The relationship between coping strategies, alcohol expectancies, drinking motives and drinking behaviour

Numerous models have been proposed in an attempt to explain both alcohol use and alcohol abuse. Many of these models propose that drinking behaviour is the result of a complex interplay of cognitive and behavioural variables including coping strategies, alcohol expectancies and motives for drinking. However few studies have explored how these elements may work together to predict drinking. The current study proposed a mediational model of alcohol use in which coping strategies are related to alcohol expectancies, which in turn are related to drinking motives. Drinking motives were then viewed as proximal predictors of drinking behaviour. There were 454 participants (55.78% female) who completed self-report questionnaires assessing the above constructs. Approximately half the participants completed the questionnaires online, while the others completed the paper and pencil versions of the same measures. Findings generally supported the hypothesised model. The relationship between avoidant coping and drinking behaviour was mediated by alcohol expectancies of increased confidence and tension reduction, which in turn were related to drinking motives. As expected, drinking motives were positively related to drinking behaviour. Negative expectancies were also directly related to drinking behaviour. The results are discussed in light of cognitive models of drinking, and implications for prevention and early intervention of alcohol-use problems.     

Variations by age and sex in alcohol-related problematic behaviour per drinking volume and heavier drinking occasion

Aims

This study aims to assess the relationships between age, sex, drinking behaviour and self-reported alcohol-related problem behaviour.

Design

Cross-sectional population survey.

Setting and participants

Interviews were undertaken in 2004, with a representative sample of Australian residents aged 12 and over (N = 29,445).

Measurements

Alcohol use was measured using graduated frequency questions and, using these questions, estimates of total annual intake and frequency of heavy drinking occasions were derived. Alcohol-related problems were measured using a 10-item scale, relating to behaviour in the 12 months prior to the survey.

Findings

Alcohol-related problem behaviours clustered into two groups: hazardous behaviour and delinquent behaviour. Rates of problem behaviours and drinking followed similar patterns for males and females, with peaks in early adulthood and a subsequent decline with age. Males drank at higher levels than females and behaved more problematically. Once alcohol consumption and drinking pattern were controlled for, male and female rates of problem behaviours were not markedly different. However, there were substantial differences by age, with young people behaving significantly more problematically than older people with the drinking variables controlled for.

Conclusions

The results of this study provide strong evidence that young drinkers behave more problematically than older drinkers with drinking behaviour controlled for. The study also provides further evidence that women and men do not report substantially different rates of alcohol-related problems for similar amounts or patterns of drinking. The study has implications for public health messages that focus on the risk of harm from drinking, clearly demonstrating that young drinkers are more likely to report problems for a given amount of drinking.     

Recent drinking consequences, motivation to change, and changes in alcohol consumption over a three month period

Little is known about what type of drinking related consequences may enhance motivation to change or may hinder behavior change over time. In order to examine this research question, 120 adult participants abusing alcohol were administered the Drinker Inventory of Consequences-Recent (DrInC-R), the Brief Readiness to Change Questionnaire (BRTC), and the Steady Pattern Chart (SP). Subscale scores from the DrInC-R and the BRTC; and alcohol consumption as assessed by the SP at baseline and three month follow-up were retained for data analyses. Greater intrapersonal DrInC-R consequences scores significantly predicted greater contemplation stage scores (R2=.37, p<.001), and lower precontemplation stage scores (R2=.32, p<.001), and DrInC-R impulse control and interpersonal consequences scores significantly predicted alcohol consumption at three month follow-up after controlling for baseline consumption (R2=.50, p<.001). Increased awareness of intrapersonal drinking related consequences may motivate change, whereas numbers of impulse control and interpersonal consequences may predict changes in drinking behavior over the short-term.     

Combat experience and problem drinking in veterans: Exploring the roles of PTSD,coping motives,and perceived stigma

PurposeThe current investigation sought to illustrate the etiology of adverse alcohol consequences in young adult veterans using a path analytic framework.MethodsA total of 312 veterans aged 19–34 were enrolled in a larger intervention study on alcohol use. At baseline, participants completed measures of combat severity, PTSD symptom severity, and drinking motives to cope. At one month follow-up, participants completed measures of perceived stigma of behavioral health treatment seeking and past 30-day alcohol consequences.ResultsAfter entering the covariates of age, gender, race/ethnicity, and past year behavioral health treatment utilization, a path analytic model demonstrated a good fit to the data predicting alcohol consequences in this population. Further, a separate exploratory analysis confirmed that both drinking motives to cope and perceived stigma of behavioral health treatment seeking mediated the link between PTSD symptom severity and alcohol consequences.ConclusionsThe current model expands upon prior research showing the relationship between combat severity and alcohol use behavior in young adult veterans. Results support the notion that veterans with PTSD symptoms may drink to cope and that perceived stigma surrounding help seeking may further contribute to alcohol related problems.     

Situational and respondent-level motives for drinking and alcohol-related aggression: A multilevel analysis of drinking events in a sample of Canadian University students

Situational drinking motives (i.e., motives specific to the drinking situation) as well as respondent-level drinking motives (i.e., usual drinking motives across drinking situations) were examined in terms of their relations with aggression experienced by university students. Secondary, multi-level analyses were conducted on the Canadian Campus Survey (CCS), a national survey of 40 Canadian universities conducted between March 1 and April 30, 2004 (N = 6 282). For their three most recent drinking events, students reported their motive for drinking (i.e., situational motive) and whether they had an argument/fight. Respondent-level drinking motives were computed by averaging motives across drinking events. Drinking to cope at the situational-level increased the likelihood of aggression. Respondent-level enhancement motives also increased the risk of aggression. Aesthetic motives were important at both situational and respondent levels decreasing the risk for alcohol-related aggression. Gender did not moderate these relations. These results suggest that prevention programming might benefit from a focus on altering drinking motives, or their underlying causes, in order to reduce alcohol-related aggression among young adults.     

Relationship of drinking motives with alcohol consumption and alcohol-related problems identified in a representative community-based study from Ningxia,China

BackgroundDrinking motives have been linked to alcohol consumption and drinking-related problems in western countries, but evidence about this relationship is largely lacking for Asian countries. We aim to assess the relationship between drinking motives and drinking-related outcomes in China, where alcohol use disorders are an increasingly important contributor to the overall burden of illness.MethodsValidated Chinese versions of the Drinking Motives Questionnaire-Revised (DMQ-R) and the Alcohol Use Disorder Identification Test (AUDIT) were used to assess drinking motives and drinking-related outcomes among 612 current drinkers identified from a cross-sectional survey of a representative sample of 2425 adults living in Ningxia Province in 2013. Structural equation modeling was used to estimate the relationships linking specific drinking motives (‘enhancement’, ‘conformity’, ‘social’ and ‘coping’) to drinking-related outcomes (‘level of alcohol consumption’, ‘alcohol dependence’ and ‘adverse consequences’).FindingsThe enhancement motive is significantly associated with the level of alcohol consumption (β = 0.52, 95% CI = 0.27, 0.78). The conformity motive is associated with higher levels of alcohol dependence (β = 0.74, 95% CI = 0.50, 0.98) and adverse consequences of drinking (β = 0.43, 95% CI = 0.04, 0.81). The social motive and drinking to cope motive are not significantly associated with any of the three drinking outcomes.InterpretationThe relationships between drinking motives and drinking-related outcomes in China are quite different from those reported in western countries. This study highlights the need to consider local context when adapting prevention or intervention strategies developed in western countries to address the problem of the harmful use of alcohol in China.     

Adolescent problem drinking: stability of psychosocial and behavioral correlates across a generation.

OBJECTIVE: Research conducted in the 1970s demonstrated that Problem Behavior Theory could account for approximately 40% of the variance in problem drinking in both local and national sample studies. The present analyses sought to determine whether the personality, perceived environment, and behavior variables of the framework continue to contribute to the explanation of problem drinking among contemporary American youth. METHOD: Correlational and multiple regression analyses were performed on six separate databases collected at different times between 1972 and 1992. Due to sociodemographic differences among the samples, separate analyses were performed for male and female adolescents, and age, ethnicity and socioeconomic status were statistically controlled. RESULTS: There was considerable consistency across the samples in both the partial correlations and the partial multiple correlations, and this result held for both genders. Not only did the framework account for the same percentage of the variance (40%) in problem drinking in the 1992 data as it did in the 1972 data, but the results for the intervening years were consistent as well. CONCLUSIONS: The consistency of results over a 20-year period confirms that the social-psychological meaning of adolescent involvement in problem drinking has remained stable despite changes in the larger sociohistorical context.     

Coping motives as a mediator of the relationship between sexual coercion and problem drinking in college students

Sexually coercive experiences, heavy alcohol use, and alcohol-related problems occur at relatively high base rates in college populations. As suggested by the self-medication hypothesis, alcohol consumption may be a means by which one can reduce negative affect or stress related to experiences of sexual coercion. However, few studies have directly tested the hypothesis that coping motives for drinking mediate the relation between sexual assault and problem drinking behaviors, and no published studies have tested this in men. The current study tested this hypothesis using structural equation modeling in a sample of 780 male and female undergraduates. Results revealed that coping motives partially mediated the relation between sexual coercion and drinking and alcohol-related negative consequences. In addition, direct and indirect paths between sexual coercion and drinking were found for men whereas only indirect paths were found for women. Results provide support for self-medication models of drinking and suggest the importance of exploring gender differences in mechanisms for drinking.     

Gene-environment interactions resulting in risk alcohol drinking behaviour are mediated by CRF and CRF1

Both genetic and environmental influences are known to influence an individuals' vulnerability to the misuse of alcohol. One of the most relevant environmental risk factors for alcoholism is that of stress. This review aims to examine the role of the biological stress systems in the etiology of alcoholism, with a focus on corticotrophin releasing factor (CRF) and its receptor CRF1. CRF is reviewed in the context of the biological stress systems within which it acts such as the HPA-axis, the noradrenergic system and the central and medial amygdale. These systems are examined in more detail by reviewing their genetic and molecular components in both humans and animals. It is concluded from the findings of the studies discussed in this review that CRF has a central role in the modulation of the stress response and that genetic variations in CRF or CRF1 may confer a susceptibility to alcoholism which is, in part, mediated by life stressors. Together these neurobiological, animal and human data suggest a role for CRF when developing treatment modalities for alcoholism alongside a pharmacogenetic approach to identify subtypes of patients which would benefit from these treatments or interventions.     

Maintenance of remission of ulcerative colitis: a comparison between balsalazide 3 g daily and mesalazine 1.2 g daily over 12 months

Background:

Despite widespread use of aminosalicylates as maintenance treatment for ulcerative colitis (UC), patients still report troublesome symptoms, often nocturnally.

Aim:

To compare the efficacy and safety of balsalazide (Colazide) with mesalazine (Asacol) in maintaining UC remission.

Methods:

A randomized, double-blind comparison of balsalazide 3 g daily (1.04 g 5-ASA) and mesalazine 1.2 g daily for 12 months, in 99 (95 evaluable) patients in UC remission.

Results:

Balsalazide patients experienced more asymptomatic nights (90% vs. 77%, P = 0.0011) and days (58% vs. 50%, N.S.) during the first 3 months. Balsalazide patients experienced more symptom-free nights per week (6.4 ± 1.7 vs. 4.7 ± 2.8; P = 0.0006) and fewer nights per week with blood on their stools or on the toilet paper, mucus with their stools or with sleep disturbance resulting from symptoms or lavatory visits (each P < 0.05). Fewer balsalazide patients relapsed within 3 months (10% vs. 28%; P = 0.0354). Remission at 12 months was 58% in both groups. Similar proportions of patients reported adverse events (61% balsalazide vs. 65% mesalazine). There were five serious adverse events (two balsalazide, three mesalazine) and four withdrawals due to unacceptable adverse events (three balsalazide, one mesalazine), of which one in each group was also a serious adverse event.

Conclusions:

Balsalazide 3 g/day and mesalazine 1.2 g/day effectively maintain UC remission and are equally well tolerated over 12 months. At this dose balsalazide prevents more relapses during the first 3 months of treatment and controls nocturnal symptoms more effectively.

     

Dependent and problem drinking over 5 years: a latent class growth analysis

Understanding the long-term course of problematic drinking is a fundamental concern for health services research in the alcohol field. The stability of, or change in, the course of drinking--especially heavy drinking--has both theoretical and applied relevance to alcohol research. We explore the application of latent class growth modeling to 5 years of survey data collected from dependent and problem drinkers--some not in treatment at baseline--in an attempt to uncover prototypical longitudinal drinking patterns. Results indicated that five profiles of drinkers can be used to represent their longitudinal course of alcohol consumption: early quitters (N = 88), light/non-drinkers (N = 76), gradual improvers (N = 129), moderate drinkers (N = 229), and heavy drinkers (N = 572). Significant baseline factors included ASI drug severity, dependence symptoms, and marital status. Attendance at AA meetings, the size of one's heavy drinking and drug using social network, past treatment, receiving suggestions about one's drinking, and contacts with the medical system were significant influences. The size of heavy drinking and drug using social networks was noticeably larger for the heavy drinkers. Findings also support the usefulness of a semi-parametric latent group-based approach as a tool for analyzing alcohol-related behaviors.     

Invisible victims or competent agents: Opinions and ways of coping among children aged 12–18 years with problem drinking parents

Aims: The article describes the lives of children with problem drinking parents from children's own perspective, emphasizing their experiences, agency and coping.

Methods: The qualitative data were collected with a web-based questionnaire advertised on two children's and adolescents’ help pages. The final sample consisted of 70 volunteers between the ages 12 and 18 years, mostly girls (17% were boys).

Findings: Children with problem drinking parents are a hidden population and neglected by services, which they need. Children have, however, developed their own ways of trying to cope. They also have various practical suggestions and opinions concerning services and the type of help they would find useful.

Conclusions: Harms inflicted to children are an important reason for preventing substance misuse. It is also important that children are heard by professionals and authorities dealing with family problems, and that one understands, supports and respects children's own agency and ways of coping. Children's ways of coping can differ from those of the adults. Further studies on children living with problem drinking parents are needed. The study shows that internet can be one way of collecting research data from this otherwise hard-to-reach group.     

A liquid chromatography–tandem mass spectrometry method for the determination of cocaine and metabolites in blood and in dried blood spots collected from postmortem samples and evaluation of the stability over a 3‐month period

The aims of this study were (1) to identify and quantify cocaine (COC), benzoylecgonine (BE), ecgonine methyl ester (EME), and cocaethylene (CE) in DBS; (2) to compare dried blood spots (DBSs) analytical results with the routine blood analyses; (3) to monitor analytes stability on DBS within a 3‐month period. Eighty‐five μL of blood from postmortem cases were put on a card for DBS analysis and kept in the dark, at room temperature. Samples were extracted through solid‐phase extraction (SPE) cartridges and injected in the liquid chromatography–tandem mass spectrometry (LC–MS/MS) system. The analytical procedure is simple, sensitive, and specific. Limits of detection (LODs) and quantification (LOQs) were calculated at 1.0 and 5.0 ng/mL(g) for COC and CE, and at 0.5 and 2 ng/mL for EME and BE, respectively. Validation parameters fulfilled all the acceptance criteria. Fifty‐five postmortem cases were evaluated. Eighteen cases were positive for COC (44–2456 ng/mL) and BE (228–4700 ng/mL), 12 for EME (92–1500 ng/mL), and 11 cases for CE (11–273 ng/mL). Stability was evaluated on 8 cases collected in the period January 2017–January 2018. For each case, 5 DBSs were collected at T0. Four DBSs were analyzed within the 4 following weeks and 1 sample was analyzed after 3 months. The concentrations on DBSs, stored at room temperature, always matched the ones obtained on blood samples kept at ?20°C (<20% variation, both at T0 and after 3 months). BE and COC concentrations remained stable after a 3‐month storage, EME concentrations slightly increased after 3 weeks in the 2 analyzed samples, while CE provided a less homogeneous stability depending on the sample.     

Binge drinking behaviour, attitudes and beliefs in a UK community sample: An analysis by gender, age and deprivation

Binge drinking has sparked considerable interest and concern. However, despite this interest little is known about the lay understanding of binge drinking and whether there are differences in understanding by gender, age and level of deprivation.

Aims: This study investigated the beliefs and attitudes to binge drinking of a sample in the Inverclyde area.

Methods: Using both cluster and quota sampling, 586 subjects completed a structured interview, using open questions about their beliefs on binge drinking and whether it was a problem generally and locally.

Findings: Definitions of binge drinking tended to concentrate on intoxication and some described a dependent drinking pattern. Causes and solutions offered were varied but pointed-up levels of deprivation in respect of jobs and entertainment. More subjects regarded binge drinking as a problem in society than locally, which is consistent with research suggesting that misperceptions of others' drinking increases with social distance. Differences in beliefs were found by age and level of deprivation but not gender. It was marked that no subject offered the 'official' definition of bingeing or even an approximation of it.

Conclusions: Further research is required if future mass-media campaigns and interventions are to be relevant to the population.     

A comparison of hospitalized veterans' attitudes toward smoking and smoking cessation over a four year period

A questionnaire designed to assess the attitudes of patients in a Veterans Administration Hospital toward smoking was administered and the results compared to data from the same questionnaire given four years earlier. With few exceptions, the attitudes were resistant to change over that period. Comparisons were made between smokers' and non-smokers' background, attitudes, and behavior. The relationship of cigarette consumption and self-reported shortness of breath was discussed. Also, specific recommendations for smoking programs and directions for future smoking research were suggested.     

Probe drug T-1032 N-oxygenation mediated by cytochrome P450 3A5 in human hepatocytes in vitro and in humanized-liver mice in vivo

Polymorphic cytochrome P450 3A5 (CYP3A5) expression contributes to individual differences in the pharmacokinetics of probe drugs. The identification of suitable in vivo CYP3A5 probes would benefit drug metabolism and drug interaction studies using chimeric mice with humanized liver. In this study, we investigated the pharmacokinetic profiles of T-1032, which is known as an in vitro CYP3A5 probe substrate, using humanized-liver mice. Substantial N-oxygenation of T-1032 was observed in hepatocytes from humans and from humanized-liver mice. Hepatocytes from the human donor genotyped as CYP3A513/13 (poor expressers) showed significantly lower T-1032 N-oxidation rates than those from donors harboring CYP3A511. After a single oral dose of T-1032 (1.0 mg/kg) in humanized-liver mice, the plasma levels of T-1032 N-oxide were higher in five mice with CYP3A511/17 hepatocytes than in four mice with CYP3A513/13 hepatocytes. The maximum concentrations of T-1032 N-oxide after oral administration of T-1032 in humanized-liver mice with CYP3A511/17 hepatocytes were twice (a significant difference) those from humanized-liver mice with CYP3A513/13 hepatocytes. These results suggest that polymorphic CYP3A5-dependent T-1032 N-oxidation was observed in humanized liver mice in vitro and in vivo. However, the contribution of CYP3A5 genotypes may have little or only limited effects on the overall pharmacokinetic profiles of T-1032 in vivo.