Retail analysts Neilsen said sales of wine fell by 5%, spirits 3% and beer 8% during the first eight weeks of the ban, compared with the same period of 2010.

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BBC News (Scotland) - Scottish alcohol sales fall after multibuy ban

The amount of alcohol sold in Scottish shops and supermarkets has fallen since a ban on multi-buy deals was brought in this October, figures show.

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Telegraph.co.uk (UK) - Unhealthy lifestyle responsible for 'half of cancers'

Almost half of cancers are caused by an unhealthy lifestyle that could be avoided by quitting smoking, losing weight, exercising and drinking less alcohol, the most comprehensive study of its kind has found.

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Daily Mail (UK) - Drinks company slammed for handing out free alcohol to student blood donors

A drinks company has been slammed for handing out free alcohol to teenage blood donors.

Photographs posted via Facebook showed students being given cases of Turbo shandy as they queued at a temporary blood bank outside a church in Leeds, West Yorkshire.

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NPR (France) - French Lessons: Why Letting Kids Drink At Home Isn't Tres Bien

Many European parents, and some American ones, too, have long figured if they let their kids drink alcohol at home, they'd be less likely to go hog wild with their friends. But recent studies of teen drinking behavior don't bear that out.

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Telegraph.co.uk - Middle-aged drive to avoid peer pressure of drinking

Middle-aged people regularly volunteer to drive to dinner parties just to resist "mature" peer pressure to drink, according to new research.

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The Daily Telegraph (Australia) - Alcohol labels to warn mums-to-be

THE country's leading health experts will today call on the federal government to impose mandatory warning labels for pregnant women on all alcoholic drinks.

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7thSpace Interactiv (EU) - Drinking behaviours and blood alcohol concentration in four European drinking environments: a cross-sectional study

Reducing harm in drinking environments is a growing priority for European alcohol policy yet few studies have explored nightlife drinking behaviours. This study examines alcohol consumption and blood alcohol concentration (BAC) in drinking environments in four European cities.

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Stuff.co.nz (New Zealand) - Booze and networking meet online

An iPhone cover that counts how many beers you have opened, an app that stops you sending drunken abusive texts, and a program that matches your drinks to your musical tastes are all encouraging a strong link between social media and drinking, researchers say.

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PhysOrg.com - The perils of drunken walking

Drinking and driving is a much-publicized, dangerous combination, but is walking after drinking any safer?

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HGV UK (EU) - Motorists get pan-European drink drive warning

Motorists across Europe, including truck drivers can expect to be tested for alcohol as police officers conduct a week-long enforcement operation starting tomorrow, Monday 12 December.

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Croatian Times (Croatia) - Croatian parents accustomed to giving children alcohol

Some Croatian parents continue to believe in nutritional values of alcohol and give their first graders wine or beer often, recent research shows.

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Malta Independent Online (Malta) - Zero tolerance approach to drink-driving – Health Minister

Health Minister Joe Cassar yesterday urged the public to adopt a zero tolerance mentality to drink-driving and called on society to evaluate whether too much alcohol is being consumed for enjoyment, not just at Christmas but all year round.

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The History of Our Field: Reflections on the Solid Foundations on Which We Stand—The Contributions of Griffith Edwards

THIS IS THE FIRST OF WHAT I HOPE to be an occasional series of articles in the Journal of Studies on Alcohol and Drugs helping those of us who work in the alcohol and other drug fields to think about where we currently are and where we seem to be going. To accomplish those tasks, it is important that we understand more about where we come from and the accomplishments that made our work possible.

When I began my own career in substance use disorders as a medical student in the 1960s, alcohol and other drug issues were often relegated to second-class citizenship in the fields of health care delivery and research. At that time, the budget of the National Institute on Alcohol Abuse and Alcoholism was less than $6 million and careful research was relatively rare, although clinical and research advances were beginning to appear. The difference between what our field
was then and what it is now didn’t just happen but developed through the work and infl uences of many men and women, some of whom I hope to highlight through this series of editorials.

When one recognizes how many people have
influenced our efforts over the years, it is a challenge to try to decide on where to start. Although there are many people I hope to learn more about and whose accomplishments I plan to share with you in the future, from my standpoint, Griffith Edwards is as fine a first subject as any for this first commentary. > > > > Read More

Older and wiser? Men’s and women’s accounts of drinking in early mid-life

Most qualitative research on alcohol focuses on younger rather than older adults.

To explore older people’s relationship with alcohol, we conducted eight focus groups with 36 men and women aged 35 to 50 years in Scotland, UK.

Initially, respondents suggested that older drinkers consume less alcohol, no longer drink to become drunk and are sociable drinkers more interested in the taste than the effects of alcohol.

However, as discussions progressed, respondents collectively recounted recent drunken escapades, challenged accounts of moderate drinking, and suggested there was still peer pressure to drink.

Some described how their drinking had increased in mid-life but worked hard discursively to emphasise that it was age and stage appropriate (i.e. they still met their responsibilities as workers and parents)

Women presented themselves as staying in control of their drinking while men described going out with the intention of getting drunk (although still claiming to meet their responsibilities).

While women experienced peer pressure to drink, they seemed to have more options for socialising without alcohol than did men.

Choosing not to drink alcohol is a behaviour that still requires explanation in early mid-life. Harm reduction strategies should pay more attention to drinking in this age group.

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Twelve-step attendance trajectories over seven years among adolescents entering substance use treatment in an integrated health plan

This study examines twelve-step attendance trajectories over seven years, factors associated with the trajectories, and relationships between the trajectories and long-term substance use outcomes among adolescents entering outpatient substance use treatment in a private, non-profit integrated managed care health plan.

Longitudinal observational study.

Four Kaiser Permanente Northern California substance use treatment programs.

391 adolescents entering treatment between 2000 and 2002 who completed at least one follow-up interview in year one, and at least one during years three to seven, after treatment entry.

Alcohol and drug use, twelve-step meeting attendance and activity involvement, and post-treatment medical service utilization.

Semiparametric group-based modeling identified three distinct twelve-step attendance trajectory groups over seven years: low/no attendance (60%), early but not continued (26%), and continued (14%). There were lower proportions of males and of adolescents with prior substance use treatment experience in the low/no attendance group (p = 0.019 and p = 0.003, respectively). In addition, those in the low/no attendance group had lower perception on circumstances, motivation and readiness for treatment at baseline (p = 0.023). Multivariate logistic generalized estimating equation analyses found that those in the continued group were more likely to be abstinent from both alcohol and drugs during follow-ups than those in the low/no attendance group (OR = 2.40, p = 0.003 and OR = 1.96, p = 0.026, respectively). However, no differences in long-term outcomes were found between those in the other two groups.

Robust connection with twelve-step groups appears to be associated with better long-term outcomes among adolescents with substance use disorders.



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Request Reprint E-Mail: Felicia.W.Chi@kp.org

An intervention to increase alcohol treatment engagement: A pilot trial

Previous research has documented the difficulty individuals with alcohol use disorders have initiating alcohol treatment.

This study assessed the feasibility of a brief, cognitive–behavioral intervention designed to increase treatment initiation among individuals with alcohol use disorders.

This randomized controlled trial included 196 participants who screened positive for a possible alcohol use disorder on the Alcohol Use Disorders Identification Test. Randomly assigned intervention participants were administered a brief cognitive–behaviorally-based intervention by telephone designed to modify beliefs that may interfere with treatment-seeking behavior. Beliefs about treatment and treatment-seeking behavior were assessed postintervention.

Participants receiving the intervention had significantly improved their attitudes toward addiction treatment (p < .002) and increased their reported intention-to-seek treatment (p < .000) postintervention. Further, intervention participants were almost three times more likely to attend treatment within a 3-month period (odds ratio = 2.60, p < .025) than participants in the control group.

A brief, cognitive–behavioral intervention delivered by telephone and focused on modifying treatment-interfering beliefs holds promise for increasing alcohol treatment seeking among individuals in need.

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Request Reprint E-Mail: tracy.stecker@dartmouth.edu

Examination of the latent factor structure of the Alcohol Use Disorders Identification Test in two independent trauma patient groups using confirmator

Recent research on the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) provides support for two underlying factors: consumption and consequences.

The current study sought to extend these findings to two independent and diverse trauma populations: traumatic injury patients and military veterans treated for posttraumatic stress disorder.

The 2- and 3-factor solutions provided the best fit to the data, but there was a very high correlation between the second and third factors of the 3-factor solution. Parsimony suggests that the 2-factor solution is the preferred model.

The 2-factor model has implications for alcohol screening using the AUDIT and supports the goal of screening to identify those with hazardous drinking and alcohol use disorders.

An algorithm is proposed to inform alcohol screening protocols in a range of health settings for trauma-exposed patient groups.


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Request Reprint E-Mail: dwade@unimelb.edu.au

The effect of anxiety sensitivity on alcohol consumption among individuals with comorbid alcohol dependence and posttraumatic stress disorder.

Existing research has shown that anxiety sensitivity (AS) is positively associated with alcohol use, and that individuals with high AS use alcohol to avoid or escape negative affect associated with aversive stimuli.

The current study investigated the associations between AS and drinking behavior among individuals with comorbid alcohol dependence and posttraumatic stress disorder (PTSD).

We assessed baseline PTSD symptoms, AS, and drinking behavior among 151 participants enrolled in a randomized clinical trial for alcohol dependence.

We hypothesized that AS would moderate the association between PTSD symptoms and drinking behavior, with PTSD symptoms being more strongly associated with drinking behavior among individuals with high AS.

Results showed that AS was strongly associated with PTSD (r = .48) and moderately associated with drinking behavior (r = .18).

As predicted, the interaction of AS with severity of PTSD symptoms was associated with frequency of drinking; however, contrary to our hypothesis, PTSD symptoms were more strongly associated with drinking behavior among individuals with relatively low AS.

The implication of the present results for treatment of both PTSD and alcohol dependence are discussed.



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Request Reprint E-Mail: gillihan@mail.med.upenn.edu

Adolescent alcohol-related risk cognitions: The roles of social norms and social networking sites.

The present study examined the impact of socially based descriptive norms on willingness to drink alcohol, drinker prototype favorability, affective alcohol attitudes, and perceived vulnerability for alcohol-related consequences within the Prototype Willingness model.

Descriptive norms were manipulated by having 189 young adolescents view experimenter-created profile pages from the social networking site Facebook, which either showed older peers drinking or not.

The results provided evidence that descriptive norms for alcohol use, as portrayed by Facebook profiles, significantly impact willingness to use, prototypes, attitudes toward use, and perceived vulnerability.

A multiple mediation analysis indicated that prototypes, attitudes, and perceptions of use mediated the relationship between the content of the Facebook profile and willingness.

These results indicate that adolescents who perceive that alcohol use is normative, as evidenced by Facebook profiles, are at higher risk for cognitions shown to predict alcohol use than adolescents who do not see alcohol use portrayed as frequently on Facebook.



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Request Reprint E-Mail: dlitt@uw.edu

A beverage-specific measure of expectancies for malt liquor: Development and initial testing.

Malt liquor (ML) is a unique, high alcohol content beverage marketed to encourage heavy drinking. We developed the Malt Liquor Expectancy Questionnaire (MLEQ), a beverage-specific measure of alcohol expectancies, and examined its association with typical weekly ML use, typical weekly alcohol use, and alcohol problems.

Forty positive and 40 negative expectancy items were administered to a sample of 639 young adults who regularly consumed ML.

Exploratory and confirmatory factor analyses led to the development of the 30-item MLEQ. The MLEQ consists of two positive (i.e., Social Facilitation and Enjoyment, Enhanced Sexuality) and two negative factors (i.e., Aggression and Negative Consequences; Impairment and Physical Symptoms) that possess good internal consistency, test–retest reliability, and convergent validity.

The psychometrically sound MLEQ contributes to the limited research on beverage-specific expectancies and heavy drinking.



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Request Reprint E-Mail: lcollins@buffalo.edu

The influence of confidence on associations among personal attitudes, perceived injunctive norms, and alcohol consumption.

Social norms theories hold that perceptions of the degree of approval for a behavior have a strong influence on one's private attitudes and public behavior. In particular, being more approving of drinking and perceiving peers as more approving of drinking, are strongly associated with one's own drinking.

However, previous research has not considered that students may vary considerably in the confidence in their estimates of peer approval and in the confidence in their estimates of their own approval of drinking.

The present research was designed to evaluate confidence as a moderator of associations among perceived injunctive norms, own attitudes, and drinking. We expected perceived injunctive norms and own attitudes would be more strongly associated with drinking among students who felt more confident in their estimates of peer approval and own attitudes. We were also interested in whether this might differ by gender.

Injunctive norms and self-reported alcohol consumption were measured in a sample of 708 college students.

Findings from negative binomial regression analyses supported moderation hypotheses for confidence and perceived injunction norms but not for personal attitudes.

Thus, perceived injunctive norms were more strongly associated with own drinking among students who felt more confident in their estimates of friends' approval of drinking.

A three-way interaction further revealed that this was primarily true among women.

Implications for norms and peer influence theories as well as interventions are discussed.



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Request Reprint E-Mail: claytonn@u.washington.edu