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

Profiles of transdermal alcohol concentration and their prediction of negative and positive alcohol-related consequences in young adults' natural settings

OBJECTIVE

Transdermal alcohol concentration (TAC) sensors provide a multidimensional characterization of drinking events that self-reports cannot. These profiles may differ in their associated day-level alcohol-related consequences, but no research has tested this. We address this using multilevel latent profile analysis.

METHOD

Two hundred twenty-two young adults who regularly engage in heavy drinking (Mage = 22.3, 64% female, 79% non-Hispanic White) responded to surveys and wore TAC sensors for 6 consecutive days. We tested whether four previously identified TAC profiles: (1) high-fast (8.5% of days), (2) moderate-fast (12.8%), (3) low-slow (20.4%), and (4) little-to-no-drinking days (58.2%) differed in numbers of negative and positive consequences and in the odds that both consequence types occurred on the same day.

RESULTS

High-fast (incident rate ratio [IRRlow-slow] = 6.18; IRRlittle-to-no-drinking = 9.47) and moderate-fast (IRRlow-slow = 3.71; IRRlittle-to-no-drinking = 5.68) days contained more negative consequences compared to low-slow and little-to-no-drinking days. High-fast (IRR = 2.05), moderate-fast (IRR = 1.88), and low-slow (IRR = 1.43) days contained more positive consequences than little-to-no-drinking days. The odds of having only positive consequences were highest on low-slow, χ²(3) = 9.10, p < .05, days but the odds of experiencing both consequence types increased on moderate-fast and high-fast days, χ²(3) = 39.63, p < .001.

CONCLUSIONS

Compared to little-to-no-drinking days, TAC profiles indicative of drinking (high-fast, moderate-fast, and low-slow) contained more negative and positive consequences. However, the odds of experiencing only positive consequences were highest among low-slow days and decreased on moderate-fast and high-fast days as the odds of negative consequences rose. These findings provide novel evidence reinforcing harm reduction approaches that seek to maximize positives and minimize negatives of alcohol consumption through emphasis on slow-paced, low-volume drinking. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Profiles of alcohol intoxication and their associated risks in young adults' natural settings: A multilevel latent profile analysis applied to daily transdermal alcohol concentration data

OBJECTIVE

Transdermal alcohol concentration (TAC) sensors capture aspects of drinking events that self-reports cannot. The multidimensional nature of TAC data allows novel classification of drinking days and identification of associated behavioral and contextual risks. We used multilevel latent profile analysis (MLPA) to create day-level profiles of TAC features and test their associations with (a) daily behaviors and contexts and (b) risk for alcohol use disorders at baseline.

METHOD

Two hundred twenty-two regularly heavy-drinking young adults (Mage = 22.3) completed the Alcohol Use Disorders Identification Test (AUDIT) at baseline and then responded to mobile phone surveys and wore TAC sensors for six consecutive days. MLPA identified day-level profiles using four TAC features (peak, rise rate, fall rate, and duration). TAC profiles were tested as correlates of daily drinking behaviors, contexts, and baseline AUDIT.

RESULTS

Four profiles emerged: (a) high-fast (8.5% of days), (b) moderate-fast (12.8%), (c) low-slow (20.4%), and (d) little-to-no drinking days (58.2%). Profiles differed in the odds of risky drinking behaviors and contexts. The highest risk occurred on high-fast days, followed by moderate-fast, low-slow, and little-to-no drinking days. Higher baseline AUDIT predicted higher odds of high-fast and moderate-fast days.

CONCLUSIONS

Days with high and fast intoxication are reflective of high-risk drinking behaviors and were most frequent among those at risk for alcohol use disorders. TAC research using MLPA may offer novel and important insights to intervention efforts. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Psychometric evaluation of a Swedish version of the Impaired Control Scale for individuals with alcohol use disorder

Aim: The aim of this study was to evaluate the psychometric properties of a Swedish version of the Impaired Control Scale. Impaired control (IC) over alcohol consumption is a core symptom of alcohol use disorder and a predictor of treatment outcome, but measures of IC are not well utilised in clinical practice. Methods: The study comprised 250 individuals from a randomised controlled trial conducted at an adult outpatient addiction clinic in Sweden. The statistical analyses concern dimensionality, convergent and divergent validity, reliability, measurement invariance and sensitivity to change. Results: Regarding dimensionality, a principal component analysis of the standardised residuals from a Rasch model indicated some evidence of further dimensions underlying the responses in the Failed Control (FC) and Perceived Control (PC) parts. Two parallel items (12 and 22 respectively) seemed to drive potential multidimensionality. When these items were excluded, goodness of fit to one-dimensional models was improved. Tests of convergent and divergent validity showed that failed control had the strongest associations to impaired control and alcohol use disorder while the attempted control part was not associated with the construct of impaired control or alcohol use disorder. Conclusion: The present results show that the FC part is the most valid measure of the underlying construct of IC. In addition, FC had close to a large effect in regard to sensitivity to change. This suggests that the FC part has potential utility for use as an assessment and evaluation tool of treatment effect on impaired control of drinking.