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1.  APOE e4 Genotype and Cigarette Smoking in Adults with Normal Cognition and Mild Cognitive Impairment: A Retrospective Baseline Analysis of a National Dataset 
APOE e4 genotype is known to be a risk factor for Alzheimer's disease and atherosclerosis. Recently, published evidence has shown that APOE e4 genotype may also be associated with the cessation of cigarette smoking.
The aim of this retrospective analysis was to explore whether any past smoking outcomes differed based on APOE e4 genotype in a large national dataset.
Data were extracted from the National Alzheimer's Coordinating Center's longitudinal Uniform Data Set study. We limited this retrospective baseline analysis to the normal cognition (n = 2,995) and mild cognitive impairment (n = 1,627) groups that had APOE genotype and smoking data. Since this was an exploratory retrospective analysis, we conducted descriptive analyses on all variables based on APOE e4 genotype. We controlled for demographic, clinical, medication, and neurocognitive data in the analyses.
In both the normal cognition group and the mild cognitive impairment group, e4 carriers and e4 non-carriers did not significantly differ on total years smoked, age when last smoked, and the average # of packs/day smoked during the years they smoked. In both groups, e4 carriers and e4 non-carriers differed on various neurocognitive measures.
These data do not support the recently published evidence of the association between APOE e4 genotype and smoking outcomes.
Scientific Significance
Larger prospective clinical trials are needed to further explore the relationship between APOE genotype and smoking outcomes.
PMCID: PMC3710309  PMID: 23808899
APOE; e4; cigarette smoking; neurocognitive; cognitive; mild cognitive impairment
2.  Marijuana use is associated with risky sexual behaviors in treatment-seeking polysubstance abusers 
Multiple types of substance use are associated with HIV risk behaviors, but relatively little research has examined the association between marijuana use and risky sexual activities in treatment-seeking polysubstance abuse patients.
This study evaluated the relationship between marijuana use and sexual behaviors in 239 patients with cocaine, opioid, or alcohol use disorders who were initiating outpatient substance use treatment.
Participants completed the HIV Risk Behavior Scale and were classified into one of three groups based on their marijuana use histories: never (n = 66), past but not current use (n = 124), or current use (n = 49).
Compared to never marijuana users, current and former marijuana users had a greater likelihood of having more than 50 lifetime sexual partners [odds ratio (OR) and 95% confidence interval (CI) = 3.9 (1.0 – 15.7) and 5.2 (1.6 – 17.3), respectively]. Former marijuana users had increased risk of low frequency condom use with casual partners relative to never users [OR (95% CI) = 2.9 (1.1 – 7.6)]. Moreover, current marijuana users were more likely than never users to have had more than two recent sexual partners [OR (95% CI) = 8.1 (1.94 – 33.44)].
Treatment-seeking polysubstance abusers with current or past marijuana use histories may be at greater risk of HIV infection than their counterparts who do not use marijuana. These data underscore the importance of increasing awareness about the potential association between marijuana use and increased high risk sexual behavior among polysubstance abusing patients.
PMCID: PMC3793248  PMID: 23841867
marijuana; HIV risk behaviors; sexual behaviors
3.  Factors Associated with High-Frequency Illicit Methadone Use among Rural Appalachian Drug Users 
The American journal of drug and alcohol abuse  2013;39(4):10.3109/00952990.2013.805761.
In recent years there has been a sharp increase in the use of illicit methadone as well as methadone-related overdose deaths.
The purpose of this study is to describe factors associated low- and high-frequency methadone use in a cohort of rural Appalachian drug users.
Interviews assessing sociodemographics, illicit drug use and drug treatment, psychiatric disorders, health, and sociometric drug network characteristics were conducted with 503 rural drug users between 2008 and 2010. A two-level mixed effects regression model was utilized to differentiate low- (one use per month or less in the past 6 months) versus high-frequency (daily or weekly use in the past 6 months) illicit methadone users.
The lifetime prevalence of illicit methadone use in this population was 94.7% (n=476) and slightly less than half (46.3%) were high-frequency users. In the mixed effects regression model, initiating illicit methadone use at a younger age was associated with high-frequency illicit methadone use. Whereas taking a prescribed medication for a physical problem, undergoing additional weeks of outpatient drug free treatment, daily OxyContin® use in the past month, and having fewer ties and second order connections in the drug network reduced the odds of high-frequency illicit methadone use.
Rates of illicit methadone use and high-frequency illicit methadone use among this sample of rural drug users were considerably higher than those previously reported in the literature. Health practitioners in rural areas should routinely screen for illicit opioid use, including methadone.
PMCID: PMC3810268  PMID: 23841864
4.  Preliminary evaluation of a model of stimulant use, oxidative damage, and executive dysfunction 
Illicit stimulant use increases oxidative stress and oxidative stress has been found to be associated with deficits in memory, attention, and problem-solving.
To test a model of the association among oxidative DNA damage, a severe form of oxidative stress, and stimulant use, executive function, and stimulant-use outcomes.
Six sites evaluating 12-step facilitation for stimulant abusers obtained peripheral blood samples from methamphetamine-dependent (n=45) and cocaine-dependent (n=120) participants. The blood samples were submitted to a comet assay to assess oxidative DNA damage. Executive Dysfunction was assessed with the Frontal Systems Behavior Scale (FrSBe), which is a reliable and valid self-report assessment of executive dysfunction, disinhibition, and apathy. Stimulant-use measures included self-reported stimulant use and stimulant urine drug screens (UDS).
While more recent cocaine use (<30 days abstinence) was associated with greater oxidative DNA damage (W=2.4, p<.05, d=.36), the results did not support the hypothesized relationship between oxidative DNA damage, executive dysfunction, and stimulant-use outcomes for cocaine-dependent patients. Support for the model was found for methamphetamine-dependent patients, with oxidative DNA damage significantly greater in methamphetamine-dependent patients with executive dysfunction (W=2.2, p<.05, d=.64) and with executive dysfunction being a significant mediator of oxidative DNA damage and stimulant use during active treatment (ab=0.089, p<.05). As predicted, neither disinhibition nor apathy were significant mediators of oxidative damage and future stimulant use.
These findings provide preliminary support for a model in which oxidative damage resulting from methamphetamine use results in executive dysfunction which in turn increases vulnerability to future stimulant use.
PMCID: PMC4042831  PMID: 23808868
oxidative damage; stimulant-dependence; executive function
5.  Effects of alcohol use initiation on brain structure in typically developing adolescents 
Alcohol use in excessive quantities has deleterious effects on brain structure and behavior in adults and during periods of rapid neurodevelopment, such as prenatally. Whether similar outcomes characterize other developmental periods, such as adolescence, and in the context of less extensive use is unknown. Recent cross-sectional studies suggest that binge drinking as well as alcohol use disorders in adolescence are associated with disruptions in white matter microstructure and gray matter volumes.
The current study followed typically developing adolescents from a baseline assessment, where no experience with alcohol was present, through two years, after which some individuals transitioned into regular use.
Participants (n = 55) completed MRI scans and behavioral assessments.
Alcohol initiators (n = 30; mean baseline age 16.7 ± 1.3 years), compared to non-users (n = 25; mean baseline age 17.1 ± 1.2 years), showed altered patterns of neurodevelopment. They showed greater-than-expected decreases in cortical thickness in the right middle frontal gyrus from baseline to follow-up as well as blunted development of white matter in the right hemisphere precentral gyrus, lingual gyrus, middle temporal gyrus and anterior cingulate. Diffusion tensor imaging revealed a relative decrease over time in fractional anisotropy in the left caudate/thalamic region as well as in the right inferior frontal occipital fasciculus. Alcohol initiators did not differ from non-users at the baseline assessment; the groups were largely similar in other premorbid characteristics.
Subclinical alcohol use during mid-to-late adolescence is associated with deviations in neurodevelopment across several brain tissue classes. Implications for continued development and behavior are discussed.
PMCID: PMC4076828  PMID: 24200204
Adolescence; brain development; MRI
7.  Bupropion-SR for Smoking Cessation in Early Recovery from Alcohol Dependence: A Placebo-Controlled, Double-Blind Pilot Study 
We conducted a double-blind pilot study involving 11 alcohol and nicotine dependent patients randomized to receive either bupropion or placebo. Four of 6 patients on bupropion and 1 of 5 patients on placebo were abstinent from smoking at the end of medication phase. Those in the bupropion group reported significantly less craving (p < 0.02) and less exposure to cigarette smoke over time (expired CO; p < 0.01). There were no serious adverse events, and no main effects of medication group on either per subject or total number of adverse events. All those who completed treatment remained abstinent from alcohol.
PMCID: PMC4048722  PMID: 21797811
Bupropion; smoking cessation; alcohol dependence
8.  Does stress mediate the development of substance use disorders among youth transitioning to young adulthood? 
Stress is a well-documented factor in the development of addiction. However, no longitudinal studies to date have assessed the role of stress in mediating the development of substance use disorders (SUD). Our previous results have demonstrated that a measure called Transmissible Liability Index (TLI) assessed during pre-adolescent years serves a significant predictor of risk for substance use disorder among young adults. However, it remains unclear whether life stress mediates the relationship between TLI and SUD, or whether stress predicts SUD.
We conducted a longitudinal study involving 191 male subjects to assess whether life stress mediates the relationship between TLI as assessed at age 10–12 and subsequent development of SUD at age 22, after controlling for other relevant factors.
Logistic regression demonstrated that the development of SUD at age 22 was associated with stress at age 19. A path analysis demonstrated that stress at age 19 significantly predicted SUD at age 22. However, stress did not mediate the relationship between the TLI assessed at age 10–12 and SUD in young adulthood.
Conclusions and scientific significance
These findings confirm that stress plays a role in the development of SUD, but also shows that stress does not mediate the development of SUD. Further studies are warranted to clarify the role of stress in the etiology of SUD.
PMCID: PMC4044823  PMID: 24735415
Stress; substance use disorders; youth
9.  Sex differences in psychosocial correlates of concurrent substance use among heterosexual, homosexual and bisexual college students 
College students identifying as Lesbian, Gay or Bisexual (LGB) are at increased risk for substance use. Few studies have assessed correlates of concurrent substance use, which increases the risk for substance use disorders.
The current study aimed to (1) examine differences in substance use among male and female sexual minorities and (2) explore the impact of psychosocial factors on the relationship between sexual identity and concurrent substance use.
A web-based survey assessing health behavior, psychosocial characteristics, attitudes and demographics was administered to students from six colleges in the southeastern US. A total of 4840 students responded to the survey; 2.9% reported a homosexual identity (n = 111) and 3.5% reported a bisexual identity (n = 135). Multivariable modeling was used to assess the relationship between sexual identity and the number of substances used, adjusting for demographic and psychosocial factors.
Bisexual females were significantly more likely than their homosexual or heterosexual counterparts to report tobacco use (p < 0.0001), binge drinking (p < 0.05) and marijuana use (p < 0.0001) in the past 30 days. No differences in substances used existed among males. Adjusted for age and ethnicity, homosexually- and bisexually-identified females were more likely to have concurrent substance use than those who identified as heterosexual (p < 0.0001 and p < 0.0001, respectively). Adjusting for psychosocial factors decreased the magnitude and significance of the association (p < 0.01 and p < 0.001, respectively). Conclusion: Female sexual minorities are at high risk for substance use. Targeting specific psychosocial factors might be useful in efforts to address use of tobacco, alcohol and marijuana among LGB young adults.
PMCID: PMC4043213  PMID: 23773221
Concurrent substance use; LGBT health; young adults
10.  Reinforcement Sensitivity Theory and Alcohol Outcome Expectancies in Early Adolescence 
Little research has examined the development of alcohol expectancies in childhood, a notable omission as expectancies are viable targets for prevention programs. Moreover, limited alcohol expectancies research has been conducted from the perspective of psychobiological models of motivation despite the strong conceptual links between such models and cognitive models of alcohol use.
To examine if the associations between individual differences from the revised reinforcement sensitivity theory and alcohol use is mediated by alcohol expectancies in a large community sample of early adolescents using a prospective design.
378 families (1 caregiver; 1 child) were recruited via random digit phone call using a prospective design.
Our findings suggest that both a strong behavioral approach system and fight-flight or freeze system were associated with high levels of positive outcome expectancies, which subsequently predicted an increase in likelihood of alcohol use. There was also some evidence that drive (an aspect of behavioral approach system) was also positively associated with negative expectancies, which subsequently predicted a low probability of alcohol use.
Conclusions and Scientific Significance
Individual differences in reinforcement sensitivity may influence the acquisition of positive and negative outcome expectancies, thereby potentially influencing the likelihood of alcohol use in early adolescence. Thus, reinforcement sensitivity theory is a promising theory to account for the link between neural models of addiction and early acquisition of alcohol use in humans.
PMCID: PMC4033694  PMID: 22220630
BAS; BIS; FFFS; substance use initiation; expectancies; adolescence
11.  The Anticonvulsant Zonisamide Reduces Ethanol Self-Administration by Risky Drinkers 
The purpose of this study is to examine the effects of zonisamide on ethanol self-administration and subjective effects in risky drinkers using a human laboratory paradigm.
We conducted a double-blind, placebo-controlled study of the effects of zonisamide 100 mg on ethanol self-administration and urge to drink in risky drinkers (N = 10) (1).
During the second hour of a 2-hour self-administration session ethanol consumption was 50% lower in the zonisamide group as compared to the placebo group. Urge to drink was also significantly lower under the zonisamide condition.
These results indicate that a single dose of zonisamide reduces urge to drink and the quantity of ethanol self-administered by risky drinkers during their second hour of access to alcohol.
Scientific Significance
Zonisamide may help individuals drinking at risky levels reduce their intake of alcohol.
PMCID: PMC4028067  PMID: 19637104
Alcohol urges; anticonvulsants; ethanol; Human laboratory study; pharmacotherapy; Sulfonamide
12.  Social networks and alcohol use disorders: findings from a nationally representative sample 
While some argue that social network ties of individuals with alcohol use disorders (AUD) are robust, there is evidence to suggest that individuals with AUDs have few social network ties, which are a known risk factor for health and wellness.
Social network ties to friends, family, co-workers and communities of individuals are compared among individuals with a past-year diagnosis of alcohol dependence or alcohol abuse to individuals with no lifetime diagnosis of AUD.
Respondents from Wave 2 of the National Epidemiologic Survey on Alcohol Related Conditions (NESARC) were assessed for the presence of past-year alcohol dependence or past-year alcohol abuse, social network ties, sociodemographics and clinical characteristics.
Bivariate analyses showed that both social network size and social network diversity was significantly smaller among individuals with alcohol dependence, compared to individuals with alcohol abuse or no AUD. When social and clinical factors related to AUD status were controlled, multinomial logistic models showed that social network diversity remained a significant predictor of AUD status, while social network size did not differ among AUD groups.
Social networks of individuals with AUD may be different than individuals with no AUD, but this claim is dependent on specific AUD diagnosis and how social networks are measured.
PMCID: PMC4004646  PMID: 24405256
Alcohol use disorders; National Epidemiologic Survey on Alcohol Related Conditions (NESARC); social networks
13.  Changes in Smoking for Adults with and without Alcohol and Drug Use Disorders: Longitudinal Evaluation in the U.S. Population 
Little is known about the smoking cessation and smoking relapse behavior of adults with alcohol use disorders (AUDs) and drug use disorders (DUDs).
The current study used longitudinal data from a representative sample of the U.S. adult population to examine changes in smoking over three years for men and women with and without AUD and DUD diagnoses.
Participants were current or former daily cigarette smokers at Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions who completed the Wave 2 assessment three years later (n=11,973; 46% female). Analyses examined the main and gender-specific effects of AUD and DUD diagnoses on smoking cessation and smoking relapse.
Wave 1 Current Daily Smokers with a Current AUD (OR=0.70, 95% CI=0.55, 0.89), Past AUD (OR=0.73, 95% CI=0.60, 0.89), Current DUD (OR=0.48, 95% CI=0.31, 0.76), and Past DUD (OR=0.62, 95% CI=0.49, 0.79) were less likely to have quit smoking at Wave 2 than those with no AUD or DUD diagnosis. Wave 1 Former Daily Smokers with a Current AUD (OR=2.26, 95% CI=1.36, 3.73), Current DUD (OR=7.97, 95% CI=2.51, 25.34), and Past DUD (OR=2.69, 95% CI=1.84, 3.95) were more likely to have relapsed to smoking at Wave 2 than those with no AUD or DUD diagnosis. The gender-by-diagnosis interactions were not significant.
Current and Past AUDs and DUDs were associated with a decreased likelihood of quitting smoking while Current AUDs, Current DUDs, and Past DUDs were associated with an increased likelihood of smoking relapse.
PMCID: PMC3696891  PMID: 23721534
14.  Probability and Predictors of Transition from Abuse to Dependence on Alcohol, Cannabis, and Cocaine: Results from the National Epidemiologic Survey on Alcohol and Related Conditions 
Little is known about the transition from substance abuse to substance dependence. Objectives: This study aims to estimate the cumulative probability of developing dependence and to identify predictors of transition to dependence among individuals with lifetime alcohol, cannabis, or cocaine abuse.
Analyses were done for the subsample of individuals with lifetime alcohol abuse (n = 7802), cannabis abuse (n = 2832), or cocaine abuse (n = 815) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Estimated projections of the cumulative probability of transitioning from abuse to dependence were obtained by the standard actuarial method. Discrete-time survival analyses with time-varying covariates were implemented to identify predictors of transition to dependence.
Lifetime cumulative probability estimates indicated that 26.6% of individuals with alcohol abuse, 9.4% of individuals with cannabis abuse, and 15.6% of individuals with cocaine abuse transition from abuse to dependence at some point in their lives. Half of the transitions of alcohol, cannabis, and cocaine dependence occurred approximately 3.16, 1.83, and 1.42 years after abuse onset, respectively. Several sociodemographic, psychopathological, and substance use-related variables predicted transition from abuse to dependence for all of the substances assessed.
The majority of individuals with abuse do not transition to dependence. Lifetime cumulative probability of transition from abuse to dependence was highest for alcohol, followed by cocaine and lastly cannabis. Time from onset of abuse to dependence was shorter for cocaine, followed by cannabis and alcohol. Although some predictors of transition were common across substances, other predictors were specific for certain substances.
PMCID: PMC3755735  PMID: 23721532
transition; abuse; dependence; cannabis; alcohol; cocaine
15.  Barriers to Employment among Unemployed Drug Users: Age Predicts Severity 
Drug users in treatment or exiting treatment face many barriers to employment when entering the job market, such as low levels of education and technical skills, and low levels of interpersonal skills. As a result of these and other barriers, employment rates in these groups are generally low.
This article examines the existence and possible predictors of specific barriers to employment related to interpersonal and technical skills in a sample of participants enrolled in a therapeutic workplace intervention for substance abuse.
In Study I (N = 77), we characterized and examined predictors of participant scores on a staff-rated scale of interpersonal skills (Work Behavior Inventory). In Study II (N = 29), we examined whether participants had lower levels of computer knowledge than job seekers in the general population, and investigated possible predictors of computer knowledge in the sample.
In general, participants in Study I displayed low levels of interpersonal skills, and participants in Study II scored lower on the computer knowledge test than job seekers in the general population. Older participants tended to have lower levels of interpersonal skills and lower levels of computer knowledge.
Conclusions and Scientific Significance
These results suggest that providers of workforce development services for drug users in treatment or exiting treatment should attend to these specific barriers to employment, which may also be more pronounced among older clients.
PMCID: PMC3985289  PMID: 22242680
computer skills; employment; employment barriers; social skills; substance abuse
16.  The social support and social network characteristics of smokers in methadone-maintenance treatment 
Previous studies have shown social support and social network variables to be important factors in smoking cessation treatment. Tobacco use is highly prevalent among individuals in methadone maintenance treatment (MMT). However, smoking cessation treatment outcomes in this vulnerable subpopulation have been poor and social support and social network variables may contribute. The current study examined the social support and social network characteristics of 151 MMT smokers involved in a randomized clinical trial of smoking cessation treatments. Participants were 50% women and 78% Caucasian. A high proportion (57%) of MMT smokers had spouses or partners who smoke and over two-thirds of households (68.5%) included at least one smoker. Our sample was characterized by relatively small social networks, but high levels of general social support and quitting support. The number of cigarettes per day was found to be positively associated with the number of smokers in the social network (r = .239, p < .05) and quitting self-efficacy was negatively associated with partner smoking (r = −.217, p < .001). Findings are discussed in the context of developing smoking cessation interventions that address the influential role of social support and social networks of smokers in MMT.
PMCID: PMC3971529  PMID: 22571553
Social Support; Social Network; Smoking; Methadone-Maintenance
17.  Family History of Alcohol Use Disorders and Neuromaturation: A Functional Connectivity Study with Adolescents 
A positive family history (FHP) of alcohol use disorders (AUD) is linked to increased risk for personal AUD, but the mechanisms behind this risk are unclear. Previous research suggests that a subtle neurodevelopmental lag in FHP adolescents may contribute to risk for future AUD.
Functional magnetic resonance imaging (fMRI) response to a spatial working memory (SWM) task was examined for markers of neuromaturational delay in 85 youth with and without FHP. It was hypothesized that FHP adolescents (n=24, ages 12-14), as compared to matched FHN youth (n=26, ages 12-14), would show less similarity to brain connectivity observed in older adolescents (OA; n=35, ages 16-20) and that statistical comparison of SWM functional connectivity models would differentiate FHN and FHP youth. Structural equation modeling tested the fit of brain response connectivity between FH groups and against the OA model.
Patterns of connectivity were more similar between OA and FHN than FHP adolescents; FHP youth demonstrated higher association between right posterior and left frontal brain regions than FHN and OA youth. Comparison of FH groups indicated a significant difference on the pathway from the right superior parietal lobule to the left middle frontal gyrus.
These findings provide additional support for the notion of a neuromaturational lag in FHP youth. Protracted neuromaturation may be a mechanism by which FH increases risk for alcohol dependence, and this less mature neural connectivity pattern may provide a novel endophenotype for identifying youth at risk for drinking problems.
PMCID: PMC3959877  PMID: 24200205
18.  High and Low Neurobehavior Disinhibition Clusters within Locales: Implications for Community Efforts to Prevent Substance Use Disorder 
Knowledge of where substance use and other such behavioral problems frequently occur has aided policing, public health, and urban planning strategies to reduce such behaviors. Identifying locales characterized by high childhood neurobehavioral disinhibition (ND), a strong predictor of substance use and consequent disorder (SUD), may likewise improve prevention efforts.
The distribution of ND in 10–12-year olds was mapped to metropolitan Pittsburgh, PA, and tested for clustering within locales.
The 738 participating families represented the population in terms of economic status, race, and population distribution. ND was measured using indicators of executive cognitive function, emotion regulation, and behavior control. Innovative geospatial analyzes statistically tested clustering of ND within locales while accounting for geographic barriers (large rivers, major highways), parental SUD severity, and neighborhood quality.
Clustering of youth with high and low ND occurred in specific locales. Accounting for geographic barriers better delineated where high ND is concentrated, areas which also tended to be characterized by greater parental SUD severity and poorer neighborhood quality.
Conclusions and Significance
Offering programs that have been demonstrated to improve inhibitory control in locales where youth have high ND on average may reduce youth risk for SUD and other problem behaviors. As demonstrated by the present results, geospatial analysis of youth risk factors, frequently used in community coalition strategies, may be improved with greater statistical and measurement rigor.
PMCID: PMC3912733  PMID: 23721535
disinhibition; children; geospatial analysis; substance use
19.  Hippocampal Volumes in Adolescents with and without a Family History of Alcoholism 
Background and Objectives
The hippocampus may be vulnerable to the effects of heavy alcohol use during adolescence, which is a time of continued neurodevelopment. However, differences in hippocampal volume may be due to risk factors such as a family history (FH) of alcoholism. We examined hippocampal volumes in youth with and without a FH of alcoholism prior to the initiation of alcohol use.
Participants were demographically matched adolescents (aged 12-14) with positive (n=15; FHP) and negative (n=15; FHN) FH of alcoholism. Each group consisted of 10 males and 5 females with minimal previous substance use. Manual hippocampal tracings were completed on high-resolution magnetic resonance images by reliable raters, and intracranial volumes were controlled in analyses.
FH groups did not differ on memory or hippocampal volumes, but group × gender interactions (p<.05) indicated that FHP males had larger left hippocampi than FHN males. Females showed greater left versus right hippocampal asymmetry, while males showed larger right versus left asymmetry. For all adolescents, larger right hippocampal volumes predicted poorer delayed visual memory (p<.01).
Conclusion and Significance
Alcoholism risk factors, such as family history of alcoholism, may differentially influence adolescent hippocampal development for boys as compared to girls. Results suggest that FH does not account for prior findings of reduced left hippocampal volumes in heavy drinking youth. Findings are preliminary, but suggest that future studies examining the effects of alcohol use on the adolescent brain should consider the influence of FH, especially among boys.
PMCID: PMC3891832  PMID: 20465374
family history of alcoholism; alcohol; adolescence; hippocampus; memory; gender
20.  Are “extreme consumption games” drinking games? Sometimes it's a matter of perspective 
The American journal of drug and alcohol abuse  2013;39(5):10.3109/00952990.2013.827202.
Drinking games are widespread on college campuses and pose health risks to their players. Although there has been considerable research progress in the college drinking games literature, there does not appear to be a standard definition of the term “drinking games.” Researchers, however, have attempted to classify and categorize drinking games in a systematic manner. For example, one category of drinking games (e.g., chugging, keg stands) is often referred to as consumption or extreme consumption games. Questions remain as to whether or how these types of games align with researchers' definitions of drinking games or the categorization systems advanced by researchers in the field. Potential challenges regarding the definition and categorization of drinking games, particularly with respect to extreme consumption types of games, are discussed.
PMCID: PMC3884949  PMID: 23968169
College students; drinking games; pregaming; problem drinking
21.  Paying Substance Abusers in Research Studies: Where Does the Money Go? 
The American journal of drug and alcohol abuse  2011;38(1):10.3109/00952990.2011.563337.
Research involving substance abusing participants is often hindered by low rates of recruitment and retention. Research suggests that monetary payment or remuneration can be an effective strategy to overcome these obstacles. This paper provides a brief overview of these issues and provides data reflecting how substance abusing participants in several of our studies used their baseline and follow-up payments. We also present research findings related to how the mode of payment (i.e.., cash, check, gift card) may affect how payments are used. Overall, our findings suggest that participants use their research payments in a responsible and safe manner. Limitations and recommendations for future research are discussed.
PMCID: PMC3881275  PMID: 22185328
Remuneration; Participant payment; Substance abuse research; Monetary incentives
22.  Social contexts of drinking and subsequent alcohol use disorder among college students 
Previous research has suggested important contextual factors that can differentiate problem and non-problem drinkers.
To evaluate the strength of the prospective association between social contexts of drinking and subsequent alcohol use disorder and drunk driving 2 to 3 years later.
The sample consisted of 652 individuals who were originally recruited at college entry, had complete data on at least one social context subscale, met minimum criteria for Year 1 drinking, and had non-missing data on at least one of the outcome variables in Years 3 and/or 4. Social contexts of drinking were assessed in Year 1 using previously-validated scales measuring six different situational and motivational contexts in which alcohol is consumed. DSM-IV criteria for alcohol abuse and dependence and drunk driving were assessed annually.
Holding constant gender, race/ethnicity, and baseline drinking frequency, the frequency of drinking in a context of social facilitation, sex-seeking, or in a motor vehicle during Year 1 was significantly related to a greater likelihood of alcohol abuse, alcohol dependence, and drunk driving in Years 3 and/or 4. Drinking in a context of emotional pain was related to alcohol dependence and drunk driving but not to alcohol abuse.
The Social Context of Drinking Scales have utility for identifying students who are at risk for developing alcohol-related problems. Scientific Significance: Identifying college students who might develop alcohol dependence requires an assessment of both situational and motivational factors that influence drinking, especially drinking in a motor vehicle.
PMCID: PMC3465632  PMID: 22746152
Alcohol use disorder; college students; social context; longitudinal study
23.  Correlates of Concurrent Energy Drink and Alcohol Use among Socially Active Adults 
Research indicates that energy drink consumption and the combined use of energy drinks and alcohol are popular among young adults, although this research has typically focused on college students. Because of the potential for harms associated with this combination, it is critical to understand use among adults in nightlife scenes who may be most at risk for harms associated with combined energy drink and alcohol consumption.
By focusing our sample on individuals in a range of nightlife scenes, we aim to gain a deeper understanding of the demographic factors associated with energy drink use and combined energy drink and alcohol consumption to benefit the targeting of intervention and prevention efforts beyond college campuses.
Using a field-based survey in New York City to survey adults active in various nightlife scenes, this study reports on the survey results of 1476 venue patrons at venues in five nightlife scenes in addition to college bar scenes
Men, younger individuals, Latinos, and sexual minority individuals reported higher prevalence of recent energy drink consumption. Younger individuals, men, and those recruited in gay venues reported higher prevalence of combining alcohol and energy drinks.
These findings provide information useful to target education and prevention efforts. They also suggest the need for additional research to understand differences in motivations for use and in the behavioral and alcohol-related outcomes associated with consuming energy drinks and combining them with alcohol.
PMCID: PMC3683298  PMID: 23030475
energy drink; alcohol
24.  Interpersonal guilt in college student pathological gamblers 
The American journal of drug and alcohol abuse  2012;39(1):10.3109/00952990.2012.694520.
Interpersonal guilt is associated with psychopathology, but its relationship to pathological gambling has not been studied.
This study examined the relationship between interpersonal guilt and pathological gambling.
In total, 1,979 college students completed a questionnaire containing the South Oaks Gambling Screen, Interpersonal Guilt Questionnaire, and questions about substance use. Students identified as pathological gamblers (n = 145) were matched to non-problem gamblers with respect to demographics and substance use.
Pathological gamblers had significantly higher interpersonal guilt than their non-problem gambling peers.
Conclusions and Scientific Significance
Pathological gambling college students have excessive interpersonal guilt, and these findings may lead to novel treatment approaches.
PMCID: PMC3829613  PMID: 22746179
25.  A preliminary investigation of Stroop-related intrinsic connectivity in cocaine dependence: Associations with treatment outcomes 
The American journal of drug and alcohol abuse  2013;39(6):10.3109/00952990.2013.841711.
Cocaine-dependent individuals demonstrate neural and behavioral differences compared to healthy comparison subjects when performing the Stroop color-word inference test. Stroop measures also relate to treatment outcome for cocaine dependence. Intrinsic connectivity analyses assess the extent to which task-related regional brain activations are related to each other in the absence of defining a priori regions-of-interest.
This study examined: 1) the extent to which cocaine-dependent and non-addicted individuals differed on measures of intrinsic connectivity during fMRI Stroop performance; and, 2) the relationships between fMRI Stroop intrinsic connectivity and treatment outcome in cocaine dependence.
Sixteen treatment-seeking cocaine-dependent patients and matched non-addicted comparison subjects completed an fMRI Stroop task. Between-group differences in intrinsic connectivity were assessed and related to self-reported and urine-toxicology-based cocaine-abstinence measures.
Cocaine-dependent patients vs. comparison subjects showed less intrinsic connectivity in cortical and sub-cortical regions. When adjusting for individual degree of intrinsic connectivity, cocaine-dependent vs. comparison subjects showed relatively greater intrinsic connectivity in the ventral striatum, putamen, inferior frontal gyrus, anterior insula, thalamus, and substantia nigra. Non-mean-adjusted intrinsic-connectivity measures in the midbrain, thalamus, ventral striatum, substantia nigra, insula, and hippocampus negatively correlated with measures of cocaine abstinence.
The diminished intrinsic connectivity in cocaine-dependent vs. comparison subjects suggests poorer communication across brain regions during cognitive-control processes. In mean-adjusted analyses, the cocaine-dependent group displayed relatively greater Stroop-related connectivity in regions implicated in motivational processes in addictions. The relationships between treatment outcomes and connectivity in the midbrain and basal ganglia suggest that connectivity represents a potential treatment target.
PMCID: PMC3827911  PMID: 24200209
intrinsic connectivity; cocaine dependence; functional magnetic resonance imaging; Stroop color-word interference test; treatment outcome; addiction; cognitive control

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