Cognitive impairments and changes in the structure and function of related brain regions, namely the prefrontal cortex and striatum, have long been implicated in drug addiction. However, it is unknown whether these abnormalities predate substance abuse, potentially serving as risk factors for dependence, or if they are the consequence of protracted use. To address this question, endophenotype research using stimulant-dependent individuals’ biological siblings has been used to investigate traits implicated in the pathology of addiction. Impairments present in both groups suggest an underlying risk-state for dependence, while additional abnormalities present only in stimulant-dependent individuals reflect potential effects of the drugs themselves. Contrastingly, there are also individuals who use stimulant drugs in a controlled manner without developing dependence. These ‘recreational users’ may lack the underlying traits that comprise a greater risk for dependence, or they might maintain additional protective factors against the development of addiction. Experiments in the first half of this dissertation used functional magnetic resonance imaging to investigate neurocognitive similarities and differences between dependent stimulant users, their non-dependent siblings, recreational users of cocaine, and unrelated healthy control volunteers. In Chapter 2, performance on a colour-word Stroop task was impaired in both stimulant-dependent individuals and their siblings, suggesting an endophenotype of cognitive inefficiency. However, neural activity significantly differed between the groups, indicating additional changes specific to the use of stimulant drugs. In Chapter 3, dependent users showed significant attentional bias to salient stimuli on a cocaine-word Stroop task, with a concurrent increase in prefrontal activation. Conversely, recreational users showed resilience in the face of cocaine cues and a decrease in arousal. Finally, Chapter 4 explored differences in reward sensitivity to both generic and drug-specific reinforcers, comparing the effects of personal and family history of stimulant exposure on a monetary incentive delay task. It is also under debate whether the neurocognitive differences seen in stimulant-dependent individuals are unique to substance abuse, or if parallel changes in behaviour and neurobiology are present in similar addiction-spectrum disorders, such as binge eating leading to obesity. In Chapter 5, stimulant-dependent and obese individuals with binge-eating behaviours showed differences in their substance-specific and general reward responsivity on a novel reward-valuation task. However, in Chapter 6 a similar decline in orbitofrontal cortex grey matter volume in relation to both years of stimulant use and body mass index was identified, implicating an overlap in this area between both conditions. These findings are integrated in Chapter 7, discussing the neurocognitive risk and protective factors that underlie an individual’s vulnerability for addiction, not only to stimulant drugs, but also potentially for other addictive behaviours.

The current dissertation is comprised of two studies that examined the relationship between group dynamics, attachment anxiety, and post-treatment outcomes in a sample of women (N = 102) with binge eating disorder (BED) who received Group Psychodynamic Interpersonal Psychotherapy. The first study explored the relationship between the development of group cohesion, the individuals’ level of attachment anxiety, and frequency of binge eating, symptoms of depression, and self-esteem at post-treatment. The second study explored the relationship between the interpersonal learning, individuals’ level of attachment anxiety, and outcomes. Interpersonal learning was conceptualized as the convergence between multiple perspectives of group cohesion: one’s own and the group’s perception of one’s cohesion to the group. Parallel measures of individual self-rated cohesion (CQ-I) and mean group-rated cohesion (CQ-G) were developed based on the original Cohesion Questionnaire (CQ; Piper et al., 1983) for this study. Participants were assigned to homogeneous groups composed of either high or low attachment anxiety to assess the impact of pre-treatment attachment anxiety. Findings indicated significant growth in cohesion over time, and a significant convergence in multiple ratings of cohesion. These processes did not differ significantly based on level of attachment anxiety. Growth in cohesion was related to greater reductions in binge eating for those high in attachment anxiety, while the convergence in ratings of cohesion (i.e., interpersonal learning) was related to improvements in self-esteem for individuals in both attachment anxiety conditions. The findings support the importance of group interventions for BED that are sensitive to individuals’ attachment anxiety, and that emphasize cohesiveness, and interpersonal learning to improve outcomes.

This thesis examines how drinking behaviours are associated with violent behaviour amongst young people in England and Wales. It is argued that in order to deconstruct the alcohol-violence relationship, it is necessary to critically examine drinking patterns and the development thereof as well as attitudes held towards alcohol consumption. The study comprises secondary statistical analyses of the Home Office’s Offending Crime and Justice Survey, a survey providing data on young people’s drinking and offending behaviour over four successive annual sweeps. Cross-sectional models are used to examine the predictors of violent offending and the role of alcohol consumption. These are subsequently extended into longitudinal models to examine change over time. Collectively, these models provide a detailed exploration of how alcohol consumption influences violent behaviour amongst young people and offer some insights into ways in which alcohol-related violence can be moderated. Whilst, on the whole, individual attitude items did not significantly predict violent behaviour amongst regular drinkers, findings did, however, suggest three distinct classifications based on attitudes held towards drinking: ‘social drinkers’, ‘positively motivated drinkers’ and ‘problem drinkers’, which were significantly associated with age, binge drinking frequency and violent offending. Findings also support existing evidence that the pattern of drinking (rather than the frequency of alcohol consumption) is associated with violent offending and the study identifies a contemporaneous (time-specific) association between levels of binge drinking and assault outcomes. That is, that high frequency binge drinking is a temporally proximal risk factor for the increased propensity of committing assault offences and that occurrences in assault outcomes over time are relatively dependent on levels of drinking over time. In turn, this suggests that the periods in which young people are drinking more, they also offend more. The thesis thus provides evidence that reducing alcohol consumption in late adolescence may, in turn, reduce the prevalence of violent assault offences in and immediately after drinking occasions.

While it is clear that alcohol use among immigrants from Mexico has serious consequences, limited data exist on the correlates of this behavior for Mexican immigrants residing in rural, traditionally non-Hispanic settings. A cross-sectional survey with an outreach approach was used to target 173 male Mexican immigrants in rural eastern North Carolina. Questionnaires including demographics, pre and post immigration alcohol use, acculturation, stress, social support, and depressive symptoms were administered through oral interview by trained bilingual interpreters. Results show a higher prevalence of binge drinking in the study sample compared to rate of alcohol use by Hispanics in the United States. Relationships were identified between Pre-immigration alcohol use, lower perceived social support, socialization within one’s own cultural group, and binge drinking. These findings provide a preliminary basis in the development of interventions to address the problem of binge drinking in this population. Further exploration of the interaction between social isolation and social support is also needed.

<p>The development of alcohol use disorder (AUD) is believed to involve functional adaptations in corticostriatal projections which regulate the reinforcing properties of ethanol (EtOH). To further our understanding of how repeated EtOH consumption impacts the corticostriatal circuit, extracellular electrophysiological recordings (local field potentials; LFPs) were gathered from the nucleus accumbens and prefrontal cortex of female and male C57BL/6J mice voluntarily consuming EtOH or water using ‘drinking-in-the-dark’ (DID) procedures. Mice were given 15 consecutive days of two-hours of access to EtOH (20% v/v), three hours into the dark cycle while LFPs were recorded. To determine the impact of repeated EtOH consumption on neural activity between these brain regions, theta phase-locking value (PLV, a measure of synchrony) was calculated. Specifically, theta PLV was calculated during active drinking periods (bouts) and average PLV during the first bout was compared to the last bout to determine within session changes in synchrony. Results indicated significantly lower PLV during the last bout than the first bout. Additionally, longer bouts predicted lower PLV during the last bout, but not the first bout when mice were consuming EtOH. These results may suggest that alcohol intoxication decreases corticostriatal synchrony over a drinking period. Results considering changes in theta power spectral density (PSD) indicated an increase in PSD when mice were given access to water during the typical EtOH access time following the 15-day EtOH drinking history. This effect was not seen when mice were drinking water prior to EtOH access and may be indicative of a successive negative contrast effect. This work identifies unique functional characteristics of corticostriatal communication associated with binge-like EtOH intake and sets the stage for identifying the biological mechanisms subserving them.</p>

The relatively new phenomenon of binge watching presents a dramatic shift from the norm of traditional television viewing. However, is this ubiquitously popular media marathon that contains negative connotations really bad for you? A survey administered to 157 television binge-watchers identified the role of stress and self-control in influencing both the gratifications sought and the consequences of binge watching through the Structural Equation Modeling (SEM) analysis. The current study found that binge watching to avoid problems is a commonly employed strategy for individuals to cope with stress. However, engaging in binge-watching behavior as a coping mechanism to purposefully avoid problems can result in feelings of guilt and regret. It is also surprising that self-control has no impact on one's binge watching gratifications. The findings of this thesis encourage future researchers and binge watching lovers to view this new behavior from a new perspective and to practice it with caution.

Asian cultures have been heavily influenced by Western culture due to globalization. Video on demand (VOD) services provide a means to quantify the westernization of Asian cultures, especially those within South Korea. As the majority of current binge-watching studies have been conducted utilizing U.S. samples, there is a need for comparative research between the two cultures, to see if westernization can be quantified via these means. The current study examined the relative levels of five Korean binge-watching motivations (enjoyment, efficiency, recommendation of others, perceived control, fandom) and eight American binge-watching motivations (escape, information, engagement, relaxation, passing time, hedonism, social, habit) sourced from prior research, among a Korean (n =113) and American (n = 193) sample. Results indicated that both Americans and Koreans scored highly on enjoyment and engagement. Americans scored higher on nine out of the 13 motivations: efficiency, recommendation of others, fandom, escape, relaxation, passing time, hedonism, social, and habit. Koreans scored higher on two out of the 13 motivations: information and perceived control. Also, Americans binge-watched more frequently than Koreans. In conclusion, the outcome of the study suggests where society is going with VOD services and binge-watching as a deeper understanding of binge-watching in a cross-cultural setting. Future researchers should consider a qualitative study to overcome the limited range of TV viewing motivational scales and a random sampling, assuring diversity in sample groups.

Background: Previous studies provided inconsistent associations of smoking, stroke, and serious psychological distress (SPD) with epilepsy while urban-rural differences in the associations of risk factors with epilepsy are not well documented. Objectives: This study aimed to evaluate the associations of lifestyle, health conditions, and SPD with epilepsy and to examine whether the associations differ between urban and rural areas. Patients and Methods: A total of 604 adults with epilepsy and 42416 controls were selected from the 2005 California Health Interview Survey. Weighted univariate and multiple logistic regression analyses were used to estimate the associations of potential factors (behavioral factors, SPD, social factors and health conditions) with epilepsy. The odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. Results: The overall prevalence of epilepsy was 1.3% and the prevalence was higher in urban area than rural area (1.4 vs. 1.1%). The prevalence of SPD was 11% in cases and 4% in controls, respectively. The percentage of stroke was higher in cases than in controls (9% vs. 2%). After adjusting for other factors using multiple logistic regression, current smoking, stroke, cancer, SPD and living in urban were positively significantly associated with epilepsy (OR = 1.74, 95% CI = 1.28 - 2.38; OR = 4.81, 95% CI = 3.13 - 7.41; OR = 1.52, 95% CI = 1.12 - 2.06; OR = 2.02, 95% CI = 1.39 - 2.92, and OR = 1.4, 95% CI = 1.08 - 1.81, respectively); while binge drinking was negatively associated with epilepsy (OR = 0.65, 95% CI = 0.43 - 0.99). Stratified by residence, in the urban area, current smoking and race were only associated with epilepsy. Stroke and SPD showed stronger association with epilepsy in the rural area (OR = 7.63, 95% CI = 3.68 - 15.8, and OR = 3.14, 95% CI = 1.52 - 6.47, respectively) comparing with urban region (OR = 4.51, 95% CI = 2.79 - 7.28 and OR = 1.9, 95% CI = 1.27 - 2.86, respectively). Conclusions: Smoking, stroke, and SPD were associated with epilepsy; while the associations differed between urban and rural areas.

Asian cultures have been heavily influenced by Western culture due to globalization. Video on demand (VOD) services provide a means to quantify the westernization of Asian cultures, especially those within South Korea. As the majority of current binge-watching studies have been conducted utilizing U.S. samples, there is a need for comparative research between the two cultures, to see if westernization can be quantified via these means. The current study examined the relative levels of five Korean binge-watching motivations (enjoyment, efficiency, recommendation of others, perceived control, fandom) and eight American binge-watching motivations (escape, information, engagement, relaxation, passing time, hedonism, social, habit) sourced from prior research, among a Korean (n =113) and American (n = 193) sample. Results indicated that both Americans and Koreans scored highly on enjoyment and engagement. Americans scored higher on nine out of the 13 motivations: efficiency, recommendation of others, fandom, escape, relaxation, passing time, hedonism, social, and habit. Koreans scored higher on two out of the 13 motivations: information and perceived control. Also, Americans binge-watched more frequently than Koreans. In conclusion, the outcome of the study suggests where society is going with VOD services and binge-watching as a deeper understanding of binge-watching in a cross-cultural setting. Future researchers should consider a qualitative study to overcome the limited range of TV viewing motivational scales and a random sampling, assuring diversity in sample groups.

Indiana University-Purdue University Indianapolis (IUPUI) / Recently, the co-consumption of highly caffeinated energy drinks and alcohol has become a public health concern. Consumption of these beverages has been linked to a wide variety negative consequences including alcohol poisoning, driving under the influence, physical harm, and sexual violence. The more protracted consequences of caffeinated alcohol consumption have received very little attention, however. Some evidence suggests that individuals that frequently consume energy drinks mixed with alcohol are more likely to develop an alcohol use disorder. Interestingly, both caffeine and alcohol use alone have been linked to polydrug abuse. It is therefore of interest whether combined caffeine and alcohol consumption may pose an additive risk for substance abuse. Given that both compounds can positively influence dopamine signaling in mesolimbocortical reward circuitry via different mechanisms, this is an important question to address. Psychostimulants, such as cocaine, are of particular interest considering the significant involvement of dopamine in their effects. The current project explored this possibility employing an established mouse model of binge caffeine and alcohol co-consumption. Male C57BL/6J mice underwent 14 days of daily, 2hr limited access to water, alcohol, caffeine, or combined caffeine and alcohol. Water was freely available after these sessions. In Experiment 1, mice underwent an 11-day locomotor sensitization protocol for cocaine initiating on day 15. Locomotor sensitization has been associated with a greater propensity to self-administer psychostimulants in rodents. Mice were subjected to injections of cocaine (5 or 10 mg/kg; i.p.) or saline every other day, with 15 minute activity monitoring until day 25. In Experiment 2, a separate group of mice underwent an identical drinking procedure. A conditioned place preference (CPP) protocol commenced on day 15. CPP assesses the conditioned rewarding effects of cues associated with drugs of abuse. On day 15, mice received saline injections and were immediately placed onto a neutral floor texture (paper) in the place conditioning box for 15 minutes in order to habituate the animals to the apparatus and injection procedure. Starting on day 16, mice received daily alternating systemic injections of cocaine (1 or 5 mg/kg; i.p.) and saline or saline throughout (naïve controls) and were placed onto one of two particular tactile floor cues: a metal floor with holes punched out or a grid floor made of metal rods. Mice were exposed to the other injection/floor pairing on the alternate days. Mice were placed into these activity monitors for 15 minute conditioning sessions. These sessions alternated drug and vehicle over the course of 8 days so that a total of 4 drug and 4 saline injections were given. The first place preference test occurred on day 24 wherein all mice were injected with saline and offered access to both floor textures. On day 25, mice were returned to the conditioning protocol for another 8 days and a second CPP test on day 33. The results of Experiment 1 suggested that prior caffeine consumption, irrespective of the presence of ethanol, enhanced the initial psychomotor stimulating effect of 10 mg/kg cocaine. However, prior fluid consumption history did not influence the capacity to develop locomotor sensitization. The results of Experiment 2 indicate that prior caffeine and/or ethanol consumption had no influence on the development or expression of CPP for 1 mg/kg or 5 mg/kg cocaine. Collectively, these results suggest that a history of caffeine consumption may increase the stimulant response to a moderate dose of cocaine, perhaps indicating cross-sensitization. Although the conditioned rewarding effects of cocaine were not altered by prior caffeine and/or ethanol consumption, an enhanced stimulant response may be indicative of enhanced cocaine abuse potential. This study demonstrates that moderate caffeine consumption may influence an individual’s early interactions with cocaine which may eventually influence the likelihood of later problematic use.