Meenu Minhas1, Assaf Oshri2, Michael Amlung1,3,4, Ashley Dennhardt5, Mark Ferro6, Jillian Halladay7, Catharine Munn1, Jalie Tucker8, James Murphy5, James MacKillop1. 1. From the, Peter Boris Centre for Addictions Research, (MM, MA, CM, JMa), St. Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON, Canada. 2. Department of Human Development and Family Sciences, (AO), University of Georgia, Athens, Georgia. 3. Department of Applied Behavioral Science, (MA), University of Kansas, Lawrence, Kansas. 4. Cofrin Logan Center for Addiction Research and Treatment, (MA), University of Kansas, Lawrence, Kansas. 5. Department of Psychology, (AD, JMu), University of Memphis, Memphis, Tennessee. 6. School of Public and Health Systems, (MF), University of Waterloo, Waterloo, ON, Canada. 7. Offord Centre for Child Studies, (JH), McMaster University, Hamilton, ON, Canada. 8. Department of Health Education & Behavior, (JT), Center for Behavioral Economic Health Research, University of Florida, Gainsville, Florida.
Abstract
BACKGROUND: Heavy episodic drinking (HED) is a major public health problem among emerging adults (individuals 18 to 25), but with considerable heterogeneity in concurrent substance use and psychopathology. The current study used latent profile analysis (LPA) to detect discrete subgroups of HED based on alcohol, other drug severity, and concurrent psychopathology. A reinforcer pathology approach was used to understand motivational differences among the latent subgroups. METHODS: Participants were 2 samples of emerging adults reporting regular HED, 1 Canadian (n = 730) and 1 American (n = 602). Indicators for the LPA were validated dimensional self-report assessments of alcohol severity, cannabis severity, other drug severity, nicotine dependence, depression, anxiety, posttraumatic stress disorder, and attention-deficit/hyperactivity disorder. Reinforcer pathology indicators were measures of alcohol demand, proportionate substance-related reinforcement, and discounting of future rewards. RESULTS: The LPA yielded parallel 3-class solutions in both samples. The largest subgroup was characterized by comparatively low substance severity and psychopathology (Low overall severity). The second largest subgroup was characterized by comparatively high alcohol and other drug severity (excluding tobacco) and high levels of psychopathology (Heavy alcohol & high psychiatric severity). The third subgroup exhibited high alcohol, smoking and intermediate levels of other substance use and psychopathology (Heavy alcohol, smoking, & intermediate psychiatric severity). The Heavy alcohol & high psychiatric severity and Heavy alcohol, smoking, & intermediate psychiatric severity subgroups exhibited significantly higher alcohol demand, greater proportionate substance-related reinforcement, and steeper delay discounting. CONCLUSIONS: Parallel latent subgroups of emerging adults engaging in HED were present in both samples, and the high-risk subgroups were significantly differentiated by the reinforcer pathology indicators. These latent profiles may ultimately inform heterogeneity in the longitudinal course of HED in emerging adults.
BACKGROUND: Heavy episodic drinking (HED) is a major public health problem among emerging adults (individuals 18 to 25), but with considerable heterogeneity in concurrent substance use and psychopathology. The current study used latent profile analysis (LPA) to detect discrete subgroups of HED based on alcohol, other drug severity, and concurrent psychopathology. A reinforcer pathology approach was used to understand motivational differences among the latent subgroups. METHODS:Participants were 2 samples of emerging adults reporting regular HED, 1 Canadian (n = 730) and 1 American (n = 602). Indicators for the LPA were validated dimensional self-report assessments of alcohol severity, cannabis severity, other drug severity, nicotine dependence, depression, anxiety, posttraumatic stress disorder, and attention-deficit/hyperactivity disorder. Reinforcer pathology indicators were measures of alcohol demand, proportionate substance-related reinforcement, and discounting of future rewards. RESULTS: The LPA yielded parallel 3-class solutions in both samples. The largest subgroup was characterized by comparatively low substance severity and psychopathology (Low overall severity). The second largest subgroup was characterized by comparatively high alcohol and other drug severity (excluding tobacco) and high levels of psychopathology (Heavy alcohol & high psychiatric severity). The third subgroup exhibited high alcohol, smoking and intermediate levels of other substance use and psychopathology (Heavy alcohol, smoking, & intermediate psychiatric severity). The Heavy alcohol & high psychiatric severity and Heavy alcohol, smoking, & intermediate psychiatric severity subgroups exhibited significantly higher alcohol demand, greater proportionate substance-related reinforcement, and steeper delay discounting. CONCLUSIONS: Parallel latent subgroups of emerging adults engaging in HED were present in both samples, and the high-risk subgroups were significantly differentiated by the reinforcer pathology indicators. These latent profiles may ultimately inform heterogeneity in the longitudinal course of HED in emerging adults.
Authors: James G Murphy; Ashley A Dennhardt; Jessica R Skidmore; Brian Borsari; Nancy P Barnett; Suzanne M Colby; Matthew P Martens Journal: J Consult Clin Psychol Date: 2012-06-04
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