A new statistical model for binge drinking pattern classification in college-student populations

BackgroundBinge drinking (BD) among students is a frequent alcohol consumption pattern that produces adverse consequences. A widely discussed difficulty in the scientific community is defining and characterizing BD patterns. This study aimed to find homogenous drinking groups and then provide a new tool, based on a model that includes several key factors of BD, to assess the severity of BD regardless of the individual’s gender.MethodsUsing the learning sample (N1 = 1,271), a K-means clustering algorithm and a partial proportional odds model (PPOM) were used to isolate drinking and behavioral key factors, create homogenous groups of drinkers, and estimate the probability of belonging to these groups. Robustness of our findings were evaluated with Two validations samples (N2 = 2,310, N3 = 120) of French university students (aged 18–25 years) were anonymously investigated via demographic and alcohol consumption questionnaires (AUDIT, AUQ, Alcohol Purchase Task for behavioral economic indices).ResultsThe K-means revealed four homogeneous groups, based on drinking profiles: low-risk, hazardous, binge, and high-intensity BD. The PPOM generated the probability of each participant, self-identified as either male or female, to belong to one of these groups. Our results were confirmed in two validation samples, and we observed differences between the 4 drinking groups in terms of consumption consequences and behavioral economic demand indices.ConclusionOur model reveals a progressive severity in the drinking pattern and its consequences and may better characterize binge drinking among university student samples. This model provides a new tool for assessing the severity of binge drinking and illustrates that frequency of drinking behavior and particularly drunkenness are central features of a binge drinking model

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

The behavioral economics of alcohol demand in Greek-affiliated college students

International audienceBackground College students affiliated with fraternity and sorority, or ``Greek'' life represent a known high-risk group for alcohol consumption and related consequences, but little is known about demand for alcohol in this population. The current study examined behavioral economic demand for alcohol in a sample of Greek life-affiliated undergraduate students using the alcohol purchase task (APT) and a novel variation of the APT that included a fixed-price, nonalcoholic alternative (APT Choice). Methods Participants (n = 229) completed the APT, APT Choice, Alcohol Use Disorders Identification Test (AUDIT), and Daily Drinking Questionnaire (DDQ). Group demand indices were calculated for the entire sample and then separately for participants who met or did not meet the legal drinking age (21+ or underage, respectively). Independent-sample t tests assessed whether there were any significant differences between the two age cohorts in the percent change in each behavioral economic index from the APT to APT Choice. Tests of correlation evaluated the construct validity of the demand indices from both hypothetical purchase tasks. Results Descriptive statistics on alcohol use in this Greek-affiliated sample revealed ``hazardous'' drinking scores, with AUDIT-C scores exceeding the threshold of alcohol misuse. These measures were significantly correlated with demand indices from both APT conditions, and demand was inversely related to price; however, demand for alcohol was reduced when a nonalcoholic alternative was available. Both age cohorts reported a reduction in BP1 (highest price of nonzero consumption) and an increase in alpha (rate of change in elasticity), but these changes were significantly greater among underage participants. Conclusions Although Greek life-affiliated students demonstrate high demand for alcohol, the concurrent availability of a nonalcoholic alternative reduces alcohol demand, particularly for underage students. These findings suggest that nonalcoholic options may enhance the effectiveness of increasing alcohol prices to reduce alcohol consumption among students at higher risk for alcohol use

The Effects of Next-Day Class Characteristics on Alcohol Demand in College Students

International audienceBehavioral economic principles have been useful for addressing strategies to reduce alcohol consumption among college students. For example, academic variables (such as class schedule or academic rigor) have been found to affect alcohol demand assessed with a hypothetical alcohol purchase task (APT). The present studies used the APT to address the effects of 2 academic variables: next-day course level (no class, introductory level or upper level) and class size (no class, 30-student or 12-student). In each of 2 experiments, undergraduate participants read a description of a drinking context (either a no-class control version or 1 of the academic constraint conditions) and were asked to indicate how many drinks they would purchase at a variety of prices. Hursh and Silberberg's (2008) exponential demand equation was used to determine intensity and elasticity of demand, and Hursh and Roma's (2015) essential value (EV) parameter was calculated to assess essential value. In both experiments, a next-day class reduced alcohol demand, and alcohol consumption decreased as drink price increased. The presence of a smaller next-day class reduced alcohol demand compared with a larger next-day class; however, course level did not differentially affect alcohol demand. These results suggest that smaller next-day classes may reduce alcohol demand among college students and also provide initial evidence for the reliability of EV across studies

THE BEHAVIORAL ECONOMICS OF ALCOHOL DEMAND IN GREEK-AFFILIATED COLLEGE STUDENTS

41st Annual Scientific Meeting of the Research-Society-on-Alcoholism, San Diego, CA, JUN 16-20, 2018International audienc

The Behavioral Economics of the Bottomless Cup: The Effects of Alcohol Cup Price on Consumption in College Students

International audienceHeavy drinking among college students is a public health concern in part due to the accessibility of alcohol and promotions such as ``happy hours,'' which discount the price of alcohol. In addition, consuming alcohol at unregulated off-campus parties may result in greater alcohol consumption, higher blood alcohol concentrations, and increased negative consequences. The purpose of the current study was to assess demand for a refillable red ``Solo'' cup using a new hypothetical purchase task, the Cup-Price Purchase Task (CPPT). The CPPT asked college student participants to read a description of an off-campus party drinking context and indicate the likelihood of purchasing a refillable cup at prices ranging from \0.00-\60.00. We found that at cup prices of \5.00 or below, the likelihood of purchase was 75% or higher; however, probability of purchase decreased to about 47% at a cup price of \10.00. In addition, several CPPT behavioral economic parameters were positively correlated with the Alcohol Purchase Task (APT) and other alcohol-related measures, providing support for the CPPT's construct validity. Finally, hierarchical regression analyses revealed that maximum expenditure on the CPPT was a unique predictor of both alcohol consumption and alcohol-related consequences, even after controlling for the APT metrics. These findings may inform future studies investigating the behavioral economics of high-risk drinking situations and potential strategies to reduce binge drinking

Animal models of binge drinking, current challenges to improve face validity

International audienc

Changes in Alcohol Consumption among Users of an Internet Drug Forum during a COVID-19 Lockdown

Background: The aim of the present study was to assess the frequency and clinical correlates of users of an Internet drug forum who changed their alcohol use during the March–May 2020 COVID-19 lockdown in France. Methods: An anonymous Internet-based cross-sectional survey during the COVID-19 lockdown was used via messages on a French Internet drug forum. Participants reported any increase in their alcohol consumption during the lockdown. Alcohol craving and depressive/anxiety symptoms were assessed using the Obsessive and Compulsive Drinking scale (OCDS) and Hospital Anxiety and Depression scale (HADS). Results: Of 1310 respondents, 974 (79% of 1270) participants reported alcohol use before lockdown. During the lockdown, 405 participants (41.6%; IC95 (38.5–44.7)) reported an increase. Odds of an increase in alcohol consumption was higher for those with HADS scores higher than 7 (aOR: 2.19; p = 0.00002), OCDS scores greater than 7 (aOR: 3.50; p < 0.001), and daily psychostimulant use (aOR: 1.85; p = 0.002). Conclusions: Users of an Internet drug forum who reported high levels of depressive symptoms, high levels of alcohol craving, and the use of psychostimulants were more likely to increase alcohol consumption during a COVID-19 lockdown

Alcohol use increase in polysubstance users during quarantine related to SARS-Cov2 infection-19

International audienc

Ethanol (EtOH)-Related Behaviors in alpha-Synuclein Mutant Mice and Association of SNCA SNPs with Anxiety in EtOH-Dependent Patients

International audienceBackground Data have shown a role of alpha-synuclein in anxiety and also in addiction, particularly in alcohol use disorders (AUD). Since the comorbidity between AUD and anxiety is very high and because anxiety is an important factor in ethanol (EtOH) relapse, the aim of the present study was to investigate the role of alpha-synuclein in moderating EtOH intake, the anxiolytic effects of EtOH, and EtOH withdrawal-induced anxiety and convulsions in mice. The study aimed to determine whether SNCA variants moderated anxiety in EtOH-dependent patients. Methods We analyzed the moderator effect of 3 SNCA Tag-single nucleotide polymorphisms (Tag-SNPs) rs356200, rs356219, and rs2119787 on the anxiety symptoms in 128 EtOH-dependent patients. We used the C57BL/6JOlaHsd Snca mutant mice to assess EtOH intake; sensitivity to the anxiolytic effects of EtOH in a test battery comprising the open field, the light-dark box, and the elevated plus maze; and both anxiety and convulsions induced by EtOH withdrawal. Results Our results demonstrated a reduction in both EtOH intake and preference and also a lack of sensitivity to the anxiolytic effects of EtOH in alpha-synuclein mutant mice. Results on anxiety-like behavior were mixed, but mutant mice displayed increased anxiety when exposed to a low anxiogenic environment. Mutant mice also displayed an increase in handling-induced convulsion scores during withdrawal after EtOH inhalation, but did not differ in terms of EtOH withdrawal-induced anxiety. In humans, we found a significant association of the rs356219 SNP with a high level of anxiety (Beck Anxiety Inventory score >15) and the rs356200 SNP with a positive familial history of AUD. Conclusions Our translational study highlights a significant role of alpha-synuclein in components of AUD