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Valyear MD, LeCocq MR, Brown A, Villaruel FR, Segal D, Chaudhri N. Learning processes in relapse to alcohol use: lessons from animal models. Psychopharmacology (Berl) 2023; 240:393-416. [PMID: 36264342 DOI: 10.1007/s00213-022-06254-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/02/2022] [Indexed: 11/29/2022]
Abstract
RATIONALE Alcohol use is reliably preceded by discrete and contextual stimuli which, through diverse learning processes, acquire the capacity to promote alcohol use and relapse to alcohol use. OBJECTIVE We review contemporary extinction, renewal, reinstatement, occasion setting, and sex differences research within a conditioning framework of relapse to alcohol use to inform the development of behavioural and pharmacological therapies. KEY FINDINGS Diverse learning processes and corresponding neurobiological substrates contribute to relapse to alcohol use. Results from animal models indicate that cortical, thalamic, accumbal, hypothalamic, mesolimbic, glutamatergic, opioidergic, and dopaminergic circuitries contribute to alcohol relapse through separable learning processes. Behavioural therapies could be improved by increasing the endurance and generalizability of extinction learning and should incorporate whether discrete cues and contexts influence behaviour through direct excitatory conditioning or occasion setting mechanisms. The types of learning processes that most effectively influence responding for alcohol differ in female and male rats. CONCLUSION Sophisticated conditioning experiments suggest that diverse learning processes are mediated by distinct neural circuits and contribute to relapse to alcohol use. These experiments also suggest that gender-specific behavioural and pharmacological interventions are a way towards efficacious therapies to prevent relapse to alcohol use.
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Affiliation(s)
- Milan D Valyear
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada. .,Department of Psychology, McGill University, 1205 Ave. Dr. Penfield, Room N8/5, Montréal, QC, H3A 1B1, Canada.
| | - Mandy R LeCocq
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Alexa Brown
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Franz R Villaruel
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Diana Segal
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Nadia Chaudhri
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
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Gender Differences among Sardinians with Alcohol Use Disorder. J Clin Med 2021; 10:jcm10204688. [PMID: 34682808 PMCID: PMC8537954 DOI: 10.3390/jcm10204688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/27/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
Sardinia is an Italian island in the Mediterranean characterized by secular isolation and the singular genetic characteristics of its inhabitants. Findings obtained in populations with diverse genetic make-up and cultural background indicate gender differences and/or similarities in drinking characteristics of patients with alcohol use disorder (AUD). Knowledge of these characteristics in AUD patients is useful to improve access to treatments. This paper investigated the drinking characteristics of 66 female and 282 male outpatients with AUD, born from 1937 to 1991, living in Sardinia, and compared their characteristics with those of AUD patients living in other countries. Most Sardinian patients were men, approximately 3 years younger than women; women consumed lower amounts of alcohol than men but did not differ from men in the severity of AUD. Men were more often single than women, while a higher proportion of women reported that their mother or spouse was affected by AUD. Anxiety and depression were more prevalent among women while a higher proportion of men were affected by substance use disorders. Women were older than men at the age of first drink, regular drinking, and onset of AUD, and progressed faster than men from regular use to AUD onset. Women did not differ from men in age at first request for care, and in the lapse from AUD onset to first request for care. Women and men waited for more than 8 and 9 years, respectively, before receiving medical treatment. Gender differences progressively decreased among younger patients. Although the scarce number of women in some cohorts limits the strength of these findings, drinking characteristics of Sardinian patients did not vary significantly from those of AUD patients living in other countries. These results suggest that the number of Sardinian women with AUD is increasing and services for treatment of AUD should (a) consider women’s specific needs, and (b) realize effective policies to reduce latency prior to accessing medical treatment for both men and women with AUD.
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Chatterjee K, Dwivedi A, Singh R. Age at first drink and severity of alcohol dependence. Med J Armed Forces India 2021; 77:70-74. [PMID: 33487869 PMCID: PMC7809520 DOI: 10.1016/j.mjafi.2019.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 05/20/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Early age at first drink (AFD) has been linked to early onset and increased severity of alcohol dependence in various studies. Few Indian studies on AFD have shown a negative correlation between AFD and severity of alcohol dependence. Our study aimed to explore this relationship in patients with alcohol dependence syndrome (ADS) diagnosed using ICD-10 criteria. METHODS One hundred fifty-one consecutive patients freshly diagnosed with ADS were included in the study, which was conducted at the psychiatry unit of a tertiary care, multispecialty hospital. The Addiction Severity Index (ASI) was used to assess severity of alcohol dependence. RESULTS Mean AFD was 24.85 years (range = 13-40 years). Median ASI score was 36 (range = 21 to 57). The study yielded a weak negative correlation (ρ = -.105) between AFD and ASI, which was statistically not significant. CONCLUSIONS We found no correlation between AFD and severity of alcohol dependence at detection in Indian Armed Forces personnel, which is contrary to what has been reported worldwide and in previous Indian studies. Delayed initiation of alcohol use among those enrolling in the Indian Armed Forces and early detection of alcohol dependence within the military environment are possible explanations.
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Affiliation(s)
- K. Chatterjee
- Consultant & Professor and Head (Psychiatry), INHS Asvini, Colaba, Mumbai, India
| | - A.K. Dwivedi
- Graded Specialist (Psychiatry), Base Hospital, Delhi Cantt, India
| | - R. Singh
- Classified Specialist (Psychiatry), Command Hospital (Southern Command), Pune 411040, India
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Further Utilization of Emergency Department and Inpatient Psychiatric Services Among Young Adults Admitted at the Emergency Department With Clinical Alcohol Intoxication. J Addict Med 2020; 14:32-38. [PMID: 32012139 DOI: 10.1097/adm.0000000000000529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess in a cohort of young adults admitted with alcohol intoxication (AI) to the Emergency Department (ED): how many patients are readmitted to the ED or to a Psychiatric Department (PD) inpatient unit; and which characteristics are associated with further ED and PD inpatient admissions. METHODS In 630 patients aged 18 to 30 years admitted for AI in 2006 to 2007 to the ED of a Swiss tertiary hospital, further ED and PD inpatient admissions through 2013 were assessed. Patient characteristics at the index (initial) ED visit were assessed using administrative and medical records. MEASUREMENTS Proportion of subjects with at least 1 further ED admission, 1 further ED admission with AI, and any PD admission over the study period.Associations between patients' characteristics at index visit and readmissions were assessed using backward selection multivariate regression analyses. RESULTS Mean age was 24, 66% were male, 60% had any ED/PD admissions during the study period, 17.9% a PD admission, and 13.8% were re-admitted to ED with AI. Disruptive behavior at the index visit was associated with further ED (odds ratio [OR] 1.69 [1.13; 2.54]) and PD admissions (OR 2.41 [1.44; 4.05]). Psychiatric diagnosis was associated with any further ED admission (OR 2.07 [1.41; 3.05]), with further ED admission with AI (OR 4.56 [2.36; 8.81]) and with PD admission (OR 3.92 [2.40; 6.41]). Female sex predicted any further ED admission (OR 1.65 [1.14; 2.39]). CONCLUSIONS Young adults presenting with alcohol intoxication have high rates of subsequent inpatient emergency and psychiatric admissions. Being female, presenting with disruptive behavior, and having a psychiatric diagnosis at the ED visit were predictors of further admissions.
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Sern KR, Fultz EK, Coelho MA, Bryant CD, Szumlinski KK. A prior history of binge-drinking increases sensitivity to the motivational valence of methamphetamine in female C57BL/6J mice. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2020; 14:1178221819897073. [PMID: 32009790 PMCID: PMC6971957 DOI: 10.1177/1178221819897073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 12/02/2019] [Indexed: 12/11/2022]
Abstract
Methamphetamine (MA) and alcohol use disorders exhibit a high degree of co-morbidity and sequential alcohol-MA mixing increases risk for co-abuse. Recently, we reported greater MA-conditioned reward in male C57BL/6J mice with a prior history of binge alcohol-drinking (14 days of 2-hour access to 5, 10, 20 and 40% alcohol). As female mice tend to binge-drink more alcohol than males and females tend to be more sensitive than males to the psychomotor-activating properties of MA, we first characterized the effects of binge-drinking upon MA-induced place-conditioning (four pairings of 0.25, 0.5, 1, 2, or 4 mg/kg IP) in females and then incorporated our prior data to analyze for sex differences in MA-conditioned reward. Prior binge-drinking history did not significantly affect locomotor hyperactivity or its sensitization in female mice. However, the dose-response function for place-conditioning was shifted to the left of water-drinking controls, indicating an increase in sensitivity to MA-conditioned reward. The examination of sex differences revealed no sex differences in alcohol intake, although females exhibited greater MA-induced locomotor stimulation than males, irrespective of their prior drinking history. No statistically significant sex difference was apparent for the potentiation of MA-conditioned reward produced by prior binge-drinking history. If relevant to humans, these data argue that both males and females with a prior binge-drinking history are similarly vulnerable to MA abuse and it remains to be determined whether or not the neural substrates underpinning this increased vulnerability reflect common or sex-specific adaptations in reward-related brain regions.
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Affiliation(s)
- Kimberly R Sern
- Department of Psychological and Brain Sciences, Developmental and Cell Biology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Elissa K Fultz
- Department of Psychological and Brain Sciences, Developmental and Cell Biology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Michal A Coelho
- Department of Psychological and Brain Sciences, Developmental and Cell Biology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Camron D Bryant
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Karen K Szumlinski
- Department of Psychological and Brain Sciences, Developmental and Cell Biology, University of California Santa Barbara, Santa Barbara, CA, USA.,Department of Molecular, Developmental and Cell Biology, University of California Santa Barbara, Santa Barbara, CA, USA
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Cheng HG, Parker MA, Anthony JC. Female-male differences in prescription pain reliever dependence levels: Evidence on newly incident adolescent and young adult users in the United States, 2002-2014. Drug Alcohol Depend 2019; 204:107466. [PMID: 31518887 PMCID: PMC6878123 DOI: 10.1016/j.drugalcdep.2019.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 05/02/2019] [Accepted: 05/02/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND A comprehensive epidemiology of dependence on prescription opioid pain relievers requires evidence about age-specific female-male differences, possibly manifest during adolescent and early adult years. In this study, we identified newly incident extra-medical users of prescription pain relievers (EMPPR), all observed with onsets before the 22nd birthday. We then quantified female-male differences in clinical features or manifestations of opioid dependence (OD), devised a measurement-equivalent OD dimension, and estimated age-specific female-male differences in OD levels. METHOD The population under study included 12-to-21-year-old non-institutionalized civilian community residents of United States sampled for recent nation-scale surveys. Confidential computer-assisted self-interviews identified newly incident EMPPR users (n = 10,188). Analysis-weighted estimation procedures yielded cumulative incidence proportions for each OD feature, evaluated measurement non-equivalence across subgroups, and estimated female-male differences age-by-age. RESULTS (1) Tolerance and salience ('spending a lot of time') are most common OD features. (2) Measurement non-equivalence (bias) was found across sex- and onset-age groups. (3) With biasing features removed, we can see elevated OD levels for female new initiates, age-by-age. Subsidiary analyses suggested possibly accelerated progression toward higher OD levels when extra-medical PPR use starts before age 18. CONCLUSIONS Dimensional approaches to OD and other drug use disorders have gained popularity but can be fragile when differential measurement biases are left uncontrolled. This study's bias-corrected dimensional view of female-male differences shows elevated OD levels among newly incident female EMPPR users relative to new male initiates. Future studies can check for accelerated progression to higher OD levels when EM use starts before age 18 years.
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Affiliation(s)
- Hui G. Cheng
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, 48824, USA
| | - Maria A. Parker
- Department of Psychiatry, Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, 05401, USA
| | - James C. Anthony
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, 48824, USA
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Studer J, Gmel G, Bertholet N, Marmet S, Daeppen JB. Alcohol-induced blackouts at age 20 predict the incidence, maintenance and severity of alcohol dependence at age 25: a prospective study in a sample of young Swiss men. Addiction 2019; 114:1556-1566. [PMID: 31059161 DOI: 10.1111/add.14647] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/02/2018] [Accepted: 04/29/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIMS Alcohol-induced blackout (AIB) is a common alcohol-related adverse event occurring during teenage years. Although research provides evidence that AIB predicts acute negative consequences, less is known about the associations of AIB with chronic consequences, such as alcohol dependence (AD). This study estimated the associations between an experience of AIB at age 20 and the incidence, maintenance and severity of AD at age 25 among Swiss men. DESIGN Prospective cohort study with 5.5 years separating baseline and follow-up. SETTING Switzerland. PARTICIPANTS Swiss male drinkers (n = 5469, age 20 at baseline) drawn from the Cohort Study on Substance Use Risk Factors (C-SURF). MEASUREMENTS Self-report questionnaires assessing AIB, AD, alcohol (drinking volume, binge drinking), cigarette and cannabis use, several risk factors (sensation-seeking, family history of problematic alcohol use, age of first alcohol intoxication) and socio-demographic variables. FINDINGS Generalized estimating equation models with and without adjustment for risk factors, including alcohol use and socio-demographics, showed that AIB at age 20 significantly predicted the incidence of AD at age 25 in men without AD at age 20 [odds ratio (OR) = 2.52, 95% confidence interval (CI), unadjusted = 2.04, 3.11, P < 0.001; fully adjusted, OR = 1.47, 95% CI = 1.13, 1.91, P = 0.004], maintenance of AD in men with AD at age 20 (unadjusted, OR = 1.82, 95% CI = 1.12, 2.95, P = 0.015; fully adjusted, OR = 1.66, 95% CI = 1.00, 2.76, P = 0.048] and AD severity [unadjusted incidence rate ratio (IRR) = 1.89, 95% CI = 1.69, 2.11, P < 0.001; fully adjusted, IRR = 1.20, 95% CI = 1.10, 1.31, P < 0.001]. CONCLUSIONS Among Swiss men, alcohol-induced blackout at age 20 predicts the development, maintenance and severity of alcohol dependence at age 25.
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Affiliation(s)
- Joseph Studer
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Gerhard Gmel
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Addiction Switzerland, Lausanne, Switzerland.,Center for Addiction and Mental Health, Toronto, Ontario, Canada.,University of the West of England, Bristol, UK
| | - Nicolas Bertholet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Simon Marmet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean-Bernard Daeppen
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Boissoneault J, Lewis B, Nixon SJ. Characterizing chronic pain and alcohol use trajectory among treatment-seeking alcoholics. Alcohol 2019; 75:47-54. [PMID: 30359794 DOI: 10.1016/j.alcohol.2018.05.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/11/2018] [Accepted: 05/21/2018] [Indexed: 01/31/2023]
Abstract
Accumulating evidence indicates pain may be an important risk factor for development of alcohol use disorder (AUD) and risk of relapse for people recovering from AUD. This study was conducted to characterize the prevalence and severity of significant recurrent pain and various chronic pain conditions in treatment-seeking alcoholics. In addition, we sought to examine associations between alcohol use trajectory and pain presence/severity. Four hundred fifty-one treatment-seeking alcoholics were recruited for this study. Participants completed a battery of assessments, including measures of demographics, affect, alcohol and other drug use, presence/absence of significant recurrent pain, recent pain severity, and chronic pain type. Analyses indicated significant recurrent pain was highly prevalent in the study sample (53.66%), and was significantly more common among women (62.57%) than men (47.35%; p = 0.001). Typical drinking prior to treatment did not differ by pain status, but participants with pain were more likely to report current opioid use. Individuals with pain reported greater depression and anxiety than those without (p < 0.0008), and pain tended to be more severe among women than men (p = 0.035). Both men and women with pain indicated that pain had affected their substance use. In addition, both later age of first treatment and longer transition time from alcohol dependence to treatment were associated with greater pain severity, especially among men. These data suggest chronic pain is highly prevalent among treatment-seeking alcoholics, especially women, and that delays to first treatment are associated with pain presence and intensity. These results highlight the importance of effective pain management for the subset of treatment seekers with pain.
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Szumlinski KK, Coelho MA, Lee KM, Tran T, Sern KR, Bernal A, Kippin TE. DID it or DIDn't it? Exploration of a failure to replicate binge-like alcohol-drinking in C57BL/6J mice. Pharmacol Biochem Behav 2018; 178:3-18. [PMID: 30529114 DOI: 10.1016/j.pbb.2018.12.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 10/26/2018] [Accepted: 12/05/2018] [Indexed: 01/19/2023]
Abstract
We previously reported that commercially-sourced C57BL/6J (B6) male mice with a history of adult-onset binge-drinking exhibit anxiety-like behavior in early withdrawal, while the negative affective state incubates during protracted withdrawal in adolescent-onset binge-drinking males. As the results of such studies are potentially confounded by age-related differences in reactivity to environmental stress, we employed a 2-bottle-choice DID procedure (20 and 40% alcohol; 20 min habituation to the drinking cage) to examine the effects of binge-drinking on negative affect in male and female, adult and adolescent, B6 mice from our university colony. Unexpectedly, the mice in the initial experiment exhibited very low alcohol intake, with little sign of withdrawal-induced negative affect. This failure to replicate prompted us to examine how the duration of drinking cage habituation, the number of alcohol concentrations presented and the animal source might influence the propensity to binge-drink. Herein, we show that both male and female adult mice from our colony will binge-drink when allowed 45 min to habituate to the drinking cages, irrespective of whether mice are offered a choice between 2, 3 or 4 alcohol concentrations. Further, when drinking under 4-bottle-choice procedures (5, 10, 20 and 40% alcohol), adult-onset binge-drinking females exhibit robust negative affect in early withdrawal akin to that reported previously for adult males; however, the negative affective state persists for at least 30 days into withdrawal. Also unlike males, adolescent-onset binge-drinking females exhibit some signs of negative affect, as well as potentiated alcohol intake, in early withdrawal, which persist into later withdrawal. These latter data suggest that the age-related differences in the temporal patterning of the negative affective state produced by alcohol withdrawal may vary as a function of sex, which may have implications for understanding sex differences in the etiology of affective disorders and alcoholism co-morbidity.
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Affiliation(s)
- Karen K Szumlinski
- Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA, USA; Department of Molecular, Developmental and Cell Biology and the Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, CA, USA.
| | - Michal A Coelho
- Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Kaziya M Lee
- Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Tori Tran
- Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Kimberly R Sern
- Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Alexandria Bernal
- Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Tod E Kippin
- Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA, USA; Department of Molecular, Developmental and Cell Biology and the Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, CA, USA; Institute for Collaborative Biotechnology, University of California at Santa Barbara, Santa Barbara, CA, USA
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Huggett SB, Hatoum AS, Hewitt JK, Stallings MC. The Speed of Progression to Tobacco and Alcohol Dependence: A Twin Study. Behav Genet 2018; 48:109-124. [PMID: 29427143 PMCID: PMC5851595 DOI: 10.1007/s10519-018-9888-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 02/02/2018] [Indexed: 10/18/2022]
Abstract
We investigated the etiological role of genetic and environmental influences for two milestones of tobacco and alcohol use: age of initiation, and speed of progression to dependence (latency). Study participants included 1352 monozygotic and 1422 dizygotic twins (mean age at assessment = 24.31). Earlier ages of initiation significantly increased the likelihood of developing dependence, but were associated with longer dependence latencies for tobacco and alcohol. Latencies to dependence were heritable traits for tobacco (a2 = 0.63) and alcohol (a2 = 0.64). Genetic influences contributing to early age of initiation were associated with faster latencies to dependence but sometimes were counteracted by environmental factors, the extent to which depended on substance and, sometimes, sex. Our findings may have important implications for public policy and add to the literature by characterizing the genetic and environmental contributions to the speed of progression to tobacco and alcohol dependence.
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Affiliation(s)
- Spencer B Huggett
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA.
- Institute for Behavioral Genetics, University of Colorado Boulder, 1480 30th St, Boulder, CO, 80303, USA.
| | - Alexander S Hatoum
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA
- Institute for Behavioral Genetics, University of Colorado Boulder, 1480 30th St, Boulder, CO, 80303, USA
| | - John K Hewitt
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA
- Institute for Behavioral Genetics, University of Colorado Boulder, 1480 30th St, Boulder, CO, 80303, USA
| | - Michael C Stallings
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA
- Institute for Behavioral Genetics, University of Colorado Boulder, 1480 30th St, Boulder, CO, 80303, USA
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11
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Becker JB, McClellan ML, Reed BG. Sex differences, gender and addiction. J Neurosci Res 2017; 95:136-147. [PMID: 27870394 DOI: 10.1002/jnr.23963] [Citation(s) in RCA: 318] [Impact Index Per Article: 45.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 09/17/2016] [Accepted: 09/19/2016] [Indexed: 12/13/2022]
Abstract
This review discusses alcohol and other forms of drug addiction as both a sociocultural and biological phenomenon. Sex differences and gender are not solely determined by biology, nor are they entirely sociocultural. The interactions among biological, environmental, sociocultural, and developmental influences result in phenotypes that may be more masculine or more feminine. These gender-related sex differences in the brain can influence the responses to drugs of abuse, progressive changes in the brain after exposure to drugs of abuse and whether addiction results from drug-taking experiences. In addition, the basic laboratory evidence for sex differences is discussed within the context of four types of sex/gender differences. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jill B Becker
- Department of Psychology and the Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, 48109
| | - Michele L McClellan
- Department of History and the Residential College, University of Michigan, Ann Arbor, MI, 48109
| | - Beth Glover Reed
- School of Social Work and the Department of Women's Studies, University of Michigan, Ann Arbor, MI, 48109
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Quadir SG, Guzelian E, Palmer MA, Martin DL, Kim J, Szumlinski KK. Complex interactions between the subject factors of biological sex and prior histories of binge-drinking and unpredictable stress influence behavioral sensitivity to alcohol and alcohol intake. Physiol Behav 2017; 203:100-112. [PMID: 28803118 DOI: 10.1016/j.physbeh.2017.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 08/08/2017] [Indexed: 11/28/2022]
Abstract
Alcohol use disorders, affective disorders and their comorbidity are sexually dimorphic in humans. However, it is difficult to disentangle the interactions between subject factors influencing alcohol sensitivity in studies of humans. Herein, we combined murine models of unpredictable, chronic, mild stress (UCMS) and voluntary binge-drinking to examine for sex differences in the interactions between prior histories of excessive ethanol-drinking and stress upon ethanol-induced changes in motor behavior and subsequent drinking. In Experiment 1, female mice were insensitive to the UCMS-induced increase in ethanol-induced locomotion and ethanol intake under continuous alcohol-access. Experiment 2 revealed interactions between ethanol dose and sex (females>males), binge-drinking history (water>ethanol), and UCMS history (UCMS>controls), with no additive effect of a sequential prior history of both binge drinking and UCMS observed. We also observed an interaction between UCMS history and sex for righting recovery. UCMS history potentiated subsequent binge-drinking in water controls of both sexes and in male binge-drinking mice. Conversely, a prior binge-drinking history increased subsequent ethanol intake in females only, irrespective of prior UCMS history. In Experiment 3, a concurrent history of binge-drinking and UCMS did not alter ethanol intake, nor did it influence the ethanol dose-locomotor response function, but it did augment alcohol-induced sedation and reduced subsequent alcohol intake over that produced by binge-drinking alone. Thus, the subject factors of biological sex, prior stressor history and prior binge-drinking history interact in complex ways in mice to impact sensitivity to alcohol's motor-stimulating, -incoordinating and intoxicating effects, as well as to influence subsequent heavy drinking.
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Affiliation(s)
- Sema G Quadir
- Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Eugenie Guzelian
- Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Mason A Palmer
- Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Douglas L Martin
- Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Jennifer Kim
- Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Karen K Szumlinski
- Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA, USA; Department of Molecular, Developmental and Cell Biology, Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, CA, USA.
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Associations between early internalizing symptoms and speed of transition through stages of alcohol involvement. Dev Psychopathol 2017; 29:1455-1467. [PMID: 28397620 DOI: 10.1017/s0954579417000384] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Alcohol use disorders and internalizing disorders are highly comorbid, but how this comorbidity unfolds over development is not well understood. The present study investigated effects of internalizing symptoms in late childhood on speed of transition between three alcohol involvement milestones: first drink, first binge, and onset of first alcohol dependence symptom. Greater early internalizing symptoms were expected to predict a later age of first drink, a slower transition from first drink to first binge, and a faster transition from first binge to first dependence symptom. The effects of age and moderating effects of gender were also examined. Data were from a longitudinal study of children of alcoholics and matched controls (N = 454) followed from late childhood to midlife. Generally, stage-specific hypotheses were not supported; rather, greater internalizing symptoms predicted an earlier age of first drink and a faster transition through the full interval from first drink to first dependence symptom. Regarding gender moderation, internalizing significantly predicted a faster transition between each milestone as well as through the full interval among women but not men. These results suggest that early internalizing problems confer risk for a rapid transition through all stages of alcohol involvement, and this risk may be limited to women.
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Randall PA, Stewart RT, Besheer J. Sex differences in alcohol self-administration and relapse-like behavior in Long-Evans rats. Pharmacol Biochem Behav 2017; 156:1-9. [PMID: 28347737 DOI: 10.1016/j.pbb.2017.03.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 03/22/2017] [Accepted: 03/24/2017] [Indexed: 01/22/2023]
Abstract
Alcohol use disorders are a costly public health dilemma. Complicating this issue is the general lack of basic research assessing sex differences in many aspects of alcohol seeking and taking behaviors. The current experiments sought to decrease this gap in our understanding of sex differences in alcohol use disorders by assessing both male and female Long-Evans rats in parallel on alcohol self-administration, relapse-like behavior following abstinence and extinction, and motivation to respond for the standard alcohol solution and a quinine-adulterated alcohol solution. Here, we show that while males tend to have greater alcohol-reinforced responses throughout self-administration training, females show similar or greater alcohol intake (g/kg). Additionally, when tested for reinstatement of alcohol seeking and self-administration, following abstinence or extinction, males consistently showed greater reinstatement responding than females, which may be related to their training history. However, when assessed using the progressive ratio, there were no sex differences in motivation to respond for alcohol. Further, the consistent patterns of responding across months of self-administration training in both males and females, lend support for the feasibility of conducting these studies in male and female rats in parallel without concerns about daily variability. Our data also suggest that males and females should not be pooled as differences in alcohol lever responses and differences in reinstatement, as observed in the current experiments, could affect the overall outcome and possibly confound data interpretation. These studies demonstrate the importance of assessing males and females in parallel and advance the body of preclinical research on sex differences in alcohol self-administration and relapse.
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Affiliation(s)
- Patrick A Randall
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7178, USA
| | - Robert T Stewart
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7178, USA
| | - Joyce Besheer
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7178, USA; Curriculum in Neurobiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7178, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7178, USA.
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Adam A, Faouzi M, Yersin B, Bodenmann P, Daeppen JB, Bertholet N. Women and Men Admitted for Alcohol Intoxication at an Emergency Department: Alcohol Use Disorders, Substance Use and Health and Social Status 7 Years Later. Alcohol Alcohol 2016; 51:567-75. [PMID: 27358186 DOI: 10.1093/alcalc/agw035] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 05/23/2016] [Indexed: 12/18/2022] Open
Abstract
AIMS To assess the prevalence of alcohol use disorder (AUD), substance use, mental health and social status 7 years following an Emergency Department (ED) admission for alcohol intoxication. To assess gender differences in these prevalences. METHODS Cohort of 631 patients aged 18-30 years admitted for alcohol intoxication in 2006-2007 at a tertiary referral hospital in Switzerland, contacted for an interview in 2014. Assessment consisted of demography, Alcohol Use Disorders Identification Test-Consumption, Mini International Neuropsychiatric Interview for AUD, Patient Health Questionnaire (depression, anxiety) and lifetime/past year use of tobacco/illegal drugs. Gender differences were assessed with Chi-square tests, t-tests and Wilcoxon tests. RESULTS In 2014, 318/631 (50.4%) completed the interview. Study completers were not different from non-completers on baseline characteristics (all P > 0.2). Of study completers, 36.8% were unemployed, 56.9% reported hazardous alcohol use, 15.1% alcohol dependence, 13.2% harmful use, 18.6% depression, 15.4% anxiety disorder. Prevalence of any use (lifetime/past year) was 93.4%/80.2% for tobacco, 86.6%/53.1% for cannabis, 54.7%/22.6% for cocaine, 25.6%/13.5% for sedatives, 40.9%/11.0% for stimulants, 21.7%/7.2% for opioids. Men reported significantly more binge drinking, AUD, cannabis use (past year) and more lifetime cannabis, cocaine and stimulants use (all P < 0.05). There was no gender difference in the prevalence of hazardous alcohol use and tobacco use. The prevalence of psychiatric disorders was significantly higher in women (P < 0.05). CONCLUSIONS Seven years after being admitted for alcohol intoxication, young patients are likely to present substance misuse, mental health disorders and social problems, suggesting that they should be offered secondary prevention measures while in the ED. SHORT SUMMARY We studied a cohort of patients aged 18-30 and admitted for alcohol intoxication in 2006-2007 at a tertiary hospital. Participants were interviewed in 2014. Seven years after an admission for alcohol intoxication, patients are likely to present AUDs, substance misuse, mental health disorders and social problems.
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Affiliation(s)
- Angéline Adam
- Alcohol Treatment Center, Lausanne University Hospital, Pavillon P2, Etage no 02, Avenue de Beaumont 21bis, 1011 Lausanne, Switzerland
| | - Mohamed Faouzi
- Alcohol Treatment Center, Lausanne University Hospital, Pavillon P2, Etage no 02, Avenue de Beaumont 21bis, 1011 Lausanne, Switzerland
| | - Bertrand Yersin
- Emergency Department, Lausanne University Hospital, BH 09 773, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Patrick Bodenmann
- Vulnerable Populations Center, Department of Ambulatory Care and Community Medicine, Lausanne University, BU44 06 2202, Rue du Bugnon 44, 1011 Lausanne, Switzerland
| | - Jean-Bernard Daeppen
- Alcohol Treatment Center, Lausanne University Hospital, Pavillon P2, Etage no 02, Avenue de Beaumont 21bis, 1011 Lausanne, Switzerland
| | - Nicolas Bertholet
- Alcohol Treatment Center, Lausanne University Hospital, Pavillon P2, Etage no 02, Avenue de Beaumont 21bis, 1011 Lausanne, Switzerland
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Traube DE, Yarnell LM, Schrager SM. Differences in polysubstance use among youth in the child welfare system: toward a better understanding of the highest-risk teens. CHILD ABUSE & NEGLECT 2016; 52:146-157. [PMID: 26726761 PMCID: PMC4779713 DOI: 10.1016/j.chiabu.2015.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 11/22/2015] [Accepted: 11/25/2015] [Indexed: 06/05/2023]
Abstract
The current study extended limited prior work on polysubstance use among youth in the child welfare system (CWS) by addressing their potentially greater risk of engaging in polysubstance use, the causes of interpersonal variation in use, and changes in use over time, particularly at later points of involvement in the CWS. Using longitudinal data from the National Survey of Child and Adolescent Well-Being (n=1,178), a series of time-invariant and time-varying demographic and contextual factors were explored to assess their role both overall and at unique points of involvement in the CWS. A series of unconditional and conditional curve-of-factor models were estimated and results indicated that time-invariant characteristics of ethnicity and gender were not related to polysubstance use. Time-variant characteristics of age and placement were associated with polysubstance use and highlighted the dynamic nature of age as a risk factor. Out-of-home placement was protective against later substance use for youth who had been removed from contexts with their original caretaker where there were higher levels of reported violence. Our results suggest that in the child welfare population, the modeling of multiple substances rather than a single substance in isolation is more informative because it yields information on the confluence of behaviors that tend to occur and evolve together.
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Affiliation(s)
- Dorian E. Traube
- School of Social Work, University of Southern California, 669 W. 34th St., Los Angeles, CA 90089-0411, United States of America; Tel: (213) 740-1989
| | - Lisa M. Yarnell
- American Institutes for Research, 1000 Thomas Jefferson St., NW, Office 3263, Washington, DC 20007-3835, United States of America; Tel: 202-403-6263
| | - Sheree M. Schrager
- School of Social Work, University of Southern California, 669 W. 34th St., Los Angeles, CA 90089-0411, United States of America; Tel: (213) 740-1989
- Division of Hospital Medicine, Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS #94, Los Angeles, CA 90027, United States of America; Tel: (323) 361-5727
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Morales M, McGinnis MM, McCool BA. Chronic ethanol exposure increases voluntary home cage intake in adult male, but not female, Long-Evans rats. Pharmacol Biochem Behav 2015; 139:67-76. [PMID: 26515190 PMCID: PMC4722864 DOI: 10.1016/j.pbb.2015.10.016] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 10/22/2015] [Accepted: 10/23/2015] [Indexed: 11/30/2022]
Abstract
The current experiment examined the effects of 10 days of chronic intermittent ethanol (CIE) exposure on anxiety-like behavior and home cage ethanol intake using a 20% intermittent access (M, W, F) paradigm in male and female Long-Evans rats. Withdrawal from alcohol dependence contributes to relapse in humans and increases in anxiety-like behavior and voluntary ethanol consumption in preclinical models. Our laboratory has shown that 10 days of CIE exposure produces both behavioral and neurophysiological alterations associated with withdrawal in male rats; however, we have yet to examine the effects of this exposure regime on ethanol intake in females. During baseline, females consumed more ethanol than males but, unlike males, did not show escalations in intake. Rats were then exposed to CIE and were again given intermittent access to 20% ethanol. CIE males increased their intake compared to baseline, whereas air-exposed males did not. Ethanol intake in females was unaffected by CIE exposure. Notably, both sexes expressed significantly elevated withdrawal-associated anxiety-like behavior in the plus maze. Finally, rats were injected with the cannabinoid CB1 receptor antagonist, SR141716A (0, 1, 3, 10mg/kg, i.p.) which reduced ethanol intake in both sexes. However, females appear to be more sensitive to lower doses of this CB1 receptor antagonist. Our results show that females consume more ethanol than males; however, they did not escalate their intake using the intermittent access paradigm. Unlike males, CIE exposure had no effect on drinking in females. It is possible that females may be less sensitive than males to ethanol-induced increases in drinking after a short CIE exposure. Lastly, our results demonstrate that males and females may have different pharmacological sensitivities to CB1 receptor blockade on ethanol intake, at least under the current conditions.
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Affiliation(s)
- Melissa Morales
- Wake Forest University, School of Medicine, Dept. of Physiology & Pharmacology, Winston-Salem, NC 27101, United States
| | - Molly M McGinnis
- Wake Forest University, School of Medicine, Dept. of Physiology & Pharmacology, Winston-Salem, NC 27101, United States
| | - Brian A McCool
- Wake Forest University, School of Medicine, Dept. of Physiology & Pharmacology, Winston-Salem, NC 27101, United States.
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18
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Erol A, Karpyak VM. Sex and gender-related differences in alcohol use and its consequences: Contemporary knowledge and future research considerations. Drug Alcohol Depend 2015; 156:1-13. [PMID: 26371405 DOI: 10.1016/j.drugalcdep.2015.08.023] [Citation(s) in RCA: 537] [Impact Index Per Article: 59.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 08/12/2015] [Accepted: 08/13/2015] [Indexed: 01/16/2023]
Abstract
AIMS To review the contemporary evidence reflecting male/female differences in alcohol use and its consequences along with the biological (sex-related) and psycho-socio-cultural (gender-related) factors associated with those differences. METHODS MEDLINE, PubMed, Web of Science, SCOPUS, PsycINFO, and CINAHL databases were searched for relevant publications, which were subsequently screened for the presence/absence of pre-specified criteria for high quality evidence. RESULTS Compared to men, more women are lifetime abstainers, drink less, and are less likely to engage in problem drinking, develop alcohol-related disorders or alcohol withdrawal symptoms. However, women drinking excessively develop more medical problems. Biological (sex-related) factors, including differences in alcohol pharmacokinetics as well as its effect on brain function and the levels of sex hormones may contribute to some of those differences. In addition, differences in alcohol effects on behavior may also be driven by psycho-socio-cultural (gender-related) factors. This is evident by variation in the magnitude of differences in alcohol use between countries, decreasing difference in the rates of alcohol consumption in recent generations and other findings. Evidence indicates that both sex and gender-related factors are interacting with alcohol use in complex manner, which differentially impacts the risk for development of the behavioral or medical problems and alcohol use disorders in men and women. CONCLUSIONS Discovery of the mechanisms underlying biological (sex-related) as well as psycho-socio-cultural (gender-related) differences in alcohol use and related disorders is needed for development of personalized recommendations for prevention and treatment of alcohol use disorders and related problems in men and women.
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Affiliation(s)
- Almila Erol
- Department of Psychiatry, Ataturk Education and Research Hospital, Basinsitesi, Izmir 35250, Turkey; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, 200 First Stret SW, Rochester, MN, 55905, USA.
| | - Victor M Karpyak
- Department of Psychiatry, Ataturk Education and Research Hospital, Basinsitesi, Izmir 35250, Turkey.
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19
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Oberleitner LMS, Smith PH, Weinberger AH, Mazure CM, McKee SA. Impact of Exposure to Childhood Maltreatment on Transitions to Alcohol Dependence in Women and Men. CHILD MALTREATMENT 2015; 20:301-8. [PMID: 26130105 PMCID: PMC4868049 DOI: 10.1177/1077559515591270] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
BACKGROUND Childhood maltreatment decreases age of first use and speeds the transition from first use to dependence (i.e., telescoping) for alcohol use, however, it is currently unknown whether this influence is the same for men and women. METHOD Analyses were conducted with the National Epidemiologic Survey on Alcohol and Related Conditions (n = 34,653). Outcome variables included age of alcohol initiation and time to onset of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition alcohol dependence. Predictor variables included gender and childhood maltreatment. Linear and Poisson regression analyses were conducted. RESULTS Results demonstrated that in regard to age of drinking initiation, individuals who experienced childhood maltreatment initiated 1 year earlier than those without maltreatment, however, there was no interaction of this relationship with gender. Regarding the time to dependence, it was found that women who experienced childhood maltreatment demonstrated telescoping (shorter time between onset and dependence) compared to women without maltreatment and men (both with and without maltreatment). CONCLUSION Women with a history of childhood maltreatment are particularly vulnerable to an accelerated time from initiation of alcohol use until dependence, a pattern indicative of increased negative alcohol-related outcomes. Findings highlight the need for development of gender-specific prevention efforts and behavioral treatments to aid in early intervention of problematic alcohol use in women.
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Affiliation(s)
| | - Philip H Smith
- Epidemiology & Public Health, Yale University School of Medicine, New Haven, CT, USA
| | - Andrea H Weinberger
- Psychiatry, Yale University School of Medicine, New Haven, CT, USA Women's Health Research at Yale, New Haven, CT, USA Cancer Prevention and Control Research Program, Yale Cancer Center, New Haven, CT, USA Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Carolyn M Mazure
- Psychiatry, Yale University School of Medicine, New Haven, CT, USA Women's Health Research at Yale, New Haven, CT, USA
| | - Sherry A McKee
- Psychiatry, Yale University School of Medicine, New Haven, CT, USA Women's Health Research at Yale, New Haven, CT, USA Cancer Prevention and Control Research Program, Yale Cancer Center, New Haven, CT, USA
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20
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Richmond-Rakerd LS, Fleming KA, Slutske WS. Investigating Progression in Substance Use Initiation Using a Discrete-Time Multiple Event Process Survival Mixture (MEPSUM) Approach. Clin Psychol Sci 2015; 4:167-182. [PMID: 27127730 DOI: 10.1177/2167702615587457] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The order and timing of substance initiation has significant implications for later problematic patterns of use. Despite the need to study initiation from a multivariate framework, survival analytic methods typically cannot accommodate more than two substances in one model. The Discrete-Time Multiple Event Process Survival Mixture (MEPSUM; Dean, Bauer, & Shanahan, 2014) model represents an advance by incorporating more than two outcomes and enabling establishment of latent classes within a multivariate hazard distribution. Employing a MEPSUM approach, we evaluated patterns of tobacco, alcohol, and cannabis initiation in the National Longitudinal Study of Adolescent to Adult Health (N=18,923). We found four classes that differed in their ages and ordering of peak initiation risk. Demographics, externalizing psychopathology, and personality significantly predicted class membership. Sex differences in the association between delinquency and initiation patterns also emerged. Findings support the utility of the MEPSUM approach in elucidating developmental pathways underlying clinically relevant phenomena.
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Affiliation(s)
- Leah S Richmond-Rakerd
- Department of Psychological Sciences, University of Missouri - Columbia; Alcoholism Research Center at Washington University School of Medicine
| | - Kimberly A Fleming
- Department of Psychological Sciences, University of Missouri - Columbia; Alcoholism Research Center at Washington University School of Medicine
| | - Wendy S Slutske
- Department of Psychological Sciences, University of Missouri - Columbia; Alcoholism Research Center at Washington University School of Medicine
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21
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Kuhn C. Emergence of sex differences in the development of substance use and abuse during adolescence. Pharmacol Ther 2015; 153:55-78. [PMID: 26049025 DOI: 10.1016/j.pharmthera.2015.06.003] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 04/29/2015] [Indexed: 12/24/2022]
Abstract
Substance use and abuse begin during adolescence. Male and female adolescent humans initiate use at comparable rates, but males increase use faster. In adulthood, more men than women use and abuse addictive drugs. However, some women progress more rapidly from initiation of use to entry into treatment. In animal models, adolescent males and females consume addictive drugs similarly. However, reproductively mature females acquire self-administration faster, and in some models, escalate use more. Sex/gender differences exist in neurobiologic factors mediating both reinforcement (dopamine, opioids) and aversiveness (CRF, dynorphin), as well as intrinsic factors (personality, psychiatric co-morbidities) and extrinsic factors (history of abuse, environment especially peers and family) which influence the progression from initial use to abuse. Many of these important differences emerge during adolescence, and are moderated by sexual differentiation of the brain. Estradiol effects which enhance both dopaminergic and CRF-mediated processes contribute to the female vulnerability to substance use and abuse. Testosterone enhances impulsivity and sensation seeking in both males and females. Several protective factors in females also influence initiation and progression of substance use including hormonal changes of pregnancy as well as greater capacity for self-regulation and lower peak levels of impulsivity/sensation seeking. Same sex peers represent a risk factor more for males than females during adolescence, while romantic partners increase risk for women during this developmental epoch. In summary, biologic factors, psychiatric co-morbidities as well as personality and environment present sex/gender-specific risks as adolescents begin to initiate substance use.
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Affiliation(s)
- Cynthia Kuhn
- Department of Pharmacology and Cancer Biology, Box 3813, Duke University Medical Center, Durham, NC 27710, United States.
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22
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Hallgren KA, Owens MD, Brovko JM, Ladd BO, McCrady BS, Epstein EE. Trajectories of Drinking Urges During Individual- and Couple-based Cognitive-Behavioral Treatment for Alcohol Use Disorders. ALCOHOLISM TREATMENT QUARTERLY 2015; 33:161-184. [PMID: 27453630 DOI: 10.1080/07347324.2015.1018778] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Individuals receiving treatment for alcohol use disorders (AUDs) often experience urges to drink, and reductions in drinking urges during cognitive-behavioral therapy (CBT) predict better treatment outcomes. However, little previous work has examined patterns of daily drinking urges during treatment. The present study examined patterns of change in daily drinking urges among participants in two randomized clinical trials of males (N = 80 with 4401 daily recordings) and females (N = 101 with 8011 daily recordings) receiving individual- or couples-based CBT. Drinking urges were common during treatment, occurring on 45.1% percent of days for men and 44.8% for women. Drinking urges and alcohol use for both genders decreased substantially during the course of treatment. Both genders had increases in drinking urges as more time elapsed since attending a treatment session. For men, this increase was most pronounced at the beginning of treatment, but for women it was most pronounced near the end of treatment. Alcohol use and drinking urges were both more likely to occur on weekends. The results suggest that these times may lead to higher risk for drinking, and clients may benefit from high-risk planning that is focused on these times.
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Affiliation(s)
- Kevin A Hallgren
- University of Washington, Center for the Study of Health and Risk Behaviors, Seattle, WA USA
| | - Mandy D Owens
- University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions, Albuquerque, NM USA
| | - Julie M Brovko
- University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions, Albuquerque, NM USA
| | - Benjamin O Ladd
- Reed College, Adolescent Health Research Program, Portland, OR USA
| | - Barbara S McCrady
- University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions, Albuquerque, NM USA
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Moore CF, Lynch WJ. Alcohol preferring (P) rats as a model for examining sex differences in alcohol use disorder and its treatment. Pharmacol Biochem Behav 2015; 132:1-9. [PMID: 25712173 DOI: 10.1016/j.pbb.2015.02.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 02/04/2015] [Accepted: 02/16/2015] [Indexed: 10/24/2022]
Abstract
RATIONALE Despite epidemiological and clinical data indicating marked gender differences in alcohol use disorders (AUDs), few preclinical studies have examined sex differences in animal models of AUDs. OBJECTIVE The purpose of this study was to first characterize sex differences in ethanol consumption and reinforcement in an alcohol preferring (P) rat model of alcoholism, then use this model to screen pharmacological treatments for sex-specific effects. METHODS Ethanol consumption was first assessed in male and female P rats under a three-bottle free-choice procedure. Next, ethanol's reinforcing effects were assessed under a fixed-ratio 1 (FR1) schedule followed by a progressive-ratio (PR) schedule. Finally, the effects of two pharmacological treatments for AUDs, naltrexone (1mg/kg) and topiramate (10 or 20mg/kg), alone and in combination, were tested for sex-specific differences in their efficacy at reducing ethanol's reinforcing effects. RESULTS Although females initially had higher consumption of and preference for ethanol, male rats increased their consumption and preference over time and rapidly became equal to females. Following prolonged 24-hour/day access, males and females self-administered similar levels of ethanol under FR1 and PR schedules. In response to pharmacological treatment, we observed some sex differences and similarities, most notably, a more robust effect of the combination of naltrexone and topiramate in males as compared to females. CONCLUSIONS This model of selectively bred P rats may be useful for understanding sex differences in AUDs and related behavior and their underlying neurobiological mechanisms and treatment.
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Affiliation(s)
- Catherine F Moore
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, United States
| | - Wendy J Lynch
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, United States.
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24
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Gender and race/ethnicity differences for initiation of alcohol-related service use among persons with alcohol dependence. Drug Alcohol Depend 2014; 140:48-55. [PMID: 24780308 PMCID: PMC4079072 DOI: 10.1016/j.drugalcdep.2014.03.010] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Revised: 03/04/2014] [Accepted: 03/05/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND Prior studies on treatment for alcohol-related problems have yielded mixed results with respect to gender and race/ethnicity disparities. Additionally, little is known about gender and racial differences in time to first alcohol-related service contact amongst persons with alcohol dependence. This study explored gender and race/ethnicity differences for first alcohol-related service utilization in a population-based sample. METHODS Primary analyses were restricted to Blacks, Whites and Hispanics, ages 18-44, with lifetime alcohol dependence (n=3311) in Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions. We compared time to service use among men and women within and across race/ethnicity strata using multivariable Cox proportional hazard methods. RESULTS In the sample of individuals age <45 with alcohol dependence, only 19.5% reported alcohol-related service use. Overall, women were less likely than men to receive alcohol-related services in their lifetime. However, women who did receive treatment were younger at first service utilization and had a shorter interval between drinking onset and service use than men. Gender differences were consistent across racial/ethnic groups but only statistically significant for Whites. There were no appreciable race/ethnicity differences in hazard ratios for alcohol-related service use or time from drinking initiation to first service contact. Results of sensitivity analyses for persons ≥45 years old are discussed. CONCLUSIONS There are important gender differences in receipt of and time from drinking initiation to service utilization among persons with alcohol dependence. Increased recognition of these differences may promote investigation of factors underlying differences and identification of barriers to services.
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25
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Koordeman R, Anschutz DJ, Engels RCME. Self-control and the effects of movie alcohol portrayals on immediate alcohol consumption in male college students. Front Psychiatry 2014; 5:187. [PMID: 25691873 PMCID: PMC4314948 DOI: 10.3389/fpsyt.2014.00187] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 12/10/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In movies, alcohol-related cues are frequently depicted and there is evidence for a link between movie alcohol cues and immediate alcohol consumption. Less is known about factors influencing immediate effects movie alcohol exposure on drinking. The exertion of self-control is thought to be important in avoiding or resisting certain temptations. AIMS The aim of the present study was to assess the immediate effects of movie alcohol portrayals on drinking of male social drinkers and to assess the moderating role of self-control in this relation. It was hypothesized that participants would drink more when exposed to movie alcohol portrayals and that especially participants with low self-control would be affected by these portrayals. METHODS A between-subjects design comparing two movie conditions (alcohol or no portrayal of alcohol) was used, in which 154 pairs of male friends (ages 18-30) watched a 1-h movie in a semi-naturalistic living room setting. Their alcohol consumption while watching was examined. Participants completed a questionnaire assessing self-control as well as their self-reported weekly alcohol use. A multivariate regression analysis was conducted to test the effects of movie condition on alcohol comsumption. RESULTS Self-control moderated the relation between movie condition and alcohol consumption. Assignment to the alcohol movie condition increased alcohol consumption during the movie for males with high self-control but not for males with low self-control. CONCLUSION Viewing a movie with alcohol portrayals can lead to higher alcohol consumption in a specific sample of young men while watching a movie.
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Affiliation(s)
- Renske Koordeman
- Behavioural Science Institute, Radboud University , Nijmegen , Netherlands
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26
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Lewis B, Nixon SJ. Characterizing gender differences in treatment seekers. Alcohol Clin Exp Res 2013; 38:275-84. [PMID: 23930695 DOI: 10.1111/acer.12228] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 05/13/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Available evidence suggests women may be more vulnerable to the effects of chronic alcohol consumption than men. The few investigations of gender differences in treatment-seeking populations have often involved study samples restricted by selection criteria (e.g., age, education). The current study examined gender differences in a heterogeneous sample of individuals seeking treatment for a substance use disorder. We examined alcohol drinking levels, age at drinking milestones (e.g., first drink, first intoxication), and progression from milestones to alcohol problems or treatment. Additionally, family history, spousal alcoholism, and nicotine use were analyzed. METHODS Participants included men (n = 274) and women (n = 257) in substance abuse treatment facilities. Participants completed inventories quantifying affect, intellectual ability, and drinking consequences. A family tree for substance use and personal histories for alcohol and nicotine use, including chronicity, frequency, and regularity, were collected. RESULTS Telescoping was not observed when progression from drinking milestones to alcoholism or alcohol problems was compared between men and women. In contrast, when considered as progression to treatment, marked telescoping effects were detected, with women entering treatment more rapidly by approximately 4 years. Familial differences included a greater proportion of women reporting alcoholic parents (73% women; 61% men) and alcoholic spouses (58% women; 38% men). Smoking behaviors were similar between genders; however, men reporting higher levels of alcohol consumption reported greater intensity of chronic smoking. Smoking and drinking behaviors were correlated among men, but not women. Rates of pretreatment drug problems were equivalent between genders. CONCLUSIONS When contrasted with the available literature, our data were only partially supportive of gender-contingent telescoping. While women did not experience alcohol problems or alcoholism earlier than men, they progressed to treatment more quickly. These results highlight the importance of carefully considering the sample and specific outcome variables when interpreting gender differences.
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Affiliation(s)
- Ben Lewis
- Department of Psychiatry , University of Florida, Gainesville, Florida
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Sex differences in neuroadaptation to alcohol and withdrawal neurotoxicity. Pflugers Arch 2013; 465:643-54. [PMID: 23559099 DOI: 10.1007/s00424-013-1266-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 03/05/2013] [Accepted: 03/08/2013] [Indexed: 12/28/2022]
Abstract
Recent work suggests that sex differences exist with regard to both the nature of neuroadaptation to alcohol during the development of dependence, and possibly, the neurodegenerative consequences of alcohol dependence. Volumetric studies in human samples show that females may demonstrate increased volumetric brain loss with equal or lesser dependence histories than males. Furthermore, animal studies demonstrate sex differences in glutamatergic, GABAergic, and adenosinergic receptor signaling and endocrine responses following prolonged alcohol exposure. These differences may influence the development of dependence, neuronal function, and viability, particularly during alcohol withdrawal. The present review discusses the current state of knowledge in this regard. It is concluded that there exists a clear need for a more extensive examination of potential sex differences in neurodegenerative consequences of alcohol dependence in men and women, particularly with regard to the role that alterations in amino acid signaling and hypothalamic-pituitary-adrenal axis function may play. Furthermore, we note the need for expanded examination of the unique role that alcohol withdrawal-associated neuronal activity may have in the development of dependence-associated neurotoxicity.
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McKellar J, Austin J, Moos R. Building the first step: a review of low-intensity interventions for stepped care. Addict Sci Clin Pract 2012; 7:26. [PMID: 23227807 PMCID: PMC3554471 DOI: 10.1186/1940-0640-7-26] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 12/02/2012] [Indexed: 11/30/2022] Open
Abstract
Within the last 30 years, a substantial number of interventions for alcohol use disorders (AUDs) have received empirical support. Nevertheless, fewer than 25% of individuals with alcohol-related problems access these interventions. If several intensive psychosocial treatments are relatively effective, but most individuals in need do not access them, it seems logical to place a priority on developing more engaging interventions. Accordingly, after briefly describing findings about barriers to help-seeking, we focus on identifying an array of innovative and effective low-intensity intervention strategies, including telephone, computer-based, and Internet-based interventions, that surmount these barriers and are suitable for use within a stepped-care model. We conclude that these interventions attract individuals who would otherwise not seek help, that they can benefit individuals who misuse alcohol and those with more severe AUDs, and that they can facilitate subsequent help-seeking when needed. We note that these types of low-intensity interventions are flexible and can be tailored to address many of the perceived barriers that hinder individuals with alcohol misuse or AUDs from obtaining timely help. We also describe key areas of further research, such as identifying the mechanisms that underlie stepped-care interventions and finding out how to structure these interventions to best initiate a program of stepped care.
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Affiliation(s)
- John McKellar
- Center for Healthcare Evaluation, Health Services Research and Development Service, Department of Veterans Affairs Health Care System and Stanford University School of Medicine, Palo Alto, CA, USA.
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Myeong Sook Yoon, 조혜정. A Study of Husband's Problem Drinking on the Wife's Problem Drinking -Focused on the mediating Effect of Spouse Abuse-. ACTA ACUST UNITED AC 2012. [DOI: 10.20970/kasw.2012.64.2.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kushner MG, Maurer E, Menary K, Thuras P. Vulnerability to the rapid ("telescoped") development of alcohol dependence in individuals with anxiety disorder. J Stud Alcohol Drugs 2012; 72:1019-27. [PMID: 22051216 DOI: 10.15288/jsad.2011.72.1019] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The frequent co-occurrence of alcohol dependence and anxiety disorder is a long-standing clinical conundrum. An underdeveloped perspective on this issue concerns the impact of a co-occurring anxiety disorder on the sequence and developmental course of alcohol-related milestones. Extrapolating from the body of basic science indicating overlap in the neurobiological processes associated with both anxiety disorder and alcohol dependence-particularly those involving the hypothalamic-pituitary-adrenal axis and elements of the amygdala- we hypothesized that anxiety-disordered individuals are vulnerable to the rapid development of alcohol dependence. Specifically, we predicted that the time from pre-dependence alcohol milestones (e.g., age at which regular drinking began) to post-dependence alcohol milestones would be briefer ("telescoped") among those with an anxiety disorder. METHOD Seventy-eight individuals with alcohol dependence who had recently begun a chemical dependency treatment program underwent a diagnostic interview to determine the presence of current anxiety disorders and to establish the age at which several alcohol use and dependence milestones were first achieved. RESULTS We found that, compared with others in the sample, anxiety-disordered individuals transitioned significantly more quickly from the time they first began drinking regularly and first began getting drunk regularly to the onset of alcohol dependence, as well as from most pre-dependence alcohol milestones to the point at which their alcohol dependence was most severe. CONCLUSIONS Individuals with anxiety disorders transition from regular drinking to alcohol dependence more rapidly than do individuals without anxiety disorders. These findings contribute to an improved understanding of the etiology of comorbidity and suggest novel directions for future research.
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Affiliation(s)
- Matt G Kushner
- Department of Psychiatry, University of Minnesota--Twin Cities Campus, Box 282 2A-West, 2450 Riverside Avenue, Minneapolis, Minnesota 55454, USA.
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Alvanzo AAH, Storr CL, La Flair L, Green KM, Wagner FA, Crum RM. Race/ethnicity and sex differences in progression from drinking initiation to the development of alcohol dependence. Drug Alcohol Depend 2011; 118:375-82. [PMID: 21652154 PMCID: PMC3190032 DOI: 10.1016/j.drugalcdep.2011.04.024] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 04/18/2011] [Accepted: 04/22/2011] [Indexed: 11/27/2022]
Abstract
BACKGROUND Prior studies on the course of alcohol use disorders have reported a "telescoping" effect with women progressing from drinking initiation to alcohol dependence faster than men. However, there is a paucity of population-based analyses that have examined progression to alcohol dependence comparing race/ethnicity subgroups, and little is known about whether the telescoping effect for women varies by race/ethnicity. We examined whether a telescoping effect is present in the general population comparing race/ethnicity subgroups and comparing men and women stratified by race. METHODS This study uses data from Wave I of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to compare a nationally representative sample of White, Black and Hispanic adults 18-44 years of age (n=21,106). Time to event analyses compare the risk of alcohol initiation, onset of alcohol dependence, and the transition from initial use to onset of alcohol dependence in the three race/ethnicity groups and for males and females in each race/ethnicity group. RESULTS Whites were younger than Blacks and Hispanics of the same sex at drinking onset and progressed to alcohol dependence at a faster rate than both Blacks and Hispanics. In addition, we found no evidence of a telescoping effect in women for any race/ethnicity group. CONCLUSIONS The present study illustrates differences in the course of transition from alcohol initiation to the development of dependence by race/ethnicity but not sex. Our findings highlight the need for additional study of factors resulting in race/ethnicity differences in order to inform culturally relevant prevention and intervention initiatives.
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Affiliation(s)
- Anika A. H. Alvanzo
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Room 8047a, Baltimore, MD 21205 USA, , Phone: 410-502-2048, Fax: 410-502-6952
| | - Carla L. Storr
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD, 21201, USA,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205 USA
| | - Lareina La Flair
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205 USA
| | - Kerry M. Green
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, 20742 USA
| | - Fernando A. Wagner
- Prevention Sciences Research Center, Morgan State University, Baltimore, MD 21251 USA,School of Community Health and Policy, Morgan State University, Baltimore, MD 21251 USA
| | - Rosa M. Crum
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205 USA,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205 USA
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van Beek JHDA, Kendler KS, de Moor MHM, Geels LM, Bartels M, Vink JM, van den Berg SM, Willemsen G, Boomsma DI. Stable genetic effects on symptoms of alcohol abuse and dependence from adolescence into early adulthood. Behav Genet 2011; 42:40-56. [PMID: 21818662 PMCID: PMC3253297 DOI: 10.1007/s10519-011-9488-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 07/14/2011] [Indexed: 11/29/2022]
Abstract
Relatively little is known about how genetic influences on alcohol abuse and dependence (AAD) change with age. We examined the change in influence of genetic and environmental factors which explain symptoms of AAD from adolescence into early adulthood. Symptoms of AAD were assessed using the four AAD screening questions of the CAGE inventory. Data were obtained up to six times by self-report questionnaires for 8,398 twins from the Netherlands Twin Register aged between 15 and 32 years. Longitudinal genetic simplex modeling was performed with Mx. Results showed that shared environmental influences were present for age 15-17 (57%) and age 18-20 (18%). Unique environmental influences gained importance over time, contributing 15% of the variance at age 15-17 and 48% at age 30-32. At younger ages, unique environmental influences were largely age-specific, while at later ages, age-specific influences became less important. Genetic influences on AAD symptoms over age could be accounted for by one factor, with the relative influence of this factor differing across ages. Genetic influences increased from 28% at age 15-17 to 58% at age 21-23 and remained high in magnitude thereafter. These results are in line with a developmentally stable hypothesis that predicts that a single set of genetic risk factors acts on symptoms of AAD from adolescence into young adulthood.
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Affiliation(s)
- Jenny H D A van Beek
- Department of Biological Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
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Repercusiones orgánicas del consumo de alcohol: diferencias entre hombres y mujeres. Med Clin (Barc) 2011; 137:66-7. [DOI: 10.1016/j.medcli.2010.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 12/23/2010] [Indexed: 11/23/2022]
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McCutcheon VV, Agrawal A, Heath AC, Edenberg HJ, Hesselbrock VM, Schuckit MA, Kramer JR, Bucholz KK. Functioning of alcohol use disorder criteria among men and women with arrests for driving under the influence of alcohol. Alcohol Clin Exp Res 2011; 35:1985-93. [PMID: 21631541 DOI: 10.1111/j.1530-0277.2011.01550.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Many states require screening of individuals arrested for driving under the influence (DUI) of alcohol to determine recidivism risk and the need for treatment based on severity of alcohol problems. Several screening instruments use DSM-IV criteria for alcohol abuse and dependence to assess alcohol problems in this population, but whether they adequately measure alcohol problems in individuals with DUIs has not been examined. In addition, gender differences in DUI samples suggest that female offenders have more severe alcohol problems than male offenders. The current study examines differences in alcohol criteria functioning by DUI history and gender using an item response theory (IRT) approach. METHODS Data from diagnostic interviews with 8,605 participants in the Collaborative Study on the Genetics of Alcoholism, including 1,655 who ever reported a DUI arrest (20% women), were used to examine differences in alcohol criteria functioning between men and women with and without DUIs. The factor underlying item response was conceptualized as unidimensional, representing alcohol problem severity. RESULTS Social/interpersonal problems, larger/longer, and inability/persistent desire to quit displayed greater discrimination of IRT-defined alcohol problem severity among individuals with DUIs than those without. Irrespective of DUI status, women had a higher threshold than men for time spent drinking or recovering. Women without DUIs had a higher threshold than similar men for social/interpersonal problems. Taken as a whole, the criteria yielded similar amounts of information in all groups. CONCLUSIONS DSM-IV criteria for alcohol abuse and dependence adequately detect alcohol problem severity in individuals with DUIs, and some are better at detecting severity in this particularly high-risk group than in individuals without DUIs. However, the criteria as a whole are equally effective in measuring alcohol problem severity among individuals with and without DUIs and may be used with confidence in screening DUI offenders.
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Affiliation(s)
- Vivia V McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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Koordeman R, Kuntsche E, Anschutz DJ, van Baaren RB, Engels RCME. Do we act upon what we see? Direct effects of alcohol cues in movies on young adults' alcohol drinking. Alcohol Alcohol 2011; 46:393-8. [PMID: 21493639 DOI: 10.1093/alcalc/agr028] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Ample survey research has shown that alcohol portrayals in movies affect the development of alcohol consumption in youth. Hence, there is preliminary evidence that alcohol portrayals in movies also directly influence viewers' drinking of alcohol while watching movies. One process that might account for these direct effects is imitation. The present study therefore examined whether young people imitate actors sipping alcohol on screen. METHODS We observed sipping behaviours of 79 young adults (ages 18-25) watching a 60-min movie clip, 'What Happens in Vegas', in a semi-naturalistic home setting. Each of the 79 participants was exposed to 25 alcohol cues. Two-level logistic regression analyses were used to analyse whether participants in general imitated actors' sipping during this clip. In addition, we applied proportional hazard models in a survival analysis framework (Cox regression) to test whether there was a difference in imitation of the cues between male and female participants, and to test whether the timing of the actors' sipping throughout the movie played a role. RESULTS The findings showed that participants were more likely to sip in accordance with the actors' sipping than without such a cue. Further, we found that men were more likely to imitate actors' sipping than females and that participants tended to respond to actors' sipping at the beginning of the movie rather than at the end. CONCLUSION Exposure to actors sipping alcohol in a movie seems to have an immediate impact on the drinking behaviour of viewers, via the mechanism of imitation.
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Affiliation(s)
- Renske Koordeman
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
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Koordeman R, Anschutz DJ, van Baaren RB, Engels RCME. Effects of alcohol portrayals in movies on actual alcohol consumption: an observational experimental study. Addiction 2011; 106:547-54. [PMID: 21134018 DOI: 10.1111/j.1360-0443.2010.03224.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS This study uses an experimental design to assess the effects of movie alcohol portrayal on alcohol consumption of young adults while watching a movie. Gender, weekly alcohol use and identification with the movie actor/character were assessed as moderators. DESIGN A two (sex) × two (movie: alcohol or no portrayal of alcohol) between-subject design was used. SETTING Participants watched a contemporary movie in a semi-naturalistic living room setting. PARTICIPANTS A total of 122 same-sex, young adult dyads (ages 18-29 years) participated in the experiment. MEASUREMENTS Their actual alcohol consumption while watching was examined. A multivariate regression analysis was used to examine the effects of the movie condition on alcohol consumption. FINDINGS Assignment to movie alcohol increased alcohol consumption during the movie for men but not women. Identification and weekly alcohol consumption did not moderate the relation between movie condition and alcohol consumption. CONCLUSIONS Viewing a movie with alcohol portrayal can lead to higher alcohol consumption in young men while watching the movie.
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Affiliation(s)
- Renske Koordeman
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.
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Chartier KG, Hesselbrock MN, Hesselbrock VM. Alcohol problems in young adults transitioning from adolescence to adulthood: The association with race and gender. Addict Behav 2011; 36:167-74. [PMID: 21115225 PMCID: PMC3018558 DOI: 10.1016/j.addbeh.2010.10.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 08/30/2010] [Accepted: 10/18/2010] [Indexed: 11/20/2022]
Abstract
Race and gender may be important considerations for recognizing alcohol related problems in Black and White young adults. This study examined the prevalence and age of onset of individual alcohol problems and alcohol problem severity across race and gender subgroups from a longitudinal study of a community sample of adolescents followed into young adulthood (N=166; 23-29 yrs. old who were drinkers). All alcohol problems examined first occurred when subjects were in their late teens and early 20s. Drinking in hazardous situations, blackouts, and tolerance were the most common reported alcohol problems. In race and gender comparisons, more males than females experienced alcohol problems. Blacks generally had a later age of onset of alcohol problems. Multivariate regressions showed greater alcohol problem severity in males compared to females, but no significant differences between Blacks and Whites. Education, family environment and earlier alcohol use behaviors and expectancies were reliable predictors of alcohol problem severity in young adulthood. White males were at particular risk for experiencing more severe alcohol problems. Findings may inform the design of more targeted interventions for alcohol problems in different populations.
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Schuckit MA, Smith TL. Onset and course of alcoholism over 25 years in middle class men. Drug Alcohol Depend 2011; 113:21-8. [PMID: 20727682 PMCID: PMC3000869 DOI: 10.1016/j.drugalcdep.2010.06.017] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Revised: 05/21/2010] [Accepted: 06/21/2010] [Indexed: 11/24/2022]
Abstract
BACKGROUND Patterns of drinking and alcohol problems change with age. However, few studies use multiple data points and detailed history spanning early adulthood to middle age. This study reports such data from 373 men in the San Diego Prospective Study. METHODS Data were generated at baseline (T1) at ∼age 20, and through face-to-face followup interviews ∼every 5 years in >90% of these eligible Caucasian and relatively higher educated men. Subjects were placed into 4 groups regarding their course: 62.5% with no alcohol use disorder (AUD); 17.2% with AUD onset 5 years before the 25-year followup. RESULTS On a univariate level, low level of response (LR) to alcohol, family history of AUDs, and higher Novelty Seeking at ∼age 20 predicted AUDs with onset before age 30 (mean age∼25), but among these only LR predicted later onset (mean age 38) as well. Additional predictors of AUDs included demography (lower education), and greater involvement with alcohol, drugs, and nicotine prior to T1. Sustained remission from AUDs among alcoholics was predicted by lower T1 and T10 drinking frequencies, and being separated or divorced at T10, along with a trend for higher Reward Dependence. CONCLUSION These data indicate that information available in ages of the late teens to early twenties can help predict the future onset and course of AUDs, and underscore the importance of longitudinal studies in substance use disorders.
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Kim J, Xiang H, Yang Y, Lewis MW. Disparities in Alcohol Treatment Utilization by Race and Type of Insurance. ALCOHOLISM TREATMENT QUARTERLY 2010. [DOI: 10.1080/07347320903446382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Keyes KM, Martins SS, Blanco C, Hasin DS. Telescoping and gender differences in alcohol dependence: new evidence from two national surveys. Am J Psychiatry 2010; 167:969-76. [PMID: 20439391 PMCID: PMC3767417 DOI: 10.1176/appi.ajp.2009.09081161] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The course of alcohol disorders in women is often described as "telescoped" compared to that in men, with a later age at initiation of alcohol use but shorter times from use to dependence and treatment. This study examined evidence for such a telescoping effect in the general population and tested birth cohort effects for gender differences. METHOD Data from two U.S. national surveys conducted 10 years apart (1991-1992 and 2001-2002) using the same diagnostic instrument (the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV) were used to analyze five birth cohorts. Age at initiation of alcohol use, time from first use to dependence, and time from dependence to first treatment were analyzed. Interaction terms (cohort by gender; cohort by gender by time) were tested in Cox proportional hazards models. RESULTS Little evidence was found for a telescoping effect in women. For alcohol use and dependence, cohort and gender interacted, which suggests that gender differences are diminished in more recent cohorts. A three-way interaction of cohort, gender, and time was significant for time from first use to dependence, suggesting that men have a shorter time to dependence, especially in younger cohorts. CONCLUSIONS A telescoping effect is not evident in the general population. Gender differences in the overall hazard of alcohol use and dependence are decreasing in more recent cohorts, while gender differences in time from first use to dependence are increasing. These findings challenge the commonly held notion of a gender-specific course of alcohol disorders and suggest the need for a greater clinical focus on problem drinking in women and further research on accelerated time to dependence in men.
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Ehlers CL, Gizer IR, Vieten C, Gilder A, Gilder DA, Stouffer GM, Lau P, Wilhelmsen KC. Age at regular drinking, clinical course, and heritability of alcohol dependence in the San Francisco family study: a gender analysis. Am J Addict 2010; 19:101-10. [PMID: 20163381 DOI: 10.1111/j.1521-0391.2009.00021.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We examined gender differences in age of onset, clinical course, and heritability of alcohol dependence in 2,524 adults participating in the University of California San Francisco (UCSF) family study of alcoholism. Men were significantly more likely than women to have initiated regular drinking during adolescence. Onset of regular drinking was not found to be heritable but was found to be significantly associated with a shorter time to onset of alcohol dependence. A high degree of similarity in the sequence of alcohol-related life events was found between men and women, however, men experienced alcohol dependence symptoms at a younger age and women had a more rapid clinical course. Women were found to have a higher heritability estimate for alcohol dependence (h(2)= .46) than men (h(2)= .32). These findings suggest that environmental factors influencing the initiation of regular drinking rather than genetic factors associated with dependence may in part underlie some of the gender differences seen in the prevalence of alcohol dependence in this population. (Am J Addict 2010;00:1-10).
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Affiliation(s)
- Cindy L Ehlers
- Department of Molecular and Integrative Neurosciences, The Scripps Research Institute, La Jolla, California, USA.
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Abstract
There is a paucity of research on pharmacotherapies in adolescents with substance use disorders. This paucity is partly because of the fact that most people with substance dependence do not get diagnosed until early adulthood, that is, after 18 years of age. This article reviews pharmacotherapies used for aversion, substitution, anti-craving, and detoxification of alcohol, nicotine, cocaine, and opioids dependence. Adult research is referenced when applicable and generalized to adolescents with caution. Continued evaluation and development of pharmacotherapy for youth in controlled studies are needed to examine medication effectiveness, safety, potential for abuse, compliance, and potential interactions with other medications or substances of abuse.
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Geirsson M, Hensing G, Spak F. Does gender matter? A vignette study of general practitioners' management skills in handling patients with alcohol-related problems. Alcohol Alcohol 2010; 44:620-5. [PMID: 19846585 DOI: 10.1093/alcalc/agp071] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS The aims of this study were to analyse the perceptions of female and male primary care physicians (PCPs) of alcohol problems in male and female patients, their recommendations to reduce or abstain from alcohol, their referrals to treatment and their views of safe levels of drinking for male and female patients. These factors were related to the physicians' own alcohol consumption. METHODS A slightly adjusted version of the WHO Collaborative Study Questionnaire for General Practitioners was posted to all PCPs (n = 132) in the district of Skaraborg, Sweden, of whom 68 PCPs responded. In the questionnaire, the PCPs' perceptions of two patient vignettes were analysed. RESULTS Both the gender of the patients in the vignettes and of the PCPs influenced the advice and the referrals that the patients received: 83% of male excessive drinkers and 47% of female excessive drinkers were recommended to cut down on drinking. In 50% of cases, the male excessive drinker was not referred, compared with 25% for the female excessive drinker. This was statistically significant only for excessive drinkers. The odds ratio for referral to any treatment was 0.33 (CI = 0.12-0.93) for the male excessive drinker compared with the female excessive drinker. The male PCP referred the excessive drinker less often to any treatment than did the female PCP, odds ratio 0.26 (CI = 0.08-0.90). The upper limit of alcohol consumption before the PCPs would advise the patient to cut down was significantly higher for PCPs with the AUDIT-C score >or= 3. The limit was 146 g/week for male patients and 103 g/week for female patients. Corresponding figures for PCP with the AUDIT-C score <or= 2 were 89 and 68 g/week. CONCLUSION Male patients were less likely to be advised to stop drinking altogether than female patients and were less likely to be referred, according to this vignette study. Taking into account that male patients have a higher prevalence of alcohol problems, this may be of considerable importance for men's health outcomes. Implications of these findings are the need to increase awareness of male excessive drinking and that gendered perceptions might bias alcohol management recommendations.
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Kelly JF, Stout RL, Magill M, Tonigan JS, Pagano ME. Mechanisms of behavior change in alcoholics anonymous: does Alcoholics Anonymous lead to better alcohol use outcomes by reducing depression symptoms? Addiction 2010; 105:626-36. [PMID: 20102345 PMCID: PMC2857524 DOI: 10.1111/j.1360-0443.2009.02820.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
RATIONALE Indices of negative affect, such as depression, have been implicated in stress-induced pathways to alcohol relapse. Empirically supported continuing care resources, such as Alcoholics Anonymous (AA), emphasize reducing negative affect to reduce relapse risk, but little research has been conducted to examine putative affective mechanisms of AA's effects. METHODS Using lagged, controlled, hierarchical linear modeling and mediational analyses this study investigated whether AA participation mobilized changes in depression symptoms and whether such changes explained subsequent reductions in alcohol use. Alcohol-dependent adults (n = 1706), receiving treatment as part of a clinical trial, were assessed at intake, 3, 6, 9, 12 and 15 months. RESULTS Findings revealed elevated levels of depression compared to the general population, which decreased during treatment and then remained stable over follow-up. Greater AA attendance was associated with better subsequent alcohol use outcomes and decreased depression. Greater depression was associated with heavier and more frequent drinking. Lagged mediation analyses revealed that the effects of AA on alcohol use was mediated partially by reductions in depression symptoms. However, this salutary effect on depression itself appeared to be explained by AA's proximal effect on reducing concurrent drinking. CONCLUSIONS AA attendance was associated both concurrently and predictively with improved alcohol outcomes. Although AA attendance was associated additionally with subsequent improvements in depression, it did not predict such improvements over and above concurrent alcohol use. AA appears to lead both to improvements in alcohol use and psychological and emotional wellbeing which, in turn, may reinforce further abstinence and recovery-related change.
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Affiliation(s)
- John F. Kelly
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, 60 Staniford St., Suite 120, Boston, MA 02114
| | - Robert L. Stout
- Decision Sciences Institute/PIRE, 1005 Main St., Pawtucket, RI 02860-7802
| | - Molly Magill
- Brown University, Center for Alcohol and Addiction Studies, Providence RI 02912
| | - J. Scott Tonigan
- Center on Alcoholism, Substance Abuse and Addiction (CASAA), 2650 Yale SE., Suite 243, Albuquerque, NM 87106
| | - Maria E. Pagano
- Case Western Reserve University School of Medicine, Department of Psychiatry, Division of Child Psychiatry, W.O. Walker Center, 10524 Euclid Avenue
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Kelly JF, Magill M, Slaymaker V, Kahler C. Psychometric validation of the Leeds Dependence Questionnaire (LDQ) in a young adult clinical sample. Addict Behav 2010; 35:331-6. [PMID: 20004062 DOI: 10.1016/j.addbeh.2009.11.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Revised: 11/16/2009] [Accepted: 11/22/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Measures of substance dependence severity that are both clinically efficient and sensitive to change can facilitate assessment of clinical innovation necessary for improving current evidence-based practices. The Leeds Dependence Questionnaire (LDQ) is a 10-item, continuous, self-report measure of dependence that is not specific to any particular substance and has shown promise in preliminary psychometric research. The present study investigates its psychometric properties in a large clinical sample of young adults. METHOD Young adults (N=300) were enrolled in a naturalistic treatment process and outcome study of residential substance dependence treatment (mean age 20.4 [1.6], range 18-25; 27% female; 95% White). Dependence severity by demographic and diagnostic groupings, factor structure and internal consistency, and criterion- and construct-related validity were examined. RESULTS Dependence severity in this cohort of youth overall was high (M=18.65 [8.65]). LDQ scores were highest among opiate and stimulant users, and there was a trend for higher scores among women compared to men (t=1.869, p=.063). Factor analysis using a robust alpha factoring extraction revealed a single factor accounting for 63% of the variance in reported dependence severity. The internal consistency was also very high (alpha=.93). Concurrent and convergent validity with dependence criteria, substance use frequency, and general symptom severity, respectively, were also acceptable. CONCLUSIONS The LDQ shows considerable promise as a brief, psychometrically sound, measure of substance dependence useful across a variety of substances, that has clinical and research utility. This study supports its use among young adults.
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Differences between men and women in the course of opiate dependence: is there a telescoping effect? Eur Arch Psychiatry Clin Neurosci 2010; 260:235-41. [PMID: 19838765 DOI: 10.1007/s00406-009-0053-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 09/09/2009] [Indexed: 10/20/2022]
Abstract
According to the so-called telescoping effect, there is a gender-specific course of alcohol dependence with women starting alcohol use later than men and having a faster development of harmful consequences. There are inconsistent data regarding a telescoping effect in opiate dependence. In each of six European centres, 100 opiate addicts were investigated by a structured interview (mainly the EuropASI and CIDI) at admission to various kinds of treatment (TREAT project). In a secondary analysis of the TREAT data, women and men were compared regarding age at onset of heroin use and the current severity of addiction. In addition, a comparison of female (n = 140) and male (n = 140) addicts matched for age and study centre were carried out. Eventually, multiple logistic and linear regressions were done with the interaction term of gender and time of regular consumption as predictor for the severity of dependence, besides, other sociodemographic variables. There was no difference between genders regarding the age at onset of regular heroin consumption. Up to 4 years of regular consumption, there are gender-specific differences in the course of opiate dependence, e.g. a faster progression of legal problems in men and social problems in women. There were no differences in the severity of dependence other than more economic problems for women. A telescoping effect could only partially be observed in this large sample of opiate addicts. A gender-specific course was limited to the first years of consumption, and included domains with a faster progression for men. It has to be assumed that opiate dependence is a rapidly developing disorder with early chronification. Afterwards, only individual courses with influences of the national treatment system were observed.
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Clemens SL, Matthews SL, Young AF, Powers JR. Alcohol consumption of Australian women: results from the Australian Longitudinal Study on Women's Health. Drug Alcohol Rev 2009; 26:525-35. [PMID: 17701516 DOI: 10.1080/09595230701499142] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION AND AIMS Alcohol misuse is responsible for extensive personal harm and high societal costs. Research related specifically to women's alcohol consumption is important due to gender differences in clinical outcomes and disease progression. DESIGN AND METHODS This study examines longitudinal changes in the patterns of alcohol consumption associated with harm in the long term (chronic) and short term (acute) as defined by the Australian National Health and Medical Research Council. Results are presented for three age cohorts (18 - 23 years, 45 - 50 years and 70 - 75 years) using data from the Australian Longitudinal Study on Women's Health 1996 - 2003. Initial response rates for the study were 41%, 54% and 36% for the Younger, Mid-aged and Older cohort, respectively. RESULTS The percentages of women that initiated usual weekly consumption in excess of 140 g of alcohol, designated as long-term risky or high risk consumption, between surveys 1 and 2 were 2.7%, 2.1% and 1.7% (Younger, Mid-aged and Older cohorts, respectively). Similarly, between surveys 1 and 2, 7.8% of younger women and 2.5% of mid-aged women initiated consumption of 50 g of alcohol on one occasion at least weekly, placing them at risk of alcohol-related harm in the short-term weekly. Examining data across the three time-points in the Younger cohort, 0.3% of women were at risk of alcohol-related harm in the long term across all three time-points, and 9.2% were at risk at one or two time-points. The percentage of younger women at risk of alcohol-related harm in the short term at least weekly was 3.4% at risk at all three time-points and 24% at risk at one or two time-points. DISCUSSION AND CONCLUSIONS This study indicates that there is a small percentage of women who maintain levels of alcohol consumption associated with increased risk of morbidity and mortality over time, but a much larger proportion of women that drink at hazardous levels sporadically during the life course. Prevention efforts may need to target transient high-risk alcohol consumers differently than consistently heavy alcohol consumers. Non-response bias and attrition may have caused the prevalence of both entrenched and episodic heavy consumption to be underestimated.
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Trim RS, Schuckit MA, Smith TL. The relationships of the level of response to alcohol and additional characteristics to alcohol use disorders across adulthood: a discrete-time survival analysis. Alcohol Clin Exp Res 2009; 33:1562-70. [PMID: 19485971 DOI: 10.1111/j.1530-0277.2009.00984.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND A low level of response (LR) to alcohol has been shown to relate to a higher risk for alcohol use disorders (AUDs). However, no previous research has examined the association between LR and the development of AUDs in the context of additional robust risk factors for AUDs. This study evaluated whether LR and other related characteristics predicted the occurrence of AUDs across adulthood using discrete-time survival analysis (DTSA). METHODS A total of 297 probands from the San Diego Prospective Study reported on the LR to alcohol, a family history (FH) of AUDs, the typical drinking quantity, the age of drinking onset, the body mass index and the age at the baseline (T1) assessment. Alcohol use disorders (AUDs) were evaluated at the 10-year (T10), T15, T20, and T25 follow-ups. RESULTS A low LR to alcohol predicted AUD occurrence over the course of adulthood even after controlling for the effects of other robust risk factors. Interaction effects revealed that the impact of FH on AUDs was only observed for subjects with high T1 drinking levels, and probands with high T1 drinking were at high risk for AUDs regardless of their age of onset. CONCLUSIONS The findings illustrate that LR is a unique risk factor for AUDs across adulthood, and not simply a reflection of a broader range of risk factors. The continued investigation of how LR is related to AUD onset later in life will help inform treatment providers about this high-risk population, and future longitudinal evaluations will utilize DTSA to assess rates of AUD remission as well as the onset of drinking outcomes in adolescent samples.
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Affiliation(s)
- Ryan S Trim
- Department of Psychiatry, University of California, San Diego, CA 92161-2002, USA.
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McCutcheon VV, Heath AC, Edenberg HJ, Grucza RA, Hesselbrock VM, Kramer JR, Bierut LJ, Bucholz KK. Alcohol criteria endorsement and psychiatric and drug use disorders among DUI offenders: greater severity among women and multiple offenders. Addict Behav 2009; 34:432-9. [PMID: 19167170 DOI: 10.1016/j.addbeh.2008.12.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 11/14/2008] [Accepted: 12/11/2008] [Indexed: 10/21/2022]
Abstract
PURPOSE Data from the Collaborative Study on the Genetics of Alcoholism (COGA), a high-risk family study of alcohol dependence, were used to examine differences in alcohol diagnostic criteria endorsement and psychiatric and drug use disorders by gender and by number of DUI offenses. RESULTS Individuals with two or more DUIs exhibited greater severity of alcohol dependence than those with none or one DUI. This severity was characterized in three ways: (1) higher endorsement of alcohol diagnostic criterion items, with evidence of greater severity among women, (2) higher prevalence of co-occurring lifetime psychiatric disorders, and (3) higher rates of drug use and of dependence on cocaine, stimulants, and, for women only, marijuana and opiates. CONCLUSIONS By examining gradations of disorder within a combination of two high-risk indicators, DUI and family vulnerability, this study provides useful information for clinical research about individuals with chronic and severe alcohol problems. In addition, the observed gender differences in this high-risk sample will contribute to the literature on alcohol dependence among women at the more severe end of the dependence spectrum.
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