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This study compared the cost-effectiveness of Life Skills Training (LST) to a LST curriculum infusion approach (I-LST) and to control schools. Male and female seventh graders from nine rural schools (3 in each condition) were followed for two years. Path models were used to test the main effect and were modeled separately for males and females. After one year, significant effects were observed only for females on alcohol, marijuana, and inhalant use in LST condition and for tobacco, alcohol, and marijuana use for I-LST females. After year two, only the I-LST program affected female smoking. Costs for the programs included actual expenditures for training and materials as well as estimates of teachers' salaries for their project time. Both programs were almost equally effective after one year, but LST was more cost-effective. Although I-LST had higher costs, it was the only approach with any outcomes in year two and therefore more cost-effective.

BACKGROUND: Video games have rapidly become mainstream in recent decades, with over half of the US population involved in some form of digital gaming. However, concerns regarding the potential harms of excessive, disordered gaming have also risen. Internet gaming disorder (IGD) has been proposed as a tentative psychiatric disorder that requires further study by the American Psychological Association (APA) and is recognized as a behavioral addiction by the World Health Organization. Substance use among gamers has also become a concern, with caffeinated or energy drinks and prescription stimulants commonly used for performance enhancement. OBJECTIVE: This study aimed to identify substance use patterns and health-related concerns among gamers among a population of Reddit users. METHODS: We used the public streaming Reddit application programming interface to collect and analyze all posts from the popular subreddit, r/StopGaming. From this corpus of posts, we filtered the dataset for keywords associated with common substances that may be used to enhance gaming performance. We then applied an inductive coding approach to characterize substance use behaviors, gaming genres, and physical and mental health concerns. Potential disordered gaming behavior was also identified using the tentative IGD guidelines proposed by the APA. A chi-square test of independence was used to assess the association between gaming disorder and substance use characteristics, and multivariable logistic regression was used to analyze whether mental health discussion or the mention of any substance with sufficient sample size was significantly associated with IGD. RESULTS: In total, 10,551 posts were collected from Reddit from June 2017 to December 2022. After filtering the dataset for substance-related keywords, 1057 were included for further analysis, of which 286 mentioned both gaming and the use of ≥1 substances. Among the 286 posts that discussed both gaming and substance use, the most mentioned substances were alcohol (n=132), cannabis (n=104), and nicotine (n=48), while the most mentioned genres were role-playing games (n=120), shooters (n=90), and multiplayer online battle arenas (n=43). Self-reported behavior that aligned with the tentative guidelines for IGD was identified in 66.8% (191/286) posts. More than half, 62.9% (180/286) of the posts, discussed a health issue, with the majority (n=144) cited mental health concerns. Common mental health concerns discussed were depression and anxiety. There was a significant association between IGD and substance use (P

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

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

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

Purpose: Sexual and gender minority (SGM) people are at greater risk for substance use than heterosexual and cisgender people, but most prior work is limited by cross-sectional analyses or the examination of single substance use. This study examined substance use over time among SGM people to identify patterns of polysubstance use at the intersection of sex and gender. Methods: Data were collected annually over 4 years from SGM respondents (n = 11,822) in The Population Research in Identity and Disparities for Equality (PRIDE) Study. Differences in substance use patterns (any prior 30-day use of 15 substances) by gender subgroup were examined with latent class analysis, and multinomial regression models tested relationships between gender subgroup and substance use. Results: Eight classes of substance use were observed. The three most common patterns were low substance use (49%), heavy episodic alcohol use (≥5 alcoholic drinks on one occasion) with some cannabis and tobacco use (14%), and cannabis use with some tobacco and declining heavy episodic alcohol use (13%). Differences observed included lower odds of patterns defined by heavy episodic alcohol use with some cannabis and tobacco use in all gender subgroups relative to cisgender men and persons with low substance use (odds ratios [ORs] 0.26-0.60). Gender expansive people assigned female at birth, gender expansive people assigned male at birth, and transgender men had greater odds of reporting cannabis use with small percentages of heavy episodic alcohol and tobacco use (ORs: 1.41-1.60). Conclusion: This study suggests that there are unique patterns of polysubstance use over time among gender subgroups of SGM people.

BackgroundPrevious investigations that have examined associations between family history (FH) of alcohol/substance use and adolescent brain development have been primarily cross-sectional. Here, leveraging a large population-based sample of youths, we characterized frontal cortical trajectories among 9- to 13-year-olds with (FH+) versus without (FH-) an FH and examined sex as a potential moderator.MethodsWe used data from 9710 participants in the Adolescent Brain Cognitive Development (ABCD) Study (release 4.0). FH+ was defined as having ≥1 biological parents and/or ≥2 biological grandparents with a history of alcohol/substance use problems (n = 2433). Our primary outcome was frontal cortical structural measures obtained at baseline (ages 9-11) and year 2 follow-up (ages 11-13). We used linear mixed-effects models to examine the extent to which FH status qualified frontal cortical development over the age span studied. Finally, we ran additional interactions with sex to test whether observed associations between FH and cortical development differed significantly between sexes.ResultsFor FH+ (vs. FH-) youths, we observed increased cortical thinning from 9 to 13 years across the frontal cortex as a whole. When we probed for sex differences, we observed significant declines in frontal cortical thickness among boys but not girls from ages 9 to 13 years. No associations were observed between FH and frontal cortical surface area or volume.ConclusionsHaving a FH+ is associated with more rapid thinning of the frontal cortex across ages 9 to 13, with this effect driven primarily by male participants. Future studies will need to test whether the observed pattern of accelerated thinning predicts future substance use outcomes.

Background: It is necessary to understand drinking motives to inform tailored interventions counteracting high-risk alcohol use and alcohol use disorder. Research suggests that, during the COVID-19 pandemic, drinking to cope with the current situation (i.e. coping motive) increased. This was alarming since the coping motive is a predictor of alcohol use and alcohol-related problems.Objective: In the current study, we aimed to elucidate whether this COVID-19-induced increase in coping-motivated alcohol use outlasted the COVID-19 pandemic in the USA, Great Britain, Mexico, Spain, and Germany. We provide a 2023 post-COVID-19 update on alcohol use and drinking motives.Methods: In spring 2023, 1032 participants recruited via Prolific (48% female) across the five countries completed a cross-sectional online survey, including the Alcohol Use Disorder Identification Test (AUDIT) for alcohol use patterns and the Drinking Motives Questionnaire-Revised (DMQ-R) for drinking motives.Results: Across all five countries, 20–30% of the participants exceeded the AUDIT cutoff score for high-risk alcohol use. The ranking of all four motives for alcohol use was cross-nationally consistent: Social > Enhancement > Conformity > Coping.Conclusion: Compared to most research before the pandemic, with a Social > Enhancement > Coping > Conformity motive ranking, and research during COVID-19, with an Enhancement > Coping > Social > Conformity motive ranking, our data suggests that post-COVID drinking to socialize and to enhance one’s own mood, are again the most important motives to drink alcohol. Furthermore, it seems like the increase in the coping motive found in research during the pandemic, did luckily not persist but conversely, post- compared to pre-COVID, the conformity motive seems more important than coping motive. [ABSTRACT FROM AUTHOR]

Background and objective: Temporary abstinence campaigns (TAC) are a promising approach to reduce alcohol consumption. This study examined changes in (at-risk) alcohol consumption and determinants of alcohol consumption among Belgian adults participating in the Tournée Minérale Campaign (TMC, Belgian TAC). In addition, moderating effects of age, sex, education level, successfully refraining from alcohol during TMC, risk drinking, drinking levels and binge drinking were investigated. Methods: TMC is a fully automated mass media prevention campaign challenging Belgian adults to refrain from alcohol during the month February. This study includes a baseline, post- (four weeks after TMC) and follow-up (six months after TMC) test using online recruitment and an online questionnaire. Participants were self-selected by signing up on the TMC website. Repeated measures ANCOVAs were used to examine changes over time in alcohol consumption (log transformed due to skewness) and determinants among TMC participants (n = 8,730, 48.4 ± 12.9 years old, 37.4% males) who filled in all three measurements. Moderation effects were assessed for age, sex, education level, successfully refraining from alcohol during TMC, risk drinking, drinking levels and binge drinking at baseline. McNemar tests were used to examine the change in prevalence of risk drinking and binge drinking. Results: TMC participants showed a significant decrease in weekly alcohol consumption (mean exp(x)-1) and CI) from baseline (6.2 [6.4,6.7]) to post (4.2 [4.1,4.3], F = 22.0, p <.001 d = -2.4 [-2.4,-2.3]) and from baseline to follow-up (5.1 [4.9,5.2], F = 24.2, p <.001, d = -1.5 [-1.5,-1.4]), and an increase from post to follow-up (F = 21.1, p <.001). In the short term (from baseline to post), the decreases were stronger among older, male and lower educated TMC participants, those successfully refraining during TMC, higher risk drinkers and binge drinkers. In the medium term (from baseline to follow-up), changes in alcohol consumption were moderated by education (stronger among lower educated) and risk drinking (increase in lower risk drinkers and decrease in higher risk drinkers). Participants' baseline drinking level moderated changes in alcohol consumption. Both short and medium term increases in alcohol consumption were observed among those with a low drinking level (those who drank 0 to < 4 glasses at baseline), while short and medium term decreases were observed among those with higher drinking levels, i.e. those with moderate (≥ 4 to ≤ 10 glasses), high (> 10 to ≤ 17 glasses) and highest (> 17 glasses) drinking level at baseline. A reduction in the proportion of risk drinkers and binge drinkers and changes in determinants of alcohol consumption (e.g. attitudes towards drinking less alcohol and habit of drinking alcohol) were observed among TMC participants. Conclusions: TMC participants reported favourable changes in (the underlying determinants of) alcohol consumption in the short and medium term. Higher level drinkers appear to be especially attracted to participate in TMC and to experience the strongest decreases in alcohol consumption. However, without comparison with a control group of non-participants or comparison points, we cannot simply attribute the changes over time to participation in TMC. Future research with a stronger study design is needed to rule out possible bias (e.g., selection bias, seasonal effects or regression to the mean) and to examine mechanisms and longer term effects of TACs. [ABSTRACT FROM AUTHOR]

Background: Individuals with a minority sexual orientation have consistently been found to face a greater risk of mental health problems and problematic substance use than heterosexual individuals. The present study examined whether differences in alcohol use or alcohol use disorder (AUD) symptoms across the spectrum of sexual orientations could be explained by drinking motives (i.e., enhancement, social, coping and conformity motives). Method: A non-self-selective sample of non-abstinent, young Swiss men (N = 5,139; mean age = 25.4, SD = 1.25) completed a self-reporting questionnaire on sexual orientation (on a five-point attraction scale: heterosexual, mostly-heterosexual, bisexual, mostly-homosexual, homosexual), drinking motives, alcohol use indicators (e.g., heavy episodic drinking, Alcohol Use Disorders Identification Test-Consumption [AUDIT-C]), and AUD symptoms. Structural equation modeling was used to test whether drinking motives mediated the associations between dummy-coded sexual orientation (with heterosexual men as the reference) and alcohol use indicators or AUD symptoms. Results: Mostly-heterosexual men exhibited higher scores on alcohol use indicators than heterosexual men, with almost full mediation through their drinking motives, specifically higher enhancement motives. They also reported more AUD symptoms, partially mediated through drinking motives, with comparable contributions from enhancement and coping motives. Homosexual men, however, displayed similar or lower scores for alcohol use indicators and AUD symptoms than heterosexual men, but these differences were not mediated by drinking motives. Indeed, homosexual men exhibited greater coping motives than heterosexual men. No significant results or discernible patterns emerged for bisexual or mostly-homosexual men. Discussion: These findings highlight the importance of considering the full spectrum of sexual orientations in healthcare and of broadening the focus on drinking motives beyond coping. Understanding the varied motives for alcohol use across the spectrum of sexual orientations facilitates tailored prevention strategies. [ABSTRACT FROM AUTHOR]

Objective: Alcohol use is a substantial problem among college students and has several negative consequences. The current study examined the associations between anhedonia and alcohol use and related problems via impulsive behavior (e.g., negative urgency, sensation seeking). We parsed anhedonia into four specific facets: consummatory, anticipatory, recreational, and social anhedonia. Participants: Six hundred and forty college students aged 18-25 were included in the final analysis. Method: Data were collected via Amazon Mechanical Turk. Self-report inventories assessing for anhedonia, alcohol use, impulsive behavior, and depressed mood were utilized. Results: Recreational consummatory anhedonia was negatively associated with alcohol use and alcohol-related problems through negative urgency. Recreational consummatory anhedonia also had significant negative associations with alcohol consumption via sensation seeking. Further, social anticipatory anhedonia was positively associated with alcohol use and related problems via negative urgency. Conclusions: This study highlights important associations between anhedonia, impulsivity, and alcohol use and related problems. [ABSTRACT FROM AUTHOR]

Objectives: Intimate partner violence (IPV) is associated with an elevated risk of substance use, but few studies have simultaneously examined other aspects of victimization history that may contribute to substance use. The current study examined the direct and moderating effects of childhood polyvictimization (i.e., multiple experiences of violence victimization before age 18) on the association between IPV subtypes (physical, sexual, psychological, and injury) and alcohol/drug use. Methods: A sample of 256 college students ages 18–25 (72% female, 68% white) completed a survey assessing past-year IPV, childhood polyvictimization, and past three-month substance use. Results: There were no direct or joint associations between IPV, childhood polyvictimization, and alcohol use. There were direct associations between psychological IPV, childhood polyvictimization, and drug use. No other forms of IPV were significantly associated with drug use. Conclusions: Results highlight unique direct associations between violence victimization and drug use risk compared to alcohol use risk in this context. [ABSTRACT FROM AUTHOR]

Objectives: American Indian and Alaskan Native (AIAN) populations have the highest rate of alcohol use disorder (AUD). Binge drinking is a known predecessor of AUD and is prevalent in college-attending populations. However, little is known about the prevalence and risk factors related to AIAN college student binge drinking. The current study examines prevalence of binge drinking and association with socio-demographic features, other substance use, exposure to discrimination and feelings of belonging within collegiate institutions. Design: Data were collected by the Healthy Minds Study. Present analyses were restricted to 2- and 4-year college attending students in the 2021–2022 academic year who identified as AIAN (n = 1383). We used descriptive, bivariate and multivariate Poisson weighted models to evaluate distributions and associations of binge drinking, age, gender, socioeconomic status, degree program, military experience, substance use, sexual assault, discrimination, and feelings of belonging within the institution. Results: In the prior 2 weeks, 26.3% of AIAN students reported binge drinking. Binge drinking commonly overlapped with other substance use. AIAN students aged 21–34 reported the highest rates of binge drinking, as did students pursuing bachelor's degrees. AIAN students who identified as trans or queer gender were less likely to report binge drinking, while across gender identities those reporting sexual assault or racial discrimination were more likely to report binge drinking in multivariate analyses. Conclusion: There are multiple factors associated with binge drinking, representing individual and contextual influences on AIAN students. Developing prevention and intervention activities to address overlap in substance use and high concurrence of sexual assault and binge drinking are critical. Additionally, colleges must make concerted efforts to reduce racial discrimination and be more inclusive of AIAN students to reduce institutional-based features that exacerbate risk. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to estimate the prevalence of past alcohol use and to evaluate patterns of alcohol use among Chinese adolescents. Methods: 1,707 students from 11 high schools in Macao (SAR) China self-reported their alcohol use measured by the Alcohol Use Disorder Identification Test (AUDIT). Latent class analysis and multinomial logistic regression were conducted to examine patterns of drinking and their correlates with alcohol-related use problems. Results: The prevalence of past alcohol use and problematic alcohol use (AUDIT ≥8) was 26.0% and 3.2%, respectively. Latent class analysis demonstrated that a five-class model best fit the participants' alcohol use patterns, including a heavy consumption group, two moderate consumption groups and two light consumption groups. Compared with the light consumption group, adolescents over the age of 15 (vs. 15 years or younger) were more likely to be classified into the moderate consumption group with mild negative consequences, and adolescents who smoked were more likely to be classified into all other groups vs. the reference group. Conclusion: The results suggest a high prevalence of alcohol use and several sub-groups were at increased odds of alcohol related harms. [ABSTRACT FROM AUTHOR]

Background: University students are an at-risk group for alcohol use. Fear of Missing Out (FoMO), the feeling that others are having rewarding experiences that one is missing out on, may drive alcohol use and harm. We aimed to investigate whether FoMO could uniquely predict alcohol use over and above known predictors like the big five personality traits. Methods: We recruited 392 university students and invited them to take part in a daily diary study where they reported their alcohol use daily over 13 days. Participants also completed a baseline survey and reported personality traits (neuroticism, extraversion, openness, agreeableness, and conscientiousness), and alcohol-related consequences and completed a final follow-up survey where they reported FoMO. Results: Using a zero-inflated negative binomial mixed model, we found that those higher in FoMO consumed more alcohol on drinking days (IRR = 1.11) when controlling for personality traits. Similarly, we found that those higher in FoMO experienced more harms (IRR = 1.10), when controlling personality traits. Conclusion: We found that FoMO is a distinct construct and not just isomorphic with the big five personality traits. This suggests that reducing FoMO may be a key aim for alcohol interventions and should be considered when aiming to reduce university student alcohol use. [ABSTRACT FROM AUTHOR]

Objective: To examine the impact of COVID-19 lockdown on drug consumption and sexual behaviors, among people living in Australia. Methods: Retrospective data analysis via logistic regression of 806 responses from an online, cross-sectional survey conducted during August 2020 was performed. State was a proxy for lockdown (Victoria = lockdown, other states = no lockdown). Results: Some participants increased drug usage from 2019–2020: 25.0% for alcohol, followed by marijuana (11.0%), other drugs (8.9%), and tobacco (7.0%). Risk factors for increasing use included women who have sex with women (WSW) and unsecure employment; protective factors included being in a relationship. TAFE/Diploma/Certificate level education was a risk factor for tobacco use, but a protective factor for alcohol use. There was a strong association between drug use and high-risk sexual behaviors. Multivariable analysis found no significant difference in patterns of drug use in Victoria (lockdown), relative to other states (without lockdown). Conclusion: Several risk factors for drug use were identified, and high-risk sexual behaviors were associated with drug use. However, given the lack of difference between Victoria and other states, it is unclear if these changes are attributable to lockdown. Further research could explore the nature/causes of these changes, to inform future pandemic preparedness. [ABSTRACT FROM AUTHOR]

Appetitive and aversive motivation are prominent in theories of dysregulated behaviors. The authors conducted a meta-analysis of the association between individual differences in appetitive and aversive motivation and several dysregulated behaviors (i.e., alcohol use, marijuana use, tobacco use, binge eating, aggression, gambling, and nonsuicidal self-injury). Alcohol use (r =.17, k = 141), marijuana use (r =.13, k = 23), aggression (r =.22, k = 52), and gambling (r =.08, k = 55) were all significantly positively related to appetitive motivation. Binge eating (r =.28, k = 34) and self-injury (r =.17, k = 10) were significantly positively related to aversive motivation. Effect sizes were similar to the median effect size in personality research. Together, these results provide some evidence that some dysregulated behaviors are more correlated with approach motivation, whereas others are more correlated with aversive motivation, which may indicate distinct etiological pathways. [ABSTRACT FROM AUTHOR]

Background: Preventure is a selective school-based personality-targeted program that has shown long-term benefits in preventing student alcohol use, internalising and externalising problems when delivered by psychologists. In this first Australian randomised controlled trial of school staff implementation of Preventure, we aimed to examine i) acceptability, feasibility, and fidelity and ii) effectiveness of Preventure on student alcohol use, internalising, and externalising symptoms. Methods: A cluster-randomised controlled implementation trial was conducted in Sydney, Australia and was guided by the RE-AIM framework (Glasgow et al. 1999); which measures reach, effectiveness, adoption, implementation, and maintenance. Schools were randomly assigned to either the Preventure intervention or active control (health education as usual). Nominated school staff from intervention schools received training and delivered the program to students with elevated scores on one of four personality types targeted in the program. School staff completed surveys on RE-AIM measures, which were analysed using descriptive statistics and thematic analysis. Students completed surveys at baseline and six months post-intervention; mixed-effects regression examined intervention by time interactions on alcohol use, internalising and externalising problems, at six-month follow-up. The study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000790943, registration date 6 August 2020). Results: 553 students across 8 schools participated in the baseline survey. Of these, 40% had elevated scores on one of the four personality profiles, resulting in 220 students in the current study (102 students in intervention schools, 118 students in control schools; mean age 13.6, 45.7% female). Most RE-AIM domains showed high ratings, with school staff showing good adherence and confidence in delivery. However, teachers reported difficulties with feasibility, particularly a lack of time. Student outcomes: There were significant improvements in depression and conduct problems across both intervention and control across time. There were no significant main or interaction effects of the intervention on student alcohol use, internalising, or externalising problems. Discussion: Teachers and students rated the program highly. However, concerns around feasibility may limit teacher-led application of the program in the Australian context. Alternative approaches, such as delivery by dedicated personnel within schools without a teaching load, may be critical in implementing such evidence-based interventions at scale. Trial registration: The study was prospectively registered with the Australian New Zealand Clinical Trials Registry, registration number: ACTRN12620000790943, registration date: 6 August 2020. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionsThis longitudinal study aims to explore several individual psychological vulnerability factors that could predict the onset or escalation of alcohol use in early adolescents.A total of 792 adolescents participated in all stages of this study. Participants were divided into two groups based on their alcohol use patterns: no drinking group (ND) and light drinking group (LD). Cognitive, personality, and neuropsychological measures were assessed using questionnaires, and alcohol use was evaluated at baseline (T1). After two years, alcohol use was reassessed (T2) and participants were categorized into three groups: no drinking group (ND), light drinking group (LD), and heavy episodic drinking group (HED).Results indicated that low inhibition, high sensitivity to reward, high openness to experience, and high motor impulsivity were primary predictors of the transition from no alcohol use (T1) to alcohol use (T2), regardless of subsequent drinking trajectory (LD or HED). The transition from LD (T1) to HED (T2) was primarily predicted by low inhibition, high cognitive impulsivity, high sensitivity to reward, and sex.This longitudinal study provides a novel approach to the study of HED initiation in adolescence. The findings expand our understanding of the risk of psychological factors associated with adolescent alcohol initiation, enabling clinicians to tailor primary and secondary prevention programs in schools and other relevant settings. [ABSTRACT FROM AUTHOR]

Background: Unhealthy alcohol use is an independent, modifiable risk factor for HIV, but limited research addresses alcohol use and HIV prevention synergistically. Groups that experience chronic stigma, discrimination, and/or other marginalization, such as sexual and gender minoritized groups, may have enhanced HIV risk related to unhealthy alcohol use. We described awareness of and experiences with pre-exposure prophylaxis (PrEP) among a community sample of Veterans reporting unhealthy alcohol use (relative to those without), overall and across self-reported sexual orientation and gender identity. Methods: Using data collected from a national online survey of Veterans recruited via Facebook ads, community organizations, and listservs, we assessed variation in four PrEP outcomes (knowledge, experience, willingness, and conversations with doctors) across patterns of unhealthy alcohol use among all respondents reporting any lifetime drinking (n = 1,041) and then within sexual orientation and gender identity groups using Chi-square or Fisher's exact tests. Results: Among 1,041 eligible Veterans, 440 (42%) screened positive for unhealthy alcohol use. Veterans with unhealthy alcohol use were not more likely to have heard of PrEP (58.2% vs. 55.4%, p = 0.37), but trended toward more likely to have taken PrEP (7.5% vs. 5.0%, p = 0.09), to be willing to take PrEP (30.5% vs. 27.6%, p = 0.06), and to have spoken with a doctor about PrEP (11.4% vs. 7.7%, p = 0.04). Those with heavy episodic drinking also trended toward higher prevalence of PrEP awareness (60.0% vs. 54.6%, p = 0.09), and were more likely to have taken PrEP (8.3% vs. 4.7%, p = 0.02), to be willing to use PrEP (34.6% vs. 25.5%, p < 0.01), and to have had conversations with doctors about PrEP (12.7% vs. 7.2%, p < 0.01). Similar patterns were observed for severe unhealthy alcohol use and past-year frequent heavy episodic drinking. Generally, sexual/gender minoritized Veterans with unhealthy alcohol use reported more PrEP-affirming responses than those without but associations with unhealthy alcohol use were similar. Conclusions: Unhealthy alcohol use was prevalent, particularly among Veterans with minoritized sexual orientation/gender identity, but not clearly linked to increased PrEP-literacy and use despite its known status as an HIV risk factor. Across groups, > 25% of individuals were willing to take PrEP. Interventions targeting both alcohol use and HIV prevention should capitalize on this. [ABSTRACT FROM AUTHOR]

AbstractObjectiveParticipants/MethodsResultsConclusionThis study examined the independent and joint effects of ADHD status, distress tolerance, and delay of gratification on the propensity to engage in health risk behaviors (drug use, alcohol use, disordered eating).Participants included 115 female college students (41.7% with ADHD) who completed online questionnaires.College students with a prior diagnosis of ADHD reported significantly lower distress tolerance, decreased delay of gratification, more drug and alcohol use, and more disordered eating in comparison to those without ADHD. Main effects for delay of gratification in predicting uncontrolled and emotional eating and two significant moderation analyses emerged. For individuals with ADHD, poorer distress tolerance was associated with more drug use.Results highlight the potential to target distress tolerance to reduce engagement in drug use among female college students with ADHD, and to target the ability to delay gratification to reduce risk for disordered eating among all college students. [ABSTRACT FROM AUTHOR]

The current study investigated the relationship between adverse childhood experiences (ACEs), post-traumatic stress disorder (PTSD) symptoms, within-network resting-state functional connectivity (rs-FC), and alcohol use during adolescence using functional magnetic resonance imaging (fMRI) data from the National Consortium on Alcohol and Neurodevelopment in Adolescence study (NCANDA; N = 687). Significant rs-FC differences emerged that linked participant ACEs, PTSD symptoms, and alcohol use problems. Participants with ACEs compared to those without had diminished rs-FC within the default mode, salience, and medial frontoparietal networks (p ≤ 0.005). Further reduction in rs-FC within the default mode and medial frontoparietal networks (p ≤ 0.005) was found when PTSD symptoms were present in addition to ACEs. Findings suggest that PTSD symptoms are associated with lower within network rs-FC beyond exposure to ACEs, and some of these rs-FC changes were associated with worsened alcohol use problems (i.e. withdrawal symptoms). These findings highlight the importance of addressing PTSD symptoms in adolescents with a history of ACEs as it may mitigate problematic changes in brain connectivity and reduce the risk of developing alcohol use problems. [ABSTRACT FROM AUTHOR]

AbstractBackground: This study investigated relationships between low-income adolescent drinkers’ frequent alcohol use and five factors: social disorganization, social structural, social integration, mental health, and access to healthcare. Objective: A sample of 1,256 low-income adolescent drinkers and caregivers were extracted from the Future of Families and Child Wellbeing Study. Results: Logistic regression yielded results showing adolescent drinkers’ weekly drinking to be associated positively with Hispanic adolescents, drinking peers, adolescents’ depression/anxiety, and caregiver’s daily drinking. Adolescent drinkers’ weekly drinking was associated negatively with caregiver’s age, family income below 100% of federal poverty level, caregiver supervision, and having usual place for health care. Conclusions/Importance: Implications included support of adolescents’ selection of desirable peers, promotion of caregiver supervision (especially among Hispanic adolescents), provision of assistance to families in poverty, provision of substance use treatment for caregivers and adolescents, and provision of mental health services to adolescents with depression or anxiety. [ABSTRACT FROM AUTHOR]