The temporal relationship between alcohol consumption and HIV-medication adherence: A multilevel model of direct and moderating effects.

Previous studies documenting an association between alcohol use and HIV medication nonadherence, have been unable to distinguish between-persons characteristics from within-person characteristics representing the temporally linked effects of alcohol. Hierarchical Linear Modeling (HLM) explored within- and between-person predictors of adherence during the past 14 days, as well as factors that moderate the event-level effects of alcohol consumption among 272 HIV-positive men and women with alcohol problems. On days in which participants drank, they had almost 9 times higher odds of medication nonadherence, with each drink increasing the odds by 20%. The cognitive and alcohol factors had significant between-person effects on adherence. Individuals with strong and rigid beliefs about the importance of strict medication adherence were significantly more affected by each dose of alcohol, while individuals with more alcohol use and problems were less affected by each drink. Regimen complexity increased the effects of having 1 or more drinks. These results highlight the importance of promoting medication adherence among alcohol-using adults, especially among patients with complex regimens or with high confidence and positive attitudes toward HIV medication. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Topiramate use in pediatric patients

Topiramate (TPM), a new antiepileptic medication, is efficacious as adjunctive therapy in adults with partial onset seizures. Its efficacy as adjunctive therapy in children was evaluated in two randomized double-blind placebo-controlled trials involving childhood epileptic encephalopathy (the Lennox-Gastaut syndrome) and partial onset seizures. In these studies, topiramate adjunctive therapy resulted in a significant reduction in drop attacks (tonic or atonic seizures) in patients with the Lennox Gastaut syndrome and a significant reduction in partial onset seizures in children with refractory partial epilepsy. In both trials, TPM's efficacy improved as the dose escalated from the double-blind phase to the open-label portion. The minimally effective topiramate dose for adjunctive therapy in children with refractory epilepsy appears to be 6 mg/kg/day. Topiramate was well tolerated with mild or moderate side effects, predominantly related to the central nervous system. Practical tips are provided that may increase the chance that topiramate will be effective and well tolerated. The most important advice is a "start low, go slow" approach. An initial TPM dose of 0.5-1 mg/kg/day followed by weekly increments of 0.5-1 mg/kg is usually well tolerated. Based on these studies, topiramate appears to be an important addition to our pediatric AED armamentarium.     

Comparison of specificity between IgG, IgE and T cells to three casein components: implication for the role of circulating allergen-specific T cells in food allergy

Juvenile absence epilepsy (JAE) is a common subtype of idiopathic generalized epilepsy (IGE). Hereditary factors play a major role in its etiology. The important function of glutamate receptors (GluRs) in excitatory neurotransmission, synaptic plasticity, and neurodevelopment suggests their involvement in epileptogenesis. A tetranucleotide repeat polymorphism in the non-coding region of the kainate-selective GluR5 receptor gene (GRIK1) on chromosome 21q22.1 provides the tool to investigate this candidate gene. The present association and linkage study tested the hypothesis that allelic variants of GRIK1 confer genetic susceptibility to the pathogenesis of JAE. Our family-based association analysis using the haplotype-based haplotype relative risk statistic revealed an association of JAE with the nine-repeat containing allele of the GRIK1 tetranucleotide polymorphism (chi2 = 8.31, df = 1, P = 0.004). Supportive evidence for linkage to a JAE related IGE spectrum (Zmax = 1.67 at GRIK1) under an autosomal dominant mode of inheritance and significant allele sharing (P < 0.05) among the affected family members suggest that allelic variants of GRIK1 contribute a major genetic determinant to the pathogenesis of JAE-related phenotypes.     

Parental alcoholism and the effects of alcohol on mediated semantic priming.

In this study, researchers tested the effects of a moderate dose of alcohol on the spread of activation of associated information in memory using a mediated semantic priming task in which target words are preceded by primes that are either unrelated or indirectly related to the target. Male and female participants with or without a parental history (PH+ and PH-, respectively) of alcoholism were administered the priming task after consuming alcohol or a placebo beverage. Among PH- individuals, alcohol constrained the spread of activation of associated information, as manifested by a reduced priming effect. In contrast, alcohol enhanced priming effects among PH+ participants, though this latter effect appears to be due to a particularly slow response among these individuals to unprimed words. Results are discussed with regard to theories of alcohol's effects on cognitive processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clubgoers and their trendy cocktails: Implications of mixing caffeine into alcohol on information processing and subjective reports of intoxication.

Alcoholic drink preferences in college students have made an interesting shift recently, with trends in consumption leaning toward caffeinated alcohol in various forms (e.g., Red Bull and vodka or caffeinated beers such as Anheuser-Busch's B-to-the-E). Despite the dramatic rise in popularity of these beverages, little research has examined the combined effects of alcohol and caffeine, which is problematic for adequately informing the public about the risk or lack thereof of these drinks. The purpose of this study was to directly investigate the acute effects of alcohol and caffeine, alone and in combination, on well-validated measures of cognitive performance and subjective intoxication in social drinkers. Participants (N = 12) performed a psychological refractory period task that measured dual-task interference as the prolonged reaction time to complete the 2nd of 2 tasks performed in close temporal sequence. Performance was tested under 2 active doses and 1 placebo dose of caffeine (0.0 mg/kg, 2.0 mg/kg, and 4.0 mg/kg) in combination with 1 active dose and 1 placebo dose of alcohol (0.0 g/kg and 0.65 g/kg). As expected, alcohol impaired task performance by increasing dual-task interference and increasing errors. The coadministration of caffeine counteracted the effects of alcohol on interference but had no effect on the degree to which alcohol increased errors. Subjective measures of intoxication showed that coadministration of caffeine with alcohol reduced participants' perceptions of alcohol intoxication compared with administration of alcohol alone. The results highlight the complexity of drug interactions between alcohol and caffeine. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Polymorphisms of the μ-opioid receptor and dopamine D? receptor genes and subjective responses to alcohol in the natural environment.

Polymorphisms of the μ-opioid receptor (OPRM1) and dopamine D? receptor (DRD4) genes are associated with subjective responses to alcohol and urge to drink under laboratory conditions. This study examined these associations in the natural environment using ecological momentary assessment. Participants were non-treatment-seeking heavy drinkers (n = 112, 52% female, 61% alcohol dependent) who enrolled in a study of naltrexone effects on craving and drinking in the natural environment. Data were culled from 5 consecutive days of drinking reports prior to medication randomization. Analyses revealed that, after drinking, carriers of the Asp40 allele of the OPRM1 gene reported higher overall levels of vigor and lower levels negative mood, as compared to homozygotes for the Asn40 variant. Carriers of the long allele (i.e., ≥7 tandem repeats) of the DRD4 endorsed greater urge to drink than homozygotes for the short allele. Effects of OPRM1 and DRD4 variable-number-of-tandem-repeats genotypes appear to be alcohol dose-dependent. Specifically, carriers of the DRD4-L allele reported slight decreases in urge to drink at higher levels of estimated blood alcohol concentration (eBAC), and Asp40 carriers reported decreases in vigor and increases in negative mood as eBAC rose, as compared to carriers of the major allele for each gene. Self-reported vigor and urge to drink were positively associated with alcohol consumption within the same drinking episode. This study extends findings on subjective intoxication, urge to drink, and their genetic bases from controlled laboratory to naturalistic settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interactive effects of alcohol outcome expectancies and alcohol cues on nonconsumptive behavior.

Experimental research and popular belief suggest that, among its many effects, alcohol consumption reduces tension and facilitates aggression. Such observations could result from direct, pharmacological effects of alcohol on neural control of behavior but also may be accounted for by positing that drinking behavior activates mental representations of relaxation-related or aggression-related alcohol expectancies in long-term memory. Building on this latter view, in 2 experiments, the authors investigated whether rudimentary drinking-related cues, which presumably activate encoded alcohol expectancies, facilitate tension reduction and hostility in the complete absence of actual or placebo alcohol consumption. In Experiment 1, following contextual exposure to alcohol-related words, individuals with stronger expectancies that drinking reduces tension showed an increased willingness to meet with an opposite-gender stranger under relatively anxiety-provoking circumstances, suggesting that they experienced less apprehension regarding the meeting. Analogously, in Experiment 2, following near-subliminal exposure to alcohol-related words, individuals with stronger expectancies that drinking fosters aggression showed greater hostility toward a target person following an experimentally engineered provocation. Neither of the latter effects was obtained following exposure to nonalcoholic beverage words, which presumably did not activate alcohol outcome expectancy representations in long-term memory. Moreover, the strength of relevant, content-specific expectancies (i.e., for tension reduction or aggression, respectively) moderated alcohol cue exposure effects, but the strength of other expectancies (e.g., for sociability or sexual arousal) did not. Together, these findings demonstrate that exposure to rudimentary alcohol cues independently engenders expectancy-consistent behavior, thereby attesting to the remarkable breadth and subtlety of the behavioral impact of alcohol expectancy activation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influences of sexual sensation seeking, alcohol consumption, and sexual arousal on women's behavioral intentions related to having unprotected sex.

This experimental study examined effects of alcohol consumption and sexual sensation seeking on unprotected sex intentions, taking into account sexual arousal, indirectly discouraging sex, and condom insistence. Women (N = 173; mean age = 25.02) were randomly assigned to a control, placebo, low-dose beverage (target blood alcohol level = .04), or high- dose beverage (target blood alcohol level = .08) condition. Participants projected themselves into a hypothetical sexual interaction with a man in which no condom was available. Structural equation modeling demonstrated that both sexual sensation seeking and alcohol dose directly increased sexual arousal early in the interaction, but later sexual arousal indirectly increased unprotected sex intentions by decreasing endorsement of indirect discouragement and, in turn, condom insistence. These findings help to clarify the role of alcohol consumption and sensation seeking in women's sexual decision making and point to the importance of examining it as a multistage process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol and erectile response: The effects of high dosage in the context of demands to maximize sexual arousal.

Although drinking often precedes men's sexual activity, basic questions about alcohol's effects on men's sexual arousal remain unanswered. Inconsistencies in findings from studies examining subjective and physiological effects on erectile functioning suggest these effects are context specific, for example, dependent on whether a man wants to maximize or suppress his arousal. To address unresolved questions about alcohol and erectile functioning, the authors evaluated the effects of high blood alcohol concentrations (BACs) and arousal instructional demands on indices of penile circumference change and self-reported sexual arousal. In Study 1, a target BAC of .10% (vs. .00%) attenuated peak circumference change from a neutral baseline but did not affect mean change, latency to arousal onset (a 5% increase in circumference from baseline), latency to peak achieved arousal, or subjective arousal, which correlated moderately with physiological indices. In Study 2, instructions to maximize (vs. suppress) arousal increased peak and mean circumference change and interacted with a target BAC of .08% (vs. .00%) to influence latency to arousal onset. Sober men instructed to maximize showed a shorter latency to arousal onset than did those instructed to suppress arousal; however, intoxicated men did not show a differential pattern. Moreover, compared with intoxicated counterparts, sober men instructed to maximize arousal showed a marginally shorter latency to arousal onset. Overall, alcohol and arousal instructions had small but discernible effects. Findings highlight the importance of contextual factors in alcohol's impact on erectile functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The DRD4 VNTR polymorphism moderates craving after alcohol consumption.

Recent research has suggested that alterations in mesolimbic dopamine neurotransmission are central to the development and expression of craving for alcohol. Because the D? dopamine receptor gene, variable numbers of tandem repeats (DRD4 VNTR) polymorphism putatively expresses functional differences in dopamine receptors, the present study tested whether this polymorphism influences the effects of a priming dose of alcohol on craving. Participants consumed 3 alcoholic drinks or 3 control drinks and completed measures of craving after each drink. Participants who were homozygous or heterozygous for the 7 (or longer) repeat allele were classified as DRD4 L, whereas the other participants were classified as DRD4 S. Results suggested that DRD4 L participants demonstrated significantly higher craving after consumption of alcohol as compared with the control beverage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correction to Guillot et al. (2010).

Reports an error in "Effects of alcohol on tests of executive functioning in men and women: A dose response examination" by Casey R. Guillot, Jennifer R. Fanning, Joshua S. Bullock, Michael S. McCloskey and Mitchell E. Berman (Experimental and Clinical Psychopharmacology, 2010[Oct], Vol 18[5], 409-417). This article contained errors in the text. These errors are explained and corrected in the correction. (The following abstract of the original article appeared in record 2010-21046-003.) Alcohol has been shown to affect performance on tasks associated with executive functioning. However, studies in this area have generally been limited to a single dose or gender or have used small sample sizes. The purpose of this study was to provide a more nuanced and systematic examination of alcohol's effects on commonly used tests of executive functioning at multiple dosages in both men and women. Research volunteers (91 women and 94 men) were randomly assigned to one of four drink conditions (alcohol doses associated with target blood alcohol concentrations of .000%, .050%, .075%, and .100%). Participants then completed three tasks comprising two domains of executive functioning: two set shifting tasks, the Trail Making Test and a computerized version of the Wisconsin Card Sorting Task, and a response inhibition task, the GoStop Impulsivity Paradigm. Impaired performance on set shifting tasks was found at the .100% and .075% dosages, but alcohol intoxication did not impair performance on the GoStop. No gender effects emerged. Thus, alcohol negatively affects set shifting at moderately high levels of intoxication in both men and women, likely attributable to alcohol's interference with prefrontal cortex function. Although it is well established that alcohol negatively affects response inhibition as measured by auditory stop-signal tasks, alcohol does not appear to exert a negative effect on response inhibition as measured by the GoStop, a visual stop-signal task. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The intoxicated witness: Effects of alcohol on identification accuracy from showups.

The effect of alcohol on identification accuracy is potentially an important topic. This study examined the effects of alcohol consumption on identification accuracy from showups, the identification procedure most likely to be used by police with intoxicated witnesses. The blood alcohol level of people exposed to a target was measured. In the target-present showup condition, blood alcohol level was not significantly related to correct identification rate. In the target-absent showup condition, the higher the blood alcohol level, the more people were likely to make a false identification. Implications for law enforcement and future research directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic Associations of Alcohol Dehydrogenase With Alcohol Use Disorders and Endophenotypes in White College Students.

Associations of alcohol dehydrogenase (ADH) gene polymorphisms (ADH1B*2 and ADH1C*1) with a lifetime alcohol use disorder (AUD) were examined in White college students. Alcohol-related endophenotypes likely to be influenced by elevations in acetaldehyde were also assessed. Individuals with an ADH1B*2 allele had lower rates of AUDs, consumed a lower maximum number of drinks in a 24-hr period, reported a greater level of response to alcohol, were more likely to have experienced alcohol-induced headaches following 1 or 2 drinks, and reported more severe hangovers than those lacking this allele. These findings are consistent with the hypothesis that enhanced sensitivity to alcohol and lower levels of alcohol use reflect the mechanism by which ADH1B*2 protects against developing an AUD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Processing bimodal stimulus information under alcohol: Is there a risk to being redundant?

The impairing effects of alcohol are especially pronounced in environments that involve dividing attention across two or more stimuli. However, studies in cognitive psychology have identified circumstances in which the presentation of multiple stimuli can actually facilitate performance. The “redundant signal effect” (RSE) refers to the observation that individuals respond more quickly when information is presented as redundant, bimodal stimuli (e.g., aurally and visually), rather than as a single stimulus presented to either modality alone. The present study tested the hypothesis that the response facilitation attributed to RSE could reduce the degree to which alcohol slows information processing. Two experiments are reported. Experiment 1 demonstrated the validity of a reaction time model of RSE by showing that adults (N = 15) responded more quickly to redundant, bimodal stimuli (visual + aural) versus either stimuli presented individually. Experiment 2 used the RSE model to test the reaction time performance of 20 adults following three alcohol doses (0.0 g/kg, 0.45 g/kg, and 0.65 g/kg). Results showed that alcohol slowed reaction time in a general dose-dependent manner in all three stimulus conditions with the reaction time (RT) speed-advantage of the redundant signal being maintained, even under the highest dose of alcohol. Evidence for an RT advantage to bimodal stimuli under alcohol challenges the general assumption that alcohol impairment is intensified in multistimulus environments. The current study provides a useful model to investigate how drug effects on behavior might be altered in contexts that involve redundant response signals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring alcohol expectancies with the implicit association test.

Researchers have relied primarily on self-report questionnaires to measure alcohol expectancies. These questionnaires assess explicit expectancies about alcohol but do not provide any measure of the implicit processes that might also play an important role in determining drinking. The implicit association test (IAT: A. G. Greenwald, D. E. McGhee, & L. K. Schwartz, 1998), a reaction time task, measures differential associations of 2 target concepts with an attribute. In this study, the IAT provided a measure of the strength of associations of alcohol concepts to positive or negative outcomes in memory. This implicit measure of alcohol expectancies successfully predicted alcohol use in 103 undergraduates. The findings also supported the hypothesis that an implicit measure of expectancy can add to the predictive power of existing questionnaire-based measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of alcohol on tests of executive functioning in men and women: A dose response examination.

[Correction Notice: An erratum for this article was reported in Vol 19(4) of Experimental and Clinical Psychopharmacology (see record 2011-16762-001). This article contained errors in the text. These errors are explained and corrected in the correction.] Alcohol has been shown to affect performance on tasks associated with executive functioning. However, studies in this area have generally been limited to a single dose or gender or have used small sample sizes. The purpose of this study was to provide a more nuanced and systematic examination of alcohol's effects on commonly used tests of executive functioning at multiple dosages in both men and women. Research volunteers (91 women and 94 men) were randomly assigned to one of four drink conditions (alcohol doses associated with target blood alcohol concentrations of .000%, .050%, .075%, and .100%). Participants then completed three tasks comprising two domains of executive functioning: two set shifting tasks, the Trail Making Test and a computerized version of the Wisconsin Card Sorting Task, and a response inhibition task, the GoStop Impulsivity Paradigm. Impaired performance on set shifting tasks was found at the .100% and .075% dosages, but alcohol intoxication did not impair performance on the GoStop. No gender effects emerged. Thus, alcohol negatively affects set shifting at moderately high levels of intoxication in both men and women, likely attributable to alcohol's interference with prefrontal cortex function. Although it is well established that alcohol negatively affects response inhibition as measured by auditory stop-signal tasks, alcohol does not appear to exert a negative effect on response inhibition as measured by the GoStop, a visual stop-signal task. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Twelve-Week Outcomes From an Investigation of High-Dose Nicotine Patch Therapy for Heavy Smokers With a Past History of Alcohol Dependence.

This study reports findings from an investigation of the efficacy of high-dose nicotine patch (NP) therapy for heavy smokers with a past history of alcohol dependence. One hundred thirty participants were randomly assigned to 42 mg or 21 mg of transdermal nicotine for 4 weeks, followed by an 8-week dose titration. Follow-up assessments were conducted at 4 and 12 weeks. Differences between dose conditions were nonsignificant, although unexpectedly, outcomes favored participants in the 21-mg NP condition. Nicotine abstinence at follow-up was related to longer length of alcohol abstinence at time of enrollment. Future research should investigate ways to improve smoking quit rates in this population, including more frequent counseling sessions and/or other pharmacotherapies. These investigations should focus primarily on smokers in early alcohol recovery. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Movie exposure to alcohol cues and adolescent alcohol problems: A longitudinal analysis in a national sample.

The authors tested a theoretical model of how exposure to alcohol cues in movies predicts level of alcohol use (ever use plus ever and recent binge drinking) and alcohol-related problems. A national sample of younger adolescents was interviewed by telephone with 4 repeated assessments spaced at 8-month intervals. A structural equation modeling analysis performed for ever-drinkers at Time 3 (N = 961) indicated that, controlling for a number of covariates, movie alcohol exposure at Time 1 was related to increases in peer alcohol use and adolescent alcohol use at Time 2. Movie exposure had indirect effects to alcohol use and problems at Times 3 and 4 through these pathways, with direct effects to problems from Time 1 rebelliousness and Time 2 movie exposure also found. Prospective risk-promoting effects were also found for alcohol expectancies, peer alcohol use, and availability of alcohol in the home; protective effects were found for mother's responsiveness and for adolescent's school performance and self-control. Theoretical and practical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increased sensitivity to the disinhibiting effects of alcohol in binge drinkers.

Heavy episodic alcohol use, or binge drinking, is a serious public health problem. Binge drinking is endemic in college students and has resulted in numerous alcohol-related tragedies, including acute alcohol poisonings, falls, and automobile collisions. Such negative outcomes might occur because binge drinkers are generally more impulsive, and this impulsivity might be exacerbated under alcohol. The purpose of this study was to examine this hypothesis by comparing the acute effects of alcohol on a cognitive measure of behavioral control in binge and nonbinge drinkers. The results indicated that binge drinkers act more impulsively and report feeling more stimulated under an acute 0.65 g/kg dose of alcohol compared to nonbinge drinkers. The present finding of a heightened disinhibitory reaction to alcohol in binge drinkers may help explain the link between impulsivity and problem drinking at a more fundamental level of behavioral control. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Simulated driving performance of adults with ADHD: Comparisons with alcohol intoxication.

Previous research has demonstrated that adults with attention deficit/hyperactivity disorder (ADHD) are more likely to experience driving-related problems, which suggests that they may exhibit poorer driving performance. However, direct experimental evidence of this hypothesis is limited. The current study involved 2 experiments that evaluated driving performance in adults with ADHD in terms of the types of driving decrements typically associated with alcohol intoxication. Experiment 1 compared the simulated driving performance of 15 adults with ADHD to 23 adult control participants, who performed the task both while sober and intoxicated. Results showed that sober adults with ADHD exhibited decrements in driving performance compared to sober controls, and that the profile of impairment for the sober ADHD group did in fact resemble that of intoxicated drivers at the blood alcohol concentration level for legally impaired driving in the United States. Driving impairment of the intoxicated individuals was characterized by greater deviation of lane position, faster and more abrupt steering maneuvers, and increased speed variability. Experiment 2 was a dose-challenge study in which 8 adults with ADHD and 8 controls performed the driving simulation task under 3 doses of alcohol: 0.65g/kg, 0.45g/kg, and 0.0g/kg (placebo). Results showed that driving performance in both groups was impaired in response to alcohol, and that individuals with ADHD exhibited generally poorer driving performance than did controls across all dose conditions. Together the findings provide compelling evidence to suggest that the cognitive and behavioral deficits associated with ADHD might impair driving performance in such a manner as to resemble that of an alcohol intoxicated driver. Moreover, alcohol might impair the performance of drivers with ADHD in an additive fashion that could considerably compromise their driving skill even at blood alcohol concentrations below the legal limit. (PsycINFO Database Record (c) 2010 APA, all rights reserved)