Questions about the validity of the binge or heavy drinking criterion have implications for more than just treatment evaluation

Havard, Alys

doi:10.1111/add.13294

Cited by 6 publications

(7 citation statements)

References 5 publications

(5 reference statements)

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“…We are pleased to respond to the thoughtful comments of the esteemed authors. Overall, all authors are in agreement with the limited utility of the 4/5+ criterion in the treatment context . Some authors extended our critiques to other contexts , and some argued for the context in which this criterion may remain useful .…”

supporting

confidence: 79%

“…when used as an inclusion/exclusion criterion) . Further, we also agree with Havard that the reliance on an oversimplified 4/5+ criterion for public health messages probably leads individuals who ‘note that the advice does not fit with their experience… to dismiss the advice altogether’ .…”

supporting

confidence: 76%

“…mean, median) and variability (e.g. range, standard deviation), which may improve ‘understanding of the distribution of alcohol‐related harm’ . Secondly, one serious criticism of the 4/5+ cut‐off is that it does not consider contextual factors appropriately, including the immediate drinking context (e.g.…”

mentioning

confidence: 99%

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We still question the utility and validity of the binge/heavy drinking criterion

2016

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supporting

confidence: 79%

supporting

confidence: 76%

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We still question the utility and validity of the binge/heavy drinking criterion

2016

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“…Previous studies examining the relationship between impulsivity‐related ERPs and alcohol focused on number of drinks consumed (see previous studies). Consumption‐based measures of alcohol use can also be more susceptible to ecological biases and variability in group dichotomization . The Alcohol Use Disorders Identification Test (AUDIT) includes standardized measures of alcohol use and of alcohol‐related problems .…”

Section: Introductionmentioning

confidence: 99%

Inhibitory‐control event‐related potentials correlate with individual differences in alcohol use

et al. 2019

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Impulsivity is a multidimensional construct that is related to different aspects of alcohol use, abuse, and dependence. Inhibitory control, one facet of impulsivity, can be assayed using the stop-signal task (SST) and quantified behaviorally via the stopsignal reaction time (SSRT) and electrophysiologically using event-related potentials (ERPs). Research on the relationship between alcohol use and SSRTs, and between alcohol use and inhibitory-control ERPs, is mixed. Here, adult alcohol users (n = 79), with a wide range of scores on the Alcohol Use Disorders Identification Test (AUDIT), completed the SST under electroencephalography (EEG) (70% of participants had AUDIT total scores greater than or equal to 8). Other measures, including demographic, self-report, and task-based measures of impulsivity, personality, and psychological factors, were also recorded. A machine-learning method with penalized linear regression was used to correlate individual differences in alcohol use with impulsivity measures. Four separate models were tested, with out-of-sample validation used to quantify performance. ERPs alone statistically predicted alcohol use (cross-validated r = 0.28), with both early and late ERP components contributing to the model (larger N2, but smaller P3, amplitude). Behavioral data from a wide range of impulsivity measures were also associated with alcohol use (r = 0.37). SSRT was a relatively weak statistical predictor, whereas the Stroop interference effect was relatively strong. The addition of nonimpulsivity behavioral measures did not improve the correlation (r = 0.34) and was similar when ERPs were combined with non-ERP data (r = 0.29).These findings show that inhibitory control ERPs are robustly correlated individual differences in alcohol use.

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“…The key finding that some individuals (44 and 53% in the two samples, respectively) who continue to engage in episodic heavy drinking following treatment for AUDs still improve in other domains of psychosocial functioning, is provocative. Moreover, as noted by the authors, it calls into question the definition of treatment success in terms of episodes of heavy drinking (comprising four or more drinks per occasion for women and five or more drinks for men), contributing an important piece of evidence to an ongoing discussion and debate on this issue [4][5][6][7][8][9][10]. The authors note that the characterization of heavy drinking episodes with this 4+/5+ threshold may be somewhat limited and arbitrary, as it is supported only weakly by empirical evidence and these data indicated a linear relationship rather than a pattern that would support a cut-off.…”

Section: Commentary On Wilson Et Al (2016): the Meaning Of Success Imentioning

confidence: 99%

Commentary on Wilson et al. (2016): The meaning of success in failure

Moyer

2016

Addiction

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Commentary on Wilson et al. (2016): The meaning of success in failureThe finding that some individuals who continue to engage in episodic heavy drinking following treatment for alcohol use disorders (AUDs) improve in other domains of psychosocial functioning raises the question of whether such individuals fare well despite, or as a consequence of, their continued drinking.Wilson and colleagues [1], using latent class analysis of data from the well-known COMBINE (Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence) [2] and Project MATCH (Matching Alcoholism Treatment to Client Heterogeneity) [3] intervention studies, present an innovative way of considering alcohol use disorder (AUD) treatment 'failures' as a non-monolithic group. These novel analyses reveal that individuals who engage in one or more episodes of heavy drinking over a 90-day period at 10-15-month follow-up fall into groups that can be characterized as low, average and high in terms of their psychosocial functioning. The key finding that some individuals (44 and 53% in the two samples, respectively) who continue to engage in episodic heavy drinking following treatment for AUDs still improve in other domains of psychosocial functioning, is provocative. Moreover, as noted by the authors, it calls into question the definition of treatment success in terms of episodes of heavy drinking (comprising four or more drinks per occasion for women and five or more drinks for men), contributing an important piece of evidence to an ongoing discussion and debate on this issue [4][5][6][7][8][9][10]. The authors note that the characterization of heavy drinking episodes with this 4+/5+ threshold may be somewhat limited and arbitrary, as it is supported only weakly by empirical evidence and these data indicated a linear relationship rather than a pattern that would support a cut-off. Similarly, a question prompted by the report is whether there was a dose-response relationship between the proportion of heavy drinking days and membership in the high, average and low psychosocial functioning categories. In addition, examining what the number of heavy drinking episodes was in the high functioning 'failure' group would provide a sense of how chronic or sporadic such episodes might be in this set of individuals.Wilson et al.'s results also prompt questions about the meaning of psychosocial improvements in the context of episodes of heavy alcohol consumption; that is, is it the case that such individuals fare well despite their occasional heavy drinking? The idea that some people can function well alongside alcohol consumption is related to the notion that a treatment goal of moderate drinking has the potential to reduce harm for some individuals with AUDs [11] and, as the authors point out, is in line with some evidence that some heavy drinking has been found to result in similar consequences and health outcomes as low-risk drinking and abstinence [12,13]. However, drawing such a conclusion from Wilson et al.'s results is complicated by the fac...

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Questions about the validity of the binge or heavy drinking criterion have implications for more than just treatment evaluation

Abstract: Commentary to: http://onlinelibrary.wiley.com/doi/10.1111/add.13210/abstract

Cited by 6 publications

References 5 publications

We still question the utility and validity of the binge/heavy drinking criterion

We still question the utility and validity of the binge/heavy drinking criterion

Inhibitory‐control event‐related potentials correlate with individual differences in alcohol use

Commentary on Wilson et al. (2016): The meaning of success in failure

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