<p>The relationship between positive urgency, a personality trait reflecting rash action during extreme positive emotional states, and risk-taking has previously been experimentally examined. However, how positive urgency is related to risk-taking while under the acute influence of alcohol has not been examined. The overarching goal of this dissertation was to generate behavioral evidence concerning how the interaction between positive urgency and alcohol consumption influences risk-taking via changes in emotional arousal. In this study, 59 community-dwelling adults (mean age = 29.45 (SD = 10.96), 32.2% women, 78% White) completed mood induction procedures (positive or neutral) while consuming a beverage (alcohol or placebo) and then completed the Balloon Analogue Risk Task (BART) as a measure of risk-taking. The positive mood induction was effective in inducing high arousal positive emotions. Overall, study hypotheses were not supported; however, because of low power, effect sizes and patterns of relationship are reported. The relationship between positive urgency and risk-taking was positive and small in the positive mood condition but negative and small in the neutral mood condition. The alcohol group and the placebo group showed similar patterns of risk-taking that are positive and small. Finally, the relationship between positive urgency changes in emotional arousal was positive and small only in the positive/alcohol condition; however, there was no relationship between changes in emotional arousal and risk-taking. These findings suggest that, while changes in emotional arousal may result from a combination of positive urgency and alcohol consumption, it may not be a focal mechanism that explains the relationship between positive urgency and risk-taking. Further, positive urgency is a risk factor whether or not alcohol consumption is present. Although the small sample size limited the power to test the hypotheses, the effect size estimates obtained in this study provide preliminary data for a more properly powered future study. The pattern of findings suggests the viability of further developing the current positive mood induction to establish a lab-based paradigm for positive urgency and the use of a different experimental risk-taking task to examine positive emotion-based risk-taking.</p>

Indiana University-Purdue University Indianapolis (IUPUI) / Continued consumption of alcohol despite the knowledge of negative consequences is a hallmark of alcohol use disorder (AUD), yet much remains unknown about what motivates these behaviors. Compulsive drinking may require motivational resources that are not necessary when drinking in unchallenged conditions in order to counteract the addition of these negative consequences. Increased sensitivity to drug-paired stimuli via associative learning processes may provide this additional motivation. To evaluate if alcohol-paired stimuli enhance alcohol seeking, selectively bred crossed High Alcohol Preferring mice experienced Pavlovian conditioning procedures with an alcohol unconditioned stimulus. We hypothesized that after repeated pairings, alcohol cues would elicit seeking conditioned responses. Then, to determine if the motivation provided by these cues influenced responding, mice were trained to respond for alcohol and tested in the presence of alcohol cues. Finally, to test if alcohol-paired cues influence compulsive drinking, this same test was repeated with the addition of response-contingent footshock. We hypothesized the cue paired with alcohol would increase responding for alcohol in unchallenged conditions, but especially in challenged conditions, contributing to compulsivity. An auditory stimulus paired with alcohol did elicit enhanced seeking responses, but contrary to hypothesis, we observed no effect of these same cues on instrumental responding. To validate these findings, training and testing procedures must be optimized to ensure conditioning has properly occurred and compulsivity is being appropriately measured.

No description available.

This secondary analysis describes the additional psychological symptoms experienced by women in substance abuse treatment who have an alcohol use disorder (AUD) in addition to a drug use disorder (DUD). Results show high levels of certain patterns of psychological symptoms, which include Paranoid Ideation, Phobic Anxiety, Anxiety, and Psychoticism, on the Brief Symptom Inventory (BSI) subscales. Also, age had an adverse effect, with Depression and Psychoticism scores higher with increasing age. Nurse practitioners are ideally situated to assess and screen for patterns of co-occurring psychological symptoms in women with an AUD, which can complicate treatment and lead to practice implications.

Background: While the integration of alcohol screening, treatment, and referral in primary care and other medical settings in the U.S. and worldwide has been recognized as a key health care priority, it is not routinely done. In spite of the high co-occurrence and excess mortality associated with alcohol use disorders (AUDs) among individuals with tuberculosis (TB), there are no studies evaluating effectiveness of integrating alcohol care into routine treatment for this disorder. Methods: We designed and implemented a randomized controlled trial (RCT) to determine the effectiveness of integrating pharmacotherapy and behavioral treatments for AUDs into routine medical care for TB in the Tomsk Oblast Tuberculosis Service (TOTBS) in Tomsk, Russia. Eligible patients are diagnosed with alcohol abuse or dependence, are newly diagnosed with TB, and initiating treatment in the TOTBS with Directly Observed Therapy-Short Course (DOTS) for TB. Utilizing a factorial design, the Integrated Management of Physician-delivered Alcohol Care for Tuberculosis Patients (IMPACT) study randomizes eligible patients who sign informed consent into 1 of 4 study arms: (1) Oral Naltrexone + Brief Behavioral Compliance Enhancement Therapy (BBCET) + treatment as usual (TAU), (2) Brief Counseling Intervention (BCI) + TAU, (3) Naltrexone + BBCET + BCI + TAU, or (4) TAU alone. Results: Utilizing an iterative, collaborative approach, a multi-disciplinary U.S. and Russian team has implemented a model of alcohol management that is culturally appropriate to the patient and TB physician community in Russia. Implementation to date has achieved the integration of routine alcohol screening into TB care in Tomsk; an ethnographic assessment of knowledge, attitudes, and practices of AUD management among TB physicians in Tomsk; translation and cultural adaptation of the BCI to Russia and the TB setting; and training and certification of TB physicians to deliver oral naltrexone and brief counseling interventions for alcohol abuse and dependence as part of routine TB care. The study is successfully enrolling eligible subjects in the RCT to evaluate the relationship of integrating effective pharmacotherapy and brief behavioral intervention on TB and alcohol outcomes, as well as reduction in HIV risk behaviors. Conclusions: The IMPACT study utilizes an innovative approach to adapt 2 effective therapies for treatment of alcohol use disorders to the TB clinical services setting in the Tomsk Oblast, Siberia, Russia, and to train TB physicians to deliver state of the art alcohol pharmacotherapy and behavioral treatments as an integrated part of routine TB care. The proposed treatment strategy could be applied elsewhere in Russia and in other settings where TB control is jeopardized by AUDs. If demonstrated to be effective, this model of integrating alcohol interventions into routine TB care has the potential for expanded applicability to other chronic co-occurring infectious and other medical conditions seen in medical care settings.

Objectives: To show forgiveness to be a central component in substance abuse and recovery and to encourage the empirical investigation of such realtionships. Methods: Literature reviewed and synthesized to support the role of forgiveness in addiction and recovery and to justify its empirical investigation. Results: The construct and process of forgiveness are present in 12-Step Facilitation Therapy, Motivational Enhancement Therapy, and Cognitive Behavioral Coping Skills Therapy, and other psychotherapies applicable to the treatment of substance abuse. Nevertheless, few studies exist to provide empirical support for these relationships. Conclusions: Religion and spirituality can have a salutary effect on substance use disorders. However, little is known regarding the effects of specific manifestations of religiosity and spirituality. Forgiveness, decreasing negative responses to offense irrespective of interaction with the offender, has been argued to be highly relevant to problematic substance use. Although the process of forgiveness is conceptually found in empirically validated forms of treatment for alcohol problems, little quantitative evidence exists to verify and illuminate the relationships between forgiveness and substance abuse. Empirical investigation into the basic, indirect, contextual, and interventional relationships between forgiveness and substance use disorders, including development, maintenance, and recovery, is warranted and encouraged.

Background: Women experience greater health consequences of alcohol compared to their male counterparts. In recent years, rates of drinking and heavy alcohol use have increased in women while remaining relatively steady in men. Thus, our aim was to newly examine associations between sex, AUD, and the presence of medical conditions in a large nationally representative, cross-sectional dataset. Methods: Using data from the U.S. National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III; n = 36,309), we evaluated relationships among sex and DSM-5 AUD, and their association with past year clinician-confirmed medical conditions. Results: Women were 1.5 to 2 times more likely to be diagnosed with a past year cancer, pain, respiratory, or other significant medical condition compared to men (odds ratio [OR] = 1.331–2.027). Individuals with an ongoing DSM-5 AUD were nearly 1.5 to 2 times more likely to report a confirmed past year liver, cardiovascular, cancer, or other significant medical condition compared to those without an AUD (OR = 1.437–2.073). Interactive effects demonstrated that women with an ongoing AUD were 2 to 3 times more likely to report a past year doctor- or health professional-confirmed medical condition compared to men; specifically, respiratory conditions and cancers (OR = 1.767–2.713). Conclusions: Results identify that AUD is a critical factor associated with disease that spans organ systems. Associations between AUD and respiratory conditions or cancers are particularly robust in women. Effective interventions for a broad spectrum of medical conditions should consider the role of problematic alcohol use, especially given that rates of drinking in women are increasing.

Objectives:The objective of the present study was to evaluate the reliability and validity of the Psychache Scale in college students considered to be problematic drinkers. Methods:Cross-sectional self-report data from 463 undergraduate students who were likely to be hazardous or harmful drinkers were used to study the internal factor structure, internal consistency, and concurrent validity of the scale. Results:A series of factor analyses revealed that the scale appears to consist of 2 factors, in contrast to the hypothesized unidimensional structure. These 2 factors appear to capture the frequency and severity of the respondents' levels of psychache. Moreover, these 2 factors appear to be a result of the test's construction in that item stems with identical response options loaded on the same factor. The scale was also significantly correlated with other measures of psychological distress including depression, hopelessness, and substance use. Conclusion:The clinical implications of these findings are briefly discussed, with further research being needed to better understand the Psychache Scale's characteristics in substance use and other populations likely to experience psychological pain, and therefore at risk for suicidal behavior.

Previous research has suggested that forgiveness of self and forgiveness of others might function differently over the course of addiction recovery. However, we know little about the longitudinal process of these dimensions of forgiveness for individuals addressing alcohol-use disorders. Increased knowledge would inform the content and sequencing of intervention strategies. Three-hundred and sixty four individuals managing alcohol dependence participated in a 30-month longitudinal study, reporting their capacity to forgive self and to forgive others every 6 months. Findings indicated that (a) participants were more forgiving of others than themselves; (b) both types of forgiveness increased over time; (c) forgiveness of self increased more rapidly than forgiveness of others; and (d) while increases in both types of forgiveness predicted increases in the other type, the effect of forgiveness of others on forgiveness of self was twice as strong as the reverse effect. Implications for facilitating forgiveness in treatment are discussed.

The purpose of this practicum is to describe the destructive use of alcohol among Southeastern Idaho Indians. This practicum is based on John and Irma Honigmann's (1) theory of· "loss of stake. " It is John and Irma Honigmann' s contention that whatever may be the social functions of drinking, and whatever the personal reasons, having a stake in society tends to induce people to conform to the norms of society with regard to drinking behavior. The three case histories in this practicum will illustrate more of what is meant by the theory of stake in society.