scholarly journals Screening and brief interventions for adolescent alcohol use disorders presenting through emergency departments: a research programme including two RCTs

2020 ◽  
Vol 8 (2) ◽  
pp. 1-144 ◽  
Author(s):  
Paolo Deluca ◽  
Simon Coulton ◽  
Mohammed Fasihul Alam ◽  
Sadie Boniface ◽  
Kim Donoghue ◽  
...  
Keyword(s):  
At Risk ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Use Disorders ◽  
Research Programme ◽  
Cost Effective ◽  
Prevalence Study ◽  
Age Appropriate ◽  
Alcohol Related Problems

Background Alcohol consumption and related harm increase steeply from the ages of 12–20 years. Adolescents in the UK are among the heaviest drinkers in Europe. Excessive drinking in adolescents is associated with increased risk of accidents, injuries, self-harm, unprotected or regretted sex, violence and disorder, poisoning and accidental death. However, there is lack of clear evidence for the most clinically effective and cost-effective screening and brief interventions for reducing or preventing alcohol consumption in adolescents attending emergency departments (EDs). Objectives To estimate the distribution of alcohol consumption, alcohol-related problems and alcohol use disorders in adolescents attending EDs; to develop age-appropriate alcohol screening and brief intervention tools; and to evaluate the clinical effectiveness and cost-effectiveness of these interventions. Design The research has been conducted in three linked stages: (1) a prevalence study, (2) intervention development and (3) two linked randomised controlled trials (RCTs). Setting Twelve EDs in England (London, North East, and Yorkshire and The Humber). Participants A total of 5376 participants in the prevalence study [mean age 13.0 years, standard deviation (SD) 2.0 years; 46.2% female] and 1640 participants in the two linked RCTs (mean age 15.6 years, SD 1.0 years; 50.7% female). Interventions Personalised feedback and brief advice (PFBA) and personalised feedback plus electronic brief intervention (eBI), compared with alcohol screening alone. These age-appropriate alcohol interventions were developed in collaboration with the target audience through a series of focus groups and evaluations during stage 2 of the research programme and following two literature reviews. Main outcome measures Total alcohol consumed in standard UK units (1 unit = 8 g of ethanol) over the previous 3 months at 12-month follow-up, assessed using the Alcohol Use Disorders Identification Test, Consumption (3 items) (AUDIT-C). Results In the prevalence study, 2112 participants (39.5%) reported having had a drink of alcohol that was more than a sip in their lifetime, with prevalence increasing steadily with age and reaching 89.5% at the age of 17 years. The prevalence of at-risk alcohol consumption was 15% [95% confidence interval (CI) 14% to 16%] and the optimum cut-off point of the AUDIT-C in identifying at-risk drinking was ≥ 3. Associations of alcohol consumption and early onset of drinking with poorer health and social functioning were also found. In the RCT, the analysis of the primary outcome (average weekly alcohol consumption at month 12) identified no significant differences in effect between the three groups in both trials. In the high-risk drinking trial, the mean difference compared with control was 0.57 (95% CI –0.36 to 1.70) for PFBA and 0.19 (95% CI –0.71 to 1.30) for eBI. In the low-risk drinking trial, the mean difference compared with control was 0.03 (95% CI –0.07 to 0.13) for PFBA and 0.01 (95% CI –0.10 to 0.11) for eBI. The health economic analysis showed that eBI and PFBA were not more cost-effective than screening alone. Conclusions The ED can offer an opportunity for the identification of at-risk alcohol use in adolescents. A simple, short, self-completed screening instrument, the AUDIT-C, is an effective tool for identifying adolescents who are at risk of alcohol-related problems. Associations of alcohol consumption and earlier onset of drinking with poorer health and social functioning were observed in the prevalence study. The trials were feasible to implement and exceeded the recruitment target and minimum follow-up rates. However, PFBA and eBI were not found to be more effective than screening alone in reducing or preventing alcohol consumption in 14- to 17-year-olds attending EDs. Limitations and future work Only one-third of participants engaged with the application program; this is likely to have limited the effect of the intervention. We recommend that future research should focus on methods to maximise engagement with digital interventions and evaluate the effect of such engagement on clinical outcomes. Trial registration Current Controlled Trials ISRCTN45300218. Funding This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 8, No. 2. See the NIHR Journals Library website for further project information.

scholarly journals Identity, influence, and intervention: The roles of social media in alcohol use

2018 ◽  
Author(s):  
Erin Corwin Westgate ◽  
Jason Holliday
Keyword(s):  
Social Media ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Social Influence ◽  
Drinking Behavior ◽  
Alcohol Use Disorders ◽  
Online Identity ◽  
Use Of Social Media ◽  
The Relationship ◽  
Alcohol Related Problems

Alcohol-related content is common on social media and may both reflect and influence offline drinking behavior. Posting alcohol-related content has been linked to alcohol outcomes, including higher rates of alcohol consumption, cravings, alcohol-related problems, and clinical alcohol use disorders. Exposure to alcohol-related content on social media has likewise been associated with adverse alcohol outcomes. In this paper, we review research on the relationship between social media and alcohol use, and explore the ways that online identity and social influence can account for this relationship. Finally, we call for further research on the use of social media as a platform for prevention and intervention efforts.

scholarly journals The acute effects of alcohol on state rumination in the laboratory

2021 ◽  
Author(s):  
O. Merve Mollaahmetoglu ◽  
Edward Palmer ◽  
Emily Maschauer ◽  
Melissa C. Nolan ◽  
Tobias Stevens ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Negative Mood ◽  
Alcohol Use Disorders ◽  
Preliminary Evidence ◽  
High Dose ◽  
Acute Effects ◽  
High Doses ◽  
Alcohol Related Problems

Abstract Rationale Rumination is a repetitive, negative, self-focused thinking style associated with various forms of psychopathology. Recent studies suggest that rumination increases craving for alcohol and predicts harmful drinking and alcohol-related problems. However, the acute effects of alcohol on rumination have not been previously studied. It is proposed that alcohol may reduce ruminative thinking through decreasing negative mood. Objectives In the present study, we aimed to test the previously unexplored effects of acute alcohol consumption on rumination in a hazardous drinking population. Methods We conducted a randomised placebo-controlled laboratory study to examine the effect of low (0.4 g kg−1) and high doses (0.8 g kg−1) of alcohol on state rumination compared to placebo. Participants completed a rumination induction task prior to receiving drinks. We then measured state rumination and mood at repeated time points; 30 min, 60 min and 90 min post-drinks consumption. Results We found a significant decrease in state rumination in the low-dose alcohol group compared to placebo at 30 min post-alcohol consumption, but no difference was observed between the high-dose alcohol and placebo groups. Mediation analysis provided evidence for an indirect effect of alcohol on state rumination through concurrent changes in negative mood. Conclusions These findings suggest that acute alcohol consumption can regulate negative mood and concurrently rumination, providing preliminary evidence for the role of rumination in alcohol use disorders. Rumination may be a treatment target in alcohol use disorders.

scholarly journals Hospital morbidity and alcohol consumption in less severe psychiatric disorder: 7-year outcomes

2006 ◽  
Vol 188 (6) ◽  
pp. 554-559 ◽  
Author(s):  
Robert J. Tait ◽  
Gary K. Hulse
Keyword(s):  
Mental Health ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Hospital Admissions ◽  
Psychiatric Morbidity ◽  
Alcohol Use Disorders ◽  
Population Based ◽  
Hospital Morbidity ◽  
First Time

BackgroundSubstance use by people with severe psychiatric morbidity is associated with negative outcomes.AimsTo assess in adults with less severe psychiatric morbidity the relationship between alcohol consumption and subsequent 7-year hospital admissions, and the development and recurrence of alcohol use disorders.MethodFollow-up data were assembled via a population-based hospital record-linkage system.ResultsBaseline alcohol use groups were: dependent (n=31), harmful (n=114), moderate (n=621) and abstinent (n=249). The moderate but not the abstinent group had fewer mental health admissions and a longer time to first admission than the harmful and dependent groups. Both the moderate and the abstinent groups had longer times to ‘all-cause’ admissions than the dependent group. Many of those with alcohol use disorders at baseline relapsed (66%) but few (14%) developed a first-time alcohol use disorder.ConclusionsOverall, moderate alcohol consumption among those with less severe psychiatric morbidity was not associated with more mental health admissions; those with alcohol dependence had poorer health outcomes than the remaining categories.

scholarly journals Alcohol Consumption during COVID among Women with an Existing Alcohol-Use Disorder

2021 ◽  
Vol 18 (18) ◽  
pp. 9460
Author(s):  
Jessica D. Hanson ◽  
Carolyn Noonan ◽  
Amy Harris ◽  
Kyra Oziel ◽  
Michelle Sarche ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
American Indian ◽  
Binge Drinking ◽  
Research Team ◽  
Controlled Trial ◽  
Alcohol Use Disorders ◽  
American Indian Women ◽  
Indian Women

Prior to the pandemic, our research team implemented a randomized controlled trial of an intervention to reduce risk for alcohol-exposed pregnancy (AEP) in American Indian women. When active recruitment for the in-person trial was paused due to COVID, the research team moved to conducting follow-up surveys with participants who had completed the intervention to better understand changes to their alcohol use during the pandemic. We collected surveys from 62 American Indian women who had completed the Native CHOICES intervention. Baseline data collected pre-COVID included demographics and scores on the Alcohol Use Disorders Identification Test (AUDIT). Follow-up surveys conducted during the active pandemic period included a self-reported questionnaire about changes in drinking patterns. At pre-COVID baseline, all participants were engaged in heavy or binge drinking. At follow-up during COVID, 24.2% reported drinking more, and over half had at least one binge drinking episode. Approximately half reported reduced drinking. We found that risky drinking remained an issue during the pandemic for many American Indian women who had engaged in this behavior pre-COVID, while others reported reducing their alcohol consumption. As the pandemic abates, concerted efforts must be made to reach those with identified alcohol use disorders to offer resources and intervention as needed.

“I’ll Take a Shot for Every Like I Get on This Status”: Posting Alcohol- related Facebook Content Predicts Drinking Outcomes

2018 ◽  
Author(s):  
Erin Corwin Westgate ◽  
Kristen Lindgren
Keyword(s):  
Social Media ◽  
Alcohol Use ◽  
Pacific Northwest ◽  
Alcohol Use Disorders ◽  
Drinking Motives ◽  
The Pacific ◽  
Social Media Platforms ◽  
And Coping ◽  
Drinking Outcomes ◽  
Alcohol Related Problems

Objective:This study investigated whether self-reports of alcohol-related postings on Facebook by oneself or one’s Facebook friends were related to common motives for drinking and were uniquely predictive of self-reported alcohol outcomes (alcohol consumption, problems, and cravings).Method:Pacific Northwest undergraduates completed a survey of alcohol outcomes, drinking motives, and alcoholrelated Facebook postings. Participants completed the survey online as part of a larger study on alcohol use and cognitive associations. Participants were randomly selected through the university registrar’s office and consisted of 1,106 undergraduates (449 men, 654 women, 2 transgender, 1 declined to answer) between the ages of 18 and 25 years (M = 20.40, SD = 1.60) at a large university in the Pacific Northwest. Seven participants were excluded from analyses because of missing or suspect data.Results:Alcohol-related postings on Facebook were significantly correlated with social, enhancement, conformity, and coping motives for drinking (all ps < .001). After drinking motives were controlled for, self–alcohol-related postings independently and positively predicted the number of drinks per week, alcohol-related problems, risk of alcohol use disorders, and alcohol cravings (all ps < .001). In contrast, friends’ alcohol-related postings only predicted the risk of alcohol use disorders (p < .05) and marginally predicted alcohol-related problems (p = .07).Conclusions:Posting alcohol-related content on social media platforms such as Facebook is associated with common motivations for drinking and is, in itself, a strong predictive indicator of drinking outcomes independent of drinking motives. Moreover, self-related posting activity appears to be more predictive than Facebook friends’ activity. These findings suggest that social media platforms may be a useful target for future preventative and intervention efforts.

Reducing the Risk of Alcohol-Exposed Pregnancies: A Study of a Motivational Intervention in Community Settings

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_1) ◽  
pp. 1131-1135
Author(s):  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Alcohol Use ◽  
Contraceptive Use ◽  
Controlled Trial ◽  
Counseling Session ◽  
Community Settings ◽  
Motivational Intervention ◽  
Effective Contraception

Objectives. To test the feasibility and impact of a motivational intervention in reducing drinking and/or increasing effective contraception in women who are at risk for an alcohol-exposed pregnancy. Methods. A multisite single-arm pilot study was conducted in 6 community settings in 3 large cities. A total of 2384 women were screened for eligibility; 230 were eligible on the basis of their alcohol use and lack of contraception. Of the eligible women, 190 consented and were enrolled, and 143 (75.3%) completed the 6-month follow-up. The intervention consisted of 4 manual-guided motivational counseling sessions delivered by mental health clinicians and 1 contraceptive counseling session delivered by a family planning clinician. Outcome measures include intervention completion rates, alcohol use (frequency, quantity, and bingeing), contraceptive use and effectiveness, and risk for alcohol-exposed pregnancy. Results. Among women who completed the 6-month follow-up, 68.5% were no longer at risk of having an alcohol-exposed pregnancy; 12.6% of women who completed the program reduced drinking only; 23.1% used effective contraception only; and 32.9% reported both. Results were consistent across the 6 diverse high-risk settings. Conclusions. This study provides evidence that providing 4 sessions of motivational interviewing plus a contraception counseling session is feasible and strongly suggests that this intervention can decrease the risk of alcohol-exposed pregnancy in women in high-risk settings. Additional investigation in a randomized controlled trial is warranted.

scholarly journals Comparing short versions of the Alcohol Use Disorders Identification Test (AUDIT) in a military cohort

2018 ◽  
Vol 165 (5) ◽  
pp. 312-316 ◽  
Author(s):  
Jason Watterson ◽  
B Gabbe ◽  
P Dietze ◽  
A Bowring ◽  
J V Rosenfeld
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Internal Consistency ◽  
Alcohol Use Disorders ◽  
Pearson’S Correlation ◽  
Identification Test ◽  
Hazardous Alcohol ◽  
Military Populations ◽  
Pearson's Correlation ◽  
Short Versions

BackgroundThe Alcohol Use Disorders Identification Test (AUDIT) is widely used for monitoring harmful alcohol consumption among high-risk populations. A number of short versions of AUDIT have been developed for use in time-constrained settings. In military populations, a range of AUDIT variations have been used, but the optimal combination of AUDIT items has not been determined.MethodsA total of 952 participants (80% male), recruited as part of a wider study, completed the AUDIT-10. We systematically assessed all possible combinations of three or four AUDIT items and established AUDIT variations using the following statistics: Cronbach’s alpha (internal consistency), variance explained (R2) and Pearson’s correlation coefficient (concurrent validity).ResultsMedian AUDIT-10 score was 7 for males and 6 for females, and 380 (40%) participants were classified as having a score indicative of harmful or hazardous alcohol use (≥8) according to WHO classifications.A novel four-item AUDIT variation (3, 4, 8 and 9) performed consistently higher than established variations across statistical measures; it explained 85% of variance in AUDIT-10, had a Pearson’s correlation of 0.92 and Cronbach’s alpha was 0.63. The FAST, an established shortened AUDIT variant, together with several other four-item novel variants of AUDIT-10 performed similarly. The AUDIT-C performed consistently low on all measures, but with a satisfactory level of internal consistency (75%).ConclusionShortened AUDIT variations may be suitable alternatives to the full AUDIT for screening hazardous alcohol consumption in military populations. Four-item AUDIT variations focused on short-term risky drinking and its consequences performed better than three item versions.Trial registration numberACTRN12614001332617.

scholarly journals Satisfaction With Life, Mental Health Problems and Potential Alcohol-Related Problems Among Norwegian University Students

2021 ◽  
Vol 12 ◽  
Author(s):  
Pia Jensen ◽  
Ellen Haug ◽  
Børge Sivertsen ◽  
Jens Christoffer Skogen
Keyword(s):  
Mental Health ◽  
Logistic Regression ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Satisfaction With Life ◽  
Mental Health Problems ◽  
Health Problems ◽  
Harmful Alcohol ◽  
Risky Alcohol ◽  
Alcohol Related Problems

Objective: Recent studies have shown that today's college students more than ever are struggling with mental health and alcohol problems. While poor satisfaction with life and mental health problems have been linked to higher alcohol consumption, there is still a lack of studies examining in detail the shape and nature of the relationship between mental health and alcohol consumption.Aim: To investigate the associations between satisfaction with life, mental health problems and potential alcohol-related problems among Norwegian university students. The shape of the associations was also examined.Methods: Data were drawn from a 2018 national survey of students in higher education in Norway (the SHoT-study). Associations between satisfaction with life, mental health problems and potential alcohol-related problems (AUDIT; risky and harmful alcohol use) were investigated using logistic regression. Both crude models and models adjusted for age, gender and marital status were conducted. To investigate the shape of the associations, logistic regression with quadric and cubic terms was tested.Results: Decreased satisfaction with life and increased mental health problems were associated with potential alcohol-related problems. For satisfaction with life, a curvilinear association with risky alcohol use and a linear association with harmful alcohol use was identified. For mental health problems, curvilinear associations were found for both risky and harmful alcohol use.Conclusion: Many students report potential alcohol-related problems. Students with harmful alcohol use seem to be more at risk of reduced satisfaction with life and increased mental health problems than students with risky alcohol use. Educational institutions may be an ideal setting for raising awareness of mental health issues and responsible alcohol consumption among students. The present study contributes with important information about the shape of the associations between satisfaction with life, mental health problems and potential alcohol-related problems in the student population.

Sign in / Sign up

Export Citation Format

Share Document