Historical misrepresentation in science: The case of fetal alcohol syndrome

The history of the fetal alcohol syndrome (FAS) provides a microcosm in which to explore the larger ramifications of historical citations in biomedical publications. Though some historical references such as Biblical writings may hint at a rudimentary understanding of the relationship between maternal drinking and fetal development, no definitive case can be made for an understanding of FAS dating back hundreds of years. Authors who claim an impressive history for FAS misrepresent that history. The modern history of FAS raises a question concerning citations of original discoveries. The first paper describing ethanol-induced damage to the fetus appeared in 1968 yet most researchers cite one of two papers from 1973. Both ancient citations and modern references to original discoveries pose difficult questions for the scientist. Both dilemmas may be solved by a better reading of the literature and a more judicious wording when writing about history. This work was supported in part by Grant # AA10681 to SNP.     

Analogue drinking assessment: Sensation seeking and gender

This study assessed the relationship between sensation seeking measured as a trait variable and drinking behaviors observed unobtrusively in the laboratory. It was hypothesized that high-sensation-seeking subjects would consume more alcohol than low sensation seekers and experience greater enhancement of positive moods and body sensations associated with intoxication. Thirty female and 31 male subjects divided into high- and low-sensation-seeking subgroups participated in an ad libitum drinking situation with the manifest task of taste rating three types of vodka (actually 95% alcohol) or tonic. Dependent variables included beverage consumption, positive/negative mood states, body sensations, breath estimates of blood alcohol levels, and self-rated level of intoxication. All subjects reported feeling the effects of alcohol. Contrary to predictions, high-sensation-seeking subjects neither consumed more alcohol than their low-sensation-seeking counterparts nor drank more alcohol than tonic, Paradoxically, low-sensation-seeking women displayed significantly greater alcohol intake and intoxication than all other groups. Possible explanations for findings were considered as well as the necessity for multimethod assessments of both predictor (i.e., sensation seeking) and criterion (i.e., alcohol consumption) variables across time and situations.This research was supported by Grant Award AA04042-03 from the National Institute on Alcohol Abuse and Alcoholism to the first and third authors. Special Appreciation is expressed to Anne T. Patsiokas, Susan W. Altman, Victoria Molony-Sinnott, and Pamela J. Thompson for their invaluable assistance in collecting and analyzing the data.     

Culturally grounded strategies for suicide and alcohol risk prevention delivered by rural Alaska Native communities: A dynamic wait-listed design evaluation of the Qungasvik intervention

We examined the effectiveness of the Qungasvik (Tools for Life) intervention in enhancing protective factors as a universal suicide and alcohol prevention strategy for young people ages 12−18 living in highly affected rural Alaska Native communities. Four communities were assigned to immediate intervention or to a dynamic wait list. Outcomes were analyzed for 239 young people at four time points over two years of community intervention. Outcomes assessed two ultimate variable protective factors buffering suicide and alcohol risk, and three intermediate variable protective factors at the individual, family, and community level. Dose dependent intervention effects were associated with growth in ultimate but not intermediate variables. This evaluation of the Qungasvik intervention provides support for the effectiveness of its Indigenous strategies for suicide and alcohol misuse prevention in this rural Alaska Native setting. Though findings did not provide support for a theory of change where growth in ultimate variables is occasioned through effects on intermediate variables, research designs focused on young people who enter intervention at lower levels of preexisting protection hold promise for better understanding of intervention change processes. The Qungasvik intervention is responsive to an acute public health need for effective rural Alaska Native suicide and alcohol risk prevention strategies.     

Primary Care Treatment Integrating Motivation and Exposure for PTSD Symptoms and Hazardous Alcohol Use: A Case Series

Symptoms of posttraumatic stress disorder (PTSD) and hazardous alcohol use are highly comorbid. Research on integrated interventions to address PTSD symptoms and hazardous alcohol use concurrently has demonstrated efficacy, yet integrated treatments are underutilized. Both patient (e.g., stigma, scheduling/logistics) and clinician (e.g., concern about symptom exacerbation and/or treatment dropout) barriers may impede utilization of integrated interventions among those with comorbid PTSD symptoms and hazardous alcohol use. Primary care behavioral health models (PCBH), in which embedded behavioral health providers deliver treatment to individuals with mild or moderate behavioral health symptoms in primary care, may help address treatment barriers by offering accessible behavioral health interventions in a destigmatizing setting. This paper presents two case examples from a randomized controlled trial testing the efficacy of an integrated intervention for PTSD symptoms and hazardous alcohol use developed for and delivered in primary care. Outcome data and session-by-session content for two participants are included, along with discussion of barriers encountered during the course of treatment. Clinician-suggested strategies for navigating barriers to facilitate utilization of integrated interventions for PTSD symptoms and hazardous alcohol use are also discussed.     

“In my own comfort zone”: Clients' experiences of relational aspects of online therapy for alcohol problems

Background

Therapists and counsellors increasingly use online video applications to offer treatment in place of face-to-face delivery. In the alcohol treatment sector, this offers a range of potential benefits for treatment providers. However, the impact of working remotely via video on the therapeutic relationship remains unclear and under-researched.

Aims

This study aimed to explore how alcohol treatment clients make sense of the relational aspects of therapy delivered remotely, and to examine how the use of remote therapy might disrupt existing ideas around the therapeutic relationship.

Methodology

This study utilised a qualitative design using thematic analysis, with 15 participant interviews with adult service users from a single treatment provider. All participants had previously undertaken at least four 1-h online therapy sessions.

Findings

The themes that were identified highlighted the significance of the participants' own homes as the site of therapy, with emphasis on the comfort of the home, and the presence of family members and pets. Participants stressed the importance of viewing the face of the therapist, the establishment of a therapeutic bond and specific therapist qualities. Participants also reflected on issues around denial and avoidance associated with self-image and identity.

Discussion

There are nuanced and potentially unforeseen consequences of undertaking therapy for alcohol problems via video, relating to the significance of the therapy environment and relationship between client and therapist. This may include issues of shame, denial and avoidance, which are of particular significance for clients experiencing difficulties associated with alcohol.     

Aggressive disposition,alcohol, and aggression

This study investigated the effect of aggressive disposition on intoxicated and non-intoxicated aggressive behavior. Prior aggressiveness was measured with a structured questionnaire. Based on a bipartite split of scores, 28 subjects were assigned to the high aggressor group, and 29 to the low aggressor group. Subjects in both disposition groups were then randomly assigned to either a drunk or sober condition, and participated in a competitive reaction time task involving the administering and receiving of electric shocks to/from a fictitious opponent under conditions of high and low provocation. Aggression was defined as shock level intensity delivered to the sham opponent. When highly provoked, sober high aggressors were significantly more aggressive than low aggressors, thus validating the measure of aggressive disposition. When intoxicated, highly provoked individuals in both the high and low aggressive disposition groups attained equal levels of aggression. It was low aggressors who responded to escalated provocation with a significant increase in aggression responding when intoxicated. These results lend support to the notion that a pharmacological effect of alcohol can increase aggressive behaviour. Aggr. Behav. 23:11–18, 1997. © 1997 Wiley-Liss, Inc.     

Adolescent gambling and drug use

In this study, 4516 adolescents (aged 11–16 years) completed a questionnaire examining the relationship between underage National Lottery gambling, underage scratchcard gambling, cigarette smoking, drinking alcohol and drug use. It was found that these behaviours were closely linked. Adolescent gamblers reported that they were significantly more likely to drink alcohol (particularly ‘alcopops’), smoke tobacco and take drugs compared to non-gamblers. © 1998 John Wiley & Sons, Ltd.     

Self-medication Hypothesis and Family Socialization Theory: Examining Independent and Common Mechanisms Responsible for Binge Drinking

For many, binge drinking behaviors start early and become a persistent pattern of use throughout the lifespan. In an effort to strengthen understanding of etiology, this study considered the mechanisms from the self-medication hypothesis and family socialization theory. The goal was to identify whether emotional distress is a potential shared mechanism that accounts for the development of binge drinking in different developmental periods. This study used the National Longitudinal Study of Adolescent to Adult Health (Add Health) dataset to examine binge drinking across time for n = 9,421 participants ranging in age from 11 to 18 (M = 15.39, SD = 1.62) at Wave I and ranging from 24 to 32 (M = 28.09, SD = 1.61) at Wave IV of the study. Using an autoregressive cross-lagged model, I examined how parent-child closeness, depressive symptoms, and binge drinking were related over three developmental periods. In examining cross-sectional and longitudinal relations, depressive symptoms were significantly related to binge drinking more often than parent-child closeness; however, results indicated the self-medication model may primarily account for concurrent drinking behaviors rather than long-term. The family socialization theory was indicated to account for some variability above and beyond the self-medication hypothesis. No indirect association between binge drinking and the parent-child relationship was detected through depressive symptoms, failing to support a shared mechanism between the two theories. The results provide support for a multifaceted assessment process for substance using clients, and support the use of Multisystemic Family Therapy, Multidimensional Family Therapy, and perhaps Attachment-Based Family Therapy.     

Manipulation and force as sexual coercion tactics: conceptual and empirical differences

This study examines the relationship between perpetrator characteristics, situational characteristics, and type of sexual coercion tactics used to obtain sexual contact (including sexual intercourse) with an unwilling partner. Men who used manipulation or force were compared to each other and to men who engaged in only consensual sex. Participants were college men drawn from the first wave of a 5-year longitudinal study. Stepwise discriminant function analyses, univariate analyses of variance (ANOVA), and chi(2) analyses tested group differences. As predicted, men who used force reported more childhood sexual abuse, witnessed more domestic violence, were more accepting of male violence, and were less likely to endorse love as a motive for sex than men in both the manipulation and consent groups. Men in the force group were also more likely to have had a casual relationship with the woman, and to be drinking and also intoxicated during the coercive incident than men in the manipulation group. Hypothesized differences between men who used force and manipulation regarding parental physical punishment, traditional gender role attitudes, delinquency, hedonistic and dominance motives for sex, prior sexual contact, and the length of the relationship were not supported. The results suggest that types of tactic used in sexual assaults can be distinguished on the basis of person and situational variables and that knowledge of these differences can facilitate future research, as well as rape deterrent and intervention programs.     

青少年饮酒期望与饮酒行为的关系:追踪研究的证据

通过对1000余名青少年为期一年的追踪调查,探讨了青少年饮酒期望与饮酒行为之间的关系,同时考察了饮酒期望的发展和性别差异。研究结果表明:(1)一年来青少年的饮酒行为、饮酒消极期望和饮酒积极期望都显著增加;女生的饮酒行为和饮酒积极期望的增加都显著高于男生。(2)第二次测查时,青少年的饮酒行为、饮酒积极期望和饮酒消极期望高于一年前原同年级的学生。(3)饮酒积极期望、消极期望和饮酒行为之间的基本关系一年来没有发生变化:消极期望可能降低饮酒行为,积极期望可能增加饮酒行为,消极期望对积极期望与饮酒行为的关系具有显著的调节作用。但是消极期望对饮酒行为的作用降低,积极期望的作用升高。