Controlled Trial Examining the Strength-Based Grit Wellbeing and Self-Regulation Program for Young People in Residential Settings for Substance Use.

This cohort-controlled trial examined whether the 12-session Grit Wellbeing and Self-regulation Program enhanced the treatment outcomes of young people accessing residential alcohol and other drug (AOD) treatment. Grit focuses on increasing wellbeing and reducing substance use and mental health problems by building self-regulation skills, strengths, social connections, and health behaviours. Participants were 194 (66% male, Mage 27.40) young people (aged 18-35 years) accessing a six-week residential treatment program for substance use. Participants received standard treatment, or standard treatment plus Grit (two sessions/week for six weeks). The primary outcome was substance use, measured as: (i) global substance use and (ii) alcohol, methamphetamine, and cannabis use involvement. Secondary outcomes included wellbeing, depression, anxiety, and vocational engagement. Participants were assessed at baseline, and 6-weeks (secondary outcomes only), 3-months, 6-months, and 12-months post-program enrolment. Results revealed that both groups showed a significant improvement in all outcomes at three months, and improvements were maintained at 6- and 12-month follow-ups. The Grit group had a larger reduction in methamphetamine and cannabis use involvement compared to the control group. This study presents promising evidence that a six-week residential program can achieve improvements in AOD use, depression, anxiety, wellbeing and vocational engagement. Further, targeting self-regulation may enhance such programs.

Changes in Substance Use Among People Seeking Alcohol and Other Drug Treatment During the COVID-19 Pandemic: Evaluating Mental Health Outcomes and Resilience.

BACKGROUND: Alcohol and other drug (AOD) use patterns have altered as a result of the coronavirus (COVID-19) pandemic restrictions. This study aimed to: (i) determine the impact of the pandemic on patterns of AOD use among individuals seeking treatment, (ii) identify which mental health and resilience factors were associated with changes in patterns of AOD use and (iii) evaluate changes in the contextual factors (eg, motivations) associated with use. METHODS: Cross-sectional surveys were completed by clients (n = 325) who had sought AOD treatment from January 2020 onwards. We measured quantity and frequency of AOD use now compared to before the pandemic, mental health (depression, anxiety, trauma exposure), resilience and contextual factors related to AOD use. RESULTS: Quantity of tobacco and cannabis use increased post-pandemic, while methamphetamine and alcohol did not change. Depression was associated with more frequent alcohol use now compared to before the pandemic, while anxiety and lower resilience were associated with less frequent cannabis use now. Lower resilience was associated changes in methamphetamine use. Depression was associated with using more frequently for enjoyment and to alleviate loneliness following the pandemic, and anxiety was associated with using earlier in the day and to alleviate boredom. CONCLUSIONS: The pandemic has led to increased frequency of AOD use for a subset of individuals seeking treatment. Depression, anxiety and resilience are important factors associated with altered AOD use, and changes in the motivations and control surrounding use. Special consideration of this should be considered during AOD treatment through the pandemic.

FullFix: a randomised controlled trial of a telephone delivered transdiagnostic intervention for comorbid substance and mental health problems in young people.

INTRODUCTION: Transdiagnostic cognitive-behavioural therapy (CBT) targets common psychological factors that underlie multiple disorders. While transdiagnostic interventions are a promising new approach, limited research has evaluated these treatments within the alcohol and other drug (AOD) sector for young people with comorbid mental health symptoms. This project will examine the feasibility and preliminary efficacy of FullFix-a new risk-targeted transdiagnostic CBT telehealth programme for comorbid AOD and depression/anxiety disorders in young people. Secondary aims are to identify moderators and mediators of treatment outcomes, to determine how and why treatment is effective and who is most likely to benefit. METHODS/DESIGN: Participants will be 130 young people (aged 16-35) accessing AOD services in Queensland, Australia, with comorbid mental health symptoms. They will be randomised to receive either the FullFix intervention plus standard AOD care or standard AOD care alone. Primary outcomes on AOD use and mental health symptoms will be reassessed at 6 weeks, 3 months, 6 months and 12 months, along with secondary outcomes of emotion regulation, social connectedness, perceived self-efficacy, coping skills and quality of life. The trial commenced on October 2018 and expected completion date is September 2021. ETHICS AND DISSEMINATION: Ethical approval for this trial was provided by the University of Queensland (#2018001185). The results of the trial will be disseminated through publication in a peer-reviewed scientific journal, scientific presentations at conferences and distributed via a report and presentations to the partner organisation. TRIAL REGISTRATION NUMBER: ACTRN12618001563257.

Social Cognitive Moderators of the Relationship Between Social Anxiety and Alcohol Outcomes in Young People.

OBJECTIVE: Social anxiety has been linked to problem drinking in young people. Identifying moderators of this relationship will aid the development of effective interventions for this at-risk group. This cross-sectional study examined whether anticipated social outcomes and controlled drinking self-efficacy moderated the relationship between social anxiety and alcohol outcomes. METHOD: A total of 385 participants (drinkers and nondrinkers; mean age = 20.98, SD = 2.35; 65% female; 81% born in Australia), completed an online survey measuring alcohol consumption, alcohol-related harms, social anxiety, anticipated social outcomes, and controlled drinking self-efficacy. Regressions examined the interactive effects of social anxiety, anticipated social outcomes, and controlled drinking self-efficacy on alcohol consumption and alcohol-related harms. RESULTS: A significant three-way interaction was found for alcohol consumption (95% CI [-0.523, -0.018]). Simple slopes revealed an inverse relationship between social anxiety and alcohol consumption when participants anticipated positive evaluations for being drunk and had high controlled drinking self-efficacy (95% CI [-1.181, -0.273]). The three-way interaction for alcohol-related harms was not significant (95% CI [-1.445, 0.799]). A significant two-way interaction revealed that the relationship between social anxiety and alcohol-related harms was only significant when individuals had low (95% CI [0.571, 3.943]), but not high (95% CI [-1.149, 0.735]), controlled drinking self-efficacy. CONCLUSIONS: Social anxiety was associated with reduced alcohol consumption when young people anticipated positive evaluations for being drunk and had high confidence to control their drinking. Further, social anxiety was associated with alcohol-related harms when young people had low confidence to control their drinking. Interventions for alcohol use among socially anxious young people could focus on increasing confidence to control drinking.

Does self-efficacy moderate the effect of gambling advertising on problem gambling behaviors?

Problem gambling causes significant harm to individuals and society. Financial losses from gambling in Australia exceed those anywhere else in the world. Problem gamblers are overrepresented among substance users and rural and remote Australians. Limited research exists on the impact of gambling advertising on problem gambling among those seeking substance use treatment, in rural/remote areas, and protective factors that may guard against these impacts. This study examined whether self-efficacy to control gambling moderated the relationship between the perceived impact of gambling advertising and problem gambling in people seeking treatment for substance use. Participants (N = 198, 60% female) who had recently sought treatment for substance use from services in rural/remote areas of Queensland and New South Wales, Australia, completed an anonymous online survey. Problem gambling severity was measured by the Problem Gambling Severity Index, with 30% of participants showing at least moderate-risk problem gambling behaviors (12% moderate-risk gambling, 18% high-risk gambling). Moderated regression analyses found self-efficacy to control gambling significantly moderated the relationship between the perceived impacts of gambling advertising and the severity of problem gambling. At low levels of self-efficacy to control gambling, higher perceived impacts of advertising on gambling involvement and awareness were associated with higher levels of problem gambling behavior. However, at high levels of self-efficacy to control gambling, the association between problem gambling and impact of gambling advertising was weaker for involvement and not significant for awareness. Findings suggest that self-efficacy could be targeted as a treatment option to protect vulnerable groups from the effects of gambling advertising. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Impact of a brief psychoeducational intervention for reducing alcohol use and related harm in school leavers.

INTRODUCTION AND AIMS: Many young people engage in risky partying behaviours and excessive alcohol use in the transition period following high school graduation. Despite this, there is limited longitudinal research on adolescents before and after school graduation; and limited evaluation of interventions targeting these high-risk periods. The present study aims to address this gap in the literature by examining the impact of brief psychoeducation interventions on substance use, psychological distress and well-being during this important life transition. DESIGN AND METHODS: Participants were 334 high school leavers (53% female, Mage = 17.14) from Queensland, Australia. They received either: (i) a psychoeducation intervention on safe partying behaviours; (ii) a reconstructed version of the psychoeducation intervention; or (iii) a standard health curriculum control. Surveys were conducted at baseline; 2 weeks, immediately following post-graduation celebratory event 'Schoolies'; and 4 months, immediately following university orientation 'O-week'. RESULTS: Significant time by group effects were found for problem drinking, F(2, 227) = 3.07, P < 0.05, and well-being, F(4, 439) = 3.54, P < 0.01. There was stability in problem drinking from baseline to follow-up for the psychoeducation groups but small increases in problem drinking for the control (d = 0.12). Both psychoeducation groups had improvements in well-being scores from baseline to post-Schoolies (d = 0.40; 0.20), which were maintained across time. In contrast, the control condition showed a decrease in well-being scores from baseline to the post O-week follow-up (d = 0.15). DISCUSSION AND CONCLUSIONS: Brief school-based psychoeducational interventions may result in small improvements in well-being, and possibly stabilise the trajectory of problematic drinking in high-risk environments.

The interactive effects of perceived peer drinking and personality profiles on adolescent drinking: a prospective cohort study.

AIMS: (1) To classify Australian adolescents according to their alcohol consumption trajectories; and (2) to assess the direct and interactive effects of perceived peer drinking (PPD) and personality on adolescent drinking. DESIGN: Prospective cohort study comprising secondary analysis of six waves of prospective data (collected between 2014 and 2016) from the control arm of the Climate Schools Combined Study. SETTING: Nineteen schools across three Australian states. PARTICIPANTS: A total of 1492 socio-demographically diverse students (mean age at baseline: 13.47; 68% female; 82% born in Australia). MEASUREMENTS: Alcohol consumption trajectories were assessed using self-reported sipping of alcohol, full standard drink consumption, binge drinking and quantity and frequency of alcohol consumption. One item assessed PPD and personality was assessed using the Substance Use Risk Profile Scale. FINDINGS: Eight hundred and sixty-four (58%) adolescents consumed alcohol across the study period. Four drinking trajectories were identified: abstaining (n = 513; reference group); onset (n = 361; initiated after baseline); persistent (n = 531; initiated prior to baseline); and decreasing (n = 50; consumed alcohol at baseline but ceased or decreased thereafter). A significant PPD × anxiety sensitivity (AS) interaction affected probability of belonging to the onset (P < 0.001) and persistent (P = 0.003) trajectories. The effect of PPD on probability of belonging to the onset trajectory was only significant when adolescents reported low [95% confidence interval (CI) = 1.464-2.646, P < 0.001], but not high AS. The effect of PPD on probability of belonging to the persistent drinking trajectory was stronger at low (95% CI = 2.144-3.283, P < 0.001), compared with high (95% CI = 1.440-2.308, P < 0.001) AS. CONCLUSIONS: In Australian adolescents, self-reported drinking onset and persistent drinking appear to be more strongly associated with perceived peer drinking in those with low anxiety sensitivity than those with high anxiety sensitivity.

An Examination of Gender Differences in the Association of Adolescent Substance use with Eating and Weight Loss Attitudes.

OBJECTIVE: To assess gender differences in the relationship between eating and weight loss attitudes (EWAs), and 30-day tobacco and alcohol use among adolescents, while controlling for potential confounds (age, country of birth, psychological distress, pubertal development, peer alcohol and tobacco use, and sexual activity). METHODS: School students aged between 11 and 17 years (N = 10,273) from high schools in the State of Victoria (Australia) completed surveys in class under conditions of anonymity and confidentiality. RESULTS: The interaction between EWAs and gender was significant for tobacco use but not for alcohol use, indicating that the effect of EWAs on tobacco use, but not alcohol use, vary by gender. CONCLUSIONS: Tobacco use was related to EWAs in adolescent females but not males, and this is consistent with the possibility that females use tobacco in an instrumental fashion to control weight. Implications and Contribution: Female adolescents high in eating and weight loss attitudes were more likely to engage in tobacco use. In contrast, eating and weight loss attitudes were not related to male tobacco use. These results point to the potential importance of developing gender-specific approaches towards addressing problematic behaviors in adolescent populations.

The interactive effects of personality profiles and perceived peer drinking on early adolescent drinking.

Early adolescent drinking has been identified as an important risk factor for the development of alcohol dependence. Both perceived peer drinking and personality profiles have been implicated as risk factors for early adolescent drinking. However, research is yet to determine how these 2 factors may interact to increase such risk. This study aimed to determine whether personality profiles moderated the relationship between perceived peer drinking and early adolescent drinking. Baseline data were utilized in the analyses, from 3,287 adolescents (Mage = 13.51 years, SD = .58; 54% female; 78% born in Australia) participating in the Climate Schools Combined Study (a cluster randomized controlled trial with 75 schools located across Queensland, New South Wales, and Western Australia, Australia). Lifetime consumption of alcohol, perceived peer drinking, and personality profiles (Substance Use Risk Profile Scale) were measured. A moderated binary logistic regression found the personality profiles of impulsivity, sensation seeking, and hopelessness were positively related to early adolescent drinking, whereas anxiety sensitivity had a negative association. A significant interaction revealed that adolescents with higher levels of sensation seeking and who perceived their peers to be drinking were significantly more likely to report early adolescent drinking (consumption of a full standard drink; OR = 1.043; 95% CI [1.018-1.069]). These results indicate that perception of peer drinking is more strongly associated with early adolescent drinking, when adolescents are also high on sensation seeking. Prevention and intervention programs could consider targeting both sensation seeking and perceived peer drinking in adolescents. (PsycINFO Database Record

Development and validation of the cannabis experiences questionnaire - Intoxication effects checklist (CEQ-I) short form.

OBJECTIVE: To develop and validate a short form of the Cannabis Experiences Questionnaire - Intoxication Effects (CEQ-I), a 42-item scale which measures the euphoric and paranoid-dysphoric effects of cannabis intoxication. METHOD: Exploratory and confirmatory factor analyses were conducted among 604 past-month cannabis users to develop the short form. The factor structure was replicated in a second sample of 146 past-month cannabis users. The concurrent validity of the scale was also examined. RESULTS: Consistent with previous research, two factors were identified (paranoid-dysphoric; euphoric), and were replicated with confirmatory factor analyses. The most parsimonious scale consisted of 13 items. Correlations of short-form subscales with corresponding original subscales were high. The paranoid-dysphoric subscale was also moderately positively correlated with measures of psychotic-like experiences (PLEs) and psychological distress. CONCLUSIONS: The revised and validated CEQ-I short form can be used to explore the euphoric and paranoid-dysphoric effects of cannabis intoxication in young cannabis users, and whether these experiences increase their risk of developing cannabis use and psychotic disorders. The CEQ-I short form has the potential to aid in the identification of young cannabis users at risk of the paranoid-dysphoric effects of cannabis intoxication and may assist in the development of early intervention strategies targeting cannabis users with PLEs.

Associations between the group processes of bullying and adolescent substance use.

The adverse impact of bullying and victimization on substance use among youth has received increasing attention. Bullying is a specific type of aggressive behavior that not only involves bullies and victims but also followers, who actively support or reinforce the bully; defenders, who intervene to defend or assist the victim; or outsiders who passively observe or ignore the bullying. Limited research to date has linked these five bullying role behaviors to substance use. The aim of this study was to investigate the relationship between each of the bullying role behaviors and adolescent alcohol and tobacco use. Participants were 1255 (748 female) students (Mage=15.3, age range: 13-17years) in Grades 9 (n=714) and 11 (n=541). Bullying role behaviors, alcohol and tobacco onset and intensity, and alcohol-related harms were assessed. Results revealed an association between pro-bullying behavior (bullying and following) and all substance use variables, and between defender behavior and smoking and alcohol-related harm. No relationship between victimization, or outsider behavior, and substance use was found after controlling for the other bullying roles. The findings highlight the complex relationship between bullying roles, alcohol and tobacco use and alcohol-related harm in adolescents.

Moral Disengagement, Anticipated Social Outcomes and Adolescents' Alcohol Use: Parallel Latent Growth Curve Analyses.

Moral disengagement is a social cognitive process that has been extensively applied to transgressive behaviors, including delinquency, aggression and illicit substance use. However, there has been limited research on moral disengagement as it relates to underage drinking. The current study aimed to examine moral disengagement contextualized to underage drinking and its longitudinal relationship to alcohol use. Moreover, the social context in which adolescent alcohol use typically occurs was also considered, with a specific emphasis on the social sanctions, or social outcomes, that adolescents anticipate receiving from friends for their alcohol use. Adolescents were assessed across three time-points, 8 months apart. The longitudinal sample consisted of 382 (46% female) underage drinkers (12-16 years at T1). Parallel latent growth curve analysis was used to examine the bi-directional influence of initial moral disengagement, anticipated social outcomes, and alcohol use on subsequent growth in moral disengagement, anticipated social outcomes and alcohol use. The interrelation of initial scores and growth curves was also assessed. The findings revealed that, in the binary parallel analyses, initial moral disengagement and anticipated social outcomes both significantly predicted changes in alcohol use across time. Moreover, initial anticipated social outcomes predicted changes in moral disengagement. These findings were not consistently found when all three process analyses were included in a single model. The results emphasize the impact of social context on moral disengagement and suggest that by targeting adolescents' propensity to justify or excuse their drinking, as well as the social outcomes adolescents anticipate for being drunk, it may be possible to reduce their underage drinking.

Synthesis of stable isotope labeled anacetrapib, its major metabolites and [(14) C]anacetrapib.

Cholesteryl ester transfer protein inhibitors are an important class of compounds designed to treat hypocholesterolemia and prevent cardiovascular disease. Anacetrapib (MK-0859) is currently in phase III trials for the treatment of elevated cholesterol levels and prevention of cardiovascular disease. In order to further support the development of anacetrapib, we prepared [M + 6]MK-0859, which was required in support of an absolute bioavailability study of the active pharmaceutical ingredient (API). Additional support included the synthesis of an internal standard [M + 13] and three stable isotope labeled metabolites, which were used to analyze clinical samples, and [(14) C]MK-0859 to support drug metabolism studies.

Total synthesis and cytoprotective properties of dykellic acid.

Small molecule inhibitors of apoptosis hold considerable promise for the treatment of a host of diseases, including neurodegeneration, myocardial infarction, and stroke. Many compounds that delay or prevent apoptotic death either reduce the amount of cellular reactive oxygen species (ROS) or are direct inhibitors of caspases. With the goal of using small molecules to identify novel antiapoptotic targets, we have investigated the cytoprotective activity of the natural product dykellic acid. Described herein is the first total synthesis of dykellic acid, the synthesis of several dykellic acid derivatives, and the evaluation of these compounds in assays related to cell death. We have found that dykellic acid protects cells from death as induced by etoposide and rotenone. Further experiments strongly suggest that dykellic acid does not scavenge ROS or directly inhibit caspase enzymes, and analysis of synthetic derivatives establishes key functional groups of the molecule that are essential for its cytoprotective activity.