Kenneth J Sher

• Ph.D.
• Curators' Distinguished Professor at University of Missouri

Objective: Epidemiologic surveys aim to estimate the population prevalence of cannabis use and cannabis use disorder. Prevalences estimates are important for understanding trends, such as the impact of policy change. Existing epidemiologic surveys have produced discrepant and potentially unreliable estimates. The current meta-analysis (PROSPERO CR...

Objective: Epidemiologic surveys aim to estimate the population prevalence of cannabis use and cannabis use disorder. Prevalences estimates are important for understanding trends, such as the impact of policy change. Existing epidemiologic surveys have produced discrepant and potentially unreliable estimates. The current meta-analysis (PROSPERO CRD...

Although substance use disorders are widely known to be influenced by myriad etiologic factors, recent research promotes the notion that liability toward addiction broadly construed can be described by a single, unitary dimension that we term “general addiction liability.” Here, we revisit the concept of general addiction liability by placing it at...

As part of the special issue of Development and Psychopathology honoring the remarkable contributions of Dr Dante Cicchetti, the current paper attempts to describe the recent contributions that a developmental psychopathology perspective has made in understanding the development of alcohol use and alcohol-related problems over the lifespan. The pap...

Background Symptoms often play an important role in the scientific inquiry of psychological disorders and have been theorized to play a functional role in the disorders themselves. However, little is known about the course of specific symptoms and individual differences in course. Understanding the course of specific symptoms and factors influencin...

Several dimensional frameworks for characterizing heterogeneity in alcohol use disorder (AUD) have been proposed, including the Addictions Neuroclinical Assessment (ANA). The ANA is a framework for assessing individual variability within AUD across three domains corresponding to the proposed stages of the addiction cycle: reward (binge-intoxication...

Objective. To assess associations of student academic characteristics, communities-of-origin and high schools attended with pre-enrollment and collegiate alcohol consumption using university, census, and public school data.Participants. 2,740 first-time, freshman college students at a large, public, Midwestern university (54% female).Measures. Self...

Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyd...

Objective: Alcohol Use Disorder (AUD) has traditionally been viewed as a chronic, progressive, relapsing disorder (Jellinek, 1960; National Institute on Drug Abuse, 2018). However, little is known about the course of individual AUD criteria. To the extent that individual symptoms represent the focus of some treatments (e.g., withdrawal, craving), u...

Across various cultures there are robust stereotypes regarding how alcohol intoxication alters individuals’ normative personalities. However, whether these stereotypes are rooted in genuine average effects or in salient, socially proliferated exemplars remains unclear. The current study tested if differences between sober and intoxicated personalit...

Introduction: The Wisconsin Inventory of Smoking Dependence Motives (WISDM) is a multidimensional measure of smoking motives that was developed to facilitate research aiming to refine the nomological network surrounding tobacco dependence. Recent evidence suggests that a composite of four subscales, termed the Primary Dependence Motives (PDM), may...

Aims: To compare the acute effects of alcohol on set-shifting task performance (relative to sober baseline performance) during ascending and descending limb breath alcohol concentration (BrAC), as well as possible moderation of these effects by baseline individual differences. Design: Shifting performance was tested during an initial baseline an...

Research indicates 10% of college student drinkers report deliberately training to increase alcohol tolerance (a diagnostic criterion for alcohol use disorder) to avoid passing out early or to keep up with peers. Given that tolerance training may be considered a harm reduction technique designed to reduce acute aversive consequences, we examined th...

Background: Underage college students who obtain and use false identification (fake ID) are at risk for negative outcomes. However, it is currently unclear how uniquely the fake ID itself serves as a vehicle to subsequent harm (i.e., the "fake ID effect") over and above general and trait-related risk factors (e.g., deviant peers, low self-control)...

The goal of the present study was to compare etiologically and clinically relevant correlates of lifetime AUD (e.g., alcohol consumption, personality traits, psychiatric disorders) based on a single assessment compared to a cumulative, prospective assessment of lifetime AUD. Data were drawn from the Alcohol, Health and Behavior (AHB; baseline N=489...

Background: The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) and AUDADIS-5 are diagnostic interviews used in major epidemiological and other studies of alcohol use disorder (AUD). Much of what we know regarding the prevalence of AUD in the United States is based upon this interview. However, past research and...

Rationale Low sensitivity to alcohol is a well-established risk factor for alcohol use disorder (AUD). However, little is known about how the low sensitivity phenotype is expressed on a fine-grained, momentary level in drinkers’ daily experience. Objectives The objective of the study is to evaluate individual differences in subjective states and ap...

Substance use is highly prevalent in our society, and substance use disorders are comorbid with most psychiatric disorders, including borderline personality disorder (BPD). Craving is a fundamental feature of addiction and disorder, yet the contexts in which craving occurs and is associated with substance use is still underresearched. We examined a...

Peer drinking norms are arguably one of the strongest correlates of adolescent drinking. Prospective studies indicate that adolescents tend to select peers based on drinking (peer selection) and their peers' drinking is associated with changes in adolescent drinking over time (peer socialization). The present study investigated whether the peer sel...

Substance use and substance use disorders are of great public health significance because of their high prevalence and associated mortality, morbidity, and economic cost. Moreover, substance use and substance use disorders must be studied within a developmental context, given the etiological importance of age-related neurobiological maturation of r...

Purpose: Contemporary approaches to clinical diagnosis have not adequately exploited state-of-the-art empirical techniques in deriving diagnostic criterion sets that are statistically optimal based on 1) relevant external indicators and 2) replicability across data sets. We provide a proof of concept that optimal criterion sets can be derived with...

Background. Variability in sensitivity to the acute effects of alcohol is an important risk factor for the development of alcohol use disorder (AUD). The most commonly used retrospective self-report measure of sensitivity, the Self-Rating of the Effects of Alcohol form (SRE), queries a limited number of alcohol effects and relies on respondents’ ab...

Background: Variability in sensitivity to the acute effects of alcohol is an important risk factor for the development of alcohol use disorder (AUD). The most commonly used retrospective self-report measure of sensitivity, the Self-Rating of the Effects of Alcohol form (SRE), queries a limited number of alcohol effects and relies on respondents’ ab...

Background “Maturing out” of problem drinking is associated with both role transitions (e.g., getting married) and personality development. However, little is known concerning how these 2 mechanisms jointly influence problem‐drinking desistance. This study investigated whether salutary effects of role transitions and personality occur at different...

Many researchers have argued for a differential presentation of alcohol use disorder (AUD) between men and women. Latent class analysis is the most commonly used analytic technique for modeling AUD subcategories, and latent class analyses have supported a variety of class structures of AUD. This article examines whether these differential results a...

(1) To compare affective changes over drinking and non-drinking days among frequent drinkers. (2) To evaluate whether drinkers' expectations influence affective changes and perceived pleasure and relief from drinking. Observational study involving ecological momentary assessments collected via electronic diaries over the course of three weeks. Drin...

Some individuals “change” more dramatically than others when intoxicated, and the nature and magnitude of these changes can result in harmful outcomes. This study utilized reports (N = 374) of participants’ “typical” five-factor model (FFM) characteristics across sober and intoxicated states and assessed the degree to which these reports could be g...

Naltrexone, an opioid antagonist, may facilitate reduction in drinking among young adults. We compared the efficacy and safety of naltrexone administered daily plus targeted dosing with placebo to reduce drinking in young adults who engage in heavy drinking. A randomized, double-blind, placebo-controlled study was conducted in an outpatient researc...

Studying how genetic predispositions come together with environmental factors to contribute to complex behavioral outcomes has great potential for advancing our understanding of the development of psychopathology. It represents a clear theoretical advance over studying these factors in isolation. However, research at the intersection of multiple fi...

There is some evidence that college student drinkers may continue drinking in the face of adverse consequences. We examined 2 hypotheses: (a) that this seemingly pathological behavior is a phenomenon of university life, occurring with consistency throughout the entirety of college, and (b) that individuals accumulate these consequences over multipl...

Within the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), some diagnoses are now associated with a severity gradient based on the number of diagnostic criteria satisfied. Reasons for questioning the validity of this approach include the implicit assumptions of equal criterion severity and strict additivity of cr...

The purpose of this study was to examine whether published findings regarding the association of personality disorders (PDs) with the persistence of substance use disorders (SUDs) are attributable to an artifact due to time of assessment of the PD. Two previous studies analyzed data from the National Epidemiologic Survey on Alcohol and Related Cond...

A low level of response to alcohol is considered a significant risk factor for alcohol use disorder. Survey measures of this construct assess the number of drinks required to experience various alcohol effects, so data will be missing for effects participants have not experienced. Furthermore, missingness will likely be more common for items with h...

The need for comprehensive analysis to compare and combine data across multiple studies in order to validate and extend results is widely recognized. This paper aims to assess the extent of data compatibility in the substance abuse and addiction (SAA) sciences through an examination of measure commonality, defined as the use of similar measures, ac...

AimsThis commentary critically evaluates the use of substance-related negative psychosocial and health consequences to define and diagnose alcohol and other substance use disorders. Methods Narrative review. ResultsThe consequences of substance use cause much suffering and are major public health and economic problems. However, there are a number o...

Integrative data analysis (IDA) is a methodological framework that allows for the fitting of models to data that have been pooled across 2 or more independent sources. IDA offers many potential advantages including increased statistical power, greater subject heterogeneity, higher observed frequencies of low base-rate behaviors, and longer developm...

Existing literature supports the five-factor model (FFM) of personality (i.e., Extraversion, Agreeableness, Conscientiousness, Emotional Stability, and Intellect or Openness) as a comprehensive representation of stable aspects of mood, affect, and behavior. This study evaluated the FFM as a framework for both self-perceptions of drunkenness (i.e.,...

Objective: Some individuals will not meet criteria for a lifetime alcohol use disorder (AUD) at a baseline assessment but will at a follow-up measurement, but not because the disorder began after the initial evaluation. Despite several research implications, this type of unreliability of lifetime AUD estimates has not been studied extensively. The...

Measures of hangover are associated with current and future problematic alcohol use. At present, it is not known whether these associations reflect any direct influence of hangover events on near-term drinking behaviors. The current study aimed to determine whether hangover following a drinking episode influences time to next drink (TTND) and, if s...

Of all the personality traits associated with problematic alcohol involvement, traits related to impulsivity appear to show the most robust relations to alcohol use and alcohol-related problems. This article reviews both seminal articles that focus on broadband measures of impulsivity and newer research linking more specific impulsivity-related tra...

Alcohol use can be understood as a strategic behavior, such that people choose to drink based on the anticipated affective changes produced by drinking relative to those produced by alternative behaviors. This study investigated whether people who report drinking for specific reasons via the Drinking Motives Questionnaire-Revised (DMQ-R; Cooper, 19...

The last 25 years have seen significant advances in our conceptualization of alcohol use and alcohol use disorders within a developmental framework, along with advances in our empirical understanding that have been potentiated by advances in quantitative methods. These include advances in understanding the heterogeneity of trajectories of alcohol o...

Objectives: Our aim was to determine if the decrease in drug use disorders with age is attributable to changes in persistence, as implied by the notion of maturing out. Also, we examined the association between role transitions and persistence, recurrence, and new onset of drug use disorders. Methods: We performed secondary analysis of the 2 wav...

Recent studies using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) have found that some personality disorders (PDs) increase the persistence of several Axis I disorders. However, these effects are potentially confounded with the data collection wave in which PDs were assessed. Our aim was to extend published...

Prior research indicates that assessments of lifetime alcohol use disorders (AUDs) show low sensitivity and are unreliable when assessed by a single, retrospective interview. This study sought to replicate and extend previous research by calculating the lifetime prevalence rate of AUDs using both single retrospective assessments of lifetime diagnos...

Examining the natural language college students use to describe various levels of intoxication can provide important insight into subjective perceptions of college alcohol use. Previous research (Levitt et al., Alcohol Clin Exp Res 2009; 33: 448) has shown that intoxication terms reflect moderate and heavy levels of intoxication and that self-use o...

Cox, Clara, Worobec, and Grant (2012) recently presented results from a series of analyses aimed at identifying the factor structure underlying the DSM-IV-TR (APA, 2000) personality diagnoses assessed in the large NESARC study. Cox et al. (2012) concluded that the best fitting model was one that modeled three lower-order factors (the three clusters...

Background: There is evidence that measures of alcohol consumption, dependence and abuse are valid indicators of qualitatively different subtypes of alcohol involvement yet also fall along a continuum. The present study attempts to resolve the extent to which variations in alcohol involvement reflect a difference in kind versus a difference in deg...

This study provides estimates of the prevalence and demographic features of borderline personality disorder (BPD) in a community sample as well as BPD comorbidity rates with Axis I and II disorders. In addition, the authors provide data on general functioning and treatment seeking among individuals with BPD. Data from 34,481 participants in the Nat...

Objective: Cross-sectional data show that college athletes consume more alcohol and experience more general alcohol-related problems than those not participating in athletics. To our knowledge, the current study is the first to use a longitudinal design to examine the extent to which the course of drinking and alcohol-related problems relates to i...

The current investigation tested whether low sensitivity to alcohol, as measured by the Self-Rating of the Effects of Alcohol (SRE) form, is associated with hangover occurrence or resistance, two potentially important predictors of later problematic drinking outcomes. Drinkers who reported using alcohol at least four times in the past month (N = 40...

This study used a person-centered approach to test whether drinking motive typologies could be identified. Longitudinal study of college students within the Intensive Multivariate Prospective Alcohol College-Transitions (IMPACTS) data set. University campus in the United States. University students (baseline n reporting alcohol motives = 2158; base...

How to best classify concerns related to eating, weight, and shape (CREWS) in men remains an open question. Research on men considering CREWS during different developmental periods could be particularly informative. Focusing on one potentially dynamic developmental period, this study charts the course of CREWS in men over the college years. Latent...

This study examined the interplay between the influence of peers who promote alcohol use and μ-opioid receptor M1 (OPRM1) genetic variation in the intergenerational transmission of alcohol use disorder (AUD) symptoms while separating the "traitlike" components of AUD symptoms from their age-specific manifestations at three ages from emerging adulth...

Presents an obituary for G. Alan Marlatt. In a career spanning more than four decades, G. Alan Marlatt conducted research that fundamentally changed how psychologists and society view addiction. No other scientist has introduced more innovation to addiction theory, research, and practice, successfully challenging orthodoxy and demonstrating how add...

Tobacco and alcohol are frequently used together, and this may be partly explained by a distinct profile of subjective effects associated with co-administration. Ecological momentary assessment studies have examined effects of naturally occurring co-use, but, to date, have not assessed differing effects as alcohol levels rise and fall. The objectiv...

We examined the latent structure underlying the criteria for DSM-IV-TR (American Psychiatric Association, 2000, Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.) personality disorders in a large nationally representative sample of U.S. adults. Personality disorder symptom data were collected us...

Existing literature supports the use of the five-factor model (FFM) personality dimensions (i.e., Neuroticism, Extraversion, Agreeableness, Intellect, and Conscientiousness) as a comprehensive representation of mood, affect, and behavior. This study evaluated the use of the FFM as an organizational framework for understanding self-reported percepti...

The endocannabinoid system has been implicated in stress adaptation and the regulation of mood in rodent studies, but few human association studies have examined these links and replications are limited. To examine whether a synonymous polymorphism, rs1049353, in exon 4 of the gene encoding the human endocannabinoid receptor (CNR1) moderates the ef...

We attempted to replicate and extend (Welch, P., & Poulton, R. [2009]. Personality influences on change in smoking behavior. Health Psychology, 28, 292-299. doi:10.1037/a0013471) findings regarding the relationship between smoking involvement and personality change. Two time frames (18-25, 18-35) in a cohort of college students (N = 489 at baseline...

The current study develops an empirically determined classification of sexual orientation developmental patterns based on participants' annual reports of self-identifications, sexual attractions, and sexual behaviors during the first 4 years of college. A secondary aim of the current work was to examine trajectories of alcohol involvement among ide...

Self-perceptions of adulthood during the 20s and 30s are influenced by role transitions, age-related norms, and character traits. These factors are also associated with alcohol use disorders (AUDs), which peak and subsequently decrease during this time of life. Previous developmental research has found that alcohol misuse in adolescence predicts lo...

Although correlated changes between personality and alcohol involvement have been shown, the functional relation between these constructs is also of theoretical and clinical interest. Using bivariate latent difference score models, we examined transactional relations (i.e., personality predicting changes in alcohol involvement, which in turn predic...

Although there is a long tradition in alcoholism research of using family history ratings, the interpretability of family history reports of alcoholism from general community samples has yet to be established. Telephone interview data obtained from a large cohort of female like-sex twins (N = 3,787, median age 22) and their biological parents (N =...

To estimate ethnic differences in three components of alcohol use disorder and alcohol dependence course (onset, persistence and recurrence) in a developmental framework. Longitudinal data from The National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), collected using face-to-face interviews. Civilian non-institutionalized US pop...

Epidemiological studies have consistently demonstrated that heavy alcohol use and alcohol dependence (AD) tend to increase in adolescence and emerging adulthood and then show a large decline in the late 20s, a phenomenon called maturing out. This decline has been explained as an effect of "role incompatibility" in which involvement in new roles and...

Alcohol dependence is more prevalent among those with any one of several anxiety or depressive ("internalizing") disorders than among those in the general population. However, because internalizing disorders are highly intercorrelated, it is ambiguous whether alcohol dependence is related to internalizing psychopathology components that are: (i) un...

Twenty-first birthday celebrations often involve dangerously high levels of alcohol consumption, yet little is known about risk factors for excessive drinking on this occasion. Participants (N = 150) from a larger prospective study who consumed at least one drink during their celebration completed questionnaires and semistructured interviews about...

Background: Motivational models of alcohol use propose that the motivation to consume alcohol is the final common pathway to its use. Both alcohol consumption and drinking motives are influenced by latent genetic factors that partially overlap. This study investigated whether drinking motives mediate the associations between alcohol consumption an...

Genetic risk for alcohol dependence has been shown to overlap with genetic factors contributing to variation in dimensions of personality. Although drinking motives have been posited as important mediators of the alcohol-personality relation, the extent to which the genetic covariance between alcohol use disorder (AUD) symptoms (i.e., abuse and dep...

The Hangover Symptoms Scale (HSS) assesses the frequency of 13 symptoms experienced after drinking in the past year. Cross-sectional analyses in college drinkers showed preliminary evidence for the validity of the HSS (Slutske et al., 2003). The current investigation extended this work by examining the construct validity of the HSS in an ecological...

Alcohol dependence and Comorbid Personality Disorders: antisocial and borderline symptom analysis

Clinical and population-based samples show high comorbidity between Substance Use Disorders (SUDs) and Axis II Personality Disorders (PDs). However, Axis II disorders are frequently comorbid with each other, and existing research has generally failed to distinguish the extent to which SUD/PD comorbidity is general or specific with respect to both s...

Substance-use disorder (SUD) diagnoses are critically important for research and clinical practice. Unlike the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), the draft diagnostic criteria for SUDs in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) define a single SUD for variou...

Reports an error in "Alcohol use trajectories and the ubiquitous cat's cradle: Cause for concern" by Kenneth J. Sher, Kristina M. Jackson and Douglas Steinley (Journal of Abnormal Psychology, np). Due to formatting problems, some of the data and graphic information in the original Figure 7 are not correctly displayed. Although not all data in the o...

Previous research has shown that sexual minority (i.e., nonheterosexual) individuals report increased problematic substance use involvement, compared with their sexual majority counterparts. We hypothesize that feelings of an unstable sense of self (i.e., identity disturbance) may potentially drive problematic substance use. The purpose of the curr...

The recent proposal to dissolve the National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse and create a new institute for substance use, abuse, and addiction will require significant effort by the staff of both institutes, the Advisory Councils, and outside experts to overcome complex challenges that could threaten...

Alcohol and tobacco use covary at multiple levels of analysis, and co-use of the 2 substances may have profound health consequences. To characterize the motivationally relevant processes contributing to co-use, the current study used ecological momentary assessment (EMA) to examine the subjective consequences of naturally occurring simultaneous use...

A recent debate regarding the theoretical distinction between explicit and implicit cognitive processes relevant to alcohol-related behaviors was strongly shaped by empirical findings from dual-process models (Moss & Albery, 2009; Wiers & Stacy, 2010; Moss & Albery, 2010). Specifically, as part of a broader discussion, Wiers & Stacy (2010) contende...

The manifestation of alcohol dependence at different developmental stages may be associated with different genetic and environmental factors. Taking a developmental approach, we characterized interaction between the dopamine receptor 4 variable number tandem repeat (DRD4 VNTR) polymorphism and developmentally specific environmental factors (childho...

In recent years, trajectory approaches to characterizing individual differences in the onset and course of substance involvement have gained popularity. Previous studies have sometimes reported 4 prototypic courses: (a) a consistently "low" group, (b) an "increase" group, (c) a "decrease" group, and (d) a consistently "high" group. Although not alw...

Very few studies have investigated the "real world" prospective, predictive value of behavioral instruments used in laboratory studies to test decision-making abilities or impulse control. The current study examines the degree to which 2 commonly used decision-making/impulse control measures prospectively predict (heavy) alcohol use in a sample of...

Two nationally representative epidemiological samples (the National Longitudinal Alcohol Epidemiological Survey and the National Epidemiological Survey of Alcohol and Related Conditions) have been used to track changes in the prevalence of alcohol use disorders (AUDs) between 1992 and 2002 in the United States. Strikingly, estimates from these two...

Excessive alcohol consumption contributes to significant morbidity and mortality. Heritable influences contribute to 50% of the variation in alcohol consumption, suggesting the important role of genes. We used data on a previously defined alcohol consumption factor score in a sample of 827 young women to investigate association with 1,014 single-nu...

Outcome expectancy is a central construct in models of addiction. Several outcome expectancies associated with smoking cigarettes have been identified, and studies suggest that individual differences in smoking expectancies are related to important aspects of tobacco use, including levels of smoking, nicotine dependence and smoking cessation. In th...

Despite similar normative changes in antisocial behavior (AB) and traits of disinhibition and negative emotionality during "emerging adulthood," few studies have tested if there are developmental differences in personality over this period for distinct courses of AB. In a college cohort assessed at ages 18 and 25, we examined if mean-level changes...