Latent Profile Analysis of Heavy Episodic Drinking in Emerging Adults: A Reinforcer Pathology Approach

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.

Understanding Sexual and Gender Minority Substance use through Latent Profiles of Ecological Systems

“…The study was also limited due to our use of Prolific as a recruitment site, which may be reflected in our demographics: our sample was predominantly White (69.2%) and educated (fewer than 20% of the sample had only a high school diploma or less). These demographics are not representative of the entire SGM community and this likely influenced the findings, as previous research reveals an inverse relationship between education and the use of substances 49 . Our study was also limited due to the use of single items for our self-esteem, hope, and community connection variables.…”

Associations between alcohol demand, delayed reward discounting, and high-intensity drinking in a diverse emerging adult sample.

“…Participants were 591 emerging adults recruited as part of a larger, longitudinal study on drinking pattern trajectories (see Minhas et al, 2020). The present analyses used only baseline data.…”

“…A higher k -value indicates a higher discounting of larger future rewards (i.e., stronger preference for an immediate reward and steep discounting of bigger, temporally delayed reward). DRD is associated with heavy drinking in emerging young adults (Campbell et al, 2021; Minhas et al, 2020; Tucker et al, 2021).…”

“…A meta-analysis found robust associations between DRD and problem severity as well as quantity and frequency across several addictive behaviors (alcohol, tobacco, cannabis, stimulant, opiate, and gambling; M. Amlung et al, 2017). Although several studies have found an association between DRD and alcohol-related risk among emerging adults (Minhas et al, 2020;Vuchinich & Simpson, 1998), the literature examining DRD and alcohol use and associated problems in nonclinical emerging adult samples is mixed, with some studies finding no association between discounting rates and drinking risk 2011;McCarthy et al, 2012;Teeters & Murphy;. Campbell et al (2021) used latent class analyses to examine specific patterns of behavioral economic risk in a sample of heavy-drinking college students and found evidence for a high reward, high discounting class (i.e., high intensity, high O max , lower elasticity, and steep discounting) that was significantly associated with greater alcohol consumption, HED, alcohol-related consequences, and alcohol use disorder symptoms.…”

Subtypes in addiction and their neurobehavioral profiles across three functional domains

“…Through literature searches (PubMed, Google Scholar), we have identified over 120 published studies that have subtyped individuals with SUDs using symptom scales (e.g., AUDIT, ASI, AUDADIS-IV, SSADDA, DSM-IV, ICD-10 1 ). These initial efforts to define subgroups or "subtypes" in individuals with SUDs consistently found that substance users can be separated into a milder "late onset" type, consisting of individuals characterized by low psychiatric comorbidity versus a more severe "early onset" type with high psychiatric comorbidity, more poly-substance use, and worse treatment prognosis [24][25][26][27][28][29][30][31][32][33]. In contrast, previous research characterizing individual differences in the multidimensional mechanisms (rather than symptom presentation) of addiction is extremely limited.…”