Psychometric validation of the Positive Drinking Consequences Questionnaire in adolescents.

BACKGROUND: The Positive Drinking Consequences Questionnaire (PDCQ) was developed to measure positive consequences of alcohol use endorsed by college drinkers. Efforts to assess positive drinking consequences experienced by adolescents have been much more limited. The aim of the present study was to advance the psychometric testing and evaluation of the factor structure of the PDCQ in adolescents. METHODS: The current sample consisted of 173 adolescents at T1 (mean age = 15 years, range = 13-17; 61% female) who reported alcohol use in the past 12 months. Data were collected at two time points over a 12-month interval in the United States. Confirmatory factor analyses, internal consistency, test-retest reliability, and discriminant, concurrent, predictive, and incremental validity were tested. RESULTS: Our analyses supported four factors of positive alcohol-related consequences: sociability, liquid courage, sexual enhancement, and tension reduction. Internal consistency was moderate to high (α = 0.78-0.94, ω = 0.86-0.91 at T1; α = 0.59-0.93, ω = 0.85-0.93 at T2). Test-retest reliability was fair to good (ICC = 0.46-0.55). The PDCQ total and subscale factor scores demonstrated discriminant validity from negative alcohol expectancy. PDCQ total and subscale factor scores were positively associated with current alcohol consumption (ρs = 0.19-0.50 at T1; ρs = 0.17-0.46 at T2), indicating concurrent validity. Predictive validity analyses showed that the overall PDCQ scale score and the sociability subscale positively predicted maximum drinks 1 year later (ρs = 0.18-0.22). However, the sexual enhancement subscale was negatively predictive of typical drinking frequency 1 year later. Finally, the PDCQ showed incremental validity for concurrent alcohol consumption beyond that for alcohol expectancies and drinking motives. CONCLUSION: The present findings support for the reliability and validity of PDCQ for use in adolescents where it may have utility as an assessment tool for characterizing various aspects of positive drinking.

Self-Compassion and Self-Forgiveness in Alcohol Risk, Treatment and Recovery: A Systematic Review.

INTRODUCTION: Self-compassion and self-forgiveness are two self-focused, positive coping approaches that may reduce risk of problem drinking and/or aid in treatment/recovery from alcohol use disorder. The present systematic review aimed to evaluate support for the unique and complementary roles of self-compassion and self-forgiveness in alcohol outcomes. METHODS: A systematic literature search yielded 18 studies examining self-compassion, 18 studies examining self-forgiveness and 1 study examining both constructs in alcohol outcomes. RESULTS: Findings suggest greater self-compassion and self-forgiveness relate to lower likelihood of problem drinking. Self-forgiveness was considerably more researched in treatment/recovery outcomes than self-compassion; self-forgiveness-based interventions appear able to improve drinking-adjacent outcomes, and self-forgiveness may increase across various alcohol treatments. Finally, research suggests that associations of self-compassion and/or self-forgiveness with alcohol outcomes could be driven by numerous factors, including coping-motivated drinking, depression, psychache, social support perceptions, mental health status and/or psychiatric distress. CONCLUSIONS: Self-compassion and self-forgiveness both appear protective against harmful alcohol outcomes. Nevertheless, many questions remain about the role of self-forgiveness and, particularly, self-compassion in alcohol treatment and recovery outcomes. Future research should examine whether targeted interventions and/or adjunctive therapeutic supports designed to increase self-compassion or self-forgiveness can reduce alcohol use disorder symptoms to facilitate alcohol treatment and recovery success.

Parent Alcohol Use and Problems in Children's Alcohol-Related Learning and Subsequent Alcohol Use.

Background: Alcohol cognitions can emerge early in life and have lasting associations with alcohol use behavior. Observational learning theories suggest that witnessing alcohol use and its consequences may be an important mechanism underlying early development of alcohol cognitions. Parents are among the earliest contributors to children's alcohol-related learning, although findings regarding the association of parental alcohol use and problems with children's alcohol-related beliefs and attitudes are considerably mixed. This study tested associations of parent alcohol use and problems with adolescent alcohol expectancies, motives, and subsequent alcohol use to help clarify this literature. Methods: Families (N = 227) comprising family alcohol use disorder cases and demographically matched controls were recruited as part of a longitudinal investigation on child development. Parents reported on their alcohol use and problems at seven assessments throughout the index adolescents' childhood, and adolescents reported on their own alcohol expectancies in 6th grade, alcohol motives in 8th grade, and alcohol use in 12th grade. Results: Father alcohol problems and mother alcohol use were linked to more positive and less negative child alcohol expectancies, respectively. However, these cognitions did not contribute unique variance in adolescent alcohol use after accounting for additional risks included in the model. Conclusions: Findings highlight the need for future research aimed at modeling broader and potentially indirect sources of parent influences on adolescent alcohol-related learning and subsequent drinking behavior.

Associations Between Latent Classes of Trauma Exposure and Minority Stressors and Substance Use Among Cisgender Sexual Minority Women.

Psychosocial stressors (e.g., minority stressors, trauma exposure) profoundly impact sexual minority women's (SMW's) risk of alcohol and other drug (AOD) use. However, research has not examined whether there are distinct typologies (i.e., patterns) of psychosocial stressors and whether these vary based on sociodemographic characteristics or are differentially associated with AOD outcomes (e.g., alcohol dependence) among SMW. This study aimed to identify latent classes of SMW reporting distinct typologies of psychosocial stressors and examine predictors and outcomes of latent classes of psychosocial stressors among SMW. Participants included a community sample of 602 SMW (Mage = 39.9, SD = 14.0; 74.0% lesbian; 37.4% White, 36.6% Black, 22.3% Latinx; 26.6% annual income ≤$14,999). Latent class analysis was used to identify typologies of psychosocial stressors. Regression analyses were employed to examine sociodemographic predictors and AOD outcomes of class membership. Three classes of psychosocial stressors emerged. Participants in Class 1 were likely to report relatively low adversity. SMW in Class 2, who reported childhood physical abuse (CPA), severe childhood sexual abuse, and adult physical assault, were vulnerable to discrimination and stigma consciousness. A distinct subgroup of SMW (Class 3) was at heightened risk of CPA, adult sexual assault (ASA), and stigma consciousness. Older SMW, Black SMW, and SMW with lower social support were more likely to be in classes characterized by higher adversity. Older SMW were at disproportionate risk of CPA and ASA. Different combinations of psychosocial stressors were uniquely associated with AOD outcomes. Findings underscore the importance of considering within-group heterogeneity in SMW's differential risk of psychosocial stressors and AOD outcomes. Routine screening of psychosocial stressors across several dimensions, brief interventions targeting AOD outcomes, and policies mitigating structural drivers of SMW's increased risk of trauma and minority stressors may be especially important for older SMW, Black SMW, and SMW who lack social support.

Coping-motivated escalations in adolescent alcohol problems following early adversity.

OBJECTIVE: The present study examined whether early stressful events precipitate drinking risks across adolescence and whether coping-motivated drinking mediates such relations. METHOD: Families comprised 387 adolescents (55% female, 83% White) recruited for a longitudinal study. Caregivers reported on adolescents' experience of potentially stressful events, including conflict (i.e., disruption of harmonious family relations) and separation (i.e., decreased contact with important persons) events, over the past year when adolescents were approximately 14 years of age. Adolescents reported on their drinking motives, alcohol use, and alcohol problems annually from 18 to 20 years of age. Growth curve models tested associations of stressful events with latent coping and enhancement/social drinking motives growth factors and subsequent alcohol outcomes. RESULTS: Most adolescents experienced at least one potentially stressful event. Growth modeling suggested no change in coping motives, but increases in enhancement/social motives over time. Greater conflict events predicted higher frequency of drinking for coping reasons (i.e., coping intercept), which in turn predicted increases in alcohol problems as adolescents began transitioning into young adulthood. Conflict, separation, or total stressful events were not significantly associated with initial level or change in enhancement/social motives, suggesting specificity of mediation by coping-motivated drinking. CONCLUSIONS: Findings support enduring elevations in drinking risk over 6 years following disruptive family relations in early adolescence. Such risks appear to be driven by negative affect regulation mechanisms through coping-motivated drinking. Future work should assess generalizability of these findings across diverse samples and could test similar negative reinforcement mechanisms of drinking following exposure to clinically impairing traumatic experiences. Public Health Significance Statement: This study demonstrated that disruptive family relations in early adolescence are linked to greater motivation to drink to cope with negative affect up to 6 years later. Greater coping motives, in turn, were related to increases in alcohol problems over time, even when controlling for alcohol consumption. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Social influences on alcohol outcome expectancy development from childhood to young adulthood: A narrative review.

Purpose of Review: Alcohol outcome expectancies emerge in early childhood, develop throughout adolescence, and predict alcohol outcomes well into adulthood. Social factors shape how expectancies are learned in myriad ways, yet such social learning influences seldom are examined in the context of developmental factors. This review summarized literature on the social origins of alcohol expectancies through vicarious (observational) and experiential (direct) alcohol-related learning from childhood to young adulthood within a social learning framework. Recent Findings: Young children primarily endorse negative expectancies, which decline rapidly with age amidst escalations in positive expectancies across adolescence. Parents and peers can contribute to vicarious learning about alcohol and facilitate experiential learning in different ways and to varying degrees across development. Media and social media, which children are increasingly exposed to as they mature, often depict alcohol-outcome relations that may further contribute to expectancy development in later adolescence and young adulthood. Summary: Social influences on alcohol expectancy learning are complex and change over time, although this dynamic complexity typically is not depicted in extant literature. Developmentally-informed research capturing co-occurring shifts in social influences and alcohol expectancies is needed.

Alcohol and Cannabis Use Milestones in Diverse Urban Adolescents: Associations with Demographics, Parental Rule Setting, Sibling and Peer Deviancy, and Outcome Expectancies.

Objective: Alcohol and cannabis use progression milestones in adolescence (such as ages at first use, first intoxication and at onset of regular use) may inform the development of alcohol and cannabis use disorders. Although parent, sibling, and peer behavior and alcohol-related cognitions have been shown to be associated with alcohol milestone attainment, findings have been mixed; further, those factors' associations with cannabis use milestones are unknown. This study examined whether progression through such milestones differed as a function of perceived peer/sibling deviancy, parental rule-setting, and substance use outcome expectancies in a racially diverse adolescent sample.Methods: Data were drawn from a two-wave longitudinal health survey study of 9-11th graders (n = 355 for the current analyses; Mage=15.94 [SD = 1.07]; 44% male; 43% Black; 22% White; 18% Asian; 17% Multiracial; 10% Hispanic/Latinx ethnicity) at an urban high school. A series of logistic and proportional hazards regressions examined associations of peer/sibling deviancy, parental rule-setting, and outcome expectancies with age and attainment of alcohol/cannabis use milestones.Results: For both alcohol and cannabis, greater peer deviancy and positive expectancies were associated with higher odds of milestone attainment, while negative expectancies were associated with slower progression through milestones. For cannabis, but not alcohol, greater perceived sibling deviancy was positively associated with milestone attainment, while negative expectancies were associated with lower odds of milestone attainment.Conclusions: Perceived deviant behavior by peers and siblings, in addition to adolescents' expectancies for either alcohol or cannabis use, is associated with attainment and progression through key adolescent substance use milestones.

Effects of varenicline and bupropion on laboratory smoking outcomes: Meta-analysis of randomized, placebo-controlled human laboratory studies.

Human laboratory studies are widely used to evaluate behavioural mechanisms of pharmacotherapy effects. Results from human laboratory studies examining smoking cessation pharmacotherapies have not been examined in aggregate. The current meta-analysis aimed to synthesize data from randomized, placebo-controlled human laboratory studies on the effects of non-nicotine pharmacotherapies on outcomes relevant for smoking cessation. Literature searches identified 15 human laboratory studies of varenicline (n = 697) and 9 studies of bupropion (n = 313) with sufficient data for inclusion. Studies involved acute or subacute pharmacotherapy treatment with administration durations ranging from a single dose to 8 weeks. Primary outcomes examined were craving, withdrawal and behavioural indices of smoking. Varenicline significantly reduced craving (Hedge's g = -0.36[-0.54,-0.17], p < 0.001), withdrawal (g = -0.25[-0.41,-0.09], p = 0.003) and behavioural indices of smoking (g = -0.36[-0.63,-0.08], p = 0.01) relative to placebo. In contrast, results were inconclusive regarding bupropion's effects on craving (g = -0.13[-0.32,0.05], p = 0.15), withdrawal (g = -0.15[-0.44,0.14], p = 0.31) and behavioural indices of smoking (g = -0.05[-0.35,0.24], p = 0.73) relative to placebo. Findings provide meta-analytic support that short-term varenicline treatment decreases craving, withdrawal symptoms and smoking behaviour under controlled laboratory conditions. However, findings also suggest the ability of human laboratory paradigms to detect pharmacotherapy effects may differ by treatment type. Pharmacotherapy discovery and evaluation efforts utilizing human laboratory methods should aim to align study designs and laboratory procedures with presumed therapeutic mechanisms when possible.

Cannabis use for sleep aid among high school students: Concurrent and prospective associations with substance use and sleep problems.

INTRODUCTION: Adolescents are at risk for both sleep problems and cannabis use. Despite emerging evidence for college students' self-medication with cannabis to help sleep, generalizability to earlier developmental stages remains unknown. This study remedied this literature gap by characterizing high school students' cannabis sleep aid use in terms of psychosocial correlates and prospective associations with substance use and sleep. METHODS: Data were drawn froma longitudinal urban adolescent health behavior study, Project Teen, including 4079th-11thgraders(Year 1 Mage = 16.00 [SD = 1.08, range = 13-19]; 58% female; 41% Black, 22% White, 18% Asian, 17% multiracial,2% Native Hawaiian or other Pacific Islander, 1% American Indian or Alaska Native; 12% Hispanic/Latinx). Students completed two web-based surveys (Minterval = 388.89 days [SD = 27.34]) assessingsubstance use and sleep at Year 1 (Y1) and Year 2 (Y2). RESULTS: Students reporting lifetime cannabis sleep aid use (8%) endorsed greater depression and anxiety symptoms at Y1, as well as greater cannabis, alcohol, and cigarette use (but not insomnia symptoms or sleep durations) at Y1 and Y2, compared to non-using peers. Over one year, cannabis sleep aid use was associated with increased cannabis dependence symptoms among students using cannabis, past-2-week binge drinking among students using alcohol, and lifetime cigarette use. However, cannabis sleep aid use was not prospectively associated with changes in insomnia symptoms or sleep durations. CONCLUSIONS: Although replication is needed, cannabis sleep aid use among high school students may be associated with exacerbated cannabis dependence symptoms and increased binge drinking and cigarette use over time, without the intended sleep benefit.

Racial/ethnic discrimination, ADH1B*3, and coping-motivated drinking among Black college students.

BACKGROUND AND OBJECTIVES: Discrimination due to race and/or ethnicity can be a pervasive stressor for Black college students in the United States beyond general negative life events and has demonstrated associations with adverse health and alcohol outcomes. Genetics may confer individual differences in the risk of drinking to cope with discrimination-related stress. This study tested whether associations of racial/ethnic discrimination with coping drinking motives and alcohol use differ as a function of a well-documented variant in the alcohol dehydrogenase 1B gene (ADH1B*3). METHODS: Cross-sectional data were obtained from 241 Black students (Mage = 20.04 [range = 18-53]; 66% female) attending a predominantly White university in the northeastern United States. Participants provided a saliva sample for genotyping and self-reported on their racial/ethnic discrimination experiences, coping drinking motives, and past-month total alcohol quantity. RESULTS: Path models demonstrated that associations of discrimination with alcohol quantity directly or indirectly through coping drinking motives did not differ as a function of ADH1B*3, after controlling for gender, age, negative life events, and potential confounding interactions of covariates with model predictors. Regardless of ADH1B*3, greater experience of negative life events was associated with higher coping drinking motives, which in turn were associated with greater alcohol quantity. CONCLUSION AND SCIENTIFIC SIGNIFICANCE: Findings represent a novel investigation into gene-environment interplay in associations of alcohol use with racial/ethnic discrimination. Findings demonstrate coping-motivated drinking associated with negative life events within Black college drinkers regardless of ADH1B*3. Future research should leverage longitudinal designs to characterize associations of genetics, stressful experiences, and coping-motivated drinking over time.

Prospective Associations of Discrimination, Race, and Sexual Orientation with Substance Use in Adolescents.

Objective: Adolescents are at high risk for alcohol and cannabis use. Emerging evidence suggests that discrimination exposure is prospectively associated with risk for alcohol use among adolescents of marginalized race, sexual orientation, or gender identity. However, it is unknown whether prospective discrimination-substance use associations among marginalized adolescents are also present for cannabis use. This study examined prospective associations of race, sexual orientation, and discrimination exposure with alcohol and cannabis use over one year. Methods: Data were drawn from a two-wave longitudinal health survey study of 9-11th graders (n = 350 for the current analyses; Year 1 Mage=15.95 [SD = 1.07, range = 13-19]; 44% male; 44% Black, 22% White, 18% Asian, 16% Multiracial; 16% LGB; 10% Hispanic/Latinx ethnicity) at an urban high school. Two multinomial logistic regressions examined associations of Year 1 race, sexual orientation, and discrimination experiences with Year 2 alcohol and cannabis consumption separately. Results: Year 1 Discrimination exposure was associated with increased risk for Year 2 past-year alcohol use among Asian (OR = 1.34) and past-month alcohol use among Multiracial (OR = 1.30) adolescents, but not Black or LGB adolescents. Discrimination exposure was not associated with any cannabis use pattern in any group. Independent of discrimination, LGB adolescents were at greater risk for monthly alcohol (OR = 3.48) and cannabis use (OR = 4.07) at Year 2. Conclusions: Discrimination exposure is prospectively associated with risk for alcohol use among adolescents of understudied (Asian, Multiracial) racial backgrounds, and should be considered in alcohol prevention and intervention strategies. Risk factors for alcohol and cannabis use among LGB adolescents should continue to be explored.

Characterizing the role of early alcohol reexposure in associations of prenatal alcohol exposure with adolescent alcohol outcomes.

BACKGROUND: Prenatal alcohol exposure has been linked to a host of negative outcomes, although it is largely unknown whether prenatal exposure leads to an earlier age of initiation of alcohol use or exacerbates early alcohol initiation. The current study examined whether adolescents exposed to heavy drinking during gestation began drinking earlier than their nonexposed peers and whether an earlier age of alcohol reexposure in adolescence exacerbated associations with adverse alcohol outcomes. METHODS: Adolescents (17 years of age; 57% female; 96% White) from a longitudinal, population-based cohort study, the Avon Longitudinal Study of Parents and Children, reported on the age they first consumed a whole drink and other alcohol behaviors. Adolescents' mothers also reported on their own heavy drinking during pregnancy (i.e., any consumption of 4+ U.K. units in a drinking day at either 18 or 32 weeks of gestation). RESULTS: Survival analyses indicated that prenatal heavy drinking exposure was not associated with an earlier initiation of alcohol use after controlling for potential demographic and parental mental health and substance use confounds. Generalized negative binomial models demonstrated that prenatal heavy drinking exposure moderated associations of the age of alcohol initiation with alcohol quantity and heavy drinking frequency (but not alcohol frequency or Alcohol Use Disorders Identification Test score), after controlling for the same demographic and parental confounds. Specifically, earlier alcohol initiation was associated with more adverse alcohol outcomes regardless of prenatal exposure. However, the protective associations of delayed alcohol initiation were lower among adolescents exposed to prenatal heavy drinking. CONCLUSIONS: This study provides evidence for the interplay between prenatal and postnatal alcohol exposures. Importantly, adolescents who were prenatally exposed to heavy drinking appeared to be less protected by later alcohol initiation than those who were not exposed in utero.

Characterizing the role of impaired control over alcohol in associations of impulsive personality traits with alcohol use as a function of depressive disorder.

Impulsive personality traits have well-documented associations with at-risk drinking, although the role of impaired control over alcohol in these associations requires further study. Additionally, it remains unknown whether such relationships differ in the context of concurrent depressive disorder, which is a priority due to the high rates of mood dysregulation particularly in clinical samples. This project examined associations of impulsivity, impaired control over alcohol, and alcohol use within 201 adult general outpatients recruited from specialty mental health and addictions clinics at a psychiatric hospital. Outpatients completed the Structured Clinical Interview for DSM-IV Patient version (SCID) and assessments of impulsivity, impaired control over alcohol, and alcohol use. Over 35% of outpatients met criteria for a current depressive disorder. Path models supported associations of impulsivity with impaired control over alcohol and, in turn, at-risk drinking that differed significantly as a function of current depression. Among individuals with current depression, greater tendency to act rashly when experiencing negative affect (negative urgency) was associated with more frequent failures to control drinking (failed control) and, in turn, more at-risk drinking. In contrast, among individuals without current depression, greater positive urgency and lower sensation seeking were associated with greater failed control and, in turn, more at-risk drinking. Findings represent an important step toward clarifying the role of impaired control over alcohol in impulsivity and alcohol use associations and suggest divergent associations of negative urgency, positive urgency, and sensation seeking with at-risk drinking across clinical presentations.

Effects of Polygenic Risk and Perceived Friends' Drinking and Disruptive Behavior on Development of Alcohol Use Across Adolescence.

OBJECTIVE: Developmental theory posits interacting individual and contextual factors that contribute to alcohol use across adolescence. Despite the well-documented salience of peer environmental influences on adolescent drinking, it is not known whether peer environments moderate polygenic risks for trajectories of alcohol use. The current theoretically based investigation aimed to test developmental gene-environment interaction (G×E) effects across adolescence. METHOD: Latent growth curve models tested interactive associations of polygenic risk scores and adolescents' perceived friend drinking and disruptive behavior with adolescents' initial level of alcohol use frequency at age 16 years old and change in alcohol frequency from ages 16 to 20. The sample comprised 8,941 White adolescents (49% female) from Great Britain within the Avon Longitudinal Study of Parents and Children (ALSPAC). RESULTS: Greater polygenic risk was associated with more frequent initial drinking as well as escalations in drinking frequency over the subsequent 5 years in latent growth curve models. Contrary to study hypotheses, no significant G×E effects were identified after controlling for confounding main and interaction effects. CONCLUSIONS: Adolescents at heightened genetic risk may accelerate their alcohol use across adolescence, although not significantly more so in the presence of these alcohol-promoting peer environments. Future well-powered, theoretically driven replication efforts are needed to examine generalizability of these findings across diverse samples.

Interaction Between the 5-Hydroxytryptamine Transporter-Linked Polymorphic Region (5-HTTLPR) and Negative Life Events in Adolescent Heavy Drinking.

OBJECTIVE: This study investigates whether the reciprocal associations between negative life events and drinking over time differ as a function of 5-HTTLPR (5-hydroxytryptamine [serotonin] transporter-linked polymorphic region) genotype (i.e., candidate gene and environment interaction and correlation) using large and population-based prospective data from adolescents. METHOD: A total of 4,916 White adolescents in the United Kingdom (mean ages = 16, 17, and 18 years old over three assessment points; 47% female) were used. Tri-allelic 5-HTTLPR genotype was assessed; negative life events were assessed at ages 16 and 17; and frequency of heavy drinking was assessed at ages 16, 17, and 18. Path analyses after controlling for covariate interactions and multigroup cross-lagged analyses were conducted. RESULTS: The null findings of candidate gene and environment interaction and correlation were found in the path analyses controlling for covariate interactions, and they were replicated in the multigroup cross-lagged analyses. No moderation by 5-HTTLPR in the association of negative life events at age 16 with heavy drinking at age 17 as well as no association of negative life events at age 17 with heavy drinking at age 18 were found. Also, the 5-HTTLPR genotype did not moderate the association of heavy drinking at age 16 with negative life events at age 17. CONCLUSIONS: Using large prospective data, it appears that there is no evidence for 5-HTTLPR-moderated drinking following experience of negative life events and no support for 5-HTTLPR-moderated selection to negative life events among mid/late adolescents. This finding may inform developmental patterns in gene and environment interaction effects by showing that the effects are less pronounced in mid/late adolescence than in early adolescence.

Drinking Motives as Moderators of In-the-Moment Drinking Risks in Response to Trauma-Related Distress.

BACKGROUND: Trauma exposure and posttraumatic stress disorder (PTSD) symptomatology are linked to increased risk for problematic drinking, yet the factors that increase such risk remain largely unknown. Theoretical models suggest that affectively oriented drinking motives may be central to trauma-related drinking. Specifically, individual-level motivations to drink to regulate affect may be important for moderating drinking urges that occur acutely in response to trauma cues. Further, elevated distress associated with PTSD symptomatology may increase any affectively motivated, momentary drinking risks. However, research has yet to examine these dynamic affective processes. In a large experimental sample, the current study tested whether affective (i.e., coping and enhancement) drinking motives and PTSD symptomatology moderated individuals' drinking urge in response to a trauma cue in a laboratory cue reactivity paradigm. METHODS: College drinkers (n = 611, 53% female) were recruited and selected across levels of trauma exposure and PTSD symptomatology by a structured clinical interview. Participants were randomized to a personalized trauma or neutral cue, reporting on their urge to drink alcohol before and after cue exposure. Drinking motives were assessed at the end of the experimental session. RESULTS: Trauma cue associations with drinking urge were moderated by coping, but not enhancement, motives. Specifically, stronger coping motives were associated with increases in urge to drink alcohol following exposure to a trauma but not neutral cue. PTSD classification did not significantly moderate these associations. CONCLUSIONS: Coping motives may increase drinking urge immediately following exposure to trauma cues and may differentiate individuals most at risk for problematic drinking during trauma-associated distress. Findings support momentary negative affect processes driving dynamic, immediate trauma-related drinking risks.

Sleep Problems and Drinking Frequency among Urban Multiracial and Monoracial Adolescents: Role of Discrimination Experiences and Negative Mood.

Mounting evidence suggests that multiracial adolescents may be at greater risk than their monoracial peers for both sleep problems and alcohol use. However, mechanisms underlying these uniquely-heightened risky health behaviors among multiracial adolescents remain a gap in the literature. This cross-sectional study examined a risk pathway involving discrimination experiences and negative mood underlying racial disparities in concurrent sleep problems and drinking frequency. Students at an urban, socioeconomically-disadvantaged high school (N = 414; grades 9-11, Mage = 16.00 [SD = 1.08]; 57% female; 17% multiracial, 41% Black, 22% White, 18% Asian, 2% Other; 12% Hispanic/Latinx) completed a survey. Path analysis demonstrated that associations of multiracial status with sleep problems (insomnia symptom severity and insufficient weekday sleep duration), but not drinking frequencies (past-year drinking or past-2-week binge-drinking frequencies), were explained by discrimination experiences and, in turn, negative mood. In ancillary analysis excluding White students, the serial indirect risk pathway was significant for both insomnia symptom severity and past-year drinking frequency outcomes. Discrimination experiences and negative mood may function as intermediate factors contributing to racial disparities in adolescent sleep problems, although longitudinal replication is needed.

Prescription Stimulant Misuse and Risk Correlates among Racially-Diverse Urban Adolescents.

BACKGROUND: Most research on prescription stimulant misuse has focused on college students, and research on high school-aged adolescents is limited. OBJECTIVES: This study aimed to characterize risk correlates of prescription stimulant misuse among a racially-diverse and socioeconomically-disadvantaged sample of urban adolescents. METHOD: Cross-sectional data were drawn from an ongoing study of adolescent health behaviors, Project Teen. Participants were 414 9th to 11th graders (Mage=16.00 [SD = 1.08]; 57% female; 41% Black or African American, 22% White, 18% Asian, 17% Multiracial, 2% Pacific Islander, and 1% Native American; 12% Hispanic/Latinx). Participants completed a web-based survey assessing prescription stimulant misuse, demographics, mental health and personality, social environment, and substance use. RESULTS: Eight percent of participants endorsed past-year prescription stimulant misuse. Compared to non-misusing peers, participants endorsing past-year prescription stimulant misuse reported greater depression/anxiety symptoms, sensation seeking, perceived peer risk behavior, and alcohol and cigarette use, as well as a lower level of parental monitoring; null group differences were observed for academic goal orientation, perceived peer approval of risk behavior, and cannabis use. Binary logistic regression demonstrated that binge drinking and cigarette use were significantly associated with prescription stimulant misuse over and above all other identified risk variables. CONCLUSIONS: Adolescent prescription stimulant misuse appears to overlap with general adolescent substance use, sharing several known risk correlates. Results highlight potential targets for identification of emerging prescription stimulant misuse risk profiles at earlier stages of development. Longitudinal replication is needed to examine directional associations and risk mechanisms underlying adolescent prescription stimulant misuse.

OPRM1 Moderates Daily Associations of Naltrexone Adherence With Alcohol Consumption: Preliminary Evidence From a Mobile Health Trial.

BACKGROUND: Initial evidence that OPRM1 genotype moderates the clinical response to naltrexone has not been replicated in prospective clinical trials. However, the use of traditional statistical analyses and clinical endpoints might limit sensitivity for studying pharmacogenetic associations, whereas the use of intensive daily assessments and person-centered analytic methods might increase sensitivity. This study leveraged person-centered analyses and daily measures of alcohol use, craving, and medication adherence to investigate OPRM1 as a moderator of changes in clinical outcomes during naltrexone treatment. METHODS: Treatment-seeking participants with alcohol use disorder (n = 58; Mage  = 38 years; 71% male) provided daily cell phone reports of craving and consumption while taking naltrexone as part of a mobile health trial. Daily medication adherence was measured remotely using electronic pill cap recordings. Multilevel modeling and multilevel structural equation modeling analyses evaluated the hypotheses that OPRM1 genotype would moderate prospective reductions in daily alcohol use and craving, and would also moderate within-person associations of daily adherence with same-day craving and consumption. RESULTS: OPRM1 genotype moderated the association of daily adherence with reduced same-day consumption (p = 0.007) and craving (p = 0.06), with these associations being stronger for participants with the 118G variant. OPRM1 genotype did not moderate changes in craving and consumption over time. CONCLUSIONS: These findings suggest that high-density assessments and person-centered analytic approaches, including modeling within-person variation in medication adherence, could be advantageous for pharmacogenetic studies.

Treatments for Adolescents With Comorbid ADHD and Substance Use Disorder: A Systematic Review.

Objective: Comorbid ADHD and substance use disorder (SUD) presents frequently in adolescence, a developmental period that may promote the emergence of substance misuse among individuals with ADHD. Comorbid ADHD and SUD in adolescence results in significant and unique treatment challenges, necessitating examination into effective interventions. Method: This systematic review examined existing research into the treatment of comorbid adolescent ADHD and SUD. Results: Findings from a small number of pharmacological intervention studies suggest potential efficacy of extended-release stimulant and nonstimulant medications. Efficacy of psychotherapeutic interventions has not been systematically examined. Conclusion: Current research on treatments for comorbid ADHD and SUD in adolescence is limited. Future placebo-controlled clinical trials using large samples are needed to examine the efficacy of psychotherapeutic interventions, the heightened risk of prescription stimulant misuse, and the long-term maintenance of treatment gains in this population. Clinical guidelines for the treatment of comorbid ADHD and SUD are discussed.