PTSD Symptoms and Hazardous Drinking Indicators among Trauma-Exposed Sexual Minority Women during Heightened Societal Stress.

Trauma-exposed sexual minority women (SMW) are at elevated risk of posttraumatic stress disorder (PTSD) and hazardous drinking compared to trauma-exposed heterosexual women. To understand whether these problems might be exacerbated during times of elevated societal stress, we collected data from a New York-based sample of trauma-exposed SMW between April 2020 and August 2020, a period of notable, compounding societal stressors, including: (a) living in or near one of the first epicenters of the coronavirus disease 2019 (COVID-19) epidemic in the United States and (b) living through multiple high-profile occurrences of racism-related police violence and subsequent racial unrest. SMW (n = 68) completed online self-report questionnaires related to trauma, PTSD symptoms, and alcohol use, and a subset (n = 29) completed semi-structured qualitative interviews. PsycINFO was searched with terms related to SMW, PTSD, and alcohol use to identify studies with samples of SMW from articles published within the last 10 years to which we could compare our sample; this produced nine studies. Welch's t-tests and Chi-square analyses revealed that SMW within our sample reported significantly higher PTSD symptom severity, probable PTSD, and hazardous drinking indicators (i.e., alcohol use disorder and heavy episodic drinking) between April 2020 and August 2020 compared to similar samples (i.e., trauma-exposed SMW and general samples of SMW) assessed previously. Qualitative reports also indicated that the societal stressors of 2020 contributed to mental and behavioral health concerns. These results underscore the need for integrated PTSD and alcohol use prevention and intervention efforts for trauma-exposed SMW during times of heightened societal stress.Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.2006132 .

Increased alcohol use, heavy episodic drinking, and suicide ideation during the COVID-19 pandemic in Canada.

OBJECTIVE: Alcohol use is a known risk factor for suicidality, yet this relationship has not been explored during the pandemic in Canada. As a growing body of evidence demonstrates the negative impact of COVID-19 on alcohol consumption and associated harms in Canada, there is a need to examine this more closely. METHODS: Using the Survey on COVID-19 and Mental Health 2020, we compared the prevalence of suicide ideation among: (1) individuals who reported an increase in alcohol consumption vs those who reported a decrease/no change, and (2) individuals who reported past month heavy episodic drinking vs those who did not. We compared overall unadjusted odds ratios and across a number of sociodemographic and mental health variables. All estimates were weighted to ensure they were nationally representative. RESULTS: The prevalence and likelihood of suicide ideation were significantly higher among people who reported increased alcohol consumption during the pandemic (4.9% vs 2.0%; OR = 2.6, 95% CI: 1.8, 3.7) and people who reported past month heavy episodic drinking (3.4% vs 2.1%; OR = 1.7, 95% CI: 1.2, 2.3). Males and middle-aged and older-aged individuals had the highest odds ratios for increased alcohol consumption and past month heavy episodic drinking with suicide ideation. CONCLUSION: In the Canadian general population during the COVID-19 pandemic, there were significant associations between suicide ideation and increased alcohol use as well as past month heavy episodic drinking across specific sociodemographic subgroups. Future research could explore these associations while adjusting for social determinants of health such as income security, employment, education, social support, stress, and mental health.

RéSUMé: CONTEXTE: La consommation d'alcool est un facteur de risque connu de suicidabilité, mais cette relation n'a pas été explorée pendant la pandémie au Canada. Comme un nombre croissant de preuves démontre les répercussions négatives de la COVID-19 sur la consommation d'alcool et les méfaits associés au Canada, il est nécessaire d'examiner cette question de plus près. MéTHODES: En utilisant l'enquête de 2020 sur la COVID-19 et la santé mentale, nous avons comparé la prévalence des idées suicidaires chez : (1) les individus qui ont déclaré une augmentation de leur consommation d'alcool par rapport à ceux qui ont déclaré une diminution ou aucun changement, et (2) les individus qui ont déclaré une consommation épisodique excessive d'alcool au cours du dernier mois par rapport à ceux qui n'en ont pas déclaré. Nous avons comparé les rapports des cotes globaux non ajustés et selon un certain nombre de variables sociodémographiques et de santé mentale. Toutes les estimations ont été pondérées afin de garantir leur représentativité nationale. RéSULTATS: La prévalence et la probabilité d'idées suicidaires étaient considérablement plus élevées chez les personnes ayant déclaré une consommation d'alcool accrue pendant la pandémie (4,9 % contre 2,0 %; RC=2,6, IC à 95 % : 1,8 à 3,7) et chez les personnes ayant déclaré une consommation épisodique excessive au cours du mois écoulé (3,4 % contre 2,1 %; RC=1,7, IC à 95 % : 1,2 à 2,3). Les hommes, les personnes d'âge moyen et les personnes âgées présentaient les rapports des cotes les plus élevés pour une consommation d'alcool accrue et une consommation épisodique excessive d'alcool au cours du mois précédent avec des idées suicidaires. CONCLUSION: Dans la population générale canadienne, pendant la pandémie de COVID-19, il y avait des associations significatives entre les idées suicidaires et l'augmentation de la consommation d'alcool ainsi que la consommation épisodique excessive d'alcool au cours du dernier mois dans des sous-groupes sociodémographiques précis. Les recherches futures pourraient explorer ces associations tout en ajustant les déterminants sociaux de la santé tels que la sécurité du revenu, l'emploi, l'éducation, le soutien social, le stress et la santé mentale.

Changes in alcohol use during the COVID-19 pandemic and previous pandemics: A systematic review.

The objective of this study is to summarize the research on the relationships between exposure to the COVID-19 pandemic or previous pandemics and changes in alcohol use. A systematic search of Medline and Embase was performed to identify cohort and cross-sectional population studies that examined changes in alcohol use during or following a pandemic compared to before a pandemic occurred. Outcomes examined included differences in the volume and frequency of alcohol consumption and the frequencies of heavy episodic drinking (HED) and alcohol-related problems during a pandemic compared to before a pandemic. Quality assessment was performed using the Cochrane Risk of Bias Tool for Nonrandomized Studies. This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search yielded 672 articles; 27 were included in the narrative review, of which 6 were cohort studies (all from high-income countries). A total of 259,188 participants were included. All cohort studies examined the impact of COVID-19 and associated pandemic-related policies, including social distancing and alcohol-specific policies, on alcohol use. Cohort studies demonstrated a consistent significant decrease in total alcohol consumption (Australia) and a significant increase in the frequency of alcohol use (United States). A significant decrease in the frequency of HED was observed in Australia and Spain but not in the United States. A significant increase in the proportion of people with problematic alcohol use was observed in the United Kingdom. Initial insights into changes in alcohol use indicate substantial heterogeneity. Alcohol use may have decreased in some countries, while HED and the proportion of people with problematic alcohol use may have increased. The lack of high-quality studies from low- and middle-income countries reflects a dearth of information from countries inhabited by most of the world's population.

Did COVID-19-Related Alcohol Sales Restrictions Reduce Alcohol Consumption? Findings from a National Online Survey in South Africa.

BACKGROUND: South Africa has a high prevalence of heavy episodic drinking (HED). Due to the high levels of alcohol misuse and violence, public hospital intensive care units were often overrun during the COVID-19 pandemic. This research investigated alcohol intake behaviour change during differing levels of lockdown restrictions, which included bans on alcohol sales. METHODS: A self-reported Facebook survey ran from July to November 2020. The questions included socio-demographics, income, alcohol intake, purchasing behaviour, and reasoning. Chi-square tests/Fisher's exact test for categorical data, Student's t-test for normal continuous data, and the Mann-Whitney U test for non-normal data were applied. Multiple logistic regression was run for HED versus moderate drinkers. RESULTS: A total of 798 participants took part in the survey, of which 68.4% were female. Nearly 50% of participants fell into the HED category and the majority bought alcohol illegally during restrictions. HED respondents who drank more alcohol than usual during restrictions reported that they felt stressed, needed to relax, and were bored. CONCLUSIONS: Policies intended to increase the pricing of alcohol may have the potential to reduce alcohol intake. Reducing stress and anxiety may be key to curtailing HED during emergency situations.

Changes in college student alcohol use during the COVID-19 pandemic: Are perceived drinking norms still relevant?

With widespread concern for increased alcohol use during the COVID-19 pandemic, there is a pressing need to examine changes in young adults' alcohol use and to identify antecedents of increased use. We tested the hypothesis that self-reported changes in alcohol use during the pandemic (frequency, quantity, heavy episodic drinking) would relate to perceptions of peers' changes in alcohol use. In April of 2020, 507 college students self-reported changes in their alcohol use and perceived changes in use for typical students at their university (i.e., norms). Most students in our sample reported decreased alcohol use and perceived decreases in peers' alcohol use. Perceptions of peers' changes in alcohol use behavior strongly related to changes in students' own alcohol use. Findings provide strong support for norms-based strategies that can correct normative misperceptions by highlighting the fact that most college students are not in fact engaging in heavier alcohol use during the COVID-19 pandemic.

What is associated with the increased frequency of heavy episodic drinking during the COVID-19 pandemic? Data from the PAHO regional web-based survey.

BACKGROUND: To estimate the prevalence of changes in the frequency of self-reported heavy episodic drinking (HED) among drinkers in Latin America and Caribbean countries on alcohol consumption during the COVID-19 pandemic, and to assess self-reported factors associated with the increased frequency of HED. METHODS: Data from 12,328 adults who responded to the cross-sectional survey conducted in 33 countries of Latin America and the Caribbean by Pan American Health Organization were used. Logistic regression analyses were performed to estimate the effect of the sociodemographic characteristics, quarantine practices, and anxiety symptoms on the increase in frequency of HED among the 2019 drinkers. RESULTS: 65 % of drinkers in 2019 self-reported HED during the COVID-19 pandemic with 13.8 % of the drinkers reporting an increase in HED compared to a 33.38 % decrease in HED. Multivariable analysis indicated that male gender (aOR 1.29, 95 %CI 1.13; 1.49), higher income (aOR 1.64, 95 %CI 1.35; 1.99) and higher level of quarantine practices (aOR 1.10, 95 %CI 1.04; 1.16) were positively associated with increased frequency of HED; unemployment (aOR 0.78, 95 %CI 0.64; 0.96), student status (aOR 0.53, 95 %CI 0.43; 0.64) and living with children (aOR 0.91, 95 %CI 0.84; 0.99) were negatively associated with increased frequency of HED. A gradient of association was found between generalized anxiety disorder and an increase in HED frequency during the pandemic. CONCLUSION: Along with other measures to decrease the spread of COVID-19, it is important to include measures to reduce alcohol consumption and address mental health conditions in the national response to the pandemic.