Negative Affect, Harassment and Problematic Alcohol Use in Young Adults.

Background: While research suggests that both negative affect and alcohol use are impacted by exposure to harassment (i.e., sexual harassment, generalized harassment or bullying), less is known about the effect of harassment on negative affect subsequently leading to alcohol consumption, particularly in young adults. We examined the mediating role of negative affect on the relationships between sexual and generalized harassment at school and alcohol misuse. Methods: Participants were 2899 incoming freshmen in fall of 2011 who completed a Web-based survey assessing demographics (T0), sexual and generalized harassment at school (T0-T2), negative affect (T3), and problems associated with drinking, binge drinking, and drinking to intoxication (T0, T4, T5). Separate hybrid path models were fitted in Mplus v.8.8 for generalized harassment and sexual harassment and each outcome. Results: Mediation analyses showed a small but significant indirect effect for the sexual harassment model (beta = 0.05, S.E. = 0.01, p < 0.001) and generalized harassment (beta = 0.03, S.E. = 0.01, p < 0.01), indicating that negative affect partially mediated the associations between harassment early in students' college experience and later problems associated with drinking. No significant indirect effects were found for the binge drinking or intoxication models. Conclusions: High levels of negative affect associated with harassment may contribute to longer term impact on problematic use of alcohol in young adults, providing evidence that the effects of harassment on drinking may partly stem from harassment's lingering effects on negative affective pathways.

Association of Changes in Neural Targets and Dietary Outcomes among Patients with Comorbid Obesity and Depression: Post hoc Analysis of ENGAGE-2 Mechanistic Clinical Trial.

BACKGROUND: Disruptions in brain circuits that regulate cognition and emotion can hinder dietary change and weight loss among individuals with obesity and depression. OBJECTIVE: The study aimed to investigate whether changes in brain targets in the cognitive control, negative affect, and positive affect circuits after 2-mo problem-solving therapy (PST) predict changes in dietary outcomes at 2 and 6 mo. METHODS: Adults with obesity and depression from an academic health system were randomly assigned to receive PST (7-step problem-solving and behavioral activation strategies) over 2 mo or usual care. Seventy participants (mean age = 45.9 ± 11.6 y; 75.7% women, 55.7% Black, 17.1% Hispanic, 20.0% White; mean BMI = 36.5 ± 5.3 kg/m2; mean Patient Health Questionnaire-9 depression score = 12.7 ± 2.8) completed functional MRI and 24-h food recalls. Ordinary least square regression analyses were performed. RESULTS: Among intervention participants, increased left dorsal lateral prefrontal cortex (dLPFC) activity of the cognitive control circuit at 2 mo was associated with increased diet quality (ß: 0.20; 95% CI: -0.02, 0.42) and decreased calories (ß: -0.19; 95% CI: -0.33, -0.04), fat levels (ß: -0.22; 95% CI: -0.39, -0.06), and high-sugar food intake (ß: -0.18; 95% CI: -0.37, 0.01) at 6 mo. For the negative affect circuit, increased right dLPFC-amygdala connectivity at 2 mo was associated with increased diet quality (ß: 0.32; 95% CI: -0.93, 1.57) and fruit and vegetable intake (ß: 0.38; 95% CI: -0.75, 1.50) and decreased calories (ß: -0.37; 95% CI: -1.29, 0.54), fat levels (ß: -0.37; 95% CI: -1.50, 0.76), sodium concentrations (ß: -0.36; 95% CI: -1.32, 0.60), and alcohol intake (ß: -0.71; 95% CI: -2.10, 0.68) at 2 but not at 6 mo. The usual care group showed opposing associations. The 95% CIs of all between-group differences did not overlap the null, suggesting a significant treatment effect. CONCLUSIONS: Among adults with obesity and depression who underwent PST compared with those under usual care, improved dLPFC-amygdala regulation of negative affective brain states predicted dietary improvements at 2 mo, whereas improvements in dLPFC-based cognitive control predicted dietary improvements at 6 mo. These findings warrant confirmatory studies. This trial was at clinicaltrials.gov as NCT03841682.

Affective neural circuits and inflammatory markers linked to depression and anxiety symptoms in patients with comorbid obesity.

Although we have effective treatments for depression and anxiety, we lack mechanistic understanding or evidence-based strategies to tailor these treatments in the context of major comorbidities such as obesity. The current feasibility study uses functional neuroimaging and biospecimen data to determine if changes in inflammatory markers, fecal short-chain fatty acids, and neural circuit-based targets can predict depression and anxiety outcomes among participants with comorbid obesity. Blood and stool samples and functional magnetic resonance imaging data were obtained at baseline and 2 months, during the parent ENGAGE-2 trial. From 30 participants with both biospecimen and fMRI data, this subsample study explored the relationship among changes in inflammatory markers and fecal short-chain fatty acids and changes in neural targets, and their joint relationship with depression and anxiety symptoms. Bivariate and partial correlation, canonical correlation, and partial least squares analyses were conducted, with adjustments for age, sex, and treatment group. Initial correlation analyses revealed three inflammatory markers (IL-1RA, IL-6, and TNF-α) and five neural targets (in Negative Affect, Positive Affect, and Default Mode Circuits) with significantly associated changes at 2 months. Partial least squares analyses then showed that changes in IL-1RA and TNF-α and changes in three neural targets (in Negative Affect and Positive Affect Circuits) at 2 months were associated with changes in depression and anxiety symptoms at 6 months. This study sheds light on the plausibility of incorporation of inflammatory and gastrointestinal biomarkers with neural targets as predictors of depression and comorbid anxiety outcomes among patients with obesity.

Negative urgency, PTSD symptoms, and alcohol risk in college students.

Theoretical models of trauma and alcohol use suggest that trauma-exposed individuals with higher levels of PTSD symptoms are at increased risk of problematic and coping-oriented alcohol use to alleviate unwanted internal states. The goal of the current study was to evaluate whether these associations are enhanced among young adults who report engaging in impulsive behavior in the context of negative affect (i.e., high negative urgency). It was hypothesized that (a) higher negative urgency would be associated with problematic alcohol use; and that (b) negative urgency would moderate the association between PTSD symptoms and problematic alcohol use. Methods: This study used a cross-sectional, secondary data analysis design run on 213 participants: college students, ages 18-25, who endorsed both having an interpersonal traumatic event and current weekly alcohol use. Participants completed a series of assessments and self-report questionnaires. Results: Results of hierarchical linear regression models indicated that greater negative urgency was significantly associated with greater negative alcohol-related consequences and greater coping motives for alcohol, but not past 30-day binge frequency or past 30-day alcohol quantity. Negative urgency did not moderate associations between PTSD symptoms and alcohol outcomes. Conclusions: PTSD symptoms and negative urgency are uniquely associated with indices of alcohol risk in college students with a history of trauma exposure. However, individuals high in negative urgency are not necessarily consuming more alcohol, nor does negative urgency increase the association between PTSD symptoms and drinking outcomes in this population.

A qualitative exploration of young adults' perceptions of a new intervention for alcohol use disorder.

BACKGROUND: Due to the rising prevalence of alcohol use disorders among young adults, the need for effective and accessible interventions has become increasingly imperative. In acknowledgment of this issue, we developed a novel intervention known as contingency management plus problem solving therapy (CM-PST). The aim of the current study was to gain insight into the perspectives on the effectiveness of the newly developed CM-PST using focus group discussion among young adults who consume alcohol regularly. MATERIALS AND METHODS: The study employed a qualitative research design, utilizing focus group discussions as the primary data collection method. Participants described their perceptions regarding the newly developed CM-PST. Semi-structured focus group sessions were conducted via Zoom in November 2022. A total of 19 young adults, aged 18-24 years old, participated in five focus group sessions. Data were analyzed using deductive content analysis. RESULTS: Participants demonstrated overall positive attitudes toward the novel intervention, recognizing the potential benefits, it could offer in terms of alcohol use reduction and emotional well-being. They emphasized the importance of incentives in motivating behavioral changes, as well as the practicality of problem-solving techniques in addressing everyday challenges. Additionally, participants provided valuable insights into potential barriers and implementation challenges, highlighting the need for flexible and personalized approaches to accommodate individual preferences and needs. CONCLUSIONS: The results of this study contribute to the growing body of literature on innovative intervention approaches for young adults facing alcohol use issues. The findings shed light on the acceptability and perceived effectiveness of the CM-PST intervention from the perspective of the target population.

Trauma and alcohol characteristics related to high intensity binge drinking during college.

High intensity (HI) binge drinking has emerged as a high-risk drinking phenotype in young adult drinkers, yet few studies have evaluated clinically meaningful correlates of HI binge drinking among young adults at risk for co-occurring psychopathologies, such as interpersonal trauma-exposed drinkers. The present study compared three groups (i.e., HI binge, standard binge, non-binge drinkers) of interpersonal trauma-exposed college student drinkers (N = 221) on alcohol and interpersonal trauma characteristics. Results of one-way ANOVAs indicated that the HI binge group endorsed significantly greater negative alcohol-related consequences relative to the other two groups. The HI binge group endorsed significantly greater enhancement motives compared to the non-binge group, and no group differences were detected for PTSD and interpersonal trauma characteristics. Individuals who engage in HI binge drinking may experience greater alcohol problems due to their use of alcohol to enhance positive mood. HI binge drinking does not differentiate individuals on the basis of interpersonal trauma experiences or related psychopathology.

Alcohol Disorders in Military Veterans: An Evaluation with the Roy Adaptation Model.

The purpose of this paper was to evaluate a role for the Roy adaptation model (RAM) for the nursing care of military veterans with alcohol use disorder. Parse's criteria were used to critique the RAM. The RAM's humanistic philosophy emphasizes the ability to develop new coping skills and adapt to complex environments. The framework can define physical, emotional, and social responses to stressors faced by veterans. The RAM could guide new research and practice initiatives that optimize the health of military veterans.