The association of diabetes and older age with the absence of chest pain during acute coronary syndromes

Cardiac autonomic neuropathy associated with diabetes can cause silent myocardial ischemia and may influence the way that patients perceive symptoms of acute coronary syndromes (ACS). The purpose of this study was to examine symptoms of ACS in patients with and without diabetes while controlling for length of time with diabetes. A convenience sample of 256 patients from two large medical centers in the Midwest participated. Patients with diabetes comprised 33.2% of the sample and reported significantly less chest pain and more unusual fatigue. Patients with diabetes of longer duration (10 or more years) reported more difficulty breathing than did patients with diabetes of shorter duration (fewer than 10 years). Older patients with the same diabetes status also reported less chest pain. For older patients and for patients with diabetes, lack of chest pain during ACS could delay treatment and is thus a concern.     

Evaluating personal alcohol feedback as a selective prevention for college students with depressed mood

OBJECTIVE: This research evaluated a brief mailed intervention for alcohol use as an adjunct to a brief treatment for college students with depression symptoms. The intervention aimed to correct normative misperceptions and reduce students' drinking and related consequences. METHOD: One hundred seventy seven college students (70% Female) with elevated scores on the Beck Depression Inventory were randomly assigned to intervention or control group. Participants in the intervention were mailed feedback and information detailing their reported alcohol use, moderation strategies, and accurate normative information regarding student drinking. RESULTS: Results indicated no main effects of the intervention on drinking or related problems but students receiving feedback showed significant reductions in their perception of drinking norms compared to the control group. Furthermore, students whose normative perceptions reduced showed significant reductions in total drinks per week and total alcohol related problems compared to those whose norms did not reduce. CONCLUSIONS: Results support the importance of correcting normative perceptions and provide direction for selective prevention of alcohol use and related problems among college students with depressed mood.     

Domestic violence and alcohol use: trauma-related symptoms and motives for drinking

Alcohol use is frequently associated with posttraumatic stress disorder (PTSD), especially in the face of chronic traumatic experiences. However, the relationship between alcohol use and symptoms associated with chronic trauma exposure has not been evaluated. This study examined alcohol use in recently battered women (N=369). Differences were found in trauma symptoms between abstainers, moderate drinkers, and heavy drinkers, with heavy drinkers reporting more severe symptoms. Mediational analyses suggest that the relationship between drinking and trauma symptoms is mediated by drinking to cope, which has not been previously demonstrated in a battered population. Results suggest the importance of assessing trauma symptoms and motives for drinking in understanding alcohol use in recent survivors of domestic violence.     

Exploring productivity outcomes from a brief intervention for at-risk drinking in an employee assistance program

Brief intervention (BI) research has traditionally examined alcohol and drug use outcomes; however it is unknown whether BIs can also impact on-the-job productivity. This exploratory study examines changes in workplace productivity and related costs for clients receiving a BI for at-risk drinking in the employee assistance program (EAP). Participants were 44 clients attending the EAP for behavioral health concerns, screened for at-risk drinking, assigned to BI + Usual Care (n = 25) or UC alone (n = 19), and who completed 3-month follow-up. Absenteeism, presenteeism, and productivity costs were derived as outcomes. At follow-up, participants in the BI + UC group had improved productivity when at work (presenteeism) compared to the UC group. The estimated cost savings from improved productivity for the BI + UC group was $1200 per client over the UC group. Groups did not differ by absenteeism (missed days of work). Preliminary evidence suggests the broad impact BIs may have. Implications for future BI research are discussed.     

Whose opinion matters? The relationship between injunctive norms and alcohol consequences in college students

Harm reduction approaches may benefit from research extending the exploration of predictors of alcohol use per se to those components most directly related to alcohol-related harm. This investigation evaluated the relationship between perceived injunctive norms of alcohol use (level of approval of drinking behaviors in specific situations) and the experience of alcohol-related consequences as a function of typical student reference groups at increasing levels of similarity to the respondent: based on race, gender, Greek status, and combinations of these dimensions, as well as parents, close friends, and the students' own attitudes. Participants were 3753 students (61% female) from two campuses who completed an online survey. Preliminary analyses determined that there were no differences in the relationship between perceived injunctive norms and consequences across the eight student groups of varying specificity, thus all eight levels were combined into one variable of perceived student injunctive norms. However, the relationship between this variable and consequences was weaker than the perceived attitudes of more proximal referents (parents, close friends, as well as their own personal attitudes). Subsequent analyses predicting consequences while controlling for demographic variables and drinking level, revealed that perceived injunctive norms for students, parents, and close friends as well as personal attitudes each significantly predicted consequences. Results suggest an important role for perceived injunctive norms in the experiencing of consequences over and above the amount of consumption and point to types of injunctive norms feedback that might form effective interventions (i.e., incorporating close friend and parent feedback as well as general student feedback).     

Anterior temporal lobes and hippocampal formations: normative volumetric measurements from MR images in young adults

Volumes of the right and left anterior temporal lobes and hippocampal formations were measured from magnetic resonance images in 52 healthy volunteers, aged 20-40 years. Subjects were selected by age, sex, and handedness to evaluate possible effect of these variables. Data were normalized for variation in total intracranial volume between individuals. Right-left asymmetry in the volumes of the anterior temporal lobes and hippocampal formations was a normal finding. The anterior temporal lobe of the non-dominant (right) hemisphere was larger than the left by a small (mean right-left difference, 2.3 cm3) but statistically significant amount (P less than .005) in right-handed subjects. No significant effect of age or sex was seen in normalized right or left anterior temporal lobe volume. The right hippocampal formation was larger than the left for all subjects by a small (mean right-left difference, 0.3 cm3) but statistically significant amount (P less than .001). No effect of age, sex, or handedness was seen in normalized hippocampal formation volumes.     

Family risk factors for alcohol-related consequences and poor adjustment in fraternity and sorority members: exploring the role of parent-child conflict

OBJECTIVE: The relationship between perceptions of parent-child conflict and alcohol-related consequences was examined in a sample of first-year fraternity and sorority members. METHOD: Members (N = 302) were asked to complete measures of conflict with their mothers and fathers and report on parent problem drinking. Drinking rates, alcohol-related consequences, depression, and global psychological distress were assessed 1 year later (N = 233). RESULTS: From a final sample with complete mother and father information (N = 202), parent-child conflict at baseline significantly predicted alcohol-related consequences 1 year later for all students. Father-child conflict was a significantly better predictor for male students. Parent histories of problem drinking did not account for this relationship. Although male students reported substantially higher rates of drinking, the relationship between drinking and alcohol-related consequences was stronger among female students. Parent-child conflict at baseline also predicted adjustment to college at 1-year follow-up. Students who perceived higher levels of mother-child and father-child conflict reported higher levels of depression. Students who perceived higher levels of father-child conflict reported higher levels of global psychological distress. CONCLUSIONS: Results indicate that perceptions of conflict in specific parent-child relationships constitute a risk factor for poor college adjustment and the experience of alcohol-related consequences.