Effects of anxiety sensitivity on cannabis, alcohol, and nicotine use among adolescents: evaluating pathways through anxiety, withdrawal symptoms, and coping motives

Anxiety sensitivity (AS) is a promising intervention target due to its relevance to negative health behaviors broadly, and substance use specifically. The aim of the current study was to evaluate the direct and indirect pathways through which elevated AS could relate to recent substance use among a national adolescent sample recruited via social-media. As predicted, AS was indirectly associated with greater likelihood of using alcohol, cigarettes, and electronic nicotine delivery systems in the past-month through anxiety symptoms. Regarding cannabis, AS was directly related to increased likelihood of past-month cannabis use; however, the indirect relation between AS and likelihood of past-month use via anxiety symptoms was not significant. Through chained indirect effects, AS was related positively to past-month alcohol and cannabis use via anxiety symptoms and coping-related motives, and through withdrawal symptoms and coping-related motives. Study findings can be used to generate hypotheses on potential pathways through which AS could prospectively relate to substance use among youth.

Effectiveness of symptom-triggered regimen versus fixed-dosage regimen of benzodiazepine treatment for alcohol detoxification: a systematic review protocol

OBJECTIVE

The objective of this review is to evaluate the effectiveness of a symptom-triggered regimen versus a fixed-dosage regimen of benzodiazepine treatment for alcohol detoxification.

INTRODUCTION

Patients with alcohol use disorder who suddenly decrease their alcohol consumption or abstain completely may experience alcohol withdrawal syndrome. Adequate treatment of detoxification can relieve the patient's distress, prevent the development of more serious symptoms and forestall collective effects that might worsen future withdrawals.

INCLUSION CRITERIA

The review will consider studies that include people with alcohol withdrawal syndrome who are taking benzodiazepine treatment in an inpatient setting. Studies of people with alcohol withdrawal syndrome who are under the age of 18 will be excluded. This review will exclude studies of people with alcohol withdrawal syndrome who are non-verbal (e.g. stupor due to head injury) or have a history of seizure. Studies published in English will be included.

METHODS

An initial limited search of MEDLINE and CINAHL was undertaken to identify articles. The text words contained in the titles and abstracts, and index terms were used to develop a full search strategy. The search strategy, including all identified keywords and index terms, will be adapted for each included information source. Studies will be pooled for statistical meta-analysis. Effect sizes will be expressed as odds ratios (for categorical data) or weighted mean differences (for continuous data), and their 95% confidence intervals will be calculated for analysis. The heterogeneity will be assessed using the I test and chi-squared test.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42018115777.