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Drinking to Cope with the Pandemic: The Unique Associations of COVID-19-Related Perceived Threat and Psychological Distress to Drinking Behaviors in American Men and Women
Abstract
The 2019 Coronavirus pandemic has brought about significant and unprecedented changes to the modern world, including stay-at-home orders, high rates of unemployment, and more than a hundred thousand deaths across the United States. Derived from the self-medication hypothesis, this research explored how perceived threat and psychological distress related to the COVID-19 pandemic are associated with drinking behavior among an American sample of adults. We also evaluated whether links between COVID-19-related perceived threat and psychological distress with drinking behavior are different for men and women. Participants (N=754; 50% women) completed an online Qualtrics Panels study between April 17th and 23rd, 2020. Results suggested that psychological distress related to the COVID-19 pandemic was consistently related to alcohol use indices, and moderation results indicated this pattern was significant only among women for number of drinks consumed during the recent heaviest drinking occasion and number of drinks consumed on a typical evening. COVID-related distress’ link to frequency of drinking and heavy drinking episodes was not different for men and women. Our results suggest that continued monitoring, particularly among women, should be conducted as this pandemic continues to evolve to identify the long-term public health impacts of drinking to cope with COVID-19 distress.
... Women make up slightly more than half of the US population, and a significant proportion of them (15%) engage in illicit substance use [6] or have a formal diagnosis of a substance use disorder (5%) at any given time [8]. Furthermore, the COVID-19 pandemic has had a disproportionate impact on the mental health of women and low-income individuals, and this has led to an increase in alcohol consumption and alcohol use disorders among women [9,10]. ...
... Furthermore, the COVID-19 pandemic has had a disproportionate impact on the mental health of women and low-income individuals, and this has led to an increase in alcohol consumption and alcohol use disorders among women [9,10]. Substantial increases in alcohol consumption and alcohol use disorders in women linked to disproportionate psychological distress during the pandemic are of particular concern [7][8][9]11]. Excessive alcohol use can lead to a variety of negative health outcomes, including liver disease, heart disease, and certain types of cancer. It can also increase the risk of accidents, injuries, and violence. ...
... Data shows that people with SUD, especially individuals with opioid use disorder and African Americans, may be at higher risk of COVID-19 infection and poorer outcomes [20]. Higher psychological distress in men and women related to coping with COVID-19 and SUD [12] and increased alcohol use as a coping skill [8] have also been linked to the pandemic. People with lower incomes are generally more likely to report major negative mental health impacts from worry or stress over COVID-19. ...
Background: The COVID-19 pandemic exacerbated disparities in mental healthcare and substance use disorder (SUD) treatment access, especially in under-resourced communities. This study aimed to comprehend the experiences of under-resourced women with SUD during the pandemic, their knowledge and attitudes toward it, and its impact on substance use and treatment access.
Methods: A cross-sectional study included 66 under-resourced women receiving medically managed withdrawal treatment at a community residential SUD center. Data collection occurred between November 2021 and August 2022, utilizing a 75-item instrument covering COVID-19 exposure and its impact on health, substance use, treatment access, vaccination status, beliefs, and knowledge. Descriptive analyses summarized the data.
Results: Participants faced various challenges during the pandemic. Many reported increased substance use, especially alcohol, opioids, benzodiazepines, and nicotine. Mental health stability was negatively affected, exacerbating existing disorders and limiting mental healthcare access. A majority (56.1%) reported that their chronic mental health disorder was less stable during the pandemic. Twenty (30.3%) participants reported that they had been diagnosed with a new mental health disorder since the pandemic, and 28.8% reported that it was harder for them to access mental healthcare during the pandemic. Job loss, housing instability, and financial strain were prevalent. Half (n=33, 50%) received a COVID-19 vaccine dose, while 27.3% (n=18) declined vaccination due to knowledge gaps and religious beliefs. The majority (n=41, 62.1%) worried about securing basic needs such as groceries and medication, with 64.6% (n=42) expressing a desire to cope using alcohol or drugs.
Conclusions: This study expands upon previous research by examining the effect of the COVID-19 pandemic on mental health in the context of substance use disorder treatment. Unlike previous data, which focused solely on substance use behaviors, our study delves into the impact of the pandemic on co-occurring mental health disorders. Findings underscore the need for gender-responsive and culturally appropriate SUD treatment. Vaccine hesitancy, as reflected in the study, necessitates more effective, tailored evidence-based informational campaigns. Efforts must focus on enhancing mental healthcare access, reducing stigma, and supporting individuals with co-occurring conditions amidst this evolving COVID-19 health crisis.
... This means that job satisfaction decreases with perceived threats (Cheng & Kao, 2022). Employee satisfaction with basic psychological needs is an essential factor in higher levels of commitment (Meyer & Maltin, 2010;Rodriguez, Litt, & Stewart, 2020), and provisions that can boost individual employee job satisfaction should be increased (Lin, Jang, & Roberts, 2018;Rodriguez et al., 2020). There is a research gap due to the moderation of perceived threats to employees amid the COVID-19 pandemic, which can increase moonlighting intentions. ...
... This means that job satisfaction decreases with perceived threats (Cheng & Kao, 2022). Employee satisfaction with basic psychological needs is an essential factor in higher levels of commitment (Meyer & Maltin, 2010;Rodriguez, Litt, & Stewart, 2020), and provisions that can boost individual employee job satisfaction should be increased (Lin, Jang, & Roberts, 2018;Rodriguez et al., 2020). There is a research gap due to the moderation of perceived threats to employees amid the COVID-19 pandemic, which can increase moonlighting intentions. ...
... The moonlighting intentions Indicator uses an instrument adapted from Seema and Sachdeva (2020) and used by Seema et al. (2021), which coincides with seven items and has a Cronbach's α of 0.913. The perceived COVID-19 threats indicator uses an instrument adapted from Conway et al. (2020), which is used by Rodriguez et al. (2020) and Cheng and Kao (2022), which coincides with three items that have a Cronbach's α of 0,91. Analysis techniques evaluate the structural equation model (SEM) by Smart PLS by Smart PLS Series 3.2.9 ...
This study headed to probe the moonlighting intentions (MI) empirically from non-monetary factors, including job satisfaction (JS) through the mediation of organizational commitment (OC) and the moderation role of perceived COVID-19 threats (PCT) and perceived financial threats (PFT) during the pandemic. The study accustomed quantitative methods with a survey and a cross-sectional design. This study gathered data from 81 employees at Community College (AK-Tekstil Solo) and analyzed it using SMART PLS. This study discovered that job satisfaction majorly impacts organizational commitment and moonlighting intentions. Organizational commitment negatively influences moonlighting intentions due to its indirect-only (full mediation) relationships with job satisfaction. PCT and PFT did not play a moderating role, but they did diminish the effect sizes between constructs. The results of this study confirmed the substantial non-monetary facets of moonlighting intentions. This research contributes to the development of theory by validating the relationships that it draws from social exchange theory, and the novelty is the introduction of moderating variables in terms of threat aspects perceived during the pandemic, PCT, and PFT. The relevance of the research findings provides some practical implications and valuable insights for managers of formal educational institutions in the environmental condition that may change at any time without certainty
... De hecho, la pandemia de la COVID-19 afectó la salud mental y el bienestar de las personas en todo el mundo. Las diferentes reacciones emocionales asociadas a la pandemia de la COVID-19 se han descrito como un síndrome de estrés COVID (16) , y parecen haber contribuido a incrementar el uso de sustancias (16,17) . Asimismo, las preocupaciones específicas sobre el contagio por la COVID-19 pueden incrementar el uso de drogas (18) . ...
... Se reportaron niveles moderados de estrés académico (37,8 %) y de miedo a la COVID-19 (63,6 %) (5,19,20) . En Perú, es probable que las regulaciones impuestas durante la primera fase de la pandemia hayan incrementado la sensación de aislamiento, miedo y preocupación de los estudiantes, lo que generó a un ambiente altamente estresante (1,17,23) . ...
Prevalence, characteristics and factors associated with alcohol consumption among Peruvian university students during the early stage of the COVID-19 pandemic
Objective: To identify the prevalence, characteristics and factors associated with alcohol consumption among university students in the Lima Metropolitan Area during the early stage of the COVID-19 pandemic in Peru, from March 16 to June 30, 2020. Materials and methods: A cross-sectional and analytical study was conducted using an online survey administered to 257 students. Descriptive analyses and logistic regressions were performed to determine odds ratios (OR) and their 95 % confidence intervals (95 % CI). The study evaluated the association between alcohol consumption and various sociodemographic, economic and health variables, as well as general and academic stress, fear of COVID-19, third-party provision of alcohol and perceived ease of access to alcohol. Results: A total of 43.6 % of respondents reported consuming alcohol between March and June 2020. Among these, 32.1 % engaged in excessive alcohol consumption and 22.3% experienced episodes of drunkenness. In addition to assessing alcohol consumption in the 12 months preceding the early stage of lockdown, minimal differences were observed in alcohol consumption rates between men and women. During the lockdown, 43.8 % of students reduced their alcohol consumption, while 46.4 % maintained their pre-lockdown consumption levels. Significant associations were found between alcohol consumption and high levels of general stress (aOR = 2.33; 95 % CI: 1.13-4.75), third-party provision of alcohol (aOR = 13.63; 95 % CI: 6.55-28.3) and perceived ease of access to alcohol (aOR = 4.49; 95 % CI: 1.96-10.3). Conclusions: During
the early stage of the COVID-19 pandemic, alcohol consumption among university students was significantly associated with high levels of general stress, third-party provision of alcohol and perceived ease of access to alcohol. Despite lockdown restrictions, nearly half of the students maintained their pre-pandemic alcohol consumption levels. These findings highlight the need for targeted prevention and intervention strategies addressing alcohol consumption within the university setting.
... Moreover, the During the SARS-CoV-2 pandemic and particularly during lockdown, increased psychological distress, anxiety, depression, stress and loneliness, resulting from perceived social isolation [17,18], were repeatedly reported in general, but especially in women [19][20][21][22][23][24][25][26]. Here, as opposed to men, women showed a positive association between COVID-19-related psychological distress (including self-reported depressed mood) and drinking quantity [27]. ...
... Contrary to our second hypothesis and previous studies [4,6,27], we found no gender differences in associations of AC with mood or perceived stress, and no moderating influence of lockdown phase. Instead, we observed in both genders a drinking pattern that was frequently found in men, with heavier momentary AC on days with elevated mood [12][13][14][15][16]. ...
Alcohol consumption (AC) is a leading risk factor for death, morbidity, and disability worldwide. Gender-specific differences in AC and its moderators, which may serve as markers for preventing severe alcohol use disorders (AUD), showed inconsistent results. Additionally, the impact of COVID-19-related lockdowns on these differences remains unclear. We examined gender-specific differences in short- and long-term factors affecting AC in individuals at risk for alcohol dependence, focusing on mood, stress, and the influence of restriction-dependent lockdown phases. 358 subjects with AUD aged 16 to 65 were studied over one year. Daily electronic diaries and monthly questionnaires were conducted from 10/01/2020 to 09/30/2021, assessing real-world trajectories of AC, mood (MDMQ), and stress (PSS-10) during Germany’s second COVID-19 wave. Multi-level models were used to assess associations between these measures and with several within- and between-subject variables. During lockdown, women experienced lower and even decreasing mood (valence: β = − 0.2, p < .039; calmness: β = − 0.3, p < .010), while men’s mood increased from the most restrictive lockdown phase (valence: β = 0.2, p < .001; calmness: β = 0.3, p < .001) to post-lockdown (valence: β = 0.5, p < .001; calmness: β = 0.6, p < .001). Stress increased earlier (β = 0.8, p < .001) and more prolonged (β = 0.4, p = .021) in women than in men. For both genders, daily mood was positively associated with daily AC (valence: β = 0.6, p = .004; calmness: β = 0.4, p = .013), leading to stronger drinking on days with elevated mood. Conversely, average mood was negatively associated with average AC (valence: β = − 1.6, p = .011; calmness: β = − 1.2, p = .041), indicating higher overall consumption with worse overall mood. Our findings highlight the need for interventions targeting mental distress in women with AUD during pandemics, as this group faces increased mental burden during social isolation and increased risk of alcohol dependence during persistent distress.
... Interestingly, among the decedents with ALD, cirrhosis accounted for 55% of deaths while COVID-19 infection accounted for less than 10%. This is consistent with the data that during the pandemic alcohol consumption may have led to more severe liver disease and effected the elderly more often than those younger [10,11,29,30]. Additionally, our study findings validate the negative indirect effects of COVID-19 among those with ALD to include the hastening of cirrhosis [4,7,[31][32][33]. ...
... One study using EHR record data reported that Blacks carried a higher proportion of alcohol associated gastrointestinal disorders during the first year of the pandemic than did other ethnicities [47], results that others have shown as well [48,49]. It is known that alcohol use disorder was already increasing prior to the pandemic and during the first year of the pandemic alcohol sales increased most likely as a coping mechanism in response to the stress of the pandemic [4,29,[47][48][49]. However, disturbing is that investigators determined the highest relative increase in alcohol use was among women and Black individuals with the highest relative increase for alcohol hepatitis among women and Blacks and the highest relative increase in ALD mortality was among women [49]. ...
Introduction
We assessed chronic liver disease (CLD)-related mortality in the U.S. using death data (2011–2021) obtained from National Vital Statistics System (NVSS). The average annual percentage change (AAPC) from the models selected by Joinpoint regression analysis over the pre-pandemic (2011–2019) and the 2019–2021 were reported because non-linear trend in death rates were observed over the 2011–2021. Liver-specific death was defined as an underlying cause of death and Chronic liver disease (CLD)-related death was defined as any cause of death. During the pre-pandemic, age-standardized HCC- and cirrhosis-specific death rates were annually increased by AAPC = +1.18% (95% confidence interval, 0.34% to 2.03%) and AAPC = +1.95% (1.56% to 2.35%). In contrast, during the 2019–2021, the AAPC in age-standardized cirrhosis-specific death rate (per 100,000) accelerated by up to AAPC +11.25% (15.23 in 2019 to 18.86 in 2021) whereas that in age-standardized HCC-specific death rate slowed to -0.39 (-1.32% to 0.54%) (3.86 in 2019 to 3.84 in 2021). Compared to HCC-specific deaths, cirrhosis-specific deaths were more likely to be non-Hispanic white (72.4% vs. 62.0%) and non-Hispanic American Indian and Alaska native (AIAN) (2.2% vs. 1.1%) and have NAFLD (45.3% vs. 12.5%) and ALD (27.6% vs. 22.0%). During the 2019–2021, the age-standardized HCV- and HBV-related death rate stabilized, whereas the age-standardized NAFLD- and ALD-related deaths rate increased to 20.16 in 2021 (AAPC = +12.13% [7.76% to 16.68%]) and to 14.95 in 2021 (AAPC = +18.30% [13.76% to 23.03%]), which were in contrast to much smaller incremental increases during the pre-pandemic (AAPC = +1.82% [1.29% to 2.35%] and AAPC = +4.54% [3.97% to 5.11%]), respectively). The most pronounced rise in the age-standardized NAFLD-related death rates during the pandemic was observed among AIAN (AAPC = +25.38%), followed by non-Hispanic White female (AAPC = +14.28%), whereas the age-standardized ALD-related death rates during the pandemic were highest among AIAN (AAPC = +40.65%), followed by non-Hispanic Black female (AAPC = +26.79%).
Conclusions
COVID-19 pandemic had a major negative impact on cirrhosis-specific and CLD-related mortality in the U.S. with significant racial and gender disparities.
... Há divergências na literatura sobre a diferença neste consumo entre os gêneros, ora sendo apontado o incremento do uso dessa substância no contexto pandêmico como sendo maior nas mulheres (Barbosa et al., 2021;Rodriguez et al., 2020), ora nos homens (Thompson et al., 2021), e ora indicando não existir diferença entre gêneros (Malandain et al., 2022). ...
... Nesse mesmo sentido, o aumento do consumo de substâncias psicoativas se associou ao uso para o alívio da tensão, da ansiedade e das preocupações, como já foi demonstrado pela literatura, que ocorre em períodos de crise(Ornell, Moura et al., 2020). Infere-se, portanto, que a pandemia trouxe como um dos seus efeitos o aumento da experiência de estados emocionais desagradáveis, o que intensificou o uso de drogas como estratégia de regulação das emoções, como ressaltado porRodriguez et al. (2020).Sabe-se que a utilização de substâncias psicoativas para o alívio de estados emocionais pode trazer impactos negativos à saúde física e mental dos sujeitos(Schulte & Hser, 2014). Por isso, se os efeitos da pandemia no dia a dia das pessoas se prolongam no tempo e os sujeitos continuam fazendo uso de drogas para alívio de estados emocionais negativos, tal uso pode se configurar como uma estratégia de enfrentamento com efeitos mal-adaptativos a longo prazo requerendo, portanto, atenção no campo das políticas públicas em saúde mental (Portaria nº3.088, 2011; Farah, 2016). ...
A pandemia impactou a saúde mental da população. Analisaram-se as relações entre estados emocionais e uso de substâncias psicoativas – SPA (álcool, outras drogas e psicotrópicos). 2.113 pessoas (77% mulheres) de diversos estados do Brasil responderam um questionário online. Os resultados das análises estatísticas demonstraram que: 1) uso de SPA aumentou 17,3% na pandemia, com diferença significativa para as mulheres; 2) ansiedade, depressão e problemas de sono se associaram com aumento do uso de álcool e psicotrópicos; e 3) uso “recreativo” de álcool permaneceu estável, mas aumentou como coping das emoções. Discutem-se as implicações para políticas públicas de saúde da populaçã
... risk of problematic use, as drinking may be used as a coping strategy (Lechner et al., 2020;Rodriguez et al., 2020). ...
This study aims to analyse the evolution of problematic alcohol use among Spanish university students. A longitudinal analysis was performed on data from the uniHcos cohort (n = 1181; 76.7% female). Participants were assessed at university entry (T1) and after 2–3 years (T2). The overall alcohol consumption prevalence remained high and stable (past 30-days alcohol use 76.2% at T1; 76.4% at T2). Binge drinking practice in the past 30 days was also consistent (44.0% at T1; 44.3% at T2). Regarding the risk of problematic alcohol (measured with AUDIT), the prevalence rates remained stable over time (28.2% in T1 to 30.3% in T2). However, a high persistence rate was observed during university (61% of cases), and 18% of new incident cases were detected during follow-up. Factors associated with an increased risk of problematic alcohol included cohabitation with peers, psychological distress, smoking, and drug experimentation. No sex differences were identified. These findings highlight the need for targeted prevention strategies to address increasing risky alcohol use among university students and mitigate its long-term effects.
... This theory is particularly relevant in high-stress contexts, such as during the COVID-19 pandemic, where alcohol consumption has been shown to increase as a response to elevated stress levels (29). Consistent with the exist- Adopting an attitude aligned with self-compassion is hypothesized to support individual well-being, reduce distress and foster adaptive functioning (27). ...
Background: Alcohol is a widely consumed psychoactive substance, with significant global prevalence and a major impact on public health. The World Health Organization estimates that approximately 2.6 million deaths occur annually due to alcohol-related causes, highlighting the urgent need to address alcohol use disorders. Self-compassion, defined as being kind and understanding toward oneself in times of suffering or failure, has been linked to better emotional regulation and coping strategies. Understanding the relationship between self-compassion and problematic alcohol use may offer insights into effective intervention strategies. Methods: This cross-sectional study involved 142 participants aged 18 and older with a history of alcohol use, assessed through the Alcohol Use Disorders Identification Test (AUDIT), the Self-Compassion Scale-Short Form (SCS-SF), and the Patient Health Questionnaire-4 (PHQ-4). Results: The analysis revealed that individuals with higher self-compassion reported significantly lower levels of psychological distress. Conversely, those experiencing greater psychological distress exhibited higher levels of problematic alcohol use, indicated by elevated AUDIT scores. Mediation analysis demonstrated that psychological distress serves as a significant mediator in the relationship between self-compassion and alcohol use. Conclusion: The findings emphasize the protective role of self-compassion against psychological distress and maladaptive drinking patterns. This study highlights the potential benefits of integrating self-compassion-based interventions into therapeutic interventions for individuals with alcohol use disorders. Future research should consider longitudinal designs and a broader range of socio-psychological factors to deepen our understanding of these relationships and enhance the effectiveness of treatment strategies.
... Initial evidence suggests an increase of drinking among the general US population during the COVID-19 pandemic (Grossman et al. 2020) due to COVID-19 related stressors (Rodriguez et al. 2020). The increase is associated with worse mental health (Hart and Han 2021). ...
Aims
The COVID-19 pandemic had a demonstrated impact on parenting but little is known about how parental drinking, stress, and use of aggressive discipline (a parenting behavior associated with abusive parenting and negative outcomes for children) have changed over time. We examine rates of alcohol use, stress, and aggressive discipline at three time points during the COVID-19 pandemic and investigate what maternal, child, and time-varying factors predict weekly use of aggressive parenting.
Methods
We use longitudinal data from the Central Ohio Family Study (COFLS), including women (n = 234) with a child between the ages of 0–12 and recruited via Facebook, Craigslist.org, and word of mouth. Participants completed an on-line survey for 3 consecutive years beginning in April–May 2020 and 1 and 2 years later. Multilevel logistic regression models were used to examine use of aggressive discipline at the three time points, controlling for time-varying, and maternal and child characteristics.
Results
Past week use of aggressive discipline peaked in Wave 1 (35.9%) and decreased at Wave 2 (3.8%) and Wave 3 (28.2%; OR = .463; 95% CI: .369, .580). Parental stress (OR = 1.052; 95% CI: 1.010, 1.096), social isolation (OR = 1.412; 95% CI: 1.197, 1.668), social companionship (OR = 1.113; 95% CI: 1.007, 1.229), and frequency of drinking (OR = 1.049; 95% CI: 1.014, 1.085) were significantly related to higher odds of using aggressive discipline over the three waves.
Conclusions
Although rates of aggressive discipline declined, frequency of drinking and stress demonstrated a consistent pattern in relation to aggressive discipline during the COVID-19 pandemic.
... The effect of COVID-19 stress on drinking also impacted women more severely, as women were 7 times more likely to experience hazardous drinking compared to men, who were only 3.7 times more likely to misuse alcohol (Anker & Krill, 2021). These findings corroborate with reports that women experiencing COVID-19-related anxieties were more likely to engage in heavy drinking episodes (Hahm et al., 2023;Rodriguez et al., 2020). Women with a prior incidence of AUD also drank more compared to their male counterparts during the COVID-19 pandemic (Meyers et al., 2023). ...
... Moreover, our study demonstrated that individuals with higher Coronavirus Anxiety Scale (CAS) scores were more highly engaged in HED. Similarly, several studies have reported that the pandemic was also resulted in an increased prevalence of stress, anxiety, depression, and other mental health issues [10,13,32,33], that may results in hazardous drinking and increased alcohol use among NCD patients [16,34]. Alcohol consumption is a common coping mechanism for anxiety, tension, uncertainty, and negative emotions [35], with evidence indicating increased consumption during difficult times such as disasters and pandemics [36]. ...
Introduction
Managing non-communicable diseases (NCDs) requires adherence to lifestyle recommendations like a healthy diet, regular exercise, smoking cessation, and limiting alcohol intake. The COVID-19 pandemic introduced barriers to maintaining these habits, including limited healthcare access, increased stress, and reduced physical activity. This study assessed adherence to lifestyle recommendations, with a focus on heavy episodic drinking (HED), among NCD patients during the pandemic in Arba Minch, Ethiopia, to identify areas for public health intervention.
Method
A cross-sectional study was conducted among 310 randomly selected NCD follow-up patients at Arba Minch General Hospital. The data was collected using the WHO STEPS and Coronavirus Anxiety Scale (CAS) tool from March 1 to April 30, 2022. Data analysis included both descriptive and inferential statistics (bivariate analyses and multivariable logistic regression). Confounding variables were identified and controlled for to ensure result accuracy.
Results
Adherence to lifestyle recommendations was found to be low, at just 16.1% [n=50, 95% Confidence Interval (CI) (12.5–20.6%)]. The prevalence of HED was 12.6%, with a higher prevalence among males (18.4%) compared to females (7.4%). Recent alcohol consumption was reported by 29.0% of participants, and among these, 43.3% engaged in HED. Factors significantly associated with HED included male gender (Adjusted Odds Ratio (AOR) 2.63, 95% CI 1.11, 6.24), higher education level (AOR 2.91, 95% CI 1.11, 7.58), and current tobacco use (AOR 6.36, 95% CI 1.62, 25.04). Healthcare disruptions due to COVID-19 (AOR 3.28, 95% CI 1.16, 9.26) and COVID-19-related anxiety (AOR 1.29, 95% CI 1.06, 1.56) were also linked to HED.
Conclusion
The study revealed low adherence to lifestyle recommendationsand significant prevalence of HED among NCD patients during the pandemic. Associations between HED, healthcare disruptions, and anxiety highlight the critical role of mental health and healthcare access in risky behaviors. Targeted public health interventions are essential, including community-based alcohol reduction programs, improved mental health support, and stronger healthcare systems. Integrating mental health services and culturally sensitive health education and community engagement can help improve adherence to lifestyle recommendations.
... Indeed, evidence to date provides a mixed picture regarding how drug use changed for the general population during the COVID-19 pandemic. In accordance with concerns that heightened mental distress, isolation, and job insecurity would lead to increased drug use [11,12], early data from the United States and Canada indicated a rise in substance use among habitual users, potentially driven by self-isolation challenges [13,14]. Furthermore, key workers, particularly in the hospitality sector, were reported to have increased their drug consumption, which could be attributed to the stress of working during the pandemic [15]. ...
... Additionally, the COVID-19 pandemic has led to substantial changes in students' lives, including abrupt adaptation to remote learning, reduced social and academic activities, and limited access to support systems (Biwer et al., 2021). These disruptions in academic and social life have subsequently increased psychological distress (e.g., depression and anxiety; Rodriguez et al., 2020) and academic challenges among university students which impedes the academic success of emerging adults. ...
Compared with adolescence, emerging adulthood is associated with increases in mental well-being, which likely reflects developmental gains in autonomy as youth navigate new learning, occupational, and social environments. However, individuals with distress-prone personality traits such as higher levels of hopelessness (HOP) may be more at risk for psychological maladjustment, which can in turn affect their sense of well-being and ability to overcome challenges associated with the transition to post secondary education. The current study examines whether distress-prone personality traits (HOP and neuroticism) influence postsecondary students’ mental well-being and academic engagement through mediational links with a range of psychological distress indicators (depressive symptoms, anxiety symptoms, and COVID-19-related traumatic distress). The participants (N = 1507; 65.2% women) were first- and second-year undergraduate students aged 18 to 25 years (M = 19.17, SD = 1.52) from five universities across Canada who completed surveys that assessed their personality (traits related to hopelessness and neuroticism), psychological distress (anxious and depressive symptoms and pandemic-related distress), mental well-being and academic engagement behaviors. The results showed that students with higher HOP and greater neuroticism reported more depressive symptoms, which in turn was associated with poorer mental well-being and academic engagement. In contrast, higher levels of HOP and neuroticism were associated with greater academic engagement through increasing anxiety symptoms, which may reflect an underlying fear of failure. These findings suggest that young adults with distress-prone personality traits can increase vulnerability to poorer mental health and academic engagement. Educational interventions that target specific personality traits may help identify high-risk students and provide more tailored academic support to help them cope with psychological distress and reduce maladaptive learning patterns during the transition to university.
... En la segunda encuesta (SENDA, 2021) se encontraron resultados similares: el 70% de las personas encuestadas reportaron haber mantenido o disminuido su patrón de consumo. Una posible explicación podría ser que, en general, el consumo de alcohol no haya funcionado como una estrategia de afrontamiento durante el inicio de la pandemia para los participantes del estudio (Rodriguez et al., 2020), por lo que el patrón de consumo se mantuvo sin cambios significativos. ...
El COVID-19 es una enfermedad respiratoria que se transmite rápidamente y se convirtió en pandemia. Muchos países implementaron cuarentenas y distanciamiento social como medidas preventivas, lo que pudo tener consecuencias en la salud mental. El miedo a enfermar por el virus podría incrementar el malestar psicológico, lo que podría influir en la conducta de consumo de alcohol como estrategia de afrontamiento. El estudio explora la trayectoria de consumo de alcohol durante 15 días de la primera ola de COVID-19 en Chile. La muestra por conveniencia estuvo compuesta por 164 adultos, con media edad de 32.2 años y 60.6% de mujeres. Se utilizó un cuestionario de información general, el Cuestionario de Consumo de Alcohol SENDA, el cuestionario FIVE y el PHQ-9. Para el análisis de datos se realizó un análisis de curva de crecimiento de la trayectoria de consumo, incluyendo predictores: miedo a enfermar, edad, sexo, sintomatología depresiva y estrés económico. Los principales resultados indican que, aunque se observan diferencias entre los individuos en el consumo inicial, este se mantiene estable en el tiempo. Además, controlando las distintas covariables, el mayor nivel de miedo al COVID-19 y específicamente, el temor a limitaciones y a las dificultades para cubrir las necesidades básicas asociadas a la enfermedad, sería un predictor de un mayor nivel de consumo al inicio y predeciría una reducción leve en el patrón de consumo en el tiempo de medición, lo que podría deberse a que el miedo podría motivar conductas como la reducción del consumo de alcohol.
... A substantial body of work has used quantitative methods to identify the characteristics of people for whom alcohol use increased or decreased during the pandemic. US studies have shown any and heavy alcohol use increased among women [11], Black people [6,12], people with mental health struggles [8,13], and people who engaged in heavy drinking before the pandemic [14]. On the other hand, studies have shown decreases in any and heavy alcohol use among young people [3,6] and in any and heavy drinking among men [6], with reductions in opportunities for social engagement due to social distancing measures and business closures and changes in living circumstances as possible drivers of these decreases [15,16]. ...
(1) Background: Although alcohol use increased overall in the US during the COVID-19 pandemic, approximately 16% of people decreased their drinking. Understanding reasons for decreasing or discontinuing alcohol use during a time of crisis could inform alcohol messaging during future crises. (2) Methods: We conducted hour-long interviews with 26 participants who reported drinking above NIAAA guidelines at the second wave of the National Alcohol Survey COVID Cohort (a longitudinal study of alcohol use during the COVID-19 pandemic). Data were analyzed using codebook thematic analysis. (3) Results: Many participants reported decreasing use after a period of heavy drinking. Four themes emerged as reasons for doing so: (1) health conditions attributed to or worsened by drinking, (2) concerns about developing the same alcohol problems as a family member, (3) life demands and transitions that limited drinking opportunities, and (4) disliking the side- and after-effects of drinking (e.g., hangovers). (4) Conclusions: Concerns about negative health consequences from heavy alcohol use and limited opportunities to use alcohol due to competing life demands were salient reasons for reducing or abstaining from alcohol use during COVID-19. Incorporating themes about health and life obligations into messaging to reduce alcohol use during crises may improve message relevance.
... Next, we evaluated DRN 5-HT neuron excitability in EtOH-exposed female rats. Since the majority of SIS's physiological effects in EtOH-naïve rats were seen in females and preclinical studies in our laboratory and others have shown the vulnerability of female rats to elevated EtOH intake (Bertholomey and Torregrossa 2019;Logrip et al. 2018;McElroy et al. 2023;Pirino et al. 2022) as well as higher sensitivity to stress-induced alcohol consumption in female clinical populations (Peltier et al. 2019;Rodriguez et al. 2020), we focused on this population for electrophysiology studies in EtOH-exposed rats. In contrast to data from naïve subjects, we did not see a persistence of DRN 5-HT neuron hypoexcitability in EtOH-exposed SIS females compared to their GH controls. ...
Rationale
Alcohol is one of the most frequently used drugs of abuse and has a major impact on human health worldwide. People assigned female at birth and those with adverse childhood experiences are stress-vulnerable and more likely to report drinking as a means of “self-medication.” Prior studies in our laboratory showed that adolescent social isolation stress (SIS) increases vulnerability to ethanol (EtOH) intake and consumption despite negative consequences in female rats.
Objectives
Here, we explored modulation of the dorsal raphe nucleus (DRN)-serotonin (5-HT) system, a sexually dimorphic neurotransmitter system involved in stress-reward interactions, to determine its contribution to EtOH-motivated behaviors in rats that have undergone SIS.
Results
We employed electrophysiological and functional neuroanatomy strategies to show that both SIS and EtOH exposure induce persistent hypofunction of the DRN 5-HT system, particularly in females. Chemogenetic activation of DRN 5-HT neurons attenuated reward value for both EtOH and sucrose and elevated punished responding for EtOH in a stress-dependent manner.
Conclusions
Our results highlight an inverse relationship between EtOH consumption and the 5-HT system, the sex- and stress-dependent nature of this relationship, and a connection between DRN 5-HT signaling and acute responding to rewards and punishment. These data support the DRN 5-HT system as a potential target to treat aberrant alcohol consumption and drinking despite negative consequences in stress-vulnerable populations.
... [74][75][76][77] Psychological distress may lead to alcohol consumption as a coping strategy. 14,39,55,58,66,78 This could generate a two-way relationship because alcohol is a central nervous system depressant, leading to co-morbidity between alcohol dependence and mental disorders. 76 Some studies found that some of the participants showed yet moderate or high symptoms of alcohol dependence 46,49,55 highlighting a difference in easy cessation between regular or occasional consumers. ...
Objectives: The COVID-19 pandemic caused unprecedented restrictions, leading to differences in the frequency
and patterns of alcohol consumption, especially among young adults. This systematic review aims to investigate
the overall evidence concerning changes in alcohol consumption in this period.
Study design: Systematic review.
Methods: Adhering to PRISMA and SWiM guidelines, this study’s review protocol is registered in PROSPERO
(CRD42023464591). The studies research was carried out in PubMed, Scopus, and Web of Science. Inclusion
criteria involved observational studies focusing on participants aged 18 to 35, exploring alcohol consumption
during at least the first wave of COVID-19, and publications in English or Spanish.
Results: A total of 28 studies conducted in different countries were included, European (18), North American (9),
and Latin American (1). Although in many studies the overall prevalence of alcohol use was reduced, it was
mainly among occasional users, in which the main motivation was the lack of social contact. It was exposed that
participants with a high risk of problematic use increased their alcohol consumption, showing associated factors
such as poor mental health, depressive symptoms, stress, and coping motivations. Males generally exhibited a
higher risk of problem use and risky behaviours than females.
Conclusions: During COVID-19, youth alcohol consumption decreased overall, especially among social drinkers,
but increased among high-risk users due to factors like distress and loneliness. Similar trends during other disasters emphasize the importance of addressing high-risk drinking in disaster planning. Also, preventing highrisk drinking from adolescence and youth could be helpful in reducing the global burden and impact of
alcohol consumption.
... Another inflection point in 2019-2020 is suggested by data, although values for subsequent years were unavailable at the time of this analysis to generate a trend after 2019. Nevertheless, this inflection likely reflects the impact of COVID-19 with associated socioeconomic stress and adverse effects on physical and mental health infrastructure leading to increased rates of AUD and related mortality, as has been observed by other epidemiologic analyses of alcohol-related mortality during the pre-and peri-COVID era (Marlowe et al., 2023;Rodriguez et al., 2020;White et al., 2022). ...
Background
Alcohol‐associated hepatitis (AH) is a subtype of alcohol‐associated liver disease (ALD) resulting in severe acute liver inflammation. This study aims to examine longitudinal trends in mortality from AH in the United States (US) from 1999 to 2020, stratifying the data by sex, age, and racial/ethnic groups.
Methods
We performed a cross‐sectional study using data from the US Centers for Disease Control and Prevention Wide‐ranging Online Data for Epidemiologic Research (WONDER) to determine annual AH‐related mortality rates (MR) in adults ≥21 years between 1999 and 2020. Data were stratified by sex, race, and 10‐year age groups. Considering 1999 as baseline, mortality rate ratio (MRR) was calculated to characterize the MR in a particular year compared to baseline. Joinpoint regression analysis was conducted to characterize year‐wise log‐linear time calendar trends in MR.
Results
From 1999 through 2020, AH‐related deaths doubled from 0.5 per 100,000 (95% CI 0.5 to 0.6) to 1.1 per 100,000 (95% CI 1.1 to 1.2). While mortality rates for males doubled from 0.8 per 100,000 (95% CI 0.7 to 0.8) to 1.5 per 100,000 (95% CI 1.4 to 1.6), mortality rates for females almost tripled from 0.3 per 100,000 (9%% CI 0.3 to 0.4) to 0.8 per 100,000 (95% CI 0.7 to 0.8). The steepest increase in AH‐related deaths from 1999 to 2020 were among American Indians/Alaska Natives and young adults 25–34 years, and particularly young adult females.
Conclusions
Over the past two decades, overall AH‐related mortality in the US has doubled. The steepest increase in AH‐related mortality was noted among American Indians/Alaska Natives and young adults, particularly young adult females. Education and prevention efforts should target these high‐risk populations, and studies aimed at elucidating biological and sociodemographic factors resulting in the differential rise in mortality are warranted.
... A study conducted by Taha and colleagues (2014) during the H1N1 pandemic found that emotion-focused coping is profound in individuals showing higher levels of perceived threat. In another study investigating drinking as a type of avoidance coping mechanism during COVID-19, drinking was observed amongst respondents experiencing more severe psychological distress and who typically displayed higher levels of perceived threat (Rodriguez et al., 2020). Yet, contradictory results have emerged in this regard. ...
Background
Psychological distress in response to pandemics is debated to have a serious and long-lasting impact on consumers’ well-being. The unprecedented nature of pandemics is associated with a wide range of life stressors and coping strategies that vary across countries. Understanding the stressors and coping strategies during pandemics is imperative for social and business reasons.
Focus of the Article
The study contributes to the area of positive behavior change during critical life events where social marketing can play a profound role in undertaking downstream marketing initiatives that promote adaptive coping strategies for handling emergent threats and stressors.
Research Question
What coping mechanisms are employed to handle the stressors during times of change? How do individual’s appraisals of the potential threat and self-efficacy affect their coping strategies?
Importance to Social Marketing Field
The study provides valuable insights to inform social marketing strategies by enriching the field of health communication within social marketing. By exploring the psychological and emotional stressors as well as the coping strategies, this research underscores the importance of targeted communication strategies to support community well-being and resilience.
Methods
To provide evidence on stressors and coping strategies during COVID-19, a sample of 50 Egyptian adults were interviewed.
Results
The majority of the participants mentioned the fear of losing loved ones, health threats, and uncertainty as the main stressors. Emotion-focused coping was adopted more often than problem-focused coping. Pursuing hobbies and home tasks and seeking support from family and friends were among the most used coping strategies. High self-efficacy was found to be associated with problem-focused coping strategies.
Recommendations for Research and Practice
Findings add to the growing literature demonstrating the unique impacts of COVID-19 on consumers’ well-being and their corresponding coping strategies. The specific types of coping strategies people endorse in managing stress and building resilience in handling the pandemic offer important policy and managerial implications.
Limitations
Given the qualitative nature of the study, the sample size limits the generalizability of the results. Despite the rich insights generated from the qualitative investigation, employing quantitative methods in future studies would help in examining the impact of coping strategies on consumers’ well-being.
... 8,12,20,[42][43][44] Alcohol use and misuse are well-known to be linked to increased levels of stress, 45 and higher level of stress and anxiety probably contributed to the use of alcohol to cope with the pandemic situation. 46 Similarly, increased levels of uncertainty caused by the 2008 financial crisis have led to an increase in the prevalence of binge drinking, despite an overall decrease in the prevalence of alcohol use, suggesting the possibility that more vulnerable segments of alcohol drinkers may increase their consumption of alcohol in a maladaptive direction. 47,48 A study conducted on the first LOST survey linked worsening in smoking habits with mental distress. ...
Background: The lockdowns imposed by the government during coronavirus disease 2019 (COVID-19) pandemic have had a significant impact on the Italian population habits.
Methods: LOckdown and lifeSTyles in Italy and in Tuscany studies collected data on a representative sample of the Italian adult population in 2020 (n = 6,003) followed up through 2023 via four additional surveys (3,000 ≤ n ≤ 6,600) through an online self-administered questionnaire. The Alcohol Use Disorders Identification Test-Concise was used to identify at-risk drinkers. Considering the cohort of individuals who took part to the first and at least one other wave (n = 5,378), a multilevel logistic model was used to derive odds ratios (ORs) and corresponding 95% confidence intervals (CIs) of being at-risk drinkers.
Results: The prevalence of at-risk drinkers was 26.4% before, 23.4% during the first lockdown, and stabilized around 30.0% thereafter. Being at-risk alcohol consumers decreased with decreasing economic status (P for trend <0.001), was less frequent among middle-aged compared to younger (OR 0.73; 95% CI, 0.60–0.89) and among divorced/separated (OR 0.77; 95% CI, 0.60–0.99) or single (OR 0.75; 95% CI, 0.64–0.89) compared to married individuals. It was more frequent among individuals with anxiety or depressive symptoms (OR 1.24; 95% CI, 1.12–1.37), those using psychotropic drugs (OR 1.99; 95% CI, 1.69–2.35) and users of conventional and/or alternative nicotine products (OR 3.67; 95% CI, 3.00–4.48).
Conclusion: The long-term trends in alcohol consumption after the COVID-19 pandemic are unfavorable in Italy. The results point to an increased vulnerability for at-risk alcohol consumption among younger individuals, women with higher economic status, and married individuals. At-risk drinking is strongly related to mental health symptoms and nicotine consumption.
... Previous work has also shown that young people's drinking likely declined in Australia during the pandemic [20], and the reductions in heavy episodic drinking found here likely reflect this shift. Previous international studies suggested that increases in drinking may reflect its use as a negative coping mechanism during the pandemic to manage psychological distress [45,46], and there is some evidence that severe alcoholrelated harms increased in Australia during the pandemic [47], so the reductions identified here may reflect the particular characteristics of our study sample although we expected the sub-populations we recruited to experience higher levels of distress given their increased exposure to risk. On the whole, the negative association between lockdowns and alcohol consumption observed in this sample does alleviate some concern about unintended consequences of public health measures used to control future pandemics, at least where those measures are successful. ...
Objectives
Whilst public health measures were effective in reducing COVID-19 transmission, unintended negative consequences may have occurred. This study aims to assess changes alcohol consumption and the heavy episodic drinking (HED) during the pandemic.
Methods
Data were from the Optimise Study, a longitudinal cohort of Australian adults September 2020–August 2022 that over-sampled priority populations at higher risk of contracting COVID-19, developing severe COVID-19 or experiencing adverse consequences of lockdowns. Frequency of alcohol consumption (mean number of days per week) and past-week HED were self-reported. Generalised linear models estimated the association between time and (1) the frequency of alcohol consumption and (2) heavy episodic drinking.
Results
Data from 688 participants (mean age: 44.7 years, SD:17.0; 72.7% female) and 10,957 surveys were included. Mean days of alcohol consumption per week decreased from 1.92 (SD: 1.92) in 2020 to 1.54 (SD:1.94) in 2022. The proportion of participants reporting HED decreased from 25.4% in 2020 to 13.1% in 2022. During two lockdown periods, known as “lockdown five”, (OR:0.65, 95%CI [0.47,0.90]) and “lockdown six” (OR:0.76, 95%CI [0.67,0.87]), participants were less likely to report HED.
Conclusions
Participants alcohol drinking frequency and HED decreased during the pandemic. This study provides a strong description of alcohol consumption during the pandemic and suggests that lockdowns did not have the unintended consequences of increased alcohol consumption.
... Furthermore, the experience of the COVID-19 pandemic could evoke negative emotions and increase stress, and social distancing measures could lead to boredom and depression [3][4][5] . ...
Purpose
This study aims to describe and analyze the factors associated with dependence and motivation to stop smoking in patients with schizophrenia.
Design/methodology/approach
This descriptive, analytical study was conducted between October 2021 and April 2023 at two psychiatric centers in Morocco. The study population consisted of 274 smokers diagnosed with schizophrenia, who were examined just before their discharge. In addition to sociodemographic and economic data, tobacco use status and clinical information, the authors assessed dependence with Fagerström Test for Nicotine Dependence (FTND), motivation to quit and depression.
Findings
Around three-quarters (74%) smoked more than 10 cigarettes a day, with a mean FTND score of 5.61 (±1.94). Dependence was reported in 76% of smokers. More than two-thirds (69%) had made at least one attempt to quit, and almost all participants (99%) had done so without medical assistance. Nicotine dependence was associated with income, illness duration, motivation to stop smoking and depression. In addition, lower income, level of education, number of hospitalizations, attempts to stop smoking and nicotine dependence were associated with motivation to quit tobacco use. However, depression was not associated with motivation to stop smoking.
Research limitations/implications
The present study has the following limitations: the cross-sectional nature of the study does not allow for temporal evaluation, the sampling technique does not allow for generalization of the results, participants’ responses may be subjective despite the use of validated psychometric scales.
Practical implications
The results of this research have important public health implications: Duration of schizophrenia progression was associated with nicotine dependence – highlighting the need to offer help as soon as possible after diagnosis, as a preventative measure; Calgary depression score was a factor associated with increased dependence – suggesting that screening and additional help for people with co-existing mental health problems could be important. Similarly, the onset of depression after the development of schizophrenia should be monitored.
Originality/value
The authors have further searched the literature and have not found similar studies. The absence of such studies justifies the significance of this research, and its results will be valuable for publication to guide researchers in the treatment of tobacco dependence and, furthermore, to guide the preventive efforts of health authorities in Morocco. Additionally, to the best of the authors’ knowledge, this study is the first of its kind in Morocco and among the few in North Africa.
... Research from the COVID-19 pandemic indicates that women were more susceptible to psychological distress than men, which increased their likelihood of using alcohol to cope with pandemic-related stress [35]. In this context, heavy alcohol use was linked to high levels of COVID-19-related distress in women but not in men [36], with alcohol consumption in women rising by 17% during lockdown [37]. A number of studies have also found that the relationship between alcohol use disorders and major depression is stronger for women than for men [38,39]. ...
This study investigates the combined effects of environmental pollutants (lead, cadmium, total mercury) and behavioral factors (alcohol consumption, smoking) on depressive symptoms in women. Data from the National Health and Nutrition Examination Survey (NHANES) 2017–2018 cycle, specifically exposure levels of heavy metals in blood samples, were used in this study. The analysis of these data included the application of descriptive statistics, linear regression, and Bayesian Kernel Machine Regression (BKMR) to explore associations between environmental exposures, behavioral factors, and depression. The PHQ-9, a well-validated tool that assesses nine items for depressive symptoms, was used to evaluate depression severity over the prior two weeks on a 0–3 scale, with total scores ranging from 0 to 27. Exposure levels of heavy metals were measured in blood samples. BKMR was used to estimate the exposure–response relationship, while posterior inclusion probability (PIP) in BKMR was used to quantify the likelihood that a given exposure was included in the model, reflecting its relative importance in explaining the outcome (depression) within the context of other predictors in the mixture. A descriptive analysis showed mean total levels of lead, cadmium, and total mercury at 1.21 µg/dL, 1.47 µg/L, and 0.80 µg/L, respectively, with a mean PHQ-9 score of 5.94, which corresponds to mild depressive symptoms based on the PHQ-9 scoring. Linear regression indicated positive associations between depression and lead as well as cadmium, while total mercury had a negative association. Alcohol and smoking were also positively associated with depression. These findings were not significant, but limitations in linear regression prompted a BKMR analysis. BKMR posterior inclusion probability (PIP) analysis revealed alcohol and cadmium as significant contributors to depressive symptoms, with cadmium (PIP = 0.447) and alcohol (PIP = 0.565) showing notable effects. Univariate and bivariate analyses revealed lead and total mercury’s strong relationship with depression, with cadmium showing a complex pattern in the bivariate analysis. A cumulative exposure analysis of all metals and behavioral factors concurrently demonstrated that higher quantile levels of combined exposures were associated with an increased risk of depression. Finally, a single variable-effects analysis in BKMR revealed lead, cadmium, and alcohol had a stronger impact on depression. Overall, the study findings suggest that from exposure to lead, cadmium, mercury, alcohol, and smoking, cadmium and alcohol consumption emerge as key contributors to depressive symptoms. These results highlight the need to address both environmental and lifestyle choices in efforts to mitigate depression.
... Data were collected in October 2022 through a web-based survey distributed by Qualtrics Panel Services. Similar methods to obtain a large pool of representative respondents have been utilized in prior alcohol and addiction research (e.g., Rodriguez et al., 2020). ...
Background
Problematic alcohol use (PAU) is highly prevalent in the United States. Although bereavement, a highly stressful and ubiquitous experience across the lifespan, is believed to increase the risk for PAU based on a small number of studies, research using large diverse samples of bereaved adults has yet to be conducted. Therefore, relations between PAU and bereavement remain poorly understood, hampering the reach and effectiveness of alcohol interventions. The current study addresses this limitation by investigating rates and correlates of PAU and service utilization among a large national sample of bereaved adults.
Methods
Participants were adults who reported the death of a significant other in their lifetime (N = 1529). Most participants identified as female (69.1%) and White (68.2%), with an average age of 44.7 (SD = 16.29). Online self‐report surveys assessed the prevalence of PAU using the AUDIT‐C, mental health service utilization, and associated characteristics.
Results
Nearly one‐third (n = 463; 30.3%) screened positive for PAU, which surpasses rates found in the general US population. After accounting for other characteristics, time since the death (OR, 3.63; 95% CI, 2.59–5.08) and meeting presumptive criteria for depression (OR, 2.28; 95% CI, 1.64–3.18) and prolonged grief disorder (PGD; OR, 1.66; 95% CI, 1.13–2.25) significantly increased risk for PAU among the bereaved. Approximately half (n = 244; 52.7%) of bereaved adults with PAU received any mental health service since the death. Time since the death (OR, 4.19; 95% CI, 2.38–7.48) and presumptive depression (OR, 2.16; 95% CI, 1.25–3.74) were associated with service utilization after accounting for other characteristics.
Conclusions
The high prevalence of PAU among bereaved adults, particularly among those with a diagnosis of PGD, and limited use of support services underscore the need for greater empirical attention and integrated substance use care for bereaved adults.
... This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. Additional stressors brought on by COVID-19 have resulted in increased rates of anxiety, depression, and trauma symptoms among frontline workers (Benfante et al. 2020;Cabarkapa et al. 2020;Conti et al. 2020;Giorgi et al. 2020;Lai et al. 2020;Lasalvia et al. 2021;Mayer et al. 2022;Rodriguez, Litt, and Stewart 2020;Sasangohar et al. 2020). These mental health issues are known to affect cognitive function, including concentration and decision-making (Hartley and Phelps 2012;Starcke and Brand 2012). ...
Prolonged stress and the need for rapid uptake of information can have detrimental effects on memory and cognition, whereas meaningfulness of study material and motivation to learn can have positive effects. How do these opposing conditions impact workplace learning in essential frontline workers during a global pandemic? We analyzed learning data collected longitudinally since before the pandemic in over 85,000 essential frontline grocery workers and nonessential telecommunications workers via a learning management system that incorporates a spaced retrieval schedule, where items are retrieved following retention intervals of varying length. Findings indicate more rapid knowledge uptake in grocery workers (a) during than before the pandemic, (b) for COVID‐19‐related content than non‐COVID content, and (c) in the United States than in Canada. Longer‐term maintenance of training material was similar across groups. Evidence of enhanced workplace learning and retention supports efforts to integrate empirically based strategies from the behavioral sciences into learning‐based technologies.
... There are also interactions between alcohol consumption, impulsivity and perceived boredom (Clay et al., 2023a, b). Hazardous drinking is conceived as an attempt to cope with stress (Clay et al., 2023a;Rodriguez et al., 2020), which has led some researchers to further investigate possible stressors and behaviors associated with the development of a hazardous pattern of alcohol consumption. Some of them included lower income, lack of social support and social isolation, with remote work and distance learning being particularly related to the latter (Acuff et al., 2022;Molsberry et al., 2021;Törrönen et al., 2022;Valente et al., 2021). ...
Background
As a severe and prolonged stressor, the COVID-19 pandemic has contributed to development or exacerbation of mental disorders. For substance use disorder, the link between stress and alcohol consumption is well established. However, there have been conflicting findings in the context of the pandemic. The aim of this study was to characterize the group of high-risk alcohol consumers in terms of perceived stress and potential stressors during the third wave of the pandemic.
Participants and procedure
Adult Polish men (N = 295) from the Tricity metropolitan area participated in the study. They were subdivided into high-risk (n = 104) and low-risk (n = 191) alcohol consumers based on their self-reported weekly alcohol consumption. A demograph-ic survey (including COVID-19 vaccination status), the Perceived Stress Scale (PSS-10) and an original questionnaire meas-uring causes of concern were used.
Results
Overall PSS-10 results did not differ significantly between high-risk and low-risk alcohol consumers (18.40, 17.50, respec-tively, p = .185). However, the percentage distribution of perceived stress showed lower incidence of low and high levels of stress in high-risk than in low-risk alcohol consumers (9.6%, 2.9% vs. 25.7%, 6.8%, p = .001). High-risk alcohol consumers reported no pandemic-related worries more often than low-risk consumers (46.2% vs. 5.2%, p < .001), but at the same time 67.3% of them named at least one pandemic-related stressor. High-risk alcohol consumers also showed less concern about the situation on the labor market (19.2% vs. 29.3%, p < .001). Limited access to medical services and other people’s attitudes to the pandemic were common stressors in both groups, with high-risk alcohol consumers showing more indifference to the latter.
Conclusions
High-risk and low-risk alcohol consumers have been clearly impacted by pandemic-related factors. The protective effect of alcohol is debatable, given the high prevalence of medium and high stress levels among high-risk alcohol consumers. It appears that the pandemic and associated restrictions posed such a significant risk for distress escalation that they re-mained unrelated to the pattern of alcohol consumption or its alteration.
... Students who were compliant with COVID-19 health guidelines (e.g., social distancing; Einberger et al., 2021) or believed in adjusting their behavior to help reduce the spread of COVID-19 (Charles et al., 2021) also reported less alcohol use. However, one study found no associations between perceived threat of COVID-19 and number of drinking days or overall levels of alcohol consumption (Rodriguez et al., 2020), and another study indicated that well over a third (39%) of students attending social events did not or hardly wore a face mask, and a little over 10% of party attendees reported COVID-19 concerns (Rosenblum et al., 2022). In short, certain demographic and COVID-19-related factors posed a risk for increased alcohol use during the pandemic. ...
Playing drinking games (DGs) in person during a pandemic is risky, given the contagious nature of viruses. We explored the number and nature of data-derived subgroups of students based on their demographics and reported levels of coronavirus disease 2019 (COVID-19) concerns/cognitions. We then examined differences across subgroups in DG participation, the number of drinks typically consumed while playing in-person DGs, and the occurrence of playing DGs in person with 10 or more people. Students (N = 633) from seven universities across five states in the United States (Mage = 22.32/SD = 4.64; female = 74.5%) completed self-report surveys. Multilevel latent class analyses identified two subgroups: Class 1—The more the merrier (n = 230) and Class 2—Too many cooks spoil the game (n = 403). Students who were female, older, and lived with their families were more likely to be in Class 2. Students in Class 1 had fewer COVID-19 concerns, felt less confident in wearing a mask/social distancing while under the influence, were less likely to believe in mask mandates until the end of the pandemic, felt less socially isolated, and had a higher likelihood of ever having a COVID-19 diagnosis than students in Class 2. Finally, compared to students in Class 2, students in Class 1 were more likely to play DGs, play in-person DGs more frequently, and play DGs with 10 or more people over and above the weekly drink quantity. Given the possibility of another highly infectious disease, knowing the risk factors associated with behaviors like playing DGs in person during a pandemic can assist university personnel in curating/implementing alcohol guidelines.
... Alcohol availability also saw changes, with a 243% increase in online sales in the U.S. as home delivery services surged, making it more accessible to underage individuals [11]. Illicit drug distribution adapted quickly, with traffickers using encrypted online platforms and social media, such as Snapchat, Instagram, and TikTok, to sell drugs. ...
Aim: This study aims to review the emerging trends in adolescent substance abuse in the post-COVID era and evaluate effective prevention strategies tailored to these evolving challenges. Study Design: A comprehensive review of recent data and research on adolescent substance abuse trends and prevention strategies during and after the COVID-19 pandemic. Place and Duration of Study: The study encompasses global data from the onset of the COVID-19 pandemic in early 2020 to the present, focusing on adolescents' mental health and substance use patterns. Methodology: The study involved an extensive literature review of peer-reviewed journals, reports from health organizations, and data from national surveys. It analyzed the impact of pandemic-related factors such as lockdowns, social distancing, remote learning, and increased screen time on adolescent mental health and substance use. Additionally, the effectiveness of school-based, community, and family-based prevention programs was evaluated. Results: The review identified increased use of marijuana, prescription drugs, synthetic substances, and alcohol among adolescents. Mental health issues, exacerbated by prolonged isolation and disrupted routines, significantly contributed to substance use. Digital platforms emerged as new channels for substance access and exposure. Effective prevention strategies included school-based programs like Life Skills Training and Project ALERT, community initiatives such as Communities That Care, and family-based approaches like the Strengthening Families Program. Conclusion: The post-COVID era has introduced unique challenges to adolescent substance abuse prevention. Effective strategies must integrate mental health support, digital literacy education, and targeted interventions for high-risk groups. By adapting to evolving trends and leveraging comprehensive, multi-faceted approaches, we can enhance adolescent well-being and mitigate the impact of substance abuse.
... This 'trade off' was set against public discussion that women deserved better than the gendered impacts of the pandemic (Johnson, 2022) and marketing to women a message that it was 'safer' to stay at home to drink alcohol than it was to leave the house (Kennedy et al., 2022). This discursive positioning created novel opportunities for targeted marketing, development and delivery of alcohol products to women; in addition to re-casting women's alcohol consumption as an effect of harm rather than a source of pleasure (Keane, 2023) that needs to be 'monitored' (Rodriguez et al., 2020). We note that such surveillance was not applied to masculinities during the pandemic (Duncan et al., 2022) and tends to be missed in Australian alcohol policies more broadly (Moore et al., 2017). ...
... Pandemic conditions are thought to cause certain stressors and challenges affecting women. Women can often carry more burdens with family responsibilities and household chores, face economic hardships such as unemployment or loss of income, and have limited access to support services (13). These factors may cause women to turn to substance use or increase their current use. ...
Objective: As the pandemic spreads worldwide, individuals are exposed to factors such as social isolation, economic uncertainty, and general stress, which has increased the risk of substance use and addiction. Studies show that the SARS-CoV-2 (COVID-19) pandemic has increased substance use disorders. The aim of this study is to examine the impact of the COVID-19 pandemic on substance use disorders. Method: The study was planned as a retrospective study. This study was based on March 11, 2020, the date when the COVID-19 case was first seen in Turkey, for 4 years, including two years before the pandemic and two years during the pandemic process, between 11.03.2018 and 11.03.2022. 1743 cases referred to the psychiatric outpatient clinic within the scope of probation were included. Results: While substance use was detected in 834 people in the pre-COVID-19 pandemic period (March 2018-March 2020), substance use was detected in 909 people during the COVID-19 pandemic period (March 2020-March 2022). A significant increase in substance use was detected in female gender during the pandemic period. A statistically significant increase was observed in methamphetamine, opioid, cocaine and multiple substance use during the pandemic period compared to the pre-pandemic period. Conclusion: The data of our study show substance use rates in Turkey before and during the pandemic. The study will be useful to understand the impact of COVID-19 on drug use frequencies in Türkiye.
... In consequence, people's life experiences became impoverished (e.g., Brooks et al., 2020;Kokkoris & Stavrova, 2021;Rajkumar, 2020;Rodriguez et al., 2020). The ensuing "covid fatigue" often motivated bucking the restrictions, throwing caution to the wind, and resuming unconstrained behavior. ...
It is commonly surmised that restrictions limit freedom. Yet, the sense of freedom is a psychological experience only partially determined by objective restrictions. Deriving from the psychology of goals, we propose that people’s sense of freedom depends on the goals they focus on, and their attainability. Across four preregistered studies, we investigated the impact of goal focus on participants’ sense of freedom. In Studies 1–3, participants indicated the goals they could pursue despite the pandemic restrictions (commitment condition), the goals they needed to relinquish due to the restrictions (sacrifice condition), or no goals whatsoever (control condition). In Study 4, we manipulated goal focus by priming participants with the goal of socializing (which was hindered during the pandemic) and the goal of spending time alone (which was facilitated during the pandemic). Consistently across four studies, we found that participants experienced a significantly higher sense of freedom when they focused on enabled versus disabled goals. Moreover, in Studies 2 and 3, we observed that a greater sense of freedom was associated with better coping during the pandemic, reduced resistance to imposed constraints (reduced reactance), and a more positive evaluation of the imposed restrictions. These findings indicate that focusing on attainable goals instills a sense of freedom and contributes to constructive coping under objective constraints.
Objective
Mindfulness is a promising psychological resource that can alleviate dysfunctional fear responses and promote mental health. We investigated how mindfulness affects fear and depression in isolated patients with coronavirus disease 2019 (COVID-19), and whether it acts as a mediator.
Methods
We conducted an online survey of COVID-19 patients undergoing at-home treatment from February to April 2022. The survey included a questionnaire on fear of COVID-19 (measured by the Fear of COVID-19 Scale), mindfulness (measured by the Mindful Attention Awareness Scale), and depression (measured by the Patient Health Questionnaire). A total of 380 participants completed the questionnaire. We analyzed the correlation between each variable and performed a mediation analysis using hierarchical regression and bootstrapping to verify the statistical significance of the mediating effects.
Results
Each variable was significantly correlated. Hierarchical regression analysis showed that the association between the fear of COVID-19 and depression decreased from 0.377-0.255, suggesting that mindfulness partially mediates the relationship between fear of COVID-19 and depression. Bootstrapping analysis showed that the indirect effect of the mediating variable (mindfulness) is 0.121, which accounts for 32.3% of the total effect.
Conclusions
Interventions that promote mindfulness in patients with acute COVID-19 may be beneficial for their mental health.
Background
Evidence shows that alcohol use in the United States increased during the COVID-19 pandemic. This primarily quantitative work has not examined how the unique context of the COVID-19 pandemic in the U.S. may have shaped motivations for alcohol use during this crisis. To address this knowledge gap, we conducted an analysis of qualitative data from in-depth interviews examining people’s motivations for using alcohol during the COVID-19 pandemic.
Methods
Participants (N = 26) were derived from those who completed all three waves of the National Alcohol Survey COVID Cohort- a longitudinal population-based survey of non-institutionalized U.S. adults. Interviews were conducted from April-July 2022 over Zoom. Interview transcripts were analyzed iteratively via codebook thematic analysis.
Results
Participants described how both contextual and individual level factors resulted in increased alcohol use. Contextual factors included reductions in barriers to alcohol use and increases in alcohol availability and accessibility. Individual level factors included using alcohol to regulate emotions (e.g., to alleviate boredom and as an end of day “reward”) and to celebrate reconnecting with loved ones once social distancing restrictions began to ease.
Conclusions
Our results suggest that environmental forces may have interacted with individuals’ emotions to shape alcohol use motivations during the COVID-19 pandemic. This work helps to contextualize quantitative research on changes in alcohol use observed during the COVID-19 pandemic. More research is needed to determine the long-term impacts of pandemic era changes in alcohol use. It is also necessary for future studies to examine how such impacts may manifest differently across the U.S. population (e.g., among racial/ethnic minority individuals).
Objective
The purpose of this systematic review was to summarize the impact of the 2019 coronavirus disease (COVID‐19) pandemic on individuals' alcohol consumption.
Methods
PubMed was searched to identify relevant studies. Articles were included if they provided information on overall (changes in) alcohol consumption, and factors that may influence alcohol consumption including demographics, socioeconomic status, educational background, living situation, and health status. Following screening, 100 articles were identified and included in this review.
Results
Overall findings show no change (51%) or a reduction (23%) in alcohol consumption during the COVID‐19 pandemic. However, across countries, on average 1 in 4 individuals reported an increase in alcohol consumption (26%), in particular during the COVID‐19 lockdown periods. Most common correlates of increased alcohol consumption were being female, having a child at home, higher educational level, and poorer mental health (including higher scores for stress, anxiety and depression).
Conclusion
Although overall alcohol consumption was reduced during the COVID‐19 pandemic, a considerable subpopulation of drinkers increased their alcohol consumption.
Objective The COVID-19 pandemic has caused unprecedented disruptions to daily life worldwide, leading to significant changes in various aspects of lifestyle, including dietary habits, eating behaviors, physical activity, and sleep patterns. However, the specific impacts of the COVID-19 pandemic on these aspects remain unclear.
Methods Among those who underwent an annual health examination at the Health Evaluation and Protection Center of Tokai University Hachioji Hospital from June 2022 to January 2023, we mailed a questionnaire to individuals who had undergone at least one annual health evaluation at the same center before January 2020, before the COVID-19 pandemic. We collected the questionnaires during their health examination visits. Ultimately, we analyzed the questionnaire responses from 396 men and 198 women.
Results The pandemic has led to notable changes in physical activity levels, transportation methods, sleep patterns, and dietary habits among both genders. Specifically, changes in transportation methods were observed, with a shift towards more private modes of transportation and reduced use of public transport. While some participants reported decreased physical activity and increased sedentary behavior, these changes were not universally experienced. Sleep patterns were affected, with some participants going to bed later and experiencing irregular sleep schedules and changes in total sleeping hours. Dietary habits also varied, with some participants reporting meal timing and frequency changes.
Conclusions This study provides detailed insights into how the COVID-19 pandemic has affected our lifestyle, dietary habits, physical activity, sleep, and transportation methods. Further research is necessary to investigate how these changes influence metabolic health.
Background
Women were more prone to consuming alcohol as a coping mechanism for COVID-19 pandemic stressors than men. Worldwide evidence shows increased consumption during the social restriction phases, adversely impacting women’s health. The study aimed to describe women’s alcohol use throughout the restriction phases of the COVID-19 pandemic in São Paulo, Brazil.
Method
A cross-sectional self-report survey was conducted by telephone with women who sought primary health care services. The sample comprised 3252 women, and 1308 (40%) reported consuming alcohol. The independent variable was the timing of the COVID-19 pandemic’s restriction phases. The AUDIT-C was used as a measurement instrument. The covariates included sociodemographic factors, lifestyle characteristics, and outcomes related to COVID-19 infection. Univariate and bivariate models were used for analysis. A negative binomial distribution with zero inflation was used for the AUDIT-C score as the outcome variable in the entire sample.
Findings
Women’s alcohol consumption during the COVID-19 restriction phase was compatible with moderate-risk use 3.5 (SD = 2.9). Binge drinking was observed in 41.8% of the participants. Alcohol consumption was 28.9% higher in the transition phase of social restriction than in the restriction and flexibilization phases. Hospitalization for COVID-19 and losing a loved one due to COVID-19 were associated with alcohol consumption.
Conclusions
Women presented a moderate-risk pattern of alcohol use. This consumption was higher during the restriction phase of the pandemic in South America’s largest city. Therefore, this study provides critical reflections on women’s patterns of alcohol consumption. It reveals this population’s social and clinical vulnerability, which might be considered in future health policies and programs.
Aims:
Alcohol consumption along with negative sequelae from excess alcohol intake increased during the COVID-19 pandemic. We evaluated the association between binge alcohol use and long-term functional outcomes among COVID-19-positive individuals.
Methods:
Using a prospective, longitudinal, multisite cohort study design, we evaluated the association between binge alcohol use and mental and physical functional outcomes using Patient-Reported Outcomes Measurement Information System (PROMIS)-29 scores three and six months postinfection. Eligible patients were those who presented with COVID-19-like symptoms, tested positive for COVID-19, and completed a three-month survey. Binge drinking was identified at the time of infection using the Tobacco, Alcohol, Prescription medication and other Substance use screener. Generalized estimating equation models, adjusted for demographic characteristics, social determinants of health, substance use, comorbidities, and COVID-19 vaccine status, were used to assess the association between binge alcohol use and mental and physical functional outcomes.
Results:
Of 3529 individuals, 23.7% screened positive for binge drinking. At three months, prior self-reported binge drinking was associated with differences in physical function [estimate: 1.08; 95% confidence interval (CI) 0.44, 1.71], pain interference (estimate: -0.86; 95% CI -1.57, -0.15), and physical health (estimate: 1.09; 95% CI 0.43, 1.75). At six months, no associations were found between binge drinking and outcomes.
Conclusions:
Binge alcohol use before COVID-19 infection was associated with statistically significant but clinically irrelevant improvements in function at three months, which were not sustained at six months. Postinfectious and postpandemic stressors may have played a larger impact on functional outcomes than binge alcohol use. A higher frequency of binge drinking and its association with functional outcomes, particularly among individuals with COVID-19 warrants further study.
This study compared a purposive sample of secular and religious female social work students during four years of the pandemic. The objective of this study was to assess the association between COVID-19 fear, religiosity, well-being, and substance use in Israel. The Fear of COVID-19 Scale (FCV-19S) was used for study purposes. A total of 1790 students completed an online survey from May 2020 to April 2023. Findings evidence deterioration of student well-being, as well as increased substance use and alcohol binge drinking over 4 years of the pandemic. Regression analysis shows that the predictors associated with substance use are most evident during the first 2 years of COVID-19. The last 2 years of COVID-19 evidence less fear and substance use due to possible student adjustment to health conditions. Present findings do not evidence religiosity as a protective factor. Additional research is needed over time, academic study profession and location to further understand the possible impact of fear on healthcare students during and after disaster conditions including those related to war and violence.
Objective: Playing drinking games (DGs) is a common, socially-interactive risky drinking activity. During the pandemic, many students either returned home to live with their parents or remained on campus. Because DGs often require social interaction, playing DGs in-person can increase students' risk for COVID-19 exposure. Thus, we examined whether living situation and perceptions of one's college/university as a party school increased risk for playing DGs in-person during a pandemic. Method: Students who reported recent alcohol use from 12 colleges/universities (n = 874; Mage = 19.38/SDage = 1.40; 75.6% White) completed self-report measures of alcohol use, DGs participation, demographics, and residential status in Fall 2020 to Spring 2021. Univariate and multivariate analyses were conducted. Results: Overall, 62.8% of students played DGs in-person during the pandemic. Those who lived with roommates were at increased risk compared to those who lived with parents. Conclusions: Given health risks of playing DGs in-person, targeted efforts may be warranted among at-risk students.
The evaluation of innovative web-based data collection methods that are convenient for the general public and that yield high-quality scientific information for demographic researchers has become critical. Web-based methods are crucial for researchers with nationally representative research objectives but without the resources of larger organizations. The web mode is appealing because it is inexpensive relative to in-person and telephone modes, and it affords a high level of privacy. We evaluate a sequential mixed-mode web/mail data collection, conducted with a national probability sample of U.S. adults from 2020 to 2022. The survey topics focus on reproductive health and family formation. We compare estimates from this survey to those obtained from a face-to-face national survey of population reproductive health: the 2017–2019 National Survey of Family Growth (NSFG). This comparison allows for maximum design complexity, including a complex household screening operation (to identify households with persons aged 18–49). We evaluate the ability of this national web/mail data collection approach to (1) recruit a representative sample of U.S. persons aged 18–49; (2) replicate key survey estimates based on the NSFG, considering expected effects of the COVID-19 pandemic lockdowns and the alternative modes on the estimates; (3) reduce complex sample design effects relative to the NSFG; and (4) reduce the costs per completed survey.
Background: During the COVID-19 pandemic, caregiving responsibilities may have been associated with increased substance use.Objectives: To characterize substance use to cope with stress and willingness to seek help among (i) parents, (ii) unpaid caregivers of adults, and (iii) parent-caregivers.Methods: Data were analyzed for 10,444 non-probabilistic internet-based survey respondents of the COVID-19 Outbreak Public Evaluation (COPE) initiative (5227 females, 5217 males). Questions included new or increased substance use, substance use in the past 30 days to cope, insomnia, mental health, and willingness to seek help.Results: Nearly 20% of parents and unpaid caregivers of adults each reported new or increased use of substances to cope with stress or emotions; 65.4% of parent-caregivers endorsed this response. Compared to non-caregivers, all caregiver groups had higher odds of new or increased use of substances, with parent-caregivers showing the largest effect size (aOR: 7.19 (5.87-8.83), p < .001). Parent-caregivers had four times the adjusted odds of using drugs other than cannabis (aOR: 4.01 (3.15-5.09), p < .001) compared to non-caregivers.Conclusions: Caregivers may initiate or increase substance use as a coping strategy when under stress. The higher odds of substance use underscores the importance of efforts to screen for sleep disturbances and adverse mental health symptoms, particularly among parent-caregivers. Clinicians may consider asking patients about family situations more broadly to help identify people who may be experiencing stress related to caregiving and, if indicated, offer treatment to potentially alleviate some of the risks.
In psychology and the social sciences, researchers often model count outcome variables accounting for latent predictors and their interactions. Even though neglecting measurement error in such count regression models (e.g., Poisson or negative binomial regression) can have unfavorable consequences like attenuation bias, such analyses are often carried out in the generalized linear model (GLM) framework using fallible covariates such as sum scores. An alternative is count regression models based on structural equation modeling, which allow to specify latent covariates and thereby account for measurement error. However, the issue of how and when to include interactions between latent covariates or between latent and manifest covariates is rarely discussed for count regression models. In this paper, we present a latent variable count regression model (LV-CRM) allowing for latent covariates as well as interactions among both latent and manifest covariates. We conducted three simulation studies, investigating the estimation accuracy of the LV-CRM and comparing it to GLM-based count regression models. Interestingly, we found that even in scenarios with high reliabilities, the regression coefficients from a GLM-based model can be severely biased. In contrast, even for moderate sample sizes, the LV-CRM provided virtually unbiased regression coefficients. Additionally, statistical inferences yielded mixed results for the GLM-based models (i.e., low coverage rates, but acceptable empirical detection rates), but were generally acceptable using the LV-CRM. We provide an applied example from clinical psychology illustrating how the LV-CRM framework can be used to model count regressions with latent interactions.
Oxidative stress has been known about in biological sciences for several decades; however, the understanding of this concept has evolved greatly since its foundation. Over the past years, reactive oxygen species, once viewed as solely deleterious, have become recognized as intrinsic components of life. In contrast, antioxidants, initially believed to be cure-all remedies, have failed to prove their efficacy in clinical trials. Fortunately, research on the health-promoting properties of antioxidants has been ongoing. Subsequent years showed that the former assumption that all antioxidants acted similarly was greatly oversimplified. Redox-active compounds differ in their chemical structures, electrochemical properties, mechanisms of action, and bioavailability; therefore, their efficacy in protecting against oxidative stress also varies. In this review, we discuss the changing perception of oxidative stress and its sources, emphasizing everyday-life exposures, particularly those of dietary origin. Finally, we posit that a better understanding of the physicochemical properties and biological outcomes of antioxidants is crucial to fully utilize their beneficial impact on health.
The COVID-19 pandemic has contributed to significant societal challenges, including increased substance misuse. The COVID stress syndrome is a constellation of interrelated processes that occur in response to pandemics, including danger/contamination fears, fears concerning economic consequences, xenophobia, compulsive checking/reassurance-seeking, and pandemic-related traumatic stress symptoms. In the present study, using a sample of 812 adults collected during the early stages of the COVID-19 pandemic in May 2020, we examined the relations between identified profiles of the COVID Stress Scales (CSS) and behavioral and cognitive aspects of substance misuse. Using profile analysis via multidimensional scaling (PAMS), we identified two core profiles of the CSS, which explained 60% of the variance in participant responding: 1) High compulsive checking & Low xenophobia and 2) High xenophobia & Low danger/contamination. The first profile is consistent with the COVID stress syndrome, while the second profile aligns with the COVID disregard syndrome, which is a constellation of interrelated processes distinguished by a denial or downplaying of the seriousness of the COVID-19 pandemic and lack of perceived vulnerability to disease. Both profiles demonstrated significant positive correlations with drug and alcohol misuse, respectively. However, only the High xenophobia & Low danger/contamination profile demonstrated relations with cognitive aspects of substance misuse via positive and negative correlations with positive and negative expectancies of alcohol use, respectively. These findings provide further support for the relationship between the COVID stress syndrome and substance misuse and offer insight into how unique profiles of this syndrome may impact pandemic-related mental and public health interventions.
Only some vulnerable individuals who recreationally drink alcohol eventually develop the compulsive drinking pattern that characterizes alcohol use disorder. A new frontier in biomedical research lies in understanding the neurobehavioural mechanisms of this individual vulnerability, a necessary step towards developing novel effective therapeutic strategies. Translational research has been hindered by the lack of valid, reliable and robust approaches that enable the study of the influence of the reliance on alcohol to cope with stress or self-medicate negative emotional states on the subsequent transition to alcohol use disorder. We have therefore developed a behavioural task in the rat that enables the investigation of the neural and cellular basis of the exacerbation of the vulnerability to develop compulsive alcohol drinking by the use of alcohol to develop an adjunctive, anxiolytic, polydipsic drinking behaviour in a schedule-induced polydipsia procedure. Hence, in our task, alcohol is introduced in the schedule-induced polydipsia context after several weeks of training with water so that rats are exposed to alcohol for the first time in a distressing context and learn to drink alcohol as a coping strategy. Capitalizing on this protocol, we have consistently been able to identify a subpopulation of rats that were unable to learn to cope with negative states by drinking water and relied on alcohol to do so. This maladaptive reliance on alcohol drinking to cope with distress has been shown to be associated with an exacerbation of the subsequent transition to compulsive drinking. Furthermore, these vulnerable rats reached blood alcohol levels comparable to that of intoxication in humans, thereby developing two key features of alcohol use disorder, namely excessive alcohol intake and compulsive drinking. Altogether, this behavioural task provides a novel and unique tool for the investigation of the neurobehavioural mechanisms underlying the exacerbation of the individual vulnerability to developing compulsive alcohol drinking by the use of alcohol as a strategy to cope with distress, and for the evaluation of the efficacy of potential therapeutic strategies in a personalized medicine approach. This procedure, which focuses on an understudied but key factor of the development of alcohol use disorder, may become widely used as it benefits the fields of alcohol, emotion regulation and stress, the interest in which has substantially increased since the evidence of a profound exacerbation of alcohol use and alcohol-related negative consequences by the distress and social isolation engendered by the various measures implemented worldwide in response to the COVID-19 pandemic.
Background: This study explored the increased quantity and frequency of alcohol use in the American Indian (AI) population during the COVID-19 pandemic.Objectives: The aims of this study were to explore possible associations between covariables and both binge drinking and alcohol consumption during COVID-19.Methods: This cross-sectional survey study analyzed data from a sample of AI individuals (63% female) residing in California (n = 411) and Oklahoma (n = 657) between October 2020-January 2021. Analysis included summary statistics and multivariable logistic regression, including a variety of socio-economic, COVID-19 concern, and tobacco and marijuana use variables.Results: One or more alcohol binge episodes were reported between October 2020-January 2021 in 19.3% of participants and elevated overall alcohol consumption was reported by 21.6% of participants. Higher odds of elevated alcohol consumption occurred in women and those following more social distancing measures. The odds of binge drinking or elevated alcohol consumption in those using both marijuana and tobacco (aOR/ adjusted odds ratio:18.9, 95% CI = 8.5, 42.2, and aOR:3.9, 95% CI = 1.7, 8.6, respectively) were higher compared to those using neither. Similarly, the odds of binge drinking or elevated alcohol consumption in those using tobacco only (aOR:4.7, 95% CI = 2.9, 7.7 and aOR: 2.0, 95% CI = 1.1, 3.5, respectively) were higher compared to those using neither.Conclusions: This study found high rates of alcohol use and bingeing during the COVID-19 pandemic. Offering collaborative, culturally sensitive, and affordable support services are important components of intervention and preparation for future stressful events on local, as well as global levels.
Social media has become an increasingly important way to seek and share experiences, support, knowledge, and advice during the COVID-19 pandemic. Reddit, a pseudonymous social media platform, was one way that young people interacted during the pandemic. Our study goals were two-fold: (1) to categorize information sought and provided by users of r/saplings, a subreddit devoted to cannabis use and is often used by young people, and (2) to examine if conversations changed during the COVID-19 pandemic. We extracted 213 randomly selected posts and 2,546 related comments across four time periods (before the pandemic, during the first wave, summer, and next fall). We assessed the volume of posts and comments throughout our study period and conducted a qualitative content analysis. Quantitatively, the findings demonstrated an increase in the number of posts and comments throughout the study period. Given the substantial growth in subreddit activity throughout our study period, Reddit may play an increasingly important role in youth socialization related to cannabis. From the content analysis, we identified three major themes: how to acquire cannabis, how to use cannabis, and associated consequences. Reddit-users prioritized certain content in their posts at different stages of the pandemic. ‘Places to acquire’ and ‘future use’ were most common at the beginning of the pandemic, while the theme of ‘consequences’ and the topic of ‘tolerance’ became more prominent during the summer months. The comments to these posts were generally thorough and responsive to the post. Nearly all the information came from opinions or personal experiences. Firstly, our findings suggest that young people viewed Reddit as a viable outlet for conversations about cannabis. Secondly, due to the nature of the peer comments and lack of verifiable information being exchanged, misinformation may still circulate and inadvertently worsen the efforts to reduce cannabis-related harm. Interventions that provide understandable and accurate cannabis-related information in accessible formats may increase young people’s ability to access and practice harm reduction.
Objective
To examine the psychological effects on clinicians of working to manage novel viral outbreaks, and successful measures to manage stress and psychological distress.
Design
Rapid review and meta-analysis.
Data sources
Cochrane Central Register of Controlled Trials, PubMed/Medline, PsycInfo, Scopus, Web of Science, Embase, and Google Scholar, searched up to late March 2020.
Eligibility criteria for study selection
Any study that described the psychological reactions of healthcare staff working with patients in an outbreak of any emerging virus in any clinical setting, irrespective of any comparison with other clinicians or the general population.
Results
59 papers met the inclusion criteria: 37 were of severe acute respiratory syndrome (SARS), eight of coronavirus disease 2019 (covid-19), seven of Middle East respiratory syndrome (MERS), three each of Ebola virus disease and influenza A virus subtype H1N1, and one of influenza A virus subtype H7N9. Of the 38 studies that compared psychological outcomes of healthcare workers in direct contact with affected patients, 25 contained data that could be combined in a pairwise meta-analysis comparing healthcare workers at high and low risk of exposure. Compared with lower risk controls, staff in contact with affected patients had greater levels of both acute or post-traumatic stress (odds ratio 1.71, 95% confidence interval 1.28 to 2.29) and psychological distress (1.74, 1.50 to 2.03), with similar results for continuous outcomes. These findings were the same as in the other studies not included in the meta-analysis. Risk factors for psychological distress included being younger, being more junior, being the parents of dependent children, or having an infected family member. Longer quarantine, lack of practical support, and stigma also contributed. Clear communication, access to adequate personal protection, adequate rest, and both practical and psychological support were associated with reduced morbidity.
Conclusions
Effective interventions are available to help mitigate the psychological distress experienced by staff caring for patients in an emerging disease outbreak. These interventions were similar despite the wide range of settings and types of outbreaks covered in this review, and thus could be applicable to the current covid-19 outbreak.
Rates of alcohol use disorder (AUD) have increased in women by 84% over the past ten years relative to a 35% increase in men. This substantive increase in female drinking is alarming given that women experience greater alcohol-related health consequences compared to men. Stress is strongly associated with all phases of alcohol addiction, including drinking initiation, maintenance, and relapse for both women and men, but plays an especially critical role for women. The purpose of the present narrative review is to highlight what is known about sex differences in the relationship between stress and drinking. The critical role stress reactivity and negative affect play in initiating and maintaining alcohol use in women is addressed, and the available evidence for sex differences in drinking for negative reinforcement as it relates to brain stress systems is presented. This review discusses the critical structures and neurotransmitters that may underlie sex differences in stress-related alcohol use (e.g., prefrontal cortex, amygdala, norepinephrine, corticotropin releasing factor, and dynorphin), the involvement of sex and stress in alcohol-induced neurodegeneration, and the role of ovarian hormones in stress-related drinking. Finally, the potential avenues for the development of sex-appropriate pharmacological and behavioral treatments for AUD are identified. Overall, women are generally more likely to drink to regulate negative affect and stress reactivity. Sex differences in the onset and maintenance of alcohol use begin to develop during adolescence, coinciding with exposure to early life stress. These factors continue to affect alcohol use into adulthood, when reduced responsivity to stress, increased affect-related psychiatric comorbidities and alcohol-induced neurodegeneration contribute to chronic and problematic alcohol use, particularly for women. However, current research is limited regarding the examination of sex in the initiation and maintenance of alcohol use. Probing brain stress systems and associated brain regions is an important future direction for developing sex-appropriate treatments to address the role of stress in AUD.
Introduction:
Binge drinking (four or more drinks for women, five or more drinks for men on an occasion) accounts for more than half of the 88,000 U.S. deaths resulting from excessive drinking annually. Adult binge drinkers do so frequently and at high intensity; however, there are known disparities in binge drinking that are not well characterized by any single binge-drinking measure. A new measure of total annual binge drinks was used to assess these disparities at the state and national levels.
Methods:
Behavioral Risk Factor Surveillance System 2015 data (analyzed in 2016) were used to estimate the prevalence, frequency, intensity, and total binge drinks among U.S. adults. Total annual binge drinks was calculated by multiplying annual binge-drinking episodes by binge-drinking intensity.
Results:
In 2015, a total of 17.1% of U.S. adults (37.4 million) reported an annual average of 53.1 binge-drinking episodes per binge drinker, at an average intensity of 7.0 drinks per binge episode, resulting in 17.5 billion total binge drinks, or 467.0 binge drinks per binge drinker. Although binge drinking was more common among young adults (aged 18-34 years), half of the total binge drinks were consumed by adults aged ≥35 years. Total binge drinks per binge drinker were substantially higher among those with lower educational levels and household incomes than among those with higher educational levels and household incomes.
Conclusions:
U.S. adult binge drinkers consume about 17.5 billion total binge drinks annually, or about 470 binge drinks/binge drinker. Monitoring total binge drinks can help characterize disparities in binge drinking and help plan and evaluate effective prevention strategies.
The chapter ‘Women, girls and alcohol’ reviews evidence for ‘ convergence’, or women’s drinking catching up with that of men, and ‘telescoping’, or how in women the time from initiating drinking to dependence is shorter than in men. Prescription drug misuse, a growing problem in UK clinical practice, is also discussed. It is the one area of substance misuse where problems are as common in women as they are in men and it is frequently associated with dual diagnoses and chronic pain. Disappointingly, however, there is little on new treatment strategies and nothing at all on benzodiazepine misuse. The chapter dealing with pregnancy emphasises alcohol as the most important and most common teratogenic substance and it also discusses methadone as the treatment of choice in opiate users. The authors specifically state that the UK practice of detoxification from opiates in pregnancy is not supported by the evidence and is associated with high levels of relapse and complications of pregnancy.
The comorbidity of substance use disorders (SUDs) with anxiety and depression is the focus of substantial research attention and approached from myriad perspectives. This chapter focuses on the resultant complex research literature, first providing an overview of epidemiologic studies that have examined the prevalence of co-occurrence of SUDs (including alcohol and other drug use disorders) with anxiety and depressive disorders, as well as clinical correlates of these forms of comorbidity. Next, theoretical models of the onset and maintenance of emotional disorder–SUD comorbidity are considered, followed by a review of various types of studies evaluating these theoretical models (studies focusing on order-of-onset, the independent versus substance-induced disorder distinction, self-reported motives for use, genetic epidemiology, and experimental studies). Distinctions and commonalities between anxiety–SUD associations and depression–SUD associations are examined throughout. The chapter concludes by examining treatment implications of this comorbidity and suggests future directions for this burgeoning field.
Aims:
To review the contemporary evidence reflecting male/female differences in alcohol use and its consequences along with the biological (sex-related) and psycho-socio-cultural (gender-related) factors associated with those differences.
Methods:
MEDLINE, PubMed, Web of Science, SCOPUS, PsycINFO, and CINAHL databases were searched for relevant publications, which were subsequently screened for the presence/absence of pre-specified criteria for high quality evidence.
Results:
Compared to men, more women are lifetime abstainers, drink less, and are less likely to engage in problem drinking, develop alcohol-related disorders or alcohol withdrawal symptoms. However, women drinking excessively develop more medical problems. Biological (sex-related) factors, including differences in alcohol pharmacokinetics as well as its effect on brain function and the levels of sex hormones may contribute to some of those differences. In addition, differences in alcohol effects on behavior may also be driven by psycho-socio-cultural (gender-related) factors. This is evident by variation in the magnitude of differences in alcohol use between countries, decreasing difference in the rates of alcohol consumption in recent generations and other findings. Evidence indicates that both sex and gender-related factors are interacting with alcohol use in complex manner, which differentially impacts the risk for development of the behavioral or medical problems and alcohol use disorders in men and women.
Conclusions:
Discovery of the mechanisms underlying biological (sex-related) as well as psycho-socio-cultural (gender-related) differences in alcohol use and related disorders is needed for development of personalized recommendations for prevention and treatment of alcohol use disorders and related problems in men and women.
This chapter uses Cox and Klinger’s motivational model of alcohol use as a framework for reviewing research on motives for using alcohol, marijuana, and tobacco. Results of this review provide strong support for key premises underpinning this model in the alcohol literature, including that people drink alcohol to manage internal feeling states and to obtain valued social outcomes. Importantly, these motives may provide a final common pathway to alcohol use through which the influences of more distal variables are mediated. The research literature on motives for marijuana use revealed important similarities in the nature of motives underlying use and in the unique patterns of use and use-related consequences associated with specific motives. Research on tobacco use motives showed few similarities, with tobacco use being more habitual, automatic, and largely motivated by withdrawal cues, at least among more experienced and dependent users.
Purpose:
To test whether differences in alcohol use between boys and girls and between northern and southern/central Europe are mediated by social, enhancement, coping, and conformity motives.
Methods:
Cross-sectional school-based surveys were conducted among 33,813 alcohol-using 11- to 19-year-olds from northern Europe (Denmark, Estonia, Finland, Ireland, Poland, Scotland, and Wales) and southern/central Europe (Belgium, Hungary, Italy, Portugal, Slovakia, and Switzerland).
Results:
Particularly in late adolescence and early adulthood, boys drank more frequently and were more often drunk than girls. Instead of mediation, gender-specific motive paths were found; 14- to 16-year-old girls drank more because of higher levels of coping motives and lower levels of conformity motives, whereas 14- to 19-year-old boys drank more because of higher levels of social and enhancement motives. Geographical analyses confirmed that adolescents from southern/central European countries drank more frequently, but those from northern Europe reported being drunk more often. The strong indirect effects demonstrate that some of the cultural differences in drinking are because of higher levels of social, enhancement, and coping motives in northern than in southern/central Europe.
Conclusions:
The results from the largest drinking motive study conducted to date suggest that gender-specific prevention should take differences in the motivational pathways toward (heavy) drinking into account, that is, positive reinforcement seems to be more important for boys and negative reinforcement for girls. Preventive action targeting social and enhancement motives and taking drinking circumstances into account could contribute to tackling underage drinking in northern Europe.
Substance dependence is more common among trauma-exposed individuals; however, most studies suggest that Posttraumatic Stress Disorder (PTSD) accounts for the link between trauma exposure (TE) and substance dependence.
This study examined associations between TE and substance dependence (alcohol, nicotine, and marijuana), and whether PTSD accounted for this association.
1317 Jewish Israeli household residents completed in-person structured interviews assessing TE, PTSD, and substance (alcohol, nicotine, marijuana) dependence between 2007 and 2009. Regression analyses examined associations among TE, PTSD, and substance dependence.
In the full sample, mean number of traumatic events was 2.7 (sd=2.2), with 83.7% experiencing at least one event. In the full sample, mean number of PTSD symptoms was 2.5 (sd=3.4), with 13.5% meeting PTSD diagnostic criteria. Prevalence of alcohol dependence was 13.4%; nicotine dependence 52.8%; and marijuana dependence 12.1%. Number of traumatic events was associated with increased odds of alcohol (OR=1.3; 95% CI=1.2-1.4) and nicotine (OR=1.2; 95% CI=1.1-1.3) dependence. Similarly, any traumatic event exposure was associated with increased odds of alcohol (OR=3.1; 95% CI=1.6-6.0) and nicotine (OR=1.9; 95% CI=1.2-2.9) dependence. PTSD symptoms were associated with increased odds of alcohol (OR=1.2; 95% CI=1.1-1.3), nicotine (OR=1.1; 95% CI=1.1-1.2), and marijuana (OR=1.1; 95% CI=1.04-1.2) dependence; similarly, a PTSD diagnosis was associated with increased odds of alcohol (OR=3.4; 95% CI=2.1-5.5), nicotine (OR=2.2; 95% CI=1.4-3.4), and marijuana (OR=2.6; 95% CI=1.2-5.9) dependence. PTSD symptoms accounted for a sizeable proportion of the TE effect on alcohol (46%) and nicotine dependence (31%).
Individuals with more traumatic events had heightened risk for alcohol and nicotine dependence, and PTSD symptoms partially accounted for this risk. However, marijuana dependence was only significantly related to PTSD symptoms. Clinicians and researchers should separately assess different types of dependence among trauma-exposed individuals both with and without PTSD symptoms.
Objectives:
This study investigated the psychosocial responses of children and their parents to pandemic disasters, specifically measuring traumatic stress responses in children and parents with varying disease-containment experiences.
Methods:
A mixed-method approach using survey, focus groups, and interviews produced data from 398 parents. Adult respondents completed the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (PTSD-RI) Parent Version and the PTSD Check List Civilian Version (PCL-C).
Results:
Disease-containment measures such as quarantine and isolation can be traumatizing to a significant portion of children and parents. Criteria for PTSD was met in 30% of isolated or quarantined children based on parental reports, and 25% of quarantined or isolated parents (based on self-reports).
Conclusions:
These findings indicate that pandemic disasters and subsequent disease-containment responses may create a condition that families and children find traumatic. Because pandemic disasters are unique and do not include congregate sites for prolonged support and recovery, they require specific response strategies to ensure the behavioral health needs of children and families. Pandemic planning must address these needs and disease-containment measures.
Research suggests that posttraumatic stress disorder (PTSD) is associated with increased alcohol use, but the findings have not been consistent. We assessed alcohol use, binge drinking, and psychotropic medication use longitudinally in 1,681 New York City adults, representative of the 2000 census, 2 years after the World Trade Center attacks. We found that, with the exception of a modified CAGE Questionnaire index for alcohol, alcohol use showed a modest increase over time and was related to PTSD symptoms, with an increase of about 1 more drink per month for those with PTSD, even though overall levels appeared to be within the National Institute on Alcohol Abuse and Alcoholism's safe range. Psychotropic medication use followed a similar trend; those with PTSD used psychotropics about 20 more days over the past year than those without. Because the study analyses adjusted for key psychosocial variables and confounders, it is not clear if the increased alcohol use following trauma exposure is associated with self-medication of PTSD symptoms, whether increased alcohol use prior to exposure is a risk for delayed-onset PTSD, or whether a third unmeasured variable is involved. Further research is warranted.
Although several studies have suggested that alcohol use may increase after disasters, it is unclear whether any apparent postdisaster increases regularly translate into new cases of alcohol use disorders.
To determine the relationship of predisaster and postdisaster prevalence of alcohol use disorders and to examine the incidence of alcohol use disorders in relation to disasters.
Data from 10 disasters, studied within the first few postdisaster months and at 1 to 3 years postdisaster, were merged and examined.
Six hundred ninety-seven directly exposed survivors of 10 disasters.
The Diagnostic Interview Schedule for DSM-III-R provided lifetime diagnoses of alcohol abuse and dependence, and onset and recency questions allowed a determination of whether the disorder had been present either prior to or following the event, or both.
While the postdisaster prevalence of alcohol use disorders was 19%, only 0.3% of the sample developed an acute new postdisaster alcohol use disorder. Most of those in recovery, however, consumed alcohol after the disaster (83%) and coped with their emotions by drinking alcohol (22%). Those with a postdisaster alcohol use disorder were more than 4 times as likely as those without to cope with their disaster-related emotions by drinking alcohol (40% vs 9%).
The vast majority of postdisaster alcohol use disorders represented the continuation or recurrence of preexisting problems. Findings suggest that those in recovery as well as those who drink to cope with their emotions represent groups warranting potential concern for postdisaster mental health intervention. Further research is needed to clarify the clinical significance of changes in alcohol use after disasters.
The present study examined survivors' use and misuse of cigarettes and alcohol following Hurricane Katrina. We also examined several psychosocial factors that we expected would be associated with higher or lower rates of substance use following the hurricane. Participants were 209 adult survivors of Hurricane Katrina interviewed in Columbia, SC or New Orleans, LA between October 31, 2005 and May 13, 2006. Results revealed that survivors were smoking cigarettes, consuming alcohol, and experiencing alcohol consumption-related problems at a substantially higher rate than expected based on pre-hurricane prevalence data. Results also suggested that certain psychosocial factors were associated with participants' substance use and misuse following the hurricane.
Little systematic research attention has been devoted to the impact of natural disasters on adolescent substance use. The present study examined relationships among exposure to Hurricane Rita, post-traumatic stress (PTS) symptoms, and changes in adolescent substance use from 13 months pre-disaster to seven and 19 months post-disaster. Subjects were 280 high school students in southwestern Louisiana who participated in a drug abuse prevention intervention trial prior to the hurricane. Two-thirds of participants were female and 68% were white. Students completed surveys at baseline (13 months pre-hurricane) and two follow-ups (seven and 19 months post-hurricane). Results indicated a positive bivariate relationship between PTS symptoms, assessed at 7 months post-hurricane, and increases in alcohol (p < .05) and marijuana use (p < .10) from baseline to the 7 months post-hurricane follow-up. When these associations were examined collectively with other hurricane-related predictors in multivariate regression models, PTS symptoms did not predict increases in substance use. However, objective exposure to the hurricane predicted increases in marijuana use, and post-hurricane negative life events predicted increases in all three types of substance use (ps < .10). These findings suggest that increased substance use may be one of the behaviors that adolescents exhibit in reaction to exposure to hurricanes.
In this article, the author critically reviews studies on the relationship between exposure to trauma, posttraumatic stress disorder (PTSD), and alcohol abuse. After establishing that strong relationships exist between exposure to traumatic events and alcohol problems, and particularly between the diagnoses of PTSD and alcoholism, the author discusses various factors, theories, and possible mechanisms to account for these associations. Moreover, she discusses applications of these findings to the assessment and treatment of people exposed to trauma who abuse alcohol. Finally, the author outlines novel methods for testing theoretical hypotheses and makes suggestions for methodological improvements in future research.
The self-medication hypothesis of addictive disorders derives primarily from clinical observations of patients with substance use disorders. Individuals discover that the specific actions or effects of each class of drugs relieve or change a range of painful affect states. Self-medication factors occur in a context of self-regulation vulnerabilities--primarily difficulties in regulating affects, self-esteem, relationships, and self-care. Persons with substance use disorders suffer in the extreme with their feelings, either being overwhelmed with painful affects or seeming not to feel their emotions at all. Substances of abuse help such individuals to relieve painful affects or to experience or control emotions when they are absent or confusing. Diagnostic studies provide evidence that variously supports and fails to support a self-medication hypothesis of addictive disorders. The cause-consequence controversy involving psychopathology and substance use/abuse is reviewed and critiqued. In contrast, clinical observations and empirical studies that focus on painful affects and subjective states of distress more consistently suggest that such states of suffering are important psychological determinants in using, becoming dependent upon, and relapsing to addictive substances. Subjective states of distress and suffering involved in motives to self-medicate with substances of abuse are considered with respect to nicotine dependence and to schizophrenia and posttraumatic stress disorder comorbid with a substance use disorder.
How people diagnosed with schizophrenia cope with positive symptoms after their first hospitalization is explored, along with the relationship of their coping strategies to their psychosocial functioning. Data on coping with psychosis were obtained from a total of 95 respondents diagnosed with schizophrenia, schizoaffective disorder and schizophreniform disorder. Overall, the 95 respondents with available coping data were predominantly 18–22 yrs old at baseline. The strategies most frequently endorsed were cognitive in type, while those considered most helpful were behavioral. Respondents identifying an active strategy as most helpful displayed better psychosocial functioning at 24-mo follow-up.
We examined demographic predictors of longitudinal patterns in alcohol consumption.
We used mixed-effects models to describe individual alcohol consumption and change in consumption with age, as well as the associations between consumption and birth year, national alcohol consumption, and demographic factors, among 14 105 adults from the National Health and Nutrition Examination Survey I Epidemiologic Follow-Up Study.
Alcohol consumption declined with increasing age, and individual consumption mirrored national consumption. Higher consumption was associated with male gender, being White, being married, having a higher educational level, having a higher income, being employed, and being a smoker. Faster age-related decline in consumption was associated with earlier cohorts, being male, being married, having a lower educational level, and being a smoker.
Compared with alcohol consumption among earlier cohorts, that among recent cohorts declined more slowly with increasing age, suggesting that negative health effects of alcohol could increase in the future.
After the tsunami disaster in the Indian Ocean basin an Internet based self-screening test was made available in order to facilitate contact with mental health services. Although primarily designed for surviving Swiss tourists as well as relatives and acquaintances of the victims, the screening instrument was open to anyone who felt psychologically affected by this disaster. The aim of this study was to evaluate the influences between self-declared increased substance use in the aftermath of the tsunami disaster, trauma exposure and current PTSD symptoms.
One section of the screening covered addiction related behavior. We analyzed the relationship between increased substance use, the level of PTSD symptoms and trauma exposure using multivariable logistic regression with substance use as the dependent variable. Included in the study were only subjects who reported being residents of Switzerland and the analyses were stratified by gender in order to control for possible socio-cultural or gender differences in the use of psychotropic substances.
In women PTSD symptoms and degree of exposure enlarged the odds of increased alcohol, pharmaceuticals and cannabis use significantly. In men the relationship was more specific: PTSD symptoms and degree of exposure only enlarged the odds of increased pharmaceutical consumption significantly. Increases in alcohol, cannabis and tobacco use were only significantly associated with the degree of PTSD symptoms.
The tsunami was associated with increased substance use. This study not only replicates earlier findings but also suggests for a gender specificity of post-traumatic substance use increase.
The outbreak of COVID-19 is severely affecting mental health worldwide, although individual response may vary. This study aims to investigate the psychological distress perceived by the Italian general population during the early phase of the COVID-19 pandemic, and to analyze affective temperament and adult attachment styles as potential mediators. Through an online survey, we collected sociodemographic and lockdown-related information and evaluated distress, temperament, and attachment using the Kessler 10 Psychological Distress Scale (K10), the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire short version (TEMPS-A) and the Attachment Style Questionnaire (ASQ).
In our sample (n=500), 62% of the individuals reported no likelihood of psychological distress, whereas 19.4% and 18.6% displayed mild and moderate-to-severe likelihood. Cyclothymic (OR: 1.24; p<0.001), depressive (OR: 1.52; p<0.001) and anxious (OR: 1.58; p=0.002) temperaments, and the ASQ “Need for approval” (OR: 1.08; p=0.01) were risk factors for moderate-to-severe psychological distress compared to no distress, while the ASQ “Confidence” (OR: 0.89; p=0.002) and “Discomfort with closeness” were protective (OR: 0.92; p=0.001). Cyclothymic (OR: 1.17; p=0.008) and depressive (OR: 1.32; p=0.003) temperaments resulted as risk factors in subjects with moderate-to-severe psychological distress compared to mild distress, while the ASQ “Confidence” (OR: 0.92; p=0.039) and “Discomfort with closeness” (OR: 0.94; p=0.023) were protective.
Our data indicated that a relevant rate of individuals may have experienced psychological distress following the COVID-19 outbreak. Specific affective temperament and attachment features predict the extent of mental health burden. To the best of our knowledge, these are the first data available on the psychological impact of the early phase of the COVID-19 pandemic on a sizeable sample of the Italian population. Moreover, our study is the first to investigate temperament and attachment characteristics in the psychological response to the ongoing pandemic. Our results provide further insight into developing targeted intervention strategies.
The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.
Major journals have sounded the call for social psychologists to do research on the novel Coronavirus (COVID-19). Such research is only as good as the measurements used. Across three studies (total n = 984), we developed a battery of social psychology-relevant questionnaires to measure COVID-19 phenomena: (1) Perceived Coronavirus Threat Questionnaire, (2) Governmental Response to Coronavirus Questionnaire, (3) Coronavirus Impacts Questionnaire, and (4) Coronavirus Experience Questionnaire. Exploratory (Study 1) and Confirmatory (Studies 2 and 3) Factor Analyses revealed excellent factor structures for the one-factor Perceived Coronavirus Threat, the six-factor Governmental Response Questionnaires, and the three-factor Coronavirus Impacts Questionnaire. The three-factor Coronavirus Experience Questionnaire yielded poorer psychometric properties overall. Given that brevity is often desired for online studies, we further recommend psychometrically sound short versions of each questionnaire. Taken in total, this work offers social psychology researchers a battery of questionnaires to measure Coronavirus-related phenomena for the duration of the pandemic in U.S. participants.
The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
Introduction and Aims
Parental role modelling of alcohol use is known to influence alcohol consumption in adolescence and in later life. This study aimed to assess relationships between parental status, child age and alcohol consumption, which have not been well documented.
Design and Methods
Data were sourced from the 2013 Australian National Drug Strategy Household Survey. Analyses were conducted for 25–55 year olds (n = 11 591) by parental status, gender and age of youngest child in the household, controlling for socio‐demographic factors.
Results
Parents were less likely than non‐parents to exceed the alcohol guideline for increased lifetime risk (18.2% vs. 24.2%) and short‐term risk: at least weekly (14.2% vs. 21.2%); and at least monthly (27.5% vs. 35.9%). Fathers were just as likely to exceed the guidelines for lifetime risk as other men, but those with children aged 0–2, were less likely to exceed the guideline for short‐term risk. Women were least likely to exceed the guideline for lifetime risk if they had children aged 0–2, 6–11 or 15 years and over, or the guideline for short‐term risk, if they had children aged 0–2, or 15 years and over in the household. Parents were more likely to report drinking in the home.
Discussion and Conclusions
Parents were less likely to exceed alcohol guidelines than non‐parents, especially mothers whose youngest child was an infant or in high school or older. Consistent with population rates in men, fathers were more likely to exceed alcohol guidelines than mothers, and this excess consumption warrants public health attention.
The purpose of this review is to discuss ways to think about and study sex differences in preclinical animal models. We use the framework of addiction, in which animal models have excellent face and construct validity, to illustrate the importance of considering sex differences. There are four types of sex differences: qualitative, quantitative, population, and mechanistic. A better understanding of the ways males and females can differ will help scientists design experiments to characterize better the presence or absence of sex differences in new phenomena that they are investigating. We have outlined major quantitative, population, and mechanistic sex differences in the addiction domain using a heuristic framework of the three established stages of the addiction cycle: binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation. Female rats, in general, acquire the self-administration of drugs and alcohol more rapidly, escalate their drug taking with extended access more rapidly, show more motivational withdrawal, and (where tested in animal models of "craving") show greater reinstatement. The one exception is that female rats show less motivational withdrawal to alcohol. The bases for these quantitative sex differences appear to be both organizational, in that estradiol-treated neonatal animals show the male phenotype, and activational, in that the female phenotype depends on the effects of gonadal hormones. In animals, differences within the estrous cycle can be observed but are relatively minor. Such hormonal effects seem to be most prevalent during the acquisition of drug taking and less influential once compulsive drug taking is established and are linked largely to progesterone and estradiol. This review emphasizes not only significant differences in the phenotypes of females and males in the domain of addiction but emphasizes the paucity of data to date in our understanding of those differences.
Participants are not always as diligent in reading and following instructions as experimenters would like them to be. When participants fail to follow instructions, this increases noise and decreases the validity of their data. This paper presents and validates a new tool for detecting participants who are not following instructions – the Instructional manipulation check (IMC). We demonstrate how the inclusion of an IMC can increase statistical power and reliability of a dataset.
We examined the psychological impact of the 2003 outbreak of severe acute respiratory syndrome (SARS) on hospital employees in Beijing, China.
In 2006, randomly selected employees (n = 549) of a hospital in Beijing were surveyed concerning their exposure to the 2003 SARS outbreak, and the ways in which the outbreak had affected their mental health.
About 10% of the respondents had experienced high levels of posttraumatic stress (PTS) symptoms since the SARS outbreak. Respondents who had been quarantined, or worked in high-risk locations such as SARS wards, or had friends or close relatives who contracted SARS, were 2 to 3 times more likely to have high PTS symptom levels, than those without these exposures. Respondents' perceptions of SARS-related risks were significantly positively associated with PTS symptom levels and partially mediated the effects of exposure. Altruistic acceptance of work-related risks was negatively related to PTS levels.
The psychological impact of stressful events related to an infectious disease outbreak may be mediated by peoples' perceptions of those events; altruism may help to protect some health care workers against these negative impacts.
Two motives for alcohol consumption have been emphasized in the etiological and the reasons-for-drinking literature: (a) people drink alcohol to cope with stress, and (b) people drink alcohol because of social influences. There is support for both of these hypotheses, but the results are usually modest and most authors agree that more complex theories of alcohol consumption are needed. This study examined the interactional effects of reasons for drinking alcohol and situational factors on alcohol consumption. Standardized telephone interviews were conducted with 781 randomly selected Michigan drinkers. Hierarchical multiple regression analyses indicated that gender, friends' alcohol consumption, coping, and social motives for drinking were significant predictors of study participants' alcohol consumption. As predicted, there was a significant interaction between drinking to cope with stress and perceived stress, and there was also a significant interaction between drinking for social reasons and friends' alcohol consumption. Similarities and differences in the results for women, men, Blacks, and Whites are described.
We examine whether exposure to traumatic events increases the risk for nicotine dependence or alcohol or other drug use disorders, independent of posttraumatic stress disorder (PTSD).
Data come from a longitudinal epidemiologic study of young adults in southeast Michigan. Prospective data covering a 10-year period and retrospective lifetime data gathered at baseline were used to estimate the risk for onset of substance use disorders in persons with PTSD and in persons exposed to trauma without PTSD, compared with persons who have not been exposed to trauma. The National Institute of Mental Health Diagnostic Interview Schedule for DSM-III-R was used. Logistic regression was used to analyze the prospective data, and Cox proportional hazards survival analysis with time-dependent variables was applied to the lifetime data.
The prospective and retrospective data show an increased risk for the onset of nicotine dependence and drug abuse or dependence in persons with PTSD, but no increased risk or a significantly (P =.004) lower risk (for nicotine dependence, in the prospective data) in persons exposed to trauma in the absence of PTSD, compared with unexposed persons. Exposure to trauma in either the presence or the absence of PTSD did not predict alcohol abuse or dependence.
The findings do not support the hypothesis that exposure to traumatic events per se increases the risk for substance use disorders. A modestly elevated risk for nicotine dependence might be an exception. Posttraumatic stress disorder might be a causal risk factor for nicotine and drug use disorders or, alternatively, the co-occurrence of PTSD and these disorders might be influenced by shared risk factors other than traumatic exposure.
Disaster exposure may exacerbate psychopathology and substance-related disorders. Four months after September 11, 2001, using random-digit dialing to contact a representative sample of adults (N = 2001) living in New York City, we assessed cigarette smoking and symptoms of probable cigarette dependence using measures from the National Survey on Drug Use and Health. A total of 36.8% of smokers reported increased cigarette use; 10.4% of respondents reported three or more symptoms of cigarette dependence and were considered cases of probable cigarette dependence based on DSM-IV criteria. Cases were more likely to report an increase in cigarette use since September 11 than non-cases (69.4% among cases vs. 2.2% among non-cases, p < 0.001). Cases were more likely to have probable posttraumatic stress disorder (PTSD) and depression than non-cases (18.1% vs. 5.7% for PTSD, p < 0.001; 23.6% vs. 6.0% for depression, p < 0.001). Increased cigarette use since September 11 was associated with probable PTSD among cases (23.4% vs. 6.4%, p = 0.011) and non-cases (15.1% vs. 5.5%, p = 0.034) but was associated with probable depression only among cases of probable cigarette dependence (28.3% vs. 13.3%, p = 0.027). This study showed the co-occurrence of probable cigarette dependence with increased cigarette use and the co-occurrence of probable cigarette dependence with probable PTSD and depression after September 11.
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