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Malone SG, Davis CN, Piserchia Z, Setzer MR, Toikumo S, Zhou H, Winterlind EL, Gelernter J, Justice A, Leggio L, Rentsch CT, Kranzler HR, Gray JC. Alcohol use disorder and body mass index show genetic pleiotropy and shared neural associations. medRxiv 2024:2024.05.03.24306773. [PMID: 38746260 PMCID: PMC11092735 DOI: 10.1101/2024.05.03.24306773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Background The prevalence of co-occurring heavy alcohol consumption and obesity is increasing in the United States. Despite neurobiological overlap in the regulation of alcohol consumption and eating behavior, alcohol- and body mass index (BMI)-related phenotypes show no or minimal genetic correlation. We hypothesized that the lack of genetic correlation is due to mixed effect directions of variants shared by AUD and BMI. Methods We applied MiXeR, to investigate shared genetic architecture between AUD and BMI in individuals of European ancestry. We used conjunctional false discovery rate (conjFDR) analysis to detect loci associated with both phenotypes and their directional effect, Functional Mapping and Annotation (FUMA) to identify lead single nucleotide polymorphisms (SNPs), Genotype-Tissue Expression (GTEx) samples to examine gene expression enrichment across tissue types, and BrainXcan to evaluate the shared associations of AUD and BMI with brain image-derived phenotypes. Results MiXeR analysis indicated polygenic overlap of 80.9% between AUD and BMI, despite a genetic correlation (r g ) of -.03. ConjFDR analysis yielded 56 lead SNPs with the same effect direction and 76 with the opposite direction. Of the 132 shared lead SNPs, 53 were novel for both AUD and BMI. GTEx analyses identified significant overexpression in the frontal cortex (BA9), hypothalamus, cortex, anterior cingulate cortex (BA24), hippocampus, and amygdala. Amygdala and caudate nucleus gray matter volumes were significantly associated with both AUD and BMI in BrainXcan analyses. Conclusions More than half of variants significantly associated with AUD and BMI had opposite directions of effect for the traits, supporting our hypothesis that this is the basis for their lack of genetic correlation. Follow-up analyses identified brain regions implicated in executive functioning, reward, homeostasis, and food intake regulation. Together, these findings clarify the extensive polygenic overlap between AUD and BMI and elucidate several overlapping neurobiological mechanisms.
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Chassin L, Sher KJ. Understanding alcohol use and alcohol use disorders from a developmental psychopathology perspective: Research advances, challenges, and future directions. Dev Psychopathol 2024:1-15. [PMID: 38655739 DOI: 10.1017/s0954579424000671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
As part of the special issue of Development and Psychopathology honoring the remarkable contributions of Dr Dante Cicchetti, the current paper attempts to describe the recent contributions that a developmental psychopathology perspective has made in understanding the development of alcohol use and alcohol-related problems over the lifespan. The paper also identifies some of the future challenges and research directions. Because the scope of this task far exceeds the confines of a journal length article this paper does not attempt a comprehensive review. Rather, it builds on an earlier review and commentary that was published in Development and Psychopathology in 2013, with a similar goal.)Building on that work and updating its conclusions and suggestions for future directions, the current paper emphasizes findings from the research areas that were identified for further study in 2013 and the findings that have been published since that time.
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Capasso A, Tozan Y, DiClemente RJ, Pahl K. Childhood Violence, High School Academic Environment, and Adult Alcohol Use Among Latinas and Black Women: A Structural Equation Modeling Study. J Interpers Violence 2024:8862605241243372. [PMID: 38587260 DOI: 10.1177/08862605241243372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
OBJECTIVE Young Latinas and Black women drink less than women of other racial/ethnic groups but experience more alcohol-related problems in midlife. This study aims to identify modifiable factors to prevent adult onset of alcohol use disorder (AUD) in this population. METHODS Data were collected at six time points as part of the Harlem Longitudinal Development Study from 365 Latinas (47%) and Black (53%) women (mean age at time 1 = 14, standard deviation 1.3). Structural equation modeling was used to test hypothesized pathways from childhood physical and sexual abuse to AUD via depressive mood, anxiety disorders, and somatic complaints in the 20s. We also tested the moderation effect of the high school academic environment by including in the structural equation model two latent variable interaction terms between the school environment and each of the abuse variables. RESULTS Childhood physical and sexual abuse was positively associated with depressive mood, anxiety disorders, and somatic complaints when participants were in the 20s. Depressive mood mediated childhood abuse and AUD when women were in the 30s. The high school academic environment attenuated the effect of physical, but not sexual abuse, on depressive mood (β = -0.59, B = -9.38, 95% CI [-14.00, -4.76]), anxiety symptoms (β = -0.61, B = -14.19, 95% CI [-21.76, -6.61]), appetite loss (β = -0.41, B = -10.52, 95% CI [-15.61, -5.42]), and sleeplessness (β = -0.50, B = -9.56, 95% CI [-13.95, -5.17]) in the early 20s. CONCLUSIONS Our findings underscore the need to invest in early violence prevention interventions and in education to ensure equitable access to quality, academically oriented, and safe schools.
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Affiliation(s)
- Ariadna Capasso
- NYU School of Global Public Health, New York University, USA
- Health Resources in Action, Boston, MA, USA
| | - Yesim Tozan
- NYU School of Global Public Health, New York University, USA
| | | | - Kerstin Pahl
- Department of Psychiatry, New York University School of Medicine, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
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Fisher S, Benner K, Huang H, Day E. Substance Use Screening, Brief Intervention, and Referral to Treatment in Urban Settings: Barriers and Facilitators to Implementation With Minoritized Youth. J Sch Health 2024; 94:299-307. [PMID: 38239183 PMCID: PMC10939917 DOI: 10.1111/josh.13430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 12/06/2023] [Accepted: 12/17/2023] [Indexed: 02/18/2024]
Abstract
BACKGROUND Substance use in minoritized youth is associated with negative long-term health and life outcomes. The present study explores perspectives of school stakeholders at urban minority-serving schools regarding integration of an evidence-based intervention, screening, brief intervention, and referral to treatment (SBIRT) into existing school prevention models. METHODS Twenty-two participants were interviewed using the Consolidated Framework for Implementation Research to identify barriers and facilitators to SBIRT implementation. Qualitative data were transcribed, coded, and analyzed. RESULTS Four major themes related to barriers to SBIRT implementation included: lack of training, unclear role expectations, student confidentiality, and punitive school climates. The 3 major facilitators included: the feasibility of the intervention, its fit within multi-tiered systems of support, and the districts increasing collaboration with community mental health providers. These major themes along with other minor themes are discussed. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY SBIRT implementation within low-income, minority-serving schools may reduce substance use disparities among minoritized youth, improving health and life outcomes. Recommendations addressed training, school climate, and student engagement, highlighting a collaborative and supportive approach involving all stakeholders. CONCLUSIONS While SBIRT implementation has barriers and facilitators, overall, school staff were optimistic about implementation. In light of these findings, additional research should embed SBIRT in these settings.
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Affiliation(s)
- Sycarah Fisher
- Department of Educational Psychology, University of Georgia, Athens, GA USA
| | - Kalea Benner
- College of Social Work, University of Kentucky, Lexington, KY, USA
| | | | - Elizabeth Day
- Department of Educational Psychology, University of Georgia, Athens, GA USA
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Mahrs-Gould R, Jallo N, Svikis D, Ameringer S, Robins J, Elswick RK. Family history of substance problems among African Americans: Associations with drug use, drug use disorder, and prescription drug misuse. J Ethn Subst Abuse 2024:1-28. [PMID: 38530153 DOI: 10.1080/15332640.2024.2331108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
A family history of substance problems is a well-known risk factor for substance use and use disorders; however, much of this research has been conducted in studies with predominantly White subjects. The aim of this study was to examine the associations between family history density of substance problems and drug use, risk for drug use disorder, and prescription drug misuse in a sample of African American adults. Results indicate that family history density of substance problems increased the risk for all drug outcomes in the full sample. However, when subgroup analyses by gender were conducted, family history was not a risk factor among men for prescription drug misuse.
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Affiliation(s)
| | - Nancy Jallo
- Virginia Commonwealth University, Richmond, Virginia, USA
| | - Dace Svikis
- Virginia Commonwealth University, Richmond, Virginia, USA
- Institute for Women's Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | | | - Jo Robins
- Virginia Commonwealth University, Richmond, Virginia, USA
| | - R K Elswick
- Virginia Commonwealth University, Richmond, Virginia, USA
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Miller AP, Baranger DAA, Paul SE, Garavan H, Mackey S, Tapert SF, LeBlanc KH, Agrawal A, Bogdan R. Neuroanatomical variability associated with early substance use initiation: Results from the ABCD Study. medRxiv 2024:2024.03.06.24303876. [PMID: 38496425 PMCID: PMC10942495 DOI: 10.1101/2024.03.06.24303876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
The extent to which neuroanatomical variability associated with substance involvement reflects pre-existing risk and/or consequences of substance exposure remains poorly understood. In the Adolescent Brain Cognitive DevelopmentSM (ABCD®) Study, we identify associations between global and regional differences in brain structure and early substance use initiation (i.e., occurring <15 years of age; nsanalytic=6,556-9,804), with evidence that associations precede initiation. Neurodevelopmental variability in brain structure may confer risk for substance involvement.
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Affiliation(s)
- Alex P. Miller
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - David A. A. Baranger
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States
| | - Sarah E. Paul
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont Lamer College of Medicine, Burlington, VT, United States
| | - Scott Mackey
- Department of Psychiatry, University of Vermont Lamer College of Medicine, Burlington, VT, United States
| | - Susan F. Tapert
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
| | - Kimberly H. LeBlanc
- Division of Extramural Research, National Institute on Drug Abuse, Bethesda, MA, United States
| | - Arpana Agrawal
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - Ryan Bogdan
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States
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Goldstein SC, Newberger NG, Schick MR, Ferguson JJ, Collins SE, Haeny AM, Weiss NH. A systematic meta-epidemiologic review on nonabstinence-inclusive interventions for substance use: inclusion of race/ethnicity and sex assigned at birth/gender. Am J Drug Alcohol Abuse 2024:1-15. [PMID: 38411974 DOI: 10.1080/00952990.2024.2308087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/16/2024] [Indexed: 02/28/2024]
Abstract
Background: Minoritized racial/ethnic and sex assigned at birth/gender groups experience disproportionate substance-related harm. Focusing on reducing substance-related harm without requiring abstinence is a promising approach.Objectives: The purpose of this meta-epidemiologic systematic review was to examine inclusion of racial/ethnic and sex assigned at birth/gender in published studies of nonabstinence-inclusive interventions for substance use.Methods: We systematically searched databases (PubMed and PsycINFO) on May 26, 2022 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Articles were eligible for inclusion if they: 1) reported in English language, 2) had a primary goal of investigating a nonabstinence-inclusive intervention to address substance use, 3) used human subjects, and 4) only included adults aged 18 or older. Two coders screened initial articles and assessed eligibility criteria of full text articles. A third consensus rater reviewed all coding discrepancies. For the remaining full-length articles, an independent rater extracted information relevant to study goalsResults: The search strategy yielded 5,759 records. 235 included articles remained. Only 73 articles (31.1%) fully reported on both racial/ethnic and sex assigned at birth/gender, and only seven articles (3.0%) reported subgroup analyses examining treatment efficacy across minoritized groups. Nine articles (3.8%) mentioned inclusion and diversity regarding both racial/ethnic and sex assigned at birth/gender in their discussion and four articles (1.7%) broadly mentioned a lack of diversity in their limitationsConclusion: Findings highlight that little is known about nonabstinence-inclusive interventions to address substance use for individuals from minoritized racial/ethnic and sex assigned at birth/gender groups.
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Affiliation(s)
- Silvi C Goldstein
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Noam G Newberger
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Melissa R Schick
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Susan E Collins
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Angela M Haeny
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
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Wallace GT, Whichard C, Augustyn M, Henry KL. Heavy episodic drinking in adolescence and alcohol-related problems in adulthood: A developmental approach to alcohol use across the life course. Dev Psychopathol 2024; 36:349-365. [PMID: 36503558 DOI: 10.1017/s0954579422001249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Heavy episodic drinking (HED) is a major public health concern, and youth who engage in HED are at increased risk for alcohol-related problems that continue into adulthood. Importantly, there is heterogeneity in the onset and course of adolescent HED, as youth exhibit different trajectories of initiation and progression into heavy drinking. Much of what is known about the etiology of adolescent HED and alcohol-related problems that persist into adulthood comes from studies of predominantly White, middle-class youth. Because alcohol use and related problems vary by race/ethnicity and socioeconomic status, it is unclear whether previous findings are relevant for understanding developmental antecedents and distal consequences of adolescent HED for minoritized individuals. In the current study, we utilize a developmental psychopathology perspective to fill this gap in the literature. Using a racially and economically diverse cohort followed from adolescence well into adulthood, we apply group-based trajectory modeling (GBTM) to identify patterns of involvement in HED from age 14 to 17 years. We then investigate developmental antecedents of GBTM class membership, and alcohol-related distal outcomes in adulthood (∼ age 31 years) associated with GBTM class membership. Results highlight the importance of adolescent alcohol use in predicting future alcohol use in adulthood.
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Affiliation(s)
- Gemma T Wallace
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Corey Whichard
- School of Criminal Justice, University at Albany, State University of New York, Albany, NY, USA
| | - Megan Augustyn
- Department of Criminology & Criminal Justice, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Kimberly L Henry
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
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Smith NC. Residential segregation and Black-White differences in physical and mental health: Evidence of a health paradox? Soc Sci Med 2024; 340:116417. [PMID: 38007966 DOI: 10.1016/j.socscimed.2023.116417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/30/2023] [Accepted: 11/09/2023] [Indexed: 11/28/2023]
Abstract
Ample research finds that residential segregation is detrimental to Black Americans' physical health and exacerbates Black-White physical health disparities. However, less is known about how residential segregation may influence Black Americans' mental health and Black-White differences in mental health. Drawing on U.S. census data and a state representative study of Indiana residents (N = 2,685), I examine associations between residential segregation and multiple dimensions of physical and mental health. Consistent with past research, I find that residential segregation has an adverse association with physical health among Black respondents. In contrast, I find residential segregation to have a salubrious association with Black respondents' mental health, producing a Black mental health advantage at higher levels of segregation. I conclude by discussing the implications of these findings for research on residential segregation and health and the Black-White mental health paradox.
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Affiliation(s)
- Nicholas C Smith
- University of Maryland, Department of Sociology, 3141 Parren J. Mitchell Art-Sociology Building, RM 3137, College Park, MD, 20742, USA.
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Buckner JD, Zvolensky MJ, Scherzer CR. Alcohol and cannabis dual use among Black adults: Associations with alcohol use, use-related problems, and race-based discrimination. Am J Addict 2024; 33:65-70. [PMID: 37689991 PMCID: PMC10846665 DOI: 10.1111/ajad.13480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Black adults who drink alcohol appear at risk for poor alcohol-related outcomes, yet little research has examined whether cannabis use among those who consume alcohol (alcohol-cannabis dual use) is related to worse alcohol-related consequences, as observed in predominantly White samples. Further, it may be that experiencing more race-based discrimination may be related to using multiple substances to cope with such experiences; however, no known studies have examined the impact of race-based discrimination on alcohol-cannabis dual use. METHODS Participants were 270 Black undergraduates who endorsed past-month drinking, 112 of whom endorsed alcohol-cannabis dual use. RESULTS The dual use group reported heavier drinking, more drinking-related problems, and more race-based microaggressions (but not overt racism) than the alcohol-only group. CONCLUSIONS The use of cannabis among Black young adults who drink alcohol was related to heavier drinking and more alcohol-related problems. Further, experiencing more microaggressions may place these individuals at risk for using multiple substances, presumably to cope with these experiences. SCIENTIFIC SIGNIFICANCE Considering models suggesting that the dual use of cannabis may result in less alcohol use, the current study highlights that for Black adults who consume alcohol, cannabis dual use is related to heavier drinking and more alcohol-related problems, which can inform intervention and treatment efforts.
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Affiliation(s)
- Julia D. Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, United States
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- HEALTH Institute, University of Houston, Houston, TX, United States
| | - Caroline R. Scherzer
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
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Haeny AM, Chowdhary A, King J, Sypher I, O'Malley SS, Sinha R. A thematic analysis of stress, substance-cue, and neutral/relaxing events to inform approaches for improving treatment among Black adults who use substances. J Subst Use Addict Treat 2024; 156:209184. [PMID: 37866439 DOI: 10.1016/j.josat.2023.209184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION To inform approaches for adapting substance use treatment for Black adults, the aim of this study was to thematically analyze the stressors, triggers for substance use, and neutral/relaxing events reported among Black adults who participated in a lab paradigm. METHODS The sample included 36 Black adults (mean age [years] = 37.47, SD = 7.30; 53 % male, 12 (33 %) with alcohol use disorder, 12 (33 %) with cocaine use disorder, and 12 (33 %) healthy controls). All participants provided detailed stimulus and response context information on the most stressful event they experienced in the past year, an event that involved substance use, and a neutral/relaxing event in a structured interview using a scene development questionnaire, and this information was utilized to generate a personalized imagery script for each event using standardized procedures. Thematic analyses identified the key themes reported within scripts. RESULTS Consistent with a prior thematic analysis on a majority White sample, we found the following themes for the stress scripts: Relational (Violation, Loss, Parenting, Betrayal, Isolation vs. support), Environmental (Housing, Legal), and Achievement (Employment, Role in household). However, our analyses also resulted in new stress themes: Relational (Violation-Racial Microaggressions) and Institutional (Time Wasted). The substance use scripts consisted of the following trigger themes: Social (Social Facilitation, Socially-Sanctioned Substance Use Event, Exposure to Substance Use Friends/Associates), Internal (Free Time, Boredom, Thoughts of Using Substance, Frustration, Reward), and Environment (Availability of Substance, Celebration, Party Environment, Food, Hot Day, Money/Payday). The neutral/relaxing scripts themes were: Outdoor Activities (Admiring Nature, People Watching, Observing Surroundings, Enjoying the Sun, Playing in the Sand, Walking), Quiet Activities (Silence/Quiet, Prayer, Reading), and Indoor Activities (Radio, Television, Bath/Shower, Bed/Chair, Observing from a Window). We found sex differences across scripts. CONCLUSIONS The results suggest that Black people experience unique stressors (e.g., institutional and racial stressors) that are important to consider when modifying treatment to improve outcomes among this group. In addition to stressors, this study also identified high-risk situations involving triggers for use. Taken together these findings suggest targets for the tailoring of coping strategies that could be incorporated for the development of culturally relevant behavioral treatment for SUD.
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Affiliation(s)
- Angela M Haeny
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; Race Equity and Addiction Lab at Yale, New Haven, New Haven, CT 06519, USA.
| | - Aishwarya Chowdhary
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; Yale Stress Center, New Haven, CT 06511, USA
| | - Jaelen King
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; Race Equity and Addiction Lab at Yale, New Haven, New Haven, CT 06519, USA
| | - Isaiah Sypher
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; Race Equity and Addiction Lab at Yale, New Haven, New Haven, CT 06519, USA
| | | | - Rajita Sinha
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; Yale Stress Center, New Haven, CT 06511, USA
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Abstract
The current review describes updated information on the evidence-based assessment of substance use disorder. We offer an overview of the state of the science for substance-related assessment targets, instruments (screening, diagnosis, outcome and treatment monitoring, and psychosocial functioning and wellbeing) and processes (relational and technical) as well as recommendations for each of these three components. We encourage assessors to reflect on their own biases, beliefs, and values, including how those relate to people that use substances, and to view the individual as a whole person. It is important to consider a person's profile of symptoms and functioning inclusive of strengths, comorbidities, and social and cultural determinants. Collaborating with the patient to select the assessment target that best fits their goals and integration of assessment information in a holistic manner is critical. We conclude by providing recommendations for assessment targets, instruments, and processes as well as recommendations for comprehensive substance use disorder assessment, and describe future directions for research.
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Affiliation(s)
- Cassandra L Boness
- University of New Mexico, Center on Alcohol, Substance use, And Addictions, Albuquerque, NM, USA
| | | | - Chelsea Sleep
- Cincinnati VA Medical Center, OH, USA
- University of Cincinnati, OH, USA
| | - Kamilla L Venner
- University of New Mexico, Center on Alcohol, Substance use, And Addictions, Albuquerque, NM, USA
| | - Katie Witkiewitz
- University of New Mexico, Center on Alcohol, Substance use, And Addictions, Albuquerque, NM, USA
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Sun S. Racial/Ethnic Heterogeneity in Parental Wealth and Substance Use from Adolescence to Young Adulthood. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01893-y. [PMID: 38114858 DOI: 10.1007/s40615-023-01893-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/26/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Substance use has a negative impact on health outcomes, at the individual and population levels. Little consensus exists regarding the relationship between socioeconomic position and substance use across race/ethnicity. This study examines how race/ethnicity and socioeconomic factors, especially parental wealth, are associated with substance use across an 18-year span from adolescence to young adulthood. METHOD Data were drawn from the National Longitudinal Survey of Youth 1997. Substance use behaviors were measured by self-reported heavy episodic drinking, daily cigarette smoking, and use of cannabis. Parental wealth and parental education were measured at baseline. Other socioeconomic factors included education, employment status, and household income. Two-level logistic regression was performed. RESULTS White respondents were more likely to drink, smoke cigarettes, and use cannabis compared to other racial/ethnic groups. More parental wealth was associated with greater odds of heavy episodic drinking, but lower odds of cigarette and cannabis usage. Race/ethnicity modifies the relationships between parental wealth and substance use. Whereas Black respondents from wealthier families had lower odds of heavy episodic drinking, the direction was opposite among white respondents. Wealth functioned as a protective factor against smoking for all groups, although to a lesser extent among respondents of color than for white respondents. Finally, wealthier Hispanics were more likely to smoke daily and use cannabis compared to other racial/ethnic groups. CONCLUSION These findings highlight a nuanced patterning of racial/ethnic heterogeneity in the relationship between parental wealth and substance use behaviors. Implications for policy and programming are discussed.
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Affiliation(s)
- Sicong Sun
- School of Social Welfare, The University of Kansas, 1545 Lilac Lane, Lawrence, KS, 66045, USA.
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Waddell JT, Okey SA, McDonald A, Quiroz SI, Woods-Gonzalez R, Corbin WR. Cannabis use in context: Relations among impulsive personality traits, context, and cannabis problems. Addict Behav 2023; 147:107841. [PMID: 37651903 PMCID: PMC10563507 DOI: 10.1016/j.addbeh.2023.107841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/05/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION Impulsive personality traits are associated with cannabis problems. Person-Environment Transactions Theory suggests that highly impulsive individuals behave differently in certain contexts, however little research has focused on the context in which cannabis is used. Therefore, the current study tested whether impulsive traits moderated relations between cannabis use contexts (social vs. solitary) and cannabis problems. METHOD In this cross-sectional study, college student who use cannabis (N = 435; 60.7% female) reported on their impulsive traits (i.e., negative urgency, positive urgency, premeditation, perseverance, and sensation seeking), typical cannabis use context (i.e., alone, with friends), typical cannabis use frequency, and past 30-day cannabis problems. RESULTS Both solitary cannabis use and negative urgency were associated with more cannabis problems. There were significant interactions between negative urgency and solitary cannabis use and lack of perseverance and solitary cannabis use, such that high and mean (but not low) levels of both negative urgency and lack of perseverance were associated with more cannabis problems the more frequently an individual used cannabis alone. There was also a significant interaction between sensation seeking and social cannabis use, such that high and mean (but not low) levels of sensation seeking were associated with cannabis problems for individuals who used cannabis more socially. CONCLUSIONS Findings suggest that impulsivity may potentiate risk for cannabis problems depending on the context in which cannabis is used. Prevention efforts may benefit from targeting protective strategy use in certain cannabis use contexts based upon an individual's personality traits.
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Affiliation(s)
- Jack T Waddell
- Department of Psychology, Arizona State University, USA.
| | - Sarah A Okey
- Department of Psychology, Arizona State University, USA
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15
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Shahid M, Ibrahim R, Arakelyan A, Hassan K, Sainbayar E, Pham HN, Mamas MA. Alcoholic cardiomyopathy mortality and social vulnerability index: A nationwide cross-sectional analysis. Int J Cardiol Cardiovasc Risk Prev 2023; 19:200224. [PMID: 37964864 PMCID: PMC10641739 DOI: 10.1016/j.ijcrp.2023.200224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/17/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
Background Social vulnerability index (SVI) plays a pivotal role in the outcomes of cardiovascular diseases and prevalence of alcohol use. We evaluated the impact of the SVI on alcoholic cardiomyopathy (ACM) mortality. Methods Mortality data from 1999 to 2020 and the SVI were obtained from CDC databases. Demographics such as age, sex, race/ethnicity, and geographic residence were obtained from death certificates. The SVI was divided into quartiles, with the fourth quartile (Q4) representing the highest vulnerability. Age-adjusted mortality rates across SVI quartiles were compared, and excess deaths due to higher SVI were calculated. Risk ratios were calculated using univariable Poisson regression. Results A total of 2779 deaths were seen in Q4 compared to 1672 deaths in Q1. Higher SVI accounted for 1107 excess-deaths in the US and 0.05 excess deaths per 100,000 person-years (RR: 1.38). Similar trends were seen for both male (RR: 1.43) and female (RR: 1.67) populations. Higher SVI accounted for 0.06 excess deaths per 100,000 person-years in Hispanic populations (RR: 2.50) and 0.06 excess deaths per 100,000 person-years in non-Hispanic populations (RR: 1.46). Conclusion Counties with elevated SVI experienced higher ACM mortality rates. Recognizing the impact of SVI on ACM mortality can guide targeted interventions and public health strategies, emphasizing health equity and minimizing disparities.
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Affiliation(s)
- Mahek Shahid
- Department of Medicine, University of Arizona Tucson, Tucson, AZ, USA
| | - Ramzi Ibrahim
- Department of Medicine, University of Arizona Tucson, Tucson, AZ, USA
| | - Anna Arakelyan
- Department of Anesthesiology, University of Arizona Tucson, Tucson, AZ, USA
| | - Kamal Hassan
- New York Presbyterian/Weill Cornell Medical Center, New York, NY, USA
| | | | - Hoang Nhat Pham
- Department of Medicine, University of Arizona Tucson, Tucson, AZ, USA
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16
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Kwon E, Oshri A, Zapolski TCB, Zuercher H, Kogan SM. Substance use trajectories among emerging adult Black men: Risk factors and consequences. Drug Alcohol Rev 2023; 42:1816-1824. [PMID: 37486247 PMCID: PMC10805973 DOI: 10.1111/dar.13728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
INTRODUCTION Young, Black American men experience greater social, legal and economic consequences of substance use compared with White men for comparable levels of consumption. The development of tailored interventions requires prospective information on their substance use patterns, risk factors and consequences. We identified longitudinal substance use profiles and examined their links to childhood adversity, racial discrimination and young adult problem substance use and mental health. METHODS Emerging adult Black men (n = 504, mean age = 20.26, SD = 1.08) provided fours waves of data between January 2012 and March 2021. We conducted a parallel process latent class growth analysis for three substances to explore conjoint longitudinal use patterns and investigated the risk factors and consequences of each pattern. RESULTS Three trajectory classes emerged: non-using (n = 201, 39.9%), cannabis using (n = 202, 40.1%) and poly-substance using (n = 101, 20%) groups. Threat-based childhood adversity and racial discrimination were associated with higher odds of being members of cannabis or poly-substance groups than non-using group. Deprivation-based adversity was associated with higher odds for membership in poly-substance than non-using group. At Wave 4, elevated depressive symptoms were more prevalent among poly-substance compared with cannabis using group. DISCUSSION AND CONCLUSIONS Heterogeneous substance use patterns emerged among Black American men and each pattern has distinct risk factors and outcomes in young adulthood. For prevention, more attention is needed for cannabis use patterns and psychosocial adversities that are unique to Black population.
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Affiliation(s)
- Elizabeth Kwon
- Department of Public Health, Baylor University, Waco, USA
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, USA
| | - Tamika C. B. Zapolski
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, USA
| | | | - Steven M. Kogan
- Department of Human Development and Family Science, University of Georgia, Athens, USA
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17
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Su J, Kuo SIC, Aliev F, Rabinowitz JA, Jamil B, Chan G, Edenberg HJ, Francis M, Hesselbrock V, Kamarajan C, Kinreich S, Kramer J, Lai D, McCutcheon V, Meyers J, Pandey A, Pandey G, Plawecki MH, Schuckit M, Tischfield J, Dick DM. Alcohol use polygenic risk score, social support, and alcohol use among European American and African American adults. Dev Psychopathol 2023:1-13. [PMID: 37781861 PMCID: PMC10985050 DOI: 10.1017/s0954579423001141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Alcohol use is influenced by genetic and environmental factors. We examined the interactive effects between genome-wide polygenic risk scores for alcohol use (alc-PRS) and social support in relation to alcohol use among European American (EA) and African American (AA) adults across sex and developmental stages (emerging adulthood, young adulthood, and middle adulthood). Data were drawn from 4,011 EA and 1,274 AA adults from the Collaborative Study on the Genetics of Alcoholism who were between ages 18-65 and had ever used alcohol. Participants completed the Semi-Structured Assessment for the Genetics of Alcoholism and provided saliva or blood samples for genotyping. Results indicated that social support from friends, but not family, moderated the association between alc-PRS and alcohol use among EAs and AAs (only in middle adulthood for AAs); alc-PRS was associated with higher levels of alcohol use when friend support was low, but not when friend support was high. Associations were similar across sex but differed across developmental stages. Findings support the important role of social support from friends in buffering genetic risk for alcohol use among EA and AA adults and highlight the need to consider developmental changes in the role of social support in relation to alcohol use.
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Affiliation(s)
- Jinni Su
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Sally I-Chun Kuo
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, USA
| | - Fazil Aliev
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, USA
| | - Jill A Rabinowitz
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Belal Jamil
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Grace Chan
- Department of Psychiatry, University of Connecticut, Farmington, CT, USA
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis, IN, USA
| | - Meredith Francis
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Victor Hesselbrock
- Department of Psychiatry, University of Connecticut, Farmington, CT, USA
| | - Chella Kamarajan
- Department of Psychiatry, State University of New York Downstate Medical Center, Brooklyn, USA
| | - Sivan Kinreich
- Department of Psychiatry, State University of New York Downstate Medical Center, Brooklyn, USA
| | - John Kramer
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Donbing Lai
- Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis, IN, USA
| | - Vivia McCutcheon
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Jacquelyn Meyers
- Department of Psychiatry, State University of New York Downstate Medical Center, Brooklyn, USA
| | - Ashwini Pandey
- Department of Psychiatry, State University of New York Downstate Medical Center, Brooklyn, USA
| | - Gayathri Pandey
- Department of Psychiatry, State University of New York Downstate Medical Center, Brooklyn, USA
| | | | - Marc Schuckit
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Jay Tischfield
- Department of Genetics, Rutgers University, New Brunswick, NJ, USA
| | - Danielle M Dick
- Rutgers Addiction Research Center, Rutgers University, New Brunswick, NJ, USA
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Sypher I, Pavlo A, King J, Youins R, Shumake A, Lopez J, Haeny AM. What's race got to do with it? Factors contributing to self-change from cocaine use disorder among Black adults. J Subst Use Addict Treat 2023; 153:208945. [PMID: 37654008 DOI: 10.1016/j.josat.2022.208945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/09/2022] [Accepted: 12/30/2022] [Indexed: 09/02/2023]
Abstract
INTRODUCTION A substantial number of people with substance use disorders recover without formal treatment, though we know little about the process of self-change among Black adults with cocaine use disorder (CUD) and whether racism contributes to the development of CUD and these adults' process of self-change. METHODS The study team conducted qualitative interviews with 29 Black adults using a narrative and phenomenological approach. At the time of the interview, all participants met criteria for DSM-5 CUD prior to the past year but did not meet criteria for CUD in the past year and reported that they reduced their cocaine use without formal treatment. Participants completed a qualitative interview followed by the UConn Racial/Ethnic Stress & Trauma Survey. Thematic analyses informed key themes from the qualitative interviews. RESULTS Qualitative analyses indicated several major factors that contributed to self-change from CUD: racial identity, responsibility to family, social regard, spirituality, turning point for change, and changing one's environment. These results highlight that self-change from CUD is a complex, ongoing, and multifaceted process. The identified themes align with several theories of recovery, including social control theory and the theory of stress and coping. Furthermore, the results suggest that experiences of racism are common among Black adults recovering from CUD, and that the multiple strategies employed for coping with racism may be consistent with the process of self-change. CONCLUSIONS This study shows that multiple race-related factors contribute to the development of, maintenance of, and self-change from CUD among Black adults. Better understanding these factors can help to inform drug treatment.
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Affiliation(s)
- Isaiah Sypher
- Yale School of Medicine, Yale University, New Haven, CT, United States of America.
| | - Anthony Pavlo
- Yale School of Medicine, Yale University, New Haven, CT, United States of America.
| | - Jaelen King
- Yale College, Yale University, New Haven, CT, United States of America.
| | - Richard Youins
- Yale School of Medicine, Yale University, New Haven, CT, United States of America.
| | - Amina Shumake
- Yale Divinity School, Yale University, New Haven, CT, United States of America.
| | - Joel Lopez
- Yale School of Medicine, Yale University, New Haven, CT, United States of America.
| | - Angela M Haeny
- Yale School of Medicine, Yale University, New Haven, CT, United States of America.
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19
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Jones DM, Masyn KE, Spears CA. Associations among discrimination, psychological functioning, and substance use among US Black adults aged 18-28: Moderation by racial attribution and sex. J Subst Use Addict Treat 2023; 153:209080. [PMID: 37230392 PMCID: PMC10526892 DOI: 10.1016/j.josat.2023.209080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 01/02/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Discrimination is associated with poor mental health and substance use among Black Americans, but research is needed on mediators and moderators of these relationships. This study tested whether: 1) discrimination is associated with current alcohol, tobacco (cigarette or e-cigarette), and cannabis use among US Black emerging adults; 2) psychological distress (PD) and positive well-being (PW) are mediators of discrimination-substance use relationships; and 3) these relationships are moderated by sex and attributions to discrimination (racial vs. nonracial). METHODS Using data from a 2017 US nationally representative survey, we conducted bivariate and multiple-group moderated mediation analyses among 1118 Black American adults aged 18-28. The study assessed discrimination and attribution to discrimination using the Everyday Discrimination scale, past 30-day PD with the Kessler-6 scale, and past 30-day PW with the Mental Health Continuum Short Form. We utilized probit regression for all structural equation models and adjusted final models for age. RESULTS Discrimination was positively associated with past 30-day cannabis and tobacco use directly and indirectly through PD in the overall model. Among males who reported race as the sole/main attribution to discrimination, discrimination was positively associated with alcohol, cannabis, and tobacco use through PD. Among females who reported race as the sole/main attribution to discrimination, discrimination was positively associated with cannabis use through PD. Discrimination was positively associated with tobacco use among those who reported nonracial attributions to discrimination and with alcohol use among those whose attribution was not assessed. Discrimination was positively associated with PD among those who reported race as a secondary attribution to discrimination. CONCLUSIONS Discrimination specifically attributed to race may contribute to greater PD and in turn alcohol, cannabis, and tobacco use among Black emerging adults, especially males. Future substance use prevention and treatment efforts targeted to Black American emerging adults may benefit from addressing racial discrimination and PD.
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Affiliation(s)
- Dina M Jones
- Center for the Study of Tobacco, Department Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Box #820, Little Rock, AR 72205, USA.
| | - Katherine E Masyn
- Department of Population Health Sciences, School of Public Health, Georgia State University, 140 Decatur St., Suite 471, Atlanta, GA 30303, USA.
| | - Claire A Spears
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, 140 Decatur St., Suite 612, Atlanta, GA 30303, USA.
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20
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Liu M, Wu W, Zapolski T, Cyders MA. Measurement Invariance and Differential Relationship to Substance Use of the Short UPPS-P Impulsive Behavior Scale Across Racial Groups. Assessment 2023; 30:2212-2222. [PMID: 36604806 PMCID: PMC10634311 DOI: 10.1177/10731911221146339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The Short UPPS-P Impulsive Behavior (SUPPS-P) scale assesses impulsive traits; however, its use among racial/ethnic minorities needs further testing. The aims of this study are to (a) test the measurement invariance of the SUPPS-P scale between White and racial/ethnic minority groups and (b) determine whether impulsive personality traits differentially relate to substance use outcomes across these groups. Participants were 1,301 young adults and recruited through a large public university or Amazon's Mechanical Turk. Multigroup confirmatory factor analysis concluded strong measurement invariance for Black, Asian American, and Hispanic/Latino groups, each compared with a White group. Most relationships between SUPPS-P traits and substance use did not differ across the groups compared, although two differences emerged with alcohol use. The SUPPS-P can validly and reliably measure impulsive traits in Black, Hispanic/Latino, and Asian American young to middle adults. Previous findings on risk patterns with the SUPPS-P likely generalize to these groups.
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Affiliation(s)
- Melissa Liu
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Wei Wu
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Tamika Zapolski
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Melissa A. Cyders
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN
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21
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Zapolski TCB, Deppermann VA. Examining promotive and protective effects of ethnic identity on alcohol and cannabis use among Black young adults. J Subst Use Addict Treat 2023; 153:209009. [PMID: 36921769 DOI: 10.1016/j.josat.2023.209009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/20/2022] [Accepted: 02/27/2023] [Indexed: 03/14/2023]
Abstract
INTRODUCTION Experiences of racial discrimination among Black Americans are associated with numerous adverse behavioral health outcomes, including risk for substance use. Research has shown ethnic identity to be directly related to reduced substance use risk among Black Americans, as well as mitigate substance use risk as a consequence of exposure to racial discrimination. However, whether the specific facet of ethnic identity (affirmation and exploration), is related to the relationship between racial discrimination and problem substance use based on substance type is unclear. Thus, the current study examined 1) the association between ethnic identity (affirmation and exploration) and problem alcohol and cannabis use, and 2) whether ethnic identity affirmation or exploration moderates the association between racial discrimination and problem substance use among a sample of Black young adults. METHODS Three-hundred and ninety Black young adults ages 18-24 (M = 20.6, 62 % female, 85 % monoracial) completed an online survey that included measures on past-year experiences of racial discrimination, ethnic identity affirmation and exploration, and problem alcohol and cannabis use. Utilizing multiple linear regression and the PROCESS macro, the study examined the promotive (direct) association between ethnic identity and problem substance use, and the protective (moderating) effect of ethnic identity on the relationship between racial discrimination and problem substance use. RESULTS After accounting for the demographic covariates of age, gender (male, female, and other), and race (monoracial and bi/multiracial), higher ethnic identity affirmation was significantly associated with lower problem alcohol, and higher ethnic identity exploration was significantly associated with lower problem alcohol and cannabis use. The study also observed a moderating effect of ethnic identity affirmation and exploration on the relationship between racial discrimination and problem alcohol use. Specifically, the association between racial discrimination and problem alcohol use weakened at higher levels of ethnic identity affirmation and exploration. Neither ethnic identity affirmation nor exploration significantly moderated the relationship between racial discrimination and problem cannabis use. CONCLUSION Findings suggest that ethnic identity is associated with problem alcohol use and may also reduce the strength of the association between racial discrimination and problem alcohol use, although these findings need to be confirmed with longitudinal study designs. If supported, interventions focused on strengthening one's ethnic identity affirmation and exploration may offer a potential target for interventions addressing alcohol misuse among Black young adults. However, more research should seek to understand promotive and protective factors for problem cannabis use among Black young adults.
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Affiliation(s)
- Tamika C B Zapolski
- Department of Psychiatry, Indiana University School of Medicine, 410 W 10th St, HITS 2017, Indianapolis, IN 46202, United States of America.
| | - Venessannah A Deppermann
- Department of Psychological Science, Ball State University, North Quad (NQ), Room 104, Muncie, IN 47306, United States of America.
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22
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Figuereo V, Rosales R, Zelaya DG, Inirio Z, Moreno O. Examining a Race-Sex Interaction Effect on Binge Drinking Among Afro-Latina/o Adults in the US. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01778-0. [PMID: 37697146 DOI: 10.1007/s40615-023-01778-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/13/2023]
Abstract
Latinx/es are often racially homogenized in alcohol use disparities research, leaving the behavioral and mental health status of Afro-Latinx/es unknown. Though Latina/o and Black adults consume less alcohol than non-Latina/o Whites, they may binge drink to cope with discrimination. Gendered racism uniquely and negatively affects Black women's psychological well-being and may increase their chances of engaging in risky drinking. This may be the case for Afro-Latina women, but no study has disaggregated alcohol use disparity outcomes among a nationally representative sample of Latina/o adults by race and sex. This study (1) examines the relationship between racial self-classification (White-Latina/os vs. Afro-Latina/os) and binge drinking in the past year and (2) tests whether sex (male vs. female) moderates the relationship between race and binge drinking. Secondary data that included a respondent sample of 9415 Latina/o adults was obtained and analyzed from the 2013-2018 National Health Interview Survey. Multivariate analyses included logistic regression models to assess the main effects of race, sex, and interaction effect of the two on binge drinking while controlling for sociodemographic variables. The probability of Afro-Latina/o adults binge drinking trends lower than White-Latina/os. Respondents' sex moderated the association between racial self-classification and binge drinking. We discuss racial identity salience, mujerismo, and gendered racism as possible protective and risk factors for Afro-Latina/os and Afro-Latina women to contextualize these findings.
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Affiliation(s)
- Victor Figuereo
- School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Robert Rosales
- School of Public Health, Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - David G Zelaya
- School of Public Health, Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Zuly Inirio
- Center for Ethnic Studies Research, University of Pittsburgh, Pittsburgh, PA, USA
| | - Oswaldo Moreno
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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23
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Trucco EM, Fallah-Sohy N, Cristello JV, Hartmann SA. The Role of Socialization Contexts on Adolescent Substance Use across Racial and Ethnic Groups. Curr Addict Rep 2023; 10:412-421. [PMID: 37691834 PMCID: PMC10491413 DOI: 10.1007/s40429-023-00496-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 09/12/2023]
Abstract
Purpose of Review This review summarizes theories and empirical work regarding socialization contexts contributing to substance use across marginalized adolescents. Future directions and recommendations to minimize the perpetuation of racial stereotypes are provided. Recent Findings Neighborhoods high in social cohesion may offset substance use risk. Promoting school connectedness via increased support from teachers and peers could reduce school-based discrimination and enhance feelings of belongingness. The influence of peers on substance use engagement largely differs across racial groups and level of acculturation. Family cultural values emphasizing respect, obedience, and collectivism offer protection from substance use. Summary Despite lower prevalence rates of adolescent substance use within racial/ethnic groups, rates of negative consequences due to substances are far greater compared to White adolescents. Transcultural factors (e.g., strong family ties), as well as culture-specific factors, should be leveraged to delay the onset of substance use and prevent negative sequelae resulting from substance use initiation.
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Affiliation(s)
- Elisa M Trucco
- Florida International University, Psychology Department, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
- Florida International University, Center for Children and Families, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
- University of Michigan, Psychiatry Department, 4250 Plymouth Road, Ann Arbor, MI 48109
| | - Nilofar Fallah-Sohy
- Florida International University, Psychology Department, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
- Florida International University, Center for Children and Families, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
| | - Julie V Cristello
- Florida International University, Psychology Department, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
- Florida International University, Center for Children and Families, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
| | - Sarah A Hartmann
- Florida International University, Psychology Department, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
- Florida International University, Center for Children and Families, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
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24
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Cockerham WC. Health Lifestyle Theory in a Changing Society: The Rise of Infectious Diseases and Digitalization. J Health Soc Behav 2023; 64:437-451. [PMID: 36912383 DOI: 10.1177/00221465231155609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Social change produces alterations in society that necessitate changes in sociological theories. Two significant changes affecting health lifestyle theory are the behaviors associated with the COVID-19 pandemic and the digitalization of society. The health-protective practices emerging from the ongoing pandemic and the recent parade of other newly emerging infectious diseases need to be included in the theory's framework. Moreover, the extensive digitalization of today's society leads to the addition of connectivities (electronic networks) as a structural variable. Connectivities serve as a computational authority influencing health lifestyle practices through health apps and other digital resources in contrast to collectivities (human social networks) as a normative authority. The recent literature supporting these features in an updated and expanded model of health lifestyle theory is discussed.
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Affiliation(s)
- William C Cockerham
- University of Alabama at Birmingham, Birmingham, AL, USA
- College of William & Mary, Williamsburg, VA, USA
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25
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Jia-Richards M, Williams EC, Rosland AM, Boudreaux-Kelly MY, Luther JF, Mikolic J, Chinman MJ, Daniels K, Bachrach RL. Unhealthy alcohol use and brief intervention rates among high and low complexity veterans seeking primary care services in the Veterans Health Administration. J Subst Use Addict Treat 2023; 152:209117. [PMID: 37355154 PMCID: PMC10527472 DOI: 10.1016/j.josat.2023.209117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/31/2023] [Accepted: 06/21/2023] [Indexed: 06/26/2023]
Abstract
INTRODUCTION Brief intervention (BI) is recommended for all primary care (PC) patients who screen positive for unhealthy alcohol use; however, patients with multiple chronic health conditions who are at high-risk of hospitalization (i.e., "high complexity" patients) may face disparities in receiving BIs in PC. The current study investigated whether high complexity and low complexity patients in the Veterans Health Administration (VHA) differed regarding screening positive for unhealthy alcohol use, alcohol-use severity, and receipt of BI for those with unhealthy alcohol use. METHODS Patients were veterans receiving PC services at the VHA in a mid-Atlantic region of the United States. The study extracted VHA administrative and clinical data for a total of 282,242 patients who had ≥1 PC visits between 1/1/2014 and 12/31/2014, during which they were screened for unhealthy alcohol use by the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). The study defined high complexity patients as those within and above the 90th percentile of risk for hospitalization per the VHA's Care Assessment Need Score. Logistic regression models assessed if being a high complexity patient was associated with screening positive for unhealthy alcohol use (AUDIT-C ≥ 5), severity of unhealthy alcohol use in those who screened positive (AUDIT-C score range 5-12), and receipt of BI in those who screened positive. RESULTS Our sample was 94.5% male, 83% White, 13% Black, 4% other race, and 1.7% Hispanic. A total of 10,813 (3.8%) patients screened positive for unhealthy alcohol use from which we identified 569 (5.3%) high complexity and 10,128 (93.6%) low complexity patients (n = 116 removed due to missing complexity data). Relative to low complexity patients, high complexity patients were less likely to screen positive for unhealthy alcohol use (3.3% vs. 4.1%, AOR = 0.59, p < .001); however, in patients who screened positive, high complexity patients had higher AUDIT-C scores (Mean AUDIT-C = 7.75 vs. 6.87, AOR = 1.46, p < .001) and were less likely to receive a BI (78.0% vs. 92.6%, AOR = 0.42, p < .001). CONCLUSIONS Disparities in BI exist for highly complex patients despite having more severe unhealthy alcohol use. Future research should examine the specific patient- and/or clinic-level factors impeding BI delivery for complex patients.
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Affiliation(s)
| | - Emily C Williams
- Department of Health Systems and Population Health, University of Washington, School of Public Health, Seattle, WA, USA; Health Services Research & Development (HSR&D) Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Ann-Marie Rosland
- Center for Health Equity and Research Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - James F Luther
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA; Mental Illness Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Joseph Mikolic
- StatCore, Veterans Affairs Pittsburgh Healthcare System Research Office, Pittsburgh, PA, USA
| | - Matthew J Chinman
- Center for Health Equity and Research Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA; Mental Illness Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA; The RAND Corporation, Pittsburgh, PA, USA
| | - Karin Daniels
- Center for Health Equity and Research Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Rachel L Bachrach
- Center for Health Equity and Research Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Mental Illness Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
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Wandji SR, Abshire DA, Davis JE, Tavakoli AS, Pope R. Substance use disorders among African-American men in the rural south: A scoping review. J Ethn Subst Abuse 2023:1-23. [PMID: 37655703 DOI: 10.1080/15332640.2023.2248029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
African American (AA) men in the rural South may be at high risk for experiencing adverse health outcomes from substance use (SU). We conducted a scoping review to explore the research on SU among rural AA men in the rural South of the United States (US). Ten articles addressed the following thematic areas pertaining to SU: factors associated with SU (n = 6), associations between substance use and health outcomes (n = 2), and the influence of impulsivity on SU (n = 2). Additional research on SU among AA men in the rural South is needed, particularly pertaining to treatment-related considerations.
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Affiliation(s)
| | | | - Jean E Davis
- University of South Carolina, Columbia, South Carolina
| | | | - Robert Pope
- Dominican University of California, San Rafael, California
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Banks AN. Adverse Childhood Experiences and Alcohol Use among Black College Students: Examining the Mediating Roles of Depression and Coping Drinking Motives. Subst Use Misuse 2023; 58:1798-1804. [PMID: 37644693 DOI: 10.1080/10826084.2023.2247058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Background: Over the past two decades, research has linked adverse childhood experiences (ACEs) to adult health-risk behaviors such as excessive alcohol use. Yet, few have investigated health-risk behaviors among Black college students. Research suggests that Black college students are at lower risk for hazardous drinking patterns, yet ACEs appear to alter the drinking patterns of Black students. Other studies have also shown depressive symptoms and coping-motivated drinking to predict greater alcohol consumption for this ethnic group. Objective: The current study investigated the relationship between ACEs and hazardous patterns of drinking, including frequency of alcohol use, binge, and heavy drinking episodes, using a sample of 282 Black students attending a historically black college/university (HBCU). Results: Depressive symptoms and coping drinking motives were tested as serial mediators between ACEs and the three drinking patterns. Results revealed a significant indirect effect of ACEs on the frequency of alcohol use, binge, and heavy drinking episodes, through depressive symptoms and coping drinking motives. Depressive symptoms also independently mediated the relationship between ACEs and heavy drinking episodes. Conclusion: The finding suggested that drinking perhaps serves as a maladaptive coping strategy to address underlying early life stress and depression for Black students.
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Affiliation(s)
- Amanda N Banks
- Department of Psychology, Prairie View A&M University, Prairie View, Texas, USA
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Vincent W, Del Río-González AM, Neilands TB, Bowleg L. Resilience and Its Limits: The Roles of Individual Resilience, Social Capital, Racial Discrimination, and Binge Drinking on Sexual Behavior Among Black Heterosexual Men. Arch Sex Behav 2023; 52:1419-1434. [PMID: 36512168 DOI: 10.1007/s10508-022-02488-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/21/2022] [Accepted: 11/16/2022] [Indexed: 06/17/2023]
Abstract
In response to the increased recognition of racism as a public health crisis, we assessed links between racial discrimination and HIV-related risk behavior for Black men. Specifically, using survey data from 530 Black heterosexual men (18-44 years old, M = 31.0, SD = 7.8), we tested two moderated-mediation models: (1) a protective model, in which resilience and social capital protected against the indirect effect of racial discrimination on alcohol-related sexual behavior via binge drinking, and (2) a bounded model, in which racial discrimination limited the indirect effects of resilience and social capital on alcohol-related sexual behavior via binge drinking. We found support for the bounded model only. Specifically, resilience was indirectly associated with decreased alcohol-related sexual behavior via lower binge drinking when racial discrimination was low to moderately high, but not when racial discrimination was at its highest levels. Resilience was not directly associated with alcohol-related sexual behavior. Social capital was directly related to lower odds of alcohol-related sexual behavior. At high levels of racial discrimination, however, social capital was indirectly related to increased alcohol-related sexual behavior via binge drinking. High levels of racial discrimination limit beneficial effects of resilience on alcohol-related sexual behavior. Social capital maintains a beneficial effect if social bonds are not associated with binge-drinking norms or behaviors. Results highlight the limitations of individual-level resilience and the need to conceptualize and support resilience as a social-structural resource.
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Affiliation(s)
- Wilson Vincent
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, USA.
| | | | - Torsten B Neilands
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, CA, USA
| | - Lisa Bowleg
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
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Farmer EJ, Gerst K, Finn PR. Social incentives are stronger predictors of drinking decisions than alcohol incentives in young adults: The role of alcohol use disorder. Alcohol 2023; 108:21-29. [PMID: 36435263 PMCID: PMC10033338 DOI: 10.1016/j.alcohol.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 11/25/2022]
Abstract
This study investigated the influence of social incentives, alcohol incentives, and responsibility disincentives on decisions to attend and drink at party events in young adult college students (n = 82; 55 women, 27 men) where 36 (20 women; 16 men) had an Alcohol Use Disorder (AUD) and 46 (35 women; 11 men) were control participants without an AUD. In this within-subjects design, participants were presented with a series of hypothetical drinking event scenarios that varied in terms of social incentives (knowing many vs. few people), alcohol incentives (more vs. less alcohol available), and next-day responsibility disincentives (high vs. moderate vs. low). Participants were asked whether they would attend the event and how many drinks they would consume. Social incentives significantly predicted both decisions to attend party events and decisions about how much to drink for all participants. Participants were more likely to decide to attend and drink more at high social incentive party events (where they knew more people). However, while low social incentives generally discouraged attendance decisions, AUD participants were more likely than controls to decide to attend party events in low social incentive contexts. Alcohol incentives did not affect attendance decisions. However, alcohol incentives did increase drinking amount decisions for AUD participants. Finally, while disincentives decreased attendance and drinking amount decisions in general, AUD participants were less deterred by responsibility disincentives than controls. The results highlight the important influence of social rewards on drinking-related decisions and suggest individual differences in how incentives and disincentives affect drinking decisions in persons with an AUD.
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Affiliation(s)
- E J Farmer
- Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10th Street, Bloomington, IN, 47405, United States
| | - K Gerst
- Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10th Street, Bloomington, IN, 47405, United States
| | - Peter R Finn
- Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10th Street, Bloomington, IN, 47405, United States.
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Zhen-Duan J, Colombo D, Cruz-Gonzalez MA, Hoyos M, Alvarez K. Adverse childhood experiences and alcohol use and misuse: Testing the impact of traditional and expanded adverse childhood experiences among racially/ethnically diverse youth transitioning into adulthood. Psychol Trauma 2023; 15:S55-S64. [PMID: 37476532 PMCID: PMC10356013 DOI: 10.1037/tra0001458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Objective Traditional Adverse Childhood Experiences (T-ACEs), such as abuse and neglect, have been associated with an increased risk of youth alcohol use and misuse. This study aims to compare associations of T-ACEs and Expanded ACEs (E-ACEs), an expanded set of ACEs that encompass community-level adversities, with alcohol use and misuse by race/ethnicity. Method Data came from a three-wave (1998-1999; 1999-2000; 2004-2005) community-based study in Houston, including youth transitioning into adulthood. We compared associations between ACEs at Wave 1 and past-year alcohol use, abuse, and dependence at Wave 3. Results Participants (n = 2,391) included White (n =908), Black (n = 898) and Latinx (n = 585) youth (M (SD) = 14.00 (2.04)) transitioning into young adulthood (M (SD) = 19.77 (2.34)). T-ACEs were associated with higher odds of alcohol use, abuse, and dependence (OR = 1.15, OR = 1.18, OR = 1.24, respectively) while E-ACEs increased the odds of alcohol dependence (OR = 1.23) in the total sample. No significant differences by race/ethnicity were found. Racial/ethnic differences in increased alcohol risk were observed for some ACE items, such as bullying and use for Latinx youth (OR = 2.13) and poverty and dependence for White youth (OR = 2.01). Conclusions T-ACES and E-ACEs increase the risk of alcohol use and misuse. Results highlight the importance of preventing ACEs exposure as a risk factor for youth alcohol use and misuse. Public policies must also focus on preventing ACEs through multi-level interventions aimed at reducing violence, bullying, and financial instability.
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Affiliation(s)
- Jenny Zhen-Duan
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | - Mario A. Cruz-Gonzalez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mercedes Hoyos
- Department of Political Science, Boston College, Chestnut Hill, MA, USA
| | - Kiara Alvarez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Sterrett-Hong EM, Aliev F, Dick DM, Hooper LM, Mustanski B. Genetic Risk, Neighborhood Characteristics, and Behavioral Difficulties Among African American Adolescents Living in Very Low-Income Neighborhoods. Res Child Adolesc Psychopathol 2023; 51:653-664. [PMID: 36645613 PMCID: PMC10121776 DOI: 10.1007/s10802-023-01021-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 01/17/2023]
Abstract
Behavioral difficulties among African American youth are disproportionately detrimental to their future well-being compared to when demonstrated by White American youth. The majority of gene-environment studies of behavior have been conducted with European ancestry samples, limiting our knowledge of these processes among African Americans. This study examined the influence of positive and negative neighborhood conditions, in the context of genetic risk, on behavioral difficulties among low-income African American adolescents. Data were from the Genes, Environment, and Neighborhood Initiative study of African American youth in high-poverty neighborhoods, n = 524, M age = 15.89, SD = 1.42. DNA samples were collected using the Oragene Discovery 500 series, and polygenic risk scores for behavioral difficulties computed. Neighborhood informal social control, social cohesion, physical disorder, and social disorder were assessed. Adolescent alcohol use, hyperactivity/inattention and conduct problems were examined as outcomes. After controlling for polygenic risk, lower levels of neighborhood social disorder and higher levels of social cohesion were associated with fewer youth-reported hyperactivity/inattention and conduct problems. Less social disorder also was associated with fewer parent-reported behavioral difficulties. Neighborhood characteristics did not moderate associations between genetic risk and the outcomes. Higher levels of positive and lower levels of negative neighborhood characteristics can be associated with lower levels of behavioral difficulties among African American youth living in poverty, even after taking into account genetic risk.
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Affiliation(s)
- Emma M Sterrett-Hong
- Kent School of Social Work & Family Science, University of Louisville, Oppenheimer Hall #102, 2217 S. 3rd St, 40292, Louisville, KY, USA.
| | - Fazil Aliev
- Rutgers University, New Brunswick, United States
| | | | - Lisa M Hooper
- University of Northern Iowa, Cedar Falls, United States
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Matson PA, Stankov I, Krutkova M, Flessa S, Fichtenberg CM, Ellen JM. Investigating the Relative Influence of Romantic Sex Partners and Close Friends on Adolescent Alcohol and Marijuana Use. Prev Sci 2023; 24:676-687. [PMID: 37115474 DOI: 10.1007/s11121-023-01536-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2023] [Indexed: 04/29/2023]
Abstract
A large body of research has identified peer exposure as a key factor driving adolescent substance use. However, findings on the role of sex partners are less robust and mixed. This study aims to fill this gap by examining the independent contribution of close friends' and sex partners' alcohol and marijuana use on adolescents' use of these substances. A secondary data analysis of social network data collected in 2000-2002 from a household sample of African American youth (14-19 years old) in the Bayview and Hunter's Point neighborhoods of San Francisco was conducted. Index participants and their nominated close friends and romantic sex partners (N = 104 triads) self-reported recent alcohol and marijuana use (defined as any use in the past 3 months). Generalized estimated equations were used to estimate the independent association between adolescent's recent substance use and their friend's and sex partner's use. Adolescents with a marijuana-using romantic sex partner had a nearly six-fold higher odds of using marijuana compared to adolescents with a non-using partner, controlling for close friend's marijuana use and other confounders [OR:5.69, 95%CI: 1.94, 16.7]; no association with close friend's marijuana use was found. A similar pattern was observed for alcohol use. Adolescents with an alcohol-using romantic sex partner had increased odds of using alcohol compared to adolescents with a non-using partner, controlling for close friend's alcohol use and other confounders [OR:2.40, 95%CI: 1.02, 5.63]; no association with close friend's alcohol use was found. Romantic sex partners may play a unique and significant role in adolescent substance use. Peer-focused interventions may be more effective if they consider romantic sex partners. Future research should consider the role of romantic sex partners in changing social context related to substance use from adolescence to young adulthood.
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Affiliation(s)
- Pamela A Matson
- Department of Pediatrics, Johns Hopkins University School of Medicine, Rm 2025, 200 N. Wolfe St., David M. Rubenstein Child Health Building, Baltimore, 21287, MD, USA.
| | - Ivana Stankov
- Dornsife School of Public Health, Urban Health Collaborative, Drexel University, 3600 Market St, 7th Floor, PA, 19104, Philadelphia, USA
- UniSA Allied Health and Human Performance, University of South Australia, SAHMRI, North Tce, Adelaide, SA, 5000, Australia
| | - Mariya Krutkova
- Department of Pediatrics, Johns Hopkins University School of Medicine, Rm 2025, 200 N. Wolfe St., David M. Rubenstein Child Health Building, Baltimore, 21287, MD, USA
| | - Sarah Flessa
- Department of Pediatrics, Johns Hopkins University School of Medicine, Rm 2025, 200 N. Wolfe St., David M. Rubenstein Child Health Building, Baltimore, 21287, MD, USA
| | - Caroline M Fichtenberg
- Social Interventions Research and Evaluation Network, University of California, San Francisco, 3333 California Street, Suite 465, San Francisco, CA, 94118, USA
| | - Jonathan M Ellen
- Department of Pediatrics, Johns Hopkins University School of Medicine, Rm 2025, 200 N. Wolfe St., David M. Rubenstein Child Health Building, Baltimore, 21287, MD, USA
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Abstract
African American women experience a high prevalence of alcohol-related consequences, and no studies have explicitly examined the associations among lifetime interpersonal abuse, emotion dysregulation, and alcohol-related outcomes during the critical period of young adulthood within this population. This study used baseline data from a sample of African American young women (N = 560) who use alcohol, aged 18 to 24, enrolled in an HIV prevention intervention trial to examine whether emotion dysregulation mediated the relation between lifetime history of abuse and problematic alcohol use. Further, we sought to examine whether there were potential differential levels of problematic alcohol use based on the number of abuse types experienced. Multiple regression analyses showed that exposure to two or more forms of abuse was associated with problematic alcohol use, β = .24, p < .001, and heavy alcohol consumption, β = .23, p < .001, whereas history of a single form was not. Indirect effects of both single and multiple forms of abuse on problematic alcohol use (95% confidence interval [CI] [.16, 1.02]; [.46, 1.64]) and heavy alcohol consumption (95% CI [.02, .26]; [.05, .45]) via emotion dysregulation severity were found. Abuse and emotion dysregulation were associated with frequency of alcohol use and binge drinking, but not typical amount consumed. Hazardous alcohol consumption was prevalent among this sample of African American young women who use alcohol. This study provides preliminary evidence that emotion dysregulation may be an important mechanism buttressing the association between lifetime history of interpersonal abuse and problematic alcohol use among African American young women who use alcohol.
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Affiliation(s)
- Anthony E. Hitch
- Department of Psychology, University of Cincinnati, 4150 Edwards One Center, Cincinnati, OH, 45221
| | - Jennifer L. Brown
- Department of Psychology, University of Cincinnati, 4150 Edwards One Center, Cincinnati, OH, 45221
- Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45299, Cincinnati, OH
- Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45299
| | - Ralph J. DiClemente
- Department of Social and Behavioral Sciences, New York University, 715/719 Broadway, New York, NY, 10003
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Abstract
Behavioural economic accounts of addiction conceptualize harmful drug use as an operant reinforcer pathology, emphasizing that a drug is consumed because of overvaluation of smaller immediate rewards relative to larger delayed rewards (delay discounting) and high drug reinforcing value (drug demand). These motivational processes are within-individual determinants of behaviour. A third element of learning theory posits that harmful drug use depends on the relative constraints on access to other available activities and commodities in the choice context (alternative reinforcers), reflecting the substantial influence of environmental factors. In this Perspective, we integrate alternative reinforcers into the contemporary behavioural economic account of harmful drug use - the contextualized reinforcer pathology model - and review empirical literature across the translational spectrum in support of this model. Furthermore, we consider how increases in drug-related mortality and health disparities in addiction can be understood and potentially ameliorated via a contextualized reinforcer pathology model in which lack of alternative reinforcement is a major risk factor for addiction.
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Affiliation(s)
| | - James MacKillop
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, McMaster University/St Joseph’s Healthcare Hamilton, Hamilton, Ontario Canada
- Homewood Research Institute, Guelph, Ontario, Canada
| | - James G. Murphy
- Department of Psychology, University of Memphis, Memphis, TN USA
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Regan T, Gette J, McAfee N, Parker J. Substance use disparities by age, race, sex, and sexual orientation among persons living with HIV in the Southern U.S. Int J STD AIDS 2023:9564624231162150. [PMID: 36919911 DOI: 10.1177/09564624231162150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Alcohol and drug use is overrepresented among individuals living with Human Immunodeficiency Virus (HIV) and is associated with poor health outcomes. Determining the extent to which substance use differs between demographic profiles of people living with HIV (PLWH) would determine at-risk groups that would benefit from intervention. METHODS Cross-sectional screening data (N = 1307, Mage = 42.7 years, 66% male, 86% African American, 39% sexual minority) was examined from an HIV clinic in the southern U.S. largely treating underserved and low-income patients. Age, gender, race/ethnicity, sexual orientation, and their interactions were entered as predictors of substance use and related impairment in a series of zero-inflated negative binomial regressions. RESULTS African Americans reported more drug use (p = 0.004) and drug-related negative consequences (p = 0.003). Notably, alcohol-related negative consequences of African American heterosexuals were much higher at younger ages, compared to sexual minorities (regardless of race) and White heterosexuals of all age groups (p = 0.04). CONCLUSIONS Among PLWH in the U.S. South, African Americans may be uniquely at-risk with for problems related to drug-related functional impairment. Specifically, young heterosexual African Americans are at high risk for alcohol-related impairment. Implications are discussed.
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Affiliation(s)
- Timothy Regan
- Department of Mental Health, RinggoldID:25802Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jordan Gette
- Center of Alcohol and Substance Use Studies, RinggoldID:242612Rutgers University, Piscataway, NJ, USA
| | - Nicholas McAfee
- Department of Psychiatry and Human Behavior, RinggoldID:12276University of Mississippi Medical Center, Jackson, MI, USA
| | - Jefferson Parker
- Department of Psychiatry and Human Behavior, RinggoldID:12276University of Mississippi Medical Center, Jackson, MI, USA
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Ranney RM, Bernhard PA, Vogt D, Blosnich JR, Hoffmire CA, Cypel Y, Schneiderman AI, Maguen S. Alcohol use and treatment utilization in a national sample of veterans and nonveterans. J Subst Use Addict Treat 2023; 146:208964. [PMID: 36880905 DOI: 10.1016/j.josat.2023.208964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/01/2022] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Research comparing prevalence of alcohol use problems and alcohol treatment utilization between veterans and nonveterans is lacking. Whether predictors of alcohol use problems and alcohol treatment utilization differ in veterans vs. nonveterans is also unclear. METHODS Using survey data from national samples of post-9/11 veterans and nonveterans (N = 17,298; 13,451 veterans, 3847 nonveterans), we investigated associations between veteran status and 1) alcohol consumption, 2) need for intensive alcohol treatment, and 3) past-year and lifetime alcohol treatment utilization. We also investigated associations between predictors and these three outcomes in separate models for veterans and nonveterans. Predictors included age, gender, racial/ethnic identity, sexual orientation, marital status, education, health coverage, financial difficulty, social support, adverse childhood experiences (ACEs), and adult sexual trauma. RESULTS Population weighted regression models demonstrated that veterans reported modestly higher alcohol consumption than nonveterans, but were not significantly more likely to need intensive alcohol treatment. Veterans and nonveterans did not differ in past-year alcohol treatment utilization, but veterans were 2.8 times more likely to utilize lifetime treatment than nonveterans. We found several differences between veterans and nonveterans in associations between predictors and outcomes. For veterans, being male, having higher financial difficulty, and lower social support were associated with need for intensive treatment, but for nonveterans, only ACEs were associated with need for intensive treatment. CONCLUSIONS Veterans may benefit from interventions with social and financial support to reduce alcohol problems. These findings can help to identify veterans and nonveterans who are more likely to need treatment.
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Affiliation(s)
- Rachel M Ranney
- San Francisco VA Health Care System, 4150 Clement St, San Francisco, CA 94121, USA; University of California - San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA; Sierra Pacific Mental Illness Research Education, and Clinical Center, 4150 Clement St, San Francisco, CA 94121, USA.
| | - Paul A Bernhard
- Health Outcomes of Military Exposures, Epidemiology Program, Office of Patient Care Services, Veterans Health Administration, 810 Vermont Ave NW, Washington, DC 20420, USA
| | - Dawne Vogt
- VA Boston Health Care System, 150 S Huntington Ave, Boston, MA 02130, USA; Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
| | - John R Blosnich
- University of Southern California, 669 W 34th St, Los Angeles, CA 90089-0411, USA; VA Pittsburgh Healthcare System, 4100 Allequippa St, Pittsburgh, PA 15240, USA
| | - Claire A Hoffmire
- VA Rocky Mountain MIRECC for Suicide Prevention, 1700 N Wheeling St, Aurora, CO 80045, USA; University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, 13001 E 17(th) Pl, Aurora, CO 80045, USA
| | - Yasmin Cypel
- Health Outcomes of Military Exposures, Epidemiology Program, Office of Patient Care Services, Veterans Health Administration, 810 Vermont Ave NW, Washington, DC 20420, USA
| | - Aaron I Schneiderman
- Health Outcomes of Military Exposures, Epidemiology Program, Office of Patient Care Services, Veterans Health Administration, 810 Vermont Ave NW, Washington, DC 20420, USA
| | - Shira Maguen
- San Francisco VA Health Care System, 4150 Clement St, San Francisco, CA 94121, USA; University of California - San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA
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Miller MB, Freeman LK, Aranda A, Shoemaker S, Sisk D, Rubi S, Everson AT, Flores LY, Williams MS, Dorimé-Williams ML, McCrae CS, Borsari B. Prevalence and correlates of alcohol-induced blackout in a diverse sample of veterans. Alcohol Clin Exp Res (Hoboken) 2023; 47:395-405. [PMID: 36533546 PMCID: PMC9992316 DOI: 10.1111/acer.15002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/16/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Alcohol-induced blackouts have been associated concurrently and prospectively with alcohol-related harm. Although rates of heavy drinking among military samples tend to be comparable or higher than rates among civilian samples, the prevalence and correlates of blackout in the military population are understudied. METHODS Veterans (N = 241, 29% female, 39% Black) reported on their alcohol consumption and mental health as part of a larger health-related study among veterans. In this secondary analysis, we tested theoretically and empirically informed predictors (gender, drinking quantity, and other drug use) and consequences [depression, posttraumatic stress disorder (PTSD)] of alcohol-induced blackout. Given the diversity of the sample, potential roles of racial/ethnic discrimination and drinking to cope in alcohol-induced blackout were also tested. RESULTS Past-year prevalence of alcohol-induced blackout was 53% among veterans who drank alcohol and 68% among those who screened positive for hazardous drinking. Everyday experience of racial discrimination was the strongest concurrent predictor of alcohol-induced blackout. Drinking quantity and use of other drugs were significant correlates only in bivariate models. Controlling for gender, race, drinking quantity, other drug use, and discrimination, blackout frequency was significantly associated with symptoms of depression, but not symptoms of PTSD. Both blackout and racial discrimination were associated with drinking to cope. CONCLUSIONS The prevalence and correlates of alcohol-induced blackout among veterans are largely consistent with those documented in civilian and young adult populations. Among racially diverse groups, racial discrimination may be more strongly associated with mental health symptoms than alcohol consumption or acute alcohol consequences such as blackout.
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Affiliation(s)
- Mary Beth Miller
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
- Department of Psychological Sciences, University of Missouri, College of Arts & Sciences, 210 McAlester Hall, Columbia, MO 65211, USA
| | - Lindsey K. Freeman
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
- Department of Psychological Sciences, University of Missouri, College of Arts & Sciences, 210 McAlester Hall, Columbia, MO 65211, USA
| | - Amaya Aranda
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
- Department of Psychological Sciences, University of Missouri, College of Arts & Sciences, 210 McAlester Hall, Columbia, MO 65211, USA
| | - Sydney Shoemaker
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
| | - Delaney Sisk
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
| | - Sofia Rubi
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
| | - Adam T. Everson
- Department of Psychiatry, University of Missouri, School of Medicine, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
| | - Lisa Y. Flores
- Department of Psychological Sciences, University of Missouri, College of Arts & Sciences, 210 McAlester Hall, Columbia, MO 65211, USA
| | - Michael S. Williams
- Department of Educational Leadership & Policy Analysis, University of Missouri, College of Education, 202 Hill Hall, Columbia, MO 65211, USA
| | - Marjorie L. Dorimé-Williams
- Department of Educational Leadership & Policy Analysis, University of Missouri, College of Education, 202 Hill Hall, Columbia, MO 65211, USA
| | | | - Brian Borsari
- Mental Health Service, San Francisco VA Health Care System, San Francisco, CA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA
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Bo A, Goings TC, Evans CBR, Sharma A, Jennings Z, Durand B, Bardeen A, Murray-Lichtman A. Culturally sensitive prevention programs for substance use among adolescents of color: A systematic review and meta-analysis of randomized controlled trials. Clin Psychol Rev 2023; 99:102233. [PMID: 36495737 PMCID: PMC9847495 DOI: 10.1016/j.cpr.2022.102233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 11/05/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022]
Abstract
This systematic review and meta-analysis aims to synthesize the efficacy of culturally sensitive prevention programs for substance use outcomes among U.S. adolescents of color (aged 11 to 18 years old) and explore whether the intervention effects vary by participant and intervention characteristics. Eight electronic databases and grey literature were searched for eligible randomized controlled trials through September 2022. Robust variance estimation in meta-regression was used to synthesize treatment effect size estimates and to conduct moderator analysis. After screening, 30 unique studies were included. The average treatment effect size across all substance use outcomes (including 221 effect sizes) was Hedges's g = -0.20, 95% CI = [-0.24, -0.16]. The synthesized effect sizes were statistically significant across types of substances (alcohol, cigarette, marijuana, illicit and other drugs, and unspecified substance use), racial/ethnic groups (Hispanic, Black, and Native American), and different follow-ups (0-12 months, >12 months). Very few studies reported substance use consequences as outcomes and the synthesized effect size was non-significant. Meta-regression findings suggest that the intervention effects may vary based on the type of substance. This meta-analysis found supportive evidence of culturally sensitive prevention programs' efficacy in preventing or reducing substance use among Black, Hispanic, and Native American adolescents. More substance use prevention efforts and evidence is needed for Asian American, Pacific Islander, and multiracial adolescents.
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Affiliation(s)
- Ai Bo
- Helen Bader School of Social Welfare, Department of Social Work, University of Wisconsin-Milwaukee, Milwaukee, WI, United States.
| | - Trenette Clark Goings
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Caroline B R Evans
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Anjalee Sharma
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Zoe Jennings
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Brenna Durand
- Helen Bader School of Social Welfare, Department of Criminal Justice & Criminology, University of Wisconsin-Milwaukee, WI, United States
| | - Angela Bardeen
- Research and Instructional Services, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Andrea Murray-Lichtman
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Tran AGTT, Eustice KL, Mintert JS, Lam CK, Holzapfel J. Perceptions of peer mental health: impact of race and student-athlete status. J Am Coll Health 2023; 71:626-638. [PMID: 33830892 DOI: 10.1080/07448481.2021.1903477] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 01/26/2021] [Accepted: 02/21/2021] [Indexed: 06/12/2023]
Abstract
Objective: This study used a multi-faceted methodological approach to examine if peer perceptions of stereotyped student groups' mental health needs varied by target race and student-athlete status.Participants: In Study 1, 502 university students completed an online experiment. Study 2 data were drawn from the American College Health Association (ACHA)-National College Health Assessment (N = 65,167) and Healthy Minds Study (N = 43,487).Methods: Study 1 participants rated the severity of various mental health concerns for Black non-student-athletes, White non-student-athletes, Black student-athletes, or White student-athletes. Study 2 conceptualized peer perceptions vis-à-vis mental health patterns in national data.Results: Study 1 generally revealed lower perceived severity of mental health concerns for Black non-student-athletes. In contrast, Study 2 patterns revealed more variations across student status groups, including that Black non-student-athletes exhibited relatively high prevalence rates of numerous mental health concerns.Conclusions: Results may suggest mental health under-/over-pathologizing, with implications for training and peer-to-peer mental health interventions.
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Affiliation(s)
- Alisia G T T Tran
- College of Integrated Sciences and Arts, Arizona State University, Tempe, Arizona, USA
| | - Kristi L Eustice
- College of Integrated Sciences and Arts, Arizona State University, Tempe, Arizona, USA
| | - Jeffrey S Mintert
- College of Integrated Sciences and Arts, Arizona State University, Tempe, Arizona, USA
| | - Christina K Lam
- College of Integrated Sciences and Arts, Arizona State University, Tempe, Arizona, USA
| | - Jenny Holzapfel
- College of Integrated Sciences and Arts, Arizona State University, Tempe, Arizona, USA
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Abstract
Background: Black individuals who consume alcohol are at risk of experiencing alcohol-related problems. Psycho-sociocultural models of substance use posit that these individuals may continue to drink despite alcohol-related problems to cope with psychological distress. Emerging data indicate that social anxiety is one type of distress that may play an important role in drinking behavior among Black adults. Objectives: Yet despite evidence that drinking to cope varies as a function of sex among predominantly White samples, this is the first known study to test whether socially anxious Black women are similarly at risk for coping motivated drinking and its negative sequelae. Participants were 257 (75% female) Black undergraduates endorsing current alcohol use. Results: Among women and men, social anxiety was significantly related to more alcoholrelated problems and coping-depression and conformity motives. Among women (but not men), social anxiety was also significantly related to more coping-anxiety and greater typical drinking. Serial mediation analyses among women indicated that social anxiety was indirectly related to more alcohol problems via the serial effect of each of the relevant drinking motives (copinganxiety, coping-depression, conformity) and drinking frequency. Among men, social anxiety was indirectly related to alcohol problems via coping-depression and conformity motives. Conclusions/Importance: Findings highlight the importance of considering sex in research on psychosocial vulnerability factors associated with alcohol-related problems among Black adults.
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Affiliation(s)
- Julia D Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Paige E Morris
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Mara L Ferrie
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Caroline R Scherzer
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
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Phillips AZ, Mulia N, Subbaraman MS, Kershaw KN, Kerr WC, Karriker-Jaffe KJ. Does the relationship between alcohol retail environment and alcohol outcomes vary by depressive symptoms? Findings from a U.S. Survey of Black, Hispanic and White drinkers. Addict Behav 2023; 136:107463. [PMID: 36029722 DOI: 10.1016/j.addbeh.2022.107463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 07/19/2022] [Accepted: 08/08/2022] [Indexed: 02/03/2023]
Abstract
AIMS To assess whether associations between alcohol availability and consumption, drinking to drunkenness, and negative drinking consequences vary among individuals with elevated depressive symptoms. METHODS 10,482 current drinkers in 2005-2015 National Alcohol Surveys (50.0% female; 74.4% White, 8.7% Black, 11.1% Hispanic). Elevated depressive symptoms was defined as having symptoms suggestive of major depressive disorder (above CES-D8/PHQ-2 cut-offs) versus no/sub-threshold symptoms (below cut-offs). Inverse probability of treatment weighted and covariate adjusted Poisson models with robust standard errors estimated associations of ZIP-code bar density and off-premise outlet density (locations/1,000 residents), elevated depressive symptoms, and their interaction with past-year volume consumed, monthly drinking to drunkenness, and negative drinking consequences. Models were then stratified by sex and race and ethnicity. RESULTS Overall, 13.7% of respondents had elevated depressive symptoms. Regarding density, the only statistically significant association observed was between off-premise density and volume consumed (rate ratio = 1.3, 95% confidence interval = 1.0, 1.7). Elevated depressive symptoms were associated with higher volume consumed, prevalence of drinking to drunkenness, and prevalence of negative consequences when controlling for off-premise density or bar density. However, there was no evidence of interaction between symptoms and density in the full sample nor among subgroups. CONCLUSION This study suggests that, while elevated depressive symptoms do not alter associations between alcohol availability and alcohol use and problems, they remain associated with these outcomes among past-year drinkers in a U.S. general population sample even when accounting for differential availability. Addressing depressive symptoms should be considered along with other policies to reduce population-level drinking and alcohol problems.
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Affiliation(s)
- Aryn Z Phillips
- Northwestern University Feinberg School of Medicine, 680 N. Lakeshore Drive Suite 1400, Chicago IL 60611, USA.
| | - Nina Mulia
- Alcohol Research Group, 6001 Shellmound St. #450, Emeryville, CA 94608, USA
| | | | - Kiarri N Kershaw
- Northwestern University Feinberg School of Medicine, 680 N. Lakeshore Drive Suite 1400, Chicago IL 60611, USA
| | - William C Kerr
- Alcohol Research Group, 6001 Shellmound St. #450, Emeryville, CA 94608, USA
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Pahl K, Williams SZ, Capasso A, Lewis CF, Lekas HM. A longitudinal pathway from ethnic-racial discrimination to sexual risk behaviors among Black women and Latinas: Ethnic-racial identity exploration as a protective factor. Soc Sci Med 2023; 316:115061. [PMID: 35637046 DOI: 10.1016/j.socscimed.2022.115061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 05/11/2022] [Accepted: 05/18/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Black women and Latinas in their thirties continue to be at risk for HIV transmission via heterosexual intercourse. METHODS Informed by the Theory of Gender and Power, this study investigated a longitudinal path model linking experiences of ethnic-racial discrimination in late adolescence to sexual risk behaviors in adulthood among 492 Black women and Latinas. We also tested whether ethnic-racial identity exploration served as a resilience asset protecting women against the psychological impact of ethnic-racial discrimination. Survey data from female participants in the Harlem Longitudinal Development Study, which has followed a cohort of New York City Black and Latinx youth since 1990, were analyzed. Data for this analysis were collected at four time points when participants were on average 19, 24, 29, and 32 years of age. Structural equation modeling was used to examine a hypothesized pathway from earlier ethnic-racial discrimination to later sexual risk behaviors and the protective role of ethnic-racial identity exploration. RESULTS Results confirmed that ethnic-racial discrimination in late adolescence was linked with sexual risk behaviors in the early thirties via increased levels of affective distress in emerging adulthood, experiences of victimization in young adulthood, and substance use in the early thirties among women low in ethnic-racial identity exploration. We also found that ethnic-racial identity served as a resilience asset, as the association between discrimination in late adolescence and affective distress in emerging adulthood was not significant among women with higher levels of ethnic-racial identity exploration. CONCLUSIONS The results provide important preliminary evidence that ethnic-racial identity exploration may serve as a resilience asset among Black women and Latinas confronting racial discrimination. Further, we suggest that ethnic-racial identity exploration may constitute an important facet of critical consciousness.
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Affiliation(s)
- Kerstin Pahl
- Department of Psychiatry, New York University Grossman School of Medicine, One Park Avenue, 8th Floor, New York, NY, 10016, USA; Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.
| | - Sharifa Z Williams
- Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA
| | - Ariadna Capasso
- NYU School of Global Public Health, New York University, 708 Broadway, New York, NY, 10003, USA
| | - Crystal Fuller Lewis
- Department of Psychiatry, New York University Grossman School of Medicine, One Park Avenue, 8th Floor, New York, NY, 10016, USA; Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA
| | - Helen Maria Lekas
- Department of Psychiatry, New York University Grossman School of Medicine, One Park Avenue, 8th Floor, New York, NY, 10016, USA; Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA
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Park CJ, Freeman LK, Hall NA, Singh S, Carey KB, Merrill JE, DiBello AM, Miller MB. Gender, acculturation, and alcohol-related consequences among college students of color. J Am Coll Health 2023; 71:44-52. [PMID: 33651663 PMCID: PMC8410888 DOI: 10.1080/07448481.2021.1891079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 01/17/2021] [Accepted: 02/11/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The present study examined if identification with mainstream American culture (acculturation) and heritage culture (enculturation) are differentially associated with blackouts and other drinking consequences among male and female college students of color. PARTICIPANTS Participants were college students (N = 150) who self-identified as a racial/ethnic minority and endorsed blackouts in the past year. METHODS Regression models were used to examine gender-by-acculturation/enculturation interaction effects on alcohol-induced blackout and other alcohol-related consequences. RESULTS While acculturation was not significantly associated with either drinking outcome, enculturation showed a significant relationship with blackout frequency. Gender moderated this relationship; greater enculturation was associated with increased blackout frequency among male but not female students. CONCLUSIONS The present findings suggest the importance of considering the interplay between enculturation and gender in understanding alcohol use among college students of color. Men who endorse high levels of enculturation may be at an increased risk of experiencing negative drinking-related consequences.
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Affiliation(s)
- Chan Jeong Park
- Department of Psychiatry, University of Missouri, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
| | - Lindsey K. Freeman
- Department of Psychiatry, University of Missouri, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
| | - Nicole A. Hall
- Department of Psychiatry, University of Missouri, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
| | - Samyukta Singh
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, USA
| | - Kate B. Carey
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, USA
| | - Jennifer E. Merrill
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, USA
| | - Angelo M. DiBello
- Department of Psychology, City University of New York, Brooklyn College, 2900 Bedford Ave, Brooklyn, NY 11210, USA
| | - Mary Beth Miller
- Department of Psychiatry, University of Missouri, 1 Hospital Dr DC067.00, Columbia, MO 65212, USA
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Johnson ME, Rigg KK, Vroom EB, Akbari Z, Bristol SC. Racial/Ethnic Differences in the Effects of Adverse Childhood Experiences on Substance Misuse among Justice-Involved Children. Subst Use Misuse 2022; 58:54-65. [PMID: 36469650 PMCID: PMC9975643 DOI: 10.1080/10826084.2022.2148477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Adverse childhood experiences (ACEs) are linked to substance use (SU) and substance use disorders (SUD). However, this relationship has yet to be tested among justice-involved children (JIC), and it is unclear if racial/ethnic differences exist. This study aimed to determine: (1) whether ACEs are associated with increased risk of SU and SUD among JIC; and (2) if the effects of ACEs on SU and SUD are moderated by race/ethnicity. Methods: Bivariate and multivariate logistic regression analyses were employed to examine a statewide dataset of 79,960 JIC from the Florida Department of Juvenile Justice. Marginal odds were estimated to examine how race moderates the relationship between ACEs and SU and SUD. Results: Results showed higher ACEs scores were linked to SU and SUD. Black JIC were 2.46 times more likely, and Latinx JIC were 1.40 times more likely to report SU than white JIC. Specifically, Black and Latinx JIC with a higher average ACEs score were more likely to report SU but less likely to have ever been diagnosed with a SUD when compared to white JIC with equivalent ACEs. Conclusions: Study results highlight the need to develop trauma-informed and culturally appropriate interventions for SU and SUD among JIC.
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Affiliation(s)
- Micah E. Johnson
- Substance Misuse and Addiction Research Traineeship (SMART), Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Khary K. Rigg
- Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Enya B. Vroom
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Zahra Akbari
- Department of Economics, Martha and Spencer Love School of Business, Elon University, Elon, North Carolina, USA
| | - Skye C. Bristol
- Substance Misuse and Addiction Research Traineeship (SMART), Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
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Marks RM, Bennett ME, Williams JBW, DuMez EL, Roche DJO. SIGH, what's in a name? An examination of the factor structure and criterion validity of the (Structured Interview Guide for the) Hamilton Anxiety scale (SIGH-A) in a sample of African American adults with co-occurring trauma experience and heavy alcohol use. Exp Clin Psychopharmacol 2022; 30:841-852. [PMID: 34291990 PMCID: PMC9447374 DOI: 10.1037/pha0000508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The Hamilton Anxiety Inventory (HAM-A) is one of the oldest and most commonly used anxiety rating scales in clinical research. Despite its ubiquity, no studies have examined the scale's underlying factor structure and criterion validity among Black and African American adults with psychopathology (Mage = 42.25, SD = 11.44). Therefore, we estimated a confirmatory factor analysis of the commercially available Structured Interview Guide for the Hamilton Anxiety scale (SIGH-A; Williams, 1996) among African American adults (n = 88; 43% female) with co-occurring heavy alcohol use and trauma-related symptoms. Next, we examined the criterion validity of its Psychic and Somatic factors and overall anxiety severity score from participants who completed a single screening session (i.e., cross-sectional analysis) for a larger study. Results indicated that a two-factor solution provided an adequate fit to the data. Regression analyses indicated that the total SIGH-A score, but not its subscales, significantly predicted posttraumatic stress disorder (PTSD) severity. Neither the SIGH-A subscales nor total scores were significant predictors of alcohol consumption. The current findings suggest that the SIGH-A factor structure among African American adults with alcohol and trauma-related conditions is similar to previous reports that have tested largely White samples but highlight potential shortcomings when its subscales are used independently. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Russell M. Marks
- Department of Psychiatry, Baltimore VA Medical Center, Baltimore, MD, United States
| | - Melanie E. Bennett
- Department of Psychiatry, Baltimore VA Medical Center, Baltimore, MD, United States,Department of Psychiatry, University of Maryland Baltimore
| | | | - Emma L. DuMez
- Department of Psychiatry, University of Maryland Baltimore
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Hunter DS, Kennedy TM, Cason I, Holmes J, Pedersen SL. Examination of cross-group contact at work and school in relation to acute and retrospective discrimination experiences and drinking to cope for Black and White young adult drinkers. Exp Clin Psychopharmacol 2022; 30:820-830. [PMID: 34410795 PMCID: PMC9115889 DOI: 10.1037/pha0000515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Black drinkers experience more alcohol problems compared to White drinkers at comparable levels of alcohol use (Mulia et al., 2009; Witbrodt et al., 2014; Zapolski et al., 2014). Research has found that Black compared to White drinkers endorse drinking to cope more frequently via retrospective report (Bradizza et al., 1999; Cooper et al., 2008). Additional research is needed to understand contributors to these racial differences. The primary aim of the present study was to examine how quality and frequency of cross-group contact at work and/or school relates to experiencing discrimination and, in turn, drinking to cope. Seventy-two young adult drinkers (Mage = 25, 72% female, 28% male; 64% Black, 36% White) completed baseline questionnaires and a subset (n = 50) completed a 17-day ecological momentary assessment (EMA) protocol. Cross-group contact frequency and quality was assessed at baseline while discrimination and coping motives were assessed via retrospective report at baseline and acutely via EMA. Accounting for sociodemographic covariates, path analyses utilizing retrospective measures revealed a significant indirect pathway from race to coping motives through quality of work/school cross-group contact and discrimination experiences related to assumptions of inferiority. Identical path analyses utilizing the acute EMA data revealed a significant indirect pathway from race to coping motives through quality of work/school cross-group contact. Improving cross-group contact at work and school may reduce drinking to cope. Additional research examining multiple domains of discrimination, quality of cross-group contact, and alcohol problems over time is needed to further understanding of social determinants of health inequities in alcohol problems. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | | | - Isaac Cason
- Graduate School of Public Health, University of Pittsburgh
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Jones DM, Masyn KE, Spears CA. Discrimination, psychological functioning, and substance use among U.S. young adults aged 18-28, 2017. Exp Clin Psychopharmacol 2022; 30:884-896. [PMID: 34398638 PMCID: PMC9134875 DOI: 10.1037/pha0000502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aimed to test whether (a) discrimination is associated with past 30-day/current alcohol, cigarette, e-cigarette, alcohol, marijuana, and other illicit drug use among Black and White U.S. adults aged 18-28, (b) psychological distress (PD) and positive well-being (PW) are mediators of the discrimination-substance use relationships, and (c) the associations are moderated by race and sex. Using data from a 2017 U.S. nationally representative survey we conducted multiple-group moderated mediation analyses among 2,192 young adults aged 18-28 (508 Black males, 594 Black females, 533 White males, 557 White females). Black males had higher discrimination, Whites had higher PW, and females had higher PD scores. Discrimination was positively associated with PD and negatively associated with PW. Among all groups, discrimination was positively associated with other illicit drug (direct and indirect), and marijuana use through PD. Indirect effects were stronger among White males for other illicit drugs and Black males for marijuana. The indirect effect of discrimination and alcohol use through PW was positive for Black females and negative for all other groups examined. Among Black males only, discrimination was positively associated with cigarette and alcohol use through PD (positive) and cigarette smoking through PW (negative). This study highlights the negative influence of perceived discrimination on current licit and illicit substance use among Black and White young adults. Our results suggest that this relationship may be partially mediated by PD and PW, especially among Black male young adults. Future discrimination and substance use studies should consider potential mediation effects of poor mental health and differences by race and sex. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Dina M. Jones
- Center for the Study of Tobacco, Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences
| | - Katherine E. Masyn
- Department of Population Health Sciences, School of Public Health, Georgia State University
| | - Claire Adams Spears
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University
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Waddell JT, Gress-Smith JL, Hartman JD, Doran N, Reed B. Age, sex, and race-varying rates of alcohol use, cannabis use, and alcohol and cannabis co-use in veterans vs. non-veterans. Addict Behav 2022; 134:107418. [PMID: 35816904 DOI: 10.1016/j.addbeh.2022.107418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/10/2022] [Accepted: 06/26/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Military veterans are a high-risk group for health risk behaviors, including alcohol and cannabis use. However, research on veteran vs. non-veteran rates of alcohol/cannabis use are inconsistent across studies. Further, no research has investigated veteran vs. non-veteran rates of alcohol and cannabis co-use, and few studies have tested whether demographic variables, particularly race/ethnicity, moderate group differences. Therefore, the current study tested whether 1) veteran vs. non-veterans differed in rates of alcohol use, cannabis use, and alcohol and cannabis co-use, and 2) whether demographic covariates (age, sex, race/ethnicity) moderated associations. METHODS Data on adults (N = 706,897; 53.4% female) were derived from the 2002-2019 National Study on Drug Use and Health. Participant demographics, alcohol use frequency, drinking quantity, and cannabis use frequency were self-reported. RESULTS Non-veterans reported higher drinking quantity, cannabis frequency, and co-use. However, being a veteran was a risk factor for heavier drinking for women, ethnic/racial minoritized participants, and adults under the age of 50. Additionally, veteran status was a risk factor for cannabis use frequency in racial/ethnic minoritized participants and women. Similarly, being a veteran was a risk factor for alcohol and cannabis co-use for racial/ethnic minoritized participants, and the buffering effect of being a Veteran on co-use was reduced for older participants and women. CONCLUSIONS Results suggest that, at the population level, non-veterans may be heavier alcohol/cannabis users. However, moderating analyses suggested that being a veteran is a risk factor for women, racial/ethnic minoritized individuals, and younger individuals. Findings are discussed in terms of public health implications.
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Affiliation(s)
- Jack T Waddell
- Arizona State University, United States; Phoenix VA Health Care System, United States.
| | | | | | - Neal Doran
- University of California-San Diego Health Care System, United States
| | - Brandon Reed
- University of California-San Diego Health Care System, United States
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49
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Andrzejewski J, Calzo JP, Smith LR, Corliss HL, Felner JK. Binge drinking disparities by gender identity, race, and ethnicity in California secondary schools. J LGBT Youth 2022; 20:896-917. [PMID: 38031567 PMCID: PMC10683934 DOI: 10.1080/19361653.2022.2113198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/20/2022] [Accepted: 08/09/2022] [Indexed: 12/01/2023]
Abstract
Our objective was to estimate disparities in binge drinking among secondary school students in California at the intersection of gender identity, race, and ethnicity, without aggregating racial and ethnic categories. We combined two years of the Statewide middle and high school California Healthy Kids Survey (n=951,995) and regressed past month binge drinking on gender identity (i.e., cisgender, transgender, or not sure of their gender identity), race (i.e., white, American Indian or Alaskan Native, Asian, Black or African American, Native Hawaiian or Pacific Islander, or multiracial), and ethnicity (i.e., Hispanic/Latinx or non-Hispanic/Latinx), and their interaction. Transgender students had greater odds of reporting past month binge drinking than cisgender students, with greater magnitudes among students with minoritized racial or ethnic identities compared to non-Hispanic/Latinx white students. For example, among non-Hispanic/Latinx white students, transgender students had 1.3 times greater odds (AOR=1.30, 95% CI=1.17-1.55), whereas among Hispanic/Latinx Black or African American students, transgender students had 5.3 times greater odds (AOR=5.33, 95% CI=3.84-7.39) of reporting past month binge drinking than cisgender students. Transgender adolescents, particularly those with minoritized racial or ethnic identities, may be at disproportionate risk of binge drinking. Interventions that address systemic racism and cisgenderism from an intersectional perspective are needed.
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Affiliation(s)
- Jack Andrzejewski
- San Diego State University—University of California, San Diego, Joint Doctoral Program in Public Health, San Diego, CA
| | - Jerel P. Calzo
- San Diego State University School of Public Health, San Diego, CA
- Institute for Behavioral and Community Health, San Diego, CA
| | - Laramie R. Smith
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA
| | - Heather L. Corliss
- San Diego State University School of Public Health, San Diego, CA
- Institute for Behavioral and Community Health, San Diego, CA
| | - Jennifer K. Felner
- San Diego State University School of Public Health, San Diego, CA
- Institute for Behavioral and Community Health, San Diego, CA
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50
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Schwartz GL, Wang G, Kershaw KN, McGowan C, Kim MH, Hamad R. The long shadow of residential racial segregation: Associations between childhood residential segregation trajectories and young adult health among Black US Americans. Health Place 2022; 77:102904. [PMID: 36063651 PMCID: PMC10166594 DOI: 10.1016/j.healthplace.2022.102904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 01/10/2023]
Abstract
Residential racial segregation is a key manifestation of anti-Black structural racism, thought to be a fundamental cause of poor health; evidence has shown that it yields neighborhood disinvestment, institutional discrimination, and targeting of unhealthy products like tobacco and alcohol. Yet research on the long-term impacts of childhood exposure to residential racial segregation is limited. Here, we analyzed data on 1823 Black participants in the Panel Study of Income Dynamics, estimating associations between childhood segregation trajectories and young adult health. Black young adults who consistently lived in high-segregation neighborhoods throughout childhood experienced unhealthier smoking and drinking behaviors and higher odds of obesity compared to other trajectory groups, including children who moved into or out of high-segregation neighborhoods. Results were robust to controls for neighborhood and family poverty. Findings underscore that for Black children who grow up in segregated neighborhoods, the roots of structurally-determined health inequities are established early in life.
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Affiliation(s)
- Gabriel L Schwartz
- UCSF Philip R. Lee Institute for Health Policy Studies, 490 Illinois St, 7th Floor, San Francisco, CA, 94158, United States.
| | - Guangyi Wang
- UCSF Philip R. Lee Institute for Health Policy Studies, 490 Illinois St, 7th Floor, San Francisco, CA, 94158, United States
| | - Kiarri N Kershaw
- Northwestern Feinberg School of Medicine, Suite 1400, 680 N Lake Shore Drive, Chicago, IL, 60611, United States
| | - Cyanna McGowan
- Northwestern Feinberg School of Medicine, Suite 1400, 680 N Lake Shore Drive, Chicago, IL, 60611, United States
| | - Min Hee Kim
- UCSF Philip R. Lee Institute for Health Policy Studies, 490 Illinois St, 7th Floor, San Francisco, CA, 94158, United States
| | - Rita Hamad
- UCSF Philip R. Lee Institute for Health Policy Studies, 490 Illinois St, 7th Floor, San Francisco, CA, 94158, United States
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