Maternal and paternal alcohol misuse and alcohol-related outcomes among college students

Using a large college student sample (N = 1,095), the present study examined whether the relationship between parental alcohol abuse and offspring alcohol use varied as a function of parent and offspring gender, and whether the relationship to the non-substance-abusing mother or father buffered against the risk associated with being an adult child of an alcoholic (ACOA). Among women, maternal ACOAs (i.e., the mother only was suspected of alcohol misuse) had the greatest risk of problematic alcohol consumption, whereas among men, both parent ACOAs (i.e., both parents were suspected of alcohol misuse) had the greatest risk of problematic alcohol consumption. No support was found for the buffering hypothesis. We discuss implications of our findings and future directions.     

Maternal and paternal alcoholism and depressive mood in college students: parental relationships as mediators of ACOA-depressive mood link

The present study examined whether suspecting one's mother versus father of alcohol abuse was associated with parent-offspring relationships, and the degree to which parent-child relationships were associated with depressive symptoms. As compared to non-ACOAs (n=288), ACOAs (n=100) reported more negative parent-child relationships (i.e., greater alienation, poorer communication, less trust, greater emotional longing, and more negative attitudes toward the parent) and increased depressive symptoms on the POMS (McNair, Lorr, & Droppleman, 1992). A closer look revealed that suspected maternal alcohol abuse was associated with more negative mother-child relationships, whereas suspected paternal alcohol abuse was associated with more negative father-child relationships. Both maternal alcohol abuse and paternal alcohol abuse predicted depressive symptoms.     

Self-regulation as a buffer of the relationship between parental alcohol misuse and alcohol-related outcomes in first-year college students

Alcohol misuse among college students is a large public health concern, thus, it is imperative to identify factors that reduce this risk. One risk factor associated with developing alcohol-related problems is meeting criteria for being an adult child of an alcoholic (ACOA). Conversely, self-regulation has been identified as a protective factor that is inversely associated with drinking-related outcomes. The purpose of the present study was to examine whether self-regulation buffers the risk associated with ACOA status on alcohol use and alcohol-related consequences. In a sample of 195 first-year college students, we found that ACOA status had a unique effect on both alcohol consumption and alcohol-related consequences. Self-regulation was unrelated to alcohol use but inversely associated with alcohol-related consequences. Notably, self-regulation moderated the effect of ACOA status on alcohol-related problems (but not alcohol consumption) such that self-regulation was most strongly related to alcohol-related problems among ACOAs. Our results suggest that self-regulation helps explain the resilience of many ACOAs.     

Adverse Childhood Experiences (ACEs) and Alcohol Abuse among South Carolina Adults

Background: Adverse childhood experiences (ACEs) have been associated with negative adult health outcomes, including alcohol misuse. The impact of ACEs on alcohol use may vary by gender, with ACEs impacting women more than men in coping with adulthood stressors. Objectives: The objective of this study is to examine the gender-specific relationships between ACEs and self-reported binge drinking and heavy drinking in adulthood among South Carolina residents. Methods: This study analyzed a sample of 8492 respondents who completed the 2014 or 2015 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) survey. Logistic regression was used to examine the impact of types and the number of ACEs on binge drinking and heaving drinking in adulthood. Results: Thirty-seven percent of men and 22.8% of women survey respondents reported binge drinking and 12.2% of men and 4.1% of women reported heavy drinking. Almost all categories of ACE were associated with increased odds of reporting binge and heavy drinking; household mental illness had the greatest odds for men (aOR 1.31, 95% CI 1.30–1.33) and emotional abuse had the greatest odds for women (aOR 1.42, 95% CI 1.40–1.43). Men and women with four or more ACEs had greater odds of reporting binge and heavy drinking compared to their counterparts. Conclusions/Importance: Given the potential for negative outcomes associated with alcohol misuse and transmission of risky alcohol-related behaviors from parent to child, strategies that utilize a multigenerational approach could have a large impact on population health.     

Concussion History,Hazardous Drinking,and BrAC Levels Among a Sample of Bar Patrons, 2015

Background: Alcohol consumption and experiencing a concussion are positively correlated. Concussion history has not been examined previously in any alcohol field study (i.e., conducted in a natural setting). Objective: To better understand the relationship between concussion history and alcohol consumption. Methods: We conducted two anonymous field studies among a 2015 sample of bar patrons (N = 544; 62.5% males) in a college town to assess concussion history and two alcohol consumption measures: (1) breath alcohol concentration (BrAC) levels and (2) hazardous drinking scores (based on the AUDIT-C). Next, we conducted a logistic regression analysis to predict concussion history using the two alcohol consumption measures and other potential covariates (i.e., age, gender, race, college student status). Results: Among participants in our sample, the average BrAC level was.070 (SD =.053) and the average hazardous drinking score was 4.7 (SD = 2.5). Less than half of participants indicated that they had experienced a concussion in their lifetime (235; 43.2%). The logistic regression model indicated that hazardous drinking scores were significantly, positively associated with having experienced a concussion, whereas other covariates (i.e., BrAC, age, gender, race, college student status) did not significantly predict concussion history. Conclusions/Importance: Hazardous drinkers were more likely to have experienced a concussion. Therefore, the relationship found in this sample, between hazardous drinking behavior and concussion history, points to hazardous drinking as a possible risk factor for having had a concussion in the past.     

Prospective associations among approach coping,alcohol misuse and psychiatric symptoms among veterans receiving a brief alcohol intervention

Brief alcohol interventions (BAIs) target alcohol consumption and may exert secondary benefits including reduced depression and posttraumatic stress disorder (PTSD) symptoms among non-veteran and veteran populations. This study examined whether approach coping, alcohol misuse, and an interaction of these two factors prior to the administration of a BAI (i.e., baseline) would predict depression and PTSD symptoms 6-months post BAI (i.e., follow-up). Veterans (N = 166) received a BAI after screening positive for alcohol misuse during a primary care visit and completed assessments of alcohol misuse, approach coping, and depression and PTSD symptoms at baseline and follow-up. Baseline substance misuse, but not approach coping, significantly predicted depression and PTSD symptoms at follow-up. Approach coping moderated associations between baseline alcohol misuse and psychiatric symptoms: Veterans reporting more alcohol misuse and more (relative to less) approach coping at baseline evidenced fewer psychiatric symptoms at follow-up after accounting for symptoms assessed at baseline.     

Alcohol screening scores and the risk of intensive care unit admission and hospital readmission

ABSTRACT

Background: The association between alcohol misuse and the need for intensive care unit admission as well as hospital readmission among those discharged from the hospital following a critical illness is unclear. This study sought to determine whether alcohol misuse was associated with (1) admission to an intensive care unit (ICU) among a cohort of patients receiving outpatient care and (2) hospital readmission among those discharged from the hospital following critical illness. Methods: This was a retrospective cohort study conducted with data from 24 Veterans Affairs (VA) health care facilities between 2004 and 2007. Scores on the Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) questionnaire were used to identify patients with past-year abstinence, lower-risk alcohol use, moderate alcohol misuse, or severe alcohol misuse. The primary outcome was admission to a VA intensive care unit within the year following administration of the AUDIT-C. In an analysis focused on patients discharged from the ICU, the 2 main outcomes were hospital readmission within 1 year and within 30 days. Results: Among 486,115 veterans receiving outpatient care, the adjusted probability of ICU admission within 1 year was 2.0% (95% confidence interval [CI]: 1.7%–2.3%) for abstinent patients, 1.6% (95% CI: 1.3%–1.8%) for patients with lower-risk alcohol use, 1.8% (1.4%–2.3%) for patients with moderate alcohol misuse, and 2.5% (2.0%–2.9%) for patients with severe alcohol misuse. Among the 9,030 patients discharged from an ICU, the adjusted probability of hospital readmission within 1 year was 48% (46%–49%) in abstinent patients, 44% (42%–45%) in patients with lower-risk alcohol use, 42% (39%–45%) in patients with moderate alcohol misuse, and 55% (49%–60%) in patients with severe alcohol misuse. Conclusions: Alcohol misuse may represent a modifiable risk factor for a cycle of ICU admission and subsequent hospital readmission.     

Gender Difference in Offspring's Alcohol Use Disorder by 21 Years: A Longitudinal Study of Maternal Influences

Aims: There is little known about the extent to which maternal alcohol consumption influences offspring's alcohol use disorder. This study aims to examine whether different maternal alcohol consumption trajectories predict gender difference in adolescent alcohol use disorder at child age 21 years. Methods: Data are from a prospective cohort, the Mater-University of Queensland Study of Pregnancy (MUSP) and its outcomes. The study involves 2531 mother–child pairs for whom data are available at the 21-year follow-up survey. Maternal alcohol consumption trajectories were determined by group-based trajectory modelling. Offspring's lifetime ever alcohol use disorder was assessed using DSM-IV diagnostic criteria. Results: Over 14 years of follow-up after the birth of a child, three distinct alcohol consumption trajectories were identified (abstainer, low-stable. and moderate-escalating drinker). A maternal trajectory of moderate-escalating alcohol consumption independently predicted offspring's lifetime ever alcohol use disorder at 21 years after adjustment for a range of potential confounders. “Cross-gender influence” is observed in the study. Conclusions: A maternal life course pattern of alcohol consumption may have an independent effect on offspring alcohol consumption, with male offspring being more vulnerable to the effects of maternal alcohol use than are female offspring. Programs intended to address alcohol consumption by adolescents and young adults need to focus on the behaviors of both parents but acknowledging that maternal patterns of alcohol consumption may be particularly important for male offspring.     

Hospitalization due to Alcohol and Drug Abuse in First- and Second-Generation Immigrants: A Follow-Up Study in Sweden

The detrimental effects of substance abuse on the individual and on society are well known. Health care resources must target where they are most needed. This study investigated (1) whether the increased risk of being hospitalized for alcohol abuse and drug abuse among certain immigrant groups is present in the next generation and (2) whether having one parent born in the host country (i.e., Sweden) has a protective effect on the risk of being hospitalized for alcohol abuse and drug abuse among second-generation immigrants. In total, 2,243,546 persons aged 20–39 years were followed from 1 January 1992 until 31 December 1999 for first hospital admission due to alcohol abuse or drug abuse. A Cox regression model was used to estimate hazard ratios for each diagnosis group. When the Swedish majority population was used as reference, the highest risks of alcohol abuse and drug abuse were found among first- and second-generation Finns, after adjustment for income. Among second-generation Finns with one parent born in Sweden, the increased risk of being hospitalized for alcohol abuse and drug abuse was lower than among second-generation Finns with both parents born in Finland. Health care resources need to target certain groups of first- and second-generation immigrants.     

A Dyadic Growth Approach to Partner Regulation Attempts on Changes in Drinking and Negative Alcohol-Related Consequences

Background: Many individuals engage in regulation attempts to manage or reduce their partner's alcohol use. Research on partner social control behaviors has shown that regulation attempts generally factor into negative (i.e., punishing) and positive (i.e., rewarding) dimensions. In the alcohol domain, partner drinking has been associated with poorer relationship functioning through punishment. Objectives: This research applied a dyadic growth model approach to investigate changes in alcohol consumption and negative alcohol-related consequences over 6 months, and evaluated whether partner regulation attempts (punishment and reward) were influential (i.e., successful) in these changes. Methods: Married couples (N = 123 dyads) completed web-based measures of partner regulation attempts, alcohol consumption, and alcohol-related consequences three times over a 6-month period. Results: Results from dyadic growth curve analyses showed that partner punishment was significantly associated with increases in alcohol-related consequences—and marginally associated with increases in alcohol consumption—over the 6-month period. Partner reward was associated with decreases in consumption over the study period. These effects were not different for husbands and wives. Conclusion/Importance: Results support previous research demonstrating deleterious impact of partner punishing control strategies and provide important implications for future interventions and treatment.     

Caregiver Burden and Alcohol Use in a Community Sample

ABSTRACT

Little attention has been paid to the relationship between caregiver burden and alcohol use. It is important to examine the particular aspects of caregiver burden that most influence alcohol use. A mail survey was conducted using a representative sample of 998 employed Chicago residents who provided informal care for at least one person. Ordinary least squares regression models were computed to examine the relationship between caregiver burden and drinking outcomes. Findings suggest that caregivers who experience social and emotional burdens related to caregiving are at risk for problematic alcohol use and warrant attention from health care and mental health service professionals.     

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.     

The Effect of Neighborhood Context on the Relationship Between Substance Misuse and Weapons Aggression in Urban Adolescents Seeking ED Care

Background: Frameworks for studying the ecology of human behavior suggest that multiple levels of the environment influence behavior and that these levels interact. Applied to studies of weapons aggression, this suggests proximal risk factor (e.g., substance use) effects may differ across neighborhoods. Objectives: To estimate how the association between weapons aggression and substance use varies as a function of several community-level variables. Methods: Individual-level measures (demographics, behavioral measures) were obtained from a survey of youth aged 14–24 years old seeking care at a Level-1 ED in Flint, Michigan. Community-level variables were obtained from public sources. Logistic generalized additive models were used to test whether community-level variables (crime rates, alcohol outlets, demographics) modify the link between individual-level substance use variables and the primary outcome measure: self-reported past 6-month weapon (firearm/knife) related aggression. Results: The effect of marijuana misuse on weapons aggression varied significantly as a function of five community-level variables: racial composition, vacant housing rates, female headed household rates, density of package alcohol outlets, and nearby drug crime rates. The effect of high-risk alcohol use did not depend on any of the eight community variables tested. Conclusions: The relationship between marijuana misuse and weapons aggression differed across neighborhoods with generally less association in more disadvantaged neighborhoods, while high-risk alcohol use showed a consistently high association with weapons aggression that did not vary across neighborhoods. The results aid in understanding the contributions of alcohol and marijuana use to the etiology of weapon-related aggression among urban youth, but further study in the general population is required.     

A typology of families with parental alcohol or drug abuse

Objectives To estimate the prevalence of parental alcohol abuse (PAA) or parental drug abuse (PDA), to compare families with PAA/PDA to non-PAA/PDA families, and to identify different types of families with PAA/PDA in terms of mental disorders in parents, family separation, financial difficulties and educational level. Methods Register-based data from a complete birth cohort of children born in 1991 in Finland (N?=?62,751), and their biological parents. Data were derived from Finnish administrative registers from 1991 to 2009. Latent class analysis was used to construct typology of families with PAA/PDA. Results 10.5% of families were affected by PAA or PDA before the children’s 18th birthday. Of these families, five family types were identified. The most common type was characterised by father’s alcohol abuse but had no other detectable problems besides parental separation. The second type was a family where the father had a drinking or drug problem, had financial difficulties and had moved away from the family’s home. The two less common family types were characterised by the mother’s drinking or drug abuse and mental disorders. The mothers of these family types were rather commonly living with their children. In the fifth family type, child typically did not live with either of the parents, both parents had alcohol/drug abuse and accumulated problems. Conclusions Early prevention and treatment are needed to avoid the accumulation of parental problems in PAA/PDA families. As both biological parents rather rarely were substance abusers, the parental role of the non-substance abusing parent should be supported and strengthened.     

Testing daily associations between impulsivity,affect, and alcohol outcomes: a pilot study

Background: Considerable research has examined impulsivity between individuals, but less research has focused on whether impulsivity fluctuates within a person. Although previous research supports trait levels of impulsivity as a risk factor for increased alcohol involvement, it is unclear whether daily (i.e., state) fluctuations in impulsivity coincide with same-day drinking behaviors. The present pilot study tested (1) the extent to which impulsivity fluctuates within-person; (2) the influence of daily impulsivity on alcohol use outcomes across all days (i.e., whether drinking occurred, the number of drinks consumed, and intentions to drink) and on drinking days only (i.e., whether heavy episodic drinking occurred and the number of problems experienced); and (3) daily affect as moderators of these relationships.

Method: Participants were 24 young adult drinkers without postsecondary education who completed a baseline plus 14 follow-up daily surveys. Each day, participants reported their impulsivity, affect, and drinking behavior.

Results: Multilevel modeling revealed that 42.5% of the variability in daily impulsivity was due to within-person differences. Impulsivity was related to greater odds of heavy episodic drinking and more alcohol-related problems on drinking days. Positive affect moderated the relationship between impulsivity and alcohol-related problems, and the relationship between impulsivity and drinking intentions.

Conclusions: Findings suggest that changes in positive affect and impulsivity may be a risk factor for alcohol problems in a daily context. Future research examining within-person impulsivity and negative outcomes may benefit from considering positive affect.     

Earlier Alcohol Use and Lower Neuropsychological Performance in Brazilian Adolescence: Is the School Environment Related to This?

Objectives: The aim of this study was to evaluate impulsivity, inhibitory control, and alcohol use in preadolescents and adolescents aged 10 to 16 from public and private schools. Methods: Participants were 190 adolescents selected from public and private schools in Brazil. Neuropsychological measures related to impulsivity (i.e., Barratt Impulsiveness Scale), inhibitory control (i.e., Go/No-go Task), and processing speed (i.e., Five Digits Test) were assessed. Results: 60% of the sample had started drinking alcohol. Early alcohol consumption is not influenced by type of school, indicating that adolescents consume alcohol early, regardless of the type of education or income. Although there were significant differences in neuropsychological performance between types of schools, better neuropsychological performance was found in students from private schools. Conclusions: When comparing consumption of alcohol among public and private school students, there were no significant differences, perhaps because the use of early alcohol can be a public health problem. Private school students may perform better in inhibitory control task because they have a good school environment, which serves as a protective factor.     

The Relationship Between Generalized Anxiety Symptoms and Treatment Dropout Among Women in Residential Treatment for Substance Use Disorders

Background: Generalized anxiety disorder (GAD) co-occurs with substance use disorders (SUDs) at an alarmingly high rate, and the presence of anxiety is associated with an increased risk for relapse to substance use following treatment. Furthermore, comorbid SUDs and other forms of psychopathology are associated with an increased risk for leaving treatment against medical advice (AMA). Objective and Method: Research has yet to examine whether the presence of GAD symptoms is associated with leaving treatment AMA in SUDs populations. Thus, the current study sought to address this important gap in the literature by examining this relationship among a sample of 122 women in residential treatment for SUDs. Results: Results demonstrated that GAD symptoms were significantly associated with the decision to leave treatment AMA after controlling for age, education, problematic alcohol and drug use, and depression symptoms. Conclusions/Importance: Our finding indicates the potential importance of assessing and targeting GAD in treatment for SUDs, which may increase treatment compliance.     

Drinking motives and PTSD-related alcohol expectancies among combat veterans

IntroductionCombat veterans are at increased risk for PTSD and alcohol misuse, and expectancies and motives for drinking may help explain the link between these comorbid issues. This investigation explored the relationships between PTSD symptoms, PTSD-related alcohol expectancies, motives for drinking, and alcohol consumption/misuse.Method67 veterans of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) participated in this project. We examined correlations between PTSD severity, alcohol misuse, drinking motives, PTSD alcohol expectancies, and tested models of mediation and moderation.ResultsCoping-anxiety drinking motives and positive PTSD-related alcohol expectancies were associated with alcohol misuse and alcohol-related consequences, but not with consumption. Each PTSD symptom cluster was associated with positive and negative PTSD alcohol expectancies, and coping-anxiety was specifically related to reexperiencing and avoidance. Drinking to cope mediated the relationship between PTSD symptoms and hazardous drinking. Moderation analyses showed that a positive relationship between PTSD severity and hazardous drinking existed among those with moderate and higher levels of positive PTSD-alcohol expectancies.DiscussionOur findings point to surprising, and in some cases complex, relationships between PTSD and alcohol use. Although related, PTSD alcohol expectancies and drinking motives seem to function differently in the relationship between PTSD and alcohol misuse.     

Experienced-Based Versus Scenario-Based Assessments of Shame and Guilt and Their Relationship to Alcohol Consumption and Problems

Background: Empirical studies of the relationships between shame, guilt, and drinking are sparse and sometimes appear contradictory. However, a more coherent picture emerges when researchers differentiate between measures of experienced of guilt and shame (i.e., questionnaires that ask how often people experience thoughts, feelings, and sensations associated with the emotion) versus proneness to guilt and shame (i.e., self-report of likely responses to imagined situations) is understood. Objectives: Assess the extent to which experiential versus proneness measures of shame and guilt are associated with alcohol consumption and alcohol-related problems. Methods: Between 2012 and 2013, 89 community-dwelling non-abstaining adults were interviewed on a single occasion about their drinking and completed self-report measures of shame, guilt, and drinking-related behaviors. Results: Overall, shame and guilt were most strongly related to alcohol-related problems and not drinking amount per se, and shame was more strongly related to alcohol-related problems than was guilt. A measure of experienced shame, the Internalized Shame Scale, was the strongest predictor of drinking-related problems and predicted problems above and beyond other measures of shame and guilt. While guilt proneness was related to less problematic drinking, guilt experienced at the time of the assessment was related to more problematic drinking. Conclusions: Shame appears to be more central to the experience of problematic drinking than guilt. Results also support the idea that guilt/shame proneness is distinct from experienced shame and guilt. Incorporating this distinction appears to account for the inconsistencies in the literature regarding how shame and guilt are related to drinking.