Alcohol (Hanover, York County, Pa.)最新文献

{"title":"Exploring the role of gender on treatment outcomes in older adults with alcohol use disorder.","authors":"Jeppe Sig Juelsgaard Tryggedsson, Kjeld Andersen, Silke Behrendt, Michael P Bogenschutz, Gerhard Buehringer, Anette Søgaard Nielsen","doi":"10.1111/acer.70164","DOIUrl":"https://doi.org/10.1111/acer.70164","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use disorder (AUD) among older adults, particularly with respect to gender differences in treatment outcomes, remains underexplored. Our objective was to explore gender differences in AUD treatment outcomes among older adults, focusing on continuous measures (e.g., drinks per day) and binary measures (e.g., abstinence) across a 1-year period.</p><p><strong>Methods: </strong>We analyzed data from a multinational randomized controlled trial involving 693 older adults (60+) diagnosed with DSM-5 AUD. Participants received motivational enhancement therapy and the community reinforcement approach, across sites in Denmark, Germany, and the United States. Participants were assessed at baseline and after 4, 12, 26, and 52 weeks. Multilevel mixed-effects linear and logistic regressions were used, adjusted for sociodemographic and baseline drinking characteristics.</p><p><strong>Results: </strong>Both men and women showed significant improvements across all outcomes. At baseline, females reported 0.75 fewer drinks/day, 1.33 fewer drinks/drinking day, and 50% lower odds of low blood alcohol content (BAC) compared to males (OR = 0.50; p < 0.05). Gender-time interactions showed smaller reductions in females' drinks per day and drinks per drinking day (p < 0.05), resulting in similar drinking levels at follow-ups. No gender differences were found at any time points for percent days abstinent and percent heavy drinking days (p ≥ 0.05). A significant gender-time interaction was found for percent days abstinent (p = 0.04), but no consistent direction was observed across time points. For abstinence and no heavy drinking, no gender differences were found (p ≥ 0.05). No interactions between gender and time were found for any binary outcome (p ≥ 0.05).</p><p><strong>Conclusions: </strong>Among older adults with DSM-5 AUD diagnosis, treatment led to substantial and sustained improvements across genders. While women showed less favorable drinking reductions, adjusted estimates were broadly comparable. Given women's increased physiological vulnerability to alcohol, this may not imply equivalent clinical risk. Still, findings support the potential for meaningful treatment benefits regardless of gender.</p>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting G9a decreases escalated alcohol drinking in male mice in a model of combined stress and chronic alcohol exposure.","authors":"Marcelo F Lopez, Paulina Misztak, Howard C Becker, Christopher W Cowan, Ethan M Anderson","doi":"10.1111/acer.70142","DOIUrl":"https://doi.org/10.1111/acer.70142","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use disorder (AUD) is a pervasive problem in society afflicting millions of people worldwide. One reason for the prevalence of AUD is that heavy alcohol drinking can produce alcohol dependence. In addition, alcohol dependence dysregulates the body's stress systems to increase alcohol drinking. Therefore, targeting dependence- and/or stress-related alcohol drinking clinically could reduce heavy drinking in patients with AUD. One key mechanism thought to contribute to behaviors associated with AUD is long-lasting epigenetic alterations of gene expression. We recently showed that the epigenetic regulatory enzyme G9a (also known as euchromatic histone-lysine N-methyltransferase 2 or EHMT2) is downregulated in the nucleus accumbens (NAc) in mice by alcohol dependence produced by the chronic intermittent alcohol (CIE) model. Also, we showed that either viral-mediated NAc G9a knockdown or a systemically administered G9a inhibitor reduced stress-potentiated alcohol drinking by the kappa-opioid agonist U50,488.</p><p><strong>Methods: </strong>Here, we tested whether NAc G9a knockdown reduces escalated alcohol drinking in a mouse model of combined dependence plus forced swim stress (CIE + FSS) in male mice. We also tested for changes in sucrose drinking, sucrose preference, and water consumption as controls. In addition, we tested whether systemic administration of a G9a inhibitor, UNC0642, could reduce alcohol drinking in the CIE + FSS model.</p><p><strong>Results: </strong>We found that either NAc G9a knockdown or repeated systemic UNC0642 administration reduced escalated ethanol drinking following CIE + FSS, but without altering control levels of ethanol drinking or sucrose drinking or water drinking in male mice.</p><p><strong>Conclusions: </strong>These preclinical data suggest that reducing NAc G9a levels, or suppressing its enzymatic activity, can effectively reduce potentiated alcohol drinking produced by stress and/or alcohol dependence. These data suggest that G9a inhibition holds promise as a potential therapeutic for individuals who suffer from AUD.</p>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internalizing symptoms are indirectly associated with simultaneous alcohol and cannabis use through specific motives for simultaneous use: A longitudinal study of young adults.","authors":"Jeffrey D Wardell, Kyra N Farrelly, Annabelle Moore, Nicolle Fox, Sophie G Coelho, John A Cunningham, Roisin M O'Connor, Christian S Hendershot","doi":"10.1111/acer.70147","DOIUrl":"https://doi.org/10.1111/acer.70147","url":null,"abstract":"<p><strong>Background: </strong>This study examined motivational pathways between internalizing symptoms (i.e., depression, anxiety, stress) and simultaneous alcohol and cannabis use among young adults.</p><p><strong>Methods: </strong>Participants (N = 151; 64% female, Mean age = 22.07) completed baseline questionnaires assessing internalizing symptoms and simultaneous use motives, and then reported their alcohol and cannabis use each day for 21 days. Participants repeated these procedures again 6 months and 12 months postbaseline. Daily survey responses were used to calculate the number of simultaneous use days involving heavy drinking (4 or more drinks for females; 5 or more drinks for males) and light drinking at each wave for each participant. The total number of negative consequences reported across all simultaneous use days was also calculated for each participant at each wave.</p><p><strong>Results: </strong>Multilevel mediation analyses revealed that within-person increases in internalizing symptoms (a latent factor consisting of depression, anxiety, and stress indicators) at a given wave were indirectly associated with (a) a greater number of heavy drinking simultaneous use days (controlling for number of cannabis-only days and heavy drinking alcohol-only days) and (b) greater negative consequences on simultaneous use days (controlling for negative consequences on cannabis-only and alcohol-only days). These within-person associations were mediated by increases in positive (i.e., reward/enhancement) motives for simultaneous use. At the between-person level, greater average internalizing symptoms (aggregated across waves) were indirectly associated with more light drinking simultaneous use days via coping motives, and with fewer heavy drinking simultaneous use days via conformity motives (controlling for frequency of single substance use).</p><p><strong>Conclusions: </strong>Young adults may combine cannabis with heavy episodic drinking more frequently during periods when they experience elevations in internalizing symptoms, mediated by a desire to achieve the positive/enhancing effects of simultaneous use. Findings may inform alcohol and cannabis harm reduction interventions tailored for young adults with internalizing symptoms.</p>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain network signatures of spatial memory in adolescents at risk for substance use.","authors":"Jennifer T Sneider, Julia E Cohen-Gilbert, Emily N Oot, Anna M Seraikas, Eleanor M Schuttenberg, Andie Stallman, Derek A Hamilton, Sion K Harris, Helen Sabolek, Poornima Kumar, Lisa D Nickerson, Marisa M Silveri","doi":"10.1111/acer.70155","DOIUrl":"https://doi.org/10.1111/acer.70155","url":null,"abstract":"<p><strong>Background: </strong>Examining youth before engagement in risky behaviors may help identify neurobiological signatures that prospectively predict susceptibility to initiating and escalating alcohol and other substance use. Given that frontal and medial temporal (e.g., hippocampal) regions continue developing during adolescence, identifying vulnerabilities in these systems is critical.</p><p><strong>Methods: </strong>This study evaluated baseline brain activation during spatial memory performance using a virtual functional magnetic resonance imaging (fMRI) Morris water task (MWT). Participants were healthy, substance-naïve adolescents aged 13-14 years (n = 51, 27 females) who underwent brain imaging annually for 3 years and were evaluated quarterly for substance use. For the present report, only baseline imaging data were analyzed. During quarterly follow-ups, 22 participants initiated alcohol or other substance use, while 29 remained substance-naïve. Network activation strength was extracted for the retrieval > motor contrast in the dorsal attention network (DAN), salience network (SN), and medial temporal lobe subnetwork of the default mode network (MTL-DMN).</p><p><strong>Results: </strong>DAN and SN activation strengths were significantly lower in initiators than in noninitiators. No group differences emerged for MTL-DMN activation. While minimal group or sex differences were observed in task performance, greater MTL-DMN activation was associated with better performance across the full sample, whereas better performance was associated with reduced DAN activation only in noninitiators.</p><p><strong>Conclusions: </strong>Adolescents who later initiated substance use showed distinct baseline network patterns in systems supporting spatial memory and attention (DAN) and task control and salience detection (SN). In contrast, hippocampal network activation (MTL-DMN) was not evident before initiation but may emerge later as a consequence of use. Because substance use status was categorized for group comparisons, early variability may not be fully captured. These findings underscore the need for future longitudinal analyses to disentangle neurobiological markers of risk that precede adolescent substance use from alterations that arise as a result of use.</p>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Directional associations between antisocial behavior and alcohol use disorder symptoms from adolescence through adulthood: A sibling comparison cross-lagged approach","authors":"Connor J. McCabe,&nbsp;Jarrod M. Ellingson,&nbsp;Jesse D. Hinckley,&nbsp;Michael Stallings,&nbsp;Christian Hopfer,&nbsp;Soo Hyun Rhee,&nbsp;Robin P. Corley,&nbsp;Daniel E. Gustavson,&nbsp;J. Megan Ross,&nbsp;Tamara L. Wall","doi":"10.1111/acer.70134","DOIUrl":"10.1111/acer.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A well-established link between antisocial behavior (ASB) and problematic alcohol use in adolescence has been demonstrated, yet the direction of this association across the lifespan remains unclear. Although antisocial conduct may increase exposure to known social and environmental risk factors for developing alcohol use disorder (AUD), alcohol use may also impair social functioning and self-regulation that subsequently increases ASB risk. Using a sibling comparison design in a high-risk sample, this study tested bidirectional associations between symptom counts of ASB and AUD from adolescence through adulthood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Participants were a sample of 783 probands with adolescent-onset ASB and AUD symptoms at baseline and 556 of their siblings assessed during adolescence (18 years and younger), emerging adulthood (19–26 years), and later adulthood (27 years and older). We applied multilevel cross-lagged panel models to assess lagged associations between ASB and AUD symptoms across three waves. Clustering was specified at the family level, with outcomes centered within families.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Greater within-family ASB in adolescence predicted moderate increases in AUD in emerging adulthood (<i>ß</i> = 0.25, <i>p</i> &lt; 0.001); whereas adolescent AUD did not predict subsequent ASB. Within-family associations between AUD and ASB were not found in the emerging-to-later adult periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Accounting for family-level confounding, ASB symptoms in adolescence may be a precursor to AUD in emerging adulthood; whereas AUD and ASB symptoms may follow independent trajectories through adulthood. Findings highlight the importance of considering developmental specificity in the prevention and treatment of copresenting AUD and ASB risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"49 9","pages":"2092-2102"},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latent profile analysis of trait impulsivity facets and associations with resilience, problematic alcohol use, and quality of life.","authors":"Heidi H Meyer, Matthew F Thompson, Tommy Gunawan, Melanie L Schwandt, Vijay A Ramchandani, Nancy Diazgranados, Jeremy W Luk","doi":"10.1111/acer.70158","DOIUrl":"https://doi.org/10.1111/acer.70158","url":null,"abstract":"<p><strong>Background: </strong>Impulsivity is a multidimensional construct that is associated with problematic alcohol use and alcohol use disorder (AUD). Modeling within-person clustering of impulsivity facets has the potential to aid clinical case conceptualization, and examining associations with resilience and well-being outcomes can inform strength-based intervention approaches. In this study, we utilized latent profile analysis (LPA) to capture the clustering of trait impulsivity facets and tested resilience as a mediational pathway linking impulsivity latent profiles to problematic alcohol use and quality of life domains.</p><p><strong>Methods: </strong>A total of 401 adults (59.9% male and 71.6% with past-year AUD) who completed self-reported measures of trait impulsivity (Barratt Impulsiveness Scale and UPPS-P Impulsive Behavior Scale), resilience, and alcohol-related outcomes were included in this study. Statistical analyses included LPA, linear regression, and path analysis.</p><p><strong>Results: </strong>LPA identified three profiles that varied by overall impulsivity as well as specific levels of negative and positive urgency: Profile 1-Low Impulsivity/Urgency (36.4%), Profile 2-Medium Impulsivity (45.6%), and Profile 3-High Impulsivity/Urgency (18.0%). The percentages of past-year AUD were 37.7% in Profile 1, 87.4% in Profile 2, and 100% in Profile 3. Latent profiles with higher impulsivity had lower resilience, higher problematic alcohol use, and lower quality of life. Low resilience was a significant mediator of associations between Medium/High Impulsivity profiles and all clinical outcomes, including problematic alcohol use and four quality of life domains.</p><p><strong>Conclusions: </strong>In this person-centered analysis, individuals who scored high on negative urgency also had elevated scores on positive urgency and several other impulsivity facets. Within-person clustering of impulsivity facets was associated with differential risk for AUD, and latent profile differences in problematic alcohol use and quality of life outcomes were mediated by low resilience. Findings highlight resilience as a potential treatment target that warrants further evaluation in clinical research.</p>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosing prenatal alcohol exposure and fetal alcohol syndrome in military-connected children: Insights from US military data claims, 2016-2023.","authors":"Elizabeth H Lee, Madison Cirillo, Zoe Solomon, Amanda Banaag, Barbara Fuhrman, Rachel Sayko Adams, Tracey P Koehlmoos","doi":"10.1111/acer.70157","DOIUrl":"https://doi.org/10.1111/acer.70157","url":null,"abstract":"<p><strong>Background: </strong>Fetal alcohol spectrum disorder (FASD) is a lifelong neurodevelopmental condition resulting from prenatal alcohol exposure (PAE) during gestation. Conservative estimates of FASD prevalence in United States children are 1%-5%. Early identification could facilitate early intervention, yet fewer than 1% of children with FASD receive a diagnosis. Although heavy alcohol use has been part of military culture for decades, the epidemiology of FASD is unknown in the Military Health System (MHS), where 1.9 million children receive care.</p><p><strong>Methods: </strong>Using an open cohort design and military claims data for 2016-2023, we calculated period prevalence, annual and cumulative incidence, and average age at first diagnosis for FASD in military children 0-18 years. FASD diagnosis was defined using available diagnostic codes representing a small subset of the broader FASD spectrum of conditions, that is, newborn affected by PAE and fetal alcohol syndrome (FAS). We conducted chi-squared tests and multivariable logistic regression to identify sociodemographic factors associated with these combined diagnoses.</p><p><strong>Results: </strong>One thousand four hundred seventy six unique children had any diagnosis between 2016 and 2023 (PAE only: 301; FAS only: 1061; both: 114). Period prevalence was 0.42 cases per 1000 children. Cumulative incidence was 0.34 cases per 1000 children for 2017-2023 using 2016 as a 1-year washout. Average age at any diagnosis was 8.3 years. Factors associated with increased likelihood of diagnosis were male sex; being in guardianship; sponsor of senior officer rank; and sponsor affiliated with the Air Force or Other Service branch. Factors associated with decreased likelihood of diagnosis included Black or Other race; being a stepchild; sponsor of junior enlisted or junior officer rank; and sponsor in the Marine Corps.</p><p><strong>Conclusions: </strong>Like in the US general population, FASD is underdiagnosed in the MHS. Further study of an expanded set of co-occurring conditions under the FASD umbrella may aid in refining estimates of FASD in the MHS.</p>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding clustered behavioral risk factors among adults in the United States: A gender-specific analysis of alcohol and other substance use and obesity.","authors":"Won Kim Cook, Libo Li, William C Kerr, Priscilla Martinez","doi":"10.1111/acer.70148","DOIUrl":"https://doi.org/10.1111/acer.70148","url":null,"abstract":"<p><strong>Background: </strong>Individuals who consume alcohol often use other drugs as well. Little is known about the clustering of heavy and binge drinking with the use of other substances (tobacco, cannabis, illicit drugs, and nonmedical prescription drugs). Overweight/obesity, highly prevalent in the United States (US) and an established health risk factor, may also cluster with them. We aimed to identify patterns of clustering of these behavioral risk factors and demographic and chronic disease profiles of individuals who show each pattern of clustering.</p><p><strong>Methods: </strong>Latent class analyses and multinomial and logistic regressions were conducted using a nationally representative sample of US adults (Analytic N = 214,505) from the 2015-2019 National Survey on Drug Use and Health. Demographic characteristics (age, race and ethnicity, education, and income) and chronic health conditions associated with each cluster of behavioral risk factors were examined, also adjusting for health insurance coverage and marital status. Analyses were stratified by gender.</p><p><strong>Results: </strong>Four clusters with similar behavioral risk profiles were identified for both men and women: heavy-drinking-tobacco-some-cannabis-use-obese group, high-substance-use group, obese group, and relatively-healthy-lifestyle group. Additionally, heavy-drinking-tobacco-some-cannabis-use-overweight group and low-drinking-high-other-substance-use group for men and heavy-drinking-tobacco-some-cannabis-use group for women were identified. The high substance use group was more likely to be aged under 35. However, clusters featuring more commonly used substances (alcohol, tobacco, and, to a lesser degree, cannabis) were more likely to be midlife for men and to have higher income for both men and women. Clustered behavioral risk factors were positively associated with being White and having no college degree (with some exceptions) and negatively associated with self-rated health status and chronic conditions (except hypertension) for both sexes.</p><p><strong>Conclusions: </strong>Clustered multisubstance use and obesity is a problem affecting a significant segment of the US population. Tailored multibehavior interventions are warranted.</p>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Person-environment transactions of impulsive traits and day-level alcohol use: A narrative review.","authors":"Jack T Waddell, Ian A McNamera, Shu Inamura, Riley C Tolbert","doi":"10.1111/acer.70159","DOIUrl":"10.1111/acer.70159","url":null,"abstract":"<p><strong>Background: </strong>Person-Environment Transactions Theory purports that certain individuals react differently (and gain different experiences) based upon their environment, which therefore informs acute and long-term behavioral development. Given the central role of impulsive traits (i.e., positive urgency, negative urgency, lack of premeditation, lack of perseverance, and sensation seeking) in the etiology of alcohol use/misuse, a variety of studies have tested person-by-environment transactions between impulsive traits and environmental, day-level variables predicting drinking behavior. Yet, a synthesis of these findings remains needed to best characterize the literature, inform future studies, and spur conversation among the research community.</p><p><strong>Methods: </strong>This narrative review identified studies testing cross-level interactions between Urgency, Premeditation, Perseverance, Sensation Seeking (UPPS-P) impulsive traits and day/moment-level environmental variables, broadly defined, predicting alcohol use/misuse using daily diaries/surveys, ecological momentary assessment, and timeline followback interviewing.</p><p><strong>Results: </strong>Thirteen studies met inclusion criteria, testing interactions between UPPS-P impulsive traits and day-level pregaming, affect/PTSD symptoms, alcohol and cannabis couse, planned drinking, physical activity, rate of alcohol consumption, and state impulsivity. Across studies with significant interactions, all but one found interactions wherein positive urgency potentiated the influence of the given day-level variable on heavier drinking. Findings for lack of premeditation and perseverance were less common but in the same direction as positive urgency, while findings for negative urgency and sensation seeking were sparse, inconsistent, and mixed.</p><p><strong>Conclusions: </strong>A host of day/moment-level environmental variables, broadly defined, appear to potentiate riskier drinking dependent upon impulsive personality traits. Themes across studies and the need for continued research and environment-specific intervention development are discussed.</p>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences and barriers to alcohol use disorder treatment among adults with and without self-reported executive functioning challenges: A mixed-methods study.","authors":"Cayley Russell, Jessica L Wiese, Anthony C Ruocco, Nikki Bozinoff, Raul Gonzalez, Sheila Jennings, Marco Leyton, Yuliya S Nikolova, Josh Orson, Marc N Potenza, Lena C Quilty, Kevin D Shield, Antonio Verdejo-Garcia, Samantha Wells, Shannon Lange","doi":"10.1111/acer.70154","DOIUrl":"https://doi.org/10.1111/acer.70154","url":null,"abstract":"<p><strong>Background: </strong>Executive functioning (EF)-the ability to plan, organize, and complete goal-directed tasks-plays a critical role in the onset and course of alcohol use disorder (AUD). Individuals with AUD often report challenges in EF domains, such as initiating, planning, and performing key tasks, including seeking, engaging in, and adhering to treatment. While AUD treatment efficacy is well-established, little is known about individuals' lived experiences with AUD treatment, especially among those with EF challenges. To date, no studies have explored how self-reported EF challenges shape treatment-seeking experiences in people with AUD using a mixed-methods approach. This study addresses that gap.</p><p><strong>Methods: </strong>We conducted a mixed-methods study involving 30 adults seeking AUD treatment between June 2022 and June 2023. This work was part of a broader research program examining cognitive functioning in addictions within a mental health and addictions hospital in Toronto, Canada. Data collection included semistructured qualitative interviews and a standardized self-administered EF questionnaire. Data were integrated, analyzed thematically, and narratively synthesized.</p><p><strong>Results: </strong>Approximately half of participants (53%) met the threshold for EF challenges. Many described multiple prior treatment attempts, a delayed recognition of problematic alcohol use, and an incongruence between treatment expectations and experiences. Those with EF challenges described distinct barriers to care and expressed a need for additional supports, including access to psychotherapy, clearer treatment pathways and timelines, and more proactive communication and follow-up from healthcare providers.</p><p><strong>Conclusions: </strong>Individuals with AUD often experience co-no studies have explored how self-reported EF difficulties intersect with lived experiences of accessing AUD treatment using a mixed-method approachoccurring mental health and EF challenges that may affect their motivation to seek treatment and shape treatment experiences and trajectories. Tailored treatment approaches that address EF challenges through enhanced support, structure, and provider communication may improve treatment engagement and outcomes among this population.</p>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}