The Serotonin Transporter Polymorphism (5-HTTLPR) and Alcohol Problems in Heavy Drinkers: Moderation by Depressive Symptoms.

Heavy alcohol use in young adults has been prospectively associated with a host of psychosocial and alcohol-related problems. Recent studies have supported the interaction between serotonin transporter polymorphism and adverse environmental factors, as a predictor of alcohol use and the development of alcohol dependence. The current study examined the role of depressive symptoms in combination with the serotonin transporter polymorphism as a predictor of alcohol use and alcohol-related problems. Results revealed a significant genotype by depressive symptom interaction, such that heavier alcohol use was associated with depressive symptoms in L allele homozygotes but not among S allele carriers. These results remained significant after controlling for ethnicity and gender effects. These findings extend the emerging literature supporting 5-HTTLPR genotype as a risk factor for alcohol-related problems in the context of co-occurring symptoms of depression

Relationship between tonic and phasic craving for alcohol.

BackgroundMultiple measures are utilized to assess alcohol craving, often interchangeably. Little is known about the relationship between tonic and phasic craving. This study fills this gap in the literature by examining the association between tonic levels of alcohol craving and phasic craving for alcohol that is provoked by alcohol administration.MethodsForty-three non-treatment seeking problem drinkers underwent an initial interview and two laboratory testing sessions, where either alcohol or a saline placebo was administered intravenously. Tonic craving was assessed via the Penn Alcohol Craving Scale (PACS) and Obsessive Compulsive Drinking Scale (OCDS) at the initial interview. Phasic craving was assessed during the laboratory sessions (i.e., alcohol and saline administrations, single blinded) at baseline and at 3 subsequent breath alcohol concentrations (0.02, 0.04, and 0.06 g/dl).ResultsThere was a main effect of PACS in predicting phasic craving across both saline and alcohol administration conditions (p < 0.05). The OCDS was predictive of phasic craving when alcohol, but not saline, was administered (p = 0.058); the obsessive subscale (p = 0.01), but not the compulsive subscale (p > 0.10), predicted phasic craving during alcohol, as compared to saline administration.ConclusionIn sum, tonic craving captured by the OCDS was predictive of phasic craving during alcohol administration whereas the PACS more generally captured the increase in phasic craving. Therefore, these measures of tonic craving may function differently in capturing the experience of phasic craving. Implications for the utilization of the PACS and OCDS as well as assessments of craving in alcoholism research are discussed

Convergence between the Penn Alcohol Craving Scale and diagnostic interview for the assessment of alcohol craving.

IntroductionThe Penn Alcohol Craving Scale (PACS) is one of the most widely used instruments to measure craving for alcohol. Recent research has suggested that scores on the PACS can be used as a "stand in" for the diagnostic criterion of alcohol craving with a proposed cutoff of >20 on the PACS indicating a "positive" alcohol craving symptom. The present study examined the convergence between the PACS and face-to-face diagnostic interview for the assessment of alcohol craving.MethodA sample of non-treatment seeking heavy drinkers (N = 338) enrolled in experimental studies of AUD completed the PACS as well as a face-to-face diagnostic interview for AUD, which included the craving item from the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA).ResultsUsing the PACS cut-off score of >20, 12.9% (N = 43) of the sample met criteria for alcohol craving compared to 21% (N = 74) of the sample meeting criteria based on the diagnostic interview. Using the PACS cutoff of >20, sensitivity (i.e., true positive rate) was 41% and specificity (i.e., true negative rate) was 95%. Exploratory analyses suggested that a cut-off score of ≥15 achieved the optimal balance of sensitivity (67%) and specificity (81%) in our sample.ConclusionsAdvancing the assessment of alcohol craving and the conversion from DSM-IV to DSM-5 diagnostic criteria represents an important research direction. The present study recommends that a PACS score cut off of ≥15 should be used as an indicator of clinically significant alcohol craving in community samples of non-treatment seekers

An Examination of Motivation to Change and Neural Alcohol Cue Reactivity Following a Brief Intervention.

Background: Brief interventions represent a promising psychological intervention targeting individuals with heavy alcohol use. Motivation to change represents an individual's openness to engage in a behavior change strategy and is thought to be a crucial component of brief interventions. Neuroimaging techniques provide a translational tool to investigate the neurobiological mechanisms underlying potential mediators of treatment response, including motivation to change. Therefore, this study aimed to examine the effect of a brief intervention on motivation to change drinking behavior and neural alcohol taste cue reactivity. Methods: Non-treatment-seeking heavy drinkers were randomized to receive a brief drinking intervention (n = 22) or an attention-matched control (n = 24). Three indices of motivation to change were assessed at baseline and after the intervention or control session: importance, confidence, and readiness. Immediately following the intervention or control session, participants also underwent an functional magnetic resonance imaging (fMRI) during which they completed an alcohol taste cues paradigm. Results: There was a significant effect of the brief intervention on increasing ratings of importance of changing drinking behavior, but not on ratings of confidence or readiness to change. Ratings of importance after the intervention or control session were associated with neural alcohol taste cue reactivity, but notably, this effect was only significant for participants who received the intervention. Individuals in the intervention condition showed a positive association between ratings of importance and activation in the precuneus, posterior cingulate, and insula. Conclusions: The brief drinking intervention was successful at improving one dimension of motivation to change among non-treatment-seeking heavy drinkers. The brief intervention moderated the relationship between ratings of importance and brain activation in circuitry associated with interoceptive awareness and self-reflection. Together, findings represent an initial step toward understanding the neurobiological mechanisms through which a brief intervention may improve motivation to change

The Effects of Naltrexone Among Alcohol Non-Abstainers: Results from the COMBINE Study

These analyses of the COMBINE Study examined the effects of naltrexone among non-abstainers. Given that one of the most well-established mechanisms of action of naltrexone involves blunting of alcohol reward, it is hypothesized that naltrexone should be more effective among individuals who drank during treatment. Participants were 952 (78% of the total COMBINE Study sample) treatment-seeking alcohol-dependent men and women who received pharmacotherapy for alcoholism and drank at least once during the 16-week trial. Mixed model analyses revealed that individuals who drank more regularly during the trial seemed to benefit most from naltrexone and the effects of naltrexone on heavy drinking was significant in treatment months 2 through 4 among individuals who reported drinking on 81, 68, and 60% or more of days, respectively. Those drinking frequencies were observed in 11, 15, and 19% of the sample. Similar effects were not observed for drinks per drinking day. These results suggest that a small subgroup of non-abstainers, composed primarily of very regular drinkers, appears to benefit from naltrexone in reducing heavy drinking days. Naltrexone may be effective in the context of controlled-drinking approaches, even among very frequent drinkers

Modelización de la atractividad territorial en las metrópolis

This article is a theoretical-methodological review of Territorial Attractiveness for the construction of a qualitative model. The aforementioned is one of the main contributions of this research, which is built on the basis of the revised literature. There is little bibliography on the subject: “the study of the metropolis analyzed from the Territorial Attractiveness and the marketing of cities.” Therefore, the discussions presented in the article come from other territories, it should also be noted that studying the metropolis from the marketing point view  is an area that is not very dabbled at present in Mexico; nevertheless this could represent truly significant changes if the use of these tools is enhanced. The conduct of this research was inductive in nature, taking a descriptive and analytical qualitative approach through the application of the modeling technique, which dates back from 2015 to 2018 taking four perspectives of Territorial Attractiveness. Among the important findings, it can be indicated that metropolitan areas have their own characteristics and can consciously position themselves in the minds of their citizens, public servants, tourists, investors and human capital through the adoption of a metropolitan city brand. On top of that, it assumes that all cities, including metropolises, can develop positioning strategies from competitiveness and marketing with a view to inserting themselves in the international environment.El presente artículo es una revisión teórico-metodológica de la Atractividad Territorial para la construcción de un modelo cualitativo siendo este uno de los principales aportes de la investigación, construido con base en la literatura revisada.Sobre el tema existe poca bibliografía del estudio de las metrópolis analizadas desde la Atractividad Territorial y de la Mercadotecnia de ciudades, por lo cual las discusiones presentadas en el artículo, provienen de otras escalas territoriales, aunado a eso, cabe señalar que estudiar metrópolis desde el punto de vista de la mercadotecnia es un área poco incursionada en la actualidad en México, pero que esto podría representar cambios verdaderamente significativos si se potencializa el uso de dichas herramientas. La realización de esta investigación fue de corte inductivo tomando un enfoque cualitativo de carácter descriptivo y analítico mediante la aplicación de la técnica de modelización, el cual data del 2015 al 2018 tomando cuatro perspectivas de la Atractividad Territorial. Entre los hallazgos importantes se puede indicar que las áreas metropolitanas poseen características propias y pueden posicionarse de manera consciente en la mente de su ciudadanía, servidores públicos, turistas, inversionistas, capital humano, a través de la adopción de una marca ciudad metropolitana. Y con ello, asume que todas las ciudades, incluidas las metrópolis, pueden desarrollar estrategias de posicionamiento desde la competitividad y la mercadotecnia con miras a insertarse en el medio internacional

Sensitivity and specificity of a commercial urinary ethyl glucuronide (ETG) test in heavy drinkers.

Introduction:To advance the use of alcohol metabolites as biomarkers in the context of alcohol research, the present study tested the sensitivity and specificity of a commercially available urinary ethyl glucuronide (uEtG) test (DrugConfirm Advanced 80hr EtG) in a clinical research context. Methods:A community sample of heavy drinkers (N = 68) completed the 30-day Timeline Follow-Back (TLFB) interview and provided a urine sample for uEtG analysis. Analyses of sensitivity and specificity of the uEtG assay were conducted using the following outcomes: (a) past day drinking, (b) past day binge drinking (defined as ≥4 drinks for women and ≥5 drinks for men), (c) past 3-day drinking, and (d) past 3-day binge drinking. Results:The majority of participants reported past-3-day drinking (80.9%) and a sizeable minority reported past day drinking (33.8%). While uEtG-based detection of past day drinking and binge drinking was acceptable (sensitivity = 73.91%, and 83.33%; specificity = 80.00% and 66.13%, respectively), detection of any drinking and binge drinking in the past 3 days was poor (sensitivity and specificity of 43.64% and 84.62%, and 39.39% and 62.86%, respectively). Conclusions:This study contributes to the mixed findings on the validity of EtG tests, which suggest that commercial uEtG tests with conservative detection thresholds are not a reliable alcohol biomarker without corroborating self-report data. Lower detection thresholds are recommended when using uEtG as an alcohol biomarker. Efforts to reach acceptable levels of sensitivity and specificity with commercial assays hold potential to advance the measurement of alcohol intake, overcoming the pitfalls of self-report data

Experimental and observational studies on alcohol use and dietary intake: a systematic review

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153599/1/obr12950_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153599/2/obr12950.pd

A Brief Smoking Cessation Intervention for Heavy Drinking Smokers: Treatment Feasibility and Acceptability

Approximately 20–25% of regular smokers report heavy drinking. Abstinent smokers are five times as likely to experience a smoking lapse during drinking episodes. Current efforts seek to improve treatments for this subgroup of heavy-drinking smokers. This study tested the feasibility and acceptability of addressing alcohol use in a brief, single session smoking cessation intervention (SMK+A) compared to smoking cessation counseling only (SMK); these interventions were grounded in a motivational interview framework and included personalized feedback, decisional balance, quit day setting, and tailored skills building (e.g., breathing techniques, coping with urges, dealing with social pressures) to maintain abstinence. Descriptive outcomes included reported helpfulness of intervention skills, readiness to change scores, and feasibility of participant recruitment and retention. We also assessed 7-day point prevalence of smoking cessation, and smoking and drinking reduction at 1-month follow-up. Participants (N = 22) were community-based treatment-seeking daily smokers (≥5 cigarettes/day) who were also heavy drinkers (≥14 drinks/week for men, ≥ 7 drinks/week for women; or ≥5 drinks on one episode in past week for men, ≥4 for women). Twenty five percent of interested individuals were eligible after initial phone screen, and all randomized participants were retained through follow up. All skills demonstrated high acceptability (i.e., rated between moderately and very helpful), and a significant proportion of participants in each condition reported taking action to reduce cigarette smoking and/or alcohol use at 1-month post-quit. Three participants in each condition (27.3%) attained bioverified (CO ≤ 4 parts per million and cotinine ≤ 3 ng/mL) smoking quit at follow-up. Given the modified intervention's acceptability and flexibility, larger studies may help to elucidate this intervention's effects on readiness to change, smoking cessation, and alcohol reduction