Background: Nearly all U.S. emerging adults use social media at least daily, and most discuss their offline activities online, including their alcohol misuse. As a result, developing evidence finds a correlation between social media use and offline alcohol drinking, suggesting that social media may be a novel risk factor for alcohol misuse. However, there are conflicting findings about what specific function of social media use is risker - does the amount of time spent online or the types of online activities matter more? Study Aim: Our multidisciplinary team of human-computer interactionists, social workers, and public health scholars aimed to refine our understanding of the association between emerging adult social media use and alcohol misuse. To do so, we conceptualized social media use as a multidimensional construct, examining how much time emerging adults spend online (i.e., screen time) and their different online activities (i.e., social media engagement, such as posting pictures or reacting to posted content [e.g., liking shared pictures]). Taking this conceptualization a step further, we distinguished general online activities (i.e., general social media engagement, such as sharing pictures of food) from those explicitly related to offline alcohol consumption (i.e., alcohol -related social media engagement, such as sharing a video of someone drinking alcohol at a party). Finally, we examined if different levels of these three conceptualizations of social media use were risk factors for alcohol misuse and related negative consequences. Method: We collected survey data from 249 emerging adults on Amazon Mechanical Turk. Using latent profile analyses, we attempted to distinguish the different ways we conceptualized social media use (i.e., screen time from general social media engagement and alcohol -related social media engagement.) We then examined whether significant differences existed between identified profiles and various alcohol -related outcomes in a typical and heavy drinking week. Findings: We identified 3 -profile solutions for both screen time (low, medium, and high) and general social media engagement (minimum, moderate, and high) and a 2 -profile solution for alcohol -related social media engagement (minimal and moderate). When we assessed for alcohol risk, screen time was not related to drinking at all (neither frequency nor quantity), not even for emerging adults who reported using social media almost constantly. However, during a heavy drinking week, those who moderately post alcohol -related content online drank more heavily and had more binge drinking days. Notably, and contrary to previous research, emerging adults who reported high general social media engagement were most at risk for binge drinking and experiencing more alcohol -related negative consequences. Conclusions: Findings underscore the importance of considering various forms of social media engagement - and not screen time - when studying the harms associated with using social media, including offline risk -taking behaviors like alcohol misuse. Results indicate that research, interventions, and clinical practice that target and treat emerging adult alcohol misuse should assess their social media behavior, concentrating on their engagement. This is especially true for the highest general engaging emerging adults who almost constantly post, respond, and react while online; these individuals might be the most at -risk and need support.

The purpose of this study was to examine the relationships between child sexual abuse (CSA) and components related to the CSA experience, betrayal, dissociative amnesia, and childhood autobiographical memory loss (CAML). The a priori hypothesis was that components related to the CSA experience (such as abuse characteristics, disclosure characteristics, betrayal, and dissociative amnesia) would act as direct risk factors/predictors for CAML. It was further hypothesized that betrayal and dissociative amnesia would each act as a mediator of the relationships between these components related to the CSA experience and CAML. This retrospective survey was conducted online, anonymously, and contained a sample of 297 participants who were adult survivors of CSA. Data was analyzed using logistic and linear regressions, as well as path analysis. The results of this study suggest that betrayal, dissociation, duration of abuse, and dissociative amnesia had direct effects on CAML, and age at onset of abuse had indirect effects on CAML through dissociative amnesia. These results have both research and clinical implications, in terms of both prevention and intervention with survivors of CSA.

Objective: A common intervention to prevent alcohol -impaired driving are alcohol ignition interlock devices (IIDs), which prevent drivers with a blood alcohol concentration greater than .025% from starting the car. These devices force drivers to adapt their drinking to accommodate the device. Prior studies indicated a transfer of risk as some drivers with an IID may increase cannabis use as they decrease alcohol use. This study examines whether this increase in cannabis use persists after IID removal when alcohol use reverts to pre-IID levels. ' Method: The data are from the Managing Heavy Drinking (MHD) study of drivers in New York State. The MHD is a comprehensive three-wave study of drivers convicted of driving under the influence from 2015 to 2020. Participants (N = 189) completed all waves, and provided oral fluid/blood and hair samples to measure cannabis and alcohol use, respectively. Mixed between-within analysis of variance was conducted to assess cannabis use at IID installation (Time 1), removal (Time 2), and at 6-month follow-up (Time 3). Results: In aggregate, participants increased their cannabis use over the course of the study. Drivers who decreased their alcohol use while the IID was installed on their car sig-nificantly increased their cannabis use while the IID was in place and further increased cannabis use after the device's removal. Conclusions: IIDs are efficacious in preventing alcohol-impaired driving. However, in some cases, they may have the unintended effect of increasing other substance use. The current study outlines the need for supplemental treatment interventions while on IID to prevent a transfer of risk to other substances, or polysubstance use after the device is removed. (J. Stud. Alcohol Drugs, 83, 486-493, 2022)

Previous research has demonstrated that behavioral healthcare workers' experiences of autonomy and decision-making power in the workplace are positively associated with their commitment to the organization and negatively associated with occupational burnout. Models examining the relationships between workplace climate and staff member well-being generally conceptualize workplace climates as predictors of individual commitment and burnout. However, the relationships among these constructs have primarily been explored in cross-sectional study designs. The current study adds to the existing literature by examining the relationships among perceived autonomy and decision-making power in the organizational climate, and individual levels of organizational commitment and burnout over a 12-month period (N = 43). The study was done in a public hospital's behavioral healthcare department in the Western New York region. Cross-lagged panel analyses were conducted to assess if time-one scores on perceived autonomy and decision-making power predicted time-two scores of organizational commitment and burnout. Findings indicate that, contrary to popular conceptualization, individual staff member's commitment to the organization predicted future states of perceived autonomy and decision-making power. Individual commitment to the organization may be a driving factor in how staff members experience and perceive the service environment.

Abstract Objective Self-medication using alcohol is a common coping response among individuals dealing with trauma as is driving under the influence of alcohol (DUI). A common intervention for drivers convicted of DUI, is an alcohol ignition interlock device (IID)—which requires breath samples before starting the car. If the sample is above a predetermined limit (.025), the car will not start, thus preventing impaired driving. IIDs are an effective intervention to reduce rates of drinking and driving among high risk populations; however, limited research has examined how traumatic experiences may impact performance on IIDs. Methods This study is an archival analysis of the Managing Heavy Drinking (MHD) study of drivers in New York state. The MHD is a comprehensive study of drivers convicted of a DUI from 2015–2020. Participants (N = 121) completed questionnaires and provided consent to retrieve information from interlock providers. Outcome variable included high BAC lockout ratios (number of high BAC lockouts [BAC>.08]/number of clean blows [BAC ≤ .025]). Other variables included demographic variables, alcohol treatment history, trauma experiences, and prior DUI history. Variables were entered into a structural equation model. Results In the final structural model, pathways that demonstrated a p-value of greater than .10 were dropped from the model. This produced acceptable overall model fit statistics (χ2 = 27.059(10), p=.003; CFI = .900; NFI = .898; RMSEA = .063). A significant pathway was found from the trauma measure to alcohol use (β = .132), and from alcohol use to interlock performance (β = .636). However, no significant relationship was found between trauma and interlock performance other than through alcohol use. Conclusions The current study provides a useful framework upon which to understand the role traumatic experiences have on alcohol IID performance. Traumatic experiences are in of themselves insufficient to impact IID performance directly, but it may indirectly impact IID performance through increasing alcohol use.

Background Item specification is foundational to measurement development but rarely reported in depth. We address this gap by explicating our use of qualitative methods to ground and develop items for a new recovery capital measure, the Multidimensional Inventory of Recovery Capital. Method We recruited a diverse sample of service providers (n = 9) and people in recovery from alcohol problems (n = 23) to provide feedback on an item pool assessing social, human, physical, community, and cultural capital. Using applied qualitative analysis, we coded findings from interviews and focus groups and made final decisions by consensus regarding item elimination, retention, or revision. This process yielded a 49-item draft measure. Results Only nine items from an initial 90-item list were retained in their original form. Participant feedback guided item elimination, addition, and revision for linguistic or conceptual clarity. We detected little systematic variation in feedback based on income or race; however, there were stark divergences on particular items based on recovery pathway (i.e. 12-step versus other approaches). Conclusions The high degree of alteration to the item pool highlights the importance of establishing validity with respondents. Response variation based on recovery pathway suggests the need for broad heterogeneity in respondents. Measures that are sensitive, psychometrically sound, and aligned with theory are critical for advancing research on recovery capital and related disparities for diverse populations.

Purpose: A trauma-informed educational support group pilot addressed traumatic stress, substance use disorders (SUDs), and child-rearing for clients who were pregnant and/or parenting young children. Methods: Seeking Safety was adapted with parenting content and delivered at two intensive residential rehabilitation facilities. An explanatory sequential mixed methods approach was used to evaluate the pilot. Forty-eight participants completed starting assessments (intention-to-treat) and 31 graduates completed postgroup surveys (per protocol). Focus group sessions were completed with 19 graduates. Results: Paired samples t tests of intention-to-treat data showed a statistically significant decrease in self-reported symptoms of stress and substance cravings and increases in positive behaviors and parenting self-efficacy. There were no statistically significant differences on lifestyle behaviors, parenting skill, and parenting confidence. Most participants found the intervention acceptable and felt supported to improve their parenting. Discussion: Trauma-informed parenting education support in inpatient rehabilitation settings may offer an important complement to existing SUD and parenting programming.

Purpose: There is little or no information on how individuals with alcohol use disorders and limited financial resources manage/deal with their alcohol problems during the pandemic outbreak. Two broad scenarios were posited: one predicting an increase in alcohol consumption as a coping mechanism;another forecasting a reduction in drinking based on the decreased physical access to alcohol and financial resources. This study examines whether and how the COVID-19 outbreak induced changes in the drinking patterns of a group of individuals with a history of alcohol problems. Methods: Data came from an add-on survey of participants in the Managing Heavy Drinking (MHD) study conducted in Erie County, New York. MHD participants were DWI offenders recruited for the most part from IID installers and from the required impaired driving education program classes. Pre-outbreak data was leveraged with additional information collected after the outbreak (July-August 2020). About 184 eligible MHD participants were invited to complete a short 15- minute Survey Monkey questionnaire. Of them, 92 agreed to participate. Results: Most participants (78.3%) had no direct experience with COVID-19. Overall, there was an increase in the number of drinking days after the outbreak, paralleled with a slightly (but non-significant) decrease in the average number of drinks per drinking day (from 3.7 to 2.8). Those who reported a significant increase in drinking days after the outbreak were those who: i) BEFORE the outbreak had done most of their drinking in places other than their homes, and had received an AUDIT score < 8 (relative to those with a ≥ 8);and ii) those who AFTER the outbreak were worried about their health and/or their finances, and did not stay in alcohol treatment (online). Conclusion: This is one of the first studies that looked at the impact of the COVID-19 pandemic on the use of alcohol by a group of individuals who have already shown problems associated with alcohol use. The study's findings emphasize the need for developing and implementing effective tele-health approaches that could be delivered under severe restrictions such as those imposed by the COVID-19 pandemic, as well as in situations in which those in need of treatment face extreme access impediments.

Introduction Literature notes the efficacious use of alcohol ignition interlock devices (IID) in reducing rates of drinking and driving while installed on the vehicle. Some drivers who are convicted of driving while intoxicated (DWI) elect to have their license suspended/revoked instead of installing the device. These individuals represent a high-risk subsample of drivers, yet limited literature has addressed this concern. The current study seeks to fill this gap using qualitative interviews addressing: (i) why do non-installers make the choice to not install a mandated IID; and (ii) how are non-installers managing without the IID? Methods The study utilises the Managing Heavy Drinkers study of drivers in Erie County, New York, USA. Participants were purposively sampled from a group of non-installers (n = 6; four females, two males) who completed semi-structured interviews. Constructed grounded theory was used to develop a theoretical understanding of participant's experiences. Results To understand why participants elect not to install the IID, thematic analysis revealed: alleviating constraints, predominantly the financial burdens associated with an IID, and institutional mistrust. Additionally, data revealed that participants are managing without the IID by mitigating apprehension. This included driving cautiously to avoid detection and utilising alternative transportation. Discussion and Conclusions This study furthers understanding of why drivers convicted of a DWI elect not to install an IID. Future research should seek to identify barriers to IID installation. This work provides evidence for establishing institutional protocols that ensure drivers convicted of a DWI receive consistent and correct information about the IID process.

BACKGROUND:Before the COVID-19 pandemic, very little was known about the impact of social isolation on individuals' alcohol use and misuse. This study examines how socially isolated individuals with a history of heavy drinking used alcohol during the pandemic. METHODS:Data for this study came from an add-on to the Managing Heavy Drinking (MHD) longitudinal study of drivers convicted of DWI that was conducted in Erie County, New York. Pre-COVID information (October 2019-March 2020) was augmented with a COVID-19 questionnaire collected between July and August 2020. A total of 92 participants completed the COVID-19 survey. RESULTS:The sample of problem drinkers showed a significant increase after the pandemic outbreak in the average number of drinking days from 1.99 to 2.49 per week (p = 0.047), but a significant decrease in the average number of drinks per drinking day, from 3.74 to 2.74 (p = 0.003). The proportion of individuals who drank more frequently was greater among those who, before the outbreak had an Alcohol Use Disorders Identification Test (AUDIT) score <8 (26% increase) compared with those with an AUDIT score of >8 (13%). Alcohol treatment was also associated with the frequency of drinking, with individuals who were not in alcohol treatment showing a 16% increase in frequency compared with a 10% increase among those in treatment. Further, individuals who, after the outbreak worried about their health (30%) or finances (37%) reported greater increases in the frequency of drinking than those who did not worry about their health (17%) or finances (10%). CONCLUSIONS:Overall, the individuals in our sample showed small changes in the frequency andheaviness of drinking after the outbreak of COVID-19, effects that opposite in direction from one another and thus resulted in no overall change in drinks consumed. Nonetheless, we identified factors that influenced the effects of the pandemic on drinking behavior among individuals convicted of DWI, which emphasizes the need to individualize these individuals' treatment, particularly in the context of dramatic environmental change.

BACKGROUND Half of the offenders convicted of impaired driving in the United States are sentenced to install alcohol ignition interlock devices (IIDs), which prevent them from starting their vehicles if they have been drinking. No research has yet explored offenders' patterns of alcohol consumption and driving under the influence of alcohol (DUI) from the time before the arrest to the time period after the IID is installed. This study aims to fill that gap in knowledge. METHODS Using the Timeline Follow-back interview procedure, we assessed the daily drinking of 153 convicted DUI offenders' self-reported total alcohol consumption and rates of self-reported driving after drinking over 4 phases: before DUI arrest, between arrest and IID installation, during the phase on the interlock, and after the interlock is removed. Because information about behaviors in each period was not available for every participant, comparisons were made using paired-sample contrasts. RESULTS Compared with before the arrest, total alcohol use decreased by 50% in the 4-month phase following arrest and before IID installation, though it did not change much afterward. The frequency of drinking and driving decreased sharply after the arrest (-82%), with further decrease upon installation of the interlock (-58%, p = 0.05). The frequency of drinking and driving after the IID was removed returned to preinstallation drinking and driving status (+58%, p = 0.01). CONCLUSIONS Participants made significant adjustments to their drinking behavior by adhering to the traditional DUI driving restrictions in the postarrest phase. Although installation of an IID was not associated with a significant change in drinking, it further reduced the frequency of drinking and driving. Evaluations of the IID experience should take into account information on an individual's drinking and DUI behaviors not only before the IID was installed, but before the individual was arrested.

Purpose Research suggests that interpersonal and intrapersonal resiliency factors protect against poor post-deployment mental health outcomes among Reserve/Guard soldiers who have been deployed. There is increasing awareness that never-deployed soldiers are also at risk. The purpose of this study was to examine the relationships between resiliency factors and a range of mental health outcomes among a sample of United States Army Reserve and National Guard (USAR/NG) soldiers who have and have not experienced deployment. Methods A subset of data was drawn from Operation: SAFETY (N = 360), an ongoing study examining the health and well-being of USAR/NG soldiers. We used a multivariate path analysis approach to examine the simultaneous effects of unit support, marital satisfaction, and psychological hardiness on the following mental health outcomes, concurrently: anger, anxiety, depression, and posttraumatic stress disorder (PTSD) symptomatology. We also examined interaction effects between resiliency factors and deployment status on mental health outcomes. Results Greater unit support (ps < 0.01), marital satisfaction (ps < 0.001), and psychological hardiness (ps < 0.001) were associated with less anger, anxiety, depression, and PTSD symptomatology. Psychological hardiness had significant interactions with deployment status on anxiety, depression, and PTSD, such that the protective effects of psychological hardiness were even stronger among never-deployed soldiers than previously deployed solders. Conclusion Resiliency factors can be targeted for intervention to prevent poor mental health outcomes among USAR/NG soldiers, regardless of deployment status. Further, psychological hardiness may be an even more important protective factor among soldiers who have never been deployed.

Objective There is a substantial body of evidence that the recidivism of impaired-driving offenders is reduced while an ignition interlock device (IID) is on their vehicles. This study examines changes in driving behaviors and drinking behaviors used by DWI offenders to manage driving with the IID.Methods A total of 166 IID participants who completed two surveys covering the period from arrest to IID installation (T1) and during IID use (T2) were examined. Four domains were covered: demographics, driving environments and transportation needs, reported driving activity, and reported drinking activities. Participants were on average 38 years old, 43% were female, 35% completed college, 34% had an income of more than $50,000, and 83% were employed. For those who provided it, the mean blood alcohol content (BAC) at arrest was .184 g/dL, with only 8 (5%) individuals below .08 g/dL, and 93 (56%) at over .18 g/dL. About 45% were repeat DWI offenders.Results Between T1 and T2 there was a slight increase in acknowledging public transportation was available (p=.001), an increase in other individuals driving the interlock-equipped vehicle (p=.002), an increase in the number of vehicles in the household not registered to the DWI offender (p< .001), and an increase in the number of participants who reported that driving was important to their lifestyle (p=.008). Initial (T1) expectations about whether the interlock would be a problem were significantly different from actual experiences reported in T2 (p<.001). With respect to alcohol consumption, 14% reported abstinence at T2 compared to 2% at T1 (p=.001) and the number of drinks per drinking occasion decreased from a mean of 4.90 at T1 to 3.14 at T2 (p=.001), but the number of drinking occasions increased by a third (p=.003). The number of drinking locations (p=.001), the frequency of stopping after work for a drink (p=.001), and drinking at a bar all decreased (p<.001).Conclusions Interlock users make some adjustments in how they drink, the amount they drink, and where they drink. This finding suggests that there may be methods that can be used to extend the benefits of the IID beyond the sanction period.

Alcohol ignition interlock devices (IIDs) reduce rates of drinking and driving when installed on the vehicles of offenders. While the IID is installed on their vehicle, some drivers adapt their drinking behaviors, while others cannot. Heavy alcohol use and mental health concerns reduce treatment adherence in clinical settings, but it has not yet known how they pertain to behavioral adaptation to IIDs. This study focuses on identifying driver typologies as predictors of performance while on alcohol IIDs. The study utilizes the Managing Heavy Drinking study of drivers in New York state. Participants (N = 101; 59 males, 42 females) completed questionnaires assessing demographic information, drinking behaviors, driving history, and mental health measures. All participants had been convicted of a DUI, and installed an IID. Latent class analysis was used to establish typologies and predict lockout ratios. Four typologies emerged and drivers with elevations in mental health concerns had significantly worse lockout ratios than those in other classes. The current study may provide support for interventions designed to identify drivers with comorbid mental health concerns and tailor appropriate interventions to administer while the IID is installed with the aim of improving behavioral adaptation to the device.

Complex trauma (CT; for example, childhood abuse) has been associated with significant behavioral health problems (i.e., mental health and substance use disorders) and symptoms that are consistent with complex posttraumatic stress disorder (C-PTSD). CT is prevalent in adult forensic populations, and particularly important for women as they tend to report more adverse consequences of exposure to traumatic stressors and are entering the criminal justice system at a heightened rate compared with men. However, no studies have empirically tested the relationship among CT, C-PTSD, and behavioral health problems with gender among incarcerated adults. The present study examined the relationship between gender and childhood abuse history, C-PTSD symptom severity, and behavioral health problems in 497 incarcerated adults. Findings indicate that women were more likely to report a history of childhood abuse, and more severe C-PTSD symptoms and behavioral health problems than men. Childhood abuse history significantly accounted for the gender difference observed in C-PTSD symptom severity. C-PTSD partially mediated the gender difference in psychiatric morbidity and in risk of hard drug use. Implications for trauma-informed and gender-responsive services and research in the adult criminal justice system are discussed.

Background: Some alcohol interventions have been found to have the adverse outcome of increasing non-alcohol-related substance use. It is unknown, however, how changes in alcohol use over the course of alcohol ignition interlocks - a common DUI intervention - may impact other substance use. Methods: Alcohol and cannabis use were measured using hair ethylglucuronide and Delta-9-Tetrahydrocannabinol concentrations in blood, respectively. Participants (N = 69) were measured at the interlock installation period and again 6-months later while the interlock was installed. A mixed ANOVA was conducted to examine changes in levels of ethanol and THC over time. Results: On measures of marijuana use, there was a significant interaction effect between the group that increased alcohol use and time F(2, 66) = 7.863, p =.001; partial eta(2) =.192; as well as a main effect for time F(2, 66) = 21.106, p eta(2) =.242. Conclusions: Installing interlocks may inadvertently increase cannabis use among those who decrease alcohol use. Crash risk associated with cannabis use is notably less than that of alcohol use, however, continued cannabis use may be problematic when the device is removed and alcohol use is expected to return to the higher pre-interlock levels.