Psychology of Addictive Behaviors

Content analysis of perceptions of combined pharmacobehavioral treatment for American Indian people with opioid use disorder.
Objective: Both opioid misuse and overdose mortality have disproportionately impacted the American Indian population. Although medications for opioid use disorder, such as buprenorphine (BUP-NX), are highly effective in reducing overdose mortality, questions have been raised about the cultural acceptability of Western medical approaches in this population. Understanding patients’ desired recovery pathways can lead to more culturally appropriate, patient-centered, and effective approaches to opioid use disorder (OUD) treatment. In this qualitative study, we document experiences with combined pharmacobehavioral treatment for OUD and suggestions for enhancing it. Method: Participants (N = 45) were American Indian patients and community members impacted by OUD. They participated in one-time, 45- to 60-min, semistructured interviews. Results: Findings from conventional content analysis indicated participants were grateful for a Tribally run combined pharmacobehavioral OUD treatment program, which made treatment more financially and geographically accessible over a large, rural area. Participants expressed satisfaction with BUP-NX and the accompanying behavioral health programming but were interested in making it more accessible through telemedicine appointments and mailed prescriptions. Participants noted the importance of clear communication about this kind of programming, which tends to be less structured than other substance-use treatment programs, but also appreciated its tailored, compassionate, and holistic approach. Participants were interested in robust counseling options; a low-barrier, acceptance-based, and harm-reduction orientation; as well as more culturally aligned programming that honored their Native heritage and traditional medicine. Conclusions: Treatment providers, researchers, and policymakers should consider integration of more patient-driven, compassionate, and culturally aligned means of intervention for American Indian patients with OUD. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Designing and piloting a sequential multiple assignment randomized trial for opioid prevention among youth in the legal system.
Objective: Youth in the legal system are vulnerable to initiation and escalation of opioid use. The transition period during which a young person is released from the institutional setting to the community is a critical window of opportunity for preventive intervention targeting the uptake and intensification of opioid and other drug use. Adaptive preventive interventions are a promising approach to systematically varying the timing and intensity of substance use preventive interventions for these youth. Method: This pilot study of 30 youth (97% young men; 37% White; Mage = 18.34, SD = 1.84) examined the feasibility and acceptability of adaptive and nonadaptive preventive interventions that incorporate components of the Adolescent Community Reinforcement Approach with Assertive Continuing Care, Trauma Affect Regulation: Guide for Education and Treatment, and Motivational Interviewing using the Sequential Multiple Assignment Randomized Trial study design. Participants completed assessments at baseline, 1-month postrelease, and 2-months postrelease. Results: Enrollment rate was 65%. Nearly three-quarters (73%) of enrolled youth had substance use disorder at intake. Moreover, 60% of enrolled participants completed the 2-month postrelease follow-up assessment. Participants reported high satisfaction with the interventionist interactions, and 95% indicated they would recommend the program to other youth. The pilot study revealed the need for several adaptations to study and intervention protocols. Conclusions: This pilot study provides evidence of the feasibility of a research–practice partnership with state juvenile rehabilitation facilities, successful recruitment of youth involved in the legal system, and feasibility and acceptability of adaptive preventive interventions spanning pre- and post-release for legal system-involved youth. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Bystander assessments for hazardous alcohol use: Qualitative methods for item development informed by bystander theory.
Objective: Dissemination of methods for developing psychometric instruments is essential for the production of high-quality research. This article describes a multistep process used to conduct the qualitative phase in the development of a battery of measures related to bystander behavior for hazardous alcohol use among young adults. Method: Qualitative methods were used to inform the content and wording of developed items to be relevant to young adults’ lived experiences. First, focus groups (eight groups; N = 60) used multiple approaches to revise items on available bystander measures from the interpersonal violence prevention literature and to create new items relevant for hazardous drinking situations. Thematic analysis of focus group transcripts yielded several themes within identified categories of signs (i.e., exposure to hazardous drinking), strategies, barriers, facilitators, positive consequences, and negative consequences. Following item development and revision by a team of content experts, cognitive interviews (N = 20) ensured clarity of instructions, items, and response options. Results: This qualitative work yielded item sets that are ready to move on to administration for quantitative psychometric validation. We used a rigorous qualitative approach to ensure constructs, items, and eventual measures accurately reflect the experience of witnesses to hazardous drinking among others. Conclusions: Generated item sets will facilitate research applying bystander intervention to alcohol-related harm. Qualitative methods described herein should be useful for researchers applying existing frameworks to new areas and themes identified from this work will facilitate research focused on bystander intervention to prevent alcohol-related harms. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
The role of perceived parent drinking motives on alcohol use among adolescents with and without childhood attention-deficit/hyperactivity disorder.
Objective: Parent history of alcohol-related problems and antisocial behaviors contribute to adolescent alcohol use and are associated with offspring attention-deficit/hyperactivity disorder (ADHD). Youth with ADHD may be susceptible to intergenerational transmission of alcohol-related cognitions, which may model drinking motives that enhance risk for adolescent alcohol use. We examined whether childhood ADHD and parent history of alcohol use disorder, with or without antisociality, were associated with adolescents’ perceptions of their parents’ drinking motives and whether these perceptions predicted their alcohol use behaviors. Method: Adolescents (N = 199; 56% with ADHD; Mage = 15.73) completed the Drinking Motives Questionnaire regarding perceptions of their parents’ drinking motives. Participants subsequently reported their past-year alcohol use behaviors (Mage = 16.95). Parents reported their history of alcohol-related problems and antisocial symptoms. Covariates included adolescent gender (7% girls), race (9% self-identified Black), and parental education and marital status. Results: Perceived parent drinking motives were highest for social and lowest for conformity motives, consistent with adult self-reports in the literature. Parent alcohol use and antisociality history predicted perceptions of parent drinking motives, and child ADHD only predicted perceptions of parent social drinking motives. Perceived parent drinking motives predicted adolescent alcohol use, but only among youth without ADHD. Conclusion: Findings reflect the potential importance of assessing adolescent perceptions of parent drinking motives for adolescents without ADHD and a possible need for supporting parents in communicating about their own alcohol use. Future research should consider alternative strategies (e.g., assessing implicit cognitions) for studying the link between alcohol-related cognitions and behaviors for adolescents with ADHD. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Stay focused! Exploring the compulsive nature of alcohol-related attentional bias in severe alcohol use disorder.
Objective: Prominent models postulate that alcohol-related attentional bias (AB), emerging from the overactivation of the reward system, plays a key role in severe alcohol use disorder (sAUD) and is independent from voluntary control. We determined whether AB is indeed compulsive or can be modulated by the control/inhibition system. Method: Patients with sAUD (17 women, 13 men, mean age of 47, White) and matched healthy controls (16 women, 14 men, mean age of 44, White) performed a visual probe task with behavioral (reaction time) and eye-tracking (first fixation location and duration, second fixation location, dwell time) measures. They also performed an avoidance task, requiring to focus on a target by voluntarily inhibiting eye movements toward alcohol/nonalcohol/nonappetitive distractors and measuring overt (break frequency) and covert (fixational eye movements) attentional processes. Results: Patients with sAUD exhibited an avoidance AB indexed by (a) reduced attentional resources dedicated to alcohol-related stimuli, namely, reduced dwell time (p = .040) and second fixation (p = .001) toward these stimuli; (b) increased inhibitory processes, namely, easier inhibition of saccades toward alcohol measured by lower break frequency (p <.001); and (c) covert eye movements posited further away from alcohol. Conclusions: In contradiction with theoretical models, our two tasks did not show any AB toward alcohol in sAUD. Instead, patients exhibited an avoidance AB indexed by increased inhibitory processes as well as reduced overt and covert attentional resources dedicated to alcohol-related stimuli. These results question the theoretical and clinical role of AB, as measured through reliable eye-tracking tasks, in sAUD. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Genetic risk for trait aggression and alcohol use predict unique facets of alcohol-related aggression.
Objective: A propensity for aggression or alcohol use may be associated with alcohol-related aggression. Previous research has shown genetic overlap between alcohol use and aggression but has not looked at how alcohol-related aggression may be uniquely influenced by genetic risk for aggression or alcohol use. The present study examined the associations of genetic risk for trait aggression, alcohol use, and alcohol use disorder (AUD) with alcohol-related aggression using a polygenic risk score (PRS) approach. Method: Using genome-wide association study summary statistics, PRSs were created for trait aggression, alcohol consumption, and AUD. These PRSs were used to predict the phenotype of alcohol-related aggression among drinkers in two independent samples: the University of California at San Francisco (UCSF) Family Alcoholism Study (n = 1,162) and the National Longitudinal Study of Adolescent to Adult Health (Add Health; n = 4,291). Results: There were significant associations between the AUD PRS and lifetime alcohol-related aggression in the UCSF study sample. Additionally, the trait aggression PRS was associated with three or more experiences of hitting anyone else and getting into physical fights while under the influence of alcohol, along with a composite score of three or more experiences of alcohol-related aggression, in the UCSF study sample. No significant associations were observed in the Add Health sample. Limited sex-specific genetic effects were observed. Conclusions: These results provide preliminary evidence that genetic influences underlying alcohol use and aggression are uniquely associated with alcohol-related aggression and suggest that these associations may differ by type and frequency of alcohol-related aggression incidents. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Alcohol use prior to episodes of nonsuicidal self-injury in women with borderline personality disorder participating in a randomized clinical trial of dialectical behavior therapy.
Objective: Alcohol use is an important, but understudied, risk factor for nonsuicidal self-injury (NSSI), defined as deliberate physical harm to oneself without intent to die. Alcohol use may facilitate engagement in NSSI by increasing impulsivity and physical pain tolerance. Limited data also suggest that people engage in more medically severe NSSI under the influence of alcohol. Method: This secondary analysis study examined the use of alcohol prior to NSSI in a sample of 79 female patients with borderline personality disorder who were enrolled in a randomized clinical trial of dialectical behavior therapy. We used multilevel modeling (MLM) to examine preregistered hypotheses that alcohol use prior to NSSI would be related to the impulsivity of NSSI, physical pain experienced during NSSI, and the medical severity of injuries from NSSI. Results: Participants endorsed alcohol use prior to 21.96% (47/221) of NSSI episodes, and roughly one third of participants (n = 27) reported at least one episode of NSSI preceded by alcohol use. For NSSI episodes preceded by alcohol use, more than half (52.38%) of participants reported using alcohol up to the moment of initiating NSSI. Alcohol use was significantly associated with higher impulsivity of NSSI episodes (b = 1.16, p = .041), but not physical pain from NSSI or medical severity of NSSI. Conclusions: Findings need to be replicated but indicate that alcohol use occurs frequently prior to NSSI and could be a target for reducing impulsive episodes of NSSI. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Motives for alcohol use across the 24 hours prior to a suicide attempt.
Objective: Acute alcohol use is a risk factor for suicidal behavior. This study examined sources of variance (between-person, within-person) in hour-to-hour self-reported alcohol consumption and drinking motives and assessed the interrelations of different motives for alcohol use across the 24 hr preceding a suicide attempt. Method: This multisite study utilized interview data obtained retrospectively from adult patients hospitalized following a suicide attempt. The current analysis examined participants (n = 110) who reported using alcohol within 24 hr of the attempt (Mage = 39.59; 48.2% female, 72.7% White; 4.5% Hispanic/Latinx). Participants reported suicide-facilitative drinking motives using three items from the Suicide Facilitative Drinking Motives Scale and reported typical, nonfacilitative motives using three items from the Drinking Motives Questionnaire–Revised. Data were analyzed using hierarchical linear modeling. Results: Most variance in reported drinking motives occurred between participants, though there was substantial within-person variability. Within-person increases in alcohol use were associated with suicide-facilitative motives for alcohol use, but not nonfacilitative motives. Social and enhancement motives were consistently negatively associated with facilitative motives, while coping motives were positively associated with reported drinking to reduce fear regarding suicide. Conclusions: Results suggest the assessment of motives for alcohol use in at-risk patients may provide key clinical targets (i.e., the function of drinking) for preventing suicidal behavior. When alcohol is consumed for coping motives or used to facilitate suicidal behavior, it is particularly concerning and warrants clinical intervention. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Interpersonal factors associated with suicide ideation among gamblers.
Objective: Recent meta-analyses have confirmed an appreciable relationship between problem gambling and suicidality. We explored the potential mechanisms underlying this relationship by testing the applicability of the interpersonal theory of suicide (Joiner, 2005) to problem gambling. This theory proposes, in part, that feelings of perceived burdensomeness and thwarted belongingness increase one’s risk for suicidal desire, typically operationalized as suicide ideation. Method: Using mediation and moderated mediation analyses, we examined whether perceived burdensomeness and thwarted belongingness help explain the relationship between problem gambling and suicidal ideation among 598 crowdsourced survey workers with past-year gambling experience. We also explored the roles of debt stress, household breadwinner status, and gambling in isolation in these relationships. Finally, we explored the idiosyncrasy of the interpersonal theory of suicide to problematic gambling by replicating some of our analyses substituting a measure of heavy drinking for problem gambling. Results: Controlling for depression severity, perceived burdensomeness mediated the effects of problem gambling on suicide ideation, especially when combined with thwarted belongingness. Debt stress mediated the relationship between problem gambling and perceived burdensomeness regardless of breadwinner status. Problem gambling predicted thwarted belongingness, but contrary to predictions, this relationship was not especially strong among people who tend to gamble in isolation. Perceived burdensomeness and thwarted belongingness did not play a mediational role in the relationship between heavy drinking and suicidal ideation. Conclusions: Findings support the utility of the interpersonal theory of suicide in regard to suicide ideation in problem gambling and highlight the need for family involvement in problem gambling treatment. (PsycInfo Database Record (c) 2025 APA, all rights reserved)

Psychology of Addictive Behaviors - Vol 39, Iss 1