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Codependency is defined as a dysfunctional pattern of relating to others, present in relatives of those with a substance use disorder or other chronic disease. It is characterized by emotional dependence, extreme focus in the other person, and self-neglect. Aim: to present results of the process of development and validation of a new measure to evaluate codependency. Method: The Argentinean codependency scale was administered to a convenience sample of 347 subjects between 15 and 80 years, in Mar del Plata. AFE was used (main axes extraction method). The number of factors was determined by parallel analysis. Internal consistency was assessed using Cronbach's Alpha. Item level statistics were also estimated. Results: Three factors were obtained. The internal consistency of the total scale and the three subscales was satisfactory. Relatives of alcohol or drugs dependents and of people with other chronic diseases had scores significantly higher in the codependency measure than those in the general population group.

This study aimed to identify alcohol use disorder (AUD) criteria that better characterized those who seek treatment and those who recover on their own. We gathered data from help-seeking (HS) patients in an alcohol unit and compared them with self-achieved remission (SAR) patients. The best criteria to predict HS were psychological problems due to use, physical problems due to use, repeated attempts or desire to stop using, and not being able to stop drinking. The best criteria to predict SAR were tolerance, craving, hazardous use, much time spent, larger/longer use than intended, and role impairment. We discuss the impact of these results in current efforts to improve the accuracy of AUD diagnosis. [ABSTRACT FROM AUTHOR]

Objective: Adding a craving criterion presently in the International Classification of Diseases, 10th Revision, diagnosis of alcohol dependence--has been under consideration as one possible improvement to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and was recently proposed for inclusion by the DSM Substance-Related Disorders Work Group in the Fifth Revision of diagnostic criteria for alcohol use disorders. To inform cross-cultural applicability of this modification, performance of a craving criterion was examined in emergency departments in four countries manifesting distinctly different culturally based drinking patterns (Mexico, Poland, Argentina, United States). Method: Exploratory factor analysis and item response theory were used to examine psychometric properties and individual item characteristics of the 11 DSM-IV abuse and dependence criteria with and without craving for each country separately. Differential item functioning analysis was performed to examine differences in the difficulty of endorsement (severity) and discrimination of craving across countries. Results: Exploratory factor analysis found craving fit well within a one-dimensional solution, and factor loadings were high across all countries. Results from item-response theory analyses indicated that both discrimination and difficulty estimates for the craving item were located in the middle of the corresponding discrimination and difficulty ranges for the other 11 items for each country but did not substantially increase the efficiency (or information) of the overall diagnostic scheme. Across the four countries, no differential item functioning was found for difficulty, but significant differential item functioning was found for discrimination (similar to other DSM-IV criteria). Conclusions: Findings suggest that, although craving performed similarly across emergency departments in the four countries, it does not add much in identification of individuals with alcohol use disorders., WORK IS CURRENTLY UNDER WAY by the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 2000) Substance-Related Disorders Work Group to inform the Fifth Revision (DSM-V) of [...]

Although Brief Intervention (BI) has proven to reduce alcohol consumption during pregnancy in high income countries, there is no evidence from the Southern Cone of America. Thus, we conducted a study to assess BI efficacy among Argentinean pregnant women. We collected data on pregnant women receiving prenatal care at the public health system in Mar del Plata, Argentina. Women with less than 26 weeks of gestation (n = 486) were randomized to brief advice (BA) or BI. Three months later they were re-assessed; women with more than 26 weeks of gestation constituted a screening only control group (SC) (n = 154). Self-reported quantity and frequency of alcohol consumption, frequency of binge drinking, and related problems after three months were used as outcomes. We performed generalized estimating equations and clinical significance analyses. Also, we obtained newborn health indicators from the city's health system database to use as objective outcomes. Women who did not participate in any of the three former conditions were randomly selected to constitute a non-screening control group (NSC) (n = 150). We compared objective outcomes among BI, BA, and NSC groups using the Wilcoxon rank test. In comparison with SC, BI and BA reduced alcohol consumption, without differences between the latter two. Newborns of women who received BI and BA had better health indicators compared with the NSC group. performing either a BI or BA reduces alcohol consumption among Argentinean pregnant women and might lead to healthier newborns. [ABSTRACT FROM AUTHOR]

Objective: Although injured patients in the emergency department (ED) report more frequent use of the ED compared with the general population, and alcohol-related admissions and chronic alcohol misuse have been found to be predictive of future ED admissions, these data are based on only a few U.S. studies. The purpose of this article was to explore the association of alcohol use and ED services use among injured patients cross-nationally. Method: Binary and multinomial logistic regression were used to analyze the association of alcohol consumption with prior ED visits among 9,743 injured patients surveyed in 37 EDs in 14 countries and reported in 23 studies from the combined Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and World Health Organization Collaborative Study of Alcohol and Injuries. Results: Drinking within 6 hours before injury was associated with prior ED visits during the last 12 months (odds ratio = 1.25, p < .05), with a positive dose-response relationship. Heavy drinkers and those drinkers who were alcohol-dependent were also significantly more likely to report multiple prior ED visits, reflecting an elevated burden of services use. At the ED level, stigmatization of alcohol use was the only significant contextual variable that consistently predicted cross-ED variation in the relationship between drinking and ED use, in which the association was weaker in areas where alcohol use is less accepted. Conclusions: This study lends additional support to the potential effectiveness of screening for acute and chronic alcohol use among ED injured patients to reduce ED services use and associated costs., EMERGENCY DEPARTMENT (ED) STUDIES in the United States have found that substantial proportions of both injured and noninjured patients report frequent use of the ED. One study found more than [...]

Objective: There are little data available on the performance of brief screening instruments for alcohol-use disorders cross-nationally; therefore, we analyzed the performance of one such instrument in a number of countries. Method: Performance of the RAPS4 for tolerance and the RAPS4-QF for heavy drinking are analyzed from emergency room data across 13 countries included in the combined Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and the World Health Organization Collaborative Study on Alcohol and Injuries. Results: The RAPS4 showed good sensitivity and specificity for tolerance across most of the countries, but was higher in countries that were higher on societal-level detrimental drinking patterns. Prevalence of tolerance was also higher in those countries with high detrimental drinking pattern scores. Sensitivity of the RAPS4-QF for heavy drinking was uniformly high across countries, while maintaining good specificity, and did not vary by detrimental drinking patterns. Conclusions: Findings suggest the RAPS4 and RAPS4-QF may hold promise cross-nationally. Future research should more fully address the performance of brief screening instruments for alcohol-use disorders (using standard diagnostic criteria) cross-nationally, with consideration of the impact of societal drinking patterns., A NUMBER OF BRIEF SCREENING INSTRUMENTS have been developed for identifying alcohol-use disorders in clinical settings (Bradley et al., 1998). These instruments, however, have not been evaluated cross-nationally, with the [...]

Objective: To examine the impact of usual drinking patterns and related problems on the acute use of alcohol in injury. Method: The impact of quantity and frequency of drinking, alcohol problems and dependence symptoms on admission to the emergency room (ER) for an alcohol-related injury (based, separately, on a positive blood alcohol concentration [BAC] and self-reported drinking within 6 hours prior to injury), compared with a nonalcohol related injury, was examined using meta-analysis, across 15 ER studies covering seven countries. Results: Pooled effect size for consuming five or more drinks on an occasion at least monthly was significant but not homogeneous, with odds ratios (ORs) of 4.16 for BAC and 3.92 for self-report. Frequency of drinking among nonheavy drinkers was found to have the largest effect size (5.93 for BAC and 4.93 for self-report). Heavy drinking, controlling for frequency, was also significant (ORs of 2.08 for BAC and 1.86 for self-report), but effect size was homogeneous only for self-report. Effect sizes for consequences of drinking and dependence symptoms were also significant and homogeneous, with ORs of 4.29 and 3.55, respectively, for BAC, and 3.84 and 3.94, respectively, for self-report. In meta-regression analysis, among contextual variables the level to which alcohol use is stigmatized in the culture was most consistently predictive of heavy-drinking effect size on an alcohol-related injury, with larger effect sizes found in those studies reporting a lower level of stigmatization. Conclusions: Whereas quantity and frequency of drinking were both found to be highly predictive of an alcohol-related injury, sociocultural variables may affect observed associations of heavy drinking with an alcohol-related injury., TRAUMA IS a significant problem in many countries and a substantial literature exists, a great deal of which is from emergency room (ER) studies, implicating alcohol as a major risk [...]

Introduction and Aims: Research on corporate behaviour can contribute to the understanding of the possible adverse impacts of alcohol‐industry corporate social responsibility (CSR) initiatives and their potential influence on policymaking. This study explores the association between alcohol‐industry CSR activities and selected country features in Latin America and the Caribbean. Design and Methods: Nine health experts evaluated 148 CSR activities using a standardised protocol; activities were classified into the categories risk management CSR (rmCSR), that is, to avoid/rectify externalities (n = 67), and strategic CSR, that is, to fulfill philanthropic responsibilities (n = 81). We evaluated the associations, separately, between the number of rmCSR and of strategic CSR actions in each country with threats from public health measures (specifically, the level of research into alcohol consumption and harms, the existence of an alcohol surveillance system and the number of governmental alcohol policy actions) and per capita alcohol consumption; we adjusted by economic indices (country income level and the gross domestic product) and population size. Results: Multivariate analyses showed that the higher the level of alcohol research within a country and its per capita consumption, the more likely rmSCR activities were to occur, independently of the country's economic development or population. Discussion and Conclusions: Results suggest rmSCR actions could be implemented as a way to preserve markets by counteracting scientific evidence about alcohol related harms. This evidence could serve as a starting point to future research, contributing to the understanding of alcohol industry behaviour and the advancement of effective public policies. [ABSTRACT FROM AUTHOR]

Evidence regarding the association between early drinking (ED) and later dependence is controversial. It has been alternately hypothesized that ED either plays a causal role in the development of dependence or that it is an early marker of increased psychosocial vulnerabilities. Despite a clear rationale for delaying youth consumption, it is important to discern this relationship. However, most epidemiological evidence comes from individual studies and high-income countries. If there is a causal link between ED and dependence, an association at the aggregate level would be expected. Furthermore, if the link is due to biological mechanisms, the association should be rather invariable regardless of the drinking context, while if the association is due to psychosocial factors, a wider variability is to be expected. We explored whether the association between ED and dependence varied across countries clustered by their shared contextual drinking characteristics. We used data from 169 countries from the Global Information System on Alcohol and Health of the World Health Organization: ED, alcohol dependence, heavy episodic drinking (HED), actual drinkers, and alcohol policy. To cluster countries by their shared drinking characteristics (prevalences of HED and actual drinkers, and alcohol policy), we used, sequentially, two multivariate data reduction techniques: a multiple correspondence analysis (MCA) and a hierarchic classification. To estimate the association between ED and alcohol dependence, beta regressions were performed, and then adjusted by country income-level and repeated by gender. The results indicated four country clusters: primarily abstainers (class 1), low drinking countries (class 2), high drinking countries (class 3), and very high drinking countries (class 4). Positive relationships between ED and alcohol dependence were found for all the countries in the world and for those in classes 1 and 2. No significant relationships were found for class 3 or class 4. These results were similar for males, but not for females, where no significant relationships were found after adjusting for income level. The association between ED and dependence varies according to the drinking context. Our findings either suggest that the ED–dependence association may be due to individual or environmental vulnerabilities that promote consumption outside cultural norms or that, if there is a causal link between ED and dependence, it is strongly moderated by psychosocial characteristics. [ABSTRACT FROM AUTHOR]

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Objectives The aims of this study were to: (1) describe alcohol industry corporate social responsibility (CSR) actions conducted across six global geographic regions; (2) identify the benefits accruing to the industry ('doing well'); and (3) estimate the public health impact of the actions ('doing good'). Setting Actions from six global geographic regions. Participants A web-based compendium of 3551 industry actions, representing the efforts of the alcohol industry to reduce harmful alcohol use, was issued in 2012. The compendium consisted of short descriptions of each action, plus other information about the sponsorship, content and evaluation of the activities. Public health professionals (n=19) rated a sample (n=1046) of the actions using a reliable content rating procedure. Outcome measures WHO Global strategy target area, estimated population reach, risk of harm, advertising potential, policy impact potential and other aspects of the activity. Results The industry actions were conducted disproportionately in regions with high-income countries (Europe and North America), with lower proportions in Latin America, Africa and Asia. Only 27% conformed to recommended WHO target areas for global action to reduce the harmful use of alcohol. The overwhelming majority (96.8%) of industry actions lacked scientific support (p<0.01) and 11.0% had the potential for doing harm. The benefits accruing to the industry ('doing well') included brand marketing and the use of CSR to manage risk and achieve strategic goals. Conclusion Alcohol industry CSR activities are unlikely to reduce harmful alcohol use but they do provide commercial strategic advantage while at the same time appearing to have a public health purpose. [ABSTRACT FROM AUTHOR]

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Alcohol consumption is the leading risk factor for morbi‐mortality in many Latin American Countries. However, epidemiologic studies are relatively scarce. Among factors such as limited research capacity, disciplinary traditions and an emphasis on psychopathology within the field of psychology, have been postulated to account for this. The aim of this article is to review epidemiologic research on alcohol in Spanish Speaking Latin American Countries, and to measure the contribution of psychology to the field. A systematic search was performed in English and Spanish using regional and international data bases. We identified 269 articles. Most focused on consumption patterns in youth, with samples from a single school and using a variety of measures. With the exception of multinational efforts like Emergency Room Collaborative Alcohol Analysis Project or those supported by World Health Organization/Pan American Health Organization, studies reviewed reflected little cross country collaboration. Mexico accounted for most of the productivity, while many countries had very few or no articles. Most research was performed by health science researchers with a small contribution from psychology, but which increased significantly over time. The results of this review provide a broad identification of patterns regarding epidemiologic research on alcohol, and demonstrate the need for national scientific policies to promote research on public health topics. [ABSTRACT FROM AUTHOR]

Copyright of Clinica y Salud is the property of Colegio Oficial de Psicologos de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Health & Addictions / Salud y Drogas is the property of Health & Addictions / Salud y Drogas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims The aims were to: (1) identify, monitor and analyse the Corporate Social Responsibility (CSR) practices of the alcohol industry in Latin America and the Caribbean (LAC) and (2) examine whether the alcohol industry is using these actions to market their products and brands. Methods Nine health experts from Argentina, Brazil and Uruguay conducted a content analysis of 218 CSR activities using a standardized protocol. A content rating procedure was used to evaluate the marketing potential of CSR activities as well as their probable population reach and effectiveness. The LEAD procedure (longitudinal, expert and all data) was applied to verify the accuracy of industry-reported descriptions. Results A total of 55.8% of the actions were found to have a marketing potential, based on evidence that they are likely to promote brands and products. Actions with marketing potential were more likely to reach a larger audience than actions classified with no marketing potential. Most actions did not fit into any category recommended by the World Health Organization; 50% of the actions involving classroom and college education for young people were found to have marketing potential; 62.3% were classified as meeting the definition of risk management CSR. Conclusion Alcohol industry Corporate Social Responsibility activities in Latin America and the Caribbean appear to have a strategic marketing role beyond their stated philanthropic and public health purpose. [ABSTRACT FROM AUTHOR]

Background: Alcohol consumption and its related consequences are not equal for women and men, although related studies do not frequently include gender analysis. Objective: Our aim was to characterize differences in endorsement of ICD-10 and DSM 5 alcohol use disorder (AUD) criteria by gender in an Argentinean emergency department population. Methods: A probability sample of patients (N = 923) from the largest emergency department in the city of Mar del Plata, Argentina (44% were females, aged 16 to 86, M (SD) = 37.31(15.20) was collected. Using a structured questionnaire, diagnostic criteria for alcohol use disorders, alcohol consumption, and socio-demographic variables were obtained. Bivariate and multivariate analyses were used to assess differences in the endorsement of each diagnostic criterion by gender. Results: Women were less likely to endorse each of the criteria for each of the diagnostic schemes. Even after controlling alcohol consumption, socio-demographic variables, severity of alcohol use disorders and adjusting for multiple comparisons females had a lower probability than males of endorsing withdrawal and impaired control. Conclusions: gender differences in the endorsement of diagnostic criteria for both the DSM 5 and ICD-10 were found. Some differences in endorsement but not all, might be partially explained by alcohol consumption patterns and socio-demographic factors, and same remained after controlling severity of the AUD. Results also suggest a differential functioning of DSM 5 and ICD-10 AUD criteria for women and men. [ABSTRACT FROM AUTHOR]

A significant percentage of people with an alcohol-use disorder (AUD) recover on their own and differ substantially from those who do not. Those who do not seek assistance for AUD include a high proportion of university students. The aim of this study was to describe, in a cohort of Argentinean university students, the differences among drinkers who had never had an alcohol-related problem, those who recovered from an AUD on their own (natural recovery), and those who currently had an AUD. Participants were 1170 randomly selected students from the National University of Mar del Plata. They were assessed regarding the quantity and frequency of alcohol consumption, AUD severity, and sociodemographic variables. Descriptive and multivariate analyses (logistic regressions) were performed. Differences were found primarily in alcohol consumption variables, gender, and age. Natural recovery and current AUD groups drank higher quantities of alcohol and did so more frequently compared with drinkers who had never met any AUD criteria. Students with a current AUD drank higher quantities than did those who were in natural recovery. Students who recovered naturally had less severe AUDs, but many still had an alcohol-related problem. The implications of self-promoted changes in drinking behaviors are discussed. [ABSTRACT FROM AUTHOR]

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Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Copyright of Health & Addictions / Salud y Drogas is the property of Health & Addictions / Salud y Drogas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Substance Use & Misuse is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The performance of the Alcohol Use Disorders Identification Test (AUDIT), CAGE, Brief Michigan Alcohol Screening Test (Brief MAST), Rapid Alcohol Problems Screen (RAPS), Rapid Alcohol Problems Screen-Quantity and Frequency (RAPS4-QF), and TWEAK was evaluated against a diagnosis of alcohol dependence and harmful drinking or alcohol abuse from ICD-10 and DSM-IV criteria. Data were collected from a probability sample of 779 patients admitted to the emergency department of a public general hospital in Mar del Plata, Argentina, during the year 2001. The majority of the patients sampled were male. The age range was 18 to 89 years, with a mean value of 36 years and a median of 31 years. Almost half of the sample had an elementary school education or less. All instruments were more sensitive for alcohol dependence than for harmful drinking or abuse and more sensitive for men than for women. Findings suggest the RAPS4 and RAPS4-QF may be preferred when screening for alcohol use disorders in the emergency department in Argentina. The study's limitations are noted. [ABSTRACT FROM AUTHOR]

Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

AbstractBackground: Personalized Normative Feedback (PNF) aims to modify misperceptions about peer consumption that influence one’s drinking. PNF is usually a component in Brief Interventions delivered to university students. Despite this, whether PNF contributes to improving the effect of brief interventions is unclear. Objectives: This randomized controlled trial aimed to determine the role of PNF as an active ingredient in a face-to-face motivational brief intervention. Results: Participants were students from an Argentinian university (n=806; M=20.14; SD=3.17; 63.2% women) who presented at least one binge drinking episode in the last 12 months. Students were randomly assigned to 1) a Brief Intervention, 2) a Brief Intervention with PNF, or 3) an evaluation-only control group. The follow-up was three months later. After controlling sex and age, General Linear Models showed that both the brief intervention and the brief intervention with PNF reduced the quantity and frequency of alcohol consumption, binge drinking, and alcohol problems compared to the control condition. No differences were found between the brief intervention and the brief intervention with PNF. Also, treating eight students with brief intervention and 10 with brief intervention with PNF was necessary to benefit one student. Conclusions: In conclusion, this study demonstrates that brief intervention reduces alcohol consumption among Latin American university students and that PNF might not be an active ingredient of its effectiveness in this population. However, PNF could benefit students with specific characteristics, like those who overestimate their peers’ drinking, highlighting the need to study moderators of effectiveness further. [ABSTRACT FROM AUTHOR]

Codependency (COD) is a pattern of dysfunctional interpersonal bonding characterized by excessive attention to others´ needs and behaviors, neglecting oneself. It is often confused with emotional dependency (ED) and dependent personality disorder (DPD). In order to contribute to the debate regarding COD as an independent phenomenon, this study evaluates the relationship between these constructs. For this purpose, the Argentine Codependence Scale, the Emotional Dependence Questionnaire and the dependent subscale of the Millon Multiaxial Clinical Inventory were applied to a sample of 261 participants. COD was more strongly related to ED than to DPD. Although the results indicate some overlap between these concepts, this overlap does not seem to be so high as to suggest that COD is equivalent to ED or DPD. [ABSTRACT FROM AUTHOR]

According to the dual process model, the interaction between explicit (controlled) and implicit (automatic) cognitions would allow the understanding of irrational actions like addictive behaviors. This model has gained great popularity among addiction researchers, leading to an exponential growth in publications on implicit alcohol related cognition (IAC). Hence, the goal of this article is to identify trends in the study of IAC by means of a bibliometric and content analysis of the empirical studies published up to May, 2013. Throughout this paper, the studied topics of IAC were characterized, the most prolific countries, authors and journals were recognized, the most cited publications were detected and the most employed methods were identified. [ABSTRACT FROM AUTHOR]

Objective. Describe alcohol consumption by Argentine women before and during pregnancy and identify the factors associated with consumption- and pregnancyrelated changes. Methods. Cross-sectional observational study. Women were interviewed after giving birth and receiving care at two perinatal health care centers in Santa Fe, Argentina. Sociodemographic information, data on their alcohol use, and other information were obtained from the participants. A descriptive analysis of consumption prevalence rates was made and the factors associated with patterns of alcohol use were identified by means of repeated measure analysis. Results. Of the 614 participants, 75.2% had had at least one alcoholic drink (standard unit) during pregnancy and 83.3% had done so in the previous year; 15.1% admitted having at least one episode of binge drinking (five or more drinks) during pregnancy and 27.6% in the year prior to pregnancy. Only 30.6% of the women said they had made any change in consumption during the previous year; of those, 55.6% reduced their consumption and 41.8% stopped drinking. Women who consumed the most alcohol before and during pregnancy reported higher consumption by their partners, smoked, and had more permissive attitudes about alcohol use during pregnancy. Conclusions. A specific prevention plan is required in Argentina to reduce alcohol use in pregnant women, adjusted to local patterns of use, with interventions that include couples, and focused on the youngest women, those who use tobacco, and those who have more permissive attitudes about alcohol use. [ABSTRACT FROM AUTHOR]