From the, Peter Boris Centre for Addictions Research, (MM, MA, CM, JMa), St. Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON, Canada.
Department of Human Development and Family Sciences, (AO), University of Georgia, Athens, Georgia.
Alcohol Clin Exp Res. 2020 Oct;44(10):2130-2140. doi: 10.1111/acer.14438. Epub 2020 Sep 23.
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.
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.
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.
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.
重度间断性饮酒(HED)是青年期个体(18 至 25 岁)的一个主要公共卫生问题,但同时存在相当大的物质使用和精神病理学异质性。本研究使用潜在剖面分析(LPA),根据酒精、其他药物严重程度和同时存在的精神病理学,检测 HED 的离散亚组。采用强化病理方法来理解潜在亚组之间的动机差异。
参与者为报告有规律的 HED 的两个青年期个体样本,一个来自加拿大(n=730),另一个来自美国(n=602)。LPA 的指标是经过验证的、维度性的酒精严重程度、大麻严重程度、其他药物严重程度、尼古丁依赖、抑郁、焦虑、创伤后应激障碍和注意缺陷/多动障碍的自我报告评估。强化病理指标包括酒精需求、比例物质相关强化和未来奖励折扣。
LPA 在两个样本中都产生了平行的 3 类解决方案。最大的亚组特点是物质严重程度和精神病理学相对较低(总体严重程度低)。第二大亚组的特点是酒精和其他药物严重程度(不包括烟草)较高,精神病理学水平较高(重度酒精和高精神病严重程度)。第三个亚组表现为酒精、吸烟和中等水平的其他物质使用和精神病理学(重度酒精、吸烟和中度精神病严重程度)。重度酒精和高精神病严重程度以及重度酒精、吸烟和中度精神病严重程度亚组表现出明显更高的酒精需求、更大的比例物质相关强化和更陡峭的延迟折扣。
在两个样本中都存在进行 HED 的青年期个体的平行潜在亚组,高风险亚组通过强化病理指标显著区分。这些潜在剖面最终可能为青年期个体 HED 的纵向病程异质性提供信息。