How Individuals Feel About the Past,Present, and Future Bears Little Relation to Alcohol-Related Problems,Anxiety, and Depression: A Person-Centered Analysis in a University Sample

Previous studies using bivariate or correlational analyses have established a relationship between alcohol use, symptoms of anxiety and depression, and scores on a range of temporal psychology measures. Temporal psychology measures variously assess the cognitive or affective (or in some cases, both) engagement with the past, present, and future. Although developed and validated in adolescents, recent research has suggested that the Time Attitudes Scale is internally consistent and reliable in adults also. The present study is the first to apply a person-centered approach to assessing the relationship between scores on the Time Attitudes Scale and symptoms of anxiety, depression, and alcohol-related problems in adults. Participants were recruited from a University in England. Results support the validity and internal consistency of the Time Attitudes Scale. Meaningful time attitudes profiles emerged, however, taking the sample size into account, the only substantive finding showed that those with a negative time attitudes profile scored higher on depressive symptomatology than those with a positive profile. While elsewhere, Zimbardo Time Perspective Inventory scores have been shown to be meaningfully related to anxiety, depression and alcohol use, the present study questions the degree to which the affective dimension of temporal psychology is driving that relationship.     

Lifetime marijuana and alcohol use,and cognitive dysfunction in people with human immunodeficiency virus infection

ABSTRACT

Background: Substance use is common among people with human immunodeficiency virus (HIV) infection. Alcohol, marijuana, and HIV can have negative effects on cognition. Associations between current and lifetime marijuana and alcohol use and cognitive dysfunction in people with HIV infection were examined. Methods: Some 215 HIV-infected adults with Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) substance dependence or ever injection drug use were studied. In adjusted cross-sectional regression analyses associations were assessed between current marijuana use, current heavy alcohol use, lifetime marijuana use, lifetime alcohol use, duration of heavy alcohol use (the independent variables), and 3 measures of cognitive dysfunction (dependent variables): both the (i) memory and (ii) attention domains from the Montreal Cognitive Assessment (MoCA) and the (iii) 4-item cognitive function scale (CF4) from the Medical Outcomes Study HIV Health Survey (MOS-HIV). Analyses were adjusted for demographics, primary language, depressive symptoms, anxiety, comorbidities, antiretroviral therapy, hepatitis C virus (ever), duration of HIV infection (years), HIV-viral load (log copies/mL), CD4 cell count, lifetime and recent cocaine use, and recent illicit and prescribed opioid use. Results: Current marijuana use was significantly and negatively associated with the MOS-HIV CF4 score (adjusted mean difference = ?0.40, P = .01). Current marijuana use was not significantly associated with either MoCA score. Lifetime marijuana use and current heavy and lifetime alcohol use and duration of heavy alcohol use were not associated with any measure of cognitive dysfunction. Conclusion: Current marijuana use was associated with one measure of cognitive dysfunction, but there was not a consistent pattern of association with lifetime marijuana use or alcohol use and measures of cognitive dysfunction. Understanding the mechanism by which marijuana, with and without alcohol, are associated with worse cognition warrants larger, longer studies with more precise and diverse measurements of cognitive function.     

Retrieval strategies and cultural differences in answering survey questions on drinking: A cross-national comparison

Aim. This research compares retrieval strategies and cultural differences in answering survey questions using protocol analysis on four alcohol use items: frequency of drinking, quantity of drinking, frequency of drunkenness, and the context of drinking in the last 12 months. Data. The data came from a project to improve the comparability of health behaviour surveys in Europe (the EuroHIS study). The participating countries were Finland, Germany, Italy and the Netherlands, results from which form the basis of this article. In each country 21 to 45 voluntary respondents were recruited for interviews. Results. Overall, the comparison between the four countries shows: (a) a remarkable similarity in profiles of cognitive strategies in answering survey questions, (b) an equally remarkable difference in the number of uses of different strategies and (c) important differences relating to cultural understanding on certain specific questions. Conclusions. These results suggest variation across countries in cognitive strategies and cultural sensitivity with respect to survey questions on alcohol. Part of these differences can be interpreted in the context of differences in drinking patterns and culture. Although differences in cognitive strategies and cultural sensitivity are embedded in drinking patterns and drinking culture, these differences do not necessarily invalidate the answers to the survey questions. However, further and more controlled studies are needed to assess the extent to which there are cross-national differences in the validity of answers to questions about alcohol consumption.     

Lifetime alcohol use and cognitive performance in older adults

Substance use is an important clinical issue in the older adult population. As older adults are susceptible to cognitive disorders, the intersection of the fields of substance use and cognitive neuroscience is an active area of research. Prior studies of alcohol use and cognitive performance are mixed, and inconsistencies may be due to under- or over-adjustment for confounders. This article adds to this literature by conducting a secondary analysis of self-reported lifetime history of alcohol use and cognitive performance in older adults (n = 133). It was hypothesized that current alcohol users would have poorer cognitive performance compared to never/minimal and former alcohol users. Older adult participants were classified into never/minimal alcohol users, former alcohol users, and current alcohol users. A neurocognitive battery included a global cognitive measure and individual measures of attention, memory, fluency, and executive function. A directed acyclic graph-based approach was used to select variables to be included in the multiple linear regression models. Though unadjusted analyses showed some significant associations between alcohol use and cognitive performance, all associations between alcohol use and cognitive performance were eliminated after adjusting for age, education, sex, race, and smoking pack years. Alcohol drink years were not significantly associated with cognitive performance among current and former alcohol users. These results suggest that lifetime alcohol use is not significantly associated with cognitive performance in older adults after adjustment for key confounders. Inconsistencies in prior studies may be due to uncontrolled confounding and/or unnecessary adjustment of mediators and/or colliders.     

Alexithymia,Impulsivity, and Reward Sensitivity in Young Adult University Student Children of Alcoholics

Background and Objectives: Personality traits previously known as risk factors for alcohol use disorder (AUD) were assessed in 29 young adult children of alcoholics (COAs) and 68 young adult children of nonalcoholics (non-COAs). Male and female university students (M_age?=?22.11?years) completed questions pertaining to demographics and alcohol use, and the Children of Alcoholics Screening Test; Toronto Alexithymia Scale; Barratt Impulsiveness Scale; Sensitivity to Punishment and Sensitivity to Reward Questionnaire; and Depression Anxiety Stress Scales. Results: Results indicated that personality traits of alexithymia, reward sensitivity, and impulsivity, as well as negative moods, were significantly elevated in COAs compared to non-COAs, independent of current alcohol consumption and drinking history. Conclusions: Findings are consistent with familial transmission of AUD-associated personality traits in COAs, presumably via influences of genetics and/or familial environment.     

Consistency between adolescent reports and adult retrospective reports of adolescent marijuana use: explanations of inconsistent reporting among an African American population

Drug use trends are typically monitored by surveys of retrospective self-reports of drug use; yet we know little about the consistency of reports made across the life course. This study examines the consistency of marijuana self-reports from adolescence and adulthood and what characterizes inconsistent reporting among a cohort of African American first graders followed longitudinally from age 6 to 32 (N=599, 51% female). Self-reported lifetime adolescent marijuana use (ages 16-17) and retrospective reports at age 32 were combined to categorize respondents as consistent reporters of nonuse (22%), consistent reporters of use (42%), adult recanters (19%), adolescent underreporters (8%), and inconsistent reporters of age of initiation (9%). Overall, about 64% of the population were consistent in their reports of adolescent marijuana use from adolescence to age 32. Multivariate logistic regression analyses found that recanters reported less marijuana use as adolescents, lower parental supervision during adolescence, lower deviant behavior as an adult, and stronger anti-drug values as adults than did consistent reporters. Adolescent underreporters reported less assault behaviors and less alcohol use as adolescents and had lower first grade math achievement than consistent reporters. Family background, depression, criminal arrests, and the field conditions of the interview were not related to inconsistent reporting.     

Development and evaluation of two instruments for assessing screening,brief intervention,and referral to treatment (SBIRT) competency

Background: Screening, brief intervention, and referral to treatment (SBIRT) is shown to be effective in identifying, intervening with, and making appropriate referrals for patients with unhealthy alcohol use. SBIRT training consists of knowledge-based and skill-based components and has increased the use of screening and intervention skills in clinical settings. This article reports on the development and evaluation of 2 SBIRT proficiency checklists for use across institutions to assess SBIRT skills in both simulated and clinical encounters. Methods: A national panel of 16 experts identified 137 discrete SBIRT skills items for the checklists. From this final list, 2 proficiency checklists were derived: the SBIRT Proficiency Checklist (SPC), composed of 22 questions for videotaped interviews, and the Clinical SBIRT Proficiency Checklist (CSPC), composed of 13 questions for direct clinical observation. An evaluation was conducted to test the reliability of the SPC and to assess the utility of the CSPC. Results: Two checklists for assessing SBIRT proficiency were developed by a collaborative workgroup. Fleiss' kappa analyses indicated moderate agreement. In addition, faculty recorded satisfaction with the CSPC for assessing residents on their SBIRT performance during clinical encounters. Conclusions: The SPC and the CSPC are practical tools for assessing competence with SBIRT and are easily integrated as standard instruments in a wide range of training settings. Future advancements to the checklists and their evaluation include modification of the SPC rating scale to be consistent with the CSPC, developing a training program for using the checklists, and further testing to improve interrater reliability.     

Health-related material needs and substance use among emergency department patients

Abstract

Background: Emergency department (ED) visits related to substance use are common. ED patients also have high levels of health-related material needs (HRMNs), such as homelessness and food insecurity. However, little research has examined the intersection between ED patient HRMNs and substance use. Methods: We surveyed a random sample of public hospital ED patients. Surveys included validated single-item screeners for unhealthy alcohol and any drug use and questions on self-reported past-year material needs. We compared individual HRMNs and cumulative number of HRMNs by substance use screening status using bivariate and multivariable analyses. Results: A total of 2312 surveys were completed. Nearly one third of patients (32.3%, n?=?747) screened positive for unhealthy alcohol use, and 21.8% (n?=?503) screened positive for drug use. Prevalence of HRMNs for all patients—including food insecurity (50.8%), inability to meet essential expenses (40.8%), cost barriers to medical care (24.6%), employment issues (23.8%), and homelessness (21.4%)—was high and was significantly higher for patients with unhealthy alcohol use or drug use. In multivariable analyses, homelessness was independently associated with unhealthy alcohol use (adjusted odds ratio [aOR]: 1.61, 95% confidence interval [CI]: 1.24–2.09) and drug use (aOR: 2.30, 95% CI: 1.74–3.05). There was a significant stepwise increase in the odds of patient unhealthy alcohol or drug use as number of HRMNs increased. Conclusions: ED patients with unhealthy alcohol or drug use have higher prevalence of HRMNs than those without. Our findings suggest that HRMNs may act additively and that homelessness is particularly salient. Patients’ comorbid HRMNs may affect the success of ED-based substance use interventions.     

Work-place screening of mine employees using the alcohol use disorders identification test (AUDIT) and alcohol breathalyzation

Although public health campaigns focusing on alcohol in the work-place are receiving increasing attention, there is little empirical evidence regarding the use of screening. In this work-place study, 152 mining personnel (67% of the work-force) completed a self report screen using the Alcohol Use Disorders Identification Test (AUDIT). One hundred and thirty-three of these (58.5% of the work-force) also consented to be breathalysed and one (0.75%) recorded a BAC just over threshold for detection. Forty-eight males (37.7% of the male work-force) recorded AUDIT scores of eight or more consistent with hazardous alcohol use and one female registered a cumulative score above the female cut-off level for hazardous alcohol use. Eighty males (67% of the work-force), recorded binge drinking at least monthly and 81 males recorded a cumulative AUDIT score of less than eight; however, on item analysis, 64 (83%) of these recorded binge drinking at least sometimes. There is substantial hazardous alcohol use in this sample work group and younger males had higher alcohol consumption, more adverse consequences and higher total AUDIT scores identifying them as particularly at risk. The Cronbach & AUDIT was 0.72, confirming adequate internal consistency.     

Use of Alcohol Protective Behavioral Strategies as a Moderator of the Alcohol Use–Consequences Relationship: Evidence from Multiple Replications

Background: The use of protective behavioral strategies (PBS) has been found to attenuate the relationship between alcohol use and related consequences. Objectives: The current study examined PBS use as a moderator of the association between alcohol use and consequences in multiple samples (N?= 9) of college students with different sample sizes (e.g., ns 125–736). We also examined sex as a moderator of the PBS moderation analyses. Across all samples, we predicted that the use of more PBS would attenuate the use–consequences relation. Methods: In total, 3,524 college students completed online measures of alcohol use, consequences, and PBS use (i.e., PBSS) across two sites. Conclusions/importance: In the analyses, 3 two-way interactions were consistent with the literature (i.e., use–consequences relation weakest among those with high PBS use), 6 were opposite of what was reported in the literature (i.e., use–consequences relation strongest among those with high PBS use), and 39 were not statistically significant. These results corroborate, contradict, and extend the current body of knowledge in the extant alcohol PBS literature. In the examination of three-way interactions in the combined sample, serious harm reduction (SHR) PBS was found to moderate the use–consequences relation among female, but not among male students. Specifically, the use–consequences relation was weakest among female students who used more SHR PBS indicating that SHR PBS may be an important intervention target for female college students. Additional experimental and longitudinal studies are needed to examine the effects of PBS use on the use–consequences relation.     

Validation of the Comprehensive Effects of Alcohol Questionnaire in Older Adults

Background: Alcohol expectancies have been established as an important construct in the prediction of alcohol use among younger adults, but there is little understanding about the perceived expected effects of consuming alcohol in older adults. Beliefs about the expected effects of alcohol may be quite different in older adults compared to young adults, which may also play a different role in their drinking behavior. In older cohorts there may be stigma may be associated with drinking and the nature of drinking experiences may differ to those of younger adults. Existing measures of expectancies are based on the perspectives of younger adults and therefore warrant validation in an older sample. Objectives: The aim of this study is to validate the comprehensive effects of alcohol questionnaire (CEOA) in a sample of older adults, and to investigate the relationships between alcohol expectancies, their evaluations and alcohol use. Methods: A sample of community dwelling older adults (N?=?473) completed self-report measures assessing drinking behavior and alcohol expectancies. Exploratory factor analysis, confirmatory factor analysis, and hierarchical multiple regressions were conducted. Results: The final model of the CEOA supported two global dimensions of positive and negative expectancies, and showed excellent goodness-of-fit and internal consistency. Male drinkers were more likely to endorse positive expectancies and favorable evaluations of positive and negative expectancies. Favorable evaluations of positive expectancies were the strongest predictors of drinking frequency and quantity. Conclusions/Importance: The results support for the empirical validity of a two-factor expectancy model consisting of a 10-item negative expectancy factor and a 10-item positive expectancy factor. This more concise version could offer a more acceptable and time efficient measure of expectancies and valuations for older adults. Furthermore, the study provides important findings for the role of evaluations in their prediction of alcohol use.     

The validity of an Australian modification of the AUDIT questionnaire

The Alcohol Use Disorders Identification Test (AUDIT) has been used widely and is reported to be superior to conventional questionnaires in detection of current hazardous and harmful alcohol use. We assessed the validity of an Australian modification of the AUDIT (the AusAUDIT), which has been employed widely in Australian and New Zealand early intervention programmes. We used a cross-sectional study of 370 subjects from the follow-up phase of a randomized controlled trial of early intervention to reduce hazardous alcohol consumption. Scores on the AusAUDIT were compared against 12-month ICD-10 diagnoses of harmful alcohol use and dependence, as determined by the Composite International Diagnostic Interview, and against self-report of alcohol consumption exceeding Australian National Health and Medical Research Council (NH&MRC) recommended limits. AusAUDIT had good internal consistency and discriminated significantly between persons meeting criteria for ICD-10 alcohol use disorders, and drinkers who did not. At currently recommended cut-off scores, AusAUDIT detected more than 85% of people meeting criteria for ICD-10 alcohol use disorders, or drinking over NH&MRC recommended limits, but its specificity was limited (29% in men, and 58% in women for drinking over NH&MRC limits). No subset of questions performed as well as the full AusAUDIT in detection of drinking problems, but the alcohol consumption items provided a reasonable screen for drinking over NH&MRC limits. We conclude that AusAUDIT is effective in detecting problematic drinking, but positive cases should be confirmed by clinical assessment. The findings illustrate the need for validation of questionnaire modifications, and the difficulty in increasing test sensitivity without reducing specificity. \[Degenhardt LJ, Conigrave KM, Wutzke SE, Saunders JB. The validity of an Australian modification of the AUDIT questionnaire. Drug Alcohol Rev 2001;20:143-154]     

Self-report stability of adolescent substance use: are there differences for gender, ethnicity and age?

This study used the National Longitudinal Survey of Youth and is the first to examine a 2-year report stability of substance use among adolescents while stratifying for gender, ethnicity, and age. This study examined lifetime use and age at onset report stability, and the internal consistency of reports while excluding nonusers and incident cases (respondents who may have initiated substance use between the two reporting periods) from the analyses. Report agreement of lifetime use for each substance was over 80% and was highest among alcohol users and lowest for cigarette and marijuana users. Report agreement was higher for female compared to male cigarette users. External consistency of lifetime use of cigarettes and marijuana was higher for whites compared to Hispanic or African American adolescents. Internal consistency was high but lifetime use reports were more stable than age at onset reports.     

Attitudes towards substance use and substance use disorders among medical students in Israel

Background: Negative attitudes towards substance use and Substance Use Disorders (SUDs) are among the commonly cited barriers to screening and treating these disorders by physicians. These negative attitudes have also been reported in medical students. The aim of this study was to examine attitudes of medical students in Israel towards nicotine, alcohol and drug use and SUDs based on their stage of training and personal experience. Methods: A sample of 329 medical students responded to the Attitudes Towards Substance Use questionnaire, which includes 50 questions regarding substance use and SUDs, as well as specific questions focusing on nicotine, alcohol, cannabis and heroin use. Results: Students at the clinical phase of their training had higher rates of moralism and lower rates of self-reported competency in treating SUDs compared to those in the pre-clinical phase of training. Personal experience with nicotine or alcohol use, as well as having a friend who suffers from addiction, were associated with lower rates of moralism. Across substances, the lowest ratings of treatment efficacy and of self-reported competence, were directed towards alcohol dependence. Conclusions: Medical education programs should include training in addiction medicine throughout all phases of medical school. This may have a significant role in future physicians’ attitudes towards individuals with substance use and SUDs, and eventually in the treatment these patients receive.     

Measurement of negative consequences of substance use in street youth: an expanded use of the Rutgers Alcohol Problem Index

The Rutgers Alcohol Problem Index (RAPI) was used to assess negative consequences due to both alcohol and drug use. Data were collected from 173 substance using homeless adolescents (13-19 years of age, 58% male) who were grouped based on the substances rated: alcohol only, alcohol and drugs, or drugs only. The RAPI retained good internal consistency across substance categories, exhibited strong measurement construct congruence, and good convergent validity based upon correlations with assessed DSM diagnostic criteria (both dependence and abuse). Discussion focuses on the RAPI as a reliable instrument for the measurement of negative consequences for alcohol and drug use.     

Neurocognitive Functioning and Treatment Outcome Following Detoxification Among Asian Alcohol-Dependent Inpatients

Background: The prevalence of alcohol use disorders in Asia is increasing and relapse among treated populations remains the norm, not the exception. The extent to which cognitive impairment influences clinical outcome remains unclear, with research dominated by studies of Caucasian populations. Objectives: This study examines behavioral and self-reported cognitive functioning in detoxified alcohol-dependent (AD) patients in Singapore and its association with outcome. Methods: The cognitive performance of 30 recently-detoxified AD inpatients and 30 demographically-matched controls was compared using visuospatial memory, working memory, set-shifting, planning and reflection impulsivity tests of the CANTAB®, and self-reported dysexecutive symptoms and everyday cognitive difficulties. Patients’ alcohol use and self-reported cognitive functioning were reassessed 3-months post-discharge. Results: Compared to matched controls, AD inpatients exhibited significantly poorer fluid intelligence, visuospatial memory, working memory, set-shifting flexibility and planning/organization, but not reflection impulsivity. In support of Western studies, a significant proportion (three-quarters) were “clinically impaired” on subtests. Significant reductions were observed in alcohol units, frequency and dependency scores at follow-up, though improvements in self-reported cognitive functioning were limited to abstainers. Baseline cognitive performance did not differentiate those who had abstained from alcohol and relapsed at follow-up. Conclusions/Importance: Memory and executive functioning impairments were evident among Asian AD patients alongside self-reported cognitive difficulties, thus cognitively demanding psychological interventions may have limited impact during early detoxification. Future studies can build on these findings, with larger samples and measurement of moderating and mediating factors to extend our understanding of how cognitive impairment influences outcome.     

Identifying “Hitting Bottom” Among Individuals with Alcohol Problems: Development and Evaluation of the Noteworthy Aspects of Drinking Important to Recovery (NADIR)

Background: Alcohol use disorder (AUD) is a costly public health concern; yet, many individuals with AUD never receive formal treatment. Prior studies have identified that “hitting bottom” may be an important factor in seeking treatment for AUD) and the notion that “hitting bottom” is necessary for recovery is commonly portrayed in the popular media. Yet, “hitting bottom” has never been formally operationalized. Objectives: The present article aimed to operationalize “hitting bottom.” Methods: A multiphase process was used to develop a measure of hitting bottom among individuals experiencing alcohol problems: The Noteworthy Aspects of Drinking Important to Recovery (NADIR). Psychometric evaluation of the measure was conducted using online data collected from individuals who identified as moderate to heavy drinkers (N = 597). Results: The NADIR included five lower-order dimensions and one higher-order dimension (“hitting bottom”), had strong concurrent validity with measures of alcohol use severity and alcohol-related problems, and was found to have excellent internal consistency reliability (α > 0.90). An overall summary score on the NADIR of 50+ (factor scores>0) differentiated individuals who had previously sought treatment for AUD and reported more excessive alcohol use compared to those with no treatment history and lower levels of alcohol use. Thus, the NADIR with a cutoff of 50 may be a good starting point for future researchers to test as a method to identify individuals who have hit bottom. Conclusions/Importance: The NADIR provides a viable operational definition of hitting bottom. Future research should evaluate the predictive validity of the NADIR.     

Light-to-moderate drinking and dementia risk: The former drinkers problem re-visited

A growing literature ostensibly supports the contention that light-to-moderate drinking offers a protective effect with respect to late-onset dementia. The former drinkers problem, however, may mitigate or even erase any observed protective relationship. Using three recent meta-analyses as windows on the alcohol and dementia literature [Anstey, K.J., Mack, H.A., & Cherbuin, N. (2009). Alcohol consumption as a risk factor for dementia and cognitive decline: Meta-analysis of prospective studies. American Journal of Geriatric Psychiatry, 17, 542–555; Peters, R., Peters, J., Warner, J., Beckett, N., & Bulpitt, C. (2008). Alcohol, dementia and cognitive decline in the elderly: A systematic review. Age Ageing, 37, 505–512; Neafsey, E.J., & Collins, M.A. (2011). Moderate alcohol consumption and cognitive risk. Neuropsychiatric Disease and Treatment, 7, 465–484], we offer a critical review and re-examination of 24 studies employing one or another strategy to control or evaluate the impact of the former drinkers problem on the alcohol and cognitive impairment relationship. Our review is organized around four strategies and problem areas found in these studies, namely: (1) analyses using light drinkers instead of abstainers as reference, (2) time dimension problems attaching to the nondrinker category in analyses, (3) analyses excluding former drinkers or drinkers who changed categories over a study's course, and (4) other approaches and associated problems. Our review suggests that the former drinkers problem has been only incompletely addressed in this still new literature on alcohol's possible protective cognitive effects. As evidenced in the three meta-analyses employed in this review, only a fraction of alcohol and dementia studies addressed the former drinkers problem and, among those, still fewer addressed the problem adequately. Several reasons for this deficiency in the literature are discussed. We conclude that the impact of former drinkers on the alcohol and dementia relationship remains an open question.     

Prenatal alcohol exposure and cognitive development in the preschool years

The teratogenic effects of drinking during pregnancy on cognitive development were investigated in a cohort of disadvantaged mother-infant pairs. Three indices associated with maternal alcohol use were related to comprehensive cognitive measures obtained during five in-home assessments through age four years, ten months. Birth weight and a tally of craniofacial anomalies were also evaluated as early indicators of fetal alcohol damage. Multiple analyses relating the alcohol and cognitive measures provided no evidence of an adverse alcohol effect on cognitive development in the absence of Fetal Alcohol Syndrome. Assessments based on confidence intervals indicated that an average decrement of more than two points (IQ equivalent) on the five cognitive measures is unlikely for relatively heavy levels of maternal alcohol use or alcohol-related problems. Marginal relationships were observed between cognitive measures and the neonatal indicators, but depended heavily on the influence of a child exhibiting signs consistent with Fetal Alcohol Syndrome. This case therefore received special attention. The implications of the relationships involving the neonatal indicators were investigated using arguments based on path analysis.     

“This is the way we were raised”: Alcohol beliefs and acculturation in relation to alcohol consumption among Native Americans

Native Americans have the highest rates of alcohol use in comparison to other ethnic groups, placing them at risk for experiencing alcohol-related problems. The present study examined the beliefs that some Native Americans may have related to alcohol use; specifically, the belief that alcohol is a key component in Native American cultures. To assess these beliefs, we developed the Stereotypical Alcohol Beliefs Scale for Native Americans (SABSNA). The new 20-item measure was administered to 144 individuals who identified as Native American along with a measure of acculturation and other drinking-related measures, including perceived norms, alcohol expectancies, and drinking motives. An exploratory factor analysis revealed that the measure is unidimensional in structure and has excellent internal consistency. SABSNA scores were found to be positively associated with typical week drinking, alcohol expectancies, and drinking motives (social, coping, enhancement, and conformity). Hierarchical regression analyses revealed that level of acculturation moderated the association between alcohol beliefs and weekly drinking. Native Americans who identified less with mainstream culture demonstrated a positive association between their cultural alcohol beliefs and their weekly drinking. The findings suggest that alcohol beliefs would be an appropriate additional target for interventions for individuals who are not oriented to the mainstream culture.