The relationship among depressive symptoms, urgency, and problematic alcohol and cannabis use in community adults

This study examined alternative models for how negative and positive urgency influence the relationship between depressive symptoms and alcohol and cannabis use in a community sample. Methods Participants included adults (n = 675; age = 42.57, SD = 15.66; 65.0% female; 74.2% White) in the community sample from the Rockland Project by the Nathan Kline Institute. Path analyses were conducted. Results Negative urgency was a unique mediator in the relationship between depressive symptoms and problematic alcohol use (β =0.121, 95% CI = 0.060–0.182) and problematic cannabis use (β =0.120, 95% CI = 0.060–0.179). Negative and positive urgency significantly moderated the relationship between depressive symptoms and problematic cannabis use (negative urgency: β = 0.092, 95% CI = 0.040–0.145; positive urgency: β = 0.070, 95% CI = 0.022–0.119), such that the relationship was positive at high levels and negative at low levels of urgency. The patterns and levels of the relationships between depressive symptoms and cannabis use differed between negative and positive urgency. Neither urgency trait moderated the relationship between depressive symptoms and problematic alcohol use. Conclusions Despite being strongly related, negative and positive urgency have distinct roles in the relationship between depressive symptoms and problematic alcohol and cannabis use. Previous finding with younger samples that do not include both traits in the model at time generalize and at other times do not replicate, which warrants the continued examination of how these traits impart risk across the lifespan

The relationship between the UPPS-P impulsive personality traits and substance use psychotherapy outcomes: A meta-analysis

Background Although impulsive personality traits have been well implicated in substance use disorder (SUD) risk, little work has established how specific impulsive personality traits influence and are influenced by SUD psychotherapy outcomes. The purpose of this meta-analysis was to quantitatively review existing work to examine 1) how impulsive personality traits affect SUD psychotherapy outcomes and 2) reductions in impulsive personality traits during SUD psychotherapy. Methods Studies were identified by conducting a comprehensive review of the literature. Results For aim one (k = 6), significant effects were found for lack of premeditation (g = 0.60, SE = 0.30, 95% CI 0.01–1.20; z = 1.99, p = 0.05) and negative urgency (g = 0.55, SE = 0.17, 95% CI 0.22–0.88, z = 3.30, p=0.001), with trait scores related to poorer SUD psychotherapy outcomes. For aim two (k = 10), decreases in sensation seeking (g = −0.10, SE = 0.05, 95% CI −0.20 to 0.004; z = −1.88, p=0.02) and negative urgency (g = −0.25, SE = 0.14, 95% CI −0.53 to 0.03; z = −1.75, p=0.03) during SUD psychotherapy were significant. Conclusions Overall, our quantitative synthesis suggests that lack of premeditation and negative urgency are related to poorer SUD psychotherapy outcomes. Although negative urgency and sensation seeking are decreasing during SUD psychotherapy, the magnitude of the change is quite small. Overall, we suggest that the measurement and targeting of impulsive personality traits in psychotherapy has strong potential to improve clinical outcomes across SUDs and a wide range of clinical problems and disorders

Combined expectancies of alcohol and e-cigarette use relate to higher alcohol use

Electronic cigarettes (e-cigs) were created to approximate the look, feel, and experience of using a cigarette. Since cigarette and alcohol use co-occur, we hypothesized that e-cig and alcohol use also co-occur, likely due to shared positive drug expectations. Using self-report data from two independent samples of community-dwelling alcohol using adults, the present study: (1) modified the Nicotine and Other Substance Interaction Expectancy Questionnaire (NOSIE) to assess expectancies of combined e-cig and alcohol use (i.e. the individuals perceived likelihood of using e-cigs and alcohol together; NOSIE-ER); and (2) examined the relationships among e-cig use, expectancies, and alcohol use across e-cig use status. In the first sample (N=692, mean age=32.6, SD=9.74, 50.7% female, 82.2% Caucasian), exploratory factor analysis suggested the presence of two factors: (1) alcohol use leads to e-cig use (Scale 1; α=0.85); and (2) e-cig use leads to alcohol use (Scale 2; α=0.91). In the second sample (N=714, mean age=34.1, SD=10.89, 47.8% female, 75.6% Caucasian), confirmatory factor analysis supported this factor structure (χ(2)=47.00, p<0.01, df=19; RMSEA=0.08, 90% CI=0.05-0.11; TLI=0.99; CFI=0.99). Compared to non e-cig users, e-cig users had significantly higher problematic alcohol use in both samples (b's=0.09 to 0.14, p's<.05). Expectancies of combined e-cig and alcohol use were significantly related to problematic alcohol use (b's=-0.92 to 0.26, p's<.05). In sum, e-cig use is related to alcohol use and expectancies of combined e-cig and alcohol use; consequently, reshaping of beliefs about needs or desires to co-use could be a prime point of intervention

UPPS-P Model Impulsivity and Marijuana Use Behaviors in Adolescents: A Meta-Analysis

Background Impulsivity is often included as a risk factor in models of adolescent marijuana use behaviors; however, the magnitude of the association between impulsivity and marijuana use behaviors is variable across studies. The present study reviewed existent literature to 1) quantify the relationship between separable impulsivity-related traits and both marijuana use and negative marijuana consequences and 2) quantify the size of the effect of gender on these relationships. Method Thirty-eight studies (41 independent samples) were meta-analyzed using a random effects model to examine the relationship between impulsivity traits and marijuana use behaviors. Results Marijuana use was significantly related to all impulsivity-related traits except lack of perseverance (r’s ranging from 0.13–0.23, p’s < 0.01). Negative marijuana consequences were only significantly related to sensation seeking, lack of planning, and positive urgency (r’s ranging from 0.37–0.39, p’s < 0.01). Effects were small for marijuana use, but medium for negative marijuana consequences. Gender was not a significant moderator of any relationships. Conclusions Impulsivity-related traits had more robust relationships with negative marijuana consequences than marijuana use, suggesting impulsivity-related traits are important in differentiating adolescents most likely to experience negative consequences from marijuana use. Few relationships examined gender and many of the impulsivity-related traits, other than sensation seeking. Data and trends suggest a more multi-dimensional approach to marijuana use and consequences is warranted

Prohibition of e-cigarettes in the US: Are prohibitions where alcohol is consumed related to lower alcohol consumption?

Recently, research has suggested negative consequences related to electronic cigarette (e-cig) use, including the increased risk for alcohol use and abuse. Previous work found that cigarette smoking ban legislation lowered overall smoking and alcohol use rates; however, researchers have not yet examined the potential effects of prohibiting e-cig use. The present study surveyed 617 individuals from a community-based online sample in the US (mean age = 33.33, SD = 10.50, 54.7 per cent female) who reported their smoking/e-cig use status, alcohol consumption, and the presence of e-cig prohibitions where they consume alcohol. E-cig prohibition was associated with a lower likelihood of being an e-cig user (OR = 0.12, p < 0.001) or dual user (use both cigarettes and e-cigs) (OR = 0.07, p < 0.001). Alcohol Use Disorder Identification Test scores (b = -1.92, p < 0.001), total drinks consumed over 14 days (b = -4.58, p = 0.002), and average drinks per drinking day (b = -0.71, p < 0.001) were all lower when e-cigs were prohibited. Findings are an initial step in this line of research and suggest important future work examining implications of e-cig prohibition recommendations and policy

Transitioning from cigarettes to electronic cigarettes increases alcohol consumption

Objective Electronic cigarettes (e-cigs) are a nicotine delivery device that have recently been linked to alcohol use. Many individuals that smoke cigarettes transition to e-cigs as an alternative to cigarette use, despite potential negative health effects of e-cigs. No research to date has examined how former smokers that have transitioned to e-cigs differ from former smokers that do not use e-cigs, particularly in relation to alcohol use. Further, no research has examined how former smokers that use e-cigs regularly or socially may differ in alcohol consumption. Method Using an online community dwelling sample (Former smokers N=198, mean age=34.70, SD=11.45, 56.1% female, 78.3% Caucasian, 37.9% e-cig users), the present study assessed smoking status and alcohol use, with the latter assessed using a Timeline Followback calendar and the Alcohol Use Disorder Identification Test (AUDIT). Results In all former smokers, total drinks (b=4.01, p=0.02) and average drinks per drinking day (b=0.61, p=.01) were both related to e-cig use status, with e-cig users reporting higher alcohol consumption. Among e-cig using former smokers, social users, but not regular users, showed positive relationships with AUDIT scores, b=1.90, p=.02, total drinks, b=9.12, p<.001, average drinks, b=0.98, p=.006, and hazardous drinking status, OR=3.21, p=.01. Conclusions Findings suggest that: (1) former smokers who use e-cigs may have a potential for higher alcohol use; and (2) those who use e-cigs socially may be at heightened risk for hazardous patterns of alcohol consumption. This should be taken into consideration by healthcare providers

Beliefs About the Direct Comparison of E-Cigarettes and Cigarettes

Background: Recent data suggests that positive beliefs about electronic cigarettes (e-cigs) use can lead to later e-cig use. Considering that many advertisements claim that e-cigs are superior to cigarettes, individuals' likelihood to view e-cigs more favorably than cigarettes can also influence subsequent e-cig use; however, no studies have directly assessed such a comparison. Objectives: The present study created and validated the Comparing E-Cigarettes and Cigarettes questionnaire (CEAC), which asks individuals to directly compare e-cigs and cigarettes on a number of dimensions, in two independent samples. Methods: In sample 1 (451 undergraduates; mean age = 20.35, SD = 5.44, 72.4% female, 73.4% Caucasian) we explored the factor structure of the CEAC and in sample 2 (699 community adults collected via Amazon's Mechanical Turk; mean age = 34.04, SD = 10.9, 47.7% female, 83.3% Caucasian) we replicated the factor structure. Results: Exploratory factor analysis suggested a three-factor structure: General Benefits (α = 0.80), General Effects (α = 0.86), and Health Benefits (α = 0.88), which was replicated via confirmatory factor analysis, χ2 = 4.36; RMSEA = 0.07, 90% CI = 0.06–0.08; TLI = 0.99; CFI = 0.99, and was relatively invariant across product use and gender. Individuals reported viewing e-cigs as safer and more beneficial than cigarettes and these beliefs were higher in e-cig users. Conclusions: Future work should establish how these comparative beliefs are influenced by e-cig use and/or influence subsequent transition to and increases in e-cig use. Although e-cigs are likely less harmful than cigarettes, and thus these comparative beliefs represent that state of nature, e-cigs are not completely without risk

Predicting running away in girls who are victims of commercial sexual exploitation

Youth that are victims of commercial sexual exploitation of children (CSEC) have a host of clinical problems and often run away from home, residential care, and treatment, which complicates and limits treatment effectiveness. No research to date has attempted to predict running away in CSEC victims. The present study aimed to 1) characterize a clinically referred sample of girls who were victims of CSEC and compare them to other high-risk girls (i.e., girls who also have a history of trauma and running away, but deny CSEC); and 2) examine the utility of using the Youth Level of Service/Case Management Inventory (YLS/CMI) to predict future running away. Data were collected from de-identified charts of 80 girls (mean age = 15.38, SD = 1.3, 37.9% White, 52.5% CSEC victims) who were referred for psychological assessment by the Department of Child Services. Girls in the CSEC group were more likely to have experienced sexual abuse (χ2 = 6.85, p = .009), an STI (χ2 = 6.45, p = .01), a post-traumatic stress disorder diagnosis (χ2 = 11.84, p = .001), and a substance use disorder diagnosis (χ2 = 11.32, p = .001) than high-risk girls. Moderated regression results indicated that YLS/CMI scores significantly predicted future running away among the CSEC group (β = 0.23, SE = .06, p = .02), but not the high-risk group (β = -.008, SE = .11, p =.90). The YLS/CMI shows initial promise for predicting future running away in girls who are CSEC victims. Predicting running away can help identify those at risk for and prevent running away and improve treatment outcomes. We hope current findings stimulate future work in this area

Conduct disorder symptoms and illicit drug use in juvenile justice involved youth: The reciprocal relationship between positive illicit drug use attitudes and illicit drug use

Conduct disorder (CD) symptoms cooccur at high rates with illicit drug use in juvenile justice involved youth, which results in poorer outcomes; however, research has not identified where best to intervene in this relationship, limiting the identification of modifiable risk factors to reduce negative effects of CD symptoms. Two mediation models were examined to investigate the potential for CD symptoms to influence a reciprocal relationship between illicit drug use and positive drug attitudes, controlling for age, gender, and race. Data were examined for 245 juvenile justice involved youth (mean age = 15.46, SD = 1.30, range 12-18, 64.9% Black, 80.4% male) who completed court-ordered psychological assessments. Findings indicate: (1) Positive attitudes toward illicit drug use significantly mediated the relationship between CD symptoms and illicit drug use (β = 0.16, CI 0.09-0.27; test for indirect effect z = 4.17, p < .001) and (2) illicit drug use significantly mediated the relationship between CD symptoms and positive attitudes toward illicit drug use (β = 0.20, CI 0.12-0.32; test for indirect effect z = 4.87, p < .001). Overall, the present study suggests that CD symptoms impart risk for illicit drug use both indirectly, through more positive attitudes toward illicit drug use, and directly, which further strengthens positive attitudes toward illicit drug use

PTSD Symptoms Mediate the Relationship Between Sexual Abuse and Substance Use Risk in Juvenile Justice-Involved Youth

Juvenile justice-involved youth face disproportionate rates of sexual abuse, which increases the risk of post-traumatic stress disorder (PTSD) and substance use disorders (SUDs), both of which are associated with poor long-term outcomes. The present study tested two mediation and moderation models, controlling for age, race, and history of physical abuse, with gender as a moderator, to determine whether PTSD symptoms serve as a risk factor and/or mechanism in the relationship between sexual abuse and substance use. Data were examined for 197 juvenile justice-involved youth (mean age = 15.45, 68.9% non-White, 78.4% male) that completed court-ordered psychological assessments. Results indicated that PTSD symptoms significantly mediated the relationship between sexual abuse and drug (β = 3.44, confidence interval [CI] [0.26, 7.41]; test for indirect effect z = 2.41, p = .02) and alcohol use (β = 1.42, CI [0.20, 3.46]; test for indirect effect z = 2.23, p = .03). PTSD symptoms and gender were not significant moderators. Overall, PTSD symptoms mediate the relationship between sexual abuse and SUDs in juvenile justice-involved youth, which suggests viability of targeting PTSD symptoms as a modifiable risk factor to reduce the effects of sexual abuse on substance use in this high-risk population