Addictive Behaviors

Nicotine or expectancies? Using the balanced-placebo design to test immediate outcomes of vaping Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Amanda M. Palmer, Thomas H. Brandon Abstract Introduction Electronic (e-)cigarette use has increased in popularity, especially among those attempting to quit smoking. Previous studies evaluating the therapeutic efficacy of e-cigarettes have suggested that non-pharmacologic factors, such as expectancies about nicotine effects, may influence the experienced effects of e-cigarettes. Method The independent and synergistic influences of drug and expectancies were parsed using a balanced-placebo design, whereby 128 participants (52 dual users) were provided an e-cigarette that either contained nicotine or non-nicotine solution, while told that it did or did not contain nicotine. We hypothesized main effects of nicotine content on physiological, objective outcomes (attention, appetite, aversion, respiratory tract sensations), and main effects of the instructions on more subjective, psychosocial outcomes (affect, reward, satisfaction). Sex was included as a moderator. Results Results showed that nicotine increased sustained attention, and more so among females. Nicotine delivery was associated with aversion among females, but not males. Among those who were both told and did not receive nicotine, higher enjoyment of respiratory tract sensations was reported. Nicotine with complementary instructions produced the highest reward ratings; additionally, nicotine was rewarding to males but not females. Discussion Findings demonstrated that both nicotine content and non-pharmacologic factors impact acute outcome effects of e-cigarettes, with moderation by sex in some cases. Results are relevant to the interpretation of clinical trials of e-cigarettes and suggest a more nuanced view of reinforcement pathways.

Corrigendum to “Comparing cigarette and e-cigarette dependence and predicting frequency of smoking and e-cigarette use in dual-users of cigarettes and e-cigarettes.” [Addict Behaviour. 87(2018), 92–96] Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Meghan E. Morean, Suchitra Krishnan-Sarin, Stephanie S. O'Malley

Corrigendum to “The war on antidepressants: What we can, and can't conclude, from the systematic review of antidepressant withdrawal effects by Davies and Read” [Addictive Behaviors (2019)] Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Sameer Jauhar, Joseph Hayes

The war on antidepressants: What we can, and can't conclude, from the systematic review of antidepressant withdrawal effects by Davies and Read Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Sameer Jauhar, Joseph Hayes

A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based? Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): James Davies, John Read Abstract Introduction The U.K.'s current National Institute for Health and Care Excellence and the American Psychiatric Association's depression guidelines state that withdrawal reactions from antidepressants are ‘self-limiting’ (i.e. typically resolving between 1 and 2 weeks). This systematic review assesses that claim. Methods A systematic literature review was undertaken to ascertain the incidence, severity and duration of antidepressant withdrawal reactions. We identified 24 relevant studies, with diverse methodologies and sample sizes. Results Withdrawal incidence rates from 14 studies ranged from 27% to 86% with a weighted average of 56%. Four large studies of severity produced a weighted average of 46% of those experiencing antidepressant withdrawal effects endorsing the most extreme severity rating on offer. Seven of the ten very diverse studies providing data on duration contradict the U.K. and U.S.A. withdrawal guidelines in that they found that a significant proportion of people who experience withdrawal do so for more than two weeks, and that it is not uncommon for people to experience withdrawal for several months. The findings of the only four studies calculating mean duration were, for quite heterogeneous populations, 5 days, 10 days, 43 days and 79 weeks. Conclusions We recommend that U.K. and U.S.A. guidelines on antidepressant withdrawal be urgently updated as they are clearly at variance with the evidence on the incidence, severity and duration of antidepressant withdrawal, and are probably leading to the widespread misdiagnosing of withdrawal, the consequent lengthening of antidepressant use, much unnecessary antidepressant prescribing and higher rates of antidepressant prescriptions overall. We also recommend that prescribers fully inform patients about the possibility of withdrawal effects.

A preliminary study of early childhood parenting and adult past month drug use risk in low-income African American women Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Tyralynn Frazier, Jessica McDermott Sales Abstract Purpose This preliminary study was designed to assess the feasibility of examining early childhood parenting factors and their relationship with adult past month drug use among low-income African American women. Methods A cross-sectional survey of 156 low-income African American women was conducted. Measures included the childhood parental bonding scale, frequency of exposure to corporal punishment (CP) in childhood, The Drug Abuse Screening Test (DAST) and The Differentiation of Self Scale. Structural equation modeling (SEM) was used to assess the relationship between the primary predictors, latent parental bonding and corporal punishment exposure, with past month drug use. The intermediary construct, emotional reactivity, was also included in the SEM model to test mechanisms of mediation. Results There was a significant main effect for maternal care on lower emotional reactivity patterns in adulthood. There was also a significant main effect for frequent CP on higher emotional reactivity patterns in adulthood. The relationship between both parenting measures and drug use were mediated by emotional reactivity. Conclusion Childhood maternal factors are a strong predictor of adult past month drug use, and this may be accounted for, in part, by the influence that parenting patterns in childhood have on adult emotional reactivity patterns. These observations should be examined in a longitudinal study to determine the stability of our observation that CP in childhood, even when controlling for positive maternal bonding patterns, influences emotional reactivity patterns that predispose an individual to negative coping strategies, such as drug use, in adulthood, among low-income African American women.

Stigma and help-seeking: The interplay of substance use and gender and sexual minority identity Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Madeline B. Benz, Kathleen Palm Reed, Lia S. Bishop Abstract Problematic substance use is a global public health concern. However, despite high rates of substance use (SU) and related consequences, rates of treatment seeking remain low. Furthermore, individuals who identify as a gender/sexual minority (GSM) have both increased rates of problematic use and less mental health treatment utilization. Society has stigmatized both SU and GSM identity and created marginalized communities. Individuals who identify with both groups are uniquely situated in that they experience stigma related to both their SU (SU stigma) and their GSM identity (GSM stigma). The objective of this study was to examine how identifying with these stigmatized groups may influence help-seeking behavior for SU treatment. Participants were N = 171 individuals with a history of problematic SU recruited on a national scale, including N = 67 identifying as GSM. Results from multiple and logistic regression found main effects for SU stigma, such that, more anticipated SU stigma predicted more help-seeking intentions (β = 0.25, p = .04), and, controlling for SU severity, more enacted SU stigma was associated with a higher likelihood of having sought help in the past (Expβ = 4.18, p = .001). However, while we found a main effect for GSM stigma of the same direction when predicting intentions to seek help (β = 0.28, p = .02), GSM stigma was not associated with past help-seeking behavior. Lastly, the interaction between SU stigma and GSM stigma was not significant. Clinical implications are discussed, as well as future directions for subsequent research.

Spatial and sociodemographic correlates of gambling participation and disorder among female Filipino migrant workers in Macao, People's Republic of China Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Grace Yi, Lei Huang, Agnes I.F. Lam, Carl Latkin, Brian J. Hall Abstract Background and aims Correlates and risk factors for gambling disorder among vulnerable or transient populations such as transnational migrant workers are unknown. The current study examined sociodemographic and spatial correlates of gambling disorder among female Filipino domestic workers in Macao (SAR), China. Design Survey-based, respondent-driven sampling study administered from November 2016 to August 2017. Setting Macao (SAR), which encompassed 38 casinos within its 30.4 km2 area at the time of this study. Participants Representative sample of N = 1194 female Filipino domestic workers in Macao. Measurements Symptoms of gambling disorder based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Correlates evaluated included sociodemographic information, proximity to venues, perceived social support, and symptoms of depression and anxiety. Findings Prevalence of gambling disorder was 5.1%. Multivariable regression analyses indicated that likelihood of gambling participation (i.e., ever gambling) was associated with current indebtedness (RR = 1.56, 95%CI = 1.08–2.25, p = .017) and worse self-reported health (RR = 1.31, 95%CI = 1.04–1.65, p = .02). Increased symptoms of gambling disorder were independently associated with lower perceived social support (RR = 0.92, 95%CI = 0.87–0.98, p = .006), increased dependents relying upon monthly remittances (RR = 1.10, 95%CI = 1.06–1.16, p < .001), increased depression severity (RR = 1.16, 95%CI = 1.07–1.25, p < .001), decreased salary quintile (RR = 0.97, 95%CI = 0.94–1.00, p = .04), and proximity to the nearest Mocha Club gaming venues (RR = 1.04, 95%CI = 1.02–1.07, p = .005). The association between proximity to casinos and increased symptoms of gambling disorder was significant only for domestic workers living apart from employers (RR = 1.07, 95%CI = 1.00–1.14, p = .04). Conclusions Increased spatial proximity to gambling venues and greater financial and psychosocial burdens are associated with gambling disorder among domestic workers in Macao.

A gender-based analysis of nonmedical prescription opioid use among people who use illicit drugs Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Tessa Cheng, Ekaterina Nosova, Will Small, Robert S. Hogg, Kanna Hayashi, Kora DeBeck Abstract Background Research investigating the unique impacts associated with engaging in nonmedical prescription opioid use (NMPOU) among males and females who also use illicit drugs is needed. Methods Data were collected between 2013 and 2017 from two linked prospective cohort studies in Vancouver: the At-Risk Youth Study and Vancouver Injection Drug Users Study. Generalized estimating equations were used to identify factors associated with engaging in NMPOU among females and males separately. Results Among 1459 participants, 534 were female (37%). Similar proportions of females (46%) and males (48%) engaged in NMPOU at their first visit during the study period. In multivariable analyses, factors associated with NMPOU among both males and females included heroin use, overdose, drug dealing, and difficulty accessing health and social services. Among females, those who engaged in NMPOU were more likely to report Caucasian or white ethnicity, cocaine use, crystal methamphetamine use, and sex work; among males, those who engaged in NMPOU were older, reported crack use and engaged in binge drug use (all p < 0.05). Conclusion The prevalence of NMPOU was similar among males and females who use illicit drugs in Vancouver, and NMPOU was independently associated with markers of vulnerability among both genders. Findings highlight the need for a comprehensive public health approach to address NMPOU that integrates overdose prevention and reversal services, employment opportunities, and better access to services for both women and men.

An Assessment of the Validity of the Gamblers Belief Questionnaire Publication date: October 2019 Source: Addictive Behaviors, Volume 97 Author(s): Kahlil S. Philander, Sally M. Gainsbury, Georgia Grattan Abstract Cognitive distortions in gambling are irrational thoughts that cause an individual to overestimate their level of control over the outcome of the game and diminish the role of chance. Due to their strong relation to gambling disorders, they are a particularly important characteristic to assess and understand in gamblers. Although numerous measures of gambling-related cognitive distortions exist, studies assessing criterion validity are scarce. In this study, we develop several tests of the Gamblers Belief Questionnaire (GBQ), a versatile and widely used scale. A sample of 184 U.S. adults was recruited through Amazon Mechanical Turk to complete an online study that included measurement of the GBQ and an assessment of the perceived role of skill and chance in various gambling and non-gambling activities. In addition to a confirmatory factor analysis of the scale, three novel validation tests were developed to understand whether the GBQ subscales can identify and discriminate measures of illusion of control and gambler's fallacy distortions. Our validation tests demonstrate that the scale does measure both distortions, providing information about gamblers' cognition that is unexplained by gambling problems, frequency of play, and demographics. Conversely, our analysis of the factor structure does not show good fit. We conclude that the GBQ measures gambling-related cognitive distortions, but there may be an opportunity to reduce the number of scale items and further refine precision of the two subscales.