A pilot study of naltrexone and BASICS for heavy drinking young adults

Heavy drinking young adults often have limited motivation to change their drinking behavior. Adding pharmacotherapy to brief counseling is a novel approach to treating this population. A small open-label pilot study was conducted to assess the feasibility of offering eight weeks of daily and targeted (i.e., taken as needed in anticipation of drinking) naltrexone with BASICS (brief motivational) counseling to heavy drinking young adults; to assess the tolerability of the medication in this population and to obtain preliminary efficacy data. The sample (N=14) showed strong adherence to study appointments and medication taking, supporting the feasibility of this approach. Overall, the medication was well-tolerated. Significant reductions from baseline were observed in drinks per drinking day and in percent heavy drinking days and these gains were maintained one month after treatment ended. A significant decrease in alcohol-related consequences was also observed. Findings from this small pilot study suggest that naltrexone in combination with BASICS represents a promising strategy to reduce heavy drinking among young adults.     

Protective behavioral strategies mediate the effect of drinking motives on alcohol use among heavy drinking college students: gender and race differences

Objective

This study examined the extent to which protective behavioral strategies (PBS) mediated the influence of drinking motives on alcohol consumption, and if these hypothesized relationships were corroborated across subsamples of gender and race.

Method

Online surveys were completed by 1592 heavy drinking college undergraduates from two universities (49.9% male and 50.1% female; 76.9% Caucasian and 23.1% Asian). Independent samples t-tests compared males and females as well as Caucasians and Asians on measures of drinking motives, PBS use, and alcohol consumption, and structural equation models examined the mediating role of PBS.

Results

Consistent with predictions, t-tests revealed that males reported greater levels of consumption than females, but females reported greater use of PBS than males. Caucasians reported greater consumption levels, endorsed higher enhancement motives, and higher PBS related to serious harm reduction, but Asians endorsed higher coping and conformity motives, and PBS focused on stopping/limiting drinking. In multiple-sample SEM analyses, PBS were shown to largely mediate the relationship between motives and consumption in all demographic subsamples.

Conclusions

Findings indicate that PBS use leads to reductions in drinking despite pre-established drinking motives, hence pointing to the potential value of standalone PBS skills training interventions in lowering alcohol use among diverse groups of heavy drinking college students.     

Drinking motives,drinking restraint and drinking behaviour among young adults

Motives to drink alcohol are widely thought to be the proximal cognitive factors involved in the decision to consume alcohol beverages. However it has also been argued that the ability to restrain drinking may be a more proximal predictor of drinking behaviour. The current study aimed to examine the relationships between drinking motives, drinking restraint and both alcohol consumption and alcohol-related problems in a sample of young adults. A sample of 221 young adults (aged 17–34 years) completed self-report measures assessing drinking behaviour, motives for drinking and drinking restraint. Multiple regression analyses revealed that coping, enhancement and social motives were related to alcohol consumption and alcohol-related problems, while Cognitive and Emotional Preoccupation with drinking was related to all criterion variables. Further, the relationship between coping motives and drinking behaviour was mediated by preoccupation with drinking. The results are discussed in light of the roles of drinking motives and drinking restraint in risky drinking among young people, and implications for prevention and early intervention are presented.     

Negative mood,implicit alcohol-related memory,and alcohol use in young adults: The moderating effect of alcohol expectancy

ObjectiveAlcohol-related implicit (preconscious) cognitive processes are established and unique predictors of alcohol use, but most research in this area has focused on alcohol-related implicit cognition and anxiety. This study extends this work into the area of depressed mood by testing a cognitive model that combines traditional explicit (conscious and considered) beliefs, implicit alcohol-related memory associations (AMAs), and self-reported drinking behavior.MethodUsing a sample of 106 university students, depressed mood was manipulated using a musical mood induction procedure immediately prior to completion of implicit then explicit alcohol-related cognition measures. A bootstrapped two-group (weak/strong expectancies of negative affect and tension reduction) structural equation model was used to examine how mood changes and alcohol-related memory associations varied across groups.ResultsExpectancies of negative affect moderated the association of depressed mood and AMAs, but there was no such association for tension reduction expectancy.ConclusionSubtle mood changes may unconsciously trigger alcohol-related memories in vulnerable individuals. Results have implications for addressing subtle fluctuations in depressed mood among young adults at risk of alcohol problems.     

Adolescent heavy episodic drinking trajectories and health in young adulthood

OBJECTIVE: This study examined the association of trajectories of heavy episodic drinking (at least five alcoholic drinks on one occasion) during adolescence with health status and practices at age 24. METHOD: Semiparametric group-based modeling and logistic regressions were used to analyze data from a longitudinal panel of 808 youths interviewed between 10 and 24 years of age. RESULTS: Four distinct trajectories of adolescent heavy episodic drinking were identified: nonheavy drinkers, late onsetters, escalators and chronic heavy drinkers. Overall, young adults who did not engage in heavy episodic drinking during adolescence had the lowest occurrence of health problems and were most likely to engage in safe health behaviors at age 24. Chronic and late-onset heavy episodic drinking during adolescence had negative effects on health status and practices at age 24. Adolescent chronic heavy drinkers were more likely to be overweight or obese and to have high blood pressure at age 24 than those who did not drink heavily in adolescence. Late-onset heavy drinkers were less likely to engage in safe driving practices at age 24 and were more likely to have been ill in the past year than adolescents who did not drink heavily. These health disparities remained even after current frequency of heavy episodic drinking at age 24, other adolescent drug use, ethnicity, gender and family poverty were controlled. CONCLUSIONS: Heavy episodic alcohol use during adolescence has long-term, negative health consequences. Distinct patterns of adolescent heavy drinking affect health status and practices in young adulthood differently.     

Changing drinking styles in Denmark and Finland. Fragmentation of male and female drinking among young adults

A traditional heavy intoxication-oriented drinking style, "heroic drinking," is a central drinking practice in Denmark and Finland, especially among men. However, it seems that another drinking style leading to intoxication, "playful drinking," has become more prevalent in Denmark as well as in Finland. Playful drinking is characterized by self-presentations in diverse forms of game situations in which you need to play with different aspects of social and bodily styles. We approach the positions of heroic drinking and playful drinking among young adults (between 17 and 23 years) in Denmark and Finland by analyzing how they discuss these two drinking styles in focus groups (N = 16).     

Country of origin, age of drinking onset, and drinking patterns among Mexican American young adults

This study examines relationships between country of origin, age of drinking onset, and adverse drinking outcomes among young adult Mexican Americans in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Logistic regression models estimate associations between age of drinking onset, age of onset in relation to age at immigration, and adverse drinking outcomes, controlling for sex, age, employment, education, marital status, and income. Adjusted analyses indicate the odds of adverse drinking outcomes decreased as age of drinking onset increased. Mexican Americans who initiated drinking in Mexico had significantly lower odds of current or lifetime harmful drinking than U.S. born but the odds were not significantly different between foreign-born Mexican Americans who initiated drinking in the U.S. and U.S. born. Irrespective of whether drinking onset was in Mexico or the U.S., foreign-born Mexican Americans had lower odds of alcohol abuse than U.S. born. However, odds of dependence were not significantly different between foreign-born and U.S.-born Mexican Americans. While findings suggest that being foreign born may be protective, further research on social and cultural factors impacting drinking onset and related outcomes among young Mexican Americans may help inform prevention efforts.     

The effect of past-year heavy drinking on alcohol-related aggression

OBJECTIVE: The primary goal of this study was to determine the moderating effect of a history of heavy episodic drinking on the alcohol-aggression relation in men and women. METHOD: Participants were 310 (152 men and 158 women) healthy social drinkers between 21 and 35 years of age. Drinking history was operationalized as participants' average number of alcoholic drinks consumed per drinking occasion during the past year. Following the consumption of either an alcohol or a placebo beverage, participants were tested on a modified version of the Taylor Aggression Paradigm in which mild electric shocks were received from, and administered to, a fictitious opponent during a competitive task. Aggressive behavior was operationalized as the shock intensities administered to the fictitious opponent under conditions of low and high provocation. RESULTS: Alcohol increased aggression only among highly provoked men who reported a history of heavy episodic drinking. A history of high-frequency drinking did not moderate the alcohol-aggression relation. CONCLUSIONS: These findings highlight the importance of considering a history of heavy episodic drinking in the prediction of intoxicated aggression.     

Parental problem drinking predicts implicit alcohol expectancy in adolescents and young adults

The present study aimed to investigate the influence of parental problem drinking on implicit and explicit alcohol expectancy of adolescents and young adults (12-24 years). The study was conducted via the Internet, employing a between-subjects design. We measured alcohol expectancy by means of an Implicit Association Test (IAT) and a self-report questionnaire. A short version of the Children of Alcoholics Screening Test (CAST) was used to measure alcohol-related parental problem behavior. Our results showed that increased CAST-scores were correlated with a stronger implicit association between the concepts alcohol and arousal. In contrast, no such relationship was observed between parental problem drinking and self-reported expectancy of alcohol arousal. These findings provide tentative evidence that an implicit cognitive processing bias is implicated in the intergenerational transmission of addictive behaviors.     

Moderating effects of race in clinical trial participation and outcomes among marijuana-dependent young adults

Background

Few studies have examined clinical trial participation rates and treatment outcomes among underserved young adults who are dependent on marijuana, the most commonly abused illicit drug.

Method

The present study was a secondary analysis of a trial of court-referred marijuana-dependent young adults (ages 18–25) randomized to one of four treatment conditions: Motivational Enhancement Therapy/Cognitive Behavioral Therapy (MET/CBT), MET/CBT + Contingency Management (CM), Drug Counseling (DC) or DC + CM. African American (N = 81) participants were compared to White (N = 31) participants with respect to rates of participation in phases of treatment and substance use outcomes. In addition, the interaction of race and treatment condition was examined to ascertain if the interventions yielded different effects based on race.

Results

Among those who started treatment, African American young adults were significantly less likely to complete the treatment and posttreatment phases of the clinical trial than their White counterparts. Irrespective of treatment type, substance use outcomes (i.e., percentage of marijuana-negative specimens and longest duration of continuous abstinence) did not vary by race. However, there was a significant interaction effect between treatment type and race; African American young adults did not benefit differentially from any specific type of treatment, but CM was effective in reducing proportion of marijuana positive samples among White young adults.

Conclusions

Findings suggest that clinical trial treatment and posttreatment completion rates vary by race in this population, as does response to specific treatment types. More treatment research focusing specifically on African American marijuana-dependent young adults is warranted.     

Integrated smoking cessation and binge drinking intervention for young adults: A pilot efficacy trial

Alcohol consumption is strongly associated with cigarette smoking in young adults. The primary aim of this investigation was to complete a pilot evaluation of the efficacy of an integrated intervention that targets both cigarette smoking and binge drinking on the cigarette smoking and binge behavior of young adults at 6-month follow-up. Participants were 95 young adult (M = 24.3; SD = 3.5 years) smokers (≥ 1 cigarettes per day) who binge drink (≥ 1 time per month) and who were randomly assigned to standard treatment (n = 47) involving six individual treatment visits plus eight weeks of nicotine patch therapy or the identical smoking cessation treatment integrated with a binge drinking intervention (integrated intervention; n = 48). Using an intent-to-treat analysis for tobacco abstinence, at both 3 month end of treatment and 6 month follow-up, more participants who received integrated intervention were biochemically confirmed abstinent from tobacco than those who received standard treatment at 3 months (19% vs. 9%, p = 0.06) and 6 months (21% vs. 9%, p = 0.05). At 6 months, participants who completed the study and who received integrated intervention consumed fewer drinks per month (p < 0.05) and number of binge drinking episodes per month (p < 0.05) than those who received standard treatment. Preliminary data supports that integrated intervention enhances smoking cessation and reduces binge drinking compared to standard treatment.     

Effects of tobacco deprivation on alcohol cue reactivity and drinking among young adults

Nicotine and alcohol may have common neurobiological mechanisms of reinforcement. Therefore, withholding one substance might result in compensatory increases in self-administration of the other. This laboratory study investigated the effects of brief tobacco deprivation on alcohol cue-elicited urges to drink, corresponding psychophysiological reactions, and alcohol consumption. Young adults (N=78) who were moderate to heavy smokers and drinkers were stratified and randomized to a 2 x 2 design. Participants were either deprived of tobacco for 5 h or not deprived and then exposed to in vivo alcohol or control beverage cues. Subsequently, participants engaged in a taste-rating task as an unobtrusive measure of alcohol consumption. Tobacco deprivation resulted in increased urge to smoke and decreased cardiovascular responses but did not increase alcohol urges or alcohol consumption. Results indicate that brief tobacco deprivation does not result in compensatory increases in alcohol consumption among young moderate to heavy drinkers.     

Alcohol problems in young adults transitioning from adolescence to adulthood: The association with race and gender

Race and gender may be important considerations for recognizing alcohol related problems in Black and White young adults. This study examined the prevalence and age of onset of individual alcohol problems and alcohol problem severity across race and gender subgroups from a longitudinal study of a community sample of adolescents followed into young adulthood (N=166; 23-29 yrs. old who were drinkers). All alcohol problems examined first occurred when subjects were in their late teens and early 20s. Drinking in hazardous situations, blackouts, and tolerance were the most common reported alcohol problems. In race and gender comparisons, more males than females experienced alcohol problems. Blacks generally had a later age of onset of alcohol problems. Multivariate regressions showed greater alcohol problem severity in males compared to females, but no significant differences between Blacks and Whites. Education, family environment and earlier alcohol use behaviors and expectancies were reliable predictors of alcohol problem severity in young adulthood. White males were at particular risk for experiencing more severe alcohol problems. Findings may inform the design of more targeted interventions for alcohol problems in different populations.     

Direct and indirect effects of impulsivity traits on drinking and driving in young adults

ABSTRACT. Objective: Impulsivity is strongly associated with alcohol-related risk-taking behavior, and this association has been found to be mediated by alcohol cognitions. The current study expanded this literature by comparing the relative association of distinct impulsivity traits with a specific risky behavior-drinking and driving. We then tested whether drinking-and-driving expectancies uniquely mediated this relation over and above other cognitions about alcohol and drinking and driving. Method: College student drivers (n = 816; 53.6% women) completed a paper-and-pencil survey in small groups. Self-report measures assessed alcohol use, impulsivity traits, alcohol expectancies, drinking-and-driving cognitions (i.e., expectancies, attitudes, beliefs), and drinking and driving. Results: Although all impulsivity traits were correlated with drinking and driving, only urgency uniquely contributed to drinking and driving. Indirect effect tests indicated that drinking-and-driving convenience expectancies partially mediated this association as well as that between (lack of) perseverance and drinking and driving. These results remained significant after controlling for alcohol expectancies and other drinking-and-driving cognitions. Conclusions: These findings highlight the importance of distinguishing among impulsivity traits to improve theoretical models of the processes by which personality leads to specific alcohol-related consequences. In addition, results extend previous research by providing evidence for the unique importance of expectancies regarding the convenience of drinking and driving over and above more global alcohol expectancies and other drinking-and-driving cognitions. (J. Stud. Alcohol Drugs, 73, 794-803, 2012).     

Self-administered web-based timeline followback procedure for drinking and smoking behaviors in young adults

ABSTRACT. Objective: The goal of the current investigation was to test the psychometric properties of a self-administered web-based version of the Timeline Followback (TLFB), a retrospective calendar method of assessing daily behaviors. Method: The study used a within-subjects, counterbalanced design to compare estimates of daily drinking and smoking behaviors obtained by a self-administered web-based version of the TLFB with estimates obtained by a telephone interview version. The sample consisted of 120 social drinker-smoker young adults (65 men). Results: Correlations between the two modalities for total number of drinks, total drinking days, and heavy drinking days in a 4-week period ranged from .83 to .93; those for total cigarettes, total smoking days, and heavy smoking days ranged from .90 to .95. The correlation between the two modalities for estimates of the number of co-use days was .90. Drinking and smoking estimates from the online TLFB also correlated significantly with scores from the Alcohol Use Disorders Identification Test and Fagerstr?m Test of Nicotine Dependence. Conclusions: Overall, the results demonstrated strong support for the use of a self-administered web-based TLFB assessment tool to capture concurrent reports of social drinking and smoking behaviors in young adults. The web-based TLFB may be particularly well suited for assessment in clinical trials, longitudinal designs, and epidemiological studies. (J. Stud. Alcohol Drugs, 73, 829-833, 2012).     

Parental drinking, parent-child communication, and social skills in young adults.

The goals of this study are to determine (1) if parent-child communication is associated with the level of alcoholic problems within the family and (2) if there is a relationship between problem drinking, family communication and the self-reported social skills of the young adult child. The self-reports of 338 students indicate that young adults who have memories of regular problem drinking within the family perceive less positive regard and a greater denial of or inattention to their feelings by the parents. Problem-drinking level interacted with either criticism or denial of feelings or emotional support to parents to predict primarily nonverbal social skills such as decreased emotional expressivity and increased sensitivity to the emotional cues of others. The results indicate that the effect of parental alcoholism on social skills of the young adult child must be considered in conjunction with specific types of family communication.     

Teaching moderate drinking behaviors to young adult heavy drinkers: The effects of three training procedures

The present study employed an objective assessment methodology to investigate the effectiveness of instructions, self-monitoring, and practice in teaching young adult heavy drinkers a specific moderate drinking style. The results, specific to young male (age 19–24) heavy social drinkers, indicate that the practice training procedure was superior to the other two training procedures. Implications for the treatment of alcohol abuse as well as the development of preventive programs designed to teach beginning drinkers responsible drinking behavior are discussed.     

Drinking and heavy drinking by students in 18 countries

This paper examines how levels of drinking, daily drinking and heavy drinking are related in 18 countries. There is wide national variation in consumption patterns. The proportions of students drinking and the proportion drinking at least six times in the past month correlated with per capita consumption in the total adult population. Some student drinking variables correlated with each other. Most countries (n=14) could be classified into one of two distinct groups based on the percentage of students who reported drinking at least six times per month, the percentage reporting drinking at least five drinks per day at any time in the last month and per capita alcohol consumption. Some countries in these groups were geographically close but others were not. Further research is needed to understand differences and similarities among countries with respect to student drinking.     

Using personalized feedback to reduce alcohol use among hazardous drinking college students: the moderating effect of alcohol-related negative consequences

Web-based screening and brief interventions that include personalized feedback about their alcohol use have proven to be particularly promising for reducing hazardous drinking among university students. Despite the increasing use of these approaches, there is still relatively little known about how the content of these interventions may influence outcomes and who may benefit most from these approaches. The current study sought to address these issues by examining how individual differences in alcohol consequences influence outcomes of a laboratory-based computerized intervention.