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APA Journal: Psychology of Addictive Behaviors

Clarification to Bechtold et al. (2015).Open in a New Window

Reports an error in "Chronic adolescent marijuana use as a risk factor for physical and mental health problems in young adult men" by Jordan Bechtold, Theresa Simpson, Helene R. White and Dustin Pardini (Psychology of Addictive Behaviors, 2015[Sep], Vol 29[3], 552-563). For the article, planned analyses using a Wald joint significance test examined whether four adolescent marijuana use trajectory groups differed on self-reported physical and mental health outcomes assessed at age 36. This omnibus test indicated that the groups did not significantly differ in terms of their probability of reporting targeted health problems. The results from this study generated considerable controversy, including requests for supplemental analyses. More details are included. (The following abstract of the original article appeared in record 2015-34684-001.) Some evidence suggests that youth who use marijuana heavily during adolescence may be particularly prone to health problems in later adulthood (e.g., respiratory illnesses, psychotic symptoms). However, relatively few longitudinal studies have prospectively examined the long-term physical and mental health consequences associated with chronic adolescent marijuana use. The present study used data from a longitudinal sample of Black and White young men to determine whether different developmental patterns of marijuana use, assessed annually from early adolescence to the mid-20s, were associated with adverse physical (e.g., asthma, high blood pressure) and mental (e.g., psychosis, anxiety disorders) health outcomes in the mid-30s. Analyses also examined whether chronic marijuana use was more strongly associated with later health problems in Black men relative to White men. Findings from latent class growth curve analysis identified 4 distinct subgroups of marijuana users: early onset chronic users, late increasing users, adolescence-limited users, and low/nonusers. Results indicated that the 4 marijuana use trajectory groups were not significantly different in terms of their physical and mental health problems assessed in the mid-30s. The associations between marijuana group membership and later health problems did not vary significantly by race. Findings are discussed in the context of a larger body of work investigating the potential long-term health consequences of early onset chronic marijuana use, as well as the complications inherent in studying the possible link between marijuana use and health effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Development of a face-to-face injunctive norms brief motivational intervention for college drinkers and preliminary outcomes.Open in a New Window

Findings are presented from the first randomized clinical trial that compared changes in alcohol consumption and alcohol-related consequences among college student drinkers from baseline to follow-up across 4 conditions: (a) a new single component injunctive norms brief motivational intervention (IN-BMI) condition; (b) a single component descriptive norms brief motivational intervention (DN-BMI); (c) a combined IN and DN brief motivational intervention (Combined-BMI); and (d) assessment-only control. DN-BMI focused on the juxtaposition of personal, perceived, and actual alcohol use by typical same-sex students at your university. IN-BMI focused on the juxtaposition of personal, perceived, and actual attitudes about alcohol-related consequences by the typical same-sex student at your university. Exploratory analyses assessed the effect of IN-BMI and DN-BMI on matched (e.g., the effect of DN-BMI on perceived DN) and mismatched norms (e.g., the effect of DN-BMI on perceived IN). IN-BMI resulted in greater decreases in alcohol use and consequences when delivered alone and in conjunction with DN-BMI compared with the control condition. Further, the Combined-BMI condition reported greater reductions in alcohol use but not consequences compared to the DN condition. Receiving IN-BMI either alone or in combination with DN-BMI produced greater changes in IN perceptions than were produced in the control group. Grounded in norms theory, this study examined how college student problem drinking is affected by both IN-BMI and DN-BMI alone and in combination. We conclude that IN-BMI alone or in combination with DN-BMI is able to modify alcohol use and reduce alcohol-related consequences. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Is motivational interviewing effective at reducing alcohol misuse in young adults? A critical review of Foxcroft et al. (2014).Open in a New Window

Foxcroft, Coombes, Wood, Allen, and Almeida Santimano (2014) recently conducted a meta-analysis evaluating the effectiveness of motivational interviewing (MI) in reducing alcohol misuse for youth up to Age 25. They concluded that the overall effect sizes of MI in this population were too small to be clinically meaningful. The present article critically reviews the Foxcroft et al. meta-analysis, highlighting weaknesses such as problems with search strategies, flawed screening and reviews of full-text articles, incorrect data abstraction and coding, and, accordingly, improper effect size estimation. In addition, between-study heterogeneity and complex data structures were not thoughtfully considered or handled using best practices for meta-analysis. These limitations undermine the reported estimates and broad conclusion made by Foxcroft et al. about the lack of MI effectiveness for youth. We call for new evidence on this question from better-executed studies by independent researchers. Meta-analysis has many important utilities for translational research. When implemented well, the overall effectiveness, as well as different effectiveness for different populations, can be examined via meta-analysis. Emerging methods utilizing individual participant-level data, such as integrative data analysis, may be particularly helpful for identifying the sources of clinical and methodological heterogeneity that matter. The need to better understand the mechanisms of alcohol interventions has never been louder in the addiction field. Through more concerted efforts throughout all phases of generating evidence, we may achieve large-scale evidence that is efficient and robust and provides critical answers for the field. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Stimulus control in intermittent and daily smokers.Open in a New Window

[Correction Notice: An Erratum for this article was reported in Vol 29(4) of Psychology of Addictive Behaviors (see record 2015-33590-001). There was an error in the reported value in the Discussion section. The second sentence of the second paragraph should have read, “Notably, DS also showed strong stimulus control in this analysis, implying 85% accuracy in identifying smoking situations.” This was a result of a transcription error. All versions of this article have been corrected.] Many adult smokers are intermittent smokers (ITS) who do not smoke daily. Prior analyses have suggested that, compared with daily smokers (DS), ITS smoking was, on average, more linked to particular situations, such as alcohol consumption. However, such particular associations assessed in common across subjects may underestimate stimulus control over smoking, which may vary across persons, due to different conditioning histories. We quantify such idiographic stimulus control using separate multivariable logistic regressions for each subject to estimate how well the subject’s smoking could be predicted from a panel of situational characteristics, without requiring that other subjects respond to the same stimuli. Subjects were 212 ITS (smoking 4–27 days/month) and 194 DS (5–30 cigarettes daily). Using ecological momentary assessment, subjects monitored situational antecedents of smoking for 3 weeks, recording each cigarette in an electronic diary. Situational characteristics were assessed in a random subset of smoking occasions (n = 21,539), and contrasted with assessments of nonsmoking occasions (n = 26,930) obtained by beeping subjects at random. ITS showed significantly stronger stimulus control than DS across all context domains: mood, location, activity, social setting, consumption, smoking context, and time of day. Mood and smoking context showed the strongest influence on ITS smoking; food and alcohol consumption had the least influence. ITS smoking was under very strong stimulus control; significantly more so than DS, but DS smoking also showed considerable stimulus control. Stimulus control may be an important influence on maintaining smoking and making quitting difficult for all smokers, but especially among ITS. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

“Stimulus control in intermittent and daily smokers”: Correction to Shiffman, Dunbar, and Ferguson (2015).Open in a New Window

Reports an error in "Stimulus Control in Intermittent and Daily Smokers" by Saul Shiffman, Michael S. Dunbar and Stuart G. Ferguson (Psychology of Addictive Behaviors, Advanced Online Publication, Feb 23, 2015, np). There was an error in the reported value in the Discussion section. The second sentence of the second paragraph should have read, “Notably, DS also showed strong stimulus control in this analysis, implying 85% accuracy in identifying smoking situations.” This was a result of a transcription error. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2015-07274-001.) Many adult smokers are intermittent smokers (ITS) who do not smoke daily. Prior analyses have suggested that, compared with daily smokers (DS), ITS smoking was, on average, more linked to particular situations, such as alcohol consumption. However, such particular associations assessed in common across subjects may underestimate stimulus control over smoking, which may vary across persons, due to different conditioning histories. We quantify such idiographic stimulus control using separate multivariable logistic regressions for each subject to estimate how well the subject’s smoking could be predicted from a panel of situational characteristics, without requiring that other subjects respond to the same stimuli. Subjects were 212 ITS (smoking 4–27 days/month) and 194 DS (5–30 cigarettes daily). Using ecological momentary assessment, subjects monitored situational antecedents of smoking for 3 weeks, recording each cigarette in an electronic diary. Situational characteristics were assessed in a random subset of smoking occasions (n = 21,539), and contrasted with assessments of nonsmoking occasions (n = 26,930) obtained by beeping subjects at random. ITS showed significantly stronger stimulus control than DS across all context domains: mood, location, activity, social setting, consumption, smoking context, and time of day. Mood and smoking context showed the strongest influence on ITS smoking; food and alcohol consumption had the least influence. ITS smoking was under very strong stimulus control; significantly more so than DS, but DS smoking also showed considerable stimulus control. Stimulus control may be an important influence on maintaining smoking and making quitting difficult for all smokers, but especially among ITS. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Social processes explaining the benefits of Al-Anon participation.Open in a New Window

This study examined social processes of support, goal direction, provision of role models, and involvement in rewarding activities to explain benefits of participating in Al-Anon, a 12-step mutual-help program for people concerned about another person’s substance use. Newcomers to Al-Anon were studied at baseline and 6 months later, at which time they were identified as having either sustained attendance or dropped out. Among both newcomers and established Al-Anon members (“old-timers”), we also used number of Al-Anon meetings attended during follow-up to indicate extent of participation. Social processes significantly mediated newcomers’ sustained attendance status versus dropped out and outcomes of Al-Anon in the areas of life context (e.g., better quality of life, better able to handle problems due to the drinker), improved positive symptoms (e.g., higher self-esteem, more hopeful), and decreased negative symptoms (e.g., less abuse, less depressed). Social processes also significantly mediated newcomers’ number of meetings attended and outcomes. However, among old-timers, Al-Anon attendance was not associated with outcomes, so the potential mediating role of social processes could not be examined, but social processes were associated with outcomes. Findings add to the growing body of work identifying mechanisms by which 12-step groups are effective, by showing that bonding, goal direction, and access to peers in recovery and rewarding pursuits help to explain associations between sustained Al-Anon participation among newcomers and improvements on key concerns of Al-Anon attendees. Al-Anon is free of charge and widely available, making it a potentially cost-effective public health resource for help alleviating negative consequences of concern about another’s addiction. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Integrating acquired preparedness and dual process models of risk for heavy drinking and related problems.Open in a New Window

The acquired preparedness model (APM) posits that alcohol expectancies mediate effects of personality traits on drinking outcomes, whereas the dual process model (DPM) suggests that top-down behavioral control (e.g., self-control) moderates the impact of bottom-up risk factors such as alcohol expectancies. This study sought to integrate the APM and DPM by examining the extent to which indirect effects of impulsive sensation seeking on drinking outcomes are moderated by self-control. We hypothesized that the APM may hold more strongly for people who are higher in self-control, as they may engage in alcohol use for the explicit purpose of meeting sensation-seeking goals. Data were from 462 participants (ages 15–63 years; 58.4% male) who completed 1 of 5 studies affiliated with the Center for the Translational Neuroscience of Alcoholism. Consistent with the APM, higher levels of impulsive sensation seeking were associated with stronger positive expectancies, which, in turn, contributed to heavier drinking and related problems. Consistent with the DPM, among nondependent drinkers, indirect effects of impulsive sensation seeking on alcohol use were present only among those who were high in self-control. These findings suggest that expectancy challenges may be most effective for those with high levels of self-control prior to the development of alcohol dependence. However, future studies integrating the APM and DPM should include both implicit and explicit measures of expectancies to address the possibility that individuals with lower levels of self-control may be more influenced by automatic or implicit influences and may, therefore, respond well to implicit expectancy challenges. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Does drinking to cope explain links between emotion-driven impulse control difficulties and hazardous drinking? A longitudinal test.Open in a New Window

Difficulty controlling impulsive behaviors when experiencing negative emotions is a prominent risk factor for hazardous alcohol use, and prior research suggests that drinking to cope may mediate this association. The present study examines this possibility prospectively in a sample of 490 young adult women between the ages of 18 and 25. Participants completed measures of emotion-driven impulse control difficulties, drinking to cope, and hazardous alcohol use at 6 time points over the course of approximately 20 months (i.e., 1 assessment every 4 months). Multilevel structural equation modeling revealed that drinking to cope fully mediated the relationship between emotion-driven impulse control difficulties and hazardous alcohol use when examining these relationships between individuals and partially mediated this relation when examining these relationships within individuals. These findings suggest that drinking to cope is a key mechanism in the relationship between emotion-driven impulse control difficulties and hazardous drinking. Results highlight the importance of targeting both emotion dysregulation and drinking to cope when treating young women for alcohol use problems. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Reciprocal relationships over time between descriptive norms and alcohol use in young adult sexual minority women.Open in a New Window

Young adulthood, roughly ages 18–25, is a period of great risk for excessive consumption of alcohol, especially among sexual minority women (SMW). Despite the substantial literature examining the relationships between social norms and behavior in general, little attention has been given to the role of descriptive norms on the drinking behaviors of sexual minorities. The present study had 3 aims: to compare both typical woman descriptive norms and sexual minority–specific descriptive normative perceptions among a sample of SMW, to examine reciprocal associations between sexual minority–specific descriptive norms and alcohol consumption over time, and to examine whether these reciprocal associations were moderated by sexual orientation (i.e., whether 1 identifies as lesbian or bisexual). A national sample of 1,057 lesbian and bisexual women between the ages of 18 and 25 was enrolled in this study. Participants completed an online survey at 4 time points that assessed the constructs of interest. Results indicated that SMW consistently perceived that SMW drank more than their nonsexual minority peers; that SMW-specific descriptive drinking norms and alcohol consumption influenced 1 another over time in a reciprocal, feed-forward fashion; and that these associations were not moderated by sexual orientation. These findings highlight the importance of considering SMW-specific norms as an important factor in predicting alcohol consumption in SMW. Results further support the development and testing of normative interventions for high-risk drinking among SMW. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Ecological momentary assessment of PTSD symptoms and alcohol use in combat veterans.Open in a New Window

Despite high rates of comorbid hazardous alcohol use and posttraumatic stress disorder (PTSD), the nature of the functional relationship between these problems is not fully understood. Insufficient evidence exists to fully support models commonly used to explain the relationship between hazardous alcohol use and PTSD including the self-medication hypothesis and the mutual maintenance model. Ecological momentary assessment (EMA) can monitor within-day fluctuations of symptoms and drinking to provide novel information regarding potential functional relationships and symptom interactions. This study aimed to model the daily course of alcohol use and PTSD symptoms and to test theory-based moderators, including avoidance coping and self-efficacy to resist drinking. A total of 143 recent combat veterans with PTSD symptoms and hazardous drinking completed brief assessments of alcohol use, PTSD symptoms, mood, coping, and self-efficacy 4 times daily for 28 days. Our results support the finding that increases in PTSD are associated with more drinking within the same 3-hr time block, but not more drinking within the following time block. Support for moderators was found: Avoidance coping strengthened the relationship between PTSD and later drinking, while self-efficacy to resist drinking weakened the relationship between PTSD and later drinking. An exploratory analysis revealed support for self-medication occurring in certain times of the day: Increased PTSD severity in the evening predicted more drinking overnight. Overall, our results provide mixed support for the self-medication hypothesis. Also, interventions that seek to reduce avoidance coping and increase patient self-efficacy may help veterans with PTSD decrease drinking. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Predictors of patient retention in methadone maintenance treatment.Open in a New Window

This study sought to determine whether select pretreatment demographic and in-treatment clinical variables predict premature treatment discharge at 6 and 12 months among patients receiving methadone maintenance treatment (MMT). Data were abstracted from electronic medical records for 1,644 patients with an average age of 34.7 years (SD = 11.06) admitted to 26 MMT programs located throughout the United States from 2009 to 2011. Patients were studied through retrospective chart review for 12 months or until treatment discharge. Premature discharge at 6- and 12-month intervals were the dependent variables, analyzed in logistic regressions. Clinical predictor variables included average methadone dosage (mg/d) and urinalysis drug screen (UDS) findings for opioids and various nonopioid substances at intake and 6 months. Pretreatment demographic variables included gender, race/ethnicity, employment status, marital status, payment method, and age at admission. UDS findings positive (UDS+) for cocaine at intake and 6 months were found to be independent predictors of premature discharge at 12 months. UDS+ for opioids at 6 months was also an independent predictor of premature discharge at 12 months. Higher average daily methadone dosages were found to predict retention at both 6 and 12 months. Significant demographic predictors of premature discharge at 6 months included Hispanic ethnicity, unemployment, and marital status. At 12 months, male gender, younger age, and self-pay were found to predict premature discharge. Select demographic characteristics may be less important as predictors of outcome after patients have been in treatment beyond a minimum period of time, while others may become more important later on in treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Nonjudging facet of mindfulness predicts enhanced smoking cessation in Hispanics.Open in a New Window

Although most smokers express interest in quitting, actual quit rates are low. Identifying strategies to enhance smoking cessation is critical, particularly among underserved populations, including Hispanics, for whom many of the leading causes of death are related to smoking. Mindfulness (purposeful, nonjudgmental attention to the present moment) has been linked to increased likelihood of cessation. Given that mindfulness is multifaceted, determining which aspects of mindfulness predict cessation could help to inform interventions. This study examined whether facets of mindfulness predict cessation in 199 Spanish-speaking smokers of Mexican heritage (63.3% male, mean age of 39 years, 77.9% with a high school education or less) receiving smoking cessation treatment. Primary outcomes were 7-day abstinence at weeks 3 and 26 postquit (biochemically confirmed and determined using an intent-to-treat approach). Logistic random coefficient regression models were utilized to examine the relationship between mindfulness facets and abstinence over time. Independent variables were subscales of the Five Facet Mindfulness Questionnaire (Observing, Describing, Acting With Awareness, Nonjudging, and Nonreactivity). The Nonjudging subscale (i.e., accepting thoughts and feelings without evaluating them) uniquely predicted better odds of abstinence up to 26 weeks postquit. This is the first known study to examine whether specific facets of mindfulness predict smoking cessation. The ability to experience thoughts, emotions, and withdrawal symptoms without judging them may be critical in the process of quitting smoking. Results indicate potential benefits of mindfulness among smokers of Mexican heritage and suggest that smoking cessation interventions might be enhanced by central focus on the Nonjudging aspect of mindfulness. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Sociodemographic and psychiatric diagnostic predictors of 3-year incidence of DSM–IV substance use disorders among men and women in the National Epidemiologic Survey on Alcohol and Related Conditions.Open in a New Window

Incidence rates of alcohol and drug use disorders (AUDs and DUDs) are consistently higher in men than women, but information on whether sociodemographic and psychiatric diagnostic predictors of AUD and DUD incidence differ by sex is limited. Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, sex-specific 3-year incidence rates of AUDs and DUDs among United States adults were compared by sociodemographic variables and baseline psychiatric disorders. Sex-specific logistic regression models estimated odds ratios for prediction of incident AUDs and DUDs, adjusting for potentially confounding baseline sociodemographic and diagnostic variables. Few statistically significant sex differences in predictive relationships were identified and those observed were generally modest. Prospective research is needed to identify predictors of incident DSM-5 AUDs and DUDs and their underlying mechanisms, including whether there is sex specificity by developmental phase, in the role of additional comorbidity in etiology and course, and in outcomes of prevention and treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

The prospective effects of perceived and laboratory indices of distress tolerance on cannabis use following a self-guided quit attempt.Open in a New Window

The majority of individuals who attempt to quit using cannabis do not seek formalized treatment. To better understand which malleable factors contribute to cannabis use following a self-guided quit attempt, we concurrently examined 2 measures of distress tolerance (DT) as prospective predictors of cannabis use post quit attempt. We hypothesized that veterans with higher in relation to lower levels of DT would be less likely to use cannabis following a self-guided quit attempt. In this study, we included 103 cannabis-dependent veterans (Mage = 50, 95% male, 37% White, 36% Black, 14% Hispanic, 14% other) who reported being motivated to quit using cannabis. Veterans completed 2 measures of DT, the Distress Tolerance Scale (perceived distress tolerance) and the Mirror-Tracing Persistence Task (laboratory analogue of distress tolerance). Findings indicated that veterans with greater perceived distress tolerance used less cannabis over the quit period than did veterans with less perceived distress tolerance. However, contrary to expectations, baseline performance on a laboratory analogue of distress tolerance was not related to cannabis use over the quit period. Results suggest that veterans’ perceived ability to tolerate distress is an important predictor of cannabis use following a self-guided quit attempt. Thus, the Distress Tolerance Scale could serve as an important tool for helping to identify veterans at risk for cannabis use postquit. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Temporal variation in facilitator and client behavior during group motivational interviewing sessions.Open in a New Window

There is considerable evidence for motivational interviewing (MI) in changing problematic behaviors. Research on the causal chain for MI suggests influence of facilitator speech on client speech. This association has been examined using macro (session-level) and micro (utterance-level) measures; however, effects across sessions have largely been unexplored, particularly with groups. We evaluated a sample of 129 adolescent Group MI sessions, using a behavioral coding system and timing information to generate information on facilitator and client speech (CT; change talk) within 5 successive segments (quintiles) of each group session. We hypothesized that facilitator speech (open-ended questions and reflections of CT) would be related to subsequent CT. Repeated measures analysis indicated significant quadratic and cubic trends for facilitator and client speech across quintiles. Across quintiles, cross-lagged panel analysis using a zero-inflated negative binomial model showed minimal evidence of facilitator speech on client CT, but did indicate several effects of client CT on facilitator speech, and of client CT on subsequent client CT. Results suggest that session-level effects of facilitator speech on client speech do not arise from long-duration effects of facilitator speech; instead, we detected effects of facilitator speech on client speech only at the beginning and end of sessions, when open questions, respectively, suppressed and enhanced client expressions of CT. Findings suggest that clinicians must remain vigilant to client CT throughout the group session, reinforcing it when it arises spontaneously and selectively employing open-ended questions to elicit it when it does not, particularly toward the end of the session. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Associations between neighborhood alcohol availability and young adolescent alcohol use.Open in a New Window

We investigated the association between alcohol outlet density and adolescent alcohol use, including whether this association differed by sociodemographic characteristics. We geocoded and mapped active license data from the year 2011 to calculate the number of outlets within multiple circular buffers of varying sizes (density), centered at households of adolescents ages 10–16 (n = 2,724). We examined 2 indicators of alcohol use: any lifetime use, but not in past month, and any past month heavy use. Cross-sectional hierarchal multivariate regression analyses were used to examine associations between alcohol outlet density and alcohol use, including the potential moderating effect of age, gender, race/ethnicity, and socioeconomic status. Analyses controlled for neighborhood-level socioeconomic status and accounted for census tract-level clustering. A higher number of on- and off-premise outlets within 0.10, 0.25, and 0.50 miles around the respondents’ homes was associated with higher odds of being a heavy drinker. In addition, the number of on-premise outlets within the 0.25-mile radius was associated with greater odds of lifetime drinking. For on-premise outlets where minors were not allowed (clubs/bars), we observed a positive and significant association between clubs/bars within the 0.25-mile buffer zone and higher odds of both lifetime and heavy drinking. Findings suggest that youth who are exposed to higher densities of on-premise alcohol outlets are at risk for both lifetime use and recent heavy use. It is critical to advocate for stricter laws limiting the number of alcohol outlets in neighborhoods, including clubs/bars where minors are restricted, and putting into place more stringent enforcement of age identification requirements to limit distribution of alcohol to minors. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

The relation between stress and alcohol use among Hispanic adolescents.Open in a New Window

We explored the relation between 8 domains of Hispanic stress and alcohol use and frequency of use in a sample of Hispanic adolescents between 11 and 19 years old (N = 901). Independent t tests were used to compare means of domains of Hispanic stress between adolescents who reported alcohol use and those who reported no use. In addition, multinomial logistic regression was used to examine whether domains of Hispanic stress were related to alcohol use and whether the relation differed by gender and age. Multiple imputation was used to address missing data. In the analytic sample, 75.8% (n = 683) reported no use and 24.2% (n = 218) reported alcohol use during the previous 30 days. Higher mean Hispanic stress scores were observed among youths who reported alcohol use during the previous 30 days in 5 domains: acculturation gap, community and gang violence, family economic, discrimination, and family and drug-related stress. Increased community and gang violence, family and drug, and acculturative gap stress were found to be associated with some alcohol use categories beyond the effect of other domains. Few differences in the association between Hispanic stress and alcohol use by gender and age were observed. Study findings indicate that family and drug-related, community and gang violence, and acculturative gap stress domains are salient factors related to alcohol use among Hispanic adolescents, and their implications for prevention science are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

The influence of cultural variables on treatment retention and engagement in a sample of Mexican American adolescent males with substance use disorders.Open in a New Window

Adolescent substance abuse is a serious public health concern, and in response to this problem, a number of effective treatment approaches have been developed. Despite this, retaining and engaging adolescents in treatment are 2 major challenges continuously faced by practitioners and clinical researchers. Low retention and engagement rates are especially salient for ethnic minority adolescents because they are at high risk for underutilization of substance abuse treatment compared to their White peers. Latino adolescents, in particular, are part of the fastest growing ethnic minority group in the United States and experience high rates of substance use disorders. Heretofore, the empirical examination of cultural factors that influence treatment retention and engagement has been lacking in the literature. The goal of this study was to investigate the influence of the cultural variables ethnic identity, familism, and acculturation on the retention and engagement of Latino adolescents participating in substance abuse treatment. This study used data collected from a sample of Latino adolescent males (N = 96), predominantly of Mexican descent, and largely recruited from the juvenile justice system. Analysis was conducted using generalized regression models for count variables. Results indicated that higher levels of exploration, a subfactor of ethnic identity, and familism were predictive of attendance and engagement. In contrast, higher levels of Anglo orientation, a subfactor of acculturation, were predictive of lower treatment attendance and engagement. Clinical implications for the variables of ethnic identity, acculturation, and familism as well as suggestions for future research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Trajectories of binge drinking and personality change across emerging adulthood.Open in a New Window

College students binge drink more frequently than the broader population, yet most individuals “mature out” of binge drinking. Impulsivity and sensation seeking traits are important for understanding who is at risk for maintaining binge drinking across college and the transition to adult roles. We use latent class growth analysis (LCGA) to examine longitudinal binge-drinking trajectories spanning from the end of high school through 2 years after college (M ages = 18.4 to 23.8). Data were gathered over 10 waves from students at a large Southwestern university (N = 2,245). We use latent factor models to estimate changes in self-reported impulsive (IMP) and sensation-seeking (SS) personality traits across 2 time periods—(a) the end of high school to the end of college and (b) the 2-year transition out of college. LCGA suggested 7 binge-drinking trajectories: frequent, moderate, increasing, occasional, low increasing, decreasing, and rare. Models of personality showed that from high school through college, change in SS and IMP generally paralleled drinking trajectories, with increasing and decreasing individuals showing corresponding changes in SS. Across the transition out of college, only the increasing group demonstrated a developmentally deviant increase in IMP, whereas all other groups showed normative stability or decreases in both IMP and SS. These data indicate that “late bloomers,” who begin binge drinking only in the later years of college, are a unique at-risk group for drinking associated with abnormal patterns of personality maturation during emerging adulthood. Our results indicate that personality targeted interventions may benefit college students. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Negative evaluations of negative alcohol consequences lead to subsequent reductions in alcohol use.Open in a New Window

Alcohol use during young adulthood may reflect a learning process whereby positive and negative alcohol-related experiences and interpretations of those experiences drive subsequent behavior. Understanding the effect of consequences and the evaluation of consequences could be informative for intervention approaches. The objective of this study was to examine the extent to which the number of positive and negative alcohol consequences experienced and the evaluation of those consequences predict subsequent alcohol use and consequences in college students. Students at 3 colleges (N = 679) completed biweekly web-based surveys on alcohol use, positive and negative consequences, and consequence evaluations for 2 academic years. Hierarchical linear modeling tested whether consequences and evaluations in a given week predicted changes in alcohol use and consequences at the next assessment. Moderation by gender and class year were also evaluated. Evaluating past-week negative consequences more negatively than one’s average resulted in decreases in alcohol use at the next assessment. More negative evaluation of negative consequences was followed in the subsequent observation by a higher number of positive consequences for females but not for males. A higher number of positive consequences in a given week was followed by a higher number of both positive and negative consequences in the subsequent observation. Number of negative consequences experienced and evaluation of positive consequences had no effect on later behavior. Salient negative consequences may drive naturalistic reductions in alcohol use, suggesting the possible efficacy of programs designed to increase the salience of the negative effects of alcohol. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Descriptive norms and expectancies as mediators of a brief motivational intervention for mandated college students receiving stepped care for alcohol use.Open in a New Window

Stepped care approaches for mandated college students provide individual brief motivational interventions (BMI) only for individuals who do not respond to an initial, low-intensity level of treatment such as Brief Advice (BA). However, how BMIs facilitate change in this higher-risk group of mandated students remains unclear. Perceived descriptive norms and alcohol-related expectancies are the most commonly examined mediators of BMI efficacy but have yet to be examined in the context of stepped care. Participants were mandated college students (N = 598) participating in a stepped care trial in which mandated students first received BA. Those who reported continued risky drinking 6 weeks following a BA session were randomized to either a single-session BMI (N = 163) or an assessment-only comparison condition (AO; N = 165). BMI participants reduced alcohol-related problems at the 9 month follow up significantly more than AO participants. Multiple mediation analyses using bootstrapping techniques examined whether perceived descriptive norms and alcohol-related expectancies mediated the observed outcomes. Reductions in perceptions of average student drinking (B = −.24; 95% CI [−.61, −.04]) and negative expectancies (B = −.13; 95% CI [−.38, −.01]) mediated the BMI effects. Furthermore, perceived average student norms were reduced after the BMI to levels approximating those of students who had exhibited lower risk drinking following the BA session. Findings highlight the utility of addressing perceived norms and expectancies in BMIs, especially for students who have not responded to less intensive prevention efforts. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Trajectories of gambling problems from mid-adolescence to age 30 in a general population cohort.Open in a New Window

Studies of gambling starting before adulthood in the general population are either cross-sectional, based on the stability of these behaviors between 2 time points, or cover a short developmental period. The present study aimed at investigating the developmental trajectories of gambling problems across 3 key periods of development, mid-adolescence, early adulthood, and age 30, in a mixed-gender cohort from the general population. Using a semiparametric mixture model, trajectories were computed based on self-reports collected at ages 15 (N = 1,882), 22 (N = 1,785), and 30 (N = 1,358). Two distinct trajectories were identified: 1 trajectory including males and females who were unlikely to have experienced gambling problems across the 15-year period, and 1 trajectory including participants likely to have experienced at least 1 problem over the last 12 months at each time of assessment. Participants following a high trajectory were predominantly male, participated frequently in 3 to 4 different gambling activities, and were more likely to report substance use and problems related to their alcohol and drug consumption at age 30. Thus, gambling problems in the general population are already observable at age 15 in a small group of individuals, who maintain some level of these problems through early adulthood, before moderately but significantly desisting by age 30, while also experiencing other addictive behaviors and related problems. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Motivational pathways from reward sensitivity and punishment sensitivity to gambling frequency and gambling-related problems.Open in a New Window

Motives for gambling have been shown to have an important role in gambling behavior, consistent with the literature on motives for substance use. While studies have demonstrated that traits related to sensitivity to reward (SR) and sensitivity to punishment (SP) are predictive of substance use motives, little research has examined the role of these traits in gambling motives. This study investigated motivational pathways from SR and SP to gambling frequency and gambling problems via specific gambling motives, while also taking into account history of substance use disorder (SUD). A community sample of gamblers (N = 248) completed self-report questionnaires assessing SR, SP, gambling frequency, gambling-related problems, and motives for gambling (social, negative affect, and enhancement/winning motives). Lifetime SUD was also assessed with a structured clinical interview. The results of a path analysis showed that SR was uniquely associated with all 3 types of gambling motives, whereas SP and SUD were associated with negative affect and enhancement/winning motives but not social motives. Also, both negative affect and enhancement/winning motives were associated with gambling problems, but only enhancement/winning motives were significantly related to gambling frequency. Analyses of indirect associations revealed significant indirect associations from SR, SP, and SUD to gambling frequency mediated through enhancement/winning motives and to gambling problems mediated through both negative affect and enhancement/winning motives. The findings highlight the importance of SR and SP as independent predictors of gambling motives and suggest that specific motivational pathways underlie their associations with gambling outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Measurement error and outcome distributions: Methodological issues in regression analyses of behavioral coding data.Open in a New Window

Behavioral coding is increasingly used for studying mechanisms of change in psychosocial treatments for substance use disorders (SUDs). However, behavioral coding data typically include features that can be problematic in regression analyses, including measurement error in independent variables, non normal distributions of count outcome variables, and conflation of predictor and outcome variables with third variables, such as session length. Methodological research in econometrics has shown that these issues can lead to biased parameter estimates, inaccurate standard errors, and increased Type I and Type II error rates, yet these statistical issues are not widely known within SUD treatment research, or more generally, within psychotherapy coding research. Using minimally technical language intended for a broad audience of SUD treatment researchers, the present paper illustrates the nature in which these data issues are problematic. We draw on real-world data and simulation-based examples to illustrate how these data features can bias estimation of parameters and interpretation of models. A weighted negative binomial regression is introduced as an alternative to ordinary linear regression that appropriately addresses the data characteristics common to SUD treatment behavioral coding data. We conclude by demonstrating how to use and interpret these models with data from a study of motivational interviewing. SPSS and R syntax for weighted negative binomial regression models is included in online supplemental materials. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Interaction of depressive symptoms and smoking abstinence on delay discounting rates.Open in a New Window

Delay discounting and depressive symptomatology have strong connections with smoking. However, few studies have examined interactions across delay discounting, depressive symptoms, and smoking status. The primary goal of this secondary analysis was to assess the interrelations across these 3 variables among treatment-seeking smokers. Delay discounting and depressive symptoms were assessed in 95 smokers enrolled in a clinical trial for smoking cessation at intake and 6-month follow-up. Participants with and without depressive symptoms did not differ in their discounting rates neither at intake nor at 6-month follow-up. However, delay discounting was significantly lower among abstainers at 6-month follow-up, and changes in discounting associated with smoking status were more pronounced among participants with depressive symptoms. These results clarify the relationship between delay discounting and depressive symptoms among current and former smokers and suggest that the association between smoking abstinence and lower delay discounting is significantly greater among individuals with depressive symptoms versus those who do not have depressive symptomatology. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Adaptation of the Monetary Choice Questionnaire to accommodate extreme monetary discounting in cocaine users.Open in a New Window

Delay discounting, which refers to the phenomenon that rewards decrease in subjective value as the delay associated with their receipt increases, is a paradigm that has been used extensively in substance abuse research to understand impulsive decision making. One common measure to assess delay discounting is the Monetary Choice Questionnaire (MCQ) developed by Kirby, Petry, and Bickel (1999). While the MCQ has great utility because of its simplicity and brief administration time, it is possible that the MCQ produces a ceiling effect in estimating delay discounting parameters in highly impulsive individuals. In the present study, we adapted the MCQ to attempt to address this ceiling effect by extending the original scale with 9 items, and we then compared scores on the original MCQ with the extended MCQ in a sample of active cocaine users. The ceiling effect, while observed in the original MCQ scores for over a quarter of the sample, was largely eliminated with the extended scale. Highly impulsive participants, whose scores on the extended scale exceeded the highest possible score on the original scale, had higher levels of sensation seeking compared to other participants, but not trait impulsivity. The extended MCQ may be useful in populations with high rates of impulsivity, where the original measure may underestimate discounting rates due to a ceiling effect. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

 

Perceived addiction to Internet pornography and psychological distress: Examining relationships concurrently and over time.Open in a New Window

In the United States, Internet pornography use is a common behavior that has risen in popularity in recent years. The present study sought to examine potential relationships between pornography use and well-being, with a particular focus on individual perceptions of pornography use and feelings of addiction. Using a large cross-sectional sample of adults (N = 713), perceived addiction to Internet pornography predicted psychological distress above and beyond pornography use itself and other relevant variables (e.g., socially desirable responding, neuroticism). This model was replicated using a large cross-sectional sample of undergraduates (N = 1,215). Furthermore, a 1-year, longitudinal follow-up with a subset of this sample (N = 106) revealed a relationship between perceived addiction to Internet pornography and psychological distress over time, even when controlling for baseline psychological distress and pornography use. Collectively, these findings suggest that perceived addiction to Internet pornography, but not pornography use itself, is uniquely related to the experience of psychological distress. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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