An investigation of intra-individual variability in children with fetal alcohol spectrum disorder (FASD)

Intra-individual variability (IIV) is defined as systematic within-person variation in performance either across test sessions (e.g., test/retest performance on the same task) or in one session (e.g., variations in performance on multiple trials of a single task). Higher levels of IIV have been noted as a characteristic of neurodevelopmental disorders such as attention deficit/hyperactivity disorder? (ADHD), but IIV is yet to be investigated in fetal alcohol spectrum disorder (FASD). FASD is a term used to describe a range of conditions resulting from prenatal exposure to alcohol. As part of a comprehensive neuropsychological battery, four study groups (1. fetal alcohol syndrome/partial fetal alcohol syndrome; 2. static encephalopathy/alcohol exposed; 3. neurobehavioral disorder/alcohol exposed as diagnosed using the University of Washington FASD 4-Digit Code; 4. typically-developing (TD) age-matched children with no prenatal alcohol exposure) were administered measures of motor response and inhibitory control, attention, and adaptive behavior. The results indicate increased levels of IIV in those with FASD compared to the TD controls. It was found that IIV uniquely contributes to predicting adaptive behavior above and beyond attention, while attention partially mediates the relationship between IIV and adaptive behavior. This is the first study to the authors’ knowledge to show the presence of increased IIV in children with FASD. It additionally provides evidence that IIV measures some inherent variability in performance independent of poor attention in children with FASD.     

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.     

Motives and Consequences of Alcohol Use in People With Social Anxiety Disorder: A Daily Diary Study

People with social anxiety disorder (SAD) are at increased risk for alcohol-related problems. Most research exploring social anxiety and alcohol use has examined negative drinking consequences, with less consideration of positive consequences—namely positive social experiences—that may reinforce alcohol use. In this daily diary study, we examined how adults diagnosed with SAD (N = 26) and a psychologically healthy control group (N = 28) experienced positive drinking consequences in naturally occurring drinking episodes during the study period. For 14 consecutive days, participants answered questions about alcohol use, motives for drinking, and positive consequences of drinking. On days when participants drank, those with SAD were more likely than healthy controls to perceive a reduction in anxiety, but the two groups did not differ in their likelihood of experiencing positive social drinking consequences. For both groups, on days when they were more motivated to drink to enhance social experiences (affiliation motives) or cope with distress (coping motives), they were more likely to obtain positive consequences from drinking. Compared to controls, participants with SAD endorsed stronger trait and daily coping motives (anxiety-coping, social anxiety-coping, and depression-coping). Results are discussed in the context of reinforcement mechanisms that may maintain social anxiety and alcohol use.     

Effects of blood alcohol testing programmes on drinking behaviour among driving crash patients in emergency departments: A cluster quasi-experimental study

This study aimed to evaluate the effectiveness of blood alcohol testing in decreasing the prevalence of current one-month drinkers among road traffic crash patients within emergency departments at one, two, and three months after a crash. A cluster quasi-experimental study was conducted on 600 crash patients who visited one of the emergency departments at 21 hospitals in Udon Thani province, Thailand. The hospitals were categorised into a (i) high-adherence hospital group (≥70% of all patients) and (ii) low-adherence hospital group (<70% of all patients) according to the compliance of blood alcohol testing in their emergency departments. The data were collected by a trained nurse using a structured questionnaire. The primary outcome was the prevalence of one-month current drinkers. We included 600 patients: 291 from six hospitals in the high-adherence group and 309 from 15 hospitals in the low-adherence group. The prevalence of one-month current drinkers significantly decreased in both the high-adherence and low-adherence groups. However, the prevalence of current drinkers at two and three months after a crash was not statistically significant compared to that one month prior to a crash (48.0% to 19.3% and 31.7% to 13.8% in the high- and low-adherence hospital groups, respectively; p < 0.05 from McNemar’s test). The effectiveness of blood alcohol testing in decreasing the prevalence of one-month current drinkers among traffic crash patients within emergency departments was observed to be statistically significant only at one month after a crash, and not at two and three months.     

我国酒精性肝病的医学困惑与应对策略

酒精性肝病是导致我国肝脏损害的第二大原因,已成为最严重的健康问题之一。我国已经迎来了酒精性肝病的高峰时期,并将会持续增长,卫生系统将面临巨大的压力。然而,对于酒精性肝病本身,还存在着诊断、治疗、预防等众多医学困惑;饮酒的危害不仅仅局限在肝脏,还可引起全身多器官的损害;酒害也早已超越了医疗界,是一个严重的社会问题。对于酒精性肝病的防治需要全社会共同参与,并且将是一条极其漫长而艰难的路程。     

The Links Between Social Anxiety Disorder,Insomnia Symptoms,and Alcohol Use Disorders: Findings From a Large Sample of Adolescents in the United States

Social anxiety disorder (SAD) is associated with increased risk of developing an alcohol use disorder (AUD). Most of the current literature has focused on the role of acute stress responding in this relation; however, both SAD and AUDs also are linked to insomnia symptoms (i.e., difficulty falling or staying asleep). As adolescence is a sensitive period for the onset of these disorders, the present study examined if insomnia symptoms might partially account for the SAD-AUD link in a large sample of adolescents. Data from the National Comorbidity Survey–Adolescent Supplement were examined. Participants (N = 10,140) completed interviews to assess past 12-month SAD and AUD diagnostic status as well as insomnia symptoms. Analyses tested whether insomnia symptoms accounted for a significant proportion of the SAD-AUD relation. Results indicated that insomnia symptoms were positively related to both SAD and AUD status, and the relation between SAD and AUD status was significantly reduced when insomnia symptoms were included in the model. Findings remained significant after controlling for the effects of age, gender, posttraumatic stress disorder, major depressive disorder, and other drug dependence status. Experimental examination and intensive longitudinal assessment of these relationships are needed before strong conclusions can be inferred about causality and temporal relationships. The current findings do indicate insomnia may be an important indirect and stigma-free treatment target to address in prevention and treatment efforts for SAD, AUDs, and their co-occurrence.     

Testing the properties of the triarchic model of psychopathy in a community sample: Self‐reported trait aggression and drug consumption associations

The triarchic model of psychopathy encompasses different conceptions of psychopathic personality characterized by three phenotypic components: boldness, disinhibition, and meanness. Psychopathy is a complex construct at both emotional and behavioral level. The aim of this study was to determine the core elements of psychopathic personality in a community sample and analyze the relation between these elements and other personality traits such as aggression, and certain specific behavioral manifestations such as substance use. The study sample comprised 1,159 participants aged between 17 and 74 years, who were administered the Triarchic Psychopathy Questionnaire, the Impulsive‐Premeditated Aggression Scale, and the Aggression Questionnaire. The results show that the constructs of meanness and disinhibition are more highly associated with different forms of both impulsive and premeditated aggression. Furthermore, men scored higher on all three components of the triarchic model compared to women. Finally, higher substance use (tobacco and drugs) was associated with higher scores in meanness, boldness, and disinhibition. These findings demonstrate the importance of assessing psychopathy in a community sample, and the detection of possible risk factors for the disorder.