After how many drinks does someone experience acute consequences-determining thresholds for binge drinking based on two event-level studies

Predictors and consequences of unplanned drinking among young adults

OBJECTIVE

Unplanned drinking, or drinking that violates intentions to limit alcohol consumption, has been linked to significant alcohol-related consequences in college students; however, predictors and outcomes remain incompletely understood among other populations of young adults. This study identified person- and event-level predictors of unplanned drinking and explore the association of unplanned drinking with negative alcohol-related consequences in a racially and educationally diverse cohort of young adults.

METHOD

A total of 938 young adults (aged 18-25; 70 % female; 60 % non-college; 37 % Black) participating in a randomized trial testing text-message alcohol interventions completed ecological momentary assessments (EMA) reporting drinking intentions and alcohol consumption twice weekly for at least 4 weeks over a 14 week period. Controlling for intervention effects, mixed-effects models examined predictors of unplanned drinking days, and zero-inflated negative binomial regression models assessed the relationship between frequency of unplanned drinking and negative alcohol consequences at a 14-week follow-up.

RESULTS

Participants reported alcohol consumption on 16.9 % of days when they had no plan to drink. Odds of unplanned drinking was higher for older age (adjusted Odds Ratio [aOR] = 1.06, p < 0.01), Black race (aOR = 1.25, p < 0.01), higher AUDIT-C score (aOR = 1.14, p < 0.001), and higher negative urgency score (aOR = 1.05, p < 0.01), weekends (aOR = 1.63, p < 0.001) and the presence of friends drinking (aOR = 9.37, p < 0.001). Compared to participants in the lowest unplanned drinking day category, those in the highest category showed a 26 % higher negative alcohol consequence rate ratio (RR = 1.26, 95 % CI [1.07, 1.48]).

CONCLUSIONS

Unplanned drinking in young adults is strongly influenced by social context and individual risk factors. This behavior, when extreme, was associated with increased negative alcohol-related consequences. Interventions targeting impulsivity and peer influence may reduce unplanned drinking and mitigate its harmful effects.

Cheers to tomorrow? Alcohol use predicts poorer mood and well-being the next day in young adults

Alcohol use is embedded within university culture. While the consequences of alcohol use on next-day physical health are well-known, less is known about the consequences to next-day emotional health. This study investigated the relationship between alcohol use and next-day mood and well-being using two daily diary studies with New Zealand university students. Participants completed a daily diary for 13 days (Study 1, n = 1114; 30.6% men, Mage = 19.6) or 7 days (Study 2, n = 212; 24.5% men, Mage = 19.4) where they reported previous night's alcohol consumption and sleep quality, along with today's mood and well-being. Night-time alcohol consumption was categorised into low-risk (women 1-4 drinks, men 1-5 drinks), medium-risk (women 5-9 drinks, men 6-11 drinks) and high-risk (women 10+ drinks, men 12+ drinks) according to New Zealand public health guidelines. Across both studies, medium- and especially high-risk drinking, but not low-risk drinking, was associated with lower next-day positive mood and well-being compared to nondrinking days. Poorer sleep quality partially accounted for the relationship of drinking with next-day mood and well-being in Study 1, but less so in Study 2. Findings suggest that interventions could promote lower risk drinking behaviours to benefit students' well-being.

A text message intervention aimed at nurturing peer outreach to help meet drinking limit goals: A remote pilot randomized trial in non-collegiate young adults

OBJECTIVE

Scalable interventions attempting to nurture peer outreach to help young adults meet drinking limit goals remain under-developed. To address this gap, we developed ASPIRE, a text message intervention focused on coaching individuals to engage with close peers to assist them in meeting drinking limit goals.

METHOD

Non-collegiate young adults who had reported one or more heavy drinking days in the preceding month and were at least contemplating change were recruited through social media. Participants were randomly assigned to one of three 6-week text message interventions: Control, Goal Support, or ASPIRE. All groups completed baseline assessments and received weekly text message assessments on Thursdays and Sundays. Control and ASPIRE groups were prompted to complete web-based outcome assessments at 6- and 12-weeks.

RESULTS

We enrolled 92 young adults from 31 US states (65% female; 73% White). All groups had high text response rates but intervention usability was sub-optimal. Follow-up rates were 87% at 6-weeks and 79% at 12-weeks. Compared to Control, ASPIRE participants reported significantly more peer support and less peer pressure to drink. ASPIRE exhibited higher goal confidence compared to the Goal Support group. Using multiple imputation, there were no significant differences in drinking outcomes between groups.

CONCLUSIONS

Preliminary findings from this pilot study suggest that a text message intervention focused on nurturing peer outreach to help meet drinking limit goals holds promise in altering peer support and pressure as well as boosting drinking limit goal confidence. Design improvements are needed to reduce alcohol consumption.

Affect trajectories surrounding binge eating episodes and heavy drinking episodes in adults with binge-spectrum eating disorders

OBJECTIVE

The comorbidity of binge eating and heavy drinking (BE + HD) is concerning due to high prevalence and associated consequences. Affective pathways may maintain BE + HD, yet more micro-level research is needed. This study used ecological momentary assessment (EMA) to examine between-person and day-level relationships between positive and negative affect and binge eating or heavy drinking episodes in BE + HD.

METHODS

Participants (N = 53) were adults with binge-spectrum eating disorders who completed between 7 and 14 days of EMA prior to a treatment for binge eating.

RESULTS

Anxiety was highest on days with both binge eating and heavy drinking, while excitement and confidence were highest on days with only heavy drinking episodes for BE + HD. Global negative affect was relatively stable surrounding binge eating episodes. Guilt significantly increased prior to binge eating, and sadness significantly decreased following binge eating. Global positive affect significantly decreased prior to and stopped decreasing following heavy drinking episodes.

DISCUSSION

Results support binge eating being negatively reinforced by specific aspects of negative affect, while heavy drinking may be positively reinforced by global positive affect for individuals with BE + HD. Clinicians should incorporate interventions that focus on specific negative affect dimensions and that promote alternative rewarding activities besides heavy drinking.

Negative but Not Positive Alcohol-Related Consequences Tend to Occur Above the Heavy Episodic Drinking Threshold: A Daily Study of Young Adult Heavy Drinkers

AIMS

This study used event-level data to identify the threshold (i.e. number of standard alcoholic drinks) at which specific negative and positive alcohol-related consequences are likely to occur.

METHODS

Ninety-six college students aged 18-20 reporting weekly heavy episodic drinking (HED) or at least one negative alcohol-related consequence in the past 2 weeks completed ecological momentary assessment over 28 days. Participants reported number of standard drinks consumed and negative (e.g. nausea) and positive (e.g. new friend) alcohol-related consequences on 492 drinking nights. The area under the receiver operating characteristic (AUROC) curve measured the ability of an increasing number of drinks consumed to discriminate between nights with versus without a given consequence. The Youden Index method was used to identify the optimal threshold of drinks for each consequence. Thresholds were examined for each consequence by participants' biological sex and heavy drinking status.

RESULTS

Across subgroups, most consequences occurred on nights where participants reported higher consumption levels relative to nights where consequences did not occur. Thresholds for negative consequences ranged between four and nine drinks and thresholds for positive consequences were between three and six drinks.

CONCLUSIONS

Many negative consequences are likely to occur following the traditional HED threshold of 4+/5+ drinks (females/males), with more severe consequences occurring at slightly higher thresholds. Positive consequences are likely to occur at lower thresholds. There may be an optimal number of drinks that maximize positive while minimizing negative consequences for heavy drinking college students.

Alcohol use disorder: Neuroimaging evidence for accelerated aging of brain morphology and hypothesized contribution to age-related dementia

Excessive alcohol use curtails longevity by rendering intoxicated individuals vulnerable to heightened risk from accidents, violence, and alcohol poisoning, and makes chronically heavy drinkers vulnerable to acceleration of age-related medical and psychiatric conditions that can be life threatening (Yoon, Chen, Slater, Jung, & White, 2020). Thus, studies of factors influencing age-alcohol interactions must consider the potential that the alcohol use disorder (AUD) population may not represent the oldest ages of the unaffected population and may well have accrued comorbidities associated with both AUD and aging itself. Herein, we focus on the aging of the brains of men and women with AUD, keeping AUD contextual factors in mind. Knowledge of the potential influence of the AUD-associated co-factors on the condition of brain structure may lead to identifying modifiable risk factors to avert physical declines and may reverse or arrest further AUD-related degradation of the brain. In this narrative review, we 1) describe quantitative, controlled studies of brain macrostructure and microstructure of adults with AUD, 2) consider the possibility of recovery of brain integrity through harm reduction with sustained abstinence or reduced drinking, and 3) speculate on the ramifications of accelerated aging in AUD as contributing to age-related dementia.

Pre-drinking motives are directly associated with alcohol-related consequences even after adjusting for alcohol use on a given night: A consequence-specific analysis

INTRODUCTION

Pre-drinking motives (PDM) are linked with different characteristics of pre-drinking occasions (e.g., fast-paced drinking, socializing, moving across locations) that are potentially related to adverse night-level consequences. This study examines the direct associations of three PDM dimensions (fun/intoxication, facilitation, and conviviality) with the occurrence of five consequences (hangover, impaired driving, blackout, risky sex, fight/injury) over and above amounts of alcohol consumed that night.

METHODS

A sample of 138 young adult nightlife goers (55.1 % men, M_age = 19.0 SD = 2.4) in Switzerland reported PDM at baseline, and subsequently reported night-level alcohol use and consequences the next morning on 12.1 weekend nights on average (N = 1,663 participant-nights). Correlational analyses and multilevel logistic regression models assessed associations between PDM and night-level consequences.

RESULTS

After adjusting for amounts consumed, age, sex and monthly pre-drinking frequency, conviviality PDM were associated with higher odds of risky sex (OR = 2.68) and lower odds of blackout (OR = 0.57) while fun/intoxication PDM were associated with lower odds of risky sex (OR = 0.35). Interaction analyses per gender showed that fun/intoxication PDM were associated with lower odds of impaired driving among women (OR = 0.25). Results remained the same when adjusting for general drinking motives, which were not associated with night-level consequences.

CONCLUSION

PDM might better capture risk factors for experiencing night-level consequences than general drinking motives. Preventive intervention should make young people aware that pre-drinking is not only associated with higher amounts of alcohol consumed, but also with increased risks of specific night-level consequences, including blackouts and risky sexual behaviors, depending on the level of endorsement of each PDM.

All alcohol exposure counts - testing parental, older sibling, best friend and peer exposure on young adolescent drinking in a seven-wave longitudinal study

AIMS

Role models around the adolescent, including parents, peers, best friends and older siblings, all act in ways to socialize the adolescent into alcohol use. This study aims to examine the effect of exposure to siblings' drinking alongside the more traditionally examined role models on alcohol use among adolescents.

DESIGN

A longitudinal study followed adolescents (45.6% male) who completed a questionnaire every 6 months over 3 years (seven in total).

SETTING

Netherlands PARTICIPANTS: This resulted in 5112 observations clustered in 765 participants aged between 10 and 16 years.

MEASUREMENTS

We examined three alcohol use measures: alcohol use in the last 6 months, in the last 4 weeks and binge drinking in the last 4 weeks-both cross-sectionally at each time-point and their change from one time-point to the next in a series of multi-level logistic regression models.

FINDINGS

Results revealed a non-significant difference in any of the exposure or alcohol use variables between those with or without older siblings. Higher exposure to sibling drinking was significantly associated with all alcohol use outcomes: use in the last 6 months, odds ratio (OR) = 1.54, 95% confidence interval (CI) = 1.25-1.91; last 4 weeks, OR = 2.04, 95% CI = 1.60-2.60; and binge drinking, OR = 2.35, 95% CI = 1.82-3.05. When adding the other role models (i.e. peers, mothers, fathers and best friends), the significant association between siblings' exposure and adolescents' alcohol use remains.

CONCLUSIONS

It would appear that, after adjustment for the effect of role models, adolescents who are exposed to more sibling drinking are more likely to have drunk alcohol during the past 6 months and past 4 weeks and also to binge drink.

A mixed-methods approach to improve the measurement of alcohol-induced blackouts: ABOM-2

BACKGROUND

Alcohol-induced blackouts describe memory loss resulting from alcohol consumption. Approximately half of college students report experiencing a blackout in their lifetime. Blackouts are associated with an increased risk for negative consequences, including serious injury. Research has documented two types of blackouts, en bloc (EB) and fragmentary (FB). However, research is limited by the lack of a validated measure that differentiates between these two forms of blackout. This study used a mixed-methods approach to improve the assessment of FB and EB among young adults. Specifically, we sought to improve the existing Alcohol-Induced Blackout Measure (ABOM), which was derived from a relatively small pool of items that did not distinguish FB from EB.

METHODS

Study 1 used three rounds of cognitive interviewing with U.S. college students (N = 31) to refine existing assessment items. Nineteen refined blackout items were retained for Study 2. Study 2 used face validity, factor analysis, item response theory, and external validation analyses to test the two-factor blackout model among U.S. heavy-drinking college students (N = 474) and to develop and validate a new blackout measure (ABOM-2).

RESULTS

Iterative factor analyses demonstrated that the items were well represented by correlated EB and FB factors, consistent with our hypothesis. External validation analyses demonstrated convergent and discriminant validity. These analyses also provided preliminary evidence for the two factors having differential predictive validity (e.g., FB correlated with enhancement drinking motives, while EB correlated with coping and conformity motives).

CONCLUSIONS

The Alcohol-Induced Blackout Measure-2 (ABOM-2) improves the measurement of blackout experiences among college students. Its use could facilitate the examination of EB and FB as differential predictors of alcohol-related outcomes in future studies.

Daily-level analysis of drinking intensity and acute physical consequences

OBJECTIVE

We examined associations of drinking intensity on a given drinking day with acute physical consequences in a sample of U.S. young adult drinkers.

METHODS

Participants were past 30-day drinkers at modal age 18 in the 2018 12th-grade Monitoring the Future study who were followed up as part of a daily study in 2019 (n = 911). Of these participants, n = 489 reported at least one drinking day. At age 19, they reported their alcohol use and consequences for 14 consecutive days (n = 1051 drinking days). Daily data were used to examine within- and between-person associations of drinking intensity (moderate [1-3 drinks for women, 1-4 drinks for men], binge [4-7/5-9], or high-intensity [8+/10+]) with four acute physical consequences: hangover, nausea, blackout, and passing out.

RESULTS

At least one acute physical consequence was reported on more than half (59.3%) of high-intensity drinking days compared to 40.7% of binge and 4.9% of moderate drinking days. Blackouts and passing out were reported on 17.1% and 9.2% of high-intensity drinking days, respectively. Compared to binge drinking days, high-intensity drinking days were associated with a greater likelihood of any physical consequences (adjusted odds ratio [aOR] = 4.64; 95% confidence interval [CI] = 2.00,10.75), a greater number of consequences (adjusted incident rate ratio [aIRR = 1.99; 95% CI = 1.16,3.42), and a greater likelihood of hangover (aOR = 3.72; 95% CI = 1.58,8.74). Acute physical consequences were also more likely on high-intensity and binge drinking days versus moderate drinking days.

CONCLUSIONS

High-intensity drinking days were associated with a distinctly greater risk for acute physical consequences than binge or moderate drinking days.

Association between self-reported binge drinking and absenteeism in the Baltic countries

Objective

Substantial loss of productivity due to absenteeism is associated with alcohol use. This study examined the associations between absenteeism in the workplace and in schools and binge drinking across various beverage types in the Baltic countries.

Methods

We utilised a dataset of 3,778 individuals compiled from 2015 to 2016 and performed multiple negative binomial regression analysis with multiple imputations to deal with missing data. Self-reported measures were used for both absenteeism and binge drinking.

Results

We found evidence to support the claim that absenteeism, in terms of self-reported absence days, is positively associated with self-reported binge drinking, specifically with beer bingeing. On average, beer bingers reported 49% (p < .05) more absences than people who drink alcohol but do not binge on beer. For wine and spirits variables, the estimates indicated positive but statistically insignificant associations. No group differences were identified across gender and education.

Conclusions

A considerable proportion of days absent from work and from school can be associated with beer bingeing. Therefore, it should be acknowledged that beverage-specific alcohol policies that are more lenient toward beer than other types of alcohol can inadvertently increase absenteeism and decrease workplace productivity.

Alcohol use and binge drinking in baccalaureate nursing students: A descriptive study

BACKGROUND

Current literature validates that drinking is a problem on many college and university campuses. While educators are aware that drinking negatively impacts learning, it is imperative that nursing educators understand why this behavior exists and recognize strategies and opportunities to mitigate drinking for students in the nursing major.

PURPOSE

The purposes of this study were to understand the prevalence of and reasons for alcohol use and binge drinking in undergraduate baccalaureate nursing students in the United States and identify ways faculty may promote a healthy learning environment to decrease the incidence of alcohol use and binge drinking.

METHOD

This descriptive study used a web-based survey methodology. The survey contained a demographic questionnaire, alcohol use survey, and open-ended questions to address reasons for drinking and stressors. The survey was randomly distributed to baccalaureate nursing programs throughout the United States.

RESULTS

The final sample included 937 participants. Nursing students abuse alcohol for a variety of reasons including lack of understanding of binge drinking, peer pressure, dealing with mental health issues, and as a way to cope with multifaceted life stressors. Slightly over half (51%) of these participants reported drinking behavior that would be considered hazardous and 3% were in the alcohol dependent category on the alcohol use survey.

CONCLUSION

These findings are consistent with social concerns about alcohol use. Nursing students yearned for help and support from faculty regarding how to handle stress and desired faculty to be role models. Faculty who form collaborative partnerships with students, foster healthy coping strategies which may promote academic success and more importantly favorable outcomes as future practicing nurses.

Exposure to Parental Alcohol Use Is Associated with Adolescent Drinking Even When Accounting for Alcohol Exposure of Best Friend and Peers

AIMS

To further disentangle the role of exposure to drinking of role models (parents, peers, best friends) in the development of young adolescent alcohol use, the current study examined (a) whether parent's alcohol use exposure was associated with alcohol use outcomes among adolescents and (b) whether this association remained significant when including best friend and peer drinking exposure.

METHODS

A longitudinal study followed 765 adolescents from the Netherlands over 3 years. Adolescents (45.6% male, Mage = 11.78, standard deviation = 0.49 at baseline) completed questionnaires every 6 months, resulting in seven measurement waves. Adolescents reported their own alcohol use and exposure to parental, best friend and peers drinking.

RESULTS

Multilevel regression analyses indicated that parental alcohol use exposure was positively associated with a higher likelihood of adolescent alcohol use in the past 6 months, drinking in the last month and binge drinking in the last month. These associations remained significant when including exposure to peer and best friend's alcohol use, also when controlling for alcohol use at the previous timepoint (i.e. change in drinking). These associations were also consistent for boys and girls.

CONCLUSIONS

Throughout early adolescence, parental alcohol exposure matters for their offspring's alcohol use, independently of whether peers or their best friend expose them to alcohol or not. Parental alcohol exposure should be considered in prevention efforts to further decrease the number of adolescents that engage in early alcohol use and binge drinking.

Students in Danger: Binge Drinking Behaviour and Associated Factors in Hungary

Introduction

Among young adults, high rates of binge drinking were observed in certain European countries. Binge drinking is associated with several health problems (unplanned pregnancy, HIV infections, problems with memory, and injuries). The aim of this questionnaire-based study was to measure the frequency of binge drinking and its association with sociodemographic, familial, lifestyle factors and school performance among secondary and university students (n=2449) in Csongrád County, Hungary.

Methods

In this cross-sectional study the students’ sociodemographic data, parents’ educational and economic level, and students’ academic performance and self-reported use of tobacco, drugs, and alcohol were collected by a questionnaire. Descriptive statistics and multivariable binary logistic regression analyses were applied using SPSS 24.0 software.

Results

Altogether 2449 Hungarian secondary school students and university students participated in the study. Nearly one-third of the students were classified as binge drinkers, significantly more male university students. Tobacco or illicit drug use resulted in higher odds of being a binge drinker in both subgroups. Poor school performance and binge drinking were significantly correlated especially among secondary school students.

Conclusions

Targeting alcohol, tobacco, and illicit drug use together, including education, parent interventions, and public health policies, are crucial in the prevention of possible serious consequences.

Characterising patterns of alcohol use among heavy drinkers: A cluster analysis utilising alcohol biosensor data

INTRODUCTION

Previous research has predominately relied on person-level or single characteristics of drinking episodes to characterise patterns of drinking that may confer risk. This research often relies on self-report measures. Advancements in wearable alcohol biosensors provide a multi-faceted objective measure of drinking. The current study aimed to characterise drinking episodes using data derived from a wearable alcohol biosensor.

METHODS

Participants (n = 45) were adult heavy drinkers who wore the Secure Continuous Remote Alcohol Monitoring (SCRAM) bracelet and reported on their drinking behaviours. Cluster analysis was used to evaluate unique combinations of alcohol episode characteristics. Associations between clusters and self-reported person and event-level factors were also examined in univariable and multivariable models.

RESULTS

Results suggested three unique clusters: Cluster 1 (most common, slowest rate of rise to and decline from peak), Cluster 2 (highest peak transdermal alcohol concentration and area under the curve) and Cluster 3 (fastest rate of decline from peak). Univariable analyses distinguished Cluster 1 as having fewer self-reported drinks and fewer episodes that occurred on weekends relative to Cluster 2. The effect for number of drinks remained in multivariable analyses.

DISCUSSION AND CONCLUSIONS

This is the first study to characterise drinking patterns at the event-level using objective data. Results suggest that it is possible to distinguish drinking episodes based on several characteristics derived from wearable alcohol biosensors. This examination lays the groundwork for future studies to characterise patterns of drinking and their association with consequences of drinking behaviour.

What We Talk About When We Talk About Binge Drinking: Towards an Integrated Conceptualization and Evaluation

RATIONALE

Binge drinking (BD), characterized by recurring alternations between intense intoxication episodes and abstinence periods, is the most frequent alcohol consumption pattern in youth and is growing in prevalence among older adults. Many studies have underlined the specific harmful impact of this habit by showing impaired abilities in a wide range of cognitive functions among binge drinkers, as well as modifications of brain structure and function.

AIMS

Several controversies and inconsistencies currently hamper the harmonious development of the field and the recognition of BD as a specific alcohol consumption pattern. The main concern is the absence of consensual BD conceptualization, leading to variability in experimental group selection and alcohol consumption evaluation. The present paper aims at overcoming this key issue through a two-step approach.

METHODS AND CONCLUSIONS

First, a literature review allows proposing an integrated BD conceptualization, distinguishing it from other subclinical alcohol consumption patterns. Six specific characteristics of BD are identified, namely, (1) the presence of physiological symptoms related to BD episodes, (2) the presence of psychological symptoms related to BD episodes, (3) the ratio of BD episodes compared to all alcohol drinking occasions, (4) the frequency of BD episodes, (5) the consumption speed and (6) the alternation between BD episodes and soberness periods. Second, capitalizing on this conceptual clarification, we propose an evaluation protocol jointly measuring these six BD characteristics. Finally, several research perspectives are presented to refine the proposed conceptualization.

What is binge drinking? Insights from a network perspective

This study aimed to delineate the specific characteristics of binge drinking habits by capitalizing on data-driven network analysis. Such an approach allowed us to consider binge drinking as a network system of interacting elements, thus identifying the key variables involved in this phenomenon. A total of 1,455 university students with excessive drinking habits were included in this study. We assessed the most critical features of binge drinking (i.e., the consumption of more than six alcohol units per occasion, drunkenness frequency, consumption speed), together with alcohol use and more general alcohol-related components of dysfunction and harm. All variables were considered in the network analysis. Centrality analysis identified drunkenness frequency as the most influential variable in the entire network. Community detection analysis showed three distinct subnetworks related to alcohol use, drunkenness, and dysfunction/harm components. Drunkenness frequency and blackout occurrence emerged as core bridge items in the binge drinking network. Drunkenness is recognized as the hallmark feature of binge drinking.

Fun/intoxication pre-drinking motives lead indirectly to more alcohol-related consequences via increased alcohol consumption on a given night

INTRODUCTION

Pre-drinking increases alcohol use on drinking nights, which is associated with various adverse alcohol-related consequences but what motivates people to do so, i.e. the role of pre-drinking motives (PDM) in this link, is unclear. The current study examined a) the association of three PDM factors (fun/intoxication, facilitation, and conviviality) with average night-level alcohol use, b) whether PDM are associated with adverse alcohol-related consequences (hangover, drunk driving, blackout, risky sex, injury, and fights) and c) whether PDM mediates the link between night-level alcohol use and negative consequences.

METHODS

A sample of 204 young adult nightlife goers (48.8% males, M_age = 19 SD = 2.4) from Switzerland reported PDM at baseline, and subsequently participated in a 2-month event-level study. Regressions models assessed direct and mediated associations.

RESULTS

Fun/intoxication PDM predicted alcohol use in subsequent drinking nights (11.3 nights per participant on average), but not the two other PDM. No direct link between PDM and consequences was found. However, fun/intoxication PDM lead indirectly to more adverse consequences through higher alcohol use.

CONCLUSION

This study shows that predominantly 'fun/intoxication' predrinkers are at increased risk for alcohol consumption and consequences, but not those who predrink for conviviality or facilitation motives. The outcomes thus suggest the importance of specific PDM in preventing alcohol use for instance by tailoring interventions based on individuals' PDM in order to curb drinking and its associated consequences among young adults on weekend nights out.

How much and how fast: Alcohol consumption patterns, drinking-episode affect, and next-day consequences in the daily life of underage heavy drinkers

BACKGROUND

Understanding how alcohol consumption patterns are associated with negative and positive outcomes can inform efforts to reduce negative consequences through modification of those patterns. This is important in underage drinkers, many of whom drink heavily despite negative consequences. Most work has focused on the amount of alcohol consumed, but amount provides limited information about consumption patterns compared to rate of consumption, or how fast individuals drink. We therefore examined associations of both amount and rate of consumption with negative and positive outcomes (immediate affective states and next-morning consequences) in daily life.

METHOD

Ninety-five college students aged 18-20 years completed ecological momentary assessment over 28 days. Participants reported number of standard drinks consumed and positive and negative affect hourly within drinking episodes. Estimated blood alcohol concentration (eBAC) values were used to create amount and rate of consumption indicators. Each morning after drinking, participants reported negative (e.g., blackout, hangover) and positive (e.g., new friend, making others laugh) consequences.

RESULTS

Within drinking episodes, multilevel models showed faster consumption was associated with reduced negative affect and both larger amount and faster consumption were associated with greater positive affect. Further, amount and rate were both associated with greater likelihood of a negative consequence the next morning. Rate, but not amount, was associated with more positive consequences.

CONCLUSIONS

Not only how much but also how fast individuals drink may be important for the positive and negative outcomes they experience. Interventions to reduce negative alcohol-related outcomes should consider not only amount, but also rate of consumption.

Are changes in binge drinking among European adolescents driven by changes in computer gaming?

INTRODUCTION

There is currently no good explanation for the decline in adolescent drinking reported for many Western countries in recent years. As modern computer gaming is highly exciting and socially rewarding, it may function as a substitute for adolescent binge drinking. We hypothesized a negative correlation between country-level changes in computer gaming and binge drinking.

METHODS

We analysed within-country changes based on data from 15-16 year-old pupils (n = 517 794) participating in the European School Survey Project on Alcohol and Drugs from 1995 to 2015. Binge drinking in the last 30 days (5+ units on one occasion) was regressed on frequency of computer gaming and three control variables measuring the frequency of engagement in other hobbies, reading books and going out (to a disco, cafe, etc.).

RESULTS

Descriptive data showed no general decline in binge drinking across European countries. In contrast to our prediction, the association between binge drinking and computer gaming was not negative [b = 0.26, one-sided 95% confidence interval (-∞, 0.47), P = 0.98, Bayes Factor = 0.21]. We found the same pattern of result in a secondary analysis on six Nordic countries that have experienced declines in adolescent drinking recent years. In analyses with covariates reflecting engagement in other activities, we only observed statistical evidence for an effect of going out.

DISCUSSION AND CONCLUSIONS

A substantial decline in adolescent binge drinking during the years 1995-2015 is only evident in some European countries, and it is likely not caused by increased computer gaming.

Discrete time measures versus trajectories of drinking frequency across adolescence as predictors of binge drinking in young adulthood: a longitudinal investigation

OBJECTIVES

We compared discrete time measures with trajectories of adolescent drinking frequency as predictors of sustained binge drinking in young adulthood.

DESIGN

Prospective longitudinal study.

SETTING

10 high schools in Montréal, Canada.

PARTICIPANTS

1293 high-school students followed from mean (SD) age 12 (0.6) to 24 (0.7) years.

PRIMARY OUTCOME MEASURES

Patterns of drinking frequency (self-reports every 3 months from ages 12 to 17) identified using group-based trajectory modelling. Sustained binge drinking was defined as binging monthly or more often at both ages 20 and 24.

ANALYSES

Using logistic regression, sustained binge drinking was regressed on trajectory group membership and on four discrete time measures (frequency of drinking at age 12; frequency of drinking at age 17; age at drinking onset; age at onset of drinking monthly or more often).

RESULTS

We identified seven drinking trajectories: late triers (15.2%), decreasers (9.5%), late escalators (10.4%), early slow escalators (16.5%), steady drinkers (14.4%), early rapid escalators (15.8%) and early frequent drinkers (18.2%). Sustained binge drinking was reported by 260 of 787 participants (33.0%) with complete data at both ages 20 and 24. Decreasers did not differ from late triers; all other patterns were associated with higher odds of sustained binge drinking (adjusted ORs: AORs=1.4-17.0). All discrete time measures were associated with sustained binge drinking, notably frequency at age 12 (a bit to try and drinking monthly: (AORs=2.6 (1.7; 3.9) and 2.8 (1.3; 6.1), respectively), age of drinking onset <13 years (AOR=7.6 (3.0; 24.1)), and any age of onset of drinking monthly or more often (AORs=5.1-8.2).

CONCLUSION

Youth at risk of sustained binge drinking as young adults can be identified with indicators of early drinking as early as 7th grade (aged 12-13 years). Identification of easy-to-obtain indicators can facilitate screening and intervention efforts.

Alcohol-related risk from pre-loading and heavy episodic drinking (HED) among a cohort of young Australian women: a cross-sectional analysis

OBJECTIVE

To cross-sectionally examine heavy episodic drinking (HED) and pre-loading with alcohol among young Australian women in relation to the alcohol-induced adverse outcomes of memory loss, vomiting and injury.

METHODS

A total of 7,800 participants, aged 20-25 years, from the 1989-95 cohort of the Australian Longitudinal Study on Women's Health answered all questions on alcohol use, reported drinking alcohol in the previous year and were not pregnant at the third survey in 2015. Log-binomial models were used to estimate prevalence ratios for adverse outcomes associated with increased frequency of HED and pre-loading.

RESULTS

The majority of participants reported HED (83.4%) and/or pre-loading (65.6%), which had a moderate correlation (r=0.646). Just over half (55.2%) of participants experienced at least one adverse event, with vomiting being most common. As the frequency of HED or pre-loading increased, so did the risk of an adverse outcome.

CONCLUSIONS

Both HED and pre-loading pose a risk to young Australian women, and that risk rises with increased frequency. Implications for public health: Although HED has been a target of public health policy and interventions, pre-loading has received limited attention. In addition to addressing HED, there is a need to consider the risk posed by pre-loading, a related, yet unique risky drinking behaviour.

Behavioral inhibition and reward processing in college binge drinkers with and without marijuana use

AIM

Binge drinking is common during college, and studies have shown that many college students drink in quantities that far exceed the standard binge drinking threshold. Previous research has noted personality differences in individuals who engage in binge drinking, but few studies have examined neurobiological differences in both standard bingers (4/5 drinks in two hours for females/males; sBinge) and extreme binge drinkers (8+/10+ drinks in two hours for females/males; eBinge).

METHOD

The current study of 221 college students used functional magnetic resonance imaging (fMRI) to study neural activation on a stop signal task (SST) to assess behavioral inhibition and a monetary incentive delay (MID) task to assess activation to rewards and losses. Non-bingeing controls, sBinge, and eBinge freshmen and sophomores were recruited. In addition, because binge/extreme binge drinking is often associated with marijuana (MJ) use, MJ + sBinge and MJ + eBinge groups were also included.

RESULTS

All five groups showed strong activation in expected key cortical and striatal regions on both the SST and the MID. However, there were no significant differences between groups either at the whole-brain level or in specific regions of interest. Behavioral performance on the fMRI tasks also did not differ between groups.

CONCLUSIONS

These results suggest that our sample of individuals who engage in binge or extreme binge drinking with or without MJ co-use do not differ in brain activity on reward and inhibitory tasks. Neural differences may be present on other cognitive tasks or may emerge later after more sustained use of alcohol, MJ, and other drugs.

A systematic review of event-level measures of risk-taking behaviors and harms during alcohol intoxication

Alcohol intoxication is associated with transient increases in risk-taking behaviors which can lead to harm. Certain assessment and intervention evaluation approaches require measurement of risk behaviors and associated harms at the event-level (i.e., within a single drinking session). This systematic review aimed to identify measures solely assessing risk-taking behaviors and harms while intoxicated and identify evidence of their reliability and validity. EMBASE, Medline, PsycINFO, and PsycTESTs were searched for articles published between 1997 and 2019. Articles were selected based on use of a scale with one or more items measuring risk-taking behaviors and harms (to the individual or others around them) occurring while intoxicated. Additional searches were run to identify studies reporting estimates of reliability and validity for identified measures. Nineteen measures were identified containing at least one relevant item. Most measures indexed both acute and chronic risk behaviors and consequences, mainly with the intent of screening for established patterns of problematic use. No individual measure was identified exclusively quantifying risk-taking behavior and harms which had occurred within a drinking session (with the exception of one scale measuring tendency to engage in risk behaviors), yet three measures had a subscale meeting this criterion. These measures demonstrated good validity and reliability. This gap represents an opportunity for scale development, designed for use in ecological momentary assessment and evaluation of structural interventions targeting risk behaviors and harms whilst intoxicated.

Event-Level Correlates of Drinking Events Characterized by Alcohol-Induced Blackouts

BACKGROUND

Prior research identifies a range of potential predictors of blackouts and suggests that blackouts increase risk for additional negative consequences. However, these studies are based on epidemiological work that allows us to draw conclusions about groups of people but not within-person processes. The present study examined within-person, event-level correlates of blackouts.

METHODS

Ninety-six heavy drinking college students (52% female) completed 28 days of daily reports of alcohol use and consequences, including blackouts. Thirty-three participants reported 56 blackouts. Hierarchical linear modeling compared morning reports of drinking events on which participants did versus did not report a blackout, controlling for total drinks at the event.

RESULTS

Blackout likelihood increased as a function of total drinks consumed and of crossing thresholds for heavy episodic drinking (4+/5+ drinks for women/men) and high-intensity drinking (8+/10+). Participants reported a higher total number of additional negative consequences on blackout events. Specific consequences that were more likely included embarrassing oneself and hangover. Blackouts were associated with morning ratings of less positive mood and a less favorable drinking event. Motives for drinking and simultaneous use of marijuana were not associated with blackouts.

CONCLUSIONS

Event-level findings of this study document that events leading to alcohol-induced memory loss are associated with other adverse experiences relative to drinking events that do not result in blackout, and offer potentially motivational levers for preventive interventions.

Neurobiological and Cognitive Profile of Young Binge Drinkers: a Systematic Review and Meta-Analysis

This review provides the first systematic and quantitative synthesis of the literature examining the relationship between binge drinking, cognition, brain structure and function in youth aged 10 to 24 years. PubMed, EMBASE, Medline, PsychINFO and ProQuest were searched for neuroimaging, neurophysiological, and neuropsychological studies. A total of 58 studies (21 neuroimaging, 16 neurophysiological, 21 neuropsychological) met the eligibility criteria and were included in the review. Overall, abnormal or delayed development of key frontal executive-control regions may predispose youth to binge drink. These abnormalities appear to be further exacerbated by the uptake of binge drinking, in addition to alcohol-related neural aberrations in reward-seeking and incentive salience regions, indexed by cognitive deficits and maladaptive alcohol associations. A meta-analysis of neuropsychological correlates identified that binge drinking in youth was associated with a small overall neurocognitive deficit (g = -0.26) and specific deficits in decision-making (g = -1.70), and inhibition (g = -0.39). Using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) Evidence Profile, the certainty in outcomes ranged from very low to low. Future prospective longitudinal studies should address concomitant factors, exposure thresholds, and age-related vulnerabilities of binge drinking, as well as the degree of recovery following discontinuation of use.

Brain-behavior relations and effects of aging and common comorbidities in alcohol use disorder: A review

OBJECTIVE

Alcohol use disorder (AUD) is a complex, dynamic condition that waxes and wanes with unhealthy drinking episodes and varies in drinking patterns and effects on brain structure and function with age. Its excessive use renders chronically heavy drinkers vulnerable to direct alcohol toxicity and a variety of comorbidities attributable to nonalcohol drug misuse, viral infections, and accelerated or premature aging. AUD affects widespread brain systems, commonly, frontolimbic, frontostriatal, and frontocerebellar networks.

METHOD AND RESULTS

Multimodal assessment using selective neuropsychological testing and whole-brain neuroimaging provides evidence for AUD-related specific brain structure-function relations established with double dissociations. Longitudinal study using noninvasive imaging provides evidence for brain structural and functional improvement with sustained sobriety and further decline with relapse. Functional imaging suggests the possibility that some alcoholics in recovery can compensate for impairment by invoking brain systems typically not used for a target task but that can enable normal-level performance.

CONCLUSIONS

Evidence for AUD-aging interactions, indicative of accelerated aging, together with increasing alcohol consumption in middle-age and older adults, put aging drinkers at special risk for developing cognitive decline and possibly dementia. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Social and Situational Party Characteristics Associated With High-Intensity Alcohol Use Among Youth and Young Adults

BACKGROUND

Rates of high-intensity drinking, which is alcohol consumption that exceeds standard heavy drinking levels, have increased in recent years and peak in young adulthood. To identify modifiable environmental targets for prevention of high-intensity drinking, we identified characteristics of parties attended by youth and young adults that were associated with high-intensity drinking and the consequences of this excessive form of drinking.

METHODS

Data are from 15- to 20-year-old participants in an online survey (n = 2,442; 55.4% female, 74.8% White) who resided in 24 communities across 7 states that were a part of a community randomized intervention trial to reduce the incidence and consequences of underage drinking parties. We used multinomial logistic regression to predict level of drinking by 6 party characteristics (size, location, age and gender composition, supervision, others' drinking behavior), and to predict 6 consequences (hangover, not remember event, passed out, punished by parents, broke something/got in fight, and sex against will) from level of drinking. We tested study hypotheses in 2 models, one that used a single binge drinking threshold (below binge vs. at or above binge level) and one that additionally used a high-intensity drinking level (below binge, 1 to 2 times binge, 2+ times binge level).

RESULTS

We found that larger party size and a mostly male composition were unique predictors of high-intensity drinking when compared to those who consumed 1 to 2 times the binge drinking level. Odds of passing out, not remembering the drinking event, breaking/damaging property, or getting in a fight were more than double for high-intensity drinkers compared to standard binge level drinkers.

CONCLUSIONS

Results from this study indicate there are unique precursors and consequences of high-intensity alcohol consumption among youth and young adults. These environmental factors associated with high-risk drinking contexts can be used to develop prevention strategies to mitigate the harms associated with excessive alcohol consumption.

Patterns of alcohol consumption and nutrition intake in patients with alcoholic liver disease and alcoholic pancreatitis in North Indian men

Background and Aim

Chronic alcoholism and nutrition play an important role in liver and pancreatic diseases. To compare drinking habits and nutritional data in patients with alcoholic liver disease (ALD) and alcoholic pancreatitis (ALP).

Methods

Clinical, anthropometric, dietary intake, laboratory, and imaging data were recorded in consecutive patients of ALD and ALP.

Results

In 150 patients of ALP (n = 76) and ALD (n = 74), the age of starting alcohol consumption (19.03 ± 3.78 vs 18.0 ± 2.59 years) and the mean amount of alcohol consumed per day (165.63 ± 87.99 vs 185.50 ± 113.54 g; P = 0.230) were similar. Patients with ALD consumed alcohol on a daily basis more frequently (90.5 vs 72.3%; P = 0.003) and had a longer duration of alcohol intake (21.6 + 0.2 vs 14.5 + 6.9 years; P < 0.0001) than patients in the ALP group. Binge drinking was more common in patients with ALP compared to patients with ALD (60.5 vs 20.3%); P < 0.0001). Patients with ALP had a lower body mass index (19.9 ± 3.49 vs 22.64 ± 4.88 kg/m²; P = 0.001) and more frequent decrease in mid arm circumference (57.9 vs 44.6%; P = 0.042) and triceps skin fold thickness (67.1 vs 52.7%; P = 0.072) compared to patients with ALD.

Conclusion

There was no difference in the age of starting alcohol consumption and mean amount of alcohol consumption per day between the groups. Patients with ALD were more likely to be daily drinkers with a longer duration of alcohol intake. However, binge drinking and malnourishment was more common in the ALP group.

Behavioral and Cerebral Impairments Associated with Binge Drinking in Youth: A Critical Review

Binge drinking is a widespread alcohol consumption pattern in youth that is linked to important behavioral and cerebral impairments, in both the short and the long term. From a critical review of the current literature on this topic, we conclude that binge drinkers display executive impairments, cerebral modifications, and problems with emotion-related processes. Five key empirical and theoretical topics are discussed to pave the way for future research in the field: (1) the specificity of the brain modifications observed in binge drinkers that may index a compensatory mechanism or result from multiple withdrawals; (2) the nature of the relationship between binge drinking and impairments, suggesting reciprocal influences between excessive alcohol consumption and executive deficits; (3) the possible recovery of brain and cognitive functioning after the cessation of binge drinking; (4) the validity of the continuum hypothesis, suggesting links between binge drinking and severe alcohol use disorders; and (5) the existing strategies to reduce binge drinking habits or rehabilitate the associated cognitive deficits. Future perspectives are described in relation to the questions raised to identify the crucial variables to be addressed in research and clinical practice.