The role of gender in the associations among posttraumatic stress disorder symptom,severity, difficulties regulating emotions,and alcohol misuse

IntroductionThe co-occurrence of posttraumatic stress disorder (PTSD) and alcohol misuse is highly prevalent and clinically significant. Delineating mediators (i.e., emotion regulation) and moderators (i.e., gender) of this co-occurrence is critical to understanding underlying mechanisms of such comorbidity and intervention development/refinement.MethodThe present study examined the potential mediating role of difficulties regulating negative and positive emotions in this association as well as the moderating role of gender using a moderated mediation analysis. Participants were 475 trauma-exposed community adults recruited from Amazon's Mechanical Turk (MTurk) platform (M_age = 35.62, 55.4% women, 77.0% White).ResultsDifficulties regulating positive (but not negative) emotions significantly mediated the relation between PTSD symptom severity and alcohol misuse. Further, gender was found to significantly moderate each of the paths in this mediation model.ConclusionsResults highlight gender-specific intervention targets for reducing alcohol misuse among trauma-exposed individuals who experience PTSD symptoms.     

Posttraumatic stress disorder and substance use: Identifying the underlying role of difficulties regulating positive emotions

The co-occurrence of posttraumatic stress disorder (PTSD) and substance use is clinically-relevant. Emotion dysregulation is one factor that has been shown to underlie this association. However, literature in this area has been limited in its exclusive focus on emotion dysregulation stemming from negative emotions. The goal of the current study was to extend prior research by exploring the role of difficulties regulating positive emotions in the associations between PTSD symptom severity and both alcohol use and problems from drug use. Participants were 463 trauma-exposed individuals recruited from Amazon's MTurk (M age = 35.66 years; 55.7% female; 76.6% White). PTSD symptom severity, difficulties regulating positive emotions, alcohol use, and problems from drug use demonstrated significant positive zero-order correlations. Further, difficulties regulating positive emotions were found to account for the associations between PTSD symptom severity and both alcohol use and problems from drug use. Our results suggest the potential utility of addressing difficulties regulating positive emotions in interventions aimed at reducing substance use and abuse among individuals with PTSD.     

The Mediating Role of Impulsivity Between Psychological Distress and Alcohol Misuse Among College Students at a Historically Black University

Objective: Alcohol misuse is prevalent and clinically significant among college students. Psychological distress is one factor that has been found to predict alcohol misuse in this population. However, relatively few investigations examined the association of psychological distress to alcohol misuse or its underlying mechanisms among students attending historically Black colleges and universities (HBCUs). The present study examined whether impulsivity explains the relation between psychological distress and alcohol misuse in this population using structural equation modeling. Methods: Participants were 287 undergraduate students attending an HBCU in the southern United States (M_age = 22.5, 66.3% female, 93.7% Black). Results: Impulsivity was found to significantly mediate the association of psychological distress to alcohol misuse, such that higher levels of psychological distress were associated with greater impulsivity which, in turn, was related to more alcohol misuse. Further analyses indicated that attentional impulsivity significantly mediated the association of psychological distress to alcohol misuse. Conclusions: These findings suggest the utility of targeting impulsivity in interventions aimed at preventing and reducing alcohol misuse among college students attending HBCUs who experience psychological distress.     

Posttraumatic Symptomatology and Alcohol Misuse Among Black College Students: Examining the Influence of Anxiety Sensitivity

Objective: Posttraumatic stress symptoms (PTSS) have been found to be associated with alcohol (mis)use among college students. Anxiety sensitivity has been theoretically and empirically linked to both PTSS and alcohol (mis)use. The goal of the present study was to extend research by examining the relations among PTSS, anxiety sensitivity, and alcohol misuse within a sample of trauma-exposed Black college students. Methods: Participants were 121 Black undergraduate college students who endorsed exposure to a traumatic event (M age = 22.98, 77.7% female). Results: Correlational findings provide support for significant positive relations between PTSS and both anxiety sensitivity and alcohol misuse. Further, analyses revealed a significant indirect effect of anxiety sensitivity on alcohol misuse through PTSS. Specifically, greater anxiety sensitivity was associated with higher levels of PTSS, which, in turn, were associated with higher levels of alcohol misuse. Conclusions: These findings suggest that the assessment of anxiety sensitivity may be useful in identifying trauma-exposed Black individuals who are likely to experience alcohol misuse and the clinical utility of addressing PTSS in this population reporting anxiety sensitivity to possibly prevent alcohol misuse and related negative consequences.     

Low rates of alcohol and tobacco use,strong cultural ties for Native American college students in the Southwest

IntroductionCollege attendance is associated with an increased risk for substance use yet we know little about substance use among Native American college students and its regional variation. This study examined alcohol, tobacco, and drug use and their relation to gender, institution, age, and cultural involvement among Native American college students in the Southwest.MethodsNative American community college and university students in a large Southwest city (N = 347) completed an online survey about past-month and lifetime substance use and involvement in cultural activities.ResultsCultural involvement was related to less past-month substance use. In the past month, 43% drank alcohol, 27% binge drank, 20% used drugs, and 13% were current smokers. Males, community college students, and older individuals were more likely to have a positive CAGE-AID and have used drugs more than 100 times. Younger individuals were more likely to use marijuana in the past month.ConclusionsThese findings highlight cultural strengths and comparatively low rates of tobacco and alcohol use among Native American college students in the Southwest.     

Attachment anxiety and avoidance,emotion dysregulation,interpersonal difficulties and alcohol problems in emerging adulthood

Background: Current models of alcohol problems in emerging adulthood (EA) have not fully considered the developmental context and integrated developmental, social, and emotional mechanisms. Attachment styles contribute to the development of emotion regulation and interpersonal functioning, which are both critical for managing periods of transition. The current study tested a model of alcohol problems in EA that considers emotion dysregulation and interpersonal difficulties as mediators of the relationship between attachment anxiety and avoidance and alcohol problems.

Method: Emerging adults (n?=?203, ages 18–24, 64.7% female) who drank 2?+?times in the past 30?days completed measures at baseline and for 30?days after the baseline assessment.

Results: Path analysis was used to test the indirect relationships between attachment anxiety and avoidance and alcohol problems via emotion dysregulation and interpersonal difficulties. There was a positive indirect relationship between anxious attachment and alcohol problems via both emotion dysregulation and interpersonal difficulties, and between avoidant attachment and alcohol problems via interpersonal difficulties, but not via emotion dysregulation. Follow-up analyzes examining pathways from attachment anxiety and avoidance to alcohol problems via the individual emotion dysregulation subscales revealed different emotion regulation pathways associated with higher anxious and avoidant attachment, but were generally in line with analyzes using a summed total score for emotion dysregulation.

Conclusions: Interventions for alcohol problems in emerging adults should consider anxious and avoidant attachment as precursors to alcohol problems and should include skills training in adaptive strategies for emotion regulation and interpersonal functioning.     

Alcohol misuse in psychiatric patients and nonclinical individuals: The role of emotion dysregulation and impulsivity

Notwithstanding the relevance of both emotion dysregulation and impulsivity to alcohol misuse, there is a dearth of study addressing their reciprocal interaction. The first aim of this study was to confirm the role played by difficulties in emotion regulation and trait impulsivity in explaining maladaptive alcohol use, comparing a mixed psychiatric sample (N?=?130; 64.4% males; mean age?=?43.30 years, SD?=?11.83) with community-dwelling individuals (N?=?307; 54.3% males; mean age?=?36.01 years, SD?=?11.88). Results corroborate this hypothesis, with emotion dysregulation and impulsiveness showing their significant association with alcohol misuse, and with levels of all these three components being significantly higher in the clinical sample. This study also extended extant research by explicating the hypothesised indirect effect of emotion dysregulation on alcohol misuse, through the effect of trait impulsivity. Results are also consistent with this latter hypothesis, with trait impulsivity accounting for the association between emotion dysregulation and alcohol misuse, albeit partially. As a whole, findings of this study highlight the potential utility of prevention and intervention efforts targeting emotion dysregulation and impulsivity in reducing alcohol misuse.     

Effects of an alcohol intervention on drinking among female college students with and without a recent history of sexual violence

Objective

Alcohol misuse among college students is a significant public health problem that can have negative long-term implications. One important correlate of problem drinking among college female populations is sexual violence. The current study investigated: (1) past year sexual violence and its association with alcohol consumption and related psychosocial variables (stress, coping, and mental health); and (2) whether the impact of an alcohol intervention was different for college women with a history of sexual violence compared to those without such a history.

Methods

Female undergraduate students (N = 351) who participated in the Brief Alcohol Screen in College Students (BASICS) completed web-based surveys measuring alcohol and drug use, psychosocial factors, and sexual violence at baseline and six-month follow-up.

Results

At baseline, women who experienced sexual violence reported less use of protective alcohol strategies, more positive coping skills, and more mental health symptoms. Following the intervention, alcohol consumption decreased significantly among the entire sample; however no significant differences in consumption were identified based on a history of sexual violence. Yet, compared to women not reporting sexual violence, women who reported recent sexual violence showed greater improvements in mental health outcomes (p < 0.05).

Conclusions

Findings suggest that brief alcohol interventions may have a differential impact on alcohol-related outcomes based on whether or not women have experienced recent sexual violence.     

Alcohol Use,Drug Use,and Sexual Activity among Pharmacy Students at Three Institutions

ObjectiveTo determine alcohol and drug use and sexual activity among pharmacy students at three colleges of pharmacy.Design and SettingA survey to obtain self-reported information on alcohol and drug use, and sexual activity was administered to professional pharmacy students at the University of Iowa (UI), Massachusetts College of Pharmacy, and Texas Southern University.Main Outcome MeasuresInformation on sexual activity and condom use, alcohol and drug consumption, and the effect of alcohol on unintended sexual activity.Results848 students (50% response rate) completed the survey. Alcohol use was high at all three institutions, and most students had consumed five or more drinks on one or more occasions within the last three months. The extent of drug use among pharmacy students was similar to that reported in other college students. The majority of students were sexually active. More men than women reported having been sexually active with one or more partners. Most students reported having had sexual intercourse without a condom. Significant numbers of students had engaged in unintended sex after alcohol use, especially at UI (χ² = 12.6, p = 0.002). Sexual contact and drinking were strongly correlated (Pearson r = 0.31, p = 0.0001).ConclusionAlcohol consumption among pharmacy students was high. Heavy drinking (five or more drinks on one occasion) was associated with unintended sexual contact. Given low condom use and increased sexual contact, pharmacy students are at an increased risk for HIV infection. Strategies should be developed to reduce alcohol intake and unprotected sexual activity among pharmacy students.     

In the eye of the drinker: Drinking motives influence the effectiveness of conditioning implicit alcohol attitudes

Risky alcohol use is prevalent among college students. Pre-intervention research has established methods of influencing alcohol cognition and reducing short-term alcohol consumption among students using evaluative conditioning (EC), repeatedly pairing alcohol with emotionally valenced images. Specifically, negative EC promotes negative attitudes toward alcohol, but additional research is needed to understand the range of EC effects and conditions under which it is or is not effective. For example, whether pairing alcohol with positive images promotes positive alcohol attitudes has not been tested. Further, drinking motives may influence the effectiveness of conditioning alcohol attitudes, since these motives are strongly associated with emotional stimuli like those presented in EC. The current experiment tested the interaction of drinking motives (coping and enhancement) and EC valence (negative or positive) on implicit alcohol avoidance. Participants (N = 95) were undergraduate students reporting active alcohol use. Results indicated no main effect of EC condition on implicit alcohol avoidance. However, drinking motives interacted with EC procedures assigned to participants. Those reporting greater coping motives exhibited less implicit alcohol avoidance following negative EC, whereas those reporting greater enhancement motives exhibited less alcohol avoidance following positive EC. Findings indicate drinking motives may influence the effectiveness of EC for altering alcohol attitudes. Negative EC did not promote alcohol avoidance among college students reporting higher coping motives, and positive EC only reduced avoidance among students reporting higher enhancement motives. These results indicate drinking motives interact with situational cues to impact both positive and negative responses to alcohol.     

Emotion dysregulation and cigarette dependence,perceptions of quitting,and problems during quit attempts among Spanish-speaking Latinx adult smokers

Latinx smokers in the United States (U.S.) represent an understudied health disparities group in terms of tobacco use. Despite scientific interest to elucidate individual difference risk factors for smoking, there is limited understanding of how emotional dysregulation relates to smoking outcomes among Spanish-speaking Latinx smokers. The purpose of the present investigation was therefore to explore emotion dysregulation in relation to cigarette dependence, perceived barriers for quitting, and severity of problems experienced during prior quit attempts. Participants were 363 Spanish-speaking Latinx daily smokers (58.7% female, M_age = 33.3 years, SD = 9.81). Results indicated that emotion dysregulation was significantly related to cigarette dependence, perceived barriers for quitting, and problems experienced during past quit attempts. Notably, the effects accounted for 7% to 15% of variance and were evident after adjusting for gender, income, education, number of medical conditions, depression symptoms, non-alcohol drug use, and alcohol consumption. The findings provide novel evidence that emotion dysregulation may represent an important individual difference factor for better understanding smoking-related outcomes among Latinx smokers and supports the need for greater attention to this affective vulnerability during smoking cessation treatment.     

Impulsivity-related traits,college alcohol beliefs,and alcohol outcomes: Examination of a prospective multiple mediation model among college students in Spain,Argentina, and USA

ObjectivesThe present study examined (both cross-sectionally and prospectively) the mediational role of college alcohol beliefs in the relationship between impulsivity-related traits and alcohol outcomes (i.e., alcohol use and negative consequences) among college student drinkers from the United States (U.S.), Spain, and Argentina.MethodA sample of 1429 (U.S. = 733, Spain = 292, Argentina = 404) drinkers (at least one drinking episode within the previous month) completed the baseline survey, and 242 drinkers completed the follow-up. To test study aims, a cross-sectional model was first employed to examine whether the proposed double-mediated paths (i.e., each dimension of impulsivity → college alcohol beliefs → alcohol use → negative alcohol-related consequences) extends across samples with different cultural backgrounds (i.e., structural invariance testing). A longitudinal model was then conducted to assess if college alcohol beliefs prospectively mediate the associations between trait impulsivity and alcohol outcomes.ResultsCollege alcohol beliefs were concurrently and prospectively associated with both greater alcohol use and increased number of negative alcohol-related consequences. These internalized beliefs about college student drinking culture significantly mediated the effects of several distinct impulsivity-related traits on alcohol-related outcomes including urgency (positive and negative), sensation seeking, and perseverance. These findings were invariant across gender and across three countries (Argentina, Spain, and the U.S.).ConclusionsOur findings highlight the modulatory role of cognitive factors on problematic alcohol use among college students with different cultural backgrounds. Our results suggest that, despite the cultural differences exhibited by these three countries, the unique and mediational effects of college alcohol beliefs appear relatively universal.     

Alcohol and cannabis use among college students: Substitutes or complements?

AimsEconomists debate whether changes in availability of alcohol or cannabis are positively or negatively related to changes in use of the other substance. Implicit in these arguments are two competing, individual-level hypotheses—that people use alcohol and cannabis either as complements or substitutes for one another. This is the first study to test these hypotheses using micro-longitudinal data on individuals' alcohol and cannabis use on a given evening.MethodsUnited States college students who use alcohol and cannabis (n = 876) were selected from a larger sample who participated in a 30-day online daily diary study. At baseline, students reported their proclivity to use alcohol/drugs to cope with stress. Each day students reported their level of alcohol use from the prior evening as well as whether they had used cannabis.ResultsEvening levels of alcohol use and mean levels of alcohol use positively predicted the likelihood of evening cannabis use, results indicative of complementary use. This relation, however, was moderated by coping style, such that students who were more likely to use alcohol/drugs to cope were less likely to use cannabis as their evening or mean alcohol use levels increased, results indicative of substitution.ConclusionsSubstance-using college students showed evidence for complementary alcohol and cannabis use at both the within- and between-person levels. Students with a proclivity toward using alcohol/drugs to cope, however, showed evidence of substitution. These findings suggest that studies based on economic theories of substance use should take into account individual differences in substance use motives.     

Key personality traits and alcohol use disorder symptoms in first and second year college students: detangling antecedent from consequence

BackgroundStudies have consistently shown that low constraint and high negative emotionality are associated with higher levels of alcohol use and greater alcohol related problems. Less research has examined associations between these traits and alcohol use disorder (AUD) from the first to second year of college, when alcohol use increases rapidly, or has evaluated gender differences in these associations.MethodsThe longitudinal College Experiences Study (N = 209, 60% female, 90% white) was used to detangle antecedent vs. consequence between constraint, negative emotionality, and AUD symptoms using multiple methods (cross-lagged panel analysis, latent difference score approach).ResultsProviding evidence for a scar/complication model, greater AUD symptoms in the first year of college was predictive of rank-order and correlated decreases in constraint in the second year, but only for males. Surprisingly, negative emotionality was not associated with AUD symptoms for either gender. Qualitative analyses show that the vast majority of those that met an AUD diagnosis (90%+) did not consider their drinking to be problematic.ConclusionGiven the vast majority of college students with AUD do not perceive their drinking to be problematic, results support the potential of using personality-based risk prevention/intervention programs to target at-risk individuals for problematic drinking, rather than targeting problematic drinking alone.     

Drug Misuse Among University Students in the UK: Implications for Prevention

Aims: The aim of the research was to identify the types of drugs currently being used by university students, their involvement in multiple drug misuse and drug combinations, and the consequences of drug misuse in terms of associated harms. Methods: The research was based on an email survey of all first- and second-year students registered as undergraduates at a university in south Wales during October 2012. Results: The results of the research showed that drug misuse on the university campus studied was widespread in terms of the types and patterns of drug misuse. The most troublesome findings concern the high levels of multiple drug use, the use of some of the most dangerous drugs (including crack and powder cocaine and heroin, as well as ketamine), and the list of recorded harms experienced as a result of drug misuse. Conclusions: The article concludes that little attention has been paid outside of the United States to drug use among university students or to interventions designed to prevent it. However, there are signs that government policy in the United Kingdom is beginning to pay attention to the specific problems of drug misuse among university students.     

Trauma exposure and heavy drinking and drug use among college students: Identifying the roles of negative and positive affect lability in a daily diary study

Trauma exposure is linked to heavy drinking and drug use among college students. Extant research reveals positive associations between negative affect lability and both trauma exposure and alcohol use. This study aimed to extend past research by using daily diary methods to test whether (a) individuals with (versus without) trauma exposure experience greater negative and positive affect lability, (b) negative and positive affect lability are associated with heavy drinking and drug use, and (c) negative and positive affect lability mediate the relations between trauma exposure and heavy drinking and drug use. Participants were 1640 college students (M age = 19.2, 54% female, 80% European American) who provided daily diary data for 30 days via online surveys. Daily diaries assessed negative and positive affect and substance use (i.e., percent days of heavy drinking, percent days of drug use, total number of drugs used). Individuals with (versus without) a history of trauma exposure demonstrated higher levels of negative and positive affect lability. Negative, but not positive, affect lability was associated with percent days of heavy drinking, percent days of drug use, and total number of drugs used, and mediated the associations between trauma exposure and heavy drinking and drug use outcomes. Findings provide support for the underlying role of negative affect lability in the relations between trauma exposure and heavy drinking and drug use among college students, suggesting that treatments targeting negative affect lability may potentially serve to reduce heavy drinking and drug use among trauma-exposed college students.     

Caffeine Use and Alexithymia in University Students

Alexithymia refers to difficulties with identifying, describing, and regulating one’s own emotions. This trait dimension has been linked to risky or harmful use of alcohol and illicit drugs; however, the most widely used psychoactive drug in the world, caffeine, has not been examined previously in relation to alexithymia. The present study assessed 106 male and female university students aged 18-30 years on their caffeine use in relation to several traits, including alexithymia. The 18 participants defined as alexithymic based on their Toronto Alexithymia Scale (TAS-20) scores reported consuming nearly twice as much caffeine per day as did non-alexithymic or borderline alexithymic participants. They also scored significantly higher than controls on indices of frontal lobe dysfunction as well as anxiety symptoms and sensitivity to punishment. In a hierarchical linear regression model, sensitivity to punishment negatively predicted daily caffeine intake, suggesting caffeine avoidance by trait-anxious individuals. Surprisingly, however, TAS-20 alexithymia scores positively predicted caffeine consumption. Possible reasons for the positive relationship between caffeine use and alexithymia are discussed, concluding that this outcome is tentatively consistent with the hypo-arousal model of alexithymia.