Alcohol use disorder (AUD) is a highly stigmatized condition, often associated with negative stereotypes such as being morally weak, incompetent, unpredictable, and aggressive. People with AUD are at risk of experiencing self-stigma, a social-cognitive experience in which people think others hold negative stereotypes about them, expect to be treated unfairly, and/or believe that negative stereotypes are personally accurate. Women in the criminal justice system with AUD in particular are at risk of experiencing self-stigma due to intersecting sources of disadvantage. Given that self-stigma can lead to treatment avoidance and dropout, it is important to understand risk factors for self-stigma to inform prevention and intervention efforts in the justice system. Incarcerated women with AUD (=185) completed measures of alcohol self-stigma as well as a variety of theoretically relevant risk factors including sociodemographics, baseline levels of stress and depression, and alcohol-related factors (i.e., length of drinking history, frequency/amount of use, consequences of use, physician advice to stop, belief that legal involvement is related to alcohol use, alcohol-related charges, self-efficacy to quit, readiness for treatment, pressures to enter treatment, factors that influence treatment) and other stigmatized conditions (drug use, exchanging sex, and homelessness). Results showed that experiencing more consequences of alcohol use, pressures to enter treatment, and perceived stress were associated with internalized stigma and anticipated/enacted stigma. This study begins to identify which incarcerated women with AUD are most at risk of experiencing self-stigma that may interfere with alcohol treatment.

Alcohol use disorder (AUD) is a chronic, relapsing condition with a complex etiology and heritable susceptibility factors interact with environmental factors to produce and maintain the disease. One goal of current neuroscience research is to identify the neuroadaptations mediating the propensity to consume high amounts of alcohol, of either innate or environmental origin. Dysfunctional neuronal communication between prefrontal cortical regions and the nucleus accumbens (NAcc) have been implicated in excessive alcohol drinking and proposed to play a critical role in AUD. However, the exact mechanism by which altered prefrontostriatal transmission may perpetuate excessive drinking is poorly understood. In addition, the exact role of dopamine receptor 1 (D1R) or dopamine receptor 2 (D2R)-expressing medium spiny neurons in the NAcc is unclear and adds another layer of complexity to this framework. This thesis concerns pituitary adenylate cyclase-activating polypeptide (PACAP), a highly conserved 38 amino acid neuropeptide, and its receptor PAC1R. Studies in rodents and humans have implicated PACAP and PAC1R in the actions of drugs of abuse, including more recently, alcohol. Notably, the PACAP/PAC1R system has also been shown to increase glutamatergic neurotransmission in several circuits. The overall hypothesis of this project was that the PACAP/PAC1 system in the prefrontal cortex-NAcc pathway regulates excessive drinking and the long-lasting neuroplastic changes observed in alcohol addiction, via the modulation of the glutamatergic system. Using alcohol-preferring rats, a hereditary model of AUD, we found that intracerebroventricular administration of a PAC1R antagonist blocked excessive alcohol drinking, motivation to drink, and alcohol seeking behavior selectively in this line and not in outbred rats. Alcohol-preferring rats displayed a higher number of PAC1R positive cells in the NAcc Core. Blockade of PAC1R in the NAcc Core, via pharmacology or gene knockdown, resulted in reduced alcohol drinking. Conversely, we found that knockdown of the PAC1R in the NAcc Shell led to increased alcohol drinking and motivation to drink in alcohol-preferring rats, suggesting that the PACAP/PAC1R system may play an opposite role in these two NAcc subregions. Using a mouse exposure model of excessive drinking, a glutamatergic projection from PACAP-expressing cells in the prelimbic portion of the prefrontal cortex (PrL) to the NAcc Core circuit was found to be recruited by alcohol exposure. Inhibition of these neurons, as well as PACAP neuron ablation or PACAP deletion, led to decreased alcohol intake that was specific to male mice. Systemic PAC1R antagonism, and specific knockdown of PAC1R in the NAcc Core, also decreased alcohol intake in male mice. Using slice electrophysiology and channelrhodopsin assisted circuit mapping, we found that this pathway is biased to D1R-expressing neurons in the NAcc Core following alcohol exposure in males, and that PACAP application increases post-synaptic measures of glutamatergic transmission in this circuit. Overall, these data describe a key role for the corticostriatal PACAP/PAC1R system in aberrant alcohol drinking in both hereditary- and exposure-based models of AUD and give novel insights into the underlying mechanisms of alcohol addiction. / 2025-01-23T00:00:00Z

Objectives: To evaluate associations between public health measure adherence and changes in alcohol consumption and binge drinking during the COVID-19 pandemic and identify potential modifiers of these associations. Methods: A longitudinal study was conducted using the Canadian Longitudinal Study on Aging Baseline, Follow-Up 1, and COVID-19 Questionnaires (N=23,615). Multinomial logistic regression was used to examine associations between public health measure adherence (including self-quarantine, public gathering attendance, leaving home, mask-wearing, and handwashing) and 1) self-reported alcohol consumption changes during the first year of the pandemic 2) prospectively measured alcohol consumption changes from 2015-2018 to early pandemic (2020), and 3) prospectively measured changes in binge drinking events from 2015-2018 to early pandemic. Models were adjusted for sex, age, education, marital status, region, income, immigration status, and racial background. Results: During the first year of the pandemic, 13% (N=2,733) of participants self-reported increased alcohol use, while 13% (N=2,921) reported decreased use. Prospective measures suggested 19% (N=4,421) increased and 35% (N=7,971) decreased use, while 13% (N=1,427) increased and 18% (N=1,953) decreased binge drinking events. Compared to low public health measure adherence, high adherence was not associated with self-reported changes in alcohol use, with prospectively measured increased alcohol use, or with prospectively measured changes in binge drinking. However, high adherence was associated with higher odds of prospectively measured decreased alcohol use (aOR=1.17; 95% CI=1.05, 1.29). Conclusion: Higher public health measure adherence during the COVID-19 pandemic was not associated with increased alcohol use, suggesting that adherence did not negatively impact alcohol consumption. Findings may inform public health interventions throughout future pandemics. / Thesis / Master of Public Health (MPH)

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Alcohol use disorder (AUD) and post-traumatic stress disorder (PTSD) are debilitating conditions that often co-occur, with an estimated 41-79% comorbidity rate. A major concern with the co-occurrence of these disorders is the tendency for one to exacerbate the other. Specifically, symptoms related to PTSD are a significant risk factor for the development of AUD, and alcohol abuse worsens PTSD symptoms. This cycle, along with a lack of effective pharmacological treatment options, leads to significant behavioral and physiological deficits. Additionally, remission for comorbid AUD and PTSD is much more difficult to attain due to exacerbated symptomology and a lack of FDA-approved medications. In recent years, cannabidiol (CBD), a non-psychoactive compound found in cannabis, has been a focus of study due to its therapeutic potential. Researchers have demonstrated the anxiolytic and anti-inflammatory effects of CBD in both humans and animals, showing its promise as a novel therapeutic agent in the treatment of psychiatric disorders. The purpose of this study is to investigate the hypothesis that CBD will reduce fear-related behaviors and neuroinflammation in a rat model of comorbid AUD and PTSD. Our AUD/PTSD model utilized restraint stress and chronic intermittent ethanol exposure procedures. To investigate changes in future stress sensitivity all animals were exposed to a contextual fear conditioning paradigm, which was used to train the animals to associate environmental and auditory cues (environment appearance and tone) with an aversive stimulus (mild foot-shock). 30 minutes prior to each conditioning session, rats received an intraperitoneal injection of CBD (20mg/kg) or 0.9% Saline. Once the animals learned to associate the cues with a shock, they were exposed to an extinction learning procedure that involved presentation of the cue alone (no shock). This procedure parallels exposure therapy in humans, allowing for the assessment adaptations to fear learning. The amount of time the rats remain still (freezing) during the tone represents fear-related behavior. Our current results indicate rats with a history of stress and alcohol exposure displayed significantly higher freezing behaviors and this effect was significantly decreased with CBD treatment. This suggests that when CBD is administered during fear learning, it is able to attenuate heightened stress sensitivity associated with AUD/PTSD. To evaluate how CBD mediates the neuroinflammatory response associated with AUD and PTSD, brains from the rats were extracted and analyzed for the inflammatory cytokine tumor necrosis factor a (TNF-a). Specific regions of interest included the medial prefrontal cortex and hippocampus, areas associated with anxiety, memory, and addiction. Neuroinflammation analyses are still ongoing, however it is predicted that rats who received CBD will show a reduction in inflammation in the medial prefrontal cortex and hippocampus. Taken together, the current results show promise for CBD to reduce enhanced fear-related behavior associated with comorbid AUD and PTSD.

The purpose of this study was to examine the hypocrisy paradigm as an experimental alcohol intervention to determine if participants who complete the hypocrisy paradigm will experience a significant reduction in the number of negative consequences associated with their alcohol use, quantity and frequency of alcohol use, and average and peak eBAC compared to college students in the control condition. Participants were 53 college students randomly assigned to an experimental hypocrisy paradigm intervention or a control condition. Contrary to prediction, the hypocrisy paradigm was not found to be significantly different than the control condition. Exploratory analyses examining within-group differences were conducted. All outcome measures decreased from pre-intervention to follow-up within the hypocrisy paradigm condition. Future directions and implications are discussed.

Alcohol and substance use among a college population has become a norm for our society. Even more intriguing are the possible factors that may lead to use and abuse of alcohol and substances. The purpose of the current study was to examine the relationship between multiple participant characteristics (i.e., ethnicity, gender, year in college, socioeconomic status) and alcohol and substance use. A total of 902 participants from the University of Central Florida answered multiple questionnaires via the Sona system. Items in the questionnaires included topics such as demographic variables, social class variables, and items regarding alcohol and substance use in the past thirty days. The majority of participants were white females with an average age of 21.58. This study hypothesized that participants who identify as white males, those classified as a junior or senior in class standing, as well as those in a higher socioeconomic status would be more likely to report alcohol and substance use when compared to other participants. The current study also sought to assess how these different factors combine to best predict alcohol and substance use among a college sample. Data in the study was analyzed using SPSS in which correlations, t-tests, and an ANOVA were used to determine how participant characteristics and alcohol and substance use among college students are related. Linear regression analyses were conducted as well to determine how different participant characteristics can combine to best predict alcohol and substance use among college students. Results indicated that those participants whom identify as being white males, participants in a higher socioeconomic status, and, participants in later years of college are more likely to partake in alcohol and substance use. Results also indicated that the main factors that predicted alcohol and substance use are social class and year in college.

Hispanic/Latinx are the largest growing population in the U.S. Moreover, discrimination has been researched as a sociocultural factor that contributes to alcohol use in ethnic minorities. This study examines whether discrimination is related to drinking status among Hispanic/Latinx college students. To better understand ethnic disparities, acculturation is considered at high and low levels, as well as sex differences. 283 college students that identified as Hispanic/Latinx completed the survey. After answering demographic information, participants self-reported their alcohol use (AUDIT), discrimination experiences (EDS), and acculturation (SMAS). For females, the analysis indicated that there was a significant positive relationship between discrimination and problem drinking at high levels of acculturation (B = 1.56, p =.003), but not low levels (B = 0.36, p =.490). For males, the opposite was observed. At low levels of acculturation, there was a modest relationship between discrimination and problem drinking (B = 1.30, p =.064). This research adds to the literature on acculturation’s impact on problem drinking and discrimination, and sex differences concerning acculturation. Furthermore, it may inform intervention, suggesting that discrimination should be targeted to help ease the burden on alcohol use. Lastly, this research furthers research on the impact of acculturation on Hispanic/Latinx.

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