Hyperventilation, anxiety sensitivity, and the expectations for alcohol use: subjective and physiological reactivity to alcohol cues.

The present study examined the relation between alcohol-related expectancies, body sensation fear and reactions to cues for alcohol following a hyperventilation task. Forty-two undergraduate students participated for course credit. Each student hyperventilated for 5 min, paced at a rate of 30 breaths per minute. Following hyperventilation, each student was exposed to containers with alcohol (beer and wine coolers), with subjective urge to consume and heart rate measures taken. Path analysis supported models associated with tension reduction and self-focused attention expectancies as significant contributors to increased urge to consume alcohol and lowered heart rate following hyperventilation. However, social-anxiety-related expectancies failed to demonstrate a relationship. These results suggest that additional work on the tension reduction model of alcohol use should examine physiological stressors in association with subject characteristics such as proneness to experience panic symptoms.     

Controlled vaporized cannabis,with and without alcohol: subjective effects and oral fluid‐blood cannabinoid relationships

Vaporized cannabis and concurrent cannabis and alcohol intake are commonplace. We evaluated the subjective effects of cannabis, with and without alcohol, relative to blood and oral fluid (OF, advantageous for cannabis exposure screening) cannabinoid concentrations and OF/blood and OF/plasma vaporized‐cannabinoid relationships. Healthy adult occasional‐to‐moderate cannabis smokers received a vaporized placebo or active cannabis (2.9% and 6.7% Δ⁹‐tetrahydrocannabinol, THC) with or without oral low‐dose alcohol (~0.065g/210L peak breath alcohol concentration [BrAC]) in a within‐subjects design. Blood and OF were collected up to 8.3 h post‐dose and subjective effects measured at matched time points with visual‐analogue scales and 5‐point Likert scales. Linear mixed models evaluated subjective effects by THC concentration, BrAC, and interactions. Effects by time point were evaluated by dose‐wise analysis of variance (ANOVA). OF versus blood or plasma cannabinoid ratios and correlations were evaluated in paired‐positive specimens. Nineteen participants (13 men) completed the study. Blood THC concentration or BrAC significantly associated with subjective effects including ‘high’, while OF contamination prevented significant OF concentration associations <1.4 h post‐dose. Subjective effects persisted through 3.3–4.3 h, with alcohol potentiating the duration of the cannabis effects. Effect‐versus‐THC concentration and effect‐versus‐alcohol concentration hystereses were counterclockwise and clockwise, respectively. OF/blood and OF/plasma THC significantly correlated (all Spearman r≥0.71), but variability was high. Vaporized cannabis subjective effects were similar to those previously reported after smoking, with duration extended by concurrent alcohol. Cannabis intake was identified by OF testing, but OF concentration variability limited interpretation. Blood THC concentrations were more consistent across subjects and more accurate at predicting cannabis' subjective effects. Copyright © 2015 John Wiley & Sons, Ltd.     

Predictors and consequences of simultaneous alcohol and cannabis use in adolescents

Background/Aims

The simultaneous use of alcohol and cannabis is common among adolescents, but has been little studied. In this study, we examine predictors and consequences of this behavior in a population-based sample of high school students.

Method

Self-reports were obtained from students in Quebec (Canada) followed throughout high school (N = 6589). Logistic regressions were used to test the association between individual, family, and peer-related predictors in grades 7–8 and simultaneous alcohol and cannabis use in grade 10, as well as between simultaneous alcohol and cannabis use in grade 10 and experiencing 3 or more substance-related problems of various types (legal, physical, etc.) in grade 11.

Results

Most predictors in grades 7–8 were associated with simultaneous alcohol and cannabis use in grade 10. Only variables reflecting early-onset substance use involvement — alcohol intoxication, cannabis use, and drug use by close friend(s) — remained predictive in a multivariate model. Simultaneous alcohol and cannabis use was associated with increased substance-related problems in grade 11, above and beyond baseline problems and the concurrent use of the two substances in separate episodes in grade 10.

Conclusions

Simultaneous alcohol and cannabis use 1) is anticipated by multiple psychosocial risk factors which come together with individual and peer substance use in early high school and 2) is independently predictive of subsequent substance-related problems. Providing adolescents with adequate information regarding the potential harm of simultaneous use may be a useful prevention strategy.     

Bidis--hand-rolled, Indian cigarettes: effects on physiological, biochemical and subjective measures

Bidis, hand-rolled cigarettes imported from India, have become increasingly popular among US teenagers. These cigarettes are perceived as a safer, more natural alternative to conventional cigarette smoking. The present study was conducted to determine whether the acute effects of bidis and conventional cigarettes are similar. Undergraduate cigarette smokers with a history of bidi smoking were tested in two experimental sessions, using a within-subject design. Subjects smoked both a bidi and a conventional cigarette. Physiological and biochemical measures, subjective evaluations, and smoking behavior characteristics were obtained before, during, and after smoking each experimental cigarette. Although time to smoke and puffs per cigarette were significantly higher after the bidi, physiological and biochemical effects of bidi smoking were similar to those of smoking conventional cigarettes. Bidis were rated less satisfying than the conventional cigarette. However, there were no significant differences between the cigarettes in other subjective measures. Our results do not support the belief that bidis are a safe alternative to conventional cigarettes. Furthermore, bidi smoking, like conventional cigarette smoking, may lead to nicotine dependence.     

Extroversion, anxiety and the perceived effects of alcohol

To test the hypothesis that personality characteristics are related to alcohol-effect expectancies, 256 (115 men) college students were divided into groups on the basis of self-reported alcohol consumption and anxiety and introversion scores on the Sixteen Personality Factor Questionnaire. Three-way multivariate analyses of variance were conducted to determine expectancy differences by drinking behavior, personality characteristics and sex. Alcohol expectancy scores were found to vary with drinking behavior and personality measures. Elevated expectancy scores were associated with higher quantity-frequency measures of drinking; however, no significant sex differences were obtained. Extroverted students expected more social and physical pleasure, more relaxation and less arousal with drinking. Students with higher levels of trait anxiety expected more global positive changes, sexual enhancement, social assertion and arousal. The association of drinking behavior and personality with expectancies appears to be independent and additive.     

Clinical characteristics of treatment-seeking adolescents with opioid versus cannabis/alcohol use disorders

ObjectivesTo assess the clinical characteristics of adolescents with DSM-IV opioid use disorder (OUD) and compare them to adolescents with cannabis/alcohol use disorders.Method94 adolescents (ages 14–18 years) with a current OUD and 74 adolescents with a current non-OUD cannabis/alcohol use disorders were recruited from admissions, predominantly residential, to a substance abuse treatment program in Baltimore, ML. Participants were assessed cross-sectionally using standardized interviews and self-reports. Chi-square, t-tests and ANCOVA (adjusting for age, gender and treatment setting, race and residence) were performed to determine group differences on demographic, substance use, psychiatric and HIV-risk behaviors; logistic regression analyses, both unadjusted and adjusted for the above five factors were conducted to assess the strength of associations.ResultsThe OUD group was more likely to be Caucasian, to have dropped out of school and to live in the suburbs (trend). They also had greater substance use severity with higher proportion of current sedative and multiple substance use disorders (SUD). There were generally no differences in rates of criminal behaviors. Both groups had high rates of current psychiatric disorders (83% vs. 78%, n.s.) but the OUD adolescents reported higher depressive symptoms, mostly in the moderate range. Injection drug use (IDU) and needle sharing was almost exclusive to the OUD group, while both groups reported similar high rates of risky sexual behaviors.ConclusionsWhile there were similarities between the two groups, OUD adolescents evidenced greater impairment in academic, substance use, depressive symptom and IDU-related HIV-risk areas. Findings suggest poorer long-term prognosis and highlight the need for specialized interventions for treatment-seeking OUD adolescents.     

The relationship among depressive symptoms,urgency, and problematic alcohol and cannabis use in community adults

BackgroundThis study examined alternative models for how negative and positive urgency influence the relationship between depressive symptoms and alcohol and cannabis use in a community sample.MethodsParticipants included adults (n = 675; age = 42.57, SD = 15.66; 65.0% female; 74.2% White) in the community sample from the Rockland Project by the Nathan Kline Institute. Path analyses were conducted.ResultsNegative urgency was a unique mediator in the relationship between depressive symptoms and problematic alcohol use (β =0.121, 95% CI = 0.060–0.182) and problematic cannabis use (β =0.120, 95% CI = 0.060–0.179). Negative and positive urgency significantly moderated the relationship between depressive symptoms and problematic cannabis use (negative urgency: β = 0.092, 95% CI = 0.040–0.145; positive urgency: β = 0.070, 95% CI = 0.022–0.119), such that the relationship was positive at high levels and negative at low levels of urgency. The patterns and levels of the relationships between depressive symptoms and cannabis use differed between negative and positive urgency. Neither urgency trait moderated the relationship between depressive symptoms and problematic alcohol use.ConclusionsDespite being strongly related, negative and positive urgency have distinct roles in the relationship between depressive symptoms and problematic alcohol and cannabis use. Previous finding with younger samples that do not include both traits in the model at time generalize and at other times do not replicate, which warrants the continued examination of how these traits impart risk across the lifespan.     

Sleep patterns and problems among early adolescents: Associations with alcohol use

IntroductionSleep and sleep-related problems are associated with alcohol use and related problems among adults. However, existing research on associations between sleep and alcohol use among early adolescents is minimal, and potential individual and family factors that may affect this association remain largely unexplored. We examined potential associations between frequency of alcohol use and initial insomnia, subjective daytime sleepiness, sleep irregularity, and disturbed sleep among a low-income, ethnic minority sample of early adolescents; we also considered whether psychopathology symptoms and/or parental monitoring accounted for any associations found.Methods127 youth who participated in the Camden Youth Development Study (64 male; mean age = 13.2; 71% Hispanic, 32% African-American) were assessed using self-report measures of sleep, alcohol use, psychopathology symptoms (depressive and conduct disorder), and parental monitoring; in addition, teacher reports of attention-deficit hyperactivity disorder were used.ResultsInitial insomnia and daytime sleepiness (but not sleep irregularity or disturbed sleep) were associated with frequency of alcohol use. The association between initial insomnia and alcohol use remained significant when each form of psychopathology and parental monitoring were adjusted for.ConclusionsAmong early adolescents, frequency of alcohol use is associated with initial insomnia, even once symptoms of psychopathology and family environment (parental monitoring) are adjusted for. Longitudinal research investigating the direction of this effect and other possible mediators and moderators would be useful in developing preventative and treatment interventions.     

The influence of race and religion on abstinence from alcohol, cigarettes and marijuana among adolescents

OBJECTIVE: Past research has not fully explained why black youth are less likely than white youth to use alcohol and other substances. One plausible yet underexamined explanation is the "religion hypothesis," which posits that black youth are more likely than white youth to abstain because they are more religious than white youth. The present study tested this hypothesis empirically. METHOD: The study examined data from large, nationally representative samples of white and black 10th graders from the Monitoring the Future project. RESULTS: Relative to white students, black students are more likely to abstain from alcohol, cigarettes and marijuana and are more highly religious. Consistent with the "religiosity hypothesis," race differences in abstinence are substantially reduced when race differences in religiosity are controlled. Unexpectedly, however, highly religious white youth are more likely than highly religious black youth to abstain from alcohol and marijuana use. CONCLUSIONS: Although religion is an important protective factor against alcohol and other substance use for both white and black adolescents, it appears to impact white youth at an individual level, whereas for black youth the influence of religion seems greatest at the group level. Future research should seek to better understand the mechanisms through which religion promotes adolescents' abstinence from the use of drugs and should seek to explain why the magnitude of its effect varies for black and white adolescents.     

Impact of alcohol detoxification on anxiety and depressive symptoms

Anxiety and depression are frequently encountered 'collateral' symptoms in alcohol abusing subjects. The present study investigated the effect of detoxification on these symptoms over 4-5 weeks of abstinence from alcohol. Psychopathology and global functioning were assessed at baseline and at weekly intervals over this period from 28 alcoholics treated on an inpatient basis. At intake, they displayed high levels of anxiety and depression; also, global functioning was seriously impaired. Following detoxification, scores on all measures of psychopathology were notably reduced. These findings allude to the depression-inducing properties of alcohol, which should be considered in the differential diagnosis of mood symptoms in alcohol abusing individuals.     

Relations between dissociative experiences,borderline personality disorder symptoms and cannabis use in adolescents and young adults

The aim of the study was to evaluate the relations between cannabis use, dissociative experiences and borderline personality disorder symptoms. A convenient sample of 212 subjects composed of high school students completed questionnaires assessing cannabis use frequency, the symptoms of dependence, the symptoms of dissociation and borderline personality disorder using the Dissociative Experience Scale (DES) completed by a subscale measuring hyper-personalization/hyper-realization experiences and the Borderline Personality Inventory (BPI), respectively; 114 (54%) were cannabis users. Multiple regression analyses showed that the frequency of cannabis use was negatively predicted by the frequency of spontaneous experiences of absorption and imaginative involvement and positively predicted by the frequency of experiences of absorption and hyper-personalization and hyper-realization linked to cannabis use. Cannabis dependence was predicted only by borderline personality symptoms. Positive dissociative experiences appear to be an important element in the understanding of cannabis use in adolescents and young adults.     

The effects of smoking high nicotine cigarettes on prepulse inhibition, startle latency, and subjective responses

RATIONALE: Several previous investigations with animals and humans have suggested that nicotine enhances prepulse inhibition of the startle reflex (PPI). However, the administration of nicotine activates mesolimbic dopamine, and activation of mesolimbic dopamine is known to attenuate prepulse inhibition of the startle reflex (PPI), which might suggest that nicotine would decrease PPI. OBJECTIVE: The primary aim of this study was to test rigorously the effects of smoking high nicotine cigarettes on PPI and other measures (e.g., heart rate, craving, and mood) when the concentration of nicotine peaks in the brain (i.e., immediately after smoking). METHODS: Thirty smokers participated in two experimental sessions 1 week apart. Two high nicotine cigarettes were smoked in one session, and two control cigarettes were smoked in the other session after overnight deprivation. RESULTS: The results indicated that smoking the high nicotine cigarettes decreased PPI and that PPI increased across trials in both conditions. The interaction between nicotine dose and trial was not significant, although it appeared that high nicotine may have reversed an increase in PPI across trials in the control condition. High nicotine cigarettes also significantly increased heart rate, decreased the latency to peak startle response on control trials, but did not alter the magnitude of the startle response. DISCUSSION: The findings suggest that either high nicotine cigarettes reduced PPI, or possibly, that high nicotine cigarettes may have reversed an increase in PPI across trials as evident in the control condition.     

Use of cigarettes to improve affect and depressive symptoms in a longitudinal study of adolescents

Smoking to alleviate negative affect or improve physiological functioning (i.e., self-medication) is one explanation for the association between depression and smoking in adolescents. This study tests whether using cigarettes to improve mood or physiological functioning is associated with the onset, and change over time, of elevated depressive symptoms.     

Anxiety sensitivity components in relation to alcohol and cannabis use,motives, and problems in treatment-seeking cigarette smokers

Anxiety sensitivity (AS)— fear of anxiety symptoms and their potential negative consequences—has been implicated in the development of substance use problems and motivation to use substances for coping with distress, though the AS components (physical, cognitive, and social concerns) have not been studied extensively in relation to alcohol- and cannabis-related variables. In a cross-sectional design, self-report measures of AS and alcohol and cannabis use, motives, and problems were administered to 364 treatment-seeking cigarette smokers with a history of alcohol and cannabis use. In both adjusted and unadjusted analyses, linear regression models indicated that AS cognitive concerns are related to cannabis-use conformity motives, alcohol-use coping motives, and alcohol problems; AS physical and cognitive concerns are related to greater cannabis problems specifically in males; and AS social concerns are associated with greater social, coping, enhancement, and conformity drinking motives. AS cognitive and physical concerns were also related to greater alcohol and cannabis problems, respectively, in subsamples limited to 214 current alcohol users and 170 current cannabis users. Together with prior work, current findings suggest that it may be beneficial to focus more on addressing AS cognitive concerns in individuals with tobacco-alcohol problem comorbidity, whereas it may be beneficial to focus on addressing both AS physical and cognitive concerns in males with tobacco-cannabis problem comorbidity. In addition, cigarette smokers high in AS social concerns may benefit from relaxation training to lessen their social anxiety as well as behavioral activation to enhance their positive affect.     

The interactive effects of emotional clarity and cognitive reappraisal on problematic cannabis use among medical cannabis users

This study examined whether emotional clarity (i.e., the extent to which one can identify and understand the type and source of emotions one experiences) and cognitive reappraisal (i.e., altering how potentially emotion-eliciting situations are construed to change their emotional impact) would individually or jointly be associated with problematic cannabis use among individuals receiving cannabis for medical reasons (n = 153). Findings indicated that problematic cannabis use was predicted by the interaction between emotional clarity and cognitive reappraisal. In particular, low levels of emotional clarity combined with high levels of cognitive reappraisal predicted problematic cannabis use. The current study is the first to demonstrate the interactive effects of emotional clarity and the use of cognitive reappraisal in predicting substance use disorder outcomes. Such findings are important given the lack of empirical data demonstrating for whom and for which conditions cannabis is either beneficial or detrimental.     

Self-esteem and self-efficacy: Associations with alcohol consumption in a sample of adolescents in Northern Ireland

Background: Little is known about the factors that influence injecting drug users’ (IDUs) choice of outlet, and in particular why some IDUs might prefer to use pharmacies. Greater understanding of the influences on this choice will contribute to more sophisticated policy and programme responses for blood-borne virus prevention and for health and wellbeing programmes for people who inject drugs.

Method: In-depth interviews were conducted with 15 IDUs about their experiences of accessing injecting equipment from pharmacies that participated in the government-sponsored pharmacy needle and syringe scheme.

Results: A range of factors influenced participants’ decisions about equipment access. The advantages of the pharmacy scheme access included convenience, relative anonymity, increased positive feelings of self-worth when accessing equipment from pharmacies where they had a good relationship with staff, less police surveillance and access to a greater range of equipment than available in publicly funded Needle and Syringe Programmes. The disadvantages of pharmacy access included the cost of equipment and complications related to methadone dosing and equipment access.

Conclusion: Pharmacy access to injecting equipment is highly valued by IDUs. The results of this study direct attention to several elements of programme and policy in the area that would increase access to equipment from pharmacies relating to cost, need for exchange, police surveillance practices, out-of-hours access and anonymity.     

Associations between problematic gaming and psychiatric symptoms among adolescents in two samples

The aim of the present study was to investigate associations between problematic gaming and psychiatric symptoms among adolescents. Data from adolescents in the SALVe cohort, including adolescents in Västmanland who were born in 1997 and 1999 (N = 1868; 1034 girls), and data from consecutive adolescent psychiatric outpatients in Västmanland (N = 242; 169 girls) were analyzed. Adolescents self-rated on the Gaming Addiction Identification Test (GAIT), Adult ADHD Self-Report Scale Adolescent version (ASRS-A), Depression Self-Rating Scale Adolescent version (DSRS-A), Spence Children's Anxiety Scale (SCAS), and psychotic-like experiences (PLEs). Multivariable logistic regression analyses were performed, and adjusted for sex, age, study population, school bullying, family maltreatment, and interactions by sex, with two-way interactions between psychiatric measurements. Boys had higher self-rated problematic gaming in both samples, whereas girls self-rated higher in all psychiatric domains. Boys had more than eight times the probability, odds ratio (OR), of having problematic gaming. Symptoms of ADHD, depression and anxiety were associated with ORs of 2.43 (95% CI 1.44–4.11), 2.47 (95% CI 1.44–4.25), and 2.06 (95% CI 1.27–3.33), respectively, in relation to coexisting problematic gaming. Problematic gaming was associated with psychiatric symptoms in adolescents; when problematic gaming is considered, the probability of coexisting psychiatric symptoms should also be considered, and vice versa.     

Social anxiety and alcohol consumption: The role of alcohol expectancies and reward sensitivity

Although the relationship between social anxiety and alcohol consumption has been the subject of extensive exploration, previous studies have failed to draw consistent conclusions about the nature of this relationship.Gray [Gray, J.A. (1970). The psychophysiological basis of introversion–extraversion. Behaviour Research and Therapy, 8, 249–266] suggested that individuals who are sensitive to reward are likely to place themselves in potentially rewarding environments (e.g. pubs and clubs). As such these individuals will have a greater chance to experience and vicariously observe the effects of alcohol in these environments, leading to the formation and modification of alcohol expectancies. Consequently, reinforcement sensitivity theory and alcohol expectancies are inherently related, yet have remained disparate areas of research. In this study, a total of 454 young adults responded to a questionnaire assessing social anxiety, alcohol consumption, reward sensitivity and alcohol expectancies. Regression analyses revealed a positive relationship between reward sensitivity, expectations of tension reduction and increased confidence, and alcohol consumption. Expectations of tension reduction were observed to moderate the relationship between social anxiety and alcohol consumption. In addition, three-way relationships between reward sensitivity, alcohol expectancies and social anxiety were observed to predict alcohol consumption. Overall, these results suggest that both reward sensitivity and alcohol expectancies play a role in the relationship between social anxiety and alcohol consumption, and that inclusion of these constructs in further research may aid in further clarifying the mechanisms underlying comorbid social anxiety and alcohol abuse.     

The effects of energy drink in combination with alcohol on performance and subjective awareness

Rationale

This study investigated the coadministration of an energy drink with alcohol to study the effects on subjective intoxication and objective performance.

Objectives

This study aims to evaluate the objective and subjective effects of alcohol versus placebo at two alcohol doses, alone and in combination with an energy drink, in a balanced order, placebo-controlled, double-blind design.

Methods

Two groups of ten healthy volunteers, mean (SD) age of 24 (6.5), participated in the study. One group consumed energy drink containing 80?mg of caffeine and the other consumed a placebo drink, with both receiving two alcohol doses (0.046 and 0.087% breathalyser alcohol concentration). Tests included breath alcohol assessment, objective measures of performance (reaction time, word memory and Stroop task) and subjective visual analogue mood scales.

Results

Participants showed significantly impaired reaction time and memory after alcohol compared to the no alcohol condition and had poorer memory after the higher alcohol dose. Stroop performance was improved with the energy drink plus alcohol combination compared to the placebo drink plus alcohol combination. Participants felt significant subjective dose-related impairment after alcohol compared to no alcohol. Neither breath alcohol concentration nor the subjective measures showed a significant difference between the energy drink and the placebo energy drink when combined with alcohol.

Conclusions

Subjective effects reflected awareness of alcohol intoxication and sensitivity to increasing alcohol dose. There were no overall significant group differences for subjective measures between energy drink and placebo groups in the presence of alcohol and no evidence that the energy drink masked the subjective effects of alcohol at either dose.