Alcohol use among college students is often in the news. Some scholars argue, with literature to support it, that problem drinking in college is just a media-driven myth (Lederman et al. 2004). Yet it is clear that college students do drink, some to excess. Various reasons are cited from alcohol availability to the "freedom" associated with this stage of life. However, very few researchers have attempted to determine whether religiosity affects alcohol use among college students. The purpose of this study was to further examine the combined issues of religiosity and alcohol use among college students. Is excessive use of alcohol during this time of life simply an adult transition issue, as Jackson et al. (2005) contend, or is there more to it? Research seems to point to the fact that religiosity plays a role. The primary hypothesis tested was that students who valued religious activities as part of their college experience would use alcohol less, including binge drinking, than those who did not. The second hypothesis tested was that students who valued parties and Greek life would use alcohol and binge more than students who did not. The data set used was constructed by the Harvard School of Public Health and included data from 120 four-year colleges and universities from throughout the United States. The analysis supported the hypothesis that religiosity was a factor in reduced alcohol use by college students. College students who valued religious activities drank less than those who did not. The study also supported the hypothesis that students who valued parties and Greek life drank more. The heaviest drinkers were those who valued parties. These results are highly significant given the size of the sample. No other study that looked at religiosity and alcohol use among college students used a sample this large. These results help us to better understand the negative association between religiosity and alcohol use among college students as well as the positive association between parties and alcohol use. They especially help us to formulate strategies that might be considered to alleviate problem drinking during this stage of life.

Eating and feeding disturbances are prevalent yet understudied health conditions in youth. They are characterized by aberrant eating behaviors, cognitive and emotional dysfunctions, and dysregulated body weight. The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition defines several feeding and eating disorders with a common onset in youth; however, data on their clinical validity at young ages are lacking. Further non-normative eating behaviors exist, but their clinical relevance needs elucidation. This Special Issue compiles state-of-the-art reviews and empirical research on the presentation, development, course, and maintenance of diverse eating and feeding disturbances as a prerequisite for delineating evidence-based interventions for treatment and prevention.

No description available.

Die Binge-Eating-Störung (BES), als eigenständige Essstörung erstmals im Diagnostischen und Statistischen Manual psychischer Störungen DSM-5 definiert, ist durch wiederkehrende Essanfälle ohne gewichtskompensatorische Verhaltensweisen gekennzeichnet. Die breitere Definition in der avisierten International Classification of Diseases ICD-11 wird zu Veränderungen in Präsentation und Prävalenz dieser Störung führen. Die BES tritt vor dem Hintergrund einer komplexen, multifaktoriellen Ätiologie auf und geht mit einer erhöhten Essstörungs- und allgemeinen Psychopathologie, psychischen und körperlichen Komorbidität einschließlich Adipositas und verringertem Funktionsniveau einher. Trotz dieser Beeinträchtigungen wird die BES häufig weder diagnostiziert noch behandelt. Evidenzbasierte Therapien für die BES umfassen die Psychotherapie, wobei die Kognitive Verhaltenstherapie das etablierteste Verfahren darstellt, und die strukturierte Selbsthilfebehandlung. Andere Therapien wie die Pharmakotherapie, behaviorale Gewichtsreduktionstherapie und Kombinationstherapien erhielten in den aktuellen evidenzbasierten S3-Essstörungsleitlinien einen geringeren Empfehlungsgrad für spezielle Indikationen.

This study employs Michel Foucault's conceptualization of governmentality, or dispersed rationalities that seek to calculate and maximize the health of the population, to study how eating regimes of truth influence how individuals relate to their bodies and each other. Importantly, the study of eating regimes elucidates how food rules are portrayed in the discourses, institutions, philosophical and moral propositions, administrative measures, and technologies (what Foucault refers to as societal apparatuses of power, or dispositifs) that address what and how to eat. In this dissertation, I specifically analyze dispositifs that promote certain foodstuffs as devotional objects that can be utilized as forms of pleasure and/or self-control. I conceptualize artificial sweeteners as ingestible stores of self-control and biopower, arguing that they provide a lens through which to view how mealtime rituals, temporalities of eating, and the intersubjective perceptions of the relationship between food consumption and the ideal healthy body have transformed in the face of discourses that emphasize the need to strip food of carbohydrate- and calorie-loaded consequences. The dissertation analyzes how contemporary dietary discourses in the United States encourage individuals to view freedom of food choice as a binary selection between binge and restrict eating practices. I argue that this notion of dietary balance is part of what I refer to as the neoliberal binge-restrict eating regime. I analyze the binge-restrict eating regime on three different yet supplementary registers: 1) that of neoliberal discourses of dietary balance, which are premised on logics and technologies of rigid, machine-like correction and anticipatory compensation through carefully planned periods of restriction and healthy eating followed by food binges, or periods where an individual indulges in seemingly unhealthy foodstuffs; 2) that of discourses that encourage the individual to consume endlessly but not allow signs of "excessive" consumption to develop in the body; 3) and that of edible instantiations of the binge-restrict eating regime, with a particular emphasis on artificial sweeteners. The dissertation concludes that the contemporary notion of dietary balance as "binge-restrict" is informed by a popular interpretation of food rules as rigid, algorithmic truths and contributes to a loss of embodied knowledge regarding how to eat well. / Doctor of Philosophy / This study provides an analysis of forms of dietary advice and food rules that problematize the use of individual dietary discretion, prompt individuals to rely on systems of dietary advice, and present certain foodstuffs, such as artificial sweeteners, as ingestible stores of self-control. I argue that certain accepted ways of understanding, categorizing, and portraying food knowledge mold and shape how individuals experience reality, and that these ways of understanding can be referred to as regimes of truth. The study examines how eating regimes of truth, or ways of portraying food knowledge that influence how individuals define and categorize normal and abnormal eating behaviors, can be discerned across diet manuals, advertisements for diet products, life insurance pamphlets, governmental documents, and weight loss technologies from the 17th century to the present in Western Europe and the United States. More specifically, I analyze how food rules are increasingly shaped by advertising media that portray food knowledge as an object of expert control since food selection is perceived to be an increasingly risky activity. Given the extensive ingredient lists on food labels, along with the shifting regulatory and scientific statements that characterize how foodstuffs are grown or produced, prepared, packaged, labeled, and sold, embodied relationships to food remain difficult to cultivate given that the lines between natural, artificial, toxic, and safe ingredients and foodstuffs have been blurred. Even the consumption of seemingly "natural" products must constantly be monitored, since grocery store produce items often contain lead, arsenic, cadmium, and other synthetic materials that are portrayed as being dangerous to the health of consumers. Through advertising and digital technologies, food rules are portrayed as rigid algorithms that must be rigorously and rigidly applied to one's food selection and eating habits.

Financial strain and substance use are widespread in the United States (US), as many adults struggle to meet basic financial needs. There are many contributing causes of financial strain, such as unemployment or job loss and poverty or income loss. However, financial strain is distinct from its sources, as the experience of strain (i.e., inability to pay for bills, housing, healthcare, or food) may be necessary to produce a stress response that prompts substance use as a coping mechanism. Studies examining the relationship between financial strain and substance use have predominantly focused on the association between financial strain and alcohol use or acute financial strain due to brief changes in employment or income. However, there is a need to examine whether the relationship between financial strain and substance use varies by substance and the duration of financial strain (e.g., acute or brief financial strain, chronic or persistent financial strain, or intermittent financial strain due to repeated periods of financial strain). Several social safety net programs may mitigate financial strain, such as Unemployment Insurance, the Temporary Assistance for Needy Families program, the Supplemental Nutritional Assistance Program, and economic policies such as the federal Earned Income Tax Credit (EITC). Anti-poverty programs such as the federal EITC may provide an opportunity to reduce financial strain and subsequent substance use by providing financial support to low-income working populations. The purpose of this dissertation was to provide novel insights into the associations between acute, chronic, or intermittent financial strain and substance use and whether federal EITC eligibility altered these relationships. To achieve these goals, I had four aims. First, I sought to understand the associations between substance use and financial strain and its contributing causes (e.g., unemployment, poverty, etc.) by conducting a scoping review of the substance use literature (Aim 1; Chapter 2). Second, I examined the associations between acute, chronic, and intermittent financial strain and past month binge alcohol, cannabis, central nervous system (CNS) depressant (i.e., painkillers, sedatives, or tranquilizers), stimulant,and poly-drug use and whether these associations varied by sex (Aim 2.1; Chapter 3.1). Third, I examined the relationships between any financial strain and chronic financial strain on past month cannabis, CNS depressant, stimulant, and poly-drug use, adjusting for the time-dependent relationship between financial strain and drug use (Aim 2.2; Chapter 3.2). Fourth, I examined whether federal EITC eligibility was associated with short-term changes in financial strain, cannabis use, and CNS depressant use and whether this varied by state EITC policies or sex (Aim 3; Chapter 4). I conducted the scoping review presented in Chapter 2 in July-August 2023, searching for literature on the US, published since 2001 in PubMed, EBSCOhost [APA PsycINFO Database, EconLit with Full Text Database, SocINDEX with Full Text Database, Social Sciences Full Text Database], Web of Science, and Scopus. Two reviewers screened each abstract and title and conducted the full-text review. I extracted study characteristics and synthesized and evaluated evidence of the relationships between financial strain and its contributing causes and substance use. I found that more than one-third of studies examined employment-related measures (i.e., unemployment, job loss, or duration of unemployment) as indicators of financial strain, approximately 31% examined income-related measures (e.g., poverty, income loss) as indicators of financial strain, and only one-fifth of studies directly assessed financial strain, with more than half of those studies using a single-item question to assess financial strain. Job loss and duration of unemployment were generally associated with increased tobacco, binge alcohol, cannabis, opioid, drug, and substance use. Income-related indicators of financial strain were positively associated with tobacco, binge alcohol, and opioid use but inversely associated with any alcohol and cannabis use. Most studies found that financial strain was positively associated with tobacco and binge alcohol use. There was also evidence of a bi-directional relationship between alcohol and drug use and disorder with unemployment. My empirical aims leveraged individual- and state-level data from 5 waves (2013-2019) of the Population Assessment of Tobacco and Health study, a longitudinal cohort of >30,000 US adults. In Chapter 3.1, I characterized financial strain exposure patterns (i.e., none, acute, chronic, and intermittent) across Waves 1-5 and used survey-weighted multinomial logistic regression models to estimate the adjusted relative risk ratio of past month binge alcohol, cannabis, CNS depressants, stimulants, and poly-drug use at Wave 5 by financial strain exposure patterns, and whether this varied by sex. Consistent with prior research, I found that the relationship between financial strain and substance use varied by substance. Acute and intermittent financial strain were associated with an increased likelihood of binge alcohol, stimulant, and poly-drug use, whereas chronic financial strain was associated with an increased likelihood of cannabis or CNS depressant use. I found modest or no sex differences in the relationship between financial strain duration and binge alcohol, cannabis, CNS depressant, stimulant, or poly-drug use. Findings were robust in sensitivity analyses when I varied the number of waves considered chronic financial strain. Together, findings suggest that individuals experiencing a period of financial strain may be at greater risk of past month binge alcohol or drug use, and the risk for cannabis and CNS depressant use may increase with financial strain duration. In Chapter 3.2, I used longitudinal targeted maximum likelihood estimation methods to account for time- dependent confounding between financial strain and drug use and to estimate the association between any financial strain or chronic financial strain and cannabis, CNS depressants, stimulants, and poly-drug use across Waves 1-5. This doubly robust method allowed me to predict the average expected outcomes if everyone had never experienced financial strain across the study period (i.e., a never financial strain scenario) and if everyone had experienced financial strain at every time point across the study period (i.e., a chronic financial strain scenario). I then compared the expected outcomes under the never financial strain scenario to outcomes in the observed data to estimate the association between any financial strain and drug use. I found that if everyone had never experienced financial strain, the prevalence of past month cannabis use would be lower than the prevalence of past month cannabis use observed in the data. When I compared the expected outcomes under the never financial strain scenario to the expected outcomes in the chronic financial strain scenario, I found that the likelihood of past month cannabis or CNS depressant use would be significantly higher if everyone had experienced chronic financial strain across all five waves of data collection. These findings confirm the results in Chapter 3.1, suggesting that the association between chronic financial strain and drug use remained elevated after accounting for the potentially reinforcing relationship between financial strain and drug use over time. These analyses additionally revealed that the risk of cannabis use would have been slightly lower if no one had ever experienced financial strain compared with any financial strain. In Chapter 4, I examined changes in financial strain, cannabis use, and CNS depressant use associated with federal EITC eligibility during the EITC disbursement period. EITC could be considered a short-term intervention for financial strain and could provide temporary relief to people experiencing chronic financial strain, helping them transition from chronic to intermittent financial strain and lowering the likelihood of cannabis and CNS depressant use. I used survey participants’ interview dates to assess if EITC-eligible people who were randomly interviewed during the EITC disbursement period (February-April) had a lower risk of financial strain compared with EITC-eligible people interviewed outside the disbursement period (May-January) and EITC-ineligible people, using linear binomial models with a two-way interaction term for EITC eligibility and the EITC disbursement period. I then assessed whether changes in financial strain, cannabis use, and CNS depressant use associated with EITC eligibility during the EITC disbursement period varied by state refundable EITC policies. To do this, I used linear binomial models with a three-way interaction term between EITC eligibility, EITC disbursement period, and refundable state EITC policies. Finally, I conducted stratified analyses by sex to examine whether changes in financial strain, cannabis use, and CNS depressant use associated with EITC eligibility during the EITC disbursement period varied by men and women. Results indicated that receiving an EITC refund of at least $500 or more was associated with decreased financial strain, particularly among women. However, EITC eligibility during the EITC disbursement period was not significantly associated with past month cannabis or CNS depressant (i.e., painkiller, sedative, or tranquilizer) use overall or by sex at Wave 1. Changes in financial strain, cannabis use, and CNS depressant use associated with federal EITC eligibility during the disbursement period did not vary by whether the participant’s state of residence offered an additional refundable EITC. Findings from this dissertation provide empirical support for financial strain as a potential predictor of binge alcohol, cannabis, CNS depressant, stimulant, and poly-drug use. This relationship varied by duration of strain, and the association between chronic financial strain and drug use remained elevated when adjusting for potential time-varying confounding in this relationship. I also found that the likelihood of cannabis use would decrease if no one had ever experienced financial strain. When I examined the federal EITC as a potential short-term intervention for financial strain, I found that refunds of at least $500 or more were associated with decreased financial strain without increasing cannabis or CNS depressant use in the overall population. Thus, expanded and more generous income support policies such as the EITC may be effective tools to intervene on financial strain.

No description available.

Indiana University-Purdue University Indianapolis (IUPUI) / It has traditionally been posited that women show a "telescoped" development of alcohol use disorders (Kuhn, 2011). In particular, a number of clinical studies support striking sex differences in the progression from initial use of alcohol to dependence on the compound; with women showing a faster progression through landmark events associated with the development of alcohol addiction (Randall et al., 1999). However, recent studies have challenged this tenet (Keyes et al., 2010). The work presented herein was designed to determine whether females are indeed more vulnerable to the development of behavioral maladaptations following binge drinking and whether sex differences in GABA(A) receptor regulation might underlie this vulnerability. Using a mouse model of binge drinking this dissertation established that, compared to males, females escalate their binge drinking at a faster rate and maintain altered responsivity to the locomotor effects of alcohol after extended abstinence from binge drinking. Female mice also displayed significant increases in ethanol preference and intake in a continuous, two-bottle choice protocol following a shorter history of binge drinking than males. The final goal was to determine if binge drinking results in unique patterns of anxiety- or depressive-like symptoms in males and females and whether these behaviors would be associated with the dimorphic regulation of GABAA receptor subunits across the prefrontal cortex and hippocampus. Male binge drinkers displayed anxiety-like behavior during early withdrawal that dissipated after 2 weeks of abstinence. There were no significant changes in the expression of delta or gamma2 GABAA receptor subunit mRNA at this time point in the regions analyzed. Females also showed temporary anxiety-like behavior during early withdrawal from binge drinking. Additionally, females displayed significant depressive-like behavior after 2 weeks of abstinence from binge drinking. In particular, diestrus-phase females displayed significantly greater immobility in the forced-swim test after ethanol exposure and no longer maintained the reduced swim-time behavior associated with this phase of the cycle at baseline (when compared to the estrus-phase). qPCR analysis of hippocampal tissues from diestrus females supported a significant reduction in expression of gamma2 GABA(A) subunit mRNA after binge drinking. This effect was not noted for RNA isolated from hippocampal tissues taken during the estrus phase of bingers. These final data suggest possible interaction of estrous-cycle and binge drinking history that may result in the unique expression of deficits following binge drinking for females. Taken together, this work supports sex and estrous dependent effects of binge drinking on behavior and gene regulation.

Indiana University-Purdue University Indianapolis (IUPUI) / It has been proposed that the GABAB receptor subtype plays a role in alcoholism and alcohol use disorders (AUDs) (Cousins et al., 2002; Agabio et al., 2012). Specifically, the GABAB agonist baclofen has been looked at extensively in clinical and pre-clinical studies. In various animal models of chronic and intermittent consumption, baclofen has been shown to both increase (Petry, 1997; Smith et al., 1999; Czachowski et al., 2006; Moore et al., 2007) and decrease (Colombo et al., 2000; 2002; 2005; Stromberg, 2004; Moore et al., 2009) drinking. A critical issue in determining pharmacological effects of a drug is using the appropriate animal model. The drinking-in-the-dark (DID) model, developed by Rhodes et al. (2005, 2007), produces high levels of drinking in a binge-like paradigm and has been used to assess many pharmacological targets (e.g. Kamdar et al., 2007; Gupta et al., 2008; Moore et al., 2007; 2009). While DID produces high-levels of binge drinking, it is unclear what areas of the brain are involved in this behavior. A direct way to target areas that are believed to be involved in the circuitry of particular behaviors is through microinjection of drugs (Kiianmaa et al., 2003). Of particular recent interest involving motivated behaviors and addiction is the nucleus accumbens (Acb) (Everitt & Robbins, 2005); specifically the accumbens shell (AcbSh) (e.g. Rewal et al., 2009, 2012; Nie et al., 2011; Leriche et al., 2008). The current study aimed to investigate the role of GABAB receptors in the AcbSh by examining the ability of two different enantiomers of baclofen to alter ethanol and saccharin intake in male C57BL/6J (B6) mice. B6 mice underwent bilateral cannulation surgery targeting the AcbSh. After 48 hours of recovery time, animals began a five day Drinking-in-the-Dark (DID) procedure where they received 20% ethanol or 0.2% saccharin for two hours, three hours into the dark cycle, each day. Throughout the five drinking sessions, animals were kept in home-cage locomotor activity chambers to monitor activity throughout the drinking cycle. Day 4 drinking was immediately preceded by a mock microinjection, whereas Day 5 drinking was immediately preceded by a drug microinjection. Microinjection of one of five doses of baclofen was given in ng/side dissolved in 200 µl of aCSF (aCSF alone, 0.02 R(+)-, 0.04 R(+)-, 0.08 S(-)-, or 0,16 S(-)-). Intake was recorded every twenty minutes on Days 4 and 5. Retro-orbital sinus blood samples were taken from ethanol animals immediately following the Day 5 drinking period to determine blood ethanol concentrations (BECs). A one-way ANOVA on total Day 4 ethanol consumption revealed no baseline differences between dose groups. A one-way ANOVA on total Day 5 ethanol consumption revealed that the 0.04 R(+)- baclofen dose reduced total drinking, but the 0.16 S(-)- baclofen dose increased total drinking (p’s<0.05). This pattern was reflected in the BECs; 0.04 R(+)- baclofen reduced BECs, whereas 0.16 S(-)- baclofen increased BECs (p’s<0.05). These results were also time-dependent, with R(+)-baclofen reducing drinking in the first 20 minutes of the session and S(-)- increasing drinking in the last 40 minutes of the session. There were no effects on saccharin intake. An issue with the locomotor activity boxes led to unreliable locomotor activity counts. However, because there were no drug effects on saccharin consumption, it was concluded that locomotor effects did not contribute to the decreases or increases in ethanol consumption. These results further implicate the role of GABAB receptors in modulating ethanol intake. The bidirectional effects shown highlight the importance of considering enantioselective drug effects when interpreting data. Finally, these results also support previous conclusions that the AcbSh plays an important role in modulating use of drugs of abuse, but not other reinforcers.

There has been substantial scientific debate about the impact of alcohol marketing on consumption. Relying mainly on econometric studies, the alcohol industry has traditionally maintained that alcohol marketing does not influence consumption, but is merely limited to brand level effects. Public health advocates, on the other hand, point to consumer-level research that shows a relationship between exposure to marketing and alcohol consumption, especially amongst the young. Recent longitudinal research has firmly established a causal relationship between alcohol marketing and alcohol consumption, giving the upper hand to the public health critics of alcohol marketing. The new consensus forged by these recent cohort studies has led to two separate, but related, debates. In the first instance, having answered the question of whether marketing influences drinking behaviour, there is a need to establish how and when such effects occur. Secondly, in the face of the mounting longitudinal evidence on the effects of marketing, representatives of the alcohol industry have sought to move the debate away from marketing by explicitly highlighting peer influence as a more significant causal factor in problematic youth alcohol consumption. This thesis tackles both of these new questions simultaneously by harnessing insights developed from social norms theory. An online survey (N = 1,071) was administered to undergraduates of the Dublin Institute of Technology in Ireland, and mediation relationships were tested with logistic and multiple linear regression methods as appropriate. Amongst other findings, the main contributions of this thesis are: (1) that marketing may play a key role in establishing perceived social norms around alcohol consumption, and that these perceived norms may act as an indirect pathway for the influence of marketing on behaviour and (2) that the association between alcohol marketing and consumption may increase as levels of engagement with marketing increase; this engagement appears to be at its most potent when marketing facilitates simultaneous interaction between the consumer, the brand and the consumer’s peers in an online social media environment. This thesis helps to move the field of alcohol marketing scholarship beyond questions of whether marketing influences alcohol consumption to how and when that influence occurs. By showing how peers may act as perpetuators and magnifiers of marketing influence it also undermines the argument that peers matter more than marketing, and suggests that peer norms can act as a powerful marketing tool.