Does gender moderate associations among impulsivity and health-risk behaviors?

The present study explores the relations among gender, impulsivity and three health-risk behaviors relevant to young adults (tobacco use, alcohol problems and gambling problems) in a sample of 197 college-age individuals. We sought to determine whether impulsivity is associated with health-risk behaviors in the same ways for men and women. For tobacco use and gambling problems, men were at higher risk than women, and impulsivity was not significantly associated with higher risk. Higher levels of motor impulsivity in men accounted for a significant amount of the gender difference in risk for alcohol problems. That is, impulsivity as measured by the Barratt Impulsiveness Scale (version 11), mediated the association between gender and risk for alcohol problems. For impulsivity as measured by Stop Signal Reaction Time (i.e. response inhibition), gender moderated the association between impulsivity and alcohol problems. Specifically, lower levels of impulsivity were associated with greater risk for alcohol problems in both men and women, but the effect was stronger in men. We speculate that this seemingly paradoxical result might be the result of coping drinking to deal with negative affect associated with behavioral overcontrol. These findings suggest that prevention efforts might well focus on identifying individuals at high risk for alcohol problems, especially males, by assessing response inhibition.     

Gender differences in the prediction of problem alcohol use in adulthood: exploring the influence of family factors and childhood maltreatment

OBJECTIVE: The purpose of this study was to contrast men and women in prospective relationships among family-oriented and alcohol-related variables obtained during adolescence, childhood physical, emotional and sexual abuse collected retrospectively, and later adult problem alcohol use. METHOD: In structural equation models, early family processes (support/bonding, parent drug-use problems, parental divorce and childhood maltreatment) and prior alcohol use simultaneously predicted adult problem alcohol use at two later time points in a longitudinal community sample of 426 (305 female) adults. RESULTS: Significant relationships were found among family processes, childhood maltreatment, and problem alcohol use within time and longitudinally for both men and women. Greater family support/bonding during adolescence predicted less problem alcohol use in adulthood. Men and women who experienced sexual abuse as a child reported more problem alcohol use in adulthood. Problem alcohol use was stable across time. Men reported more problem alcohol use in adolescence and adulthood, and women reported more early sexual abuse. These results contradict those that find no significant relationships between childhood abuse and subsequent alcohol-related problems. Parental drug use problems during the participant's adolescence did not directly predict problem alcohol use in adulthood. The relationship was more indirect in that parental drug use was associated with family-related concomitants that in turn were significant predictors of more problem alcohol use in adulthood. CONCLUSIONS: The strong stability for problem alcohol use across the three time periods is a signal that alcohol use in adolescence should not be ignored; furthermore, family dynamics need attention in addressing problem alcohol use.     

Child maltreatment,alcohol use and drinking consequences among male and female college students: An examination of drinking motives as mediators

Although the relationship between child maltreatment and alcohol use and drinking problems is well established, the mechanisms involved in this relationship remain largely unknown and research has focused primarily on women. Using the Modified Drinking Motives Questionnaire-Revised (M-DMQ-R; Grant, Stewart, O'Connor, Blackwell & Conrod, 2007), drinking motives were examined as mediators in the relationship between childhood maltreatment and alcohol consumption and consequences among male and female college student drinkers (N = 218, 60.6% women). Participants completed questionnaires assessing child maltreatment, drinking motives, alcohol consumption and alcohol consequences. Enhancement motives in particular mediated the relationship between childhood abuse and alcohol consequences for men, whereas coping-depression motives mediated this relationship for women. Implications of these findings for alcohol interventions and future research are discussed, along with limitations of the present study.     

Alcohol and Risks for HIV/AIDS Among Sexually Transmitted Infection Clinic Patients in Cape Town,South Africa

Abstract

Alcohol use is prevalent in South Africa and alcohol use may be associated with higher risk for HIV transmission. This paper reports a study of the association between alcohol use and HIV risk-related behavior among 134 men and 92 women receiving sexually transmitted infection (STI) clinic services in Cape Town, South Africa. Participants completed anonymous surveys of demographic information, substance use, and sexual risk behaviors. Results showed that problem drinking was common among STI clinic patients; 58% of men and 28% of women scored above a cut-off of 9 on the Alcohol Use Disorders Identification Test (AUDIT) suggesting possible problem drinking and 46% of men and 19% of women scored above 12 on the AUDIT indicating probable drinking problems. For men, heavier alcohol use was associated with having multiple sex partners in the past month, less condom use, and having a history of sexually assaulting women. Among women, higher scores on the AUDIT were also related to having multiple sex partners as well as a history of exchanging sex for money or materials. The association between alcohol use and sexual risk behaviors in a population at high-risk for HIV transmission demonstrates the need for integrating alcohol risk reduction counseling with HIV prevention counseling among STI clinic patients in South Africa.     

Childhood maltreatment and alcohol use in young adulthood: the role of self-regulation processes

IntroductionChildhood maltreatment has been linked to later alcohol use and disorders. Few studies have examined the pathways linking child maltreatment to alcohol use during the transition to adulthood. Currently, minimal understanding of such developmental pathways limits the success of alcohol prevention and intervention efforts for this highly vulnerable population. The present study examined if individual differences in self-regulation processes are critical factors that mediate the association between childhood maltreatment and risk for alcohol use.MethodYoung adults (N = 335; mean age = 21.7), who were recruited from the community, completed self-report measures of childhood maltreatment, different facets of self-regulation processes, and alcohol use. Multiple structural equation modeling (SEM) analyses were performed to specify the roles of two related, but different, self-regulation processes (i.e., behavioral self-control and behavioral dysregulation) in linking child maltreatment to four different patterns of drinking behaviors, including drinking frequency, binge drinking, alcohol-related problems, and alcohol dependence. Common risk factors for alcohol use, such as psychological symptoms and peer alcohol use, were also entered into the models.ResultsWe found that behavioral dysregulation particularly plays a mediating role in the associations between childhood emotional abuse and problematic alcohol use during young adulthood.ConclusionThe results of this research suggest that self-control processes would be potentially useful targets to prevent problematic alcohol use among young people who have had exposure to childhood maltreatment.     

Alcohol and risks for HIV/AIDS among sexually transmitted infection clinic patients in Cape Town, South Africa.

Alcohol use is prevalent in South Africa and alcohol use may be associated with higher risk for HIV transmission. This paper reports a study of the association between alcohol use and HIV risk-related behavior among 134 men and 92 women receiving sexually transmitted infection (STI) clinic services in Cape Town, South Africa. Participants completed anonymous surveys of demographic information, substance use, and sexual risk behaviors. Results showed that problem drinking was common among STI clinic patients; 58% of men and 28% of women scored above a cut-off of 9 on the Alcohol Use Disorders Identification Test (AUDIT) suggesting possible problem drinking and 46% of men and 19% of women scored above 12 on the AUDIT indicating probable drinking problems. For men, heavier alcohol use was associated with having multiple sex partners in the past month, less condom use, and having a history of sexually assaulting women. Among women, higher scores on the AUDIT were also related to having multiple sex partners as well as a history of exchanging sex for money or materials. The association between alcohol use and sexual risk behaviors in a population at high-risk for HIV transmission demonstrates the need for integrating alcohol risk reduction counseling with HIV prevention counseling among STI clinic patients in South Africa.     

Making the Transition from High School to College: The Role of Alcohol-Related Social Influence Factors in Students' Drinking

Using a sample of entering college freshmen (N = 311), the purposes of this study were to examine 1) whether perceived norms for college student alcohol use and problems differed by gender and level of intended Greek involvement (Greek intent); 2) associations between perceived norms, Greek intent, and alcohol use and problems; and 3) whether relations between perceived norms, Greek intent, and alcohol use and problems were moderated by gender. Results revealed no differences in levels of perceived norms for alcohol use and problems as a function of gender or intention to affiliate with a Greek letter organization. Perceived norms demonstrated consistent, significant associations with both alcohol use and problems, while Greek intent demonstrated significant associations only with alcohol problems. Examination of gender effects in associations between perceived norms, Greek intent, and alcohol use and problems revealed a number of differences in these relations. Specifically, Greek intent was significantly associated with measures of alcohol use and problems for men, but not for women. Likewise, the association between perceived norms and alcohol use and problems were significant for men, but not for women. Finally, although perceived norms were a significant predictor of heavy drinking for both men and women, the association was much stronger among male students. These findings suggest that alcohol prevention interventions may benefit from specifically targeting perceived norms among incoming students who are at highest risk (i.e., male pledges).     

Making the transition from high school to college: The role of alcohol‐related social influence factors in students' drinking

Using a sample of entering college freshmen (N = 311), the purposes of this study were to examine 1) whether perceived norms for college student alcohol use and problems differed by gender and level of intended Greek involvement (Greek intent); 2) associations between perceived norms, Greek intent, and alcohol use and problems; and 3) whether relations between perceived norms, Greek intent, and alcohol use and problems were moderated by gender. Results revealed no differences in levels of perceived norms for alcohol use and problems as a function of gender or intention to affiliate with a Greek letter organization. Perceived norms demonstrated consistent, significant associations with both alcohol use and problems, while Greek intent demonstrated significant associations only with alcohol problems. Examination of gender effects in associations between perceived norms, Greek intent, and alcohol use and problems revealed a number of differences in these relations. Specifically, Greek intent was significantly associated with measures of alcohol use and problems for men, but not for women. Likewise, the association between perceived norms and alcohol use and problems were significant for men, but not for women. Finally, although perceived norms were a significant predictor of heavy drinking for both men and women, the association was much stronger among male students. These findings suggest that alcohol prevention interventions may benefit from specifically targeting perceived norms among incoming students who are at highest risk (i.e., male pledges).     

Childhood Adversities and Substance Misuse Among the Incarcerated: Implications for Treatment and Practice in Correctional Settings

Background : Incarcerated populations have high rates of childhood adversities and substance use problems. Moreover, childhood adversities are well-documented predictors of substance misuse. Objective: To investigate the impact of childhood sexual and physical abuse, caregiver abuse of drugs or alcohol, and time spent in foster care on several substance misuse outcomes. Methods: Data comes from a sample of 16,043 incarcerated men and women in the United States Survey of Inmates in State and Federal Facilities. Bivariate analyses revealed differences by sex in childhood adversities and socioeconomic characteristics. Logistic regression analyses assessed the data for a link between childhood adversities and substance misuse after adjusting for other variables. Analyses were stratified by sex to show differences in predictors of substance misuse between men and women. Results: Childhood adversities increased the risk of many substance misuse outcomes. The prevalence of physical abuse, sexual abuse, foster care, and caretaker abuse of drugs or alcohol were greatest for inmates who reported injecting and sharing drugs. Growing up with a caregiver that used drugs or alcohol was a consistent predictor of increased risk of substance misuse for men and women. However, childhood sexual abuse increased risk for only women. Conclusions: Inmates who experience physical abuse, sexual abuse, foster care involvement and caretakers who use drugs and alcohol are at an increased risk of substance misuse, injecting drug use and syringe sharing. Implications suggest correctional HIV prevention and substance misuse programs must address unresolved trauma and important gender differences.     

Trauma-related risk factors for substance abuse among male versus female young adults

Clinical efforts to reduce risk for Substance Use Disorders (SUDs) among young adults rely on the empirical identification of risk factors for addictive behaviors in this population. Exposure to traumatic events and Posttraumatic Stress Disorder (PTSD) have been linked with SUDs in various populations. Emerging data, particularly from adolescent samples, suggest that traumatic event exposure increases risk for SUDs for young women, but not young men. The purpose of the current study was to examine trauma-related risk factors for alcohol and drug abuse among a national sample of young adults and compare such risk factors between men and women. Participants were 1753 young adults who participated in the 7–8 year follow-up telephone-based survey to the original National Survey of Adolescents. In the full sample, 29.1% met criteria for substance abuse. Trauma-related risk factors for alcohol and drug abuse differed for men and women. Clinical implications of these results are discussed.     

Event-level associations between affect,alcohol intoxication,and acute dependence symptoms: Effects of urgency,self-control,and drinking experience

This study used experience sampling to examine within-person associations between positive affect, anxiety, sadness, and hostility and two outcomes: alcohol intoxication and acute dependence symptoms. We examined the role of urgency, premeditation, and perseverance in predicting the alcohol outcomes and tested whether the affective associations varied as a function of urgency. Participants completed baseline assessments and 21 days of experience sampling on PDAs. Hypotheses were partially confirmed. Positive affect was positively, and sadness inversely, associated with intoxication. Hostility was associated with intoxication for men but not women. Negative urgency moderated the association between anxiety and intoxication, making it stronger. However, positive urgency did not moderate the effect of positive affect. Heavier drinkers exhibited the greatest number of symptoms, yet the association between intoxication and acute signs of alcohol disorder was attenuated among these individuals. Results support the use of experience sampling to study acute signs and symptoms of high risk drinking and dependence.     

Genome-wide analysis of emotional lability in adult attention deficit hyperactivity disorder (ADHD)

Emotional lability is strongly associated with Attention Deficit Hyperactivity Disorder (ADHD), represents a major source of impairment and predicts poor clinical outcome in ADHD. Given that no specific genes with a role in the co-occurrence of both conditions have been described, we conducted a GWAS of emotional lability in 563 adults with ADHD. Despite not reaching genome-wide significance, the results highlighted genes related with neurotransmission, cognitive function and a wide range of psychiatric disorders that have emotional lability as common clinical feature. By constructing polygenic risk scores on mood instability in the UK Biobank sample and assessing their association with emotional lability in our clinical dataset, we found suggestive evidence of common genetic variation contributing to emotional lability in general population and in clinically diagnosed ADHD. Although not conclusive, these tentative results are in agreement with previous studies that suggest emotion dysregulation as a transdiagnostic construct and highlight the need for further investigation to disentangle the genetic basis of mood instability in ADHD and co-occurring psychiatric disorders.     

Substance Use in Undergraduate Students With Histories of Attention-Deficit/Hyperactivity Disorder (ADHD): The Role of Impulsivity

Background: Emerging adulthood (18–25 years old) is regarded as a time of identity exploration that includes a peak in risky behaviors, such as substance use and misuse. Attention-deficit/hyperactivity disorder (ADHD) is also associated with greater levels of risky behaviors, including substance use and misuse; however, there is a lack of research on substance use by emerging adults with ADHD, in particular the potential mechanisms that may facilitate this risk. Objectives: The present study builds on the existing research regarding the association between ADHD and substance use by examining roles of multiple facets of impulsivity in facilitating this association during emerging adulthood. Methods: In a sample of 197 undergraduate students (24 students with an ADHD diagnostic history), we assessed for components of impulsivity (e.g., urgency, sensation-seeking) and rates of alcohol abuse, tobacco use, cannabis use, illicit drug use, and stimulant medication misuse within the past year. Results: Findings indicate that facets of impulsivity, as a whole, explained the association between an ADHD diagnostic history and both illicit drug use and alcohol abuse such that students with ADHD histories tended to report higher levels of impulsivity, which increased risk of alcohol abuse and illicit drug use. Higher levels of specific facets of impulsivity, particularly negative urgency, also facilitated associations between having ADHD and engaging in most forms of substance use tested herein. Conclusions/Importance: Specific facets of impulsivity appear to be important mediators of the association between ADHD and substance use, and should be considered as potential targets of substance use interventions for this population.     

The role of distress tolerance in the relationship between cognitive schemas and alcohol problems among college students

IntroductionThe current study tested the role of distress tolerance in the relationship between three early maladaptive cognitive schemas (Abandonment, Defectiveness/Shame, and Insufficient Self-Control) and alcohol problems among college students (N = 364). Previous research suggests that maladaptive cognitive schemas may be a risk factor for alcohol-related problems. However, the mechanism underlying this association is unclear. One's tolerance for emotional distress may play an important role in understanding the nature of this association.MethodsWe tested a structural equation model where distress tolerance was expected to explain or moderate associations between early maladaptive schemas and alcohol outcomes.ResultsResults indicated distress tolerance partially mediated the relationships between schemas of Abandonment and Insufficient Self-Control and alcohol problems. Distress tolerance also significantly moderated the relationship between the Defectiveness/Shame schema and alcohol-related problems, reducing the strength of the association.ConclusionsDistress tolerance is a modifiable risk factor and the results of this study support the inclusion of emotional regulation strategies in the prevention and treatment of alcohol problems among young adults.     

The contribution of emotional maltreatment to alcohol dependence in a treatment-seeking sample

Studies reporting a link between child maltreatment and addiction have typically focused on physical and sexual abuse. In contrast, emotional maltreatment has rarely been studied in substance-abusing samples although it is associated with a wide range of dysfunction. The current study aimed to determine the specific impact of different types of maltreatment and peer victimization on alcohol dependence and to examine the potentially mediating role of psychopathology. A sample of treatment seeking adults with alcohol dependence (N = 72) underwent an extensive clinical examination including both a standardized interview and self-report measures. Child maltreatment, peer victimization, severity of alcohol dependence, and general psychopathology were assessed. Regression analyses revealed that emotional maltreatment was the strongest predictor of alcohol dependence severity whereas a unique contribution of peer victimization was not found. Our findings suggest that emotional maltreatment might have a major role in the etiology of AD that seems to exceed the contribution of other abuse and victimization experiences. Thereby, the study underscores the need for considering child maltreatment experiences in the prevention and treatment of AD.     

ADHD,stimulant treatment in childhood and subsequent substance abuse in adulthood — A naturalistic long-term follow-up study

The purpose of the study was to estimate the risk of substance use disorder (SUD) and alcohol abuse in adulthood among children and adolescents with attention-deficit hyperactivity disorder (ADHD) compared to the background population. Furthermore, to examine whether the age at initiation and duration of stimulant treatment in childhood predicts SUD and alcohol abuse in adulthood. 208 youths with ADHD (183 boys; 25 girls) were followed prospectively. Diagnoses of SUD and alcohol abuse were obtained from The Danish Psychiatric Central Register. The relative risk (RR) of SUD and alcohol abuse for cases with ADHD, compared to the background population was 7.7 (4.3–13.9) and 5.2 (2.9–9.4), respectively. Female gender, conduct disorder in childhood and older age at initiation of stimulant treatment increased the risk of later SUD and alcohol abuse. Our results warrant increased focus on the possibly increased risk of substance abuse in females with ADHD compared to males with ADHD.     

Exploring the Relationship Between Alcohol Use,Childhood Maltreatment,and Treatment Needs Among Female Prisoners

Objective.?This study examined the relationship between child maltreatment and adult alcohol dependency among a sample of newly incarcerated female prisoners. Method.?This secondary data analysis utilized information gathered through face-to-face interviews with female inmates at intake (N = 1198) within the Texas prison system from 1998 to 1999. Results.?Using DSM-IV criteria we found that, among women who reported drinking at least 10 drinks in the last year, 40% scored as alcohol dependent. Bivariate findings revealed that women who were alcohol dependent were also more likely to have grown up in disorganized family situations, including parental drug and alcohol use-related problems, childhood neglect, and childhood physical and sexual abuse. As adults, these women were far more likely to have utilized mental health services and substance user treatment programs. Supportive of Widom and colleagues (), multivariate analyses revealed that childhood neglect (not physical or sexual abuse) was a significant predictor of alcohol dependency. Finally, among the alcohol dependent group, 62% indicated a willingness to participate in substance user treatment programs. Conclusions.?These findings emphasize that childhood neglect is related to long-term negative consequences in the form of alcohol use related problems in adulthood. Our findings strongly point to the need for improved screening, assessment procedures, and programming for women prisoners.     

Exploring the relationship between alcohol use, childhood maltreatment, and treatment needs among female prisoners

OBJECTIVE: This study examined the relationship between child maltreatment and adult alcohol dependency among a sample of newly incarcerated female prisoners. METHOD: This secondary data analysis utilized information gathered through face-to-face interviews with female inmates at intake (N = 1198) within the Texas prison system from 1998 to 1999. RESULTS: Using DSM-IV criteria we found that, among women who reported drinking at least 10 drinks in the last year, 40% scored as alcohol dependent. Bivariate findings revealed that women who were alcohol dependent were also more likely to have grown up in disorganized family situations, including parental drug and alcohol use-related problems, childhood neglect, and childhood physical and sexual abuse. As adults, these women were far more likely to have utilized mental health services and substance user treatment programs. Supportive of Widom and colleagues (1995), multivariate analyses revealed that childhood neglect (not physical or sexual abuse) was a significant predictor of alcohol dependency. Finally, among the alcohol dependent group, 62% indicated a willingness to participate in substance user treatment programs. CONCLUSIONS: These findings emphasize that childhood neglect is related to long-term negative consequences in the form of alcohol use related problems in adulthood. Our findings strongly point to the need for improved screening, assessment procedures, and programming for women prisoners.     

An affective and cognitive model of marijuana and alcohol problems

This study examined a six-month prospective model of marijuana and alcohol problems among college students. Among marijuana users, there was an indirect positive association between use utility and Time 1 (T1) marijuana-related problems through T1 marijuana use, whereas there was a direct positive association between affect lability and T1 marijuana-related problems. A multi-group analysis of alcohol problems compared models for users of alcohol and marijuana and users of alcohol only. For both groups, there was a direct positive association between T1 use utility and T2 alcohol consumption and an indirect association with T2 alcohol problems via alcohol consumption. Impulsivity was directly and positively associated with T1 alcohol problems among the alcohol-only group. For the alcohol-only group, impulsivity moderated the association between T2 consumption and problems, making it stronger. Associations between affect lability and alcohol problems as well as alcohol consumption and problems were stronger in the alcohol and marijuana group. Results support differential pathways to substance-related problems, an indirect pathway, in which problems are an unintended consequence of goal-directed use activity, as well as direct and interactive pathways in which problems may be viewed as consequences of broader regulatory problems.     

Discrimination, historical loss and enculturation: culturally specific risk and resiliency factors for alcohol abuse among American Indians

OBJECTIVE: This report investigates the effects of discrimination, historical loss and enculturation on meeting diagnostic criteria for 12-month alcohol abuse among American Indians who share a common culture in the upper Midwest. We introduce an empirical measure of historical loss and hypothesize that historical loss will mediate the effects of discrimination on meeting 12-month diagnostic criteria for alcohol abuse. We also hypothesize that enculturation will be negatively associated with 12-month alcohol abuse and mediate or moderate the effects of discrimination. METHOD: A sample of 452 (351 women) American-Indian parents/caretakers (mean age: women = 39 years, men = 42 years) of children ages 10 to 12 years participated in diagnostic interviews for lifetime and 12-month alcohol abuse. The subjects' perceptions of discrimination, historical loss and enculturation were also measured. Structural equation modeling was used to evaluate direct and potential mediating effects of latent constructs of enculturation (a resiliency factor) and historical loss (a risk factor) on the relationship between discrimination and meeting criteria for 12-month alcohol abuse. RESULTS: Historical loss mediated the effects of discrimination on 12-month alcohol abuse among women. Enculturation neither mediated nor moderated the effects of discrimination but had an independent negative effect on alcohol abuse. In a combined model comprising both enculturation and historical loss, the effects of discrimination on 12-month alcohol abuse were mediated. CONCLUSIONS: This study presents important new evidence that historical loss affects American-Indian alcohol abuse. It also provides evidence for the resiliency effects of enculturation on alcohol abuse.