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Item Alcohol Use and Alcohol Use Disorder Differ in their Genetic Relationships with PTSD: A Genomic Structural Equation Modelling Approach(Elsevier, 2022) Bountress, Kaitlin E.; Brick, Leslie A.; Sheerin, Christina; Grotzinger, Andrew; Bustamante, Daniel; Hawn, Sage E.; Gillespie, Nathan; Kirkpatrick, Robert M.; Kranzler, Henry; Morey, Rajendra; Edenberg, Howard J.; Maihofer, Adam X.; Disner, Seth; Ashley-Koch, Allison; Peterson, Roseann; Lori, Adriana; Stein, Dan J.; Kimbrel, Nathan; Nievergelt, Caroline; Andreassen, Ole A.; Luykx, Jurjen; Javanbakht, Arash; Youssef, Nagy A.; Psychiatric Genomics Consortium Posttraumatic Stress Disorder Working Group; Amstadter, Ananda B.; Biochemistry and Molecular Biology, School of MedicinePurpose: Posttraumatic Stress Disorder (PTSD) is associated with increased alcohol use and alcohol use disorder (AUD), which are all moderately heritable. Studies suggest the genetic association between PTSD and alcohol use differs from that of PTSD and AUD, but further analysis is needed. Basic procedures: We used genomic Structural Equation Modeling (genomicSEM) to analyze summary statistics from large-scale genome-wide association studies (GWAS) of European Ancestry participants to investigate the genetic relationships between PTSD (both diagnosis and re-experiencing symptom severity) and a range of alcohol use and AUD phenotypes. Main findings: When we differentiated genetic factors for alcohol use and AUD we observed improved model fit relative to models with all alcohol-related indicators loading onto a single factor. The genetic correlations (rG) of PTSD were quite discrepant for the alcohol use and AUD factors. This was true when modeled as a three-correlated-factor model (PTSD-AUD rG:.36, p < .001; PTSD-alcohol use rG: -0.17, p < .001) and as a Bifactor model, in which the common and unique portions of alcohol phenotypes were pulled out into an AUD-specific factor (rG with PTSD:.40, p < .001), AU-specific factor (rG with PTSD: -0.57, p < .001), and a common alcohol factor (rG with PTSD:.16, NS). Principal conclusions: These results indicate the genetic architecture of alcohol use and AUD are differentially associated with PTSD. When the portions of variance unique to alcohol use and AUD are extracted, their genetic associations with PTSD vary substantially, suggesting different genetic architectures of alcohol phenotypes in people with PTSD.Item Application of the Acquired Preparedness Model for Alcohol and Cigarette Use Among Reserve-Dwelling First Nation Adolescents(American Psychological Association, 2022) Schick, Melissa R.; Williams, Jessica N.; Kirk-Provencher, Katelyn T.; Cyders, Melissa A.; Spillane, Nichea S.; Psychology, School of ScienceObjective: North American Indigenous youth experience disproportionate harm associated with alcohol and cigarette use compared to other racial/ethnic groups. The Acquired Preparedness Model (APM), developed and tested in primarily White samples, hypothesizes that urgency contributes to risk for substance use by influencing the degree to which adolescents attend to positive aspects of substance use, leading to the development of more positive expectations about the consequences of substance use, and increasing subsequent substance use. The purpose of the present study was to provide an initial test of whether the APM generalizes to understanding alcohol and cigarette use among high-risk First Nation adolescents. Method: First Nation adolescents (n = 106, Mage = 14.6, 50.0% female) recruited from reserve communities in Eastern Canada completed self-report measures as part of a larger community-based participatory research project. Procedures were approved by tribal chief, council, and university IRB. Results: The hypothesized model demonstrated excellent fit for alcohol use, χ²(1) = 1.07, p = .30, CFI = 0.99, RMSEA = .03, SRMR = .02, and adequate fit for cigarette use, χ²(1) = 2.58, p = .11, CFI = 0.98, RMSEA = 0.12, SRMR = 0.03. The indirect effects of urgency on alcohol consumption and cigarette smoking through alcohol and cigarette expectancies were each significant. Conclusions: Findings of the present study provide initial support for the generalizability of the APM in understanding risk for alcohol and cigarette use among reserve-dwelling First Nation youth. The next important step is to replicate this finding in a prospective sample.Item Benzodiazepine and Unhealthy Alcohol Use Among Adult Outpatients(Managed Care & Healthcare Communications, 2019-12-13) Hirschtritt, Matthew E.; Palzes, Vanessa A.; Kline-Simon, Andrea H.; Kroenke, Kurt; Campbell, Cynthia I.; Sterling, Stacy A.; Medicine, School of MedicineOBJECTIVES: Concomitant excessive alcohol consumption and benzodiazepine use is associated with adverse health outcomes. We examined associations of unhealthy alcohol use and other patient characteristics with benzodiazepine use. STUDY DESIGN: A cross-sectional analysis of 2,089,525 Kaiser Permanente of Northern California outpatients screened for unhealthy alcohol use in primary care between November 1, 2014, and December 31, 2016. METHODS: We fit multivariable generalized linear models to estimate the associations between unhealthy alcohol use and benzodiazepine dispensation and, among patients who were dispensed a benzodiazepine, mean doses (in mean lorazepam-equivalent daily doses [LEDDs]) and prescription durations. We controlled for patient sex, age, race/ethnicity, estimated household income, Charlson Comorbidity Index (CCI) score, anxiety disorder, alcohol use disorder, insomnia, musculoskeletal pain, and epilepsy. RESULTS: In the 12 months centered around (6 months before and 6 months after) the first alcohol-screening visit, 7.5% of patients used benzodiazepines. The following characteristics were independently associated with higher rates of benzodiazepine use, higher LEDD, and longer prescription duration: older age, white race/ethnicity, lower estimated household income, higher CCI score, and the presence of an anxiety disorder, insomnia, musculoskeletal pain, or epilepsy. Women and patients with an alcohol use disorder or unhealthy alcohol use, compared with men and patients with low-risk drinking or abstinence, were more likely to use a benzodiazepine; however, their LEDDs were lower and their prescription durations were shorter. CONCLUSIONS: Benzodiazepine use in primary care was associated with older age, female sex, white race/ethnicity, lower socioeconomic status, and unhealthy alcohol use. These findings may be applied to develop policies and interventions to promote judicious benzodiazepine use.Item Combined expectancies of alcohol and e-cigarette use relate to higher alcohol use(Elsevier, 2016-01) Hershberger, Alexandra R.; Karyadi, Kenny A.; VanderVeen, J. Davis; Department of Psychology, School of ScienceElectronic 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.Item Cultural socialization and alcohol use: The mediating role of alcohol expectancies among racial/ethnic minority youth(Elsevier, 2018-11-20) Zapolski, Tamika C.B.; Clifton, Richelle L.; Psychology, School of ScienceIntroduction: Cultural socialization is associated with reduced risk for several health outcomes among racial/ethnic minority youth. However, to date, less is known about its effect on substance use or the mechanisms through which this process may operate. The current study aimed to examine the effect of cultural socialization on alcohol use through alcohol expectancies among racial/ethnic minority youth. Methods: 113 minority adolescents (69.9% African American; 13.3% Hispanic; 10.6% Multiracial; 2.7% American Indian/Alaskan Native) between ages 12 and 18 (mean age 15) were recruited from community-based after school centers. Participants completed measures on cultural socialization, four alcohol expectancy domains (i.e., positive social, wild and crazy, negative arousal, and sedation), and past year alcohol use. Results: A significant indirect pathway between cultural socialization, alcohol expectancies and alcohol use was found for negative arousal expectancies (b = -0.160, Boot CI [95] = -0.413, -0.021). Indirect paths were non-significant for the other three alcohol expectancies. Conclusions: Our findings suggest that cultural socialization can help reduce alcohol use among racial/ethnic minority adolescents, in part though influencing negative arousal expectancies. Given evidence that alcohol expectancies play an important and long-lasting role in alcohol use across development, incorporating cultural socialization into intervention programming for racial/ethnic minority youth may prove beneficial to reduce risk for alcohol use.Item Education Matters: Longitudinal Pathways to Midlife Heavy Drinking in a National Cohort of Black Americans(Wiley, 2022) Mulia, Nina; Witbrodt, Jane; Karriker-Jaffe, Katherine J.; Li, Libo; Lui, Camillia K.; Zapolski, Tamika; Psychology, School of ScienceAims To estimate longitudinal pathways from childhood socioeconomic position (SEP) to educational attainment and midlife heavy drinking in Black Americans in order to identify potential points of early intervention to reduce risk for alcohol-related problems in adulthood. Design, Setting, Participants Data are from 1,299 Black Americans in the US National Longitudinal Survey of Youth, followed from 1979 (ages 15-19) through 2012. Given gender differences in factors related to education and alcohol outcomes, gender-stratified path models were analyzed. Measurements Youth socioeconomic indicators included parental education (approximating childhood SEP) and adolescent poverty duration. Education-related measures included high-poverty school, perceived school safety, academic problems, suspension from school, educational expectations, and educational attainment. Adulthood measures included repeated unemployment, poverty duration, and mean frequency of heavy drinking (6+ drinks/day) in young adulthood and midlife. Covariates included age, dual-parent household, marital status, early drinking onset, and family history of alcohol problems. Findings For both genders, two main pathways originating from low childhood SEP flowed to educational attainment through (1) educational expectations and (2) suspension, and from educational attainment to midlife heavy drinking (total indirect effect = 0.131 (95% confidence interval [CI]: .072-.197) for women, and 0.080 (.035-.139) for men). For both genders, adolescent poverty (standardized βs >.135), academic problems (βs >.220), and school suspension (βs >.165) were significantly (ps <.05) related to lower educational expectations. In adulthood, educational attainment was indirectly protective against midlife heavy drinking through its significant effects (ps <.05) on young adult heavy drinking for both genders (βs < -.200) and economic hardships for women (βs < -.290). Conclusions Low childhood socioeconomic position among Black Americans appears to be associated with subsequent, adverse socioeconomic and school experiences that lead to lower educational attainment and, ultimately, greater heavy drinking at midlife. Interventions that mitigate these earlier, adverse experiences might have indirect effects on midlife heavy drinking.Item The Experience of Racism on Behavioral Health Outcomes: the Moderating Impact of Mindfulness(Springer, 2018-06-04) Zapolski, Tamika C. B.; Faidley, Micah T.; Beutlich, Marcy R.; Psychology, School of ScienceResearch shows that racial discrimination results in adverse behavioral health outcomes for African–American young adults, including risk for depression, anxiety, and substance use. Although high levels of mindfulness have been shown to reduce risk for such health outcomes, it is unknown whether mindfulness can reduce risk as a consequence of racial discrimination, particularly among African Americans. Three-hundred and eighty-eight African–American young adults between the ages of 18 and 24 (M = 20.6, 62% female) completed measures assessing past-year experiences of racial discrimination, depressive symptoms, anxiety symptoms, alcohol use, and trait mindfulness. A positive correlation was found between racial discrimination and the behavioral health outcomes, as well as a negative correlation between mindfulness and the behavioral health outcomes. Moreover, mindfulness was found to significantly moderate the effect of racial discrimination on mood symptoms. Although mindfulness was found to lessen the effect of racial discrimination on alcohol use, this difference was not statistically significant. In line with previous literature, racial discrimination was shown to have a negative impact on behavioral health outcomes among African Americans. Moreover, our findings provide support for the buffering effect of mindfulness on mood symptoms as a consequence discrimination. This suggests that increasing mindfulness may be an effective strategy to include in interventions targeting improvement in mood symptoms for African–American young adults. However, alternative strategies may be more appropriate to address outcomes, such as alcohol use, as a consequence of racial discrimination.Item Impulsivity and Problem Drinking in College: Examining the Mediating Role of Sex-Related Alcohol Expectancies and Alcohol Use at Sex(Taylor & Francis, 2017-07-03) Banks, Devin E.; Zapolski, Tamika C. B.; Psychology, School of ScienceBACKGROUND: Dispositional impulsivity has been consistently implicated as a risk factor for problem drinking among college students and research suggests that this relationship may be explained in part by alcohol expectancies. A subset of alcohol expectancies, sex-related alcohol expectancies, is particularly linked to problem drinking among college students. The acquired preparedness model of risk postulates that people with dispositional impulsivity develop stronger sex-related alcohol expectancies, are subsequently more likely to drink at problematic levels in sexual situations, and thus, engage in more problem drinking. OBJECTIVES: Using this model, the current study examined whether sex-related alcohol expectancies and alcohol use at sex mediated the relationship between impulsivity and problem drinking among college students. METHODS: College students (N = 101) completed self-report measures of alcohol use, sex-related alcohol expectancies, and five dimensions of impulsivity: negative urgency, positive urgency, sensation seeking, lack of premeditation, and lack of perseverance. RESULTS: Two facets of impulsivity-sensation seeking and lack of premeditation-provided unique contributions to problem drinking. Sex-related alcohol expectancies significantly mediated the effects of lack of premeditation and sensation seeking on problem drinking. In support of the acquired preparedness model, the relationship between the impulsivity traits and problem drinking was serially mediated by sex-related alcohol expectancies and alcohol use at sex. CONCLUSIONS: Results suggest that sensation seeking and lack of premeditation continue to be areas of intervention for problem drinking among college students, and implicate sex-related alcohol expectancies as an area of intervention for alcohol use at sex and problem drinking.Item Peer Victimization, Mood Symptoms, and Alcohol Use: Examining Effects Among Diverse High School Youth(Springer Verlag, 2019-05) Rowe, Alia T.; Zapolski, Tamika C. B.; Hensel, Devon J.; Fisher, Sycarah; Barnes-Najor, Jessica; Psychology, School of SciencePeer victimization is associated with alcohol use among adolescents. However, few studies have examined the mediating role of depression and anxiety, or differences by race. The current study examined the prospective relationship of peer victimization, depressive and anxiety symptoms, and alcohol use across two timeframes: 9th to 11th grade and 10th to 12th grade among African American and White youth. 2,202 high school youth (57.6% female) who identified as either African American (n=342, 15.2%) or White (n=1860, 82.6%) provided data on study variables. Path analysis among the overall sample indicated that anxiety symptoms was a significant mediator for both timeframes, with depressive symptoms mediating the pathway during the 10th to 12th grade timeframe. The findings were most consistent among White youth, with no significant indirect effects observed for African American youth. Thus, addressing depressive and anxiety symptoms may be effective targets to decrease alcohol use risk as a result of peer victimization among White youth. However, further research is needed to better understand risk models for peer victimization exposure on substance use outcomes among racial/ethnic minority youth.Item Problematic alcohol use and sexting as risk factors for sexual assault among college women(Taylor & Francis, 2018-10) Dir, Allyson L.; Riley, Elizabeth N.; Cyders, Melissa A.; Smith, Gregory T.; Pediatrics, School of MedicineSexual assault is a major public health concern and college women are four times more likely to experience sexual assault than any other group. We investigated whether sexting is a mechanism by which alcohol use increases risk for college women to be targeted for sexual assault. We hypothesized that sexting would mediate the relationship between problem drinking and sexual assault, such that drinking (T1 = beginning fall semester) would contribute to increased sexting (T2 = end fall semester), and in turn increase the risk of being targeted for sexual assault (T3 = end spring semester). Results: Among 332 undergraduate women (M(SD)age = 19.15(1.69), 76.9% Caucasian), sexting (T2) predicted sexual assault (T3; b = 3.98, p = .05), controlling for baseline sexual assault (b = 0.82, p < .01). Further, sexting (T2) mediated the relationship between problem drinking (T1) and sexual assault (T3) (b = 0.04, CI[.004,.12]). Conclusion: Findings suggest that sexting is one mechanism through which drinking increases the risk of college women being targeted for sexual assault.