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The effects of academic achievement may extend beyond economic success to influence social functioning, including future parenting. To evaluate whether adolescent academic achievement forecasts future parenting (both positive and negative) and the family home environment of parents. We used prospectively gathered intergenerational data from a population‐based birth cohort born in 1972/1973 in Dunedin, New Zealand, including data from Generation 1 (parents of the birth cohort), the birth cohort (Generation 2; G2), and G2's children (Generation 3). Adolescent academic achievement in G2 was used to predict observed and reported parenting outcomes when offspring (G3) were aged 3 years after controlling for a range of covariates, including G2's adolescent wellbeing, early childhood socioeconomic status (collected from G1), and G2's age at child's birth. We also evaluated 2‐way interactions between academic achievement and G2 parent sex, G3 child behaviour, and G2 adolescent wellbeing. Greater G2 academic achievement, net of controls, predicted more positive and less negative parenting (for mothers only), and a more positive home environment. For the home environment outcome, the effect of adolescent academic achievement was moderated by wellbeing. Adolescent academic achievement may positively influence parenting behaviour and the quality of the home environment. [ABSTRACT FROM AUTHOR]

Background: The relationship between thiamine blood level (TBL) and cognition remains uncertain, including among alcohol-dependent persons (ADP)., Aim: To evaluate this relationship during protocol-driven inpatient alcohol detoxification treatment including thiamine supplementation (AD + Th)., Methods: Prospective 3-week study with 100 consecutively admitted detoxification-seeking ADP (47.7 ± 11 years old, 21% females) without superseding comorbidities requiring treatment. TBL and Montreal Cognitive Assessment (MoCA) were measured at admission (t 1 , pre-AD + Th) and discharge (t 3 , post-AD + Th). Frontal Assessment Battery (FAB) was performed at t 1 . AD + Th included abstinence, pharmacological alcohol withdrawal syndrome treatment, and oral thiamine supplementation (200 mg/day for 14 days). Regression and mediation analyses assessed TBL-cognition relationships., Results: We found no cases of Wernicke Encephalopathy (WE) and only one case of thiamine deficiency. Both MoCA and TBL significantly improved across AD + Th (with medium-to-large effect sizes). At t 1 , TBL significantly predicted MoCA and FAB sum scores (medium effect sizes; extreme and very strong evidence, respectively). The clear TBL-MoCA association disappeared at t 3 . In multivariate regression and mediation analyses exploring key influential factors of cognition (identified by LASSO regression), the TBL-MoCA interactions did not relevantly change at t 1 and t 3 . Age, serum transaminases, vitamin D levels, drinking-years, and depression score weakly modified the relationship., Conclusion: TBL was a robust predictor of pre-detoxification cognitive impairment, and both TBL and cognition improved significantly during AD + Th (including abstinence) in our ADP population, supporting routine thiamine supplementation for ADP, even those at low WE-risk. The TBL-cognition relationship was minimally confounded by age, alcohol-toxicity proxies, mood, and vitamin D levels., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Competing Interests: The authors have no conflict of interest to declare.

Personality reliably predicts life outcomes ranging from social and material resources to mental health and interpersonal capacities. However, little is known about the potential intergenerational impact of parent personality prior to offspring conception on family resources and child development across the first thousand days of life. We analysed data from the Victorian Intergenerational Health Cohort Study (665 parents, 1030 infants; est. 1992), a two-generation study with prospective assessment of preconception background factors in parental adolescence, preconception personality traits in young adulthood (agreeableness, conscientiousness, emotional stability, extraversion, and openness), and multiple parental resources and infant characteristics in pregnancy and after the birth of their child. After adjusting for pre-exposure confounders, both maternal and paternal preconception personality traits were associated with numerous parental resources and attributes in pregnancy and postpartum, as well as with infant biobehavioural characteristics. Effect sizes ranged from small to moderate when considering parent personality traits as continuous exposures, and from small to large when considering personality traits as binary exposures. Young adult personality, well before offspring conception, is associated with the perinatal household social and financial context, parental mental health, parenting style and self-efficacy, and temperamental characteristics of offspring. These are pivotal aspects of early life development that ultimately predict a child's long-term health and development., (© 2023. The Author(s).)

This study examined whether positive development (PD) in adolescence and young adulthood predicts offspring behavior in two Australasian intergenerational cohorts. The Australian Temperament Project Generation 3 Study assessed PD at age 19-28 (years 2002-2010) and behavior in 1165 infants (12-18 months; 608 girls) of 694 Australian-born parents (age 29-35; 2012-2019; 399 mothers). The Dunedin Multidisciplinary Health and Development Parenting Study assessed PD at age 15-18 (years 1987-1991) and behavior in 695 preschoolers (3-5 years; 349 girls) and their New Zealand born parents (age 21-46; 1994-2018; 363 mothers; 89% European ethnicity). In both cohorts, PD before parenthood predicted more positive offspring behavior (β range  = .11-.16) and fewer behavior problems (β range  = -.09 to -.11). Promoting strengths may secure a healthy start to life., (© 2022 The Authors. Child Development published by Wiley Periodicals LLC on behalf of Society for Research in Child Development.)

Introduction: In extending work on early life antecedents of parenting, we investigate associations between childhood family history of disadvantage, adolescent socioemotional wellbeing, and age at first parenthood and subsequent parenting behaviour., Methods: Parent-child interactions were recorded when participants in the longitudinal Dunedin Multidisciplinary Health and Development Study (New Zealand) had a three-year-old child. Data were available for 358 mothers and 321 fathers, aged between 17.7 and 41.5 at the time of their child's birth. Associations between parenting and antecedent data on socioeconomic disadvantage, adolescent wellbeing and mental health, as well as current adult mental health and age at parenting, were tested for using structural equation modelling., Results: Family disadvantage in childhood and lower adolescent wellbeing was associated with less positive future parenting, but only adult (not adolescent) anxiety/depression symptoms were directly associated with parenting behaviour. Childhood family disadvantage was associated with further disadvantage across the life course that included less positive parenting of the next generation. In contrast, socioemotional wellbeing during adolescence and later age of onset of parenting were associated with more positive parenting., Conclusions: Reducing childhood disadvantage and improving socioemotional wellbeing during childhood and adolescence is likely to have intergenerational benefits through better parenting of the next generation., (Copyright © 2020 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Background: For cannabis-dependent subjects, the relationship between cannabis withdrawal syndrome (CWS) severity and the urine cannabinoid concentrations are unclear; we investigated this using a commercial point-of-care (POC) enzyme immunoassay detecting 11-nor-9-carboxy-Delta-9-tetrahydrocannabinol (THC-COOH). Methods: Observational study of 78 adult chronic cannabis-dependent subjects assessed over a 24-day inpatient detoxification treatment, with 13 serial measurement days. Repeated Measures Correlation and Multilevel Linear Models were employed. Results: Absolute urinary THC-COOH levels significantly correlated with Marijuana Withdrawal Checklist (MWC) scores across the entire study duration ( r = 0.248; p < 0.001). Correlation between serial creatinine-adjusted THC-COOH ratios and serial MWC scores emerged as significant only in the sample with higher MWC scores (>11 points) at admission ( n = 21; r = 0.247; p = 0.002). The aforementioned significant relationships have persisted when replacing the absolute THC-COOH-levels with the (relative) day-to-day change in urinary THC-COOH levels. MWC scores were significantly correlated with the Clinical Global Impression-Severity (CGI-S; r = 0.812; p < 0.001). Females showed a significantly slower decline in urine THC-COOH levels and prolonged CWS course characterized by substantial illness severity (per CGI-S), occurring in nearly 30% of cases. Conclusion: Urine cannabinoid levels (THC-COOH) determined by POC assay significantly predicted CWS severity (moderate correlation), guiding detoxification treatment duration. In patients with MWC > 11 points upon admission, creatinine-adjusted THC-COOH ratios also significantly predicted CWS severity-again with moderate effect size. Females showed prolonged urinary THC-COOH elimination and cannabis withdrawal., Competing Interests: NS has received honoraria for several activities (e.g., advisory board membership, lectures, manuscripts) from AbbVie, Camurus, Hexal, Janssen-Cilag, MSD, Medice, Mundipharma, Reckitt-Benckiser/Indivior, and Sanofi-Aventis. During the last 3 years he has participated in clinical trials financed by the pharmaceutical industry. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2020 Claus, Specka, McAnally, Scherbaum, Schifano and Bonnet.)

Introduction: Recent years have seen a dramatic escalation of off-label prescribing for gabapentin and pregabalin (gabapentinoids) owing in part to generic versions of each being released over the past two decades, but also in part as a response to increasing calls for multimodal and non-opioid pain management strategies. In this context, several recent articles have been published alleging widespread misuse, with speculations on the unappreciated addictive potential of the gabapentinoid class of drugs. Reports of a 1% population-level abuse prevalence stem from a single internet survey in the UK, and the vanishingly small adverse event outcomes data do not support such frequency. In this targeted narrative review, we aim to disabuse pain physicians and other clinicians, pharmacists, and policymakers of both the positive and negative myths concerning gabapentinoid medications., Results: Gabapentinoids inhibit the joint action of voltage-gated calcium channel (VGCC) α2δ subunits in conjunction with the n-methyl-D-aspartate (NMDA) receptor, with subsequent downregulation of VGCC expression and excitatory neurotransmitter release, and possibly synaptogenesis as well, through actions on thrombospondins. These activities reduce the likelihood of central sensitization, which explains in part the efficacy of the gabapentinoids in the management of neuropathic pain. Gabapentinoids also facilitate slow-wave sleep, a relatively rare phenomenon among central nerve system-acting agents, which is also thought to explain some of the therapeutic benefit of the class in conditions such as fibromyalgia. The number needed to treat to see benefit overlaps that of the nonsteroidal anti-inflammatory drugs, but with a considerably improved safety profile. Along these lines, in the context of over 50 million prescriptions per year in the USA alone, the gabapentinoids display remarkably low risk, including risks of misuse, abuse, and dependence. Furthermore, the neurobiology of these agents does not lend plausibility to the allegations, as they have never been shown to elicit dopaminergic activity within the nucleus accumbens, and in addition likely confer a "negative-feedback loop" for habituation and dependence by serving as functional NMDA antagonists, possibly through their actions on thrombospondins. Clinical and epidemiological addictionology studies corroborate the lack of any significant addictive potential of the gabapentinoids, and these drugs are increasingly being used in the treatment of addiction to other substances, with excellent results and no evidence of cross-addiction. However, among individuals with other substance use disorders and, in particular opioid use disorder, there are consistent data showing misuse of gabapentinoids in up to 20% of this population. Although there are allegations of using gabapentinoids to amplify the hedonic effects of opioids, the vast majority of misuse events appear to occur in an attempt to ameliorate opioid withdrawal symptoms. Furthermore, rare but potentially serious respiratory depression may occur, again amplified in the context of opioid or other sedative use. Careful risk:benefit assessment and stratification are warranted when prescription of a gabapentinoid is under consideration, in particular among individuals using opioids., Conclusions: Gabapentinoids remain a vital tool in the pain physician's multimodal armamentarium, but these drugs may not be effective in every clinical situation. Individuals with central sensitization and pain associated with slow-wave sleep deficits and potentially persons with comorbid addictions may benefit the most. The gabapentinoids appear to possess no addictive potential on their own, based on laboratory and clinical data, but they may be abused by persons with opioid use disorders; consequently, cautious risk stratification must take place.

Background: Over the past 15 years, comparative assessments of psychoactive substance harms to both users and others have been compiled by addiction experts. None of these rankings however have included synthetic cannabinoids or non-opioid prescription analgesics (NOAs, e.g., gabapentinoids) despite evidence of increasing recreational use. We present here an updated assessment by German addiction medicine experts, considering changing Western consumption trends-including those of NOAs. Methods: In an initial survey, 101 German addiction medicine physicians evaluated both physical and psychosocial harms (in 5 dimensions) of 33 psychoactive substances including opioids and NOAs, to both users and others. In a second survey, 36 addiction medicine physicians estimated the relative weight of each health and social harm dimension to determine the overall harm rank of an individual substance. We compared our ranking with the most recent European assessment from 2014. Results: Illicit drugs such as methamphetamine, heroin, cocaine and also alcohol were judged particularly harmful, and new psychoactive drugs (cathinones, synthetic cannabinoids) were ranked among the most harmful substances. Cannabis was ranked in the midrange, on par with benzodiazepines and ketamine-somewhat more favorable compared to the last European survey. Prescribed drugs including opioids (in contrast to the USA, Canada, and Australia) were judged less harmful. NOAs were at the bottom end of the ranking. Conclusion: In Germany, alcohol and illicit drugs (including new psychoactive substances) continue to rank among the most harmful addictive substances in contrast to prescribed agents including opioid analgesics and NOAs. Current laws are incongruent with these harm rankings. This study is the first of its kind to include comparative harm rankings of several novel abused substances, both licit/prescribed and illicit., (Copyright © 2020 Bonnet, Specka, Soyka, Alberti, Bender, Grigoleit, Hermle, Hilger, Hillemacher, Kuhlmann, Kuhn, Luckhaus, Lüdecke, Reimer, Schneider, Schroeder, Stuppe, Wiesbeck, Wodarz, McAnally and Scherbaum.)

Background: Parental depression and anxiety have been consistently linked to offspring behavior problems across childhood. However, many of the risks for these common mental health problems are established well before pregnancy. This study takes advantage of rare, prospective data to examine relations between parental mental health histories (from adolescence onwards) and next generation offspring behavior problems., Methods: Data were drawn from a multi-generational cohort study that has followed Australians from infancy to adulthood since 1983, and 1171 of their offspring assessed prospectively from pregnancy. Generalized estimating equation models were used to estimate associations between parents' depression/anxiety symptoms in adolescence and young adulthood and offspring behavior problems at 1 year., Results: In analyses of 648 mother-infant and 423 father-infant dyads, after adjustment for confounders and concurrent mental health problems, mean behavior problem scores in infants of mothers with a history of mental health problems in both adolescence and young adulthood were over half a standard deviation higher than those of mothers without problems during these periods, B = 2.19, 95% CI 1.21 - 3.17, β = 0.52. No association was observed for fathers., Limitations: We only included infants born to participants aged 29-35 years and we assessed behavior problems via parent-report., Conclusions: A mother's history of persistent depression and anxiety from adolescence to young adulthood can predict higher levels of behavior problems in her infant. Findings support calls for greater policy and prevention focus on preconception and postnatal mental health, particularly a mother's early emotional health history, prior to parenthood., Competing Interests: Declaration of Competing Interest There are no conflicts of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Maternal mental health during pregnancy and postpartum predicts later emotional and behavioural problems in children. Even though most perinatal mental health problems begin before pregnancy, the consequences of preconception maternal mental health for children's early emotional development have not been prospectively studied., Methods: We used data from two prospective Australian intergenerational cohorts, with 756 women assessed repeatedly for mental health problems before pregnancy between age 13 and 29 years, and during pregnancy and at 1 year postpartum for 1231 subsequent pregnancies. Offspring infant emotional reactivity, an early indicator of differential sensitivity denoting increased risk of emotional problems under adversity, was assessed at 1 year postpartum., Results: Thirty-seven percent of infants born to mothers with persistent preconception mental health problems were categorised as high in emotional reactivity, compared to 23% born to mothers without preconception history (adjusted OR 2.1, 95% CI 1.4-3.1). Ante- and postnatal maternal depressive symptoms were similarly associated with infant emotional reactivity, but these perinatal associations reduced somewhat after adjustment for prior exposure. Causal mediation analysis further showed that 88% of the preconception risk was a direct effect, not mediated by perinatal exposure., Conclusions: Maternal preconception mental health problems predict infant emotional reactivity, independently of maternal perinatal mental health; while associations between perinatal depressive symptoms and infant reactivity are partially explained by prior exposure. Findings suggest that processes shaping early vulnerability for later mental disorders arise well before conception. There is an emerging case for expanding developmental theories and trialling preventive interventions in the years before pregnancy.

This long-term follow-up of an early childhood training study (Growing Memories) to promote elaborative reminiscing tested continued effects on mother-child reminiscing and on adolescents' narrative coherence. Of the original 115 families, 100 participated when their children were 3.5 years of age and 76 participated when their children were young adolescents (M age  = 11.2 years). Mothers and children reminisced about a positive event and a negative event at each timepoint, and adolescents narrated high points and low points. Mothers and children who had participated in the reminiscing intervention in early childhood remained more elaborative in dyadic reminiscing over time. Moreover, adolescents whose mothers had participated in elaborative reminiscing training in early childhood told more coherent low-point narratives (with respect to context and theme) than adolescents of mothers in the control group. These long-term benefits for the quality of mother-adolescent reminiscing and adolescents' narrative coherence have implications for theories of narrative identity development and for designing interventions in early childhood to foster autobiographical memory, which may help later understanding of difficult life events., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Purpose of Review: This study and literature review were carried out to investigate whether oxycodone is the most addictive prescription opioid., Recent Findings: This was a cross-sectional survey from a pain management practice in south-central Alaska and review of the literature involving 86 patients diagnosed with opioid dependence/opioid use disorder from 2013 to 2018. Patients were given a list of prescription opioids and asked to identify the one (1) most desirable to themselves, (2) most desirable among drug-using associates or community, and (3) they deemed most addictive. Patients with a history of heroin use were asked which, if any, served as their gateway drug to heroin. The literature was reviewed using a PubMed search for articles containing the words "oxycodone" and "abuse," "addiction," "dependence," "disorder," and "euphoria." Oxycodone was ranked most highly in all four questions (n = 50, 60.2%; n = 46, 75.4%; n = 38, 60.2%; n = 14, 77.8%, respectively) by a wide margin. Numerous observational studies performed over the past few decades have demonstrated the supreme "likability" and abuse and dependence liability/addictiveness of oxycodone, with more recent mechanistic studies illuminating biological underpinnings including markedly increased active transport across the blood-brain barrier, increased phasic dopaminergism in the ventral tegmental area, nucleus accumbens and related striatal reward centers, and possibly increased kappa opioid receptor-mediated withdrawal dysphoria. Oxycodone possesses pharmacologic qualities that render it disproportionately liable to abuse and addiction and the risks of any long-term prescription outweigh the benefits.

The practice of chronic opioid prescription for chronic non-cancer pain has come under considerable scrutiny within the past several years as mounting evidence reveals a generally unfavorable risk to benefit ratio and the nation reels from the grim mortality statistics associated with the opioid epidemic. Patients struggling with chronic pain tend to use opioids and also seek out operative intervention for their complaints, which combination may be leading to increased postoperative "acute-on-chronic" pain and fueling worsened chronic pain and opioid dependence. Besides worsened postoperative pain, a growing body of literature, reviewed herein, indicates that preoperative opioid use is associated with significantly worsened surgical outcomes, and severely increased financial drain on an already severely overburdened healthcare budget. Conversely, there is evidence that preoperative opioid reduction may result in substantial improvements in outcome. In the era of accountable care, efforts such as the Enhanced Recovery After Surgery (ERAS) protocol have been introduced in an attempt to standardize and facilitate evidence-based perioperative interventions to optimize surgical outcomes. We propose that addressing preoperative opioid reduction as part of a targeted optimization approach for chronic pain patients seeking surgery is not only logical but mandatory given the stakes involved. Simple opioid reduction/abstinence however is not likely to occur in the absence of provision of viable and palatable alternatives to managing pain, which will require a strong focus upon reducing pain catastrophization and bolstering self-efficacy and resilience. In response to a call from our surgical community toward that end, we have developed a simple and easy-to-implement outpatient preoperative optimization program focusing on gentle opioid weaning/elimination as well as a few other high-yield areas of intervention, requiring a minimum of resources.

Adolescents' intergenerational narratives-the stories they tell about their mothers' and fathers' early experiences-are an important component of their identities (Fivush & Merrill, 2016; Merrill & Fivush, 2016). This study explored adolescents' intergenerational narratives across cultures. Adolescents aged 12 to 21 from 3 cultural groups in New Zealand (Chinese: n = 88; Māori: n = 91; European: n = 91) narrated stories about their mothers' and fathers' childhood experiences. In these narratives, New Zealand Chinese and Māori adolescents included more identity connections (statements linking their own identities to their parents' experiences) than did New Zealand European adolescents, and New Zealand Chinese adolescents' intergenerational narratives were more coherent than were New Zealand European and Māori adolescents' narratives. New Zealand Chinese and Māori adolescents were also more likely to report didactic reasons for their mothers' telling of the narratives, whereas New Zealand European adolescents were more likely to report reasons of sharing family history. Across cultures, but only in their mother narratives, adolescent girls included more references to subjective perspectives (emotions, evaluations, and cognitions) than did adolescent boys. Older adolescents also used more subjective perspective terms than younger adolescents. These findings suggest that intergenerational narratives serve different functions when adolescents across cultures explore their identities. These narratives may be especially important for adolescents growing up in cultures with an interdependent orientation. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

This study investigated the relation between ratings of 6-n-propylthiouracil (PROP) and two psychosocial constructs, socioeconomic status and IQ, which are related to health outcomes. A 3.2mM solution of PROP was rated by 922 32-year-old members of a birth cohort (450 women) relative to the strongest imaginable sensation of any kind using the generalised Labelled Magnitude Scale. Women had higher PROP ratings than men. Following normalisation of PROP ratings, multiple linear regression showed that higher ratings were independently associated with lower childhood socioeconomic status, lower childhood IQ scores and ratings of an imagined stimulus made on the same scale (r(2)=0.12). Results suggest that psychosocial variables, sex and scale use, in addition to established genetic determinants, may help explain variability in ratings of supra-threshold concentrations of PROP.

Previous case reports indicate that cocaine-associated rhabdomyolysis and excited delirium share many similar features, suggesting that they may be different stages of the same syndrome. We tested this hypothesis by comparing data from 150 cases of cocaine-associated rhabdomyolysis reported in the medical literature with data from an autopsy registry for 58 victims of fatal excited delirium and 125 victims of fatal acute cocaine toxicity. Patients with rhabdomyolysis are similar to victims of fatal excited delirium with regard to age; gender; race; route of cocaine administration; the experiencing of excitement, delirium, and hyperthermia; and the absence of seizures. Compared with victims of fatal acute cocaine toxicity, patients with rhabdomyolysis are different with regard to each of these variables. Compared with victims of fatal acute cocaine toxicity, both victims of rhabdomyolysis and fatal excited delirium are more likely to be black, male, and younger; to have administered cocaine by smoking or injection; and to have experienced excitement, delirium, and hyperthermia; they are also less likely to have had seizures. Because cocaine-associated rhabdomyolysis and excited delirium have similar clinical features and risk factors, occur in similar populations of drug users, and can be explained by the same pathophysiologic processes, we conclude that they are different stages of the same syndrome. It appears that this syndrome is caused by changes in dopamine processing induced by chronic and intense use of cocaine rather than by the acute toxic effects of the drug.