The role of alcohol in maxillofacial trauma—a comparative retrospective audit between the two centers

Alcohol abuse and maxillofacial trauma, particularly that due to interpersonal violence, have a well-established relationship in the literature. 

We present a retrospective audit comparing the role of alcohol in maxillofacial trauma between Selly Oak Hospital in Birmingham, United Kingdom and Westmead Hospital in Sydney, Australia, and the association between alcohol involvement and patient demographics, including age, sex, marital status, and employment status. Also presented are the differences between the two centers in terms of mechanisms and types of injuries and the locations where these injuries were sustained. 

Alcohol was involved in 34.78 and 30.77% of patients at Westmead and Birmingham, respectively. A multiple logistic regression analysis revealed a reduced likelihood of alcohol involvement in episodes of maxillofacial trauma where patients were unemployed (P=.04), and where injuries were sustained secondary to mechanisms other than assault (P<.001) and in locations other than pubs and nightclubs (P=.024). 

There appeared to be no statistically significant contribution to the likelihood of alcohol involvement by treating center, marital status, patient sex, or age. 

Alcohol continues to be a strong driving factor in cases of maxillofacial trauma, particularly those due to alleged assault, with a typical patient demographic of the gainfully employed frequenting drinking establishments being most at risk for alcohol-related trauma, most commonly sustaining their injuries secondary to assault. 

Identifying patient groups most at risk is a key step in developing public health strategies aimed at prevention, and our findings would appear to suggest this group of patients as being the most worthwhile to target with measures aimed at reducing alcohol-fueled maxillofacial trauma.

Read Full Abstract

Request Reprint E-Mail:   rosselledge@doctors.net.uk     

Alcohol and multiple trauma—is there an influence on the outcome?

A relevant number of trauma patients are intoxicated with alcohol at admission in trauma centers. Meanwhile, some studies provide data suggesting a profound influence of ethanol on the posttraumatic clinical course; others could not confirm these findings. 

Knowledge of the influence of ethanol in a multiple trauma cohort is lacking. Therefore, we performed a retrospective outcome study of initially intoxicated multiple trauma patients in a German level-1 trauma center. 

Patients with an Injury Severity Score greater than or equal to 16 and aged 16–65 years were included in our study. Ventilation time, duration of intensive care unit treatment, the course of cytokines, and the incidence of systemic inflammatory response syndrome (SIRS), sepsis, and multiple organ dysfunction syndrome (MODS) were analyzed. Total in-patient time, mortality, and the requirement for blood products were evaluated. Logistic regression analyses were performed. 

Injury severity was comparable in both groups but there were more severe abdominal injuries in alcohol-intoxicated patients. The clinical course was comparable in both groups.

Alcohol consumption was not an independent risk factor to sustain SIRS (odds ratio [OR], 1.00; 95% confidence interval [CI], 0.59–1.70), sepsis (OR, 0.84; 95% CI, 0.54–1.31), or for mortality (OR, 1.08; 95% CI, 0.53–2.13). There was a trend toward an increased incidence of MODS in alcohol-intoxicated patients (OR, 2.74; 95% CI, 0.90–8.35).

Blood alcohol level at the time of admission is not a valuable marker for worse or improved outcome in multiple trauma patients. 

There were no ethanol-related differences concerning overall injury severity; however, more severe abdominal injuries were found in alcohol-intoxicated patients. 

There was no increased risk for posttraumatic complications in primarily alcohol–intoxicated multiple trauma patients.

Read Full Abstract 

Request Reprint E-Mail: zeckey.christian@mh-hannover.de  

Effects of Alcohol on Histone Deacetylase 2 (HDAC2) and the Neuroprotective Role of Trichostatin A (TSA)

Previous studies have implicated histone deacetylases (HDACs) and HDAC inhibitors (HDIs) such as trichostatin A (TSA) in the regulation of gene expression during drug addiction. Furthermore, an increase in HDAC activity has been linked to neurodegeneration. Alcohol has also been shown to promote abundant generation of reactive oxygen species (ROS) resulting in oxidative stress. TSA inhibits HDACs and has been shown to be neuroprotective in other neurodegenerative disease models. Although HDACs and HDIs have been associated with drug addiction, there is no evidence of the neurodegenerative role of HDAC2 and neuroprotective role of TSA in alcohol addiction. 

Therefore, we hypothesize that alcohol modulates HDAC2 through mechanisms involving oxidative stress.

To test our hypothesis, the human neuronal cell line, SK-N-MC, was treated with different concentrations of ethanol (EtOH); HDAC2 gene and protein expression were assessed at different time points. Pharmacological inhibition of HDAC2 with TSA was evaluated at the gene level using qRT-PCR and at the protein level using Western blot and flow cytometry. ROS production was measured with a fluorescence microplate reader and fluorescence microscopy.

Our results showed a dose-dependent increase in HDAC2 expression with EtOH treatment. Additionally, alcohol significantly induced ROS, and pharmacological inhibition of HDAC2 with TSA was shown to be neuroprotective by significantly inhibiting HDAC2 and ROS.

These results suggest that EtOH can upregulate HDAC2 through mechanisms involving oxidative stress and HDACs may play an important role in alcohol use disorders (AUDs). Moreover, the use of HDIs may be of therapeutic significance for the treatment of neurodegenerative disorders including AUDs.


Read Full Abstract 

Request Reprint E-Mail:   nairm@fiu.edu 

Zinc Supplementation Restores PU.1 and Nrf2 Nuclear Binding in Alveolar Macrophages and Improves Redox Balance and Bacterial Clearance in the Lungs of Alcohol-Fed Rats

Chronic alcohol abuse causes oxidative stress, impairs alveolar macrophage immune function, and increases the risk of pneumonia and acute lung injury. Recently we determined that chronic alcohol ingestion in rats decreases zinc levels and macrophage function in the alveolar space; provocative findings in that zinc is essential for normal immune and antioxidant defenses. Alveolar macrophage immune function depends on stimulation by granulocyte/monocyte colony-stimulating factor, which signals via the transcription factor PU.1. In parallel, the antioxidant response element signals via the transcription factor Nrf2. However, the role of zinc bioavailability on these signaling pathways within the alveolar space is unknown.



To determine the efficacy of dietary zinc supplementation on lung bacterial clearance and oxidative stress, we tested 3 different groups of rats: control-fed, alcohol-fed, and alcohol-fed with zinc supplementation. Rats were then inoculated with intratracheal Klebsiella pneumoniae, and lung bacterial clearance was determined 24 hours later. Isolated alveolar macrophages were isolated from uninfected animals and evaluated for oxidative stress and signaling through PU.1 and Nrf2.

Alcohol-fed rats had a 5-fold decrease in lung bacterial clearance compared to control-fed rats. Dietary zinc supplementation of alcohol-fed rats normalized bacterial clearance and mitigated oxidative stress in the alveolar space, as reflected by the relative balance of the thiol redox pair cysteine and cystine, and increased nuclear binding of both PU.1 and Nrf2 in alveolar macrophages from alcohol-fed rats.


Dietary zinc supplementation prevents alcohol-induced alveolar macrophage immune dysfunction and oxidative stress in a relevant experimental model, suggesting that such a strategy could decrease the risk of pneumonia and lung injury in individuals with alcohol use disorders.



Read Full Abstract

Request Reprint E-Mail:    amehta4@emory.edu

Alcohol Use Disorders and Hazardous Drinking among Undergraduates at English Universities

To report on alcohol use disorders and hazardous drinking from a survey of university students in England in 2008–2009.  

A cross-sectional survey using the Alcohol Use Disorders Identification Test (AUDIT) was carried out in a purposive sample of 770 undergraduates from seven universities across England. 

Sixty-one per cent of the sample (65% men; 58% women) scored positive (8+) on the AUDIT, comprising 40% hazardous drinkers, 11% harmful drinkers and 10% with probable dependence. There were large and significant differences in mean AUDIT scores between the universities taking part in the survey. Two universities in the North of England showed a significantly higher combined mean AUDIT score than two universities in the Midlands which in turn showed a significantly higher mean AUDIT score than three universities in the South. When the effects of university attended were extracted in a binary logistic regression analysis, independent significant predictors of AUDIT positive status were younger age, ‘White’ ethnicity and both on-campus and off-campus term-time student accommodation.  

Undergraduates at some universities in England show very high levels of alcohol-related risk and harm. University authorities should estimate the level of hazardous drinking and alcohol use disorders among students at their institutions and take action to reduce risk and harm accordingly. 

Research is needed using nationally representative samples to estimate the prevalence of alcohol risk and harm in the UK student population and to determine the future course of drinking problems among students currently affected. 

Read Full Abstract 

Request Reprint E-Mail:  nick.heather@northumbria.ac.uk

 

Policies for alcohol restriction and their association with interpersonal violence: a time-series analysis of homicides in Cali, Colombia

Cali, Colombia, has a high incidence of interpersonal violence deaths. Various alcohol control policies have been implemented to reduce alcohol-related problems. 

The objective of this study was to determine whether different alcohol control policies were associated with changes in the incidence rate of homicides. 

Ecologic study conducted during 2004–08 using a time-series design. Policies were implemented with variations in hours of restriction of sales and consumption of alcohol. Most restrictive policies prohibited alcohol between 2 a.m. and 10 a.m. for 446 non-consecutive days. Moderately restrictive policies prohibited alcohol between 3 a.m. and 10 a.m. for 1277 non-consecutive days. Lax policies prohibited alcohol between 4 a.m. and 10 a.m. for 104 non-consecutive days. In conditional autoregressive negative binomial regressions, rates of homicides and unintentional injury deaths (excluding traffic events) were compared between different periods of days when different policies were in effect. 

There was an increased risk of homicides in periods when the moderately restrictive policies were in effect compared with periods when the most restrictive policies were in effect [incidence rate ratio (IRR) 1.15, 90% confidence interval (CI) 1.05–1.26, P = 0.012], and there was an even higher risk of homicides in periods when the lax policies were in effect compared with periods when the most restrictive policies were in effect (IRR 1.42, 90% CI 1.26–1.61, P < 0.001). 

Less restrictive policies were not associated with increased risk of unintentional injury deaths. 

Extended hours of sales and consumption of alcohol were associated with increased risk of homicides. Strong restrictions on alcohol availability could reduce the incidence of interpersonal violence events in communities where homicides are high. 

Read Full Abstract 

Request Reprint E-Mail:    ais6@pitt.edu 

Critique 037: Genes found to relate to level of alcohol consumption among Asians

In a study of 1,721 Korean male drinkers aged 40–69 y in an urban population–based cohort, and another sample of 1,113 male drinkers from an independent rural cohort, information on average daily alcohol consumption was collected and DNA samples were collected for genotyping.  In a genome-wide association (GWA) study, 12 single-nucleotide polymorphisms (SNPs) on chromosome 12q24 had genome-wide significant associations with alcohol consumption.  These polymorphisms were closely related to genes that determine levels of ALDH, low levels of which relate to flushing after even small amounts of alcohol.  Such enzymes are much more common among Asians than among westerners.  Further, associations were tested only with the weekly amount of alcohol consumed, not the pattern of drinking; hence, these findings are not direct measures of alcoholism.
> > > >  Read More

Creativity and Psychopathology: A Shared Vulnerability Model

Creativity is considered a positive personal trait. However, highly creative people have demonstrated elevated risk for certain forms of psychopathology, including mood disorders, schizophrenia spectrum disorders, and alcoholism. 

A model of shared vulnerability explains the relation between creativity and psychopathology. This model, supported by recent findings from neuroscience and molecular genetics, suggests that the biological determinants conferring risk for psychopathology interact with protective cognitive factors to enhance creative ideation. 

Elements of shared vulnerability include cognitive disinhibition (which allows more stimuli into conscious awareness), an attentional style driven by novelty salience, and neural hyperconnectivity that may increase associations among disparate stimuli. 

These vulnerabilities interact with superior meta-cognitive protective factors, such as high IQ, increased working memory capacity, and enhanced cognitive flexibility, to enlarge the range and depth of stimuli available in conscious awareness to be manipulated and combined to form novel and original ideas.


Read Full Article     (PDF)

Heart rate stress response dampening: The impact of alcohol, family history, and gender on at risk children and siblings

In the following study we tested the stress response dampening (SRD) model which postulates that stress responses are more likely to be attenuated by alcohol in individuals at risk for alcohol dependence than in persons without that risk. In a laboratory experiment we examined a) if SRD effects exist for both sons and healthy daughters of alcohol dependent fathers, and b) if SRD effects exist for siblings of alcohol dependent males.

We recruited 104 subjects at risk and 51 matched control subjects. In a laboratory experiment, study subjects received alcohol in one of two laboratory sessions and a stress paradigm served to elicit heart rate stress responses.

Heart rate stress responses were attenuated by alcohol in female family history positive (FHP) and female family history negative (FHN) subjects, however not in males. A multiple regression analysis revealed “Heart Rate Stress Response in the Non-Alcohol Condition” and “Blood Alcohol Level” as significant predictors of SRD.

According to our findings, females carry a distinct risk for developing alcohol dependence, regardless of their family history and regardless of their degree of familial relationship. This is an important issue for devising models concerning the development and maintenance of alcohol dependence in females. The study extends the current research literature, which mainly focuses on male subjects at risk, by including female subjects at risk, as well as siblings at risk of both genders.


Read Full Abstract 

Request Reprint E-Mail:   b.croissant@klksig.de  

Alcohol use and spirituality among nursing students

The purpose of this cross-sectional study was to investigate alcohol use and the levels of spirituality among nursing students. 

The tests used were the Alcohol Use Disorders Identification Test and the Spirituality Scale. 

Participants were 191 (80.2%) nursing undergraduates from a city in the state of Minas Gerais, 75.4% of which were female, average age 25 years, and 149 (78%) were Catholic. 

As for alcohol use per gender, 117 (75%) women used alcoholic beverages and 33 (56.9%) had a drinking problem (p?0.05), against 25 men (431%). 

Low scores for spirituality levels were found in the sample: in average, women had lower scores compared to men (12.7 against 13.5). 

Comparing the level of spirituality with having a drinking problem, it was observed that students with low risk alcohol use had lower levels of spirituality. 

In conclusion, spirituality may not function as a protecting factor for alcohol use, hence this behavior may be under the control of other variables.

Read Full Article   (PDF)

Undocumented alcoholism and its correlation with tobacco and illegal drug use in advanced cancer patients

The objectives of this retrospective study were to determine the frequency of undiagnosed alcoholism among patients with advanced cancer who were referred to palliative care and to explore its correlation with alcoholism, tobacco abuse, and use of illegal drugs.

 

The authors reviewed 665 consecutive charts and identified 598 patients (90%) who completed a screening survey that was designed to identify alcoholism, the Cut Down, Annoyed, Guilty, Eye Opener (CAGE) questionnaire, including 100 consecutive patients who had CAGE-positive and CAGE-negative results. Data on tobacco and illegal drug use, the Edmonton Symptom Assessment Scale, and the morphine equivalent daily dose were collected.

 

The frequency of CAGE-positive results in this palliative care population was 100 of 598 patients (17%). Only 13 of 100 patients (13%) in that CAGE-positive group had been identified as alcoholics before their palliative care consultation. Compared with CAGE-negative patients, CAGE-positive patients were younger (aged 58.6 years vs 61.3 years; P = .07), predominantly men (68 of 100 patients vs 51 of 100 patients; P = .021), more likely to have a history of tobacco use (86 of 100 patients vs 48 of 100 patients; P < .001), more likely to be actively using nicotine (33 of 100 patients vs 9 of 100 patients; P = .02), and more likely to have a history of illegal recreational drug use (17 of 100 patients vs 1 of 100 patients; P < .001). Pain and dyspnea were worse in patients who had a history of nicotine use. Both CAGE-positive patients and patients who had a history of tobacco use more frequently were receiving strong opioids at the time of their palliative care consultation.

 

The current findings suggested that alcoholism is highly prevalent and frequently under diagnosed in patients with advanced cancer. CAGE-positive patients were more likely to have a history of, or to actively engage in, smoking and illegal recreational drug use, placing them at risk for inappropriate opioid escalation and abuse.


Read Full Abstract 

Request Reprint E-Mail:  rdev@mdanderson.org  

Commentary: Sinners, preachers and natural experiments

Two papers in this issue demonstrate the utility of observational methods for evaluating the health effects of policies. ^{1 , 2} These are helpful as they show the value of such approaches and also identify some of the methodological and other challenges. They are also timely because debates about the need for more evaluations of public health policies and other types of intervention research have moved on significantly in the past 10 years. Macintyre recently noted that commentaries from the 1990's had pointed to the lack of robust evidence to support social and public health policies in the UK. ³ These highlighted the need for more robust and relevant evidence, and noted the lack of evaluations, particularly around health inequalities. This debate about gaps in the evidence base seems to have developed rapidly in recent years into discussions about the methodological implications of such gaps, and the challenges in producing new, reliable evidence. One important piece of methodological guidance to public health researchers in the UK emerged in 2000: this was the first edition of the Medical Research Council's (MRC) Guidance on complex interventions, which focused on the development and evaluation of complex public health interventions, and randomized controlled trials in particular. ⁴ The … 

Request Reprint E-Mail:   

Mark.Petticrew@lshtm.ac.uk

 

An evaluation of the impact of a large reduction in alcohol prices on alcohol-related and all-cause mortality: time series analysis of a population-based natural experiment

We examined the effect of a large reduction in the price of alcohol that occurred in Finland in 2004 on alcohol-related and all-cause mortality, and mortality due to cardiovascular diseases (CVDs) from which alcohol-attributable cases were excluded. 

Time series intervention analysis modelling was applied to the monthly aggregations of deaths in Finland for the period 1996–2006 to assess the impact of the reduction in alcohol prices. Alcohol-related mortality was defined using information on both underlying and contributory causes of death. Analyses were carried out for men and women aged 15–39, 40–49, 50–69 and >69 years. 

Alcohol-related deaths increased in men aged 40–49 years, and in men and women aged 50–69 years, after the price reduction when trends and seasonal variation were taken into account: the mean rate of alcohol-related mortality increased by 17% [95% confidence interval (CI) 1.5, 33.7], 14% (95% CI 1.1, 28.0) and 40% (95% CI) 7.1, 81.7), respectively, which implies 2.5, 2.9 and 1.6 additional monthly deaths per 100 000 person-years following the price reduction. In contrast to alcohol-related mortality, CVD and all-cause mortality decreased: among men and women aged >69 years a decrease of 7 and 10%, respectively, in CVD mortality implied 19 and 25 fewer monthly deaths per 100 000 person-years, and a decrease of 7 and 14%, respectively, in all-cause mortality similarly implied 42 and 69 fewer monthly deaths. 

These results obtained from the time series analyses suggest that the reduction in alcohol prices led to an increase in alcohol-related mortality, except in persons <40 years of age. However, it appears that beneficial effects in older age, when CVD deaths are prevalent, counter-balance these adverse effects, at least to some extent. 

Read Full Abstract

Request Reprint E-Mail:    kimmo.herttua@helsinki.fi

 

Changes in alcohol-related harm in Sweden after increasing alcohol import quotas and a Danish tax decrease—an interrupted time-series analysis for 2000–2007

Denmark decreased its tax on spirits by 45% on 1 October 2003. Shortly thereafter, on 1 January 2004, Sweden increased its import quotas of privately imported alcohol, allowing travellers to bring in much larger amounts of alcohol from other European Union countries. Although these changes were assumed to increase alcohol-related harm in Sweden, particularly among people living close to Denmark, analyses based on survey data collected before and after these changes have not supported this assumption. 

The present article tests whether alcohol-related harm in southern Sweden was affected by these changes by analysing other indicators of alcohol-related harm, e.g. harm recorded in different kinds of registers. 

Interrupted time-series analysis was performed with monthly data on cases of hospitalization due to acute alcohol poisoning, number of reported violent assaults and drunk driving for the years 2000–07 in southern Sweden using the northern parts of Sweden as a control and additionally controlling for two earlier major changes in quotas. 

The findings were not consistent with respect to whether alcohol-related harm increased in southern Sweden after the decrease in Danish spirits tax and the increase in Swedish alcohol import quotas. On the one hand, an increase in acute alcohol poisonings was found, particularly in the 50–69 years age group, on the other hand, no increase was found in violent assaults and drunk driving.

The present results raise important questions about the association between changes in availability and alcohol-related harms. More research using other methodological approaches and data is needed to obtain a comprehensive picture of what actually happened in southern Sweden. 

Read Full Article     (PDF)

Hazardous alcohol use among active duty Air Force personnel: Identifying unique risk and promotive factors

Hazardous drinking is a significant public health concern and an important target for prevention efforts within both military and civilian populations. 

For such efforts to be maximally effective, comprehensive information regarding factors that increase or decrease risk for hazardous drinking is necessary. 

This is the first study to investigate risk and promotive factors across individual, family, community, and organizational levels in a representative sample of Air Force personnel (N = 52,780). 

Unique predictors of men's and women's hazardous drinking were identified both within and across ecological levels. Predictors that accounted for the most variance in predicting hazardous versus non-hazardous drinkers included family income, number of children, depressive symptoms, religious involvement, and perceived financial stress for men and women; and years in the military for men. 

Among hazardous drinkers, a different set of predictors best explained variance in severity of drinking problems. 

Results of the current study help identify key targets for prevention efforts operating at different levels (e.g., individual therapy, community-wide programs). 

Read Full Abstract

Request Reprint E-Mail:   heather.foran@sunysb.edu 

Age of onset of first alcohol intoxication and subsequent alcohol use among urban American Indian adolescents

The objective was to assess the effect of early onset intoxication on subsequent alcohol involvement among urban American Indian youth. 

The data come from the American Indian Research (AIR) project, a panel study of urban Indian youth residing in King County, Washington. Data were collected annually from the adolescent and his/her primary caregiver from the 1988–89 school year to the 1996–97 school year, providing a total of nine waves of data. 

Early intoxication (by age 14) was related to delinquency, family history of alcohol abuse or dependence, poverty, broken family structure, less family cohesiveness, and more family conflict.

The effects of these characteristics were, therefore, partialed out in testing effects of early intoxication on later alcohol involvement. Two-part latent growth models of alcohol use and alcohol problems were specified. Effects of early onset intoxication on these trajectories, as well as lifetime alcohol abuse or dependence by the transition to young adulthood, were examined. 

Findings indicate that adolescents who experienced their first intoxication early (by age 14), used alcohol more heavily from the ages of 16 to 18, experienced more problems related to the alcohol's use from the ages of 16 to 18, and were more likely to have a diagnosed alcohol disorder by the final wave of data collection. 

Congruent with similar studies in the general population, early intoxication appears to be associated with a deleterious course of alcohol involvement during adolescence and into the transition to young adulthood among urban American Indian youth. Implications for prevention are discussed.

Read Full Abstract 

Request Reprint E-Mail:   

kim.henry@colostate.edu

 

The effect of drink price and next-day responsibilities on college student drinking: A behavioral economic analysis.

More than [3/4] of U.S. college students report a heavy drinking episode (HDE; 5 (for men) and 4 (for women) drinks during an occasion) in the previous 90 days. 

This pattern of drinking is associated with various risks and social problems for both the heavy drinkers and the larger college community. 

According to behavioral economics, college student drinking is a contextually bound phenomenon that is impacted by contingencies such as price and competing alternative reinforcers, including next-day responsibilities such as college classes. 

This study systematically examines the role of these variables by using hypothetical alcohol purchase tasks to analyze alcohol consumption and expenditures among college students who reported recent heavy drinking (N = 207, 53.1% women). 

The impact of gender and the personality risk factor sensation seeking (SS) were also assessed. 

Students were asked how many drinks they would purchase and consume across 17 drink prices and 3 next-day responsibility scenarios.

Mean levels of hypothetical consumption were highly sensitive to both drink price and next-day responsibility, with the lowest drinking levels associated with high drink prices and a next-day test. 

Men and participants with greater levels of SS reported more demand overall (greater consumption and expenditures) than women and students with low SS personality. 

Contrary to our hypotheses women appeared to be less sensitive to increases in price than men. 

The results suggest that increasing drink prices and morning academic requirements may be useful in preventing heavy drinking among college students. 

Read Full Abstract 

Request Reprint E-Mail:   jskidmor@memphis.edu 

Changes in neuropsychological functioning over 10 years following adolescent substance abuse treatment.

Previously, Anderson, Ramo, Cummins, and Brown (2010) described six distinct patterns of alcohol and other drug (AOD) use during the decade following adolescents' treatment for alcohol and other substance use disorders (A/SUD). 

This time period represents a phase of significant neurodevelopment, and the influence of substance use on the brain is a concern. 

In the present study, we examined patterns of neuropsychological function over these 10 years in relation to the AOD trajectories identified for youth as they transition into their twenties. 

Participants were part of a longitudinal research project following adolescents with and without A/SUD who received neuropsychological examinations at baseline and up to 7 times thereafter spanning 10 years (N = 213; 46% female at baseline). 

Neuropsychological trajectories were significantly related to substance involvement patterns over time on measures of verbal learning and memory (ps = .011 to <.0001), visuospatial memory (p = .0002), and verbal attention/working memory (p = .020), with heavier use patterns generally followed by poorer cognition. 

Heavy use of alcohol alone was independently associated with poorer verbal memory over time. 

Furthermore, substance withdrawal symptoms during each follow-up time point were related to poorer verbal learning and memory scores (ps < .05), whereas substance abuse/dependence diagnostic criteria were not related to neuropsychological performance levels. 

These findings suggest that AOD use during adolescence and young adulthood may primarily influence performance that relies on later maturing brain structures, although further research is needed. 

Higher levels of AOD withdrawal symptoms may signify greater neuropsychological impairment, reflecting potential neurotoxic effects of AOD use.

Read Full Abstract 

Request Reprint E-Mail:   klhanson@ucsd.edu

Measuring university students' self-efficacy to use drinking self-control strategies

Using a Web-based, self-administered questionnaire, we assessed 498 university-student drinkers' self-efficacy to use 31 different behavioral strategies to reduce excessive drinking in each of three different locations (bar, party, own dorm/apartment). 

Averaging all 31 items within each drinking situation to create a single scale score revealed high internal consistency reliabilities and moderate inter-item correlations. 

Testing the association of self-efficacy with drinking location, sex, and frequency of recent binge drinking, we found that respondents reported higher self-efficacy to use these strategies when drinking in their own dorm/apartment than when drinking in bars and at parties; women reported higher mean self-efficacy than men; and drinkers who engaged in 3-or-more binges in the previous 2 weeks reported lower self-efficacy than those who reported either 0 or 1-or-2 binges in the same time period. 

This questionnaire could be used to identify self-efficacy deficits among clients with drinking problems and as an outcome measure to assess the degree to which interventions influence reported confidence to use specific drinking-reduction strategies in high-risk drinking situations. 

Read Full Abstract 

Request Reprint E-Mail:  

erin.bonar@gmail.com

  

How many versus how much: 52 weeks of alcohol consumption in emerging adults.

In previous research using timeline follow-back methods to closely monitor drinking and related variables over the first year of college (9 months), we showed that drinking varied considerably over time in accord with academic requirements and holidays. 

In a new community sample (N = 576) of emerging adults (18- and 19-year-olds who reported having begun drinking prior to recruitment), we used similar methods to compare drinking patterns in college and noncollege individuals over a full calendar year (including summer). 

To reduce the extreme distortion in computations of average drinking over restricted time spans (i.e., 1 week) that arise because large numbers of even regular drinkers may not consume any alcohol, we analyzed data using recently developed two-part latent growth curve modeling. This modeling distinguished consumption levels from numbers of individuals drinking in a given period. 

Results showed that drinking levels and patterns generally did not differ between college and noncollege drinkers, and that both groups responded similarly to even those contexts that may have seemed unique to one (i.e., spring break). 

We also showed that computation of drinking amounts without accounting for “zero drinkers” could seriously distort estimates of mean drinking on some occasions; for example, mean consumption in the total sample appeared to increase on Thanksgiving, whereas actual average consumption for those who were drinking diminished.

Read Full Abstract 

Request Reprint E- Mail: 

mgoldman@usf.edu