Showing papers in "Psychology of Addictive Behaviors in 2022"

Changes in alcohol use during COVID-19 and associations with contextual and individual difference variables: A systematic review and meta-analysis.

Abstract: The present study meta-analyzed studies examining changes in alcohol consumption during the coronavirus disease (COVID-19) pandemic and systematically reviewed contextual and individual difference factors related to these changes.Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) protocol, studies were gathered via PsycINFO, PubMed/MEDLINE, and preprint databases (published April 29, 2021) that examined individual-level changes in consumption during the initial COVID-19 mitigation measures (before October 2020). Next, sample proportion increases and decreases in consumption, in addition to mean change in consumption variables from pre- to during-COVID, were meta-analyzed, and contextual and individual difference variables related to consumption changes during the pandemic were summarized.One hundred and twenty-eight studies provided data from 58 countries (M n = 3,876; Mdn n = 1,092; aggregate sample n = 492,235). The average mean change in alcohol consumption was nonsignificant (Cohen's d = -0.01, p = .68); however, meta-analysis revealed that 23% of participants reported increases in consumption and 23% reported decreases. These changes were moderated by per capita gross domestic product and country. Narrative synthesis revealed multiple predictors of increased drinking, including contextual changes (e.g., children at home, income loss, working remotely), individual difference variables (being female, a young-to-middle aged adult, or Black), and mental health/alcohol-related risk factors (e.g., depression).The identified factors associated with increased alcohol consumption should be considered in planning behavioral health services during future crisis events that abruptly alter everyday environments in ways that increase stress and decrease access to naturally occurring rewards. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Does comorbid anxiety or depression moderate effects of approach bias modification in the treatment of alcohol use disorders?

Abstract: Objective: Approach bias modification (ApBM) is a promising new add-on training intervention for patients with alcohol use disorder (AUD). Given that comorbid anxiety and major depressive disorders are very common in AUD, and that such comorbidity affects psychological treatments negatively, the primary aim of the present study was investigating whether ApBM training is moderated by anxiety/major depressive disorder comorbidity. The secondary aim was to examine whether ApBM's relapse-preventive effect can be replicated. Method: We conducted a large-scale randomized controlled trial (RCT) in a clinical sample of AUD inpatients (n = 729) with a follow-up assessment after 1 year. All patients received 12 weeks of inpatient treatment as usual (TAU). On top of that, patients were randomized to a 12-session ApBM (TAU + ApBM), and a no-training control condition (TAU-only). Treatment success was defined as either no relapse or a single lapse shorter than 3 days in duration, ended by the patient and followed by at least 4 weeks of abstinence. Failure was defined as relapse, passed away, no contact, or refusal to provide information. Results: We found that TAU + ApBM had significantly higher success rates than TAU-only at 1-year follow-up. Importantly, anxiety/depressive comorbidity moderated ApBM's effects: Adding ApBM to TAU increased success rates more for patients with a comorbid anxiety and/or depressive disorder than for patients without such comorbidity. Conclusions: Our data suggest that adding ApBM to TAU works better in patients with a comorbid anxiety and/or depressive disorder; a promising finding gave the high rates of comorbidity in clinical practice. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Changes in emerging adults' alcohol and cannabis use from before to during the COVID-19 pandemic: Evidence from a prospective birth cohort.

Abstract: OBJECTIVE Prospective research is needed to better-understand changes in substance use from before to during the coronavirus disease (COVID-19) pandemic, among emerging adults (18-25 years), a high-risk group for substance use. METHOD N = 1,096 (weighted sample N = 1,080; 54% female) participants enrolled in the Québec Longitudinal Study of Child Development, who completed prepandemic (2019; 21 years) and COVID-19 (mid-March to mid-June 2020) surveys. COVID-19-related and preexisting factors were examined as moderators of change in substance use. RESULTS Full sample analyses revealed decreased binge drinking (p < .001, Bayes factor [BF] = 22, Cohen's f² = 0.02), but no changes in alcohol and cannabis use. Stratified analyses revealed emerging adults who reported < monthly use prepandemic increased their alcohol use (p < .001, BF > 150, f² = 0.05) and binge drinking (p < .001, BF = 27, f² = 0.01), but not their cannabis use. Conversely, emerging adults who reported >monthly use prepandemic decreased their binge drinking (p < .001, BF > 150, f² = .12) and cannabis use (p < .001, BF > 150, f² = .06), but did not change their alcohol use frequency. Several factors moderated change in substance use, including employment loss (p = .005, BF > 39, f² = .03) and loneliness (p = .018, BF > 150, f² = .10) during COVID-19. CONCLUSIONS Changes in alcohol and cannabis use frequency among emerging adults in the first 3 months of COVID-19 largely differed according to prepandemic substance use, COVID-19-related factors, and preexisting factors. While some youth with preexisting vulnerabilities (e.g., more frequent substance use prepandemic) remained stable or decreased their substance use during COVID-19, emerging adults who experienced employment loss, loneliness, and financial concerns during COVID-19 increased their substance use, highlighting the need for increased supports for vulnerable populations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The role of impaired control in screening problematic pornography use: Evidence from cross-sectional and longitudinal studies in a large help-seeking male sample.

Abstract: In help- or treatment-seeking people, there may be a portion of individuals with self-perceived addiction; however, how to distinguish these individuals from help-seeking patients with dysregulated pornography use remains unclear. The present study sought to examine the specific role of impaired control in identifying individuals with self-perceived problems when screening problematic pornography use (PPU) in a large help-seeking male sample (N = 8,845; Mage = 25.82 years, SD = 7.83). Based on the results of latent profile analysis, three groups were identified in the help-seeking sample: Self-perceived PPU group (n = 2,089; 23.6%), impaired control group (n = 4,180; 47.3%), and PPU group (n = 2,576; 29.1%). The self-perceived PPU group was characterized by the highest moral incongruence, but not objectively dysregulated in pornography use. The other two groups met the criteria of impaired control, suggesting that, impaired control may distinguish between self-perceived PPU and dysregulated use in help-seeking men. Six months later, self-reported data were collected again from 972 of these help-seeking men. The longitudinal cross-lagged analysis showed that impaired control at baseline positively predicted PPU at the 6-month follow-up; simultaneously, the reverse association was also significant and positive. In sum, impaired control functioned as a criterion to differentiate between self-perceived PPU and dysregulated pornography use. Impaired control might be used as a robust and reliable predictor of PPU, but it may not be a sufficient criterion of PPU in itself. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Limitations of cross-lagged panel models in addiction research and alternative models: An empirical example using project MATCH.

Abstract: Models of addiction often posit bidirectional and dynamic associations between constructs relevant to the etiology and maintenance of addictive behaviors. The cross-lagged panel model (CLPM) is commonly used in addiction research but has been critiqued for not appropriately adjusting for between-person variance. Alternatives to the CLPM have been suggested but remain underutilized. The primary purpose of this article is to highlight interpretational limitations of the CLPM and to provide examples of alternative models.We specified CLPM, Random-Intercept CLPM, and a Latent Curve Model with Structured Residuals using four waves of data from Project MATCH (n = 1,201). We modeled prospective relations among depression symptoms and temptation to drink. Substantive inferences and assumptions across models were compared.The CLPM provided the most evidence of significant cross-lagged paths but the poorest fit to the data compared to other models. Alternative models found little evidence of prospective within-person associations, and more evidence for between-person associations and wave-specific within-person relations between depression symptoms and temptation to drink.This study highlights shortcomings of the CLPM and details alternative models to consider. Addiction researchers should consider alternatives to the CLPM to more optimally delineate relations among constructs across time. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Pooled and person-specific machine learning models for predicting future alcohol consumption, craving, and wanting to drink: A demonstration of parallel utility.

Abstract: The specific factors driving alcohol consumption, craving, and wanting to drink, are likely different for different people. The present study sought to apply statistical classification methods to idiographic time series data in order to identify person-specific predictors of future drinking-relevant behavior, affect, and cognitions in a college student sample.Participants were sent 8 mobile phone surveys per day for 15 days. Each survey assessed the number of drinks consumed since the previous survey, as well as positive affect, negative affect, alcohol craving, drinking expectancies, perceived alcohol consumption norms, impulsivity, and social and situational context. Each individual's data were split into training and testing sets, so that trained models could be validated using person-specific out-of-sample data. Elastic net regularization was used to select a subset of a set of 40 variables to be used to predict either alcohol consumption, craving, or wanting to drink, forward in time.A west-coast university.Thirty-three university students who had consumed alcohol in their lifetime.Mobile phone surveys.Averaging across participants, accurate out-of-sample predictions of future drinking were made 76% of the time. For craving, the mean out-of-sample R² value was .27. For wanting to drink, the mean out-of-sample R² value was .27.Using a person-specific constellation of psychosocial and temporal variables, it may be possible to accurately predict drinking behavior, affect, and cognitions before they occur. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Associations of mode of administration on cannabis consumption and subjective intoxication in daily life.

Abstract: As cannabis products are becoming increasingly available and young adults are increasingly using vaporizers to consume cannabis, there is a need to understand how this population is using different modes of administration and the extent to which specific modes are associated with differential cannabis use outcomes. Toward this end, the current study characterized predictors of cannabis mode of administration and examined how consumption levels and subjective intoxication vary as a function of mode of administration in daily life.Participants were 106 young adult cannabis and heavy alcohol users (51% female) who completed up to 14 daily diaries (n = 1,405 person days). Each day, participants reported whether they used any cannabis and, if any, which mode(s) were used, number of hits used per mode, overall subjective intoxication, and the socio-environmental context in which they used cannabis.Across all cannabis use days, Bong-Only and Vape-Only days were the most common, followed by Multimode, Joint-, Pipe-, and Blunt-Only days. Participants reporting a greater proportion of cannabis use days were more likely to report Bong-Only and Multimode days than Vape-Only days. Compared to Vape-Only days, participants reported fewer hits on Bong-Only days and more hits on Blunt-Only, Pipe-Only, and Multimode days. Participants felt more intoxicated on Bong-Only days than Vape-Only days.Mode-specific associations with cannabis consumption and subjective intoxication levels suggest assessing modes of administration may be a meaningful way to guide individual and public health intervention efforts. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Accuracy of self-reported gambling frequency and outcomes: Comparisons with account data.

Abstract: Objectives: The ability to accurately recall past gambling behavior and outcomes is essential for making informed decisions about future gambling. We aimed to determine whether online gambling customers can accurately recall their recent gambling outcomes and betting frequency. Method: An online survey was distributed to 40,000 customers of an Australian sports and race wagering website which asked participants to recall their past 30-day net outcome (i.e., total amount won or lost) and number of bets. We compared responses to these questions with participants' actual outcomes as provided by the online site. Results: Among the 514 participants who reported their net outcome, only 21 (4.09%) were accurate within a 10% margin of their actual outcome. Participants were most likely to underestimate their losses (N = 333, 64.79%). Lower actual net losses were associated with greater underestimation and overestimation of losses. Of the 652 participants who reported their gambling frequency, 48 (7.36%) were accurate within a 10% margin of their actual frequency. Most participants underestimated their number of bets (N = 454, 69.63%). Higher actual betting frequencies were associated with underestimating betting and lower actual frequencies with overestimating betting. Conclusions: The poor recall accuracy we observed suggests public health approaches to gambling harm minimization that assume people make informed decisions about their future bets based on past outcomes and available funds should be reconsidered. Findings also question the reliability of research outcomes predicated on self-reported gambling behavior. Research is needed to determine the best methods of increasing people's awareness of their actual expenditure and outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Alcohol use and cannabis use trajectories and sexual/gender minority disparities in young adulthood.

Abstract: OBJECTIVE Sexual and gender minority (SGM) young people may use alcohol or cannabis (A/C) at higher rates that non-SGM peers, but little is known about whether SGM young adults experience poorer health, psychosocial, and other outcomes at similar levels of A/C use. METHOD We used longitudinal survey data from a community cohort recruited from California middle schools in 2008 (average age 11.5) and followed across 12 waves through 2020. Participants reported on past-month A/C use at each wave. Individuals also reported SGM status as well as outcomes in multiple domains in Wave 12. Sequelae of change models tested differences in intercept and slope for A/C use trajectories from Waves 1-12 across SGM groups, and simultaneously examined differences in outcomes by SGM status adjusting separately for A/C trajectories. RESULTS SGM (n = 445) and non-SGM (n = 2,089) groups did not differ on baseline probability of A/C use. SGM individuals showed steeper increases in probability of cannabis but not alcohol use over time. Adjusting for trajectories of A/C use, SGM individuals had significant disparities relative to non-SGM peers with respect to: Employment and economic stability, criminal justice involvement, social functioning, subjective physical health, behavioral health, and perceived unmet mental health treatment need. CONCLUSIONS At the same levels of A/C use from middle school through young adulthood, SGM individuals show disparities in multiple domains compared to non-SGM peers. Targeted efforts to reduce substance use in conjunction with other structural disadvantages experienced by SGM youths are needed to address the emergence of disparities in young adulthood. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Addictive behavior as molar behavioral allocation: Distinguishing efficient and final causes in translational research and practice.

Abstract: OBJECTIVE Translational research on addictive behaviors viewed as molar behavioral allocation is critically reviewed. This work relates rates of behavior to rates of reinforcement over time and has been fruitfully applied to addictive behaviors, which involve excessive allocation to short-term rewards with longer term costs. METHOD Narrative critical review. RESULTS This approach distinguishes between final and efficient causes of discrete behaviors. The former refers to temporally extended behavior patterns into which the act fits. The latter refers to environmental stimuli or internal psychological mechanisms immediately preceding the act. Final causes are most clear when addictive behaviors are studied over time as a function of changing environmental circumstances. Discrete acts of addictive behavior are part of an extended/molar behavior pattern when immediate constraints on engagement are low and few rewarding alternatives are available. Research framed by efficient causes often use behavioral economic simulation tasks as individual difference variables that precede discrete acts. Such measures show higher demand for addictive commodities and steeper discounting in various risk groups, but whether they predict molar addictive behavior patterning is understudied. CONCLUSIONS Although efficient cause analysis has dominated translational research, research supports viewing addictive behavior as molar behavioral allocation. Increasing concern with rate variables underpinning final cause analysis and considering how study methods and temporal units of analysis inform an efficient or final cause analysis may advance understanding of addictive behaviors that occur over time in dynamic environmental contexts. This approach provides linkages between behavioral science and disciplines that study social determinants of health. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Making sense of some odd ratios: A tutorial and improvements to present practices in reporting and visualizing quantities of interest for binary and count outcome models.

Abstract: Generalized linear models (GLMs) such as logistic and Poisson regression are among the most common statistical methods for modeling binary and count outcomes. Though single-coefficient tests (odds ratios, incidence rate ratios) are the most common way to test predictor-outcome relations in these models, they provide limited information on the magnitude and nature of relations with outcomes. We assert that this is largely because they do not describe direct relations with quantities of interest (QoIs) such as probabilities and counts. Shifting focus to QoIs makes several critical nuances of GLMs more apparent.To bolster interpretability of these models, we provide a tutorial on logistic and Poisson regression and suggestions for enhancements to current reporting practices for predictor-outcome relations in GLMs.We first highlight differences in interpretation between traditional linear models and GLMs, and describe common misconceptions about GLMs. In particular, we highlight that link functions (a) introduce nonconstant relations between predictors and outcomes and (b) make predictor-QoI relations dependent on levels of other covariates. Each of these properties causes interpretation of GLM coefficients to diverge from interpretations of linear models. Next, we argue for a more central focus on QoIs (probabilities and counts). Finally, we propose and provide graphics and tables, with sample R code, for enhancing presentation and interpretation of QoIs.By improving present practices in the reporting of predictor-outcome relations in GLMs, we hope to maximize the amount of actionable information generated by statistical analyses and provide a tool for building a cumulative science of substance use disorders. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The role of alcohol demand on daily microaggressions and alcohol use among emerging adult bisexual+ women.

Abstract: Objective: Bisexual women drink more and have more alcohol consequences than heterosexual and lesbian women. This higher risk may in part be attributable to sexual orientation microaggressions. Drinking to cope motivations and alcohol demand may influence the association between microaggressions and alcohol use. The present study used a daily diary design to examine the association between microaggressions and same-day alcohol use (yes/no, quantity) and consequences, and if drinking to cope and alcohol demand moderate this association among bisexual+ (i.e., bi+) women. Method: Participants were 103 emerging adult bi+ women who completed a baseline assessment, including an alcohol purchase task to measure alcohol demand. Subsequently, participants reported their experiences of microaggressions, alcohol use, and alcohol consequences for 28 days. Multilevel model analyses were conducted. Results: Microaggressions were associated with a higher likelihood to drink and greater same-day alcohol use and consequences. The association between microaggressions and alcohol quantity was stronger for those who had a lower price associated with the highest expenditure (lower P max). For those who would stop drinking at lower price values (lower breakpoint), reported spending less overall on alcohol (lower O max), and had lower P max values, microaggressions were associated with more consequences. For those with higher breakpoint, O max, and P max microaggressions were not associated with consequences. Conclusions: Microaggressions may have a deleterious impact on alcohol use and consequences for bi+ women, particularly for those with lower alcohol demand. Clinicians should encourage bi+ clients to consider how microaggressions influence their drinking and support clients to engage in positive coping skills. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Prevalence of medical and nonmedical cannabis use among veterans in primary care.

Abstract: This study examined past-year cannabis use prevalence and sociodemographic and clinical correlates of cannabis use among Veterans Health Administration (VHA) primary care patients in a state with legalized medical cannabis.Participants were 1,072 predominantly white, male, VHA primary care patients enrolled in a drug screening validation study (2012-2014). Sociodemographic and clinical correlates were examined by past-year cannabis use status. Multivariate regression models, adjusted for demographics, estimated cannabis use prevalence and clinical correlates among recreational, medical, and both medical and recreational users.Nearly one in five (18.7%) veterans endorsed past-year cannabis use, with 14.1% of the total sample reporting any recreational use and 7.0% reporting any medical use. Correlates of any past-year use included younger age, period of service, being unmarried, lower education, lower income, other substance use, meeting criteria for an alcohol or drug use disorder or posttraumatic stress disorder, higher pain rating, and lower self-reported well-being. Compared to veterans endorsing only recreational use, veterans endorsing only medical use reported more cannabis use days but had lower odds of other drug use, alcohol or drug-related problems, or alcohol or drug use disorders. Differences between recreational only users and those using medical and recreational cannabis were minimal.Veterans enrolled in VHA in states with legalized cannabis may be particularly likely to use cannabis. Veterans identifying as recreational users may be at increased risk for adverse clinical outcomes compared to medical-only users. Prevalence monitoring, assessment, and intervention services should be considered, particularly in states with legalized cannabis. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Thirty years of BASICS: Dissemination and implementation progress and challenges.

Abstract: The first clinical trial of the Brief Alcohol Screening and Intervention for College Students (BASICS) was launched at the University of Washington in 1990. Since that time, multiple trials have demonstrated the efficacy of BASICS and related approaches in a variety of young adult populations and this information has been widely disseminated. However, in practice BASICS implementation varies considerably, including formats and mediums (e.g., group, telehealth, written/electronic feedback alone) not studied in the original research. Even if delivered in an individual in-person format, implementation can stray substantially from the original design. Adaptations may be necessary to address campus resource constraints or other barriers to implementation but can have unknown impacts on intervention effectiveness. Thus, despite wide-scale efforts to disseminate and implement BASICS, challenges remain, and there are several critical research gaps that need to be addressed to support campuses in implementing BASICS successfully. The current manuscript reviews several ways in which BASICS has been adapted to address these challenges, and provides recommendations for best implementation practices as well as future research needed to improve implementation and effectiveness of BASICS going forward. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Unplanned versus planned simultaneous alcohol and cannabis use in the daily lives of a predominantly white college student sample: What are the motives, contexts, and outcomes?

Abstract: Simultaneous alcohol and cannabis use is common among college students and associated with more consumption and consequences compared to single-substance use. This study examined occasions of simultaneous use and compared planned occasions to unplanned occasions with respect to motives, contexts, consumption, and consequences.College student simultaneous users (N = 341; 53% women; 74% White) completed five daily surveys for 54 days. Mixed-effects models examined motives and contexts of simultaneous use occasions as a function of whether alcohol and cannabis use were (a) both planned versus (b) unplanned, no use planned, or (c) unplanned, single-substance use planned and whether alcohol and cannabis consumption and negative simultaneous use-related consequences varied across planned versus unplanned occasions.Social and enhancement motives were related to planned simultaneous use; offered and coping motives were associated with planned single-substance use that became simultaneous use (vs. planned simultaneous use). Compared to unplanned use, planned simultaneous use was negatively associated with using at home or alone, and positively associated with using with others, more intoxicated people, and more people using cannabis. Planned simultaneous use was associated with more alcohol and cannabis consumption. No significant differences were found for negative consequences.Planned simultaneous use was motivated by social and enhancement reasons, whereas planned single-substance use that became simultaneous use was more likely motivated by offers or for coping. Planned simultaneous use resulted in greater consumption, but not negative consequences. Results provide specific motives and contexts associated with unplanned and planned simultaneous use to be incorporated into real-time interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Marijuana use and intentions among American Indian adolescents: Perceived risks, benefits, and peer use.

Abstract: The present study examines how perceptions of peer use, risks of use, and benefits to oneself and others from marijuana use are associated with past-month marijuana use and intentions to use marijuana socially among American Indian (AI) youth.The American Drug and Alcohol Survey (ADAS), a measure of substance use and related factors, was administered to AI youth living on or near reservations across six geographic regions (n = 3,498, 49.5% female, M age = 14.8).Greater perceived peer use was significantly associated with more frequent past-month marijuana use (b = .05, p = .038) and intentions to use marijuana socially (b = .74, p < .001). Greater benefits to oneself were associated with greater marijuana use intentions (b = .35, p < .001). Greater perceived risks and benefits to others were significantly associated with less frequent past-month use (b = -.02, p = .002; b = -.01, p = .007, respectively) and intentions to use marijuana socially (b = -.05, p = .001; b = -.03, p = .002, respectively). Multilevel moderation analyses revealed that the effects of perceived peer use and benefits to oneself were related to intentions to use although stronger for those who had used; however, the effects of perceived risks and benefits to others were only significantly related to intentions to use marijuana for those who had used marijuana.Results suggest that perceived benefits to others and risks are malleable factors that may be effective components of treatment programs for youth who report lifetime marijuana use, but that perceived peer use and benefits to oneself may be useful in both treatment and prevention efforts for youth who have or have not used marijuana. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Reinforcer pathology predicts relapse in smokers.

Abstract: The purpose of this secondary analysis is to analyze whether both of the processes of the reinforcer pathology model (delay discounting and demand) are predictors of relapse up to 12-month follow-up in a sample of abstinent smokers who received a smoking cessation treatment.Participants were 202 abstinent smokers who completed the delay discounting task and the cigarette purchase task. In order to analyze the smoking relapse predictors and the impact of time to relapse, Kaplan-Meier curves, log-rank test, and Cox regression analysis were carried out.Fewer years of regular smoking (HR = .79, p = .014), as well as higher delay discounting (HR AUClogd = .80, p = .019) and intensity of demand (HR = 1.26, p = .019) were associated with a higher likelihood of smoking relapse. These variables were associated with a faster relapse.High delay discounting and intensity of demand were associated with a higher risk of relapse after quitting smoking. These findings highlight the importance of adapting treatment strategies for these two variables (delay discounting and cigarette demand), which might confer protective risk against smoking relapse. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Fentanyl overdose concerns among people who inject drugs: The role of sex, racial minority status, and overdose prevention efforts.

Abstract: BACKGROUND People who inject drugs (PWID) have an elevated risk of fentanyl-related overdoses. This study explores fentanyl overdose concerns among PWID and the role of sex, racial minority status, and overdose prevention efforts in these concerns. METHOD Data were from 498 PWID from Baltimore City, MD, recruited using street-based outreach between 2016 and 2019. Multinomial logistic regressions assessed correlates of participants' level of concern for themselves and their peers overdosing from fentanyl. RESULTS A third of participants were female, half were Black, over two-thirds perceived fentanyl to be in all/most of heroin, 40% expressed low fentanyl overdose concern, and a third overdosed in the past 6 months. After controlling for sociodemographic characteristics, female sex was associated with being very concerned about fentanyl overdoses for oneself (adjusted relative risk [aRR]: 2.13; 95% CI: 1.22, 3.72) and peers (aRR: 1.98; 95% CI: 1.14, 3.45). Compared to Black participants, White participants were less likely to be very concerned about fentanyl overdoses for themselves (aRR: 0.35; 95% CI: 0.19, 0.65). Participants who often/always carried naloxone (aRR: 2.91; 95% CI: 1.42, 5.95) perceived fentanyl in most heroin (aRR: 2.78; 95% CI: 1.29, 5.97) or were on medications for opioid use disorder (MOUD) (quite a bit concerned aRR: 2.18; 95% CI: 1.28, 3.69; very concerned: aRR: 1.96; 95% CI: 1.19, 3.22) were more likely than their counterparts to report being concerned for their peers, but not for themselves. CONCLUSION Female sex and racial minority status were associated with greater concern regarding fentanyl overdoses for oneself. Increasing overdose deaths in these populations suggests disparate access to harm-reduction initiatives rather than interest or concern. Furthermore, findings on naloxone, MOUD, and concerns for peers support social network-based interventions among PWID. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Patterns of polyvictimization predict stimulant use, alcohol and marijuana problems in a large cohort of sexual minority and gender minority youth assigned male at birth.

Abstract: Men who have sex with men (MSM) and gender minorities (GM) are more likely to have substance problems and experience various forms of victimization compared to their heterosexual and cisgender counterparts. Polyvictimization allows for the assessment of the combined impact of multiple forms of victimization on health. This study examines the effects of polyvictimization patterns on stimulant use, alcohol and marijuana problems among a large cohort study.The sample was collected between 2015 and 2019 (n = 1,202). Mean age was 22. The sample was racially diverse (34.4% Black, 29.0% Hispanic/Latinx, 25.8% white, 5.9% other racial identity), 92.4% of the sample were MSM and 7.6% of the sample were GM. Using latent class analysis five qualitatively different polyvictimization classes were identified. Associations between these classes and stimulant use, alcohol and marijuana problems were examined using negative binomial and logistic regressions.Polyvictimization class significantly predicted alcohol problems and cannabis problems, at baseline as well as methamphetamine, and cocaine use at both time points. The polyvictimization profiles that were characterized by intimate partner violence (IPV), childhood sexual abuse (CSA), and high victimization across types were associated with substance outcomes at baseline. The polyvictimization class that was characterized by report of IPV was associated with cocaine use at 6 month follow-up. The polyvictimization class that was characterized by CSA was associated with methamphetamine use at 6 month follow-up.Researchers should examine the effects of victimization experiences more holistically and develop substance interventions that take multiple forms of victimization experiences into account. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Trajectories of motivation and self-efficacy during a smoking quit attempt: An ecological momentary assessment study.

Abstract: Conceptual models of addiction highlight self-efficacy and motivation as key variables important during a smoking quit attempt; however, recent research has primarily focused on self-efficacy. Given the importance of motivation in these models, a clearer understanding of the effects of motivation during a smoking quit attempt is needed.This study utilized ecological momentary assessment (EMA) to investigate the dynamic effects of motivation and self-efficacy early in a quit attempt. Participants were 356 smokers (45% male; 34% African American, 33% non-Hispanic White, 33% Latino). Participants completed EMAs of motivation, self-efficacy, and smoking for 4 days prequit through 1 week postquit, and returned for a follow-up assessment at 4 weeks postquit. Trajectory parameters of motivation and self-efficacy (mean, slope, and volatility) were analyzed in separate and combined regression models to predict smoking outcomes.Prequit results showed that parameters of motivation and self-efficacy were not associated with smoking on quit day. Postquit analyses revealed that participants with lower mean levels of motivation and self-efficacy were more likely to smoke at the end of Week 1. Moreover, individuals with decreasing levels of motivation over the first week of their quit attempt were more likely to be smoking at the end of Week 4.These findings highlight the need to incorporate dynamic measures of motivation in smoking research. Furthermore, the results underscore the value of utilizing EMA methods and trajectory parameters to gain a more nuanced understanding of the dynamic effects that key mechanisms have on smoking during a quit attempt. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Co-occurrence of food addiction, obesity, problematic substance use, and parental history of problematic alcohol use.

Abstract: OBJECTIVE The present study investigates the rates of co-occurrence among food addiction (FA), problematic substance use (alcohol, cannabis, cigarettes, nicotine vaping), parental history of problematic alcohol use, and obesity as an important step to understanding whether an addictive-like eating phenotype exists. METHOD A community sample of 357 U.S. adults (49.7% male, 77.6% White, Mage 40.7) completed the Yale Food Addiction Scale 2.0 (YFAS2.0), the Alcohol Use Disorders Identification Test, the Cannabis Use Disorders Identification Test, the Fagerstrom Test for Nicotine Dependence, the E-Cigarette Dependence Scale, the Family Tree Questionnaire, and demographic/self-report body mass index questions through Amazon Mechanical Turk. Risk ratios (RRs; unadjusted and adjusted for sociodemographic covariates) were calculated using modified Poisson's regression. RESULTS Risk of FA was higher in participants with problematic alcohol use (RR = 2.13, 99% CI [1.32, 3.45]), smoking (RR = 1.86, 99% CI [0.82, 3.36]), cannabis use (unadjusted; RR = 2.22, 99% CI [1.17, 4.18]), vaping (RR = 2.71, 99% CI [1.75, 4.21]), and parental history of problematic alcohol use (RR = 2.35, 99% CI [1.46, 3.79]). Risk of FA in participants with obesity was only higher in adjusted models (RR = 1.87, 99% CI [1.06, 3.27]). Obesity was not significantly associated with problematic substance use and parental history of problematic alcohol use. CONCLUSIONS FA, but not obesity, co-occurred with problematic substance use and a parental history of problematic alcohol use. Results support the conceptualization of FA as an addictive disorder. The inclusion of FA as an addictive disorder in diagnostic frameworks is an important area of future consideration. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Sustained reduction of attentional bias to smoking cues by smartphone-delivered attentional bias modification training for smokers.

Abstract: OBJECTIVE Cigarette smoking is thought to be at least partially maintained by the attentional bias (AB) toward smoking cues that develops as a consequence of drug dependence. This study evaluated the impact of smartphone-delivered, in-home attentional bias modification (ABM) to reduce AB to smoking cues and to reduce smoking behavior and withdrawal-related symptoms when used as an adjunct to conventional smoking cessation treatment. METHOD Participants (N = 246) were treatment-seeking smokers who completed up to 13 days of either ABM designed to train attention away from smoking cues, using a modified dot-probe task, or sham training, followed by 8 weeks of nicotine replacement therapy and counseling. Outcomes measured at baseline, 1-day post-ABM training, and 8 weeks post-ABM training included AB to smoking images and words using the dot-probe and smoking Stroop tasks, respectively, along with cigarettes per day, craving, and smoking abstinence. RESULTS We found that ABM training reduced AB to smoking stimuli on both the dot-probe task, ηp² = 0.056, 90% CI [0.024, 0.097], and the smoking Stroop task, ηp² = 0.017, 90% CI [0.002, 0.044], up to 8 weeks after ABM training when covarying for baseline response, but did not concurrently decrease smoking behavior or craving. CONCLUSIONS Thirteen days of smartphone-delivered ABM training, as an adjunct to smoking cessation treatment, reduced AB to both modality-specific and cross-modality smoking cues but did not impact smoking-related behavior. While ABM can reduce AB to smoking cues across modalities, it is unclear whether it has therapeutic potential as an adjunct to conventional smoking cessation therapy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A descriptive study of cervical cancer survivors’ persistent smoking behavior and perceived barriers to quitting.

Abstract: Cervical cancer survivors (CCS) tend to smoke cigarettes at rates much higher than other cancer survivors and women in the general population. However, few studies take a deep dive into the smoking behavior of cervical cancer survivors and none focus on the barriers they experience related to smoking cessation. This study aimed to describe CCS' tobacco use characteristics, quit attempts, and barriers to quit success.In a concurrent mixed-method design, 50 CCS (94% White nonHispanic) who were diagnosed in the past 5 years and were current smokers at diagnosis provided data via standardized questionnaire and semi-structured interview.More than three-quarters of participants were current smokers at the time of study participation, 25.6% of whom also reported noncigarette tobacco use (e.g., electronic cigarette, cigar, snus). Seventy percent of participants reported making at least one 24 hr quit attempt postdiagnosis, with 61.5% of current smokers preferring to quit without professional advice or counseling and 51.3% preferring to quit without medication assistance. Four themes emerged regarding barriers to smoking cessation: motivation and readiness; confidence and uncertainty; triggers; and social and environmental factors.The rate of smoking in CCS is remarkably high, which may partly be explained by negative attitudes toward and low use of evidence-based treatment as well as multi-level barriers to smoking cessation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

New approaches to deep phenotyping in addictions.

Abstract: OBJECTIVE The causes of substance use disorders (SUDs) are largely unknown and the effectiveness of their treatments is limited. One crucial impediment to research and treatment progress surrounds how SUDs are classified and diagnosed. Given the substantial heterogeneity among individuals diagnosed with a given SUD (e.g., alcohol use disorder [AUD]), identifying novel research and treatment targets and developing new study designs is daunting. METHOD In this article, we review and integrate two recently developed frameworks, the National Institute on Drug Abuse's Phenotyping Assessment Battery (NIDA PhAB) and the Hierarchical Taxonomy of Psychopathology (HiTOP), that hope to accelerate progress in understanding the causes and consequences of psychopathology by means of deep phenotyping, or finer-grained analysis of phenotypes. RESULTS AND CONCLUSIONS NIDA PhAB focuses on addiction-related processes across multiple units of analysis, whereas HiTOP focuses on clinical phenotypes and covers a broader range of psychopathology. We highlight that NIDA PhAB and HiTOP together provide deep and broad characterizations of people diagnosed with SUDs and complement each other in their efforts to address widely known limitations of traditional classification systems and their diagnostic categories. Next, we show how NIDA PhAB and HiTOP can be integrated to facilitate optimal rich phenotyping of addiction-related phenomena. Finally, we argue that such deep phenotyping promises to advance our understanding of the neurobiology of SUD and addiction, which will guide the development of personalized medicine and interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Moral incongruence and addiction: A registered report.

Abstract: OBJECTIVE Diagnostic guidelines for compulsive sexual behavior disorder note that moral distress related to sexual behavior is not sufficient to receive the diagnosis. Recent work has questioned the uniqueness of moral distress in predicting self-reported feelings of sexual addiction, demonstrating that other so-called addictive behaviors (e.g., gaming and internet use) are well-predicted by moral disapproval of those behaviors. The present work tested if moral incongruence (the interaction of behavioral frequency and moral disapproval of a behavior) is uniquely related to sexual behavior, or if it generalizes to other addictions as well. METHOD This work used a large sample (N = 4,363) involving a representative sample of the U.S. population (n = 2,806) and a sample of sports-wagering individuals in the U.S. (n = 1,557). Interactions between moral disapproval and behavioral frequency were tested for several behaviors (i.e., pornography use, gambling, and several substances). RESULTS The interaction of behavioral frequency and behavioral disapproval (i.e., moral incongruence) predicted self-reported feelings of addiction to pornography and gambling. Moral incongruence was consistently unrelated to self-reported feelings of addiction to tobacco, illicit substances, and prescription drugs. Results regarding alcohol and marijuana were inconclusive. CONCLUSIONS Moral incongruence is clearly a salient factor in understanding compulsive sexual behavior, and it appears to also be salient to gambling disorder. Though moral incongruence does not seem relevant to some substances (i.e., nicotine, prescription drug misuse, or illicit drug use), further research is needed regarding the effect of moral incongruence on self-reported feelings of addiction to alcohol and marijuana. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Examining the added value of harm reduction strategies to emailed boosters to extend the effects of online interventions for college drinkers.

Abstract: Objective: Brief computer-delivered interventions (CDIs) reduce college student drinking and related problems but can be less efficacious and enduring than in-person interventions. The present study examined: (a) the utility of emailed personalized boosters after an evidence-based online CDI for alcohol (i.e., eCHECKUP TO GO), and (b) the added value of including protective behavioral strategies (PBS) in boosters containing personalized normative feedback (PNF) versus PNF alone. Method: 528 young adult (ages 18-24) college drinkers (71.6% female; 52.5% Black, 40.3% White) with a mean age of 19.9 years (SD = 1.65) were randomized to receive: CDI-only; CDI plus a PNF-only booster; or CDI plus a booster containing both PNF and PBS feedback. Booster emails were sent 2 weeks post-intervention. Online surveys completed pre-intervention and at 1 and 3 months assessed alcohol consumption, problems, descriptive normative perceptions, and PBS use. Results: The CDI led to significant reductions in alcohol consumption across all conditions, with no effect of boosters on drinking. Controlling for quantity, no reductions in problems were observed. Descriptive norms reduced significantly, with no condition differences. Only PBS use showed condition effects, such that the CDI-only and PNF-only booster groups reported reduced PBS use at 1 month, but the norms-plus-PBS booster group did not. Conclusions: The CDI was sufficient to change alcohol consumption and perceived norms without boosters, although the inclusion of boosters with PBS feedback may mitigate against PBS use reductions. Longer follow-ups may detect delayed booster benefits, or a larger dose through repeated exposure over time may be needed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Injunctive and descriptive normative feedback for college drinking prevention: Is the whole greater than the sum of its parts?

Abstract: OBJECTIVE Single-component personalized normative feedback (PNF) interventions and multicomponent personalized feedback interventions (PFI) have been shown to reduce alcohol consumption among college students. The present study compared the efficacy of PNF interventions targeting descriptive norms alone (descriptive PNF), injunctive norms alone (injunctive PNF), or their combination (combined PNF), against a multicomponent PFI and an attention control condition. METHOD Undergraduates (N = 1,137) across two universities who reported a minimum of one past-month episode of heavy episodic drinking (i.e., 4 +/5 + drinks on a single occasion for females/males) completed assessments at baseline and 3, 6, and 12 months postintervention. RESULTS Relative to the attention control, participants in each of the four intervention conditions showed greater reductions in perceived descriptive/injunctive norms, total drinks per week, and alcohol-related consequences. Peak estimated blood alcohol concentration was also reduced in the injunctive PNF, combined PNF, and multicomponent PFI conditions, with the latter two conditions showing an advantage for duration of effects. The multicomponent PFI condition also evidenced greater reductions than the injunctive PNF in descriptive norms at 3-month and injunctive norms at 6- and 12-month follow-ups. No other group comparisons on any outcome were significant. CONCLUSIONS Each intervention has merit for use in college student harm reduction efforts. Single-component or combined PNF could be considered a potential starting point, as PNF is less burdensome than a multicomponent PFI when considering ease and length of delivery. Results can inform optimization of norms-based interventions and guide recommendations on efficacious components for reducing alcohol use and harms on college campuses. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

College students' receptiveness to intervention approaches for alcohol and cannabis use.

Abstract: Addressing high-risk alcohol and cannabis use represent major challenges to institutions of higher education. A range of evidence-based treatment approaches are available, but little is known concerning students' receptiveness to such approaches. Prior work identified that students were most open to individual therapy and self-help options for reducing alcohol use, but less open to medication. The current study examines student receptiveness to intervention approaches across a wider range of intervention approaches (e.g., remote/telehealth), and extends to evaluate cannabis intervention receptiveness.Undergraduate students reported on alcohol and cannabis use, motives for and reasons against use, and openness to an array of interventions for reducing alcohol and cannabis use.Informal options (self-help, talking with family/friends), individual therapy, and appointments with a primary care provider (PCP) were endorsed most frequently. Group therapy and medication were less commonly endorsed, though medication was endorsed at a higher prevalence than in prior studies. Women generally expressed higher receptiveness than men. Lower alcohol consumption was associated with increased receptiveness to some approaches. Students at high risk for alcohol and/or cannabis dependence were less receptive to many treatment options.College students were open to a wide variety of approaches for reducing their alcohol and cannabis use. These results can inform selection, implementation, and availability of campus-wide services, especially as low-cost technological-based approaches are expanding. Further attention to existing services (e.g., PCP) for addressing alcohol and cannabis use may be considered, given students' receptiveness to such approaches. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Heavy drinking and drinking harms for cisgender and transgender college students.

Abstract: Objective: We examined alcohol use and harms, and their interrelations among cisgender and transgender college students. Method: We conducted a secondary analysis using a U.S. sample of 4-year-college students (n = 242,624; Mage = 20.24, SD = 1.67; 12.31% Hispanic/Latinx and 62.11% non-Hispanic/Latinx White, 3.99% Black, 11.88% Asian or Pacific Islander,0.37% American Indian, Alaskan Native or Native Hawaiian, 9.35% Multiracial/ethnic/other). These outcomes were compared between cisgender women (68.53%) and cisgender men (29.27%), transgender men (0.91%), transgender women (0.23%), and nonbinary students (1.06%): level (number of drinks) of recent alcohol use, frequency of binge drinking (≥ 5 drinks) in the past 2 weeks, and occurrence and count of harms while drinking in the past year. Gender differences in the association between drinking level and consequences were also examined. Results: Cisgender women were the reference group for all of the comparisons. Cisgender men reported less occurrence of regret, sex without their consent, and unprotected sex when drinking, but the greater occurrence of injury and trouble with the police. Transgender women and nonbinary individuals reported lower odds of regret and unprotected sex when drinking. Transgender men and nonbinary individuals reported increased odds of sex without their consent when drinking. All transgender subgroups reported increased odds of suicidal ideation when drinking. Finally, associations between the level of recent drinking and odds of experiencing harms differed by gender identity. Conclusions: Patterns of alcohol use, consequences, and their interrelationship differed for cisgender men, transgender women and men, and nonbinary individuals relative to cisgender women. There is a need for gender-inclusive prevention for alcohol harms among students. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Beyond BASICS: A scoping review of novel intervention content to enhance the efficacy of brief alcohol interventions for emerging adults.

Abstract: OBJECTIVE Brief motivational interventions (BMIs) that include personalized drinking feedback delivered in a motivational interviewing (MI) style have demonstrated reductions in drinking across numerous clinical trials with emerging adults (EAs) ages 18-25. However, effect sizes for these BMIs are generally small to moderate and drinking reductions are often not maintained beyond short-term follow-ups. Additionally, EAs may be more interested in approaches that highlight wellness, mood enhancement, or goal pursuit rather than programs focused exclusively on reducing alcohol-related risk. Thus, there is a need to evaluate novel intervention content as an alternative or supplement to BMIs in this high-risk population. METHOD This scoping review examined studies of novel intervention elements to reduce alcohol consumption among EAs. Eligible studies were published in peer-reviewed journals in English from January 2015 to September 2021 and evaluated novel brief interventions, operationalized as one to five sessions focused on alcohol-related outcomes with key content beyond what has typically been included in alcohol BMIs. Results were categorized as additions to BMIs or stand-alone interventions and were synthesized within these categories by theoretical approach. RESULTS Although standard in-person BMIs have the greatest empirical support, there are a variety of alternative intervention approaches that might enhance health and wellness and that can be feasibly integrated with BMIs or offered as an appealing "gateway" to increase help-seeking among EAs who drink alcohol. CONCLUSIONS More research is needed to empirically evaluate both the relative efficacy of supplements and stand-alone alternatives to BMI among higher risk EAs and their potential for widespread dissemination. (PsycInfo Database Record (c) 2022 APA, all rights reserved).