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Background: Self-stigma is associated with low self-esteem, high shame and reduced drinking-refusal self-efficacy in people with alcohol use disorder (AUD). The Self-Stigma in Alcohol-Dependence Scale-Short Form (SSAD-SF) was designed to enable a brief, but valid assessment of AUD self-stigma. Methods: We reduced the 64-item SSAD, originally derived from 16 stereotypes towards people with AUD, by removing the most offensive items based on perspectives of people with lived experience. The newly created scale was then assessed and validated in a cross-sectional study involving 156 people reporting alcohol issues in various treatment settings. Results: The 20-item SSAD-SF includes five stereotypes, with good internal consistency for each subscale and the overall scale. It reflects the four-stage progressive model of self-stigmatization with decreasing scores over the stages awareness of stereotypes, agreement with stereotypes, self-application of stereotypes, and harmful consequences for self-esteem, and highest correlations between adjacent stages. The subscales apply and harm were associated with internalized stigma, shame, reduced self-esteem, and lower drinking-refusal self-efficacy, as supported by multivariate regression models. Discussion: The SSAD-SF is a valid instrument for measuring the process of self-stigmatization in people with AUD. Self-stigma is a consistent predictor of reduced self-esteem, higher shame and lower drinking-refusal self-efficacy in people with AUD. We discuss merits of the progressive model for understanding and addressing self-stigma in AUD. [ABSTRACT FROM AUTHOR]

Background: Only a few studies have systematically assessed sexual dysfunction and marital adjustment in married men with alcohol dependence in India. Aim: To assess the prevalence and pattern of sexual dysfunction and marital adjustment in a clinical sample of married men with alcohol dependence. The association of sexual dysfunction and marital adjustment with the severity of alcohol dependence was also explored. Materials and Methods: This cross-sectional study included 100 consecutive married men attending psychiatry outpatient department (OPD) with a diagnosis of alcohol dependence syndrome (ADS). A pre-designed study proformawas used for collecting relevant socio-demographic and clinical details of the study participants. Sexual dysfunction, marital adjustment, and alcohol dependence were assessed using the following validated tools: the Arizona Sexual Experiences Scale (ASEX), the Marital Adjustment Questionnaire (MAQ), and the Severity of Alcohol Dependence Questionnaire (SADQ), respectively. Results: Of 100 patients, about 15% had clinical sexual dysfunction based on ASEX. The most commonly reported sexual dysfunction was difficulty with erection (24.0%), followed by problems in desire (18.0%), sexual arousal (12.0%), ability to reach orgasm (12.0%), and satisfaction with orgasm (9.0%). Sexual dysfunction (ASEX score) showed significant positive correlation (rs = 0.345; P < 0.001) with alcohol dependence severity (SADQ score). Also, the severity of alcohol dependence was negatively correlated (rs = -0.240; P = 0.016) with the overall level of marital adjustment (MAQ score) with spouse. Conclusion: Sexual dysfunction is common in married men with ADS, with both sexual dysfunction intensity and marital adjustment difficulties being positively associated with the severity of alcohol dependence. [ABSTRACT FROM AUTHOR]

Cross-sectional studies show that habitual use of alcohol is associated with severity of alcohol dependence reflected across a range of domains and lower number of detoxifications in multiple settings. In this study, we investigated whether alcohol use disorder (AUD) patients with greater habitual use of alcohol at baseline showed worse outcomes after one year of follow-up. A sample of inpatients with Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition (DSM-IV) alcohol use disorder (AUD) was assessed at baseline (n = 50) and after one year (n = 30). The Habit, Reward, and Fear Scale (HRFS) was employed to quantify affective (fear or reward) and non-affective (habitual) drives for alcohol use, the Alcohol Dependence Scale (ADS) was used to assess clinical outcomes, and the Depression, Anxiety and Stress Scale (DASS-21) was used to quantify and control for associated affective symptoms. There was a significant reduction in the three HRFS scores at the follow-up. Regression analyses demonstrated that greater habit- and fear-related drives at baseline predicted greater decreases in the ADS scores at the endpoint. However, after controlling for age, sex and affective symptoms, only reward and fear were associated with reductions in ADS scores at the end of one year. Prescriptions of naltrexone and antidepressants/benzodiazepines did not predict decreases in reward and fear-related motivations. Although we were unable to confirm that habitual subscores at baseline predict worse long-term outcomes among inpatients with AUD, we found that a greater fear and reward motives for the use of alcohol predicted a greater magnitude of improvement in the AUD symptoms after one year. We hope that these findings will help develop new approaches toward AUD treatment and inform models of addiction research. [ABSTRACT FROM AUTHOR]

Background: Problems associated with alcohol use are multidimensional with psychiatric, psychological, physical, and social aspects, which makes it challenging to choose appropriate assessment scales. However, there has been no systematic evaluation of existing alcohol scales. Methods: A systematic literature search was conducted for articles that assessed the psychometric properties of scales for alcohol use disorder on March 19, 2023, using Medline, EMBASE, and PsycINFO. Only scales whose original development papers were cited more than 20 times were included. The methodological quality and psychometric properties of the scales were evaluated using COnsensus‐based Standards for the selection of health Measurement INstruments. The overall rating of the scales were assessed with a score ranging from 0 to 18. Results: In total, 314 studies and 40 scales were identified. These scales differ widely in measurement methods, target populations, and psychometric properties. The overall mean score was 6.3, and only the following three scales received >9 points suggesting a moderate level of evidence: Alcohol Use Disorders Identification Test (AUDIT), Alcohol Dependence Scale (ADS), and Short Alcohol Dependence Data Questionnaire (SADD). Measurement error and responsiveness were not evaluated or reported in the included scales. Conclusions: Although the AUDIT, ADS, and SADD were rated the highest among the 40 scales, they showed, at most, a moderate level of evidence. These findings underscore the need to accumulate further evidence to assure the quality of the scales. It may be advisable to select and combine scales to meet the purpose of the assessment. [ABSTRACT FROM AUTHOR]

This case-control study determines how alcohol cue processing in individuals with co-occurring bipolar disorder and alcohol use disorder may be distinct from that of individuals with alcohol use disorder or bipolar disorder alone. Key Points: Question: How is alcohol cue processing in individuals with co-occurring bipolar disorder and alcohol use disorder (BD + AUD) distinct from that of individuals with AUD or BD alone? Findings: In this case-control study that used a 2 × 2 factorial functional neuroimaging design, individuals with BD + AUD were uniquely characterized by reduced alcohol cue-elicited brain activation within the right inferior frontal gyrus, insula, and dorsal striatum. These reduced regional activations correlated with increased impulsivity-related features and obsessive-compulsive alcohol craving among individuals with BD + AUD but not among individuals with AUD alone. Meaning: Developing treatment strategies that target impulsivity-related neural mechanisms may expedite the identification of more effective therapeutics for BD + AUD. Importance: Reward circuitry dysfunction is a candidate mechanism of co-occurring bipolar disorder and alcohol use disorder (BD + AUD) that remains understudied. This functional magnetic resonance imaging (fMRI) research represents the first evaluation of alcohol cue reward processing in BD + AUD. Objective: To determine how alcohol cue processing in individuals with BD + AUD may be distinct from that of individuals with AUD or BD alone. Design, Setting, and Participants: This cross-sectional case-control study (April 2013-June 2018) followed a 2 × 2 factorial design and included individuals with BD + AUD, AUD alone, BD alone, and healthy controls. A well-validated visual alcohol cue reactivity fMRI paradigm was administered to eligible participants following their demonstration of 1 week or more of abstinence from alcohol and drugs assessed via serial biomarker testing. Study procedures were completed at the Medical University of South Carolina. Analysis took place between June and August 2022. Main Outcomes and Measures: Past-week mood symptoms were rated by clinicians using the Montgomery-Åsberg Depression Rating Scale and Young Mania Rating Scale. The Alcohol Dependence Scale, Obsessive-Compulsive Drinking Scale, and Barratt Impulsiveness Scale were included questionnaires. Functional MRI whole-brain data were analyzed along with percent signal change within a priori regions of interest located in the ventral striatum, dorsal striatum, and ventromedial prefrontal cortex. Exploratory analyses of associations between cue reactivity and select behavioral correlates (alcohol craving, impulsivity, maximum number of alcohol drinks on a single occasion, and days since last alcohol drink) were also performed. Results: Of 112 participants, 28 (25.0%) had BD + AUD, 26 (23.2%) had AUD alone, 31 (27.7%) had BD alone, and 27 (24.1%) were healthy controls. The mean (SD) age was 38.7 (11.6) years, 50 (45.5%) were female, 33 (30%) were smokers, and 37 (34.9%) reported recent alcohol consumption. Whole-brain analyses revealed a BD × AUD interaction (F = 10.64; P =.001; η2 = 0.09) within a cluster spanning portions of the right inferior frontal gyrus and insula. Region of interest analyses revealed a main association of BD (F = 8.02; P =.006; η2 = 0.07) within the dorsal striatum. In each instance, individuals with BD + AUD exhibited reduced activation compared with all other groups who did not significantly differ from one another. These hypoactivations were associated with increased impulsivity and obsessive-compulsive alcohol craving exclusively among individuals with BD + AUD. Conclusion and Relevance: The findings of this study suggest conceptualizing reward dysfunction in BD + AUD by the potential interaction between blunted reward responsivity and deficient inhibitory control may help guide treatment development strategies. To this end, reduced right inferior frontal gyrus and insula alcohol cue reactivity represents a novel candidate biomarker of BD + AUD that may respond to pharmacological interventions targeting impulsivity-related neural mechanisms for improved executive control. [ABSTRACT FROM AUTHOR]

BACKGROUND: Restricting the availability of alcohol in "dry states" and during the COVID-19 lockdown reveal illegal trading and consumption of illicit liquor leading to deaths and use of alternate harmful substances. The current study aims to fill the gaps in the literature to study alcohol usage and its procurement during its complete ban of sale. MATERIALS AND METHODS: A cross-sectional study of purposively sampled alcohol-dependent patients (n = 62) was conducted in an OPD setting, comparing two time periods: before and during total lockdown 2020. After reinforcing confidentiality and privacy, data were collected and analyzed. RESULTS: Alcohol usage during the lockdown was positively related to severity of alcohol dependence syndrome (r = 0.67, P = 0.00), quantity of alcohol consumed (r = 0.59, P = 0.00), and its cost of procurement (r = 0.43, P = 0.00) before lockdown. During the lockdown, the proportion of consuming alcohol more than or equal to 90 units weekly significantly decreased (Pearson Chi-square = 4.12, P = 0.04) and their predicting factors are rural residential location, moderate-income bracket, low socioeconomic class, and severe alcohol dependence. Furthermore, a significant increase in the proportion of procuring alcohol from the black market or used illicit liquor was observed (Fisher's exact test P = 0.00) with higher odds being associated with illegal procurement before lockdown (odds ratio = 22.00; 95% confidence interval = 3.93-123.28; P = 0.00). Increased use of alternate substances such as nicotine (37.1%) and cannabis (9.7%) during the lockdown was also observed. CONCLUSION: Although alcohol consumed did not significantly differ, illegal sources and money spent on procurement increased during the lockdown. Thus, a legal ban of liquor sales did not benefit alcohol dependence patients, and such restriction availability strategies may benefit from health awareness, treatment, and psychosocial support. [ABSTRACT FROM AUTHOR]

Background: Alcohol dependence (AD) is a complex addictive disorder with a high relapse rate. Previous studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and cognitive behavioral therapy (CBT) may be effective for AD, and we aim to explore more effective treatment options to reduce relapse rates for AD. Materials and methods: A total of 263 AD patients were recruited. They were divided into six groups according to the location and the type of rTMS: left dorsolateral prefrontal cortex (DLPFC), right DLPFC, sham stimulation, and whether they received CBT treatment: with a fixed schedule (C1) and without a fixed plan (C0). There were included in sham rTMS + C0 group (n = 50), sham rTMS + C1 group (n = 37), right rTMS + C0 group (n = 45), right rTMS + C1 group (n = 42), left rTMS + C0 group (n = 49), left rTMS + C1 group (n = 40). We used obsessive compulsive drinking scale (OCDS), visual analogue scale (VAS), alcohol dependence scale (ADS), montreal cognitive assessment (MoCA), generalized anxiety disorder-7 (GAD-7), patient health questionnaire-9 items (PHQ-9), and Pittsburgh sleep quality index (PSQI) to assess alcohol cravings, alcohol dependence, cognition, anxiety, depression, and sleep quality. They were followed up and evaluated for relapse. Results: The sham rTMS + C0 group relapse rate was significantly higher than the right rTMS + C1 group (P = 0.006), the left rTMS + C0 group (P = 0.031), the left rTMS + C1 group (P = 0.043). The right rTMS + C0 group showed significantly higher relapse rate compared to the right rTMS + C1 group (P = 0.046). There was no significant difference in relapse rates between other groups. The repeated-measures ANOVA showed an interaction effect between group and time was significant in the rate of patient health questionnaire-9 items (PHQ-9) scale reduction (P = 0.020). Logistic analysis indicated that smoking and alcohol consumption were independent determinants of relapse (P < 0.05). At 24 weeks of follow-up, Kaplan–Meier survival analysis reveal that there is statistically significant relapse rate between six groups (P = 0.025), left rTMS + C1 group has the best treatment effect for alcohol dependent patients. Cox regression analysis confirmed that current smoking, total cholesterol, and total bilirubin (TBIL) level were risk factors of relapse (P < 0.05). Conclusion: This study is the first to suggest that the combination of rTMS and CBT may be a potentially effective treatment for reducing relapse. [ABSTRACT FROM AUTHOR]

Objectives: To estimate mortality on grounds of the severity of alcohol dependence which has been assessed by two approaches: the frequency of alcohol dependence symptoms (FADS) and the number of alcohol dependence criteria (NADC). Methods: A random sample of adult community residents in northern Germany at age 18 to 64 had been interviewed in 1996. Among 4075 study participants at baseline, for 4028 vital status was ascertained 20 years later. The FADS was assessed by the Severity of Alcohol Dependence Scale among the 780 study participants who had one or more symptoms of alcohol dependence or abuse and vital status information. The NADC was estimated by the Munich Composite International Diagnostic Interview among 4028 study participants with vital status information. Cox proportional hazard models were used. Results: The age‐adjusted hazard ratio for the FADS (value range: 0–79) was 1.02 (95% confidence interval, CI: 1.016–1.028), for the NADC (value range: 0–7) it was 1.25 (CI: 1.19–1.32). Conclusions: The FADS and NADC predicted time to death in a dose‐dependent manner in this adult general population sample. [ABSTRACT FROM AUTHOR]

Alcohol dependence (AD), a disease can be affected by environmental factors with epigenetic modification like DNA methylation changes, is one of the most serious and complex public health problems in China and worldwide. Previous findings from our laboratory using the Illumina Infinium Human Methylation450 BeadChip suggested that methylation at the promoter of SSTR4 was one of the major form of DNA modification in alcohol-dependent populations. To investigate whether DNA methylation levels of the SSTR4 promoter influence alcohol-dependent behaviors, genomic DNA was extracted from the peripheral blood sample of 63 subjects with AD and 65 healthy controls, and pyrosequencing was used to verify the results of BeadChip array. Linear regression was used to analyze the correlation between the methylation levels of SSTR4 promoter and the scores of alcohol dependence scales. Gene expression of SSTR4 in brain tissue was obtained from the Genotype-Tissue Expression (GTEx) project and Human Brain Transcriptome database (HBT). We found the methylation levels of SSTR4 in AD group were significantly lower than healthy controls (two-tailed t -test, t = 14.723, p < 0.001). In addition, only weak to moderate correlations between the methylation levels of the SSTR4 promoter region and scale scores of Alcohol Use Disorders Identification Test (AUDIT), Life Events Scale (LES) and Wheatley Stress Profile (WSS) based on linear regression analyses (AUDIT: R 2 = 0.35, p < 0.001; LES: R 2 = 0.27, p < 0.001; WSS: R 2 = 0.49, p < 0.001). The hypomethylated status of SSTR4 may involve in the development of AD and increase the risk of AD persistence in Han Chinese males. [ABSTRACT FROM AUTHOR]

La substitution propose de remplacer une substance dont le patient est dépendant par un analogue pharmacologique moins nocif afin de faciliter l'arrêt ou la réduction des prises, et réduire les dommages induits du produit initialement consommé. Devenue classique pour les opioïdes ou le tabac, il n'existe à ce jour aucun traitement de substitution validé pour l'addiction à l'alcool. Les consommations d'alcool ou de benzodiazépines, deux agonistes des récepteurs GABA A , sont parmi les plus élevées en France, souvent associées. Alors que l'éthanol est un toxique majeur pour l'organisme, les benzodiazépines ont un meilleur profil de sécurité, malgré divers risques ou effets secondaires. Certains arguments suggèrent que les benzodiazépines pourraient être une substitution à l'alcool. Pour explorer cette hypothèse, une revue narrative de la littérature a été conduite, ne retrouvant que de rares publications, envisageant la possibilité de substitution partielle ou approchée de l'alcool par des benzodiazépines. Afin de conforter cela, des études complémentaires sont nécessaires, de validation pharmacologique ainsi que d'élaboration des abords psychosociaux d'accompagnement de cette médiation. Substitution therapy proposes to replace a substance on which the patient is dependent by another less harmful. Substitution substances are pharmacological analogues to addictive substances, used to facilitate the cessation or reduction of their use, and to reduce their deleterious consequences. Conventionally used for opioids or tobacco, there is to date no validated substitution treatment for alcohol addiction. The use rates of both alcohol and benzodiazepines are among the highest in France, and are frequently associated. France is a country in which alcohol is the second most frequent toxic used, and the most damaging determinant of health for mortality and morbidity after smoking. Meanwhile, alcohol and benzodiazepines are the two most common GABA A receptor agonists, with multiple similarities, despite some distinct chemical properties and actions. However, ethanol has a major toxicity for the body whereas benzodiazepines have a better safety profile, despite various risks and possible side effects. Benzodiazepines are the recommended treatment for alcohol withdrawal, but the guidelines are limited in time on the first two weeks, while only few studies have addressed the pros and cons of maintaining benzodiazepines beyond the detox period.Some arguments suggest that benzodiazepines could be a substitute for alcohol. Both are GABA A receptor agonists. In practice, it is frequent to observe crossed dependences, and, in particular, situations in which subjects with alcohol dependence change for benzodiazepine dependence. However, the medical practice of durably switching alcohol for benzodiazepines has been poorly explored. To review the pharmacological and clinical arguments for and against considering benzodiazepines as a potential substitution treatment for alcohol dependence. A narrative review of international literature has been conducted using the following keyword algorithm: (" substitution" OR "replacement" OR "maintenance") AND "alcohol" AND "benzodiazepine*" , without any limitation in time. Among a few hundred articles found on PubMed, only 3 were finally retained, with only 1 controlled study, no review of literature, supplemented by references found during the readings. The possibility of alcohol substitution by benzodiazepines is addressed, with a partial or approximate terminology reserve for qualifying this substitution. Diazepam appears as the molecule of choice. Such a substitution method, out of its usual field and in a design partly innovative in care, could decrease alcohol damages and perhaps consumption levels. Given the impossibility of conducting the synthesis of a non-existent literature, only an exploratory approach is possible, no recommendation or indication of the use of benzodiazepine as an alcoholic substitution can be formulated, without development validation studies of a such hypothesis (including researches about safety, choice of molecule, ways of psychosocial support...). In order to rethink the place of benzodiazepines in alcohol treatment strategies, owing to their frequent consumption with alcohol, the possibility of an approached alcoholic substitution using these drugs should be considered further. The prolonged used of benzodiazepines after alcohol withdrawal could consist of a harm reduction approach which could help support a psychosocial recovery. Long half-life molecules could be safer and easier to use, and should warrant future clinical trials. [ABSTRACT FROM AUTHOR]

Psychological trauma occurs when a person suffers from serious threat or loss to his/her life. Childhood psychological trauma can be of various forms such as physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect. Such adverse childhood experiences, if not effectively dealt or resolved, may lead to the development of drug dependence including alcohol dependence syndrome (ADS) in adult life. In many cases, development of ADS is preceded by the occurrence of childhood psychological trauma(s). Such a person with a history of childhood psychological traumas may consume alcohol to cope with his/her trauma-related distress. Alexithymia is a state characterized by a triad of difficulty in identifying one’s own feelings, difficulty in differentiating between physical sensations and emotional arousal, and difficulty in explaining one’s own feelings to others. Alexithymia has a role in the development of drug dependence including ADS. The number of childhood psychological trauma among persons with ADS was associated with alexithymia in adulthood. Childhood psychological traumas, mainly emotional abuse, might act as a predisposing factor for the development of alexithymia in persons suffering from ADS. This case series presented clinical picture of two individuals with ADS in which both childhood psychological trauma(s) and alexithymia were assessed by using standard and psychometrically valid psychological tools such as Childhood Trauma Questionnaire and Toronto Alexithymia Scale-20 item, respectively. This case series is unique because the assessment of childhood psychological trauma(s) and alexithymia is neglected area in Indian psychiatric research field and detailed ample of literature is not available at present in which the relationship between childhood psychological traumas, alexithymia, and ADS has been assessed. In the present case series, first individual with ADS had clinically significant alexithymia, severe emotional abuse, severe emotional neglect, moderate physical abuse, and moderate physical neglect, while second individual with ADS had no alexithymia but he had moderate-level emotional neglect and mild levels of emotional abuse, physical abuse, and physical neglect. [ABSTRACT FROM AUTHOR]

Background: Alcohol intake is one of the major substance abuse and the problems of alcoholism is present throughout the world. There are some fundamental differences regarding socio-demographic profile, age of onset of drinking, and the nature of drinking etc. Aims and Objectives: This study was conducted to find out the association of several determinants like onset and duration of drinking, family history and role of biomarkers like Gamma-Glutamyl transferase (GGT), Mean corpuscular volume (MCV) with severity of alcohol dependence. Materials and Methods: It was a hospital based cross-sectional and observational study. Screening and assessment of alcohol dependence was done by using scales like AUDIT and Alcohol dependence scale. Semi-structured questioner was used for assessing sociodemographic data for the total sample of 100 patients. 65 cases were selected finally after screening by AUDIT scale. GGT and MCV estimation was done for the finally selected cases along with healthy controls. Descriptive statistical analysis was done for obtaining results. Results: Findings suggest that early onset of drinking that is 17.14 years is associated with severe level of alcohol dependence. Study shows that family history of alcohol use is a predictor of developing alcohol dependence. Biomarkers like GGT, MCV had shown significant elevation for cases of severe dependence. Conclusion: The burden of alcohol use is growing alarmingly in India and before it turns out to be a giant monster encroaching upon youths, we need to focus our attention in curbing this problem by diagnosing and treating alcohol dependent patients and using preventive measures, to not allow development of dependence at all. [ABSTRACT FROM AUTHOR]

The article titled "The need for exclusion when exploring the relationship between sleep apnea and vestibular symptoms after traumatic brain injury" discusses additional commentary on the selection criteria and survey choice used in a study on the relationship between sleep apnea and vestibular symptoms following traumatic brain injury (TBI). The study analyzed responses from veterans/service members registered with the Veterans' Affairs Traumatic Brain Injury Model Systems National Database. The authors concluded that sleep apnea and vestibular dysfunction symptoms were not significantly associated once posttraumatic stress disorder was included in the analysis. The article suggests the need for exclusion criteria, such as excluding participants with prior vestibular dysfunction, and controlling for alcohol consumption, which is a known risk factor for sleep apnea. The authors commend the study and look forward to future research in this area. [Extracted from the article]

Background: Family is the key resource for providing care to patients, including those with alcohol dependence in India. Person with alcohol dependence affects almost every (personal, social, and psychological) aspects of family life. This leads to troubles, difficulty or undesirable procedures which impact on family members and causes gigantic burden on family caregivers. Aim: Aim of the study was to assess the level of family burden among the primary caregivers of alcohol dependent patients. Methods: A hospital-based study was conducted at a drug de-addiction treatment and training centre in north India. On the basis of purposive sampling technique, 30 alcohol dependent patients were recruited from the outpatient department (OPD) with the availability of primary caregivers. With informed consent from patient and caregiver, 30 caregivers (one for each patient) were included in the study. Assessment for pattern of burden faced by the family caregivers of persons with alcohol dependence was done by using the Family Burden Interview Schedule (FBIS). Results: Results showed that 93% caregivers were spouses and most (86.7%) of them were housewives. Every domain of care indicated moderate to severe level of burden. Alcohol dependence was associated with burden in family members. It showed high burden in rural location with lowincome families. Conclusion: Alcohol dependence adversely affects the patients as well as his caregivers. [ABSTRACT FROM AUTHOR]

Introduction. Studies in various countries have shown that adolescents with a history of parental use of alcohol have a greater risk of presenting alcohol problems of their own, including binge drinking, driving under the influence of alcohol, and alcohol dependence. A few studies in Mexico have also found this association, but these have been carried out with non-representative populations. Objective. To examine the association between a history of parental alcohol use and binge drinking, and parental use and possible dependence on alcohol, in a national sample of junior high and high school students in Mexico. Method. A descriptive correlational study was carried out based on a secondary analysis of the National Survey of Student Drug Use (Encuesta Nacional de Consumo de Drogas en Estudiantes, ENCODE), which questioned 114,364 respondents. The association was evaluated with an estimate of prevalence ratios (PR). Results. Students whose mothers or both parents used alcohol had a greater risk for binge drinking (PR [mother] = 2.12, p < .001; PR [both parents] = 2.18, p < .001) and possible alcohol dependence (PR [mother] = 5.43, p < .001; PR [both parents] = 5.14, p < .001). Those whose fathers alone used alcohol had a lower risk for binge drinking (PR = 1.35, p < .001) and for possible dependence (PR = 1.83, p < .001). Discussion and conclusion. This study shows differences in the effects of problematic alcohol use by parents: use by the mother or by both parents implies a greater risk of binge drinking and possible dependence for their children. This finding should be considered in the design of interventions to prevent binge drinking. [ABSTRACT FROM AUTHOR]

Introduction: The Alcohol Dependence Scale (ADS) is used to identify the overuse and dependence on alcohol taking into account the assessment of the severity of currently existing alcohol problems. So far, there has been no cultural adaptation of the ADS scale carried out in Poland. The ADS scale can be a useful tool in the social rehabilitation process and in modifying drinking patterns in general. Objective: The objective of the study was to culturally adapt the ADS and elaborate its norms. Method: The study was conducted in a group of 708 persons (F: 49%). The average age of the respondents was 35.5 years (SD = 13.72, <18.81>). The tool was translated according to the norms of the International Society for Pharmacoeconomics and Outcomes Research Quality of Life Special Interest group. Criterion validity and reliability were assessed and norms were established. Results: The validity was assessed by correlating ADS results with AUDIT (r = 0.86, p < 0.01). The total Cronbach's alpha value was 0.94. The ROC analysis demonstrated sensitivity and specificity ranging from 0.79 for Psychoperceptual and Psychophysiological Withdrawal Symptoms to 0.81 for aggregate results. Specificity ranged from 0.55 for Psychoperceptual and Psychophysiological Withdrawal Symptoms to 0.64 for Compulsive Drinking and the whole. Due to gender differences, standards for women and men were developed for the total and individual areas. Conclusions: High validity and reliability of the questionnaire was obtained. ADS is a tool that may be used in clinical practice in Polish conditions. High sensitivity and satisfactory specificity allows for using the questionnaire to select the optimal goals of the treatment. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the pattern of alcohol consumption in workers and then apply a brief intervention (BI) in those who presented a pattern of excessive drinking in order to achieve withdrawal or at least decrease consumption. Design/methodology/approach: This was an exploratory, descriptive, and quasi-experimental study carried out in four stages: initial screening, interview, BI, and follow-up sessions. Two hundred and thirty workers participated in the first stage, and sociodemographic and alcohol use disorders identification (AUDIT) data were collected, and thirty-four percent of workers were classified as positive (at risk, under harmful use, or alcohol dependent). Afterward, the drinking pattern was investigated by applying the modified brief drinker profile and alcohol dependence scale (ADS). The positive participants in the AUDIT and ADS were divided into the experimental and control groups. In the third stage, the BI was performed in the experimental group. In the follow-up sessions (the fourth stage), the AUDIT was applied three months and six months after the BI to the experimental and control groups for comparison purposes. Findings: The results showed that the BI was effective. In all follow-up sessions, the data revealed that the experimental group had lower amounts of drinking. The control group also reduced drinking, albeit not in the same proportion as the experimental group. We believe that these results can contribute to implementing programs aimed at employee health. Originality: Applying the BI on workers with excessive drinking patterns. [ABSTRACT FROM AUTHOR]

Objective: Alexithymia is common among people who abuse alcohol, yet the mechanisms by which alexithymia exerts its influence remain unclear. This analysis tested a model whereby the three subscales of the Toronto Alexithymia Scale exert an indirect effect on alcohol problems through difficulties with emotion regulation and psychological distress. Method: Men and women (n = 141) seeking alcohol use disorder (AUD) treatment completed the Toronto Alexithymia Scale, the Difficulties with Emotion Regulation Scale, the Brief Symptom Inventory, the Short Inventory of Problems, and the Alcohol Dependence Scale. Results: The Difficulty Identifying Feelings subscale of the Toronto Alexithymia Scale was positively associated with alcohol problems through emotion dysregulation and psychological distress. The other two subscales, Difficulty Describing Feelings and Externally oriented Thinking, were not associated with any other variables. Conclusion: People with alexithymia may consume alcohol to help regulate undifferentiated states of emotional arousal. Given the prevalence of alexithymia among people who abuse alcohol, treatment supplements that enhance the identification of emotions are needed. [ABSTRACT FROM AUTHOR]

Alcohol dependence (AD) is one of the most common and detrimental neuropsychological disorders. Recently, more and more studies have focused on circular RNA as markers for central nervous system (CNS) diseases. The present study was conducted to evaluate the circular RNA expression alteration in serum exosomal and to identify a novel circulating biomarker for the detection of AD. We first isolated exosomes from serum and then investigated the circRNA expression alterations by high throughput whole transcriptome sequencing. The data were then analyzed using bioinformatics methods. Moreover, we verified the circRNA‐seq by qRT‐PCR. Furthermore, we analyzed the correlations between the levels of hsa_circ_0004771 and both Severity of Alcohol Dependence Questionnaire (SADQ) and Alcohol Dependence Scale (ADS). The diagnostic value of hsa_circ_0004771 in AD patients was evaluated by receiver operating characteristic (ROC). In this study, 254 differentially expressed circRNAs were identified, with 149 upregulated and 105 downregulated. GO analysis showed that these differentially expressed circRNAs from exosomes might be associated with the regulation of neuron projection and axon regeneration. KEGG analysis revealed that T cell receptor signaling and antigen processing and presentation pathway had a regulating effect on upstream levels. We found that hsa_circ_0004771 was related to the severity of AD. The AUC for the diagnostic value of hsa_circ_0004771 in AD patients was 0.874. These findings indicated that circRNA in serum exosomes provide novel targets for further research on molecular mechanisms of AD. Among these, hsa_circ_0004771 may be a sensitive biomarker that was related to the severity of AD. [ABSTRACT FROM AUTHOR]

CEREBROVASCULAR REACTIVITY IN AGING: MEASURES OF TIMING AND AMPLITUDE PREDICT BRAIN AND COGNI... Benjamin Zimmerman, Kathy Low, Grace Clements, Daniel Bowie, Hannah Jones, Samantha Rubenstein, Gabriele Gratton, and Monica Fabiani University of Illinois, Urbana-Champaign I Descriptors: i Aging, Cerebrovascular Reactivity, Cerebrovascular Health Cerebrovascular health is an important predictor of cognitive integrity in aging, but details of how cerebrovascular health affects cognition are still lacking. A RANDOMIZED CONTROLLED EVE... Kaylie Carbine SP 1 sp , James LeCheminant SP 2 sp , Scott Baldwin SP 2 sp , Chad Jensen SP 2 sp , C. Brock Kirwan SP 2 sp , and Michael Larson SP 2 sp SP 1 sp California State University Dominguez Hills, SP 2 sp Brigham Young University I Descriptors: i N2 ERP, Inhibitory Control Training, Health The negative effects of overweight and obesity on health are well known. APERIODIC EEG POWER SPECTRUM PREDICTS ADHD RISK IN INFANCY AND ADOLESCENCE Sarah Karalunas SP 1 sp , Brendan Ostlund SP 2 sp , McKenize Figuracion SP 3 sp , Hanna Gustafsson SP 3 sp , Dan Foti SP 1 sp , Joel Nigg SP 3 sp , and Elinor Sullivan SP 3 sp SP 1 sp Purdue University, SP 2 sp Pennsylvania State University, SP 3 sp Oregon Health & Sciences University I Descriptors: i ADHD, Infancy, EEG Risk Markers Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with liability in early life. [Extracted from the article]

Background: Alcohol dependence is associated with alcohol-related problems and persistent vulnerability to relapse. Despite newer medications, frequent relapses continue to occur. Hence, there is a need to look at holistic approaches to deal with this problem. Objective: Evaluate the effectiveness of nurse-led body-mind-spirit (BMS)-based relapse prevention intervention on craving and quantity and frequency of alcohol consumption among alcohol-dependent individuals. Methods: Randomized control trial was adopted, and the study was conducted at a mental health care setting in India. Sixty individuals with alcohol use disorder were randomly assigned to a BMSgroup (n = 30) and a treatmentas-usual (TAU) group (n = 30) between June 2017 and March 2018. Subjects of both groups were initially assessed for craving and quantity and frequency of alcohol consumption. BMS subjects received seven sessions of BMS intervention and routine treatment at de-addiction wards. The interventions comprise of body, mind, and spirit strategies that aid in handling triggers, accept responsibility for their own well-being and take charge of self health. TAU group subjects received only routine treatment. All the participants were followed up over 3 months postdischarge. Results: Over 3 months of follow-up, BMS group subjects (vs. TAU group) reported significantly lesser quantity of alcohol consumption (F = 9.74, p < .001, η² = .144), fewer drinking days (F = 14.04, p < .001, η² = .195), lower relapse rates (14 vs. 28), and lesser craving (F = 14.01, p < .001, η² = .195). Regression analysis showed that number of previous attempts (>1) and increased baseline drinking were associated with relapse. Conclusion: Findings provide evidence of BMS intervention in reducing craving and drinking outcomes among alcohol-dependent individuals in India. [ABSTRACT FROM AUTHOR]

Psychological traumas may occur during childhood in the form of physical abuse, sexual abuse, emotional abuse, physical neglect, and/or emotional neglect. Trauma may be experienced when a person experiences serious loss or his/her life is under grave threat. If such traumatic event is neither dealt effectively nor resolved completely, it may predispose such a person to development of mental health issues such as drug dependence including alcohol dependence syndrome (ADS). Persons who experience or suffer from childhood psychological trauma tend to consume alcohol in order to cope with their trauma related experiences. Hence, generally, onset of alcohol dependence is preceded by the occurrence of childhood psychological trauma(s). Childhood psychological trauma especially emotional abuse acts as a risk factor for the development of alexithymia in later life among persons with alcohol dependence. Alexithymia is a state of emotional dysregulation, which is characterized by the triad of difficulty in identifying one's own feelings, difficulty in distinguishing between the physical sensation and emotional arousal, and difficulty in explaining one's own feelings to others, which is known as externally oriented style of thinking. Alexithymia is itself a risk factor for the development of ADS. Thus, both childhood psychological trauma(s) and alexithymia play a significant role in the development of ADS. Findings of the present study showed that childhood psychological trauma(s), alexithymia, and ADS are interconnected. The present study findings conclude that significant relationship exists between childhood psychological traumas, alexithymia, and ADS. [ABSTRACT FROM AUTHOR]

• Co-occurrence of AUD and obesity highlights overlapping risk factors and neurobiology. • Sensory percepts (visual, taste and smell) for alcohol/food activates reward circuitry. • Disruption of executive and default mode network occurs in AUD and obesity. • Neuromodulation using sensory cues is used for AUD and obesity treatment. • Brain stimulation could be possible treatment for AUD post bariatric surgery. Neuroimaging techniques to measure the function of the human brain such as electroencephalography (EEG), positron emission tomography (PET), and functional magnetic resonance imaging (fMRI), are powerful tools for understanding the underlying neural circuitry associated with alcohol use disorder (AUD) and obesity. The sensory (visual, taste and smell) paradigms used in neuroimaging studies represent an ideal platform to investigate the connection between the different neural circuits subserving the reward/executive control systems in these disorders, which may offer a translational mechanism for novel intervention predictions. Thus, the current review provides an integrated summary of the recent neuroimaging studies that have applied cue-reactivity paradigms and neuromodulation strategies to explore underlying alterations in neural circuitry as well in treatment strategies in AUD and obesity. Finally, we discuss literature on mechanisms associated with increased alcohol sensitivity post-bariatric surgery (BS) which offers guidance for future research to use sensory percepts in elucidating the relation of reward signaling in AUD development post-BS. [ABSTRACT FROM AUTHOR]

Wrist-worn alcohol biosensor technology has developed rapidly in recent years. These devices are light, easy to wear, relatively inexpensive, and resemble commercial fitness trackers. As a result, they may be more suitable for a wide range of clinical and research applications. In this paper, we describe three pilot projects examining the associations between reported drinking behavior and transdermal alcohol concentration (TAC) derived from a new, wrist-worn alcohol biosensor (BACtrack Skyn) in diverse participant groups and settings. Study 1 (N = 3) compared Skyn-derived TAC with that from an ankle-worn alcohol sensor (SCRAM CAM) and breath alcohol concentration (BrAC) in a laboratory setting. Study 2 (N = 10) compared Skyn TAC with BrAC during a naturalistic drinking episode in the field. Study 3 (N = 12) used the Skyn to monitor alcohol use in the field for 2 weeks. Studies 2 and 3 also collected usability and acceptability data from participants. The results of Study 1 showed that the Skyn produced a TAC curve that closely resembled that of the validated SCRAM CAM anklet. In Study 2, Skyn detected drinking for all 10 participants (peak BrAC range: 0.02-0.21) with an average delay of 35.6 ± 10.2 min after the start of self-reported drinking. In Study 3, Skyn reliably recorded continuous TAC data showing multiple drinking episodes over the monitoring period. Participants in Studies 2 and 3 both reported Skyn as highly acceptable. Collectively, the results of these pilot studies show that the Skyn was able to reliably detect drinking events in the laboratory and natural environments. We offer suggestions for further refinements of alcohol biosensors and accompanying analytic software that may facilitate adoption of these devices as cost-effective, user-friendly, and reliable tools to passively and accurately assess alcohol use in the field. [ABSTRACT FROM AUTHOR]

TURKISH SOCIETY of ANAESTHESIOLOGY and REANIMATION Doi: 10.5152/TJAR.2021.178 Habib Md Reazaul Karim Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur, India Cite this article as: Karim HMR. A systematic review in context to the reliability of the American Society of Anesthesiologists (ASA) physical status classification was also found to have a wide range of inter-rater agreements (2). Out of the 270 patients, one patient's ASA-PS was not noted in the first check-up; remaining cases ranged from ASA-PS I to IV with a mean+standard deviation age of 42.3±18.1 years. When a variation was noted, the rea sons (i.e., clinical conditions) for which the assessors assigned the different ASA-PS for the same patient were evaluated and noted. [Extracted from the article]

Background: The Yale Food Addiction Scale (YFAS) was developed in 2009 to assess food addiction (FA); a revised version was released in 2016 (YFAS 2.0). The objective of this study was to determine the statistical and clinical validity of the YFAS 2.0 in adults seeking bariatric surgery. Methods: Patients who underwent a preoperative psychological evaluation in preparation for bariatric surgery from 2015 to 2018 were included. The YFAS 2.0 was administered as part of routine clinical care and validated against an assessment battery of standardized clinical measures. Statistical analyses included chi-square and Wilcoxon rank sum tests and calculation of Spearman's rank correlation coefficients. Results: Overall, 1061 patients were included. Mean age and BMI were 47.5 ± 12.9 years and 46.9 ± 13.4 kg/m2, respectively. There were 196 (18%) patients who screened positive on the YFAS 2.0 (21% mild, 23% moderate, and 56% severe FA). The YFAS 2.0 demonstrated strong convergent validity where patients who met criteria for FA had significantly increased levels of binge eating (p < 0.001), emotional eating (p < 0.001), and lower self-efficacy (p < 0.001). Discriminant validity was demonstrated by lack of association with alcohol use (p = 0.319). The YFAS 2.0 was significantly correlated with total scores for depression (p < 0.001), anxiety (p < 0.001), bipolar disorder symptoms (p < 0.001), and trauma history (p < 0.001). Conclusions: The prevalence of FA in a large sample of patients seeking bariatric surgery was consistent with previous literature. These data suggest that the YFAS 2.0 is psychometrically valid, demonstrating strong construct validity, and is a clinically useful measure of FA severity in patients pursuing bariatric surgery. [ABSTRACT FROM AUTHOR]

Biosensors enable observation and understanding of latent physiological occurrences otherwise unknown or invasively detected. Wearable biosensors monitoring physiological constructs across a wide variety of mental and physical health conditions have become an important trend in innovative research methodologies. Within substance use research, explorations of biosensor technology commonly focus on identifying physiological indicators of intoxication to increase understanding of addiction etiology and to inform treatment recommendations. In this review, we examine the state of research in this area as it pertains to treatment of alcohol use disorders specifically highlighting the gaps in our current knowledge with recommendations for future research. Annually, alcohol use disorders affect approximately 15 million individuals. A primary focus of existing wearable technology-based research among people with alcohol use disorders is identifying alcohol intoxication. A large benefit of wearable biosensors for this purpose is they provide continuous readings in a passive manner compared with the gold standard measure of blood alcohol content (BAC) traditionally measured intermittently by breathalyzer or blood draw. There are two primary means of measuring intoxication with biosensors: gait and sweat. Gait changes have been measured via smart sensors placed on the wrist, in the shoe, and mobile device sensors in smart phones. Sweat measured by transdermal biosensors detects the presence of alcohol in the blood stream correlating to BAC. Transdermal biosensors have been designed in tattoos/skin patches, shirts, and most commonly, devices worn on the ankle or wrist. Transdermal devices were initially developed to help monitor court-ordered sobriety among offenders with alcohol use disorder. These devices now prove most useful in continuously tracking consumption throughout clinical trials for behavioral treatment modalities. More recent research has started exploring the uses for physical activity trackers and physiological arousal sensors to guide behavioral interventions for relapse prevention. While research has begun to demonstrate wearable devices' utility in reducing alcohol consumption among individuals aiming to cutdown on their drinking, monitoring sustained abstinence in studies exploring contingency management for alcohol use disorders, and facilitating engagement in activity-based treatment interventions, their full potential to further aid in understanding of, and treatment for, alcohol use disorders has yet to be explored. [ABSTRACT FROM AUTHOR]

Pharmacological studies implicate toll‐like receptor 3 (TLR3) signaling in alcohol drinking. We examined the role of TLR3 in behavioral responses to alcohol and GABAergic drugs by studying Tlr3−/− mice. Because of opposing signaling between TLR3 and MyD88 pathways, we also evaluated Myd88−/− mice. Ethanol consumption and preference decreased in male but not in female Tlr3−/− mice during two‐bottle choice every‐other‐day (2BC‐EOD) drinking. There were no genotype differences in either sex during continuous or limited‐access drinking. Null mutations in Tlr3 or Myd88 did not alter conditioned taste aversion to alcohol and had small or no effects on conditioned place preference. The Tlr3 null mutation did not alter acute alcohol withdrawal. Male, but not female, Tlr3−/− mice took longer than wild‐type littermates to recover from ataxia by ethanol or diazepam and longer to recover from sedative‐hypnotic effects of ethanol or gaboxadol, indicating regulation of GABAergic signaling by TLR3. Acute functional tolerance (AFT) to alcohol‐induced ataxia was decreased in Tlr3−/− mice but was increased in Myd88−/− mice. Thus, MyD88 and TLR3 pathways coordinately regulate alcohol consumption and tolerance to intoxicating doses of alcohol and GABAergic drugs. Despite similar alcohol metabolism and similar amounts of total alcohol consumed during 2BC and 2BC‐EOD procedures in C57BL/6J mice, only 2BC‐EOD drinking induced tolerance to alcohol‐induced ataxia. Ataxia recovery was inversely correlated with level of drinking in wild‐type and Tlr3−/− littermates. Thus, deleting Tlr3 reduces alcohol consumption by reducing AFT to alcohol and not by altering tolerance induced by 2BC‐EOD drinking. [ABSTRACT FROM AUTHOR]

Alcohol use disorder (AUD) is the most common substance use disorder worldwide. Although dopamine-related findings were often observed in AUD, associated neurobiological mechanisms are still poorly understood. Therefore, in the present study, we investigate D2/3 receptor availability in healthy participants, participants at high risk (HR) to develop addiction (not diagnosed with AUD), and AUD patients in a detoxified stage, applying 18 F-fallypride positron emission tomography (18 F-PET). Specifically, D2/3 receptor availability was investigated in (1) 19 low-risk (LR) controls, (2) 19 HR participants, and (3) 20 AUD patients after alcohol detoxification. Quality and severity of addiction were assessed with clinical questionnaires and (neuro)psychological tests. PET data were corrected for age of participants and smoking status. In the dorsal striatum, we observed significant reductions of D2/3 receptor availability in AUD patients compared with LR participants. Further, receptor availability in HR participants was observed to be intermediate between LR and AUD groups (linearly decreasing). Still, in direct comparison, no group difference was observed between LR and HR groups or between HR and AUD groups. Further, the score of the Alcohol Dependence Scale (ADS) was inversely correlated with D2/3 receptor availability in the combined sample. Thus, in line with a dimensional approach, striatal D2/3 receptor availability showed a linear decrease from LR participants to HR participants to AUD patients, which was paralleled by clinical measures. Our study shows that a core neurobiological feature in AUD seems to be detectable in an early, subclinical state, allowing more individualized alcohol prevention programs in the future. [ABSTRACT FROM AUTHOR]

This study was a secondary data analysis of clinical trial data collected from 268 active duty U.S. military service members seeking cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) at Fort Hood, Texas, related to combat operations following September 11, 2001. Our primary aim was to evaluate changes in PTSD symptom severity and alcohol misuse as a function of baseline hazardous drinking and treatment format (i.e., group or individual). At baseline and posttreatment, PTSD was assessed using the PTSD Symptom Scale–Interview Version and PTSD Checklist for DSM‐5. Hazardous drinking was categorically defined as an Alcohol Use Disorder Identification Test total score of 8 or higher. Employing intent‐to‐treat, mixed‐effects regression analysis, all groups reported reduced PTSD symptom severity, Hedges' gs = −0.33 to −1.01, except, unexpectedly, nonhazardous drinkers who were randomized to group CPT, Hedges' g = −0.12. Hazardous drinkers who were randomized to individual therapy had larger reductions in PTSD symptoms than nonhazardous drinkers who were randomized to group CPT, Hedges' g = −0.25. Hazardous drinkers also reported significant reductions in alcohol misuse, regardless of treatment format, Hedges' gs = −0.78 to −0.86. This study builds upon an emerging literature suggesting that individuals with PTSD and co‐occurring alcohol use disorder can engage successfully in CPT, which appears to be an appropriate treatment for these individuals whether it is delivered individually or in a group format. However, as a portion of participants remained classified as hazardous drinkers at posttreatment, some individuals may benefit from integrated treatment. [ABSTRACT FROM AUTHOR]

Importance: More than half of patients with alcohol use disorder who receive inpatient withdrawal treatment relapse within weeks of discharge, hampering subsequent uptake and effectiveness of psychological and pharmacologic interventions. Cognitive bias modification (CBM) improves outcomes after alcohol rehabilitation, but the efficacy of delivering CBM during withdrawal treatment has not yet been established.Objective: To test the hypothesis that CBM would increase the likelihood of abstaining from alcohol during the 2 weeks following discharge from inpatient withdrawal treatment.Design, Setting, and Participants: In a randomized clinical trial, 950 patients in 4 inpatient withdrawal units in Melbourne, Australia, were screened for eligibility between June 4, 2017, and July 14, 2019, to receive CBM or sham treatment. Patients with moderate or severe alcohol use disorder aged 18 to 65 years who had no neurologic illness or traumatic brain injury were eligible. Two-week follow-up, conducted by researchers blinded to the participant's condition, was the primary end point. Both per-protocol and intention-to-treat analysis were conducted.Interventions: Randomized to 4 consecutive daily sessions of CBM designed to reduce alcohol approach bias or sham training not designed to modify approach bias.Main Outcomes and Measures: Primary outcome was abstinence assessed using a timeline followback interview. Participants were classified as abstinent (no alcohol use in the first 14 days following discharge) or relapsed (any alcohol use during the first 14 days following discharge or lost to follow-up).Results: Of the 950 patients screened for eligibility, 338 did not meet inclusion criteria, 108 were discharged before being approached, and 192 refused. Of the 312 patients who consented (referred sample), 12 withdrew before being randomized. In the final population of 300 randomized patients (CBM, n = 147; sham, n = 153), 248 completed the intervention and 272 completed the follow-up. Of the 300 participants (173 [57.7%] men; mean [SD] age, 43.47 [10.43] years), 7 patients (3 controls, 4 CBM) withdrew after finding the training uncomfortable. Abstinence rates were 42.5% (95% CI, 34.3%-50.6%) in controls and 54.4% (95% CI, 46.0%-62.8%) in CBM participants, yielding an 11.9% (95% CI, 0.04%-23.8%; P = .04) difference in abstinence rates. In a per-protocol analysis including only those who completed 4 sessions of training and the follow-up, the difference in abstinence rate between groups was 17.0% (95% CI, 3.8%-30.2%; P = .008).Conclusions and Relevance: The findings of this clinical trial support the efficacy of CBM for treatment of alcohol use disorder. Being safe and easy to implement, requiring only a computer and joystick, and needing no specialist staff/training, CBM could be routinely offered as an adjunctive intervention during withdrawal treatment to optimize outcomes.Trial Registration: Australian New Zealand Clinical Trials Registry Identifier: ACTRN12617001241325. [ABSTRACT FROM AUTHOR]

Background: Facial emotional recognition plays a pivotal role in human interactions and behavior. Long-term alcohol use leads to brain dysfunction that causes impairment in social cognitive abilities including facial emotional recognition. Objectives: Our study was aimed to assess the facial emotional recognition pattern in patients with alcohol dependence syndrome (ADS) and compared with that of matching controls and to study the sociodemographic and clinical correlates of facial emotional recognition in ADS. Setting and Design: This cross-sectional study was conducted at a tertiary care teaching hospital for a period of 1½ years. Fifty participants having ADS and fifty controls were included in the study. Materials and Methods: Fifty participants having ADS and fifty controls were included in the study. In the group with ADS, a semi-structured pro forma was used to collect the sociodemographic and clinical profile. Rating scales such as Severity of Alcohol Dependence Questionnaire, the Clinical Institute Withdrawal Assessment for Alcohol scale-revised, and facial emotion recognition test (FERT) were administered. For the control group, FERT was administered after collecting the data regarding sociodemographic profile and clinical variables. Results: It was observed a significant impairment in FERT scores in individuals having ADS (mean score = 19.93 ± 7.67) when compared to the control population (mean score = 32.73 ± 4.96T-test = -10.86; P < 0.001). Lower scores on FERT were observed in persons with severe alcohol dependence (one-way ANOVA = 41.79, P < 0.001). Post hoc Tukey testing showed the difference between groups having moderate-to-severe dependence (P < 0.001) and mild-to-severe dependence (P < 0.001). Conclusions: Significant impairment in facial emotional recognition skills were observed in patients having ADS. The subjects in ADS group were able to identify happy and angry emotions better while facing difficulties in identifying sad and fear full stimulus. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Psychiatry Research is the property of University Hospital Center Sestre, Department of Psychiatry 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 Logopedia Silesiana is the property of Wydawnictwo Uniwersytetu Slaskiego 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.)

Objective: ADHD is common in patients with alcohol dependence, but prevalence results are inconsistent. We investigated ADHD prevalence in a complex design to avoid over- or underdiagnosing. Method: Patients with alcohol dependence starting long-term residential treatment were included. A structured interview (Diagnostic Interview for ADHD in Adults [DIVA]) was conducted on all patients. DIVA results indicating childhood or adulthood ADHD were assessed in successive diagnostic interviews by two expert clinicians. Results: 415 of 488 patients had completed the entire diagnostic assessment. ADHD prevalence was 20.5%. DIVA results correlated moderately with experts' diagnoses. In patients with ADHD, a higher comorbid illicit substance use was prevalent and alcohol dependence started earlier and was more severe. Conclusion: This study provides the largest sample on ADHD prevalence in alcohol dependent inpatients. Despite great efforts to avoid overestimation, we found every fifth patient to have ADHD. ADHD diagnosis should not be based solely on a structured interview but should be clinically confirmed. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study is to quantify the extent of specific polysubstance use, drug transitions to current substances, and describe the association with alcohol use disorders among inmates with ADHD. We also examined health risk behaviors and patterns of offending in relation with ADHD. Method: A total of 387 male British prison inmates were screened and interviewed via the Diagnostic Interview for ADHD in Adults 2.0 (DIVA-2). Results: Male prisoners with ADHD endorse more methadone and amphetamine use. There was a significantly higher linear trend among those with ADHD for the number of substances ever used. ADHD was positively associated with increasing levels of alcohol use disorder severity, and with alcohol dependence. Transition along the pathways of substance misuse and persistence of drug misuse was better explained by the presence of conduct disorder/antisocial personality traits. Conclusion: Higher rates of alcohol dependence and stimulant-cocaine misuse suggest these inmates have maladaptive coping mechanisms, such as self-medication behaviors. [ABSTRACT FROM AUTHOR]

Background: Gluteal compartment syndrome is an uncommon condition and can be difficult to diagnose. It has been diagnosed after trauma, vascular injury, infection, surgical positioning, and prolonged immobilization from drug or alcohol intoxication. The diagnosis is based on clinical findings and, in most cases, recognizing these symptoms and making a diagnosis early is critical to a complete recovery. Case presentation: A 53-year-old male who underwent left foot surgery had severe pain to his contralateral hip and posterior gluteal compartment radiating to the right lower extremity immediately postoperative. He was positioned supine with a "bump" placed under his right hip to externally rotate his operative leg during the surgery. Due to the patient's complex past medical history, a presumptive diagnosis of a herniated disc and/or compression of the sciatic nerve was made as a cause for the patient's pain. This resulted in a misdiagnosis period of 36 h until the patient was diagnosed with unilateral gluteal compartment syndrome. Performing a fasciotomy was decided against due to the increased risk of complications. The patient was treated with administration of IV fluids and closely monitored. On post-op day 6, the patient was discharged. At three months post-op, the patient was walking without a limp and he had no changes in his peripheral neurologic examination compared to his preoperative baseline. Conclusion: Gluteal compartment syndrome is a surgical emergency that must be considered postoperatively especially in obese patients with prolonged operation times who experience acute buttock pain. The use of positional bars or "bumps" in the gluteal area should be used with caution and raise awareness of this complication after orthopedic surgeries. [ABSTRACT FROM AUTHOR]

Background and Aims: In addition to craving responses to salient food cues, the anticipation of short-term rewarding consumption of palatable food may overrun the anticipation of long-term negative consequences of obesity. The present investigation addressed the potential interplay of food cravings and decision-making abilities in individuals with obesity. Method: Study 1 included 107 bariatric surgery candidates with class 2/3 obesity (OB-group) and study 2 included 54 individuals with normal weight/pre-obesity (nonOB-group). In both studies, standardized questionnaires concerning food cravings, food addiction, and psychopathology were administered. A cue-reactivity paradigm was used to measure craving responses toward semi-individualized images of highly palatable, processed food/fruit (appetitive food cues) compared to images of raw vegetables (non-appetitive food cues). Decision-making was measured with a modified computerized version of the Iowa Gambling Task (IGT) with food pictures. Both groups were divided into two subgroups that were randomized to different IGT conditions. In one IGT condition the advantageous IGT card decks were covered by pictures of palatable, processed food or fruit and the disadvantageous decks by images of raw vegetables (= congruent condition), and in the other IGT condition vice versa. Results: Participants in the OB-group admitted on average higher craving responses toward palatable, processed food or fruit cues compared to pictures of raw vegetables. This was not the case in the nonOB-group. Contrary to our hypothesis, decision-making performance in both groups was worse when pictures of palatable, processed food or fruit were associated with advantageous IGT card decks compared to performance when those pictures were linked to the disadvantageous decks. The interference effect of food pictures processing on advantageous decision-making has been observed particularly in those individuals of the OB-group who exhibited high craving responses toward palatable, processed food cues or high levels of food addiction. Discussion: The results indicate that food pictures processing interferes with decision-making, regardless of weight status. Opposed to the hypothesis, stronger tendencies to avoid than to approach pictures presenting processed, tasty food were observed. Further research should examine how cognitive avoidance tendencies toward processed, high energy food and approach tendencies toward healthy food can be transferred to real life situations. [ABSTRACT FROM AUTHOR]

Preclinical models of cocaine use disorder are widely utilized to identify neuroadaptations underlying cocaine seeking and to screen medications to reduce seeking. However, while the majority of cocaine users engage in poly-substance use (PSU), a minority of preclinical studies employ PSU models. We previously reported that when rats consume alcohol after daily intravenous cocaine self-administration, nucleus accumbens (NA) core basal glutamate levels are reduced below those of rats that consumed only cocaine, and do not increase during cue + cocaine-primed reinstatement of cocaine-seeking. Here we used the same model of sequential cocaine and alcohol self-administration to test the hypothesis that a similar pattern of glutamate changes would be observed in the NA core prior to and during a cocaine-primed reinstatement test. Rats underwent intravenous cocaine self-administration followed by access to unsweetened alcohol in the home cage for 12 days. Rats underwent a minimum of 12 daily extinction sessions prior to a cocaine-primed reinstatement test conducted during microdialysis procedures. Contrary to our previous work using the same model, here we found that access to alcohol increased cocaine intake and increased responding during early extinction training. We found that as in our previous work, cocaine + alcohol-consuming rats displayed basal glutamate levels below those of rats that self-administered only cocaine. During the cocaine-primed reinstatement test, rats that consumed only cocaine displayed increased glutamate efflux in the NA core while those that consumed cocaine + alcohol did not. These results indicate that preclinical models of PSU should be utilized to develop experimental therapeutics for the reduction of cocaine seeking. [ABSTRACT FROM AUTHOR]

Introduction: Understanding HIV risk and healthcare engagement of at‐risk individuals by HIV status is vital to informing HIV programmes in settings where the HIV epidemic is rapidly expanding like the Philippines. This study examined differences in HIV risk and healthcare engagement factors among Filipinx transgender women and cisgender men who have sex with men (trans‐WSM and cis‐MSM respectively) who self‐reported being HIV negative, HIV positive or HIV unknown. Methods: Between 2018 and 2019, we conducted Project #ParaSaAtin, an online cross‐sectional survey that examined the structural, social and behavioural factors impacting HIV services among Filipinx trans‐WSM and cis‐MSM (n = 318). We performed multinomial regression procedures to determine factors associated with HIV status (with HIV‐negative referent). Co‐variates included participant demographics, experiences of social marginalization, HIV risk, healthcare engagement and alcohol and substance problems. Results: Self‐reported HIV status of the sample was as follows: 38% HIV negative, 34% HIV positive and 28% HIV unknown. Relative to HIV‐negative respondents, HIV‐positive respondents were more likely to be older (25‐ to 29‐year‐old adjusted risk ratio [aRRR]=5.08, 95% Confidence Interval [95% CI] = 1.88 to 13.72; 30‐ to 34‐year‐old aRRR = 4.11, 95% CI = 1.34 to 12.58; and 35 + years old aRRR = 8.13, 95% CI = 2.40 to 27.54, vs. 18 to 25 years old respectively), to live in Manila (aRRR = 5.89, 95% CI = 2.20 to 15.72), exhibit hazardous drinking (aRRR = 2.87, 95% CI = 1.37 to 6.00) and problematic drug use (aRRR = 2.90, 95% CI = 1.21 to 7.13). HIV‐positive respondents were less likely to identify as straight (aRRR = 0.13, 95% CI = 0.02 to 0.72), and were more likely to avoid HIV services due to lack of anti‐lesbian, gay, bisexual and transgender (LGBT) discrimination policies (aRRR = 0.37, 95% CI = 0.14 to 0.90). Relative to HIV‐negative respondents, HIV‐unknown respondents were less educated (some college aRRR = 0.10, 95% CI = 0.02 to 0.37, beyond college aRRR = 0.31, 95% CI = 0.09 to 0.99, vs. high school or below respectively), had lower HIV knowledge (aRRR = 0.30, 95% CI = 0.20 to 0.71), and were less communicative about safer sex (ARR = 0.29, 95% CI = 0.09 to 0.92). Moreover, HIV‐unknown respondents were also more likely to have avoided HIV services due to cost (aRRR = 4.46, 95% CI = 1.73 to 11.52). Conclusions: This study highlights differences in HIV risks and healthcare engagement by HIV status. These findings show different barriers exist per HIV status group, and underscore the need to address Filipinx trans‐WSM and cis‐MSM's poor engagement in HIV services in the Philippines. [ABSTRACT FROM AUTHOR]

Background: Once a device for telecommunication, now a powerful device bringing the whole world in one's palm, smartphones are increasingly becoming a common commodity among the medical students. Smartphones foster social interaction and facilitate multitasking and learning, but they also have some adverse effects. Young people, especially students, who are always inquisitive towards new technology, are likely to be affected by both these positive and negative impacts. Objective: To assess smartphone use and its association with the quality of life (QOL) of medical students. Materials and Method: A cross-sectional study was conducted among the undergraduate medical students of Government Medical College (GMC), Haldwani. All the students enrolled in MBBS course in GMC, Haldwani, who gave consent for participation and were present on the day of questionnaire administration, were included in the study. Smartphone addiction scale (SAS-SV), and WHO-BREF questionnaires for QOL were used for assessing smartphone use, and QOL of the medical students, respectively. Results: A total of 395 medical students were included in the study; out of them, 42% considered themselves addicted to the smartphone. According to SAS-SV, smartphone addiction was found among 43.8% medical students. It was seen that the junior-most and senior-most batches were significantly less addicted to the smartphone (p-value < 0.001). Male students were more addicted (OR = 1.45, CI = 0.962–2.174) to the smartphone as compared to females. The QOL of the students was significantly affected by smartphone use in all domains assessed (p-value ranging from < 0.001 to 0.002). Conclusions: Smartphone addiction is high among medical students and it has a significant negative impact on their QOL. [ABSTRACT FROM AUTHOR]

Aim: The safety and efficacy of nalmefene in Japanese patients with high or very high World Health Organization drinking risk level of alcohol dependence were assessed in a multicenter, randomized, double‐blind, placebo‐controlled, phase 3 (lead‐in) study. Here, the long‐term safety and efficacy of nalmefene in an open‐label extension of the lead‐in study are presented. Methods: Patients who completed the 24‐week lead‐in study were eligible for the extension study, where they were treated with nalmefene 20 mg as needed for 24 weeks. The long‐term safety and efficacy of nalmefene 20 mg during the total 48‐week period were evaluated. Treatment‐emergent adverse events during the study period were recorded and change from baseline in the number of heavy drinking days and total alcohol consumption were calculated. Results: Overall, long‐term nalmefene 20 mg was well tolerated; the main treatment‐emergent adverse events reported in ≥5% of patients included nasopharyngitis (37.2%), nausea (36.5%), somnolence (21.2%), dizziness (16.8%), malaise (14.6%), and vomiting (12.4%). The number of heavy drinking days and total alcohol consumption decreased from baseline to 48 weeks (mixed model for repeated measures, least squares mean ± standard error, −15.09 ± 0.77 days/month and −53.20 ± 2.29 g/day, respectively) during the study. Conclusion: This long‐term evaluation in Japanese patients with high or very high drinking risk levels of alcohol dependence indicated that nalmefene was safe, well tolerated, and efficacious. [ABSTRACT FROM AUTHOR]

Addiction management is complex, and it requires a bio-psycho-social perspective, that ought to consider the multiple etiological and developmental factors. Because of this, a large amount of resources has been allocated to assess the vulnerability to dependence, i.e., to identify the processes underlying the transition from substance use to dependence, as well as its course, in order to determine the key points in its prevention, treatment, and recovery. Consequently, knowledge \from neuroscience must be taken into account, which is why different initiatives have emerged with this objective, such as the "Research Domain Criteria" (RDoC), and the "Addiction Neuroclinical Assessment" (ANA). Particularly, neuropsychophysiological measures could be used as markers of cognitive and behavioral attributes or traits in alcohol dependence, and even trace clinical change. In this way, the aim of this narrative review is to provide an overview following ANA clinical framework, to the most robust findings in neuropsychophysiological changes in alcohol dependence, that underlie the main cognitive domains implicated in addiction: incentive salience, negative emotionality, and executive functioning. The most consistent results have been found in event-related potential (ERP) analysis, especially in the P3 component, that could show a wide clinical utility, mainly for the executive functions. The review also shows the usefulness of other components, implicated in affective and substance-related processing (P1, N1, or the late positive potential LPP), as well as event-related oscillations, such as theta power, with a possible use as vulnerability or clinical marker in alcohol dependence. Finally, new tools emerging from psychophysiology research, based on functional connectivity or brain graph analysis could help toward a better understanding of altered circuits in alcohol dependence, as well as communication efficiency and effort during mental operations. This review concludes with an examination of these tools as possible markers in the clinical field and discusses methodological differences, the need for more replicability studies and incipient lines of work. It also uses consistent findings in psychophysiology to draw possible treatment targets and cognitive profiles in alcohol dependence. [ABSTRACT FROM AUTHOR]

Keywords: substance abuse; COVID-19 pandemic; opioids; new benzodiazepines; new psychoactive substances EN substance abuse COVID-19 pandemic opioids new benzodiazepines new psychoactive substances 1 4 4 07/22/20 20200716 NES 200716 Introduction In the late 2019, an epidemic of cases with severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) has spread from China to the rest of the world, resulting in a global pandemic (COronaVIrus Disease 19, COVID-19 pandemic). Moreover, people using high doses of prescription opioids or presenting opioid use disorder experience additional challenges for their respiratory health. Before the pandemic, patients receiving methadone had to follow an approved treatment program for opioid addicts, under which the drug could only be administered daily and under supervision. Patients under opioid addiction treatment with a reasonable degree of stabilization should obtain several doses of methadone in sufficient quantity for several days or refill their buprenorphine prescription over the phone ([26]). [Extracted from the article]

Background: Many patients report postoperative pain, limited improvement in physical function and poor quality of life (QOL) after knee replacement surgery. Our study uses baseline predictors of change to investigate the QOL of patients with knee osteoarthritis 3-months after knee replacement surgery.Methods: A prospective observational study was designed to evaluate patients (n = 132) scheduled for uni-compartmental or total knee replacement surgery who were assessed at baseline (preoperatively) and 3-months after. Physical and mental endpoints based on the component scores of the SF-12 and on the Western Ontario and McMaster Universities Arthritis (WOMAC) index were used to investigate patients' QOL. Generalised estimating equation methodology was used to assess patients' baseline characteristics (age, sex, education, body mass index (BMI), comorbidity, depressive symptoms, cognitive impairment, smoking/alcohol and type of surgery), the study endpoints and their changes over a 3-month post-surgery period. Stratified analyses by rehabilitation status after discharge were performed.Results: Longitudinal data analysis showed that the baseline factors associated with improvement in general QOL at the 3-month post-surgery assessment were higher BMI, a high comorbidity, total (as opposed to unicompartmental) knee replacement and low education level. Data analysis of the patients who underwent rehabilitation after discharge revealed that the current smokers' physical QOL worsened over time. The general QOL was unchanged over time in the presence of depressive symptomatology.Conclusions: These findings underline the importance of using comprehensive assessment methods to identify factors affecting functionality and QOL, and developing interventions to improve the health/wellbeing of patients after knee replacement. [ABSTRACT FROM AUTHOR]

Aim: The aims of this study were to study the prevalence of smartphones addiction among college and university students in Kingdom of Saudi Arabia (KSA), and to determine the risk factors and complications associated with smartphone addiction. Method: This study was conducted in all provinces of KSA from December 2015 to June 2016 by sending questionnaire to student clubs of various universities through Survey Monkey. Questionnaire included (1) sociodemographics, (2) smartphone usage patterns and addiction behavior, (3) impact of smartphone usage on driving and medical complications, and (4) smartphone addiction scale. Result: The total number of participants was 1941 (response rate 80.9%) students representing most of the provinces of Saudi Arabia. The prevalence of smartphones addiction was 19.1%. Female participants were more addicted than male participants (P < 0.001). Smartphone addition was also significantly associated with musculoskeletal complication, upper limb, eyes and sleep complications. Conclusion: High frequent usage with prolonged duration of smartphone was associated with high risk to addiction. Furthermore, smartphone addiction had significant impact on performing daily activities, sleeping disorder, and health problems. Awareness about harm of smartphones addiction is required to provide to students and parents as well. Smartphones should not be given at younger age and it only be given when a child can differentiate its healthy and productive use from addiction. [ABSTRACT FROM AUTHOR]

Introduction. Impaired control over drinking has been frequently cited in diverse theoretical descriptions regarding harmful alcohol use and is considered a DSM criterion for alcohol use disorder. Differences in the frequency of endorsement of impaired control have been viewed as a reflection of the severity of the problem. Moreover, it has been posited that the ability to place a limit on alcohol consumption may be mediated through enhanced craving. Objective. In this study, we addressed the relationship between impaired control, self-reported craving, and alcohol dependence severity among heavy drinkers. Method. We conducted a latent class analysis of impaired control dimensions (perceived control, failed control, and attempted control) of 208 heavy drinkers. To determine whether the identified classes could represent different forms of severity of the disorder, the best-fit model was contrasted with scores on the Alcohol Dependence Scale. Furthermore, we assessed the relationship between impaired control criteria (using the Impaired Control Scale [ICS]) with alcohol craving. Results. We identified a three-class solution based on impaired control severity. A graded increase of the craving scores and alcohol severity among the three classes was also identified. Only the ICS items comprising perceived control and partially those related to failed control, but not those evaluating attempted control, distinguished the gradient among the latent classes. Discussion and conclusion. This study provides further support of the proposal of a unidimensional continuum of severity among heavy drinkers and strengthens the theoretical relationship between impaired control and alcohol craving. [ABSTRACT FROM AUTHOR]

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Copyright of Alcoholism & Drug Addiction / Alkoholizm i Narkomania is the property of Termedia Publishing House 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.)