Factors predictive of a fetal alcohol spectrum disorder: Neuropsychological assessment

A variety of neurodevelopmental impairments related to fetal alcohol spectrum disorder (FASD) diagnoses have been consistently documented. However, it is not clear whether such variables are predictive of a diagnosis. The purpose of the present study is to use logistic regressions to identify predictors of FASD in neuropsychological assessment. Charts of 180 children and adolescents with prenatal alcohol exposure (PAE) who underwent psychological and diagnostic assessment for FASD were retrospectively reviewed. A total of 107 received an FASD diagnosis (the PAE-FASD group) and 73 did not (the PAE group). Following preliminary analyses, direct logistic regressions were performed to assess the contribution of different neuropsychological testing measures on the likelihood of a child or adolescent receiving an FASD diagnosis. The results indicate that the classification accuracy of the PAE-FASD and PAE groups is clinically significant across models of intelligence, academic achievement, memory, and executive functioning. Classification rates across the various models range from 67.1% to 75.5%, with models incorporating 10 intelligence subtests or 3 academic subtests emerging as superior to those using broad indices of intelligence and/or individual subtests of memory or executive functioning. A “test battery” model incorporating verbal intelligence, verbal/auditory working memory (digit span), basic reading and spelling skills, math calculations, delayed story recall, and spatial planning and problem-solving yielded a classification rate of 74.7%. These results suggest that neuropsychological testing is a critical component of FASD assessment and help guide decisions to maximize the efficiency and efficacy of the diagnostic process and treatment recommendations.     

Posttraumatic stress severity is associated with coping motives for alcohol use among in-patient and community recruited adolescents

Background and Objectives: A growing body of work suggests individuals with more severe post-traumatic stress symptoms (PTSS) are at higher risk for developing problematic alcohol use outcomes. Extending work from the adult literature, the present study was the first to examine the extent to which PTSS is related to drinking motives for alcohol use in both clinical and non-clinical samples of adolescents.

Design: Hierarchical regression analyses were used to predict coping motives for alcohol use from PTSS, above and beyond demographic variables, alcohol use frequency, and other alcohol use motives.

Methods: Trauma-exposed adolescents before entering treatment (Sample 1 n?=?41) and recruited from the local community (Sample 2 n?=?55) self-reported on PTSS and alcohol use motives.

Results: PTSS positively predicted coping motives for alcohol use after controlling for age, gender, and alcohol use frequency.

Conclusions: The current study highlights the need to consider both PTSS severity, as well as underlying cognitive mechanisms (e.g., motives), to better understand the etiology of problematic alcohol use among trauma-exposed youth. Future work focused on clarifying the trajectory of alcohol use motives and problems as a function of PTSS is needed.     

Comorbid interpretation and expectancy bias in social anxiety and alcohol use

Background: In two studies, the present research examined whether being high in both social anxiety and alcohol use disorder symptoms is associated with a comorbid interpretation and expectancy bias that reflects their bidirectional relationship.

Design: Cross-sectional, quantitative surveys.

Methods: Measures of social anxiety and alcohol use disorder symptoms, as well as an interpretation and expectancy bias task assessing biases for social anxiety, drinking, and comorbid social anxiety and drinking.

Results: In Study 1 (N?=?447), individuals high (vs. low) in social anxiety had stronger social threat bias and individuals high (vs. low) in alcohol use disorder symptoms had stronger drinking bias. Those high in both social anxiety and alcohol use disorder symptoms endorsed interpretations and expectancies linking social interaction with alcohol use. Comorbid bias predicted membership into the high social anxiety/drinking group, even after taking into account single-disorder biases. In Study 2 (N?=?325), alcohol use disorder symptoms predicted drinking bias and social anxiety symptoms predicted social anxiety bias. Alcohol use disorder symptoms, social anxiety symptoms, and their interaction predicted comorbid interpretation and expectancy bias.

Conclusion: Results indicate unique cognitive vulnerability markers for persons with comorbid social anxiety and alcohol use disorder symptoms, which may improve detection and treatment of this serious comorbidity.     

A Brief Alcohol Intervention During Inpatient Psychiatric Hospitalization for Suicidal Adolescents

Alcohol use and suicide-related thoughts and behaviors are common in psychiatrically hospitalized adolescents and each problem can exacerbate the other. Despite knowledge about the functional relationship between alcohol use and suicide-related thoughts and behaviors, inpatient psychiatric units only cursorily address alcohol use because suicide risk is considered primary. In this paper we provide theoretical and empirical rationale for the inclusion of brief motivational interventions for alcohol use in inpatient treatment settings for suicidal adolescents. We give a case example of the brief intervention in practice, including when and how to use specific techniques. Following the case example, we discuss the flexibility of this intervention and how it can be adapted for adolescents with varying risk profiles. We conclude with recommendations for future research, including the development and testing of technology-based boosters following hospital discharge.     

Affordances for drinking alcohol: A non‐participant observation study in licensed premises

Alcohol misuse is a pressing area of public health concern. This non‐participant observational study investigated the functional characteristics of on‐licensed premises where alcohol is consumed. Seven different licensed premises from South Central England were visited and observed for similar three hour periods on Saturday evenings. Observations within these ecological niches were grouped using a functional taxonomy of affordances and effectivities related to alcohol drinking. Affordances provide a theoretically grounded and useful concept for evaluating how individuals behave in drinking contexts, while identifying action opportunities for inhibiting and promoting consumption. Identified alcohol‐related affordances were related to: Alcohol access, regulations, furnishing, alternative opportunities for action, décor and lighting, drink and accessory availability, and action opportunities provided by others. This research has implications for understanding alcohol consumption in real‐time, social environments, with direct implications for preventing excessive consumption within community alcohol outlets.     

A qualitative exploration of alcohol use among student sportspeople: A social identity perspective

Research indicates that university student sportspeople are a high‐risk subgroup for hazardous alcohol consumption. Adopting a social identity perspective, we explored the social and psychological processes linking sports participation and alcohol use. Twenty‐two individual semi‐structured interviews were conducted with UK student sportspeople (male: 12; female: 10). A deductive thematic analysis identified three core themes: social identification and sports group membership, identity processes in (alcohol) behaviours and sport context‐specific significance of alcohol. Results suggest that the consumptive practices among student sportspeople were strategic activities underpinned by social identity processes, and which served to provide a positive sports experience at the group level. Our findings highlight the interactions between the sport environment, the social structure of sport participation and the multipurpose function of alcohol in this context. We discuss the implications of these results in support of a social identity approach to sport‐related drinking.     

Episode-specific drinking-to-cope motivation and next-day stress-reactivity

Background: Research consistently shows drinking-to-cope (DTC) motivation is uniquely associated with drinking-related problems. We furthered this line of research by examining whether DTC motivation is predictive of processes indicative of poor emotion regulation. Specifically, we tested whether nighttime levels of episode-specific DTC motivation, controlling for drinking level, were associated with intensified affective reactions to stress the following day (i.e. stress-reactivity). Design and Methods: We used a micro-longitudinal design to test this hypothesis in two college student samples from demographically distinct institutions: a large, rural state university (N?=?1421; 54% female) and an urban historically Black college/university (N?=?452; 59% female). Results: In both samples the within-person association between daily stress and negative affect on days following drinking episodes was stronger in the positive direction when previous night's drinking was characterized by relatively higher levels of DTC motivation. We also found evidence among students at the state university that average levels of DTC motivation moderated the daily stress-negative affect association. Conclusions: Findings are consistent with the notion that DTC motivation confers a unique vulnerability that affects processes associated with emotion regulation.     

Religious perceptions of alcohol consumption and drinking behaviours among religious and non-religious groups

Evidence indicates that religious involvement is associated with lower levels of alcohol consumption. However, mechanisms underlying the specific effects of religion on alcohol behaviours are still not entirely clear. This study examined potential differences in religious perceptions of alcohol consumption (RePAC) among Christian, Buddhist, Muslim, and non-religious individuals, and between Catholic and Baptist Christian denominations. We also assessed whether these perceptions were associated with quantity and frequency of drinking. Participants (N?=?495; 79% female) aged 18 and above completed self-report measures of alcohol consumption and religious perceptions of alcohol use. Findings indicated that non-religious individuals and Buddhists reported higher RePAC scores (i.e., more favourable attitudes toward alcohol use), followed by Christians and then Muslims. Drinking quantity was more strongly associated with RePAC for Buddhists and Christians than the same association for non-religious participants. These results provide preliminary evidence linking religious perceptions of alcohol to drinking behaviours across religious affiliations.     

Aggression is associated with greater subsequent alcohol consumption: A shared neural basis in the ventral striatum

Alcohol use and abuse (e.g., binge drinking) are among the most reliable causes of aggressive behavior. Conversely, people with aggressive dispositions (e.g., intermittent explosive disorder) are at greater risk for subsequent substance abuse. Yet it remains unknown why aggression might promote subsequent alcohol use. Both aggressive acts and alcohol use are rewarding and linked to greater activity in neural reward circuitry. Through this shared instantiation of reward, aggression may then increase subsequent alcohol consumption. Supporting this mechanistic hypothesis, participants’ aggressive behavior directed at someone who had recently rejected them, was associated with more subsequent beer consumption on an ad‐lib drinking task. Using functional MRI, both aggressive behavior and beer consumption were associated with greater activity in the bilateral ventral striatum during acts of retaliatory aggression. These results imply that aggression is linked to subsequent alcohol abuse, and that a mechanism underlying this effect is likely to be the activation of the brain's reward circuitry during aggressive acts.