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Background: An increasing number of longitudinal studies investigates long-term PTSD, related outcomes and potential gender differences herein. However, a knowledge gap exists when it comes to studies following individual civilian trauma beyond a decade post-trauma.Objective: To investigate the long-term PTSD prevalence, associated adverse psychological, functional and economic outcomes related to (suspected) serious injury of 12-15 years ago in Dutch adults, as well as potential gender differences herein.Method: N = 194 trauma-exposed adults (34% women) admitted to an emergency department following suspected serious injury completed a follow-up assessment 12-15 years (M = 14.30, SD = 1.00) post-trauma. Participants completed assessments of clinician-rated PTSD symptom severity, as well as self-report questionnaires on psychological, functional and economic outcomes.Results: Nine participants (4.8%) fulfilled the DSM-5 diagnostic criteria for PTSD related to the index trauma of 12-15 years ago. Results showed that PTSD symptom severity (CAPS-5) was significantly associated with more severe symptoms of anxiety (HADS) and depression (QIDS), lower well-being (WHO-5) and (health-related) quality of life (WHOQOL; EQ-5D-5L), but not with alcohol use (AUDIT), productivity loss at work (iPCQ) and health care use (iMCQ). No significant gender differences in the long-term PTSD prevalence nor in its related psychological, functional and economic outcomes were found.Conclusions: Our findings underscore the long-term presence of PTSD and associated adverse psychological and functional outcomes in a proportion of adults who experienced (suspected) serious injury over a decade ago. PTSD is already widely recognized for its substantial impact in the aftermath of a trauma. The current study emphasizes the potential long-term consequences of individual civilian trauma, highlighting the importance of accurate screening and prevention for PTSD.

Sexually- and gender-diverse individuals, while facing a higher prevalence of substance use, are also exposed to bias-motivated aggression. Lesbian, gay, bisexual, and transgender (LGBT) people experience stigmatization, discrimination, and violence targeting their minoritized identities, subsequently impacting their health behavior, well-being, and quality of life. While research abounds on the exacerbating influence of blatant victimization on disparate substance use outcomes among LGBT individuals, studies on the role of subtle slights—i.e., commonplace, day-to-day, and low-intensity negative interactions—are just starting to flourish. Despite this growing interest, some research gaps remain unaddressed. First, evidence about the link between subtle slights and substance use mostly comes from studies using cross-sectional non-probability designs. Second, transgender/gender-nonconforming/nonbinary/gender diverse (T/GNC/NB/GD) individuals have remained underrepresented in these studies. Finally, although studies on substance use as an outcome of subtle slight victimization have gained traction, exploring the role of substance use in subtle slight perpetration is wanting despite extant literature implicating substance use in aggressive behavior. This dissertation addressed the abovementioned gaps by examining the mechanisms involved in the relationship between subtle slights and alcohol and drug use. In Paper 1, a multilevel analysis of multi-wave data from the Generations study showed evidence for the mediating role of felt stigma (FS) and psychological distress (PD) in the link between everyday discrimination (ED) exposure and drug use (DU), but not alcohol consumption (AU), in a sample of non-transgender sexual minority-identified individuals in the US. In Paper 2, a multiple group analysis of a conditional process model, using data from the TransPop study, revealed that greater exposure to ED was associated with greater likelihood and magnitude of DU through mor

Purpose Indicators of socioeconomic status (SES), such as education and occupational grade, are known to be associated with alcohol use but this has not been examined among individuals with a mental health problem. This study developed latent classes of SES, their associations with alcohol use, and examined the indirect effect via social support and neighbourhood environment. Methods A secondary analysis of the 2014 Adult Psychiatric Morbidity Survey was conducted among participants with a mental health problem (N = 1,436). SES classes were determined using a range of indicators. Alcohol use was measured using the Alcohol Use Disorder Identification Test. Social support and neighbourhood neighbourhood environment were measured using validated questionnaires. A latent class analysis was conducted to develop SES classes. Multinomial logistic regression examined associations of SES and alcohol use. Structural equation models tested indirect effects via social support and neighbourhood environment. Results A four-class model of SES was best-fitting; “economically inactive, GCSE-level and lower educated, social renters”, “intermediate/routine occupation, GCSE-level educated, mixed owner/renters”, “retired, no formal education, homeowners”, and “professional occupation, degree-level educated, homeowners”. Compared to “professional occupation, degree-level educated, homeowners”, SES classes were more likely to be non-drinkers; odds were highest for “economically inactive, GCSE-level and lower educated, social renters” (OR = 4.96,95%CI 3.10–7.93). “Retired, no formal education, homeowners” were less likely to be hazardous drinkers (OR = 0.35,95%CI 0.20–0.59). Associations between “economically inactive, GCSE-level and lower educated, social renters” and “retired, no formal education, homeowners” and non- and harmful drinking via social support and neighbourhood environment were significant. Conclusions In contrast to the alcohol ha

Background Alcohol misuse is a significant health problem among forcibly displaced populations including male South Sudanese refugees in northern Uganda, yet interventions are sorely lacking. Developing an explanatory model of alcohol misuse in this population is the first step to designing appropriate and effective interventions. The aim of the current study was to examine alcohol misuse in this setting and to conceptualize an explanatory model of alcohol misuse. Method A total of 57 interviews were conducted with male refugees (18+ years) with alcohol misuse (n = 17), their family members (n = 15), community and religious leaders (n = 15), and mental health and psychosocial support providers (n = 10) in Rhino Camp settlement in northern Uganda. A thematic analysis approach was used to inductively analyze the data. Results Alcohol misuse was identified as a significant psychosocial problem among men in this setting. The adversity (e.g. trauma, loss, poverty), psychological distress (e.g. demoralization), perpetuators (e.g. ease of availability of alcohol, family conflict), and consequences of alcohol use (e.g. interpartner violence, exacerbated poverty) were identified. An explanatory model emerged from the data showing a reinforcing relationship in which adversity causes psychological distress, which leads to increased alcohol use via a number of personal, interpersonal, community and societal perpetuators, and over time increased alcohol use amplifies psychological distress which further increases alcohol misuse. Conclusions Given the need to address alcohol misuse in this population, this explanatory model of alcohol misuse can be used to inform prevention and treatment interventions for alcohol misuse. These interventions should endeavor to address the identified determinants of alcohol misuse while being cognizant of the social and cultural considerations specific to males in this population., Background: Alcohol misuse is a significant health problem among forcibly displaced populations including male South Sudanese refugees in northern Uganda, yet interventions are sorely lacking. Developing an explanatory model of alcohol misuse in this population is the first step to designing appropriate and effective interventions. The aim of the current study was to examine alcohol misuse in this setting and to conceptualize an explanatory model of alcohol misuse. Method: A total of 57 interviews were conducted with male refugees (18+ years) with alcohol misuse (n = 17), their family members (n = 15), community and religious leaders (n = 15), and mental health and psychosocial support providers (n = 10) in Rhino Camp settlement in northern Uganda. A thematic analysis approach was used to inductively analyze the data. Results: Alcohol misuse was identified as a significant psychosocial problem among men in this setting. The adversity (e.g. trauma, loss, poverty), psychological distress (e.g. demoralization), perpetuators (e.g. ease of availability of alcohol, family conflict), and consequences of alcohol use (e.g. interpartner violence, exacerbated poverty) were identified. An explanatory model emerged from the data showing a reinforcing relationship in which adversity causes psychological distress, which leads to increased alcohol use via a number of personal, interpersonal, community and societal perpetuators, and over time increased alcohol use amplifies psychological distress which further increases alcohol misuse. Conclusions: Given the need to address alcohol misuse in this population, this explanatory model of alcohol misuse can be used to inform prevention and treatment interventions for alcohol misuse. These interventions should endeavor to address the identified determinants of alcohol misuse while being cognizant of the social and cultural considerations specific to males in this population.

(1) Background: Ethnic minorities exhibit a higher prevalence of post-traumatic stress disorder (PTSD), while results for problematic substance use among ethnic groups remain mixed. PTSD and problematic substance use often co-occur; however, the impact of ethnicity on this association has not yet been investigated. (2) Methods: Self-report data on problematic alcohol/cannabis use (AUDIT/CUDIT) and presence of severe PTSD symptoms (PSS-SR) of N = 22,841 participants of Dutch (n = 4610), South-Asian Surinamese (n = 3306), African Surinamese (n = 4349), Ghanaian (n = 2389), Turkish (n = 3947), and Moroccan (n = 4240) origin were available from the HELIUS study. (3) Results: We found a positive association between the presence of severe PTSD symptoms and problematic alcohol and cannabis use. Ethnicity did not moderate the association between the presence of severe PTSD symptoms and problematic alcohol/cannabis use. (4) Conclusions: We demonstrated the relationship between the presence of severe PTSD symptoms and problematic alcohol/cannabis use in a multi-ethnic sample. The relationship between the presence of severe PTSD symptoms and problematic alcohol/cannabis use was similar between ethnic groups. We recommend screening for PTSD symptoms in those exhibiting problematic substance use and vice versa, regardless of ethnic background.

BACKGROUND: Video games have rapidly become mainstream in recent decades, with over half of the US population involved in some form of digital gaming. However, concerns regarding the potential harms of excessive, disordered gaming have also risen. Internet gaming disorder (IGD) has been proposed as a tentative psychiatric disorder that requires further study by the American Psychological Association (APA) and is recognized as a behavioral addiction by the World Health Organization. Substance use among gamers has also become a concern, with caffeinated or energy drinks and prescription stimulants commonly used for performance enhancement. OBJECTIVE: This study aimed to identify substance use patterns and health-related concerns among gamers among a population of Reddit users. METHODS: We used the public streaming Reddit application programming interface to collect and analyze all posts from the popular subreddit, r/StopGaming. From this corpus of posts, we filtered the dataset for keywords associated with common substances that may be used to enhance gaming performance. We then applied an inductive coding approach to characterize substance use behaviors, gaming genres, and physical and mental health concerns. Potential disordered gaming behavior was also identified using the tentative IGD guidelines proposed by the APA. A chi-square test of independence was used to assess the association between gaming disorder and substance use characteristics, and multivariable logistic regression was used to analyze whether mental health discussion or the mention of any substance with sufficient sample size was significantly associated with IGD. RESULTS: In total, 10,551 posts were collected from Reddit from June 2017 to December 2022. After filtering the dataset for substance-related keywords, 1057 were included for further analysis, of which 286 mentioned both gaming and the use of ≥1 substances. Among the 286 posts that discussed both gaming and substance use, the most mentione

Hazardous alcohol consumption is highly prevalent for men who have sex with men (MSM). The 4 treatments currently approved by the Food and Drug Administration for alcohol use are reaching an alarmingly low percentage of people who would benefit from a reduction in their alcohol use. There is increasing interest in alternative methods of treatment, such as herbal supplements, to address hazardous drinking. However, research on the acceptability of alternative pharmacotherapies among MSM remains limited. We examined the prevalence and correlates of expressing interest in using herbal supplements for alcohol treatment among MSM with hazardous alcohol consumption. We conducted a secondary data analysis from a cross-sectional study of MSM who use alcohol, conducted from March 2015 to July 2017 in San Francisco, California, to assess the overall prevalence of interest in using herbal supplements to help reduce alcohol consumption. Associations between expressing interest in herbal supplements and demographic, social, and clinical characteristics were examined using bivariate and multivariable logistic regression models. One-third (66/200, 33%) of the participants expressed interest in an herbal supplement for reducing alcohol consumption. In the multivariable analyses, weekly binge drinking (adjusted odds ratio [aOR] 2.85, 95% CI 1.17-6.93), interest in abstaining from alcohol use (aOR 5.04, 95% CI 1.46-17.40), higher severity of alcohol dependence score (aOR 1.22, 95% CI 1.04-1.41), and interest in naltrexone (aOR 3.22, 95% CI 2.12-4.91) were independently associated with higher odds of being interested in using an herbal supplement to reduce alcohol consumption, adjusting for age, race or ethnicity, and education. We found that MSM who have hazardous drinking habits, more severe alcohol dependence, and interest in pharmacotherapy were more likely to express interest in using an herbal supplement for reducing alcohol consumption. To our knowledge, this is the first study

Aim This study assessed the association between exposure to alcohol adverts on social media and alcohol use among university students in Uganda since alcohol consumption has severe effects, especially in countries with weak regulations for alcohol marketing.Methods In total, 996 undergraduate students at Makerere University responded to a questionnaire assessing exposure to alcohol advertising on social media (independent variable) and alcohol use (dependent variable). Adjusted multinomial logistic regression was used to analyse data.Results One in ten students reported hazardous drinking, while three in ten students were low-risk drinkers. Most students (70.1%) reported low exposure to alcohol adverts on social media, followed by high exposure (12.1%), and 17.8% reported no exposure. A key finding was that exposure to alcohol adverts on social media was significantly associated with alcohol use, especially the high exposure and hazardous drinking (odds ratio = 12.62, 95% confidence interval: 4.43-35.96). Students reporting high exposure to alcohol adverts on social media also had higher odds of low-risk drinking (odds ratio = 3.70, 95% confidence interval: 1.88-7.27) than those with low exposure (odds ratio = 1.77, 95% confidence interval: 1.09-2.87), in reference to no exposure.Conclusion Among Ugandan university students, exposure to alcohol adverts on social media is common and associated with alcohol use, in a dose-response manner. These findings suggest a need for a design and implementation of alcohol interventions for students using social media. Short Summary: Forty percent of students reported using alcohol, including hazardous alcohol drinking (10%). Most students were exposed to alcohol adverts on social media to some degree (low exposure, 70.1%; and high exposure, 12.1%). The exposure to alcohol adverts on social media was significantly associated with alcohol use. The association was strong for high exposure in relation to hazardous drinking.

NHTSA published the first edition of the Drugs and Human Performance Fact Sheets in 2004. These updated fact sheets include scientific knowledge about the most frequently used drugs found in drug- and alcohol- impaired driving cases. An expert panel of forensic toxicologists, DREs, and traffic safety resource prosecutors provided input to the present version of the fact sheets. The information is targeted at drug recognition experts and other law enforcement officers, attorneys, judges, and toxicologists. The fact sheets will also benefit those in research, public health, advocacy, and driver education fields.

This report reviews and assesses driver monitoring systems (DMS) and related technologies for alcohol impairment detection and Level 2 partial driving automation systems. A key focus reviewed systems being developed to detect alcohol-caused driving impairment as well as systems that can precisely estimate blood alcohol concentrations. These were classified as physiology-based, tissue spectroscopy-based, camera-based, vehicle kinematics-based, hybrid (i.e., two or more technologies), and patent-stage systems. The review of DMS for Level 2 systems involved a literature review, technology review, and interviews with subject matter experts. The report describes the current state of the technology and practice, advantages and limitations of different approaches, and the readiness of these technologies to address targeted driver states.

Alcohol-related social norms are internalized beliefs regarding the extension and approval of alcohol consumption by social reference groups. Prevention programs based on social norms and behavioral insights are empirical evidence-based approaches that challenge cognitive biases and promote healthy choices by providing actual information of targeted behaviors. These programs, to our knowledge, have not been applied to reduce alcohol use in Latin-America. Objectives: This study examined the effectiveness of a school-based social norms intervention to reduce alcohol use behaviors in high-school adolescents from Cordoba city(Argentina). Ninety-two students (Mean age = 14.18±0.82 years) participated. A 2 (type of school administration: public, private) x 2 (treatment: experimental, control) factorial design was employed. Data collections provided information on actual alcoholconsumption, perceived alcohol consumption of classmates and discrepancies (i.e., biases) between both measures. Results: A brief feedback session, which was complemented with the placement of posters inside the classroom, reduced the prevalence and frequency of several alcohol drinking behaviors. These effects were more noticeable in the public than in the private schools. Conclusions: This is, to our knowledge, the first report of a program that applied a social norms strategy to reduce alcohol consumption in high schoolers from South America, As normas sociais relacionadas ao álcool são crenças internalizadas sobre a extensão e a aprovação do consumo de álcool em grupos sociais de referência. Programas de prevenção baseados em normas sociais e percepções comportamentais desafiam vieses cognitivos e promovem escolhas saudáveis por meio de informações reais sobre comportamentos específicos. Até onde sabemos, esses programas não foram aplicados na América do Sul. Objetivos: este estudo examinou a eficácia de uma intervenção de normas sociais para reduzir comportamentos de consumo de álcool em estudantes do ensino médio na cidade de Córdoba (Argentina). Participaram 92 estudantes (M idade = 14,18 ± 0,82 anos). Foi utilizado um desenho fatorial 2 (tipo de administração escolar: pública, privada) x 2 (tratamento: experimental, controle). Foram coletadas informações sobre consumo real e percebido de álcool e detectaram-se discrepâncias entre as duas medidas. Resultados: Breves sessões de feedback, complementadas por cartazes em sala de aula, reduziram a prevalência e a frequência do consumo de álcool. Esses efeitos foram mais perceptíveis nas escolas públicas. Conclusões: Este é, até onde sabemos, o primeiro estudo sobre a aplicação de uma estratégia de normas sociais para reduzir o consumo de álcool em estudantes sul-americanos., Las normas sociales relacionadas con el alcohol son creencias internalizadas con respecto a la extensión y aprobación del consumo de alcohol en grupos sociales de referencia. Los programas de prevención basados en normas sociales y percepciones conductuales desafían los sesgos cognitivos y promueven elecciones saludables al proporcionar información real sobre conductas específicas. Hasta donde sabemos, estos programas no se han aplicado en Sudamérica. Objetivos: Este estudio examinó la efectividad de una intervención de normas sociales para reducir las conductas de consumo de alcohol en estudiantes de una escuela media de la ciudad de Córdoba (Argentina). Participaron 92 estudiantes (edad media = 14,18 ± 0,82 años). Se empleó un diseño factorial 2 (tipo de administración escolar: pública, privada) x 2 (tratamiento: experimental, controlado). Se recolectó información sobre el consumo real y percibido de alcohol,y se detectaron discrepancias entre ambas medidas. Resultados: Breves sesiones de retroalimentación, complementadascon carteles dentro del aula, redujeron la prevalencia y la frecuencia del consumo de alcohol. Estos efectos fueron másnotorios en las escuelas públicas. Conclusiones: Este es, hasta donde sabemos, el primer reporte de aplicación de una estrategia de normas sociales para reducir el consumo de alcohol en estudiantes Sudamericanos.

Background and aims: Sweden has experienced a substantial decrease in adolescent drinking over the past decades. Whether the reduction persists into early adulthood remains unclear. Using survey data, the present study aimed to determine whether reductions in indicators of alcohol use observed among adolescents remain in early adulthood and whether changes in alcohol intake are consistent among light/moderate and heavy drinkers. Design: Data from the Swedish monthly Alcohol Monitoring Survey (2001–20) were used to construct five 5-year birth cohorts (1978–82, 1983–87, 1988–92, 1993–97 and 1998–2002). Setting: Sweden. Participants: A total of n = 52 847 respondents (48% females) aged 16 and 30 years were included in this study. Measurements: For both males and females, temporal changes in the prevalence of any drinking, the prevalence of heavy episodic drinking (HED) and total alcohol intake in the past 30 days in centilitres were analysed. Findings: The prevalence of any drinking in more recent cohorts remained low until young people came into their early (females) and mid- (males) 20s. Male cohorts differed in the prevalence of HED across age, with the later cohorts showing lower odds than earlier cohorts (odds ratios between 0.54 and 0.66). Among females, no systematic differences between cohorts across age could be observed. Later male birth cohorts in light/moderate drinkers had lower alcohol intake than earlier cohorts (correlation coefficients between −0.09 and −0.54). No statistically significant cohort effects were found for male heavy drinkers. Although differences in alcohol intake among females diminished as age increased, the cohorts did not differ systematically in their level of alcohol intake. Conclusions: In Sweden, the reduced uptake of drinking in adolescents appears to fade as people move into adulthood. Observed reductions in alcohol intake among light and moderate drinkers appear to persist into adulthood. More recent male cohorts show a lower p

In South Africa, alcohol use during pregnancy is prevalent and associated with increased HIV risk. Developing locally sensitive and contextually appropriate evidence-based interventions to address alcohol use among pregnant and breastfeeding women in South Africa requires comprehensive understanding of the context of perinatal alcohol use and how relationships and lived environments may serve as barriers or supports for alcohol reduction. We conducted twenty in-depth qualitative interviews with isiXhosa speaking women who reported alcohol use during their recent pregnancy and/or recent intimate partner violence in Cape Town, South Africa between September and November 2022. We describe patterns and drivers of ongoing alcohol use during pregnancy and map them onto levels of the socioecological model. Data were analyzed utilizing the interpretivist paradigm and interpretive thematic analysis. Eight women reported alcohol use during pregnancy, sixteen reported experiencing recent IPV, and four women reported both alcohol use during pregnancy and recent IPV. In interviews, commonly cited reasons for continued alcohol use in pregnancy included stress (e.g., due to financial concerns), peer pressure, the central role of alcohol use in socialization and the persistence of misconceptions regarding the safety of alcohol use in pregnancy. Still, despite women reporting social norms that supported continued alcohol use in pregnancy, many altered who they drank with due to fear of judgement from close friends and family, leaving them isolated from their social support system. Interventions aimed at increasing interpersonal support, such as the use of peer mentors, could prove beneficial. Although the clinic provides messaging around the harms of alcohol use in pregnancy, these messages conflict with messaging received from their peers, limiting their impact on behavior. Locally sensitive tailored, relevant programming that intervenes on barriers to reducing alcohol use in pregn

BackgroundLesbian, gay, bisexual, transgender, queer, intersex, aromantic and asexual (LGBTQIA+) communities in the United States experience higher rates of alcohol use than the general population. While experiencing intimate partner violence (IPV) is thought to lead to increased alcohol use in LGBTQIA+ people, little research has investigated the temporal relationship between IPV and alcohol use in this population.MethodsData from two annual questionnaires of The Population Research in Identity and Disparities for Equality Study (The PRIDE Study) longitudinal cohort (n=3,783) were included. Overall IPV and three sub-types (physical, sexual, and emotional) - measured in 2021 using the extended Hurt, Insult, Threaten, Scream (E-HITS) screening tool - was examined as a predictor of Alcohol Use Disorders Identification Test (AUDIT) score in 2022 using multivariable linear regression to assess linear and quadratic associations. Models were adjusted for sociodemographic characteristics and history of alcohol use.ResultsOne-quarter (24.7%) of respondents reported experiencing past-year IPV in 2021. The mean AUDIT score in 2022 was 3.52 (SD = 4.13). In adjusted models, both linear (B: 0.26, 95% CI: 0.14, 0.38) and quadratic (B: -0.03, 95% CI: -0.04, -0.01) terms for overall IPV were significantly associated with next-year AUDIT score. These patterns were mirrored in each IPV sub-type, were not attenuated when accounting for relationship characteristics, and were heterogeneous across gender identity groups.ConclusionsThese results provide evidence of a temporal relationship between IPV and alcohol use in LGBTQIA+ communities, suggesting that efforts to prevent and mitigate IPV may help reduce alcohol use disparities in this population.

This dissertation project examines the mental and behavioral health consequences of racialized stressors including perceived racial/ethnic discrimination, deportation fear, and acculturative stress among Latina/o/e adolescents and emerging adults of immigrant origin or descent. This project also explores cultural and familial strengths through the potential moderating roles of communal coping, maternal positive parenting behaviors, and attachment relationship quality with mothers in the context of racialized stress. Adolescence and emerging adulthood both represent a developmental period in which individuals strive for independence from parents and transition into a phase of identity and future-oriented exploration (Arnett, 2004; Moretti & Peled, 2004). Given the pressures experienced from individual, phase of life, and developmental factors, numerous adolescents and young adults report struggling with mental health (American College Health Association, 2013; Arnett, 2000; 2004; Huynh et al., 2021; McDermott et al., 2015; Rivas-Drake et al., 2008). Additionally, Latina/o/e adolescents and young adults must contend with disproportionate mental health strain (e.g., higher depression rates) due to racialized stressors such as discrimination and acculturative conflict relative to their non-Hispanic White counterparts and even compared to older Latina/o/es (Alegría et al., 2008; Castillo & Schwartz, 2013; Huynh et al., 2012; 2021; Pérez et al., 2008). Latina/o/e culture gives prominence to interdependence, familial harmony and connection, as well as communality as a means for preserving the family’s well-being and each individual’s overall health, providing a base for coping with daily life stressors including racialized stress (Campos et al., 2014; 2018; Campos & Kim, 2017; Carter & Forsyth, 2010; Kulish et al., 2019; Molina et al., 2016; Stein et al., 2014; Umaña-Taylor et al., 2015). For instance, through a number of various closely-related concepts, f

The shift from asking 'why adolescents drink?' to 'why do they not drink?' indicates a broad declining trend in alcohol consumption among adolescents over the last couple of decades. More scientific studies have shown interest in these processes at both the individual and societal levels. This reply highlights the main key points that we find important to clarify and elaborate a bit further: 1) age differences and long-term perspectives, 2) the definition of non-drinking, 3) outcome measures, 4) the nature of the samples, and 5) attrition in longitudinal studies. By employing a stringent definition of non-drinking and focusing on social interactions and psychological health, our research complements existing literature on adolescent alcohol consumption.

Background: As cardiac surgery patients continue to age and present with more complex health conditions, the occurrence of a challenging postoperative complication known as "delirium" is becoming increasingly common. Postoperative delirium (PoD) is a complex neuropsychological disorder characterized by symptoms such as inattention, drowsiness, and agitation, which has many long-term negative health impacts. A patient-associated risk factor of PoD is presumed to be a preoperative alcohol use disorder (AUD). Objective: The primary purpose was to determine whether preoperative alcohol use, measured using the Alcohol Use Disorders Identification Test - Concise (AUDIT-C), is predictive of incident PoD in cardiac surgical patients. The secondary objective was to determine the risk factors associated with PoD available in the Manitoba Access Cardiac Surgery (MACS) database. Hypothesis: Primary: Higher AUDIT-C scores are associated with the incidence of PoD in adults who underwent cardiac surgery. Secondary: risk factors identified from the MACS database are correlated with PoD in adults who underwent cardiac surgery. Methods: This was a single-centre, retrospective observational cohort study. AUDIT-C score and PoD (as diagnosed using the Confusion Assessment Method (CAM) – ICU in the intensive care unit or CAM on the postoperative ward) were collected for all elective patients undergoing cardiac surgery between March 2015 – September 2020. Results: The overall incidence of delirium in this study was 14.2%. There was an association between preoperative alcohol use measured by AUDIT-C and PoD (0.559 OR, 0.515-0.607 95% CI, p = < 0.001) before controlling for covariates. After controlling for age, procedure category, MoCA score, CFS, LVEF category, renal insufficiency, previous CVA/TIA, recreational drug use and CPB time, there was no significant association between alcohol use and PoD (0.376 OR, 0.070-2.011 95% CI, p = 0.253). Previously known risk factors, including age, fr

Understanding the dynamics of alcohol reporting among U.S. military members is crucial for promoting their well-being and for developing effective support programs. Yet current research often overlooks the issue of potential underreporting of alcohol use among U.S. military members. This study aimed to address this gap by exploring the phenomenon of underreporting alcohol use among military personnel. This qualitative study utilized an ethnographic research method to investigate the experiences of 35 U.S. military members with various military statuses. The research questions explored the perception of the prevalence and causes of underreporting of alcohol use and possible remedies for underreporting, framed within avoidance coping and social desirability bias. Through semi-structured interviews, eight themes emerged: confirmation of underreporting, denial of underreporting, psychological barriers to reporting, avoidance of formal support services, social and career implications, social and cultural shifts, mitigating consequences and fear, and doubts about helpful solutions. The findings emphasize the need for cultural and organizational changes within military settings to support service members in disclosing alcohol-related concerns without any fear of repercussions. This study calls for prioritizing destigmatizing help-seeking behaviors and fostering transparent reporting systems to ensure the well-being of U.S. military members.

Introduction: In the 21st century, there has been a decline in alcohol use among adolescents in most Nordic countries, while trends of cannabis use have diverged. We explore how alcohol and cannabis use, respectively, and co-use of the two substances, have changed among Nordic adolescents. Three hypotheses are used to frame the study: (i) cannabis use has substituted alcohol use; (ii) there has been a parallel decline in both substances; and/or (iii) there has been a ‘hardening’ of users, implying that alcohol users increasingly use cannabis. Methods: Data from the European School Survey Project on Alcohol and Other Drugs, conducted among 15- to 16-year-olds in Denmark, Finland, Iceland, Norway and Sweden (N = 74,700, 49% boys), were used to explore trends of past-year alcohol and cannabis use in the period 2003–2019. Results: The proportion of adolescents reporting alcohol use decreased significantly in all Nordic countries except Denmark. The proportion of those using cannabis only was low (0.0%–0.7%) and stable in all countries. The total number of substance use occasions declined among all adolescents in all countries but Denmark. Among alcohol users, cannabis use became increasingly prevalent in all countries but Denmark. Discussion and Conclusions: We found no support for the ‘parallel decline hypothesis' in alcohol and cannabis use among Nordic adolescents. Partially in line with the ‘substitution hypothesis’, cannabis use accounted for an increasing proportion of all substance use occasions. Our results suggests that the co-use of alcohol and cannabis has become more common, thus also providing support to the ‘hardening’ hypothesis.

Background. Decades of research have found alcohol and negative affect (NA) are global and proximal risk factors for psychological and physical intimate partner violence (IPV), especially among college students. Despite recognition as the most common form of IPV, bidirectional psychological and physical IPV (i.e., instances where both partners are perpetrating and experiencing victimization) remains an understudied topic. Clarifying alcohol and NA’s influences on bidirectional IPV may inform the development of intervention programs. We hypothesized that the association between alcohol use (number of daily drinks and Heavy Episodic Drinking [HED]) and IPV would vary as a function of NA. Methods. Dating college students (N = 232; 67.7% women; 83.89% white) who drink alcohol completed daily surveys for 60 consecutive days assessing daily alcohol use, NA, and IPV perpetration and victimization. Generalized linear mixed models (GLMMs) tested the within- and between-person associations and interactions between alcohol use, NA, and psychological and physical unidirectional and bidirectional IPV. Results. A significant interaction between NA and the number of drinks before unidirectional psychological IPV perpetration emerged, such that the alcohol-IPV association was weaker at lower levels of NA. A main effect of NA emerged as a proximal antecedent of unidirectional psychological victimization and bidirectional psychological IPV. Main effects of within- and between-person alcohol use were insignificant across other models. Conclusion. On days of low NA, college students were less likely to perpetrate psychological IPV after drinking. Future research should clarify whether positive affect weakens the alcohol-IPV association and assess additional moderators of this link.

Objective: Parent history of alcohol-related problems and antisocial behaviors contribute to adolescent alcohol use and are associated with offspring attention-deficit/hyperactivity disorder (ADHD). Youth with ADHD may be susceptible to intergenerational transmission of alcohol-related cognitions, which may model drinking motives that enhance risk for adolescent alcohol use. We examined whether childhood ADHD and parent history of alcohol use disorder, with or without antisociality, were associated with adolescents’ perceptions of their parents’ drinking motives and whether these perceptions predicted their alcohol use behaviors. Method: Adolescents (N = 199; 56% with ADHD; Mage = 15.73) completed the Drinking Motives Questionnaire regarding perceptions of their parents’ drinking motives. Participants subsequently reported their past-year alcohol use behaviors (Mage = 16.95). Parents reported their history of alcohol-related problems and antisocial symptoms. Covariates included adolescent gender (7% girls), race (9% self-identified Black), and parental education and marital status. Results: Perceived parent drinking motives were highest for social and lowest for conformity motives, consistent with adult self-reports in the literature. Parent alcohol use and antisociality history predicted perceptions of parent drinking motives, and child ADHD only predicted perceptions of parent social drinking motives. Perceived parent drinking motives predicted adolescent alcohol use, but only among youth without ADHD. Conclusion: Findings reflect the potential importance of assessing adolescent perceptions of parent drinking motives for adolescents without ADHD and a possible need for supporting parents in communicating about their own alcohol use. Future research should consider alternative strategies (e.g., assessing implicit cognitions) for studying the link between alcohol-related cognitions and behaviors for adolescents with ADHD.

This study aimed to examine the presence of self-medication and in Swedish autobiographies, the understanding of the self-medication process. A narrated qualitative research method, with a content analysis of the autobiographies, was used to investigate the authors' descriptions of their drug and/or alcohol addiction and life story. The self-medication hypothesis and the learning model were applied for the analysis. The result of the study shows that the reason for drug or alcohol use can according to the life stories narrated in the autobiographies be more than to get high or have fun. In conclusion, the reasons for drug or alcohol use can be to change a bad feeling. The reason can be to forget, alleviate, or deal with the bad feeling or bad memories.

Adolescents are particularly prone to engage in health-risk behaviors such as alcohol and substance use, which can significantly impact their present and future lives. Our study explores the factors contributing to (1) regular alcohol use (i.e., at least 3 to 5 times in the last 30 days) and (2) binge drinking (i.e., drinking at least five glasses of alcohol in a single sitting in the last 12 months) in adolescents, in the 2014 and 2018 waves of the Health Behavior in School-Aged Children (HBSC) survey conducted in the Lombardy region, Italy. Data collection used a stratified cluster sampling method to obtain a representative sample of adolescents (N = 6506) aged 11, 13, and 15 years (49.7% females). We used structural equation models (SEM) to explore the association of individual-related factors, including health complaints (i.e., somatic problems and psychological problems) and psychosocial variables (i.e., perceived support from family, peers, and teachers), on regular alcohol consumption and binge drinking. Overall, 9.9% of adolescents reported regular alcohol drinking and 18.3% binge drinking. The findings highlighted that higher somatic problems are associated with increased regular alcohol use (OR=1.24, 95% CI: 1.04–1.46), and higher psychological problems are associated with increased binge drinking (OR=1.33, 95% CI: 1.15–1.55). Moreover, lower perceived support from teachers is significantly associated with both regular (OR=1.41, 95% CI: 1.25–1.59) and binge drinking (OR=1.42, 95% CI: 1.28–1.57), and lower perceived student support is associated with a reduced risk of both usual drinking (OR=0.87, 95% CI: 0.77–0.98) and binge drinking (OR=0.86, 95% CI: 0.78–0.96). The study findings emphasize the importance of tackling somatic and psychological health and psychosocial support, particularly in the school environment, through interventions aimed at controlling adolescent drinking habits.

This research aims to understand and describe the etiology and mechanisms that maintain the association between alcohol consumption and violence perpetrated by Mexican men against their female partners. An exploratory qualitative study was conducted using the focus group technique, with the participation of 14 men recruited through a marketing campaign in social networks, all with a history of intimate partner violence and alcohol consumption (assessed using the AUDIT and a semi-structured questionnaire). The data analysis was done manually, based on grounded theory, and subjected to three triangulation types. According to the results, the etiology of the association between alcohol consumption and intimate partner violence is the inadequate satisfaction of the need for bonding (attachment), imposed by the normative socialization of being a man, culturally known as machismo; an association that is maintained mainly by emotional dysregulation, lack of cohabitation skills in couples and poor management of the family economy. The results bring to the table a well-known, but little-considered fact: both alcohol consumption and the exercise of violence are strongly influenced by culture, which makes it necessary to investigate the phenomenon, emphasizing the peculiarities of the population under study. These results can be considered an indicator of the components necessary to develop an intervention that addresses both variables in the Mexican population, O objectivo desta investigação é compreender e descrever a etiologia e os mecanismos que mantêm a associação entre o consumo de álcool e a violência perpetrada por homens mexicanos contra as suas parceiras. Foi realizado um estudo exploratório qualitativo, recorrendo a grupos focais, com a participação de 14 homens recrutados por meio de uma campanha de marketing nas redes sociais, todos com antecedentes de violência nas relações de intimidade e consumo de álcool (avaliado através do AUDIT e de um questionário semiestruturado). A análise dos dados foi feita manualmente, com base na teoria fundamentada, e foi submetida a três tipos de triangulação. Conforme os resultados, a etiologia da associação entre o consumo de álcool e a violência entre parceiros íntimos é a incorreta satisfação da necessidade de vinculação (apelo), imposta pela socialização normativa do ser homem, culturalmente conhecida como machismo; uma associação mane é mantida principalmente pela desregulação emocional, pela falta de competências de coabitação nos casais e pela má gestão das finanças familiares. Os resultados trazem à colação um dado conhecido, mas pouco considerado: tanto o consumo de álcool como o exercício da violência são fortemente influenciados pela cultura, o que torna necessário investigar o fenômeno, enfatizando as particularidades da população em estudo. Estes resultados podem ser considerados um indicador dos componentes necessários para desenvolver uma intervenção que aborde ambas as variáveis na população Mexicana, El objetivo de esta investigación es conocer y poder describir la etiología y los mecanismos que mantienen la asociación entre el consumo de alcohol y la violencia perpetrada por hombres mexicanos en contra de sus parejas femeninas. Se realizó un estudio exploratorio cualitativo mediante la técnica de grupos focales, en el que participaron 14 hombres reclutados a través de una campaña de marketing en redes sociales, todos con antecedentes de ejercicio de violencia de pareja y consumo de alcohol (evaluados mediante el AUDIT y un cuestionario semiestructurado). El análisis de datos se hizo de forma manual, con base en la teoría fundamentada, y fue sometido a tres tipos de triangulación. De acuerdo con los resultados, la etiología de la asociación entre el consumo de alcohol y la violencia de pareja es la inadecuada satisfacción de la necesidad de vínculo (apego), impuesta por la socialización normativa de ser hombre, culturalmente conocida como machismo; asociación que se mantiene principalmente por la desregulación emocional, la falta de habilidades de convivencia en pareja y el mal manejo de la economía familiar. Los resultados ponen sobre la mesa un hecho conocido, pero poco tomado en cuenta: tanto el consumo de alcohol como el ejercicio de la violencia están fuertemente influenciados por la cultura, lo que vuelve necesaria la investigación del fenómeno enfatizando las peculiaridades de la población bajo estudio. Estos resultados pueden considerarse un indicador de los componentes necesarios para desarrollar una intervención que atienda ambas variables, en población mexicana

BACKGROUND: Stimulant use is a major public health problem that contributes to morbidity and mortality among men who have sex with men (MSM) in the United States. To reduce the harms associated with stimulant use, there is a need to identify the factors associated with stimulant use to inform interventions. Additionally, there is a need to use large crowdsourcing platforms like Amazon Mechanical Turk (MTurk) to engage more individuals who use substances across the United States. OBJECTIVE: We identified the correlates of stimulant use among people who use alcohol or stimulants in the United States recruited using MTurk. METHODS: Participants who were aged ≥18 years in the United States and reported alcohol or stimulant (ie, cocaine, crack cocaine, and methamphetamine) use were deemed eligible and recruited via the web platform MTurk. Participants completed a baseline survey, which assessed sociodemographics, psychosocial (ie, depression, affect, self-esteem, and stress) factors, substance use, and sexual behaviors. Data were collected and analyzed with STATA (version 17; StataCorp). Stratifying by MSM status, bivariate and multivariable logistic regression models were built in STATA to examine the correlates of stimulant use. Multivariable models controlled for age, race, health insurance, and relationship status. RESULTS: Of 272 participants, 201 (73.9%) identified as male, 134 (49.2%) were MSM, 52 (19.1%) were from racial and ethnic minoritized communities, and 158 (58%) were in a relationship. The mean age was 36.10 (SD 10.3) years. A total of 40 (14.7%) participants reported stimulant use in the past 6 months. Factors significantly associated with stimulant use were being MSM (adjusted odds ratio [aOR] 4.61, 95% CI 1.97-10.81), a higher Alcohol Use Disorders Identification Test-Concise score (aOR 1.24, 95% CI 1.08-1.42), more intense cravings for alcohol in the past 24 hours (aOR 1.03, 95% CI 1.01-1.04), a higher depression score (aOR 1.06, 95% CI 1.01-1.12), a

BACKGROUND AND AIMS: Whereas striatal dopamine D2 receptor (D2R) availability has shown to be altered in individuals with alcohol use disorder (AUD) and in healthy individuals with a family history of AUD, the role of D2R in the development of AUD is unknown. In this positron emission tomography (PET) study, we measured whether D2R availability is associated with subsequent alcohol use and alcohol-related factors, at a follow-up 8-to-16-years post PET scan, in social drinkers. DESIGN: Longitudinal study following healthy individuals. SETTING: Academic research imaging centre in Stockholm, Sweden. PARTICIPANTS: 71 individuals (68 of whom had evaluable PET data, 5 females, 42.0 years mean age) from a series of previous PET studies. MEASUREMENTS: One PET examination with the D2R antagonist radioligand [11 C]raclopride at baseline, and self-report measures assessing alcohol use, drug use, impulsivity, reward sensitivity, and family history of alcohol- or substance use disorder at follow-up. FINDINGS: We found no evidence for an association between D2R availability and later alcohol use (B = -.019, B 95% confidence interval [CI] = -.043-(-).006, p = .147), nor for the majority of the alcohol-related factors (B 95 % CI = -.034-.004, p = .273-.288). A negative association with a small effect size was found between D2R availability and later impulsivity (B = -.017, B 95% CI = -.034-(-).001, p = .046). CONCLUSIONS: Low striatal dopamine D2 receptor availability may not be a strong predictor in the development of alcohol use disorder.

Aim: Our aim was to investigate potential differences in mental health, self-rated health, risky sexual behaviour, alcohol use, and drug use between (1) Prospective exchange students and campus students separated by sex, and (2) male and female students as a group. Method: Comparative cross-sectional design using an online survey containing the following instruments: Knowledge, Attitudes, and Sexual Behaviour in Young People in Sweden; Self-Rated Health Questionnaire; and General Health Questionnaire 12. One-hundred and fourteen prospective exchange students and 451 campus students participated in the study. Results: Male prospective exchange students rated their mental health as being better and had used cannabis more often compared with female prospective exchange students. Male prospective exchange students also rated their mental health as being better than male campus students. Female students, in general, rated their mental health as worse than male students. A larger proportion of male prospective exchange students had sex together with alcohol compared with male campus students, and a larger proportion of female prospective exchange students had sex with a new partner and drank more alcohol compared to female campus students. Conclusion: The result shows that risky alcohol use and sexually risky behaviour is prominent amongst prospective exchange students. It is possible that they will continue, and even increase their risky behaviour whilst abroad as they find themselves in a new social context, and free from influence of the rules and restrictions that they might have at home. With limited knowledge of the local culture, native language, and in an unfamiliar environment, it is possible that the risks will be enhanced and possibly decrease their health. This highlights the need for proactive interventions, conceivably with some variations in content between sexes.

Although accumulating studies indicate that alcohol-specific self-control can be useful in predicting adolescent alcohol use, little is known about its specificity. This longitudinal study aimed to advance our understanding of domain-specific self-control by examining whether alcohol-specific self-control mediates the effect of general self-control on adolescent alcohol use or has generalizing effects by also mediating the effect of general self-control on other behavior requiring self-control (adolescent digital media use and smoking). Data from 906 adolescents aged 11-14 years who were enrolled in the Dutch study Prevention of Alcohol Use in Students were used. Data were collected using online questionnaires at four annual measurements. Structural equation modelling revealed that higher alcohol-specific self-control fully mediated the effect of higher general self-control on alcohol use. Alcohol-specific self-control did not mediate the effect of higher general self-control on digital media use, but did partially mediate the effect of higher general self-control on smoking. These results suggest that alcohol-specific self-control is domain-specific, but not necessarily substance-specific. The domain-specificity of alcohol-specific self-control provides evidence for its theoretical relevance for the explanation of adolescent alcohol use. It also suggests leverage points for intervention programs focusing on improving alcohol-specific self-control to reduce adolescent alcohol use.

BackgroundSouth African mothers confront synergistic challenges from depression, alcohol use, and HIV/AIDS. The importance of maternal functioning for child development motivates interventions, yet long-term outcomes seldom are tracked. Furthermore, little is known about trajectories and the role of social-cultural factors in maternal depression and alcohol use across parenthood in low- and middle-income countries.MethodsWe examined maternal outcomes at 5- and 8-years' post-birth, from the Philani Intervention Program (PIP), a randomized controlled trial of a prenatally-initiated home visiting intervention lasting through 6 months' post-birth which yielded some benefits for children and mothers through 3 years. Longitudinal Bayesian mixed-effects models assessed intervention effects for maternal depression and alcohol use from pre-birth through 8 years post-birth. We plotted trajectories of depression and alcohol use and analyzed their relationship over time.ResultsMaternal benefits appeared limited and intervention outcomes differed at 5 and 8 years. Reduced depression in PIP versus standard care (SC) mothers at 3 years disappeared by 5 and 8 years. Depression prevalence declined from 35.1% prenatally to 5.5% at 8 years, independent of intervention or alcohol use. Alcohol use in both groups rebounded from a post-birth nadir; fewer PIP than SC mothers drank alcohol and reported problematic use at 5 but not 8 years. HIV+ prevalence did not differ by condition and increased from 26% to 45% over the reported period.ConclusionsDissipation of early child benefits from home visiting by age 8 years likely reflects lack of durable change in maternal behaviors compounded by social-cultural factors and cumulative effects of community deprivation. High prenatal rates warrant screening and treatment for depression in standard antenatal care. Low-and-middle income countries may need sustained interventions, including alcohol use reduction, to capitalize on initial gains fro

Alcohol is the most widely used substance among adolescents. Although Black adolescents use alcohol at lower rates than White adolescents, Black adolescents tend to have worse outcomes. This includes higher rates of mood disorders and criminal justice involvement associated with alcohol use and misuse compared to any other racial group. Black adolescents are also more likely to experience racial discrimination and be exposed to traumatic events within their communities, which may increase their chances of using substances. Understanding the relationship between racial attitudes (towards ones own group and others) and substance use and mental health can provide unique and meaningful insight into prevention programming for Black adolescents. Yet, these concepts have been understudied. To fill this gap, we examined the association between racial attitudes and alcohol use and mood disorders in Black adolescents in Philadelphia, PA (N = 154). We used the revised Adolescent Survey of Black Life to measure pro-Black (positive attitudes toward being Black and factors related to Black people), anti-White (negative attitudes toward White people due to experiences of racism and discrimination) and racism awareness (recognition of racism) domains. Logistic regression analyses were conducted to test the associations. Results showed that: higher pro-Black attitudes were associated with a lower odds of mood disorder (odds ratio [OR] = 0.72, 95% CI = 0.55, 0.89); and higher racism awareness was associated with an increased odds of alcohol use (OR = 1.18, 95% confidence interval [CI] = 1.06, 1.29). Findings provide preliminary support for interventions and policies for Black adolescents that bolster positive racial identity and eliminate experiences of racism as alcohol use and mood disorder prevention strategies.

OBJECTIVES: People with HIV have a higher risk of myocardial infarction (MI) than the general population, with a greater proportion of type 2 MI (T2MI) due to oxygen demand-supply mismatch compared with type 1 (T1MI) resulting from atherothrombotic plaque disruption. People living with HIV report a greater prevalence of cigarette and alcohol use than do the general population. Alcohol use and smoking as risk factors for MI by type are not well studied among people living with HIV. We examined longitudinal associations between smoking and alcohol use patterns and MI by type among people living with HIV. DESIGN AND METHODS: Using longitudinal data from the Centers for AIDS Research Network of Integrated Clinical Systems cohort, we conducted time-updated Cox proportional hazards models to determine the impact of smoking and alcohol consumption on adjudicated T1MI and T2MI. RESULTS: Among 13 506 people living with HIV, with a median 4 years of follow-up, we observed 177 T1MI and 141 T2MI. Current smoking was associated with a 60% increase in risk of both T1MI and T2MI. In addition, every cigarette smoked per day was associated with a 4% increase in risk of T1MI, with a suggestive, but not significant, 2% increase for T2MI. Cigarette use had a greater impact on T1MI for men than for women and on T2MI for women than for men. Increasing alcohol use was associated with a lower risk of T1MI but not T2MI. Frequency of heavy episodic alcohol use was not associated with MI. CONCLUSIONS: Our findings reinforce the prioritization of smoking reduction, even without cessation, and cessation among people living with HIV for MI prevention and highlight the different impacts on MI type by gender.

Previous research shows that sleep quality may interact with some other predictors of depression, such that poor sleep could strengthen the association between these factors and depression. We aimed to determine the presence of statistical interactions between sleep quality and loneliness, risky alcohol use, perfectionistic concerns and/or physical inactivity in relation to depressive symptoms. Further, we aimed to describe the functional form of the statistical interactions and associations. We used a cross-sectional design and included 4262 Swedish university students. All measures were self-reported, sleep quality was measured with the Pittsburgh Sleep Quality Index, and depressive symptoms with the short-form Depression, Anxiety and Stress Scale. Regression models of increasing complexity (linear and non-linear, with and without interactions) were compared to determine the presence of associations and statistical interactions, and to explore the best functional form for these associations and interactions. Out-of-sample R2 from repeated cross-validation was used to select the final models. We found that sleep quality was associated with depressive symptoms in all final models. Sleep quality showed a linear interaction with perfectionistic concerns in relation to depressive symptoms, such that perfectionistic concerns were more strongly associated with depressive symptoms when sleep quality was poor. Loneliness, risky alcohol use and physical inactivity were non-linearly associated with depressive symptoms but did not interact with sleep quality. We concluded that out of the four examined variables, only perfectionistic concerns interacted with sleep quality in relation to depressive symptoms. This interaction was weak and explained little of the overall variance in depressive symptoms.

Victims of bullying are at an increased risk not only of developing adverse mental health, but also of engaging in health risk behaviours. One way in which adolescents may cope with the health-related consequences of bullying victimisation is through substance use such as alcohol and narcotics, as posited by the self-medication hypothesis. Indeed, previous research has found a link between traditional (face-to-face) bullying victimisation and alcohol use among adolescents, albeit with some inconsistencies. However, studies examining both traditional bullying and cyberbullying among youth often report an association only between cyberbullying victimisation and drinking. The current study seeks to add to this field of research by analysing the predictive capacity of traditional and cyberbullying victimisation for youth drinking whilst also adjusting for bullying perpetration and sociodemographic characteristics. In the analyses, we distinguished between occasional and frequent victimisation, and performed separate investigations of how specific types of traditional bullying and cyberbullying victimisation are related to youth drinking. Data were obtained from the Swedish Health Behaviour in School-aged Children (HBSC) survey, with pooled cross-sectional information from 2013/14 and 2017/18 collected among 13- and 15-year-old students (n =7126). Any alcohol use and drunkenness during the past 30 days were used as dependent variables. The respondents were categorised as non-victims, occasional victims, and frequent victims of traditional and cyberbullying, respectively. Binary logistic regression analyses were performed to examine the associations between bullying victimisation and youth drinking. The results showed that 21.2% of students reported that they had been bullied at least once or twice in the past months, either as victims of traditional bullying only (8.3%), cyberbullying only (7.8%), or both (5.1%). When both types of bullying victimisation were mutually ad

Introduction: Understanding how patterns of drinking are associated with risky gambling in Australia is needed to inform an effective approach to minimise harm. Methods: This cross-sectional questionnaire study reports on 2,704 subsampled participants who completed survey questions about their patterns of drinking. With logistic regressions, we examined whether frequency of heavy episodic drinking (HED) and alcohol use while gambling were associated with risky gambling while controlling for sociodemographic variables. Results: Occasional HED and monthly HED were associated with any gambling (versus no gambling), but frequent HED was not significantly associated with gambling. The opposite pattern was found when predicting risky gambling. Occasional HED (i.e. less than monthly) was not significantly associated, but a higher frequency of HED (at least weekly) was associated with a higher likelihood of risky gambling. Drinking alcohol while gambling was associated with risky gambling, over and above HED. The combination of HED and use of alcohol while gambling appeared to significantly increase the likelihood of risky gambling. Conclusions: The association of HED and alcohol use while gambling with risky gambling highlights the importance of preventing heavy alcohol use among gamblers. The links between these forms of drinking and risky gambling further suggests that individuals who engage in both activities are specifically prone to gambling harm. Policies should therefore discourage alcohol use while gambling for example by prohibiting serving alcohol at reduced prices or to gamblers who show signs of being affected by alcohol and informing individuals of the risks associated with alcohol use while gambling.

Introduction: Comparative risk assessments (CRAs) for alcohol use are based on indirect estimates of attributable harm, and usually combine country-specific exposure estimates and global risk relations derived from meta-analyses. CRAs for Eastern European countries, such as Lithuania, base their risk relations not on global risk relations, but on a large Russian cohort study. The availability of a direct estimate of alcohol-attributable mortality following the 2017 implementation of a large increase in alcohol excise taxes in Lithuania has allowed a comparison of these indirect estimates with a country-specific gold standard. Methods: A statistical modelling study compared direct (predictions based on a time-series methodology) and indirect (predictions based on an attributable-fraction methodology) estimates of alcohol-attributable mortality before and after a large increase in alcohol excise taxes in Lithuania. Specifically, Russia-specific versus global relative risks were compared against the gold standard of time-series based predictions. Results: Compared to direct estimates, indirect estimates markedly underestimated the reduction of alcohol-attributable mortality 12 months post intervention by at least 63%. While both of the indirect estimates differed markedly from the direct estimates, the Russia-specific estimates were closer to the direct estimates, primarily due to higher estimates for alcohol-attributable cardiovascular mortality. Discussion: As all indirect estimates were markedly lower than direct estimates, current overall relative risks and price elasticities should be re-evaluated. In particular, global estimates should be replaced by new regional estimates based on cohort studies.

Background: Organising alcohol retail systems with more or less public ownership has implications for health and the economy. The aim of the present study was to estimate the economic, health, and social impacts of alcohol use in Finland in 2018 (baseline), and in two alternative scenarios in which current partial public ownership of alcohol retail sales is either increased or fully privatised. Methods: Baseline alcohol-attributable harms and costs were estimated across five categories of death, disability, and criminal justice. Two alternate alcohol retail systems were defined as privately owned stores selling: (1) only low strength alcoholic beverages (public ownership scenario, similar to Sweden); or (2) all beverages (private ownership scenario). Policy analyses were conducted to estimate changes in alcohol use per capita. Health and economic impacts were modelled using administrative data and epidemiological modelling. Results: In Finland in 2018, alcohol use was estimated to be responsible for €1.51 billion (95% Uncertainty Estimates: €1.43 billion, €1.58 billion) in social cost, 3,846 deaths, and 270,652 criminal justice events. In the public ownership scenario, it was estimated that alcohol use would decline by 15.8% (11.8%, 19.7%) and social cost by €384.3 million (€189.5 million, €559.2 million). Full privatisation was associated with an increase in alcohol use of 9.0% (6.2%, 11.8%) and an increase in social cost of €289.7 million (€140.8 million, €439.5 million). Conclusion: The outcome from applying a novel analytical approach suggests that more public ownership of the alcohol retail system may lead to significant decreases in alcohol-caused death, disability, crime, and social costs. Conversely, full privatisation of the ownership model would lead to increased harm and costs.

Objective: In Sweden, national guidelines recommend that all staff in the healthcare system systematically screen patients for alcohol use and illicit substance use. Where hazardous use is identified, it should be addressed as soon as possible, preferably through brief interventions (BI). Results from a previous national survey showed that most clinic directors stated that they had clear guidelines for screening alcohol use and illicit substance use, but that fewer staff than expected used screening in their work. This study aims to identify obstacles and solutions to screening and brief intervention, based on survey respondents' free-text responses to open-ended questions. Results: A qualitative content analysis yielded four codes: guidelines, continuing education, cooperation and resources. The codes indicated that staff would need (a) clearer routines in order to optimize compliance with the national guidelines; (b) more knowledge about how to treat patients with problematic substance use; (c) better cooperation between addiction care and psychiatry; and (d) increased resources to improve routines at their own clinic. We conclude that increased resources could contribute to better routines and cooperation, and provide increased opportunities for continuing education. This could increase guideline compliance and increase healthy behavior changes among patients in psychiatry with problematic substance use.

Aims: To follow up on exchange students' alcohol use, drug use, mental health, self-rated health, and risky sexual behaviour after a semester abroad and to compare them with students who remained on campus. Methods: The study design was a follow-up study based on a previous baseline survey of 114 prospective exchange students and 451 campus students. Of the original 565 students, 48 (42.1%) prospective exchange students and 209 (43.3%) campus students responded to the follow-up. Both the baseline survey and the follow-up survey included the General Health Questionnaire 12, one single item from Self-Rated Health, and nine items from Knowledge, Attitudes and Sexual Behaviour in Young People in Sweden. Results: We found a statistically significant increase in the weekly consumption of alcohol among exchange students after their semester abroad. A larger proportion of exchange students had sex with a new partner and sex with more than three partners during their semester abroad compared to follow-up campus students. Conclusions: Our findings indicate that exchange students consume alcohol more frequently during their semester abroad and indulge in sexually risky behaviour. Exchange students' use of alcohol and sexually risky behaviour could be associated with even greater risks due to them being in an unknown environment, unfamiliar culture, and with limited support from family and friends. This highlights the need for further research on exchange students' experiences, especially concerning alcohol use and sex while abroad.

This study examines baseline associations between alcohol use and HIV sexual risk among a cohort of HIV-uninfected pregnant women (n = 1201) residing in a high HIV burdened community in Cape Town, South Africa. Alcohol use was measured using a modified version of the Alcohol Use Disorder Identification Test (AUDIT). HIV sexual risk was measured through a composite variable of four risk factors: diagnosis with a STI, self-report of > 1 recent sex partners, partner HIV serostatus (unknown or HIV+) and condomless sex at last sex. Any past year alcohol use prior to pregnancy was reported by half of participants (50%); 6.0% reported alcohol use during pregnancy. Alcohol use prior to pregnancy was associated with increased odds of being at high risk of HIV (aOR = 1.33, 95% CI 1.05-1.68, for 2 risks and aOR = 1.47, 95% CI 0.95-2.27 for 3 risks). In addition to reducing alcohol use, several other strategies to address HIV sexual risk were identified. Evidence-based interventions to address alcohol use and other HIV sexual risk behaviors during pregnancy in South Africa are desperately needed. Qualitative work exploring individual and community level drivers of alcohol use among pregnant and breastfeeding women in this setting could support development of a culturally tailored intervention to address these issues in this population.

BACKGROUND: High-risk alcohol use is a common preventable risk factor for postoperative complications, admission to intensive care, and longer hospital stays. Short-term abstinence from alcohol use (2 to 4 weeks) prior to surgery is linked to a lower likelihood of postoperative complications. OBJECTIVE: The study aimed to explore the acceptability and feasibility of 2 brief counseling approaches to reduce alcohol use in elective surgical patients with high-risk alcohol use in the perioperative period. METHODS: A semistructured interview study was conducted with a group of high responders (who reduced alcohol use ≥50% postbaseline) and low responders (who reduced alcohol use by ≤25% postbaseline) after their completion of a pilot trial to explore the acceptability and perceived impacts on drinking behaviors of the 2 counseling interventions delivered remotely by phone or video call. Interview transcripts were analyzed using thematic analysis. RESULTS: In total, 19 participants (10 high responders and 9 low responders) from the parent trial took part in interviews. Three main themes were identified: (1) the intervention content was novel and impactful, (2) the choice of intervention modality enhanced participant engagement in the intervention, and (3) factors external to the interventions also influenced alcohol use. CONCLUSIONS: The findings support the acceptability of both high- and low-intensity brief counseling approaches. Elective surgical patients are interested in receiving alcohol-focused education, and further research is needed to test the effectiveness of these interventions in reducing drinking before and after surgery. TRIAL REGISTRATION: ClinicalTrials.gov NCT03929562; https://clinicaltrials.gov/ct2/show/NCT03929562.

BackgroundIn Nepal and across the globe, the COVID-19 pandemic has primed an environment for increased rates of violence against women (VAW). This paper explores pandemic-driven economic insecurity and increased alcohol use as instigators of VAW and Intimate Partner Violence (IPV) within newly married households in the rural, Nawalparasi region of Nepal.MethodsThis study is a secondary analysis of data obtained from the Sumadhur Intervention pilot study that has been previously described and demonstrates successful implementation of group-based, household-level intervention for women's empowerment and sexual and reproductive health education (1). Our three sets of data were collected before and during the COVID-19 pandemic. The first set is from a Longitudinal Cohort of 200 newly married women who were surveyed twice a year from February 2017 through July 2020. The second data set is a subset cohort of newly married women, their husbands, and their mothers-in-law (31 women, 31 husbands and 31 mothers-in-law) who participated in Sumadhur in January 2021. The third data set was obtained through in-depth interviews in July 2021 from 15 households following Sumadhur. The interviews were thematically coded, and subthemes were identified. A t-test of the January 2021 survey data set was run to look at correlations between income loss, alcohol consumption and experience of IPV among newly married women. All other survey data was analyzed for change over time.ResultsAt three months after the onset of the pandemic (July 2020), the Longitudinal Cohort survey data from newly married women reported increased rates of husbands' alcohol use as well as personal experiences of IPV as compared to pre-pandemic averages. There was a statistically significant difference (p < 0.001) in the effects of income loss on increased alcohol use and experience of IPV. Qualitative results iterated the common theme of alcohol use and economic insecurity as upstream instigators of VAW in the com

Identifying factors associated with alcohol use changes during pregnancy is important for developing interventions for people with HIV (PWH). Pregnant PWH (n = 202) initiating antiretroviral therapy in Uganda and South Africa completed two assessments, 6 months apart (T1, T2). Categories were derived based on AUDIT-C scores: "no use" (AUDIT-C = 0 at T1 and T2), "new use" (AUDIT-C = 0 at T1, >0 at T2), "quit" (AUDIT-C > 0 at T1, =0 at T2), and "continued use" (AUDIT-C > 0, T1 and T2). Factors associated with these categories were assessed. Most participants had "no use" (68%), followed by "continued use" (12%), "quit" (11%), and "new use" (9%). Cohabitating with a partner was associated with lower relative risk of "continued use." Borderline significant associations between food insecurity and higher risk of "new use" and between stigma and reduced likelihood of "quitting" also emerged. Alcohol use interventions that address partnership, food security, and stigma could benefit pregnant and postpartum PWH.

Alcohol and substance use recovery while parenting is a complicated endeavour. People in alcohol and substance misuse recovery while parenting have unique and complex needs, which mainstream treatment approaches cannot always meet. Treatment often focuses solely on substance misuse and fails to pay attention to parenting, and most often, parents and their children are separated during residential treatment. Parents often face the tough decision to either take care of themselves or take care of their children. Integrated treatment services, which include both drug and alcohol treatment and parenting support, have been developed to break the often intergenerational cycle of substance use and troubled parenting. These programmes have rendered successful outcomes in participants achieving and maintaining abstinence, improving their mental health, and supporting responsive parenting. However, little is known about what particular factors in integrated services support these positive changes made in recovery while parenting. The current research explores the unique factors that have contributed to parents’ recovery at the Family Centre, an integrated parent-child rehabilitation facility. The research additionally illustrates the needs of these individuals in recovery. Experiences of recovery and parenting were explored in semi-structured interviews and case studies with mothers undertaking a recovery programme. Through a reflexive thematic analysis, three themes were constructed: ‘The Construction of Self’ ‘The Therapeutic Milieu’, and ‘Relational Recovery’. The complex histories and recovery journeys of research participants were given context through the use of case vignettes. The findings highlight the complex and multifaceted nature of recovery while parenting, particularly the role that parenting plays in driving recovery-orientated change. The relational nature of recovery was a prevalent factor in recovery, providing a developing perspective on how recovery is view

Alcohol use is influenced by genetic and environmental factors. We examined the interactive effects between genome-wide polygenic risk scores for alcohol use (alc-PRS) and social support in relation to alcohol use among European American (EA) and African American (AA) adults across sex and developmental stages (emerging adulthood, young adulthood, and middle adulthood). Data were drawn from 4,011 EA and 1,274 AA adults from the Collaborative Study on the Genetics of Alcoholism who were between ages 18-65 and had ever used alcohol. Participants completed the Semi-Structured Assessment for the Genetics of Alcoholism and provided saliva or blood samples for genotyping. Results indicated that social support from friends, but not family, moderated the association between alc-PRS and alcohol use among EAs and AAs (only in middle adulthood for AAs); alc-PRS was associated with higher levels of alcohol use when friend support was low, but not when friend support was high. Associations were similar across sex but differed across developmental stages. Findings support the important role of social support from friends in buffering genetic risk for alcohol use among EA and AA adults and highlight the need to consider developmental changes in the role of social support in relation to alcohol use.

Unexpected mobility disruptions during lockdown during the first wave of COVID-19 became ’tipping points’ with the potential to alter pre-pandemic routines sensitive to socialisation. This paper investigates the impact of lockdown exposure on alcohol consumption. We document two findings using information from the Google Mobility Report and longitudinal data from the Understanding Society survey (UKHLS) in the United Kingdom. First, we find a sharp reduction in both actual mobility and alcohol use (consistent with a "still and dry pandemic for the many" hypothesis). However, we document an increase in alcohol use among heavy drinkers, implying a split behavioural response to COVID-19 mobility restrictions based on alcohol use prior to the pandemic. Second, using the predictions of the prevalence-response elasticity theory, we find that the pandemic’s reduction in social contacts is responsible for a 2.8 percentage point reduction in drinking among men.