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ObjectiveTo test whether acute alcohol intoxication and alcohol expectancy affects how accurately women remember consensual and non-consensual sexual activity that occurred during an interactive hypothetical dating scenario.DesignA balanced placebo randomized study that varied alcohol dose (mean Breath Alcohol Content; BrAC = 0.06%) and alcohol expectancy prior to participants encoding a hypothetical interactive rape scenario was implemented. Participants could elect to consent to sexual activity with a male partner in the hypothetical scenario. If they stopped consenting, non-consensual sexual intercourse (i.e., rape) was described. Seven days later, participants’ memory for consensual and non-consensual sexual activity in the scenario was tested.Main outcome measuresMemory accuracy, confidence, and feelings of intoxication.ResultsA total of 90 females (M age = 20.5, SD = 2.2) were tested regarding their memory accuracy for the consensual and non-consensual sexual activities in the scenario. A multi-level logistic regression predicting memory accuracy for the perpetrator’s behaviors during the rape indicated no effect of alcohol intoxication. However, a main effect of alcohol expectancy was found, whereby participants who expected to consume alcohol, compared to those who did not, recalled the perpetrator’s behaviors during the rape more accurately. A second regression predicting memory accuracy for consensual sexual activity found no main effects for alcohol intoxication or alcohol expectancy. Participants recalled consensual sexual activity with a high degree of accuracy. Calibration analyses indicated that accuracy increased with confidence level, regardless of intoxication level or alcohol expectancy condition, but that women tended to be overconfident in general.ConclusionThis study provides an important test of how accurately women remember consensual and non-consensual sexual activities. The accuracy of this information is important for forensic medical examinations and police investigations following an allegation of sexual assault. Increased memory accuracy was found for offence details when participants expected to consume alcohol, suggesting there may be important differences in attentional processes (e.g., hypervigilance) depending on whether threat is present. Further research is necessary to investigate memory for sexual violence in real-world settings and to test methods for ascertaining the most complete and reliable accounts.

Introduction: Standardised data collection processes allow for harmonisation and comparison of data across different studies and services. This project aimed to develop a ‘core dataset’ to serve as the default collection when designing future studies and evaluations, building upon data routinely collected in clinical Alcohol and Other Drug (AOD) settings in NSW, Australia. Methods: A working group was established, comprising clinicians, researchers, data managers, consumers from public sector and NGO AOD services in the NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN). A series of Delphi meetings occurred to reach consensus on the data items to be included in the core dataset for three domains: demographics, treatment activity, and substance use variables.Results: There were 20-40 attendees at each meeting. An initial consensus criterion of having received >70% of the vote was established. Given the difficulty in reaching consensus for most items, subsequently this was changed to eliminate items that received

People with alcohol use disorder (AUD) exhibit high rates of comorbidity with cognitive deficits, particularly for executive function (EF). Cognitive impairment has been related to poorer outcomes in substance use treatment. Goal management training (GMT), a structured, therapist-led manualised intervention targeting EF, has demonstrated positive preliminary results in substance use disorder (SUD) treatment programs.. However, these studies have had strict exclusion criteria (e.g. excluding clients with mental health disorders), and the feasibility of running such a program in a broader SUD outpatient setting is unclear. The primary aim of this study was to determine the outcomes and feasibility of a cognitive remediation intervention at an outpatient alcohol treatment service in Sydney, Australia. Clients were referred to the study based on risk of cognitive deficits (as indicated by objective cognitive impairment on a screening tool or relevant collateral clinical information). Eligibility criteria included diagnosis of a current alcohol use disorder and abstinence for 2 or more weeks. The intervention consisted of 9 weekly GMT sessions. Out of 34 clients referred, 11 were eligible to participate, and of these, five were allocated to the intervention group and two to a waitlist control group. Due to poor recruitment, statistical analyses between groups were not possible; instead, this study presents a case series of the five clients recruited to the 9-week group intervention using GMT. Clients engaged in the intervention presented with a range of deficits in their cognitive functioning at baseline. Despite positive comments from participants regarding the intervention, there was a high level of attrition; while four clients (80%) completed at least four sessions, only one participant remained until the end of the nine-session program. In its current form, this program is not suitable for this cohort in the outpatient setting. Suggestions are made for tailoring GMT and other approaches to increase engagement and retention in future interventions.

Alcohol binge drinking is highly prevalent among young adults. While research has established the neurotoxic effects of general alcohol consumption, binge drinking presents unique deleterious effects on the brain through the acute intoxication and withdrawal cycle. The detrimental impacts of binge drinking have been reported across a broad range of cognitive abilities in young adults, however, the research regarding its relationship to attention is mixed. This study investigates the relationship between binge drinking and attention performance in young adults. Moreover, there is evidence to suggest that males and females are uniquely impacted by the neurotoxic effects of binge drinking, so the present study tests the moderating role of sex, as well as the influence of earlier age of binge drinking onset. One-hundred and five university students were recruited for the study. After collecting socio-demographic, and alcohol use information, participants completed four cognitive tasks designed to measure the three attention networks according to the Attention Network Theory; alerting, orienting, and executive control. Linear hierarchical regressions were used to predict performance with binge drinking score, sex and age of first binge drinking session as predictors. Binge drinking, sex, and age of first binge drinking session did not predict attention impairment, nor did sex moderate the relationship, at least in the selected cognitive tasks. The tasks used to measure attention did not relate in the expected manner. While there were no differences in attention performance between those who binge drink and controls in this study, the relationship between binge drinking and attention impairments in young adults may be more nuanced and future research directions are suggested. Theoretical and practical implications of these findings are discussed.

Background We aimed to examine the predictive validity of the Weschler Adult Intelligence Scale (WAIS-IV) in predicting treatment completion, over and above educational status. Methods One hundred and ninety-six (N = 196) individuals from the Odyssey House Residential Rehabilitation Program, NSW, Australia between 2010 and 2016 were administered a structured interview including substance use disorders and the Verbal Comprehension (VCI), Perceptual Reasoning (PRI), Working Memory (WMI), and Processing Speed (PSI) domains of the WAIS-IV. Results There were significant differences between our clinical sample and the population norm with respect to the proportion below the mean for PSI (z = 12.27, p .16) over and above educational status (p Conclusions Our findings suggest that in clients in drug and alcohol rehabilitation settings a combination of skills may be impacted including Verbal Comprehension and Processing Speed. Moreover, our findings also suggest that WAIS-IV subscales do not predict treatment completion in a drug and alcohol residential setting, over and above a brief assessment of educational status.

Naloxone is a life-saving medication that reverses opioid overdose; naloxone can be provided on a 'take-home' basis so naloxone can be administered outside of the health-care setting. The Overdose Response and Take Home Naloxone (ORTHN) project established a model of care for take-home naloxone (THN) interventions across alcohol and other drug and harm reduction services in NSW, Australia. This paper evaluates the staff training and credentialing program, and examines staff attitudes and perspectives regarding the provision of THN interventions in these settings.Staff across seven services were trained through a 'train-the-trainer' credentialing model to deliver ORTHN, including naloxone supply. Staff were surveyed regarding their experience, attitudes and knowledge on THN prior to and after training, and after 6 months. At the 6 months follow up, staff were asked about the interventions they provided, barriers and enablers to uptake, and opinions regarding future rollout.A total of 204 staff were trained and credentialed to provide the ORTHN intervention. Most (60%) were nurses, followed by needle syringe program workers and allied health/counsellors (32%). Linear and logistic regression analyses indicated that the training program was associated with significant improvements in staff knowledge and attitudes towards overdose and THN; however, only attitudinal improvements were maintained over time. There were high rates of staff satisfaction with the ORTHN intervention and training.The ORTHN program is 'fit for purpose' for broad implementation in these settings. A number of potential barriers (e.g. time, medication and staffing costs) and enablers (e.g. peer engagement, regulatory framework for naloxone supply) in implementing THN interventions were identified.

Objective This study examined how social associations from a person’s social network may be associated with their own alcohol consumption.Method Alcohol consumption behaviour was examined amongst the social networks of 784 survey respondents (54% female, mean age = 35.3 years), using egocentric social network analysis. Participants (egos) were recruited via a panel aggregator and completed an online survey about the frequency of their alcohol consumption and that of the 20 most influential people in their lives (alters). The survey also explored who these alters were (family, friends, work colleagues) and the interrelationships amongst these alters. Results Egos who consumed alcohol, or consumed alcohol more frequently, were surrounded by more alters who also drank alcohol, and felt closer (had stronger ties) to these alters. These relationships remained statistically significant when controlling for demographic and other variables. The social networks of those who consumed alcohol more frequently were more densely intertwined. Conclusions Alcohol may serve to initiate social connections and be a “social glue” that reinforces relationships. These strong social associations present a potential barrier to individuals who wish to reduce their alcohol consumption because they have few close social connections who do not drink alcohol (or who do so infrequently), and their highly interconnected social networks make it difficult to socialise only with those who do not drink frequently.

The possibility of residual impairment of cognitive performance after multiday drinking sessions is particularly important given the potential for the deleterious effects of fatigue and hangover. This pilot study aimed to devise a methodology to compare sober performance on driving-relevant attentional tasks at the end of a 4-day music festival with performance at varying levels of the breath-alcohol curve.Fifty-two participants completed selective and sustained attention tasks at a breath alcohol concentration (BrAC) of 0.00%, 0.05%, and 0.08% following acute dosing in a controlled laboratory setting. A subset of participants (n = 13) were then tested at the conclusion of a 4-day music festival at 0.00% BrAC, with task performance compared with laboratory results.During the laboratory phase, sustained attention was poorer at the 0.05% ascending timepoint only (compared to 0.00% BrAC). During the festival phase, participants made a greater number of errors on the selective attention task predeparture than at 0.00% and 0.05% BrAC in the laboratory. Sustained attention performance was poorer while intoxicated in the laboratory.Our findings suggest that the absence of blood alcohol acutely may not be indicative of unimpaired cognitive performance and that other factors related to multiday drinking may produce driving-related attentional deficits. The findings reinforce the need to measure attentional performance in real-world drinking contexts despite the methodological complexities of doing so. A larger study is warranted to replicate the findings and should include attentional measures that either are more sensitive to the effects of acute alcohol intoxication than those in our study or are based on a driving simulator.

Victims, witnesses, and suspects of crime are frequently intoxicated by Alcohol or Other Drugs (AOD) during the event. How intoxication is perceived by investigating officers, and the manner in which this is handled during interview procedures, can affect the quality of information obtained and therefore investigative outcomes. Various factors are likely to contribute to how intoxication is handled during the investigation of a crime, including standard procedures, familiarity with the effects of different substances, and cultural attitudes. While findings with respect to the effect of different substances on memory are still emerging, it is important to investigate whether police beliefs are consistent with available evidence. In this study, Australian and Indonesian police officers were surveyed about their perceptions of memory accuracy and credibility of victims and witnesses intoxicated with various substances (e.g. alcohol, cannabis, amphetamines, and opioids). A higher proportion of Australian police identified larger negative memory effects associated with alcohol intoxication. At the same time, Indonesian police were found to be more likely to report that intoxication with alcohol would make a victim or witness less credible. With regard to timing, across multiple substances, larger proportions of Australian police reported believing that information obtained from witnesses that were still intoxicated would be more accurate than if interviewed after they became sober. It is concluded that, in order to rectify misconceptions about the impact of AOD intoxication on memory and improve investigative practices, both Australian and Indonesian police would benefit from additional training on the effects of intoxication.

Significance This unique randomized, double-blind, placebo-controlled trial examined the susceptibility to false memories under the influence of cannabis, using a basic (DRM) and two applied (misinformation) paradigms. We used a highly powered experimental design, allowing us to test acute and residual drug effects. To achieve high reproducibility and ecological validity, the misinformation paradigms included an eyewitness and a perpetrator scenario, presented in a virtual-reality environment. We show across different paradigms that cannabis consistently increases susceptibility to false memories. The results have implications for police, legal professionals, and policymakers with regard to the treatment of cannabis-intoxicated witnesses and suspects and the validity of their statements., With the growing global acceptance of cannabis and its widespread use by eyewitnesses and suspects in legal cases, understanding the popular drug’s ramifications for memory is a pressing need. In a double-blind, randomized, placebo-controlled trial, we examined the acute and delayed effects of Δ9-tetrahydrocannabinol (THC) intoxication on susceptibility to false memory in 64 healthy volunteers. Memory was tested immediately (encoding and retrieval under drug influence) and 1 wk later (retrieval sober). We used three different methods (associative word lists and two misinformation tasks using virtual reality). Across all methods, we found evidence for enhanced false-memory effects in intoxicated participants. Specifically, intoxicated participants showed higher false recognition in the associative word-list task both at immediate and delayed test than controls. This yes bias became increasingly strong with decreasing levels of association between studied and test items. In a misinformation task, intoxicated participants were more susceptible to false-memory creation using a virtual-reality eyewitness scenario and virtual-reality perpetrator scenario. False-memory effects were mostly restricted to the acute-intoxication phase. Cannabis seems to increase false-memory proneness, with decreasing strength of association between an event and a test item, as assessed by different false-memory paradigms. Our findings have implications for how and when the police should interview suspects and eyewitnesses.

Although most unintentional opioid deaths in Australia are attributed to pharmaceutical opioids, take-home naloxone (THN) programmes have to date predominantly targeted people using illicit opioids in drug treatment and harm reduction settings. We sought to examine the feasibility of delivering THN brief interventions (THN-BIs) with intranasal naloxone in EDs.This pilot feasibility study was conducted across three major metropolitan EDs in Sydney and Melbourne. ED staff were surveyed about their perspectives regarding THN before completing a 30-min training programme in THN-BI delivery. Patients presenting with opioid overdose or considered high risk for future overdose were eligible to receive the THN-BI. Staff survey responses were compared between hospitals and provider types using one-way analysis of variances. Patient demographic and clinical characteristics were extracted from medical records and compared between hospitals and overdose type using Fisher's exact test and one-way analysis of variances.One hundred and twenty-two ED staff completed the survey. One hundred and ten (90.2%) agreed that EDs should provide THN-BIs, whereas 23 (19.2%) identified time constraints and 17 (12.9%) felt uncomfortable discussing overdose with patients. Fifty-seven patients received the THN-BI, with the majority (n = 50, 87.7%) having presented following opioid overdose. The median age was 44 years and 40 (71.4%) were men. Two-thirds of the overdoses (n = 31, 66.0%) were attributed to heroin with one-third (n = 16, 34%) being attributed to pharmaceutical opioids.ED-based delivery of THN-BIs can reach a wide range of individuals at-risk of overdose. The present study supports the feasibility of THN interventions in EDs and underscores the importance of addressing implementation barriers including staff training.

Summary of recommendations and levels of evidence Chapter 2: Screening and assessment for unhealthy alcohol use Screening Screening for unhealthy alcohol use and appropriate interventions should be implemented in general practice (Level A), hospitals (Level B), emergency departments and community health and welfare settings (Level C). Quantity–frequency measures can detect consumption that exceeds levels in the current Australian guidelines (Level B). The Alcohol Use Disorders Identification Test (AUDIT) is the most effective screening tool and is recommended for use in primary care and hospital settings. For screening in the general community, the AUDIT-C is a suitable alternative (Level A). Indirect biological markers should be used as an adjunct to screening (Level A), and direct measures of alcohol in breath and/or blood can be useful markers of recent use (Level B). Assessment Assessment should include evaluation of alcohol use and its effects, physical examination, clinical investigations and collateral history taking (Level C). Assessment for alcohol-related physical problems, mental health problems and social support should be undertaken routinely (GPP). Where there are concerns regarding the safety of the patient or others, specialist consultation is recommended (Level C). Assessment should lead to a clear, mutually acceptable treatment plan which specifies interventions to meet the patient’s needs (Level D). Sustained abstinence is the optimal outcome for most patients with alcohol dependence (Level C). Chapter 3: Caring for and managing patients with alcohol problems: interventions, treatments, relapse prevention, aftercare, and long term follow-up Brief interventions Brief motivational interviewing interventions are more effective than no treatment for people who consume alcohol at risky levels (Level A). Their effectiveness compared with standard care or alternative psychosocial interventions varies by treatment setting. They are most effective in primary care settings (Level A). Psychosocial interventions Cognitive behaviour therapy should be a first-line psychosocial intervention for alcohol dependence. Its clinical benefit is enhanced when it is combined with pharmacotherapy for alcohol dependence or an additional psychosocial intervention (eg, motivational interviewing) (Level A). Motivational interviewing is effective in the short term and in patients with less severe alcohol dependence (Level A). Residential rehabilitation may be of benefit to patients who have moderate-to-severe alcohol dependence and require a structured residential treatment setting (Level D). Alcohol withdrawal management Most cases of withdrawal can be managed in an ambulatory setting with appropriate support (Level B). Tapering diazepam regimens (Level A) with daily staged supply from a pharmacy or clinic are recommended (GPP). Pharmacotherapies for alcohol dependence Acamprosate is recommended to help maintain abstinence from alcohol (Level A). Naltrexone is recommended for prevention of relapse to heavy drinking (Level A). Disulfiram is only recommended in close supervision settings where patients are motivated for abstinence (Level A). Some evidence for off-label therapies baclofen and topiramate exists, but their side effect profiles are complex and neither should be a first-line medication (Level B). Peer support programs Peer-led support programs such as Alcoholics Anonymous and SMART Recovery are effective at maintaining abstinence or reductions in drinking (Level A). Relapse prevention, aftercare and long-term follow-up Return to problematic drinking is common and aftercare should focus on addressing factors that contribute to relapse (GPP). A harm-minimisation approach should be considered for patients who are unable to reduce their drinking (GPP). Chapter 4: Providing appropriate treatment and care to people with alcohol problems: a summary for key specific populations Gender-specific issues Screen women and men for domestic abuse (Level C). Consider child protection assessments for caregivers with alcohol use disorder (GPP). Explore contraceptive options with women of reproductive age who regularly consume alcohol (Level B). Pregnant and breastfeeding women Advise pregnant and breastfeeding women that there is no safe level of alcohol consumption (Level B). Pregnant women who are alcohol dependent should be admitted to hospital for treatment in an appropriate maternity unit that has an addiction specialist (GPP). Young people Perform a comprehensive HEEADSSS assessment for young people with alcohol problems (Level B). Treatment should focus on tangible benefits of reducing drinking through psychotherapy and engagement of family and peer networks (Level B). Aboriginal and Torres Strait Islander peoples Collaborate with Aboriginal or Torres Strait Islander health workers, organisations and communities, and seek guidance on patient engagement approaches (GPP). Use validated screening tools and consider integrated mainstream and Aboriginal or Torres Strait Islander-specific approaches to care (Level B). Culturally and linguistically diverse groups Use an appropriate method, such as the “teach-back” technique, to assess the need for language and health literacy support (Level C). Engage with culture-specific agencies as this can improve treatment access and success (Level C). Sexually diverse and gender diverse populations Be mindful that sexually diverse and gender diverse populations experience lower levels of satisfaction, connection and treatment completion (Level C). Seek to incorporate LGBTQ-specific treatment and agencies (Level C). Older people All new patients aged over 50 years should be screened for harmful alcohol use (Level D). Consider alcohol as a possible cause for older patients presenting with unexplained physical or psychological symptoms (Level D). Consider shorter acting benzodiazepines for withdrawal management (Level D). Cognitive impairment Cognitive impairment may impair engagement with treatment (Level A). Perform cognitive screening for patients who have alcohol problems and refer them for neuropsychological assessment if significant impairment is suspected (Level A). Summary of key recommendations and levels of evidence Chapter 5: Understanding and managing comorbidities for people with alcohol problems: polydrug use and dependence, co-occurring mental disorders, and physical comorbidities Polydrug use and dependence Active alcohol use disorder, including dependence, significantly increases the risk of overdose associated with the administration of opioid drugs. Specialist advice is recommended before treatment of people dependent on both alcohol and opioid drugs (GPP). Older patients requiring management of alcohol withdrawal should have their use of pharmaceutical medications reviewed, given the prevalence of polypharmacy in this age group (GPP). Smoking cessation can be undertaken in patients with alcohol dependence and/or polydrug use problems; some evidence suggests varenicline may help support reduction of both tobacco and alcohol consumption (Level C). Co-occurring mental disorders More intensive interventions are needed for people with comorbid conditions, as this population tends to have more severe problems and carries a worse prognosis than those with single pathology (GPP). The Kessler Psychological Distress Scale (K10 or K6) is recommended for screening for comorbid mental disorders in people presenting for alcohol use disorders (Level A). People with alcohol use disorder and comorbid mental disorders should be offered treatment for both disorders; care should be taken to coordinate intervention (Level C). Physical comorbidities Patients should be advised that alcohol use has no beneficial health effects. There is no clear risk-free threshold for alcohol intake. The safe dose for alcohol intake is dependent on many factors such as underlying liver disease, comorbidities, age and sex (Level A). In patients with alcohol use disorder, early recognition of the risk for liver cirrhosis is critical. Patients with cirrhosis should abstain from alcohol and should be offered referral to a hepatologist for liver disease management and to an addiction physician for management of alcohol use disorder (Level A). Alcohol abstinence reduces the risk of cancer and improves outcomes after a diagnosis of cancer (Level A).

Deliberate self-harm and suicide affect all age groups, sexes, and regions, and their prevention is a global health priority. Acute alcohol misuse and chronic alcohol misuse are strong, modifiable risk factors, and Internet interventions aiming to reduce alcohol misuse and comorbid mental health problems (e.g., depression) are a promising and effective treatment modality. The research team aimed to evaluate the feasibility and effectiveness of an Internet-based comorbidity intervention primarily aiming to reduce alcohol consumption, and secondarily to reduce readmission for deliberate self-harm and improve psychological outcomes among people hospitalized for deliberate self-harm who also engage in problematic alcohol use. However, due to several barriers to recruitment, the trial could not be completed and was discontinued. The authors present a “Lessons Learned” discussion and describe the Internet Intervention for Alcohol Improvement (iiAIM) trial, discuss the key barriers experienced by the research team, and recommend potential solutions that may help future trials in this area.

RATIONALE: Cannabis use is widespread and has previously been associated with memory impairments. However, the role of cannabis in relation to false memory production, i.e., memories of events that were not experienced, is less well-understood. OBJECTIVE: The aim of the current field study was to examine the impact of cannabis use on false memory production. METHODS: The Deese/Roediger-McDermott (DRM) paradigm was used to induce false memories. In this paradigm, participants study word lists that are associatively related to a non-presented word, termed the critical lure. In a later memory test, true recognition rates and false alarm rates toward critical lures and unrelated items are assessed. Memory performance was compared between three groups: regular cannabis consumers who were acutely intoxicated (n = 53), regular cannabis consumers who were sober (n = 50), and cannabis-naïve controls (n = 53). The participants were approached in Dutch coffee shops (cannabis outlets) and cafes and asked to participate in our study. After collecting general information on their cannabis use, they were subjected to the DRM procedure. RESULTS: Although false memory rates for critical lures did not statistically differ between groups, both intoxicated and sober cannabis consumers falsely recognized more unrelated items than control participants. Also, individuals without a history of cannabis use demonstrated higher memory accuracy compared with the intoxicated group. CONCLUSION: It is concluded that cannabis intoxication and history of cannabis use induce a liberal response criterion for newly presented words for which the level of association with previously learned words is low and uncertainty is high. ispartof: PSYCHOPHARMACOLOGY vol:236 issue:12 pages:3439-3450 ispartof: location:Germany status: published

Alcohol use is frequently involved in crime, making it crucial to understand the role of alcohol in facial recognition to maximize correct perpetrator identifications. Although the majority of the alcohol and face recognition research has investigated recognition with retrospective confidence judgments, we examined the effects of alcohol intoxication on face recognition with prospective metacognitive judgments. Participants (N=54 university students without a history of hazardous alcohol/substance use) consumed either alcohol (mean breath alcohol concentration of 0.06 at pretest and 0.07 at post-test) or a non-alcoholic placebo drink. Participants then studied unfamiliar male and female faces and made judgments of learning (JOLs) for each face (i.e., predicted the likelihood of recognizing that face on a future memory test). After a brief distractor task, participants completed an old-new recognition test on which they attempted to distinguish the studied faces from new faces. It was found that the alcohol manipulation had minimal effect on face recognition performance or judgments of learning. Our results suggest that theory-based cues about the effects of alcohol might play a greater role in retrospective judgments than prospective judgments. Although not a primary focus of the study, face recognition was better for male faces than female faces, and this occurred for both female and male participants. Limitations and implications of the research are discussed.

Objective: To assess Australian psychiatrists’ and psychiatry trainees’ knowledge about and attitudes towards medicinal cannabinoids, given the recent relaxation of cannabinoid-prescribing laws in Australia. Method: All Australian members of the Royal Australian and New Zealand College of Psychiatrists were invited to participate in an anonymous, 64-item online questionnaire, through Royal Australian and New Zealand College of Psychiatrists’ newsletters. The questionnaire ran for a 10-week period from March to May 2017. Participants were asked about their knowledge of the evidence for and against prescribing pharmaceutical-grade cannabidiol and tetrahydrocannabinol, and their concerns about prescribing medicinal cannabinoids. Results: In total, 88 doctors responded to the survey, with 55 completing all items (23 psychiatrists, 32 trainees). Overall, 54% of respondents would prescribe medicinal cannabinoids if it was legal to do so. Participants believed there was evidence for the use of cannabidiol and tetrahydrocannabinol in treating childhood epilepsy, chronic pain, and nausea and vomiting. They were most concerned about medicinal cannabinoids leading to psychotic symptoms, addiction and dependence, apathy and recreational use. Conclusions: Our sample of Australian psychiatrists and trainees were aware of the main clinical indications for medicinal cannabinoids, but were poor at differentiating between the indications for cannabidiol versus tetrahydrocannabinol. Further education about medicinal cannabinoids appears necessary.

Background We aimed to examine the neuropsychological profiles on the Weschler Adult Intelligence Scale (WAIS-IV) of individuals attending a drug and alcohol rehabilitation program and determine the relationship between the multiple domains of cognitive functioning, comorbid mental disorders and treatment completion.Methods One hundred and ninety-six (N = 196) individuals from the Odyssey House Residential Rehabilitation Program, NSW, Australia between 2010-2016 were administered a structured interview including mental and substance use disorders and the Verbal Comprehension (VCI), Perceptual Reasoning (PRI), Working Memory (WMI), and Processing Speed (PSI) domains of the WAIS-IV. Results Verbal Comprehension, Working Memory, and Processing Speed was below the mean relative to normative data derived from the standardisation of the WAIS-IV. Individuals with comorbid mental disorders also displayed significantly lower Verbal Comprehension relative to those without comorbid mental disorders (F = 4.56, p < 0.05). Comorbid psychotic disorders were particularly associated with poor Verbal Comprehension (p < 0.01). Treatment completion was significantly predicted by Verbal Comprehension (p < 0.05).Conclusions Verbal comprehension may be underlying poor treatment completion in drug and alcohol treatment rehabilitation settings. We also highlight an additional relationship between presence of comorbid psychotic disorders and poor verbal comprehension that may be of relevance in planning intervention programs during rehabilitation.

Research into juror perceptions regarding the impact of intoxication on eyewitness memory and credibility is scarce for substances other than alcohol. However, jurors are frequently told to draw on their personal beliefs and experience with intoxicating substances to infer their impact on the case. It is therefore important to investigate laypeople's perceptions regarding witness and victim intoxication across a range of substances, and whether these perceptions are associated with substance familiarity. Participants (n = 470) completed a survey assessing familiarity and use of different substances, as well as perceptions regarding effects on the memory and credibility of intoxicated victims and witnesses. While participants most frequently reported believing that alcohol, hallucinogens, and polysubstance use of alcohol and cannabis have large negative effects on memory, they more frequently reported that they do not know the extent to which cannabis and cocaine affect memory. In addition, attitudes were found to vary based on substance familiarity. Differences with respect to the perceived impact on memory and credibility of various substances can have relevance to court proceedings, particularly in terms of voir dire procedures, jury instructions, and whether an expert witness is required to educate the court on the impacts of different forms of intoxication.

Victims, witnesses, and suspects of crime are frequently intoxicated by Alcohol or Other Drugs (AOD) during the event. How intoxication is perceived by investigating officers, and the manner in which this is handled during interview procedures, can affect the quality of information obtained and therefore investigative outcomes. Various factors are likely to contribute to how intoxication is handled during the investigation of a crime, including standard procedures, familiarity with the effects of different substances, and cultural attitudes. While findings with respect to the effect of different substances on memory are still emerging, it is important to investigate whether police beliefs are consistent with available evidence. In this study, Australian and Indonesian police officers were surveyed about their perceptions of memory accuracy and credibility of victims and witnesses intoxicated with various substances (e.g., alcohol, cannabis, amphetamines, and opioids). A higher proportion of Australian police identified larger negative memory effects associated with alcohol intoxication. At the same time, Indonesian police were found to be more likely to report that intoxication with alcohol would make a victim or witness less credible. With regard to timing, across multiple substances, larger proportions of Australian police reported believing that information obtained from witnesses that were still intoxicated would be more accurate than if interviewed after they became sober. It is concluded that, in order to rectify misconceptions about the impact of AOD intoxication on memory and improve investigative practices, both Australian and Indonesian police would benefit from additional training on the effects of intoxication.

INTRODUCTION The ability to accurately detect alcohol intoxication is an important skill for people who use these substances and for a variety of professions (e.g. policing, responsible service of alcohol). Previous studies have found that intoxicated people are generally poor at estimating their own intoxication (particularly at high blood alcohol concentration; BAC) and the relationship between perceived intoxication and BAC appears to flatten at higher BAC levels. Studies of observer ratings of other's intoxication have yielded mixed results. The aim of this study was to investigate both self- and observer-ratings of intoxication against BAC levels to determine whether we observe a similar flattening in intoxication for both self- and observer-rated intoxication. METHODS Participants were 388 students interviewed outside three university events. Participants provided demographics, a rating of how intoxicated they felt (0 = not at all, 10 = very) and provided an alcohol breath test. Interviewers recorded a rating of how intoxicated the participant appeared to be. RESULTS A significant correlation was observed between self- and observer-ratings of intoxication (r = 0.802). We fitted our data with both linear and polynomial regressions. Polynomial regression accounted for more variance when predicting both self-rated intoxication (R2 = 0.50 vs. R2 = 0.40) and observer-rated intoxication from BAC (R2 = 0.58 vs. R2 = 0.52), suggesting a flattening for both intoxication ratings. DISCUSSION AND CONCLUSIONS Both self-rated and observer-rated intoxication appeared to flatten at higher levels of BAC. This may be due to either tolerance or a 'ceiling effect' for observable signs of intoxication.

Introduction and AimsTraining of consumers is seen as a necessary component of take home naloxone (THN) interventions, with demonstrated improvements in consumer knowledge, attitudes and self-efficacy. However, we query whether re-training is necessary component for individuals renewing naloxone supplies who have previously completed a THN intervention.Design and MethodsA secondary analysis of the Overdose Response and Take Home Naloxone (ORTHN) project, comparing participant characteristics, and changes in knowledge, attitudes and self-efficacy regarding overdose and response, following a brief THN intervention in participants who had previously undertaken THN interventions, compared to those with no prior THN interventions. Data was analysed for those completing both baseline (pre-ORTHN intervention) and follow up (3-months later).ResultsNinety-four participants completed both research interviews, of whom 29 (31%) had previously completed a THN intervention. There were few differences in baseline demographics or overdose histories between the two groups. Knowledge regarding overdose response and naloxone use indicated high baseline levels in both groups. Those with no prior THN training had lower rates of self-efficacy at baseline, and significantly improved following the ORTHN intervention, whereas those with prior THN training had higher baseline levels of self-efficacy, which was maintained following the intervention.Discussion and ConclusionsIndividuals who have previously undertaken a THN intervention may not require repeat training when renewing naloxone supplies, increasing the efficiency of THN interventions.

Introduction and Aims: The ability to accurately detect alcohol or other drug intoxication is an important skill for people who use these substances and for a variety of professions (e.g., policing, responsible service of alcohol). Previous studies have found that intoxicated people are generally poor at estimating their own level of intoxication (particularly at high Blood Alcohol Concentration; BACs) and the link between intoxication and BAC appears to drop-off at higher BAC levels. But studies of observer ratings of other’s intoxication have yielded mixed results. The aim of this study was to investigate both self- and observer-ratings of intoxication against BAC levels to determine whether we see a similar drop-off in intoxication report for both self- and observer-rated intoxication.Design and Methods: Participants were 388 students interviewed outside three university events. Participants provided demographics, a rating of how intoxicated they felt (0=not at all, 10=very), and provided a breath test. Interviewers recorded a rating of how intoxicated the participant appeared to be.Results: We fitted our data with both polynomial and linear regressions. Polynomial regression provided a better fit when predicting both self-rated intoxication (r2=0.49 vs. r2=0.40, p < 0.001) and observer-rated intoxication from BAC (r2 = 0.58 vs. r2 = 0.52, p < 0.001), suggesting that there is a drop-off for both intoxication ratings.Discussion and Conclusions: Both self-rated and observer-rated intoxication appeared to drop-off at higher levels of BAC. This may be due to either tolerance or a ‘ceiling effect’ for observable signs of intoxication.

Alcohol and other psychoactive drugs are oftentimes implicated in legal cases. A pertinent question herein is whether such substances might adversely affect testimonies of victims, eyewitnesses, or suspects by propelling the formation of false memory and increasing susceptibility to suggestion. In the current review, we amassed all available evidence on the effects of intoxication on false memory formation and suggestibility, including the substances alcohol, benzodiazepines, cannabis, stimulants, hallucinogens, and antipsychotics. Our review indicated that alcohol and cannabis under certain conditions increased the susceptibility to false memories and/or suggestion with effect sizes ranging from medium to large. When intoxicated during an event, alcohol is most likely to increase this susceptibility at high intoxication levels or after a delay, whereas cannabis exerts detrimental effects during acute intoxication but not necessarily once sober. For other substances, ecologically valid research separating different memory phases is needed. Overall, differences between substances regarding false memory effects exist, suggesting that a nuanced approach is needed when dealing with intoxicated individuals in a legal context. ispartof: NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS vol:124 pages:291-307 ispartof: location:United States status: published

Using a dual-process framework, the aim of this research was to investigate the associations between reflective and impulsive processes and saving behavior. Self-control and saving habit were tested as additional factors that potentially moderate the relationship between constructs representing reflective and impulsive processes and behavior, or exert indirect effects on behavior through these systems. A community sample of 594 participants completed measures of saving intention, buying impulsiveness, trait self-control, saving automaticity, and propensity to save money. A well-fitting variance-based structural equation model, goodness-of-fit index = 0.338, average path coefficient = .119, p < .001, accounted for statistically significant amounts of variance in the key dependent variables: intention to save, R² = .364, buying impulsiveness, R² = .232, and saving behavior, R² = .173. Self-control and saving habit were indirectly related to saving behavior through intention, and buying impulsiveness was directly related to behavior when saving habits were low. Findings indicate strong saving habits may help to protect against impulsive spending and offer several targets for interventions aimed at improving saving behavior. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

Abstract. When an individual’s memory for an event is altered by post-event information (PEI) provided by a co-witness, this is known as memory conformity ( Wright, Self, & Justice, 2000 ). The aim of this study was to investigate whether personality characteristics are associated with memory conformity. Ninety-nine participants viewed a crime film and then completed the Ten-Item Personality Questionnaire (TIPI; Gosling, Rentfrow, & Swann, 2003 ), a measure of extraversion, openness, agreeableness, neuroticism, and conscientiousness. Participants then discussed the film with a co-witness who contributed 12 items of post-event information (6 correct, 6 incorrect). Finally, participants completed a film recall questionnaire individually. Significant correlations between personality and memory conformity were found, with decreased openness, extraversion, and neuroticism related to increased reporting of post-event misinformation, increased agreeableness related to increased reporting of accurate post-event information, and decreased conscientiousness and neuroticism related to increased fabrications. These findings suggest that some individuals may be more susceptible to accepting misinformation and reporting errors than others.

Many eyewitness memory situations involve negative and distressing events; however, many studies investigating "false memory" phenomena use neutral stimuli only. The aim of the present study was to determine how both the Deese-Roediger-McDermott (DRM) procedure and the Misinformation Effect Paradigm tasks were related to each other using distressing and neutral stimuli. Participants completed the DRM (with negative and neutral word lists) and viewed a distressing or neutral film. Misinformation for the film was introduced and memory was assessed. Film accuracy and misinformation susceptibility were found to be greater for those who viewed the distressing film relative to the neutral film. Accuracy responses on both tasks were related, however, susceptibility to the DRM illusion and Misinformation Effect were not. The misinformation findings support the Paradoxical Negative Emotion (PNE) hypothesis that negative stimuli will lead to remembering more accurate details but also greater likelihood of memory distortion. However, the PNE hypothesis was not supported for the DRM results. The findings also suggest that the DRM and Misinformation tasks are not equivalent and may have differences in underlying mechanisms. Future research should focus on more ecologically valid methods of assessing false memory.

Introduction and designs Take-home naloxone (THN) interventions are an effective response to preventing overdose deaths, however uptake across Australia remains limited. This project designed, implemented and evaluated a model of care targeting opioid users attending alcohol and other drug (AOD) treatment, needle and syringe programs (NSP) and related health services targeting people who inject drugs. Design and methods Service providers, consumers and regulators collaboratively designed a THN brief intervention (ORTHN, Overdose Response with Take-Home Naloxone) involving client education and supply of naloxone in pre-filled syringes, delivered by nursing, allied health and NSP workers. ORTHN interventions were implemented in over 15 services across New South Wales, Australia. The evaluation included client knowledge, attitudes, substance use and overdose experiences immediately before and 3 months after ORTHN intervention in a subsample of participants. Results Six hundred and sixteen interventions were delivered, with 145 participants recruited to the research subsample, of whom 95 completed the three-month follow up. Overdose-related attitudes amongst participants improved following ORTHN, with no evidence of increased substance use or failure to implement other 'first responses' (e.g. calling an ambulance). Nine participants (10%) reversed an overdose using THN in the follow-up period. Participants identified a willingness to access THN from a range of services. While a minority (16%) indicated they were unwilling to pay for THN, the median price that participants were willing to pay was $AUD20 (IQR $10.40). Discussion and conclusions The ORTHN model of care for THN appears an effective way to disseminate THN to people who use opioids attending AOD, NSP and related health-care settings.

The present study investigated the impact of false feedback about individual memory performance relative to a co-witness on susceptibility to misinformation. Pairs of participants (n = 130; 65 pairs) completed a visual memory test and received false feedback on their performance indicating that the memory ability of one participant in the pair was stronger relative to the other participant. The participants then viewed a crime video (either the same video or one slightly different to their partner) and discussed their memories for this video with their co-witness. Participants completed a semi-cued recall task and a recognition test about the video. False memory feedback indicating lower relative performance was associated with significant increases in sensitivity to misinformation. The results are discussed in reference to the potential contributions that co-witnesses' perceptions of both their partner's reliability and their own reliability have on event memory.

Introduction and Aims The Australian Treatment Outcomes Profile (ATOP) is a brief instrument that assesses a range of substance use, health and well-being measures over the past 28 days. Previously, it has been validated in general adult Australian alcohol and other drug (AOD) treatment populations. However, the increasing number of older-aged clients attending AOD treatment warrants the instrument to be validated for this population. The aim of this study was to validate the ATOP for use in older AOD populations, by comparing it with validated ‘gold standard’ measures used in older populations. Design and Methods A convenience sample of 99 participants aged ≥50 attending specialist AOD services in Sydney, Australia were administered the ATOP by a researcher, along with alcohol use (AUDIT) and health questionnaires [Physical Health Questionnaire-15, 12-item short-form Health Survey (SF-12) and Geriatric Depression Scale]. Results The ATOP items had strong agreement with the comparison instruments. The highest correlation was between the 28 days alcohol use and the AUDIT. ATOP psychological health scores highly correlated with the SF-12 mental health subscale and the Geriatric Depression Scale, and ATOP physical health scores significantly correlated with the SF-12 physical health subscale and the Physical Health Questionnaire-15. The ATOP Quality of Life score significantly correlated with all health measures. Discussion and Conclusions The ATOP has good concurrent validity with other validated substance use and health measures in an older population. Comparison with general older populations demonstrated the poorer health of this group of older AOD clients in particular.[Lintzeris N, Monds L A, Rivas G, Leung S, Withall A, Draper B. The Australian Treatment Outcomes Profile instrument as a clinical tool for older alcohol and other drug clients: A validation study. Drug Alcohol Rev 2016;35:673-677]

Purpose To apply the protection motivation theory to safe food handling in order to determine the efficacy of this model for four food handling behaviours: cooking food properly, reducing cross-contamination, keeping food at the correct temperature and avoiding unsafe foods. Design A cross-sectional approach was taken where all protection motivation variables: perceived severity, perceived vulnerability, self-efficacy, response efficacy, and protection motivation, were measured at a single time point. Findings Data from 206 participants revealed that the model accounted for between 40 and 48% of the variance in motivation to perform each of the four safe food handling behaviours. The relationship between self-efficacy and protection motivation was revealed to be the most consistent across the four behaviours. Implications While a good predictor of motivation, it is suggested that protection motivation theory is not superior to other previously applied models, and perhaps a model that focuses on self-efficacy would offer the most parsimonious explanation of safe food handling behaviour, and indicate the most effective targets for behaviour change interventions. Originality This is the first study to apply and determine the efficacy of protection motivation theory in the context of food safety.

Introduction and Aims The number of older clients attending drug and alcohol (D&A) services is increasing, although there is insufficient knowledge regarding service needs for this group. The aim of this study was to document the patterns of substance use, health status, cognition, social conditions, and health service utilisation of older clients in D&A treatment. Design and Methods A cross-sectional observational study of 99 clients aged ≥50 years (M = 55, SD = 4.5; 77% male) attending specialist D&A services (N = 30 alcohol treatment, N = 69 opioid treatment) in Sydney, Australia. Participants completed a confidential research interview. Findings were compared to aggregated data from younger opioid substitution treatment (OST) clients attending the same services (N = 214). Results Alcohol (46%), benzodiazepines (40%) and cannabis (38%) were the most commonly reported substances used in the past 4 weeks; 23% reported no recent substance use, and 17% reported using three or more drugs. Participants reported high levels of physical and mental health problems, social isolation, low levels of employment, and a third reported difficulties with daily living activities. Forty percent had been injured in a fall in the past 12 months. The mean Addenbrooke's Cognitive Examination-R score was 82.4 ± 9.6, with 40% performing at a level consistent with severe cognitive impairment. A significantly higher proportion of older participants used alcohol and benzodiazepines than younger clients, and older participants had significantly poorer psychological health, physical health and quality of life. Discussion and Conclusions DA●●:●●–●●]

Supplemental Digital Content is available in the text, Introduction and Aims: Transfer from methadone to buprenorphine is problematic for many opioid-dependent patients, with limited documented evidence or practical clinical guidance, particularly for the range of methadone doses routinely prescribed for most patients (>50 mg). This study aimed to implement and evaluate recent national Australian guidelines for transferring patients from methadone to buprenorphine. Design and Methods: A multisite prospective cohort study. Participants were patients who transferred from methadone to buprenorphine-naloxone at 1 of 4 specialist addiction centers in Australia and New Zealand. Clinicians were trained in the guidelines, and medical records were reviewed to examine process (eg, transfer setting, doses, and guideline adherence) and safety (precipitated withdrawal) measures. Participants completed research interviews before and after transfer—assessing changes in substance use, health outcomes, and side effects. Results: In all, 33 participants underwent transfer, 9 from low methadone doses (50 mg). The majority of high-dose transfers occurred in inpatient settings. There was reasonable guideline adherence, and no complications identified in the low and medium-dose transfers. Three high-dose transfers (20%) experienced precipitated withdrawal, and 7/33 participants (21%) returned to methadone within 1 week of attempted transfer. Discussions and Conclusions: Transfer is feasible in outpatient settings for those transferring from methadone doses below 50 mg; however, inpatient settings and specialist supervision is recommended for higher-dose transfers. The Australian clinical guidelines appear safe and feasible, although further research is required to optimize high-dose transfer procedures.

Within the legal system an assumption exists that witness testimonies should be independent of one another; however the evidence suggests that this is frequently not the case. Witnesses commonly discuss the event with each other. It is important to determine the effects of cowitness information on the validity of eyewitness testimony. It is generally recognized that discussion between witnesses can be detrimental; the possibility of false information (or information that the participant never saw) entering recall is a key concern. We review the prevalence of cowitness discussion, legal opinions about cowitness discussion, and finally experimental research investigating the effects of discussion on eyewitness memory. We also provide some suggestions of how to prevent cowitness discussion and contamination of testimony.

Background: In order to minimise the occurrence of food-borne illness, it is recommended that individuals perform safe food-handling behaviours, such as cooking food properly, cleaning hands and surfaces before preparing food, keeping food at the correct temperature, and avoiding unsafe foods. Previous research examining the determinants of safe food-handling behaviour has produced mixed results; however, this may be due to the fact that this research examined these behaviours as a totality, rather than considering the determinants of each behaviour separately. As such, the objective for the present study was to examine the predictors of the four aforementioned safe food-handling behaviours by applying an extended theory of planned behaviour to the prediction of each distinct behaviour. Method: Participants were 170 students who completed theory of planned behaviour measures, with the addition of moral norm and habit strength at time 1, and behaviour measures one week later. Results: While the influence of injunctive and descriptive norm and perceived behavioural control differed between behaviours, it appeared that moral norm was an important predictor of intention to engage in each of the four behaviours. Similarly, habit strength was an important predictor of each of the behaviours and moderated the relationship between intention and behaviour for the behaviour of avoiding unsafe food. Conclusion: The implication of these findings is that examining safe food-handling behaviours separately, rather than as a totality, may result in meaningful distinctions between the predictors of these behaviours.

Background:Substance use disorders in older adults are expected to increase dramatically in the coming years. Given the increased susceptibility to cognitive deficits in older substance users (defined here as aged 50+ years due to the accelerated health decline observed in this population), it is important to consider the functional correlates of cognitive impairment in these older adults. This study details the cognitive status of older individuals attending outpatient drug and alcohol (D&A) treatment services and seeks to determine of the association of cognitive impairment to self-reported daily functioning.Methods:Ninety nine clients aged 50 years or over attending outpatient D&A treatment services in Sydney, Australia participated. Cognition was assessed using the Addenbrooke's Cognitive Examination – Revised (ACE-R). Recent substance use (Australian Treatment Outcome Profile), physical and mental health (SF12, Geriatric Depression Scale), social isolation (Lubben Social Network Scale), and activities of daily living (Bayer ADL Scale) were also assessed.Results:Nearly two-thirds of participants screened positive for cognitive impairment on the ACE-R; 41% and 65% of clients met the cut-off scores for mild cognitive impairment (MCI) and more severe cognitive impairment, respectively. Self-reported seizure history was a predictor of cognitive impairment.Conclusions:The results suggest that cognitive impairment in this group is common. The assessment of cognitive status for this older group of patients should not only include the identification of cognitive impairment but also encompass mental health and social functioning. A greater understanding of the needs of this cohort will also enable better co-ordination with other health and welfare services tailored to this population.

The misinformation effect is defined as an impairment in memory for past events due to exposure to misleading information (E. F. Loftus, 2005 ). Some people may be more susceptible to the misinformation effect than others, and this may also depend on their response to a distressing event. The purpose of the current study was to investigate several key factors that may contribute to misinformation susceptibility for distressing events, namely posttraumatic stress disorder symptoms such as avoidance, intrusions, and dissociation. Participants watched either a neutral or trauma film, rated their level of distress, and completed measures of trait and state dissociation. When participants returned a week later, misinformation was introduced via an eyewitness statement and free recall was assessed. Findings indicated that dissociation was related to higher distress ratings following the film but was not related to acceptance of misinformation. However, avoidance scores were related to increased recall of misinformation items, and reported experiences of intrusions were related to greater accuracy. These results are discussed in light of the paradoxical negative emotion hypothesis.

Purpose – Operational debriefing and psychological debriefing both involve groups of participants (typically from the emergency services) discussing a critical incident. Research on post‐incident debriefing has previously raised concerns over the likelihood that this discussion may affect not only psychological responses, but also memory integrity. It is possible that discussion in this setting could increase susceptibility to the misinformation effect. This paper seeks to address these issues.Design/methodology/approach – The aim of this study was to investigate whether including a warning to the debriefing instructions about the possibility of memory contamination could reduce the misinformation effect. Participants viewed a stressful film, and were assigned to one of three conditions: debriefing with standard instructions, debriefing with a memory warning, or an individual recall control condition. Free recall memory and distress for the film were assessed.Findings – Results indicate that participants ...

People with a known propensity towards false memories may be considered less credible eyewitnesses. It is therefore important to investigate individual factors related to susceptibility to false memory development. The Deese–Roediger–McDermott (DRM) procedure involves participants remembering lists of related words. The tendency to produce critical lures – words not originally presented, but strongly related to the studied words – is considered a measure of susceptibility to false memories. Participants completed the DRM using neutral and trauma-related words along with measures of dissociation, post-traumatic cognitions and the looming cognitive style. Analyses indicated that dissociation was related to false recall for traumatic stimuli; higher levels of post-traumatic cognitions were associated with a decrease in false recognition; and looming cognitive style was related to an increase in confabulations but a decrease in false recognition. The implications of this research are discussed.

Background Alprazolam, has been associated with disproportionate harms compared to other benzodiazepines, especially among people in opioid substitution treatment (OST). We examine the effect of the rescheduling of alprazolam in Australia, from Schedule 4 to Schedule 8 in February 2014 amongst a high-risk population of clients in OST. Methods OST participants who reported recent (last month) alprazolam use were recruited from three Sydney clinics. Participants ( n =57) were interviewed immediately prior to rescheduling and again three months and 12 months after rescheduling. We examined self-reported patterns of drug use, drug availability, mental and physical health. A linear mixed models approach was used to analyse changes in alprazolam and other benzodiazepine use. Results Mean days of alprazolam use in the past 28 days decreased from 13.7 to 7.1 days, and mean weekly alprazolam dose decreased from 15.1mg to 6.1mg at 12 months follow-up ( p =0.001). Total weekly benzodiazepine use also reduced from a mean of 222mg diazepam equivalent to 157mg ( p =0.044). Other substance use did not change significantly. Reported mode of cost price of street alprazolam doubled from $5 to $10 over the 12-month period. Conclusion Alprazolam rescheduling resulted in an overall reduction in alprazolam and total benzodiazepine use, without substitution with other drugs, in the short term. Unintended harms were not observed. Rescheduling appears to have been effective in reducing alprazolam use in this high-risk population.

The prototype willingness model (PWM) was designed to extend expectancy-value models of health behaviour by also including a heuristic, or social reactive pathway, to better explain health-risk behaviours in adolescents and young adults. The pathway includes prototype, i.e., images of a typical person who engages in a behaviour, and willingness to engage in behaviour. The current study describes a meta-analysis of predictive research using the PWM and explores the role of the heuristic pathway and intentions in predicting behaviour. Eighty-one studies met inclusion criteria. Overall, the PWM was supported and explained 20.5% of the variance in behaviour. Willingness explained 4.9% of the variance in behaviour over and above intention, although intention tended to be more strongly related to behaviour than was willingness. The strength of the PWM relationships tended to vary according to the behaviour being tested, with alcohol consumption being the behaviour best explained. Age was also an important moderator, and, as expected, PWM behaviour was best accounted for within adolescent samples. Results were heterogeneous even after moderators were taken into consideration. This meta-analysis provides support for the PWM and may be used to inform future interventions that can be tailored for at-risk populations.

The aim of this study was to investigate the predictive and moderating effects of HEXACO personality factors, in addition to theory of planned behavior (TPB) variables, on fruit and vegetable consumption. American college students (N = 1036) from 24 institutions were administered the TPB, HEXACO and a self-reported fruit and vegetable consumption measure. The TPB predicted 11-17% of variance in fruit and vegetable consumption, with greater variance accounted for in healthy weight compared to overweight individuals. Personality did not significantly improve the prediction of behavior above TPB constructs; however, conscientiousness was a significant incremental predictor of intention in both healthy weight and overweight/obese groups. While support was found for the TPB as an important predictor of fruit and vegetable consumption in students, little support was found for personality factors. Such findings have implications for interventions designed to target students at risk of chronic disease.

For eyewitness testimony to be considered reliable, it is important to ensure memory remains accurate following the event. As many testimonies involve traumatic, as opposed to neutral, events, it is important to consider the role of distress in susceptibility to false memories. The aim of this study was to investigate whether cortisol response following a stressor would be associated with susceptibility to false memories. Psychological distress responses were also investigated, specifically, dissociation, intrusions, and avoidance. Participants were allocated to one of three conditions: those who viewed a neutral film (N = 35), those who viewed a real trauma film (N = 35), and a trauma "reappraisal" group where participants were told the film was not real (N = 35). All received misinformation about the film in the form of a narrative. Participants provided saliva samples (to assess cortisol) and completed distress and memory questionnaires. Cortisol response was a significant predictor of the misinformation effect. Dissociation and avoidance were related to confabulations. In conclusion, following a stressor an individual may differ with regard to their psychological response to the event, and also whether they experience a cortisol increase. This may affect whether they are more distressed later on, and also whether they remember the event accurately.

Teenagers are more likely than adults to engage in binge drinking and could be more vulnerable to long-term brain changes following alcohol abuse. We investigated the possibility of excessive adolescent drinking in a rodent model in which beer (4.44% ethanol vol/vol) is presented to adult and adolescent male Wistar rats. Experiment 1 tracked ad libitum beer and water consumption in group-housed rats from postnatal day (PND) 28-96. Rats consumed an average of 7.8 g/kg/day of ethanol during adolescence (PND 34-55) and this gradually declined to a lower level of intake in adulthood (PND 56-93) of 3.9 g/kg/day. In Experiment 2, beer was made available to both adolescent (PND 29+) and adult (PND 57+) rats for 2h each day in a custom-built "lickometer" apparatus over 75 days. Access to beer was provided either 1 day out of every 3 ("intermittent" groups) or every day ("daily" groups). Relative to body weight, adolescent rats consumed more beer than adult rats in these limited access sessions. Adolescents with intermittent access consumed more than adolescents with daily access, a "binge"-like effect that was not observed in adult groups and that disappeared in adulthood. After 3 months of daily or intermittent alcohol consumption, the preference for beer versus sucrose was assessed. Rats previously kept under an intermittent schedule displayed a higher preference for beer relative to 3% sucrose, but only when testing occurred after 2 days of abstinence. In Experiment 3, adolescent (PND 30-37) and adult (PND 58-65) rats were given 20-min access to beer and their blood alcohol concentrations (BACs) were assessed. Adolescent groups consumed more alcohol than adults and showed higher BACS that were typical of human "binge" drinking (>80 mg/dL). Despite this, the correlation between BAC and beer intake was similar in both age groups. Together these results show that the intermittent presentation of alcohol itself appears to have subtle long-lasting effects on the motivation to consume alcohol. The findings support the use of beer solutions in modeling binge-like patterns of human alcohol consumption in adolescent rats.

The Australian Treatment Outcomes Profile (ATOP) is a brief instrument that assesses a range of substance use, health and well-being measures over the past 28 days. Previously, it has been validated in general adult Australian alcohol and other drug (AOD) treatment populations. However, the increasing number of older-aged clients attending AOD treatment warrants the instrument to be validated for this population. The aim of this study was to validate the ATOP for use in older AOD populations, by comparing it with validated 'gold standard' measures used in older populations.A convenience sample of 99 participants aged ≥50 attending specialist AOD services in Sydney, Australia were administered the ATOP by a researcher, along with alcohol use (AUDIT) and health questionnaires [Physical Health Questionnaire-15, 12-item short-form Health Survey (SF-12) and Geriatric Depression Scale].The ATOP items had strong agreement with the comparison instruments. The highest correlation was between the 28 days alcohol use and the AUDIT. ATOP psychological health scores highly correlated with the SF-12 mental health subscale and the Geriatric Depression Scale, and ATOP physical health scores significantly correlated with the SF-12 physical health subscale and the Physical Health Questionnaire-15. The ATOP Quality of Life score significantly correlated with all health measures. Discussion and Conclusions The ATOP has good concurrent validity with other validated substance use and health measures in an older population. Comparison with general older populations demonstrated the poorer health of this group of older AOD clients in particular.[Lintzeris N, Monds L A, Rivas G, Leung S, Withall A, Draper B. The Australian Treatment Outcomes Profile instrument as a clinical tool for older alcohol and other drug clients: A validation study. Drug Alcohol Rev 2016;35:673-677].

Chemotherapy treatment is associated with cognitive dysfunction in cancer survivors after treatment completion. The duration of these impairments is unclear. Therefore this paper aims to evaluate the lasting impact of varying doses of the chemotherapy oxaliplatin (OX) on cognition and peripheral neuropathy. In Experiment 1 rats were treated once a week for 3 weeks with either physiological saline (control) or 6 mg/kg OX i.p. and were assessed for peripheral neuropathy, using von Frey filaments, and cognitive function, using novel object and location recognition, up to 2 weeks after treatment completion. For Experiment 2 rats received 3 weekly i.p. injections of either physiological saline (control), 0.6 mg/kg, 2mg/kg or 6 mg/kg OX and assessed for peripheral neuropathy and cognitive function up to 11 months after treatment completion. Systemic OX treatment induced lasting effects on cognitive function at 11 months after treatment, and peripheral neuropathy at 1 month after treatment and these were dose dependent; higher doses of OX resulted in worse cognitive outcomes and more severe peripheral neuropathy.