Family Health Conversations should be offered as a part of standard care shortly after diagnosis and at various transitions in life.

Drinking identity – how much individuals view themselves as drinkers– is a promising cognitive factor that predicts problem drinking. Implicit and explicit measures of drinking identity have been developed (the former assesses more reflexive/automatic cognitive processes; the latter more reflective/controlled cognitive processes): each predicts unique variance in alcohol consumption and problems. However, implicit and explicit identity’s utility and uniqueness as a predictor relative to cognitive factors important for problem drinking screening and intervention has not been evaluated. Thus, the current study evaluated implicit and explicit drinking identity as predictors of consumption and problems over time. Baseline measures of drinking identity, social norms, alcohol expectancies, and drinking motives were evaluated as predictors of consumption and problems (evaluated every three months over two academic years) in a sample of 506 students (57% female) in their first or second year of college. Results found that baseline identity measures predicted unique variance in consumption and problems over time. Further, when compared to each set of cognitive factors, the identity measures predicted unique variance in consumption and problems over time. Findings were more robust for explicit, versus, implicit identity and in models that did not control for baseline drinking. Drinking identity appears to be a unique predictor of problem drinking relative to social norms, alcohol expectancies, and drinking motives. Intervention and theory could benefit from including and considering drinking identity.

Results from this study indicate bi-directional relationships between increases in alcohol associations (drinking identity, alcohol excite and alcohol approach) and subsequent increases in drinking risk. Intervention and prevention efforts may benefit from targeting these associations.

Multiple studies indicate that implicit alcohol-related associations (i.e., indices of relatively fast, spontaneous processes) predict drinking. An important next step is to investigate moderators of the implicit association-drinking relationship. Mood state has been proposed as a moderator of this relationship: implicit associations have been theorized to be stronger predictors of drinking under positive mood states. From the same theoretical perspective, explicit measures (indices of relatively slow, reflective processes) have been proposed to be stronger predictors of drinking under negative mood states. The current study evaluated these hypotheses by investigating whether mood state (manipulated via exposure to a brief video clip) moderated the relations between three types of implicit alcohol-related associations (alcohol excite, alcohol approach, and drinking identity), their explicit counterparts, and drinking in a taste test that included beer and soft drinks. A sample of 152 undergraduate social drinkers (81 men; 71 women) completed baseline measures of implicit alcohol-related associations, their explicit counterparts, and typical drinking behaviors. Participants then viewed a mood-state-inducing video clip (positive, neutral, or negative), and completed the taste test. Results were mixed but generally indicated that prediction of drinking by baseline implicit alcohol excite (but not alcohol approach or drinking identity) associations was moderated by mood. Specifically, implicit alcohol excite associations were more negatively associated with drinking after viewing the sad video and more positively associated with drinking after watching the happy/neutral video. Moderation was also observed for the explicit counterpart of alcohol excite. Findings are discussed in terms of models of negative reinforcement drinking. (PsycINFO Database Record

In recent years, the implementation of trauma-focused treatments has expanded across settings that vary widely in the availability of resources, infrastructure, and personnel. The present review aims to inform researchers, policy makers, trainers, and administrators about this diverse range of research. Taking a global health perspective, this review of effectiveness trials and implementation studies compares strategies used in high-income countries to those in low- and medium-income countries. A primary difference between studies in high-income and low- and medium-income countries is the relative emphasis placed on fidelity or adaptation. Adaptations used in low- and medium-income countries might offer useful ideas for increasing the portability, impact, and accessibility of evidence-based interventions in high-income countries.