Long-term effects of alcohol consumption on anxiety in adults: A systematic review.

OBJECTIVE: Despite the high prevalence and comorbidity of alcohol consumption and anxiety, it is unclear whether alcohol consumption influences long-term anxiety. This study aimed to systematically review the literature on the long-term longitudinal effects of alcohol consumption on anxiety in adults. METHODS: EMBASE, PsychInfo, Medline, and Web of Science databases were systematically searched from inception to April 12th, 2024. Articles analysing the relationship between alcohol consumption and anxiety symptoms or anxiety disorder diagnosis at least three-months later in adults were eligible. Articles were screened and extracted by two independent reviewers with study quality assessed using the Mixed Methods Appraisal Tool. RESULTS: From 884 records, eight studies of mixed quality met inclusion criteria. One study using a sample representative of the USA population found low volume consumption was associated with lower long-term anxiety. All other studies used a convenience sample or a specific medical population sample. The significance and direction of the relationship between alcohol consumption and long-term anxiety in these studies varied, likely due to differences in alcohol consumption thresholds used and populations studied. CONCLUSIONS: A paucity of research on the longitudinal effects of alcohol consumption on anxiety was found, highlighting a significant gap in the research literature. Furthermore, existing research, primarily focussed on clinical subpopulations, has yielded mixed results. Further research is needed to explore the longitudinal dose dependent impact of alcohol consumption on anxiety using samples representative of national populations.

Support for a browser plug-in blocking online alcohol imagery among Australian participants: A qualitative interview study.

ISSUES ADDRESSED: Alcohol depictions are extremely common online, and there is a reported relationship between alcohol exposure and alcohol use. A browser plug-in specifically designed to block online alcohol depictions may be helpful to prevent the uptake of alcohol or increased alcohol use. METHODS: Twenty-five semi-structured interviews were conducted, examining participants' beliefs about the effects of online alcohol exposure and their support for developing the browser plug-in. RESULTS: Using reflexive thematic analysis, we found participants highlighted a clear impact of viewing alcohol online and offline alcohol use. Participants believed a browser plug-in that blocked alcohol was acceptable and would be especially useful for minors (to prevent alcohol initiation) and those who are aiming to reduce their alcohol use. CONCLUSIONS: Participants emphasised that viewing online alcohol exposure had an impact on drinking behaviours, such as increased craving and temptation. The browser plug-in was considered an easy intervention tool for both parents and people who are experiencing alcohol-related problems or trying to reduce their drinking. SO WHAT?: Participants' continuous support of an alcohol-blocking browser plug-in suggests that future health promotion strategies should consider the development of a prototype plug-in.

The prevalence of alcohol references in music and their effect on people's drinking behavior: A systematic review and meta-analysis.

Understanding the prevalence of alcohol references in music and their impact on alcohol drinking behavior is important given the increased accessibility to daily music listening with the proliferation of smart devices. In this review, we estimate the pooled prevalence of alcohol references in music and its association with drinking behavior. Systematic searches were conducted across four major databases (MEDLINE, PsycINFO, EMBASE, and CINHAL). Articles were selected following duplicate checking, title and abstract screening, and full-text review. Studies reporting the prevalence of alcohol-referencing music and/or investigating its association with drinking behavior were included. Pooled prevalence with 95% confidence intervals (CIs) were computed using a random effects model. Of 1007 articles identified, 26 met inclusion criteria and 23 studies comprising 12,224 songs were eligible for meta-analysis. The overall pooled prevalence of alcohol references in music (including lyrics and videos) was 24.0% (95% CI: 19.0%-29.0%). The pooled prevalence was 22.0% (95% CI: 16.0%-29.0%) for only lyrics, 25.0% (95% CI: 18.0%-33.0%) for only the visual elements of music videos, and 29.0% (95% CI: 21.0%-38.0%) for both the lyrical content and the visual components. Only three studies assessed the relationship between listening to music with alcohol references and drinking behavior, and all three reported a positive association. Whereas almost a quarter of all songs included references to alcohol, public health preventive measures are needed to reduce alcohol exposure from music. Future research is needed to understand fully the effect of music with alcohol references on drinking behavior.

How to apply zero-shot learning to text data in substance use research: An overview and tutorial with media data.

A vast amount of media-related text data is generated daily in the form of social media posts, news stories or academic articles. These text data provide opportunities for researchers to analyse and understand how substance-related issues are being discussed. The main methods to analyse large text data (content analyses or specifically trained deep-learning models) require substantial manual annotation and resources. A machine-learning approach called 'zero-shot learning' may be quicker, more flexible and require fewer resources. Zero-shot learning uses models trained on large, unlabelled (or weakly labelled) data sets to classify previously unseen data into categories on which the model has not been specifically trained. This means that a pre-existing zero-shot learning model can be used to analyse media-related text data without the need for task-specific annotation or model training. This approach may be particularly important for analysing data that is time critical. This article describes the relatively new concept of zero-shot learning and how it can be applied to text data in substance use research, including a brief practical tutorial.

Development of the lyrics-based deep learning algorithm for identifying alcohol-related words (LYDIA).

BACKGROUND: Music is an integral part of our lives and is often played in public places like restaurants. People exposed to music that contained alcohol-related lyrics in a bar scenario consumed significantly more alcohol than those exposed to music with less alcohol-related lyrics. Existing methods to quantify alcohol exposure in song lyrics have used manual annotation that is burdensome and time intensive. In this paper, we aim to build a deep learning algorithm (LYDIA) that can automatically detect and identify alcohol exposure and its context in song lyrics. METHODS: We identified 673 potentially alcohol-related words including brand names, urban slang, and beverage names. We collected all the lyrics from the Billboard's top-100 songs from 1959 to 2020 (N = 6110). We developed an annotation tool to annotate both the alcohol-relation of the word (alcohol, non-alcohol, or unsure) and the context (positive, negative, or neutral) of the word in the song lyrics. RESULTS: LYDIA achieved an accuracy of 86.6% in identifying the alcohol-relation of the word, and 72.9% in identifying its context. LYDIA can distinguish with an accuracy of 97.24% between the words that have positive and negative relation to alcohol; and with an accuracy of 98.37% between the positive and negative context. CONCLUSION: LYDIA can automatically identify alcohol exposure and its context in song lyrics, which will allow for the swift analysis of future lyrics and can be used to help raise awareness about the amount of alcohol in music. Highlights Developed a deep learning algorithm (LYDIA) to identify alcohol words in songs. LYDIA achieved an accuracy of 86.6% in identifying alcohol-relation of the words. LYDIA's accuracy in identifying positive, negative, or neutral context was 72.9%. LYDIA can automatically provide evidence of alcohol in millions of songs. This can raise awareness of harms of listening to songs with alcohol words.

Support for policies restricting alcohol exposure in films: Does feeding back the amount of alcohol in films increase support?

INTRODUCTION: Alcohol exposure is common in popular films, and research has demonstrated a link between alcohol exposure and use. The likelihood of implementing specific policies to reduce the amount of film exposure is dependent on the level of public support; however, evidence is currently lacking. This study investigated how supportive people are of film-related alcohol policies and whether providing information about the amount of film exposure increased support. METHODS: Australian adults (N = 252) first provided estimates of how much alcohol they thought were in popular films and then were randomised to either see an infographic about the amount of alcohol in films or not. All participants rated how supportive they were of eight policies. RESULTS: The items 'alcoholic beverages and consumption should not be shown in G or PG rated films' (M = 3.54) and 'alcohol should not be glorified in films' (M = 3.49) were rated significantly higher than the scale's midpoint of 3 (p < 0.001). Participants who were older, female or reported lower alcohol use were more supportive of the policies. Only one policy item, 'information about alcohol sponsorship should be provided' received higher support from those who received the infographic compared to those who did not (M = 3.53 vs. M = 3.05; t(250) = -3.09, p = 0.002). DISCUSSION AND CONCLUSION: Participants were relatively supportive of film alcohol policies. However, providing information about the amount of alcohol in films did not make a difference on the level of support for most film alcohol policies.

Experimentally induced changes in authoritarian submission as a response to threat.

Authoritarianism is best conceptualised by three attitudinal clusters: Aggression, Submission, and Conventionalism. Once considered a fixed characteristic, recent observational research has demonstrated how the dimension of submission can fluctuate in response to COVID-19 threat as a means of maintaining collective security. However, this effect has not been investigated with other forms of threat, nor has it been supported experimentally. In the present study, we sought to test observational findings by priming 300 participants with either a COVID-19 threat, a domestic terrorism threat, or a non-threatening control. Levels of authoritarianism were tested before and after presentation of a prime and then the difference between the two measures could be compared between prime conditions. Results from a Bayesian multivariate regression analysis informed by observational findings suggested that participants who experienced the COVID-19 or terrorism primes reported higher levels of authoritarian submission after the prime compared to before the prime, relative to those who experienced the neutral control prime. In contrast, the aggression subfactor did not seem to elicit any change in response to threat, and the conventionalism subfactor showed a response only to the terrorism prime. We concluded that two different forms of societal threat could elicit changes in specific dimensions of authoritarianism over a very short time span. We caution against the common practice of treating authoritarianism as a unidimensional construct without careful consideration.

The promise of zero-shot learning for alcohol image detection: comparison with a task-specific deep learning algorithm.

Exposure to alcohol content in media increases alcohol consumption and related harm. With exponential growth of media content, it is important to use algorithms to automatically detect and quantify alcohol exposure. Foundation models such as Contrastive Language-Image Pretraining (CLIP) can detect alcohol exposure through Zero-Shot Learning (ZSL) without any additional training. In this paper, we evaluated the ZSL performance of CLIP against a supervised algorithm called Alcoholic Beverage Identification Deep Learning Algorithm Version-2 (ABIDLA2), which is specifically trained to recognise alcoholic beverages in images, across three tasks. We found ZSL achieved similar performance compared to ABIDLA2 in two out of three tasks. However, ABIDLA2 outperformed ZSL in a fine-grained classification task in which determining subtle differences among alcoholic beverages (including containers) are essential. We also found that phrase engineering is essential for improving the performance of ZSL. To conclude, like ABIDLA2, ZSL with little phrase engineering can achieve promising performance in identifying alcohol exposure in images. This makes it easier for researchers, with little or no programming background, to implement ZSL effectively to obtain insightful analytics from digital media. Such analytics can assist researchers and policy makers to propose regulations that can prevent alcohol exposure and eventually prevent alcohol consumption.

Effects of vaping on uptake and cessation of smoking: Longitudinal analysis in Aotearoa New Zealand adults.

INTRODUCTION: Globally, the use of vapes, or e-cigarettes, is increasing. While vaping is less harmful than smoking and may help smokers to quit, there is also the possibility that vaping may lead to smoking. The current study aimed to determine the prevalence of vaping and smoking in Aotearoa New Zealand and explore longitudinal pathways between smoking status and vape use. METHOD: Data related to smoking and vaping status was analysed from Times 10, 11 and 12 across 2018-2020 of the New Zealand Attitudes and Values study, a large, representative, multi-wave study of adults living in New Zealand. Weighted descriptive analyses were used to determine prevalence rates of vaping and smoking and a generalised linear modelling approach was used to examine the likelihood of changing to, or taking up, the other behaviour in the transition between time points. RESULTS: Broadly, the prevalence of smoking was found to be decreasing over time while the prevalence of vaping was increasing. Despite these general trends, no differences were observed in the likelihood of transitioning from smoking to vaping or from vaping to smoking, indicating that either pathway was equally as likely. DISCUSSION AND CONCLUSIONS: The current findings demonstrate that vaping appeared to be just as likely to have a gateway effect to smoking as it was to have a cessation effect. This highlights the need for greater consideration regarding vaping-related policies and restrictions.

High Risk or Risky Highs: Understanding the Links Between Alcohol and Cannabis Use on the Transition From Suicidal Ideation to Attempts in Australian Men.

Alcohol and cannabis use are consistently associated with greater risk of suicide, particularly among men and in higher-income countries (e.g., Australia). Adult data (n = 7,464) from waves 1 and 2 of Ten to Men: The Australian Longitudinal Study on Male Health were used to explore whether alcohol and/or cannabis use increased the longitudinal risk of a suicide attempt among suicidal ideators. Cannabis use was associated with increased risk of transitioning from suicidal ideation to making a suicide attempt; no association was found for alcohol. Broadly, these findings indicate that greater cannabis but not alcohol use may increase risk of transitioning to making a suicide attempt among those who are thinking about suicide.

Measurement of transdermal alcohol concentration using a wrist-worn enzymatic transdermal monitor.

BACKGROUND: New-generation transdermal monitors such as the ION Research Alpha Prototypes (ION RAP) hold promise for real-time alcohol measurement, with improvements in design features such as sampling frequency, size, and comfort. This paper aims to provide the first comparisons of the wrist-worn enzyme-based ION RAP and the fuel cell-based SCRAM-CAM against breath alcohol concentration (BrAC) readings. METHODS: Participants (N = 23) completed a total of 69 laboratory alcohol administration sessions while wearing both a prototype of the ION RAP wristband and a SCRAM-CAM ankle monitor; they also gave breath samples each 10 min. Analyses focused on latencies of transdermal alcohol concentration (TAC) after alcohol ingestion, correlations, and cross-correlations between BrAC and TAC measurements. RESULTS: A high failure rate of the ION RAP was observed (61.5% of the sessions were excluded due to the sessions not containing enough valid data). On average, the SCRAM-CAM and ION RAP detected alcohol 43 (SD = 21) and 50 (SD = 27) minutes after the first drink, with peak values reached after 138 (SD = 47) and 154 (SD = 56) minutes, respectively. SCRAM-CAM TAC peak (r = 0.185, p = 0.375) and area under the curve (AUC; r = 0.320, p = 0.118) showed small- and medium-sized correlations to BrAC. ION RAP TAC peak (r = -0.082, p = 0.698) and AUC (r = 0.040, p = 0.852) correlations to BrAC were close to zero. CONCLUSIONS: In this study, the new-generation ION RAP and the traditionally used SCRAM-CAM show similar delays in detection and similar TAC curves over time, despite using either enzyme- or fuel cell-based technologies, respectively. Due to high failure rates of the ION RAP prototypes and close to zero correlations to BrAC, further developments and improvements of these TAC wristbands are required for reliable and valid use in real-time alcohol measurement.

Evaluation of the English Version of the Fear of COVID-19 Scale and Its Relationship with Behavior Change and Political Beliefs.

The COVID-19 pandemic has many individuals around the world fearing for their lives. The constant news coverage, rapid transmission, and relatively high mortality rate, make fearfulness a natural response. To assess the fear of COVID-19, the Fear of COVID-19 Scale (FCV-19S) was developed. The primary aim of the present study was to conduct the first psychometric assessment and validation of the English version of the FCV-19S. Two samples were collected in New Zealand. Sample 1 comprised 1624 participants of which 1397 completed all questions and were used in the analyses. Sample 2 comprised 1111 participants of which 1023 completed all questions and were used in the analyses. Several psychometric tests were conducted to ascertain the scale's reliability and validity. Across both samples, the FCV-19S had high internal consistency. Consistent with the earlier validation studies, the FCV-19S displayed a moderately strong relationship with the perceived infectability and germ aversion subscales of the perceived vulnerability to disease scale (PVDS). Furthermore, FCV-19S scores were negatively correlated with the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) scores. With respect to the motivating role of fear, there was a significant relationship between FCV-19S scores and adherence to the lockdown rules that were implemented in New Zealand. Finally, consistent with recent reports on the politicization of the COVID-19 pandemic, an exploratory question found that participants who rated themselves as more conservative tended to report lower FCV-19S scores. The English version of the COVID-19S is a sound unidimensional scale with robust psychometric properties and can be used with confidence among English-speaking populations.

A combined web based intervention and ecological momentary intervention for reducing alcohol use among incoming first-year university students: Results from a three-arm randomised controlled trial.

BACKGROUND: The transition from high school to university is associated with increased alcohol use and harm. Web-based interventions (WBIs) and ecological momentary interventions (EMIs) are two methods that have had some success in reducing alcohol use among university students and may be particularly effective if implemented during the transition to university. The aim of the current study was to investigate the effectiveness of a combined WBI and EMI to reduce alcohol use among incoming university students. METHODS: Incoming first-year students (n = 783, in 2018 and 2019) were randomized into either a WBI + EMI, WBI-only, or an assessment-only condition. All participants completed online questionnaires before university, after their first and second semester, and reported their alcohol use fortnightly throughout their first year. Those in the WBI + EMI and WBI conditions received online feedback about their drinking (i.e., the WBI) immediately following the pre-university survey. Those in the WBI + EMI were also sent eight EMI messages to their mobile phones during Orientation Week and six EMI messages across the academic year aimed at reducing alcohol harm. RESULTS: There were no significant differences between the conditions in Orientation Week drinking, academic year drinking (both "typical" semester or fortnightly drinking), or alcohol-related harms. CONCLUSION: A WBI + EMI intervention aimed at the transition to university did not reduce university students' alcohol use. The transition, however, continues to be a period of serious harm where students drink more than any other period.

Sex differences in the interrelations between stress, craving and alcohol consumption across individuals and time during baclofen treatment for alcohol dependence.

AIMS: Recent studies have suggested that females respond more favourably to baclofen treatment for alcohol use disorder. Females are generally more likely to drink to regulate stress reactivity and negative affect. This study thus aimed to evaluate the role of sex on the effect of baclofen on the relationship between daily alcohol consumption, stress and craving. METHODS: A network analysis of fluctuations using vectorized autoregressive modelling was used to explore the relationship between daily surveys of alcohol consumption, stress and craving from daily diary data over 84 days from a randomised controlled trial of baclofen (30 mg or 75 mg per day) versus placebo in 104 participants with alcohol dependence (1, 2). Symptom interrelations across patients and across time were examined including temporal networks (time lagged), contemporaneous and between-subjects networks, and were examined for placebo and baclofen stratified by sex. RESULTS: Overall, between persons, there was a significant relationship between stress and drinking in placebo treated individuals in females (r = -0.70, p < 0.001) but not males (r = 0.32, p = 0.054) that was not observed in baclofen treated individuals. No relationship was observed between stress and drinking in the baclofen group for either sex (p's < 0.45). DISCUSSION: There appears to be some sex-specific differences whereby baclofen abolishes an overall association between stress and drinking in females, but this is not observed in males. Network analyses may assist in elucidating the mechanism of action of alcohol pharmacotherapies such as baclofen and understanding which symptoms and mechanisms are key for effective interventions.

The role of impulsivity in the relationship between affect and alcohol consumption in young adults.

BACKGROUND: Theoretical models of alcohol use posit that individuals consume alcohol to ameliorate negative affect or to heighten positive affect. It is important, however, to consider the influence of factors that may determine an individual's tendency to consume excessive amounts of alcohol under positive and negative circumstances. Thus, the current study examined a large sample of young adults to clarify whether positive and negative affect predict total alcohol consumption on drinking days and whether facets of impulsivity moderate these relationships. METHODS: Six-hundred ninety-three young adults (Mage = 19.71 years, SD = 2.04; female = 62.9%) completed the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scales at baseline followed by daily measures of positive and negative affect and self-reported alcohol use for 13 days. Generalized linear mixed models were specified to assess the role of pre-consumption affect on total drinks consumed across drinking days and to determine the moderating effect of each BIS/BAS subscale. RESULTS: Participants were significantly more likely to drink in greater quantities on occasions preceded by higher positive affect but not negative affect. While fun-seeking positively predicted total drinks consumed, there were no significant interaction effects between the BIS/BAS subscales and affect on total drinks consumed. CONCLUSIONS: These findings challenge existing affect regulation models and have implications for ecological momentary interventions aimed at addressing hazardous drinking behaviors.

Understanding Aotearoa New Zealand University Students Intentions to Seek Help If Experiencing Mental Distress: A Comparison of Naturalistic and Interventional Findings.

University students globally are consistently identified as a vulnerable group for mental distress and suicide. Despite this, students report low engagement in help-seeking behaviours. This series of studies aimed to assess barriers to help-seeking for students and the impact of an intervention that sought to increase support-seeking intentions. In Study 1, 373 undergraduate psychology students completed items related to depression, anxiety, suicidal ideation, stigma, and help-seeking intentions. In Study 2, 133 undergraduate psychology students were randomly allocated into one of three intervention groups (control, infographic, video) and completed measures as used in Study 1. Despite experiencing clinically relevant symptoms and recent suicidal ideation, students in Study 1 tended to report low intentionality to seek help, citing perceptions that their distress was not serious enough or a desire to handle their issues independently. In Study 2, an infographic about different support services increased student's intentions to access support services and reduced their perception that their issues were not serious enough. Overall, Aotearoa New Zealand students endorsed similar barriers to help-seeking as students in other countries. Importantly, we demonstrated that a simple infographic intervention reduced perceptions regarding these common barriers and may increase students' knowledge about when to seek help.

Why So Serious? An Attempt to Mitigate the Short-Term Harmful Effects of the Film Joker on Prejudice toward People with Mental Illness.

The media perpetuates many harmful stereotypes about people with mental illness. In two studies, we demonstrate the impact of negative media portrayals of mental illness on prejudice and attempt to mitigate these negative effects. Specifically, in Study 1, participants watched the movie Joker, a recent film which associates mental illness with violent behavior, or a control film (Terminator). Participants completed the Prejudice towards People with Mental Illness (PPMI) scale before and after viewing their respective films. The PPMI consists of four dimensions: fear/avoidance (i.e., wanting to avoid people with mental illness), malevolence (i.e., viewing people with mental illness as inferior), authoritarianism (i.e., preference for control over people with mental illness), and unpredictability (i.e., the behavior of people with mental illness is unreliable). We hypothesized that participants who watched the film Joker would display an increase in their fear/avoidance of people with mental illness and their support for authoritarian approaches to their treatment. Consistent with these hypotheses, participants who viewed Joker displayed a significant increase in the fear/avoidance and authoritarian subscales of the PPMI, relative to participants that watched Terminator. In Study 2, in an attempt to mitigate the impact of Joker on prejudice towards people with mental illness, directly after the film we displayed educational and counter-stereotypical statements on-screen that challenged the view that people with mental illness are violent. A control group viewed Joker without these statements. Identical to Study 1, all participants completed the PPMI scale before and after viewing the film. We hypothesized that participants who viewed Joker with the statements would display lower prejudice relative to the control condition. Unfortunately, participants in the experimental and control conditions displayed a comparable increase in prejudice. Together, these studies confirm the negative effect of media portrayals of mental illness (as depicted in Joker) and demonstrate that these effects are not easily mitigated.