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Accessible, brief, and self-directed intervention are needed to improve treatment access for individuals with co-occuring PTSD and alcohol misuse. This pilot study tests the feasibility, acceptability, and preliminary efficacy of a brief text message intervention based on cognitive behavioral therapy plus message framing (CBT + Framing) compared to active control providing kind support and attention (KAM), to reduce PTSD symptoms and alcohol use. Two waves of community-based data collection (Wave 1 n = 50; Wave 2 n = 59) were completed. Participants self-reported symptoms at baseline, post-intervention, and 8-week follow-up. Engagement and retention were high, suggesting messages were feasible and acceptable. Across waves and conditions, from baseline to follow-up primary outcomes of PTSD symptoms (medium to large effects), weekly drinks (medium effects), and heavy episodic drinking (small to medium effects) decreased. Consistent with hypotheses, CBT + Framing outperformed KAM for PTSD at post in Wave 2 and for number of heavy drinking episodes at both post and follow-up in Wave 1. Contrary to hypotheses, KAM outperformed CBT + Framing for PTSD at post in Wave 1, and minimal differences were observed between conditions for weekly drinks in both waves. Future studies should continue to develop and test brief, accessible interventions., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: The purpose of this study was to identify distinct classes of college students on the basis of recent and past drinking behaviors and evaluate how implicit and explicit measures of drinking identity predict membership in these classes., Methods: US undergraduate students (N=456) completed online implicit (Implicit Association Test) and explicit (self-report) measures of drinking identity and assessments of drinking behaviors, including past month drinking, at-risk drinking in the past year, and lifetime history of intoxication. Latent class analysis (LCA) was used to identify classes of college students based on their drinking behaviors., Results: LCA identified five classes: (1) Lifetime Nondrinker, (2) Recent Nondrinker/Past Risk, (3) Light Drinker, (4) Moderate Drinker, and (5) Heavy Drinker. Overall, stronger implicit and explicit drinking identities were uniquely associated with greater odds of belonging to classes with greater alcohol consumption and related consequences relative to those classes characterized by lower alcohol consumption and consequences. Notably, explicit drinking identity was positively associated with odds of membership to the Recent Nondrinker/Past Risk class relative to the Lifetime Nondrinker and Light Drinker classes, and implicit and explicit drinking identities were positively associated with odds of membership to the Heavy Drinker class relative to all other classes., Conclusions: Findings suggest that drinking identity is sensitive to risky drinking experiences in the past, is especially strong among the highest-risk group of college student drinkers, and may be an important cognitive factor to consider as a target for intervention., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: In spite of the significant burden associated with substance use disorders, especially among persons who inject drugs (PWIDs), most affected individuals do not engage with any type of formal or informal treatment. Addiction stigma, which is represented by negative social attitudes toward individuals who use alcohol and/or other drugs, is one of the barriers to care that is poorly understood. The current study: a) assessed implicit (indirect and difficult to consciously control) and explicit (consciously controlled) beliefs about PWIDs among visitors to a public web site; and b) experimentally investigated the effects of ethnicity/race and gender on those implicit and explicit beliefs., Methods: N=899 predominantly White (70%) and women (62%) were randomly assigned to one of six target PWIDs conditions: gender (man/woman) x race/ethnicity (White, Black, Latino/a). Participants completed an Implicit Association Test and explicit assessment of addiction stigma., Results: Participants implicitly associated PWIDs (especially Latino/a vs. White PWIDs) with deserving punishment as opposed to help (p=0.003, d=0.31), indicating presence of addiction stigma-related implicit beliefs. However, this bias was not evident on the explicit measure (p=0.89). Gender did not predict differential implicit or explicit addiction stigma (p=0.18)., Conclusions: Contrary to explicit egalitarian views towards PWIDs, participants' implicit beliefs were more in line with addiction stigma. If replicated and clearer ties to behavior are established, results suggest the potential importance of identifying conditions under which implicit bias might influence behavior (even despite explicit egalitarian views) and increase the likelihood of discrimination towards PWIDs., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Background: Recent research has demonstrated that both poor self-regulation and favorable implicit associations toward alcohol can play important roles in predicting drinking. Less well studied, however, is how the interplay between implicit associations and self-regulation may impact decisions about alcohol consumption. Behavioral economics is one important tool that may provide insight into the cognitive processes that impact demand for alcohol and drinking decisions., Methods: Healthy young adult participants completed an Implicit Association Task (IAT) that measured the strength of associations between approach/avoid attributes and target alcohol/neutral images. Impaired self-regulation was assessed by a classic delay discounting task. Participants also completed an Alcohol Purchase Task (APT), which yields multiple behavioral economic indices, chief among which are intensity (the number of drinks a participant would consume if the drinks were free) and elasticity (the degree to which an increased per-drink price impacts the number of drinks consumed in a hypothetical drinking situation). Finally, participants completed a timeline follow-back assessment of past-90-day drinking., Results: Findings indicated that implicit approach associations toward alcohol predicted increased demand for alcohol on the APT. Although delay discounting did not have a direct effect on demand for alcohol, there was a significant interaction between IAT and delay discounting, such that higher implicit alcohol approach associations predicted particularly high demand for alcohol among participants with poorer self-regulation. APT and IAT, in turn, predicted self-reported drinking behavior., Conclusions: These results suggest that favorable attitudes toward alcohol, together with poor self-regulation, can significantly impact drinking decisions in healthy young adults., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Background and Objectives: Prominent theories suggest that explicit and implicit cognitive biases are critical in the development and maintenance of posttraumatic stress disorder (PTSD). However, studies evaluating implicit PTSD-related cognitive biases are rare, and findings are mixed. We developed two adaptions of the Implicit Association Test (IAT), the "traumatized self" IAT (evaluations of the self as traumatized vs. healthy) and the "dangerous memory" IAT (evaluations of remembering as dangerous vs. safe), and investigated their psychometric properties and relations to PTSD symptoms and trauma exposure., Methods: Participants were visitors to the Project Implicit research website (Study 1: N = 347, Study 2: N = 501). They completed the IATs (Study 1: both IATs; Study 2: traumatized self IAT only), a trauma exposure measure, a PTSD symptom inventory, and explicit cognitive bias measures (Study 2 only)., Results: Both IATs had good internal consistency, but only the traumatized self IAT was correlated with PSTD symptoms and identified participants meeting clinical cutoffs for PTSD symptoms. Study 2 focused on the traumatized self IAT and included explicit cognitive bias measures. The IAT correlated with PTSD symptoms and explicit cognitions, and predicted variance in PSTD symptoms above and beyond trauma exposure and explicit cognitions., Limitations: Study designs were cross-sectional; samples were unselected; and PTSD symptoms were self-reported., Conclusions: Despite these limitations, these studies provide preliminary validation of an implicit measure of PTSD-related cognitive bias - the traumatized self IAT - that is consistent with PTSD theories and may ultimately improve the identification and treatment of individuals with PTSD., (Copyright © 2013 Elsevier Ltd. All rights reserved.)