Addictive Behaviors

Limited utility of detailed e-cigarette use measures: An analysis of NESARC-III Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Maria A. Parker, Jennifer L. Pearson, Andrea C. Villanti Abstract Introduction The heterogeneity of e-cigarette products and e-liquids pose challenges to surveillance of e-cigarette exposure. The goal of this study was to evaluate the internal consistency of e-cigarette use frequency, quantity, and duration measures in a national population-based survey. Methods Data were drawn from the 2012–2013 for the National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 36,309; NESARC-III). Adults who used e-cigarettes/e-liquid during the past year (≤18 years old; n = 1,229) were asked about their age of first use, recency of use, quantity (i.e., cartridges, drops), nicotine concentration, and duration (hours). Several internal consistency parameters were compared for e-cigarette measures in past-year (n = 750) and past 30-day e-cigarette users (n = 472) overall, and by frequency of use (i.e., infrequent [≤3 days/month], non-daily [1–6 days/week], daily). Results There were no significant differences in quantity, nicotine concentration, or duration by frequency of use in past 30-day e-cigarette users. One-third of past 30-day and almost half of past-year users did not know the nicotine concentration of their cartridge or e-liquid. Correlations between all e-cigarette use measures were low, with the highest correlations seen between e-liquid quantity and cartridge quantity in all past 30-day users (r = 0.28) and those reporting any e-liquid use (r = 0.40). Cronbach's alpha and mean interitem correlations were low across all user groups. Conclusions Low to moderate correlation across e-cigarette measures in e-cigarette users implies low internal consistency of these measures in a population survey. Findings suggest measures such as quantity and nicotine concentration might more appropriate in samples of recent experienced e-cigarette users than in general population samples.

A preliminary study of early childhood parenting and adult past month drug use risk in low-income African American women Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Tyralynn Frazier, Jessica McDermott Sales Abstract Purpose This preliminary study was designed to assess the feasibility of examining early childhood parenting factors and their relationship with adult past month drug use among low-income African American women. Methods A cross-sectional survey of 156 low-income African American women was conducted. Measures included the childhood parental bonding scale, frequency of exposure to corporal punishment (CP) in childhood, The Drug Abuse Screening Test (DAST) and The Differentiation of Self Scale. Structural equation modeling (SEM) was used to assess the relationship between the primary predictors, latent parental bonding and corporal punishment exposure, with past month drug use. The intermediary construct, emotional reactivity, was also included in the SEM model to test mechanisms of mediation. Results There was a significant main effect for maternal care on lower emotional reactivity patterns in adulthood. There was also a significant main effect for frequent CP on higher emotional reactivity patterns in adulthood. The relationship between both parenting measures and drug use were mediated by emotional reactivity. Conclusion Childhood maternal factors are a strong predictor of adult past month drug use, and this may be accounted for, in part, by the influence that parenting patterns in childhood have on adult emotional reactivity patterns. These observations should be examined in a longitudinal study to determine the stability of our observation that CP in childhood, even when controlling for positive maternal bonding patterns, influences emotional reactivity patterns that predispose an individual to negative coping strategies, such as drug use, in adulthood, among low-income African American women.

A gender-based analysis of nonmedical prescription opioid use among people who use illicit drugs Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Tessa Cheng, Ekaterina Nosova, Will Small, Robert S. Hogg, Kanna Hayashi, Kora DeBeck Abstract Background Research investigating the unique impacts associated with engaging in nonmedical prescription opioid use (NMPOU) among males and females who also use illicit drugs is needed. Methods Data were collected between 2013 and 2017 from two linked prospective cohort studies in Vancouver: the At-Risk Youth Study and Vancouver Injection Drug Users Study. Generalized estimating equations were used to identify factors associated with engaging in NMPOU among females and males separately. Results Among 1459 participants, 534 were female (37%). Similar proportions of females (46%) and males (48%) engaged in NMPOU at their first visit during the study period. In multivariable analyses, factors associated with NMPOU among both males and females included heroin use, overdose, drug dealing, and difficulty accessing health and social services. Among females, those who engaged in NMPOU were more likely to report Caucasian or white ethnicity, cocaine use, crystal methamphetamine use, and sex work; among males, those who engaged in NMPOU were older, reported crack use and engaged in binge drug use (all p < 0.05). Conclusion The prevalence of NMPOU was similar among males and females who use illicit drugs in Vancouver, and NMPOU was independently associated with markers of vulnerability among both genders. Findings highlight the need for a comprehensive public health approach to address NMPOU that integrates overdose prevention and reversal services, employment opportunities, and better access to services for both women and men.

An Assessment of the Validity of the Gamblers Belief Questionnaire Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Kahlil S. Philander, Sally M. Gainsbury, Georgia Grattan Abstract Cognitive distortions in gambling are irrational thoughts that cause an individual to overestimate their level of control over the outcome of the game and diminish the role of chance. Due to their strong relation to gambling disorders, they are a particularly important characteristic to assess and understand in gamblers. Although numerous measures of gambling-related cognitive distortions exist, studies assessing criterion validity are scarce. In this study, we develop several tests of the Gamblers Belief Questionnaire (GBQ), a versatile and widely used scale. A sample of 184 U.S. adults was recruited through Amazon Mechanical Turk to complete an online study that included measurement of the GBQ and an assessment of the perceived role of skill and chance in various gambling and non-gambling activities. In addition to a confirmatory factor analysis of the scale, three novel validation tests were developed to understand whether the GBQ subscales can identify and discriminate measures of illusion of control and gambler's fallacy distortions. Our validation tests demonstrate that the scale does measure both distortions, providing information about gamblers' cognition that is unexplained by gambling problems, frequency of play, and demographics. Conversely, our analysis of the factor structure does not show good fit. We conclude that the GBQ measures gambling-related cognitive distortions, but there may be an opportunity to reduce the number of scale items and further refine precision of the two subscales.

The influence of perceived parenting on substance initiation among Mexican children Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Alejandro L. Vázquez, Melanie M. Domenech Rodríguez, Nancy G. Amador Buenabad, Marycarmen N. Bustos Gamiño, María de Lourdes Gutierrez López, Jorge A. Villatoro Velázquez Abstract Parents shape their children's behaviors and impact their developmental trajectories. Despite this, few studies have examined the potential relationship between child reported parenting factors and lifetime substance use and use intentions. The current study examined the potential impact of parenting factors (i.e., positive parenting, supervision, parental illicit substance use, substance-specific communication) on early substance use and intentions among Latinx children. Data for the present study utilized a representative sample of Mexican children (n = 52,171; 5th and 6th grades) who participated in a national survey on substance use. Children reported their demographics, lifetime substance use/intentions, and perceived parenting characteristic and practices. Child reported parental (i.e., individual or both parents) illicit substance use was associated with the largest increases in risk for reporting lifetime use of all substances examined. Higher levels of positive parenting were consistently associated with reductions in risk for reporting intentions for and use of all substances examined. Parent-child substance specific communication was not significantly related to child reported lifetime use or use intentions, with the exception of a minor decrease in the odds of reporting lifetime inhalant use. Supervision was associated with small to modest increase in risk. Substance use prevention efforts targeting Latinx populations may benefit from promoting positive parenting and direct supervision during childhood. Targeted prevention efforts may be needed for Latinx children exposed to parental illicit substance use, as they may be especially at risk for early substance initiation.

Nicotine or expectancies? Using the balanced-placebo design to test immediate outcomes of vaping Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Amanda M. Palmer, Thomas H. Brandon Abstract Introduction Electronic (e-)cigarette use has increased in popularity, especially among those attempting to quit smoking. Previous studies evaluating the therapeutic efficacy of e-cigarettes have suggested that non-pharmacologic factors, such as expectancies about nicotine effects, may influence the experienced effects of e-cigarettes. Method The independent and synergistic influences of drug and expectancies were parsed using a balanced-placebo design, whereby 128 participants (52 dual users) were provided an e-cigarette that either contained nicotine or non-nicotine solution, while told that it did or did not contain nicotine. We hypothesized main effects of nicotine content on physiological, objective outcomes (attention, appetite, aversion, respiratory tract sensations), and main effects of the instructions on more subjective, psychosocial outcomes (affect, reward, satisfaction). Sex was included as a moderator. Results Results showed that nicotine increased sustained attention, and more so among females. Nicotine delivery was associated with aversion among females, but not males. Among those who were both told and did not receive nicotine, higher enjoyment of respiratory tract sensations was reported. Nicotine with complementary instructions produced the highest reward ratings; additionally, nicotine was rewarding to males but not females. Discussion Findings demonstrated that both nicotine content and non-pharmacologic factors impact acute outcome effects of e-cigarettes, with moderation by sex in some cases. Results are relevant to the interpretation of clinical trials of e-cigarettes and suggest a more nuanced view of reinforcement pathways.

Selective invalidation of ambivalent pro-marijuana attitude components Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): William D. Crano, Candice D. Donaldson, Jason T. Siegel, Eusebio M. Alvaro, Erin K. O'Brien Abstract Introduction Attitudes of drug-abstinent youth considering marijuana initiation can be highly ambivalent. Invalidating pro-usage elements (i.e., opinions) of ambivalent marijuana attitudes, while leaving anti-marijuana elements intact, may create stronger, less ambivalent marijuana-resistant attitudes and lower usage intentions, while concurrently elucidating the role of ambivalence in persuasive prevention. Method From an initial pool of marijuana-abstinent middle-school students (N = 538), the quintile expressing the most negative attitudes toward a marijuana prevention appeal (N = 101) were randomly assigned to one of three conditions designed to invalidate pro-marijuana opinions. Analyses then tested their susceptibility to a second marijuana prevention appeal. Results Personally threatening messages were found ineffective, but appeals contesting resistant responses significantly decreased ambivalence (p < .01). Mediational analyses showed that this decreased ambivalence was associated with less favorable attitudes and lower marijuana usage intentions (both p < .001). An attribution-based manipulation increased ambivalence (p < .05), which was associated with positive usage intentions mediated through positive attitudes (both p < .001). Conclusion Analyses elucidated the role of attitude ambivalence in prevention, providing a more complete understanding of potential facilitative use of ambivalence in prevention models based on prevention. Results support the further examination and use of methods that invalidate pro-marijuana opinions, thereby leading to greater susceptibility to subsequent prevention appeals.

Impulsivity moderates the effect of social anxiety on in-lab alcohol craving Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Theresa Adams, Karli K. Rapinda, Jona R. Frohlich, Roisin M. O'Connor, Matthew T. Keough Abstract Social anxiety (SA) is thought to relate to alcohol misuse. However, current evidence is inconsistent – especially in young adulthood. Recent non-experimental data show that trait impulsivity moderates the effect of SA on alcohol misuse. Specifically, this work suggests that concurrently elevated impulsivity may draw attention to the immediate, anxiolytic effects of drinking – thus promoting alcohol misuse among those high in SA. Otherwise, without elevated impulsivity, a socially anxious person may not drink due to focusing on alcohol's possible negative outcomes (e.g., embarrassing behaviours). The next step in this research is to examine if impulsivity impacts in-the-moment subjective craving among socially anxious individuals. This was the goal of the present experiment. After baseline measures, undergraduate participants (N = 110) completed the Trier Social Stress Test followed by an alcohol (versus neutral) cue exposure. Subjective craving ratings were collected at both baseline and post-cue exposure. Moderation analyses revealed that socially anxious individuals endorsed strong cravings following an alcohol (but not a neutral) cue exposure, but only if they also had elevated impulsivity. In-lab craving was positively correlated with retrospective reports of alcohol misuse. Our findings demonstrate that impulsivity contributes to SA-related risk for alcohol misuse.

Spatial and sociodemographic correlates of gambling participation and disorder among female Filipino migrant workers in Macao, People's Republic of China Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Grace Yi, Lei Huang, Agnes I.F. Lam, Carl Latkin, Brian J. Hall Abstract Background and aims Correlates and risk factors for gambling disorder among vulnerable or transient populations such as transnational migrant workers are unknown. The current study examined sociodemographic and spatial correlates of gambling disorder among female Filipino domestic workers in Macao (SAR), China. Design Survey-based, respondent-driven sampling study administered from November 2016 to August 2017. Setting Macao (SAR), which encompassed 38 casinos within its 30.4 km2 area at the time of this study. Participants Representative sample of N = 1194 female Filipino domestic workers in Macao. Measurements Symptoms of gambling disorder based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Correlates evaluated included sociodemographic information, proximity to venues, perceived social support, and symptoms of depression and anxiety. Findings Prevalence of gambling disorder was 5.1%. Multivariable regression analyses indicated that likelihood of gambling participation (i.e., ever gambling) was associated with current indebtedness (RR = 1.56, 95%CI = 1.08–2.25, p = .017) and worse self-reported health (RR = 1.31, 95%CI = 1.04–1.65, p = .02). Increased symptoms of gambling disorder were independently associated with lower perceived social support (RR = 0.92, 95%CI = 0.87–0.98, p = .006), increased dependents relying upon monthly remittances (RR = 1.10, 95%CI = 1.06–1.16, p < .001), increased depression severity (RR = 1.16, 95%CI = 1.07–1.25, p < .001), decreased salary quintile (RR = 0.97, 95%CI = 0.94–1.00, p = .04), and proximity to the nearest Mocha Club gaming venues (RR = 1.04, 95%CI = 1.02–1.07, p = .005). The association between proximity to casinos and increased symptoms of gambling disorder was significant only for domestic workers living apart from employers (RR = 1.07, 95%CI = 1.00–1.14, p = .04). Conclusions Increased spatial proximity to gambling venues and greater financial and psychosocial burdens are associated with gambling disorder among domestic workers in Macao.

Substance craving changes in university students receiving heart rate variability biofeedback: A longitudinal multilevel modeling approach Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Nour Alayan, David Eddie, Lucille Eller, Marsha E. Bates, Dennis P. Carmody Abstract Background Previously published findings from a study of university students living in substance use disorder (SUD) recovery housing showed an eight-session heart rate variability biofeedback (HRVB) intervention significantly reduced craving. That study, however, uncovered pronounced inter-participant variability in craving change patterns through the course of HRVB that warranted further exploration. The purpose of the current investigation was to examine how within- and between-person factors may have differentially influenced craving changes. Methods A longitudinal multilevel modeling approach was used with time at level-1 nested within persons at level-2. Multilevel models of change were estimated to model craving trajectories and predictor relationships over time as a function of age, sex, length of abstinence, daily HRVB practice, anxiety, depression, and stress. Results A quadratic pattern of craving reductions was found, indicating that craving reductions accelerated over time for some participants. Daily HRVB practice of >12 min and older age significantly enhanced craving reductions over time. Increases in depressive symptoms attenuated the effects of HRVB on craving. The other predictors were not significantly associated with craving in this study. The true R2 for the final model indicated that 20.5% of the variance in craving was explained by older age, daily HRVB >12 min, and within-person changes in depression. Conclusions HRVB shows promise as an accessible, scalable, and cost-effective complementary anti-craving intervention. Healthcare providers may help persons recovering from SUD to better manage substance craving by the routine and strategic use of HRVB practice.

Alexandros Sfakianakis
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alsfakia@gmail.com