Why Ask Why? Logical Fallacies in the Diagnosis of Fetal Alcohol Spectrum Disorder

A diagnosis of Fetal Alcohol Spectrum Disorder (FASD) ascribes cause to developmental disability; however, there are logical issues in causation with ethical implications. This article focuses on the use of fallacious logic (affirming the consequent) in FASD, focusing on the Canadian Guidelines for diagnosis, and knowledge translation issues from science to practice. The clinician’s logical fallacy is an ethical issue of veracity in the clinician–patient relationship; this then leads to issues of nonmaleficence, because the diagnosis in turn blames the mother for her child’s difficulties. Suggestions for revised diagnostic practices that avoid allusions to causation and responsibility are discussed.     

A long‐term fatty fish intervention improved executive function in inpatients with antisocial traits and a history of alcohol and drug abuse

The aim of the present study was to investigate the effects of fatty fish consumption on cognitive functioning in a group of inpatients characterized by antisocial behavior. Eighty‐three male forensic inpatients participated in this study. Participants were randomly assigned into a Fish or a Control group (e.g., meat, chicken, pork). One decision‐making task, the Iowa Gambling Task (IGT), and one planning task, the Tower of Hanoi (ToH), were administered before (pre‐test) and at the end of the intervention period (post‐test). For the IGT the Fish group showed improved performance from pre‐ to post‐ test. Moreover, the Fish group showed significantly better performance than the Control group on the IGT at post‐test. The Fish group also demonstrated improved performance from pre‐ to post‐test on the ToH; however, this was limited to participants with a history of substance abuse. Further, the improvement was only significant for tasks with high working memory load (5–7 move problems), and not for tasks with low working memory load (1–4 move problems). The Control group showed no improvement on any of the tasks regardless of alcohol or drug abuse history. The present study suggests that regular fatty fish consumption may improve executive functions in forensic inpatients with antisocial traits and a history of substance abuse. Thus, the current results may have important implications with regard to health care interventions.     

Mandatory Cancer Risk Warnings on Alcoholic Beverages: What Are the Ethical Issues?

The link between alcohol consumption and cancer is well established, but public awareness of the risk remains low. Mandated warning labels have been suggested as a way of ensuring “informed choice” about alcohol consumption. In this article we explore various ethical issues that may arise in connection with cancer warning labels on alcoholic beverages; in particular we highlight the potentially questionable autonomy of alcohol consumption decisions (either with or without labels) and consider the implications if the autonomy of drinking behavior is substantially compromised. Our discussion demonstrates the need for the various ethical issues to be considered and addressed in any decision to mandate cancer warning labels.     

Avoiding the Last Ride: Can DUI Programming Address Multiple Risk Factors to Reduce Recidivism?

A review of DUI education literature reveals weak evidence of effective interventions. New models are suggested that offer a combination of psychoeducation and evidence‐based counseling approaches. Existing DUI programming models are explored with recommendations for areas for future research.     

Concurrent alcohol and tobacco use among school-going adolescents in Namibia: Prevalence and risk factors

The aim of this study was to investigate the prevalence and risk factors for concurrent alcohol and tobacco use among school-going adolescents in Namibia. Data were from a sample of 4 531 Namibian middle school children (females = 53.1%; mean age = 15.8 years, SD = 1.8 years). They completed the Namibia Global School-based Student Health Survey (GSHS) in 2013. Overall, 74.4% of alcohol users in the past month were frequent tobacco users; whereas 40.5% of tobacco users in the past month were frequent alcohol users. Compared to students who were neither alcohol nor tobacco users (63.1%), concurrent alcohol and tobacco users were more likely to self-report with a lack of parent support, to have used illicit drugs, to have engaged in school truancy, to be sedentary in behaviour, to have engaged in a physical fight, and to have had two or more sexual partners. Substance use prevention and treatment programmes with adolescents should routinely address their risk for comorbid tobacco and alcohol use.     

Alcohol use and problem drinking in South Africa: Results from a national-population-based survey 2014-2015

The aim of this study was to estimate the pattern of alcohol use among South African adults by their socio-demographic and health status indicators. We analysed data from a 2014–2015 South African national population-based survey which sampled 22 752 adults (mean age 37.1 years, SD?=?17.6, age range of 15–109 years). Results indicate 3.9% were hazardous or harmful alcohol users. In adjusted logistic regression analysis, both men and women who self-reported to use tobacco, and women to have hypertension, were at higher risk for harmful alcohol use. Age and socioeconomic status moderated harmful alcohol use among men so that those in middle age (35–49 years) and with above average household income were at lower risk for hazardous or harmful alcohol use. Socio-demographic factors appear to primarily influence risk for hazardous or harmful alcohol use among South African adults.     

Executive function and memory in children with Fetal Alcohol Spectrum Disorder

A complex relation exists between memory and executive functioning (EF), particularly when learning and recalling multifaceted or extensive information (Moscovitch &; Winocur, 2002 Moscovitch, M. and Winocur, G. 2002. “The frontal cortex and working with memory”. In Principles of frontal lobe functioning, Edited by: Stuss, D. T. and Knight, R. T. 188–209. New York, NY: Oxford University Press.  [Google Scholar]). A common instrument for evaluating this relationship is the Rey-Osterrieth Complex Figure (ROCF; Rey, 1941 Rey, A. 1941. L'examen psychologique dans le cas d'encephalopathie traumatique [Psychological examination of traumatic encephalopathy]. Archives de Psychologie, 28: 286–340.  [Google Scholar]; Osterrieth, 1944 Osterrieth, P. A. 1944. Le test de copie d'une figure complexe: Contribution à l’étude de la perception et de la mémoire [The test of copying a complex figure: A contribution to the study of perception and memory]. Archives de Psychologie, 30: 286–350.  [Google Scholar]). The ROCF has proved particularly useful in pediatric research; however, little research has been conducted among children with Fetal Alcohol Spectrum Disorders (FASD).

Seventy children (35 FASD, 35 control), aged 6 to 12 years, were tested using the ROCF. All participants with FASD had received a diagnosis according to the Canadian guidelines for FASD (Chudley et al., 2005 Chudley, A. E., Conry, J., Cook, J. L., Loock, C., Rosales, T. and LeBlanc, N. 2005. Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. The Canadian Medical Association Journal, 172: 1–21. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) using the 4-digit diagnostic code (Astley, 2004 Astley, S. J. 2004. Diagnostic guide for fetal alcohol spectrum disorders: The 4-digit diagnostic code, 3rd, Seattle, WA: University of Washington.  [Google Scholar]). Significant group differences were revealed with children with FASD demonstrating substantial difficulties in organization, accuracy, and memory. Among children with FASD, a distinctive profile emerged, lending support to the argument that children with FASD experience deficits in EF and memory throughout their development. Information from the present study will not only help to improve understanding of functioning in this population but also provide insight into how to deal with EF and memory deficits in terms of testing, treatment, and intervention.     

‘That's OK. He's a guy’: A mixed-methods study of gender double-standards for alcohol use

Although drinking and drunkenness have traditionally been considered masculine behaviours, young women's alcohol consumption has increased in recent years. This mixed methods study was conducted to examine the extent to which young people endorse gender double-standards for alcohol use – i.e., less acceptance of drinking and drunkenness in women than men – and how these influence men's and women's alcohol consumption. A sample of 731 English university students completed an online survey of gender role attitudes, beliefs about the gendered nature of alcohol use and recent alcohol consumption. Sixteen participants were then purposively selected for individual interviews: eight women and men with the most egalitarian gender role beliefs, and eight women and men with the least egalitarian beliefs. The two sets of data revealed that although there were few sex differences in actual levels of drinking or drunkenness, gender double-standards for alcohol use persist: beer drinking, binge drinking and public drunkenness tended to be perceived as masculine, and even the most egalitarian respondents were more judgemental of women's drinking. Participants modified their drinking style so as to maintain a desired gender identity. Although gender double-standards could be a focus of interventions to encourage moderate drinking, such approaches could reinforce gender inequalities.     

Alcohol use affects sleep duration among military couples

Alcohol misuse and sleep disorders are highly comorbid, prevalent among service members and their romantic partners, and affected by relationship interdependence. As most military health research focuses on either service members or their spouses, the current study examined dyadic effects of alcohol use on sleep cycle duration in dating and married military couples (N = 149 dyads), using data from the National Longitudinal Study of Adolescent Health. Person-level results from a series of multilevel path models showed partial support for our focal hypothesis implicating high alcohol use in shortened average sleep duration for the service members and their romantic partners. Specifically, partners of service members who drank more regularly had shorter average sleep durations, as did female service members who drank more alcohol per drinking occasion. At the couple-level, a partner effect indicated that service members’ lower depressive symptoms were associated with their partner’s shorter average sleep durations. In addition, when service members reported relatively high alcohol-related problems, their partner tended to have a shorter average sleep duration. In contrast, when service members’ partners reported relatively high alcohol-related problems, they had a longer average sleep duration. This suggests the consequences of problematic alcohol use for service members’ partners depended on each dyad member’s drinking patterns. Taken together, these findings underscore the importance of viewing military couples as a dyadic unit in research studies and clinical interventions.