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Shadur JM, Felton JW, Lejuez CW. Alcohol use and perceived drinking risk trajectories across adolescence: the role of alcohol expectancies. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02178-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ismael F, Zaramella B, Battagin T, Bizario JCS, Gallego J, Villela V, de Queiroz LB, Leal FE, Torales J, Ventriglio A, Marziali ME, Gonçalves PD, Martins SS, Castaldelli-Maia JM. Substance Use in Mild-COVID-19 Patients: A Retrospective Study. Front Public Health 2021; 9:634396. [PMID: 33748068 PMCID: PMC7969785 DOI: 10.3389/fpubh.2021.634396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 02/05/2021] [Indexed: 01/24/2023] Open
Abstract
Background: There is a need for prospective studies investigating substance use variations in mild COVID-19 patients. These individuals represent the majority of patients affected by the disease and are routinely treated at home, facing periods of quarantine. Methods: This was a retrospective cohort study. All people who tested positive for COVID-19 and classified as mild cases (i.e., no alarm sign/symptom, no need for in-person consultation) during the treatment in the public health system of a Brazilian city with around 160,000 inhabitants were monitored by phone for all the COVID-19 symptoms listed by the Centers for Disease Control and Prevention (CDC) during the active phase of the disease (i.e., no longer experiencing symptoms, up to 14 days in mild cases). After this phase (median = 108 days after intake, IQR = 76–137), we asked these patients who were classified as experiencing mild COVID-19 (n = 993) about last-month substance use in three time-points: pre-COVID, just after COVID-19 acute phase (post-COVID acute phase) and in the period before survey (post-COVID follow-up phase). Results: The number of COVID-19 symptoms was not associated with pre- or post-infection substance use. Pre-COVID alcohol and non-medical benzodiazepine use were associated with specific COVID-19 symptoms. However, sensitivity analyses showed that such associations could be explained by previous psychiatric and medical profiles. Alcohol and tobacco use decreased and non-medical analgesics increased in the post-COVID acute phase. However, just alcohol use remained lower in the post-COVID follow-up period. Higher pre-COVID levels of tobacco and alcohol were associated with post-COVID follow-up cannabis and non-medical analgesic use, respectively. Non-medical benzodiazepine use had positive and negative bi-directional associations with cannabis and non-medical analgesic use, respectively. Conclusion: We were not able to find specific associations between substance use and COVID-19 symptomatology in the present study. Patients with mild COVID-19 should be monitored for substance use in the post-COVID-19 period, and preventive interventions for non-medical analgesic use should be implemented. Focused preventive interventions increasing the perceived risks of cannabis and non-medical benzodiazepine and analgesic use among people experiencing mild COVID-19 that reported previous substance use could be useful.
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Affiliation(s)
- Flavia Ismael
- Universidade Municipal de São Caetano do Sul, São Caetano do Sul, Brazil.,ABC Center for Mental Health Studies, Santo André, Brazil
| | - Beatriz Zaramella
- Universidade Municipal de São Caetano do Sul, São Caetano do Sul, Brazil
| | - Tatiane Battagin
- Universidade Municipal de São Caetano do Sul, São Caetano do Sul, Brazil
| | | | - Júlia Gallego
- Universidade Municipal de São Caetano do Sul, São Caetano do Sul, Brazil
| | - Victoria Villela
- Universidade Municipal de São Caetano do Sul, São Caetano do Sul, Brazil
| | | | - Fabio E Leal
- Universidade Municipal de São Caetano do Sul, São Caetano do Sul, Brazil
| | - Julio Torales
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, Asunción, Paraguay
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Megan E Marziali
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Priscila D Gonçalves
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - João M Castaldelli-Maia
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
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Grevenstein D, Nikendei C, Nagy E. Alcohol Use, Binge Drinking, and Drunkenness Experience in Adolescence: Complex Associations with Family, Peers, Social Context, and Risk Perceptions. Subst Use Misuse 2020; 55:1834-1845. [PMID: 32449446 DOI: 10.1080/10826084.2020.1766504] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: A number of correlates to adolescent substance use have been shown, yet their unique predictive influence is unclear. We investigated the incremental validity of demographics, family background, school variables, risk perception, parental alcohol attitudes, age of first alcohol use, peer group influence, and behavioral variables as they concurrently predicted last month alcohol use, binge drinking, and drunkenness experience frequency. Methods: Hierarchical multiple regression analyses in a sample of N = 743 adolescents (mean age = 15.01). Results: All predictors explained 26-40% of the total variance. Alcohol use was predicted by age, gender, having two working parents, academic family background, relationship to parents, relative risk perception, parental acceptance of alcohol use, age of first use, talking about positive aspects of alcohol, normality of alcohol use among peers, time spent with friends, and going out to clubs. Binge drinking was predicted by age, working parents, school problems, relative risk perception, parental alcohol acceptance, age of first use, talking about positive aspects of alcohol, time spent with friends, and going out to clubs. Drunkenness was predicted by age, relationship to parents, school problems, relative risk perception, age of first use, talking about positive aspects of alcohol, and going out to clubs. Conclusions: Researchers need to take the complexity of adolescent substance use into account when designing studies and interventions. Relative risk perception emerged as the strongest (positive) predictor, indicating that adolescents are able to rather accurately assess their own risk and risk awareness alone does not suffice to engage in protective behavior.
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Affiliation(s)
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Ede Nagy
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Sinclair J, McCann M, Sheldon E, Gordon I, Brierley-Jones L, Copson E. The acceptability of addressing alcohol consumption as a modifiable risk factor for breast cancer: a mixed method study within breast screening services and symptomatic breast clinics. BMJ Open 2019; 9:e027371. [PMID: 31209091 PMCID: PMC6609127 DOI: 10.1136/bmjopen-2018-027371] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Potentially modifiable risk factors account for approximately 23% of breast cancers, with obesity and alcohol being the two greatest. Breast screening and symptomatic clinical attendances provide opportunities ('teachable moments') to link health promotion and breast cancer-prevention advice within established clinical pathways. This study explored knowledge and attitudes towards alcohol as a risk factor for breast cancer, and potential challenges inherent in incorporating advice about alcohol health risks into breast clinics and screening appointments. DESIGN A mixed-method study including a survey on risk factors for breast cancer and understanding of alcohol content. Survey results were explored in a series of five focus groups with women and eight semi-structured interviews with health professionals. SETTING Women attending NHS Breast Screening Programme (NHSBSP) mammograms, symptomatic breast clinics and healthcare professionals in those settings. PARTICIPANTS 205 women were recruited (102 NHSBSP attenders and 103 symptomatic breast clinic attenders) and 33 NHS Staff. RESULTS Alcohol was identified as a breast cancer risk factor by 40/205 (19.5%) of attenders and 16/33 (48.5%) of staff. Overall 66.5% of attenders drank alcohol, and 56.6% could not estimate correctly the alcohol content of any of four commonly consumed alcoholic drinks. All women agreed that including a prevention-focussed intervention would not reduce the likelihood of their attendance at screening mammograms or breast clinics. Qualitative data highlighted concerns in both women and staff of how to talk about alcohol and risk factors for breast cancer in a non-stigmatising way, as well as ambivalence from specialist staff as to their role in health promotion. CONCLUSIONS Levels of alcohol health literacy and numeracy were low. Adding prevention interventions to screening and/or symptomatic clinics appears acceptable to attendees, highlighting the potential for using these opportunities as 'teachable moments'. However, there are substantial cultural and systemic challenges to overcome if this is to be implemented successfully.
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Affiliation(s)
- Julia Sinclair
- Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Mark McCann
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Ellena Sheldon
- Core Trainee in Psychiatry, Peninsula Postgraduate Medical Education, Plymouth, UK
| | - Isabel Gordon
- Department of Pharmacy Health and Well-being, University of Sunderland, Sunderland, UK
| | - Lyn Brierley-Jones
- Department of Sociology, University of York, Wentworth College, York, UK
| | - Ellen Copson
- Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
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Klepper S, Odenwald M, Rösner S, Senn S, Menning H, Pereyra-Kröll D, Rockstroh B. Experience-Induced Change of Alcohol-Related Risk Perception in Patients with Alcohol Use Disorders. Front Psychol 2017; 8:1967. [PMID: 29180975 PMCID: PMC5693910 DOI: 10.3389/fpsyg.2017.01967] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 10/26/2017] [Indexed: 11/17/2022] Open
Abstract
The role of alcohol-related risk perception for effective treatment of alcohol use disorders (AUD) is still unclear. The present study on 101 alcohol-dependent patients undergoing a 10-week AUD treatment protocol investigated the relationship between alcohol-related risk perception and alcohol use with the hypotheses that (1) risk perception changes across treatment, (2) changes vary with treatment-related experiences of abstinence/relapse indicating ‘risk reappraisal,’ and (3) adjustment of perceived own vulnerability according to ‘risk reappraisal hypothesis’ predicts abstinence during follow-up. Abstinence during treatment was related to a decrease, and relapse during treatment to a slight increase in perceived own risks. Abstinence during the 3-month follow-up varied with experience-induced risk reappraisal. The results show an impact of risk reappraisal on alcohol use and hence advocate a focus on risk reappraisal in AUD treatment.
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Affiliation(s)
- Sarah Klepper
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Michael Odenwald
- Department of Psychology, University of Konstanz, Konstanz, Germany
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Tsurugizawa T, Tokuda S, Harada T, Takahashi T, Sadato N. Pharmacological and Expectancy Effects of a Low Amount of Alcohol Drinking on Outcome Valuation and Risk Perception in Males and Females. PLoS One 2016; 11:e0154083. [PMID: 27100898 PMCID: PMC4839653 DOI: 10.1371/journal.pone.0154083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 04/08/2016] [Indexed: 11/18/2022] Open
Abstract
The high-dose, alcohol-induced influences on risk perception and loss aversion depend on sex. On the other hand, low-dose alcohol has less effect on risky behavior. However, the effect of low-dose alcohol on subjective valuation of gain or loss and also the effect of placebo (expectancy of alcohol) on risk perception have not been fully investigated. We investigated the effects of low-dose alcohol (0.02 g/100 ml blood alcohol concentration) and placebo effects on subjective risk perception and subjective valuation of uncertain gain and loss in females and males. Participants in the control group and the placebo group were served alcohol-free, wine-flavored beverage and participants of alcohol group were served wine (14% alcohol). The placebo group was not informed that the drink was not alcohol but the control group was informed. Then paper-pencil tasks for subjective risk perception and valuation of gain or loss were performed 45 min after drinking the beverage. The participants were asked to draw the line on a 180 mm scale for each question. The placebo effects as well as the low-dose alcohol effects were observed in subjective valuations of gain or loss. Except for effect of beverages, a gender difference was also observed for subjective likelihood. The females estimated a low-probability loss as more likely and estimated a high-probability gain as less likely than did the males. From the Stevens' law fitting analysis, the placebo, not alcohol, significantly induced the psychophysical effect of the subjective valuation of gain or loss. These results indicate that the psychological effects of expectancy of alcohol (placebo) could be a major factor in changing the subjective valuation of gain or loss over the pharmacological effects of a small amount of alcohol (like a glass of wine). Furthermore, these results also indicate that gender differences should be taken into account when investigating pharmacological or psychological effect on decision-making.
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Affiliation(s)
- Tomokazu Tsurugizawa
- Institute for Innovation, Ajinomoto Co., Inc., Kawasaki, Japan
- NeuroSpin, Commissariat à l'Energie Atomique et aux Energies Alternatives, CEA Saclay, Gif-sur-Yvette, France
- * E-mail:
| | - Shinsuke Tokuda
- Department of Behavioral Science, Graduate School of Letters, Hokkaido University, Sapporo, Japan
| | - Tokiko Harada
- Division of Cerebral Integration, National Institute for Physiological Sciences, Okazaki, Japan; Department of Physiological Sciences, SOKENDAI (The Graduate University for Advanced Studies), Okazaki, Japan
| | - Taiki Takahashi
- Department of Behavioral Science, Graduate School of Letters, Hokkaido University, Sapporo, Japan
| | - Norihiro Sadato
- Division of Cerebral Integration, National Institute for Physiological Sciences, Okazaki, Japan; Department of Physiological Sciences, SOKENDAI (The Graduate University for Advanced Studies), Okazaki, Japan
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Rehm J, Lachenmeier DW, Room R. Why does society accept a higher risk for alcohol than for other voluntary or involuntary risks? BMC Med 2014; 12:189. [PMID: 25424648 PMCID: PMC4203927 DOI: 10.1186/s12916-014-0189-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 09/18/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Societies tend to accept much higher risks for voluntary behaviours, those based on individual decisions (for example, to smoke, to consume alcohol, or to ski), than for involuntary exposure such as exposure to risks in soil, drinking water or air. In high-income societies, an acceptable risk to those voluntarily engaging in a risky behaviour seems to be about one death in 1,000 on a lifetime basis. However, drinking more than 20 g pure alcohol per day over an adult lifetime exceeds a threshold of one in 100 deaths, based on a calculation from World Health Organization data of the odds in six European countries of dying from alcohol-attributable causes at different levels of drinking. DISCUSSION The voluntary mortality risk of alcohol consumption exceeds the risks of other lifestyle risk factors. In addition, evidence shows that the involuntary risks resulting from customary alcohol consumption far exceed the acceptable threshold for other involuntary risks (such as those established by the World Health Organization or national environmental agencies), and would be judged as not acceptable. Alcohol's exceptional status reflects vagaries of history, which have so far resulted in alcohol being exempted from key food legislation (no labelling of ingredients and nutritional information) and from international conventions governing all other psychoactive substances (both legal and illegal). This is along with special treatment of alcohol in the public health field, in part reflecting overestimation of its beneficial effect on ischaemic disease when consumed in moderation. SUMMARY A much higher mortality risk from alcohol than from other risk factors is currently accepted by high income countries.
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Affiliation(s)
- Jürgen Rehm
- />Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON M5S 2S1 Canada
- />Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- />Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
- />Institute of Medical Science, University of Toronto, Toronto, Canada
- />Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Dirk W Lachenmeier
- />Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- />Chemisches und Veterinäruntersuchungsamt Karlsruhe, Karlsruhe, Germany
| | - Robin Room
- />Centre for Alcohol Policy Research, Turning Point, Fitzroy, VIC Australia
- />Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Australia
- />Centre for Social Research on Alcohol & Drugs, Stockholm University, Stockholm, Sweden
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Green CA, Polen MR, Janoff SL, Castleton DK, Perrin NA. "Not getting tanked": definitions of moderate drinking and their health implications. Drug Alcohol Depend 2007; 86:265-73. [PMID: 16930868 PMCID: PMC3536464 DOI: 10.1016/j.drugalcdep.2006.07.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Revised: 07/07/2006] [Accepted: 07/07/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND People encounter large amounts of sometimes-inconsistent information about risks and benefits of alcohol consumption, and about what constitutes "low-risk" or "moderate" drinking. METHODS We used 150 in-depth interviews linked to questionnaire data to learn how people define moderate drinking and to describe the relationships between definitions, attitudes, and beliefs about moderate drinking and individuals' drinking patterns. RESULTS People adhere to definitions of moderate alcohol consumption that could put them, or others, at risk for short- or long-term negative consequences of drinking. Definitions that confused increased tolerance of alcohol with moderate drinking, and those that defined moderate drinking by the absence of short-term negative consequences or ability to maintain control over drinking, ignore long-term risks of heavy consumption. Individuals with risky attitudes were also more likely to report at-risk drinking practices. CONCLUSIONS Americans have complex beliefs about benefits and risks of alcohol consumption, and public health officials have not succeeded in conveying strong or clear messages about what constitutes low-risk drinking or about dose-response effects. Different (but more consistent) approaches to public education may be needed to increase knowledge about drinking-related risks. The prevalence of diverse norm-based definitions suggests that alternative normative information could help people reassess their own consumption.
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Affiliation(s)
- Carla A. Green
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Avenue, Portland, OR 97227-1110, 503.335.2479 phone, 503.335.2424 fax
| | - Michael R. Polen
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Avenue, Portland, OR 97227-1110, 503.335.6632 phone, 503.335.2424 fax
| | - Shannon L. Janoff
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Avenue, Portland, OR 97227-1110, 503.335.6788 phone, 503.335.2424 fax
| | - David K. Castleton
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Avenue, Portland, OR 97227-1110, 503.335.6322 phone, 503.335.2424 fax
| | - Nancy A. Perrin
- School of Nursing, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97239-3098
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Daugherty R, Van Tubergen N. A comparison of two measures of low response to alcohol among heavy drinking male college students: implications for indicated prevention. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2002; 3:267-73. [PMID: 12458765 DOI: 10.1023/a:1020824508207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Low response (LR) to alcohol is a risk factor that strongly predicts later problems. This study compares subjective measures of high tolerance (HT) to measures of LR, using the Self-Rating of Effects of Alcohol (SRE) form. First-year heavy drinking students (N = 250) at an all-male college completed a survey during a mandatory class that included the SRE, past month peak consumption, 2-week heavy episodic use, family history, self-reported high tolerance, and whether it takes more alcohol to become impaired compared to others. The SRE identified LR for 96.7% of those reporting HT and 100% of those reporting both HT and that it takes comparatively more alcohol to become impaired. The measure of HT correlated more with heavy drinking than did that of LR (peak of 14.5 drinks and 4.3 occasions of heavy episodic drinking vs. 12.6 and 3.7) whereas those identified as not LR drank less than those who reported no HT (peak of 6.1 drinks and 1.3 occasions of heavy episodic drinking vs. 9.6 and 2.4). Those reporting uncertainty about HT averaged peaks of 10 drinks and 3.13 occasions of heavy episodic drinking; 73.6% scored LR on the SRE. These data suggest that, at least in a heavy drinking group, the SRE may be most effective as a selected follow-up to an initial two-question screening. Self-reporting a high tolerance provides as much information as the 12-question SRE and is associated with heavier use. The SRE may provide corrective feedback to those who report uncertainty about HT or who give conflicting responses to the two screening questions.
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Affiliation(s)
- Ray Daugherty
- Prevention Research Institute, Lexington, Kentucky 40503, USA.
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