Journal of Studies on
Alcohol
Volume 65
Number 6
November 2004
Issues Available Online
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Supplement 15 July 2005
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Selected Abstracts
ABSTRACT. Objective: Fear of jeopardizing drinking outcomes has resulted in a reluctance to treat tobacco dependence concurrently with alcohol dependence, in spite of the high prevalence of smoking among patients with alcohol dependence. The objective of this study was to compare the effects of smoking treatment and intensive treatment for alcohol dependence, delivered concurrently, with delayed smoking treatment on smoking and alcohol use. Method: For the study, 1,943 patients in intensive treatment for alcohol dependence or abuse were screened for participation. Of these, 499 smokers were enrolled and randomized to concurrent (during alcohol treatment) or delayed (6 months later) smoking intervention. The smoking intervention included individual behavioral counseling and nicotine replacement. The main smoking outcome measure was 7-day point prevalent tobacco abstinence, and the main drinking outcome was 6-month prolonged abstinence from alcohol; both measured 18 months after study enrollment. Results: Participants in the concurrent group were more likely to participate in smoking treatment than those in the delayed group (78.5% vs 64.5%, p = .005), but there was no significant difference in cessation rates at 18 months (12.4% vs 13.7%). Prolonged, 6-month abstinence from alcohol was worse in the concurrent group than in the delayed group at 6, 12 and 18 months (41% vs 56%, p = .001; 33% vs 42%, p = .06; 41% vs 48%, p = .14, respectively), and 30-day prolonged alcohol abstinence was also worse in the concurrent treatment group (51% vs 64%, p = .004; 46% vs 53%, p = .11; 48% vs 60%, p = .01, respectively). Conclusions: These data show that patients in alcohol treatment are interested in smoking cessation, participate in treatment and demonstrate success; but there was no benefit of concurrent treatment. Drinking outcomes were worse with concurrent tobacco treatment. These findings suggest that smoking cessation intervention should be provided to patients after intensive alcohol treatment; however, the data require confirmation because they are not consistent with the existing literature. (J. Stud. Alcohol 65: 681-691, 2004)
ABSTRACT. Objective: This study examined neural correlates of the low level of response to alcohol using functional magnetic resonance imaging (FMRI) during a challenging visual working memory task. Method: Participants were healthy adolescents (N = 35) with a range of drinking patterns recruited from local high schools. After a minimum 5 days of abstinence from alcohol and other drugs, FMRI, neuropsychological testing and the Self-Rating of the Effects of Alcohol were administered. Results: Self-report of initial level of response to alcohol was significantly predicted by FMRI blood oxygen level dependent (BOLD) response to the visual working memory task in the right prefrontal and bilateral anterior cingulate region (12% of unique variance, p < .05) and right cerebellum and parahippocampal gyrus (17% of unique variance, p < .01), above and beyond effects accounted for by drinks consumed per month, age, gender and ethnicity. Conclusions: Young people who report having needed more alcohol to achieve specific effects during early drinking experiences show higher levels of brain response during visual working memory, perhaps suggesting less capacity to adjust cognitive processing to contextual demands. (J. Stud. Alcohol 65: 692-700, 2004)
ABSTRACT. Objective: This study examines the stress-response-dampening (SRD) hypothesis of alcoholism from a novel vantage point. Various investigators have demonstrated that persons considered to be at risk for developing alcohol-related problems exhibit attenuation of stress reactions in psychologically challenging experimental sessions after receiving alcohol. These studies have used autonomic nervous system measures for indexing stress responses. In our report we address the question of whether people with a family history of alcoholism exhibit dampening effects of ethanol in the response of a classical stress hormone (i.e., cortisol). Method: Subjects in this report were 46 healthy male and 40 healthy female adult subjects; 36 of the men were sons and 28 of the women were daughters of alcohol-dependent fathers (sons of alcoholics, SOAs; daughters of alcoholics, DOAs); 12 women and 10 men had no family history of any alcohol use disorders (daughters of nonalcoholics, DONAs; sons of nonalcoholics, SONAs). The subjects were part of a large-scale project in which participants received two laboratory sessions with exposure in each to three experimental paradigms involving psychological stress while various psychophysiological and neuroendocrine measures were taken. In one of the sessions alcohol was administered. Results: In the 1-hour period after termination of the stress paradigms, SOAs showed significantly lower plasma cortisol levels on laboratory days with alcohol administration than on days without alcohol administration at two of the three poststress sampling points. DOAs, however, did not exhibit a dampening pattern for cortisol. In the two control groups of SONAs and DONAs, no stress response attenuation effects of alcohol were observed. Conclusions: The results of experimental laboratory work with individuals at risk of alcoholism in the present and other studies add to the validity of SRD models of this disorder. Research strategies that should provide direct evidence for the SRD hypothesis are addressed in the Discussion section. (J. Stud. Alcohol 65: 701-707, 2004)
ABSTRACT. Objective: Several studies have shown that acute alcohol use is associated with suicidal behavior, but the magnitude and nature of the relationship remain unclear. We report a study on the impact of acute alcohol use on suicide attempts treated in the emergency room (ER) using the case-crossover design. Method: Seven ER studies carried out in the United States, Canada, Mexico and Australia from 1984 to 1996 with probability samples and similar methodology were merged yielding a total of 102 suicide attempters (overall 52% were male and 59% under 30 years of age). Results: Thirty-six patients reported alcohol use within 6 hours prior to the suicide attempt. When usual alcohol consumption during the past 12 months served as the control value, the estimated relative risk (RR) for patients who reported alcohol use within 6 hours prior to the suicide attempt was 9.6 (95% confidence interval: 5.7-16.3). Although the prevalence of alcohol use differed by sex, there was no statistically significant difference in the estimated RRs (RR = 13.6 men and RR = 5.3 women, p = 0.11 for the heterogeneity test). Conclusions: A positive association was found between alcohol use 6 hours prior and suicide attempts in 102 ER cases in four countries. The case-crossover methodology is well suited to studies for which an external control group is not easily obtainable. (J. Stud. Alcohol 65: 708-714, 2004)
ABSTRACT. Objective: Prevalence data and theoretical models suggest that socially anxious individuals comprise a significant subset of college hazardous drinkers and may benefit from brief interventions for both alcohol and social anxiety problems. The present study compared hazardous drinkers who have high social anxiety (HD-HSA) with hazardous drinkers who have low social anxiety (HD-LSA) in drinking and psychological characteristics that may distinguish the two drinker groups and inform development of group-specific interventions. Method: After completing a self-report assessment battery, 152 hazardous drinkers (51% men, median age = 19) were selected from an undergraduate volunteer sample on the basis of their scores on an alcohol screen. HD-HSA (n = 76) and HD-LSA (n = 76) were hazardous drinkers who scored in the top third and the bottom third, respectively, of the volunteer sample on a social anxiety measure. Results: HD-HSA reported greater expectancies that alcohol reduces social anxiety and lower alcohol refusal self-efficacy in social drinking situations than HD-LSA did. HD-HSA also tended to report more frequent heavy drinking in negative affect situations, but the groups did not differ in consumption quantity, heavy drinking in positive affect situations or hazardous drinking levels. HD-HSA reported greater interest in attending a social anxiety workshop and showed a trend towards having stronger interest in an alcohol workshop than HD-LSA did, although the sample’s overall readiness to change alcohol behaviors was low. Conclusions: Study findings highlight the importance of situational specificity in alcohol assessment and suggest a need to develop group-specific interventions for college hazardous drinkers with high versus low social anxiety. (J. Stud. Alcohol 65: 715-724, 2004)